Q and A for CMV

23
Jun
Posted by Lauren

bellyYou may have heard of CMV because it’s the most common virus passed from mothers to babies during pregnancy.

Cytomegalovirus, also called CMV, is a kind of herpesvirus. There are many different kinds of herpesviruses – some of which are sexually transmitted diseases, but others can cause cold sores or infections like CMV.

Q. Who gets it?

A. Many people get CMV at some point in their lives, most often during childhood. Most people with CMV have no signs or symptoms but some may have a sore throat, a fever, swollen glands, or feel tired all the time.

Q. Is CMV dangerous?

A. It can be  – CMV can pass to your baby at any time during pregnancy, labor and delivery and even while breastfeeding. If you have CMV during pregnancy, there is a 1 in 3 chance it will pass to your baby. Eighty percent of babies born with CMV never have symptoms or problems caused by the infection. But about fifteen percent of babies develop a disability such as hearing loss, vision loss or an intellectual disability like trouble learning or communicating.

Q. Can you find out if you or your baby have CMV?

A. Yes. You can have a blood test done during pregnancy to test for CMV. And you can have prenatal tests to see if your baby has CMV. After birth, your baby’s bodily fluids like her urine and saliva can be tested for CMV. Some babies with CMV will have signs or symptoms at birth, but many will appear healthy so testing is important.

Q. Is there any treatment?

A. Yes. If your baby was born with CMV, she may be treated with antiviral medicines to kill the infection. Scientists are working to develop a vaccine for CMV.

In the meantime, remember to always wash your hands well after being in contact with body fluids, when changing diapers or wiping noses, and carefully throw diapers and tissues away. Don’t kiss young children on the mouth or cheek and don’t share food, glasses and eating utensils with children or anyone who may have CMV. These precautions can help you protect yourself and your baby.

Q. If you had CMV in a previous pregnancy, what are the chances you may get it again in another pregnancy? See this post for answers.

If you think you may have (or had) CMV, be sure to talk to your prenatal care provider. See our article to learn more about CMV including treatments.

Questions? Email AskUs@marchofdimes.org.

Preeclampsia: Impact on mom and baby

21
Jun
Posted by Barbara

May was Preeclampsia Awareness Month. We blogged about the signs, symptoms and causes of preeclampsia and how it may lead to premature birth. We also hosted a Twitter chat with Dr. Kjersti Aagaard of Texas Children’s Pavilion for Women, which generated some follow-up questions.

We’re happy to welcome back Dr. Aagaard and her colleague Dr. Martha Rac as guest bloggers. Both doctors are maternal-fetal medicine specialists at Texas Children’s. They will share some insight into who is most at risk of developing preeclampsia and how it can impact both mom and baby.

First, we must ask, who is at the highest risk for developing preeclampsia?

 Risk factors for preeclampsia include:

  • First time mothers
  • Pregnancy with a new partner than previous pregnancies – different partners may have varying genetic factors that may increase preeclampsia risk
  • Older mothers (>35 years old)
  • Black women
  • Medical problems including chronic high blood pressure, kidney disease, lupus, diabetes and heart disease
  • Pregnancies with multiples (twins, triplets, etc.)
  • Obesity
  • Preeclampsia in prior pregnancies
  • IVF pregnancies – particularly those with donor eggs. This is thought to occur as a result of genetic differences between the mother and fetus, causing the mother’s immune system to attack the “foreign” fetal tissue and cause excess inflammation.

In addition to the risk factors above, mothers with pregnancies spaced too closely together or very far apart can be at risk. Too close may be defined as 18 months or less and far apart as 4-5 years between pregnancies.

How does preeclampsia affect pregnancy?

Preeclampsia is classified as either mild or severe based on a woman’s symptoms, and how severely it affects her organs. It is a progressive disorder, which means that mild cases will eventually develop into severe preeclampsia, if not treated.

Preeclampsia can be very dangerous to both the mother and the baby. The very high blood pressure associated with preeclampsia can result in anything from seizures, stroke, liver and kidney dysfunction, bleeding problems, placental detachment and even death if left untreated.

If a mother-to-be suspects she may be experiencing preeclampsia, she should contact her doctor immediately.

How does preeclampsia impact the baby?

 This dangerous disorder can cause the baby’s growth to be restricted and increases the risk of stillbirth. In the most severe cases, preterm delivery may be required which may then expose the baby to the complications of prematurity such as under-developed organs, breathing difficulties, jaundice, anemia, a lowered immune system, etc.

In the worst cases, fetal death can occur from a sudden detachment of the placenta from the uterus.

For these reasons, women diagnosed with preeclampsia undergo additional monitoring such as: ultrasounds every 4 weeks to evaluate fetal growth, lab work to determine if there is multi-organ involvement, etc. and delivery no later than 37 weeks.

If you are worried you are at risk of developing this dangerous disorder, please be sure to consult with your doctor and discuss your concerns immediately.

Dr. Kjersti AagaardDr. Martha Rac

 

 

 

 

 

 

Many thanks to Dr. Aagaard  (left) and Dr. Rac  (right) for contributing their expertise. 

If you have questions, send them to AskUs@marchofdimes.org.

 

 

What’s one often forgotten, but very important, “must do” during pregnancy?

19
Jun
Posted by Barbara

teethThere are so many “do’s and don’ts” during pregnancy that it’s sometimes hard to keep track of them all. But one important “do” that sometimes gets overlooked is the need to keep up with oral care.

Somehow, brushing your teeth and going for regular dental cleanings seem to fall down on the list. But did you know that at-home and professional dental care are also important parts of a healthy pregnancy?

Pregnancy can affect dental health

During pregnancy, your changing hormones may affect the way your body reacts to plaque that builds up on your teeth. The result can be redness, swelling and bleeding gums called “pregnancy gingivitis.” In fact, nearly 70% of women experience gingivitis during pregnancy.

You also have more blood flowing through your body and more acid in your mouth when you are pregnant. All these changes mean you are more likely to have dental problems, such as loose teeth, gum disease, non-cancerous “pregnancy tumors” which form on your gums, tooth decay and even tooth loss. (See our article for more details on any of these dental issues.)

What’s the answer?

Consider oral care a “must do” on your healthy pregnancy list. Regular professional dental care as well as a good daily oral routine (brushing, flossing) are very important parts of your pregnancy.

Brushing your teeth is something that you’ve done since childhood. Even going to the dentist is something that (hopefully) you are doing regularly. Dental exams help to prevent tooth decay and gingivitis (gum inflammation), and let’s face it – your teeth look sparkly clean afterwards!

Bottom line

Take your prenatal vitamins, get plenty of rest, eat well, stay active, keep up with brushing your teeth, AND go to your prenatal and dental appointments.

Your smile and baby will thank you.

 

Have questions? Email AskUs@marchofdimes.org

NICU dad x 2 – the story of Jack and Josie

16
Jun
Posted by Barbara

Kyle Daddio and son JackIf there is one father who can talk about being a NICU dad, it is Kyle Daddio.Kyle Daddio and daughter Josephine

His son, Jack, was born at 26 weeks, more than 3 months prematurely. His daughter Josephine “Josie” came along three years later, born at 26 weeks as well. Both babies weighed one and a half pounds at birth.

Jack spent 121 days in the NICU, while Josie clocked in at 91 days.

Fortunately, Jack is doing well now, and Josie has recently gone home from the NICU to join the family.

In honor of Father’s Day, we asked Kyle to share his feelings about being a NICU dad, and to offer tips to new dads going through a similar experience.

What was the hardest moment you experienced in the NICU? 

February 13th, 2014, when our son Jack was 7 weeks old. It was the worst day of my life. It was a Thursday and, like I had been doing every day, came into the NICU early in the morning before work to read the newspaper with Jack while he was in his isolette. On Monday evening of that week Jack’s nurse had noticed that his belly started to become distended and was concerned. They began pumping him with antibiotics, running tests and getting x-rays.

The result was that he had Necrotizing Enterocolitis, NEC, which is an infection in the bowels. By Thursday morning his condition had not improved and the NICU staff was doing everything they could not to have to perform surgery. On that Thursday morning while I was reading the paper with Jack, he flat-lined. I was rushed out of the room while all the nurses and doctors ran in. His stomach was so distended that his lungs did not have enough room to fully expand, and it eventually became too difficult for him to breathe even on a ventilator. I was let back in the room about 30 minutes later to see Jack on an oscillator. I called my wife Katie to come down to the hospital and the doctors notified us that surgery was now more possible.

When he flat-lined again at 2pm, surgery was now necessary and the surgeon came in to speak with us. He notified us that given Jack’s small size (2/1/2 lbs) they were unable to know exactly how severe the infection was, and that this type of surgery at his size, given his current condition, had a success rate of less than 50%. A nurse then approached Katie and I with some holy water and said “I read on your form that you’re Catholic. You should baptize your son now.” We baptized him, and then followed the nurses and doctors as they wheeled Jack into the operating wing.

In the hall approaching the OR, Jack flat-lined for a third time. They resuscitated him and brought him into the OR for surgery. At that point we had no idea what was going to happen. We went back down to the NICU family room and sat silently waiting for a report from the OR. Many of the NICU nurses came and sat with us during that time, which was an incredible gesture. After nearly 2 hours, a call came down from the OR that the surgery was successful and Jack would be back down to the NICU for recovery in an hour or so. They removed his sigmoid colon and gave him a colostomy bag. The surgeon later told us that from a surgical standpoint it was a very good situation. The infection was focused on a small area that could easily be removed and should not have long standing effects on Jack’s GI tract. He is now a happy and healthy 3 1/2 year old and has had no resulting issues.

As a father and husband, how did you take care of yourself as you were taking care of your family throughout this difficult period?

My one advice I always tell other dads is you have to cry. You have to process your emotions at some point otherwise you will never get through it. For me, it was most mornings in the shower. On the nights that we actually slept, I would wake up in the morning and think “how am I going to get through another day of this. This isn’t how it was supposed to go.” Once those emotions hit you, you can’t push them down, you have to let them out, otherwise you’re not helping yourself and its going to begin to affect those around you.

The second thing you should do is use your support system. We were lucky enough to have our family near when Jack was born in NY, and they were absolutely amazing. When Josie was born in Colorado, family began jumping on flights the second they got the news. My father arrived the day before we delivered and my mom and brother arrived the day she was born. They made sure we had nothing to worry about other than being at the NICU with our kids, and they were very good about taking us out to get our mind off of everything. Taking us out for dinner, taking us to the movies, anything to step away from everything for a few hours.

Any tips for new NICU dads on how to support your wife or partner during this process?

My wife takes care of everything in the house, so anything I could do to shorten that list was help to her. With our son Jack, he was born while we were visiting our family in NY, so we were living at my aunt and uncle’s house for the nearly 5 months while he was in the NICU. It was an incredible gesture for them to have us but it wasn’t home. So I traveled back to Chicago to get some items that would help with our everyday lives.

With our second trip to the NICU with Josie, we had our 3 year old son Jack at home, so spending time with him so that Katie could be at the hospital with Josie was my main focus. Jack had school every day and therapy in the afternoon 2 days a week, and I was lucky enough to be able to work from home for the first 2 months of Josie’s NICU stay and help with Jack.

The most important focus for me was to make sure that Katie was getting as much time as she needed with our baby at the hospital.

What’s some advice you wish you’d had when your baby was born prematurely?

Knowing the possibilities. What are the chances that our child could be born prematurely? Why could they be born prematurely? If they’re born prematurely, what are the risks and things that can happen in week 1, week 2, etc.? We had no knowledge of anything dealing with prematurity. We had never been introduced to the March of Dimes or knew anything they did with prematurity research. It wasn’t on our radar and so we never thought about it. Our doctors never spoke about it and we never thought we were at risk so why would it ever happen to us? We joke now that after 212 days in the NICU between our two kids that we have a full year of nursing school under our belts. I have learned things and seen things that I would never have thought of prior to this experience.

We want to thank Kyle for sharing his story and giving his advice. We wish him, other NICU dads, and all fathers, a wonderful Father’s Day.

Please feel free to send a message to Kyle and his family or to share your NICU story with us.

Heat and pregnancy – what’s dangerous and how to cope

14
Jun
Posted by Barbara

heatIf you live in the northeast, you know we’ve been experiencing a heat wave. Just going from my car to the front door of the office seems too far to walk in this heat. If you’re pregnant, having an increased exposure to heat may cause problems for you or your baby.

Exposure to excessive heat affects people differently. When you are pregnant, your body works hard to cool you and your baby. So, if you are pregnant, you are more likely to develop a heat related illness sooner than someone who is not pregnant.

Heat illnesses occur when your body’s efforts to cool itself (eg. sweating) are no longer effective. Heat illnesses include a rash often known as “prickly heat,” cramps, fainting, heat exhaustion and heat stroke.

Heat exhaustion symptoms include a headache, nausea, dizziness, heavy sweating, weakness, thirst, being irritable, and having an increased body temperature.

Heat stroke is an emergency condition. It is when your body temperature goes above 104 degrees Fahrenheit. Symptoms include hot and dry skin or extreme sweating, a rapid pulse, throbbing head-ache, dizziness, nausea, confusion, slurred speech, loss of consciousness, and seizures. If untreated, it could result in permanent organ damage or even death. Seek medical attention or contact 911 immediately if someone you know has these symptoms.

Prevention is key

It is important that you take steps to stay cool and prevent heat related conditions, especially if you are pregnant. Here’s how:

  • Stay hydrated. Drink water frequently. Don’t wait until you’re thirsty to drink.
  • Stay in rooms with air-conditioning.
  • Avoid going outdoors during peak heat hours (11am – 3pm).
  • If you must go outdoors, stay in the shade, limit your physical activity, and stay hydrated. Use a cold or wet cloth to cool down by putting it on the inside of your wrists or forehead so you don’t get too hot.

Keep kids out of the heat, too

One more thing…each year at about this time, we hear of children being left in a hot car “for just a few minutes.” Tragic deaths from heat stroke can occur from leaving a child in an overheated closed car for a very short while.

Never leave a child unattended in a closed car – NEVER.

Children don’t have the same chemical makeup as adults, making it harder for their bodies to regulate temperature. Take steps to protect your child from heat-related illnesses by setting reminders. Here are a few tips to prevent a tragedy, from the American Academy of Pediatrics.

Have questions? Send them to AskUs@marchofdimes.org.

Men and Zika

12
Jun
Posted by Sara

Couple smiling looking at computerWomen are not the only ones who need to be concerned about Zika. Men need to be aware of how their exposure to Zika may affect their unborn baby. Zika has been found in an infected man’s semen more than 3 months after symptoms began. Semen contains sperm, which is what fertilizes an egg to get a woman pregnant. If a man is infected with Zika and has sex with a pregnant woman, he can pass the virus to her and then it is possible for the virus to pass to her unborn baby.

How can a man prevent a Zika infection?

  • Avoid travel to Zika-affected areas. Men whose partners may be pregnant or trying to conceive, should avoid travel to a Zika-affected area unless it is absolutely necessary.
  • Prevent mosquito bites. If a man does travel to a Zika-affected area, he should avoid mosquito bites during the trip. Continue to use insect repellant for at least 3 weeks after return, to help prevent Zika from spreading to others.
  • Use a condom. When he returns from his trip, it is important to use a condom every time he has sex to prevent passing Zika to his partner. The length of time that you should use condoms depends on your personal situation and concerns. Talk to your provider.

What if a man thinks he may have been infected with Zika?

  • Recognize the symptoms. Illness usually begin 2 to 7 days after you’ve been exposed to the virus. You can be sick with Zika for several days to a week. Signs and symptoms include:
    • Headache
    • Fever (You may or may not have a fever if you have Zika.)
    • Joint or muscle pain
    • Pink eye (also called conjunctivitis) or pain behind the eyes
    • Rash
    • Throwing up
  • Most people who have Zika don’t feel sick or have symptoms. If you think you may have Zika, talk to your health care provider. You can find out if you have Zika with a blood or urine test.
  • If you have Zika, or THINK you may have Zika, be careful not to infect your partner. Use condoms.

What can you do if you’re planning to get pregnant?

  • If a man has been tested for and has Zika, wait at least 6 months after his first sign or symptom of Zika before trying to get pregnant.
  • If a woman has been tested for and has Zika, wait at least 8 weeks from her first sign or symptom before trying to get pregnant.
  • If you or your partner may have Zika but neither of you have signs or symptoms and neither of you has been tested, wait at least 8 weeks from when you think you may have been exposed to Zika before trying to get pregnant.

The CDC recommends that you wait this long to be sure you and your partner aren’t infected with Zika when you try to get pregnant.

If you or someone you know has a baby affected by Zika, the Zika Care Connect (ZCC) website can help. It provides parents and specialists resources and a network of healthcare providers, all in one place.

You can call the ZCC Helpline 1-844-677-0447 (toll-free), Monday – Friday, 9am – 5pm EST, to get answers to questions and get referrals to healthcare providers.

See our website for more information on Zika during pregnancy, microcephaly, and congenital Zika syndrome.

Have questions? Send them to our Health Education Specialists at AskUs@marchofdimes.org.

Get outdoors but know how to protect yourself

09
Jun
Posted by Barbara

Family walking outdoorsTomorrow is National Get Outdoors Day. Now that the weather has warmed up, getting outside is a welcomed change in most parts of the country.

But getting outdoors has its own set of challenges – from bug bites to sunburn. Here’s a quick rundown on how to stay safe when heading outdoors, especially if you’re pregnant.

Bugs that bite and spread diseases

Ticks – In many areas of the country, especially wooded areas or places with high grass, Lyme disease is spread by ticks. Untreated Lyme disease can have cause complications during pregnancy.

Mosquitos – If you’re traveling, be sure to check the CDC’s map to see if the Zika virus is active in the area where you are heading. The Zika virus spreads through mosquito bites and through body fluids like blood or semen. If you’re pregnant, or thinking of becoming pregnant, don’t visit a Zika-affected area. Zika virus during pregnancy can cause serious birth defects.

What should you do?

Use an insect repellant (a product that keeps insects from biting you), like bug spray or lotion, that’s registered with the Environmental Protection Agency (also called EPA). All EPA-registered bug sprays and lotions are checked to make sure they’re safe and work well.

Make sure the product contains one or more of these substances that are safe to use during pregnancy and breastfeeding: DEET, picaridin, oil of lemon eucalyptus, para-menthane-diol, IR3535 and 2-undecanone. If the product contains DEET, make sure it has at least 20 percent (20%) DEET.

Don’t put bug spray or lotion on your skin under clothes. If you use sunscreen, put it on before the spray or lotion.

If you have children: Most bug sprays and lotions are safe to use on babies 2 months and older, but don’t use products that contain oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years. Don’t put the spray or lotion on your baby’s hands or near her eyes or mouth. Don’t put the spray or lotion on cut, sore or sensitive skin.

Protect yourself from the sun

Nothing will stop your outdoor fun faster than a nasty sunburn. Sunscreen is important whenever you are outside, especially if you are pregnant. During pregnancy your skin is more sensitive to sunlight than it was before pregnancy. The sun gives off ultraviolet radiation (UV) which can increase the risk of skin cancer, give you a bad burn and increase signs of aging.

What can you do?

Before heading outside, lather up with a sunscreen that has a sun protection factor (SPF) of 30 or higher. Use only products that have UVA and UVB or Broad Spectrum protection products. Apply sunscreen at least 15 minutes before heading outdoors and reapply every 2 hours.

If you’re sensitive to sunscreens, try one with zinc oxide or titanium dioxide as they are not as irritating to the skin. You can also cover up by wearing long sleeves and pants, and a wide brimmed hat.

Don’t use products that combine bug repellant with sunscreen. It’s important to reapply sunblock every two hours. If you use a combination product, you’ll be reapplying the bug repellant chemicals as well – not good. Too much bug repellant can be toxic. So, to be on the safe side, keep these products separate, or use the combination product once, and then apply sunblock only every two hours afterward.

Don’t choose a product with retinyl palmitate, especially if you are pregnant. This type of vitamin A has been linked to an increased risk of skin cancer and is associated with birth defects.

Check the expiration date and don’t use it if it is expired. If your sunscreen does not have a date, write one on your bottle after purchasing. Sunscreens retain their original strength for three years.

Here are tips for keeping your baby safe while outdoors.

With a little planning and care, you can get outdoors and enjoy yourself tomorrow. Enjoy!

 

Too much? Too little? Or just right?

06
Jun
Posted by Lauren

pregnant-woman-on-weight-scale-shrunkWeight gain seems to always be one of the topics of conversation for pregnant women. “How much should I gain?” “How do I stay healthy?” Turns out, how much weight you gain during pregnancy is very important.

Gaining the right amount of weight during pregnancy can help protect your health and the health of your baby. And gaining too much or too little can be harmful.

So how much weight gain is recommended?

Your health care provider uses your body mass index (BMI) before pregnancy to figure out how much weight you should gain during pregnancy. BMI is your body fat based on your height and weight.

  • Underweight = BMI less than 18.5
  • Healthy weight = BMI 18.5 to 24.9
  • Overweight = BMI 25 to 29.9
  • Obese = BMI more than 30

If you’re pregnant with one baby, the recommendations are as follows:

  • If you were underweight before pregnancy, you want to gain about 28 to 40 pounds during pregnancy.
  • If you were at a healthy weight before pregnancy, you want to gain about 25 to 35 pounds during pregnancy.
  • If you were overweight before pregnancy, you want to gain about 15 to 25 pounds during pregnancy.
  • If you were obese before pregnancy, you want to gain about 11 to 20 pounds during pregnancy.

And while you don’t want to gain too much or too little weight, don’t ever try to lose weight during pregnancy. If you have questions about healthy weight gain during pregnancy, talk to your health care provider.

Zika in New York City

02
Jun
Posted by Barbara

New York CityIf you live in the New York City area, you may have seen or heard the advertisements about the Zika virus.

There has been an increase in the number of babies born in NYC who have shown signs of the virus.

The NYC Department of Health and Mental Hygiene reports that since January 2017, 402 pregnant women have shown laboratory evidence of the Zika virus infection. Twenty three babies have been born with lab evidence of the infection, and 16 babies have been born with birth defects consistent with Zika virus infection during pregnancy.

It is important to note that all of these cases resulted from either travel to a Zika affected area, or through sex with an infected individual. The majority of the cases are believed to have resulted from travel to the Dominican Republic.

None of the cases are reported to have been due to local transmission, meaning no one became infected as a result of being bitten by a NYC mosquito.

What does all this mean?

Zika is still a threat, especially to pregnant women and babies. If a woman gets infected with Zika during pregnancy, the virus can pass to her baby. It can cause serious birth defects including microcephaly.

The most common way Zika is spread is by being bitten by an infected mosquito, or by having sex with an infected partner.

How can you protect yourself?

  • If you are trying to get pregnant, or you are pregnant, do not travel to areas with risk of Zika.
  • Protect yourself from mosquito bites by wearing long sleeved shirts and pants, using bug spray, and staying in air conditioned buildings. Learn more about how to stay safe from Zika in our article.
  • If your partner has travelled to an area with Zika and may be infected, use a barrier method of birth control (such as a condom) every time you have sex or don’t have sex at all.
  • If you’re pregnant and think you may have been exposed to Zika, see your health care provider right away.
  • If you think you may have been exposed to Zika during pregnancy and you give birth, be sure to let your baby’s pediatrician know, so that your baby can be closely monitored.
  • You can find special doctors to care for a baby potentially affected by Zika on the Zika Care Connect website.

We’re closely monitoring the Zika virus and its potential effects on women, babies and entire families. Stay tuned for more updates.

Have Zika questions? Send them to AskUs@marchofdimes.org.

 

No fruit juice for children under 1 year

30
May
Posted by Sara

hapy babyThe American Academy of Pediatrics (AAP) has recently changed its recommendations regarding how much fruit juice children should drink. They now state that children under the age of 1 year should NOT drink fruit juice.

The updated recommendations also state that:

  • Toddlers ages 1-3 should not get more than 4 ounces of 100% fruit juice each day.
  • Toddlers should not be given juice from bottles or sippy cups. This allows them to easily consume juice throughout the day and can lead to cavities. Also, toddlers should not be given juice at bedtime.
  • Breast milk or infant formula is enough for infants to drink, and low-fat/nonfat milk and water are appropriate drinks for older children.

The new policy encourages eating more whole fruits instead of drinking fruit juice. Drinking too much fruit juice can contribute to cavities. And fruit juice does not have the fiber that is generally found in fresh fruit.

“Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories,” said Melvin B. Heyman, MD, FAAP, co-author of the statement. “Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1.”

Have questions? Text or email AskUs@marchofdimes.org.