Choosing a car seat for your premature baby

Posted by March of Dimes

This is an exciting moment! Your baby has been discharge from the newborn intensive care unit (also called, NICU) and is ready to go home.

Now you need to make sure your baby gets home safe. The law requires that you use an infant car seat when transporting your baby home from the hospital. However, the federal government’s standard for car seat safety has no minimum weight limit nor does it account for the special needs of a premature baby.

Learn about how to keep your baby safe while riding in his car seat before your baby is discharged from the hospital. Here are few tips that may be of help.

Look for these specific guidelines for car seat safety for premature babies or low-birthweight baby:

  • The car seat needs to have a three point harness system. Convertible car seats with a five-point harness system are also good.
  • Don’t pick a car seat with a shield, abdominal pad or armrest. Your baby might have trouble breathing behind the shield or may hurt his face and neck in a sudden stop or crash. Premature babies have weaker breathing airways, be extra cautious with this.
  • A car seat with the shortest distance between the crotch strap and the seat back is best. Ideally, pick one with a crotch-to-seat back distance of 5 1/2 inches. This helps prevent your baby from slipping forward feet first under the harness. You can also place a rolled diaper or blanket between the crotch strap and your infant to prevent slipping.
  • Car seats with multiple harness-strap slots are also good. They offer more choices than other seats and are better for small but growing infants. It’s best to pick a car seat with harness straps that can be placed at or below your infant’s shoulders.

How to place your baby in the car seat

  • Place your baby rear-facing. Keep your baby rear-facing until she reaches the highest weight and height allowed by its manufacturer.
  • Place your baby’s buttocks and back flat against the seat back. The harness should be snug, with the car seat’s retainer clip halfway between your baby’s neck and stomach. The clip should not be on his belly or in front of his neck.
  • Use only the head-support system that comes with your car safety seat. Avoid any head supports that are sold separately. If your baby is very small and needs more support for her head and body, then place blanket rolls on both sides of your baby.

Other safety tips

  • Recline a rear-facing car seat at about 45 degrees or as directed by the instructions that came with the seat. If your baby’s head still falls forward, place a tightly rolled blanket or pool “noodle” under the car seat.
  • Never place a rear-facing car seat in the front passenger seat of any vehicle.
  • Remember, the back seat is the safest place for all children to travel while in a car.
  • Whenever possible, have an adult seated in the rear seat near the baby in the car seat. If a second caregiver is not available, know that you may need to safely stop your car to assist your baby, especially if a monitor alarm has sounded.
  • Never leave your baby unattended in a car seat, either inside or out of a car.
  • Avoid leaving your baby in car seats for long periods of time to lessen the chance of breathing trouble. It’s best to use the car seat only for travel in your car.

For more information visit Car Safety Seats tips for parents of preemies.

Gestational diabetes: How to control your blood sugar?

Posted by Azalia Fernandez

What is gestational diabetes?

Gestational diabetes is a type of diabetes that happens during pregnancy. It means that your body is not using a hormone called insulin the way it should, or your body is not making enough of it. When this happens your blood sugar increases. Having high blood sugar during pregnancy increases the risk of certain complications during pregnancy, including: preeclampsia, having a very large baby (macrosomia), premature birth, and having a c-section.

Here are some things you can do to help you manage and treat your gestational diabetes:

  • Prenatal care: Women who have gestational diabetes need to have more prenatal care checkups. This helps your healthcare provider verify that you and your baby are doing ok.
  • Monitor blood sugar: You will need to check your blood sugar regularly and keep a log. This can help your provider monitor your treatment. You may need to use a specific device to measure your blood sugar.
  • Eat healthy foods: Choosing healthy foods, eating the right portion sizes and having regular meals are key to help you control your blood sugar.
  • Being active: Physical activity helps regulate your blood sugar. Ask your provider how much and what type of activity is best for you. It’s ok for most women to do 30 minutes of moderate physical activity (like walking, riding a stationary bike) a day.
  • Medication: Your provider may recommend the use of insulin to control your blood sugar. In certain situations, an oral medication might be indicated. Your provider will give you more information according to your specific needs.

Healthy eating for gestational diabetes

The best way to make sure you are eating the right amount and types of food is to visit a registered dietitian nutritionist (also called RDN). A RDN can create an individualized nutritional plan tailored to your likes, dislikes, and your specific needs. Eating well is one of the most important steps in controlling your blood sugar and reducing the risks associated with gestational diabetes. Here are some things you can do:

  • Don’t skip meals. The best way to keep your blood sugar level from dropping or spiking is to eat regularly. This means not skipping meals. Make sure you eat breakfast, lunch and dinner every day. You might also need to have 2-3 small snacks a day. The goal is to spread your calories during the day and avoid spending many hours without eating or eating too much in one meal.
  • Portion sizes. You will need to eat frequently, but you also need to be careful not to overeat. Learn about how many calories you need to eat every day and make sure you are eating the right portion sizes. For example, one small banana (about 6”) counts as one portion, while a big banana (about 9”) counts as two.
  • Learn about carbohydrates. You will need to keep track of the amount of carbohydrates you eat per meal. This is the first step in managing your blood sugar. Foods that contain carbohydrates are: fruits, rice, pasta, potatoes, bread, milk and beans, among many others. Your RDN can make a nutritional plan that specifies the portion sizes you need of each in your meals. Certain foods that contain carbohydrates and are also high in fiber are beans, lentils and oatmeal. These are a good source of carbohydrates for women with gestational diabetes. The fiber content in these foods and the type of carbohydrate takes longer to digest and will help your blood sugar stay within your target range.
  • Proteins and fat. Make sure you eat lean proteins like chicken breast, fish low in mercury, legumes, eggs, and low fat dairy products among others. About 20 percent of your calories should come from protein sources. Healthy fats like avocado, olive oil, almonds, and nuts are good choices. Limit the amount of butter, cream, high fat meats or fried foods.
  • Vegetables are your best friend. Make sure you eat plenty of vegetables and leafy greens every day. Be adventurous and try new recipes. You might get inspired while you visit the farmers market. Ask about how to cook vegetables you’re not familiar with or ask for recipes. You might get great suggestions. Eat a variety of colors like spinach, cauliflower, yellow squash, pumpkin, beets, etc. This will help you consume a variety of nutrients too.
  • It’s ok to use artificial sweeteners. According to the American College of Obstetricians and Gynecologists (ACOG) sugar substitutes such as aspartame, stevia, sucralose and acesulfame potassium are thought to be safe to eat in moderate amounts during pregnancy. Women with a metabolic disorder known as phenylketonuria (PKU) should not have aspartame (sold as NutraSweet® or Equal®) because it contains the amino acid (phenylalanine) that their bodies can’t break down.
  • Limit or avoid certain foods. Avoid foods that are concentrated on added or simple sugars like sodas, desserts, cookies, candies, fruit juice, dried fruits, syrups, honey, agave syrup, among others. These types of foods have very low or no nutritional value, and will increased your blood sugar. Limit them as much as possible.


Pregnancy loss: Will it happen again?

Posted by March of Dimes

The loss of a pregnancy or a baby is one of the most difficult experiences. Whether you had a miscarriage, stillbirth or your baby died soon after birth, it’s normal to have mixed feelings about a future pregnancy. Some women may want to start trying getting pregnant as soon as possible, while others may prefer to wait. Will it happen again? – is a common question many women ask themselves when thinking about getting pregnant again.

Trying to get pregnant again after a baby’s death may be really stressful for you. Here are few things you can do:

  • Share your feelings with your partner about getting pregnant again. Your partner may feel differently about getting pregnant again, but you and your partner are the only ones who can decide what’s right for you.
  • Try to be hopeful. Remind yourself that every pregnancy and baby are different. Just because you’ve had a baby die doesn’t mean it will happen in your next pregnancy.
  • If you work, talk to your boss about how to reduce the stress at your job.
  • Talk to your provider or a counselor about ways you can reduce stress.
  • Go to your preconception checkup to make sure you’re healthy. Being healthy when you get pregnant can help you have a healthy pregnancy.
  • Eat healthy foods, drink lots of water and do something active every day. Try to get a full night’s sleep.
  • Don’t smoke, drink alcohol or use harmful drugs.

How long to wait before getting pregnant again?

For most women, it’s best to wait at least 18 months (1½ years) from the end of one pregnancy before getting pregnant again. This gives your body enough time to recover before your next pregnancy.

Not all women can wait 18 months between pregnancies. Talk to your provider about how long to wait between pregnancies if:

  • You’re older than 35.
  • You’ve had a miscarriage or stillbirth. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy.

When you’re ready to try again

The best thing you can do to help you have a healthy pregnancy next time is to take good care of yourself. Before your next pregnancy:

  • Get a preconception checkup. This is a medical checkup you get before pregnancy to help make sure you’re healthy when you get pregnant.
  • Take a vitamin supplement every day with 400 micrograms of folic acid in it. Folic acid is a vitamin that every cell in your body needs for healthy growth and development. If you take it before pregnancy and during early pregnancy, it can help protect your baby from birth defects of the brain and spine called neural tube defects, birth defects of the mouth called cleft lip and palate and some heart defects.
  • Get to a healthy weight. Eat healthy foods and do something active every day. Talk to your provider about the right weight for you.
  • Don’t smoke, drink alcohol or use harmful drugs. Talk to your provider if you need help to quit.

For more information

  • From hurt to healing (free booklet from the March of Dimes for grieving parents)
  • Share Your Story (March of Dimes online community for families to share experiences with prematurity, birth defects or loss)

Prescription opioids and breastfeeding

Posted by Lilliam

Prescription opioids are medicines used to relieve pain your health care provider may prescribe if you’ve been injured or had surgery or dental work. Prescription opioids include codeine, fentanyl, hydrocodone, morphine, oxycodone, and tramadol, among others. Prescription opioids are sometimes used to treat a cough or diarrhea.

Are there risks associated with taking prescription opioids?

Opioids have gotten a lot of attention in the United States because they are easy to get addicted to. Along with helping relieve pain, they also release chemicals in the brain that can make you feel calm and intensely happy (also called euphoria). Drug addiction is a brain condition that leads to using drugs, even if they’re harmful, because they affect self-control and your ability to stop using a drug. If you take prescription opioids during pregnancy, they can cause problems for your baby, such as premature birth and neonatal abstinence syndrome (also called NAS). NAS is when a baby is exposed to a drug in the womb before birth and goes through withdrawal from the drug after birth. Even if you use an opioid exactly like your health care provider tells you to, it still may cause NAS in your baby.

What can you do if you take a prescription opioid while breastfeeding?

Breastfeeding is beneficial for you and your baby. It helps you bond with your baby and your breast milk helps build your baby’s immunity to protect her from infections. If your baby has NAS, breastfeeding may help make her withdrawal less severe so she needs less medicine and can leave the hospital sooner.

If you’re taking prescription opioids for pain relief with your provider’s supervision, you can breastfeed your baby depending on the medicine you take. Some can cause serious problems for your baby. Here are some things you can do:

  • Make sure your provider who prescribes the opioid knows you’re breastfeeding.
  • Take the medicine exactly as your provider tells you to.
  • Talk to your provider about switching to a safer pain reliever if you take codeine, hydrocodone, meperidine, oxycodone, or tramadol. Pain relievers like ibuprofen (Advil®) or acetaminophen (Tylenol®) are safe to use when breastfeeding.
  • Talk to your provider about ways to avoid addiction to opioids.

For more information

If you have questions about exposures and medication use during pregnancy and while breastfeeding, call MotherToBaby toll-free at 866-626-6847 or send a text to 855-999-3525. You may also visit their website at

Can low dose aspirin reduce the risk of preeclampsia?

Posted by Juviza Rodriguez

Preeclampsia, a kind of high blood pressure, is a serious health condition that can affect women after the 20th week of pregnancy or after giving birth. Without treatment, preeclampsia can cause health problems for mom and baby. For example, a woman with untreated preeclampsia can have problems with her kidney or liver, or problems with how her blood clots. Preeclampsia during pregnancy increases the risk of premature birth (when a baby is born early, before 37 weeks of pregnancy).

How can low-dose aspirin help?

Low-dose aspirin is also called “baby aspirin” or 81 mg (milligrams) aspirin. For some women low-dose aspirin can help reduce the risk for preeclampsia. If your provider thinks you’re at risk for preeclampsia, he may want you to take low-dose aspirin to help prevent it. Make sure to talk to your provider to see if treatment with low-dose aspirin is right for you.

You can buy low-dose aspirin over-the-counter, or your provider can give you a prescription for it. If your provider wants you to take low-dose aspirin to help prevent preeclampsia, take it exactly as they tell you to. Don’t take more or take it more often than your provider says.

Am I at risk for preeclampsia?

Although we don’t know exactly what causes preeclampsia, there are some things (risk factors) that can make you more likely to have this condition than other women. You might be at higher risk for preeclampsia if:

  • You had preeclampsia before, in a previous pregnancy. The earlier in pregnancy you had preeclampsia, the higher your risk is to have it again in another pregnancy.
  • You are pregnant with multiples (twins, triplets, or more).
  • You have high blood pressure, diabetes, kidney disease or an autoimmune condition like lupus.

To diagnose preeclampsia, your provider measures your blood pressure and tests your urine for protein at every prenatal visit. If you’re at high risk for preeclampsia, your provider may want you to start taking low-dose aspirin after 12 weeks of pregnancy.

What are the signs and symptoms of preeclampsia?

Signs and symptoms of preeclampsia include:

  • Swelling in the legs, hands or face.
  • Sudden weight gain (2 to 5 pounds in a week).
  • Headache that doesn’t go away.
  • Changes in vision, like blurriness, flashing lights, seeing spots or being sensitive to light.
  • Nausea (feeling sick to your stomach), vomiting or dizziness.
  • Trouble breathing.
  • Pain in the upper right belly area or in the shoulder.

Remember, preeclampsia can happen during pregnancy, or after the baby is born (up to 6 weeks after baby’s birth). If you have even one sign or symptom, call your health care provider right away.

World Birth Defects Day 2018

Posted by Lilliam

Every year, an estimated 8 million babies around the world are born with a serious birth defects. In the United States, that’s about 1 in 33 babies. Birth defects are common, costly, and critical. All communities are affected by birth defects. That is why, on March 3, March of Dimes is joining more than 100 organizations from around the world to observe the fourth annual World Birth Defects Day.

Birth defects are health conditions that are present at birth. They can cause problems in overall health, how the body develops or how the body functions. Birth defects are a major cause of child mortality, and those who survive, may face a lifetime of disability.

There are thousands of different birth defects. The most common and severe birth defects are heart defects, neural tube defects and Down syndrome. We don’t know all the reasons why birth defects occur. Some may be caused by the genes you inherit from your parents. Others may be caused by environmental factors, such as exposure to harmful chemicals. Some may be due to a combination of genes and the environment. In most cases, the causes are unknown.

While not all birth defects can be prevented, there are steps you can take to help you have a healthy pregnancy and healthy baby. One of those steps is to take a vitamin supplement with 400 micrograms (mcg) of folic acid in it every day. Taking folic acid before and during the early weeks of pregnancy can help prevent serious birth defects of the brain and spine, called neural tube defects. Even if you’re not trying to get pregnant soon, take a vitamin supplement with folic acid. Take a look at the video at the top of the page to learn more about folic acid.

Join us tomorrow to promote World Birth Defects Day and help raise awareness to help improve the health of all babies around the world.

Here’s how you can help:

  • Lend your voice! Register with your social media account and Thunderclap will post a one-time message on March 3rd. Sign up for the World Birth Defects Day Thunderclap campaign:
  • Participate in the Buzzday on Twitter, March 3 by using the hashtag #WorldBDDay.

Learn more at:

What is a rare disease?

Posted by Juviza Rodriguez


In the United States, any disease, disorder, illness or condition that affects less than 200,000 is considered a rare disease. Health conditions such as Tay-Sachs, ocular toxoplasmosis, fragile X syndrome, and ALS (Amyotrophic lateral sclerosis) are just a few examples. However, the National Organization for Rare Diseases (NORD) says that there are more than 7,000 rare conditions that affect about 30 million people in the United States. It is estimated that 1 in 10 people have a rare disease in the U.S. — more than half of them are children.

People who have a rare disease have many different needs, but since it can be difficult to make a correct diagnosis, getting the right treatment can be difficult. Rare diseases affect the lives of people in many ways, not only because they are sick, but because they do not know much about the disease, the diagnosis, the treatment or even what they can expect to happen with their health and quality of life over time.

Sadly, about 95% of rare diseases have no treatment and none of them have a cure. The truth is that the cause of the majority of these diseases is still unknown today, although some of them might be genetic. Knowing your family medical history and discussing it with your health care provider is always a good idea, especially if you plan on having a baby.

Today, February 28th, we help raise awareness on this important issue. Join us and NORD to raise awareness about rare diseases, the impact it has on the people affected by them, their families and the community. Visit and to learn more.

Weight gain and pregnancy: what’s right for you

Posted by March of Dimes

Gaining the right amount of weight during pregnancy is important. It can help protect your health and the health of your baby.

Why is weight gain during pregnancy important?

If you gain too little weight during pregnancy, you’re more likely than other women to have a premature baby or a baby with low birthweight.

If you gain too much weight during pregnancy, you’re more likely than other women to:

  • Have a premature baby. Premature babies may have health problems at birth and later in life.
  • Have a baby with fetal macrosomia. This is when your baby is born weighing more than 8 pounds, 13 ounces. Having a baby this large can cause complications, like problems during labor and heavy bleeding after birth.
  • Need a c-section.
  • Have trouble losing weight after your baby’s birth. This can increase your risk for health conditions like diabetes and high blood pressure.

How much weight should you gain during pregnancy?

This depends on your health and your body mass index (also called BMI) before you get pregnant. BMI is a measure of body fat based on your height and weight. To find out your BMI, go to Your provider will use your BMI before pregnancy to determine how much weight you should gain during pregnancy.

In general, if you’re pregnant with one baby:

  • 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.

If you’re overweight or obese and are gaining less than the recommended amounts, talk to your provider. If your baby is still growing well, your weight gain may be fine.

Gaining weight slowly and steadily is best. Don’t worry too much if you don’t gain any weight in the first trimester, or if you gain a little more or a little less than you think you should in any week. You may have some growth spurts—this is when you gain several pounds in a short time and then level off. Don’t ever try to lose weight during pregnancy.

Just thinking about getting pregnant?

If you’re thinking about getting pregnant, remember that it’s best to start your pregnancy at a healthy weight. You can make sure you’re at a healthy weight at your well-woman checkup (which can also be your preconception checkup). Did you know that your well-woman checkup is a preventive service and is covered by most insurance plans with no extra costs to you? Learn more about recommended preventive services that are covered under the Affordable Care Act at Care Women Deserve.

How to support grieving parents

Posted by March of Dimes

The loss of a baby is one of the most painful things that can happen to a family. If you have a family member or friend that has lost a baby during pregnancy, in the first days of life, or even as an infant, it’s very hard to know what to say or do. Here are some ideas that may help.

It’s important to recognize that although the loss may have happened to friends or family, you may be affected by their baby’s death too. To be able to support the parents, try to understand your own feelings. You may feel sad, helpless, worried, angry, confused or numb. You may wonder how you can help the parents if you feel so sad yourself. There’s no right or wrong way to feel. But by understanding how you feel, you can better support the grieving family.

It’s hard to know exactly what to say to parents whose baby has died. But there are a few important things to remember:

  • Be simple: “I’m sorry for your loss.”
  • Be honest: “I don’t know what to say. I can’t imagine what you’re going through.”
  • Be comforting: “I care about you and your family. Please tell me what I can do to help.”
  • Be specific, not everyone feels comfortable asking for help: “Can I bring you dinner on Tuesday? How about I watch the kids this week”

Don’t forget about dad. Be sure to include him as a grieving parent.

Some words may not be helpful to a grieving family, in fact, they may actually be hurtful. Here are things you should NOT to say to grieving parents:

  • “You’ll get over it in time.”
  • “It’s for the best.”
  • “You can always have another baby.”
  • “Count your blessings.”

If you can’t find the right words, it’s OK to say nothing. Sometimes just being there to listen and hold a hand is all a parent needs. You don’t always have to find the perfect words to say.

Parents may need lots of comfort and support during this painful time. And there are many things you can do to help. You can read more about grief and loss on our website too. The most important thing is simply to offer your support and love to your family or friend  and let them know you are there for them as they grieve.

Preventing infections during pregnancy

Posted by March of Dimes

February is International Prenatal Infection Prevention month. Here are some ways that you can try to prevent infections during pregnancy.

Wash your hands: Washing your hands regularly can help to reduce the spread of colds, the flu and other infections, like cytomegalovirus (CMV).

Wash your hands:

  • Before preparing or eating food
  • After handling raw meat, raw eggs or unwashed vegetables
  • After being around pets or animals
  • After changing diapers, wiping runny noses, or picking up toys

Prepare food properly: Handle foods safely whenever you wash, prepare, cook and store them. Wash knives, cutting boards and dishes used to prepare raw meat, fish or poultry before using them for other foods. Foods to avoid during pregnancy include raw meat, fish, and eggs and unpasteurized foods.

Get vaccinated: Vaccinations can help protect you and your baby from certain infections during pregnancy. Some vaccinations are safe to get during pregnancy, but others are not. Talk to your provider to make sure any vaccination you get during pregnancy is safe. Make sure your vaccinations are up to date before you get pregnant.

Protect yourself from Zika: If you get infected with the Zika virus during pregnancy, you can pass it to your baby. It causes a birth defect called microcephaly and other brain problems. Zika virus spreads through mosquito bites and through body fluids, like blood and semen.

  • If you’re pregnant or trying to get pregnant, don’t visit a Zika-affected area unless absolutely necessary.
  • Protect yourself from mosquito bites.
  • If your male or female partner may be infected with Zika, use a barrier method (like 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 virus, see your health care provider right away.

Ask someone else to clean your cat’s litter box: If you have to do it yourself, wear gloves. Wash your hands thoroughly when you’re done emptying the litter. Dirty cat litter may contain toxoplasmosis, an infection caused by a parasite. Toxoplasmosis can cause health problems for your baby during pregnancy.

Get tested for sexually transmitted infections (STIs): STIs are infections you can get from having unprotected sex with someone who’s infected. If you’re pregnant and have an STI, it can cause serious problems for your baby, including premature birth and birth defects. Testing for STIs is a part of prenatal care. If you have an STI, getting treatment early can help protect your baby.

Have testing for Group B Strep (GBS): Many people carry Group B strep bacteria and don’t know it. It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, like a bladder or urinary tract infection (UTI). While GBS may not be harmful to you, it can be very harmful to your baby. Your provider tests you for GBS at 35 to 37 weeks of pregnancy. If you have GBS, you’ll receive IV antibiotics during labor and birth.

Talk to your health care provider: Talk to your provider about how to prevent infections, making sure that you’re up-to-date on your vaccinations before pregnancy, and what vaccinations you need during pregnancy.