Archive for the ‘Pregnancy’ Category

Thinking about pregnancy? Think about vaccines.

Monday, August 10th, 2015

VaccineVaccines aren’t just for children. Adults need to get vaccinated too! And if you are pregnant or planning a pregnancy, it is very important to make sure that your vaccines are up-to-date.

Vaccines help protect your body from certain diseases. During pregnancy, you pass this protection on to your baby. This is very important because it helps to keep your baby safe during the first few months of life until he can get his own vaccinations.

Here are some vaccines that are recommended before pregnancy:

  • Flu. Get the flu shot once a year during the flu season (October through May). It protects you and your baby against both seasonal flu and H1N1. If you come down with the flu during pregnancy, you’re more likely than other adults to have serious complications, such as pneumonia.
  • HPV. This vaccine protects against the infection that causes genital warts. The infection also may lead to cervical cancer. The CDC recommends that women up to age 26 get the HPV vaccine.
  • MMR. This protects you against the measles, mumps and rubella. Measles can be harmful to pregnant women and cause miscarriage.
  • Tdap. This vaccine prevents pertussis (also called whooping cough). Pertussis is easily spread and very dangerous for a baby. If you’re thinking about getting pregnant, ask your provider about getting the Tdap vaccine.
  • Varicella. Chickenpox is an infection that causes itchy skin, rash and fever. It’s easily spread and can cause birth defects if you get it during pregnancy. It’s also very dangerous to a baby. If you’re thinking about getting pregnant and you never had chickenpox or received the vaccine, tell your provider.

The Centers for Disease Control and Prevention (CDC) recommends two vaccinations during pregnancy:

  1. Flu vaccine if you weren’t vaccinated before pregnancy
  2. Tdap vaccine during each pregnancy at 27 to 36 weeks

Not all vaccinations are safe to get during pregnancy. Do not get these vaccines during pregnancy:

  • BCG (tuberculosis)
  • Memingococcal
  • MMR
  • Nasal spray flu vaccine (called LAIV). Pregnant women can get the flu shot, which is made with killed viruses.
  • Typhoid
  • Varicella (chickenpox)

You should wait at least 1 month after getting any of these vaccinations before you try to get pregnant.

Important: If you didn’t get the Tdap vaccine before or during pregnancy, you can get it right after you give birth. Getting the Tdap vaccine soon after giving birth prevents you from getting pertussis and passing it on to your baby. This vaccine is also recommended for caregivers, close friends, and relatives who spend time with your baby. Your baby should get his first pertussis vaccine at 2 months old. Babies may not be fully protected until they’ve had three doses.

Talk to your health care provider about vaccinations you need before, during or after pregnancy. And remember, getting vaccinated doesn’t just protect you–it protects your unborn baby as well.

Questions? Send them to AskUs@marchofdimes.org.

Thinking about maternity leave

Thursday, August 6th, 2015

pregnant woman with ipadHave you heard that Netflix is offering unlimited paid parental leave to their employees? During their first year as new parents, Netflix employees can take as much time off as they choose while still earning their normal salary. This is really an amazing policy. If you’re working and pregnant, you probably have thought a lot about maternity leave. Over the past 30 years, the participation rate in the labor force of women with children under age 3 has risen from 34.3% in 1975 to 60.9% in 2011. Half of all mothers work during pregnancy and return to work after their baby is born. And among women who worked during their pregnancy between 2005 and 2007, 58.6% returned to work 3 months after giving birth and 72.9% returned to work 6 months after giving birth. It is important to know what options are available to you so that you can plan ahead.

Under the Family and Medical Leave Act (FMLA) employees can take time off from work without pay for pregnancy- and family-related health issues. The act provides up to 12 weeks of unpaid, job-protected leave per year. It also requires that you can keep your health insurance benefits during the leave. To qualify, you must have worked for your employer for at least 12 months, worked at least 1,250 hours during the last 12 months, and worked at a location where the company has 50 or more employees within 75 miles.

In addition to the FMLA leave, your employer may have its own maternity leave policies. Talk to your boss or someone from human resources (also called HR). Here are some questions you may want to ask:

  • Does your employer offer paid maternity leave? Some employers offer paid time off for the birth of your baby. Talk with someone from HR to find out if you have paid maternity leave.
  • Does your health insurance continue while you’re on maternity leave? If you get your health insurance through your employer, your HR person can tell you about what your insurance plan covers. You may need to change your health plan after your baby’s born to make sure he’s covered, too.
  • Does your employer offer flex time or telecommuting for when you’re ready to go back to work? For example, can you work fewer hours each week or work from home at the beginning? And then increase your hours or your time in the office little by little over a few weeks?
  • Are there other programs or services that your employer offers to new moms? If you’re breastfeeding, find out if your employer has a lactation room. This is a private space (not a bathroom) that you can use to pump breast milk. Employers with more than 50 employees must provide this space for breastfeeding moms.

Finally, choosing a child care provider that works best for you can be tough. Try to explore your options and finalize your plans before your baby arrives.  If you can organize childcare before you deliver, it will make your time at home with your baby more relaxing and enjoyable.

How vaccines work

Friday, July 31st, 2015

niam-logoVaccines protect you from diseases that can cause severe illness and even death. Vaccines work with your body’s immune system to help it recognize and fight these infections.

Usually when you are exposed to viruses or bacteria they cause infections that make you sick. To fight this infection, your immune system produces antibodies. These are special disease-fighting cells that attack the virus, destroy it, and make you better. In many cases, once you have made antibodies against a virus, you are then immune to the infection that it causes. This means that you cannot get sick from the same infection. For instance, if you had chickenpox as a child, you are immune to it later in life because your body has produced antibodies against the varicella virus (the virus that causes chickenpox). If you are exposed to the virus again, your antibodies recognize it and destroy it before it makes you sick.

Vaccines work with your body’s natural defenses to help you safely develop immunity to certain diseases. A vaccine uses a small piece of the virus or bacteria that causes the infection. Usually this virus is greatly weakened or it is killed. But it looks enough like the live virus to make your body react and make antibodies to attack the virus in the vaccine. This allows you to become immune to the disease without having to get sick first. For example, after you get the chickenpox vaccine, you will develop antibodies against the varicella virus, but you will not get chickenpox first. This factsheet from the CDC explains the body’s immune response to disease and how vaccines work in much more detail.

There are two main types of vaccines: weakened, live virus or inactivated, killed virus.

Vaccines that use weakened, live viruses include measles, mumps, rubella, rotavirus, flu mist, and chickenpox (varicella). Natural viruses reproduce thousands of times when they infect an individual. But weakened viruses can only reproduce about 20 times. This is not enough to make you sick, so they can’t cause disease. But even a few copies of the virus will cause your immune system to react and to make antibodies against the disease. The advantage of live, weakened vaccines is that typically you only need one or two doses (or shots) to provide immunity. However, live, weakened vaccines cannot be given to people with immune systems that don’t work as well as they should, because even such a small amount of virus could make them sick.

Vaccines that use inactivated or killed viruses include polio, hepatitis A, and the flu shot. The inactivated virus cannot reproduce and therefore cannot cause disease. But the immune system still makes antibodies to protect you against disease. The advantages of inactivated viruses are that the vaccine cannot cause the disease at all, and the vaccine can be given to people with weakened immune systems. The limitation of this method is that several doses of the vaccine are required before you are immune to the disease.

August is National Immunization Awareness month. It is important for people of all ages to protect their health with vaccines. In the upcoming weeks, we will be posting more information about vaccines for women who are thinking about getting pregnant, pregnant women, and babies.

Questions? Send them to AskUs@marchofdimes.org.

Severe bleeding during pregnancy can be placenta previa

Monday, July 27th, 2015

contemplative pregnant woman During my mom’s pregnancy with me, she was diagnosed with placenta previa, a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits on the top of the vagina. If you have placenta previa, when your labor starts, your cervix begins to thin out and dilate (open up), and the blood vessels connecting the placenta to your uterus may tear. This can cause severe bleeding.

My mom remembers the day I was born, like it was yesterday. She remembers my Aunt running down the hall to get towels for her while she stood in the bathroom bleeding during her third trimester. She was rushed to the hospital and had an emergency Cesarean section (C-section) performed. My mom says she can still remember what the pressure felt like on her lower abdomen during the procedure.

We don’t know what causes placenta previa, which happens in about 1 in 200 pregnancies. If you have placenta previa early in pregnancy, it usually isn’t a problem. However, it can cause serious bleeding and other complications later in pregnancy.

Diagnosis and symptoms

The most common symptom of placenta previa is painless bleeding from the vagina during the second half of pregnancy. If you have spotting or bleeding during pregnancy, it’s important you call your provider right away. But, not all women with placenta previa have vaginal bleeding. In fact, about one-third of women with placenta previa don’t have this symptom. An ultrasound can usually pinpoint the placenta’s location to determine if you have placenta previa.

Is there treatment?

Treatment depends on how far along you are in your pregnancy, the seriousness of your bleeding and the health of you and your baby. The goal is to keep you pregnant as long as possible, but at any stage of pregnancy, a C-section may be necessary if you have dangerously heavy bleeding or if you and your baby are having problems.

How can I reduce my risk?

We don’t know how to prevent placenta previa, but you may be able to reduce your risk by not smoking or doing illicit drugs such as cocaine. If you have a healthy pregnancy, and there isn’t a medical reason for you to have a C-section, it’s best to let labor begin on its own. The more C-sections you have, the greater your risk of placenta previa.

As soon as my mom held me in her arms, she said she forgot all about the scary hours beforehand. She was so grateful that she had gone to the hospital when she did.

Remember, if you have spotting or bleeding at any point in your pregnancy, call your provider right away or go to the emergency room.

Maternal PKU

Friday, July 24th, 2015

newborn-screening-picture1PKU or phenylketonuria is a condition in which your body can’t break down an amino acid called phenylalanine.

In the US, about 3,000 women of childbearing age have PKU. A woman with PKU can have a healthy baby but it is very important that she stay on a special diet to control her phenylalanine intake while she is pregnant. According to MotherToBaby, babies born to mothers with untreated PKU (women who are not on the special diet) are commonly born smaller, have microcephaly (an abnormally small head), intellectual disabilities, behavior problems, facial features similar to those of fetal alcohol syndrome, and have higher risks of heart defects.

Managing PKU during pregnancy

If you have PKU and are planning to get pregnant, it is very important that you talk to your health care provider. Many people with PKU now maintain their special diets throughout life. But if you have not been following your PKU diet, it is best to return to your PKU meal plan at least 3 months before you try to get pregnant.

PKU meal plans are different for everyone because people with PKU can tolerate different amounts of phenylalanine. For this reason, it is very important that you talk to health care providers who are familiar with managing PKU during pregnancy. Blood tests throughout pregnancy can help to monitor your phenylalanine levels and make sure that they are not too high. And your prenatal care provider may order ultrasounds to monitor your baby’s growth.

Will my baby have PKU?

If you have PKU, your baby has a chance to have PKU. Your baby has to inherit a mutation for PKU from both parents to have PKU. Whether or not your baby will have PKU depends on if your partner has PKU or is a PKU carrier. (A PKU carrier has one copy of the PKU mutation but does not have PKU.)

  • If you and your partner both have PKU, your baby will have PKU.
  • If you have PKU and your partner is a carrier, than there is a 50% chance your baby will have PKU and a 50% chance your baby will be a PKU carrier.
  • If you have PKU but your partner does not carry the gene change for PKU, then your baby will be a PKU carrier but will not have PKU.

If you are not sure if your partner is a PKU carrier, there are tests available that can help you find out. A genetic counselor can better help you understand your chances of passing PKU to your baby.

All babies born in the United States are tested for PKU through the newborn screening program. Babies born with PKU are immediately placed on a special diet that significantly reduces the amount of phenylalanine they consume. Babies who have PKU may never show symptoms if they are transitioned to a low-phenylalanine diet soon after birth.

Questions? Send them to AskUs@marchofdimes.org.

 

Baby it’s hot outside

Tuesday, July 21st, 2015

heatExtreme heat can be dangerous. High temperatures, especially coupled with humidity, can cause heat related illnesses. If you live in the northeast, you are familiar with the brutally hot weather we have been experiencing.

Here is what you need to know to stay safe, especially if you are pregnant, have a medical condition, or have a baby or young children.

Know the signs of heat illness and what to do:

Heat cramps

  • Symptoms: Muscle cramps in legs or abdomen (stomach area), with or without sweating.
  • To do: Get the person out of the heat – into an air conditioned room, if possible. Gently massage the cramped muscles. Sips of water are ok unless the person is nauseous.

Heat exhaustion

  • Symptoms: Sweating; clammy but cool skin; cramping; dizziness; nausea and/or vomiting; fainting; weak pulse.
  • To do: Bring the person into a cool room with air conditioning. Let them lie down and sponge them with a cool, wet cloth. Let them sip water slowly. If they continue to vomit, get medical attention.

Heatstroke or sunstroke -This is the most serious of heat illnesses. Call 911 or go to the nearest hospital.

  • Symptoms: confusion nausea; dizziness; a fever; headaches; difficulty breathing; rapid pulse; hot, dry skin, sweating or both. Take steps to cool the person off by loosening or removing clothing, going inside an air conditioned room, or cooling them down with a sponge bath. Do not give water or fluids.
  • To do: Seek medical attention immediately.

Avoid heat illness by being prepared -an ounce of prevention goes a long way:

  • NEVER leave a person of any age or a pet in a parked car, even if the windows are open a little. Children die needlessly this way every year. Do not leave them in a car even for a minute!
    Here are potentially lifesaving tips for never leaving your child in your car.
  • Stay inside, in an air condition room. If you must go outside, do so in the early or late hours of the day when it is cooler. Wear sunscreen. Keep outdoor stays brief.
  • Drink plenty of water all day. Limit drinks containing sugar or caffeine and avoid alcoholic beverages.
  • Eat light foods which are easier to digest.
  • If you must be outside, take time to relax in a shady area or go inside a cool building often.
  • Wear lightweight clothing. This is very important for children – if overdressed, their body temperature can rise to over 105 degrees Fahrenheit in a very short time.
  • Take a cool bath or shower.

Here are more tips on how to keep your child cool and safe in extreme heat, from the AAP.

With a little planning and care, you can stay safe and avoid a serious problem.

Silent but dangerous bacteria

Monday, July 20th, 2015

Pregnant woman with doctorAbout 25% of pregnant women carry Group B streptococcus (also called Group B step or GBS). GBS may come and go quietly in your body without any symptoms, so you may not be aware that you are carrying it. GBS may never make you sick and we don’t know exactly how the bacteria is transmitted. But while GBS may not be harmful to you, it can be very harmful to your baby.

How can GBS affect you during pregnancy?

GBS lives in the rectum or vagina and can cause a bladder or urinary infection (UTI). Women who have symptoms can receive antibiotics from their provider. If you don’t have symptoms of an infection, you may not know you need treatment. Without treatment, a uterine infection during pregnancy can increase your chances of:

• Premature rupture of the members – When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts
• Preterm labor – Labor that happens too early, before 37 weeks of pregnancy
• Stillbirth – When a baby dies in the womb before birth, but after 20 weeks of pregnancy

Is there any good news?

Yes, you can be tested for GBS. If you are pregnant, you will be tested for GBS at 35 to 37 weeks of pregnancy. Your provider will take a swab of your vagina and rectum and the sample will be sent to the lab. The process is simple and painless and results will be available in 1 to 2 days. If you go into preterm labor, your provider can use a quick screening test during labor to test you for GBS.

If the test is positive:

You will receive an antibiotic from your provider during labor and birth through an IV, which helps prevent your baby from getting the infection. Remind your health care provider at the hospital when you go to have your baby; this way you can be treated quickly. It may be helpful to make a note and stick it on top of your hospital bag so you remember as you walk out the door. If you have GBS and a scheduled cesarean birth (C-section) before labor starts and before your water breaks, you probably don’t need antibiotics.

With treatment, a woman has only a 1 in 4,000 chance of delivering a baby with group B strep, compared to a 1 in 200 chance if she does not get antibiotics during labor.

If you are worried about GBS, speak with your health care provider. Have questions? We are here; email AskUs@marchofdimes.org.

Banking your baby’s umbilical cord blood–should you do it?

Friday, July 17th, 2015

newborn-2The umbilical cord connects your baby to the placenta. Umbilical cord blood contains stem cells, which may be used to treat certain diseases. Because of this, many people consider storing or banking the cord blood so that it may possibly be used in the future.

What are stem cells?

Stem cells can grow into specific kinds of cells in your body and may be used to treat some diseases, like cancer. In healthy people, bone marrow makes stem cells. But sometimes a person’s bone marrow stops working and doesn’t make enough healthy stem cells. For people with conditions like cancer, treatments like chemotherapy or radiation can kill healthy stem cells.

If a person needs new stem cells, he may be able to get a stem cell transplant from cord blood. New stem cells from the transplant can go on to make new, healthy cells.

Storing cord blood

There are two options for storing cord blood:

Public cord blood bank: This option is appropriate for most families and is recommended by the American Academy of Pediatrics (AAP). Cord blood donation is used for research or to help others. There’s no cost to you to donate. If you or a family member ever needs cord blood, you can’t use the blood you donated, but you may be able to use cord blood donated by others. Several cord blood banks participate in this program.

Private cord blood bank: This may be a good option for you if you have a child or family with a health condition that may need to be treated with a stem cell transplant. Depending on the bank you choose, the cost is about $2,000, plus a yearly fee of about $125. The chance that your baby or a family member may need to use your stored cord blood is very low – about 1 in 2,700.

Planning for cord blood collection

If you decide to store your baby’s cord blood (through either a public or private bank), you will need to plan ahead of time and make sure your provider is aware of your choice. Between your 28th and 34th week of pregnancy, talk to your provider about your decisions and learn if you meet the donation guidelines.  Put your decision about cord blood on your birth plan. The March of Dimes birth plan includes a question about storing umbilical cord blood.

Your provider usually uses a collection kit that you order from the cord blood bank. To collect the cord blood, your provider clamps the umbilical cord on one side and uses a needle to draw out the blood. The blood is collected in a bag and then sent to the cord blood bank. Your provider can collect cord blood if you have either a vaginal delivery or a C-section.

According to Be the Match, each year in the United States, more than 10,000 people are diagnosed with life-threatening diseases that may be treated with a stem cell transplant. When a patient with leukemia, lymphoma or other life-threatening disease needs a transplant, cord blood may be an option. Today, 15% of transplant patients receive cord blood that was generously donated to a public cord blood bank.

Questions? Email us at AskUs@marchofdimes.org.

Cleft lip and palate awareness

Monday, July 13th, 2015

baby with cleft lipI remember seeing a thin scar on my friend’s upper lip, and wondering how she had gotten it. “I was born with a cleft lip,” she said. I became curious about her cleft lip and how it turned into one tiny scar.

A cleft lip is a type of craniofacial abnormality. These are birth defects of the head (cranio) and face (facial) that are present when a baby is born. Another common type is a cleft palate (roof of the mouth). As July is National Cleft and Craniofacial Awareness and Prevention Month, it is a good time to learn more about these birth defects.

How does a cleft lip or palate form?

The lips of a baby form by about 6 weeks of pregnancy. When the lip doesn’t form completely and is left with an opening, this is called a cleft lip. A baby’s palate is formed by about 10 weeks of pregnancy. When the palate doesn’t form completely and has an opening, it’s called a cleft palate. A baby can be born with just one of these abnormalities or with both.

Each year in the U.S., about 2,650 babies are born with a cleft palate and 4,440 babies are born with a cleft lip with or without a cleft palate. The causes of clefts with no other major birth defects among most infants are unknown.

In most cases, cleft lip and cleft palate can be repaired by surgery. Each baby is unique, but surgery to repair cleft lip usually is done at 10 to 12 weeks of age. Surgery for cleft palate usually is done between 9 and 18 months of age. A child may also need more surgery for his clefts as he grows.

My friend had corrective surgery to repair her lip when she was still a baby. Now all that is left is one thin scar above her upper lip leading to her nose, which you can hardly see.

Can these birth defects be prevented?

We are not always sure what causes a cleft lip or palate.  However, there are steps a pregnant woman can take to decrease her chance of having a baby with a cleft lip or palate.

• Before pregnancy, get a preconception checkup. This is a medical checkup to help make sure you are healthy before you get pregnant.
• Take a multivitamin that contains folic acid. Take one with 400 micrograms of folic acid before pregnancy, but increase to one with 600 micrograms of folic acid during pregnancy. Your provider may want you to take more – be sure to discuss this with him.
• Talk to your provider to make sure any medicine you take is safe during pregnancy. Your provider may want to switch you to a different medicine that is safer during pregnancy.
• Don’t smoke.
• Don’t drink alcohol.
• Get early and regular prenatal care.

If you have any question about cleft or craniofacial defects, causes or prevention, read more here or email us at AskUs@marchofdimes.org.

New study looks at link between antidepressants and birth defects

Friday, July 10th, 2015

pregnant woman with MDThe use of certain antidepressants during pregnancy is associated with a higher risk of birth defects, according to a new study. But other antidepressants do not carry the same risk.

The study looked at a specific group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are medications used to treat depression and other mental health conditions. Previous studies gave conflicting evidence about potential links between the use of SSRIs during pregnancy and certain birth defects.

In this study, researchers from the CDC analyzed data from 17,952 mothers of infants with birth defects and 9,857 mothers of infants without birth defects, born between 1997 and 2009.

The researchers found that some birth defects occur about two or three times more frequently among babies born to women who took certain SSRI medications, like Prozac (fluoxetine) and Paxil (paroxetine) early in pregnancy. It is important to note that the actual risk for a birth defect among babies born to women taking Prozac or Paxil is still very low. For example, the risks for a specific heart defect could increase from 10 per 10,000 births to about 24 per 10,000 births among babies of women who are treated with Paxil early in pregnancy. Since these specific types of birth defects are rare, even doubling the risk still results in a low overall chance.

Researchers did not find a link between birth defects and other SSRIs such as Zoloft (sertraline).

“A pregnant woman should be reassured that she can choose a safe drug to treat her depression and not have to go off her medication because she is afraid her baby may develop a birth defect,” Dr. Edward McCabe, Chief Medical Officer of the March of Dimes said. “Not treating depression can be unhealthy for both the mom and her baby. It can cause stress, and stress during pregnancy is associated with early births and low-birthweight babies.”

If you are currently taking an antidepressant and are concerned, do not stop taking the medication until you talk to your health care provider. And if you are planning to become pregnant and are taking an antidepressant, schedule a preconception checkup and discuss what medications may be best for you.