Archive for the ‘Prematurity’ Category

World Prematurity Day: Why it matters

Friday, November 17th, 2017

In the United States,

About every eight seconds, a baby is born.

Every hour, about three babies die.

African-American infants are more than two times as likely as white infants to die before their first birthday.

About one in ten infants is born preterm (less than 37 weeks gestation).

About every 1½ minutes, a baby is born with low birthweight (less than 5 pounds 8 ounces).

Prematurity/low birthweight and related conditions account for more infant deaths than any other single cause (about 1 in 3).

Every year, about 4,400 babies are born weighing less than one pound.

Premature birth is birth that happens too soon, before 37 weeks of pregnancy. Each year 15 million babies worldwide are born prematurely and more than a million die as a result. Babies born too early may face life-threatening complications and have lifelong health problems. Today, in honor of World Prematurity Day, we are raising awareness of this serious health crisis.

We don’t always know what causes preterm labor and premature birth. Sometimes labor starts on its own without warning. Even if you do everything right during pregnancy, you can still give birth early. However, there are some things that you can do to reduce your risk for preterm labor and premature birth.

  • Schedule a preconception checkup with your health care provider. A preconception checkup helps your health care provider make sure that your body is ready for pregnancy.
  • Get to a healthy weight before pregnancy and gain the right amount of weight during pregnancy.
  • Wait at least 18 months between giving birth and getting pregnant again. Use birth control until you’re ready to get pregnant again.
  • Get treated for health conditions, like high blood pressure, diabetes, depression and thyroid problems.
  • Protect yourself from infections. Get vaccinated, wash your hands frequently, and don’t eat raw meat, fish or eggs. Have safe sex.
  • Reduce your stress. Eat healthy foods and do something active every day.
  • Don’t smoke, drink alcohol, or use street drugs. Ask your provider about programs that can help you quit. Tell your provider about any medicines you take, with or without a prescription.
  • Go to all your prenatal care checkups, even if you’re feeling fine. Prenatal care helps your provider make sure you and your baby are healthy.
  • Know the signs and symptoms of preterm labor. This won’t reduce your risk of preterm labor but it will allow you to get treatment quickly and that may help stop your labor.

There is no single cause of premature birth and therefore there is no simple solution. The March of Dimes is working towards giving every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

Premature birth and the NICU: a personal experience

Monday, November 13th, 2017

Every day I read and answer lots of questions on topics like pre-conception care, prenatal care, and how to have a healthy pregnancy. I also answer many questions about complications in pregnancy, like premature birth. So when I found out I was pregnant last year, I felt pretty well-prepared and knowledgeable. However, like many first time moms, I had a little anxiety those first few weeks.

The first half of my pregnancy was completely healthy and free of problems. However, at 23 weeks during my prenatal check-up, my doctor told me that there was a problem with my cervix. She told me that the ultrasound was showing I had a short cervix and explained I would need to go on bed rest and be treated with progesterone in order to help me stay pregnant longer. Unfortunately, having a short cervix is ​​a risk factor for preterm labor.

I had been on bed rest for 11 weeks, when during a routine prenatal check-up, the doctors told me that they would need to induce labor. My amniotic fluid was very low and they suspected that I had preterm premature rupture of membranes (PPROM) I was 34 weeks and 1 day. My son, Theodore (Theo), was born the next day, November 22nd, weighing 4 pounds and 14 ounces.

Although I was able to hold him in my arms for about 10 minutes after delivery, while in the recovery room, he was quickly taken to the neonatal intensive care unit (NICU) for testing and put in the incubator. Theo was born with very high levels of bilirubin (jaundice) and had problems controlling his body temperature. Despite knowing that he was in good hands and receiving the necessary treatment, it was such a hard moment.

When I saw my son in the NICU for the first time I felt so many emotions. He was in the incubator, with the special blue lights for jaundice, and a small IV that was supplying his first nutrients. A few days after, they inserted a tube through his nose to feed him my breast milk because he didn’t have enough strength to suck and swallow on his own properly. The good news is that he had no breathing problems.

Despite these challenges, I was determined to practice kangaroo care (skin-to-skin contact) and feed him breastmilk. Since Theo was still learning to suck and swallow, he couldn’t latch, so I pumped my breast milk for his feedings. Kangaroo care is especially good for preemies because it helps them stay warm, helps them sleep better, and helps with bonding.

Having to leave our son in the hospital was a very difficult experience for my husband and me. Every day we headed out to the NICU early and came back home to eat dinner and sleep. I pumped every 2 to 3 hours and stored the milk to bring to the NICU for the next day. Theo stayed in the NICU a total of 10 days from birth until being discharged. The day we took him home was one of the happiest days of our lives.

The month of November will always be special month for me. In exactly 9 days, we will be celebrating Theo’s first birthday. He is a healthy, curious, independent, and sweet boy who can make anyone’s heart melt with his sweet smiles and giggles. It’s amazing how time flies.

November is also Prematurity Awareness Month. As overwhelming as the experience of having a premature delivery and birth was, I feel even more connected to March of Dimes’ mission, to all the women and families who share their story with us, and to all those who fight to give babies a happy and healthy tomorrow.

Thinking about pregnancy after premature birth

Wednesday, November 8th, 2017

Even if you do everything right, you can still have a premature birth. We don’t always know what causes premature birth, but we do know that if you’ve had a premature baby in the past, you’re at increased risk of having a premature birth in another pregnancy. If you have given birth early, here are some ways you may be able to reduce the chances of premature birth in another pregnancy:

Wait 18 months between giving birth and getting pregnant again

Waiting at least 18 months between pregnancies gives your body time to recover from one pregnancy so that is it ready for the next one. Use birth control so you don’t get pregnant again too soon. Talk to your provider about the best birth control option for you.

Schedule a preconception checkup

Being as healthy as possible when you get pregnant can help you have a healthy, full-term pregnancy. At your preconception checkup you and your provider can talk about:

Talk to your provider about progesterone shots

Progesterone is a hormone that helps your uterus grow and keeps it from having contractions. Progesterone shots may help prevent you from giving birth early again if:

  • You’re pregnant with just one baby.
  • You were pregnant before with just one baby and had spontaneous premature birth.

Get treatment for short cervix

Your cervix is the opening to the uterus that sits at the top of the vagina. The cervix opens, shortens and gets thinner and softer so your baby can pass through the birth canal during labor and birth. Having a short cervix increases your risk for giving birth early. Talk to your provider about cerclage and vaginal progesterone.

Take low dose aspirin to help prevent preeclampsia

Preeclampsia is a kind of high blood pressure some women get after the 20th week of pregnancy or after giving birth. If not treated, it can cause serious problems during pregnancy, including premature birth. If you have risk factors for preeclampsia, like you’ve had it before or you have high blood pressure or other health conditions, your provider may want you to take low-dose aspirin during pregnancy.

Quit smoking, drinking alcohol, using street drugs and misusing prescription drugs.

All of these can put your health and your baby’s health at risk and make you more likely to give birth early. Quitting or getting help to quit is the best thing you can do. Talk to your provider about programs that can help.

Learn the signs of preterm labor

Learning the signs and symptoms of preterm labor doesn’t reduce your risk of premature birth. But if you know them and know what to do if you have them, you can get treatment quickly that may help stop your labor. If you have any signs or symptoms of preterm labor, call your provider right away or go to the hospital.

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

Premature birth rate in U.S. increases for second year

Friday, November 3rd, 2017

For the second year in a row, the rate of preterm birth in the United States has increased. The premature birth rate went up from 9.6 percent of births in 2015 to 9.8 percent in 2016, giving the U.S. a “C” on the March of Dimes 2017 Premature Birth Report Card. The report card also shows that across the U.S., black women are 49 percent more likely to deliver preterm compared to white women. American Indian/Alaska Native women are 18 percent more likely to deliver preterm compared to white women.

More than 380,000 babies are born prematurely in the U.S. each year. An additional 8,000 babies were born prematurely in 2016 due to the increase in the preterm birth rate. Premature babies may have more health problems or need to stay in the hospital longer than babies born on time. Some of these babies also face long-term health effects, like problems that affect the brain, lungs, hearing or vision.

The Premature Birth Report Card provides rates and grades for all 50 states, plus the District of Columbia and Puerto Rico. Preterm birth rates worsened in 43 states, the District of Columbia and Puerto Rico. The rates stayed the same in three states (AL, AZ, WA), and improved in only four states (NE, NH, PA, WY).

  • Four states earned an “A” on the 2017 Premature Birth Report Card;
  • 13 states received a “B”;
  • 18 states got a “C”;
  • 11 states and the District of Columbia got a “D”;
  • 4 states and Puerto Rico received an “F.”

Among the 100 cities in the U.S. with the greatest number of births (latest data is for 2015), Irvine, California had the lowest rate of preterm birth (5.8 percent), and Cleveland, Ohio had the highest preterm birth rate (14.9 percent).

This year’s Report Card also includes a preterm birth disparity ratio. This measures the disparities in preterm birth rates across racial/ethnic groups in a geographic area. The disparity ratio shows that the differences in preterm birth rates among racial/ethnic groups are getting worse nationally and no state has shown improvement since the measurements started being recorded in 2010-2012.

There is no single cause of premature birth and therefore there is no simple solution. However, things like expanding research, increasing education, strengthening advocacy, and improving clinical care and community programs can all help. The March of Dimes continues to work towards giving every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

If you want to learn how you can help increase awareness of the serious problem of premature birth throughout November, check out our blog post.

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

Prematurity Awareness Month has arrived and here’s how you can help

Wednesday, November 1st, 2017

Here at the March of Dimes November means Prematurity Awareness Month. Although we work all year round to fight preterm birth, this month we are working especially hard to get the word out about the serious problems of preterm birth and how you can help us end prematurity.

Each year in the U.S., 1 in 10 babies is born prematurely. And being born too soon is not only the leading cause of death for children under the age of five, but it can also lead to long-term disabilities. This is a heartbreaking reality for too many families. That is why we are hard at work funding groundbreaking research, education, advocacy and community programs to help give every mom the opportunity to have a healthy pregnancy and every baby the chance to survive and thrive.

Here’s how you can help:

  • Join our Twitter chat with Show Your Love on November 16th at 12pm ET. Just use #PreemieChat
  • November 17th is World Prematurity Day. Share/Retweet/Repost March of Dimes social messages with your friends and followers on Facebook, Twitter, and Instagram.
  • Change your profile picture on Facebook with our branded World Prematurity Day frame.
  • Add a #worldprematurityday profile picture to your Twitter account with the WPD Twibbon.
  • Add your voice and sign-up to automatically post a message of support and awareness of prematurity on your personal Facebook and Twitter accounts on World Prematurity Day.
  • Participate virtually in our Imagine a World event! Make a short video sharing what you imagine for future generations. Post your video on social media using #MODImagines. Together, we’re imagining a world where every baby has the chance to thrive!

Create a purple movement!

  • Wear your March of Dimes gear and share photos using #prematurityawarenessmonth and/or #worldprematurityday and @marchofdimes.
  • Light your front porch/home/office lobby/building. Purchase purple lights through Amazon Smile! For every light purchased Amazon will donate 0.5 percent of the price of your purchase to the March of Dimes. Go to smile.amazon.com, select March of Dimes and use the search term “purple lights.”
  • Host an information booth in a prominent spot, such as outside your cafeteria, to promote November as Prematurity Awareness Month to your employees or coworkers.
  • Spread your gratitude by celebrating, thanking and remembering anyone who has helped you and/or the people you care about who have been affected by our mission.

We have much more in store this month, so stay tuned as we work to spread the word about World Prematurity Month.

What is a respiratory therapist?

Monday, October 30th, 2017

If your baby is in the NICU, you know that there are a lot of people caring for her and helping her to get stronger each day. One of those NICU team members may be a respiratory therapist. A respiratory therapist (or RT) cares for babies with breathing problems.

When your baby first arrives in the NICU, a respiratory therapist evaluates her breathing. The RT looks to see if your baby is breathing too fast, if the breaths are shallow, or if she’s struggling to breathe. Then, together with the rest of the NICU team, the RT develops a treatment plan to help care for your baby.

Here are some common conditions that a respiratory therapist may see in the NICU:

Breathing problems: Premature babies often have breathing problems because their lungs are not fully developed. Full-term babies also can develop breathing problems due to complications of labor and delivery, birth defects and infections.

Apnea: Premature babies sometimes do not breathe regularly. A baby may take a long breath, then a short one, then pause for 5 to 10 seconds before starting to breathe normally. This is called periodic breathing. Apnea is when a baby stops breathing for more than 15 seconds. Apnea may be accompanied by a slow heart rate called bradycardia. Babies in the NICU are constantly monitored for apnea and bradycardia (often called “A’s and B’s”).

Respiratory distress syndrome (RDS): Babies born before 34 weeks of pregnancy often develop RDS. Babies with RDS do not have enough surfactant, which keeps the small air sacs in the lungs from collapsing.

Pneumonia: This lung infection is common in premature and other sick newborns. A baby’s doctors may suspect pneumonia if the baby has difficulty breathing, if her rate of breathing changes, or if the baby has an increased number of apnea episodes.

Many babies who need treatment for breathing problems benefit from respiratory therapy. In fact, neonatal respiratory therapy has become its own medical sub-specialty. A neonatal-pediatric RT is trained to use complex medical equipment to care for the smallest babies with mild to severe breathing challenges. They visit their patients daily or as often as needed and are an important part of your baby’s NICU team.

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

October is RSV Awareness Month

Monday, October 2nd, 2017

Respiratory syncytial virus (RSV) is a common virus that infects the lungs and breathing passages. Almost all babies get it before the age of 2. Your baby can get RSV at any time of year, but it’s most common from November to April.

Symptoms of RSV

For most healthy children, the symptoms of RSV are similar to those of a cold and can last about two weeks. They can include:

  • Cough
  • Fever
  • Irritability
  • Runny nose
  • Sneezing
  • Sluggish or being inactive
  • Trouble breathing
  • Wheezing

Some babies have a high risk of getting severe RSV. This includes babies who were born premature, have lung problems, heart problems or other chronic illnesses. Severe RSV may lead to other serious infections, like:

  • Bronchiolitis, an infection that causes swelling in the smallest air passages in the lungs
  • Pneumonia, an infection in one or both lungs

RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.

If you notice any of these symptoms, call your baby’s health care provider right away:

  • Cough that gets worse or she coughs up yellow, green or gray mucus
  • High fever. High fever is a temperature greater than 100.4 F in babies younger than 2 months, 101 F in babies aged 3 to 6 months or 103 F in babies older than 6 months.
  • Looks dehydrated
  • Loss of appetite
  • Thick nasal discharge
  • Trouble breathing or mouth and fingernails look blue

Prevent the spread of RSV

You can help protect your baby from RSV by:

  • Keeping her away from people who are sneezing or coughing
  • Making sure everyone who touches the baby has clean hands
  • Keeping your baby away from crowds of people
  • Not allowing anyone to smoke near your baby

Treatment for RSV

There is no specific treatment for RSV. If your baby has RSV, you can help to relieve the symptoms by making sure she drinks lots of fluids, using a rubber suction bulb to help clear mucus from her nose, and using a cool-mist humidifier. If your baby has a fever, talk to her health provider about using acetaminophen.

Babies who are at high risk from severe RSV may benefit from medication that helps prevent RSV from becoming severe. This medication is called palivizumab. It is given in monthly injections during the fall and winter months. However, this medication does not prevent infection with RSV and it does not help cure or treat children who already have severe RSV. If your baby is a high risk for severe RSV, talk to her provider about whether palivizumab may be an option.

Have any questions? Email or text us at AskUs@marchofdimes.org.

March of Dimes-funded researchers have identified genes involved in preterm birth

Friday, September 8th, 2017

Premature birth is a complex problem with no single solution. Each year, about 15 million babies worldwide are born prematurely, and more than one million of them will die. Over 50 percent of the time, the cause of premature birth is not known. However, scientists have always believed that genetic factors play a role. A new study led by the March of Dimes Prematurity Research Center-Ohio Collaborative, is the first to provide strong information as to what some of those genetic factors are. The team identified six genes that influence the length of pregnancy and the timing of birth. The findings were published Sept. 6 in the New England Journal of Medicine.

This international team of researchers looked at the DNA of 50,000 pregnant women from around the world. The identification of these six gene regions allowed scientists to learn that:

  • The cells within the lining of the uterus play a larger-than-suspected role in the length of pregnancy.
  • Low levels of selenium—a common dietary mineral found in some nuts, certain green vegetables, liver and other meats—might affect the risk of preterm birth. Future studies will look at selenium levels in pregnant women who live in areas with low selenium in their diet or soil.

The six genes that have been identified can now be studied in more detail. The population of women in this study was mostly from Europe. Researchers are already trying to determine if these gene associations are the same for women from Africa and Asia.

Louis Muglia, MD, PhD, co-director of the Perinatal Institute at Cincinnati Children’s and principal investigator of the March of Dimes Prematurity Research Center–Ohio Collaborative stated, “This is just the beginning of the journey, but we think it leads to an exciting horizon where we can really make a difference in human pregnancy.”

The March of Dimes believes that these new findings will lead to new diagnostic tests, medications, improved dietary supplements or other changes that could help more women have full-term pregnancies and give more babies a healthy start in life.

Retinopathy of prematurity

Friday, August 25th, 2017

If you have a premature baby, you may have heard of retinopathy of prematurity or ROP. ROP is an abnormal growth of blood vessels in the eye.

During the last 12 weeks of pregnancy, the eye develops quickly. When a baby is born full-term, the growth of the blood vessels that supply the retina is almost complete. The retina then typically finishes growing the first few weeks after birth.

However, if a baby is born too early, the blood vessels may stop growing or not grow correctly. These vessels can then leak and cause bleeding in the eye. Scar tissue forms, and if the scars shrink, they may pull the retina loose from the back of the eye. This is called retinal detachment. Retinal detachment is the main cause of vision problems and blindness in ROP.

Risk factors for ROP

Some babies are more likely to develop ROP. Risk factors include:

  • Premature birth. Although all premature babies are at risk for ROP, it occurs most often in babies born before 30 weeks of pregnancy.
  • Apnea. This is when a baby’s breathing stops for 15 to 20 seconds or more.
  • Anemia. This is when the body doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body.
  • Heart disease
  • Infection
  • Trouble breathing or respiratory distress
  • Slow heart rate (also called bradycardia)
  • Problems with the blood, including having blood transfusions.

How is ROP diagnosed?

Your baby will get a special eye exam for ROP if she:

  • Was born before 30 weeks
  • Weighed less than 3 pounds at birth
  • Has any other risk factors for ROP

A pediatric ophthalmologist will examine your baby’s eyes. Babies born at 27 weeks or later usually have their first eye exam when they’re 4 weeks old. Babies born before 27 weeks usually have the exam later, because the more premature a baby is at birth, the longer it takes to develop serious ROP. Because ROP can develop later, it’s very important to take your baby to all of her eye exams, even after she is home from the NICU.

If your baby’s first eye exam shows that the blood vessels in both retinas have finished normal development, she doesn’t need a follow-up exam. If your baby’s eye exam shows that she has ROP and needs treatment, she should start treatment within 72 hours. Early treatment gives your baby the best chance of having healthy vision.

Treatment

Most mild cases of ROP heal without treatment and with little or no vision loss. In more severe cases, the ophthalmologist may perform laser therapy or do a procedure called cryotherapy (freezing) to eliminate abnormal blood vessels and scars. Both treatments help protect the retina.

If your baby has ROP, visit our online community at Share Your Story to connect with other parents for support and comfort throughout your baby’s treatment.

Have questions? Email us at AskUs@marchofdimes.org.

Getting ready for discharge from the NICU

Monday, July 31st, 2017

In general, your premature baby will be ready to go home around her due date. But your baby will have to reach certain milestones first. Her vital signsPreemie going home–temperature, breathing, heart rate, and blood pressure–must be consistently normal. This means that your baby:

  • Keeps herself warm
  • Sleeps in a crib, not an incubator
  • Weighs about 4 pounds or more
  • Has learned to breast- or bottle-feed
  • Breathes on her own

What can you do to get ready?

Make sure you talk to your baby’s health care provider and the NICU staff about caring for your baby at home. Here are some things to think about:

  • Do you have everything you need at home to take care of your baby? Do you have medicine and equipment your baby needs? Do you know how to give your baby medicine and use the equipment?
  • Are there any videos, classes, booklets or apps that may help you learn how to take care of your baby at home? Ask about taking a CPR class prior to bringing your baby home—knowing what to do in an emergency may make you feel more comfortable.
  • What do you want discharge day to be like? Do you want family or friends to be there when you and your baby get home? Or do you want it to be just you and your partner with your baby?

Many hospitals let parents “room in” with their baby for a night or two before going home. This can be a good way to practice taking care of your baby on your own while the NICU staff is still right there to help.

Car seat

You will be required to have a car seat before you leave the hospital. Preterm and low-birthweight infants have a higher chance of slowed breathing or heart rate while in a car seat. So your baby may need a “car seat test” before being discharged. The NICU staff will monitor your baby’s heart rate and breathing while she is in her car seat for 90 to 120 minutes. They may watch your baby even longer if your travel home is more than 2 hours.

Follow-up care

Make sure you have chosen a health care provider for your baby. You can choose a:

  • Pediatrician. This is a doctor who has special training to take care of babies and children.
  • Family practice doctor. This is a doctor who provides care for every member of a family.
  • Nurse practitioner. This is a registered nurse with advanced medical education and training.

If your baby has special medical needs, you may also need a provider who specializes in that condition. The NICU staff, hospital social worker or your baby’s general care provider can help you find someone.

Have questions? Send them AskUs@marchofdimes.org.