Archive for the ‘Prematurity’ Category

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.

Medication before and during pregnancy

Monday, July 24th, 2017

Did you know that 7 out of 10 pregnant women take at least one prescription medication? According to the Centers for Disease Control and Prevention (CDC), the use of prescription medicine during the first trimester of pregnancy has increased more than 60% over the last 30 years. In the video below, Dr. Siobhan Dolan explains how taking some prescription medicines before or during pregnancy can hurt your baby. Learn how to make sure any medicines you take are safe for both you and your baby.

 

 

 

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

More babies being born too soon

Friday, June 30th, 2017

pregnant woman blood pressureFor the second year in a row, the preterm birth rate in the United States has gone up. Preterm birth is when a baby is born before 37 weeks of pregnancy. According to a preliminary report from the National Center for Health Statistics (NCHS), the preterm birth rate rose to 9.84% in 2016, up 2% from 9.63% in 2015.

 After seven years of a steady decline in the preterm birth rate, this increase is alarming.

Reduce your risk

We don’t know why this is happening. But we do know that there are some things a woman can do to help reduce her chance of giving birth too soon. Here are some of them:

  • See your prenatal care provider as soon as you think you’re pregnant. And go to all of your prenatal care appointments. Go even if you’re feeling fine. Prenatal care helps your provider make sure you and your baby are healthy.
  • Don’t smoke, drink alcohol, use street drugs or abuse prescription drugs. Ask your provider about programs in your area that can help you quit.
  • Talk to your provider about your weight. Ask how much weight you should gain during pregnancy. Try to get to a healthy weight before your next pregnancy.
  • Get treated for chronic health conditions, like high blood pressure, diabetes and thyroid problems.
  • Protect yourself from infections. Wash your hands with soap and water after using the bathroom, caring for small children, or blowing your nose. Don’t eat raw meat or fish. Have safe sex. Don’t touch cat poop.
  • Reduce your stress. Exercise and eat healthy foods. Ask for help from family and friends. Get help if your partner abuses you. Talk to your boss about how to lower your stress at work.
  • Wait at least 18 months between giving birth and getting pregnant again. See your provider for a preconception checkup before your next pregnancy.

 

Know the signs

If you have any of these signs or symptoms before 37 weeks of pregnancy, you may be having preterm labor. Call your health care provider right away if you have even one of these signs or symptoms:

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual
  • Pressure in your pelvis or lower belly, like your baby is pushing down
  • Constant low, dull backache
  • Belly cramps with or without diarrhea
  • Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.
  • Your water breaks

If you think you’re having preterm labor, call your provider. Call even if you have just one sign or symptom. There are several treatments that may help slow or stop preterm labor. And there are treatments, like antenatal corticosteroids (also called ACS), that can help reduce your baby’s chances for having health problems (like lung problems) in case he’s born early.

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

Preeclampsia: Impact on mom and baby

Wednesday, June 21st, 2017

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.

 

 

NICU dad x 2 – the story of Jack and Josie

Friday, June 16th, 2017

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.

Repeat lead tests are advised for certain children, pregnant women and breastfeeding moms

Wednesday, May 17th, 2017

blood-testsToday, the FDA and CDC issued a notice that some lead tests done by Magellan Diagnostics may be incorrect.

The FDA says “certain lead tests manufactured by Magellan Diagnostics may provide inaccurate results for some children and adults in the United States.”

If you have a child age 6 years old or younger, are pregnant or breastfeeding, speak with your healthcare provider or local health department to determine if retesting is needed.

The dangers of lead

Lead is a metal that comes from the ground, but it can be in air, water and food. You can’t see, smell or taste it. High levels of lead in your body can cause serious health problems for you and your family.

Children younger than 6 years of age can be severely affected by lead. It can cause developmental problems, hearing loss, vomiting, irritability, belly pain and weight loss. Very high levels of lead may even cause death.

Lead poisoning (high levels of lead in your body) can cause serious problems during pregnancy, such as premature birth, miscarriage, and high blood pressure. It can also cause fertility problems, mood disorders, headaches, muscle or joint pain, trouble concentrating, belly pain, anemia and fatigue in adults.

Where is lead?

Most lead comes from paint in older homes. When old paint cracks or peels, it makes dust that has lead in it. The dust may be too small to see. You can breathe in the dust and not know it.

Lead may be found in drinking water, at construction sites, in arts and crafts materials used to make stained glass, lead crystal glassware, and some soil.

For more information on lead poisoning, see our web article and the CDC’s information.

Bottom line

If you have a child age 6 or younger, or you are pregnant or breastfeeding, contact your healthcare provider to determine if a lead test should be repeated.

Have questions? Contact our health education specialists at AskUs@marchofdimes.org.

You can find more news on our News Moms Need blog.

 

Thank you to all nurses!

Wednesday, May 10th, 2017

Nurse holding babyIf your baby was in the NICU, you most likely spent a great deal of time with her team of nurses. Likewise, if you had a difficult pregnancy, a nurse was probably by your side assisting you the whole way.

Nurses are critical in the care of mothers and babies. Many families who have had a baby born prematurely or with a health condition have told us just how fantastic the nursing staff was at their hospital. Nurses are hardworking, compassionate, highly educated professionals who work around the clock to ensure that you and your baby get the care you need.

In honor of National Nurse’s Week we want to thank all of the nurses that have impacted March of Dimes’ families. In particular, we wish to congratulate the four nurses who won the March of Dimes Graduate Nursing Scholarship Awards.

To recognize and promote excellence in nursing care of mothers and babies, the March of Dimes offers several $5,000 scholarships annually to registered nurses enrolled in graduate programs of maternal-child nursing. The March of Dimes Dr. Margaret C. Freda Graduate Nursing Scholarship Award was established in 2016 to honor long-time March of Dimes National Nurse Advisory Council Chair, volunteer, and friend, Dr. Margaret Comerford Freda. This award is given each year to the highest scoring graduate nursing scholarship applicant. Congratulations to our winners!

Did you have an amazing nurse that took care of you or your baby? How did he or she impact your NICU stay?

Share your story and help us thank all nurses for their unending dedication and incredibly hard work.

 

Do you know the signs of preterm labor?

Wednesday, April 19th, 2017

If you’re pregnant, it’s important to know the signs of preterm labor and what to do if you experience any symptoms. Watch our video with Dr. Siobhan Dolan to learn more:

You can get more information about preterm labor and premature birth on our website.

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

Health disparities in premature birth

Friday, April 14th, 2017

In the United States, rates of preterm birth, low birthweight, and infant mortality are higher for black, non-Hispanic infants than for white, non-Hispanic infants. These differences, or disparities, Baby w pacifierbetween races and/or ethnicities have a great impact on the health and well-being of families.

What we know

  • Premature birth is when a baby is born too soon, before 37 weeks of pregnancy.
  • While the overall preterm birth rate in 2013 was 11.4%, the rate was higher among non-Hispanic black infants (16.3%) compared to non-Hispanic white infants (10.2%). This means that the preterm birth rate for black infants was 60% higher than the rate for non-Hispanic white infants.
  • 11.3% of Hispanic infants were born prematurely. Hispanic women account for about 1 out of every 4 premature births in the US (23.2%). The preterm birth rate among Hispanic women is falling more slowly than the rate in the non-Hispanic white population and the non-Hispanic black population.
  • The number of black infants born at a low birthweight (a baby is born weighing less than 5 pounds, 8 ounces) was almost twice that of white infants and Hispanic infants.
  • The death of a baby before his or her first birthday is called infant mortality. The rates of infant mortality are higher for babies born before 37 weeks and at a low birthweight.
  • A recent study published by the CDC, showed that from 2005 to 2014, infant mortality rates declined for all races, except American Indian or Alaska Natives. But babies born to non-Hispanic black women continue to have an infant mortality rate more than double that of non-Hispanic white women.

We don’t know why race plays a role in premature birth.

Even when researchers compare women of different races and ethnicities and remove any known risk factors in their analysis (such as smoking, obesity, and high blood pressure), the disparities in the rate of premature births still exist.

Researchers at the March of Dimes Prematurity Research Center Ohio Collaborative are trying to better understand health disparities. Dr. Irina Buhimschi has found that there is a population of Somali women in the US with a low rate of premature birth—as low as or lower than white women. Dr. Buhumschi and her team are trying to determine what makes this population different. “We believe a variety of genetic, environmental and social factors are involved in preterm birth. From stress and resilience, to diet and lifestyle, to vaginal and gut bacteria, we will comprehensively study why Somali-American women have lower rates of preterm birth.” Dr. Buhimschi then hopes to develop a plan that can help all populations reduce their chances of premature birth.

You can read more about Dr. Buhimschi’s research here.

The March of Dimes supports research, community programs, and advocacy policies that try to reduce health disparities and make sure that all babies have a healthy start in life.

Where does all the weight gain go during pregnancy?

Friday, March 24th, 2017

Now that you’re pregnant, your body is changing to get ready for your baby. Gaining weight is an important part of pregnancy.

If you gain too little or too much weight during pregnancy, you’re more likely than other women to have certain complications such as a premature birth (before 37 weeks of pregnancy).

You may be wondering – where does all the weight go? If you’re at a healthy weight before pregnancy and gain 30 pounds during pregnancy, here’s where you carry the weight:

pregnant woman on scale

  • Baby = 7.5 pounds
  • Amniotic fluid = 2 pounds. Amniotic fluid surrounds the baby in the womb.
  • Blood = 4 pounds
  • Body fluids = 4 pounds
  • Breasts = 2 pounds
  • Fat, protein and other nutrients = 7 pounds
  • Placenta = 1.5 pounds. The placenta grows in your uterus (also called womb) and supplies the baby with food and oxygen through the umbilical cord.
  • Uterus = 2 pounds. The uterus is the place inside you where your baby grows

Gaining weight slowly and steadily is best. You may not gain any weight in the first trimester, or you may gain a little more or a little less than you think you should in any week. Try not to worry about it.

Gaining weight is necessary for your pregnancy, but gaining the right amount is also important. Talk to your prenatal care provider about the weight gain that is best for you and your body.

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