Archive for the ‘Baby’ Category

Neonatal abstinence syndrome

Monday, May 22nd, 2017

infant crying“The March of Dimes has made it a priority to help and support women and infants affected by opioid use and other substance use disorders,” says Stacey D. Stewart, president of the March of Dimes. “There are few things more tragic than an infant starting out life in drug withdrawal.  We owe it to these babies to do everything in our power to ensure they are treated appropriately and can recover fully from drug exposure.”

Neonatal abstinence syndrome (NAS) happens when newborns go through drug withdrawal shortly after birth because they were exposed to drugs in the womb. In the United States, the number of babies born with NAS has been increasing. The Centers for Disease Control and Prevention (CDC) estimates that the number of babies with NAS has tripled from 1999 to 2013.

What drugs can cause NAS?

One of the most common causes of NAS is maternal use or abuse of opioids during pregnancy. Opioids are painkillers your provider may recommend if you’ve been injured or had surgery. Some common opioids that may be prescribed include:

  • Codeine and hydrocodone (Vicodin®)
  • Morphine (Kadian®, Avinza®)
  • Oxycodone (OxyContin®, Percocet®)

Heroin is also an opioid. Using it during pregnancy can cause your baby to be born with NAS.

In addition to opioids, these drugs can lead to NAS too:

  • Certain antidepressants (prescription drugs used to treat depression)
  • Benzodiazepines (sleeping pills)

What are the signs and symptoms of NAS?

Babies may exhibit different signs of NAS. Most babies will show symptoms within 3 days (72 hours) of birth, but sometimes symptoms will appear soon after birth or a few weeks later. Signs and symptoms can include:

  • Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone
  • Fussiness, excessive crying or having a high-pitched cry
  • Poor feeding, poor sucking or slow weight gain
  • Breathing very fast
  • Fever, sweating or blotchy skin
  • Trouble sleeping and lots of yawning
  • Diarrhea or throwing up
  • Stuffy nose or sneezing

NAS can last from 1 week to 6 months after birth.

How is a baby with NAS treated?

Treatment for NAS may include:

  • Taking medicines to treat or manage severe withdrawal symptoms. Your baby’s provider may give her a medicine that’s similar to the drug you used during pregnancy. This can help relieve your baby’s withdrawal symptoms. Once these symptoms are under control, your baby gets smaller doses of the medicine over time so her body can adjust to being off the medicine. Medicines used to treat severe withdrawal symptoms include morphine, methadone and buprenorphine.
  • Getting IV fluids. Babies with NAS can get very dehydrated from having diarrhea or throwing up a lot. If a baby’s dehydrated, she doesn’t have enough water in her body. Getting fluids through an IV helps keep your baby from getting dehydrated.
  • Drinking higher-calorie baby formula. Some babies with NAS need extra calories to help them grow because they have trouble feeding or aren’t growing properly. slow growth.

Most babies with NAS who get treatment get better in 5 to 30 days.

Research

The March of Dimes, together with the CDC, has awarded grants to conduct one-year of surveillance on neonatal abstinence syndrome (NAS) in three states with high rates of NAS:  Vermont, Illinois, and New Mexico. The project will enable each state to conduct enhanced identification of babies born with NAS and evaluate the health services needed by these babies through one year of age.

If you or someone you know is pregnant and struggling with drug use, please share these resources:

Have questions? Text or email AskUs@marchofdimes.org

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.

 

What is tetralogy of Fallot?

Friday, May 5th, 2017

You have probably heard about Jimmy Kimmel’s baby, Billy, being born with a critical congenital heart defect called tetralogy of Fallot (TOF). Fortunately, Billy received lifesaving heart surgery and is home from the hospital, reportedly doing well.

Congenital heart defects are the most common types of birth defects. Nearly 1 in 100 babies (about 1 percent or 40,000 babies) is born with a heart defect in the United States each year. And critical congenital heart disease (CCHD) is a group of the seven most severe congenital heart defects. About 4,800 babies each year are born with a CCHD. Babies with CCHD need treatment within the first few hours, days or months of life. Without treatment, CCHD can be deadly.

TOF is a rare congenital heart defect that affects about 1,660 babies each year in the United States. Babies born with this condition actually have four different problems with their heart. According to the CDC, they are:

  1. A hole in the wall between the two lower chambers―or ventricles―of the heart. This condition also is called a ventricular septal defect.
  2. A narrowing of the pulmonary valve and main pulmonary artery. This condition also is called pulmonary stenosis.
  3. The aortic valves, which opens to the aorta, is enlarged and seems to open from both ventricles, rather than from the left ventricle only, as in a normal heart. In this defect, the aortic valve sits directly on top of the ventricular septal defect.
  4. The muscular wall of the lower right chamber of the heart (right ventricle) is thicker than normal. This also is called ventricular hypertrophy.

Signs and Symptoms

After birth, signs and symptoms of heart defects can include:

  • Fast breathing
  • Gray or blue skin coloring (also called cyanosis)
  • Fatigue (feeling tired all of the time)
  • Slow weight gain
  • Swollen belly, legs or puffiness around the eyes
  • Trouble breathing while feeding
  • Sweating, especially while feeding
  • Abnormal heart murmur (unusual sounds heard during a heartbeat)

Diagnosis

TOF can be diagnosed during pregnancy or after birth. During a prenatal ultrasound a doctor may be able to determine that there is a problem with the baby’s heart. A fetal echocardiogram (an ultrasound of just the heart) would then be ordered for further testing. An echocardiogram is an ultrasound of the baby’s heart that can show problems with the structure of the heart and how the heart is working.

However, TOF is usually diagnosed after the baby is born. In most cases, health care providers detect a heart murmur (often a “whooshing” sound heard between heartbeats) or cyanosis (baby’s skin turns blue).

To confirm the presence of a CCHD, a health care provider will order an echocardiogram.

TOF and CCHD can also be detected with newborn screening. Newborn screening checks for serious but rare conditions at birth. It includes blood, hearing and heart screening. All states require newborn screening, but they don’t all require screening for CCHD. Babies are screened for CCHD with a test called pulse oximetry (also called pulse ox). This test checks the amount of oxygen in your baby’s blood using a sensor attached to his finger or foot.

Treatment

Babies born with TOF need to have surgery soon after they are born to widen the pulmonary valve. This allows the blood to reach the lungs and become oxygenated. They will also correct the hole between the lower chambers of the heart. And additional surgeries to replace valves may also be required.

Most babies born with TOF go on to be active and healthy, but they will need to be followed by a cardiologist throughout their lives. We’re glad Jimmy Kimmel’s baby received prompt care and continues to do well.

Research

Heart defects develop in the early weeks of pregnancy when the heart is forming, often before you know you’re pregnant and most of the time, there is no known cause of a congenital heart defect. That is why many March of Dimes grantees are pursuing a variety of approaches aimed at preventing heart defects and improving their treatment.

Join the blog-a-thon for NIIW

Wednesday, April 26th, 2017

niiw-blog-a-thon-badgeThis week is National Infant Immunization Week (NIIW), a time to talk about vaccines.

Do you remember mumps? How about chicken pox? For so many children, these are diseases they never had or will never get. But I remember them well – the incredible pain and swelling from mumps, the constant itching and scars from chicken pox, not to mention the many days of school that I missed. I knew kids who were hospitalized due to complications from both mumps and chickenpox.

Even my kids had chicken pox – one more severely than the other – as the vaccine was not yet available. How I wish they could have avoided that disease!

Rotavirus is another potentially very serious condition that most babies and children can avoid today. My daughter ended up in the hospital for two days due to complications from rotavirus – a very scary experience!

But perhaps the one that hits home the most for me is polio. The March of Dimes would not be here if it were not for this devastating disease. When President Franklin D. Roosevelt contracted this paralyzing disease, he called on our organization to raise money in order to fund research to develop a vaccine. The March of Dimes is named for the dimes that were “marched” to Washington from countless people to fund research into finding a vaccine in time to spare any more men, women, children and babies from getting this crippling disease.

We were successful. The polio vaccine was rolled out to the public in 1955 as a result of the pioneering work of March of Dimes’ funded researchers Drs. Salk and Sabin.

Due to the development of this vaccine, polio is practically a part of world history. It no longer exists in America, and is almost totally eradicated in other parts of the world. When you stop to think about it, that is really AMAZING. This little vaccine prevents lifelong paralysis and pain in millions of people.

What started with combating polio has led March of Dimes to continue working hard to ensure all babies get a fighting chance for a healthy start in life.

But vaccines are not just for babies

As important as it is for babies and children to receive their vaccines, it’s also critical that adults who come in contact with children stay up-to-date with immunizations. For example, pertussis (whooping cough) can be fatal for a baby. When parents and caretakers get the vaccine, they are ensuring that their baby will be protected until he is old enough to be immunized. In fact, it is so important to get this vaccine that all pregnant women are recommended to receive the Tdap vaccine during each pregnancy.

There’s no doubt about it -even adults need vaccines. And women need them before, during and after pregnancy.

It would be a very different world without the lifesaving vaccines that have spared us from so many diseases. NIIW is a time to highlight the importance of protecting babies and children from vaccine-preventable diseases and to celebrate the achievements of immunization programs in the U.S.

We’re a healthier nation and world because of them.

Please share your support for childhood immunizations by participating in this week’s blog-a-thon. Here are the details.

 

Sleep soundly knowing your baby is sleeping safely

Monday, April 17th, 2017

back to sleepNewborns sleep a lot, about 16 hours a day. It’s safe to say that sleeping is a big part of your baby’s life. So as your baby drifts off, dreaming of your cuddles, be sure she’s sleeping safely. Safe sleep can help protect your baby from SIDS (sudden infant death syndrome).

Here are some tips:

  • Back to sleep: always put your baby to sleep on her back on a flat surface.
  • Share a room with your baby but don’t share a bed. Make sure your baby has her own crib or bassinet to sleep in.
  • Besides your baby, the bassinet or crib should be empty. Crib bumpers, loose bedding, toys and stuffed animals can be dangerous and lead to suffocation.
  • After you and your baby have established breastfeeding (around 4 weeks) give your baby a pacifier for naps and at bedtime. Pacifiers may help protect against SIDS. If your baby doesn’t want a pacifier, don’t force it. If the pacifier falls out while your baby is sleeping, that’s OK.
  • Thinking of a cardiorespiratory monitor? These monitors track a baby’s heart rate and breathing, and in rare cases a baby may need this kind of monitor for medical problems. But there is no evidence these monitors help reduce the risk of SIDS in healthy babies.
  • Dress your baby in light sleep clothes. A blanket sleeper, a kind of clothing just for sleeping, can help keep your baby warm without covering his face or head. If your baby is sweating or her chest feels hot, she may be overheated.

If you are worried about your baby’s sleep, talk to her health care provider.

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

Developmental screenings are helpful for early diagnoses

Monday, April 10th, 2017

doctor-and-babyBefore your baby leaves the hospital, he receives a series of tests called newborn screening. These tests look for serious but rare conditions, including blood, hearing and heart disorders. If a problem is discovered through newborn screening, your baby may receive treatment and often avoid a more serious health problem. Early diagnosis is critical in detecting certain medical conditions.

Other screenings occur after your baby is home from the hospital

Between birth and age 3, your baby goes through incredible changes. He is growing and developing every day. To be sure that your baby is “on track,” your baby’s healthcare provider will check his developmental milestones at each well-baby visit.

These milestones are the major achievements in your child’s life. They include smiling, babbling, rolling over, sitting up, crawling, reaching grabbing, talking, walking and other accomplishments. Parents can check milestones, too. Here is a list of behaviors to look for at specific ages.

If either you or your baby’s provider are concerned that your baby is not progressing well, you can request a developmental screening. It is free as part of the federally funded early intervention program. Similar to newborn screening, this screening helps to identify potential health or developmental problems early.

If your child qualifies, the early intervention program may include services such as speech therapy, physical or occupational therapy, or even a special preschool setting. Early intervention can be enormously helpful in helping your child improve. And, the sooner you begin intervention, the sooner your baby can reach his full potential.

One example of a diagnosis where early intervention is particularly important is Autism. April is autism awareness month, a time to remember that this developmental disorder affects 1 in 68 children in the U.S. Officially called autism spectrum disorder or ASD, it is a developmental disability that can cause social, communication and behavior challenges – from mild to severe. This is why it is referred to as a “spectrum” disorder.

ASD can be difficult to diagnose because there is no medical test, like a blood test, to give a definite answer as to whether your child has it or not. Usually, children with ASD start showing signs or symptoms of the disorder in their toddler or preschool years, and some babies show signs in their first year of life. For this reason, taking your child for regular visits with his healthcare provider is particularly important so that his development can be monitored. If your child needs early intervention services, getting it early is key in helping him progress.

Bottom line

There is a wide range of “typical development” for children. But, if you are concerned about your child’s progress or feel he is delayed in reaching his milestones, talk to his healthcare provider sooner rather than later.

You can find more information in our series on Delays and Disabilities: How to get help for your child.

Remember – don’t delay with delays.

Have questions? Text or email AskUs@marchofdimes.org

What causes gas in breastfed babies?

Friday, March 17th, 2017

Dad calming babyEveryone has gas, adults and babies alike. Gas is a result of both swallowing air and the digestion process. If your baby has a lot of gas though, you probably have concerns about the cause and more importantly, how to fix the problem.

So what can cause gas in your baby?

  • Anything that could cause your baby to swallow air: This includes crying, sucking a pacifier and eating from either the breast or a bottle.
  • A forceful letdown: If you’re nursing and have an oversupply of milk, your baby may take in too much milk at one time and swallow air. Changing positions, nursing frequently or expressing some of your milk before latching can help.  Reach out to a Lactation Consultant for assistance.
  • An intolerance to proteins in your diet: Most breastfed babies do not have allergic reactions to their mom’s milk. However, if food allergies run in your family, you should discuss this with your lactation consultant. The proteins from foods such as cow’s milk and peanuts pass through breast milk.  Also, be sure to watch your baby for any allergic reactions such as green, mucus-like stools with signs of blood.

What can help your baby’s gas?

  • Change your position while feeding: Tilt your baby up so her head is higher than her stomach. This will allow air to come up and out and milk to go down more smoothly.
  • Burping more often: Try burping during as well as after a feeding. If you are switching breasts, try burping before moving your baby over to your other side.
  • The bicycle: Lay your baby on her back and move her legs in a bicycle motion. Tummy time can also help put pressure on your baby’s stomach to relieve gas.
  • There are over-the-counter medications that may help relieve your baby’s gas. Ask your baby’s provider for a recommendation.

If your baby has excessive gas, there may be other reasons why it is happening. Reach out to your baby’s provider or your Lactation Consultant for an evaluation.

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

Zika and sperm – a new concern

Wednesday, March 15th, 2017

spermThe latest news about the Zika virus is that there is a potential risk that some semen donated to sperm banks in South Florida might be contaminated with Zika.

Here’s why:

  • Zika can remain in semen for several months;
  • men who donated semen may not have shown signs or symptoms of Zika yet they could have been infected with the virus;
  • semen is not tested for Zika, unlike blood and tissue donations.

Therefore, it is possible that an infected man may have unknowingly donated semen contaminated with the Zika virus.

Where is the risk?

Although the Zika virus has been identified in Miami-Dade County, the risk of it spreading to other neighboring areas is possible, since individuals in this part of the state often travel to and from Broward and Palm Beach counties.

CDC says “This analysis has led to CDC identifying that since June 15, 2016, there has been a potential increased Zika risk for residents in Broward and Palm Beach counties because of local travel to areas of active transmission in Florida and challenges associated with defining sources of exposure.” The increased risk in the overall numbers of people exposed to the virus means that donor sperm may be at risk, too.

What does this mean to women trying to become pregnant by donor sperm?

Semen contains sperm, which is necessary for a woman to become pregnant. Although the risk of Zika transmission is small, if a woman wishes to become pregnant or currently is pregnant by donor sperm from these areas in Florida, she should speak with her healthcare provider. There have not been any confirmed cases of the Zika virus infecting a pregnant woman from donor sperm, but the possibility exists that it could occur.

The CDC emphasizes that Zika virus infection during pregnancy can cause brain problems, microcephaly, and congenital Zika syndrome, a pattern of conditions in the baby that includes brain abnormalities, eye defects, hearing loss, and limb defects.

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

The CDC website offers detailed guidance for people living or traveling to South Florida.

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

 

March is Trisomy Awareness Month

Monday, March 13th, 2017

chromosomesWhat is trisomy?

Babies with trisomy are born with an extra copy of a specific chromosome in most or all of their cells. This means that they have three copies of this chromosome in each cell rather than the typical number, which is two. Health conditions that may be associated with trisomy include heart defects, vision or hearing problems, and intellectual and developmental disabilities.

Chromosomes are the structures in cells that contain genes. Each person normally has 23 pairs of chromosomes, or 46 in all. An individual inherits one chromosome from the mother’s egg and one from the father’s sperm. When an egg and sperm join together, they normally form a fertilized egg with 46 chromosomes.

Sometimes a mistake in cell division occurs before a woman gets pregnant. A developing egg or sperm ends up with an extra chromosome. When this cell joins with a normal egg or sperm cell, the resulting embryo has 47 chromosomes instead of 46.

Common trisomy conditions

Although trisomy can occur with any chromosome, here are the conditions that are most often associated with an extra chromosome:

  • Trisomy 21 or Down syndrome: Down syndrome is one of the most common birth defects. In the US, about 6,000 babies (or 1 in 700) are born with Down syndrome each year. Most affected individuals have intellectual disabilities within the mild to moderate range. Although health conditions such as heart defects and vision and hearing problems are associated, most of these can be treated, and life expectancy is now about 60 years.
  • Trisomy 18 is also called Edward syndrome: Trisomy 18 occurs in about 1 in 5,000 live births each year. Affected individuals may have heart defects, significant intellectual and developmental delays, and other life-threatening medical problems.
  • Trisomy 13, also known as Patau syndrome: Trisomy 13 occurs in about 1 in 10,000 to 16,000 live births each year worldwide. Individuals with trisomy 13 often have heart defects, brain or spinal cord abnormalities, severe intellectual and developmental disabilities, and multiple physical problems in many parts of the body.

It is important to understand that every individual with a trisomy is unique and not all of them will have the same symptoms. The severity of the condition and the associated problems depend on:

  • Which chromosome is duplicated: An extra copy of certain chromosomes, like chromosome 1, is not compatible with life and the embryo will not develop.
  • How much of the extra chromosome is present: If only part of the chromosome is present, symptoms may be milder. If the complete chromosome is present, the symptoms may be more severe.
  • How many cells have the extra chromosome: If the copy of the extra chromosome is in only a few cells (mosaicism), the symptoms are usually less severe than if all of the cells in the body are affected.

In the past 10 years, the March of Dimes has invested over 15  million dollars into research for chromosomal conditions, including trisomy. And many March of Dimes grantees are studying basic biological processes of development. This important research should improve our understanding of how genes and other factors affect the development of a baby.

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

Is the Zika virus affecting babies in the U.S.?

Friday, March 3rd, 2017

microcephalyShort answer…Yes.

The CDC just released a report that measured the number of brain related birth defects in the U.S. before and after the arrival of Zika. The study focused on data from three areas of the U.S. that track brain related birth defects – Massachusetts, North Carolina, and Atlanta, Georgia – in the year 2013-2014, before Zika arrived in the U.S.

It found that during that time, brain related birth defects occurred in 3 out of 1,000 births (.3%).

A study done looking at 2016 data shows that among women in the US with possible Zika virus infection, similar brain related birth defects were 20 times more common, affecting 60 of 1,000 pregnancies (6%).

This is a huge increase.

Here’s what we know

If a pregnant woman is infected with Zika, the virus can pass to her baby. Zika has been shown to cause a range of birth defects including brain problems, microcephaly, neural tube defects, eye defects and central nervous system problems. Although none of these birth defects are new to the medical field and they can occur for other reasons, it has been clearly established that the Zika virus can cause these serious problems, too.

Babies will require coordinated, long-term care

Babies born with Zika related birth defects will require access to coordinated medical care among a team of specialists. Such care may seem daunting to the parents and even to the medical community as they gather new information about the effects of the virus on a daily basis.

Enter the Zika Care Connect Network (ZCC)

This new website will launch in April 2017 to help parents and providers coordinate care for babies with complex medical needs due to Zika infection. The ZCC aims to improve access to medical care, which will jump-start early identification and intervention. The goal is to reduce the long-term effects of Zika on children and families by making it easier to locate a network of specialists knowledgeable about services for patients with Zika. The searchable database will feature a Provider Referral Network, patient resource tools, and a HelpLine.

Bottom line

Zika is still here, and it is seriously affecting babies and families. The best line of defense is to protect yourself from infection. Our website has detailed information on how to stay safe.

If you have questions, text or email AskUs@marchofdimes.org.