Archive for the ‘Baby’ Category

Fever and your baby

Monday, July 17th, 2017

mother with sick babyWhen your baby has a fever, it can be very frightening. Here is some information that can help you better understand why your baby has a fever and what you can do to help him.

What is a fever?

A fever is a body temperature that is higher than normal. Your child’s temperature will vary with age, activity, and even the time of day. Babies have a higher temperature than older children. And everyone’s temperature is highest between late afternoon and early evening and lowest between midnight and early morning.

A normal temperature can be anywhere from 97.5°F (36.4°C) and 99.5°F (37.5°C). Most health care providers consider a temperature above 100.4°F (38°C) as a sign of a fever.

What causes a fever?

A fever is important in helping your baby or child fight an infection. If your baby has an illness of some kind, his body temperature will increase. This increase in body temperature signals certain other defenses, such as white blood cells, to work and start attacking the infection. A fever will make your baby feel uncomfortable, increase his need for fluids, and make him breathe faster and his heart beat faster.

How can I treat my baby’s fever?

First, it is important to get an accurate temperature. Feeling your baby’s forehead will not give you a precise measurement—you need to use a thermometer to get the best information. For a baby, a rectal thermometer is the most accurate way to measure temperature.

It isn’t always necessary to see your health care provider when your child has a fever. Here are some things that can help:

  • Acetaminophen (Tyleno®l) or ibuprofen (Motrin® or Advil®) will usually bring down your baby’s temperature. But make sure you give the correct dose.
  • Do not overdress your child. Alcohol bath, ice packs, etc. are NOT recommended and should not be used.
  • Make sure your baby gets a lot of fluids to help prevent dehydration. Signs of dehydration include crying without tears, a dry mouth, and fewer wet diapers.

When should I call my baby’s provider?

According to the American Academy of Pediatrics (AAP), you should call your child’s health care provider right away if he has a fever and:

  • Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher. Call even if you baby doesn’t seem sick. Babies this young can get sick very quickly.
  • Fever rises above 104°F (40°C) repeatedly for a child of any age.
  • Looks very ill, is unusually drowsy, or is very fussy.
  • Has been in a very hot place, such as an overheated car.
  • Has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea.
  • Has signs of dehydration, such as a dry mouth, sunken soft spot or significantly fewer wet diapers and is not able to take in fluids.
  • Has immune system problems, such as sickle cell disease or cancer, or is taking medications, such as steroids.
  • Has had a seizure.

Also call your child’s doctor if:

  • The fever persists for more than 24 hours in a child younger than 2 years.
  • The fever persists for more than 3 days (72 hours) in a child 2 years of age or older.
  • Your child still “acts sick” once his fever is brought down.
  • Your child seems to be getting worse.

Have questions? Send them AskUs@marchofdimes.org.

What are cleft lip and cleft palate?

Friday, July 7th, 2017

cleft lipCleft lip and cleft palate occur when a baby’s lip or mouth do not form completely during pregnancy. A cleft lip is an opening in a baby’s upper lip. Cleft palate occurs when a baby’s palate (the roof of the mouth) has an opening in it. 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 each year in the United States.

What causes cleft lip and cleft palate?

Cleft lip and palate happen very early in pregnancy. Your baby’s lips form between 4 and 7 weeks of pregnancy, and the palate forms between 6 and 9 weeks of pregnancy. Oral clefts don’t have to happen together—a baby can have one without the other.

We’re not sure what causes cleft lip and cleft palate. They may be caused by a combination of factors, like genes and things in your environment, such as medicines you may take. Some risk factors include:

  • Smoking.
  • Diabetes. If you have diabetes before pregnancy, you have an increased risk of having a baby with a cleft lip with or without cleft palate, compared to women who do not have diabetes.
  • Taking certain medicines. If you have epilepsy and take anti-seizure medicines (like topiramate or valproic acid) during the first trimester, you’re more likely to have a baby with cleft lip (with or without cleft palate) than women who don’t take these medicines.

How are cleft lip and cleft palate treated?

In most cases, surgery is needed. Each baby is unique, but surgery to repair cleft lip usually is done at 10 to 12 weeks of age. Surgery for cleft palate is done between 9 and 18 months of age. Children who have a cleft lip or palate may need services such as speech therapy and special dental care as they get older.

Can cleft lip and cleft palate be prevented?

These conditions cannot always be prevented. But here are some things you can do to reduce the chance of your baby having a cleft:

  • Take folic acid. Before pregnancy, take a multivitamin with 400 micrograms of folic acid in it every day. During pregnancy, take a prenatal vitamin with 600 micrograms of folic acid in it every day.
  • Don’t smoke or drink alcohol.
  • Get a preconception checkup.
  • Get to a healthy weight before pregnancy and talk to your provider about gaining a healthy amount of weight during pregnancy.
  • Talk to your provider to make sure any medicine you take is safe during pregnancy. Don’t stop taking any medicine without talking to your provider first.
  • Get early and regular prenatal care.
  • Protect yourself from infections. Make sure all your vaccinations are up to date, especially for rubella. Wash your hands often.

You can learn more about cleft lip and cleft palate on our website.

Have questions? Send them 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.

 

 

Heat and pregnancy – what’s dangerous and how to cope

Wednesday, June 14th, 2017

heatIf you live in the northeast, you know we’ve been experiencing a heat wave. Just going from my car to the front door of the office seems too far to walk in this heat. If you’re pregnant, having an increased exposure to heat may cause problems for you or your baby.

Exposure to excessive heat affects people differently. When you are pregnant, your body works hard to cool you and your baby. So, if you are pregnant, you are more likely to develop a heat related illness sooner than someone who is not pregnant.

Heat illnesses occur when your body’s efforts to cool itself (eg. sweating) are no longer effective. Heat illnesses include a rash often known as “prickly heat,” cramps, fainting, heat exhaustion and heat stroke.

Heat exhaustion symptoms include a headache, nausea, dizziness, heavy sweating, weakness, thirst, being irritable, and having an increased body temperature.

Heat stroke is an emergency condition. It is when your body temperature goes above 104 degrees Fahrenheit. Symptoms include hot and dry skin or extreme sweating, a rapid pulse, throbbing head-ache, dizziness, nausea, confusion, slurred speech, loss of consciousness, and seizures. If untreated, it could result in permanent organ damage or even death. Seek medical attention or contact 911 immediately if someone you know has these symptoms.

Prevention is key

It is important that you take steps to stay cool and prevent heat related conditions, especially if you are pregnant. Here’s how:

  • Stay hydrated. Drink water frequently. Don’t wait until you’re thirsty to drink.
  • Stay in rooms with air-conditioning.
  • Avoid going outdoors during peak heat hours (11am – 3pm).
  • If you must go outdoors, stay in the shade, limit your physical activity, and stay hydrated. Use a cold or wet cloth to cool down by putting it on the inside of your wrists or forehead so you don’t get too hot.

Keep kids out of the heat, too

One more thing…each year at about this time, we hear of children being left in a hot car “for just a few minutes.” Tragic deaths from heat stroke can occur from leaving a child in an overheated closed car for a very short while.

Never leave a child unattended in a closed car – NEVER.

Children don’t have the same chemical makeup as adults, making it harder for their bodies to regulate temperature. Take steps to protect your child from heat-related illnesses by setting reminders. Here are a few tips to prevent a tragedy, from the American Academy of Pediatrics.

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

No fruit juice for children under 1 year

Tuesday, May 30th, 2017

hapy babyThe American Academy of Pediatrics (AAP) has recently changed its recommendations regarding how much fruit juice children should drink. They now state that children under the age of 1 year should NOT drink fruit juice.

The updated recommendations also state that:

  • Toddlers ages 1-3 should not get more than 4 ounces of 100% fruit juice each day.
  • Toddlers should not be given juice from bottles or sippy cups. This allows them to easily consume juice throughout the day and can lead to cavities. Also, toddlers should not be given juice at bedtime.
  • Breast milk or infant formula is enough for infants to drink, and low-fat/nonfat milk and water are appropriate drinks for older children.

The new policy encourages eating more whole fruits instead of drinking fruit juice. Drinking too much fruit juice can contribute to cavities. And fruit juice does not have the fiber that is generally found in fresh fruit.

“Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories,” said Melvin B. Heyman, MD, FAAP, co-author of the statement. “Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1.”

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

 

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.