Ending preventable stillbirths

19
Jan
Posted by Barbara

lancet 1-19 stillbirth (002)It is impossible to put in to words the unimaginable pain a family experiences when a stillbirth occurs. The loss and void it creates can never be filled. Even in today’s world, stillbirths happen far too often.

Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy (although in some parts of the world the gestational age varies).

Did you know…

Worldwide:

  • At least 2.6 million babies are stillborn every year.
  • Almost 50% of stillbirths occur during labor – 1.3 million each year.
  • Every day, 7,300 women lose their babies due to stillbirth in the last 3 months of pregnancy.
  • Two-thirds of all stillbirths occur in 10 countries.

In the U.S.:

  • Stillbirth affects about 23,600 babies each year.

What’s being done?

The Lancet, the prominent British Journal, has just launched a Series, “Ending Preventable Stillbirths” which spotlights the serious problem of stillbirth. They also offer much hope: one in four stillbirths could be prevented by increasing access to interventions. By knowing specific risk factors and providing women with targeted prenatal care, the rates of stillbirth can be decreased. The Series’ goal is 12 or fewer stillbirths per 1,000 births in every country by 2030.

The March of Dimes joins our many colleagues in support of The Lancet Series. Edward R.B. McCabe, MD, PhD, Senior Vice President and Chief Medical Officer at the March of Dimes says “The targeting of modifiable risk factors in adolescence and before and during pregnancy identified in the Series—including maternal infections such as malaria and syphilis, non-communicable diseases, nutrition and lifestyle factors, advanced maternal age and prolonged pregnancy—have the potential not only to prevent stillbirth, but also to reduce death and disability from a range of other causes that share these same risks.”

To learn more about stillbirths, including risk factors, treatments, causes, tests after the birth, and whether you can have a healthy baby after having had a stillbirth, see our article.

The Lancet Series is the start of a much needed path to reducing preventable stillbirths. So many moms, dads, babies and families will be forever grateful.

Note: The March of Dimes receives many emails from women who have suffered a stillbirth. We offer bereavement materials to families in an effort to help them cope with their loss. If you or someone you know has suffered the loss of baby and would like our free bereavement materials, contact AskUs@marchofdimes.org.

Your story matters to us.

What you need to know about birth defects

18
Jan
Posted by Sara

snugglingEvery 4 ½ minutes in the US, a baby is born with a birth defect. That means that nearly 120,000 (or 1 in every 33) babies are affected by birth defects each year. They are a leading cause of death in the first year of life, causing one in every five infant deaths and they lead to $2.6 billion per year in hospital costs alone in the United States.

What are birth defects?

Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body and can affect any part of the body (such as the heart, brain, foot, etc). They may affect how the body looks, works, or both.

There are thousands of different birth defects and they can be very mild or very severe. Some do not require any treatment, while others may require surgery or lifelong medical interventions.

What causes birth defects?

We know what causes certain birth defects. For instance, drinking alcohol while you are pregnant can cause your baby to be born with  physical birth defects and mental impairment. And genetic conditions, such as cystic fibrosis or sickle cell disease, are the result of inheriting a mutation (change) in a single gene. However, we do not know what causes the majority of birth defects. In most cases, it is a number of complex factors. The interaction of multiple genes, personal behaviors, and our environment all may all play a role.

Can we prevent birth defects?

Most birth defects cannot be prevented. But there are some things that a woman can do before and during pregnancy to increase her chance of having a healthy baby:

  • See your healthcare provider before pregnancy and start prenatal care as soon as you think you’re pregnant.
  • Get 400 micrograms (mcg) of folic acid every day. Folic acid reduces the chance of having a baby with a neural tube defect.
  • Avoid alcohol, cigarettes, and “street” drugs.
  • Talk to your provider about any medications you are taking, including prescription and over-the-counter medications and any dietary or herbal supplements. Talk to your provider before you start or stop taking any type of medications.
  • Prevent infections during pregnancy. Wash your hands and make sure your vaccinations are up to date.
  • Make sure chronic medical conditions are under control, before pregnancy. Some conditions, like diabetes and obesity, may increase the risk for birth defects.
  • Learn about your family health history.

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

Folic acid fortification saves millions of dollars and reduces neural tube defects

15
Jan
Posted by Sara

grainSince the U.S. started requiring that folic acid be added to certain foods (known as fortification), there has been a 28% reduction in cases of babies born with neural tube defects (NTDs). In addition, a recent study has found that fortification also saves hundreds of millions of dollars each year in medical and associated costs.

In 1998, to help women of child-bearing age get more folic acid, the US Food and Drug Administration mandated that grains, such as bread, pasta, and breakfast cereal be fortified with folic acid. Getting the right amount of folic acid before pregnancy helps to prevent birth defects of the brain and spinal cord, called neural tube defects (NTDs). Neural tube defects include anencephaly and spina bifida.

A study published this week, estimates how much money has been saved by fortifying grain products with folic acid. The study suggests that each year, folic acid fortification saves about $603 million dollars more than the cost of fortification. The estimated lifetime cost for medical care, special education, and caregiver time for a child born with spina bifida is approximately $791,900. Since fortification prevents about 767 cases of spina bifida each year, the annual cost savings are substantial. The authors of the study conclude that “Fortification with folic acid is effective in preventing NTDs and saves hundreds of millions of dollars each year.”

The March of Dimes supports fortifying corn masa flour with folic acid. By targeting food made with corn masa for folic acid fortification, it would be possible to lower the rate of NTDs among the Hispanic population as well.

Keep in mind that even if you eat a well-balanced diet that includes fortified foods, fruits and vegetables, it can still be hard to get enough folic acid. So make sure you take a multivitamin with 400 micrograms of folic acid every day.

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

January – doldrums? extra struggles?

14
Jan
Posted by Barbara

No matter how you slContemplative womanice it, January always seems to be a tough month for people. After the holidays, it is hard to get back into the old routine. Somehow, the leftover cookies and sweets still linger, making it extra hard to get back on track.

Getting back in the swing of things is hard for parents. If this is how you have been feeling, you are far from alone.

But, if you are struggling, imagine how lost your child with special needs may be feeling! Getting your child to transition back to his “old normal” is easier said than done. If your child is experiencing a slight backward step, you might want to read these posts: Adjusting to life after the holidays gives tips on surviving “re-entry” as I call it, and this post includes suggestions on how you can help your child adjust back to your old routine.

Note:  The mini-series on Delays and Disabilities has lots of info to help you if you have a child with special needs. Please feel free to comment and make suggestions.

 

The Zika virus and microcephaly – what you need to know

12
Jan
Posted by Barbara

Zika virus - recently in the tropics- CDC

Update:  1/22/2016  The CDC recommends that women who are pregnant consider postponing travel to an area where there is a Zika outbreak. Women who are trying to become pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

The possible link between a mosquito carrying the Zika virus and an increase in babies born with microcephaly, a birth defect, is being investigated in Brazil.

Babies born with microcephaly have a smaller-than-normal head because the brain doesn’t develop properly or has stopped growing. Babies with microcephaly may have intellectual and developmental disabilities, hyperactivity (trouble sitting still or paying attention), short height, seizures, and problems with coordination and balance.

According to the CDC: “Outbreaks of Zika have occurred in areas of Africa, Southeast Asia, the Pacific Islands, and the Americas. Because the Aedes species mosquitoes that spread Zika virus are found throughout the world, it is likely that outbreaks will spread to new countries. In December 2015, Puerto Rico reported its first confirmed Zika virus case. Locally transmitted Zika has not been reported elsewhere in the United States, but cases of Zika have been reported in returning travelers.”

There is no cure for the Zika virus. If you are pregnant and have been to an affected area, watch for signs of the virus and seek the advice of your prenatal health care provider. Symptoms include fever with muscle or eye pain, and a possible rash during the next two weeks.

If you have plans to go to an affected area, the CDC recommends that you use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens. This map shows affected areas in the world.

Zika virus - from CDC

 

Folic acid is in many cereals

11
Jan
Posted by Barbara

Bowl of cerealGetting enough folic acid before pregnancy doesn’t have to be a chore. Taking a multivitamin that contains folic acid is an easy way to get the amount you need. In addition, many breakfast cereals contain folic acid because it has been added to them – this is called fortification. You can check to see if your favorite cereal is fortified by reading the nutritional label on the box.

Here is information from the CDC along with a list of cereals fortified with folic acid.  Be sure to read the label to see the amount of folic acid in a single serving.

But remember…

Although cereal fortification is a good thing, it can still be hard to get enough folic acid every day. This is why taking a multi-vitamin that contains at least 400 micrograms of folic acid is recommended. But, be sure to check with your health care provider to see if you may need higher amounts of folic acid.

Once you’re pregnant, your folic acid needs will increase to at least 600 micrograms per day. Some women, like those who’ve had a pregnancy affected by NTDs (neural tube defects) or women with sickle cell disease, may need more.

Bottom line

Read labels, take your multivitamin with folic acid, and talk to your provider to make sure you are getting the right amount of folic acid every day, before you become pregnant, as well as during pregnancy.

Three common folic acid myths

08
Jan
Posted by Sara

pills-moon vitaminWe receive a lot of questions about folic acid. Here are three of the most common misconceptions people seem to have.

Myth #1: Folic acid reduces the risk for ALL birth defects.

TRUTH: Folic acid reduces the risk of certain birth defects.

Folic acid reduces the risk for a very specific type of birth defect called a neural tube defect (NTD). The neural tube is the part of a developing baby that becomes the brain and spinal cord. A NTD can happen when the neural tube doesn’t close completely. This results in birth defects such as anencephaly and spina bifida. If all women take 400 micrograms (mcg) of folic acid every day before getting pregnant and during early pregnancy, it may help reduce the number of pregnancies affected by NTDs by up to 70 percent.

Myth #2: Folic acid will help me to get pregnant.

TRUTH: Folic acid is important to take before pregnancy, but it will not help you to become pregnant.

Folic acid does not help a woman to conceive. However, it is recommended that ALL women take folic acid, even if they are not trying to get pregnant. This is because folic acid can help prevent neural tube defects only if it is taken BEFORE pregnancy and during the first few weeks of pregnancy, often before a woman even knows she is pregnant.

The neural tube is one of the first structures that is formed in a developing embryo, therefore you need to make sure you are taking folic acid BEFORE you are pregnant. And because nearly half of all pregnancies in the United States are unplanned, it’s important that all women take folic acid every day, even if they are not planning to get pregnant. So take a multivitamin that has 400 micrograms of folic acid in it every day. Most multivitamins have this amount, but check the label to be sure.

Myth #3: I eat a healthy diet, so I can get enough folic acid from food.

TRUTH: It may be possible, but most women will not get enough from their diet.

Folic acid is naturally available in many fruits and vegetables, including:

  • Beans, like lentils, pinto beans and black beans
  • Leafy green vegetables, like spinach and Romaine lettuce
  • Asparagus
  • Broccoli
  • Peanuts (But don’t eat them if you have a peanut allergy)
  • Citrus fruits, like oranges and grapefruit

Many flours, breads, cereals, and pasta are fortified with folic acid, as well. This means they have folic acid added to them. You can look for the words “fortified” or “enriched” on the package to know if the product has folic acid in it.

However, it’s hard to get all the folic acid you need from food. And according to the Institute of Medicine (IOM), your body only absorbs about 50 % of that. So even if you eat foods that have folic acid in them, make sure you take your multivitamin each day too.

Some women, like those who’ve had a pregnancy affected by NTDs or women with sickle cell disease, may need more folic acid. Talk to your provider to make sure you get the right amount.

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

Folic acid can help reduce the risk of spina bifida

06
Jan
Posted by Barbara

Holding a multivitamin 2If a woman of childbearing age takes 400 micrograms of folic acid every day before and during early pregnancy, it can help reduce her baby’s risk for neural tube defects (NTDs). NTDs are birth defects of the brain and spinal cord. Spina bifida is the most common neural tube defect, affecting 1,500 to 2000 babies a year.

A baby’s neural tube normally develops into the brain and spinal cord. It starts out as a tiny, flat ribbon that turns into a tube by the end of the first month of pregnancy. NTDs happen if the tube doesn’t close completely.

Since birth defects of the brain and spine happen in the first few weeks of pregnancy, they often occur before a woman knows she’s pregnant. This is why it is important for a woman of childbearing age to take folic acid every day, even if she isn’t planning a pregnancy any time soon. By the time a woman realizes she’s pregnant, it might be too late to prevent these birth defects.

Types of spina bifida

There are four types of spina bifida, ranging from mild to severe. The mildest form (occulta), usually doesn’t cause health problems. However, other forms such as closed neural tube, meningocele and myelomeningocele (also known as open spina bifida) may cause symptoms such as bladder problems, infections and paralysis.

Spina bifida can also cause a number of medical conditions. If your child has spina bifida, he will need a team of medical professionals to monitor his health:

  • Pediatrician – a doctor who takes care of babies and children
  • Developmental Behavioral Pediatrician – a pediatrician with additional training in developmental disorders
  • Neurologist – a doctor who treats problems of the nervous system, brain and spinal cord
  • Psychologist – a professional trained to treat social and mental health problems
  • Psychiatrist – a doctor who specializes in treating mental health disorders
  • Urologist – a doctor who treats problems of the urinary tract (kidneys, bladder, ureters, and urethra)
  • Orthopedist – a doctor trained to treat disorders of bones, joints, muscles, ligaments, nerves, tendons and overall physical movement problems
  • Occupational Therapist – a professional trained to help with activities of daily living and fine motor problems
  • Physical Therapist – a professional trained to treat movement, balance, strength and physical problems

Learn more about the causes, types and treatments of spina bifida, on our website.

Bottom line

Take a multivitamin with 400 micrograms of folic acid every day, BEFORE and early in pregnancy, to help prevent certain birth defects.

Watch our video to learn how you can get the right amount of folic acid BEFORE and during pregnancy to keep your baby healthy.

Folic acid – why is it important?

04
Jan
Posted by Lauren

folic acid vitaminFolic acid is a B vitamin that promotes cell growth and helps prevent certain birth defects. It is Folic Acid Awareness Week – a great time to become familiar with how this vitamin can help you and your baby.

Your body needs to make new cells every day for blood, skin, hair and nails. Folic acid also plays an important role in helping red blood cells carry oxygen from your lungs to all parts of your body.

How can folic acid help your baby?

Folic acid helps prevent birth defects of the brain and spine, called neural tube defects, if taken before pregnancy and during the first few weeks of pregnancy.  So it is helpful to get in the habit of taking a multi-vitamin with at least 400 micrograms of folic acid every day, before you become pregnant.

Even if you are not planning to become pregnant, your body needs folic acid for normal growth and development.

What if you’re already pregnant?

Most pregnant women need to take a multi-vitamin with 600 micrograms of folic acid. Talk with your prenatal provider to see if this is the right dosage for you. A pregnant women needs extra folic acid throughout pregnancy to help produce the additional blood cells your body needs during pregnancy. Folic acid also supports the rapid growth of the placenta and fetus.

Can you get folic acid anywhere else?

Yes. Many foods have folic acid added to them. On packages of flour, breads, cereals and pastas, look for the words “fortified” or “enriched” – it means the product has folic acid added to it.

You can also get folic acid in its natural form – folate – in some fruits and vegetables. Folate can be found in spinach, black beans, peanuts and orange juice. Learn about the difference between folic acid and folate here.

Bottom line:

Even if you eat a well-balanced diet that includes fortified foods, fruits and veggies, it can still be hard to get enough folic acid every day.  By taking a multi-vitamin with at least 400 micrograms of folic acid every day, you will be sure to get the amount you need.

 

Holiday fatigue

29
Dec
Posted by Sara

tired santaWell, the holiday season is coming to a close. We thought we’d share this post from last year about how to combat holiday fatigue if you are pregnant. Happy New Year!!

Holiday season is in full swing—we just have to make it to New Year’s Eve. I am exhausted. Traveling, family, kids, parties—it all adds up to a lot of late nights and early mornings. And if you are pregnant, you may be more tired than usual. This is especially true during the first and third trimesters, when your body is producing new hormones and getting ready for the many changes that will be coming soon.

So what can you do to try to relieve your holiday fatigue? Here are some tips:

  • Rest when you can during the day and try to take a few breaks to renew your energy.
  • Lots of family activities may leave you feeling drained at the end of the day. Go to bed early, if you can.
  • Don’t drink lots of fluids too close to bedtime. Hopefully then, you will not have to get up to go to the bathroom.
  • If you often have heartburn, make sure you do not lie down right after you eat. Try to eat your last meal a few hours before you go to bed.
  • To avoid leg cramps, gently stretch your leg muscles before bedtime.
  • A nice 30 minute walk can refresh and invigorate you (make sure your doctor has said exercise is OK). But do not get too much exercise right before bed.
  • Be sure to drink enough fluids—water is usually best.
  • Deep breathing and meditation can help you find a moment of peace when you are feeling overwhelmed.
  • Try to limit unhealthy snacks. These can drain your energy. Fruits, vegetables, and foods high in iron and protein are good choices.
  • During this busy season, do not forget to take your prenatal vitamin. If you are anemic, ask your provider about an iron supplement.

You can read more about fatigue during pregnancy on our website. And if you have any questions, email us at AskUs@marchofdimes.org.