What is a doula?

Posted by Lauren

mom-with-newborn-in-hospitalA doula is a trained and experienced professional who provides physical, emotional and informational support to a pregnant woman and her partner. A doula provides care for moms-to-be during pregnancy, labor, delivery, and the postpartum period. She also helps women carry out their birth plans so that they have a positive childbirth and postpartum experience.  The word “doula” comes from the ancient Greek meaning “a woman who serves.”

There are different kinds of doulas:

A birth doula understands the birthing process and the emotional needs of a woman in labor. If you are pregnant, a birth doula will help you develop a birth plan and assist in carrying out your plans during labor and delivery.

Your relationship with your doula will start with one or more meetings during your pregnancy. Once you start your contractions, she will stay with you throughout your labor to provide physical comfort, emotional support and help as you make informed decisions.

A postpartum doula can provide you with education, companionship and support after your baby is born. She can assist with newborn care, meal preparation, light household tidying and can help your family adjust to your newest addition. She will also be able to offer evidence-based (scientifically proven) information on feeding, soothing, coping skills and emotional and physical recovery from your labor and delivery.

A bereavement doula is a newer form of support. Although DONA does not offer a bereavement doula training program, many doulas are able to find other programs in their communities and online to receive certification. A bereavement doula can provide assistance, support, resources and referrals to families who are experiencing the loss of their baby.

A doula that provides bereavement support may be known by a different title, such as a Baby Loss Family Advisor. These professionals have been trained to help you navigate through the difficult days – from the moment you hear the news to preparing for the hospital experience and for when you return home.

Many birth and postpartum doulas are trained and certified through DONA International, toLabor, and CAPPA.

Now that you know what a doula is, tune in next week to learn if you should consider having one help you.

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


The survival rates of extremely premature babies are improving

Posted by Sara

NICU preemieAdvances in treatment options may be helping to increase survival rates and reduce the number of complications for extremely premature babies, according to a new study published in the Journal of the American Medical Association.

The study looked at 34,636 infants born between 22-28 weeks over 20 years (1993-2012). The researchers found that the overall rate of survival for premature babies born between 22-28 weeks increased from 70% in 1993 to 79% in 2012.

According to the researchers, “Survival rates remained unchanged from1993 through 2008. After 2008, trends in survival varied by gestational age.”

  • For babies born at 23-weeks, the survival rate rose from 27% in 2009 to 33% in 2012.
  • For babies born at 24-weeks, the survival rate rose from 63% in 2009 to 65% in 2012.
  • There were smaller increases for babies born at 25 weeks and 27 weeks.
  • There was, however, no change reported for babies born at 22, 26, and 28 weeks.

The researchers also looked at how many babies survived extreme premature birth without developing major neonatal health problems. They found that the rate of survival without major complications increased approximately 2% per year for babies born between 25-28 weeks.  However, there was no change in survival without major complications for babies born between 22 to 24 weeks.

The authors of the study also observed changes in maternal and infant care which may have contributed to the increased survival rates. For instance, the use of corticosteroids prior to birth rose to 87% in 2012 (vs. 24% in 1993). Corticosteroids help to speed up your baby’s lung development. While most babies were put on a ventilator (a breathing machine that delivers warmed and humidified air to a baby’s lungs), continuous positive airway pressure (CPAP) without ventilation increased from 7% in 2002 to 11% in 2012. And the rate of late-onset infection decreased for all gestational ages.

“For parents of babies born very early — 22-28 weeks — these data are showing improvements in outcome. We are gratified by the progress, but there is so much more that could be done if we could understand what causes premature labor and birth,” said Dr. Edward McCabe, Chief Medical Officer for The March of Dimes.

“Our focus is on preventing premature births and we are making excellent progress,” he said. “We have saved hundreds of thousands of babies from premature birth since the rate peaked in 2006.”

You can read more about our Prematurity Campaign and our Prematurity Research Centers on our website.

Questions? Email or text us at AskUs@marchofdimes.org.

Learning differences, disabilities and disorders – are they all the same?

Posted by Barbara

girl at schoolIn a word…no.

People learn differently. Some people need to hear information in order to learn it; others need to see or write down items in order to remember them. Yet other people need to physically DO the activity in order to learn it completely. And then there are those people who need a combination (seeing and hearing and doing, etc.) in order to fully learn a new subject or task.

These different types of learning styles – visual (seeing), auditory (hearing) and kinesthetic (physically doing) – are called learning differences. Once you understand the kind of learner your child is, the easier it will be to help him learn.

A learning disorder or disability is a bit different.

When a child is exposed to typical teaching methods repeatedly, yet he struggles and cannot learn material in a way that is similar to his peers, then he may have a learning disorder or learning disability. The two terms mean nearly the same thing, but come from different places:

Learning disorder is the medical term for the diagnosis of persistent difficulties in reading, writing, spelling, arithmetic calculation, and mathematical reasoning. The DSM V (the official diagnostic manual) states that “Specific learning disorder disrupts the normal pattern of learning academic skills; it is not simply a consequence of lack of opportunity of learning or inadequate instruction.” A child with a learning disorder is bright – he has average or above average intelligence – and he is NOT lazy. He tries hard but struggles to learn.

There are different kinds of learning disorders, and a qualified specialist can test your child to determine the kind of disorder your child may have. A specific learning disorder is biologically based, and is usually discovered during formal years of schooling. It often runs in families, too.

Specific learning disability (SLD) is the term that is found in our special education law – IDEA (Individuals with Disabilities Education Act). IDEA’s defines SLD as “a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations…The term does not include learning problems that are primarily the result of visual, hearing, or motor disabilities; of intellectual disability; of emotional disturbance; or of environmental, cultural, or economic disadvantage.”

In other words, SLD is the legal label that is necessary in order for your child to receive special education services.

Which term should you use?

In a world that is becoming more and more sensitive towards individuals with differences, it is logical that we would gravitate toward using “learning difference” when we talk about our kids who are struggling in school. And it seems that even professionals use the terms “disorder” and “disability” interchangeably. However, it is important that the correct term be used in the right situation, so that you give your child the help he needs in order to be able to learn.

For example, special education services are available only to children with disabilities. If your child has a specific learning disability, he may qualify to receive specialized educational instruction, accommodations and curriculum modifications in school. In order to be considered to receive services, he must have the “disability” label. If your child qualifies, the special education team at your child’s school will meet with you to discuss and implement an individualized educational program (IEP) to meet your child’s needs.

Even if your child does not have a disability or disorder, he may still learn differently from his friends. It is important for your child to be taught in the way in which his brain learns. If he is in a classroom where all information and directions are given verbally, he may only process part of the information and the rest may not be absorbed or be easily forgotten. If the auditory directions are combined with a visual direction and/or perhaps even a kinesthetic direction, there is a greater chance that your child will learn and master the information.

For example, to learn the letter “C,” a child can say “C” out loud, while tracing a large, colorful letter C with his finger. His brain is taking in the information visually, auditorily and kinesthetically, and is able to process it the way his brain works best. The result is that your child will have a better chance of remembering the letter C. When different senses are used to activate learning, it becomes more fun for the student and it also makes it more likely that your child can learn and remember the information.

Try not to get hung up on the labels. As I mentioned in the beginning of this blog post – everyone learns differently. But, if your child is struggling, consider having your child evaluated to determine whether he qualifies for specialized help. The earlier he gets the help he needs, the better off he will be.

Learn more about the different kinds of learning disabilities, as well as what they ARE and are NOT.

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

See other topics in the Delays and Disabilities series here.


Is a glass of wine OK?

Posted by Lauren

Contemplative womanThere is no amount of alcohol that is proven to be safe during pregnancy. All types of alcohol are equally harmful for your baby, including wine, beer, wine coolers and mixed drinks. When you drink, the same amount of alcohol that is in your blood is also in your baby’s blood. The alcohol in your blood quickly passes through the placenta and to your baby through the umbilical cord.

Alcohol can seriously harm your baby’s development. It can cause fetal alcohol spectrum disorders (FASDs) which include a wide range of physical and mental disabilities and lifelong emotional and behavioral problems in a child. It can also cause miscarriage, premature birth and stillbirth.

If you were drinking alcohol before you knew you were pregnant, the most important thing is that you completely stop drinking after learning of your pregnancy. The sooner you stop drinking, the better off you and your baby will be.

If you have been drinking alcohol during pregnancy, it is never too late to stop. Your baby’s brain is growing throughout pregnancy, so the sooner you stop drinking the safer it will be for your baby. If you are having trouble stopping, help is available. Talk to your doctor or find a professional in your area using the Substance Abuse and Treatment Facility Locator. Or, for more information about how to stop drinking, visit us here.

MargaritaSeptember 9th is International FASD Awareness Day, and this year, NOFAS (the National Organization on Fetal Alcohol Syndrome) is dedicating the month of September to raising awareness.

Help us get the word out: FASDs are completely preventable if a woman does not drink alcohol during pregnancy. Read about Taylor’s personal struggle with FASD here.

Remember, if you are pregnant or thinking about becoming pregnant, do not drink alcohol. And don’t smoke or take any drugs or medications without talking to your provider first. Be sure to get regular prenatal care and tell your health care provider about any concerns you may have.

Email or text us at AskUs@marchofdimes.org with your questions.


Newborn screening: a personal story

Posted by Sara

All babies in the United States get newborn screening before they leave the hospital. Newborn screening looks for rare but serious and mostly treatable health disorders. Babies with these disorders often look healthy. But if the condition is not diagnosed and treated early, a baby can develop lasting physical problems or intellectual disabilities, or may even die.

The federal Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC) recently voted to recommend adding X-linked adrenoleukodystrophy (X-ALD) to the Recommended Uniform Screening Panel (RUSP).  This recommendation now needs to go to the Secretary of Health and Human Services for her review and consideration.

X-ALD is a genetic disorder that occurs mostly in boys. In this disorder, the fatty covering (myelin) that insulates nerves in the brain and spinal cord is broken down. This reduces the ability of the nerves to relay information to the brain. X-ALD can cause serious and permanent disability or death.  The only effective treatment is early identification by newborn screening, and stem cell therapy (bone marrow or cord blood transplantation), sometimes along with other life-saving treatments.

X-ALD is due to a gene change, or mutation, on the X chromosome. The X and Y chromosomes are responsible for gender. Girls have two X chromosomes (XX). They inherit one from their mom and one from their dad. Boys have an X and a Y chromosome (XY). They inherit the X from their mom and the Y from their dad. Since boys have only one copy of the X chromosome, they will have only one copy of the X-ALD gene mutation, and they will develop X-ALD. Because girls have two copies of the X chromosome, they will only have one copy of the gene mutation (inherited from their mom). A single copy of the altered gene usually does not cause any symptoms of X-ALD. Although some girls can have health problems associated with the condition, they are often mild and usually appear at a later age.

X-ALD has not been officially added to the Recommended Uniform Screening Panel. We will keep you updated. In the meantime, here is a very personal story about newborn screening and why it is so important:



Vocabulary at age 2 may predict kindergarten success

Posted by Barbara

parents reading to toddlerThe size of a child’s vocabulary at age two may predict how well he will do in kindergarten, according to a new study. The larger the oral vocabulary, the better prepared he will be for school.

The study looked at 8,500 children in the United States. The researchers found that:

  • preemies or babies with a very low birth weight, and babies whose mothers had health issues had smaller vocabularies.
  • children with parents who frequently interacted with their children and read to them on a regular basis had larger vocabularies.
  • girls tended to have a larger vocabulary than boys.
  • children from higher socioeconomic homes had larger vocabularies.
  • children with larger vocabularies at 24 months of age did better in reading and math and had fewer behavioral problems.

The researchers believe that interventions should be started early enough so that children who are at risk due to medical/health problems or socioeconomic disadvantages, have the time to develop and catch up. Interventions need to be targeted especially to toddlers who are living in disadvantaged homes.

Keep in mind that no two children develop exactly alike. Some are early bloomers while others are later bloomers. And one study cannot predict an individual child’s development.

What can you do?

The single most effective way to help your baby expand his vocabulary is to read to him. Start when your baby is born, and read every day. Reading aloud helps promote language skills – vocabulary, speech and later on, reading comprehension. See this post to learn just how important reading is for your baby and to learn where to get books. See the AAP’s article for tips on how to make it fun. And remember, the best parts about reading to your little one are the snuggles and cuddles that go along with it.

If your baby is showing signs of a developmental delay, speak with his health care provider, or contact your Early Intervention Program and ask for a free screening. If your child qualifies, he may receive personal, targeted intervention (such as speech therapy) to help him catch up.

Don’t delay with delays!

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

The study appeared in the journal Child Development.

Learn how to help your child in our Delays and Disabilities series.

Benefits of breastfeeding

Posted by Lauren

sg_breastfeeding1Breast milk is the best food for your baby during the first year of life and we recommend exclusively breastfeeding for about the first six months. Your milk helps your baby grow healthy and strong and can protect him from many illnesses. How does your breast milk do this?

Breast milk…

• has hormones and the right amount of protein, sugar, fat and most vitamins to help your baby grow and develop.
• has antibodies that help protect your baby from many illnesses. Antibodies are cells in the body that fight off infection.
• has fatty acids, like DHA (docosahexanoic acid), which help support your baby’s brain and eye development. It may lower the chances of sudden infant death syndrome, also known as SIDS, too (SIDS is the unexplained death of a baby younger than 1 year old).
• is easy to digest. A breastfed baby may have less gas and belly pain than a baby who is fed formula.
• changes as your baby grows so he gets exactly what he needs at the right time. For example, for the first few days after giving birth, your breasts make a thick, yellowish form of breast milk called colostrum. Colostrum has nutrients and antibodies that your baby needs in the first few days of life. It changes to breast milk in 3 to 4 days.
• is always ready when your baby wants to eat. Your body makes as much breast milk as your baby needs. The more your baby breastfeeds, the more milk your body makes.

What if you are sick? Should you still breastfeed?

In most cases, yes, you should continue to breastfeed. The antibodies your body produces to fight off an illness will be passed to your baby through your milk and protect him. If you stop breastfeeding when you are sick, you will reduce your baby’s protection and even increase his chance of getting sick. If you feel a cold coming on, rest, drink plenty of fluids and keep on breastfeeding. If you are uncertain about whether to breastfeed while sick, ask your Lactation Consultant or baby’s pediatrician.

Read our blog to learn how to keep your breast milk safe and other helpful posts in Breastfeeding 101.

Have questions? Text or email us at AskUS@marchofdimes.org. We are here for you.

March of Dimes remembers helping families during Hurricane Katrina

Posted by Barbara

A guest post by Capi Landreneau, Director, Mobile Health Care for March of Dimes and former Director of Program Services for the Louisiana Chapter.

Mobile UnitToday, we acknowledge the 10-year anniversary of Hurricane Katrina, a storm with devastating effects that left many without adequate care in so many ways. In the days immediately following landfall, March of Dimes volunteers and staff members were on the ground supporting families, mothers and infants.

We visited shelters in search of pregnant women and mothers in need, we convened community partners to see how we could work together in such a difficult time, we communicated with the national office advising them of the day to day needs and changes in the landscape from safety, to transportation to food shortages. Other staff traveled from New York to Louisiana to assist and slept on the floors of local staff member’s homes, in some cases having never met before.

The outpouring of support from our volunteers around the nation was incredible. Volunteers around the country gathered in groups and assembled care kits for new moms that were evacuated from hospitals. Each kit was personally assembled with comfort items, baby supplies and a handwritten note signed lovingly by a mom from another state — not a friend or family member, but a stranger who just wanted to provide comfort and care in a time when so many felt helpless.

The Louisiana March of Dimes office was literally taken over by donations and hurricane relief work. We had never done anything like that before but we also had never experienced an event like Hurricane Katrina. We distributed donated diapers and formula, we helped families with infants find shelter in places suitable for young families.

General shelters weren’t appropriate for small children running around and women’s shelters didn’t allow husbands. I remember well one family that had twin infants that couldn’t have been more than a month old. They were born prematurely and I remember our concern for their still fragile immune systems in a large shelter. We pooled contacts and several entities came together to support a family specific shelter. I will never forget the look on the mother’s face when we brought her to the shelter that was safe for her toddler to run around, safe for her preemie twins and also allowed her husband to remain with the family. It was only one family on that day, but it felt like we changed the world.

We have a very specific mission – moms and babies. A hospital or other agency would call and we would be tasked to brainstorm options, identify placement for women with infants and/or fill needs that no other agency was addressing. At that time there were no preparations for infants in a massive shelter where water wasn’t safe or abundant. We rallied the volunteers and arranged for single serve (no fridge for storage), ready to feed (no water), disposable (no place to sanitize) formula. We aided hundreds of infants and pregnant women and their families.

As weeks passed and recovery work continued, March of Dimes received a call directly from one of our longtime supporters in New Orleans, who expressed a clear need for “bricks and mortar.” Providers were ready but locations for provision of services were scarce due to the devastation and flooding throughout the area.

March of Dimes established The Hurricane Assistance Fund and raised over $5 million to support recovery efforts. The funding allowed for the design and purchase of four vehicles tailored specifically for provision of care of women and infants along with operational funding for several years.

In September of 2006, the first Mom & Baby Mobile Health Center was launched. The mobile health clinic was equipped to provide full prenatal care onsite without any need for land based support. It served moms and babies in New Orleans during the difficult years following the devastation incurred after Hurricane Katrina made landfall. The mobile clinic relocated regularly in the years following launch as areas began to revive and residents returned to their homes. This allowed the health center to go where the women were in greatest need.

Our second program launched on the Mississippi gulf coast. Serving moms and babies was critical as providers returned to flooded clinics and buildings swept off their foundations by storm surge. The Mom & Baby Mobile Health Center partnered with K-mart, one of our long standing supporters, to provide access to care in their store parking lots. Two additional locations were launched in Louisiana, Lake Charles and a second program in New Orleans to meet the increasing need as residents returned to the city. Since the program was launched, Mom & Baby Mobile Health Centers has provided over 35,000 care encounters to women and infants in Louisiana and Mississippi.

Like so many people living in or touched by Louisiana, I have many emotions today, but what I will focus on will be the incredible outpouring of love and support that we received from strangers all committed to a common cause – healthy moms and babies. I’ll verbalize once again the joy, pride and satisfaction that I feel each time I am reminded that I work for an organization that did what needed to be done in such an outstanding way with such amazing and selfless staff and volunteers. I’m so glad I have the privilege of working for March of Dimes for 11 years, the last 9 of which I’ve spent working with the Mom & Baby Mobile Health Centers. They are a wonderful legacy of March of Dimes’ commitment to support Louisiana and Mississippi in their recovery after Hurricane Katrina.

Thank you, March of Dimes and thank you volunteers — YOU made a difference then and you continue to make a difference NOW. On behalf of Louisiana mothers and infants – we are forever grateful for your generosity and care.IMG_7274

Kids with special needs head back to school

Posted by Barbara

school-bus-and-stationeryThe start of school is an exciting time for most children and their parents. Many children with special needs eagerly anticipate the start of a new school year. But lots of kids are incredibly anxious at the thought of all the unknowns: new classroom, teacher, friends or school.

If you are the parent of a child with special needs, how are you feeling about the start of the new school year?

Are you…

Scared or fearful – Will your child’s particular needs be met?

Afraid – How will your child react to new smells, lights, sounds and routines?

Overwhelmed – Is your child going to a new school? Are you wondering whether he will be able to handle the transition?

Unprepared – Do IEP meetings make you feel like you don’t know what you are doing?

Alone – Do you feel like you are the only parent with your concerns?

Worried – Is your child going to do well in a class with “typically developing” peers?

Insecure – Are you wondering when to swoop in and help your child versus sitting back and watching him and the school handle any hiccups or problems?

Nervous – Will your child make friends? Will he be by himself on the playground?

If you are experiencing any or all of the above emotions, you are not alone. There is no doubt that starting a new school year is hard on students AND parents. But, when you mix in the complications of dealing with a disability and the necessary accommodations or supports that need to be in place in order for your child to succeed, it can be very stressful!

This blog series, and all of the resources listed in each post will help you tackle whatever comes your way. By being prepared, you will calm your nerves. Hopefully, you will become excited, confident and in-control. Your little one will sense your positive outlook and enthusiasm, and it will rub off on him, too.

Check out these tips to smooth the back to school transition for your child. Learn helpful ways to make the transition from summer to school do-able and realistic, including changing bedtime hours, adjusting meds and meeting your child’s teacher.

Please share your feelings about the new school year – good, bad, up, down, and anything in between. Got any tips? Let’s hear them. We all learn from each other.


Have questions?  Text or email them to AskUs@marchofdimes.org. We are here to help.

A woman’s microbiome may influence her chance of giving birth early

Posted by Sara

research_birthdefectsresearch_rdax_50Last week, the March of Dimes announced that investigators from the Stanford Prematurity Research Center published an important study which may help to better understand some of the factors that may play a role in premature birth.

Researchers at Stanford have been looking into how the microbiomes of women who deliver babies early are different from those who have full-term births. The microbiome is a community of microorganisms (such as bacteria) in the body. Differences in the microbiomes of individuals may help explain why some women give birth early. Microbiome differences may also explain other health issues, such as asthma and inflammatory bowel disease.

Weekly samples were taken of the bacteria from the teeth, gums, saliva, reproductive tract, and stool from 49 pregnant women. Scientists found little change in the bacterial communities in each woman, week to week at each location. But they did find that microbial communities in the reproductive tracts of women who delivered their babies too soon were different from those of women who delivered full term. Those differences were identified early in the pregnancies and continued throughout the pregnancies.

“These findings may help us screen women and identify and predict those who are more likely to have a baby born too soon,” said David Relman, MD, a professor of microbiology, immunology, and of medicine at the Stanford University School of Medicine and the lead investigator for the research center on this project.

The researchers also found that the women’s microbiomes changed immediately after they delivered their babies, and did not revert back to pre-pregnancy patterns in some cases until at least a year later. “This might explain why women with closely spaced pregnancies have a higher risk of preterm birth,” said Dr. Relman.

The March of Dimes currently has five prematurity research centers. These unique, transdisciplinary centers bring together scientists from many diverse disciplines — geneticists, molecular biologists, epidemiologists, engineers, computer scientists, and others — to work together to find answers to prevent premature birth.

Questions? Text or email them to AskUs@marchofdimes.org.