Why is 39 weeks so important?

30
Mar
Posted by Sara

midwife measuring pregnancy bellyIf your pregnancy is healthy, it is best to wait for labor to begin on its own. And if you do decide to induce labor, ask your provider if you can wait until at least 39 weeks.

Most people think that pregnancy lasts 9 months. But that isn’t exactly true. Pregnancy usually lasts about 40 weeks (280 days) from the first day of your last menstrual period (also called LMP) to your due date. A first trimester ultrasound can also help to determine your due date.

In the past, a pregnancy that lasted anywhere between 37 to 42 weeks was called a term pregnancy. Health care providers once thought this 5-week period was a safe time for most babies to be born.

But experts now know that scheduling your baby’s birth a little early for non-medical reasons can cause problems for both mom and baby. Getting to at least 39 weeks gives your baby the time he needs to grow.

Why is 39 weeks so important?

Here’s why your baby needs 39 weeks:

  • Important organs, like his brain, lungs and liver, get the time they need to develop. At 35 weeks, a baby’s brain weighs just two-thirds of what it does at 39 weeks.
  • There is more time to gain weight. Babies born at a healthy weight have an easier time staying warm than babies who are born too small.
  • Your baby will be able to feed better. Babies born early can sometimes have difficulties with sucking, swallowing, and staying awake long enough to eat.
  • Your baby is less likely to have vision and hearing problems after birth.

Why can scheduling an early birth cause problems?

There are some risks associated with inducing labor:

  • Your due date may not be exactly right. Even with an ultrasound, your due date can be off by as much as 2 weeks. If you schedule an induction and your due date is wrong, your baby may be born too early.
  • Pitocin, the medication used to induce labor, can make contractions very strong and lower your baby’s heart rate.
  • You and your baby have a higher risk of infection if labor doesn’t begin soon after your water breaks.
  • If the medications used to induce labor do not work, you may need to have a c-section.

What if there are problems with your pregnancy?

You may not have a choice about when to have your baby. Your provider may need to induce labor to help keep you and your baby safe. If your provider does decide to induce labor for the health and safety of you and your baby, you can learn more about how labor is induced on our website.

Remember: If your pregnancy is healthy, it is best to let labor begin on its own. If you and your baby are healthy, and you and your provider decide to induce labor, make sure you wait until at least 39 weeks. Healthy babies are worth the wait!

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

Managing diabetes during pregnancy

28
Mar
Posted by Sara

glucose screeningDiabetes is a serious health concern. About 9 out of 100 people (9 percent) in the U.S. have diabetes – a condition in which your body has too much sugar (called glucose) in the blood. Glucose is your body’s main source of fuel for energy. Insulin is a hormone that helps the glucose get into your cells to give them energy. If your body does not produce insulin or cannot use it efficiently, then over time, high blood sugar can lead to serious problems with your heart, eyes, kidneys, and nerve cells. You can develop diabetes at any time in your life, including during pregnancy.

There are three different types of diabetes:

  • Type 1 diabetes happens most often in children and young adults but it can develop at any age. With type 1 diabetes, your body does not make insulin.
  • Type 2 diabetes is the most common type of diabetes. In this case, your body does not make insulin or can’t use it normally. You are at an increased risk for type 2 diabetes if you are older, overweight, have a family history of diabetes, or do not exercise.
  • Gestational diabetes occurs during pregnancy. Seven out of every 100 pregnant women (7 percent) develop gestational diabetes. Gestational diabetes is tested for at 24-28 weeks of pregnancy. It usually goes away after you give birth. However, if you have it in one pregnancy, you’re more likely to have it in your next pregnancy. You’re also more likely to develop diabetes later in life.

Managing your diabetes during pregnancy

If you have diabetes, it is very important that you control your blood sugar. High blood sugar can be harmful to your baby, especially during the first few weeks of pregnancy when the brain, heart, kidneys and lungs begin to form.

Your blood sugar is affected by pregnancy, by what you eat and drink, and how much physical activity you get. If you have preexisting diabetes (diabetes BEFORE pregnancy), what worked to control your blood sugar before you became pregnant, may not work as well during pregnancy.
Here are some things that you can do to have a healthy pregnancy:

  • Go to all your prenatal care visits, even if you’re feeling fine.
  • Follow your provider’s directions about how often to check your blood sugar. Call your provider if your blood sugar is too high or too low.
  • Tell your provider about any medicine you take, even medicine that’s not related to your diabetes. Some medicines can be harmful during pregnancy, so your provider may need to change them to ones that are safer for you and your baby.
  • If you don’t already have a registered dietician (RD), your provider can recommend one for you. An RD is a person specially trained in nutrition. An RD can help you learn what, how much and how often to eat to best control your diabetes.  She can help you make meal plans and help you know the right amount of weight to gain during pregnancy. Check to see if your health insurance covers treatment from an RD.
  • Do something active every day. With your health provider’s OK, being active every day can help you manage your diabetes.

Diabetes can be a challenge, especially when you are pregnant. But it is possible to manage it and have a healthy pregnancy.

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

Postpartum depression – don’t suffer in silence

27
Mar
Posted by Lauren

img_postpartum_depIf you keep up with celebrity news, you may have read about model and TV series host Chrissy Teigen’s recent struggle with Postpartum Depression (PPD). Chrissy was feeling all sorts of symptoms without knowing the cause or that there could be an explanation.

Postpartum depression (also called PPD) is a kind of depression that you can get after having a baby. PPD is strong feelings of sadness that last for a long time. It is the most common complication for women who have just had a baby; in fact 1 in 9 women suffer from PPD, which is different from the “baby blues.” Many women don’t know why they are suffering or are hesitant to reach out for help.

One of Chrissy’s greatest attributes is her ability to be truthful and “tell it like it is.” In her essay that was published in Glamour, she writes “I also just didn’t think it could happen to me… But postpartum (depression) does not discriminate. I couldn’t control it. And that’s part of the reason it took me so long to speak up: I felt selfish, icky, and weird saying aloud that I’m struggling.”

Signs of PPD

You may have PPD if you have five or more signs that last longer than two weeks:

Changes in your feelings:

  • Feeling depressed most of the day every day
  • Feeling shame, guilt or like a failure
  • Feeling panicky or scared a lot of the time
  • Having severe mood swings

Changes in your everyday life:

  • Having little interest in things you normally like to do
  • Feeling tired all the time
  • Eating a lot more or a lot less than is normal for you
  • Gaining or losing weight
  • Having trouble sleeping or sleeping too much
  • Having trouble concentrating or making decisions

Changes in how you think about yourself or your baby:

  • Having trouble bonding with your baby
  • Thinking about hurting yourself or your baby
  • Thinking about ending your life

If you have any of the symptoms mentioned above or think you may have PPD, call your health care provider. There are things you and your provider can do to help you feel better. Reach out for help and support today. For more information about PPD, see our article.

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

 

Where does all the weight gain go during pregnancy?

24
Mar
Posted by Lauren

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

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

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

pregnant woman on scale

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

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

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

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

U.S. study shows fewer babies are dying in their first year of life

22
Mar
Posted by Sara

The death of a baby before his or her first birthday is called infant mortality. A new report released by the CDC shows that the infant mortality rate in the U.S. dropped 15% from 2005 to 2014. In kangaroo-care-242005 the rate was 6.86 infant deaths per 1,000 live births. In 2014, the rate dropped to 5.82 deaths per 1,000 live births.

While the study did not look at the underlying causes of the decline, it did report valuable information:

  • Infant mortality rates declined in 33 states and the District of Columbia. The other 17 states saw no significant changes.
  • Declines were seen in some of the leading causes of infant death including birth defects (11% decline), preterm birth and low birthweight (8% decline), and maternal complications (7% decline).
  • The rate of sudden infant death syndrome (SIDS) declined by 29%.
  • Infant mortality rates declined for all races, except American Indian or Alaska Natives.
  • Infants born to non-Hispanic black women continue to have an infant mortality rate more than double that of non-Hispanic white women.

“On the surface, this seems like good news. But it is far from time to celebrate,” said Dr. Paul Jarris, chief medical officer for the March of Dimes. “What is concerning, though, is that the inequities between non-Hispanic blacks and American Indians and the Caucasian population have persisted.” Dr. Jarris adds, “This report highlights the need to strengthen programs that serve low income and at-risk communities, especially those with the highest infant mortality rates.”

The infant mortality rate is one of the indicators that is often used to measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants.

What can you do?

Having a healthy pregnancy may increase the chance of having a healthy baby. Here are some things you can do before and during pregnancy:

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

Zika travel guidance – an update and helpful tools

20
Mar
Posted by Barbara

airplaneThe CDC recently updated its Zika travel guidance. March is a time when many people get away from the snow, ice and cold and thaw out in the sunshine of a southern climate. But, before you hop on a plane, it is best to do a little homework first and find out where the Zika virus may be a threat.

An interactive world map will show you areas of Zika risk so that you are able to make an educated travel decision. The map shows international destinations as well as U.S. territories.  You can search for location-specific Zika information and travel recommendations.

Another helpful tool is CDC’s Know Your Zika Risk (scroll down the page to use the widget).  It will help you determine the risk of Zika for each person in your household and assist you in making informed decisions about your health.

If you are going to visit family or a friend in an area with Zika, the CDC tells you what you need to know before, during and after your trip, to keep you and your family safe.

Remember

  • If you are pregnant or planning on becoming pregnant, do not travel to an area with active Zika.
  • Zika can be passed from a pregnant woman to her baby and can cause serious birth defects.
  • Even men need to protect themselves from Zika, as it can be passed through semen.
  • At this time, there is no vaccine to prevent Zika, and no known cure.

Prevention and protection is key. Learn more on our website.

Have questions? Send them to AskUs@marchofdimes.org for a personalized reply from a health education specialist.

 

What causes gas in breastfed babies?

17
Mar
Posted by Lauren

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

15
Mar
Posted by Barbara

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

13
Mar
Posted by Sara

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.

Do you need carrier screening?

10
Mar
Posted by Sara

preconception healthRecently the American College of Obstetrics and Gynecology (ACOG) updated their recommendations for carrier screening.

A gene is a part of your body’s cells that stores instructions for the way your body grows and works. Genes come in pairs—you get one of each pair from each parent.

Sometimes the instructions in genes change. This is called a gene change or a mutation. Parents can pass gene changes to their children. Sometimes a gene change can cause a gene to not work correctly. Sometimes it can cause birth defects or other health conditions.

For certain conditions, if you inherit a gene change from just one parent, you have the gene change but not the disease. When this happens, you’re called a carrier. A carrier of a genetic mutation does not have any symptoms of the disease or condition. But, if their partner carries a change in the same gene, then they are at risk to have a baby with the condition.

If you and your partner both carry the gene change for a condition, your baby may get two gene changes (one from each of you) and have the disease. If both you and your partner are carriers (you both have the gene change), there is:

A 1-in-4 chance (25 percent) that your baby can have the disease

A 1-in-4 chance (25 percent) that your baby won’t have the disease and won’t be a carrier

A 1-in-2 chance (50 percent) that your baby won’t have the disease but will be a carrier

Who should get carrier screening?

Carrier screening is simply a blood test. The updated recommendations for carrier screening include:

  • All pregnant women should be offered information about carrier screening. They may then choose to have some screening or none at all.
  • Ideally, carrier screening should be done before pregnancy.
  • If a woman is a carrier for a specific condition, her partner should be offered carrier screening as well.
  • If both parents are found to be carriers of a specific disorder, they should meet with a genetic counselor. This will allow them to better understand the condition, the possible risks to their children, and how other family members may be affected.

What conditions should be tested for?

ACOG now recommends ALL WOMEN be offered carrier screening for the following conditions:

  • Spinal Muscular Atrophy (SMA): SMA is a disease that attacks nerve cells in the spinal cord. These cells communicate with your muscles. As the neurons die, the muscles weaken. This can affect walking, crawling, breathing, swallowing, and head and neck control.
  • Cystic fibrosis (CF): CF is a condition that affects breathing and digestion. It’s caused by very thick mucus that builds up in the body. This thick and sticky mucus builds up in the lungs and digestive system and can cause problems with how you breathe and digest food.
  • Hemoglobinopathies: These are blood conditions that are caused by problems with hemoglobin. Hemoglobin is a protein in the blood that carries oxygen. There are different kinds of hemoglobin in the blood, and there are many kinds of hemoglobin disorders. Some are caused when hemoglobin doesn’t form correctly or when your body doesn’t make enough hemoglobin.

Additional carrier screening should be offered for other conditions based on family history. If you are planning a pregnancy or are pregnant already, make sure you talk to your health care provider about the new guidelines and discuss any questions or concerns you may have.

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