How to support grieving parents

Posted by March of Dimes

The loss of a baby is one of the most painful things that can happen to a family. If you have a family member or friend that has lost a baby during pregnancy, in the first days of life, or even as an infant, it’s very hard to know what to say or do. Here are some ideas that may help.

It’s important to recognize that although the loss may have happened to friends or family, you may be affected by their baby’s death too. To be able to support the parents, try to understand your own feelings. You may feel sad, helpless, worried, angry, confused or numb. You may wonder how you can help the parents if you feel so sad yourself. There’s no right or wrong way to feel. But by understanding how you feel, you can better support the grieving family.

It’s hard to know exactly what to say to parents whose baby has died. But there are a few important things to remember:

  • Be simple: “I’m sorry for your loss.”
  • Be honest: “I don’t know what to say. I can’t imagine what you’re going through.”
  • Be comforting: “I care about you and your family. Please tell me what I can do to help.”
  • Be specific, not everyone feels comfortable asking for help: “Can I bring you dinner on Tuesday? How about I watch the kids this week”

Don’t forget about dad. Be sure to include him as a grieving parent.

Some words may not be helpful to a grieving family, in fact, they may actually be hurtful. Here are things you should NOT to say to grieving parents:

  • “You’ll get over it in time.”
  • “It’s for the best.”
  • “You can always have another baby.”
  • “Count your blessings.”

If you can’t find the right words, it’s OK to say nothing. Sometimes just being there to listen and hold a hand is all a parent needs. You don’t always have to find the perfect words to say.

Parents may need lots of comfort and support during this painful time. And there are many things you can do to help. You can read more about grief and loss on our website too. The most important thing is simply to offer your support and love to your family or friend  and let them know you are there for them as they grieve.

Preventing infections during pregnancy

Posted by March of Dimes

February is International Prenatal Infection Prevention month. Here are some ways that you can try to prevent infections during pregnancy.

Wash your hands: Washing your hands regularly can help to reduce the spread of colds, the flu and other infections, like cytomegalovirus (CMV).

Wash your hands:

  • Before preparing or eating food
  • After handling raw meat, raw eggs or unwashed vegetables
  • After being around pets or animals
  • After changing diapers, wiping runny noses, or picking up toys

Prepare food properly: Handle foods safely whenever you wash, prepare, cook and store them. Wash knives, cutting boards and dishes used to prepare raw meat, fish or poultry before using them for other foods. Foods to avoid during pregnancy include raw meat, fish, and eggs and unpasteurized foods.

Get vaccinated: Vaccinations can help protect you and your baby from certain infections during pregnancy. Some vaccinations are safe to get during pregnancy, but others are not. Talk to your provider to make sure any vaccination you get during pregnancy is safe. Make sure your vaccinations are up to date before you get pregnant.

Protect yourself from Zika: If you get infected with the Zika virus during pregnancy, you can pass it to your baby. It causes a birth defect called microcephaly and other brain problems. Zika virus spreads through mosquito bites and through body fluids, like blood and semen.

  • If you’re pregnant or trying to get pregnant, don’t visit a Zika-affected area unless absolutely necessary.
  • Protect yourself from mosquito bites.
  • If your male or female partner may be infected with Zika, use a barrier method (like a condom) every time you have sex or don’t have sex at all.
  • If you’re pregnant and think you may have been exposed to Zika virus, see your health care provider right away.

Ask someone else to clean your cat’s litter box: If you have to do it yourself, wear gloves. Wash your hands thoroughly when you’re done emptying the litter. Dirty cat litter may contain toxoplasmosis, an infection caused by a parasite. Toxoplasmosis can cause health problems for your baby during pregnancy.

Get tested for sexually transmitted infections (STIs): STIs are infections you can get from having unprotected sex with someone who’s infected. If you’re pregnant and have an STI, it can cause serious problems for your baby, including premature birth and birth defects. Testing for STIs is a part of prenatal care. If you have an STI, getting treatment early can help protect your baby.

Have testing for Group B Strep (GBS): Many people carry Group B strep bacteria and don’t know it. It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, like a bladder or urinary tract infection (UTI). While GBS may not be harmful to you, it can be very harmful to your baby. Your provider tests you for GBS at 35 to 37 weeks of pregnancy. If you have GBS, you’ll receive IV antibiotics during labor and birth.

Talk to your health care provider: Talk to your provider about how to prevent infections, making sure that you’re up-to-date on your vaccinations before pregnancy, and what vaccinations you need during pregnancy.


Antiviral medications for flu during pregnancy

Posted by March of Dimes

This year’s flu season has been particularly bad and shows no signs of letting up soon. Health complications from the flu, such as pneumonia, can be serious and even deadly, especially if you’re pregnant or just had a baby. If you think you may have the flu, contact your health care provider right away. Quick treatment with antiviral medications can help prevent serious flu complications.

How do you know if you have the flu?

Common signs and symptoms of the flu include:

  • Chills
  • Cough or sore throat
  • Feeling very tired
  • Fever
  • Headaches
  • Muscle or body aches
  • Runny or stuffy nose
  • Vomiting (throwing up) and diarrhea (more common in children)

Fever and most other symptoms can last a week or longer. But some people can be sick from the flu for a long time, including children, people older than 65, pregnant women and women who have recently had a baby.

Why is the flu more dangerous for pregnant women?

The flu can be dangerous during pregnancy and up to two weeks postpartum because:

  • Pregnancy affects your immune system. During pregnancy your immune system doesn’t respond as effectively to viruses and illnesses. This means you are more likely to catch the flu.
  • Your lungs need more oxygen during pregnancy but your growing belly puts pressure on your lungs, making them work harder in a smaller space. Your heart is working harder as well. This extra stress on your body can make you more likely to get the flu.
  • You’re more likely to have serious complications, like pneumonia.
  • Pregnant women who get the flu are more likely to have preterm labor and premature birth (before 37 weeks).

What treatment is available?

If you think you have the flu, your health care provider can prescribe antiviral medication. Antivirals kill infections caused by viruses. They can make your flu milder and help you feel better faster. Antivirals can help prevent serious flu complications, like pneumonia. For flu, antivirals work best if you take them within 2 days of having symptoms. But they may still be helpful if started later, so make sure you talk to you provider even if you have been sick for more than 2 days.

In the United States, two medicines are approved for preventing or treating the flu in pregnant women and women who recently had a baby. You can only get them with a prescription so talk to your provider about which one is right for you:

  • Oseltamivir (brand name Tamiflu®)
  • Zanamivir (brand name Relenza®). This medicine is a powder that you breathe in by mouth. It isn’t recommended for people with breathing problems, like asthma.

Can you still get a flu shot?

YES! It’s not too late to get a flu shot. Everyone 6 months and older should get their flu shot every year. The flu shot is safe to get during pregnancy. If you do get the flu, having had a flu shot may make your illness milder and it can reduce the risk of flu-associated hospitalization.

What should you look for in a prenatal vitamin?

Posted by March of Dimes

Your body uses vitamins, minerals and other nutrients to help it stay strong and healthy. During pregnancy it’s hard to get the right amount of some vitamins and minerals just through food. That’s why you should take a prenatal vitamin every day during pregnancy. Taking prenatal vitamins along with eating healthy foods can make sure that you and your baby get the nutrients you both need.

Here’s what you should look for in a prenatal vitamin:

Folic acid: 600 micrograms

Folic acid is a B vitamin that every cell in your body needs for healthy growth and development. Taking it before and during early pregnancy, can help prevent neural tube defects (also called NTDs).

Some foods such as bread, cereal, and corn masa have folic acid added to them. Look for “fortified” or “enriched” on the label.

When folic acid is naturally in a food, it’s called folate. Sources of folate include:

  • Leafy green vegetables, like spinach and broccoli
  • Lentils and beans
  • Orange juice

Iron: 27 milligrams

Iron is a mineral. Your body uses iron to make hemoglobin, a protein that helps carry oxygen from your lungs to the rest of your body. Your body needs twice as much iron during pregnancy to carry oxygen to your baby.

Iron-rich foods include:

  • Lean meat, poultry and seafood
  • Cereal, bread and pasta that has iron added to it (check the package label)
  • Leafy green vegetables
  • Beans, nuts, raisins and dried fruit

Calcium: 1,000 milligrams

Calcium is a mineral that helps your baby’s bones, teeth, heart, muscles and nerves develop.

Calcium is found in:

  • Milk, cheese and yogurt
  • Broccoli and kale
  • Orange juice that has calcium added to it (check the label)

Vitamin D: 600 IU (international units)

Vitamin D helps your body absorb calcium and helps your nerves, muscles and immune system work. Your baby needs vitamin D to help his bones and teeth grow.

Vitamin D is found in foods such as:

  • Fatty fish, like salmon
  • Milk and cereal that has vitamin D added to it (check the package label)

DHA: 200 milligrams

DHA stands for docosahexaenoic acid. It’s a kind of fat (called omega-3 fatty acid) that helps with growth and development. During pregnancy, DHA helps your baby’s brain and eyes develop.

Not all prenatal vitamins contain DHA, so ask your provider if you need a DHA supplement. DHA can be found in some foods including:

  • Fish that are low in mercury, like herring, salmon, trout, anchovies and halibut. During pregnancy, eat 8-12 ounces of these kinds of fish each week.
  • Orange juice, milk and eggs that have DHA added to them (check the label)

Iodine: 220 micrograms

Iodine is a mineral your body needs to make thyroid hormones. You need iodine during pregnancy to help your baby’s brain and nervous system develop.

Not all prenatal vitamins have iodine, so make sure you eat foods that have iodine in them. This includes:

  • Fish
  • Milk, cheese and yogurt
  • Enriched or fortified cereal and bread (check the package label)
  • Iodized salt (salt with iodine added to it; check the package label)

A note about vitamin A….

Your baby needs vitamin A for healthy growth and development during pregnancy. But too much may cause birth defects.

Preformed vitamin A is found in foods such as liver and fish liver oil. You should avoid fish liver oil supplements during pregnancy, but occasionally you can eat a small portion of liver. Very high levels of preformed vitamin A can cause birth defects. You should not get more than 10,000 international units (IU) of vitamin A each day.

Beta carotene is another form of vitamin A found in certain yellow and green vegetables. Beta carotene is not associated with birth defects and is safe to consume.

Talk to your health care provider about getting the right amount of vitamin A from healthy eating and your prenatal vitamin.

Make sure to tell your provider about any additional vitamins or supplements that you take.

Can you get pregnant while on your period?

Posted by March of Dimes

This is a question we often receive through What you may find surprising is that the answer is yes, you can get pregnant while having sex during your period.

Let’s back up for a minute.

Each month your ovaries release an egg about 14 days before the first day of your period. This is called ovulation. When you and your partner have unprotected sex around the time of ovulation, his sperm swim to meet your egg.

When the egg and sperm meet, it’s called fertilization. The fertilized egg (also called an embryo) moves through your fallopian tubes and attaches to the wall of your uterus where it grows and develops into a baby. When the embryo attaches to the uterus, it’s called implantation.

You can get pregnant if you have unprotected sex any time from 5 days before and the day of ovulation.

What if you have sex during your period?

It’s possible for women with a very short menstrual cycle or a very long period to become pregnant by having sex during their period. Many women have cycles that are 28 days or longer. (Your cycle length is measured from the first day of your period and all the days after, until your next period.) But others have shorter cycles, or longer periods, so ovulation can happen right after your period ends. Since sperm can live in your reproductive tract for up to 5 days before ovulation, it’s possible that you could have sex during your period and conceive when you ovulate days later.

If you’re not ready to get pregnant, use birth control until you’re ready. Talk to your health care provider about the right birth control for you.

What are antenatal corticosteroids?

Posted by March of Dimes

Preterm labor is labor that happens too early, before 37 weeks of pregnancy. If you have preterm labor, your health care provider may recommend antenatal corticosteroids to help speed up your baby’s lung development and reduce the chances of some complications.

How do antenatal corticosteroids work?

There are two types of corticosteroids that may be used if you’re in preterm labor, betamethasone and dexamethasone. Both of these steroids help your baby’s lungs produce surfactant. Surfactant is a protein that helps keep the small air sacs in the lungs from collapsing. When a baby is born full-term, her lungs produce surfactant naturally. But babies born premature do not produce enough surfactant, and that means the air sacs in the lungs do not expand the way they should. This results in premature babies having breathing difficulties.

When should you get antenatal corticosteroids?

The American College of Obstetrics and Gynecology (ACOG) recommends a single course of corticosteroids for pregnant women who are at-risk of premature birth within the next 7 days. This includes women whose membranes have ruptured and women pregnant with twins or other multiples. If you’re pregnant and at-risk for giving birth early, talk to your health care provider and discuss the best treatment options for your specific situation.

Are antenatal corticosteroids effective?

If you’re in preterm labor and you receive antenatal corticosteroids, your baby’s chances of having certain health problems after birth are reduced, including:

  • Respiratory Distress syndrome (RDS). This is a breathing problem most common in babies born before 34 weeks of pregnancy. Babies with RDS don’t have enough surfactant and it results in breathing problems.
  • Intraventricular hemorrhage (IVH). This is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid.
  • Necrotizing enterocoloitis (NEC). This is a problem with a baby’s intestines. It can cause feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature birth.

Are there side effects?

Possible side effects of medicines like betamethasone and dexamethasone for mom may include fluid build-up in the body and increased blood pressure. There are no side effects for your baby.

If you’re at risk of giving birth early, talk to your provider about antenatal corticosteroids and how they may be able to help your baby. You can learn more about other treatments for preterm labor on our website. And all pregnant women should learn the signs and symptoms of preterm labor. If you have even one sign or symptom, call your health care provider. If you’re having preterm labor, getting help quickly is the best thing to do.

Congenital heart defects: how do you know if your baby has one?

Posted by March of Dimes

Nearly 1 in 100 babies (about 1 percent or 40,000 babies) is born with a heart defect in the United States each year. About 4,800 babies each year are born with critical congenital heart defects or CCHD.

CCHD is a group of the seven most severe congenital heart defects. Many heart defects don’t need treatment or can be fixed easily. But some, like CCHD, can cause serious health problems or death. Babies with CCHD need treatment within the first few hours, days or months of life.

Severe congenital heart defects usually are diagnosed during pregnancy or soon after birth. Less severe heart defects often aren’t diagnosed until children are older.

During pregnancy

Your provider may use a test called fetal echo to check your baby’s heart. This test makes a picture of your baby’s heart while still in the uterus (womb). You can have this test as early as 18 to 22 weeks of pregnancy.

You may need a fetal echo if:

• Your provider finds a possible problem, like your baby has an abnormal heart rhythm, during an ultrasound.
• You have a medical condition, like diabetes or lupus, that may play a role in congenital heart defects.
• You have a family history of congenital heart defects or heart disease.
• Your baby has a chromosomal condition, like Down syndrome, Turner syndrome or VCF.

After birth

Your baby may be tested for CCHD as part of newborn screening before he leaves the hospital after birth. 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. Ask your provider if your state tests for CCHD. Or check for what your state covers.

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.

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

• Fast breathing
• Gray or blue skin coloring
• 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 (extra or abnormal sounds heard during a heartbeat)

If your baby shows any of these signs or symptoms, call her health care provider right away. Your baby’s provider can use additional tests to check for heart defects.

Take steps to prevent flu

Posted by March of Dimes

Flu activity increased again last week and the flu remains widespread throughout the United States. And according to CDC, flu activity is likely to remain elevated for several more weeks. So what can you do? Here are some steps that you can take to prevent the flu:

Get your flu shot!

  • It’s still not too late to get a flu shot. Everyone 6 months and older should get their flu shot every year.
  • CDC recommends that everyone, 6 months and older, get a flu shot, especially people who are at high risk of developing serious complications. This includes:
  • Children younger than 6 months are too young to be vaccinated but are still at high risk of serious flu complications. Make sure that you and anyone else who cares for your baby is vaccinated.
  • A flu shot may make your illness milder if you do get the flu. A flu shot can also reduce the risk of flu-associated hospitalization, including among children and older adults.

Prevent the spread of germs.

  • Wash your hands with soap and water regularly or use an alcohol-based hand sanitizer.
  • Avoid contact with people who are sick.
  • Cover your nose and mouth with a tissue when you sneeze or cough. Throw the tissue away after you’ve used it.
  • Avoid touching your nose, mouth and eyes.
  • If you’re sick, stay home and limit contact with others as much as possible.
  • Clean and disinfect surfaces and objects that can be contaminated with germs.

Take antivirals if they are prescribed.

  • If you get the flu, antiviral medications can make your flu milder and help you to feel better faster.
  • Antivirals can also help prevent serious flu complications, like pneumonia.
  • Antivirals work best if you take them within 2 days of having symptoms.
  • If your baby is at high risk for flu, his provider may prescribe an antiviral as soon as he begins to have flu symptoms. All children younger than 5 are at high risk for flu, especially children younger than 2. Children who were born prematurely (before 37 weeks of pregnancy) or who have chronic health conditions, like asthma or sickle cell disease, also are at high risk.
  • In the U.S, there are two medicines approved for preventing or treating the flu in pregnant women, women who recently had a baby, and children.
    • Oseltamivir (brand name Tamiflu®). This can be used in children as young as 2 weeks.
    • Zanamivir (brand name Relenza®). This is approved for individuals older than 5. This medicine is a powder that you breathe in by mouth. It isn’t recommended for people with breathing problems, like asthma.

If you or your baby have any signs or symptoms of the flu, including fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue, call your health care provider right away. Early treatment can help to prevent serious flu complications.

Your heart health and pregnancy

Posted by March of Dimes

If you have a condition related to your heart, such as high blood pressure or heart disease, you may be worried about how it could affect a pregnancy. The good news is that by taking precautions and managing your health now, you and your health care provider can make sure you’re ready for pregnancy.

High blood pressure

A condition such as high blood pressure can cause preeclampsia and premature birth during pregnancy. High blood pressure can put extra stress on your heart and kidneys. This can lead to heart disease, kidney disease and stroke. But managing your blood pressure can help you have a healthy pregnancy and a healthy baby. If you have high blood pressure, reach out to your health care provider at a preconception checkup. This is a medical checkup you get before pregnancy to take care of health conditions that may affect your pregnancy.

You can also:

  • Get to a healthy weight. Talk to your provider about the weight that’s right for you.
  • Eat healthy foods.
  • Do something active every day.
  • Don’t smoke. Smoking during pregnancy can cause problems for your baby, like premature birth. It’s also dangerous for people with high blood pressure because it damages blood vessel walls.

Heart disease

Women with heart disease can have a safe pregnancy with minimal risks. However during pregnancy, your heart has a lot more to do and this extra stress can be a concern.

If you have a congenital heart disease, the best thing you can do is to talk to both your cardiologist and obstetrician before you get pregnant. This will allow you to understand what risks (if any) are involved for your pregnancy. You can also determine if there are any concerns with your heart that need to be fixed prior to pregnancy such as any surgical repairs or medication changes.

Speaking of…

Be sure to ask your provider about any medications you are currently taking at your preconception checkup. Many heart conditions require medications to be controlled and your provider can help you choose one that’s safe for you and your baby.

Bottom line

Taking these steps now will allow you to manage any conditions before you conceive to make sure you’re healthy when you get pregnant.

Fever and pregnancy

Posted by March of Dimes

A fever is an increase in your body temperature. It usually happens when you’re sick and is a sign that your body is fighting off an infection. The average body temperature is 98.6°F (37°C). For a woman who is pregnant, a body temperature over 101°F (38.3°C) may be a concern. Fevers early in pregnancy may be linked to birth defects, like neural tube defects, and other problems in your baby. A birth defect is a health condition that is present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. Neural tube defects are birth defects of the brain and spinal cord.

Signs and symptoms

Aside from an increase in body temperature, other signs and symptoms of a fever may include:

  •  Sweating
  • Chills and shivering
  • Headache
  • Muscle aches
  • Loss of appetite
  • Irritability
  • Dehydration
  • General weakness


If you’re pregnant and have a fever, it’s very important to contact your health care provider. She can then determine what is causing your fever and if you need additional treatment. Most pregnant women can take acetaminophen (such as Tylenol®). Make sure you follow the directions on the product label and check with your provider before you take any medication.


Here are some tips that you can take that may reduce your chances of getting sick:

  • Wash your hands often with soap and water. Wash hands before preparing or eating food, after handling raw meat, raw eggs or unwashed vegetables. Wash them after being around pets or animals and after changing diapers or wiping runny noses.
  • Get your flu shot. It’s safe to get the flu shot during pregnancy. It protects you and your baby from serious health problems during and after pregnancy.
  • Try to avoid people who are sick. If you’re sick, stay home. Don’t share your dishes, glasses, utensils or toothbrush.
  • Make sure you’re up to date with all your vaccinations. Vaccinations can help protect you and your baby from certain infections during pregnancy.
  • Handle foods safely. And avoid raw meat, fish, eggs & unpasteurized foods to prevent food poisoning.

Again, make sure you contact your health care provider if you have a fever and are pregnant. Your provider can make sure that you get the treatment you need to help you to start feeling better.