Your developing baby

18
Mar
Posted by Sara

There are specific times during a baby’s development when a certain body part is especially vulnerable to damage from harmful substances and exposures. These substances can include alcohol, medications, and cigarette smoking. The chart below shows these critical periods. If something interferes or disrupts development during these times, the result may be a birth defect.

developing baby

*Image courtesy of NOFAS.

Birth defects

The dark blue segments on the picture above show when certain body parts are most at risk for major birth defects. Major birth defects cause significant medical problems and may require surgery or other treatment. Some examples of major birth defects include heart defects and spina bifida.

The light blue sections of the chart show periods when fetal development is susceptible to minor birth defects and functional defects. Minor birth defects do not cause significant problems and usually do not require medical intervention, such as treatment or surgery. Minor birth defects include things like the shape of the ears or certain facial features. Functional defects affect how a part of the body works. For example, hearing loss can be a functional defect.

Timing of exposures

According to MotherToBaby, “Harmful exposures during the first trimester have the greatest risk of causing major birth defects. This is because of the many, important developmental changes that take place during this time. The major structures of the body form in the first trimester. These include the spine, head, arms and legs.  The baby’s organs also begin to develop. Some examples of these organs are the heart, intestines and lungs.”

While exposures during the first trimester do pose the greatest risk of birth defects, exposures during the second and third trimester can cause problems with growth as well as minor birth defects. Factors that affect growth can put babies at risk for other health problems.

The brain continues to develop throughout pregnancy, after the baby is born, and into young adulthood. Harmful substances and exposures during the second and third trimester can cause developmental delays and learning disabilities.

Planning for pregnancy is important

Looking at the chart above, it is easy to see why preconception care is so important. Crucial fetal development happens very early in pregnancy– in many cases, before a woman even knows that she is pregnant. Seeing your health care provider BEFORE pregnancy and discussing any medications you are taking and underlying medical conditions, like diabetes or high blood pressure, can help you be better prepared for pregnancy and to reduce your risk of birth defects.

*We would like to thank the National Organization on Fetal Alcohol Syndrome (NOFAS) for allowing us to use their fetal development chart. Please visit their website for more important information about fetal alcohol spectrum disorders.

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

 

Pneumonia and preemies

16
Mar
Posted by Barbara

BabyOnChest-Pneumonia is an infection in the lung(s) which can make it hard to breathe. Premature infants are more prone to developing infections due to their immature immune systems. They were born before they could acquire their mother’s antibodies to fight off infection, which are usually transferred in the third trimester. In addition, due to prematurity, their lungs are not fully formed, making it easier to develop infections such as pneumonia.

Causes and treatments

Pneumonia can have different causes: viral, bacterial or even fungal. It can be hard for doctors to diagnose pneumonia, as it can look like other common preemie disorders, (eg. Respiratory Distress Syndrome). In addition, it may take some time for blood, urine or other lab tests to confirm the diagnosis. Therefore, as soon as pneumonia is suspected, most babies will receive an antibiotic that can fight a broad spectrum of bacteria to help combat the infection. Once the tests confirm the type of infection, the medication may be altered.

Your baby may also receive oxygen to help him breathe easier, or he may be placed on a ventilator. Keeping your baby well hydrated and nourished are also top priorities – his body needs nutrients to fight the infection. With all of this treatment, your baby’s lungs can begin to repair themselves.

Can pneumonia be prevented?

A premature baby may develop different infections for the reasons noted above. But the spread of infections can be avoided through the use of proper hygiene. Visitors who come to the NICU should be free from illness (colds, sore throats, coughs). All visitors should wash hands thoroughly or use foam disinfectant before seeing or touching your baby.

Some infections can spread through the air. Having visitors wear a face mask that covers the nose and mouth can provide an added layer of protection for your baby. NICU staff follows strict protocols regarding hand washing and keeping equipment squeaky clean. They are aware of how to prevent the spread of germs.

The good news

Most babies respond well to medications and recover without lasting issues.

Have questions? Send them to AskUs@marchofdimes.org

Pregnant? Feeling forgetful? Absentminded?

14
Mar
Posted by Lauren

Pregnant with mugYou may be experiencing “pregnancy brain” also referred to as “momnesia.”  We hear from many women that they have a hard time concentrating and experience forgetfulness during their pregnancy and after their baby is born. So what exactly is going on?

Unfortunately, there has been limited research conducted on the effects that pregnancy has on memory. And research findings are inconsistent. However, we do know that your hormones are increased during pregnancy, which may have an effect on your mind as well as your body.

In addition, many pregnant women and new moms are busy, stressed and tired, which greatly affects one’s ability to remember things. It is hard for your mind to stay sharp when you are exhausted.

So what can you do to help with pregnancy brain?

  • Prioritize what’s necessary for the day and concentrate on those tasks. Better yet, decide on 3 “must do” tasks for the day and focus on those. Anything beyond that needs to wait til tomorrow.
  • Simplify your life; get help with your to-do list by designating tasks to your partner, friends and family.
  • Keep a detailed calendar for events and appointments. Having a post-it notepad handy for to-do lists, reminders and phone numbers helps a lot!
  • Get more sleep. This may be difficult, but what you probably need is more zzzz’s. Take a quick nap whenever you can or ask your partner/family member or friend to watch your baby for an hour while you lie down. Make sleep a priority.
  • Keep keys and other important items in designated areas in your house so you can easily find them.
  • Eat well and drink plenty of water. Good nutrition doesn’t only feed your body – it feeds your brain, too!

Have you experienced pregnancy brain? Share your tips and tricks.

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

HIV and pregnancy – reducing the risk of passing it to your baby

10
Mar
Posted by Sara

third trimesterIf women are tested and diagnosed with HIV infection before or early in their pregnancy, they can be given medication to improve their own health and reduce the risk of transmitting HIV to their baby. When HIV is diagnosed before or during pregnancy, the risk of a woman passing it to her baby can be reduced to less than 1% if appropriate medical treatment is given and breastfeeding is avoided.

More than 1 million people in the United States live with HIV. HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome or AIDS.  HIV attacks specific cells in the body’s immune system. The immune system helps to fight off infections. Even with treatment, it is not possible for HIV to be eliminated completely from the body. So once you get HIV, you have it for life.

Over time, HIV can destroy so many cells in the immune system that the body can’t fight off infections and disease anymore. When this happens, HIV can lead to AIDS.

Testing for HIV

Approximately 18% of all people with HIV do not know their HIV status. This means that many women who are infected with HIV may not know they have it. The Centers for Disease Control (CDC) recommends routine opt-out HIV testing for all pregnant women. This means that pregnant women are typically tested for HIV at their first prenatal appointment unless they say that they do NOT want to be tested. The CDC also recommends getting tested again later in pregnancy if a woman is at risk for getting HIV.

HIV transmission during pregnancy

Women who have HIV can pass it to their babies. This is called perinatal transmission. Babies can get HIV from their mothers:

  • Before birth, when the virus crosses the placenta and infects the baby.
  • During labor and delivery from contact with their mother’s blood and vaginal fluids.
  • Through breastfeeding.

Treatment

Medications cannot cure HIV but they can treat it and slow the progression of the disease. These medications are called antiretrovirals (ARV). ARVs can keep someone with HIV healthy for many years.

If you’re pregnant, get tested for HIV. Proper treatment can significantly reduce your chances of passing HIV to your baby.

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

The A’s and B’s of the NICU

09
Mar
Posted by Barbara

help-breathingApnea (A) and bradycardia (B) are two conditions that are monitored in the NICU. Apnea refers to an interruption in your baby’s breathing, while bradycardia is the slowing of your baby’s heart rate.

Babies in the NICU are constantly monitored for these “A’s and B’s.”

Premature babies often have breathing problems because they were born before their lungs were fully developed. As many as 80 percent of babies born before 30 weeks of pregnancy have apnea. Full-term babies may have breathing problems due to birth defects, infections or complications from labor and delivery.

When is irregular breathing considered apnea?

Often, preemies do not breathe regularly. Your baby may take a long breath, a short one, and then pause for 5-10 seconds before breathing regularly. This is not considered harmful and your baby should outgrow it. But, if a preemie or sick baby stops breathing for 15 – 20 seconds or longer, or if the pause in breathing happens along with a slower heart rate (bradycardia) or a change in your baby’s color, then it is called apnea.

A premature baby’s heart beats much than faster yours. Bradycardia is defined as “the slowing of a baby’s heart rate from its usual range of 120 to 160 beats per minute to a rate of fewer than 100 beats per minute” according to the authors of the Preemies book.

The sensors on your baby’s chest are connected to a machine which will start beeping if your baby stops breathing. The nurse will check your baby and determine if she needs to be stimulated to help her start breathing again. To resume breathing, the nurse may gently touch your baby.

If necessary, your baby’s neonatologist may give your baby medication or place her on a C-PAP machine to help deliver air to your baby’s lungs. In C-PAP (continuous positive airway pressure), air is delivered to your baby’s lungs either through small tubes in her nose or through a tube that has been inserted into her windpipe. The tubes are attached to a machine, which helps your baby breathe. With C-PAP, your baby breathes on her own, but the steady flow of air coming in through the tubes keeps enough pressure in her lungs to prevent the air sacs from collapsing after each breath. It’s a little extra support to help her lungs work better.

Machines can be scary

Seeing your baby hooked up to machines can be scary, and when those machines start to beep, it can be nerve wracking. But, the way your baby looks is a very important indicator of how she is doing. For example, some experts recommend that when machines start beeping, take a look at your baby, not at the machine. Is your baby pink? Is her chest moving in and out? Are her nostrils slightly widening with each breath? If so, she is breathing and getting oxygen.

In addition, the machines are set up to start beeping with plenty of time for the nurse to attend to your baby, before your baby is in distress.

If your baby’s apnea is not resolving, the medical team will consider whether there is something else going on, such as an infection or other problem. As difficult as it is to see your baby struggle with breathing, it may be very comforting to know that apnea usually resolves without any problems.

Have questions? Send them to AskUs@marchofdimes.org. We are here to help.

Did your baby experience apnea? Did it resolve on its own?

 

Eat, sleep, and repeat

07
Mar
Posted by Lauren

sleepAs your belly is getting bigger, your hours of sleep may be getting smaller. Lack of sleep is a common complaint we hear from pregnant women. Trying to get comfortable, rearranging pillows and having to get up to use the bathroom are only a few of the culprits that can cause lack of sleep.

But getting a good night’s sleep is crucial– just as important as eating nutritious food and drinking enough water. Eating, staying hydrated and sleeping are the foundations to good health and a happy pregnancy.

Trouble sleeping doesn’t just happen late in pregnancy though; sleeplessness can happen right from the beginning. The same pregnancy hormone that causes fatigue during the day can disrupt your sleep cycle at night. And if you have added anxiety or stress, this will only increase the problem.

This week, the National Sleep Foundation is celebrating its annual Sleep Awareness Week. If you do not get the sleep you need, your body will probably not operate as it should. Your judgment and reaction times may be negatively affected. Simple things like driving a car can be severely impacted with lack of sleep – it’s as dangerous a combination as drinking alcohol and driving.

So between bathroom trips and rearranging pillows, try to catch up on sleep where you can. Here are tried and true tips, which should help.

For more information on how to get a restful night’s sleep, and when to see a doctor regarding possible sleep problems, see this handy guide.

Have questions?  Email or text AskUs@marchofdimes.org.

Trisomy Awareness Month

04
Mar
Posted by Sara

chromosomes1Have you ever heard of “trisomy”? Trisomy is a chromosomal condition that is the result of a mistake in cell division. 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 something goes wrong before fertilization. A developing egg or sperm cell may divide incorrectly, causing that egg or sperm to have an extra chromosome. When this cell joins with a normal egg or sperm cell, the resulting embryo has 47 chromosomes instead of 46.

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.

Although trisomy can occur with any chromosome, there are a few conditions that are most often associated with an extra chromosome. They are:

  • 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 delay, and other life-threatening medical problems.
  • Trisomy 13, also known as Patau syndrome, 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 problems depend on which chromosome is duplicated and how much of the extra chromosome is present. Health conditions that may be associated with trisomy include heart defects, vision or hearing problems, and intellectual and developmental disabilities.

If your baby or someone in your family has a trisomy, you may want to talk to a genetic counselor. A genetic counselor is a person who is trained to know about genetics, birth defects and other medical problems that run in families. She can help you understand the causes of chromosomal conditions, what kind of testing is available, and your chances of having a baby with these conditions. If you already have a baby with a trisomy, the chances of having another baby with the same condition are usually low.

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

Birth defects research changes lives

03
Mar
Posted by Barbara

March of Dimes invests in birth defects research

Sick babyFor many years, March of Dimes grantees have been seeking to identify genes and environmental factors that cause or contribute to birth defects. For example, in 2015, there were 78 million dollars in active birth defects research grants.

Today is World Birth Defects Day

Understanding the causes of birth defects is a crucial first step towards developing effective ways to prevent or treat them. Some birth defects are caused by a mutation (change) in a single gene. In 1991, Stephen Warren, PhD, a March of Dimes grantee at Emory University in Atlanta, Georgia, identified the gene that causes fragile X syndrome, the most common inherited cause of intellectual disabilities.

Current grantees are seeking to identify genes that may play a role in other common birth defects, such as congenital diaphragmatic hernia (CDH). Others are working on identifying environmental exposures that can cause birth defects. In fact, did you know that in 1973, March of Dimes grantees were the first to link drinking alcohol during pregnancy to a specific pattern of birth defects and intellectual disabilities now known as fetal alcohol spectrum disorders? By understanding the connection between alcohol and birth defects, pregnant moms are now able to have healthier pregnancies.

Many other birth defects appear to be caused by multiple genes and environmental factors, adding to the complexity of understanding their causes. March of Dimes grantees have discovered genes that contribute to heart defects and to cleft lip/palate, both of which are among the most common birth defects.

Please help us raise awareness of this serious global problem and advocate for more, surveillance, prevention, care and research to help babies and children. 

Join us on Twitter #WorldBDDay.

Share your stories and lend your support.

Get ready – tomorrow is World Birth Defects Day

02
Mar
Posted by Barbara

baby with cleft lipEvery parent wants a healthy baby. But, the reality is that many babies are born with birth defects.

Some birth defects are clearly seen at birth. Other times it may be weeks, months or even years before the birth defect is discovered. There are thousands of different birth defects. Some are common while others are rare.

Here are a few facts about birth defects

  • Every 4 ½ minutes, a baby is born with a birth defect in the United States. That’s 1 in 33 babies.
  • About half of all birth defects have no known cause. The other half are caused by genetic conditions (such as cystic fibrosis or sickle cell disease) or a combination of factors.
  • Some birth defects have decreased in prevalence, such as cleft lip and palate, while others have increased, such as gastroschisis.
  • Birth defects are the leading cause of death in the first year of life. Sadly, babies who survive often face a lifetime of disabilities.
  • Birth defects affect all races and ethnicities.
  • Worldwide, more than 8 million babies are born each year with a serious birth defect.
  • Learn what you can do to prevent certain birth defects.

Here’s what’s new

The PUSH! Global Alliance – People United for Spina Bifida and Hydrocephalus -is launching tomorrow for World Birth Defects Day. The mission is to provide a collective global platform for all organizations to work towards research, prevention, care, and improved quality of life for people with spina bifida or hydrocephalus. Check them out at pu-sh.org.

Help us raise awareness

You can observe World Birth Defects Day by participating in social media activities and sharing a story or picture about the impact of birth defects on you and your family.

If you are a health care professional, speak about the steps a woman can take to help lower her risk of having a baby with a birth defect. Lend us your voice! Here’s how:

  • Join the buzzday on Twitter tomorrow, March 3rd – #WorldBDDay
  • Register to be a part of the Thunderclap – a message will be sent out at 9:00 a.m. EST tomorrow to help raise awareness.

The March of Dimes and over 60 other international organizations working for birth defects are joining World Birth Defects Day. We hope you’ll join us, too!

 

The impact of rare diseases

29
Feb
Posted by Lauren

rare-disease-dayIn the U.S., any disease affecting fewer than 200,000 people is considered rare. Today, the last day of February is Rare Disease Day, an international advocacy day to spread awareness of rare diseases and their impact on patients’ lives.

There are nearly 7,000 rare diseases affecting 25 million Americans and 400 million people worldwide. At least 50% of these rare diseases affect children. Rare diseases include many birth defects, genetic disorders and chromosomal abnormalities.

A patient with a rare disease may face severe health outcomes including physical and intellectual disabilities and premature death. Often the lack of scientific knowledge and information on a rare disease can result in a delay in diagnosis. In addition, a rare disease not only affects the individual; it affects an entire family.

Rare Disease Day aims to raise awareness not only to the public, but amongst policy makers, public authorities, researchers and health professionals.  Many advancements in national plans and policies related to rare diseases has been attributed to the awareness that this day has cultivated. There is still much to do, but progress is being made every day toward the development of knowledge, research and treatment advances for rare disease patients.

Do you or someone you know have a rare disease? Feel free to share your story with us.