Posts Tagged ‘medications’

Antidepressant use and the risk of ASD

Friday, December 18th, 2015

medication bottlesA new study suggests that the use of antidepressants during pregnancy, specifically in the second and third trimesters, may increase the risk of autism spectrum disorder (ASD) in children.

While these findings help to add to our understanding of autism, it is important to recognize that this study does not prove that antidepressant use causes autism. It is difficult to determine whether the increased risk of ASD is the result of antidepressants or the result of the underlying depression.

Researchers looked at data from more than 145,000 births between 1998-2009. They found that when mothers took antidepressants during the second and third trimesters, the chance that the child would develop ASD was higher when compared to children whose mothers did not take antidepressants. Keep in mind that the overall risk of having a child with autism is 1%. This study suggests that the risk increases to 1.87% if a woman is taking certain antidepressants.

The increase was seen with a specific type of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most commonly prescribed antidepressant medicines and include medications like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®).

There are a number of causes of ASD but we don’t know all of them. More research is needed. However, there are some factors that we know increase the chance of ASD:

  • Having pregnancy complications. Some research shows that there may be a link between ASD and pregnancy complications that lead to low birthweight, premature birth or cesarean birth.
  • Taking certain prescription medicines, like valproic acid or thalidomide, during pregnancy. Taking these medicines during pregnancy has been linked with a higher risk of having a child with ASD.
  • Having an older parent. Babies born to older parents are more likely to have ASD.
  • Having genes linked to ASD. Researchers are studying a number of genes that may be linked to ASD. Children who have a brother or sister with ASD are more likely to have ASD themselves.
  • Having a genetic or chromosomal condition. ASD happens more often in children who also have certain genetic or chromosomal conditions, like fragile X syndrome or tuberous sclerosis.

Important:  If you are pregnant or thinking about getting pregnant and are taking antidepressants, you should not stop taking them until you talk to your health care provider. Together you can look at the possible risks of these drugs on your baby as well as the risk of having your depression come back if you stop taking your medicine. Learn as much as you can about the medicines so you can make the best choice for you and your baby.

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

Keeping breast milk safe

Monday, August 3rd, 2015

mom breastfeedingThere are a few things you need to take into consideration if you are breastfeeding or pumping your breast milk, in addition to
avoiding alcohol while breastfeeding.

Caffeine

Consuming coffee, tea and caffeinated sodas in moderation is fine if you are breastfeeding or pumping. If you find that your baby is fussy or irritable when you consume a lot of caffeine (usually more than 5 caffeinates beverages per day) you should consider decreasing your consumption. Keep in mind that caffeine can be found in:

• Coffee and coffee-flavored products, like yogurt and ice cream
• Tea
• Soft drinks
• Chocolate and chocolate products, such as syrup and hot cocoa
• Medications used for pain relief, migraines and colds

The amount of caffeine in different products varies as well, depending on how it was prepared and served (such as an espresso or latte beverage.) Make sure you check packaging for the number of milligrams of caffeine in one serving.

Mercury

You probably knew during your pregnancy to avoid eating fish that contains high amounts of mercury such as shark, swordfish, king mackerel and tilefish. The same is true while you are breastfeeding. Including fish in your diet is a good way to get protein and healthy omega-3 fatty acids, so eat fish that contain less mercury, like canned light tuna, shrimp, salmon, Pollock and catfish.

Medications

Some prescription medicines, such as those to help you sleep, painkillers and drugs used to treat cancer or migraine headaches, aren’t safe to take while breastfeeding. Others, like certain kinds of birth control, may affect the amount of breast milk you make. Read our post on medications and breastfeeding and speak with your provider about any over-the-counter and prescriptions medications you are taking.

Medical conditions

Certain medical conditions can make breastfeeding unsafe for your baby. These include:

• If your baby has galactosemia, a genetic condition where your baby can’t digest the sugar in breast milk.
• If you have HIV.
• If you have cancer and are getting treated with medicine or radiation.
• If you have human T-cell lymphotropic virus. This is a virus that can cause blood cancer and nerve problems.
• If you have untreated, active tuberculosis. This is an infection that mainly affects the lungs.
• If you have Ebola, a rare but very serious disease that can cause heavy bleeding, organ failure and death.

Smoking and street drugs

Don’t smoke. Nicotine, a drug found in cigarettes can pass to your baby through breast milk and make him fussy and have a hard time sleeping. It can also reduce your milk supply so your baby may not get the milk he needs.

Don’t take street drugs, like heroin and cocaine. You can pass these substances to your baby through breast milk.

Tell your provider if you need help to quit smoking or using street drugs.

Bottom Line

Don’t be afraid to ask for help. If you need support, read our article on how to receive help with breastfeeding.

 

 

Painkillers and pregnancy don’t mix

Friday, January 23rd, 2015

pregnant2Did you know that a significant number of women of childbearing age fill prescriptions for narcotic painkillers each year? If a woman becomes pregnant while taking these medications, she is at an increased risk of having a baby with birth defects.

Opioid-based (narcotic) pain medications, such as codeine, oxycodone, hydrocodone, or morphine, are used to treat moderate to severe pain. Many women are unaware that the use of these medications during pregnancy, even when used as directed, may increase their chance to have a baby with a serious birth defect of the brain, spine, or heart. They also have an increased risk of preterm birth.  Use of opioid-based painkillers during pregnancy can also cause babies to suffer withdrawal symptoms when they are born. This is a condition known as neonatal abstinence syndrome or NAS, and it is a growing problem in U.S. birthing hospitals.

A new report from the CDC found that on average, about 28% of privately insured and 39% of Medicaid-enrolled women of child-bearing age filled a prescription for an opioid between 2008-2012.

Since half of all pregnancies are unplanned, women may be prescribed opioid-based pain medications before they know they are pregnant.  “This highlights the importance of promoting safer alternative treatments, when available for women of reproductive age. We must do what we can to protect babies from exposure to opioids,” stated Coleen A. Boyle, PhD, MSHyg, Director of CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD).

“If you are using an opioid painkiller, you should also be practicing effective birth control, “ says José F. Cordero, MD, MPH, a pediatrician, birth defects expert formerly at CDC, and member of the March of Dimes Board of Trustees. “If you decide to get pregnant or do become pregnant, tell your health care provider about all the medications you are taking, right away. You may be able to switch to a safer alternative.”

The CDC’s Treating for Two: Safer Medication Use in Pregnancy initiative offers information to women and their healthcare providers about medication use during pregnancy. Go here to get more information.

Prescription drugs: new FDA labeling rules will help pregnant women

Friday, December 5th, 2014

prescription medsCurrent FDA guidelines about medication safety during pregnancy can be very confusing for women and their health care providers. Soon, however, doctors will have access to more information about the safety of prescription drugs during pregnancy.

When you are pregnant, you try to avoid anything that may harm your baby. But sometimes, you need to take medications for your own health. Managing chronic conditions like diabetes, asthma, and high blood pressure is very important, especially during pregnancy. But it is often difficult to know what medications are safe. And current FDA safety categories can be very confusing and difficult to understand.

However, in the summer of 2015, drug manufacturers will need to start providing additional details about medication safety in pregnant and breastfeeding women. The new labels will have to state how the safety information was obtained and whether the data was the result of scientific studies in people, or if it was obtained through study of animal models. The manufacturers must also include how much of the drug is excreted in breast milk and whether it affects the nursing baby, as well as how the drug may affect future fertility for both men and women of reproductive age.

These changes in labeling will provide doctors with more information about a medication’s safety during pregnancy. The information will not be on the actual medication bottle. It will be included in the official drug labeling information that doctors use when prescribing medications. It may also be included in the printed materials that pharmacies often include when filling prescriptions. This change in labeling does not apply to over-the-counter medications, though.

The new guidelines will allow doctors and patients to weigh the pros and cons of which medication is best to take during pregnancy for a given condition based on scientific evidence. And it will provide doctors and patients with more safety data than has previously been readily available.

The March of Dimes hails the release of the FDA’s final rule on pregnancy and lactation drug labeling information for prescription drugs. According to Dr. Jennifer Howse, president of the March of Dimes the new rules “will drive critical improvement to prescription drug labels regarding known effects on pregnancy, breastfeeding, and fertility.  The rule takes vital steps to improve the organization, readability, and usefulness of this information, which will enable women and their providers to find it and use it more readily….It is important to note, however, that this rule is only a first step, and it does not address other crucial issues related to pregnancy, lactation, and prescription drugs. The March of Dimes looks forward to working with the FDA and other interested stakeholders to ensure that appropriate research is performed and data generated to allow women and their health providers to make fully informed decisions about medication and its expected impact on pregnancy, lactation and childbearing.”

Summer to September

Wednesday, August 28th, 2013

going-to-daycareIt is usually hard for kids to adapt to a different schedule. For kids with challenges, it can be…well…even more challenging.

Here are some tips to help you get through the transition from the more carefree days of summer to the structure of the school year – whether your child is in day care, preschool or beyond:

• Meet the teacher and visit the classroom – If your child has an IFSP, IEP or 504 plan, be sure that the teacher is familiar with the plan and is prepared for your child’s arrival. Hopefully, you and your child have already met the new teacher and you feel comfortable with the transition plan. If not, now is the time to ask for an appointment with the teacher or the IEP team. Usually kids with special needs are allowed to visit their classrooms before the first day of school, to help them become familiar with the upcoming change.

• Change bedtime hours slowly – As tempting as it is to let your little one remain outside to take advantage of every moment of daylight in the evening, start winding back his bedtime routine now. If you make changes in quarter hour chunks it will be less of a shock to your child’s system. For instance, if “bath, books and bed” usually began at 8:00 this summer, start the process at 7:45 for a night or two, and then move it to 7:30, etc. Use room darkening shades or curtains that block the light to help your child realize that it is nighttime.

• Create a “special space” – Having a quiet, secluded spot where your little one can go to decompress can be very helpful. It can be in his room or somewhere in your home. It can even be under the dining room table! Often a beanbag chair or a blanket with 2 or 3 pillows, and a few books or special toys will help to calm your child. He can learn to go to his special space to unwind and quiet himself.

• Turn off the computer – There is a time and place for everything. If your child needs help unwinding before bedtime, or when you need to leave the house to go to daycare or school, turn off all electronics. Use a timer if you need to help you with this task. When the timer goes off, then the computer goes off.

• Meds adjustment – If your child needs medication to function at daycare or school (but he was not on the meds during the summer), be sure to talk with his doc about how to start up again. If possible start the meds a few days before school begins, to help with the adjustment and to re-check possible side effects.

• A united front – You and your partner need to agree about your parenting plan. There is nothing more confusing to a little child than hearing “yes” from Mom but “no” from Dad. Try to anticipate issues and arrive at decisions ahead of time (and out of Junior’s hearing), and then stick with the plan.

• Save the worrying – You may be consumed with worry before your little one embarks on a new year in a different class.  Even day care centers may have a different teachers and classrooms each year. Kids with special needs often have extra difficulty adapting to change…but sometimes they surprise you. Your little one may embrace the newness of the classroom or providers and all that worry was for nothing. So, don’t worry until you have to. Kids tend to pick up on a parent’s anxiety. The calmer you are – the calmer your child may be.

• Cut yourself some slack – Let’s face it, even parents have trouble transitioning from summer to September! So, give yourselves a few weeks to fully adjust to the change. And, have plenty of patience (deep breathing anyone?) as you and your child struggle to say good bye to the lazy days of summer.

What has worked for you when your little one faced big changes?

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It began in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the menu on the right side to view all of the blog posts to date. As always, we welcome your comments and suggestions for future topics.

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

Valproate for migraines is unsafe during pregnancy

Tuesday, May 7th, 2013

 

The U.S. Food and Drug Administration (FDA) is warning women and their health providers that Valproate products, a group of medicines normally used to treat seizures, is unsafe for pregnant women to use to treat migraines. A recent study found that the products may harm brain development in babies, leading to lower IQs than healthy babies later in life. FDA also says women who aren’t pregnant and are using Valproate products should use birth control.

Valproate products are usually used to treat epilepsy, a brain disorder that causes you to have frequent seizures, and bipolar disorder, a serious mental illness that leads to unusual mood changes. FDA says that Valproate products may still be used to treat epilepsy and bipolar disorder in pregnancy, but only if no other treatment is suitable.

If you’re pregnant or thinking about getting pregnant, talk to your health provider about any medicines you take. Some medicines you take can hurt your baby. Once you’re provider knows what medicines you take, she can tell you which ones are safe and which ones you need to stop taking.

Learn more about the FDA announcement on Valproate.

 

Medications and pregnancy

Wednesday, September 7th, 2011

pills-2You may have seen a lot of news coverage on a study linking some over-the-counter pain relievers to miscarriage. The Canadian study found that using non-steroidal anti-inflammatory drugs (NSAIDs), which can be found in common pain relievers like Advil®, Motrin® and Aleve®, can put women at risk for miscarriage if taken in early pregnancy.

While more research needs to be done on the safety of these pain relievers during pregnancy, it’s a good time to remember to talk to your health provider before taking any medicines during pregnancy. If you’re already taking medication to keep you healthy, talk to your provider to make sure it’s safe to continue taking the medication during pregnancy. Your provider may want to keep you on the same medicine or switch you to a safer medicine during pregnancy.

Learn more about medicines and other drugs, herbs and dietary supplements during pregnancy.

Birth defects prevention

Friday, January 7th, 2011

January 2011 is National Birth Defects Prevention Month.  This year’s theme is Medication Use Before, During, and After Pregnancy.

While most birth defects cannot be prevented because their causes are not known, women can take a number of steps before and during pregnancy to reduce their risk. These steps include taking a multivitamin containing 400 micrograms of folic acid daily starting before pregnancy and in early pregnancy. This helps to prevent serious birth defects of the brain and spinal cord, including spina bifida, and may also help prevent heart defects. Another step is getting a pre-pregnancy check up and making sure that the medications you are taking are safe to use during pregnancy.

Talk with your health care provider and pharmacist about your medications.  For the most current information about medications (prescription or over-the-counter), drugs, vaccines, chemical or environmental agents and their potential risks, we suggest that you contact a Teratology Information Service (TIS).  A teratogen is any agent or substance that can affect fetal development.  To answer questions properly, it is sometimes necessary to know how far along in her pregnancy a woman was when she came in contact with the substance, what medications she was taking at the time, some of her medical history, etc.  Trained professionals in the field of teratogens can answer your specific questions while maintaining your anonymity. They also can tell you if a medication is safe to use while breastfeeding. The national toll-free phone number to call is 866-626-6847.

Antibiotics – when to use and when to avoid them

Friday, October 3rd, 2008

October 6-10 is the first Get Smart About Antibiotics Week. It is designed to help all of us learn when it is appropriate and safe to take an antibiotic or give one to our children.

Often parents see a child with a cold (sore throat, sneezing, runny or stuffy nose, flu symptoms) and they want the doctor to prescribe an antibiotic, “the magic medicine,” to make it go away.  There usually is no such medicine, but sometimes a doctor will comply with the request to please the troubled parent.  The fact is that most colds and flu, even most cases of bronchitis, are caused by viruses and antibiotics do not work on viruses – they fight bacteria.

Taking an antibiotic for a virus can cause more harm than good.  It won’t cure the problem or make you feel better (time will likely do that), but it may encourage your body to begin building up a resistance to the antibiotic.  If resistance occurs and you end up requiring the antibiotic for a bacterial infection in the future, it may not work for you.  That’s why it is important to take antibiotics only when they are appropriate and not to ask for them “just to be safe.”  The CDC has some very good information about when to use antibiotics.

And while we’re on the subject of medications, remember not to give over-the-counter cough and cold products to infants and children younger than 2 years of age. According to the U.S. Food and Drug Administration, these medications can have serious and life-threatening side effects.  Read more about over-the-counter medications.

Gotta take my meds

Tuesday, September 9th, 2008

I can’t believe how expensive things are now! I’m not buying any more stuff than I usually need.  But it seems every time I see the cashier scan another item, my heart races as the total price keeps going up.  I’ve tried cutting back on expenses and taking advantage of coupons and that’s helped.  But there are some things I just can’t cut back on, like prescriptions.

The Wall Street Journal had an article last week about how more people are cutting back on their prescribed medications.  Folks are either cutting pills in half or not buying them at all in order to save money.  The trouble is that if you cut back on a necessary medicine, you could really do yourself harm.  Even if you don’t see any changes immediately, your body could suffer greatly in the long run.

Some prescriptions are available in generic versions, which are much more affordable than the brand name meds.  Whenever my health provider prescribes me with a new medication, I always ask her or my pharmacist for the generic kind.  Doing so helps cut down on the cost.  I also talk to my health provider to find out what other alternatives, if any, might help me.  I’m fighting allergy season right now and in addition to my allergy meds, I’m going to try clearing my sinuses with warm salt water and maybe get a humidifier.  Of course, whenever my husband and I decide to try for a baby, I’ll have to talk with my health provider just to make sure I can still take my prescription meds during pregnancy.  But I won’t stop taking them without checking with her first.

Anyone have any other tips for dealing with prescription costs?

Image: Darren Hester, Flickr