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Overweight mums linked to infant heart defects

Oct 5

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Women who are overweight or obese when they get pregnant are more likely to give birth to children with congenital heart defects.

The US study, conducted by the US Centres for Disease Control and Prevention, concluded that women who were overweight or obese at the time they became pregnant were 18 percent more likely to give birth to babies with heart defects, while severely obese women had a 30 percent increased risk.

The babies had problems including obstructive defects on the right side of the heart and defects in the tissue separating the heart’s two upper chambers, the researchers reported in the American Journal of Obstetrics and Gynaecology.

“Congenital heart defects are the most common types of birth defect, and among all birth defects, they are a leading cause of illness, death and medical expenditures,” said Dr Edwin Trevathan, a CDC expert on birth defects and developmental disabilities.

The CDC, the US government’s disease watchdog, recommends that overweight women work with their doctors to achieve a healthy weight before pregnancy.

Researchers examined the health of 6440 infants with congenital heart defects and 5673 infants without problems, all of whose mothers were interviewed as part of the CDC’s National Birth Defects Prevention Study.

They assessed obesity according to each woman’s body mass index, or BMI, which relates weight to height. A woman 165cm tall and weighing 86kg would have a BMI of 31.6, while a woman of the same height who weighs 72kg would have a BMI of 26.6.

The researchers defined overweight as a BMI of 25 to 29.9, moderate obesity as a BMI of 30 to 34.9 and severe obesity as a BMI of 35 or above.

The results showed links between obesity and 10 out of 25 kinds of heart defects. Five of the 10 were associated with women who were overweight before pregnancy.

The study accounted for important factors such as maternal age and race-ethnicity. Mothers who had diabetes before pregnancy, a strong risk factor for heart defects, were excluded from the research.

Stuff

Coroner warns against bed sharing – again

Oct 5

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The deaths of three Wellington babies while sleeping beside adults has prompted yet another warning from the coroner.

Wellington coroner Garry Evans called on the Ministry of Health to strengthen guidelines on safe sleeping practices for newborns in May and again in August after investigating the sudden deaths of eight infants.

Another warning has now been issued by fellow Wellington coroner Ian Smith after findings were issued on three more deaths.

Hope Kuti was 10 weeks old and living with her family in Wainuiomata on September 19 last year.

Hope was one of four young children, but at the time of her death only one other – a three-year-old – remained at the house due to “an extensive need for Child, Youth and Family Service (CYFS) to become involved”, Mr Smith said.

He said there had been issues with the parent’s continual domestic violence and neglect and CYFS had not yet been informed of Hope’s birth.

Her mother came home around midnight, going to bed an hour later having drunk upwards of 10 pre-mixed bourbon and colas.

The next morning she discovered Hope lying face down and not breathing.

The three-year-old had since been removed from the house and placed in the care of extended family, Mr Smith said.

A month later, in Cannons Creek, Porirua, Dante Tahuri-Uren died while sleeping on a couch beside his mother .

His mother admitted “spotting” cannabis oil and said they had stopped sleeping in her bed as she did not like the “vibes” upstairs.

They went to sleep at 8.30pm and the mother was woken around 11pm by Dante crying. She woke again at 12.30am and went to change Dante’s nappy but Dante was no longer breathing.

On January 26, 2009, Summer Lamsam was less than three weeks-old, having been born prematurely , when put to bed with her parents in their Porirua home .

She had been sharing the queen-sized bed after refusing to settle in her cot.

When her mother awoke at 4.30am she saw Summer’s father had moved and his back was on the child’s face.

An ambulance was called but Summer could not be revived.

In all three deaths the subsequent coroners’ investigations found the sleeping arrangements were unsafe and likely led to accidental asphyxia.

Mr Smith issued a letter to the Director General of Health, Stephen McKernan, urging that “the public health advice in relation to safe infant care practices and safe sleeping environments be strengthened and broadened”.

He said it should be made clear that bed sharing by adults with infants under six months exposed the child to the risk of death and the safest place for babies to sleep during this period was in a cot beside the parental bed.

The coroners’ warnings followed similar statements from child health experts in December.

Paediatrician Dawn Elder, who studied the last 10 years of unexplained baby deaths in the Wellington region, said work needed to be done on getting information to parents.

Auckland University professor of child health research Evan Mitchell said about half the cases of sudden infant death syndrome occurred in “bed sharing situations”.

South Australian deputy Coroner Tony Schapel also voiced concerns last year, warning against bed sharing as well as placing infants on overly soft mattresses and the use of V-shaped pillows.

Screaming babies – it’s all mum’s fault for fussing

Sep 6

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Screaming babies – it’s all mum’s fault for fussing
12:07PM Sunday Sep 06, 2009
By Susie Mesure
Sleep deprivation is every new parent’s worst nightmare. It is a form of torture that can leave them sobbing louder than their child. Yet a new study claims babies’ sleep problems are all in the mind – the mother’s mind before her child is even born.

Parents have only themselves to blame for all those hours of lost sleep, according to researchers in Israel who found that a mother-to-be’s expectations about infant sleep will affect how her baby sleeps after it is born.

If an expectant mother thinks that babies who cry at night are suffering distress and need comforting and soothing back to sleep, then her newborn is likely to wake more frequently during the night than if she believes babies should learn to settle themselves, according to a study in the latest issue of the journal Child Development.

Expectant mothers who believed crying babies needed their mums – or dads – tended, once their child was born, to be more active in trying to soothe them, cuddle them, feed them or let them snuggle up in the parental bed to try to get their baby back to sleep, the research showed.

The downside, the study found, was that the more a baby’s mum tried to help her child sleep, the worse that child’s sleep then became.

“Increased parental involvement at bedtime and at night predicted a higher number of reported night wakings at 12 months,” said Liat Tikotzky and Avi Sadeh, who followed 85 mothers through pregnancy and the first year of their baby’s life.

The flipside was that expectant mothers who felt it important to “limit parental night-time involvement [and use] less active soothing” techniques would go on to have infants who slept better.

Experts warn the findings will heap guilt on many new mothers who already hold themselves responsible for every element of their baby’s behaviour.

The study vindicates those parents favouring the less-is-more, “cry-it-out” method of encouraging infants to sleep through the night.

But, in a note of caution, the authors highlight the current debate regarding the consequences of leaving children to cry, pointing to a series of articles by the co-sleeping advocate James J McKenna that argue that expecting infants to self-soothe runs counter to their basic biological and emotional needs.

Sleep deprivation, which can continue well past an infant’s first birthday, is a major contributor to post-natal depression.

Studies have suggested new parents can miss out on the equivalent of two months’ sleep in the first year of their child’s life, putting pressure on their relationships with their new baby and each other.

Elizabeth Danowski, executive director of OXPIP, an Oxford-based charity that supports new parents who are finding life tough, said it was easy for anxious parents to hit a “negative loop” of creating anxious babies who would then sleep or eat badly.

“If parents have struggled with anxiety in the past that will be a good predictor that they will have difficulties [with their babies] after birth,” she said.

A huge industry has sprung up to help parents tackle the problem of broken sleep, covering books, gadgetry and even night nannies. But exhausted parents can take heart from the fact that they are not alone n studies have shown that one in three babies still wake up several times a night even past the age of one.

And Liat Tikotzky and Avi Sadeh say: “It is important to emphasise that night wakings are a natural phenomenon, characteristic for most infants and children.”

- THE INDEPENDENT

Breastfeeding: A Vital Emergency Response.

Aug 5

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Breastfeeding: A Vital Emergency Response.

Tuesday, 4 August 2009, 1:14 pm
Press Release: La Leche League

La Leche League New Zealand
www.lalecheleague.org.nz

Media Release
3 August 2009

Breastfeeding: A Vital Emergency Response. Are you ready?

This year’s World Breastfeeding Week theme is “Breastfeeding: A Vital Emergency Response”, and one of its aims is to raise awareness of the importance of breastfeeding in emergencies.

During the Sichuan earthquake in May 2008, a police officer in China made headlines by breastfeeding babies who had been orphaned or separated from their mothers

Officer Jiang Xiaojuan, a 29 year old mother to a six month old baby, said, “I am breastfeeding, so I can feed babies. I didn’t think of it much,” she said. “It is a mother’s reaction and a basic duty as a police officer to help.” At one point, Jiang was feeding nine babies. She possibly saved their lives.

Emergencies can happen anywhere in the world, and they destroy what is ‘normal,’ leaving infants and young children vulnerable to disease and death. Child mortality can soar from two to seventy times higher than average due to diarrhoea, respiratory illness and malnutrition. Breastfeeding is a life-saving intervention.

In New Zealand we are prone to natural disasters – floods, storms, earthquakes and volcanic activity. We never know what is around the corner, and it is important to be prepared. Access to shelter, neighbours, electricity, phone services, shops, medical care and reliable water can be disrupted.

A possible disaster pending at the moment is the swine flu epidemic. La Leche League endorses the statements by New Zealand health authorities which say, “Babies who are breastfed do not get as sick, and are sick less often, than babies who are not breastfed. Don’t stop breastfeeding if you are ill. Breastfeeding protects babies because breast milk passes on antibodies from the mother to her baby. Antibodies help fight off infection. Limit formula feeds if you can. If you are too sick to breastfeed, express milk and have someone give it to your baby.”

Barbara Sturmfels, Director of La Leche League New Zealand, says, “Even babies who have been weaned may be able to resume breastfeeding if formula feeding is not safe in a crisis. Any mothers in this situation are encouraged to hold their babies skin-to-skin and to feed them frequently – every two hours. A mother’s milk supply will increase gradually and the younger the baby the more rapid the establishment of a sufficient milk supply.”

During emergencies, mothers need active support to continue or re-establish breastfeeding. Many do not know that mothers can increase their milk supply, relactate after having stopped, and that wet-nursing may be an option as a temporary measure or if an infant is orphaned.

Supporting breastfeeding in non-emergency settings will strengthen mothers’ capacity to cope in an emergency. Breastfeeding support groups and programmes offering skilled breastfeeding assistance that are available at all times will be especially valuable during emergencies to provide accurate information and support.

World Breastfeeding Week runs from 1 to 7 August.

.

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Blankets Bring Ray Of Sunshine To Jaundice Babies

Aug 5

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Blankets Bring Ray Of Sunshine To Jaundice Babies

Wednesday, 5 August 2009, 11:16 am
Press Release: Starship Foundation

Blankets Bring Ray Of Sunshine To Jaundice Babies

 


Baby Charlotte on a ‘BiliBlanket’ at Starship Children’s Hospital.

Newborn babies at Starship Children’s Hospital will soon benefit from lifesaving ‘BiliBlankets’ which are used for the treatment of babies suffering from jaundice.

Starship Foundation’s Fundraising Director Bobbie Brown, said the purchase of the two blankets was due to a recent donation of nearly $14,000 made by the Sovereign Sunshine initiative.

“A BiliBlanket is a portable phototherapy device which delivers up to 45 microwatts of therapeutic blue/white light whilst the baby is swaddled, held and cared for by parents and hospital staff,” Bobbie said.

Phototherapy is used to treat neonatal jaundice which is a yellowing of the skin and other tissues of the infant.

“Jaundice is fairly common in newborn babies and is due to the breakdown of red blood cells (which release bilirubin into the blood) and to the immaturity of the newborn’s liver (which cannot effectively metabolise the bilibrubin and prepare for excretion into the urine). The BiliBlanket is a comfortable and natural way for neonates to be treated for jaundice. It means they can be picked up, cuddled and moved around without needing to be hooked up to a machine or isolated in an incubator. The two new BiliBlankets will be used in the Neonatal Intensive Care Unit.

“We are very grateful to Sovereign Sunshine and all the people who voted for us online for their generous donation. Sovereign Sunshine’s support along with that of our individual donors and corporate supporters enables us to provide children with the best we can give them, over and above what the government provides.”

Bobbie said it was a challenging time for all charities.

“At the Starship Foundation we are continuing to work hard to ensure that our fundraising programmes enable us to make the most of the ongoing technological advances, for the care and treatment of New Zealand children at Starship Hospital.”

The Sovereign Sunshine programme which is backed by Kiwi actress and mother of two, Greer Robson helps under-resourced children’s charities by providing them with funding. Each month the initiative focuses on a different charity group, with members of the public deciding via online voting which charity will receive the funding. Sovereign staff also play a part, by helping to raise funds for the different charities.

Sovereign Marketing Communications Manager, Richard Allen, said staff enjoy getting behind raising funds for the children’s charities each month.

“Sovereign is working together with the New Zealand public to make the future brighter for as many young New Zealanders as possible. We’re committed to making a difference and invite other New Zealanders to join us by voting online for their favourite charity each month.”

To find out more about Sovereign Sunshine or to vote for a charity visit www.sovereignsunshine.co.nz

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Protein ‘key to premature births’

Aug 3

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premature and full-term babies
Premature babies often have to struggle to survive

Premature labour, the major cause of death and disability among babies, may be prevented by blocking a key protein, a study suggests.

Infection is now a recognised trigger of preterm birth, but some women seem to go into labour early even when the infection is trivial.

Researchers at Imperial College London say they can isolate the protein which seems to spark this reaction.

Premature births have been estimated to cost the UK nearly £1bn every year.

Very premature babies often die within the first few days of life, while many others can spend months in intensive care.

Those who do survive are at risk of developing serious disabilities such as cerebral palsy, blindness and deafness, as well as learning difficulties.

Bacteria alert

The protein – Toll-like receptor 4, or TLR4 – is found on the surface of the cells.

When it recognises bacteria, it sparks inflammation, and it is this which appears to induce premature birth.

 

We believe this is a step forward in the development of treatments to prevent premature birth
Professor Philip Bennett
Imperial College

However while bacteria are found in the womb of most pregnant women, the vast majority do not respond in this way.

And while the reaction is thought to have an evolutionary basis – potentially saving the life of the mother when a serious bug is present – it occurs in women who have no such infection.

The team at Imperial College London said they had found a way of effectively shutting down this reaction.

Professor Philip Bennett, lead researcher from the Clinical Institute of Obstetrics and Gynaecology at Imperial College London, said: “We are excited about the findings of this research as we have now discovered how to block a key pathway which leads to premature birth.

“Although more research needs to be done, we believe this is a step forward in the development of treatments to prevent premature birth.”

Dr Yolande Harley, deputy director of research at Action Medical Research, which funded the study, said: “This research will lead to improvements in understanding the mechanisms that cause premature birth and its impact could be significant if treatments that block this pathway are shown to prevent premature labour.”

Bliss Chief Executive Andy Cole said: “We welcome this interesting piece of research and anything that helps us better understand the causes of premature birth.

“This is a step in the right direction. However, there is still much more to do to prevent babies being born too soon.”

 

BBC

Pregnant women, young children priorities for swine flu vaccination

Jul 30

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2:00PM Thursday Jul 30, 2009

ATLANTA – Pregnant women, health care workers and children six months and older should be placed at the front of the line for swine flu vaccinations later this year, a US government panel recommended yesterday.

The panel also said those first vaccinated should include parents and other caregivers of infants; non-elderly adults who have high-risk medical conditions; and young adults ages 19 to 24.

The Advisory Committee on Immunization Practices voted to set vaccination priorities for those groups Wednesday during a meeting in Atlanta. The panel’s recommendations are usually adopted by federal health officials.

The recommendations are designed to address potential limits in vaccine availability later this year if there is heavy demand and limited supplies.

The government estimates that about 120 million swine flu vaccine doses will be available to the public by late October.

Roughly 160 million people are in the priority groups considered most vulnerable to infection or most at risk for severe disease. There are more than 300 million people in the US.

Although the number recommended to get doses exceeds the projected supply, health officials don’t think everyone will run out and get vaccinated.

Traditionally, less than half of the people recommended to get seasonal flu shots get them. Only about 15 per cent of pregnant women get seasonal flu vaccinations.

If there is ample vaccine, vaccinations also would be recommended for all non-elderly adults, the panel also voted. And if there’s still plenty of vaccine, the swine flu shots and spray doses should be offered to people 65 and older.

Fewer illnesses have been reported in the elderly, who appear to have higher levels of immunity to the virus, health experts say.

However, the elderly should be pushed to get shots against seasonal flu, which is a significant health risk to older adults.

Panel members say they hope swine flu vaccinations will be opened up quickly.

“The only sin is vaccine left in the refrigerator,” said Dr William Schaffner, a Vanderbilt University flu expert, in a comment to the panel.

The panel also said if vaccine is scarce, the government could require that a much tighter group be at the front of the vaccination line, numbering about 40 million.

That would include pregnant women and household contacts of small children, just like in the general priority recommendation.

But the others would be children ages 6 months through 4 years, children with chronic medical conditions and only health care and emergency services workers who have direct contact with patients.

It’s a worst-case scenario that officials aren’t expecting, but they wanted to have a plan for it just in case, said officials with the US Centers for Disease Control and Prevention, the federal agency that reviews the panel’s recommendations.

The range of recommendations reflects how hard it is to plan for swine flu, officials said.

Variables with the swine flu virus can range from whether it mutates into a form that is more deadly, spreads more efficiently, or is better at fighting off current antiviral medications.

Variables with the vaccine include potential production problems. Production of the vaccine will be a prodigious feat: The government has already purchased 195 million doses for the coming autumn and winter, which far eclipses the 125 million or so doses generally produced for seasonal flu vaccine.

Four vaccine manufacturers are wrapping up seasonal flu vaccine production and have begun production of swine flu vaccine. But another company, Sanofi Pasteur, has been more delayed and may not finish seasonal vaccine production until September, a company spokeswoman said. Sanofi is among the largest producers of flu vaccine, so those delays could have a significant ripple effect.

Packaging, distribution and other steps can take a month or more. For those reasons, the government’s best guess at the moment is 40 million doses will be available in September and 120 million by around mid-October.

First identified in April, swine flu has likely infected more than one million Americans, the CDC believes, with many of those suffering mild cases never reported.

There have been 302 deaths and nearly 44,000 laboratory-identified cases, according to CDC numbers released last week.

It’s not clear whether the virus in its current form is much worse than seasonal flu in terms of overall threat to the US population, but it is causing more severe illness in some younger adults and children.

It has a dangerous genetic characteristic that allows it to infect the lower lungs, whereas seasonal flu tends to infect the upper respiratory tract, CDC officials said.

- AP

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Restless legs syndrome

Jul 29

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What it is and why it happens

If you’ve started feeling an uncontrollable urge to move around in bed to relieve crawling, tingling, or burning sensations deep inside your legs, you most likely have restless legs syndrome (RLS). Some researchers estimate that up to 20 percent of pregnant women develop this problem during the last few months of pregnancy, though others believe it’s much less common than that.

You’ll usually notice symptoms when you’re at rest, especially right before you fall asleep or when sitting still for long periods, such as at the movies or during long car rides. Most of the time, you’ll feel it in your legs, but some women experience it in their arms as well.

Moving your limbs brings immediate relief, but unfortunately, it’s only temporary. As soon as you sit or lie down, the sensations return. Your restless legs may even be waking you up once you’re asleep.

If symptoms are disrupting your sleep night after night, you may end up seriously fatigued. The good news is that if your RLS started during your pregnancy, it’s likely to disappear altogether within two to four weeks after you give birth.

There are a number of theories about why some women experience RLS during pregnancy. Iron deficiency, folate deficiency, hormonal changes, and circulatory changes are all possible culprits.

Recent research suggests that women may develop the sensations when certain brain cells aren’t getting enough iron. Some medications, such as antihistamines in various cold and allergy remedies, seem to make the symptoms worse for some people. About half of all sufferers have a family history of the condition.
What you can do about it

Although there are drugs that treat RLS, most are not recommended during pregnancy. Instead, ask your doctor or midwife whether you should try iron supplements. Iron can sometimes relieve RLS even in women who don’t appear to be iron-deficient.

Some women find it helpful to stretch their legs, get a massage, use hot or cold packs, take warm or cool baths, or practice relaxation techniques. Avoid caffeine and antihistamines because they can make symptoms worse.

Finally, avoid lying in bed reading or watching television before you go to sleep, because the longer you lie still, the worse your symptoms will become. Instead, go to bed only when you’re actually ready to turn in.

Babycenter

Pregnancy adds to worry of flu

Jul 27

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Wheezing, sneezing, coughing, short of breath, aches, chills and a head cold and that was only the start of what was to be a miserable few days.

Feeling early symptoms late on Friday, I tossed and turned in my sweat-soaked bedsheets, begging for morning.

Come Saturday, my head throbbed, my nose was full and my body ached.

“It’s just a cold,” I said to myself. The fact I am six months pregnant meant I could not afford anything more.

Most flu medicines are out of bounds, so, left with two paracetamol tablets every six hours, I lay on the bean bag, with a hot cup of fresh lemon and honey, drifting in and out of sleep.

Later, feeling better, I attempted to make dinner.

Bad idea.

Constant nausea meant I had not eaten much that day.

I had to lean on the bench as stars came flying towards my eyes.

Back on the bean bag, next to a roaring fire and wrapped in at least five clothing layers, I felt cold.

I knew I had to get to bed and tossed with hot, cold, sweats, chills, dreams and hallucinations until Sunday dawned.

After hearing about the impact of swine flu on pregnant women and their babies, I called the Christchurch flu hotline and was given an appointment for the flu centre that day.

I entered a large, isolated and cold warehouse in the city centre where about 10 others, all wearing masks, were waiting.

The staff wore masks, hats, gloves and disposable cloaks; only their eyes were visible. I was told to wait as a “bottleneck” of extremely sick people were taken to hospital.

I was eventually seen by nurses and a doctor, who diagnosed flu and told me 80 per cent of cases were swine flu.

A scan at Christchurch Women’s Hospital reassured me the baby was fine, the heart was beating strongly.

I decided against a swine flu test after learning it required a tube up my nose that scraped down the back of my throat to take a swab.

Whatever I had, the only cure was to go home, stay home, take plenty of fluids, rest, monitor symptoms, and not let anyone near me.

It was Monday afternoon before I started to improve.

I’m glad I caught swine flu now.

I’ve been told that I have built up a basic immunity to any mutant form the virus may take. I hope so.

FOUR MUMS SENT TO INTENSIVE CARE

Four pregnant women or new mothers with swine flu have been treated in Christchurch’s intensive care unit as expectant mothers are warned to be vigilant. Christchurch intensive care specialist Geoff Shaw said his unit treated at least two women expecting babies and two new mothers.

Last weekend, a 19-year-old Australian woman lost her unborn child at 36 weeks because of swine flu complications. Shaw said it was not clear why pregnant women were more vulnerable but recommended they stay away from anyone who was coughing or unwell.

Fran McGrath, of Public Health, warned pregnant women not to take anti-viral medicine without seeing a doctor.

- with KIM THOMAS Stuff

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Swine Flu and Breastfeeding Mothers

Jul 21

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Influenza A (H1N1) Swine Flu
Information for pregnant women and breastfeeding mothers

Pregnant women

Pregnant women are thought to be at greater risk of complications from the new Influenza A (H1N1) than many other people. If you are pregnant and have influenza symptoms, you should consult your doctor before taking any antiviral medicine. Your doctor will assess the risks and benefits of this medicine with you, and may need to seek advice from an infectious diseases specialist.

Breastfeeding mothers

Any influenza can be very serious in young babies. However, babies who are breastfed do not get as sick, and are sick less often, than babies who are not breastfed.

Don’t stop breastfeeding if you are ill. Breastfeeding protects babies because breast milk passes on antibodies from the mother to a baby. Antibodies help fight off infection. Limit formula feeds if you can. If you are too sick to breastfeed, express milk and have someone give it to your baby.

Be careful not to cough or sneeze around your baby. You may want to wear a face mask, as long as you take the necessary precautions outlined in the World Health Organization’s advice on the use of masks in the community setting in Influenza (H1N1) outbreaks (www.who.int) to keep from spreading the virus to your baby.

You are able to keep breastfeeding while you take medicines such as Tamiflu to treat the new influenza A (H1N1) virus.

NZ Ministry of Health

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