Archives for May 2010

The War on Drop-Side Cribs

A parent’s worse nightmare might be putting the baby down for a nap, and returning to find him… dead. This happened to the parents of 6-month-old Bobby Cirigliano, in 2004. But we’re not talking about SIDS or crib death… The tragedy of this story involves the side rail on his drop-side crib, which slid off the tracks, trapped his head and neck between the mattress and the malfunctioning side rail, suffocating him.

Surprisingly, there have been at least 32 other infants and toddlers killed by their drop-side cribs since 2000.  These babies were suffocated or strangled in these cribs, which have a side that moves up and down, allowing parents to lift children from the cribs more easily. Drop-sides have been around for decades, but only now are people beginning to question their safety.

The Consumer Product Safety Commission  regulates crib safety, and its chairman, Inez Tenenbaum, has pledged to make fixed-side cribs mandatory. It could take many months before becoming effective.  Big retailers such as Babies R Us and Wal-Mart have removed drop-side cribs from their sale floors. And now Congress is getting involved.

“There’s a great urgency here. We have to make sure that no parent is unaware that drop-side cribs could kill their children,” Sen. Kirsten Gillibrand, D-N.Y., said in an Associated Press interview.  She wants to accelerate efforts for a ban, and plans to introduce legislation this week to outlaw the manufacture, sale and resale of all drop-side cribs. She also wants them banned from day-care centers and hotels, and she wants to educate parents who are using them.

“There still are thousands and thousands of children who are sleeping every night in drop-side cribs and we need to protect them,” said Gillibrand.

The Juvenile Products Manufacturers Association, which represents over 90 percent of the crib industry, insists that drop-side cribs are safe w hen assembled and used properly.  But more than 7 million of these cribs have been recalled in the past five years, often because screws, safety pegs or plastic tracking for the rail can come loose or break. When the hardware malfunctions, the drop-side rail can detach partially from the crib, creating a space where a baby can get caught and suffocate or strangle.

Some people, such as Z Recommends, question the motives behind the banning of these cribs, saying there may be more to it than meets the eye. Why not issue mandated quality improvements on the design of drop-side cribs (for example: metal instead of plastic hardware, which tends to break), rather than an outright ban?  Fixed-sided cribs, even those with shorter legs (as some suggest would become the norm for cribs) will make it very difficult for tall parents, parents with bad backs, pregnant women, or older parents and caregivers to place their babies in the crib.

As one commenter puts it, “Can we put a man on the moon and not make a safe drop-side crib?”

If you are using a drop-side crib, be sure you have assembled it and are using it properly.  Check to make sure the model hasn’t been recalled. You may want to consider getting a new crib, or at least anchoring the movable side so there’s no danger of it malfunctioning.  It’s always better to be safe than sorry!

News source: Associated Press

Photo by valentinapowers, shared via Flickr.

Breastfeeding, Dieting, and Weight Loss

Congratulations, you have a new baby! Amidst all the excitement and exhaustion, we know there’s one thought niggling at the back of your mind… when will I get out of these maternity clothes and back into clothes my “real” size?! Ah, have patience… Remember that your pregnancy weight wasn’t gained overnight. And for many moms, it won’t disappear that quickly, either.

The extra weight is there for a reason!

La Leche League points out that one reason you gained extra weight during pregnancy is so you would have plenty of reserves for feeding your baby. This is particularly reassuring for nursing mothers because it means that breastfeeding help in shedding these extra pounds, as the “reserve” are converted into nutritious breast milk for you baby.

Breastfeeding helps with weight loss

You may be surprised at how much weight you can loose in the early months by simply following a normal diet and eating when you’re hungry. The LLLI BREASTFEEDING ANSWER BOOK says, “Breastfeeding mothers tend to lose more weight when their babies are three to six months old than formula-feeding mothers who consume fewer calories… Another study of mothers at one month postpartum found that mothers who breastfed (either exclusively or partially) had slimmer hips and weighed less than women whose babies received only formula…” (Yet another good reason to nurse your baby!)

Breastfeeding mothers can loose about one pound per week, while still consuming 1500 to 1800 calories per day.  The BabyCenter Medical Advisory Board says that most nursing moms actually need more like 2,000 to 2,700 calories per day! It’s very important to eat well in order to feel good, prevent mood swings, and have energy to care for your baby (especially if you are compensating for lack of sleep!).

It’s interesting to note that the composition of your milk really does not vary much with your diet. LLLI points out that mothers in famine conditions can produce perfectly nutritious milk for their babies. The main reason it’s important to eat well during lactation is for yourself– your health may suffer if too many of your own reserves are used to provide milk. Be sure to take care of yourself by “eating to hunger” and “drinking to thirst.”

Exercise and Dieting

If you feel like to need to actively work to lose weight, it is best to wait at least 2 months for your body to recover from childbirth and establish a good milk supply. Starting a diet too soon after giving birth can delay your recovery, affect your milk supply, and make you feel more tired (and no one with a newborn needs to feel MORE tired!). Always check with your doctor about increasing your activity level or reducing your calorie intake.

Exercise, not just calorie-counting, is important if you want to loose weight.  Try to be more active, whether it means hitting the gym or just walking your baby in the stroller instead of driving everywhere.

Don’t skip meals in an attempt to lose weight. It won’t help because you’ll be more likely to eat more at other meals. All you’ll accomplish is probably making yourself feel tired and grouchy. Breakfast really is important in helping you stay active and energized throughout the day. According to the National Weight Control Registry, 78% of successful dieters eat breakfast daily.

Go Slow

BabyCenter explains another danger of strict, restrictive diets. Too-rapid weight loss can release toxins that are stored in your body fat into your bloodstream and milk supply. These toxins include environmental contaminants like the heavy metals lead and mercury, persistent organic pollutants like PCBs and dioxins, and solvents.

Be realistic about weight loss

You should know that not everyone is able to return to their exact pre-pregnancy weight or shape. Pregnancy often causes permanent changes such as a softer belly, a larger waistline, and wider hips. With this in mind, you might want to adjust your goals a bit. (For a reality check, see Baby Center’s photo gallery of real post-baby bellies.)

Make good food choices

Some good food choices include:

  • low-fat milk and dairy products
  • whole grain products like whole wheat bread and whole grain cereal
  • high-fiber, low fat fruits (like apples, oranges, and berries)
  • raw vegetables (like carrots, jicama, and red pepper strips)
  • broiled or baked foods rather than fried foods
  • limit sweets and processed snack foods
  • choose “good” fats (mono- and polyunsaturated fats) like olive oil, avocado, olives, nuts and seeds, and fatty fish like salmon.
  • cut calories by drinking water instead of juice, soda, and coffee

Some suggestions for squeezing more fruits and veggies into your diet:

  • Make fruit (or veggie) smoothies
  • use fruit or vegetable salsas or sauces made from puréed vegetables over fish or chicken
  • add shredded carrots to your sandwich
  • try grilled vegetables,
  • try puréed vegetable soups. Puréeing gives you a creamy soup without having to add cream.

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Your Baby is Nicer than you Think!

Past studies have shown that babies have some basic concept of physics (objects obey the same physical laws everywhere) and psychology (people everywhere have minds, goals, desires and beliefs). But can we now say that there exists a universal moral code that even babies understand? Can babies tell right from wrong?

Researchers says yes, although this may be a controversial claim, since people’s conception of morality varies from society to society. “At the same time,” writes Paul Bloom in the New York Times, “People everywhere have some sense of right and wrong. You won’t find a society where people don’t have some notion of fairness, don’t put some value on loyalty and kindness, don’t distinguish between acts of cruelty and innocent mistakes, don’t categorize people as nasty or nice.”

How does this manifest itself in babies who can’t express themselves? To test “baby morality” studies were conducted at the Infant Cognition Center (within one of the Yale psychology buildings). Short puppet shows were shown to babies in which one puppet helped the other, and another puppet hindered. In the end, results showed that 6- and 10-month-old infants overwhelmingly preferred the helpful individual to the hindering individual. “This wasn’t a subtle statistical trend; just about all the babies reached for the good guy… babies are drawn to the nice guy and repelled by the mean guy. Again, these results were not subtle; babies almost always showed this pattern of response.” In other words, babies at an early age can identify actions which we’d call “mean” or “nice.” Even more fascinating is that the babies show an elementary appreciation for “justice,” where they favor “mean” actors, when those actors are punishing bad behavior

You can read in more detail about these studies at the New York Times or watch this NY Times video. The article concludes, “Babies possess certain moral foundations — the capacity and willingness to judge the actions of others, some sense of justice, gut responses to altruism and nastiness.”  Does the existence of an innate moral sense mean there’s something more profound going on than biological evolution could produce, “the voice of God within our souls,” to quote Dinesh D’Souza?

I, for one, would say YES. What do you think?

More Good News on Vitamin D & Pregnancy

How much Vitamin D does a pregnant woman need? According to a new study high doses of Vitamin D– 4,000 international units (IU) per day– are best. Research shows that it may reduce the risks of preterm labor, gestational diabetes, pregnancy-related high blood pressure, preeclampsia, and infection.

The more the better?

Although this is at least 10 times the amount recommended by various health groups, women in the study showed no evidence of harm. On the contrary, they had half the rate of pregnancy-related complications as women who took only 400 IU  every day. (For reference, most prenatal vitamins contain 400 IU of vitamin D.)

Controversial findings

Why are these findings so controversial?  Until now, very high doses of vitamin D have long been believed to cause birth defects. But neonatologist and study co-researcher Carol L. Wagner, MD, says that there is no evidence that vitamin D supplementation is toxic, even at levels above 10,000 IU.

Wagner says it took months to get permission to do this study, in which pregnant women were given such high doses of the vitamin.  About 500 women in Charleston, S.C.,  in their third or fourth months of pregnancy, took 400 IU, 2,000 IU, or 4,000 IU of vitamin D daily until they delivered.  The women who took the highest doses had the lowest rate of pregnancy-related complications.

Vitamin D Sources

You can get vitamin D from some foods, like fortified milk and fatty fish,  but few people get the vitamin D they need through food.  The body makes vitamin D from sunlight, but even in sunny climates like Charleston, few people are getting adequate levels of sun exposure.

Babies need vitamin D, too

Breastfed babies whose mothers have low vitamin D levels and who don’t take vitamin supplements are likely to be deficient, too. Vitamin D drops are likely to be prescribed. But not surprisingly, pregnant women who take high doses of vitamin D give birth to babies who are less likely to be vitamin D deficient.

Read more at WebMD: High Doses of Vitamin D May Cut Pregnancy Risks

Feature image from Kristi Cares: The Kristina A. Stockley Melanoma Foundation

Umbilical Hernia during Pregnancy

During pregnancy,  you can usually expect your belly button to flatten out and protrude somewhat more than usual. But sometimes this protruding navel is actually an “umbilical hernia,” a condition that is rarely serious and usually resolves on its own after birth.

What Causes an Umbilical Hernia:

Dr. Gerard M. DiLea, obstetrician-gynecologist and author of The Anxious Parents’ Guide to Pregnancy, explains (BabyZone) that to some extent, everyone has an umbilical hernia! As a fetus develops, there’s a hole in the main supporting layer of the abdomen, allowing the blood vessels of the umbilical cord to go in and out. This small opening sometimes remains after birth. For some people the opening can become larger due to increased abdominal pressure (like a chronic cough or, in our case, pregnancy.) Part of the small intestine passes through this hole causing a hernia.

Symptoms of an Umbilical Hernia

Tenderness around your belly button, especially during coughing or after straining (lifting and carrying around your toddler, for example), may indicate that you have an umbilical hernia.  Sometimes you can feel or see a protrusion right near the belly button that you can actually push back in.

Will I Need Surgery?

In most cases, an umbilical hernia does not need surgery. But sometimes a complication called incarceration develops, where organ tissues or intestines are trapped, cutting off their blood supply. The hernia will be painful. When this happens, a hernia surgery is required to repair the damage. If you suspect that your hernia is causing strangulation, you should see your doctor immediately, because if not corrected, an incarcerated hernia is very dangerous. Look out for symptoms such as swelling, pain, or discoloration.

The surgery is usually done as an outpatient procedure, under general anesthesia, and is a low-risk operation.

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Your First Prenatal Visit

Missed a period? Feeling nauseous? Taken a pregnancy test that showed positive?  You’re probably feeling excited and a little anxious too, so if you want to know what to expect during the first steps of your journey through pregnancy, we can fill you in!

When to Schedule Your First Appointment

It’s best to call your doctor or midwife as soon as you find out you are pregnant.  If you’re feeling good, your caretaker probably won’t schedule a visit before you’re 8 weeks pregnant. But if you are experiencing any pain, severe nausea or vomiting, or vaginal bleeding, you need to let him/her know so they can see you right away.  If you have a medical condition, are taking any medications, or have had pregnancy-related problems in the past, they will probably want to see your sooner as well.

What to Expect at your First Appointment

The first visit is often the longest one, as your doctor wants to make sure all is well, and let you know what else

Determine your due date: This is often calculated based on the first day of your last period, so it helps if you can recall the date. The date can also be estimated using an early ultrasound of the fetus.

Take your health history: Your doctor will ask questions about your general health, chronic conditions and gynecological issues you may have, medications you take, regularity of your menstrual cycle, and details about previous pregnancies. She’ll also ask about your family’s medical history, health habits, drug allergies, surgeries, hospitalizations, and whether you have been the victim of abuse. She will also inquire about the medical history of the baby’s father and his family.

Discuss Options for Genetic Testing: There are a number of different screening tests that done to determine your baby’s risk for birth defects, chromosomal problems, and Down syndrome.

First trimester combined screening: This consists of a blood test and, if available in your area, an ultrasound called a nuchal translucency screening. It is done between 9 and 13 weeks. This screening assess your baby’s risk of having Down syndrome and some other chromosomal abnormalities as well as major congenital heart problems.

Multiple marker screening is a blood test done between 15 and 20 weeks. It screens for Down syndrome and trisomy 18, which are chromosomal abnormalities, and neural tube defects such as spina bifida.

Carrier screening: These tests are done depending on your ethnic background and medical history, in order to see if your baby is at risk for certain genetic disorders such as Tay-Sachs disease, cystic fibrosis, sickle cell disease, or thalassemia.

Genetic diagnostic tests include chorionic villus sampling (CVS), generally done at 11 to 12 weeks, and amniocentesis, usually done at 16 to 20 weeks. These tests can tell you for sure whether your baby has Down syndrome or certain other problems. These tests are usually administered only if there is a strong risk of chromosomal problems, after the results of the screening tests are known. They are invasive and carry a risk of miscarriage.

Physical exam: Your doctor may give you a thorough physical, including a pelvic exam, a Pap smear (if you haven’t had one recently), and sometimes a culture to check for chlamydia and gonorrhea.

Blood tests are done to identify your blood type, Rh status, and to check for anemia. The lab is also looking out for syphilis, hepatitis B, and immunity to rubella (German measles).  It’s also recommended that pregnant women be tested for HIV (the virus that causes AIDS) at their first prenatal visit. Being treated for AIDS during pregnancy is very important for reducing the likelihood of passing the infection to your baby.

Urine sample tests for urinary tract infections and other things.

Counsel: Your doctor should give you advice about proper nutrition, exercise, weight gain, common discomforts of early pregnancy, and symptoms that  require immediate attention.  She’ll remind you about the dangers of smoking, alcohol, drugs, and certain medications. If you are feeling anxious or depressed she can refer you to someone who can help with your emotional health.  If you have any questions or concerns don’t hesitate to share them with your doctor. Don’t worry, she’s heard and seen in all!

feature image from Rest Assured

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