What You Can Do to Prevent SIDS

Despite the widespread believe that SIDS is a baffling and unpredictable tragedy, there are ways you can significantly protect your baby. One thing that has been proven is that babies who sleep on their backs are less likely to die of SIDS than babies who sleep on their stomachs.  And so the “Back to Sleep” program was born in 1992, when the American Academy of Pediatrics (AAP) began warning parents of babies under 1 year old never to let their infants sleep on their stomachs. Since then, the rate of SIDS has dropped by over 50%.  In addition to this, Dr. Sears explains that there is a combination of many factors that lead to death: immature development of cardio-respiratory control mechanisms, defective arousability from sleep in response to breathing difficulties, medical conditions that compromise breathing, and unsafe sleeping practices.

The main risk factors for SIDS are:

• Prematurity or low birth-weight
• Smoking or taking illegal drugs during pregnancy
• Smoking around baby after birth
• Putting baby to sleep on their stomach
• Infants who are not breastfeeding
• Having little or no prenatal care
• Unsafe sleeping environment
• Overheating from excessive sleepwear and bedding
• There is no correlation between immunizations and SIDS.

Therefore, parents should follow the AAP recommendations for reducing the risk of SIDS:

• Place your baby on a firm mattress to sleep.
• Do not put your baby to sleep on a pillow, waterbed, sheepskin, couch, chair, or other soft surface.
• To prevent rebreathing (where the baby inhales the same air he just exhaled), do not put blankets, comforters, stuffed toys, or pillows near the baby.
• Make sure your baby does not get too warm while sleeping. A good temperature is one where an adult would be comfortable in a short-sleeve shirt. Do not over-bundle or over-swaddle your baby.
• Do not smoke, drink, or use drugs while pregnant and do not expose your baby to secondhand smoke. Exposure to secondhand smoke doubles a baby’s risk of SIDS, while a mother who smoked during pregnancy triples the risk.
• Receive early and regular prenatal care.
• Make sure your baby has well-baby checkups regularly.
• Breastfeed, if possible. There is some evidence that breastfeeding may help decrease the incidence of SIDS.
• If your baby has GERD (reflux), be sure to follow your doctor’s guidelines on feeding and sleep positions.
• Put your baby to sleep with a pacifier during the first year of life. If your baby rejects the pacifier, don’t force it. Pacifiers have been linked with lower risk of SIDS.

Attachment Parenting

Dr. Sears also advocates a style of caretaking called Attachment Parenting. In addition to many benefits for you and your baby, Attachment Parenting greatly reduces the odds of your baby succumbing to SIDS. For more information, read these worthwhile articles:

• 4 Ways Attachment Parenting can Reduce the Risk of SIDS
• 3 Reasons Babywearing reduces SIDS)
• 8 Reasons Breastfeeding Reduces SIDS
• Co-sleeping SIDS
• Beware of Sleep Trainers

When Stomach Sleeping is OK

Having said all that, for some babies, it is actually recommended that they sleep on their stomachs.

Premature babies or babies with breathing difficulties are put to sleep on their tummies, since the still partially collapsed lungs of some prematures tend to expand better when front-sleeping.

If an infant has gastroesophageal reflux, it is also recommended that he sleep tummy down, at least for two hours after a feeding.  Some babies sleeping on their tummies also seemed to settle better and spit- up less after feeding.

Listen to Your Baby: If your baby is just not content to sleep on his back, is it OK to put him to sleep on his stomach?  Well, because of the new research it is best to try to get baby accustomed to sleeping on her back or side. Newborn babies tend to get in the habit of sleeping the way they are first put down.  Nevertheless, Dr. Sears says that unless advised to the contrary by your doctor, it is best to let your baby sleep in a position she prefers. This means that if your baby doesn’t settle down, or stay asleep on her back or side, front sleeping is fine.  Newborn babies DO tend to prefer their tummies. “If a baby repeatedly doesn’t settle in a certain sleeping position, this may be a clue that this position may not be the safest for this individual baby. This is just one example of how babies often try to tell us what is in their best interest. Parents should not be afraid to listen.”

Just be sure to follow all the safety precautions listed above, such as placing baby on a firm mattress, not overheating the room, etc.

Another Possible Cause of SIDS

Sleep position may be important, but there is some evidence that SIDS may be related to the fire retardants in the baby’s mattress.  The reason this may be a culprit in SIDS is that an ordinarily harmless fungus (Scopulariopsis brevicaulis) consumes the chemicals used in the plasticized mattress cover. Baby’s drool, vomit, urine, and perspiration, combined with body heat, enable the fungus to grow rapidly.  When this occurs, neurotoxic gases are emitted. If baby breathes a significant amount of these odorless gases for a prolonged time, the central nervous system can shut down, causing death.

Using a mattress pad that is NOT made from polyvinyl chloride (PVC) would eliminate this tragedy.  For more information, read Is sleep position really important in SIDS? Also, read about mattress wrapping, which means wrapping baby’s mattress in a polyethylene cover, to prevent your infant from breathing the gases. You can also look into an organic crib mattress, made from all-natural fibers which have not be treated with flame-retarding chemicals.

Feature image from Delio: Organic Bedding for Baby

Moisturize: Rub on a thick, rich moisturizer (like cocoa butter) each night before bed. It’ll soak in overnight, leaving your skin soft and less itchy.

Soft Fabrics: Wear super-soft natural fabrics, like cotton, cashmere and silk, instead of scratchy wools or heavy denims, which can make the itching worse.

Down Under: Go for undies, pants and skirts that rest under your belly. Anything that’s too tight around your belly can cause too much rubbing and irritation.

Stay Hydrated: Drink plenty of water, which will keep all of you hydrated — skin included.

Soak Smart: Avoid soaking in a hot tub; it’ll zap your skin’s moisture. However, taking a warm bath with a soothing oatmeal mix (like Aveeno) can help.

Humidify: Spending a lot of time in a central-heated or air-conditioned space can dry out your skin. Consider buying a humidifier to send some moisture back into the air, which’ll help your belly stay hydrated too.

Pregnancy Rashes:

PUPPP: Some pregnant women develop a condition characterized by itchy, red bumps and larger patches of a hive-like rash on their bellies. This is called pruritic urticarial papules and plaques of pregnancy (PUPPP) or polymorphic eruption of pregnancy. The eruptions usually show up first on the abdomen around or in stretch marks, and may spread to your thighs, buttocks, and arms. PUPPP is harmless for you and your baby, but it can itch like crazy! It is treated with topical ointment, antihistamine, or, in severe cases, oral steroids.  Visit Baby Center for more info.

Prurigo of pregnancy: This skin condition is more rare than PUPPP, and is characterized by many tiny bumps that may look like bug bites. These eruptions can occur anywhere on your body, but you’re most likely to get them on your hands, feet, arms, and legs. Although the eruptions can be itchy and annoying, prurigo of pregnancy appears to pose no risk to your baby. This condition generally starts around the beginning of the third trimester and may last for up to three months after you give birth.

Pemphigoid gestationis (or herpes gestationis, although it has nothing to do with herpes virus). In very rare cases, a pregnant woman will develop very itchy eruptions that start out like hives and then turn into large blistering lesions. It often start on the abdomen and spread to the arms and legs. This condition is considered more serious because it may be associated with an increased risk for preterm delivery and fetal growth problems.  Pemphigoid gestationis can come and go throughout pregnancy, and it often flares up after delivery as well. It usually happens again in subsequent pregnancies and tends to be more severe.

Intrahepatic cholestasis of pregnancy is a liver problem charictarized by severe itchiness in the 2nd or 3rd trimester.  When bile doesn’t flow normally in the small ducts of your liver, bile salts accumulate in your skin and make you itch all over. The itching can be quite intense. The condition itself doesn’t cause a rash, but uncotrollable scratching my turn your skin red and irritated. Call your doctor or midwife immediately if you think you have cholestasis because it may spell trouble for your baby. Depending on your health and your baby’s condition, you may be induced before your due date. Visit Baby Center for more info.
If you develop any kind of rash during pregnancy, it’s a good idea to have your caregiver evaluate it and recommend appropriate treatment, or refer you to a dermatologist.

Image from Woman’s Day

What Pregnancy does to your stomach muscles:

First a little background so you understand what’s happened to your body and what you need . During pregnancy the abdominal muscles stretch to accommodate the growing fetus, and sometimes the most superficial muscles (called rectus abdominis, or six-pack muscles) can split down the middle like a pants seam. This is a good thing because it allows room for the growing baby, said Cynthia Neville, director of women’s health rehabilitation at the Rehabilitation Institute of Chicago. But when the split is too wide, it creates instability in the abdomen, trunk and pelvis.

The split should spontaneously reduce to less than 2 centimeters within a few weeks. But if the core muscles, which include pelvic-floor muscles and deep abdominals, are not working as a team, then Neville warns that “women may continue to have flabby, bulging, weak abs, or they may leak urine, or both.” (Women who undergo Caesarean sections have a different challenge because of the way surgery affects the abs.)

If you want to tighten up your stomach after pregnancy, the goal is to strengthen the abdominal and core muscles, and get them to work together properly.  The core muscles should be the first to kick into gear; if they’re not strong enough and you’re doing ab exercises that focus on the six-pack muscle, your stomach may bulge, Neville said.

The best way to retrain stomach muscles

It starts with learning to maintain a neutral position of the spine and pelvis – not too arched or flattened. This involves retraining the deep transverse muscles. Unfortunately, traditional stomach exercises like crunches tend to by-pass the transverse abs so no matter how many sit-ups you do, your transverse muscles will barely feel the effects.

Any fitness program that targets your core, like Pilates, will include stomach exercises that target the transverse abdominals. However, you often work these muscles without realizing it. Whenever you hold your stomach in, you are working the transverse abs. For instance, when doing lunges you must keep your back straight, which is accopmlished by tightening your abdominals, or more specifically your transverse abdominals.

“The key is to ‘remind’ the core to be the first to contract to prepare for the extremity movements until it becomes automatic,” Neville said. You can do this not just during exercise, but during everyday movement such as lifting the baby or pushing a stroller. Working these muscles will not only get you a flatter stomach, but may also lead to an improvement in your posture and fewer backaches.

Erin O’Brien Denton, a personal trainer (watch a clip from her DVD called “Postnatal Rescue“), recommends lying on your back and doing leg lifts, planks, and “bridges” (raising your pelvis off the ground) for the first three months after delivery “to teach the abs to lie sleekly against the abdominal wall.”  She also suggests an exercise in which you simply lifting the head and shoulders while pulling in the abdominals.

After you have mastered those motions, Denton suggests “the old-fashioned bicycle abdominal exercise, a variety of crunches (initiating the movement from both the upper and lower abdominal wall) and various plank exercises to start toning the abs.”

Transverse Exercises

Pregnancy info.net details some exercises that target those hard to get to transverse muscles:

The No-Crunch Crunch

These exercises will help strengthen your tummy and reduce the bulge. Pilates is also popular for this area. Even if you succeed in loosing all your pregnancy weight and firming your stomach muscles, you may notice that stomach skin is still stretched out and saggy. This is usually genetic, and not something that will improve with exercise.(Some women opt for a tummy tuck.)

Abdominal separation after pregnancy is not uncommon.  If your stomach is bulging but feels frim, you may have a diastasis (space between the abdominal muscles). Talk to your doctor if you suspect this is the case.

Image from ToneZone Pilates

The pregnancy glow might make you feel pretty, but there are other changes that may be unwelcome. I thought it might be good for you to know that all those weird skin conditions are actually normal, and will most likely disappear after the baby is born! Phew!!  The following article, 11 COMMON SKIN CHANGES DURING PREGNANCY, comes straight off of Dr. Sear’s website.

1. The “pregnancy glow.” The glow that others notice (though you may not) isn’t just a sentimental old wives’ term. This facial shine actually has a biological basis. The increased volume of blood causes the cheeks to take on an attractive blush, because of the many blood vessels just below the skin’s surface. On top of this redness, the increased secretions of the oil glands give the skin a waxy sheen. The flushed face on many pregnant women is similar to the one non-pregnant people experience when they are excited, cry, or do anything that increases their heart rate (which pregnancy does constantly).

photo from EarthsBeauty.com

2. The pregnancy mask. Sometime during the second trimester you may find yourself gazing at a different face in the mirror. Brownish or yellowish patches called chloasma (also dubbed the mask of pregnancy) can appear anywhere on the face, but are seen most commonly on the forehead, upper cheeks, nose, and chin. The pregnancy hormones estrogen and progesterone stimulate the melanin cells in the skin to produce more pigment, yet because these cells do not produce extra pigment uniformly, your facial skin may acquire a blotchy tan. (If you have ever taken oral contraceptives, you may already have experienced this particular hormonal side-effect.) Brunettes and darker-skinned women may notice darkened circles, resembling eye shadow, around their eyes. Chloasma cannot be prevented, but you can minimize the intensity of these blotchy, darkened areas by limiting your exposure to ultraviolet light (i.e., sunshine), which further stimulates melanin production.

3. Acne. You probably thought your pimple days were over. While the acne of pregnancy is rarely as severe as that of adolescence, you may need to return to some of your teenage cleansing rituals. Fortunately, pregnancy is much shorter than adolescence; the bumps and pimples will subside shortly after delivery. Avoid abrasive scrubs or exfoliants; pregnant skin is too sensitive for these. Milder, oatmeal-based facial scrubs (available at nutrition stores) can help unplug the oily pores, and are much kinder to sensitive skin. Because of the risk of birth defects, the anti-acne prescription drugs Accutane and Retin-A cannot be used during pregnancy.

4. Linea nigra. Many women normally have a faint linea alba (white line) running from their navel to the center of their pubic bone. It is barely visible before pregnancy. (You may not have even known it was there). Sometime in the second trimester a linea alba becomes a linea nigra, a dark line that is much more noticeable. In some women the line extends upward from the navel as well. The linea nigra is darker in darker skinned women and disappears several months after delivery.

5. Dark areas become darker. Little moles and freckles that existed prior to pregnancy may now become bigger, and brown spots or birthmarks become browner. New moles may also appear. (Consult your doctor or dermatologist if these moles seem particularly raised, dark, or have irregular borders.) The areola and nipples of your breasts will become quite a lot darker; unlike other areas of your skin, which return to their original color after pregnancy, your areola will probably always be somewhat darker than they were before you were pregnant.

6. Red palms and soles. Even as early as the second month of pregnancy, the insides of your hands and the bottoms of your feet may itch and take on a reddish hue, called palmar erythema. The increased color is nothing more than a curiosity of pregnancy.

7. Spider veins. Those much-discussed pregnancy hormones, along with increased blood volume, cause those tiny, squiggly red or purple capillaries just below the surface of the skin to branch out and become more visible during pregnancy. It’s also common for spider veins (they resemble a small spider web), to pop out on the face or on the sclera (white part) of the eyeballs during delivery; intense, red-in-the-face pushing can break tiny blood vessels. Known as nevi, these burst vessels can be camouflaged by the appropriate use of make- up. Nevi take longer to disappear than many of the other skin problems of pregnancy, some spider veins on the legs or torso may not go away on their own. A dermatologist can remove them using injections if you feel that’s necessary.

8. Skin tags. Some pregnant women develop tiny polyps, called skin tags, in areas where skin rubs on clothing or skin rubs together. Commonly found under the arms, between neck folds, or under bra lines on the chest, skin tags are caused by hyperactive growth of a superficial layer of skin. They disappear a few months following delivery, but can be easily excised if they bother you.

9. Heat rash. You may think that only babies get prickly heat rash, but pregnant women do, too. Caused by the combination of an already overheated pregnant body, dampness from excessive perspiration, and the friction of skin rubbing against itself or against clothing, prickly heat rash is pimply and slightly irritating. It is most common in the crease between and beneath the breasts, in the crease where the bulge of the lower abdomen rubs against the top of the pubic area, and on the inner thighs.

10. Itching. Many women enjoy a good “scratch down” at the end of the day. Some areas of your skin may itch because they are dry and flaky, others may itch because of a prickly rash, as mentioned above. Many women find the itching is most bothersome in the skin that stretches, mainly over the abdomen, but also on hips and thighs.

11. Pimply eruptions. Around one percent of pregnant women experience itchy, red, raised patches on their abdomen, thighs, buttocks, and extremities. This condition is called pruritic urticarial papules and plaques of pregnancy (dubbed PUPP). It tends to come and go during the second half of pregnancy and nearly always disappears shortly after delivery. Treat this the same as any other itchy skin eruption.

Get out the face paints and have yourself a ball! You can get creative by using the brush end-on to create pointillism (paint in dots). Try other techniques such as sponge painting, finger painting, or stencils. Get your kids involved and paint a welcome message with lip-prints kisses, hand prints and hearts.

If you don’t have any face paints availible, you can use the following mixture for each color:

• 1 teaspoon corn starch
• 1/2 teaspoon water
• 1/2 teaspoon cold cream
• Food coloring

Feeling really wild? Try it at your baby shower or with a group of other pregnant friends!

Oh my!!!!