Friday, September 04, 2009

Women Urged Not to Drink While Pregnant

Learning disabilities, mental health issues and behavior problems are just some of the issues that afflict babies exposed to alcohol in the womb, yet some doctors still tell their patients it is safe to have a drink now and then while pregnant.

Those hoping to change that are meeting on September 9, the ninth day of the ninth month, for a forum dedicated to raising awareness about the dangers of drinking while pregnant and the plight of children and families affected by Fetal Alcohol Spectrum Disorders (FASD). State legislators, health care professionals, parents, social workers and drug prevention and treatment specialists are coming together at Prairie State College in Chicago to mark international FASD Awareness Day.

A new brochure titled "It's Only Nine Months" is also being released by Prevention First, a nonprofit drug prevention organization participating in the forum, addressing some of the common questions and misconceptions women have about drinking while pregnant.

"Our research found that women are getting conflicting information about drinking while pregnant," explained Karel Ares, executive director of Prevention First. One focus group participant said she had heard that wine or Champagne were good for a woman's blood while pregnant, Ares said. Others thought drinking was safe in the first few months of pregnancy. "There is no research that proves that any amount of alcohol is safe at any time for unborn babies," Ares pointed out. "But there is a great deal of research about the many lifelong problems caused by permanent brain damage from drinking alcohol while pregnant."

Ares said that one of the most important groups of people she wants to get this message are doctors. "FASD is preventable, yet some obstetricians are still telling their patients they can have a glass of alcohol now and then. It's like playing Russian Roulette with babies' lives, and we are working to educate them about the risks."

Dr. Todd Ochs, a clinical instructor of pediatrics at Northwestern University's Feinberg School of Medicine, one of the scheduled speakers at the forum, said that part of the problem is that doctor training hasn't changed to reflect new research about pre-natal alcohol exposure. "We used to worry about women using heroin or other illegal drugs while pregnant, but there are too many variables with alcohol that we don't yet understand, so the best advice a doctor can give is that they shouldn't drink at all," Ochs noted.

Dr. Ochs has diagnosed and treated many children with Fetal Alcohol Spectrum Disorders and points out, "We know that drinking will cause damage, we just don't know how much damage will occur or what amount of alcohol will cause the damage, so why would anyone do something that's known to be harmful to a baby?"

Among the speakers at the FASD Day forum are State Rep. Al Riley (D-Hazel Crest), State Sen. Maggie Crotty (D-Oak Forest) and psychologist Dr. Jacquelyn Bertrand from the Centers for Disease Control and Prevention.

Prevention First is offering the "It's Only Nine Months" brochure free through its clearinghouse in Springfield, IL, which can be ordered online at www.prevention.org/catalog, or by calling 800-252-8951, ext. 128.

For information or to register for the forum send an email to illinoisFASDforum@yahoo.com or call 815-462-4273.

Source

September is Infant Mortality Awareness Month

September is Infant Mortality Awareness Month. As a country we are failing our babies miserably. Too many never make it to their first birthday. An estimated 2 million babies die within their first 24 hours each year worldwide, and the United States has the second worst newborn mortality rate in the developed world, according to a recent report by Save the Children.

Diving into the report’s stats only darkens the picture: American babies are three times more likely to die in their first month than children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland, or Norway. Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which ranks near the bottom of industrialized nations, tying with Hungary, Malta, Poland, and Slovakia with five deaths per 1,000 births.

Although the newborn mortality rate in the United States has fallen in recent decades, it continues to disproportionately affect people of color, especially African Americans. Only 17 percent of all U.S. births were to African American families, but 33 percent of all low-birth-weight babies were African American, according to the report.

Indeed, the statistics on black babies are the most dismal of all. African Americans have 2.3 times the infant mortality rate of non-Hispanic whites. Black babies are four times as likely to die as infants due to complications related to low birth weight as non-Hispanic white infants. Other sobering statistics from the CDC:

  • African Americans had 1.8 times the sudden infant death syndrome mortality rate as non-Hispanic whites, in 2005.
  • The infant mortality rate for African American mothers with over 13 years of education was almost three times that of non-Hispanic white mothers in 2005.

This last statistic shows that education does not help protect black babies from poor birth outcomes like it does other ethnic groups, and poses a unique question about how to reverse the tide and save more black babies.

One of the theories being put forth by researchers is that black women tend to enter pregnancy unhealthy and overstressed and cannot reverse years of unhealthy habits and unresolved stress in the 40 weeks of pregnancy. The result is babies who are born too soon or too small – both avoidable outcomes. “In countries where mothers do well, children do well,” Charles MacCormack, president and CEO of Save the Children, said in a written statement accompanying the report.

As a country we have to figure out how to address this problem. Obviously teaching black women – and all women whose pregnancies are at risk in this country – to live healthier, less stressful lives isn’t going to happen overnight. And I don’t expect the government to figure out how to save our babies, or at least, I’m not willing to wait that long. As mothers, whose lives are all interconnected, we have to figure it out.

I’m going to fight it with the stories I write, the issues I bring up, and the positions I take. I’m also going to fight it with my pocketbook. This month at MochaManual.com we’re donating 50 percent of all our sale proceeds to the March of Dimes to further their research to help all of us have healthier babies. If you want to help me help us, click here to shop our line of maternity and new Dad tees, baby Onesies, gift baskets, and Mocha Manual books to help a worthy cause or just make your own donation to the March of Dimes.

Source

Erykah Badu: "I Tweeted Between Contractions"

Erykah Badu, 38, who gave birth to her third child this past February, recently sat down with Babble on her tour bus bound for Brooklyn to homebirths, veganism, homeschooling and life as a mother to Seven Sirius, 8, Puma Sabit, 5 and 6-month-old Mars Merkaba.

The mom of three, whose children were all born at home, also took to the internet during labor with her daughter Mars and Twittered between contractions.

On delivering her children at home: “I had all my children at home, naturally. First my son [Seven Sirius] was born at home in 1997, because that's the natural environment, the old way. There's not a lot of fuss and moving around. I had a very wise doula and midwives giving me the freedom to continue living my life. I didn't have to uproot myself… Maybe to some it's scary, but preparation is the whole key. When a mother has found out she's going to have a baby, her whole life — her diet, her mood, her energy — should kind of prepare her. After she prepares herself, fear is never a part of it. I expected success and health, so I made sure I surrounded myself with it. By the time I had my third baby, childbirth seemed a very natural part of life to me.”

On tweeting her birth: “I was dared to do it. Actually, Questlove of The Roots — he said, "I bet you won't Twitter while you're in labor." I said, "I bet I will." So I did. I tweeted about what was happening with the birth between contractions.”

On homeschooling her children: “I wanted to give Seven Sirius [who is entering sixth grade in the fall] special attention academically, to give him an advantage. So by being home-schooled he learned how to learn — he learned how to solve problems in a nontraditional way. In doing that he developed an edge in his schoolwork. He enjoys challenges. He pushes himself. He does his homework voluntarily. He does not want to miss school or be late or be untidy or not have his things in order because that was a big part of how he was brought up [Seven was home-schooled until he entered second grade]. I don't have any idea what Seven is going to choose to do, but he knows how to be disciplined and how to learn, and because of that he's one of the top students in his school, and one of the top students in Dallas.”

On raising her kids as vegans: “When Seven was born I was a vegetarian and his father [Andre 3000, of Outkast] was too, so it was a natural progression for him in life to eat the things we eat. Puma [whose father is the rapper The D.O.C; Mars' father is longtime boyfriend Jay Electronica] is the same way. It's just what's in the house. They also now have an understanding of how to read ingredients — it's Mommy's lifestyle so it's their lifestyle… I don't in any way force them to have the same lifestyle, but I think they should know the benefits of having a healthy body. If they were to choose to do anything else after they become high school students, I would have full confidence that they know how to take care of their bodies and themselves. By making sure they use preventive medicine — getting plenty of water, plenty of chlorophyll and vegetable juices and good, healthy rest and activity — I know they'll be able to take good care of themselves.”

On what she thinks is the worst parenting practice in America today: “Parents not participating in kids' schooling. I don't think it matters what school you go to, but I think it's important for parents to be involved. And to know that when school stops, learning continues, and to continue teaching at home.”

Source

Thursday, September 03, 2009

How Implants Affect Breastfeeding

Fake boobs don't always hinder breastfeeding. Many women have said they'd consider a Mommy Makeover — a breast lift, tummy tuck and liposuction — if money were no object, but plenty of women undergo a lil nip and tuck before they bear children.

Former Playmate Kendra Wilkinson and reality show star Kourtney Kardashian recently revealed that they hoped to breastfeed once they give birth. Well known for her purchased assets, Pamela Anderson said she nursed both her boys. To learn more about whether or not implants affect a mom's ability to feed her offspring, we spoke with Dr. Robert Zubowski.

  • On whether or not the placement of implants affects breastfeeding. "The breast implant is typically placed in a submuscular pocket which separates the implant from the breast tissue. Augmentation in a subglandular position or any position directly below the breast tissue can be done safely without affecting the ability to breastfeed."
  • On incision placement affecting nursing. "Incision placement can make a difference with regard to breastfeeding. Incisions placed in the crease of the breast or in the armpit do not interfere with the gland or the ducts and therefore will not affect breast-feeding. Incisions placed in the lower half of the areola require that some dissection occur through the breast tissue and by consequence through the ductal tissue. Therefore in some cases especially if there is very little breast tissue, this may affect the ability to breastfeed."
  • On whether or not choosing silicone or saline matters. "The type of implant whether saline or silicone does not matter. Also studies have shown that there is no risk to the baby with regard to breastfeeding whether saline or silicone implants are used."
  • On engorgement's effects on implants. "Engorgement and pumping of the breast is not effected in any way in those women who have had breast augmentation."
Source

British village has higher birth rate than world's most densely populated countries

Cambourne in Cambridgeshire produced 24.1 births per 1,000 women in 2009 - almost double the UK average of 12.1.

The village has just 7,600 residents but has a higher fertility rate than India, China, Indonesia, Brazil and the USA.

Only a handful of countries including Afghanistan and Iraq produced more children per 1,000 women, according to statistics from Cambridgeshire County Council Research Group.

Experts believe Cambourne's rising birth rate stems from the village's unusually high concentration of young couples.

Cambourne, which lies in a commuter belt seven miles outside Cambridge, was founded in 1999.

Since its creation, the village's population has grown year on year. Figures show it produced 115 babies in 2004, climbing to 129 in 2005. There were 144 births in 2006, 186 the following year, and 210 between April 1 2008 and March 31 this year.

The village's fertility rate per 1,000 women - known as the 'crude birth rate' - has been consistently higher than other UK villages of the same size for the past five years.

In 2004, the figure was 22.2 - far higher than that of nearby Cottenham, which has a similar population but produced only 13.2 babies. By 2008/9, Cambourne's birth rate had soared to 24.1, more than twice the county average of 11.9 and well above the national average of 12.1.

Even the UK's two largest cities, London and Birmingham, fell behind with just 15.8 and 15 per 1,000 women respectively.

The baby boom means the village is growing faster than India, the world's fastest-expanding country with a population of 1,338,612,968 - more than 150,000 times Cambourne's size. According to 2009 figures published by the Central Intelligence Agency (CIA), India had a crude birth rate of only 21.67.

The worldwide average is 19.95.

But Cambourne's growth has put considerable pressure on its infrastructure.

Among the immediate problems is education. A third primary school is set to open next month because of the mounting competition for places.

The world's Top Ten highest birth rates outside African countries in 2009. (Figures from CIA).

  1. Afghanistan - 45.46.
  2. Yemen - 42.14
  3. Gaza Strip - 36.93
  4. Iraq - 30.1
  5. Kiribati - 30.2
  6. Laos - 33.94
  7. Marshall Islands - 30.7
  8. Oman - 34.79
  9. Sao Tome and Principe - 38.54
  10. Saudi Arabia - 28.55

The world's Top Ten lowest birth rates:

  1. Hong Kong - 7.42
  2. Japan - 7.64
  3. Italy - 8.18
  4. Germany - 8.18
  5. Guernsey - 8.46
  6. Jersey - 8.63
  7. Singapore - 8.82
  8. Macau - 8.88
  9. South Korea - 8.93
  10. Slovenia - 8.97
Source

Lisa Loeb pregnant with first child

Singer Lisa Loeb is expecting her first child with husband Roey Hershkovitz.

A rep for the singer confirmed the news to People, saying "They're excited to welcome their first child this winter."

Loeb met Hershkovitz, who is a music production supervisor for "The Tonight Show with Conan O'Brien," in 2006 during a business meeting, according to People.

The couple tied the knot in January in a Jewish ceremony in New York City.

Source

Wednesday, September 02, 2009

Gum care smart, but it won't curb preterm delivery

It's been suggested that gum disease raises the risk of preterm birth in pregnant women and it was thought that getting rid of gum disease may potentially reduce the risk of preterm delivery.

Not so, according to a new study.

"(Our) study," lead investigator Dr. Steven Offenbacher told Reuters Health, "showed that a standard dental visit to provide periodontal care during pregnancy did not impact pregnancy outcomes, nor did it stop maternal gum problems during pregnancy."

Offenbacher of the North Carolina Oral Health Institute, Durham and colleagues draw their conclusion from a study involving 1806 pregnant women with periodontal (gum) disease, all of whom were receiving standard obstetric care.

The women were randomized to receive up to four sessions of gum care before the 24th week of pregnancy or after delivery.

According to the investigators, rates of preterm delivery were no different in the two groups. Preterm delivery rates were roughly 13 percent in the women who made the four trips to the dentist and nearly 12 percent in those that did not.

That's not to say pregnant women should not get their teeth cleaned and treated as needed; they should, the researchers emphasize, noting that treating gum disease during pregnancy is safe.

Worsening of gum disease occurs in about 25 percent of pregnancies. The bacterial infection attacks the teeth-supporting tissues below the gum line. Left untreated, it can lead to tooth loss as well as a host of other problems.

Source

Job-related claims of pregnancy bias on the rise

Samantha Stone, 29, would like to have a baby soon. But with the job market tenuous, being pregnant in the workplace has become much more risky.

Just look at the number of pregnant women who are blogging about job discrimination, filing lawsuits for unfair removal and turning to advocacy groups for relief after being targeted in job cuts.

Claims of pregnancy discrimination are on the rise, maternity leaves are a luxury and conducting a job search while pregnant is like trying to win the lottery.

Even more, many pregnant women are shocked to learn they have few workplace protections. Women swept into the layoff frenzy are discovering you can be fired while pregnant or on maternity leave.

In the tough economy, employers consider expecting mothers to be expendable employees, says Robert Weisberg, a Miami labor lawyer who represents victims of discrimination. ``In these times, pregnancy is viewed as a real liability.''

Weisberg says more employers consider new mothers less productive and don't want the disruption of maternity leave. ``Women are telling me they've been encouraged, coerced or told by their boss to have their baby and stay home.''

The numbers reflect this lack of tolerance. Pregnancy-bias complaints recorded by the Equal Employment Opportunity Commission rose 14 percent in 2008 to 5,587, the biggest annual increase in 13 years.

As the complaints stream in, Nora Curtin, an attorney with the EEOC, says, ``It's still shocking to me that some employers are blatant about this kind of discrimination.''

In Florida, the EEOC is suing one of the largest general contractors in the Southeast, Choate Construction, on behalf of an administrative assistant. The woman claims a manager on a construction site criticized her for getting pregnant, harassed her, and called her a liability. She was fired shortly after she complained to human resources.

Choate denies the claim and says the firing was performance based.

Attorney Stuart I. Grossman says the most common employer defense against pregnancy bias has become the economy. ``Companies will assert they need to reduce their workforce to survive and the burden shifts to the employee to prove otherwise.''

What employers cannot do is treat expecting mothers differently than they would another employee or job candidate. The Pregnancy Discrimination Act says it is illegal to fire, or not hire, a person because she is pregnant. To succeed in a claim, a woman who brings charges must prove an employer's action was motivated by her pregnancy or status as a mother.

In the most obvious way, getting the ax while pregnant is a double whammy. Employers are warned that asking personal questions in job interviews can get them in legal hot water. But in a tight job market, chances of finding work while pregnant are minimal, even with the law on your side.

Combine job fears with economic factors and it is no wonder America's first decline in births this decade came in 2008. Florida and California, the two states hit hardest by the housing crisis, saw the largest drops.

Such risk has become too high for families that depend on women for economic security, says Debra Ness, president of the National Partnership for Women & Families. ``In this recession, many men have been laid off, leaving families with the wife's paycheck as the primary source of income.''

New moms often are unaware they aren't entitled by federal law to paid childbirth leave. Nataly Kogan, founder of WorkItMom.com, says if your family needs your income you have to make some judgment calls. ``The harsh reality is that it's important to be in the loop, be visible. That may mean shorter maternity leave,'' she says.

It may also mean grappling with how to handle a job search. Career websites are filled with pregnant women out of work querying whether they should tell a prospective employer they're pregnant during the interview process. Kogan says the key is to emphasize commitment to your job. ``The burden is on the employee to emphasize your productivity and your intention to come back.''

Source

Tuesday, September 01, 2009

Another Baby for Mark Wahlberg and Rhea Durham?

It appears as though there are no shortage of reasons for Mark Wahlberg and Rhea Durham to celebrate.

Fresh on the heels of their August 1st wedding, Rhea was spotted on Sunday at The Grove in Los Angeles sporting quite the baby bump.

Though no official announcement has been made, a source says the couple are expecting their fourth child.

Already parents to Ella Rae, turning 6 tomorrow, Michael, 3, and Brendan Joseph, 11 ½ months, they have made no secret of their desire for a big family.

Last summer, Mark — 38-year-old executive producer of the HBO smash Entourage — joked that “when the kids are good, we want eight or nine.”

He went on to call life in a full house “hectic…but a lot of fun.”

The actor’s rep did not respond to requests for comment.

Next up for Mark is the Peter Jackson-directed feature film The Lovely Bones opposite Rachel Weisz, in theaters on Dec. 11.

Source

Report: Halle Berry Is Pregnant?

Life & Style is reporting that Halle Berry is expecting her second child. The 43-year-old Academy Award-winning actress is said to be three months along into her second pregnancy. "Halle is overjoyed,” says an insider close to Halle and the baby’s father, model Gabriel Aubry.

Reportedly, Halle conceived via "artificial insemination:"

“The first time, she struggled so much to get pregnant and eventually conceived through in vitro fertilization. This time, the baby was conceived through artificial insemination. She’s just ecstatic to be pregnant again,” the insider states. “She wasn’t sure if she’d have another baby, so she’s very happy!”

A rep for Halle did not respond to a request for comment.

Halle and Gabriel are already parents to 17-month-old daughter Nahla.

Source

Pregnant women confront rise in cancer cases

The number of women diagnosed with breast cancer during pregnancy or soon after giving birth has more than doubled since the 1960s, and researchers say cases will continue to rise as women have children later in life.

The incidence of pregnancy-associated breast cancer rose from 16 in every 100,000 deliveries to 37.4 per 100,000 deliveries between 1963 and 2002, a study has found.

Breast cancer was under-diagnosed in pregnant and breastfeeding women because they and their doctors assumed breast firmness or lumps were a normal part of childbearing, said the chief executive of the National Breast and Ovarian Cancer Centre, Helen Zorbas.

She urged health professionals to assess all women the same way, regardless of pregnancy. ''While most breast changes won't be cancer, early detection is vital for improving survival.''

Although pregnancy does not cause breast cancer, hormonal changes can accelerate its growth and tumours in pregnant women are often larger and more advanced by the time they are detected than those in women who are not pregnant.

The disease poses a dilemma for patients and their doctors. Pregnant women can have surgery but not radiotherapy. And chemotherapy is allowed only after the first trimester.

The study, published in the journal Obstetrics & Gynecology, reviewed more than 4.1 million deliveries in Sweden between 1963 and 2002.

The Karolinska Institute in Stockholm found the largest proportion of pregnancy-related breast cancers was among 25- to 29-year-olds.

But because the breast cancer risk rose with age and the average age of mothers had increased to about 30, its incidence during pregnancy was likely to increase, the institute said.

Source

Michelle Duggar Pregnant with Number 19!

Make way for more Duggars!

Jim Bob and Michelle Duggar of Tonitown, Ark., who have 18 children and one grandchild on the way, are expecting a new addition to their household – baby No. 19 will arrive in the spring.

"We are so thrilled," says Michelle, 42. "We just couldn't believe it is happening." Jim Bob, 44, agrees: "This never gets old. We are so grateful for each child. We are looking forward to our first grand baby and our 19th child."

Oldest son Joshua, 21 and his wife Anna, 21, are expecting daughter Mackynzie Renée next month, so she will be older than her new aunt or uncle.

"I think it is going to be awesome, it is going to be great," says Josh about the news that his parents are expecting. "We have been looking forward to the arrival of my little girl and to now get to celebrate for my parents, it's a wonderful thing."

"I love all of this, it is so fun," says Michelle. "Anna and I will have babies five months apart. My mother and my sister were pregnant at the same time and it was really wonderful. The kids were really close and still are. I have a nephew who grew up with me, we're just three months apart."

The Duggars live debt-free in a house they built themselves with their kids, whose names all begin with J: after Josh there are twins Jana and John-David, 19; Jill, 18; Jessa, 16; Jinger, 15; Joseph, 14; Josiah, 13; Joy-Anna, 11; twins Jedidiah and Jeremiah, 10; Jason, 9; James, 8; Justin, 6; Jackson, 5; Johanna, 3; Jennifer, 2, and Jordyn-Grace, 8 months. Their lives are featured on TLC's 18 Kids and Counting, airing Tuesday nights.

Despite being pregnant 18 times before, Michelle says this pregnancy came as a shock, although her daughters wondered why she was eating more pickles than usual.

"I was wanting pickles and the older girls were saying, 'Mom, you only crave these at the very beginning of being pregnant, You kept it from us before, now tell us. Are you?'" Michelle says. "And I kept telling them I wasn't. I just wanted some pickles."

But when she couldn't lose weight on her diet, she became suspicious.

"I was in Weight Watchers with Jim Bob and I wasn't losing any weight," she says. "I couldn't figure it out. I was doing what I should. And the baby, who was nursing, was fussy. I kept thinking, 'This isn't right. She isn't teething, she doesn't have an ear infection. I'm not cheating on my diet, I should be losing weight.' Then, I put two and two together and wondered if I could possibly be pregnant."

She took out one of two tests she had in the house and it was immediately positive.

The Duggars recently renewed their wedding vows – they've been married 25 years and one month – and say that the ceremony was a wonderful way for their own children to understand the commitment of marriage.

"We got married when Michelle was 17 and I was 19," Jim Bob says. "We were married in the hallway of a church because at the time they had no sanctuary. There were plastic chairs and crepe paper. So, when we renewed our vows, we did it in that same hallway and we splurged to make bows out of a plastic white table cloth this time, but we still had plastic chairs. I think it is important to have the kids see that commitment themselves."

Michelle says that since she was 36 years old, her doctor has given her and Jim Bob pamphlets about prenatal testing since there is an increase of risk of health problems in babies with older mothers. But, she says they don't worry about those risks and don't take the tests.

"We know what could happen," she says. "We read through the information. If the Lord chooses to give us challenges along the way, we know His grace will be there, so we don't opt to do the testing."

As far as her own health, her doctor told PEOPLE when her last child was born that Michelle's health was excellent: "Some women are made to have babies, and Michelle is to the nth degree," ob-gyn Amy Sarver told PEOPLE in December. "She is in terrific health without any strain on her uterus."

"I'm feeling nauseous right now," she says. "And, I'm tired. I am happy for the feelings of morning sickness and I'm happy for every day I get to play with my kids. We don't know what tomorrow holds and so I try to enjoy every moment."

Already, names are being discussed in the Duggar household: Jessa, 16, has printed up a list of J-names for boys and girls that have yet to be used by a Duggar, Michelle says.

Source

Monday, August 31, 2009

Drugs given during labour linked to breastfeeding problems

Drugs and painkillers that are routinely given to women in labour may reduce their ability to breastfeed their baby, reseachers say.

A study suggests that life-saving medication given to nearly all women to prevent and treat bleeding after birth is linked to reduced breastfeeding rates.

The findings indicate a potential biological reason for why so many women in Britain fail to breastfeed, despite government efforts to increase the number of infants receiving their mother’s milk.

Analysis of the records of more than 48,000 women who gave birth in South Wales found that use of the clotting agents oxytocin or ergometrine was associated with a 7 per cent decline in the proportion who started breastfeeding within 48 hours of giving birth.

It is thought that the drugs may impede a woman’s ability to produce milk, suggesting that mothers who have them may need greater time or support from midwives if they wish to breastfeed their baby.

The study, by researchers at Swansea University, also confirmed the link between high doses of injected pain relief and lower rates of breastfeeding, an association that has recently prompted revised guidelines for the NHS on the use of epidurals in labour.

Of the women involved in the study, who all gave birth between 1989 and 1999, two thirds (65.5 per cent) of those who did not receive drugs to prevent post-partum haemorrhage started breastfeeding their baby within 48 hours of giving birth.

But the proportion of those doing so reduced to 59.1 per cent among those given an injection of oxytocin, a hormone that plays an important natural role in labour, and to 56.4 per cent of women given an additional injection of ergometrine, given to address actual bleeding.

Overall, nearly eight out of ten (79 per cent) of the women in the study received either oxytocin, ergometrine or both. It is routine for women being treated on the NHS to be offered these drugs. The decline of 6-7 per cent in those being breastfed could lead to up to 50,000 fewer British babies being breastfed every year than might otherwise be possible, she added.

Because of the health benefits of breastfeeding, 50,000 bottle-fed infants represents the possibility of about 1,000 children becoming clinically obese, or 3,000 additional cases of childhood asthma. It could also greatly increase the number of mothers affected by breast cancer.

The findings are published today in BJOG: An International Journal of Obstetrics and Gynaecology.

Source

Exposure to Tobacco Smoke Before Birth Affects DNA

Women who smoke while pregnant increase their unborn child's long-term risk for health problems, including childhood asthma, cardiovascular disease and lower pulmonary function, and a new study may help experts understand why.

Researchers at the Keck School of Medicine of the University of Southern California (USC) found that maternal smoking actually changes the unborn child's DNA patterns.

The new study found that fetal exposure to maternal smoking was linked to differences in DNA methylation, an epigenetic mechanism.

Epigenetics is the study of how chemicals that attach to DNA can switch genes on and off, which leads to differences in gene expression without changing basic genetic information, according to background information in a USC news release about the study.

While epigenetics plays a role in cancer research, little is known about how epigenetic changes may be caused by environmental exposures.

In the new study, the researchers used data from the USC Children's Health Study, which examined respiratory health among children in 13 Southern California communities, as well as information from a questionnaire on maternal smoking exposure. The findings are reported in the September issue of the American Journal of Respiratory and Critical Care Medicine.

"This study provides some of the first evidence that in-utero environmental exposures such as tobacco smoke may be associated with epigenetic changes," said one of the lead authors, Carrie Breton, assistant professor in the Department of Occupational and Environmental Health at the Keck School of Medicine of USC. "This could open up a new way for researchers to investigate biological mechanisms that might explain known health effects associated with maternal smoking," she stated in the news release.

"Moms should not be smoking during pregnancy," Linda Birnbaum, director of the U.S. National Institute of Environmental Health Sciences, said in the news release. "Maternal smoking during pregnancy is not only detrimental to the health of the mom and the newborn child, but research such as this suggests that it may impact the child into adulthood and possibly even future generations as well."

Source

Perinatal Death Low with Home Births

Planned home births attended by registered midwives were associated with a very low rate of perinatal death, comparable to those of hospital births, a prospective Canadian cohort study found.

The rate of perinatal death per 1,000 planned home births was 0.35 (95% CI 0 to 1.03) compared with 0.57 (95% CI 0 to 1.43) among hospital births attended by midwives, and 0.64 (95% CI 0 to 1.56) among hospital births attended by physicians, according to Patricia A. Janssen, PhD, of the University of British Columbia in Vancouver, and colleagues.

Planned home births also were associated with fewer obstetric interventions and other adverse outcomes, the researchers reported online, ahead of print, in the Canadian Medical Association Journal.

Debates about the safety of home births continue in the literature and among policymakers, with the American College of Obstetricians and Gynecologists having long opposed the practice.

In contrast, the U.K. Royal College of Obstetricians and Gynaecologists considers it a viable choice for uncomplicated pregnancies, while the Society of Obstetricians and Gynaecologists of Canada has not taken a specific stand.

Previous studies of home birth conducted in North America, Europe, and Australia have been limited by inadequate statistical power, incomplete data, and nonrepresentative sampling.

To address these concerns, Janssen and colleagues acquired outcomes data for all planned home births attended by registered midwives in British Columbia between January 2000 and December 2004.

Eligibility requirements for home birth, according to the College of Midwives of British Columbia, include the absence of preexisting or pregnancy-onset maternal disease, a singleton fetus, and gestational age between 36 and 41 weeks.

A total of 2,899 women who began labor with the intention of giving birth at home were compared with 4,752 who also met the eligibility criteria for home birth but began labor planning to give birth in the hospital attended by a midwife.

The same cohort of midwives, all of whom had extensive academic and clinical training, attended both groups.

A second comparison group included 5,331 matched, physician-attended births, all of which took place in the hospital.

Among the women planning to give birth at home 78.8% did so, while among those planning hospital birth, 96.9% did so.

Compared with women planning a hospital birth with a midwife attending, those who planned home birth were significantly less likely to experience these complications:

  • Third- or fourth-degree perineal tear (RR 0.43, 95% CI 0.29 to 0.63)
  • Postpartum hemorrhage (RR 0.62, 95% CI 0.49 to 0.77)
  • Pyrexia (RR 0.45, 95% CI 0.29 to 0.76)

The following neonatal complications also were less likely in the setting of home birth:

  • Birth trauma (RR 0.26, 95% CI 0.11 to 0.58)
  • Resuscitation (RR 0.23, 95% CI 0.14 to 0.37)
  • Oxygen therapy beyond 24 hours (RR 0.37, 95% CI 0.24 to 0.59)

The rate of infection did not differ significantly between the two groups (RR 0.39, 95% CI 0.13 to 1.14).

Compared with women giving birth in the hospital attended by a physician, those who planned birth at home had neonates at reduced risk for:

  • Birth trauma (RR 0.33, 95% CI 0.15 to 0.74)
  • Resuscitation (RR 0.56, 95% CI 0.32 to 0.96)
  • Oxygen therapy beyond 24 hours (RR 0.38, 95% CI 0.24 to 0.61)
  • Meconium aspiration (RR 0.45, 95% CI 0.21 to 0.93)

However, neonates born at home were more likely to be admitted to the hospital, or readmitted if they were born in the hospital, despite the planned home birth (RR 1.39, 95% CI 1.09 to 1.85).

The reason for this, according to the investigators, may have been a greater incidence of admission for treatment of neonatal hyperbilirubinemia in the home-birth cohort -- a condition that can be identified and treated before discharge in up to 40% of neonates born in the hospital.

Among the strengths of the study were the completeness of data and the fact that the same cohort of midwives attended the home and hospital births.

Limitations include the self-selection of women choosing home birth, despite the investigators' efforts to closely match the comparators.

The study findings cannot be generalized to settings where midwives are less highly trained and experienced, they cautioned.

Nonetheless, they concluded, "Our study adds to the body of large cohort studies of planned home births that have reported on the relative safety of home versus hospital birth."

Source