Friday, March 26, 2010

Pregnancy Safe For Breast Cancer Survivors

Women who survive breast cancer and have children afterwards don't appear to be at any higher risk of dying from cancer, a new study says.

Doctors have long worried pregnancy might spark hormonal changes in breast cancer survivors that could spur the disease's return, and many breast cancer patients are counseled against getting pregnant after they recover.

In research presented Friday at a European breast cancer conference in Barcelona, experts said pregnancy in women who have been treated for breast cancer is safe and does not seem to be linked with the disease's recurrence.

Among women in the general population, those who have early and multiple pregnancies have a lower risk of getting breast cancer than women who don't.

Dr. Hatem Azim of the Institute Jules Bordet in Belgium and colleagues analyzed results from 14 previous trials that followed more than 1,400 pregnant women with a history of breast cancer. Those women became pregnant several months to several years after finishing treatment. Azim and colleagues compared those women to more than 18,000 women who had had breast cancer and were not pregnant.

Azim and colleagues found that the women who got pregnant had a 42 percent lower risk of dying compared with breast cancer survivors who did not get pregnant. He said part of that benefit might be due to the fact that women who were naturally healthier were those that later had children.

But in some studies, women with breast cancer who became pregnant were compared to women who remained free of the disease, i.e. the healthiest of the breast cancer survivors.

"For many years, pregnancy was considered a risk for women who had breast cancer," said Maria Leadbeater, a cancer expert at Breast Cancer Care, a British charity. "But this study seems to show the risk is not an issue once you've been treated," she said. Leadbeater was not connected to Azim's study.

Leadbeater said the advice for patients might vary depending on the type of breast cancer they've had and how they responded to treatment. Women who need hormone therapy for breast cancer typically need to be on it for five years — during which time doctors recommend against getting pregnant.

Leadbeater and others said women should try to wait until two years after their diagnosis to try for a baby, since that is thought to be the riskiest time for a relapse.

Azim, who led the study, hypothesized that the relationship between hormones and breast cancer might be more complicated than doctors initially thought. Estrogen is known to trigger breast cancer and women typically have more estrogen when they're pregnant. But very high doses of the hormone can also kill cancer cells, Azim said.

Other hormones that are elevated in pregnancy, like the one for breast-feeding, have been proven to protect against breast cancer. "What we are seeing is only the tip of the iceberg," Azim said. "It's too simple to say that pregnancy stimulates hormones and that's bad for breast cancer."

Source

Thursday, March 25, 2010

Parents who want smarter babies should use words, not babyspeak

Talking has a bigger impact on their developing minds than other sounds, even musical ones, according to a new study.

Infants as young as 3 months old who were exposed to words, not baby talk, were more capable of "categorizing" pictures than babies who just listened to tones.

"For infants as young as three months of age, words exert a special influence that supports the ability to form a category," said Susan Hespos, associate professor at Northwestern University, according to the Daily Mail. "These findings offer the earliest evidence to date for a link between words and object categories."

The research, published in the journal Child Development, focused on 50 3-month-olds who looked at a series of pictures of fish. Either words or beeps were played as the babies looked at the photos. Next, they were shown photos of a fish and of a dinosaur, side by side, as researchers checked to see how long they looked at each photo. Apparently, when the babies looked at the fish longer than the dinosaur, this meant they had already categorized the fish in their minds.

The results, according to the researchers, were "striking." The babies in the "word" group kept their eyes on the fish for a longer period of time.

Sandra Waxman, a co-author of the study, said, "We suspect that human speech, and perhaps especially infant directed speech, engenders in young infants a kind of attention to the surrounding objects that promotes categorization."

Babies as young as three months old can even benefit from having stories read to them, says Dr. Albert Levy, assistant professor of medicine at Mount Sinai School of Medicine. "I don’t encourage parents to talk baby talk to their baby all the time because when you do, the baby learns to speak that way. Use the words you want them to learn."

Just a year ago, Hespos was involved in a study that demonstrated that babies are brainier than was previously thought, according to The Sun. The research found that babies as young as 5 months old learn by themselves, rather than by being taught. In that study, researchers showed the infants a tilted glass filled with blue liquid, and then a glass containing a blue solid that had been angled to look like the first glass. The babies looked at the solid longer than at the liquid, which meant they could tell the difference between the two.

"Babies are collecting data all the time," Hespos said.

Source

Infants Recognize Voices, Emotions By 7 Months

A new study suggests that our brains develop specialized circuits to process human voices long before we learn to speak.

The study, which appears in the journal Neuron, looked at brain activity in 32 infants as they listened to recorded sounds. Half the children were 4 months old and the other half were 7 months old.

Some of the sounds they heard were nonhuman sounds, like chickens clucking, a bell ringing or a cuckoo clock. The rest were clearly human utterances including some words, though not in any language the children would have heard before.

While the children listened, researchers from Germany and the U.K. measured activity in certain areas within a part of the brain called the superior temporal cortex, which is just above the ear. Other studies have shown that these areas are where voices are processed in adults.

In 4-month-old infants, these areas did not differentiate between human voices and nonhuman sounds, says Tobias Grossman from the Centre for Brain and Cognitive Development at the University of London and the Max Planck Institute for Human Cognitive and Brain Sciences.

But it was a different story in the 7-month-old infants, Grossman says. The brain responses showed that "they process human voice distinctly from other kinds of sounds," he says.

The researchers wanted to know whether the older children's brains would also respond to the emotional meaning that's often conveyed through vocal intonation.

So they played unfamiliar words spoken with happy, unhappy and neutral intonations, and once again, certain areas of the brain seemed to know the difference.

The findings provide strong evidence that specialized voice processing in the brain develops sometime between the fourth and seventh month of life, Grossman says.

Problems with the brain systems that recognize and process human voices could offer an early warning of language difficulties.

Source

Why Are Moms Dying In Labor?

Over the past decade, the U.S. maternal mortality rate has nearly doubled, with about 500 women dying of pregnancy-related complications each year. That's a tiny percentage of the 4 million American women who give birth annually. But what's shocking is that among industrialized countries, the U.S. ranks an abysmal 41st on the World Health Organization's list of maternal death rates, behind South Korea and Bosnia-yet we spend more money on maternity care than any other nation.

Amnesty International has designated the U.S. maternal mortality rate a human-rights concern. This month, the organization called on President Barack Obama to address the crisis, noting that two to three women die of pregnancy-related complications in this country every day, as we move further away from the government’s goal of 3.3 deaths per 100,000 live births. The health-care reform bill signed into law by Obama Tuesday could help, as it requires insurance companies, for the first time, to cover prenatal care and some childbirth costs.

Skeptics attribute the rise in the maternal mortality rate to better reporting of maternal deaths—and it’s true that over the past decade, states have revised death certificates to better flag pregnancy-related mortalities. Yet review committees estimate that better reporting only accounts for about 30 to 40 percent of the rise.

More likely, the maternal death rate is going up due to a complex cocktail of factors—causes that reflect a changing population, disparities in poor women’s access to health care, and even Americans’ reliance on cutting-edge medicine. Here are seven explanations for the unsettling rise:

  1. A Skyrocketing Caesarean Rate

    Before C-sections became as safe and standard as they are today, pregnant women had few options if they found themselves in an emergency situation; aside from metal forceps, doctors lacked tools to get babies out quickly, which often led to tragedy.

    Yet as lifesaving as C-sections can be, an astounding one in three American women now give birth surgically, up from one in five a decade ago. Healthy women who give birth surgically are 80 percent more likely to be re-hospitalized than healthy women who give birth vaginally; they’re also four times more likely to die. Hemorrhage, infection, and pulmonary embolism are all more common following a surgical birth.

  2. More Obese Moms

    As the obesity epidemic swept the country, more overweight women have gotten pregnant and given birth, despite serious risks. One in five women in the U.S. are now obese at the beginning of their pregnancy, according to the Centers for Disease Control. Obese women are more likely to develop hypertension, high blood pressure, and diabetes during pregnancy, which can lead to preeclampsia and other fatal conditions. Preeclampsia is responsible for about 18 percent of maternal deaths in the U.S., and over the past decade, the incidence of the condition rose by 40 percent.

    Labor can also be more difficult for obese women, as soft tissue can impede delivery. Obese women are also at greater risk for delivering bigger babies, needing C-sections, and developing postpartum infections and heart problems.

  3. Disparities in Access to Care

    As economic disparities in the U.S. health-care system grew wider over the past several decades, fewer women got the family planning, prenatal, and postpartum care they needed. Currently, one in five women of childbearing age are uninsured, Amnesty International reports. In most states, poor women do qualify for Medicaid once they become pregnant; the problem is, six weeks after giving birth, most of these women are dropped.

    From there, a dangerous cycle can begin: If a woman has risk factors going into her first pregnancy—say, diabetes or hypertension—the conditions often get worse through the process. She can’t afford the medical care to treat her conditions. Nor can she afford contraceptives, so she often ends up getting pregnant again, this time facing even greater risks. By the time she’s back on Medicaid for her next pregnancy, she’s in big trouble.

    The good news is that the new health-care reform legislation will expand access to Medicaid for about 15 million people, and will include prenatal and maternal care in the basic package of services private insurers must cover.

  4. Unnecessary Medical Interventions

    Like C-sections, medical innovations such as drugs to induce labor and devices to monitor fetal heart rates can be lifesaving, but they can also lead to complications in healthy women. When an intervention is unnecessary—performed out of convenience or protocol—the harms can outweigh the benefits.

    In many developed countries, induction is used as a last resort, but in the U.S., hospitals induce or accelerate roughly 40 percent of labors. These drugs, in turn, can create more aggressive contractions, which increase the risk of uterine rupture. A woman who is induced is also more likely to end up needing a C-section.

  5. Older Moms

    As the rate of childbearing women over 40 has risen, so has the maternal mortality rate. Moms over 35 are more likely to develop gestational diabetes and other complications; they’re also more likely to have twins or other multiples, thanks both to biology and the wonders of fertility treatment—and multiple births are far riskier than single births, for both mother and babies.

    But Elliott Main, a San Francisco-based OB/GYN and principal investigator of the California Maternal Quality Care Collaborative, says that most American women who die in childbirth are in their twenties or thirties.

  6. Poor Birth Education

    Maternity-care advocates stress that as birth has become increasingly medicalized, American women have become surprisingly uneducated on the topic.

    In particular, low-income women with limited access to health care may not be aware of the risks of taking certain medications or engaging in certain behaviors during pregnancy. Similarly, advocates point out that with C-sections and interventions on the rise, women feel less empowered to take control of their birth experience—they don’t always know their options or trust their instincts. They must rely completely on hospital staff, who are often overworked, exhausted, and juggling many births at once.

  7. Complacency

    Despite the rising maternal mortality rate, pregnancy-related deaths in this country are still rare. Most doctors and nurses will go their entire career without encountering one. Yet as a result, many hospitals have become complacent that mothers just don’t die anymore. Hospitals need to act proactively, paying closer attention to changes in women’s vital signs.

Source

Wednesday, March 24, 2010

This Week's Celebrity Baby Bumps

Amy Poehler is riding the line of casual and conservative, Mario Lopez's girlfriend is showing style with a barely visible bump, Danica McKellar debuts her bump in a cute gray dress, Claudia Schiffer goes retro at the premiere of Kick Ass with Brad Pitt by her side, Bethenny Frankel mixes up her NY style with a pink cardigan, and Amy Adams is ready for summer in jean shorts and sandals.

Source

Infantino Baby Slings Pulled From Market

Nearly two weeks after the Consumer Product Safety Commission warned parents that over-the-shoulder baby slings can be deadly for children younger than 4 months old, San Diego-based Infantino LLC is pulling two of its carriers -- SlingRider and Wendy Bellissimo -- off the market altogether.

The deaths of at least three infants prompted the original recall of more than 1 million baby slings sold throughout North America.

"Our top priority is the safety of infants whose parents and caregivers use our products," Infantino's President Jack Vresics, said in a statement today.

"Infantino is announcing a voluntary replacement program for the Infantino SlingRider and Wendy Bellissimo infant baby carriers to address concerns raised by the Consumer Product Safety Commission," Vresics said.

The CPSC urges consumer to "stop using the recalled slings immediately and contact Infantino to receive a free replacement product."

There's a risk involved with all sling carriers, particularly for newborns the CPSC says. Babies' weak neck muscles make it difficult to move to a better position if they are suffocating. But Infantino slings have raised specific concerns.

"It does not matter how old your baby is at this point with the Infantino sling," said CPSC's Scott Wolfson. "Do not use it. This sling places the baby in a very deep part of the product," Wolfson said. "What is so dangerous is when the fabric covers nose and mouth or when baby is turned into the body of the mother and the airway is restricted."

Just about two weeks ago, Infantino released a statement to ABC News saying it believed the SlingRider was a "safe product."

In October 2009, Don Mays of Consumer Reports magazine was so concerned about Infantino slings that he wrote a letter to the CPSC, drawing attention to three known deaths and urging the agency for a recall.

So what has taken so long ?

"A case needs to be established," Wolfson said.

"Incidents need to be investigated. And we were able to reach a point with the company without having to go to court, without a protracted case, that there was a recognition that there was a risk of suffocation with the product. And the time is now to act."

Wolfson said the agency also has "additional investigations of other products that are underway."

The recall announcement lists that the slings were sold at "Walmart, Burlington Coat Factory, Target, Babies "R" Us, BJ's Wholesale, various baby and children's stores and other retailers nationwide, and on the web at Amazon.com."

Consumers looking for a replacement are urged to "contact Infantino at (866) 860-1361 between 8 a.m. and 4 p.m. PT Monday through Friday, or visit the firm's Web site at www.infantino.com."

Source

The Perks of Pregnancy

Pregnancy isn't easy for most women but here is a list of perks:

  • EATING. Most pregnant women have carte blanche to eat all they want. I'm talking Blizzards at midnight, countless snack-sized candy bars from the candy drawer and rich buttery dishes served far more often than three times daily. I recently heard from a friend that celebrities - Kate Hudson and Jessica Alba among them - loved being pregnant because it was one of the few times in their lives they could eat anything and "conceal" the weight gain. I mean, who could distinguish the baby-part of the belly from that part dedicated to the ice cream, candy and chip feedings? (Admittedly, it certainly does add to the post-pregnancy challenge of losing the pounds... but truly, perhaps spoiling yourself on late-night binges is appropriate during this time?)
  • NEW FRIENDS. You make new friends - EVERYWHERE you go. There is an overt interest in the gigantic belly. Turns out, there's a distinct advantage to that - in that, people somehow feel more connected and open to you due to that very belly. It's a disarming thing, I think, when people see that you're simultaneously so vulnerable and yet so capable of growing a new life. Let the belly continue to tear down the barriers among us.
  • FEWER CONFRONTATIONS. On a related note, people are far less confrontational with a pregnant woman. Call it a survival instinct. Yep, who is na├»ve and silly enough to think they can verbally wrestle with a hormonally-charged woman just waiting for the opportunity to conversationally take down her opponent? Few, I'd argue. Beyond that, I think again people simply let down their guards around pregnant women as they reflect on their own families. They then inevitably interact with the pregnant woman on a gentler note.
  • GETTING FROM A TO B. A colleague recently observed that whenever we're working in tight quarters - a crowded stadium, bustling mall or packed street - people will literally part ways to allow me through. Once you've reached a certain roundness (not sure of the exact circumference required) - people will just step back and let you walk - or rather, waddle - on through. They apparently don't want to interfere with what limited, slow, uncomfortable-looking progress you ARE making.
  • PERSPECTIVE. I think all of us seek to retain perspective on any given day, regardless of what we've been dealt. A tough assignment, a disappointing argument, stress related to all that needs to get done - all of those can diminish or outright derail a good - or even neutral - mood. I truly think pregnancy helps to regain that good mood; I mean, when the baby's kicking your ribcage, you can't help but remember there are other things in life. This too shall pass, you believe.

There are undoubtedly more perks - enough to fill a novel. From swollen feet to aching hands to a body that just keeps growing - there's a lot to contend with these nine months. But for at least part of that time, we should all of us - both those who are pregnant and those supporting us - remember some of the perks. What perks have you discovered during your or your partner's pregnancy?

Source

Researchers offer tips for picking the right baby bottle

Breastfeeding expert Donna Dowling, associate professor of nursing at the Frances Payne Bolton School of Nursing at Case Western Reserve University, could sympathize with the new mom next to her in a large baby store as she was also overwhelmed by the variety of bottle choices in the 12 x 8 foot display.

The expectant mom's questions inspired Dowling to explore the research evidence behind the claims of manufacturers for their baby products.

All are designed to mimic breastfeeding, according to Dowling and Laura Tycon, a nursing student at the university, from bottles shaped and pliable like a mother's breast to complicated feeding systems designed to prevent the baby's intake of excess air. In their research, it became evident that the designs of the bottles were based on research done during the 1960's and 70's that demonstrated differences in how infants obtain milk during breastfeeding and bottle feeding.

After reviewing research papers provided by the manufacturers about their baby products, Dowling and Tycon came up with some tips and report them in the Nursing for Women's Health article, "Bottle/Nipple Systems, Helping Parents Make Informed Choices."

"Babies are different and have different styles of sucking, from the slow to the fast eaters," Dowling said.

The researchers offer this advice:

  • The bottle and nipple need to fit the baby's eating style. Baby bottles come with nipples that have slow, medium or fast flows of milk. The slower milk flows are for the younger babies who are encountering their first learning experience--feeding. Some babies are very flexible and will take any nipple if they are hungry while others prefer to stay with what is familiar.
  • Consider advertising claims that bottles/nipples prevent colic or were clinically tested objectively. Seek out the research studies to see if the claims matched the findings and who funded the study.
  • Realize that no one product is best. All products are generally good in that they have bottle/nipple systems that have been based on reducing the intake of excessive air that could be uncomfortable for the baby and result in regurgitation or reflux.
  • Give baby a chance to adapt to a new bottle. Don't give up if the baby rejects the bottle on the first feeding. Too many changes of bottle and nipple systems can result in frustration for the mother and baby and be costly.
  • Seek advice from friends, other mothers, or parenting websites for information about bottles. Also beware of costs when purchasing and changing from one system to another.

Dowling also cautions about the complicated bottle and nipple systems: "The more parts and tiny areas in the components, the harder it will be to clean."

She generally suggests the simpler systems. When choosing the different flow rates, first try a slow or medium flow and stay with that if the baby is comfortable.

Source

Tuesday, March 23, 2010

A guy's guide to breastfeeding

If you're a breast man, pregnancy is better than Christmas. But this growth spurt isn't solely for your viewing pleasure. Those mammaries are about to be put to work.

Be an extra set of ears: While many expecting fathers sit quietly in the back of the breastfeeding classroom, that doesn't mean they aren't paying attention. The dads "really are listening. They often hear more than moms do," said Karen Bromberek, lactation consultant at Palos Community Hospital in Palos Heights.

Moms can be a physical and emotional wreck after childbirth. Thus dads tend to pay closer attention to the advice of lactation consultants in the hospital. Those who retain the information can bring it home and relay it to the breastfeeding moms when things have calmed down, she said.

But don't think you have to take it all in. Most hospitals send new parents home with plenty of info on breastfeeding. Gobs of info are also available online. Just don't search for "breastfeeding men" unless you want to be truly horrified.

Extra set of hands: Moms have their hands full while breastfeeding. Dads can show their support by being an extra set of hands. Helping with positioning of the baby, keeping a feeding/napping/pooping log book and occupying older siblings is a big help.

"Studies have shown that if dads are supportive of breastfeeding, the woman is more likely to breastfeed longer or try breastfeeding if they are unsure," said Assunta Osterholt, a lactation consultant and doula from Chicago Heights.

Set the table: Men may not be able to make the meal when it comes to breastfeeding, but we certainly can set the table. Burping the baby after feedings, changing diapers, giving baths, dressing the baby and making meals for mom is another way to encourage breastfeeding.

Lactation takes a lot out of moms - literally and figuratively. Pitching in with these ancillary chores is a big help.

Coach ejected: As difficult as it sounds, mom needs a cheerleader more than a coach right now. Encourage her. Compliment her often. But don't become the Bobby Knight of boobs.

"Sometimes it is the dad who wants the baby to be breastfed and the mom doesn't," Bromberek said.

Parents need to be on the same page when it comes to breastfeeding. Pushing her to do something she doesn't want to do is only going to backfire.

Run interference: Many breastfeeding moms complain about dirty looks from passersby or being subjected to negative comments, said Eileen Murphy, lactation consultant at Little Company of Mary Hospital in Evergreen Park.

"I think dads just need to totally support the mom's efforts, because so many other people are not," Murphy said.

Such instances can be an opportunity for dads to step up. Have a couple of fast facts on hand and be ready to rattle them off to naysayers. Here's a couple:

  • The American Academy of Pediatrics recommends breastfeeding for at least the first year of life.
  • Illinois law says a mother may breastfeed in any location, public or private, where the mother is otherwise authorized to be.
  • Babies breastfed for at least 6 months have fewer ear infections, urinary tract infections and allergies than artificially fed babies.

And that's just some of the benefits. Another is that this baby is going to be seeing a lot more of mom's chest than dad for quite some time. Try not to be jealous.

Source

Cesarean Births Are at an All Time High in U.S.

The Cesarean section rate in the United States reached 32 percent in 2007, the country's highest rate ever, health officials are reporting.

The rate has been climbing steadily since 1996, setting new records year after year, and Cesarean section has become the most common operation in American hospitals. About 1.4 million Cesareans were performed in 2007, the latest year for which data is available.

The increases have caused debate and concern for years. When needed, a Cesarean can save the mother and child from injury or death, but most experts doubt that one in three women needs surgery to give birth. Critics say the operation is being performed too often, needlessly exposing mothers and babies to the risks of major surgery. The ideal rate is not known, but the World Health Organization and health agencies in the United States have suggested 15 percent.

Risks to the mother increase with each subsequent Cesarean, because the surgery raises the odds that the uterus will rupture in the next pregnancy, an event that can be life-threatening for both the mother and the baby. Cesareans also increase the risk of dangerous abnormalities in the placenta during later pregnancies, which can cause hemorrhaging and lead to a hysterectomy. Repeated Cesareans can make it risky or even impossible to have a large family.

The new report notes that Cesareans also pose a risk of surgical complications and are more likely than normal births to cause problems that put the mother back in the hospital and the infant in an intensive care unit. The report states: “In addition to health and safety risks for mothers and newborns, hospital charges for a Cesarean delivery are almost double those for a vaginal delivery, imposing significant costs.”

The highest rates were in New Jersey (38.3 percent) and Florida (37.2 percent), and the lowest were in Utah (22.2 percent) and Alaska (22.6 percent).

The report notes that the rate in the United States is higher than those in most other industrialized countries. But rates have soared to 40 percent in some developing countries in Latin America, and the rates in Puerto Rico and China are approaching 50 percent. A report by the World Health Organization published earlier this year in The Lancet, a medical journal, said hospitals in China may be doing unnecessary operations to make money.

There is no single reason for the continuing increase in the United States. Rising multiple births due to fertility treatments have a role, because they often require Cesareans. But, the report notes, Cesarean rates for singletons increased substantially more than those for multiples. Another factor is that more older women are giving birth nowadays, and they are more likely to have Cesareans — but women under 25 had the greatest increases in Cesareans from 2000 to 2007.

Nonmedical issues are also involved. Obstetricians, fearful of being sued if there is harm to a baby after a normal labor and delivery, are quicker than they used to be to perform a Cesarean.

In an article published last month in the journal Obstetrics and Gynecology, the obstetricians’ college reported that a poll of 5,644 of its members found that 29 percent said they were performing more Cesareans because they feared lawsuits. Eight percent said they had quit delivering babies, and nearly a third of them said it was because of liability issues.

Some of the increase in Cesareans has also come from women requesting the surgery even when it is not medically necessary, Dr. Macones said. Caesareans have become so common that many people do not realize they are major abdominal surgery, with all the attendant risks.

In addition, the increased tendency to induce labor before a woman’s due date, for reasons of convenience, has helped push up the Cesarean rate, because induction is more likely than natural labor to fail and result in a Cesarean.

Repeat Cesareans are another part of the problem. They account for about 40 percent of the total and have become increasingly common in the past 15 years as more and more hospitals have refused to allow women who have had a Cesarean to try to give birth normally. Fewer than 10 percent of women who had Cesareans now have vaginal births, compared with 28.3 percent in 1996. Many hospitals banned vaginal birth after Cesarean because of stringent guidelines set by the obstetricians’ college, which said surgery and anesthesia teams should be “immediately available” whenever a woman with a prior Cesarean was in labor.

An expert panel convened earlier this month by the National Institutes of Health said there were too many barriers to vaginal birth after Cesarean and suggested ways to reduce them. It urged the obstetricians’ group to reassess its guidelines on “immediate availability,” and it urged hospitals to publicize their rates of vaginal birth after Cesarean, so that women could make informed choices about where to give birth. It also acknowledged the problem of malpractice suits but did not make a specific recommendation about how to solve it.

Source

Pregnancy adversely affects spatial memory

The debate over "preggo brain" continues with the release of a new study:

Pregnant women had reduced spatial recognition memory during the second and third trimesters of pregnancy, and this effect persisted for at least three months after birth, new study results suggested.

Researchers assessed the influence of sex steroids, such as estradiol, progesterone, cortisol and prolactin, on memory and attention during pregnancy in 23 women and compared results with 24 nonpregnant women. Using four computer-based tests, the researchers evaluated memory patterns, attention, mood and anxiety during each trimester and at three months after birth; some women were also tested at preconception and at 12 months.

Compared with nonpregnant women, pregnant women performed worse on the spatial memory test during the second trimester (82% vs. 70%; P=.001), third trimester (80% vs. 73%; P=.03) and at three months after birth (80% vs. 68%; P=.0001).

Moreover, pregnant women had decreased mood, greater anxiety levels and a higher risk for depression compared with nonpregnant women. Women in the control group had stable scores across all testing measures; however, a learning effect was observed.

Estradiol, progesterone, cortisol, prolactin and sex hormone-binding globulin were significantly increased during pregnancy. Conversely, dehydroepiandrosterone-sulphate levels were reduced by 50% during pregnancy.

“Forgetfulness and slips of attention are phenomena commonly reported by pregnant women, but scientists have yet to identify a specific mechanism by which this memory impairment might occur,” Diane Farrar, NP, of the Bradford Institute for Health Research, United Kingdom, said in a press release. “Indeed, some question whether the reported memory loss exists at all. More research is now needed to identify the neurological effects of pregnancy to help guide future research and provide information for women and those involved in maternity care.”

Source

Free Formula Decreases Breastfeeding Success

Looks like deciding to breastfeed depends on whether or not you get formula at the hospital.

A study of Canadian women reveals that moms who left with free samples of formula are less likely to breastfeed their children. Women who don't get formula samples (nearly 60 percent) are 3.5 times more likely to be breastfeeding after two weeks.

A similar 2005 study looked at U.S. mothers and made similar conclusions: first-time mothers were more likely to breastfeed if they did not receive samples at the hospital. For mothers who had had more than one child, the likelihood was even higher.

What contributes to these results? When women receive formula, they're getting the message that breastfeeding is really hard, that they won't be able to do it. They're urged to use an alternative. So when things do get tricky, they have something available right away - causing more and more women to rely on formula.

Which raises the question - given the reported health benefits of breastfeeding from organizations such as the World Health Organization and UNICEF, why aren't more women discouraged from formula?

There are several possible reasons - first, formula is created by large companies that have a lot of funding. Funding means that they can push product in a way that breastfeeding advocacy groups cannot.

Second, formula is easy to encourage - breastfeeding takes a lot of education, that many women may not have access to. It's quicker and easier to push formula on low-income women who have just given birth than setting up them with counseling on breastfeeding.

But perhaps it's also because there is still so much we don't know for sure about breastfeeding - the debate about it's impact on children changes so frequently that it may be difficult for medical professionals to have a clear stance on breastfeeding vs. formula.

Source

Monday, March 22, 2010

Big Changes for Working Parents

Sift through all the rhetoric surrounding the health-care reform legislation sent by Congress last night to President Obama, and it could signal some big changes in many people's juggle.

Health insurance has increasingly been the tail wagging the dog in many households-the first consideration in deciding who, if anyone, stays home with the kids. Regardless of what parents want, the person with health-care benefits is usually the one who works.

Some parents who would prefer to work part-time avoid cutting back, because fewer than half of part-timers receive health insurance. Also, while many working parents would like to start their own businesses to gain flexibility, they don’t because health insurance would become so hard to afford. Finally, many parents of college-age kids stick to jobs they don’t like, just to maintain their kids’ coverage amid a shortage of entry-level jobs offering benefits.

Over coffee recently, I was talking with a friend whose career path has been dictated almost entirely by health-insurance concerns. Because her husband is self-employed, she has chosen her employment based largely on whether she can get health insurance with coverage for him and their college-age children. Were she to follow her dream of working as a self-employed writer, her family’s bills for an individual plan would soar beyond $25,000 a year.

The plan on the President’s desk has stirred tremendous controversy. Opponents worry about the cost, projected at $940 billion over 10 years. The 2014 mandate for everyone to purchase health coverage or face a fine, with some exceptions for low-income people, also has drawn protests.

Some provisions, however, could free up your juggle. The measure would set up state-based marketplaces where self-employed people and small businesses could pool together to buy coverage. A new public nonprofit plan would be made available through the exchanges. This could end the pressure on entrepreneurs and self-employed people to have a spouse on someone else’s payroll. Also, parents would be able to keep older children on their health plans up to age 26. And people with employer-provided plans would generally be allowed to keep their coverage.

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Graduate students juggle parenthood with academic politics

University of Maryland graduate student Anupama Kothari went into labor on a Friday afternoon two years ago. After a Cesarean section, she was a first-time mother, with a baby girl with huge brown eyes.

But there wasn't much time to settle into motherhood, bond with her daughter or follow her doctor's orders to rest. Seven days later, Kothari was back at work on her doctorate in business and helping marketing professors with their research. Her body ached in protest.

Such rapid returns from even difficult births are common at many universities, as the nation's 2.6 million graduate students often have fewer legal protections than most workers. Kothari's husband, an aerospace engineering doctoral student at U-Md., took even fewer days off. The couple's daughter spent most of her first three months with her grandmother, who flew in from India to care for her.

"I just wanted to be with my child. I just wanted to spend time with my family. But I had been working on my degree for five years. I worried that it would all go away," said Kothari, 30, president of the U-Md. Graduate Student Government. "If you get pregnant in grad school, if you decide to have a child, you have to show that you are a super-human being."

At colleges and universities across the country, many graduate students who have babies work until their due dates and return soon after giving birth. If they don't, they risk getting kicked off projects, falling out of favor with powerful faculty members and losing their student status, which is often required for visas, health insurance plans and student loan grace periods.

"Workplace balance is an issue in any workplace, but it can play a huge role in academics," said Lisa Maatz of the American Association of University Women. "They judge your research, but they also judge your collegiality."

At U-Md. in College Park, students can request a leave of absence for one or two semesters to give birth, adopt a child or deal with family issues. If the absence is approved, the students' "time-to-degree clock" is stopped for up to one academic year, but they lose their stipend pay and all student privileges. About two-thirds of the text in the university's policy handbook details the half-dozen potential risks in taking a leave.

Maryland's Graduate Student Government passed a resolution this year asking the university to establish a "childbirth or adoptions accommodation fund" that would allow graduate students to take paid leave for a few weeks and retain their full-time student status. Many members of the student group said they would support a small tuition increase to raise money for the fund, said Michael Scholten, 28, a physics doctoral student who wrote the resolution.

Scholten's wife had a baby last year, and he arranged with his adviser to get a week and a half off. "My adviser was generous; not all are," he said. "If the university cares about staying competitive, they should not put you in a position where you don't get paid or you go without health insurance."

Graduate student pregnancies also create challenges for universities. Professors must find fill-in assistants to help teach their classes, keep research projects on track and meet workload goals set by funding organizations.

A growing number of research universities have begun to add maternity and family leave policies in the past few years. The policies vary from school to school and sometimes even among departments at the same institution. Some provisions apply to mothers but not fathers, and some do not cover students who adopt children. In nearly all cases, advisers have the power to give more time or benefits. Some granting agencies, such as the National Institutes of Health, have begun to issue parental leave requirements.

Maternity leave policies are often added as part of an effort to attract more women to male-dominated fields, such as chemistry and engineering. The Stanford University graduate student handbook states: "It is important to acknowledge that a woman's prime childbearing years are the same years she is likely to be in graduate school, doing postdoctoral training, and establishing herself in a career."

MIT was one of the first universities to drastically revamp its maternity policy in 2004. Students once had to petition their advisers to get a medical leave. The new policy allows pregnant graduate students to take up to eight weeks without losing any pay.

In 2006, Stanford University began to give all female graduate students six weeks of paid leave, and its chemistry department allows pregnant women and new mothers to scale back their coursework or research for up to 12 weeks. Princeton University offers three months of paid leave to birth mothers, a policy it adopted in 2007.

Kothari's daughter, now 2, is shuttled between her parents' small offices on campus as they try to complete their education. The toddler naps in a playpen in the Graduate Student Government office and accompanies her mother on research trips to India.

As mother and daughter walk around campus in their matching puffy pink coats, they are often stopped by students and faculty members enamored of the outgoing toddler.

"A baby is such a rare thing on a college campus," Kothari said after one such encounter outside the student union. "No one understands."

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Study urges vitamin D supplement for infants

Most babies should take a daily vitamin D supplement, a new study shows.

That will be a big change for most parents - and even many pediatricians.

Only 1% to 13% of infants under 1 year now get a vitamin D supplement, available in inexpensive drops, according to a study published online today in Pediatrics.

Those drops are needed, the study says, because only 5% to 37% of American infants met the standard for vitamin D set by the American Academy of Pediatrics in 2008: 400 international units a day.

Vitamin D strengthens bone and the immune system and also appears to prevent type 1 diabetes, heart disease and cancer, the paper says.

Few breast-fed babies — 5% to 13%, depending on their age — received the recommended amount of vitamin D, researchers estimated. Although breast milk is the perfect food in every other way, it's often low in vitamin D, says pediatrician Nicolas Stettler, a spokesman for the pediatrics academy who wasn't involved in the study. Because humans originated in equatorial areas with year-round sunshine, babies in the distant past wouldn't have needed to get vitamin D from breast milk, he says.

Yet many formula-fed infants don't get enough, either. Babies need to drink about 32 ounces of fortified formula a day to get 400 international units of vitamin D, says study author Cria Perrine of the Centers for Disease Control and Prevention. Babies younger than 6 months can rarely drink that much. A supplement can give babies all they need.

Many mothers also are vitamin D-deficient.

A second study in Pediatrics reports that 58% of newborns and 36% of mothers were deficient in vitamin D, according to blood tests. Although taking prenatal vitamins helped, more than 30% of moms who took them were still deficient. Getting lots of sunlight helped raise vitamin D levels in moms, but not in their newborns.

The American Academy of Pediatrics recommends babies get no direct sunlight in their first six months, to prevent skin damage and cancer. After 6 months, the academy says, babies should wear sunscreen, hats and protective clothing in the sun.

Relatively few pediatricians today talk about vitamin D with parents, says Wendy Sue Swanson, a pediatrician at Seattle Children's Hospital who wasn't involved in the new research. That may be because the pediatrics academy's previous vitamin D recommendation — 200 international units a day, set in 2003 — was easier to meet, Swanson says.

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