Friday, April 16, 2010

Delaying kids may prevent financial 'motherhood penalty'

Just when to have the first child is more than just a family decision for the couple; it may have longer-term repercussions that affect a woman's lifelong earnings, according to a preliminary study presented Thursday at a session of the Population Association of America meeting.

Researchers at the University of Maryland in College Park and the University of California at Los Angeles reviewed 35 years of data from some 2,200 women born between 1944 and 1954, and found that women who had kids in the early- to mid-20s or even younger didn't fare as well economically as those who delayed.

Research has found that women who are childless tend to have greater earnings and those with kids have what some have referred to as a "motherhood penalty," that is, lower wages for working mothers.

But this new study, presented by co-author Joan Kahn, a sociologist at the University of Maryland in College Park, finds women who got more education and job training before having children don't experience that so-called "penalty."

"Women who delay childbearing end up as successful economically as women who didn't have children, and we look at it basically throughout their adult years — well into their 50s," she says.

Although the study used age 26 as the age for these later births, Kahn says there's nothing magical about it. She says they picked it for the analysis because 20% of those studied had had their first-born at 26.

The point, she says, is that women who are younger when they have kids and attempt to get back into the workforce later may not have that up-front investment in education and training, which those who have kids later benefit from. They earned equivalent wages and had higher status occupations just like women who were childless.


Wednesday, April 14, 2010

Late pregnancy multivitamins linked to prematurity

For a woman eating a healthy diet, multivitamin supplements during late pregnancy could do more harm than good, a new study suggests.

British researchers found that a woman's risk of delivering prematurely tripled if she continued taking the prenatal pills into her third trimester.

"These supplements are available over-the-counter in the United Kingdom and frequently promoted as being beneficial for mums-to-be," Dr. Nigel Simpson of the University of Leeds in the U.K., and one of the authors of the study, told Reuters Health by email.

However, some weaknesses in the study may stand in the way of translating the finding into practice, Dr. James Mills, of the U.S. National Institute of Child Health and Human Development told Reuters Health.

While some studies in developing countries have found prenatal supplements to be beneficial, whether or not it also is in developed countries-where most women are presumably already well-nourished-has not been thoroughly studied.

To fill this void, Simpson and his colleagues assessed the diets and supplement use of nearly 1,300 pregnant women recruited at Leeds Teaching Hospitals between 2003 and 2006.

Overall, slightly more than 4 percent of babies were born weighing less than 2500 grams and categorized as low birth weight. About the same number of babies were born prematurely, defined as before 37 weeks of pregnancy.

The team saw no differences in the risks of having a low birth weight baby for the more than 80 percent of women who took supplements at any point during pregnancy compared with those who took none.

However, the approximately 30 percent of women taking supplements during their third trimester were three times as likely to have a premature delivery, after taking smoking, alcohol consumption and other relevant factors into account.

Why this would be true is unclear. One possibility, according to the authors, is that interactions between different vitamins and minerals led to a reduction in the nutrients available for the growing fetus.

And women in the study were already getting enough of most vitamins and minerals contained in prenatal supplements from their diets, with the exceptions of vitamin D, iron, folate, selenium and iodine, note the authors in the British Journal of Obstetrics and Gynecology.

The U.S. National Institute of Child Health and Human Development's Mills said that a few weaknesses of the study make its significance less clear. Since the U.K. stops short of officially recommending prenatal multivitamins, British women who chose to take the supplements may have been those who were already at a greater risk for pregnancy problems.

Mills is also concerned that the relationship with premature delivery could have simply appeared by chance, given the large number of comparisons the researchers made between various birth outcomes and supplement use.

The study team acknowledges that larger, more rigorous studies are necessary to confirm their results. For now, Simpson says pregnant women probably don't need multivitamins past their first three months, after which time they might actually do harm.

"Eating a healthy diet," he said, "is likely to be sufficient for expectant mums."


Designer baby with 'three parents' and no hereditary diseases ready in three years

Dozens of human embryos with three parents have been created by British scientists, ushering in an era of designer babies.

The embryos - which effectively have two mothers and one father - have been genetically engineered to be free from incurable muscle, brain, heart and digestive illnesses, some of which kill within hours of being born.

The Newcastle University researchers say that within as little as three years, it could allow women whose families are blighted by disease the chance of bringing a healthy child into the world.

But critics say the breakthrough is a step on the slippery slope towards human cloning and erodes the sanctity of human life.

The cutting-edge research centers around mitochondria - sausage-shaped powerhouses inside cells which turn food into energy to be used by the brain and body.

Each mitochondrion has is own DNA which gives instructions on how to build and operate the powerpack, or battery, and is passed down from mother to child.

Serious defects in this DNA affect one in 6,500 babies and cause around 50 genetic diseases, some of which kill in infancy.

With no cure for the conditions, which include some forms of diabetes, blindness and heart problems, women carrying diseased mitochondria often face the heartbreaking choice of whether it would be kinder to remain childless.

The scientists have found a way of swapping the diseased DNA with healthy genetic material, creating embryos free of mitochondrial disease.

The 'transplant' technique, which is described in the prestigious journal Nature, begins by using IVF techniques to fertilize an egg from a healthy donor.

When the resulting embryo is just a few hours old, the 'pronuclei', or nuclear DNA from the sperm and egg are removed, leaving the healthy mitochondria behind.

The would-be mother's egg is then fertilized with her partner's sperm and the pronuclei removed and popped into the donor egg.

This creates an egg where the genetic material comes overwhelmingly from the prospective parents and the mitochondria are healthy.

If the method is successful, the disease should be eradicated from future generations of the family.

Professor Alison Murdoch, head of the Newcastle Fertility Centre, whose patients donated eggs for the study, said: 'It would be hype to say we are going to get rid of mitochondrial disease but I think it's realistic to say you could get rid of it in an individual family.'

Eighty embryos were created in the Newcastle labs, each effectively with three parents - two mothers and a father.

A fourth parent - the man whose sperm was used to fertilize the donor egg - was involved, but none of his DNA was passed on.

Some of the embryos lived for six days, before they were destroyed to comply with fertility laws, which also forbid such embryos from being implanted in a woman.

But updated fertility laws which came into effect last year leave the door open for the legislation to be amended, allowing the technique women to give birth to disease-free babies.

Lead researcher Professor Doug Turnbull said that if this happened, the first babies could be born in as little as three years.


Common Test Done on Newborns Questioned

More than four million babies born in the U.S. every year are given a routine "heel-stick" blood test in the hospital to check for dozens of disorders.

About 4,000 infants will be diagnosed with a condition, according to the American Academy of Pediatrics.

Now, a study in the Journal of the American Medical Association finds that the test isn't an effective screening tool for a leading cause of hearing loss in children.

On "The Early Show," CBS News Medical Correspondent Dr. Jennifer Ashton explained the study found the "heel-stick" test may not catch some cytomegolovirus (CMV) infections.

"(The infection is) very, very common and, in its early stages, it can be treated supportively with an antiviral medication. If not treated, it can go on to cause hearing loss and deafness. And obviously in a newborn, in a child, you don't want them to have a hearing problem, because hearing has a very serious impact on speech development."

The "heel-stick" test is done on a small blood sample prick from the infant's heel, which very similar to a diabetic blood sugar test. However, according to researchers, the test is not suitable for mass tests on newborns anymore.

Ashton said, "For a test to be accurate, you want it to be positive or detect the disease about 95 percent of the time," she said. "What they found in studying this CMV 'heel-stick' blood test is it only detected about 30 percent or 40 percent of CMV infections, so it's not a great test."

Ashton said there are other saliva tests that could detect this infection more effectively, but they're more labor intensive.

Ashton said there isn't any national standard for testing babies in the hospital. She said most of the testing gets done on a newborn after about 24 hours of life.

She said, "(Testing) does vary state to state, and in general, what the pediatricians are testing for are certain genetically inherited metabolic, hormonal, functional disorders that ideally have both accuracy in terms of the test, as well as an effective treatment."

She said hospitals perform 29 core blood tests on the newborn, in addition to a direct hearing test, and then some states do an additional 25 tests for secondary disorders.

Ashton suggested pregnant women speak to a pediatrician prior to giving birth about the tests performed in the hospital.

She said, "If you have certainly a family history of a genetic disorder, or if you have another child who's been impacted with a genetic disorder, or, if, in general, you just have other reasons to be concerned, you want to talk to the pediatrician about that and find out what testing can be done in the hospital in that neonatal period."

"(In some cases) the earlier intervention and treatment, the better, (such as) certain things like PKU (phenylketonuria), which some people may know about is a metabolic disorder that can have a serious impact on nutritional status and brain development. So some things you want to intervene right away."


Monday, April 12, 2010

A little stress may boost the fetal brain

High stress during pregnancy is bad news, but it turns out that moderate stress might boost fetal brain development.

Studies in rodents suggest that stress during pregnancy inhibits neural growth, while the children of women who lived in war zones during pregnancy have a higher risk of developing schizophrenia.

To investigate the effects of moderate stress in humans, Janet DiPietro and her colleagues at Johns Hopkins University in Baltimore, Maryland, examined 112 healthy pregnant women living in the US three times during their third trimester. They asked the women about their stress levels and recorded fetal movements. They also examined the babies two weeks after birth.

Women who reported higher stress levels during pregnancy had babies that moved around more in the womb. After birth, these babies scored higher on a brain maturation test, although they were more irritable. More active fetuses had better control of body movements after birth.

The stress hormone cortisol plays a role in brain maturation, which may help explain the result (Child Development, vol 81, p 115).


New Rules About Breast Pumps at Work

Writing about the difficulty that hourly workers have finding the time and space to pump breast milk while at work, Jodi Kantor noted several years ago that while it was admirable that a former Massachusetts governor, Jane Swift, had breast-fed after returning to work, doing so was more complicated for women lower on the ladder - those who work behind fast-food counters, in catalog call centers, on factory floors or as waitresses and soldiers.

"That's a great thing to do, but she had her own office and could set her own schedule," one doctor is quoted as saying of Swift. "The one I want to know about is the lady cleaning her office."

Well, that lady is now guaranteed the right to use a breast pump at work, the result of the health care bill passed by Congress last month. Section 4207 of the bill amends the Fair Labor Standards Act of 1938 to include the guarantee of “a reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth each time such employee has need to express the milk,” for nonexempt hourly workers, and also the stipulation that this be done in “a place, other than a bathroom, that is shielded from view and free from intrusion from co-workers and the public.”

There are limits on this newly codified right. Companies of fewer than 50 employees are exempt if the employer can show that this would “impose an undue hardship,” and employees are not guaranteed pay for time spent expressing milk. There also does not seem to be a requirement that employees be given access to a place where the pumped milk can be stored. And it remains to be seen how the Department of Labor will define “a reasonable amount of time” to pump or an appropriate place to do so. It’s likely that the final regulations will be modeled on those in Oregon, thought to have a workable law. In Oregon, a the definition of a reasonable schedule is “a 30-minute rest period to express milk during each four-hour work period, or the major part of a four-hour work period, to be taken by the employee approximately in the middle of the work period.”

And a workable space? The United States Breastfeeding Committee, a nonprofit coalition of 40 organizations, has weighed in with some suggestions, many of which are already in use in the 24 states that have laws protecting breast-feeding workers:

  • Designated, permanent space, at least 4 by 6 feet with a chair, sink and electrical outlet.
  • Space designated with a sign or reserved on a calendar that rotates throughout the workspace between offices, conference rooms, clinic rooms, etc.
  • Temporary use of manager office space in fast-food restaurants, police departments or settings that lack other spaces with a locking door.
  • A curtained-off area that is nonaccessible to the public and meets privacy threshold because of clear, well-communicated policy with co-workers. This can even mean a chair behind a curtain in an employee-only bathroom lounge, if there is truly no other space available.
  • A designated space that serves employees from several employers, located in the employee-only areas of malls, airports and retail strips.
  • An agreement between work sites, where a breastfeeding employee can visit a neighboring business to access a designated space within.
  • Privacy panels to block the windows of work vehicles such as patrol cars or construction vehicles on the road.
  • Use of city or county buildings by public employees on route, such as police on patrol, bus drivers or meter readers.

A final question is whether employers will embrace the intent of the law or fight its specifics. It’s a good bet that rules like these would have helped Laura Walker, for instance, who filed a complaint with the Equal Opportunity Employment Commission after her employer, Red Lobster in Evanston, Ind., did not allow her to pump at work, despite a note from her nurse explaining it was a medical need. Instead, as Kantor described it, she was ridiculed. Her hours were reduced, and co-workers jiggled empty milk containers at her, joking they were for her. She settled for an undisclosed sum, and the company has said that they did try to assist her “multiple times.”

Whether the new rules would have protected LaNisa Allen is less clear. When she was was fired from the Totes/Isotoner company in Cincinnati last year, her employer did not argue that that she did not have the right to take a nursing break, but rather that she had not asked proper permission to do so. Is permission still necessary under the new law?

And, well meaning though they might be, these new regulations would probably not have saved the job of Marlene Warfield, a dental hygienist in Tacoma, Wash. When she brought her portable pump to the office, her boss told her to leave it home, and then donned “a Halloween costume consisting of a large silver box — his interpretation of a pump, perhaps — with a cutout labeled ‘insert breast here,’ ” Kantor wrote. Warfield quit, and the local human rights commission ruled that the dentist’s actions were not illegal.

The National Partnership for Women and Families suggests the following resources for those seeking information on the new law and suggestions of how to implement a lactation policy in their workplace:

To check on what categories of workers are covered, try

To contact the Department of Labor Wage and Hour Division to question specific provisions or report violations, the address is

A primer on breast-feeding at work, including data on how it helps an employers bottom line, visit the Web site of the The United States Breastfeeding Committee.

And for information on low cost ways to buy or rent a breast pump, try the Food and Drug Administration.