Friday, July 30, 2010

August 1-7 Is World Breastfeeding Week

This year's theme is "Breastfeeding; Just 10 Steps! The "Ten Step" theme commemorates the 20th anniversary of the Innocenti Declaration developed by the World Health Organization and the United Nations Children's Fund (UNICEF). Research shows that implementation of just some of the 10 steps recommended for maternity facilities improve breastfeeding initiation and duration rates. The Ten Steps recommended are:

  • Have a written breastfeeding policy;
  • Train healthcare staff in necessary skills to implement the policy;
  • Inform pregnant women about the benefits and management of breastfeeding;
  • Help mothers initiate breastfeeding within 60 minutes after birth;
  • Show mothers how to breastfeed and maintain lactation;
  • Give newborn infants no food or drink other than breast milk unless medically indicated;
  • Practice 24 hour rooming-in;
  • Encourage breastfeeding on demand;
  • Give no artificial teats or pacifiers;
  • Refer mothers to support groups on discharge from the facility.


For more information on breastfeeding, here are some helpful articles:

Thursday, July 29, 2010

Big Families Are Back In Style

If popular culture were any indication, you'd think big families are back. Television shows like Jon & Kate Plus 8, 19 Kids and Counting and 9 By Design follow women whose outlook on kids seems to be the more the merrier. Plus, celebrities like Heidi Klum (four kids) and Angelina Jolie (six kids) make many-children motherhood look glamorous.

All of which raises the question: Are professional women shattering the two-children, nuclear-family norm?

Susan W. Hinze, professor of sociology and women’s and gender studies at Case Western Reserve University in Ohio, offers a definitive "maybe." According to the National Center for Health Statistics, fertility rates increased steadily until 2006 to 2.1 children per American woman, hitting a high since the baby boom in 1961. However, there's been a slight decrease in births in the past few years likely because of the recession, says Hinze. This year, the Central Intelligence Agency estimates an average rate of 2.05 children per woman.

Two kids per family might remain the average, but the story doesn't end there.

Hinze says there is evidence that affluent families are beginning to have more children. According to the Council on Contemporary Families, there's been a significant increase in three- and four-children families among the "super rich," or the top-earning 2% of households, which translates to an annual household income of about $400,000 or more.

The economic costs of having children today are huge, and high-earners probably have more simply because they are able to afford them. In fact, the cost of raising a child has exploded in the past few decades. A 2009 report by the U.S. Department of Agriculture (USDA) says that in 1960 the average middle-class family spent $25,000 per child, compared with a whopping $222,000 in 2009. When adjusted for inflation, that’s an increase of 22%. The report also estimates that the current per-child cost can be as high as $370,000 from birth to age 17 (which would not factor in college tuition costs), or about $23,000 each year.

According to David Hacker, a demographic historian at State University of New York at Binghamton, eight children per family was the norm in the 1800s because infant mortality rates were high and children were economically beneficial (they helped with the family business and supported their parents into old age). Today, however, children are viewed as offering emotional value rather than practical value. Economist Ann Crittenden estimates that a college-educated woman loses about $1 million in lifetime earnings after having just one child.

Why, then, are some working moms having six, seven, even 14 kids in an age where birth control is socially acceptable and children are so expensive? Hacker says kids are now "luxury goods," which people believe fill their lives with joy and deep satisfaction (despite the fact that many studies show that children do not increase overall happiness). And if the wealthy are raising more children just because they can, it may have a ripple effect. "The rich are trendsetters," says Hacker. "It may bear watching whether these well-publicized larger families will lead to overall increases in fertility."

Lorin Arnold, dean of the College of Communication at Rowan University in New Jersey, can speak from experience. She juggles six children between the ages of 10 and 21 and her full-time job. "That means lots of laundry," she says. Arnold always wanted a big family but says that, like many working moms with multiple kids, she didn't have a goal number or work out the details on a spreadsheet first.

She also wonders if the big-family celebrities and TV moms are actually envied or if they are a bizarre fascination. "I get a lot of people coming up to me and my kids in the grocery store," she says, "asking why did I have so many? As if it's so weird."

Cortney Novogratz, star of Bravo’s 9 By Design and mother of seven, decided with her husband early on that they would recreate the happy chaos of their own childhoods. (She has four siblings; he has six.) Today, their kids range in age from 13 years to 16 months.

But the couple also owns their own real estate design and development company, Sixx Design, in New York. "If we didn't create our own hours and switch hats, I don't know how I could have done it," says Novogratz. In fact, she admits, having a large family puts more pressure on her career success because large families are so costly today.

While she occasionally becomes overwhelmed by the idea of seven college tuitions, she says she prioritizes her spending: "If we had only two kids, my wardrobe would be nicer and I'd take more extravagant trips. But having my kids is more important than my wardrobe."

Even if one could handle the finances, how does a modern mom manage a full-time career and a big brood? Novogratz has developed some tricks. She insists that the children contribute to the family, helping out with chores and watching over their siblings. Novogratz also expects her older children to be responsible for their social calendars. "I tell them, 'If you expect me to remember all your friends' birthdays and bar mitzvahs, you're dreaming,'" she says.

Even tasks that might be routine for a smaller family, such as scheduling doctors' appointments, become nearly impossible for this clan of nine. When one of the children needs a teeth cleaning, they all go in at once and overtake the dentist's office. It’s just easier that way, she notes. She has also become super mom in terms of planning and preparation. She keeps copies of the kids' health forms on her person at all times, which has been especially helpful in summers, when they all go off to camp.

Shannah B. Godfrey, a Missouri-based chemist and mother of 14, says she gave up on a lot of things to be a working mom of so many: "Like pajamas."

Godfrey, who adopted four children, gained three from her second marriage and had seven of her own, has always been a full-time mom and employee. When she was working in the rocket fuel research and design department of Alliant Techsystems ( ATK - news - people )--"yes, you could call me a rocket scientist"--she came up with some innovative solutions in the lab and at home.

Godfrey found it too difficult to dress so many kids in the morning before work. So she dressed them at night. Instead of pajamas, the kids slept in their school clothes, and the next morning Godfrey would pick them up--still sleeping--and carry each directly to the car. After dropping them off at a caregiver's house, she’d go in to work while the caregiver went on to make the children breakfast and see them to school.

"You have to know what to let go of," explains Godfrey. For her, that meant a spotless house and a full night's sleep was not in the cards. But she says having a big family was worth it and she encourages other professional women not to dismiss it.

"I was the only female scientist at work who had children," she says. “Especially if they had Ph.D.s, they thought they couldn't have kids because their careers came first. I call that reverse Darwinism--the smartest people choosing not to have kids."

Sociology professor Hinze believes the notion that career women don't have time for kids is changing. Hard-charging boomers may not have had much choice, being forced to decide between career and family. But today, many companies offer better parental leave packages and more flexible scheduling for both women and men.

Shannon Fox, a marriage and family therapist, agrees that there's been a generational shift in family size. Fox says that Generation X, those approximately 30 to 45 now, have come of age and are raising young children. Gen X is known for valuing work-life balance and for being more family-oriented, says Fox, "so it makes sense that they'd want larger families."

When asked about her predictions for Gen Y, those in their teens and twenties now, Fox says it's still too soon to tell. However, with the uptick in unmarried, cohabiting couples, she expects that Gen Y women will have more children out of wedlock than previous generations.


Christina Applegate Talks Baby Names with Jimmy Kimmel

Wednesday, July 28, 2010

Study: The Health Risks of Late Preterm Births

In the largest study of its kind, researchers find that the risk of severe breathing problems rises significantly in babies born prematurely, even those born in the so-called late preterm period.

Health experts consider babies born at or after 37 weeks' gestation to be full term, and those born between 34 weeks and 37 weeks to be late preterm. (Preterm is defined as less than 34 weeks' gestation.) Many previous studies have shown that compared with full-term babies, those who are born too early are at higher risk of dying shortly after delivery and are more likely to suffer neonatal complications that require lengthy stays in the hospital.

In the new study, Dr. Judith Hibbard at University of Illinois also found that babies born at 34 weeks were 40 times more likely to have respiratory distress syndrome, a breathing difficulty that often requires a ventilator, than babies born at 38 weeks or later.

Even at 37 weeks' gestation — the point at which mothers may ask for an elective Cesarean section or induced delivery — babies are three times more likely than full-term infants to have respiratory abnormalities at birth. "That's a remarkably increased risk," notes Hibbard, who worked with the Consortium on Safe Labor, a group of 19 hospitals that contributed volunteers and data to the study. "And I have to admit, much higher than I was expecting."

Despite the accepted 37-week full-term cutoff, the American College of Obstetricians and Gynecologists officially recommends that babies not be delivered (unless medically necessary) until after 39 weeks. Yet some 9% of all deliveries in the U.S. still occur just shy of 37 weeks, and a recent study found that as many as 23% of late pre-term births — between 34 weeks and 37 weeks — occur for no documented medical reason.

Hibbard says she was surprised by the high rate of health problems she and her team found in this group, since advances in neonatal care have allowed more high-risk babies to survive and eventually thrive after being born too early. But the fact that respiratory distress syndrome continued to occur in premature infants at 40 times the rate in full-term babies highlighted how risky premature delivery can be. At 34 weeks, infants' lungs and respiratory systems are not fully developed, making it difficult from them to survive outside the womb.

With every week of gestation after 34 weeks, however, Hibbard found that rates of complications dropped — by 40 weeks, only 0.3% of babies showed signs of respiratory distress. While 67% of babies required admission to the neonatal intensive care unit at 34 weeks, only 7% of those born at 38 weeks required the same care. Further, 1.5% of babies delivered at 34 weeks developed pneumonia, compared with practically none of those born at 38 weeks. "To be honest, with studies like this, it's hard to justify deliveries before 39 weeks," says Dr. Richard Waldman, president of the American College of Obstetricians and Gynecologists.

Both Hibbard and Waldman stress that there may be valid medical reasons for delivering a baby early — if the mother has preeclampsia, the dangerously high blood pressure that can occur during late pregnancy, for example, or if the baby is no longer growing properly in the womb — but that doctors should discourage elective delivery before 39 weeks.

The new study adjusted for many of the major contributors to prematurity, such as the mothers' weight and history of other medical conditions, including preeclampsia and diabetes, but the relationship between early delivery and risk of respiratory distress in the babies remained. "I know mothers may request early delivery for a lot of reasons," says Hibbard. "But I hope the obstetrician will pull this study out and say, 'Look, early delivery is not a good idea unless there is really a strong medical indication.'"


Personality types affect women's approach to childbirth -study

Conventional wisdom says that the better educated a woman is, the more likely she is to delay motherhood. But a new study suggests personality type could be a more powerful determinant.

The research found that high levels of "extroversion", "agreeableness" and "neuroticism" accelerated the desire of a woman to have a child. Conversely, high "conscientiousness" and "openness" were associated with delaying childbirth.

In the report, by the Institute of Social and Economic Research, the five personality traits were cross-referenced with the age at which more than 16,000 women had their first child.

Lara Tavares, author of the study – Who Delays Childbearing? The Relationships Between Fertility, Education and Personality Traits – used data from the British Household Panel Survey (BHPS) collected over the past five years.

There is on average a two-year gap between the mean age at first birth of women with and without higher educational qualifications.

But, said Tavares, personality traits could help to explain the maternity timing gap between women with differing levels of education. "Most studies do find evidence of a positive relationship between education and age at first birth," she said. "However, the nature of this relationship is far less clear. The difficulty in studying the relationship between education and fertility is that it might be spurious.

"First, personality traits influence both education and fertility decisions. Secondly, some highly educated women – the more 'open-minded' – severely postpone childbearing, and therefore they push up the average age at first birth within the group of more educated women, thereby creating a fertility timing gap between more and less educated women."

According to the BHPS categorizations, extroversion is mainly characterized by sociability, with extroverts tending to be talkative and assertive. Agreeableness relates to the subject's willingness to help others – to be caring, co-operative and kind.

Neuroticism indicates the subject's emotional stability, with high scorers tending to be anxious, depressed and insecure. Those who scored highly on conscientiousness tended to follow the rules, to be reliable, well-organised and self-disciplined.

"Openness" reflected an individual's tendency to unconventionality and intellect. Open-minded women tend to enjoy being unattached, free, not tied to people, places, or obligations – and may be rebellious.

"More 'open-minded' people might be less vulnerable to the social pressure for having children," said Tavares. "Because people who score high on openness usually have wide interests, they are less likely to be exclusively family-oriented. Consequently, they might value their careers more and therefore face higher psychological childbearing costs.

"Declining fertility rates are associated with a transition to an individualistic family model, characterized by self-development, individual autonomy and gender equality. In other words, the change in values that resulted in a greater weight being given to individual preferences. Or, to put it another way, to openness."


Older age, extra pounds may delay breast milk production

First-time moms who are older than 30, overweight or have breastfeeding difficulties on their newborn's first day may have increased odds of a delay in their full breast milk production, a new study suggests.

After giving birth, women produce a precursor to breast milk called colostrum until their full breast milk comes in; if that shift does not happen within 72 hours, researchers consider it "delayed lactogenesis."

The concern with this is that some infants may start to become dehydrated and lose excess weight (some weight loss after birth is normal), and that some mothers, worried and frustrated, may give up on breastfeeding.

However, new moms with a delay in full milk production should not be discouraged, said Dr. Laurie A. Nommsen-Rivers of Cincinnati Children's Hospital Medical Center in Ohio, the lead researcher on the new study.

Instead, she said, they should call their pediatrician or "lactation consultant" -- a specialist in breastfeeding issues who works in some hospitals and also in private practice.

With some support, Nommsen-Rivers said, mothers with delayed breast-milk production will "do just fine." She noted that nearly all new moms -- 98 percent -- have their milk come in within a week.

For the current study, published in the American Journal of Clinical Nutrition, Nommsen-Rivers and her colleagues looked at the factors associated with delayed lactation among 431 first-time mothers who gave birth at one California medical center.

The researchers focused on first-time mothers because they are significantly more likely than women who've given birth before to have a delay in their breast milk coming in.

Overall, the study found, 44 percent of the women took longer than 72 hours to have their milk come in -- which was assessed by asking the study participants whether their breasts felt "noticeably fuller" three days after giving birth.

Women who were overweight or obese were more likely than thinner women to have a delay; 45 percent and 54 percent, respectively, compared with 31 percent of normal-weight women. Age also appeared to be a factor, as 58 percent of women age 30 and older had a delay in their breast milk coming in, versus 39 percent of younger women.

In addition, mothers who said they had "breastfed well" at least twice during the first 24 hours of their newborn's life -- when colostrum is produced -- were less likely to have a delay in their milk coming in: 39 percent to 43 percent of these women had a delay, compared with 65 percent of mothers who reported only one or no instance of breastfeeding "well" in the first 24 hours.

Another factor related to delayed milk production was nipple soreness. Women who had more than mild soreness in the first few days after giving birth were less likely to have a delay than other women.

That soreness, the researchers note, may be an indicator of more-effective early breastfeeding, which would encourage full milk production.

It is not clear why relatively older age and heavier weight in the mother would be associated with a higher risk of delayed lactation, according to Nommsen-Rivers.

But both, she and her colleagues note, are related to greater odds of carbohydrate "intolerance" during pregnancy. Problems in sugar metabolism could be a factor in the higher risk of delays in full breast-milk production, they speculate.

Whatever the underlying mechanisms for the findings, Nommsen-Rivers said that the bottom line for women is to seek help for any early breastfeeding difficulties.

She suggested that during pregnancy, women try to see a provider who has an affiliation with a lactation consultant. A home visit from the consultant in the first couple days after a woman gives birth can help identify and address any breastfeeding difficulties.

Women who feel their milk has not come in within 72 hours should call their pediatrician, Nommsen-Rivers said. The doctor can weigh and assess the baby, and watch the mother breastfeed to help spot any problems.

To help support early breastfeeding success, the American Academy of Pediatrics recommends that women ask to have their newborn placed in skin-to-skin contact with them immediately after birth so that they can breastfeed.

Frequent feedings in the early days are also important, Nommsen-Rivers said. It is often recommended that women breastfeed every two hours, but she suggested that new moms try to breastfeed whenever their newborn "shows an interest," with cues such as "smacking" his or her lips.

The rate of delayed milk production in this study -- 44 percent -- is significant, according to Nommsen-Rivers. Past studies have shown that compared with U.S. women, those in less-developed nations, such as Peru and Guatemala, tend to have their milk come in more quickly.

Pinning down the reasons for that difference -- including the facets of modern maternity care that may be involved -- will be important, Nommsen-Rivers said.


Diablo Cody Welcomes a Boy!

Congratulations to Juno screenwriter Diablo Cody, 32, and husband Dan Maurio who welcomed their first child Tuesday morning (July 27).

The new mom took to Twitter to share her happy news:

We had our boy early this morning! Marcello Daniel Maurio, 7lbs, 2 oz, lightly mustachioed.

The couple, who married in the summer of 2009, announced their pregnancy in April.


Study: Acupuncture doesn't help induce labor

Although acupuncture is promoted as a way to induce labor in women who go past their due date, a new study adds to evidence doubting its usefulness.

Researchers found that among 125 pregnant women who were past their due dates, those who were randomly assigned to undergo two acupuncture sessions were no more likely to go into labor over the next 24 hours.

Of those women, 12 percent went into labor, versus 14 percent of those who were randomly assigned to have a "sham" version of acupuncture.

The findings, reported in the obstetrics journal BJOG, add to evidence that acupuncture may not be an effective way to induce labor in "post- term" pregnancies -- those that go beyond 41 weeks.

About 5 percent to 10 percent of pregnant women have a post-term pregnancy, a delay that raises the risk of complications during labor. Because of this, doctors routinely induce labor when a pregnancy lasts beyond 41 weeks.

During standard labor induction, a doctor uses instruments to rupture the amniotic sac or stretch the cervix, or gives synthetic forms of prostaglandins or oxytocin -- hormones that normally help trigger labor. Acupuncture has been promoted as an alternative; in theory, it may work by stimulating the nervous system, which in turn could cause the uterus to contract.

And there is a need for alternatives in labor induction, said Dr. Niels Uldbjerg, a professor of obstetrics and gynecology at Aarhus University Hospital in Denmark and the senior researcher on the new study.


Tuesday, July 27, 2010

Emily Procter Expecting Baby No. 1

CSI: Miami star Emily Procter is pregnant!

The 41-year-old actress is currently expecting baby no. 1 with her partner, musician Paul Bryan, confirms her rep.

According to TV Guide Magazine, the pregnancy will not be written into her character Calleigh Duquesne's role for the show's upcoming season, which is set to air in the fall.

Congratulations to the Procter-Bryans!


Daily coffee fine for pregnant women

Pregnant women need no longer give up their morning cup of coffee.

A research review by the American College of Obstetricians and Gynecologists has found that moderate caffeine consumption probably won't increase the risk of a miscarriage or premature birth.

Until recently, studies have had conflicting findings about the effect of moderate caffeine consumption on pregnancy complications but a college committee has reviewed the evidence.

"I think it's time to comfortably say that it's OK to have a cup of coffee during pregnancy," Dr. William Barth, the chair of the College committee, told Reuters Health.

The College's Committee on Obstetric Practice said that 200 milligrams of caffeine a day -- about the amount in a 12-ounce cup of coffee -- doesn't significantly contribute to miscarriages or premature births.

That definition of "moderate caffeine consumption" would also include drinking about four eight-ounce cups of tea or more than five 12-ounce cans of soda a day, or eating six or seven dark chocolate bars.

The committee said the evidence was not clear on whether consuming more than 200 mg of caffeine a day might increase pregnancy risks.

The group considered two recent studies, each of which followed more than 1,000 pregnant women.

One study, led by Dr. David Savitz of The Mount Sinai Medical Center in New York, found no increased rate of miscarriage for women who consumed low, moderate, or high levels of caffeine at different points in their pregnancy.

In the other, Dr. De-Kun Li and his colleagues at Kaiser Permanente's Division of Research in Oakland found a higher risk of miscarriage in women who consumed more than 200 mg of caffeine per day, but no extra risk at lower levels.

The committee also pointed to two other studies that found that a mother's moderate caffeine intake did not make it any more likely she would deliver a baby prematurely.

Research has shown that caffeine is able to cross the placenta, which led to worries that it could cause miscarriage or premature birth.

In the United States, about 16 per cent of all pregnancies end in miscarriage and about 12 per cent of babies are born prematurely.


Rich Sommer & Wife Expecting Baby No. 2!

Mad Men star Rich Sommer and wife Virginia are expecting their second child - a baby boy - at the end of the summer!

The 32-year-old actor, also known for his role opposite Anne Hathaway in The Devil Wears Prada, is thrilled at the idea of his 2-year-old daughter, Beatrice, becoming a big sister: “She’s gonna get a baby brother and we’re very excited!”

Rich is hoping to be by his wife’s side when his son is born. “I asked for a couple of certain days off with fingers crossed,” he explains. “But, you know, it’s kind of the nature of the job.”

"I’m hopeful that I can be there for the blessed even and we’ll see how long I get to spend there before I race back and put a tie and shirt on," he adds, with a laugh.

Congratulations to the entire Sommer family!