Friday, October 01, 2010

The Sleep Situation for Parents of Newborns

Dr. Michael Thorpy and Dr. Shelby Freedman Harris of the Sleep-Wake Disorders Center at Montefiore Medical Center:

For most parents, having a newborn in the house can wreak havoc on sleep schedules. Generally, there aren't any long-term health effects. I personally see it as an evolutionary thing that's built in to help us raise newborns, though there are really no studies on this. New parents can prepare by understanding, and accepting, that the first few months will most likely consist of disrupted nighttime sleep. If you follow the guidelines below, the disrupted sleep will likely last for only a few months, which is rather short-term in the scheme of things.

During the first six months of life, babies sleep soundly in two- to four-hour periods. Newborns are not born with a circadian cycle that makes them stay awake during the day and sleep at night. Rather, sleep is spaced evenly in chunks throughout the 24-hour day. Bottle-fed newborns tend to sleep for slightly longer periods, generally three to four hours, whereas breast-fed babies tend to sleep in one- to three-hour cycles.
After 6 months of age, infants begin to sleep for longer periods, and they generally sleep through the night (as defined by a six-hour stretch). From 6 months to 9 months, however, many infants, even those who were fantastic sleepers when they were younger, begin to exhibit episodes of night wakings. These night wakings are generally due to developmental and physiological milestones. Instead of sleeping, babies often find it more interesting to practice newly acquired skills like crawling or sitting up. About 30 percent to 50 percent of infants at this age awaken at least once per night for a short while, usually for about one to five minutes at a time, with 25 percent of 1-year-olds continuing to do so.

Since newborns sleep upward of 16 hours per day in small chunks, parents often find it difficult to get a full seven or eight hours of sleep at night. Parents need to work their sleep schedules around the newborn’s patterns. In essence, sleep when the baby sleeps. We realize that this is easier said than done, but making some changes — and enlisting the help of others, if possible — can help new parents adjust as best as they can to a fragmented sleep pattern.

Creativity and flexibility are important here. For example, some parents prefer to break up child care into “early night” and “late night” shifts, whereas others swap off nights. Once a baby is 6 weeks old, parents can start to have a standard bedtime routine set at a desired time, though it might migrate earlier or later depending on the baby’s schedule. Keep in mind that it is unlikely that your baby will be sleeping through the night just yet. These routines help to reinforce that it is bedtime and help the child ease into sleep.

Keep the routine uncomplicated, simple and always in the direction toward the crib — for example, bath, followed by bottle in a nursery chair, then reading in the chair and then crib. In addition, try not to have baby fall asleep at the bottle; instead, put the newborn to bed “drowsy but awake.” This helps the child learn to self-soothe. Becoming attuned to baby’s sleep signs, like rubbing the eyes, yawning or fussing, can be helpful. Pushing the bedtime later will only cause the baby to become overtired and sleep worse. Gradually moving the bedtime earlier can actually help lengthen the sleep period.

Remember to always put your baby to sleep on his or her back (the phrase “back to sleep” is a helpful reminder). Do not swaddle in many clothes or wrap the baby in a blanket; government officials also recently advised against using infant sleep positioners. Make it possible for the baby to be able to move around in the crib. On hot summer days, dehydration is a major cause of child discomfort, so be aware that babies lose water more easily than adults.

From 4 to 6 months of age, babies start to sleep through the night. They require few or no night feedings. Babies who are “self-soothers” can easily fall back asleep on their own, but some babies require the presence of a parent, food or object (such as a pacifier) to return to sleep.

If a baby continues to need your help to return to sleep, a number of methods have been developed to teach a baby to self-soothe. A common misconception is that babies will outgrow this phase. Studies have shown that 80 percent of children who had sleep problems as infants continue to have difficulties three years later.
There are many treatments available to help babies become self-soothers, including the “cry it out” Ferberizing method and “no cry” solutions. Choosing which treatment to use is a very personal decision, and one that some feel very passionate about. Many of these treatments can be helpful, but consistency is critical for success. A number of helpful books are available, including “Sleeping Through the Night,” by Jodi Mindell; “Healthy Sleep Habits, Happy Child,” by Dr. Marc Weissbluth; and “The No-cry Sleep Solution,” by Elizabeth Pantley.

As a baby begins to sleep through the night, many parents notice that they have trouble doing the same. They have adjusted to sleeping in short chunks, and returning to pre-baby sleep patterns takes time. Those parents who had trouble sleeping before the baby arrived often have more difficulties with this transition. Try to avoid checking in on your baby whenever you awaken. If you are needed, your baby will let you know.
If Mom or Dad continues to suffer from insomnia, cognitive behavioral therapy or pharmacological treatments may be necessary. We recommend that new parents first start with cognitive behavioral therapy for insomnia, as it can be quite effective without the addition of medication.

While poor sleep and fatigue are believed to be the norm for new parents, postpartum depression may be an underlying factor and can worsen sleep. Studies have shown that women with a prenatal history of depression may be more affected by the multitude of changes that happen after childbirth, including psychological, hormonal and immunological shifts. It is important that new mothers let their doctors know of any symptoms of depression, including sad mood, tearfulness, feelings of hopelessness or guilt, insomnia, changes in appetite, extreme loss of energy, loss of interest in things and thoughts about death, suicide or harm to others.
If a new parent or baby continues to have troubles with sleep, pediatric sleep specialists or behavioral sleep medicine specialists are available to help. The American Board of Sleep Medicine has a list of certified behavioral sleep medicine specialists on its Web site.


Using Different Positions in Labor

Throughout history, images depicted in art show that women have used many positions to give birth to their babies, including standing, sitting, hands-and-knees, and side-lying. Until doctors began using forceps in the 17th century, women rarely were shown giving birth lying on their back. With the support and encouragement of family members and community midwives, laboring women used objects such as posts and ropes to gain leverage during pushing. They often used birthing supports or stools to help them squat, crouch, or kneel. More recently, research has helped us understand how laboring women push when no one is telling them to push a certain way. Women following their own urge to push usually will wait for each contraction to build and then push for about five seconds, take a few short breaths, and then push again.

In contrast, a recent survey of women who gave birth in the United States in 2005 reported that 57% gave birth lying on their back, and an additional 35% gave birth propped up in a semisitting position . Only 21% of women in the survey followed their own urge to push. The rest of the women reported that nurses or other health-care providers told them to push a certain way.

Positions for Pushing
 By choosing the positions that feel most comfortable, you can create an overall more positive birth experience. Just as importantly, doing this enhances the progress of labor.

Using several positions during the bearing-down or pushing part of labor helps you work with your baby as she turns and comes down through your pelvis. The positions that you choose often will make you more comfortable and help your baby’s progress. There is no one position that is best for every woman and every baby. Each position has advantages and disadvantages and can be helpful in different situations.

Upright Positions
Upright positions—such as standing, kneeling, or squatting—take advantage of gravity to help your baby move down into the pelvis. Squatting increases the size of the pelvis, providing more room for the baby to move down. Squatting is the most tiring position, so you may want to rest between contractions in a position that does not use gravity, such as side-lying, semi-sitting, or kneeling on all fours.

Some women have used a “standing supported squat” or “dangle” position, as described by Penny Simkin, a well-respected childbirth educator. In this position, you are supported under your arms, putting very little weight on your legs or feet. This position is most useful for someone with a long pushing stage and also makes the trunk on your body longer. It makes more space for the baby to move, which enables the pelvis to work more freely.

Positions That Do Not Use Gravity 
Positions that do not use gravity to help move the baby down—such as hands-and-knees, side-lying and semi-sitting—are relaxing and help if you are tired. Lying on your side will help slow down a labor that is progressing too fast and may help avoid tearing of the area between the vagina and anus as the baby comes out. Research shows that the hands-and-knees position helps ease back pain in labor.

Types of Pushing
When you push in response to the natural urge to push, it is called “spontaneous pushing,” meaning you are doing what your body tells you to do. This natural urge comes and goes several times during each contraction. Each of these bearing-down efforts or urges usually lasts from five to seven seconds. However, when you are directed by your caregiver and those around you to hold your breath and push to a count of 10 seconds, repeating this two to three times during a contraction, you are using directed pushing.

Responding to the urge to push with short periods of holding your breath in a calm environment has many advantages. Your baby will get more oxygen through the placenta, you will be less likely to become physically exhausted, and there is less chance of damage to the perineum and the muscles of the pelvic floor in the vagina. If you are having a very difficult time pushing the baby out, directed pushing might help. However, pushing spontaneously will usually be easiest and safest for both you and your baby.

What Research Tells Us
According to the Cochrane Pregnancy and Childbirth Group, a respected international organization that defines best practices based on research, the use of any upright or side-lying position compared with lying on your back with your legs in stirrups is associated with the following results:
  • shorter second (pushing) stage of labor;
  • a small decrease in the use of vacuum or forceps;
  • fewer episiotomies;
  • less chance of experiencing severe pain;
  • fewer abnormal fetal heart tracings;
  • a small increase in second-degree tears (in the upright group only); and
  • an increase in estimated blood loss, although there was no evidence of serious or long-term problems from the extra blood loss.
Lying on your back may cause lower blood pressure and less blood flow to your baby due to the weight of the uterus on major blood vessels. When you lie on your back with your legs up in stirrups, you are actually pushing your baby out against gravity.

Research does not support the routine use of directed pushing, and some researchers suggest it is harmful. Holding your breath for a long time naturally decreases the flow of oxygen to your baby. Research suggests that this is stressful and may even be harmful for your baby. Also, the excess force of directed pushing can be harmful to your perineum, resulting in more tears and weaker pelvic floor muscles several months after the birth . Weakness in these muscles is associated with incontinence (involuntary loss of urine or feces). Listening to your body, working with the pushing urges, and birthing your baby between contractions reduce the risk of tears.

One study showed that the average length of the pushing part of labor is 13 minutes shorter in women who use directed pushing . However, there is no medical benefit to a shorter second stage of labor as long as you and your baby are doing well. Because there are no important benefits to directed pushing and there is the possibility of harm when it is used, it is best for you and your baby if you push how and when it feels right to you.



Lack of Sleep During Pregnancy Ups Risk of High Blood Pressure

A good night's sleep when you're pregnant may help keep your blood pressure levels normal, new research suggests.

Pregnant women who got less than six hours of nightly sleep during early pregnancy had systolic blood pressure readings in their last trimester that were nearly 4 mm/Hg higher than women who slept nine hours nightly, the study found. And women who got less than five hours of sleep increased their odds of developing preeclampsia - a serious pregnancy complication related to high blood pressure - more than ninefold.

On the other hand, getting too much sleep could also be a problem: women who reported sleeping more than 10 hours a night in their first trimester had more than a twofold increase in the risk of developing preeclampsia, according to the study published in the October issue of the journal Sleep.

"Women, in general, need about seven to nine hours of sleep during pregnancy, preferably nine hours. Getting less than that amount can have health affects," said study author Michelle Williams, a professor of epidemiology and global health at the University of Washington, and co-director of the Center for Perinatal Studies at the Swedish Medical Center in Seattle.

"Women generally already know that they're eating well and getting enough exercise for two during pregnancy. Our study suggests that women should also aspire to sleep well for two," said Williams.
But, she added, because the current study is one of the first to show this association, its findings need to be confirmed by other researchers before any recommendations can be made.

The study included 1,272 healthy pregnant women who were recruited for the study during prenatal care visits to the Swedish Medical Center in Seattle between December 2003 and July 2006.

All the women reported information on their lifestyles and health characteristics, as well as sleeping habits, in an initial interview done around 14 weeks' gestation. Blood pressure was measured periodically throughout pregnancy.

Sleep duration didn't appear to have an effect on blood pressure levels in the first and second trimesters of pregnancy. However, during the third trimester, women who slept less than six hours a night had an average systolic (that's the top number in a blood pressure reading) blood pressure that was 3.72 mm/Hg higher than women who slept nine hours. Even women who slept seven to eight hours a night had systolic blood pressure readings that were 2.43 mm/Hg higher than women who slept nine hours.

The study also found that systolic blood pressure was 4.21 mm/Hg higher in women who slept more than 10 hours each night.

To better assess what such differences in blood pressure might mean to pregnant women, the researchers also looked at the effect of sleep time on the risk of developing preeclampsia, which can have significant health consequences for both the mother and the baby.

The researchers found that women who slept less than five hours a night increased their odds of developing preeclampsia more than 9.5 times, and those who stayed in bed more than 10 hours had more than a twofold increased risk of preeclampsia.


Thursday, September 30, 2010

Fisher-Price recalls 11 million items for infants, toddlers

In the wake of multiple child injuries in the United States and Canada, Fisher-Price Inc. announced that it will recall more than 11 million items geared toward infants and toddlers, including tricycles, high chairs and toys.

The sweeping recall, announced Thursday, comes after 24 reported incidents of injuries to young children. Seven kids needed stitches after being cut by pegs on Fisher-Price high chairs, and at least six 2- to 3-year-old girls experienced genital bleeding when they sat or fell against protruding plastic ignition keys on Fisher-Price toddler tricycles.

“Consumers should immediately place the trikes out of children’s reach and contact Fisher-Price for a free replacement key,” the U.S. Consumer Product Safety Commission said in a statement about the tricycle incidents.

Other kinds of Fisher-Price toys being recalled have not caused any injuries, but they have resulted in some close calls.

A variety of baby toys and soft gyms with inflatable balls are being taken off the market because the valve of the inflatable balls can detach and pose a choking hazard. The Consumer Product Safety Commission said there have been “14 reports of the valve found in a child’s mouth and three reports of a child beginning to choke.”

Additionally, the wheels can detach from the purple and green cars that come with the Fisher-Price Little People Wheelies Stand ‘n Play Rampway. The wheels, like the inflatable-ball valves, can become choking hazards once detached.

“Consumers should immediately take the affected purple and the green cars away from children and contact Fisher-Price for free replacement cars,” the Consumer Product Safety Commission said.

Details about the specific products being recalled in the United States and Canada appear below. For additional information, visit the websites of the U.S. Consumer Product Safety Commission or Fisher-Price, which is a wholly owned subsidiary of Mattel Inc.
Consumers also can call Fisher-Price’s recall hotline toll-free at (800) 432-5437.

  • Names of products: Fisher Price Trikes and Tough Trikes toddler tricycles
  • Units: About 7 million in the United States and 150,000 in Canada
  • Sold at: Mass merchandise stores nationwide from January 1997 through September 2010 for about $25.
  • Names of products:  Baby Playzone Crawl & Cruise Playground, Baby Playzone Crawl & Slide Arcade, Baby Gymtastics Play Wall, Ocean Wonders Kick & Crawl Aquarium (C3068 and H8094), 1-2-3 Tetherball, Bat & Score Goal
  • Units: About 2.8 million in the United States and about 125,000 in Canada

  • Names of products: Healthy Care, Easy Clean and Close to Me High Chairs
  • Units: About 950,000 high chairs in the United States and 125,000 in Canada
  • Sold at: Mass merchandise retail stores nationwide from September 2001 through September 2010 for between about $70 and $115. 

  • Name of product: Fisher-Price Little People Wheelies Stand ‘n Play Rampway with model numbers T4261 and V6378
  • Units: About 100,000 in the United States and 20,000 in Canada
  • Description: Only the purple and green cars that are marked “Mexico” and do not have a yellow dot on the bottom are included in the recall. 
  • Sold at: Mass merchandise stores nationwide from April 2010 through September 2010 for about $45.



Spanish fathers entitled to breastfeeding leave

The new legislation means that both the mother and father are allowed to leave work for an hour during the day or reduce their working day by half an hour during the first nine months following the birth of a child.

The European Union Court of Justice in Luxembourg ruled on Thursday that the Spanish law caused an "unjustified discrimination on grounds of sex" because fathers do not have the same rights as mothers.

Fathers are currently only allowed to apply for breastfeeding leave if the mother is employed full time.

The Spanish man who challenged the law, Pedro Manuel Roca Alvarez, said his request to take breastfeeding leave from his job in Galicia was rejected because the mother of his child was self-employed.
The top court said such a refusal could have the effect of forcing self-employed mothers to limit their work because the father cannot share the burden.

Not giving dads the same right as mums in this case "is liable to ... keep men in a role subsidiary to that of women in relation to the exercise of their parental duties," the court ruled.

Breastfeeding leave should now be considered as "time purely devoted to the child" in order to reconcile family life and work after maternity leave.


Dogs and Cats Have Opposite Effects on Kids' Eczema

Good news for dog owners looking to raise a kid, but bad news for cat owners - Fido may help prevent your child from developing eczema, but Mittens may make it worse, researchers found.

Children who have lived with a dog since before age 1 and test positive for dog allergy on a skin prick test (SPT) have a significantly lower risk of developing eczema than children who tested positive but didn't live with a dog, a study by Tolly G. Epstein, MD, of the University of Cincinnati Medical Center, and colleagues, found.

Alternately, children whose SPT was positive for cat allergy but lived with a cat before their first year had a significantly higher rate of eczema than those who tested positive but didn't live with a cat and those who tested negative on the SPT, the researchers reported in the Sept. 15 issue of the journal Pediatrics.

The longitudinal cohort study enrolled 762 infants and tested the toddlers with SPTs for 15 aeroallergens, cow's milk allergy, and hen's egg allergy annually from ages 1 to 4 - 636 completed the annual visits to the four-year endpoint. Parents' home environments were assessed before the end of the child's first year through measuring allergens in a dust sample from his or her primary living area.

The study also proposed two definitions for eczema a priori based on either parental report through a questionnaire -- which included scratching and redness, raised bumps, or dry skin and scaling as markers -- or diagnosis through a healthcare professional associated with the study, which included erythema, papulation, excoriations, or lichenification as signs of the condition.

The control group included infants who neither had eczema by way of parental report nor were reported to have the condition after physical examination by a healthcare professional.

A child was considered positive for an allergen if he or she tested positive at least once from age 1 to 3.

Of the 636 children who completed the study, 184 had a dog in the home before age 1, while 121 had a cat.
A child's positive test for dog allergy on an SPT was associated with an increased risk of eczema in dogless homes when compared against eczema risk for kids with dogs.

Of those from homes without dogs who tested positive for dog allergy on an SPT, 30% developed eczema, while only 15% of children who tested negative for the allergy in a dogless home developed the condition, with an adjusted odds ratio of 3.9 at a 95% confidence interval from 1.6 to 9.2.

However, only 14% of children with dogs who tested positive for dog allergy on an SPT were diagnosed with eczema, while 9% of those who tested negative had the condition with an adjusted odds ratio of 1.3 at a 95% confidence interval from 0.3 to 6.8.

Among kids without cats, 33% of those with a cat allergy developed eczema, compared with 13% of those without a cat allergy with an adjusted odds ratio of 1.1 at a 95% confidence interval from 0.5 to 2.7, a nonsignificant difference.

Children of cat owners fared worse, as 54% of children who tested positive for cat allergy developed eczema, while only 11% of those who tested negative also had eczema with an adjusted odds ratio of 13.3 at a 95% confidence interval from 3.1 to 57.9.

The researchers found their study matched previous data that showed dog ownership provided a significant, fourfold protective effect against eczema at four years when compared with households without dogs. They also noted children of cat owners were 13 times more likely to develop the skin condition than children of households without cats.

The researchers also found that kids in a home with a dog were protected from positive SPT results for cat allergy, suggesting dog ownership may develop childhood tolerance to a variety of allergens. They attributed this to patients with dog allergies developing high levels of interleukin-10 and interferon-gamma after becoming tolerant.

The team was unable to identify factors exacerbating eczema in cat-allergic children.


Wednesday, September 29, 2010

Portland woman expecting identical triplets UPDATED

A North Portland woman is expecting something very rare - spontaneous identical triplets - all boys.

Janet Pittsenbarger is the expecting mom, with a pregnancy that's literally against all odds. Spontaneous identical triplets are conceived without any fertility drugs. According to doctors, the chances of that happening are 1 in 100,000.

To protect the pregnancy, Pittsenbarger takes 19 vitamins a day. She's also on a 4000-calorie diet.

"I'm feeling good overall," said Janet. "But I'm starting to reach my limit."

Dr. Leonardo Pereira, the Director of Maternal Fetal Medicine at OHSU, says there has never been a set of spontaneous identical triplets at OHSU. "I've only seen this one time before in my career," said Pereira. "These are the pregnancies that are very unusual."
They are so unusual both Janet and Philip needed proof at their first ultrasound.
"I don't know if I believed her right away," said Philip. "But sure enough we looked on the screen and there were three little blobs there."

Since that first ultrasound five months ago Janet has put on close to 60 pounds and she is now on bed rest at the orders of doctors. "Pretty much just get up to go to the bathroom and doctors appointments," said Janet. "Besides that just sit or lie down."

Pittsenbarger is seven months into her pregnancy. She’s technically due in November but doctors anticipate the boys will come a lot sooner.


UPDATE:  Janet Pittsenbarger has given birth!

Born at 10:35pm by C-section in birth order were Caleb at 4lbs. 5 oz. , Eli at 4 lbs., 1 oz., and Thomas at 4 lbs. 6 oz.

Janet's husband Phil says it all began when he and Janet went in to do fetal heart monitor check Tuesday night. One of the babies had a heart rate concern, dropping with contractions that were happening. Phil says doctors decided to admit Janet and watch her and the babies overnight, but the contractions got stronger and they decided she was in labor and it was time for the babies to be born.

The family says the babies are doing very well for their 34-weeks gestation and size. The babies did not need oxygen or any breathing assistance. The babies are in the ICU - which is standard procedure for 34 week babies.

Janet is also doing very well.


Maternal Diet High in Trans Fat Doubles Risk of Excess Body Fat in Breastfed Babies

A new University of Georgia study suggests that mothers who consume a diet high in trans fats double the likelihood that their infants will have high levels of body fat.

Researchers, whose results appear in the early online edition of the European Journal of Clinical Nutrition, found that infants whose mothers consumed more than 4.5 grams of trans fats per day while breastfeeding were twice as likely to have high percentages of body fat, or adiposity, than infants whose mothers consumed less than 4.5 grams per day of trans fats.

The researchers investigated different fatty acids, but determined trans fats to be the most important contributor to excess body fat. “Trans fats stuck out as a predictor to increased adiposity in both mothers and their babies,” said study co-author Alex Anderson, assistant professor in the UGA College of Family and Consumer Sciences.

Anderson explained that although breast milk is optimal for the health of infants, it could also contain high levels of trans fats, depending on the mother’s diet. A better understanding of how a mother’s consumption of trans fats may impact the health of her baby would aid nutritionists in making more accurate dietary recommendations to prevent chronic disease later in life by encouraging mothers to select a diet low in trans fats, he said.

To determine the effect of the intake of trans fats by the child through breast milk, the researchers studied three different groups; mothers who only breast fed their infants, those that only used formula and those that used a combination of breast milk and formula.

It is important to measure body fat in addition to weight, said Anderson, since being overweight does not always mean having a high percent of body fat and vice versa. “It’s not just the weight, but the amount of body fat in the person that affects their health,” Anderson said. “That is why adiposity is such an important measure of cardiovascular risk.”

The researchers also found that mothers who consumed more than 4.5 grams of trans fats per day increased their own risk of excessive fat accumulation, independent of pre-pregnancy weight, by almost six times. This data suggests that trans fats intake could have a more significant weight-gain effect on breastfeeding mothers than it does at other times in their lives, Anderson said.

The researchers studied 96 women, many of whom were highly educated non-Hispanic white women, and note that the study should be replicated in a larger, more diverse group to strengthen information about the health dangers of eating trans fats. “It would help to be able to follow the child from when the mother was pregnant, through birth, and then adolescence, so that we can confirm what the type of infant feeding and maternal diet during breastfeeding have to do with the recent epidemic of childhood obesity,” said Anderson.


Tuesday, September 28, 2010

James Van Der Beek Welcomes a Daughter

Congratulations to James Van Der Beek and his wife Kimberly Brook, who welcomed a baby girl over the weekend!
Olivia Van Der Beek was born on September 25, and it sounds as though she already has her doting dad wrapped around her little finger.
The Dawson's Creek alum Tweeted the happy news today, writing:
"Had the blessing of becoming a father over the weekend...Couldn't come close to describing this bliss even if I had 140 million characters."
He followed that post up with another: "I apologize in advance for any obnoxiously precious new-dad tweets that may follow. I'm under her spell..."
How sweet!
Olivia is the first child for the pair, who tied the knot last month.


More Similac Cans Recalled

The manufacturer of Similac has added another product to its list of recalled powder infant formula.
Abbott Laboratories, manufacturer of the formula, now includes a 22-ounce container of Go & Grow Milk Early Shield Powder (lot no. 93773T20). The company released its initial list last week after beetle parts were found in a small percentage of the powdered formula.

 Parents can look at the complete list at Although the list was updated Sunday, parents will still have to compare it with the list released earlier last week to make sure they haven’t missed any products that are being recalled.
Since the recall was announced, Abbott has been flooded with calls and visits to its website. As a result, the company said on Monday that it was “increasing its call center resources” as well as the bandwidth of its site.


How 'gentle' skin creams could cause baby eczema

The appearance of eczema in very young babies is one of the most common worries for new parents - and there is evidence that it is becoming increasingly common.
In the 1940s, the condition affected 4 per cent of newborns, but now the figure is around 25 per cent.
It can lead to other skin problems, such as psoriasis, and make sufferers more prone to other conditions, including asthma.
 New research by a leading expert indicates that modern-day bath oils and lotions used on babies’ skin during the first few weeks of life might be to blame for much of this increase.
Professor Richard Cork, head of academic dermatology at the School of Medicine and Biomedical Sciences at Sheffield University, says there appears to be a six-week ‘window’ after a baby is born.
During this period, babies with a genetic predisposition to eczema, caused by a hereditary gene defect, can have their immune system made more sensitive, and this makes them more likely to develop eczema.
‘These babies are born with a defective skin barrier, which means that their skin can be sensitized — made prone to an allergic reaction — much more easily if the “wrong” treatments are used,’ says ­Professor Cork.
‘The outer layer of the skin, called the stratum corneum, provides a barrier which normally prevents the penetration of irritants and allergens.
‘But in babies who are predisposed to atopic eczema, this does not work as effectively, allowing loss of water from the corneocytes (cells in the skin), which shrink and allow cracks to open between them, so irritants and allergens can ­penetrate, leading to lesions from eczema.
‘The use of soap on the skin leads to a further deterioration of the barrier, because it breaks down the cells which are still forming in babies’ skin.’
Today, babies and children are exposed to harsher soaps and detergents, containing more ­synthetic ingredients, than they were 60 years ago. Even so-called baby products can contain detergents too harsh for these at-risk children, says Professor Cork.
Worse still, he believes the very creams prescribed by doctors to treat the eczema might actually be making things worse. Indeed, he believes one particular treatment — aqueous cream — is ‘extremely damaging’ to the skin.
Although aqueous cream is ­prescribed to thousands of eczema patients as a moisturiser, it was actually developed as an alternative to soap and was not designed as a ‘leave-on’ cream.
Yet this product is on most GPs’ prescribing formularies, and is widely used because it is cheap.
One biochemist consulted by Professor Cork described aqueous cream as ‘an insane formulation’ for babies’ skin.
Another substance commonly applied to babies’ skin is olive oil — but Professor Cork says this is also unsuitable as it has a very poor balance of oleic and linoleic oil, which is damaging to skin before it develops properly.
The acid-alkali balance in these oils (measured on the pH scale) is not suitable for a baby’s sensitive skin, as it hydrates it for several minutes but then has a drying effect.
‘We need much better, high-quality, randomized controlled trials to identify which products are best for young babies’ skin,’ says Professor Cork.
He also believes that health professionals, such as midwives and health visitors, need to be more aware of the latest guidelines on treating eczema in young babies, as in some cases they do not even know about the guidelines.
Margaret Cox, chief executive of the National Eczema Society, says that eczema typically develops at the age of around two months in babies, and once it appears, it can lead to other conditions, such as asthma and food allergies.
‘There needs to be more awareness of the best way to care for babies’ skin in the first six months after they’re born, and more education for parents in picking up the early signs of eczema,’ she says.
So what creams should parents be using on their affected babies’ skin?
Professor Cork says parents must avoid all perfumed or scented products. He also advises avoiding natural or organic products which don’t contain preservatives.
‘These can be hazardous to children with eczema because they can become contaminated with bacteria.’
Medical moisturizers such as white soft paraffin, liquid paraffin 50/50, or emulsifying ointments are the best bet, although parents might need to experiment until they find one that works for their child.
Margaret Cox also urges parents to ask their GPs for an alternative to aqueous cream.
Some emollients are less likely to irritate because they don’t ­contain the detergent sodium lauryl, which can further upset sensitive skin. These include Doublebase, EpiDerm, Dermamist, Hydromol, Dexeryl and Emollin.


Monday, September 27, 2010

Gael Garcia Bernal and girlfriend expecting

Mexican actor and director Gael Garcia Bernal and his girlfriend Dolores Fonzi announced Friday that they are expecting their second child.

The couple officially announced the pregnancy in Spanish on Bernal's personal Twitter feed, telling followers that they're very happy about the news.

Bernal and Fonzi gave birth to their first child, Lazaro, on January 8, 2009.

 Bernal, famous stateside for his work in "The Motorcycle Diaries" and "Y tu mamá también," will be working next on a Spanish-language comedy with Will Ferrell and his "Y tu mamá también" costar, Diego Luna.

Fonzi is an Argentinian film and television actress.


Sperm Donor Anonymity Sparks Controversy Among Offspring

Melissa Singer always knew she didn't want to get married. It wasn't that she didn't like men, or relationships; she just never felt the desire for constant partnership. What she did want, however, was a child.

"Motherhood was the thing I wanted to do most in the world," said Singer, who lives in New York City. "I wanted to have a child. I wanted to be able to pass along the traditions that my family had. I wanted to be able to give my parents a grandchild."

So, in her mid-30s, Singer went to her doctor and said she wanted to start a family. The doctor gave her the phone number of a local sperm bank. After nine months of trying to conceive, Singer became pregnant with her daughter, Jacqueline, now 14.

Stories like Singer's have gotten a popularity boost in pop culture this summer with movies like "The Back-Up Plan" and "The Switch" focusing on parenthood via donor insemination. The latter movie sparked a minor feud between lead actress Jennifer Aniston and conservative pundit Bill O'Reilly, who said in August that Aniston's comments on women's ability to become mothers without men were "destructive to our society," and diminished the role of the dad.

Singer mostly rolls her eyes at what she calls "the same blather we've been hearing for decades." And most scientists who've researched "choice moms" who deliberately decide to raise children alone say that the kids do well. There are some reasons why: Most choice moms are highly educated, well-off financially, and, by definition, very deliberate in their decision to have a child — all generally good things for children.

The question now, many parents and researchers say, is not whether sperm donation is a valid way to have a child. It's whether the anonymity of sperm donation ultimately hurts the donor's offspring.

The truth about where (donor) babies come from
Decades ago, sperm donation was kept under a veil of secrecy. Couples with fertility problems who came to doctors were often given the sperm of medical students. Few records were kept, and many children weren't told that the man they knew as their father wasn't biologically related to them.

That's still the case for many children raised by heterosexual parents. A 1996 study published in the journal Human Reproduction found that of 111 European couples who had conceived a child by donor insemination, none had told the child. A study presented at a 2008 meeting of the European Society of Human Reproduction and Embryology found that although 46 percent of parents of donor-conceived children in the United Kingdom intended to tell their child about their conception, only 29 percent actually had by the time the child reached age 7.

Single moms, on the other hand, are much more likely to tell their child the truth.

Research on a sample of mostly American donor-conceived kids published in 2009 in Human Reproduction found that 9 percent of heterosexual couples told their kids about their conception before age 3, compared with 63 percent of single moms. Early disclosure could put single moms' kids at a psychological advantage over the two-parent children. The study found that children told after age 18, for example, were more likely than children told at earlier ages to feel "angry" or "shocked" at the news.

"The sooner they're told, in a fairly matter-of-fact way, the better," Eric Blyth, a professor of social work at the University of Huddersfield in the United Kingdom and a visiting professor at Hong Kong Polytechnic University, told LiveScience. Blyth compares the persistent secrecy over donor insemination to the way adoptions were run decades ago.

"I could never really see that there was such a big difference certainly from the child's point of view between adoption and donor conception, in terms of children knowing where they come from," Blyth said.

For Singer, the decision to tell her daughter the truth was simple. She introduced the idea in bedtime stories about a happy family that wanted to be bigger, so one of the women in the family had a baby. As her daughter got older, Singer added more details about doctors' visits and the differences between the way Jacqueline was conceived compared with other children. The disclosure is, in the words of another donor-insemination mother interviewed by LiveScience, "a nonevent."

Anonymity, pro and con
Even when children know how they were conceived, few know who their donor was. The U.K. passed legislation removing the promise of anonymity for donors registering after April 1, 2005. After age 18, children of those donors are now allowed to learn the identity of their donor. In the United States, sperm banks have begun releasing more information on donors, including detailed medical and family histories, but anonymity is still standard. Sperm banks are not required to track the number of births from donations, so children may also have multiple half-siblings they don't know about.

Not all donor-conceived children (or their parents) are satisfied with that anonymity. In 2000, Colorado mother Wendy Kramer and her donor-conceived son Ryan launched the Donor Sibling Registry, a website that helps donor half-siblings connect with one another. Ryan Kramer eventually uncovered six half-siblings, as well as his donor.

Kramer argues that donor anonymity benefits sperm banks instead of families, allowing the banks to sell sperm without tracking how many children are born as a result. About 1,200 donors are registered at her site, she said. One found out he'd fathered 125 children.

Anonymity, she contends, prevents donors from sharing updated medical information with their biological children. But seeking out a donor is about more than health history, she said.
"For a woman, the man is her sperm donor," Kramer said. "For a child, it's that child's biological father."

In May, the Commission on Parenthood's Future released a report on an Internet-based sample of people who were donor-conceived, arguing that donor conception was bad for children. The report's text was criticized by Blyth and others who argued that it overstated what the data actually indicated. The research was funded by the Institute for American Values, an organization that promotes traditional definitions of marriage and family.

For example, a finding that 19 percent of donor children "strongly agreed" and 26 percent "somewhat agreed" with the statement "The circumstances of my conception bother me," combined with the finding that 65 percent of donor children agreed or strongly agreed with the statement "My donor is half of who I am," was interpreted by study co-author Elizabeth Marquardt, director of the IAV's Center for Marriage and Families, as revealing "profound" struggles with "origins and identities.".

Mixed opinions
Opinions on anonymity in the donor community are mixed, even among children. For every child with a burning curiosity about his or her donor, there's another with only mild interest, or none at all.

Hanne Anderson, 21, was raised by her mom in Mobile, Ala., who used donor sperm to conceive her. While she might consider a search for half-siblings or her donor one day, Anderson said, she hadn't given much thought to the legality of anonymity.

"I think as far as details regarding a person's name or any way to contact them, I don't see anything wrong with that being anonymous," Anderson told LiveScience. "Of course, when you get into ethnicity and the more scientific aspects, I think that should always be made available."
Singer thinks that the practice of anonymous sperm donation will eventually come to an end. However, she said, "I'm not sure that I feel that it's fair to the guys who agree to donate under conditions of anonymity to break that open without their permission."


Book Reveals Long-Term Effects of Influences in the Womb

Over the centuries, most cultures have believed - and then dismissed the belief - that what happens to you in the nine months before you are born can affect everything that you become in life.
Now modern scientists are reviving this ancient idea, writes Annie Murphy Paul in her new book "Origins: How the Nine Months Before Birth Shape the Rest of Our Lives," which is being released tomorrow.
 The book is filled with such facts as:
  • Eating chocolate during pregnancy can lead to a happier, less fearful baby.
  • Eating lots of fish high in omega-3 fatty acids and low in mercury during pregnancy produces smarter kids, with better social, communication and motor skills.
  • “Moderate” levels of stress during pregnancy is associated with accelerated brain development at 2 weeks of age and better motor and mental development scores at age 2.
  • Severe stress, on the other hand, can have lifelong effects. Adults who were in utero during the flu pandemic of 1918, for instance, did not go as far in school or earn as much money as their adults who were in utero just before or just after the pandemic, but were more likely to suffer from disabilities and receive welfare. And people whose mothers were pregnant during the Nazi siege of Holland, the famine during China’s “Great Leap Forward” and the six-day Arab-Israeli War in 1967 are more likely to suffer from schizophrenia.
It’s not as if no one had wondered whether outside influences during pregnancy could have lasting effects on a baby. After all, look at all those couples playing Mozart for their unborn children. But only recently, Paul argues, has “the nine-month-long process of shaping and molding that goes on in the womb” been seen as “a crucial process of preparation for the specific world the baby will enter.”
There is a danger to this “pregnancy determines everything” lens, of course. It could too easily become one more source of guilt for pregnant women, as if there weren’t enough of those already.
Paul agrees it is a worry. She agreed to write a guest post today for Motherlode about how “blame the mother” would be a shortsighted and off-the-mark use for all this emerging data. Instead, she says, most of the things that can go wrong in pregnancy are “collective in nature (matters of food safety, environmental pollution, safety in disaster situations, and so on) and require collective solutions — not more responsibility and blame piled on individual pregnant women for situations they can’t possibly rectify on their own.”