Friday, December 10, 2010

Tips for the First Six Months of Breastfeeding

75 percent of moms initiate breastfeeding at birth, but only around 13 percent of moms actually make it to the bare minimum of six months of exclusive breastfeeding. Here's what you need to know to make it to at least six months exclusively.

Common times for growth spurts are during the first few days at home and around 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months. Not surprisingly, those are also the most common times women think they've stopped producing enough.

In most circumstances, your milk cannot "just dry up." You'd have to start a medication, stop eating or drinking, be under tons of stress, skip feedings, get really sick, or have some major hormone fluctuation (like getting pregnant again) for your milk to actually "go away."

What usually happens during these times is that your baby is just going to need to nurse more, to first up your supply to meet their growth spurt and then to get themselves the sustenance they need to get through it. It will slow back down after a few days or a week or so, once they're past the growth spurt. So if you notice your baby suddenly needing to nurse a lot more, don't think that your supply went DOWN -- demand temporarily just went UP. Even in the toddler years, there's a growth spurt every few months. Don't supplement or assume that it's time to start solids -- you'll create supply problems that didn't exist and babies under 6 months aren't ready for solids.

Don't expect your baby to start sleeping through the night during this time. Breast milk digests quickly, as it's supposed to, and babies who are allowed to feed themselves at their own rate (as exclusively breastfed babies usually are) have small stomachs. It's developmentally expected for a baby to wake 1-3 times at night at the very least during this period. Sleeping "through the night" is considered one five-hour stretch -- don't expect more or try to skip night feedings just yet. In fact, if you're concerned about your supply at all, letting baby be latched on for as much of the night, even while asleep, can help up your supply.

Comfort nursing isn't overfeeding. It's a common myth that comfort nursing sets bad eating habits. Fortunately, this just isn't true. Unlike when drinking from a bottle, babies can nurse at the breast and choose not to get milk. So why not use a pacifier? Well, because there's this nifty chemical hormone called cholecystokinin (CCK) that helps tell a baby when they need to suck and when they don't. Letting a baby use a pacifier can cause nipple confusion, but can also confuse your baby's hormones, letting the level rise and tell them they don't need to nurse when they actually do, and can even mess up your supply. There are ways to make pacifiers work with breastfeeding of course, but in general, there's a good rule: If you have a baby who really needs a pacifier, then use it, don't abuse it, and quickly try to lose it.

Check the flow. If baby pulls off and gets squirted with a solid stream and chokes or gurgles, and pukes or burps, you may just have overactive letdown, meaning your milk comes out very fast and hard. Try laying back with baby more on top of you, or get baby or your hand to initiate letdown, then pull off and let the initial gush go into a cup or burp cloth. If baby seems to start nursing, cry, beat your breast a little, and then nurse again, you may have a slower letdown, so again, initiating letdown yourself or even doing breast compression before putting baby on and while they're starting to nurse might help alleviate frustration. Both of these issues generally resolve themselves in a couple weeks, or at most, a couple months.


Becki Newton Welcomes First Child!

It's a boy!

Actress Becki Newton and husband Chris Diamantopoulos have welcomed a son, their rep tells

The former Ugly Betty star, 32, gave birth to their little boy in Los Angeles in early November.

It's the first child for Newton and Diamantopoulos, who wed in 2005 after meeting in NYC's Times Square.

Earlier this year, Newton told Us she was taking a laid-back approach to starting a family.

"I think someday, when the time is right, it'll happen," Newton (who'll next star in NBC's Love Bites) said.


Restless Legs Syndrome in Pregnancy Linked to Later Risk

Women who had restless legs syndrome (RLS) while pregnant were four times more likely to have the condition again after their pregnancies, and were three times more likely to have the chronic form of the condition, according to a small European study.

Researchers led by Mauro Manconi, MD, PhD, from Vita--Salute University in Milan,, Italy, and colleagues compared 74 women who had experienced restless legs syndrome during their pregnancies and 133 women who had not.
Restless legs syndrome is a neurological disorder characterized by uncomfortable sensations in the legs that sometimes lead to a feeling of needing to move the legs for relief. Symptoms are often worse during the night. The disorder affects about 10% of the U.S. population.

Symptoms of restless legs syndrome can arise during pregnancy and then disappear after childbirth. The incidence of restless legs syndrome among pregnant women ranges from 26% to 30% and often peaks during the third trimester, according to the researchers.

Study participants were surveyed and asked about their medical history, including symptoms of restless legs syndrome and medications they used within two days after delivery. The women were then followed for an average of 6.5 years to see who developed recurrent restless legs syndrome.
The researchers found that:
  • 24% of women who had restless legs syndrome during pregnancy had the disorder at the end of the study, compared with 8% of women who did not have the syndrome while pregnant.
  • 58% of women who reported restless legs syndrome symptoms while pregnant experienced symptoms again in a future pregnancy, compared with 3% of women who did not have the disorder during a first pregnancy.
  • The incidence of developing the chronic form of restless legs syndrome was 34.4 per 1,000 in the pregnancy-related restless leg syndrome group compared 11.5 per 1,000 among those who did not experience restless legs syndrome during pregnancy.
The study results suggest pregnancy-related restless legs syndrome may signal a risk for developing future transient episodes or even the chronic form of the disorder.

The findings are published in the Dec. 7 issue of Neurology.

“This is the first long-term study to look at a possible connection between restless legs syndrome in pregnancy and repeat occurrences in later years or future pregnancies,” writes study researcher Mauro Manconi, MD, PhD, with Vita-Salute University in Milan, Italy. “Most of the time, when a woman experiences RLS in pregnancy, it disappears after the baby is born. However, our results show that having the condition during pregnancy is a significant risk factor for a future chronic form or the short-term form in other pregnancies down the road. Women who experience RLS should still be reassured that symptoms will probably disappear after delivery but may reappear later on.”


Thursday, December 09, 2010

The Maternity and Style Gift Guide is Here!

Maternity and Style's Holiday Gift Guide is finally here! There's no need to feel rushed and exhausted from the chaos at every mall in town. Instead, pour yourself a cup of hot chocolate and cuddle with your little one while browsing all the wonderful gifts this year's Holiday Gift Guide has to offer.

Not only will you find great gifts for your hubby and the little one, you'll discover fabulous items to add to your own wish list! The hottest trends in jewelry, toys and electronics are yours with a simple click of the mouse. Happy shopping and Happy Holidays!

Shop here. 

Fetal DNA Sequenced From Mother's Blood

A new technique can map the genome of an unborn baby from bits of its own DNA found floating in the mother's blood, offering a way to detect inherited conditions without using invasive methods that may cause miscarriages.

The technology was used for the first time to identify the full set of genes in a fetus conceived by two parents who each carried mutations causing beta thalassemia, an inherited blood disorder. Researchers in Hong Kong obtained a blood sample from the mother and father, analyzed each parent’s genes, isolated the fetal genome from the mother’s blood and concluded the fetus had inherited the father’s and not the mother’s mutation.

Mapping the entire genome of a fetus using this method would take three weeks and costs about $200,000, said Dennis Lo, the Hong Kong professor who developed the technique. He is refining it to analyze only those portions of the genome that are suspected of harboring mutations for any particular family. This will reduce the cost, Lo said.

“For any particular family you want to screen, there are only a handful of genes that are clinically important,” Lo, who is the Li Ka Shing professor of medicine at Chinese University of Hong Kong, said yesterday in a telephone interview.

Prenatal screening now is conducted by techniques called amniocentesis and chorionic villus sampling to find birth defects and genetic mutations. Both methods involve inserting a needle, either into the amniotic sac surrounding a fetus or into the placenta to remove fluid that carries fetal DNA. The techniques carry about a 1 percent risk of inducing a miscarriage, Lo said.

Today’s report, published in the journal Science Translational Medicine, caps more than a decade of work by Lo. In 1997, he discovered that unborn fetuses release genetic material into the blood of their mothers. About 10 percent of the DNA floating in a pregnant woman’s bloodstream comes from the fetus, not the mother.

Until now, there has been no practical way to figure out which bits of DNA come from mom and which come from fetus, Lo said. He developed the technique using maps of the mother’s and father’s genes as guidelines and enlisting computational methods to determine whether bits of floating DNA carry the signature of the father or the mother. If the DNA bits are unique to the father, they must therefore belong to the fetus. He has developed software that accomplishes this analysis.

“It’s more technologically challenging than most gene sequencing,” Lo said. “Imagine millions of jigsaw puzzle pieces and then put in 10 times as many pieces from another jigsaw and you try to assemble the first one.”

Before the technique can be used clinically, the cost must be cut significantly and a host of ethical issues will need to be addressed, Lo said. These include questions about who would have access to the expensive technology, whether information gathered might encourage abortions and whether it’s ethical to collect such detailed personal information for someone who hasn’t yet been born and doesn’t have a say in the decision.

“I think we need a lot of discussion between ethicists and scientists,” Lo said.


Lawsuit alleges that state sold babies' blood

In a lawsuit filed Wednesday in federal court in San Antonio, the Texas Civil Rights Project accuses state health officials of lying about the sale and distribution of thousands of samples of babies' blood to pharmaceutical companies and the military.

The civil rights group originally sued the Texas Department of State Health Services in 2009 over what it said was the improper collection of millions of samples of babies' blood without parental consent, samples that were stored indefinitely for scientific research. State officials announced a settlement later that year that included destroying about 5 million blood samples.

The new suit seeks to recover and destroy the samples the group says were sold to pharmaceutical companies and sent to the Armed Forces Institute of Pathology for DNA research. The plaintiffs also want state Health Commissioner David Lakey to pay $1,000 for every blood sample distributed.

The lawsuit was filed on behalf of two parents who don't know whether their children's blood samples were sold. Jim Harrington, Civil Rights Project director, said that the suit estimates that 8,800 samples were sold, but that there could be more.

Harrington said he believes that the state profited more than $300,000 from the sales.

A Health Department spokeswoman issued a statement saying that the agency had not seen the suit and would not comment on specific allegations.

The state collects blood samples to screen for at least 27 birth defects and other disorders. In 2002, it began saving samples after the screenings for research.

State lawmakers in 2009 tightened procedures, extended privacy guarantees and let parents opt out.


Wednesday, December 08, 2010

Groundbreaking MRI Shows Childbirth From The Inside

Berlin's Charite Hospital has achieved a world-first by creating MRI images of a baby being born in order to provide extraordinary insights into the birthing process.

A team comprised of obstetricians, radiologists and engineers have built an "open" MRI scanner that allows a mother-to-be to fit fully into the machine and give birth there, the hospital announced on Tuesday.

The MRI (magnetic resonance imaging) scanner has already taken unique images of the body of a mother and the movement of her baby through the birth canal to the point where its head emerges into the world. The birth that took place in the scanner went smoothly and both mother and baby were in good health, a hospital spokeswoman said.

The birth was the culmination of a two-year project by the research team. MRI uses powerful magnets to magnetize some atoms in the body which makes them detectable to radio waves. Importantly, it can make cross-section images of a subject, showing intricate detail of soft tissue and bones in the body.

The team built a special “open MRI” scanner, a new type of machine whose open structure had the necessary space for the mother to give birth.

The new machine will enable the researchers to study in greater detail how the baby moves through the mother’s pelvis and down the birth canal – issues that have long been studied and debated. The hospital’s Institute for Radiology and Obstetrics Clinic will work closely together on the project.

Among other benefits, it should help researchers to understand why about 15 percent of pregnant women need a cesarian section because the baby does not progress properly into the birth canal.

Here is a video-compilation of the MRI images:


University of Rochester study shows how babies can be choosy

Blogs, e-mail, webcasts, tweets, texts and podcasts; proud of how you sort through them all?

You've got nothing on the average 7-month-old.

The University of Rochester's Baby Lab recently completed a study suggesting that even very young babies are surprisingly discriminating: "Infants prefer looking at something that's neither too predictable nor too surprising, but someplace in the middle," says Celeste Kidd, a graduate researcher in Brain & Cognitive Sciences at the Baby Lab.

In the study, which won an award from the Cognitive Science Society, Kidd and collaborators Richard N. Aslin and Steven T. Piantadosi from Massachusetts Institute of Technology dub it The Goldilocks Effect.
Babies "avoid wasting all kinds of cognitive resources on material they've already learned, or that is too difficult to learn from," Kidd explains.

And that, you could argue, takes more brainpower for infants, since being choosy may be trickier for them.

"I think babies actually are more overwhelmed than we are with potential things they can learn," Kidd says. "They don't have a lot of information that we take for granted — how things feel, how gravity works. Babies don't know physics yet."

But they know what to tune into for maximum learning.

In the study, babies watched videos of familiar objects popping out of three computer-generated boxes.

If a picture of a sippy cup popped repeatedly from box A, and that was all, the babies tended to lose interest and look away. Same deal if objects popped up in too shocking or random a manner (10 crayons from box A, say, then a balloon from C).

But a sequence that "violated their expectations just a little bit" (phone-shoe-phone-shoe-phone-shoe; piano!) kept them riveted, Kidd says.

To find out whether adults have the same tendency, the research team is doing a similar experiment — using fully grown subjects instead of diapered ones.

But Kidd and others already suspect that The Goldilocks Effect knows no age limit. After all, she says, it would explain "our attraction to things that will distract us." Consider how, in an auditorium during a dull presentation — or an overly complex one — you might surreptitiously fire up your iPhone. And then scroll through those blogs and tweets until you find one that feels just right.


Tuesday, December 07, 2010

Consumer Reports Warns Pregnant Women Against Canned Tuna

Consumer Reports tested 42 samples of tuna from cans bought in and around New York and found that white tuna usually contains far more mercury than light tuna - and that women and children should be even more cautious about eating the fish.

After analyzing the tests, the magazine's fish-safety experts concluded that pregnant women should avoid eating all tuna as a precaution. Children over 45 lbs. should stick to no more than 12.5 ounces of light tuna or 4 ounces of white tuna a week, while lighter children should have no more than 4 ounces of light tuna or 1.5 ounces of white tuna.

Why the stricter warnings? Every sample that Consumer Reports tested had measurable levels of mercury, ranging from 0.018 to 0.774 parts per million (ppm). Samples of white tuna ranged from 0.217 ppm to 0.774 ppm and averaged 0.427 ppm — enough that by eating 2.5 ounces of any of the tested samples, a woman would exceed the daily mercury intake considered safe by the EPA.

Samples of light tuna ranged from 0.018 ppm to 0.176 ppm. That's low on average, but about half the tested samples contained enough mercury that eating a single can would exceed the EPA's limit for women of child-bearing age.

Indeed, it's the outliers that pose a particular danger, not so much the average. While light tuna especially on average doesn't contain that much mercury, there's the danger of spikes in certain samples — and there's no way for pregnant women to know if the canned tuna they're eating contains unusually high levels of mercury. But the Consumer Reports study shows that it is a real threat that cautious women should take seriously.

Of course, limiting your seafood intake has its own risks. Omega-3 fatty acids — found in fish — are thought to help in developing fetal nervous systems, and they're well-known to reduce the risk of heart attack and stroke. The National Fisheries Institute, a trade group, noted that none of the canned tuna it tested — even the outliers — exceeded the FDA's allowable limit of 1 ppm or more. (That's the point at which the FDA is allowed to pull products from the shelves, though that's never been done.)

Of course, the FDA's safety limits on mercury have long been considered too lax — and compared to the rest of the world, they are. It will be a long time before we have definitive science on just how much mercury pregnant women can be exposed to without ill effect, but most people would agree that this is a time for the precautionary principle.

Read more:

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Cell Phone Use in Pregnancy: Risks for Child?

Exposure to cell phones before birth and afterward may increase a child's risk for developing certain behavioral problems, including hyperactivity, inattention, and problems getting along with peers, a study suggests.

The new research does have limitations; the researchers point out that there aren’t enough data to say how, or even if, cell phone exposure may cause any behavioral problems in children.

“There are theories, but we do not know,” says study researcher Leeka Kheifets, PhD, a professor of epidemiology in the UCLA School of Public Health. “Exposure to the fetus is likely to be very low, so it’s unclear how it can influence fetal development.”

But taking some simple precautions to reduce exposure during pregnancy and among children seems prudent. “Be aware of your exposure and while the science develops, use precaution,” she tells WebMD. “It is very easy to reduce exposure by keeping your phone away from body and using a hands-free device, so why not do it?”

The researchers analyzed data on cell phone use from 28,745 7-year-olds and their moms who were part of the Danish National Birth Cohort study. The mothers provided information on their lifestyle including cell phone use during and after pregnancy. They were interviewed again about their kids’ cell phone habits and behavioral issues when their children turned 7.

They found that 35.2% of 7-year olds used a cell phone. Less than 1% of children used their cell phone for longer than one hour a week. Based on the reports by their mothers, the majority of children (93%) had no behavioral issues, 3.3% had borderline behavioral problems, and 3.1% showed signs of behavioral problems including emotional symptoms, conduct problems, hyperactivity/inattention, and relationship problems.

Close to 18% of children were exposed to cell phones during pregnancy and after birth, and this was the group with greatest risk for behavioral problems, the study suggests.

The new findings mirror those of an earlier, smaller study of about 13,000 children from the same Danish birth cohort.

Going forward, Kheifets plans to look at the children when they turn 11 and see if the findings still hold. Children will be able to answer questions regarding their cell phone use for themselves by the time they are 11.

The time to act is now, says Devra Davis, PhD, MPH, the founder of Environmental Health Trust, a group that educates the public about environmental health risks and pushes for policy changes needed to reduce these risks. She is also the author of Disconnect: The Truth about Cell Phone Radiation, What the Industry Has Done to Hide It, and How to Protect Your Family.

“Pregnant women should be careful about exposure for lots of reasons, not this study. Warnings actually appear on phones that say pregnant woman should avoid exposure to their abdomen,” she says.

“Do not keep it on your abdomen, use it with a headset or speaker phone,” she says.

It’s not just pregnant women who need to heed this advice. Several studies have shown that men who keep their cell phones in their pocket may risk damaging their sperm, she says.

Jeff Stier, a senior fellow at the National Center for Public Policy Research, a conservative think tank, says that the new study is full of holes. “For starters, self-reporting of cell phone use makes it impossible to assign any meaning to the exposure,” he says.

“Different phones give off different exposures, and even those who were reported to be not exposed, probably had significant environmental exposure, rendering the study only slightly more than amusing,” he told WebMD.


Monday, December 06, 2010

Babies' biological clocks dramatically affected by birth light cycle

The season in which babies are born can have a dramatic and persistent effect on how their biological clocks function.

That is the conclusion of a new study published online on Dec. 5 by the journal Nature Neuroscience. The experiment provides the first evidence for seasonal imprinting of biological clocks in mammals.

The imprinting effect, which was found in baby mice, may help explain the fact that people born in winter months have a higher risk of a number of neurological disorders including seasonal affective disorder (winter depression), bipolar depression and schizophrenia.

In the experiment, groups of mouse pups were raised from birth to weaning in artificial winter or summer light cycles. After they were weaned, they were maintained in either the same cycle or the opposite cycle for 28 days. Once they were mature, the mice were placed in constant darkness and their activity patterns were observed.

The winter-born mice showed a consistent slowing of their daily activity period, regardless of whether they had been maintained on a winter light cycle, or had been shifted to summer cycle after weaning. When the scientists examined the master biological clocks in the mouse brains, using a gene that makes the clock cells glow green when active, they found a similar pattern: slowing of the gene clocks in winter-born mice compared to those born on a summer light cycle.

In addition, the experiments found that the imprinting of clock gene activity near birth had dramatic effects on the reaction of the biological clock to changes in season later in life. The biological clocks and behavior of summer-born mice remain stable and aligned with the time of dusk while that of the winter-born mice varied widely when they were placed in a summer light cycle.

"The mice raised in the winter cycle show an exaggerated response to a change in season that is strikingly similar to that of human patients suffering from seasonal affective disorder," Professor of Biological Sciences Douglas McMahon commented.

Exactly when the imprinting occurs during the three-week period leading up to weaning and whether the effect is temporary or permanent are questions the scientists intend to address in future experiments.

"We know that the biological clock regulates mood in humans. If an imprinting mechanism similar to the one that we found in mice operates in humans, then it could not only have an effect on a number of behavioral disorders but also have a more general effect on personality," said McMahon.

In humans, studies conducted in the northern and southern hemispheres have confirmed that it's the season of winter – not the birth month – that leads to increased risk of schizophrenia.

There are many possible seasonal signals that could affect brain development, including exposure to flu virus.

For the study, the researchers took groups of  newborn pups and placed them in environments with controlled day/night cycles. One group was placed in a "summer" cycle with 16 hours of light and eight hours of dark; another group was placed in a "winter" cycle with eight hours of light and 16 hours of dark; and a third group was placed in an equinox cycle with 12 hours of light and 12 hours of darkness. They were kept in these environments for three weeks until they were weaned.

"When they are born, the brains of mice are less developed than those of a human baby. As a result, their brains are still being wired during this period," McMahon said.

Once they were weaned, half of the summer-born mice were kept on the summer cycle and half were switched to the winter cycle for the following 28 days as they matured. The winter-born mice were given the same treatment. The equinox-born mice were split into three groups and put into summer, winter and equinox cycles.

After the mice matured, they were placed into an environment of continuous darkness. This eliminated the day/night cues that normally reset biological clocks and allowed the scientists to determine their biological clock's intrinsic cycles.

The scientists found a substantial difference between the summer-born and winter-born groups.
The summer-born mice behaved the same whether they had been kept on the summer cycle or switched to the winter cycle. They started running at the time of dusk (as determined by their former day/night cycle), continued for ten hours and then rested for 14 hours.

The behavior of the winter-born mice was much different. Those who had been kept on the winter light cycle through maturation showed basically the same pattern as their summer cousins: They became active at the time of dusk and continued for 10 hours before resting. However, those who had been switched to a summer cycle remained active for an extra hour and a half.

When they looked at what was happening in the brains of the different groups, they found a strikingly similar pattern.

In the summer-born mice, the activity of neurons peaked at the time of dusk and continued for 10 hours. When the winter-born mice were matured in the winter cycle, their neuronal activity peaked one hour after the time of dusk and continued for 10 hours. But, in the winter-born mice switched to a summer cycle, the master bioclock's activity peaked two hours before the time of dusk and continued for 12 hours.

When they looked at the equinox group, the scientists found variations that fell midway between the summer and winter groups. Those subjected to a summer cycle when they matured had biological clocks that peaked one hour before the time of dusk and the biological clocks of those subjected to a winter cycle peaked a half hour after the time of dusk. In both cases the duration of activity was 11 hours.


Baby Born With Full Set of Teeth

Breast feeding can be uncomfortable, but one mother who found it particularly painful was amazed to discover her new baby already had two front teeth.

Patricia Caulfield, 25, from Liverpool, said she noticed her daughter Faye's pearly whites a day after her birth at Ormskirk hospital.

Ms Caulfield said: "When she was born, I noticed two white slits on her bottom gum and the nurses said they were teeth. The next morning, when I was feeding her, I felt a sharp pain and saw they had come through fully.  My midwife told me this is really rare. Children are sometimes born with buds but hardly ever full teeth."

Two-week-old Faye Armstrong has now grown another two molars at the back of her mouth.

Most babies don't develop their first tooth until they are around six months old, and it is usually a lower central incisor.

Ms Caulfield, who works in recruitment, is currently at home on maternity leave with her Faye, who was born three weeks early, and three-year-old Alfie.

Ms Caulfield's community midwife Joyce Davies, who works for Liverpool Women's Hospital, said: "While you are always told to check for signs of teeth, it is actually a very, very rare event to find two fully erupted teeth after so few days.You often find little beads in the gums but there is no doubt about it - these are two fully-formed teeth."
"This little baby certainly got all she wanted for Christmas - her two front teeth!"


Epilepsy Drug Could Cause Birth Defects

According to a new study, European researchers have linked side effects of Tegretol, an epilepsy drug, to a risk of the serious birth defect spina bifida when the medication is taken by pregnant women.

The study, which was published online Friday by the British Medical Journal, looked at eight cohort studies of 2,680 pregnancies where the women were exposed to carbamazepine, which is marketed as Tegretol, Carbatrol, Epitol and Equetrol.

Overall, 3.3% of women who took the drug in the first trimester gave birth to children with birth defects. They determined that Tegretol side effects during pregnancy were associated with a 2.6 times risk of having a child with spina bifida than women who were not exposed to carbamazepine.

Spina bifida is a developmental birth malformation involving the spinal cord, where some vertebrae are not fully formed. The condition may allow portions of the spinal cord to protrude through the opening in the bones, leading to serious life-long injuries for the child

The use of valproate epilepsy drugs during pregnancy, such as Depakote, Depacon, Depakine and Stavzor, have also been associated with an increased risk of birth defects, including spina bifida, cleft palate, abnormal skull development, malformed limbs, holes in the heart and urinary tract problems.

Late last year, the FDA added more stringent warnings about the risk of birth defects from Depakote and other valproate-based anti-seizure drugs. The warnings came after the agency found that the risk of giving birth to a child with a neural tube defect was 1-in-20 for women who took valproate during the first 12 weeks of pregnancy, compared with a risk of only 1-in-1500 for women not taking the epilepsy drug.

In the new British Medical Journal study, researchers found that spina bifida from Tegretol and other carbamazepine drugs was the only major congenital malformation that could be significantly associated with these epilepsy drugs.

In an accompanying editorial, Irena Nulman, associate professor of paediatrics at the University of Toronto, cautioned that the links to birth defects should be carefully weighed against the benefits Tegretol, Depakote and other epilepsy drugs provide.

“For many pregnant women, discontinuing antiseizure drugs is not an option,” Nulman wrote. “Women should plan their pregnancy, receive evidence based prenatal counseling, and be given the safest antiepileptic drug.”
Tegretol (carbamazepine) was first approved in the U.S. in 1974 as an anticonvulsant. It is approved for the treatment of epilepsy, trigeminal neuralgia and bipolar disorder.