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Your Baby

Pregnant? Exercise is Good For You!

2:00

For years, the prevailing thought has been – if you didn’t exercise before, during pregnancy wasn’t the time to start. That’s no longer the case says, Alejandro Lucia, a professor of exercise physiology at the European University of Madrid.

A group of researchers want women to know that when it comes to exercise, there is a strong consensus of benefit for both the mother and developing fetus.

"Within reason, with adequate cautions, it's important for [everyone] to get over this fear," said Lucia.

According to the American College of Obstetricians and Gynecologists (ACOG), which updated its recommendations in 2015, women without major medical or obstetric complications should get at least 20 to 30 minutes of moderate-intensity aerobic exercise — enough to get you moving, while still being able to carry on a conversation — on most days of the week.

Lucia noted that evidence now suggests that starting an exercise program while pregnant can provide health benefits to both the mother and the growing fetus. Obviously, though, if you're new to exercise, take it slowly — you can work up to that 20 or 30 minutes.

The authors of the study say physical activity can prevent excessive weight gain, which can complicate the pregnancy and contribute to obesity. A review of existing research published in 2015 by the Cochrane Library found "high-quality evidence" that exercise during pregnancy can help prevent gaining too much weight, and may possibly lower the likelihood of a cesarean section, breathing problems in newborns, maternal hypertension and a baby that is significantly bigger than average. And of course, exercise promotes general cardiovascular and muscular health.

Other health problems can be helped such as chronic high blood pressure, gestational diabetes and women who are overweight or obese. Researchers say women with these conditions should be encouraged to exercise.

However, there are some health conditions in pregnancy where exercise should be avoided. According to the ACOG guidelines, women should avoid aerobic exercise if they have significant heart disease, persistent bleeding in the second or third trimester, severe anemia and risk of premature labor, among other conditions. And certain symptoms, such as contractions or dizziness during exercise, should be checked out quickly.

The bottom line is that women need to make a plan with their physician, taking into account their exercise history, their health, and the risk of pregnancy complications, says James Pivarnik, a professor of kinesiology and epidemiology at Michigan State University. He wasn't an author of the viewpoint but has conducted research on exercise and pregnancy.

Moderation is the goal during any exercise program. Long distance running and heavy weight lifting are not recommended. ACOG also recommends against contact sports, hot yoga, and exercises done in the supine position, i.e. lying face up, starting in the second trimester.

There are always exceptions to the rule, particularly with women who are highly trained athletes before they become pregnant. These women should still form plan with their OB/GYN on how much and what kinds of exercises are safe for them.

Among the general population and pregnant women specifically, people will respond differently to an exercise program. "But we know if you do the kind of things they're talking about here, the odds are your risk will be lower," says. Pivarnik.

Story source: Katherine Hobson, http://www.npr.org/sections/health-shots/2017/03/21/520951610/exercising-while-pregnant-is-almost-always-a-good-idea

Parenting

Mumps Reach 10 Year High; Hitting Colleges and Kids Hard

1:45

Mumps are making a comeback, particularly on college campuses and in daycare centers.

A recent U.S. Centers for Disease Control and Prevention report shows that mumps are at a 10-year high. As of November, 45 states and the District of Columbia had reported a total of 2,879 mumps infections — more than double the mumps cases reported in 2015.

Mumps is a contagious disease caused by a virus. Common symptoms can include swollen glands in front of and below the ear or under the jaw, pain with opening and closing the jaw, fever, fatigue and malaise, headache and earache.

Currently, college campuses are taking the brunt of the mumps outbreak.

Dr. Michael Grosso, medical director and CMO of Huntington Hospital/Northwell Health, said close quarters such as dormitory living, can make it easier to pick up the virus.

“It’s spread through respiratory secretions, coughing, sneezing, close contact and sharing the same cups and utensils,” Grosso told CBS News.

Some colleges, such as The University of Missouri’s Columbia, are asking students to restrict their social activities and to make sure they get immunized. Typically, two doses of vaccine are recommended by the American Academy of Pediatrics and the CDC, but the school is asking students to get a third measles-mumps-rubella (MMR) vaccine “based on discussions with public health officials and consistent with guidance from The Centers for Disease Control and Prevention.”

College students aren’t the only ones being hit hard by mumps; younger children are also experiencing a rise in reported cases. More parents have opted-out of getting their children the MMR vaccine - putting non-immunized children at a higher risk.

Daycare centers are similar to college dormitories in that they provide an environment where a virus can be easily spread.

While most mumps cases are mild, albeit, uncomfortable, others can be more serious.

“Most individuals recover uneventfully from mumps, however as many as 10 percent of males who get mumps will get an inflammation of the testes which can lead to permanent sterility,” Grosso said.

The brain can also be affected. About 1 percent of people who come down with the mumps get serious brain infections and can experience meningitis, encephalitis and deafness associated with a brain infection.

“That small risk was behind the original impetus to create a vaccine,” Grosso said.

 Physicians are urging students to get the immunizations and to practice good hygiene. Simple steps such as covering your cough or sneeze, washing your hands with soap and water or using an alcohol-based hand sanitizer, avoiding sharing food, drinks, cups or utensils can help prevent the spread of viruses.

Vaccines are still the most effective way to lower your risk of getting the mumps.  No vaccine is a 100 percent protective, Grosso notes, but it can help you avoid the risk of serious illness and lifelong health issues.

“Receiving two doses of mumps vaccines is said to confer about an 88 percent reduction in risk of getting mumps if you’re exposed,” said Grosso. A third dose may increase those odds.

The American Academy of Pediatrics recommends the first dose of MMR vaccine should be administered between 12 and 15 months of age, and the second dose between 4 to 6 years of age.

Grosso emphasizes that parents need to get their children vaccinated early.

“Being immunized late is better than not being immunized ever. But being immunized late is not nearly as good as being immunized on time,” Grosso said.

Story sources: Mary Brophy Marcus, http://www.cbsnews.com/news/mumps-cases-10-year-high-college-outbreaks-vaccination/

https://www.cdc.gov/mumps/

Parenting

Blue Bell Creameries Recalls All of Its Products

1:30

Say it isn’t so! Yes, one of the country’s favorite ice cream brands is recalling all of its ice cream products due to possible contamination with the bacteria Listeria monocytogenes.

Until now, Blue Bell Creameries has been issuing gradual recalls of specific ice cream items. Monday, the company decided to recall all of its ice cream, frozen yogurt, sherbet and all other frozen snacks.

Three people have died and five others have fallen ill from the bacteria that may have come from Blue Bell products, health officials have said.

Listeria is an organism that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headaches, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

Blue Bell made the decision to recall all of its products after analysis of some half-gallon containers of chocolate chip cookie-dough ice cream contained listeria.

"This means Blue Bell has now had several positive tests for Listeria in different places and plants," the company said in a written statement.

"At this point, we cannot say with certainty how Listeria was introduced to our facilities, and so we have taken this unprecedented step."

So far there have been five confirmed cases of listeria infections in Kansas and three in Texas.

According to their website notification about the recall, the company promises to sure all their products are safe before they go back on sale.

“We’re committed to doing the 100 percent right thing, and the best way to do that is to take all of our products off the market until we can be confident that they are all safe,” said Paul Kruse, Blue Bell CEO and president.

“We are heartbroken about this situation and apologize to all of our loyal Blue Bell fans and customers. Our entire history has been about making the very best and highest quality ice cream and we intend to fix this problem. We want enjoying our ice cream to be a source of joy and pleasure, never a cause for concern, so we are committed to getting this right.”

Blue Bell says it is implementing a procedure called “test and hold” for all products made at all of its manufacturing facilities. This means that all products will be tested first and held for release to the market only after the tests show they are safe. The Broken Arrow facility will remain closed as Blue Bell continues to investigate.

Sources: http://cdn.bluebell.com/the_little_creamery/press_releases/all-product-recall

Holly Yan, http://www.cnn.com/2015/04/20/health/blue-bell-ice-cream-recall/

 

Daily Dose

MMR Vaccine Update

vaccine, virus, health, parenting

Although there is more and more data to confirm that childhood vaccines are safe, and DO NOT cause autism….there  continues to be some parental concern surrounding the timing of a child’s vaccines.  The majority (read as all of my patients) receive their vaccines according to the CDC guidelines…and for the most part my patients realize the importance of vaccines and how many lives have been saved as more vaccines are given to children today than 25 years ago.  

But, when it comes time for the MMR (measles, mumps, rubella) vaccine, there are still a few parents who express concerns and some who would “like” to defer the vaccine to a later date when their child is “older”….typically after their child reaches the age of 18-24 months. Concerns are not only about safety, but also about efficacy of the vaccine at a younger age.   There have been several recent studies that should help to allay fears and actually reassure parents that giving the vaccine at 12 months of age is preferable and may have even have fewer side effects, if any, than when given when the child is older.

A study from Finland (which uses the same MMR vaccine)  looked at whether the antibody response (protection) from the MMR vaccine was any different when given at 12 months vs 18 months of age.  This study showed that the antibody response and protection from the MMR vaccine was similar when given at 12 months vs 18 months. Good news for giving it younger and protecting the child earlier.

Another study looked at the risk of febrile seizures after the MMR vaccine. This study reported that the risk of a seizure was more than 6 times higher during the 7 - 10 day interval after the MMR vaccine among children who were 16-23 months, as compared to those who were 12 -15 months.  So..in fact, delaying the vaccine actually put a child at more risk for a seizure than if given earlier.

These studies point to the win-win in giving the MMR vaccine to children at their 1 year old well child visit.  Not only does it provide earlier protection against measles, mumps and rubella ( a new outbreak of measles in the Amish community in Ohio was just reported), the chance of your child having any adverse effects are actually even lower. 

But remember, while this study showed “twice the risk” for delaying the vaccine…it is still a VERY LOW number, out of 10,000 kids there may be 4 extra febrile seizures.  While that number may seem insignificant,  when your child is one of the 4 to have a seizure it is significant. This is coming from a mother whose child had a febrile seizure (unrelated to vaccines) and who is a pediatrician.  It was even frightening for me to watch my child have a febrile seizure and I knew what was happening. While most febrile seizures only last 1-2 minutes he of course decided to have a prolonged seizure, (always doctor's kids). I am happy to report that he is of course totally fine and never had another febrile seizure…as most children “outgrow” febrile seizures during the pre-school years. 

Bottom line,  with these studies in hand…you should feel reassured that immunizing at 12 months is  preferable, safe and prevents serious illnesses.  

Your Baby

FDA Approves Newborn Screening Tests for 4 Rare Disorders

1:45

Depending on which state you live in, your newborn may be screened for a series of harmful or potentially fatal disorders when he or she is born.

With a simple blood test, doctors are often able to detect whether a newborn has certain unseen conditions that may cause problems later in life. Although these conditions are rare and most babies are given a clean bill of health, early diagnosis and proper treatment sometimes can make the difference between lifelong impairment and healthy development.

The U.S. Food and Drug Administration (FDA) recently permitted marketing of the “Seeker System,” for the screening of four rare inherited metabolic disorders. It is the first newborn screening test permitted for marketing by the FDA, for these disorders. The conditions are: Mucopolysaccharidosis Type 1 (MPS 1), Pompe, Gaucher and Fabry disease.

All of these disorders are inherited and involve deficiencies of different metabolic enzymes.  

The disorders occur in as few as 1 in 185,000 births, or as many as 1 in 1,500 births, depending on the disease, the agency said. The conditions collectively, are called Lysosomal Storage Disorders (LSDs), and can lead to organ damage and death if not treated in a timely way, the FDA added.

“The Secretary of HHS [U.S. Department of Health and Human Services] recently added Pompe and MPS I to the list of routine recommended newborn screening programs and it is anticipated that additional states will begin requiring use of screening tests to detect these disorders,” said Alberto Gutierrez, Ph.D., director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health. “Accurate screening tests will help with early detection, treatment and control of these rare disorders in newborns, before permanent damage occurs. That’s why availability of LSD screening methods that have been assessed for accuracy and reliability by the FDA are so important.”

Some states now require screening of these disorders, the FDA said, including Arizona, Illinois, Kentucky, Michigan, Missouri, New Jersey, New Mexico, New York, Ohio, Pennsylvania and Tennessee.

The newly approved tests require blood samples collected from the prick of a newborn's heel within 48 hours of birth. The agency said it reviewed data from a clinical study of more than 154,000 infants in Missouri. The system identified at least one of the four disorders in 73 of the screened newborns, the agency said.

While some parents may be aware that they could be a carrier of a particular disease, many are not. Also, parents that have adopted an infant may not have a complete family medical history. Infant screenings can help bring parents peace of mind about their baby’s health or give them an early start on treatment for their child.

Story sources: HealthDay,  https://medicalxpress.com/news/2017-02-newborn-screening.html

http://kidshealth.org/en/parents/newborn-screening-tests.html

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm539893.htm

Your Child

What to Do If Your Child Is Choking

2.30 to read

It’s more common than you probably think. On average over 12,000 children a year, under the age of 14, are treated in hospital emergency rooms for food-related choking. That’s about 34 kids a day according to a new study.

The most common choking hazards appear to be hard candy, followed by other types of candy, then meat and bones. The study noted that most of the young patients were treated and released, but around 10 per cent were hospitalized.

"These numbers are high," said Dr. Gary Smith, who worked on the study at Nationwide Children's Hospital in Columbus, Ohio.

What's more, he added, "This is an underestimate. This doesn't include children who were treated in urgent care, by a primary care physician or who had a serious choking incident and were able to expel the food and never sought care."

The estimated 12,435 children ages 14 and younger that were treated for choking on food each year also doesn't include the average 57 pediatric food-choking deaths reported by the U.S. Centers for Disease Control and Prevention annually, the researchers noted.

Smith and his colleagues analyzed injury surveillance data covering 2001 through 2009.

They found that babies one year old and younger accounted for about 38 percent of all childhood ER visits for choking on food. Many of those infants choked on formula or breast milk.

Children who choked on hotdogs, nuts and seeds were the most likely to be hospitalized.

"We know that because hot dogs are the shape and size of a child's airway that they can completely block a child's airway," Smith told Reuters Health, noting that seeds and nuts are also difficult to swallow when children put a lot in their mouths at once.

Supervision is the most important choking prevention. Parents or guardians should make sure that a small child’s food is cut up into manageable bites that can be easily chewed and swallowed. An example might be grapes and raisins. A whole raisin is probably okay to be given to a toddler, but a grape should be sliced.

What should you do if your child is choking?

For children ages 1 to 12:

1. Assess the situation quickly.

If a child is suddenly unable to cry, cough, or speak, something is probably blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn bright red or blue.

If she's coughing or gagging, it means her airway is only partially blocked. If that's the case, encourage her to cough. Coughing is the most effective way to dislodge a blockage. If the child isn't able to cough up the object, ask someone to call 911 or the local emergency number as you begin back blows and chest thrusts. If you're alone with the child, give two minutes of care, then call 911.

On the other hand, if you suspect that the child's airway is closed because her throat has swollen shut, call 911 immediately. She may be having an allergic reaction to the food.

Call 911 immediately is your child is turning blue, unconscious or appears to be in severe distress.

2. Try to dislodge the object with back blows and abdominal thrusts.

If a child is conscious but can't cough, talk, or breathe, or is beginning to turn blue, stand or kneel slightly behind him. Provide support by placing one arm diagonally across his chest and lean him forward.
Firmly strike the child between the shoulder blades with the heel of your other hand. Each back blow should be a separate and distinct attempt to dislodge the obstruction.

Give five of these back blows.

Then do abdominal thrusts

Stand or kneel behind the child and wrap your arms around his waist.

Locate his belly button with one or two fingers. Make a fist with the other hand and place the thumb side against the middle of the child's abdomen, just above the navel and well below the lower tip of his breastbone.
Grab your fist with your other hand and give five quick, upward thrusts into the abdomen. Each abdominal thrust should be a separate and distinct attempt to dislodge the obstruction.

Repeat back blows and abdominal thrusts Continue alternating five back blows and five abdominal thrusts until the object is forced out or the child starts to cough forcefully. If he's coughing, encourage him to cough up the object.

If the child becomes unconscious If a child who is choking on something becomes unconscious, you'll need to do what's called modified CPR. Here's how to do modified CPR on a child:

Place the child on his back on a firm, flat surface. Kneel beside his upper chest. Place the heel of one hand on his sternum (breastbone), at the center of his chest. Place your other hand directly on top of the first hand. Try to keep your fingers off the chest by interlacing them or holding them upward.

Perform 30 compressions by pushing the child's sternum down about 2 inches. Allow the chest to return to its normal position before starting the next compression.

Open the child's mouth and look for an object. If you see something, remove it with your fingers. Next, give him two rescue breaths. If the breaths don't go in (you don't see his chest rise), repeat the cycle of giving 30 compressions, checking for the object, and trying to give two rescue breaths until the object is removed, the child starts to breathe on his own, or help arrives.

A good rule of thumb for parents and guardians is to take a CPR class. Many hospitals and clinics also offer classes on what to do if your child is choking.

Sources: Genevra Pittman, http://www.reuters.com/article/2013/07/29/us-choking-food-idUSBRE96S04K20130729

http://www.babycenter.com/0_first-aid-for-choking-and-cpr-an-illustrated-guide-for-child_11241.bc

 

Your Child

Positioning an Unconscious Child

1:45

Children that have lost consciousness and are placed on their sides have lower odds of needing to stay in the hospital, according to a new European study.

"This is just a simple part of the first aid and resuscitation techniques that anyone can be taught," said Dr. Elizabeth Murray, who was not involved with the new study but is an expert in pediatric emergency medicine at the University of Rochester Medicine’s Golisano Children’s Hospital in New York.

The “recovery” position has the patient on their side, with the mouth facing downward to allow any fluid to drain. The researchers say this position should be used on unconscious children who are breathing normally with already cleared airways.

The researchers looked at data on 553 infants and children up to age 18 who were brought to 11 pediatric emergency rooms across Europe for loss of consciousness in 2014.

As reported in the Archives of Disease in Childhood, the average age was about three years. The average time spent unconscious was about two minutes, although about a third of the group had lost consciousness for more than 20 minutes.

About one in five patients had an existing condition like epilepsy. And about half of the patients had previously lost consciousness.

About 26 percent of parents had put their children into the recovery position, with about 70 percent of those parents reporting they'd learned that technique from doctors or first aid classes.

Those who were put into the recovery position were ultimately 72 percent less likely to be admitted to the hospital than those who weren't put in the position.

More than half of the parents had tried other potentially dangerous techniques to bring their child out of an unconscious state, such as shaking or slapping them.

Those parents said they had learned those techniques from other family members or from media outlets such as TV shows or the movies.

"You can understand why a family member would do anything to make it stop," said Murray. "Just like fever or other medical conditions, there are remedies or potentially folklore that can be passed down."

Kids whose parents used a potentially dangerous technique to try to restore consciousness had twice the odds of being admitted to the hospital, according to the researchers, who were led by Dr. Sebastien Julliand of Paris Diderot University in France.

Murray told Reuters Health that parents who don’t know what to do in this kind of situation, should call 911 and speak to an emergency operator. "It’s really important to remember that the majority of dispatchers in our 911 system can give advice over the phone," she said.

Source: Andrew M. Seaman, http://www.reuters.com/article/us-health-pediatrics-recovery-idUSKCN0V32SY

 

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Childhood Obesity

Childhood Obesity & Weight Management

Your Baby

Weight Gain During Pregnancy

2.00 to read

Every pregnant woman wonders how much weight she could gain during pregnancy. For some women, being pregnant is an open invitation to eat whatever and whenever they like, while other woman worry what the weight gain will do to their figure. There is no absolute law about weight gain during pregnancy, but there are set of guidelines that can help you.

Weight gain should be based on your pre-pregnancy body mass index (BMI.) Your health and your baby’s health also play a role in how much weight you should gain.

Here’s a list of suggested pregnancy weigh gain related to a healthy woman’s BMI.

  • Underweight (BMI less than 18.5) – 28 to 40 pounds
  • Normal weight (BMI 18.5 to 24.9) – 25 to 35 pounds
  • Overweight (BMI 25 to 29.9) – 15 to 25 pounds
  • Obese (BMI 30 or more) – 11 to 20 pounds

Multiples are a different story. If you are carrying twins or other multiples you’re likely going to need to gain more than average weight. Your health care provider can help you determine what is right for you. Here are the recommended weight gain options.

  • Normal weight (BMI 18.5 to 24.9) – 37 to 54 pounds
  • Overweight (BMI 25 to 29.9) – 31 to 50 pounds
  • Obese (BMI 30 or more) – 25 to 42 pounds

If you are overweight when you become pregnant, pregnancy increases the risk of various complications including diabetes and high blood pressure. Of course, a certain amount of weight gain is normal, but too much adds to the possibility of dangerous health risks for the woman and the child.

Remember that if you gain more than the recommended amount during pregnancy and you don't lose the weight after the baby is born, the excess pounds increase your lifelong health risks. Gaining too much weight during pregnancy can also increase your baby's risk of health problems at birth and childhood obesity.

If you're underweight, it's essential to gain a reasonable amount of weight while you're pregnant. Without the extra weight, your baby might be born earlier or smaller than expected.

Calculating your BMI is not difficult; you just need to know your height and weight. There are several online BMI calculators that will do the math for you. Your healthcare provider should also have a BMI chart that can show you your BMI.

So, how is the extra weight used by your body when your pregnant? Here’s a simple list to help you follow a normal weight gain.

  • Baby: 7 to 8 pounds
  • Larger breasts: 2 pounds
  • Larger uterus: 2 pounds
  • Placenta: 1 1/2 pounds
  • Amniotic fluid: 2 pounds
  • Increased blood volume: 3 to 4 pounds
  • Increased fluid volume: 3 to 4 pounds
  •  Fat stores: 6 to 8 pounds

During your first trimester, you probably won’t gain much weight. Steady weight gain is more important in the second and third trimesters, especially if you begin at a normal weight or are underweight.

Exercise is also important during pregnancy. Even a moderate amount of exercise will help keep your body strong as the extra pressure builds while you are carrying.

As your pregnancy develops, more than likely you’re appetite will increase. That’s not a bad thing. Just fill those hunger pains with healthy food choices!

Source: http://www.mayoclinic.org/pregnancy-weight-gain/art-20044360

 

 

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DR SUE'S DAILY DOSE

New report says not enough babies are getting much needed tummy time!

DR SUE'S DAILY DOSE

New report says not enough babies are getting much needed tummy time!

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