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Your Baby

Which Fish is Healthier for Pregnant Women?

1:45

New federal nutrition guidelines say that pregnant and breastfeeding women should eat 2 to 3 servings of fish every week. However, there are certain fish that should be eaten only once per week and other fish that should be avoided entirely by pregnant and nursing women.

One reason for the differentiation between certain types of fish is its likelihood of containing either very low or high levels of mercury.

Nearly all fish and shellfish contain traces of mercury. But some contain high levels.  A type of mercury called methylmercury is most easily accumulated in the body and is particularly dangerous.

Eating large amounts of these fish and shellfish can result in high levels of mercury in the human body. In a fetus or young child, this can damage the brain and nervous system.

The highest mercury concentration belongs to fish that typically live a long time. Pregnant and breastfeeding women should avoid King mackerel, Marlin, Orange roughy, Shark, Swordfish, Tilefish from the Gulf of Mexico and Bigeye Tuna. These are fish that usually contain high levels of mercury.

The new guidelines come with a handy chart that gives you the best choices of fish, good choices and fish to avoid.

Naturally, many pregnant women are concerned about eating fish after hearing about the possibility of consuming any mercury whatsoever. It’s important to remember that most of the fish consumed by Americans falls into the safe category.

Studies show that fish provide an array of nutrients that are important for your baby's early development. Most experts agree that the key nutrients are two omega-3 fatty acids – DHA and EPA – that are difficult to find in other foods. Fish is also low in saturated fat and high in protein, vitamin D, and other nutrients that are crucial for a developing baby and a healthy pregnancy.

How do fish end up consuming mercury? Some of the sources (such as volcanoes and forest fires) are natural. It's also released into the air by power plants, cement plants, and certain chemical and industrial manufacturers, landfills and farming runoff.

When mercury settles into water, bacteria convert it into a form called methylmercury. Fish absorb methylmercury from the water they swim in and the organisms they eat. Methylmercury binds tightly to the proteins in fish muscle and remains there even after the fish is cooked. Fish that live a long time consume more mercury.

There are many benefits to eating fish; you just need to be aware of the kinds of fish you eat. To help you make the best choices, the new chart released by the FDA and EPA is shown below.

Story sources: Megan Thielking, https://www.statnews.com/2017/01/19/fda-guidelines-fish/

http://www.babycenter.com/0_eating-fish-during-pregnancy-how-to-avoid-mercury-and-still_10319861.bc

http://www.fda.gov/downloads/Food/FoodborneIllnessContaminants/Metals/UCM536321.pdf

Parenting

Flour with Added Folic Acid Is Reducing Birth Defects

2:00

Folic acid is a B vitamin that is known to help prevent certain types of birth defects in newborns. In January 1998, the FDA added a requirement that folic acid be added to breads, cereals, and other products that use enriched flour. These fortified foods include most enriched breads, flours, corn meals, rice, noodles, macaroni, and other grain products.

Since then, a new report shows that serious birth defects have fallen 35 percent. While that is certainly wonderful news, a 2014 study found that as many as 25 percent of American women are still not receiving even the minimum amount of recommended folic acid from either their diet or through supplements.

Women who don't get enough folic acid have an elevated risk of giving birth to a child with conditions called neural tube defects, the best known of which is spina bifida, which often causes paralysis.

Health experts began recommending that women of childbearing age take folic acid in 1992 because studies showed that taking 400 micrograms a day could reduce spina bifida and related birth defects by up to 70%.

Doctors now recommend that women who are considering having children start taking folic acid before trying to get pregnant. Since some pregnancies are not necessarily planned, many doctors recommend that women of childbearing age take a daily multivitamin that contains folic acid.

The benefits of folic acid have been researched for quite some time and since food producers began adding folic acid to grains, that simple step has prevented more than 1,300 babies a year from being born with spina bifida or related conditions, according to a report from the Centers for Disease Control and Prevention.

Authors of the new study found that Hispanic women are more likely to have a baby with spina bifida or a similar birth defect.

That's partly because the "masa harina" corn flour used in tortillas and other Hispanic foods isn't fortified with folic acid, the study says. The March of Dimes has petitioned the FDA to require that folic acid be added to corn flour. Adding folic acid to corn flour would prevent another 40 cases of spina bifida or related conditions each year, the report says.

"Even with fortification, there will be some women that do not get the recommended amount of folic acid every day," says Candice Burns Hoffmann, of the CDC's National Centers for Birth Defects and Developmental Disabilities. "We still have more work to do."

If you’re considering having a baby, talk to your doctor before becoming pregnant about the benefits of folic acid and how much you may need.

Sources: Liz Szabo, http://www.usatoday.com/story/news/nation/2015/01/15/folic-acid-birth-defects/21784019/

http://www.spinabifidaassociation.org

Your Toddler

Does Parents’ Obesity Impact Toddlers’ Developmental Skills?

2:00

Children, whose parents are obese, may show signs of developmental delays by the time they are 3 years old, according to a new study.

The specific developmental problems seem to differ depending on whether the mother, father or both parents are obese, according to researchers from the U.S. National Institute of Child Health and Human Development.

"Specifically, mothers' obesity was associated with a delay in achieving fine-motor skills, and fathers' obesity in achieving personal and social skills -- that includes skills for interacting with others," said lead researcher Edwina Yeung. She's an investigator in the institute's division of intramural population health research.

"When both parents were obese, it meant longer time to develop problem-solving skills," she added.

Not everyone agrees with the researchers’ conclusion. At least one pediatric neurologist suggests that the results don’t necessarily prove a direct cause and effect.

And Yeung acknowledges the same. "We used observational data, which doesn't allow us to prove cause and effect, per se," she explained.

What the researchers found was interesting though. Compared with children of normal-weight mothers, children of obese mothers were 67 percent more likely to fail a test of fine-motor skills (using their hands and fingers) by age 3.

In addition, children of obese fathers were about 71 percent more likely to fail tests of personal and social skills, which may indicate how well they relate to and interact with others, by age 3, the researchers said.

Children whose mother and father were both obese were nearly three times more likely to fail tests of problem-solving ability by age 3, according to the researchers’ findings.

Most research into understanding child health and development has focused on mothers and their pregnancies. "Our findings suggest that factors from fathers may also play a role and deserve attention," Yeung said.

One child health expert doesn't think obese parents should be overly concerned by this study.

"Children of obese parents are not doomed to have developmental problems," said Dr. Ian Miller. He is a pediatric neurologist and director of Neuroinformatics at Nicklaus Children's Hospital in Miami.

There’s a long list of other conditions that can also impact the brain such as lead-poisoning, sickle cell disease, iron-deficiency anemia, autism, epilepsy or cerebral palsy—any of which can cause developmental problems, Miller said. He isn't ready, however, to add obesity to that list.

But, obesity may increase the risks of these health problems, Miller says. The probability for developmental problems is low among all children, including those of obese parents. "It's not a 'sky is falling' type of scenario," he said.

For the study, Yeung and her colleagues collected data on more than 5,000 women and their children who were part of the Upstate KIDS study, which sought to determine if fertility treatments could affect child development from birth through age 3.

The women were enrolled in the study about four months after giving birth in New York state, excluding New York City, between 2008 and 2010.

About one in five pregnant women in the United States is overweight or obese, Yeung said.

To check the children's development, parents completed the Ages and Stages Questionnaire after doing a series of activities with their children, Yeung said.

The test doesn't diagnose specific problems, but is a screen for potential problems, so that children can be referred for further testing, she explained.

The children were tested at 4 months and six more times through age 3 years. Mothers also gave information on their health and weight, both before and after pregnancy, and the weight of their partners, Yeung said.

More studies are needed to further examine if there is a link between obese parents and their offspring’s developmental skills, Yeung said.

The report was published online Jan. 2 in the journal Pediatrics.

Story Source: Steven Reinberg, http://www.webmd.com/children/news/20170103/can-parents-weight-hinder-toddlers-development#1

Your Baby

High-Sugar Intake During Mom’s Pregnancy May Double Child’s Risk of Asthma

2:00

It’s no secret that moms-to-be often develop a sweet tooth during pregnancy, but new information suggests high-sugar foods and drinks may double their child’s risk for developing asthma and allergies later in life.

Researchers from Queen Mary University of London used data gathered from nearly 9,000 mother-child pairs in the Avon Longitudinal Study of Parents and Children, an ongoing research project that tracks the health of families with children born between April 1, 1991, and December 31, 1992.

During the study, the participating pregnant women were asked about their weekly intake of certain foods and specific food items including sugar, coffee and tea. Their responses were used to calculate their intake of added sugar.

The researchers only saw weak evidence to suggest a link between women’s added sugar intake and their children’s chances of developing asthma overall. But when they looked specifically at allergic asthma—in which an asthma diagnosis is accompanied by a positive skin test for allergens—the link was much stronger. Children whose moms were in the top fifth for added sugar during pregnancy were twice as likely to have allergic asthma when compared to children whose moms were in the bottom fifth.

Children of mothers with the high-sugar diets were 38% more likely to test positive for an allergen and 73% more likely to test positive for more than one allergen, compared to those kids whose moms stayed away from added sugar.

"The dramatic 'epidemic' of asthma and allergies in the West in the last 50 years is still largely unexplained -- one potential culprit is a change in diet," said Annabelle Bedard, lead author and a postdoctoral fellow at Queen Mary's Centre for Primary Care and Public Health Blizard Institute. "Intake of free sugar and high fructose corn syrup has increased substantially over this period."

As with most studies, a cause and effect was not established, only an association. The study’s authors believe that the association is strong enough to warrant further investigation.

Lead researcher Professor Seif Shaheen  said: "We cannot say on the basis of these observations that a high intake of sugar by mothers in pregnancy is definitely causing allergy and allergic asthma in their offspring.

"However, given the extremely high consumption of sugar in the West, we will certainly be investigating this hypothesis further with some urgency.”

There are many health reasons why pregnant women should limit their intake of high-calorie and sugary foods and drinks. This research suggests that it may be prudent for the health of their unborn child as well.

Story sources: Susan Scutti, http://edition.cnn.com/2017/07/05/health/sugar-pregnancy-child-allergy-asthma-study/index.html

 Henry Bodkin, http://www.telegraph.co.uk/science/2017/07/06/high-sugar-intake-pregnancy-linked-double-risk-child-asthma/

Daily Dose

Zika Warning in United States

1:30 to read

The Zika virus is now here….that is, in the continental United States and specifically Miami, Florida.  There are now 4 confirmed cases of Zika infections in Florida, all thought to have been contracted from the bite of mosquitoes in early July. The cases are clustered in a northern area of Miami.  Although there have not been any mosquitoes in Miami that have tested positive for the Zika virus, epidemiologists do not think that is unusual, as the mosquitoes that were presumably infected may have already died (they have a short life cycle). Large scale testing of trapped mosquitoes in Florida is continuing.

Because the Zika virus only causes symptoms in about 20% of those infected (80% of people will never show symptoms although being infected) the health department is working to see if there may be even more cases in the Miami area. They are doing door to door surveillance in some zip codes and obtaining screening urine specimens checking for the virus….there should be more information available in the near future. At the same time, due to the fact that the Zika virus may be spread from blood and body fluids, the donated blood supply in Miami is being screened for Zika prior to being used. 

So…many of the families I care for vacation in Florida in the summer, especially along the Gulf Coast. I have received a number of phone calls in the last week from expectant mothers, as well as some who are trying to conceive, asking if they should even go to Florida?  This is a tough question, but for the time being, seeing that Texas does not YET have any locally acquired Zika virus I told them that I would probably err on the side of caution and change my beach travel plans. (England has recommended that their pregnant citizens “delay or postpone” all non essential travel to Florida).  

Here is my rationale.  Why risk going to the beach, with your family and children (who are going to spend most of their time outside), in a state known to have the Aedes aegypti mosquito and now confirming the first cases of locally acquired Zika?  The anxiety that is associated with the possibility of getting a mosquito bite ( despite using insect repellent and trying to wear protective clothing - which is difficult at the beach??), is just not worth it. Worrying for weeks after returning from vacation and never truly knowing if you might have been exposed (remember most people will not become ill when infected), and wondering if you should not conceive? Or worrying at every OB appointment that your fetus is developing normally…..because you went to the beach in Florida a month ago….? I just can’t think of a reason to go through all of that…for a week at the beach.

With that being said, I now have 4 mothers who have decided to cancel their vacation plans at the beach, and to stay home and not “take any chances”. The effects of the Zika virus on a developing fetus are life long and a vacation is just a fun filled week - so why not make a few  memories this summer with a stay-cation?  No anxiety…right?  Let’s see what happens in Florida and other southern states over the next few weeks and months as this situation continues to evolve. 

In the meantime - get rid of standing water and use your insect repellent wherever you live!

Your Baby

Eating Fish During Pregnancy Benefits Baby’s Brain Development

2:00

Can eating more fish during pregnancy help babies’ brains function better as they grow older? Yes, according to a new study from Spain. The researchers say that mothers who eat three substantial servings of fish – each week- during pregnancy may be giving their children an advantage as they mature.

Researchers followed nearly 2,000 mother-child pairs from the first trimester of pregnancy through the child’s fifth birthday and found improved brain function in the kids whose mothers ate the most fish while pregnant, compared to children of mothers who ate the least.

Even when women averaged 600 grams, or 21 ounces, of fish weekly during pregnancy, there was no sign that mercury or other pollutants associated with fish were having a negative effect that offset the apparent benefits.

“Seafood is known to be an important source of essential nutrients for brain development, but at the same time accumulates mercury from the environment, which is known to be neurotoxic,” lead author Jordi Julvez, of the Center for Research in Environmental Epidemiology in Barcelona, said in an email to Reuters Health.

This important health concern prompted the U.S. Food and Drug Administration (FDA) to come up with a guideline for pregnant women in 2014. It encourages women to eat more fish during pregnancy, but limit the intake to no more than 12 ounces per week.

For this study, researchers analyzed data from the Spanish Childhood and Environment Project, a large population study that recruited women in their first trimester of pregnancy, in four provinces of Spain, between 2004 and 2008.

Julvez and colleagues focused on records of the women’s consumption of large fatty fish such as swordfish and albacore tuna, smaller fatty fish such as mackerel, sardines, anchovies or salmon, and lean fish such as hake or sole, as well as shellfish and other seafood.

Women were tested for blood levels of vitamin D and iodine, and cord blood was tested after delivery to measure fetal exposure to mercury and PCB pollutants. At ages 14 months and five years, the children underwent tests of their cognitive abilities and Asperger Syndrome traits to assess their neuropsychological development.

On average, the women had consumed about 500 g, or three servings, of seafood per week while pregnant. But with every additional 10 g per week above that amount, children’s test scores improved, up to about 600 g. The link between higher maternal consumption and better brain development in children was especially apparent when kids were five.

The researchers also saw a consistent reduction in autism-spectrum traits with increased maternal fish consumption.

Mothers’ consumption of lean fish and large fatty fish appeared most strongly tied to children’s scores, and fish intake during the first trimester, compared to later in pregnancy, also had the strongest associations.

“I think that in general people should follow the current recommendations,” Julvez said. “Nevertheless this study pointed out that maybe some of them, particularly the American ones, should be less stringent.”

Julvez noted that there didn’t appear to be any additional benefit when women ate more than 21 ounces (about 595 g) of fish per week.

“I think it's really interesting, and it shed a lot more light on the benefits of eating fish during pregnancy,” said Dr. Ashley Roman, director of Maternal Fetal Medicine at NYU Langone Medical Center in New York.

“I think what's interesting about this study compared to some data previously is that they better quantify the relationship between how much fish is consumed in a diet and then the benefits for the fetus and ultimately the child,” said Roman, who was not involved in the study.

Roman also noted that pregnant women should avoid certain fish such as tilefish, shark, swordfish and giant mackerel. These are larger fish with longer life spans that may accumulate more mercury in their tissue.

While fish may be a great source of protein and benefit brain development in utero, most experts agree that women should consult their obstetrician about what fish are safer to eat and how much they should eat during pregnancy.

The study was published online in the January edition of the American Journal of Epidemiology

Source: Shereen Lehman, http://www.reuters.com/article/us-health-pregnancy-fish-idUSKCN0UW1S4

 

 

 

Your Baby

Mom’s Blood Pressure May Determine Sex of Baby

1:45

Parents-to-be have been looking for signs that predict the sex of their baby for thousands of years.  Carrying high? You’re having a girl! Is your baby bump round like a basketball? Congratulations, you’re having a boy! While these “old wives tales” have never been reliable, scientists can now make an educated guess at about four and half months, during pregnancy, with an ultrasound. Another test, amniocentesis, can be used to check the baby’s chromosomes. This tests is usually reserved for older mothers to identify possible genetic problems.

A new study from China, may offer another alternative for determining the sex of a pre-born baby  - tracking the mother’s blood pressure.

Researchers began their study in 2009, with just over 1,400 newly married women in Liuyang, China. All the women had the intention of becoming pregnant within 6 months.

Before becoming pregnant, all the women underwent full lab tests to record their blood pressure, cholesterol, triglycerides and glucose levels.

Once the women became pregnant, their health was tracked. All received routine obstetric care, including continual monitoring of blood pressure shifts, as well as the diagnosis of any complications throughout their pregnancies.

Ultimately, the study participants gave birth to 739 boys and 672 girls.

Researchers found that women who gave birth to boys had registered a higher pre-pregnancy systolic blood pressure (the upper number in a blood pressure reading) than women who gave birth to girls. Mothers of boys averaged about 113 mm Hg, versus mothers of girls who had an average near 110 mm Hg.

After making adjustments for maternal age, educational background, smoking history, obesity and blood labs, they found the blood pressure numbers still held up.

"The only thing that was related was blood pressure, but blood pressure was strongly related," said study co-author Ravi Retnakaran, M.D., an endocrinologist at Mount Sinai Hospital in Toronto.

The findings add another link in the mystery of what determines the sex of a fetus in utero; however, researchers say more studies are needed to prove a mother’s blood pressure determines the sex of her child.

"One of the things we don't want is for people to look at this and think, 'Oh, we can manipulate the blood pressure before pregnancy and thereby change the chances of having a boy or a girl.' We definitely are not saying that, because we are not showing cause and effect," Retnakaran said. "I think the way to look at this is that it may be telling us something very new about [our] physiology."

The study was published in the American Journal of Hypertension.

Story sources: Alan Mozes, http://www.webmd.com/baby/news/20170112/could-moms-pre-pregnancy-blood-pressure-predict-babys-gender#1

Jessica Mattern, http://www.womansday.com/health-fitness/womens-health/news/a57553/blood-pressure-sex-of-baby/

Your Baby

Gap Between Pregnancies Linked to Autism

2:00

Does it make a difference how long a woman waits between pregnancies in the health of her newborn?  According to a new large study, the closer the pregnancies, the higher the risk that her child will have autism or other neurodevelopmental disabilities.

"Based on the current best available evidence, it appears that the ideal inter-pregnancy interval -- the time elapsed between the birth of the immediate older sibling and the conception of the younger sibling -- is 2 to 5 years, in order to reduce the risk of autism," said study author Dr. Agustin Conde-Agudelo. He is a researcher at the World Health Organization Collaborating Center in Human Reproduction at the University of Valle in Cali, Colombia.

Researchers looked at existing studies involving more than 1.1 million children and also found that waiting too long between pregnancies (5 years or more) could raise the odds of autism.

The reasons for the link between short pregnancy spacing and autism are not known noted Conde-Agudelo. He said that scientists believe nutrition and other factors may play a role.

The study doesn’t prove that either long or short intervals between pregnancies actually causes autism, just that there seems to be an association between the two.

Conde-Agudelo and his team reviewed seven large studies reporting a link between short birth spacing and autism. The investigators found that children born to women with less than 12 months between pregnancies were nearly twice as likely to develop autism as children born to women with three years or longer between pregnancies.

Three of those studies also reported a significant link between long pregnancy spacing and autism, especially for two milder types, which were formerly called Asperger's syndrome and pervasive developmental disorder.

Meanwhile, the findings also suggested that shorter pregnancy spacing was associated with an increased risk of developmental delays and cerebral palsy, which can affect body movement, muscle coordination and balance.

Conde-Agudelo and other researchers conjectured that the mother’s depleted levels of folic acid between closely spaced pregnancies might play a role in the rise of autism risk.

The B vitamin folic acid is necessary for proper brain and spinal cord development in fetuses, and women are typically advised to take folic acid supplements during pregnancy.

As for longer pregnancy intervals also potentially linked to autism, Conde-Agudelo said it's been hypothesized that related factors such as infertility, unintended pregnancy and maternal inflammation levels may affect autism possibility.

Most neurodevelopmental disabilities, including autism, are thought to be caused by a complex mix of factors. These include genetics, environment, parental health and behaviors during pregnancy, and complications during birth, the researchers said in background notes.

The study was published in the April online edition of the journal Pediatrics, and will appear in the May print issue.

Story source: Maureen Salamon,  http://consumer.healthday.com/cognitive-health-information-26/autism-news-51/pregnancies-close-together-may-raise-autism-risk-study-says-709733.html

Your Baby

Eating During Labor May Speed Up Delivery

1:45

In many hospitals, when a woman is in labor, all she is allowed to eat are a few ice chips. That rule may need updating, according to a new study that finds women who were allowed to eat before delivery had a slightly shorter labor than those who were restricted to ice chips or sips of water - although the study can't prove that eating caused deliveries to happen sooner.

The practice of limiting food during labor goes back a study in the 1940s in which women who delivered under general anesthesia were at risk of inhaling their stomach contents and choking in it, writes senior author, Dr. Vincenzo Berghella, of Thomas Jefferson University in Philadelphia, and his colleagues in Obstetrics and Gynecology.

“We really don’t know how much if anything people can eat or drink in labor," said Berghella,.

Whether women can have more than water or ice chips as they labor to give birth is a common discussion among healthcare providers, he told Reuters Health.

General anesthesia is not commonly used during delivery these days, but the old guidelines are still in use.

For the new study, the researchers compiled data from randomized controlled trials that compared the labor outcomes of women who were allowed to eat only ice chips or water and those who were allowed to eat or drink a bit more.

For example, one study allowed women to drink a mixture of honey and date syrup. Another study allowed all types of food and drinks. A few others allowed women to drink liquids with carbohydrates.

Overall, the researchers analyzed 10 trials that included 3,982 women in labor. All were only delivering one child - not twins or triplets - and were not at risk for cesarean delivery.

The women with the less restrictive diets were not at increased risk for other complications, including vomiting or choking, during the use of general anesthesia.

And women who were allowed to eat and drink more than the traditional ice chips and water had labors that were shorter, by an average of 16 minutes, compared to women with the more restrictive diets.

Speaking from experience, 16 minutes less of labor pains is a real bonus. How does adding more liquid or food during delivery help reduce the time before delivery? The researchers presented some ideas.

"If we’re well hydrated and have adequate carbohydrate in our body, our muscles work better," said Berghella. A woman's uterus is largely made of muscle.

Another of his studies, which found women who received more fluid than normal delivered faster than other women, reinforces the finding.

Berghella said it's still common practice for women with uncomplicated births to be restricted to water or ice chips during labor.

"The evidence from well-done studies is they can have more than that," he said.

Do women really want to eat much during labor? Probably not, there’s a lot going on in the body as labor progresses.  But more liquids and some light carbohydrates during the early part of labor may be welcomed – especially if they shorten the time between labor and when baby enters the world.

Story source: Andrew M. Seaman, http://www.reuters.com/article/us-health-pregnancy-labor-food-idUSKBN15O2ZR

 

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