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Your Baby

Exercising During Pregnancy

2:00

If you’re pregnant, you may be wondering if you should start or continue exercising. The answer is a resounding, yes!

Regular exercise throughout your pregnancy can help you stay healthy, improve your posture and help decrease common discomforts such as backaches and fatigue.

There is even evidence that physical activity may help prevent gestational diabetes, relieve stress and build more stamina needed for labor and delivery.

All of these benefits are good things.

If you were physically active before your pregnancy, there’s no need to stop. However, don’t try to exercise at your former level; instead, do what's most comfortable for you now. Low impact aerobics are encouraged versus high impact.

Check with your obstetrician for guidance if you are a competitive athlete, you may need specialized monitoring.

What if you have never been into exercise, should you start now that you are pregnant?  Absolutely!

You can safely begin an exercise program during pregnancy after consulting with your health care provider, but do not try a new, strenuous activity. Walking is considered safe to initiate when pregnant.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate exercise per day on most if not all days of the week, unless you have a medical or pregnancy complication.

While exercise is great for most moms-to-be, there are some women who should not exercise during pregnancy. They are women with medical problems such as asthma, heart disease or diabetes. If you have one of these conditions, check with your OB/GYN about your options and follow his or her recommendations.

Exercise may also be harmful if you have a pregnancy-related condition such as:

           ·      Bleeding or spotting

           ·      Low placenta

           ·      Threatened or recurrent miscarriage

           ·      Previous premature births or history of early labor

           ·      Weak cervix

Talk with your health care provider before beginning an exercise program. Your health care provider can also give you personal exercise guidelines, based on your medical history.

Most exercises are safe to perform during pregnancy as long as you don’t overdo it.

The safest and most productive activities are swimming, brisk walking, indoor stationary cycling, step or elliptical machines, and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until birth.

What about jogging, tennis and racquetball? All these activities require balance and coordination– which may change as you progress during your pregnancy.  If you’re healthy and have discussed these sports with your OB/GYN, go ahead and enjoy, but in moderation.

There are certain exercises that can be harmful during pregnancy. What exercises should be avoided? They are:

·      Holding your breath during any activity.

·      Activities where falling is likely (such as skiing and horseback riding).

·      Contact sports such as softball, football, basketball, and volleyball.

·      Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.

·      Activities that require extensive jumping, hopping, skipping, bouncing, or running.

·      Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.

·      Bouncing while stretching.

·      Waist-twisting movements while standing.

·      Heavy exercise spurts followed by long periods of no activity.

              ·      Exercise in hot, humid weather.

Stretching exercises can help make the muscles limber and warm, which can be helpful during pregnancy.

Kegal exercises can help strengthen the muscles that support the bladder, uterus and bowels. By strengthening these muscles during your pregnancy, you can develop the ability to relax and control the muscles in preparation for labor and birth.

Tailor exercises strengthen the pelvic, hip, and thigh muscles and can help relieve low back pain.

Many health providers have DVDs, websites or exercise pamphlets with instructions and examples available for their pregnant patients. There are also classes with instructors trained in leading exercise programs specifically for pregnant women.

What should a pregnancy program consist of?

A total fitness program should strengthen and condition your muscles. Don’t forget to drink plenty of water and never exercise to the point of exhaustion.

Exercising during pregnancy has many advantages, but there are warning signals you should look out for. Stop exercising immediately and contact your health provider is you:

             ·      Feel chest pain.

             ·      Have abdominal pain, pelvic pain, or persistent contractions.

             ·      Have a headache.

             ·      Notice an absence or decrease in fetal movement.

             ·      Feel faint, dizzy, nauseous, or light-headed.

             ·      Feel cold or clammy.

            ·      Have vaginal bleeding.

            ·      Have a sudden gush of fluid from the vagina, or a trickle of fluid that leaks steadily.

            ·      Notice an irregular or rapid heartbeat.

           ·      Have sudden swelling in your ankles, hands, face, or calf pain.

           ·      Are short of breath.

           ·      Have difficulty walking.

           ·      Have muscle weakness.

The big question many women have after delivery is – when can I start working off these extra pounds? It’s best to start fitness routines gradually and follow your health provider’s recommendations. Too often, women who have just given birth are inundated with images of celebrities who look as though they have dropped 50 pounds and returned to their former sleek selves within weeks after delivery. However they accomplish this (think spandex & a personal trainer that works you relentlessly), it’s not necessary or even healthy to try to capture your former body immediately.

Most women can safely perform a low-impact activity one to two weeks after a vaginal birth (or three to four weeks after a cesarean birth). Do about half of your normal floor exercises and don't try to overdo it.

Exercising during pregnancy is not a “one routine fits all” kind of thing. You can strengthen your muscles and reap the benefits of exercise while pregnant, just do it under the guidance of your health provider. He or she knows your limits, your medical history and will be able to help you achieve the best results.

Story source:

Traci C. Johnson, MD, http://www.webmd.com/baby/guide/exercise-during-pregnancy.

 

 

Daily Dose

Teen Drivers

1.30 to read

As you know, when teens start to drive, I am a huge advocate for parent - teen driving contracts. I wrote my own contracts for my boys but I recently found a website that all parents who are getting ready to have teen drivers need to be aware of.

Injuries from motor vehicle crashes are the #1 cause of death for teens in the United States.  Studies have shown that having limits and boundaries in place for new drivers reduces the number of motor vehicle accidents that new drivers experience. Although not all states have “graduated driver’s licenses”, all parents can have discussions about the privilege and responsibility of driving and set their own guidelines for their new teen driver.

The website www.youngdriverparenting.org was developed by the National Institute of Child Health and Human Development and is an interactive site for both parent and teen.  The program is entitled “Checkpoints”.  The website includes teen driving statistics to help parents keep their teen drivers safe as well as giving information about state-specific teen driving laws.

The site has a great interactive component to help parents create their own parent-teen driving “contract” that addresses such things as teen driving hours, number of passengers allowed, and boundaries for driving. These parameters can be modified as the teen becomes more experienced and meets the “checkpoints” that were agreed to.  It is a great site as it not only gives you a template for the agreement, but sends emails as the allotted amount of time has passed for each step of the contract.  You don’t have to remember what you and your teen agreed to, they email you and then you and your child can revisit the agreement and expand it over time as your driver becomes more experienced.

Instead of handing out my “dog eared” old driving contracts that I wrote for my boys, I am now going to send my patients to this site (which is also being sustained by the American Academy of Pediatrics).  

Teen drivers whose parents are actively involved in monitoring their driving are not only less risky drivers but know ahead of time what their parent’s expectations are. Having a teen involved proactively with driving rules is far preferable to regretting that limits, boundaries and parental rules were not discussed prior to allowing your new driver on the road.

The website is not only free it is also evidence based, and within 5 - 10 minutes of reviewing the site a family is set to go with their own checkpoint agreement.  Here’s to teen driver safety!

Your Baby

Half of U.S. Parents Using Unsafe Bedding for Infants

2:00

Parents are getting better about using loose bedding and leaving soft objects in their baby’s bed, but about half of U.S. infants are still sleeping with potentially hazardous bedding according to a new study.

Blankets, quilts and pillows can obstruct an infant’s airway and pose a suffocation risk according to the American Academy of Pediatrics (AAP).  This type of bedding is a recognized risk factor for sudden infant death syndrome (SIDS).

The researchers investigated bedding use from 1993 to 2010 from the National Infant Sleep Position study.

They found that from 1993 to 2010, bedding use declined, but remained a common practice. The rate of bedding use averaged nearly 86 percent in 1993-1995, and declined to 55 percent in 2008-2010. Prevalence was highest for infants of teen mothers (83.5 percent) and lowest for infants born at term (55.6 percent). Researchers also found that bedding use was highest among infants who were sleeping in adult beds, placed to sleep on their sides, or shared a sleep surface.

AAP recommends that the best place for a baby to sleep is in the same room as his or her parents and always in a crib, not in the same bed. The crib should be free from toys, soft bedding, blankets, and pillows.

Other safe sleep practices are:

•       Place your baby on a firm mattress, covered by a fitted sheet that meets current safety standards. For more about crib safety standards, visit the Consumer Product Safety Commission’s Web site at http://www.cpsc.gov.

•       Place the crib in an area that is always smoke-free.

•       Don’t place babies to sleep on adult beds, chairs, sofas, waterbeds, pillows, or cushions.

•       Toys and other soft bedding, including fluffy blankets, comforters, pillows, stuffed animals, bumper pads, and wedges should not be placed in the crib with the baby. Loose bedding, such as sheets and blankets, should not be used as these items can impair the infant’s ability to breathe if they are close to his face. Sleep clothing, such as sleepers, sleep sacks, and wearable blankets are better alternatives to blankets.

•       Place babies to sleep on their backs to reduce the risk of SIDS. Side sleeping is not as safe as back sleeping and is not advised. Babies sleep comfortably on their backs, and no special equipment or extra money is needed.

•       “Tummy time” is playtime when infants are awake and placed on their tummies while someone is watching them. Have tummy time to allow babies to develop normally.

•       Remove mobiles when your baby is able to sit up.

Study authors conclude that while the numbers have improved significantly, infants are still being put to bed in an unsafe sleeping environment; about half still sleep with blankets, quilts, pillows, and other hazardous items.

It’s not unusual that many parents may not be aware of the dangers of blankets, pillows and quilts in a baby’s bed. Lots of people were raised with all these items in the bed, but that was also before scientists began to understand SIDS better and the possible causes. True, many babies did fine before these alerts and safety suggestions became more popular but a lot of children also died – we just didn’t know why.  Parents today are able to access better infant safety information than their own parents.

The study, “Trends in Infant Bedding Use: National Infant Sleep Position Study 1993-2010” was published in the January issue of the journal Pediatrics.

Source: http://www.healthychildren.org/English/News/Pages/Study-Shows-One-Half-of-US-Infants-Sleep-in-Potentially-Hazardous-Bedding.aspx

Your Child

Popular Gift: Hoverboards Are Catching Fire

2:00

One of the hottest gifts this Holiday season is the Hoverboard, but more and more are hot not because they are popular, but because they have burst into flames. The gliding boards have caught fire in the U.S. and throughout Europe.

Both the National Association of State Fire Marshals and the UK's National Trading Standards are raising a red flag on hoverboards, claiming that they are blowing up across the world.

The national Fire Marshals organization issued an advisory recently, warning that these explosions are "not a unique occurrence," H. Butch Browning Jr., the president of the group's Board of Directors said in a statement.

"The sheer number of incidents occurring around the country, and abroad, is what prompted our organization to address this serious issue on a national level," he said.

Hoverboards are marketed to all age groups with some specifically designed for children.

A Louisiana family lost their home a day after 12-year-old Hayden Carbo got a FitTurbo hoverboard for his birthday.  The toy exploded and burned the boy's bedroom and home to a crisp.

"It was like a firework. I saw sparks just flying and before I could yell, the house is on fire," his mother, Jessica Horne said.

On Nov. 28, an 11-year-old Florida girl barely escaped being burned while riding the explosive $300 toy. "She felt it get hot, she jumped off, and it was in flames," Pamela Levine, the girl's mother, told KSHB-TV.

The United Kingdom has taken aggressive moves in clamping down on hoverboards. Officials have detained 15,000 of the devices due to “major safety risks.” Many of the hoverboards had non-compliant plugs without fuses, which can cause the boards to overheat or catch fire.

Cheaper China made knock-offs seem to be the worst of the lot. The less expensive prices are tempting to many people, but even these aren’t cheap. The more expensive models can sell for $1500 -$1700, while the cheaper ones sell for between $350-$500.

If you’re considering buying one of these products for your family, the National Fire Marshal Association offers these safety recommendations:

·      Make sure the hoverboard is compliant with federal standards, inspections, and certifications, it will have a mark on it or indicate such on its packaging, on the device itself, or on its charging equipment. Devices not bearing a mark indicating compliance likely have not been tested to meet minimum safety standards.

·      When buying online, verify that the device meets applicable standards. There are many of these products on the market, and many may not meet this country's inspection and safety requirements. Those that do will indicate such on the packaging, and on the device or its charging equipment.

·      Buy a device with a warranty, or buy it in person at a brick and mortar store. If you are buying online, buy from a reputable source. Also, check with your retailer regarding the safety of the device you are purchasing.

When charging your self-balancing scooter or hoverboard:

·      After it has been used, give the device time to cool off prior to charging.

·      Do not leave the device unattended while it is charging. Someone should be able to observe the device during its recharging time.

·      Do not overcharge the device; follow manufacturer's recommended charging times and do not leave device plugged into an outlet overnight.

·      Do not use imitation electrical chargers, as they may be unsafe.

·      Keep to one plug per socket.

The segue-way like boards are becoming more and more popular, and the desire to own one is high. Like any other in-demand item, knock-offs move quickly into the marketplace.  These unregulated and expensive hoverboards can be dangerous to your home and family. If your child has a hoverboard, make sure an adult is always present when they ride or charge it.

Sources: Alfred NG, http://www.nydailynews.com/news/world/hoverboards-blowing-uk-officials-article-1.2457027

Jeremy Gray, http://www.al.com/news/index.ssf/2015/12/hoverboard_safety_fire_marshal.html

 

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Car Seat Safety

Buckle Up This Summer!

Your Toddler

Anchor It!

1:45

The U.S. Consumer Product Safety Commission (CPSC) has launched “Anchor It”, a national public education campaign, to help make people aware of the dangers that free-standing furniture and TVs present, particularly to children.

The annual number of children injured or killed from furniture and TV tip-overs is astounding.

According to CPSC data, unstable and unsecured TVs and large pieces of furniture kill a child every two weeks, on average, in tip-over incidents that are easily preventable.  CPSC also reported that 38,000 Americans go to emergency rooms each year with injuries related to tip-overs of top-heavy furniture or televisions placed on furniture, instead of a TV stand.  Two-thirds of those injuries involved children younger than 5.  Additionally, between 2000 and 2013, 84 percent of the 430 deaths reported to CPSC involved children younger than 10.

A January 2015 CPSC report found that a television tipping over from an average size dresser falls with thousands of pounds of force. 

The impact of a falling TV is like being caught between two NFL linemen colliding at full-speed—10 times. 

“Every 24 minutes in the U.S. a child goes to the emergency room because of a tip-over incident involving furniture or a TV,” said CPSC Commissioners Marietta Robinson and Joseph Mohorovic. “We must take action now. CPSC’s new ‘Anchor It!’ campaign is a call to action for parents and caregivers to ‘get on top of it, before they do.’ If we can prevent one more death, it will be worth it.”

Cards and posters are being distributed parents and caregivers of toddlers at daycare centers and preschools. A list of safety steps parents and caregivers can take are printed on the handouts. They are:

·      Buy and install low-cost anchoring devices to prevent TVs, dressers, bookcases or other furniture from tipping.

·      Avoid leaving items, such as remote controls and toys, in places where kids might be tempted to climb up to reach for them.

·      Store heavier items on lower shelves or in lower drawers.

·      Place TVs on a sturdy, low base and push them as far back as possible, particularly if anchoring is not possible.

·      If purchasing a new TV, consider recycling older ones not currently used. If moving the older TV to another room, be sure it is anchored properly to the wall.

The “Anchor It” campaign’s website (www.Anchorit.gov) shows you how to anchor furniture and television sets properly, with easy to follow instructions. Keep your little one safe and Anchor It!

 

Your Child

Lung Ultrasounds as Effective as Chest X-Rays for Detecting Pneumonia

1:45

Traditionally, when a child shows up at the ER or physician’s office with suspected pneumonia, a chest x-ray is ordered to verify a diagnosis.

A new report says that lung ultrasounds may offer a safer and equally effective alternative for diagnosing pneumonia in children.

"Ultrasound is portable, cost-saving and safer for children than an X-ray because it does not expose them to radiation," explained study leader Dr. James Tsung. He is an associate professor in the departments of emergency medicine and pediatrics at the Icahn School of Medicine at Mount Sinai, in New York City.

Ultrasound, also called sonography, is an imaging method that uses high-frequency sound waves to produce images that lead to diagnosis and treatment of many diseases and medical conditions. Radiation is not used in ultrasound testing, but is used in x-rays and CT scans.

The study looked at 191 emergency department patients, aged 21 and younger, who were randomly assigned to either an investigational group or a control group.

Patients in the investigational group had lung ultrasound and, if additional verification was needed, a follow-up chest X-ray. Those in the control group had a chest X-ray followed by lung ultrasound.

The patients in the investigational group had nearly 39 percent fewer chest X-rays, with no missed cases of pneumonia and no increase in complications. The reduction in chest X-rays led to overall cost savings of $9,200 and an average decrease in time spent in the emergency department of 26 minutes, according to the study published April 12 in the journal Chest.

"Our study could have a profound impact in the developing world where access to radiography is limited," Tsung said in an Icahn news release.

Pneumonia is a leading cause of death among children worldwide. Chest X-ray is considered the best way to diagnose pneumonia in children, but about three-quarters of the world's population does not have access to X-rays, according to the World Health Organization.

Parents in the U.S. may want to request a lung ultrasound instead of a chest x-ray when that option is available, to avoid their child’s exposure to radiation.

Story source: Robert Preidt, http://www.webmd.com/children/news/20160413/lung-ultrasound-may-be-best-to-spot-pneumonia-in-kids-study

Your Baby

Should Pregnant Women Buckle-Up?

2.00 to read

Should expectant mothers buckle up and make sure the air bag is turned on before driving or riding in a car?  Absolutely say researchers in a recent study by the Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.

Many women are concerned that, in case of an accident, seat belts and /or air bags might harm their unborn child, but according to the study, expectant mothers who are not restrained during a car crash are more likely to lose the pregnancy than those who are.

According to the March of Dimes, nearly 170,000 pregnant women are involved in a motor vehicle accident each year.

"One thing we're always concerned about is (educating) patients on seatbelt use," said Dr. Haywood Brown, the chair of Obstetrics and Gynecology at Duke University Medical Center and senior author of the new study.

"Nonetheless, like all individuals, some choose and some do not choose to wear their seatbelt," he added.

For the study, Brown and his colleagues searched through the trauma registry at Duke University Hospital. They found 126 cases of women in their 2nd and 3rd trimesters that had been in a car crash and were cared for at the hospital between 1994 and 2010.

What they discovered was that 86 mothers were wearing a seat belt when the crash occurred. Of that group, 3.5 percent or (3) fetuses died.

12 mothers were not wearing a seat belt. Of the unrestrained group, 25 percent or (3) fetuses died. 

"The bottom line is, you've got to wear your restraint because it decreases the risk not only for your injuries but injury to your child," Brown told Reuters Health.

Where should the seat belt be placed? The American College of Obstetricians and Gynecologists recommends that the seat belt be fitted low across the hipbones and below the belly.

The March of Dimes offers more seat belt and air bag guidelines for pregnant women:

  • Always wear both the lap and shoulder belt.
  • Never place the lap belt across your belly.
  • Rest the shoulder belt between your breasts and off to the side of your belly.
  • Never place the shoulder belt under your arm.
  • If possible, adjust the shoulder belt height to fit you correctly.
  • Make sure the seat belt fits snugly.
  • Driving can be tiring for anyone. Try to limit driving to no more than 5-6 hours per day.
  • Never turn off the air bags if your car has them. Instead, tilt your car seat and move it as far as possible from the dashboard or steering wheel.
  • If you are in a crash, get treatment right away to protect yourself and your baby.
  • Call your health provider at once if you have contractions, pain in your belly, or blood or fluid leaking from your vagina.

Researchers found that first time mothers were the least likely to use a seat belt. Brown noted it's possible that the habit of buckling in children might prompt mothers to put on their own seatbelt.

Mothers-to-be also worry about airbags and whether they could harm the fetus if a crash causes deployment.

In the study, airbags came out in 17 of the accidents, and in those cases the mother was more likely to experience the placenta separating from the uterus - a condition that can be fatal for the mother or the fetus.

Another researcher, not involved in the study, suggested to Reuters Health that the severity of the accidents, and not the airbags, might have been the cause of the serious consequences.

Brown said some women will disarm the airbag for fear that it will damage the baby in case of a crash, but "it's not the smart thing to do because it will save your life if the airbag comes out."

A study, from researchers in Washington State, found that airbags did not increase the risk of most pregnancy-related injuries.

No one likes to think about the damage a car accident can cause, but the reality is that seat belts and air bags save lives. Mothers-to-be, like everyone else, should use theirs when driving or riding in a car. You may need to make some adjustments so that your seat belt fits safely and correctly and the air bag is not right up next to your stomach, but taking those few extra steps could mean the difference between life and death.

Sources: Kerry Grens, http://www.reuters.com/article/2013/03/08/us-buckle-up-during-pregnancy-idUSBRE92710P20130308

http://www.marchofdimes.com/pregnancy/stayingsafe_seatbelts.html

Daily Dose

Swim Lessons Can Reduce Risk of Drowning

1:15 to read

Now that hot weather is with all of us, the issue of childhood drowning is an ever-present concern. The American Academy of Pediatrics recommends that after the age of five years, all children be taught to swim. The AAP does not recommend for or against swimming lessons as a measure to prevent drowning in children younger than five years. Between 2000 and 2005, 6,900 children died from non-boating accidental drowning. The rate of drowning was almost four times higher for children one to two years of age, and twice as high for those younger than five.

An article in Archives of Pediatric and Adolescent Medicine looked at the association between swimming lessons and risk of drowning specifically in the one to four year old age groups. Previous concerns had been raised about the potential for swimming lessons to increase the risk for drowning in younger children. This study provided good news that kids aged one to four who have taken formal swimming lessons have an 88% less risk of drowning. Researchers found that only three percent of the children who had drowned had taken swimming lessons. So with this news, it might be prudent to start swimming lessons at a younger age than previously thought.

But swimming lessons alone will not prevent drowning and even in this study, many of the older children who drowned were noted to have been proficient swimmers. It is still important to have other drowning prevention strategies in place including pool fencing (some parents with pools feel like their child will not be able to unlock a door and head to the pool and do not have a fence in place, and I totally disagree with that argument), constant and age appropriate adult supervision and training in CPR. Children are amazing at finding ways to unlock doors, and windows that lead outside and no parent can know where their child is for every minute of the day. If you have a pool and a child is missing always check the pool first, as a child can quietly slip into the water and lose consciousness in as little as two minutes and drown in five minutes.

That's your daily dose, we'll chat again tomorrow.

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