Archive for March, 2010

Amy Poehler accentuates her bump in black, Tiffani Thiessan poses before her baby shower, Claudia Schiffer wears a flowing gray frock with a colorful scarf, Bethenny Frankel looks comfortable in white sweats, Amy Adams dotes on her man while out shopping and later wears a blue dress to her baby shower.

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As sharply higher numbers of women work through pregnancy, many hear the same advice: Relax. Don't stress out or you will harm your unborn baby.

Contrary to old beliefs, however, research shows that ordinary day-to-day job and home stress isn't likely to cause low birth weight or other problems for most women. Traffic delays, work deadlines and other everyday hassles aren't likely to pose a threat to unborn babies, researchers say, and pregnant women who feel they are coping well tend to do just fine.

Instead, new studies are revealing a link between a certain kind of stress and some developmental delays in the baby: worrying excessively about the pregnancy itself.

This "pregnancy-specific anxiety" was linked to lower cognitive-development scores in babies at 12 months of age, based on a study published recently in Child Development by researchers at the University of California, Irvine, echoing other research. Women who experience this kind of anxiety worry excessively about potential problems with fetal development, miscarriage or giving birth.

Researchers don't yet understand the basis for this finding. Women may become excessively anxious about their pregnancies because they sense that something actually is amiss, which could account for the developmental delays. Or, a mother who is anxious and negative during pregnancy might tend to provide less nurturing and stimulating care after birth.

Whatever the cause, many obstetricians are urging pregnant women to stop obsessing about stress, and seek out more support from family and friends. "Most of my patients are so anxious it's outrageous," says Laura Riley, medical director of labor and delivery at Massachusetts General Hospital. "It's amazing how many people will come to my office and say, 'I've read that stress is very bad for pregnancy, and I'm all stressed out."' She tells patients, "Now you're all stressed-out about being stressed. This is just not helpful."

Some obstetricians are sending expectant moms to prenatal-care groups where they can get stress relief the old-fashioned way: by talking to other pregnant women. In a program called Centering Pregnancy, about 10 expectant mothers who are all at the same stage of a healthy pregnancy receive prenatal care in a group. In periodic two-hour sessions scheduled with the same frequency as standard one-on-one prenatal checkups, the women first get private screenings for blood pressure, weight and other health indicators, then gather for discussion.

A midwife or obstetrician also often gives a brief talk on a scheduled topic, answers questions and corrects misinformation.

In the process, "you create more of a support group" for mothers, lowering their stress, says Peter Bernstein, a specialist in maternal fetal medicine at Montefiore Medical Center, New York.

An estimated 300 medical-care facilities are offering Centering Pregnancy groups, says Sharon Rising, executive director of Centering Healthcare Institute, Cheshire, Conn., a nonprofit promoting group care.

A study of 1,047 young mothers, published in 2007 in Obstetrics & Gynecology, found those who received prenatal care in a Centering Pregnancy group had one-third fewer preterm births, compared with others who received standard care.

While most pregnant women face moderate stress, a smaller slice have unrelenting, chronic strain. Women facing more difficult circumstances, such as extreme poverty, racism or serious family problems, have a higher risk of preterm birth or developmental problems. Also, research shows that going through a traumatic event, such as a natural disaster, during the first trimester also raises the risk of premature delivery or low birth weight.

In coping with all kinds of stress, family and friends can help a lot. Social support—kind words, nurturing friends and surroundings that prompt smiles and laughter—is emerging as a powerful antidote to pregnancy stress.

A 2008 Swiss study that subjected 60 pregnant women to stressors, such as a simulated job interview and a math test before a camera and an audience, found those who reported more "daily uplifts" in their lives, such as smiling, laughing and receiving compliments, were less likely to react negatively to stress. Positive social experiences seem to act as a buffer, the study found.

Researchers increasingly believe that how individual women react to stress is a major factor in its effects. A study led by researchers at Michigan State University has linked a hostile attitude in and of itself—that is, the tendency in a pregnant woman to feel angry, suspicious, cynical, tense or nervous a lot of the time—with an increased risk of preterm birth.

Researchers say building "stress resiliency"—a habit of staying calm and optimistic, and continuing to care well for yourself through periods of heavy stress—is a key to healthy birth outcomes. Michael Lu, an author and associate professor of obstetrics and gynecology at University of California, Los Angeles, encourages women to start building resiliency against stress even before they become pregnant—forming good exercise, nutrition and sleep habits, and learning how to solve problems and face adversity without stressing out.

Learning to savor life's joys, be grateful, and look at seemingly negative events from a positive angle, he says, can set the stage for a pregnancy immune to the hazards of stress.

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Women with breast cancer who are diagnosed while they are pregnant do not have to worry about endangering the health of their unborn babies if they are treated with chemotherapy, according to a study presented here at the 7th European Breast Cancer Conference (EBCC7).

Sybille Loibl, MD, Obstetrics and Gynaecology, University of Frankfurt, Frankfurt, Germany, presented the findings here on March 26.

So far the evidence upon which decisions about how to treat pregnant women with breast cancer is largely based on case studies and retrospective investigations.

The German Breast Group, of which Dr. Loibl is a member, set up a registry to collect data both retrospectively and prospectively from patients who have been diagnosed with breast cancer during pregnancy.

"Ours is the only international registry to focus on outcomes affecting both mother and baby," said Dr. Loibl during his presentation.

The team of researchers entered details of 235 patients prospectively (n = 119) and retrospectively (n = 116) between April 2003 and October 2009. Breast cancer was diagnosed, on average, 23 weeks into the pregnancy.

Out of 151 women, 91 received an average of 2 cycles of chemotherapy while they were pregnant.

The average gestational age of the babies at the time of delivery was 36 weeks, ranging between 28 and 42 weeks.

The average weight of babies exposed to chemotherapy during pregnancy was slightly lighter with an average of 2,636 mg compared with 2,791 mg in babies who were not.

Among the 91 babies born who were exposed to chemotherapy in utero, 1 died after birth, 1 suffered from necrotic enterocolitis, 1 died 3 weeks after birth, 1 developed sepsis, 1 developed neutropenia, and 2 had anemia. Three of these babies were born bald, and 1 had trisomia 18.

According to Dr. Loibl most of these problems were not related to the treatment for breast cancer but were due to other circumstances.

"Our study suggests that pregnant breast cancer patients can be treated as close as possible to standard recommendations and receive chemotherapy while they are pregnant," said Dr. Loibl.

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When Rachel Sarah took her daughter in for her first dental checkup a few years ago, she got a surprise. Not only did her 24-month-old have two cavities in her baby teeth, the pediatric dentist suggested she might have "caught" them from her mom.

"The dentist handed me this piece of paper that talked about saliva transfer," said Sarah, a 37-year-old writer from San Francisco. "It said not to share cups or utensils or food and said, 'No kissing your kid on the lips.' I was shocked; I'd been taking a bite of food and then giving her a bite since she started eating. I told the dentist I’d never heard of this and he said these were new findings.”

As it turns out, studies about the transmission of cavity-causing bacteria from mom to baby have been published for 30 years. The primary culprit is Streptococcus mutans, a bacteria that can pass from person to person through the transfer of saliva, such as sharing utensils, blowing on food, and yes, even kissing that sweet little bundle of joy on the mouth.

According to a 2008 study in Pediatric Dentistry, “strong evidence demonstrated that mothers are a primary source of MS [mutans streptococci] colonization of their children; a few investigations showed other potential sources … notably fathers.”

“There have been many, many studies,” said Dr. Jane Soxman, a pediatric dentist from Allison Park, Pa. “The main thing to know is that tooth decay is a bacterial infection and you can spread it from one person to another during the window of infectivity, which is during infancy and especially during the time of tooth eruption. That’s when the teeth are most vulnerable.”

Only parents (or caregivers) with active tooth decay can spread the Streptococcus mutans bacteria through the transfer of saliva. And Soxman stressed that the transmission of bacteria-laden saliva is just one piece of the puzzle. Tooth decay is caused by a combination of factors, including the transfer of infectious saliva, genetics, oral hygiene, and feeding practices, such as letting your baby constantly suck on a sippy cup full of juice or milk or other sugar-laden liquid. (Bacteria uses the sugar to produce acid, which breaks down enamel.) Baby teeth are particularly vulnerable to decay.

But the decay won’t just impact baby teeth. If the bacteria are allowed to thrive, Soxman said, they will colonize and stick around for years, attacking the permanent teeth when they come in.

The American Academy of Pediatric Dentistry recommends that parents have their child evaluated by a dentist when the first tooth erupts, or no later than their first birthday.

Luckily, there are preventative measures that can help kick the bacteria to the curb. A January 2010 study in the Journal of Dental Research found that the children of moms who chewed Xylitol gum (starting in the sixth month of pregnancy) “were significantly less likely to show MS colonization.”

“If a woman is decay-active, she should be chewing Xylitol in the third trimester so when the baby’s born, the chance of transmission of decay-causing bacteria will be reduced,” said Soxman. “She should also have her teeth cleaned thoroughly during the second and third trimester.”

Cutting back on saliva-transferring behaviors — such as utensil-sharing, toothbrush sharing, blowing on baby’s food, pre-chewing baby’s food and cleaning off the pacifier with your own mouth — will also help.

“You could do just about everything as long as you wipe that baby’s mouth out repeatedly with a clean wet cloth,” said Soxman. “I tell parents to wipe the baby’s mouth out as often as they change the diaper. Wipe the tongue, the teeth, and the cheeks from infancy on. Then the colonies of bacteria won’t be established.”

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The new health care law was signed last week, but the fine print was not clear on whether kids with health problems were guaranteed coverage starting this year, or if they might have to wait until 2014.

The law can also be read to mean that if an insurance company accepts a particular child, it cannot write a policy for a child that excludes coverage for a given condition. For example, if the child has asthma, the insurer cannot exclude inhalers and respiratory care from coverage, as sometimes happens now.

But the company could still turn down the child altogether.

In a letter to the main industry trade group, Sebelius attempted to remove any doubt.

"Health insurance reform is designed to prevent any child from being denied coverage because he or she has a pre-existing condition," she wrote America's Health Insurance Plans. "Now is not the time to search for nonexistent loopholes that preserve a broken system."

Sebelius specified that children with a pre-existing medical problem may not be denied access to their parents' coverage under the new law. Furthermore, insurers will not be able to insure a child but exclude treatments for a particular medical problem.

The insurance industry says it won't fight President Barack Obama over fixing a coverage gap for kids in the new health care law.

In a letter Monday to Health and Human Services Secretary Kathleen Sebelius, the industry's top lobbyist says insurers will accept new regulations to dispel uncertainty over a much publicized guarantee that children with pre-existing medical problems can get coverage starting this year.

The president of America's Health Insurance Plans said the industry will "fully comply" with the regulations, expected within weeks.

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As part of the landmark health insurance reform bill that passed Congress on Monday, the Melanie Blocker Stokes MOTHERS Act – legislation sponsored by U.S. Senator Robert Menendez (D-NJ) – will become law.  The legislation will establish a comprehensive federal commitment to combating postpartum depression through new research, education initiatives and voluntarily support service programs.  [...]

Breastfeeding has been associated with multiple medical and psychological benefits. Women with a strong desire to breastfeed, but with a limited milk supply, are often interested in potential ways to augment their milk production. Fenugreek is a plant whose leaves may be used as an herb and whose seeds may be ground into a spice; it [...]

I love this shirt. I designed it when I was pregnant, had it printed in silver glitter letters, and wore it proudly around town, feeling sure some other mom-to-be would spot me, give me the secret pregnancy high-sign, and um - I don't really know what a belly war would be, exactly, but I'll bet I would totally win every time.

Didn't happen. In fact, I never even got a "yeah, I'm pregnant too" wink from other preggies. Makes me sad, but I wear the shirt anyway, to the eternal horror/derision/amusement of my stepson/husband/other stepson.

Funny maternity shirts abound, but you can make your own maternity tees too; here are two online shops with maternity options. (They have onesies on tap, too, so if you're like me and want to spend Mother's Day wearing matching mother-daughter "Ladybug-Babybug" shirts, your dream can come true!)

Prices listed are for shirts only; final price will depend on whether you go for glitter letters, whether you print both front and back, and other fun factors. And remember -- you can always buy a blank maternity shirt and tye-dye, iron-on, and Bedazzle your way to customized fun!

Inktastic

Maternity shirts come in white, pink, blue, and black, and in sizes S, M, L, XL, and 2X. Base price usually $25.99, on sale for $20.99 at press time!

Customized Girl

Maternity shirts come in black, white, pink, and blue, and in sizes S, M, L, XL, XXL, and XXXL. (This is where I made mine - be advised, they run a little big IMO.) Base price S21.97.

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According to a study from the University of North Carolina at Chapel Hill, fewer than 1 in 4 pregnant women meet the physical activity guidelines set by the American Congress of Obstetricians and Gynecologists (ACOG) in 2002. These guidelines state that pregnant women get 30 minutes or more of moderate exercise on most days of the week if they have no medical or obstetric complications.

The study included data collected from the National Health and Nutrition Examination Survey (NHANES). Over 1,000 pregnant women aged 16 and older were interviewed between 1999 and 2006. The findings were published in the March 2010 issue of the journal Preventive Medicine.

Only about 23% of the women were active enough to meet the guidelines recommendations. Walking was the most common physical activity reported.

According to author Kelly Evenson PhD, research associate professor of epidemiology in the UNC Gillings School of Global Public Health, women in their first trimester were more likely to reach the exercise guidelines that those more advanced in their pregnancy. Women with health insurance and non-Hispanic whites were more likely to meet the guidelines than other socioeconomic groupings.

Benefits of becoming and staying active during pregnancy include helping to reduce backaches, constipation, bloating, and swelling; helping to prevent or treat gestational diabetes; increasing energy; improving mood; promoting muscle tone, strength and endurance, and helping improve sleep patterns.

Exercise during pregnancy can help prepare the body to be able to cope with labor and childbirth. Continuing an exercise program after the baby is born can help get you back in shape faster.

Women who were not following a regular exercise program prior to pregnancy, but wishing to do so as a way of improving health, should start slowly and be careful not to over exert. Start at 5 minutes a day and add 5 minutes each week until 30 continuous minutes are achieved. Never exercise to the point of exhaustion or breathlessness. Take frequent breaks, wear appropriate clothing and footwear, and drink plenty of fluids while exercising.

All pregnant women participating in an exercise program should be aware that hormones produced during pregnancy cause the ligaments that support the joints to become relaxed, which makes them more mobile and at a greater risk of injury. Avoid jerky, bouncy, or high-impact motions. Also be aware that the weight gain will shift the body’s center of gravity and may make a woman less stable or more likely to lose balance.

Most forms of exercise are safe during pregnancy. Walking, swimming, stationary cycling, and low-impact aerobics are good choices. Higher-impact sports such as running and strength training can be safe for women who were already participating in these activities before pregnancy. Potentially dangerous activities include downhill snow skiing, gymnastics, horseback riding, contact sports (soccer, basketball), and scuba diving. After the first trimester, avoid doing exercises on the back, like poses performed lying down in yoga.

Warning signs to be on the lookout for are vaginal bleeding, dizziness or feeling faint, increased shortness of breath, chest pain, headache, muscle weakness, calf pain or swelling, uterine contractions, decreased fetal movement, or fluid leaking from the vagina.

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Not too many years ago it was considered risque to wear tight-fitting clothes while pregnant, let alone show off your gorgeous baby bump in its flesh!

Let's take a moment to thank Demi Moore who single-handedly changed this archaic way of thinking. While pregnant with her second daughter with Bruce Willis, Demi posed for the August 1991 edition of Vanity Fair baring her baby bump. This groundbreaking picture - dubbed "More Demi Moore" - had a lasting impact on society.

Since then, many other pregnant celebs have proudly displayed their baby bumps:

• Demi Moore (Vanity Fair, Aug. 1991)
• Britney Spears (Q Magazine, Nov. 2006)
• Monica Bellucci (Vanity Fair [Italy], Jul. 2004)
• Cindy Crawford (W, Jun. 1999)
• Christina Aguilera (Marie Claire, Jan. 2008)
• Halle Berry (InStyle, Feb. 2008)
• Paz Vega (ELLE [Spain], Aug. 2009)
• Britney Spears (Harper’s Bazaar, Aug. 2006)
• Lisa Rinna (Playboy, Sep. 1998)
• Monica Bellucci (Vanity Fair [Italy], Mar. 2010)
• Britney Spears (yes, again!) (ELLE, Oct. 2005)
• Rebecca Romjin (page six, Nov. 2008)
• Jessica Alba (Fit Pregnancy, July 2008)
• Molly Ringwald (Fit Pregnancy, July 2009)

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