Morning sickness can be one of the most miserable parts of pregnancy. Unfortunately, new research suggests that there is little women can do other than grin and bear it, since there appear to be no effective treatments.

The pharmaceutical industry once weighed in on the issue heavily, with the result being the introduction of the now-notorious thalidomide, which caused severe birth defects in a large number of infants. That episode led to increased requirements for safety screening of drugs before they are marketed and led to the still-prevalent consensus that it is generally not safe for women to take drugs during pregnancy, especially in the first trimester when morning sickness is at its worst. That has led many women to try alternative treatments, including sugar solutions, ginger, vitamin B6, acupressure and acupuncture. Unfortunately, there is little evidence that any of them are effective, Dr. Anne Matthews of the School of Nursing at Ireland's Dublin City University reported Wednesday in the Cochrane Library, a prestigious source of research on the effectiveness of medical treatments.

As many as 85% of pregnant women experience nausea, and half of those endure actual vomiting. The cause is unknown, but researchers suspect hormonal imbalances. About 1 in 200 suffer so severely that they cannot keep any food or liquids down, a condition known as hyperemesis gravidarum. It requires medical treatment and can cause blood clots and damage to the infant. On the plus side, a 2007 study found that women who suffer morning sickness are less likely to develop breast cancer.

Matthews and her colleagues reviewed 27 clinical trials involving 4,041 pregnant women who were as much as 20 weeks pregnant. In six studies of acupuncture and two of acupressure - in which pressure is applied to acupuncture sites rather than needles - they found no benefit. One study of acustimulation, in which a small electric current is applied through the needles, found some benefit over three weeks. There was also very little evidence to support the benefits of ginger (which actually made many women sick), vitamin B6, antihistamines and anti-vomiting drugs. The anti-vomiting drugs induced sleepiness in recipients.

"A number of the studies we looked at appeared to show benefits, but in general the results were inconsistent and it was difficult to draw firm conclusions about any one treatment in particular," Matthews said in a statement. "We were also unable to obtain much information about whether these treatments are actually making a difference in women's quality of life."

Your best bet, according to most experts: Get plenty of rest, drink a little at a time but often to prevent dehydration, and eat small servings of bland food such as toast and crackers. Also, avoid strong smells; eating food cold rather than hot can minimize odors that cause nausea.

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PregnancyWeekly.com

After I had my son, I desperately wanted a girl. When I got pregnant again, I was so convinced another XY was on the way that when the doctor delivered our daughter (XX, that is) and announced as much, I asked my husband: "Is he kidding?"

Had I only followed a strict meal plan of nuts and hard cheese, I presumably needn't have waited on pins and needles - at least according to a study by Maastricht University in The Netherlands. The authors say a mother's diet can determine whether her nursery ends up being swathed in pink or blue. So to boost the odds of having a girl, mothers should say, yes, to calcium and magnesium (think yogurt, spinach, tofu, almonds, cashews, beans, oatmeal, broccoli and oranges) and, no, to salt and potassium (anchovies, olives, bacon, salami, smoked salmon, shrimp, potatoes, processed meats, bread and pastries). Combine a strict diet with some carefully orchestrated sex — to increase the likelihood of having a girl, the researchers recommend avoiding sex immediately before and after ovulation — and apparently it can make all the difference.

News reports about the study, including one in the U.K.'s Daily Mail, have crowed about the nearly 80% success rate of the baby-girl diet. But the fine print — and common sense — call into question just how realistic this recipe for baby-making actually is. Of the 172 women who participated in the five-year study, only 21 ended up adhering to the stringent guidelines about what to eat (at least a pound of dairy each day) and precisely when — and when not — to rendezvous with their lovers. Of those 21, 16 ended up bearing daughters: voila, 77%.

The study further concluded that what the women ate was more important than when they had sex. “The results show that both diet and timing methods increase the probability of 
a girl — the impact of the diet being the most pronounced,” said a spokesman for the researchers.

But don't start stuffing the fridge with Stonyfield Farms just yet. “There is no physiological probability to any of this,” says Dr. Richard Paulson, director of the fertility program at the University of Southern California. “This is a great example of what we call non-science.”

This is probably not the first time you've heard about diet influencing gender. Researchers at the University of Exeter in England surveyed 740 first-time mothers and announced in 2008 that those who ate more calories — particularly those who ate breakfast cereal — had more sons. Nor is the advice new to avoid sex right before and after ovulation in order to birth a girl. When I was new to baby-making, a girlfriend told me about the Billings Method, a natural family planning method that involves timing of ovulation, which some rely upon to help select the baby's sex. Twice it let me down. (But a Nigerian study cited in Billings Method: Controlling Fertility Without Drugs or Devices reports that 310 couples who tried to conceive a boy were successful, while only four were not. Similarly, of 92 couples who tried to conceive a girl, only two failed. Daughters are apparently not so beloved in Nigeria.)

The timing factor was also famously espoused by Landrum Shettles, a Columbia professor who wrote How to Choose the Sex of Your Baby, which has sold over a million copies since coming out in 1970. Shettles postulated that male sperm are speedier swimmers, while female sperm are hardier and tend to outlast the guys. Hence, sex at ovulation should result in a boy, since male sperm should reach the elusive egg quicker, while sex a few days before or after ovulation should yield a daughter owing to the tenacity of the female sperm.

True or not, many have been persuaded. When Paulson addresses medical students and asks who believes it's possible to alter the probability of conceiving a boy versus a girl, half of would-be doctors raise their hands.

Here are nine other tried (but not likely true) ways to select the sex of your baby:

Go Blue:

• Have sex on the day of ovulation
• Avoid sex for several days before ovulation in order to concentrate the male's sperm count
• Don't spare the salt; eat meat and fish but steer clear of dairy
• Drink multiple cups of green tea daily

Pick Pink:

• Have sex several days before or after ovulation
• Have sex — lots of it — to decrease sperm count
• Stash a pink ribbon beneath your pillow
• Men, take a hot bath prior to intercourse because male sperm may be heat-averse
• Eat chocolate!

Have you tried any of these methods? Have they worked for you?

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PregnancyWeekly.com

Oxytocin has been called "the love hormone" because levels of it rise in women during childbirth and breast-feeding, and it is thought to facilitate bonding. It is present in men, too, and everything from eye contact to orgasm can increase its amount.

But does the hormone stimulate bonding in new fathers as it does in new mothers? A new study in the journal Biological Psychiatry, the first to look at what its authors describe as “the transition to fatherhood,” suggests that it does. And it also suggests a biological basis for the fact that men and women so often relate differently to infant and toddlers, with women more often cooing and cuddling and men tickling and tossing.

First, Israeli researchers took blood samples from 80 couples, all first-time parents, when their children were 6 weeks, and then 6 months, old. Oxytocin levels at 6 weeks, they found, were just as high in new fathers as they were in new mothers (partners appear to “match” each other in the production of the hormone), and the levels rose over the next four and a half months.

The researchers also observed the couples as they interacted with their infants, noting how often each parent did things like gazing at the child, talking “mommy-ese” to him or her, playing with them and otherwise stimulating love and learning. Women with the highest levels of oxytocin were most likely to demonstrate what the journal article calls “affectionate parenting behaviors” while men with the highest levels were most likely to demonstrate “stimulatory parenting behaviors.”

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PregnancyWeekly.com

Federal health officials released some interesting data Monday aimed at trying to figure out why so many U.S. women are undergoing cesarean sections to deliver their babies.

The rate at which women are having C-sections has soared in recent years. About one-third of all babies are delivered using the surgical procedure. C-sections are necessary sometimes to save the baby or the mother or both. But experts think they're being done far too frequently, putting both the woman and her baby at unnecessary risk, making the mother's recovery a lot harder and adding a lot of extra costs to the nation's health-care bill.

In the new analysis, published in the American Journal of Obstetrics & Gynecology, researchers at the National Institute of Child Health and Human Development analyzed data collected at 19 hospitals about 228,668 births that occurred between 2002 and 2008.

Overall, the researches found that about a third of the deliveries were by C-section. Surprisingly, however, that was even the case for women giving birth for the first time -- not because they had previously had a C-section, which can make trying regular labor riskier. Slightly more than one-third of first-time moms had C-sections. Also surprising was the fact that half of the women attempting regular births had their labor induced. And half of C-sections occurred in women who had been induced but had not even dilated 6 centimeters. That suggests that doctors may be jumping the gun and turning to a C-section too early. It also might support the idea that part of the problem might be that women and their doctors are scheduling their deliveries for convenience.

But none of this proves any of that. It could be that a lot of these C-sections are needed because of problem pregnancies. More women are giving birth at older ages, when complications are more common. More obese women are also giving birth. Obese women are more prone to complications.

About one-third of the C-sections were among women who had had a previous C-section. And among those who tried a C-section again even though they had already had one, they were successful in about 57 percent of the cases.

The researchers stress that the study can't determine exactly how many of the C-sections were really unnecessary and could have been avoided. But the study does provide new evidence that more could be done to avoid women getting C-sections the first time around, and more could at least try a regular birth even if they have had a previous C-section.

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PregnancyWeekly.com

Contrary to popular belief, new mothers may often get a decent amount of sleep in their babies' first few months - but it's not a good-quality sleep, a new study suggests.

The study, which followed a group of new moms, found that on average, the women got just over 7 hours of sleep per night during their babies' first four months. That is within what's generally recommended for adults, and, based on past studies, more than the average American gets.

On the other hand, the study found, that sleep is also frequently disrupted -- with the women typically being awake for a total of two hours overnight.

The finding may not sound surprising, especially to parents. But the study does challenge a central assumption about new mothers' typical sleep patterns, according to lead researcher Dr. Hawley E. Montgomery-Downs, an assistant professor of psychology at West Virginia University in Morgantown.

That assumption, she told Reuters Health, has been that most new moms are sleep-deprived -- that is, not getting enough hours of sleep.

So the advice on how to combat daytime fatigue has focused on countering sleep deprivation, Montgomery-Downs said -- such as the age-old adage to "nap when your baby naps."

But the current results, reported in the American Journal of Obstetrics & Gynecology, suggest that new mothers' highly fragmented sleep is what's behind their daytime fatigue.

That sleep pattern, Montgomery-Downs said, is similar to what's seen with certain sleep disorders, such as sleep apnea, where people log enough hours in bed, but get little restorative, good-quality sleep.

Sleep occurs in repeated cycles that each last about 90 minutes to two hours. Depending on how often a new mom is waking up, she may get few or no full cycles of sleep, Montgomery-Downs noted.

And a quick daytime nap is unlikely to counter that.

"We need to think about what kinds of strategies can help consolidate sleep" for these mothers, Montgomery-Downs said. One tactic, she suggested, could be for breastfeeding moms to find time to pump milk and store it in bottles so that they do not have to be the ones to always get up with the baby.

And while quick naps might not do much, Montgomery-Downs noted that "if you're one of the lucky parents" whose infants typically nap for at least two straight hours, taking that time to sleep could be helpful.

The findings are based on 74 new mothers who were followed between either the second and 13th week of their infants' lives, or between the 9th and 16th week. The women kept track of their sleep patterns using sleep "diaries," and also wore a wristwatch-like device called an actigraph that recorded their movements during the night.

Contrary to expectations, the researchers found that the women's average sleep time was about what it should be, at 7.2 hours. Instead, sleep fragmentation was the issue.

Relatively few mothers tried napping as a countermeasure. By the third week of their infants' lives, less than half of the women in the study said they napped, and among those who did, the average was twice per week.

Daytime fatigue, a problem reported by many new mothers in other studies, is a concern for several reasons, according to Montgomery-Downs. One is that, in some women, sleep problems and exhaustion may contribute to postpartum depression.

Beyond that, Montgomery-Downs said, fatigue can also hinder people's ability to drive safely or hurt their performance at work.

She argued that mothers' fragmented sleep and daytime fatigue call for a reconsideration of maternity work leave in the U.S. Right now, national policy states that workplaces with 50 or more employees have to offer up to 12 weeks of unpaid leave; the U.S. is the only Western country that does not mandate some amount of paid parental leave.

So many women, Montgomery-Downs said, may have to go back to work at a time when "they should really be taking care of themselves."

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PregnancyWeekly.com

Lactic acid test can predict C-section birth, say doctors, as women with a high level of the acid in their system during pregnancy and labor may be unlikely to deliver vaginally, according to a new scientific study.

Doctors in Liverpool, England say that 25% of emergency c-section births could be avoided with a simple test to determine if there is an excessive level of lactic acid in the woman's bloodstream. Lactic acid causes the womb to contract, leading to painful, unproductive labor pains. The study says that if the acid levels are indeed high, allowing the contracting uterus to "rest" can help lower those levels and allow the birth to continue normally.

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PregnancyWeekly.com

Breastfeeding for a month or longer appears to reduce a woman's risk of getting diabetes later in life, according to a new study.

The breastfeeding and diabetes link has been reported in other studies, according to researcher Eleanor Bimla Schwarz, MD, assistant professor of medicine at the University of Pittsburgh School of Medicine.

Her study lends more credence to the link, she says. "Moms who had ever breastfed were much less likely to develop diabetes," Schwarz tells WebMD. "Moms who had never breastfed had almost twice the risk of developing diabetes as moms who had."

The researchers evaluated data on 2,233 women. Of those, 405 were not mothers, 1,125 were mothers who breastfed for at least a month, and 703 were mothers who had never breastfed.

The risk of getting a diagnosis of type 2 diabetes for women who breastfed all their children for a month or longer was similar to that of women who had not given birth.

But mothers who had never breastfed were nearly twice as likely to develop diabetes as women who had never given birth.

Moms who never exclusively breastfed were about 1.4 times as likely to develop diabetes as women who breastfed exclusively for one to three months, Schwarz found.

Later in life, here is the breakdown of who developed diabetes:

• 17.5% of the women who hadn't given birth.
• 17% of the women who breastfed all their children for a month or longer.
• 20.3% of those who breastfed, but not all children for a month or longer.
• 26.7% of moms who didn't breastfeed.

Overweight and obesity were common among the participants, with 68% having a body mass index of 25 or more, considered outside the healthy weight range.

The link held, Schwarz says, even after controlling for factors such as weight, physical activity, and family history of diabetes.

While one month of breastfeeding appears to make a difference, Schwarz says even longer is better. "Previous studies have shown the longer the mom breastfeeds, the more benefit for your body."

The diabetes-breastfeeding link is probably explained by belly fat, Schwarz says. Moms who don't breastfeed, as they get older, may have more belly fat, she says, as breastfeeding helps new mothers take off weight. "Belly fat increases the risk of diabetes as you get older."

Some research has shown that breastfeeding may increase sensitivity to insulin, in turn reducing diabetes risk. But that may be short-term -- while the breastfeeding is occurring, Schwarz says. "The real problem may be the belly fat."

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PregnancyWeekly.com

Scientists have found that the first stools that a baby passes after being born can actually be used to determine how much their mother smoked, or if she was exposed to tobacco smoke during pregnancy.

Meconium is a dark and tarry stool passed by a baby during the first few days after birth.

Researchers measured tobacco smoke metabolites in meconium samples from 337 babies, finding that they correlated well with reported smoke exposure and other markers of tobacco smoke exposure.

Joe Braun, from the University of North Carolina-Chapel Hill, USA, worked with a team of researchers to carry out the study.

"Prenatal active and secondhand tobacco smoke exposure is a prevalent environmental exposure that is associated with adverse infant and childhood health outcomes. Biomarkers of exposure, like serum and meconium tobacco smoke metabolites, are useful to enhance the measurement of tobacco smoke exposure, which is often under-reported," he said.

The researchers found that tobacco smoke metabolites in meconium reflected the duration and intensity of gestational exposure to tobacco smoke.

Concentrations were higher and almost universally detected among infants born to active smokers compared to women with secondhand or no exposure.

Speaking about further applications of this research, Braun said, "Although meconium was not superior to serum as a biomarker of tobacco smoke exposure, it may be useful to estimate gestational exposure to other environmental toxicants that exhibit more variability during pregnancy, especially non-persistent compounds like bisphenol A and phthalates".

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PregnancyWeekly.com

Women who develop a mild case of gestational diabetes during pregnancy tend to have fewer complications and healthier babies if the diabetes is treated according to the first large-scale randomized trial in the U.S. to address whether such treatment leads to health benefits for mother and child.

As many as 14% of pregnant women in the U.S., or about 200,000 women annually, develop gestational diabetes. This pregnancy-related diabetes can cause the fetus to grow too rapidly, and the excess weight can make delivery difficult and lead to complications. What’s more, gestational diabetes increases the risk of preeclampsia, a potentially life-threatening rise in blood pressure in the mother.

However, the benefits of treating gestational diabetes are somewhat controversial; although most obstetricians screen and treat pregnant women for blood-sugar abnormalities, the 2008 guidelines of the U.S. Preventive Services Task Force has said there is not enough strong evidence for or against screening and treating gestational diabetes.

“Almost all obstetricians do screen for gestational diabetes, but some of them have not been particularly aggressive about treating milder cases, reserving aggressive treatment for people with higher blood-glucose results,” says lead study author Mark Landon, MD, of Ohio State University Medical Center, in Columbus. “For them, this study serves as notice that aggressive treatment with diet alone is useful for even mild gestational diabetes cases.”

Gestational diabetes can be treated with dietary restrictions, the oral drug metformin, or insulin injections. Dr. Landon says that, unfortunately, some women diagnosed with the condition are not even given a real meal plan to follow; instead they are simply advised to watch their sugar intake.

In the study, published in the New England Journal of Medicine, 958 women diagnosed with mild gestational diabetes between 24 and 31 weeks of pregnancy were divided into two groups; half were treated for diabetes, half were not. Women were considered to have mild gestational diabetes if they had an abnormal result after taking an oral glucose-tolerance test (a test in which women drink a sugary liquid and blood sugar is measured at regular intervals), but their fasting glucose level (a test in which blood sugar is measured after fasting) was below 95 milligrams per deciliter. Many doctors treat gestational diabetes only if it is more severe, generally considered to be 95 milligrams per deciliter or higher.

The new research, a partnership of 14 different institutions, showed that women were half as likely to have larger-than-normal babies if they were treated. For example, 14% of women who weren’t treated had a baby that weighed more than 8 pounds, 13 ounces, compared with only 6% who were treated.

The newborns also had fewer cases of shoulder dystocia (1.5% with treatment vs. 4% without treatment), a potential emergency in which the birthing process stalls due to entrapment of the infant’s shoulders—a problem that’s more likely if a newborn is larger-than-normal. Women who were treated had fewer cases of high blood pressure or preeclampsia (8.6% vs. 13.6%) and were less likely to need a cesarean section (about 27% vs. 33.8%) than women who were not.

Most women in the U.S. are screened for gestational diabetes between 24 to 28 weeks of pregnancy but may be tested even earlier if they are very obese, have a strong family history of the condition, or if they had gestational diabetes or gave birth to a large baby during previous pregnancies. If a one-hour oral glucose test is positive for elevated blood sugar, then women generally undergo a similar three-hour test in order to be diagnosed.

Although gestational diabetes usually goes away after a woman gives birth, women who have the condition are 50% more likely to develop type 2 diabetes within the next 20 years. For that reason, the American Diabetes Association recommends occasional blood-sugar testing, a healthy diet, and regular exercise even after childbirth.

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PregnancyWeekly.com

Taking certain antiviral medications for herpes infections during the first three months of pregnancy does not increase a child's risk of major birth defects, researchers report in this week's issue of the Journal of the American Medical Association.

The antiviral drugs acyclovir, valacyclovir, and famciclovir are often prescribed to treat herpes viral infections, such as herpes simplex virus (HSV). More than one in five pregnant women have antibodies in their blood to HSV, indicating a past or present infection.

Herpes antiviral medications are also used to treat herpes zoster infections, commonly known as shingles.

Until now, information about the safety of these antivirals during pregnancy has been limited. The medications are listed as category B by the FDA. Category B means adequate studies on pregnant women are lacking but animal studies have shown the medicine is safe during pregnancy, or human studies showed it was safe during pregnancy but animal studies offered conflicting evidence.

The new study suggests that pregnant women may be able to take some of these drugs without fear of harming their developing baby, at least during the first trimester. Researchers in Copenhagen, Denmark, looked at live birth records from more than 800,000 infants between January 1996 to September 2008, noting the link between acyclovir, valacyclovir, and famciclovir use in the first trimester of pregnancy and major birth defects. Participants had no medical history of chromosome or genetic problems or viral infections at birth. The study team also adjusted for other factors known to influence outcome.

“Our study, to our knowledge the largest of its kind, found no significant association between first-trimester exposure to antiherpetic antiviral drugs and major birth defects," the study authors write in the journal report. "Acyclovir is the most extensively documented antiviral and should therefore be the drug of choice in early pregnancy."

The study authors warn that their analysis regarding famciclovir was based on a small number of pregnancies and should "not be viewed as evidence of safety of this drug." Data on valacyclovir also remains insufficient, they say. The team encourages continued research to study the link between these medications and miscarriage and preterm labor, and their safety during breastfeeding.

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PregnancyWeekly.com