In a study published this month in Schizophrenia Research, Temple University psychologist Lauren Ellman found that exposure during pregnancy to certain immune proteins, such as those produced in response to the flu, leads to increased risk for brain abnormalities associated with schizophrenia in offspring.

The good news, says Ellman, is that not all of the women in the study who showed an increase in immune proteins gave birth to offspring who developed brain alterations. "This tells us that some other factor — perhaps a genetic vulnerability or something from the environment — must also be present for the increased immune protein levels to lead to the brain alterations we identified," she said.

Previous studies, including one by Ellman, have already established a link between maternal exposure to flu and increased risk for schizophrenia in offspring, but it was not clear why the link existed, because most infections do not cross the placenta. Researchers then began to look at maternal immune responses to infection as the possible cause for the increased risk.

Of particular interest to the researchers were proteins termed proinflammatory cytokines, which are produced by the body in response to infection.

"Now, it appears that the damaging effects to the fetus are related to these maternal responses to infection during pregnancy rather than to the infections themselves," Ellman said.

Ellman's study was conducted on archived blood samples drawn during the 1950s and 1960s from a group of approximately 12,000 pregnant women during each trimester of their pregnancies. The women and their offspring were followed after delivery, so those whose children had developed schizophrenia could be easily identified.

Her study showed a direct correlation between structural brain changes among offspring diagnosed with schizophrenia and increases in maternal levels of interleukin-8 (IL-8), one of the proinflammatory cytokines produced when fighting infection during pregnancy.

"The brain abnormalities we found are ones consistently linked with schizophrenia, suggesting that an elevated immune response during pregnancy might contribute to some of the brain abnormalities associated with the disorder," Ellman said.

Maternal IL-8 levels were not related to any brain changes among a control group of offspring, indicating that vulnerability to schizophrenia needed to be present for the fetal brain to be affected, she said.

Ellman is uniquely positioned to answer questions related to pregnancy and fetal development. An assistant professor of psychology in Temple's College of Liberal Arts, she examines how maternal stress and immune functioning during pregnancy impact fetal brain development.

"I set out to study the impact of stress during pregnancy, and it became clear pretty quickly that you couldn't study the impact of stress without looking at the immune system," she said. "The two are completely intertwined."

According to Ellman, one of the main ways pregnancy makes women susceptible to infections is that changes in the immune system during pregnancy reduce some of the body's key defenses. In addition, maternal emotional states, like stress, can alter immune functioning. This increased vulnerability to infection comes at a time when the fetal brain is experiencing enormous growth.

"In light of our study, which calls attention to a pregnant woman's increased susceptibility to infection and the potential risks to her developing fetus, it is easy to see why the medical community routinely recommends that women who are pregnant or planning to become pregnant take special precautions to prevent infection, such as getting vaccinated," she said.

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PregnancyWeekly.com

California public health officials on Monday strongly urged elderly adults, children and pregnant women to get vaccinated against whooping cough, citing an epidemic in the state that is on track to be the worst in 50 years.

Nearly 1,500 cases of whooping cough have been reported statewide this year, nearly five times the number of cases last year, according to Dr. Gil Chavez, the state's epidemiologist.

Babies under 6 months old are the most vulnerable because even those vaccinated have yet to develop immunity, Chavez said.

Five infants have died of whooping cough so far this year, all under 3 months old. Two of the deaths were in Los Angeles County. A sixth possible infant death was still being investigated Monday in L.A. County, Chavez said.

Last year three infants died of the disease, one each in Los Angeles, Kern and San Bernardino counties. All of the whooping cough deaths since 1996 have been infants under 3 months old, according to Ken August, a spokesman for the California Department of Public Health.

As of July 16, L.A. County had reported 289 possible whooping cough cases for the year, including 73 confirmed infections and 54 likely infections, according to the Department of Public Health. The county 156 reported cases of whooping cough last year.

The highly contagious upper-respiratory infection, also known as pertussis, initially may be mistaken for a cold, becoming more serious as it escalates and often causing those infected to make a tell-tale "whooping" sound as they gasp for air.

Pertussis infections typically peak every five years, Chavez said. The last outbreak in California was in 2005, when 3,182 cases were reported statewide and eight infants died. Since then, a booster vaccine was developed for adolescents and adults.

"It's time for Californians to help us by getting vaccinated and protecting themselves," Chavez said.

The Department of Public Health on Monday expanded its vaccination recommendation to include children age 7 and older; adults age 64 and older; women before, during and immediately after pregnancy; and anyone who may have contact with pregnant women or infants.

Dr. Jack Chou, a Baldwin Park family physician, said he was "heartened" by the new recommendations.

"That will allow us to give this vaccine to grandparents who care for infants," said Chou, president of the California Academy of Family Physicians.

Dr. Dean Blumberg, an associate professor of pediatric infectious diseases at UC Davis, said three-quarters of infants who catch whooping cough get it from someone in their home.

"That's why it's important to make sure their siblings and caregivers are protected," Blumberg said.

Public health officials have been tracking whooping cough cases by county, patient age and ethnicity, Chavez said. They have seen more infections in counties such as Marin, where more parents have opted out of vaccinating children, he said. Latino infants are most likely to get whooping cough, more than twice as likely as white infants. Among adults, whites are most likely to get infected, followed by Latinos, Chavez said.

Chavez said the department has provided free vaccines to local hospitals and community clinics and held a series of meetings with ethnic media outlets in Northern, Southern and Central California to raise awareness about the importance of vaccinations.

Department officials said the booster vaccine is safe for pregnant women, is made from a dead virus and is preservative-free.

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PregnancyWeekly.com

Children who get a combination of measles, mumps, rubella and chickenpox vaccines in one shot are at a slightly increased risk of getting a fever-related seizure, compared with children getting two separate shots - one containing measles, mumps and rubella and the another containing the chickenpox (varicella) vaccine, according to a new study published in the journal Pediatrics.

"The risk of a febrile seizure after any measles-containing vaccine is low - about one febrile seizure in 1,000 doses" says lead study author, Dr. Nicola Klein, co-director of Kaiser Permanente's Vaccine Study Center. "But if a child gets the combination vaccine, the risk doubles," says Klein.

Researchers looked at vaccine-safety data from more than 459,000 toddlers between the ages of 12 and 23 months and found there was one additional case of febrile seizure for every 2,300 doses of MMRV (measles, mumps, rubella, varicella) vaccine given. The seizures occurred seven to 10 days after the injection.

According to the Centers for Disease Control and Prevention, a febrile seizure is a fever-related seizure, which can occur when a child has a fever at or above 102°F or when a high fever is going down.

"Febrile seizures are benign," Klein says, meaning they're generally not dangerous. "They are very frightening to parents, but do not lead to long-term seizures or epilepsy." The American Academy of Pediatrics agrees: "While febrile seizures may be very scary, they are harmless to the child. Febrile seizures do not cause brain damage, nervous system problems, paralysis, mental retardation, or death."

Febrile seizures can occur in children ages 6 months to 5 years, but are most common in toddlers ages 12 months to 18 months, according to the American Academy of Family Physicians. Klein says up to 5 percent of children will have a febrile seizure between 6 months and 5 years, but that they are more likely to be caused by a common cold or other infections.

This combination vaccine was first approved in 2005. "The benefit of the MMRV is ease of administration," says Dr. William Schaffner, chairman, Department of Preventive Medicine at Vanderbilt University and a liaison to the Advisory Committee on Immunization Practices, the CDC's vaccine advisory board.

It was that ease – a single shot for four vaccines, which led the ACIP to recommend a preference for this new vaccine back in 2006, says Schaffner.

Klein presented early research to the ACIP in 2008 suggesting an increased risk of seizures. This led to the CDC to change its recommendation last year from preferring the combination vaccine to having no preference. This means MMRV or the MMR plus chickenpox vaccine may be given for the first dose for children 12-23 months.

This new study confirms Klein's earlier research. This "final result is exactly what we expected," says Schaffner. "This study provides a basis for every pediatrician."

"The ACIP has quite clearly said both [MMRV and MMR plus chickenpox separately] are good – both provide protection." But Schaffner says if there is any doubt for the parents or pediatrician, "two [vaccinations] is the way to go."

Klein says the benefit of the MMRV is "one less injection for children." Her study concludes that pediatricians who choose to use this combination vaccine need to be aware of the risks, albeit small, and clearly communicate them to parents. If parents choose to go with separate vaccinations, their child will get the MMR vaccine in one arm and the chickenpox vaccine in the other arm.

Although the MMRV has been available for five years now, usage of this combination vaccine dropped significantly after the manufacturer, Merck, announced it would be unavailable after July 2007 because of a shortage of the chickenpox vaccine.

According to the CDC, Merck was taking orders for the MMRV vaccine starting on May 10 of this year and according to the manufacturer, the vaccine is now available again.

The updated package insert for the MMRV vaccine say it "is associated with higher rates of fever and febrile seizures at 5 to 12 days after vaccination," compared with children who got the MMR and chickenpox shots separately.

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PregnancyWeekly.com

Babies who are born vaginally pick up different bacteria than those who are delivered by cesarean section, potentially affecting how their immune systems develop, a new study suggests.

The findings could provide more insight into why babies born through cesarean sections appear to be more at risk of allergies and asthma, researchers say. The bacteria they're exposed to at birth may help explain the relationship, since coming into contact with germs seems to help babies build defenses against them.

"We want to understand what the differences are and how they are important for the baby's health," said study author Maria G. Dominguez-Bello, an associate professor in the department of biology at the University of Puerto Rico.

The research is preliminary, she said, but it could help determine whether babies will benefit by being exposed to germs at birth that they otherwise wouldn't encounter.

While germs may sound like a bad thing, they're often beneficial to the body.

"We are all colonized -- our skin, mouth, intestines, vagina, ears -- by bacteria that have evolved with man," Dominguez-Bello said. "We are just now starting to unveil what these bacteria are, what they do, why they are important for organs to function." Colonization means the organism is present but not causing infection.

In the new study, researchers aimed to determine what types of germs colonize the bodies of babies as they're born. (The womb itself is free of germs, Dominguez-Bello noted.)

The researchers tested bacteria from the skin and mouths of 10 babies within a day after their birth. They also tested bacteria from their mothers.

Those who were born vaginally clearly picked up bacteria from their mothers since the germs matched. Those germs, which were linked to vaginal infections, gum disease and the digestion of milk, appear to have been acquired as they passed through the birth canal.

"It's very clear that the moms give the bacteria to the newborn babies. The babies are like magnets," Dominguez-Bello said.

The babies born by C-section harbored germs linked to skin infections, acne, diphtheria and food poisoning.

One theory is that it takes a little longer for babies born via cesarean section to come into contact with germs they need to survive.

"In order to be healthy adults, they'll be have to be colonized and end up having 10 times as many bacteria as their own cells," she said.

Dr. Athos Bousvaros, an associate professor at Harvard Medical School, said the study appears to be valid, although it only looked at a small number of babies over a short period of time.

"We don't know if this different colonization will persist over time," he said. Other factors -- antibiotics, genetics and breast-feeding -- may also play a role in how germs colonize babies, he pointed out.

"Pregnant moms should not be overly concerned about having a C-section based on this research," Bousvaros said. "The research does not associate this difference in colonization with the babies developing illness -- babies have been born by C-section for decades, and are generally quite healthy. As always, however, C-section should only be done if deemed medically necessary."

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PregnancyWeekly.com

Scientists have long known that breast milk is best for babies because it provides components that protect the immune system and help reduce an infant's risk for developing infections. What researchers did not know was how and why breast milk specifically protects infants, but now they are closer to an answer.

Scientists at the University of Illinois and their colleagues from Texas A&M University have been able to track specific genes in an infant's intestinal tract. They found that in newborns, this system undergoes significant changes in response to what the infant is fed.

Sharon Donovan, a University of Illinois professor of nutrition, noted that “for the first time, we can see that breast milk induces genetic pathways that are quite different from those in formula-fed infants.” She went on to explain that “the response to human milk exceeds that of formula, suggesting that the bioactive components in breast milk are important in this response.”

In the new study, intestinal gene expression was explored in 22 healthy infants, 12 who were being breast-fed and 10 who were receiving formula. The investigators isolated intestinal cells collected from the infants’ stools, which the mothers collected from their babies at ages one, two, and three months. Scientists isolated and turned their attention to RNA to uncover a gene expression or signature and found that breast milk invoked different genetic responses than did formula.

A healthy intestinal environment is critical for infants, whose immune systems are far from being mature. Donovan explained that “it’s very important that the gut learns what’s good and what’s bad. The baby’s body needs to be able to recognize a bad bacteria or a bad virus and fight it.” If something goes wrong during this early stage of development, infants can develop a variety of conditions, including food allergies, asthma, and inflammatory bowel disease.

The findings of this study will allow scientists to form a more complete idea of the activity in an infant’s gut and how the bacteria differ in breast-fed and formula-fed infants. Although the makers of infant formula have attempted to make products that are close to breast milk, Donovan noted they found that “hundreds of genes were expressed differently in the breast-fed and formula-fed groups.”

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PregnancyWeekly.com

Scientists say they've identified a culprit behind stillbirths and miscarriages in seemingly healthy pregnant women. It turns out that oral bacteria -- even the kinds that exist normally -- can travel through an open wound in the mouth into the bloodstream, settle in the placenta and potentially end a pregnancy.

When bacteria migrate from their normal environment (where they usually don't cause harm) to a new one, problems can arise. The placenta doesn't have an immune system, and it can become inflamed when the oral bacteria set up shop. This can lead to premature births as well as deaths, researchers say.

Yiping Han of the Case Western Reserve School of Dental Medicine led the study. She said they expected the bad bacteria, like the kind that causes gingivitis, to be responsible for aborted or premature pregnancies.

"We found many bacteria did locate to the placenta, but they were not the most famous periodontal pathogens," said Han. "In fact, many of the bacteria were the kind that are found in healthy people's mouths. The normal healthy woman is under risk. People should be concerned about it."

This research comes on the heels of earlier studies linking gum health to heart disease. Han said more research needs to be done to find out exactly which kinds of bacteria are colonizing the placenta so more effective treatments and therapies can be designed for pregnant women.

In the meantime, the American Dental Association recommends several ways to protect the health of your mouth. Fewer cuts and wounds inside your mouth means the oral bacteria will have less of a chance to get into the bloodstream and affect a pregnancy.

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PregnancyWeekly.com

Babies born in autumn or winter are more likely to develop a food allergy than those born in spring or summer, US researchers have found.

The Boston scientists believe the trend may be explained by a lack of the sunshine vitamin, vitamin D.

Vitamin D from natural sun exposure is needed for the healthy development of a child's immune system, experts believe.

And winter babies tend to get less sun, they explain in the journal Annals of Allergy, Asthma & Immunology.

The doctors from Massachusetts General Hospital in Boston reviewed all of 1,002 patients with food allergies who had been seen in three local hospital emergency departments over a period of six years.

They then compared the months of birth in patients with food allergy with those of patients visiting the emergency rooms for reasons other than food allergy.

From this a trend emerged - allergies appeared to be linked with season of birth, but only in the patients who were aged five or younger.

Of the children treated for allergy aged under five, 41% were born in spring or summer compared with 59% in autumn or winter.

The researchers acknowledge that other factors, such as infections, family history of allergies, maternal and infant dietary patterns, and exposure to indoor pollutants, may contribute to food allergies.

But they believe that vitamin D deficiency, and hence month of birth, "is a significant potential risk factor" in the development of food allergies.

Exposure to low vitamin D levels in the womb, immediately after birth and during early childhood may be key.

Previous studies have associated month of birth with other allergic conditions such as asthma, recurrent wheezing and dermatitis.

Dr Milo Vassallo, lead author of the study and a physician at Massachusetts General Hospital, said: "Vitamin D helps the body fight infection and suppresses its allergy cells.

"When the body is faced with a molecule of food it has to decide if it's a friend or a foe. Vitamin D contributes to tolerance but reduced levels of vitamin D triggers intolerance in the body," he said.

But the researchers stressed the findings did not mean parents should not attempt to boost their child's vitamin intake to ward off allergies.

A spokesperson for the charity Allergy UK said it was an interesting finding but more research needed to be carried out in this area.

She said: "It is unlikely that parents will change the month in which their children are born, but it might give some clues about possible links to the effects that sunlight / vitamin D has on the immune system."

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PregnancyWeekly.com

In new evidence set to spark debate over whether breastfeeding is best, scientists have found breast milk provides a natural immunity boost for youngsters.

The same compound, Human Alpha-lactalbumin Made Lethal to Tumour cells or HAMLET, could be a common cancer treatment for adults within five years.

Human trials have shown HAMLET can kill bladder cancer and laboratory tests have found it kills 40 different types of cancer.

But crucially, the chemical does not kill healthy cells which means it does not cause the nasty side effects of current chemotherapy treatments.

Assistant Professor Roger Karlsson, of the University of Gothenburg, said the discovery added to the debate over whether breast feeding or bottle feeding was best for babies.

"HAMLET is produced by combining alpha-lactalbumin in the milk and oleic acid which is found in babies' stomachs," he said.

"So breast feeding has been linked to actually reducing the risk of cancer in babies."

Prof Karlsson said tests had shown that HAMLET attacks the "power plant" of cancer cells.

"HAMLET also triggers some of the cell´s apoptotic pathways – apoptosis is programmed cell death," he said.

Human trials on male bladder cancers sufferers showed tumors were reduced without painful side effects within just five days of treatment.

Prof Karlsson said: "A pilot study of bladder cancer patients were injected with a HAMLET solution through a catheter.

"The solution killed cancer cells and the size of the tumors actually reduced within five days."

But Prof Karlsson said the treatment was limited because it had to be injected in the exact site of the cancer cells.

"It could also work if doctors were able to inject the solution into the vein which carries blood directly to the site of the cancer," he said.

A simple pill or liquid solution would just be "metabolized" by the body as normal food, he added.

Prof Karlsson said the treatment would be ideal as a complement to current chemotherapies.

He said scientists discovered the HAMLET by accident when they were investigating the health benefits of breast milk.

"They were actually looking for antibiotic powers in breast milk when they came across HAMLET and found in one of their tests that it killed cancer cells," he said.

The researchers are hoping to being human clinical trials as soon as possible.

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PregnancyWeekly.com

You take your baby to the pediatrician for her regular check-ups, vaccines, and at the first sign of a fever. You keep her away from runny-nose friends and steer clear of the sun. You babyproof your home and gently bandage her boo-boos. All to make sure your child grows up healthy and strong. But compelling new research is showing that the strength of your emotional bond with your baby may well trump all of those other measures you take to help her thrive.

A close attachment can prevent diseases, boost immunity, and enhance IQ in your baby, says Deepak Chopra, M.D., the endocrinologist turned mind-body -- medicine guru, Parenting contributing editor, and coauthor of Magical Beginnings, Enchanted Lives: A Holistic Guide to Pregnancy and Childbirth. Those hugs and kisses are a force of nature more powerful than ever thought, says Dr. Chopra. Mother-child bonding has evolved to become a complex physiological process that enlists not just our hearts, but our brains, hormones, nerves, and almost every part of our bodies.

There are decades of evidence to back up Dr. Chopra's claims. In one study from Ohio State University, rabbits that were cuddled by researchers were protected against the artery-clogging effects of a high-cholesterol diet. The love and attention affected the rabbits' hormone levels, the study authors concluded, helping them withstand heart disease. Researchers at McGill University in Montreal found that some female rats took more time and care to lick their infant pups than others; the pups that were licked frequently grew up to be less stressed and more adventurous in temperament, while pups that weren't groomed as much exhibited nervous, stressed-out behavior. And yet another study, published in Pediatrics, found that premature babies who were stroked gained nearly 50 percent more weight than those who were not. Such skin-to-skin contact (known as kangaroo care) has been shown to have other health benefits for preemies, too.

It's well known that the nipple stimulation that occurs when a baby nurses causes a hormone called oxytocin to be released in the mom, which in turn triggers milk let-down. But oxytocin is also called the "love hormone" because it's produced during orgasm and other affectionate moments. In fact, oxytocin behaves in the brain much the same way that morphine does; it turns on our "reward" center, easing pain, making us feel good, and causing us to crave that emotional high again and again. Women who don't breastfeed, or choose to eventually switch to or supplement with formula, happily do not miss out on the "love drug." Simply gazing into your baby's eyes while bottle-feeding or just snuggling or massaging also unleashes the feel-good hormones in both of you.

There's more evidence that we're hardwired to connect with our kids: Pheromones -- the chemicals we secrete to attract a partner -- are also secreted by our babies, ensuring that we're similarly smitten with them. In one study, 90 percent of moms were able to identify their newborns by scent alone after having spent as little as ten minutes with them. When the moms spent an hour with their babies, 100 percent of them correctly distinguished their own baby's smell from the smell of other infants.

A baby recognizes his mother's scent, too. Last year, researchers in Japan found that infants who smelled their own mother's milk while undergoing a routine heel-stick procedure exhibited fewer signs of distress than babies who were exposed to the odor of another mother's milk, formula, or nothing at all. The mere scent of their mother's breast milk was enough to calm the newborns and ease pain. Here's an interesting aside: The act of kissing may have evolved as an affectionate gesture because it puts our nose in direct contact with the base of our partner's nostrils, where pheromones are generated.

Just as scent motivates you to care for your child and motivates your child to stay close to you, so too does a smile. In a recent study conducted at the Baylor College of Medicine, in Houston, brain MRIs were taken of women while they looked at photos of their own children and of other kids making sad, happy, and neutral faces. The scans found that when a woman saw a photo of her own child, the parts of her brain associated with rewards processing (meaning they make you feel good!) were activated, and even more so when she saw photos of her child smiling. It's all very primitive: Mom make Baby smile, Mom get reward, Mom want to make Baby smile again.

So ignore your e-mails and forget about the laundry. Don't stress about vacuuming or entertaining guests. Let bonding with your baby become your priority. Lie around with her, doing nothing. Cuddle. Play. Dr. Chopra believes in "nourishing all of your baby's senses" by holding her, massaging her, singing to her, using soothing scents (lavender, rose, vanilla), and showing her colorful, interesting shapes and objects. Remind yourself that you're building a connection that will comfort both of you for years and years. And when you need a break, take one.

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PregnancyWeekly.com

Most babies should take a daily vitamin D supplement, a new study shows.

That will be a big change for most parents - and even many pediatricians.

Only 1% to 13% of infants under 1 year now get a vitamin D supplement, available in inexpensive drops, according to a study published online today in Pediatrics.

Those drops are needed, the study says, because only 5% to 37% of American infants met the standard for vitamin D set by the American Academy of Pediatrics in 2008: 400 international units a day.

Vitamin D strengthens bone and the immune system and also appears to prevent type 1 diabetes, heart disease and cancer, the paper says.

Few breast-fed babies — 5% to 13%, depending on their age — received the recommended amount of vitamin D, researchers estimated. Although breast milk is the perfect food in every other way, it's often low in vitamin D, says pediatrician Nicolas Stettler, a spokesman for the pediatrics academy who wasn't involved in the study. Because humans originated in equatorial areas with year-round sunshine, babies in the distant past wouldn't have needed to get vitamin D from breast milk, he says.

Yet many formula-fed infants don't get enough, either. Babies need to drink about 32 ounces of fortified formula a day to get 400 international units of vitamin D, says study author Cria Perrine of the Centers for Disease Control and Prevention. Babies younger than 6 months can rarely drink that much. A supplement can give babies all they need.

Many mothers also are vitamin D-deficient.

A second study in Pediatrics reports that 58% of newborns and 36% of mothers were deficient in vitamin D, according to blood tests. Although taking prenatal vitamins helped, more than 30% of moms who took them were still deficient. Getting lots of sunlight helped raise vitamin D levels in moms, but not in their newborns.

The American Academy of Pediatrics recommends babies get no direct sunlight in their first six months, to prevent skin damage and cancer. After 6 months, the academy says, babies should wear sunscreen, hats and protective clothing in the sun.

Relatively few pediatricians today talk about vitamin D with parents, says Wendy Sue Swanson, a pediatrician at Seattle Children's Hospital who wasn't involved in the new research. That may be because the pediatrics academy's previous vitamin D recommendation — 200 international units a day, set in 2003 — was easier to meet, Swanson says.

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