Trusted Information for Healthy Pregnancies
infants
Ultrasound Reveals Breastfeeding Mechanics
May 12th
Although it might look like a baby is chewing on the mother's nipple, ultrasound images show that the infant actually removes milk by creating a vacuum - also known as sucking.
The finding is important, as it could explain why some babies fail to take to the breast. It may also shed new light on why - for a minority of women - breastfeeding really can be a painful experience.
"There have been two theories about how breast milk is expressed," says Donna Geddes of the University of Western Australia in Crawley.
"One is that the baby uses a peristaltic or compression motion to actually push the milk out of the nipple and breast. The other theory is that vacuum is primary in removing the milk."
Until now, most studies examining the mechanics of breastfeeding have focused on bottle-feeding infants, or on old X-rays that were of poor quality.
Instead, Geddes and her colleagues combined ultrasound imaging of infants suckling on the breast with measurements of the strength of the vacuum created by the baby's mouth in 20 infants aged 3 to 24 weeks as they breastfed.
"What we see is that when the tongue is lowered and the vacuum is applied, that's when the milk is coming out of the breast, and that doesn't involve any compression of the nipple," says Geddes. "It's not a milking action at all."
They also found that infants who struggled to breastfeed generated much weaker vacuums than successful breastfeeders. This may explain why babies with a cleft palate often fail to breastfeed, as do premature babies: preterm infants don't have strong enough mouth muscles to suck hard enough.
The next step is to devise a simple and universal test that could be used to assess babies' ability to suck. This could reassure mothers whose infants are struggling to feed that it's not their fault. "Currently there are no measurements to assure the mother or the clinician that things [in the breast] are working," says Geddes.
For such women, keeping the milk flowing using a breast pump and using this to top up breastfeeding until the baby is strong enough to suck effectively may be a better option than giving up on breastfeeding altogether.
The team also looked at women who found breastfeeding painful and discovered that their infants had a particularly vigorous action.
"They're strong suckers," says Geddes. Some were also distorting or crushing the nipple. Further study of these infants may aid the development of better nipple shields to reduce pain during breastfeeding.
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Heavier Birth Weight Tied to Later Conduct Troubles
May 6th
Among twins whose weight differs markedly at birth, the heavier child is more likely to have conduct problems at ages 3 and 4, a new study finds.
"The findings suggest an effect of birth weight differences on development of subsequent conduct problems," researchers led by Dr. David Mankuta of Hadassah Hebrew University Hospital in Jerusalem, said in a news release. "Further studies are needed to clarify the mediating factors of this effect."
The team studied 112 pairs of Israeli twins in which one weighed at least 20 percent more than the other. The twins were born in 2004 and 2005.
The researchers found that the heavier twin had more conduct problems in 41 percent of the twin pairs. The twin who weighed less had more conduct problems in only 21 percent of the cases.
The study findings were published in the May issue of Archives of Pediatrics & Adolescent Medicine.
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Two languages in womb makes bilingual babies: study
Feb 17th
Babies who hear two languages regularly when they are in their mother's womb are more open to being bilingual, a study published this week in Psychological Science shows.
Psychological scientists from the University of British Columbia and a researcher from the Organization for Economic Cooperation and Development in France tested two groups of newborns, one of which only heard English in the womb and the others who heard English and Tagalog, which is spoken in the Philippines.
To determine the babies' preference for a language, the researchers studied the newborns sucking reflex; increased sucking by a neonate indicates interest in a stimulus.
In the first experiment, infants heard 10 minutes of speech, with every minute alternating between English and Tagalog.
The English-only infants were more interested in English than Tagalog -- in other words, they "exhibited increased sucking behavior" when they heard English than when they heard Tagalog being spoken.
The infants exposed to two languages, on the other hand, showed an equal preference for both English and Tagalog, suggesting to the researchers that prenatal bilingual exposure prepares infants to listen to and learn about both of their native languages.
The researchers also tested the newborns to see if they could tell the differences between two languages -- key to becoming bilingual.
The infants listened to sentences being spoken in one of the languages until they lost interest, and then heard sentences in the other language or heard sentences in the same language, but spoken by a different person.
The infants exhibited increased sucking when they heard the other language being spoken, but their sucking did not increase if they heard additional sentences in the same language.
"These results suggest that bilingual infants, along with monolingual infants, are able to discriminate between the two languages, providing a mechanism from the first moments of life that helps ensure bilingual infants do not confuse their two languages," the authors of the study said.
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Infantino Sling Rider Deaths
Feb 5th
It's been reported that a third infant has died from the use of the Infantino Sling Rider. Unfortunately, the Infantino Sling Rider and other "bag" slings are not safe. A blog called Babysosmart, has some very good information on the topic:
For the last 4 years+ I've been teaching what I call a "Benefits of Babywearing" class through several local venues. My goal has always been to open parents eyes to all the amazing physical and emotional health benefits that babywearing gives to a baby. It still blows my mind. Not the idea of babywearing, but the science behind it all. An infant's development is measurably physically improved by babywearing...
But not all baby carriers are equal, and not all of them are safe. I'll admit it: I bring a couple of the "bad carriers" to each class that I teach, to demonstrate the potential problems that can arise from using a "bad carrier." One of these "bad carriers" (and I don't usually say bad, except in regards to this one that I'm about to discuss now) is the Infantino Sling Rider. And it's BAD. I've always referred to it "lovingly" as "the Sling of Death."
My overwhelming concern with this particular style of carrier, what we refer to as a "bag sling" or "bag-style sling", is the awkward and unsafe position into which the baby slips when he is placed inside the carrier. There is no feature to keep the baby's body in good alignment, so the baby usually ends up in what we call the "chin-to-chest" position. I'm a nurse, a pediatric nurse, and just hearing those words said in relation to an infant under three months old is akin to hearing someone say they gave their newborn a razor blade to play with. Wouldn't do it, dumb, a no-brainer, and worse, dangerous. The chin-to-chest position is just that-- the infant's chin drops down to rest on their chest, and their little, teeny, floppy airway is occluded-- folded in half, if you will. The infant airway, or trachea or breathing tube, is pretty unremarkable at this stage, at least in regards to it's ability to maintain itself. It's soft, floppy, and extremely narrow; that's why infants are so grossly affected when they're hit with the common cold, for example. Let me just say it bluntly: an infant can cut off their own ability to breathe if they are placed in the chin-to-chest position.
Others have been voicing their concerns for several years as well. In fact, one third-party group reviewed the Infantino Sling Rider (along with several other styles/brands of carriers) back in the fall of 2006 or 2007, documented their findings, and presented it to the manufacturer in the following February, assuming that eyebrows would be raised, red flags would be waved, and that the offending carrier would be pulled from the market, at least until modifications could be made to make it safe for use. I'm willing to bet that they were more shocked to hear the manufacturer say (and not an actual quote, mind you)-- "Have their been any documented deaths in one of our carriers? Until then, we aren't willing to do anything."
I have pushed people to LEARN how to use their carriers correctly over the years, as even a good carrier can be used incorrectly and potentially be the "cause" of a problem (I say "cause" because it's not actually the carrier that causes the problem, it's the wearer not using it correctly). Three biggest instances of this are: a "bigger baby, let's say a 6- or 8-month old, that's just really pitching a fit, and the parent is trying to force the baby into the carrier, and the baby is thrashing, throwing itself around, a recipe for disaster. A baby carrier is just that, a carrier, not a restraining device. Next example, a parent not tightening the carrier up, wearing it very loose and low, baby hanging out, again, looking for a fall, or the potential for the baby to fall into the chin-to-chest position. I've seen this several times, usually a ring sling, and the parent is attempting to carry the baby in the cradle position, but is not adjusting the sling to support the baby, allowing the baby to just kind of curl up inside the body of the sling. And the third instance, wearing a carrier that is too big for you-- usually it is a pouch, or pouch sling, and the baby is sliding into . . . the chin-to-chest position, and we've already been through those dangers. It is critical to make sure not only that the carrier you are using fits you, but that you are also using it correctly.
My heart goes out to the families of these beautiful babies whose lives were needlessly lost. The data was there, several years ago, and the manufacturer KNEW about the dangers their product posed to babies, they just didn't care. They were busy padding their pockets.
Note: Other similar dangerous "bag style slings": the Boppy "sling", the PreMaxx "sling," the JJ Cole "sling", the bag sling by Serena and Lily, to name a few.
Read more here.
Newborns of Smokers Have Abnormal Blood Pressure
Jan 25th
Babies of women who smoked during pregnancy have blood pressure problems at birth that persisted through the first year of life, a new study finds.
"What is of concern is that the problems are present at birth and get worse over time," said Gary Cohen, a senior research scientist in the department of women and child health at the Karolinska Institute in Stockholm, and lead author of a report in the Jan. 25 online edition of Hypertension.
The study led by Cohen compared 19 infants of nonsmoking couples with 17 infants born to women who smoked an average of 15 cigarettes a day during pregnancy. At one week of age, the infants of nonsmoking mothers experienced a 2 percent increase in blood pressure when tilted upright, with a 10 percent increase at one year. The pattern for the children of smoking mothers was reversed: a 10 percent blood pressure increase at one week, a 4 percent increase at one year.
And the heart rate response to tilting of the children of mothers who smoked was abnormal and exaggerated, the report said.
It's not possible to say whether the abnormalities seen in the babies will lead to trouble later in life, Cohen said. But, he noted, "the extent of the condition at one year suggests that it is not going to disappear quickly."
The reason why exposure to tobacco in the womb affects blood pressure is not clear, Cohen said. A leading possibility is that "smoking might damage the structure and function of blood vessels," he said, mainly by damaging the endothelium, the delicate layer of cells that line the interior of blood vessels.
Whether that damage will persist is not known. "We're only up to 12 months at the moment," he said. "We plan to follow them."
The damage seen in the Karolinska study is similar to that observed in babies born to mothers whose pregnancies were marked by such abuses as drug use, said Barry M. Lester, a professor of psychiatry and pediatrics at Brown Medical School, and director of the Brown Center for the Study of Children at Risk.
"Early kinds of natal insults can cause reprogramming of brain circuitry," Lester explained. He has led studies of the long-term effects of cocaine and amphetamine use during pregnancy. Many women who take such drugs also smoke, Lester added.
"When we isolated tobacco effects, we showed that there are inborn neural effects of tobacco exposure similar to what we see in cocaine and methamphetamine abuse," he said.
Some research has connected such problems to overproduction of cortisol, a "stress hormone" that plays an important role in regulation of blood pressure and the immune system, Lester said. "Cortisol overexposure is one hypothesis," he said. "There is a lot of evidence showing that too much cortisol is damaging."
It is a reasonable hypothesis, Cohen said. Babies born preterm have problems with blood pressure that have been linked to overproduction of cortisol by the adrenal glands, he noted, "and there are some parallels between tobacco smoke exposure and preterm babies of the same age."
Whatever the mechanism of damage, treatment to eliminate the problems after birth does not seem possible, Cohen added.
"What we know from studies in older kids is that even if you remove them from an environment of exposure to tobacco smoke, it is unlikely you will get full restoration of normal function," he said. "The best intervention to solve these problems is prevention. Women who are pregnant need to avoid exposure to tobacco smoke in the air. Passive smoke exposure can be as bad as being an active smoker."
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Newborn Babies Cry in Tongues Learned in the Womb
Nov 5th
Only days after birth, babies have a bawl with language. Newborn babies cry in melodic patterns that they have heard in adults’ conversations — even while in the womb, say medical anthropologist Kathleen Wermke of the University of Würzburg in Germany, and her colleagues.
By 2 to 5 days of age, infants’ cries bear the tuneful signature of their parents’ native tongue, a sign that language learning has already commenced, the researchers report in a paper published online November 5 in Current Biology.
Fluent speakers use melodic patterns and pitch shifts to imbue words and phrases with emotional meaning. Changes in pitch and rhythm, for example, can indicate anger. During the last few months of fetal life, babies can hear what their mothers or other nearby adults are saying, providing exposure to melodies peculiar to a specific language, Wermke says. Newborns then re-create those familiar patterns in at least some of their cries, she proposes.
“Our data support the idea that human infants’ crying is important for seeding language development,” Wermke says. “Melody lies at the roots of both the development of spoken language and music.”
Scientists already knew that, in the final months of gestation, babies can hear people talking, especially their mothers. Newborns prefer the sound of their mothers’ voices to the voices of other people, for example. In the days after birth, babies show signs of discriminating the sound of their native language from others and of recognizing when voice-like tones change in pitch.
Wermke’s team goes further, suggesting that newborns adapt their cries to melodic patterns characteristic of whatever language they have heard spoken.
She and her colleagues studied 60 healthy newborns, 30 born into French-speaking families and 30 born into German-speaking families. The researchers recorded 2,500 cries as mothers changed babies’ diapers, readied babies for feeding or otherwise interacted with the youngsters.
Acoustic measures allowed the researchers to identify 1,254 cries (in this case, a cry is a vocalization produced with a single breath) that contained clear rising-and-falling arcs suitable for a detailed analysis.
German newborns’ cries tended to start out high-pitched and gravitate to increasingly lower pitches. French newborns’ cries started out low-pitched and then moved higher. Comparable high-to-low and low-to-high intonation patterns characterize words and phrases used by fluent speakers of German and French, Wermke says.
Newborns strive to imitate their mothers’ behaviors however they can, in order to attract attention and foster bonding, Wermke proposes. Newborns can readily mimic the musical structure of what a mother says, in her view.
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