News Moms Need

In honor of Mother’s Day, we’d like to offer expectant moms one more tool to help promote a healthy pregnancy. Here’s a quick introduction to elective deliveries. Find out why the latest research from the National Institutes of Health (NIH), recommendations from the American College of Obstetricians and Gynecologists, and  information from the American Academy of Pediatrics and the March of Dimes all suggest that women wait until at least 39 weeks of pregnancy to deliver unless medically necessary.
 
What is the safest point in my pregnancy for my baby to be born?

The baby’s brain, liver, and lungs continue important development in the womb until 39 weeks. Unless health risks to the mother or baby require earlier delivery, it is best to wait until at least 39 weeks to deliver and, if possible, to let labor begin on its own. This extra time improves outcomes for mother and baby.

What to ask your health provider before you decide to deliver before 39 weeks of pregnancy:
   • Are there any medical indications that suggest I should induce labor early?
   • What are the potential complications of elective early delivery for my baby?
   • What are the potential complications for my own health?
   • How do you tell when my body is ready for labor?
   • How might inducing labor affect my future pregnancies?

Just a couple weeks can make a big difference for your health and the health of your baby. As you approach the last few months of your pregnancy (or if you’re already there), keep the questions above in mind as you talk to your doctor or midwife about your delivery options. Write them down. Print them out. And watch this video from the NIH on why waiting just a few extra weeks to deliver can be critical for you and your baby.

Happy Nurse Appreciation Week to all the incredible nurses out there! Nurses play a critical role in advancing the mission of the March of Dimes. They serve the foundation in so many ways: as health care providers, educators, researchers, fundraisers, chapter volunteers and advisors. Nurses work tirelessly and we can’t thank them enough!

March of Dimes is pleased to honor nursing excellence and pay tribute to hundreds of nurses that are at the front lines of care and have had a tremendous impact on patients and their families. Each year, nurses with various specialties are nominated for Nurse of the Year awards by colleagues and families alike. A prestigious group of healthcare professionals review applications and make award selections in a number of categories. You can take a look at the amazing Nurse of the Year award winners for 2012 from around the country at this link.

Do you know an amazing nurse? Tell us about him or her!

Since this is IEP season (the time of the year when IEPs are reviewed and re-vamped for the next school year), I am going to keep focusing on this all important document and process. IEP stands for “Individualized Education Program.” It is both a process and a written educational plan for a child with a qualifying disability.  If your child is in special education due to a delay or disability, the IEP is your child’s lifeline.

What must you know about IEPs? 

If you need a crash course on how to prepare for your IEP meeting and create a winning IEP, I suggest you go to Wrightslaw’s page. In a simple “pop up” format, you will find these topics:

• Determining present levels
• Writing measurable goals
• Providing individualized services, not one-size-fits-all services
• Including related services in the IEP
• Transportation options
• Including extracurricular activities
• Measuring your child’s progress
• Receiving services while being mainstreamed

You can also see my prior post on how to create effective IEP goals.

What is the LRE?

It is very important to understand “Least Restrictive Environment” commonly known as LRE. The law says children with disabilities must be educated in the least restricted environment with non-disabled peers “to the maximum extent possible.” (This concept is also commonly called “inclusion.”) The LRE is your child’s regular education classroom. Your child can not be removed from her classroom unless her disability does not allow her to be educated there, even with supports from supplementary aids and services (that are provided through an IEP).  The IEP team (of which parents are full members) decides whether or not the nature of the disability makes it possible for your child to be educated in the regular ed classroom with individualized supports.

There is a range of options for where a child may be educated, based on her individual needs. They are (in order from the least restrictive to the most restrictive environment):

• the child’s regular education classroom
• a special class within the regular “home” school 
• an “out placement” such as a specialized school
• home schooling
• education within a hospital or institution

It is so important to remember that the goal is to give your child what she NEEDS to learn and succeed. There is no point in keeping her in a regular ed classroom if she truly needs outside services and a different placement to thrive.

When the LRE doesn’t work for your child

For a long time, my daughter (who has learning disabilities and auditory problems) was in the regular ed classroom where she received extra help and support. She was not making good progress. One day she announced to me that she found it too noisy to listen and learn in that room. Due to her auditory problems, she could not filter out the classroom noises and focus on her work. So, the IEP team decided to put her in the resource room (a small, quiet classroom with a special education teacher and only 4 children) to receive her specialized instruction. My daughter’s relief was immediately evident as she would tune in to her teacher, quiet her mind and think effectively. She received her specialized instruction in the resource room and began making gains. She liked going to the resource room. It was good for her, even if it was not the least restrictive environment.

Bottom Line

Knowing what your child needs and working with the IEP team to achieve individualized goals is what is most important. Two children with the same disabling condition may have two entirely different placements and IEP goals. There is no one-size-fits-all formula. INDIVIDUALIZED is the keyword.

Have questions?  Send them to AskUs@marchofdimes.com

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started on January 16, 2013 and appears every Wednesday. Feel free to go back to look at prior posts as the series builds on itself. As always, we welcome your comments and input.

The U.S. Food and Drug Administration (FDA) is warning women and their health providers that Valproate products, a group of medicines normally used to treat seizures, is unsafe for pregnant women to use to treat migraines. A recent study found that the products may harm brain development in babies, leading to lower IQs than healthy babies later in life. FDA also says women who aren’t pregnant and are using Valproate products should use birth control.

Valproate products are usually used to treat epilepsy, a brain disorder that causes you to have frequent seizures, and bipolar disorder, a serious mental illness that leads to unusual mood changes. FDA says that Valproate products may still be used to treat epilepsy and bipolar disorder in pregnancy, but only if no other treatment is suitable.

If you’re pregnant or thinking about getting pregnant, talk to your health provider about any medicines you take. Some medicines you take can hurt your baby. Once you’re provider knows what medicines you take, she can tell you which ones are safe and which ones you need to stop taking.

Learn more about the FDA announcement on Valproate.

You recently had a baby and life is very busy. You’re focus is on caring for this little one, but you may also be juggling other children, work, mountains of laundry, home chaos, relationships and, for many of us, exhaustion. While you might like a sibling for Junior in the future, now may not be the right time. Many parents look to contraception for help, but how do you know what to choose?

When choosing birth control, there are many things for you and your partner to think about, such as:
   - Your overall health
   - How often you have sex
   - If and when you want to have children
   - How well each method works in preventing pregnancy  
   - If the method prevents sexually transmitted infections (STIs) as well as pregnancy  
   - Any potential side effects
   - How easy the method is to use for you or your partner
   - Cost
   - If it’s a good choice for breastfeeding moms
   - How comfortable you and your partner feel about the method

Learning how to use some birth control methods can take time and practice. Don’t be afraid to talk to your doctor or midwife and ask questions. The most important thing is to find and use the birth control that works best for you. You can always try one method, and if you don’t like it, try another one.

Each year over four million babies are born in the United States and the March of Dimes helps each of them through research, education, vaccination and breakthroughs. What are your little ones born to be? Help them be great!!!

As you think of Mother’s Day coming up, give the gift of health and knowledge to the moms-to-be. Invite them to this FREE webinar on May 6 at 1:00 PM ET to learn about exercise during pregnancy with March of Dimes medical advisor Dr. Siobhan Dolan. 

Some women think that pregnancy is a perfect time to sit back and put their feet up. Not so! For most women, it’s important to exercise during pregnancy and offers many health benefits. But how much exercise should you get and what’s safe? Join us on Monday – you’ll learn a lot.

We are grateful to Community Health Charities for making this webinar possible and available to everyone. Click on this link and register now!

Recreation Services (also known as Therapeutic Recreation, Rec Therapy or “RT”) involves the use of activities to help treat a variety of challenges (physical, cognitive, emotional, social, and leisure). For children with delays or disabilities, recreation therapy focuses on the non-academic, recreational activities in your child’s life.  The end goal is for your child to become more comfortable when participating in recreational activities with his friends or classmates. The added bonus is usually a boost in self confidence, which we all know can have an enormous impact on your child’s life. 

What are examples of recreation services activities?

Rec therapy can focus on his hobbies, sports or games. They can take place in school or at a community center, indoors or outdoors, or at another place appropriate for your child’s needs. Some school systems even have arrangements for children to receive therapy at local park programs.

What else can RT include? 

Your child may need to learn how to “warm up” before playing a game, or conversely he may need to learn how to channel his energy as he plays. He may need help in navigating his body in space as he plays a sport, or need assistance in learning how to wind down and relax.  Maybe a sudden injury makes it necessary for him to learn how to adapt to his disabling condition. Special adaptive recreation equipment may be necessary to help your child participate in a particular leisure activity.

The therapist may incorporate all sorts of games, sports, dance, creative movement, music, and artistic endeavors such as crafts and acting into your child’s program.  Since RT is so pleasurable for your child, he may have an easier time participating and making progress. I know this was the case for my daughter. At first, I could not for the life of me understand how it was therapy - she was having such a good time!  She got to pick two classroom “buddies” to go with her, and they played all sorts of games in the gym and on the playground. This encouraged her to use her language with her friends and become more comfortable with the rules of games involving balls, running, etc. Over time, I saw definite improvements and watched her gain confidence and improve her skills. 

There are lots of facets to RT. For more information on how RT might be helpful for your child, see NICHCY’s excellent summary.

What should you do if you think your child could benefit from recreation services?

RT is one of the services a child may receive as part of related services. Like all related services, RT services needs to be based on your child’s individual needs as identified by his evaluation results. If your child is already receiving special education services, mention RT at your next IEP team meeting, or request an IEP meeting. Discuss your concerns with the team, and see if an assessment would be helpful. (Remember, parents are members of the team, and your child can be too, once he is old enough to participate.)

After an RT evaluation and discussion of your child’s individual needs, if the IEP team decides that RT should be included in your child’s program, specific goals are then added to your child’s IEP.  The therapist will begin working with your child either individually or in small groups. Remember, as part of related services, parents and educators may be given training on the effects of recreation therapy on your child’s education. This is so important! It ensures that skills are not taught in a vacuum, but are able to be “transferred” from one place to another (the playing field, school, home, etc.).

If your child does not currently have an IEP and you feel he could benefit from RT, see my prior posts on how to have your child evaluated for free if he is under 3 years of age or age 3 or older.

Who provides RT?

As in many other therapeutic fields, recreation therapists are college graduates who receive a credential after taking certain courses and passing tests.  The organization that certifies recreation therapists is NCTRC, the National Council for Therapeutic Recreation.

Bottom Line

Your child’s non-academic or leisure activities are a very important part of his life. But often a child with delays or disabilities struggles with these activities. Isn’t it great to know that RT exists and is a part of the related services that can be provided to children who qualify?  Every little bit of help…helps.

Have questions? Send them to AskUs@marchofdimes.com.

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It appears every Wednesday, and was started on January 16, 2013. Feel free to go back to look at prior posts as the series builds on itself. As always, we welcome your comments and input.

Asked about back labor, Dr. Siobhan Dolan answers the question in her new March of Dimes book, Healthy Mom, Healthy Baby.

“Babies are usually face-down (looking toward the mother’s spine) as they move into the pelvis. But sometimes a baby is face-up (looking toward the mother’s belly) instead. This can cause intense back pain during labor and is called back labor. If you’re having back labor, your provider may try to rotate your baby by having you change positions, although that doesn’t always work. Sometimes babies rotate (either in response to a mother’s changed position or on their own), and sometimes unrotated babies are delivered face-up.”

Dr. Dolan’s book includes a section on coping with pain through relaxation techniques and with pain medications. It’s good to know about both options. You can read more about the book at this link.

Lots of communities around the country held March for Babies walks this past weekend.  Men, women and children participated in fun, frolicking and fundraising to support our mission to improve the health of babies by preventing birth defects, premature birth and infant death.

We are incredibly grateful to all of the thousands of sponsors, individuals and family teams who laced up their sneakers and walked, strolled, ran or danced down the road to help raise funds to help give every baby a healthy start. You rock!!!

We loved reading your tweets and seeing your great photos - keep ‘em coming! And to all of you who are walking in March for Babies events in the next few weeks, thank you for joining us, send us your pictures and have a fabulously fun day.