Holidays :) or :(

16
Apr
Posted by Barbara

family eating mealFor parents of kids with special needs, just getting through a routine day is often very challenging. If you throw in changes to routine, you could really be asking for trouble. But, it is springtime, and that means certain holidays are here – Passover and Easter. Are you traveling to visit grandparents or hosting family at your home? Eating new or different foods? Have a surplus of candy and chocolate at your disposal that may have  behavioral or digestive effects on your child? Are there unrefrigerated boiled eggs lying around the house tempting hungry kids? What do these changes mean to your child and are you ready to handle them?

No two kids are alike. Some manage the changes well and even blossom with the unexpected shifts in routine. Other kids have the opposite reaction and find that all these changes in their typical day are stressful and anxiety provoking. If this is the case for your child, here are some tips from parents to help get you through your holidays:

• Have a calendar where you clearly indicate what changes are upcoming (dinner at Aunt Joan’s, going to Church or Temple, wearing the new dress, eating chocolates), etc.

• Plan ahead so that your child knows what is coming next, especially if you are in someone else’s home or in a different town or city.

• Set up a reward system for positive behavior (such as putting a sticker on a chart for desired behaviors (sitting still, listening, etc.).  Every gold star counts! Be sure to let your child know when he has done something good and when he has earned his “prize.” Lots of praise works wonders.

• Only take your child to places you know he can handle. Holidays are not the time to spring unexpected excursions on your child. If you really want to fit in new experiences, don’t cram in too many at once.

• Build in quiet time wherever you are. Take along your child’s comfort toys/items so that he can be soothed as well as possible when away from the comfort of his own home. Often bringing your child’s pillow along can also work wonders.

• Bring along favorite snacks and food. Sometimes just the change in diet will cause constipation and intestinal distress, which will then cause your child to not be at his best. If you can keep his diet somewhat consistent, you are doing everyone a favor.

Remember, when you are stressed or anxious, your child will feel it and react. Be aware of how you are feeling and try to take a moment to assess your situation. Ask yourself – is this the right thing to do for my child and our family?  Then, trust your gut and do what works well. Chances are the result will be a happier child, which always makes for a happier family and a happier holiday.

Got any tips you can share? We’d love to hear from you.

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). We welcome your comments and input. If you have questions, please send them to AskUs@marchofdimes.com.

Time for sunshine and flowers… and bugs

15
Apr
Posted by Sara

flowersPesticides are chemicals used to kill or keep away insects and rodents. You can use some pesticides in your home. Others are for use only outside or on crops. With the warmer weather finally upon us, we get to enjoy flowers blooming, grass growing, and all those pests that also enjoy the springtime weather. So is it a good idea to use pesticides to get rid of these critters?

In her book, Healthy Mom, Healthy Baby, Dr. Siobhan Dolan states that “We don’t know for sure what effect pesticides have on an unborn baby. In some studies, high-level exposure appears to increase risk of miscarriage, premature birth, low birthweight, birth defects, and learning problems. Although pesticide use is regulated by the federal government, there is a lack of agreement over pesticides’ safety.”

If you are pregnant, it makes sense to avoid pesticides whenever possible.

If you need pest or rodent control in your home:
• Try to use traps, like mousetraps,  instead of pesticides. Be careful not to set traps in places where children can get to them. Stay away from rodents and have someone else empty the trap.
• Have someone else put the pesticide in your home. Ask them to follow the directions on the product label.
• Put food, dishes and utensils away before using the pesticide.
• If you need to use it, have someone open the windows to air out your home and wash off all surfaces where food is made after using the pesticide

If you use pesticides outside your home:
• Close all the windows and turn off the air conditioning. This helps keep pesticides in the air from coming into the home.
• Wear rubber gloves when gardening to avoid touching pesticides.
• And as tempting as it might be, try to avoid walking barefoot in the grass.

In certain areas, you may need to consider using an insect repellant. Insect repellants are products you put on your skin or clothes to help keep insects, like mosquitoes and ticks, away. This helps prevent insect bites.

Many insect repellants contain DEET (diethyltoluamide).  According to Dr. Dolan, “Recommendations from the U.S. Centers for Disease Control don’t tell pregnant women to avoid DEET. But it’s reasonable to stay away from it if you possibly can, unless you’re in a situation in which using it makes more sense than not using it. For example, if you’re camping in an area that’s crawling with ticks or buzzing with mosquitoes, applying insect repellent makes a lot of sense. In that situation, the risk of getting Lyme disease or West Nile virus, which can be harmful to you and your baby, outweighs any theoretical risk that might be posed by the insect repellent.”

You also can prevent bites by staying indoors in the early morning or late afternoon when mosquitoes are most likely to bite. Wearing long pants and long sleeves when going outdoors helps, too.

Latina health chat

14
Apr
Posted by Lindsay

Join us this Wednesday!

Be sure to use #WellnesWed to fully participate in the conversation.

WellnessWed Twitter Graphic

Could Aspirin help prevent preeclampsia in some women?

11
Apr
Posted by Ivette

Could Aspirin help prevent preeclampsia in some women? That’s what a panel of experts from the U.S. Preventive Services Task Force is suggesting in this month’s Annals of Internal Medicine. The panel reviewed research and evidence and found that low doses of Aspirin may help prevent preeclampsia in women who are at risk of developing the condition.

Preeclampsia is condition that happens when a pregnant woman has both high blood pressure and protein in her urine. With early and regular prenatal care, most women with preeclampsia can have healthy babies, but it can cause severe problems for moms. Without treatment, preeclampsia can cause kidney, liver and brain damage. It also may affect how the blood clots and cause serious bleeding problems.

No one knows what causes preeclampsia. But some women may be more likely than others to have preeclampsia. Some risks include:
• Having your first baby
• Having preeclampsia in a previous pregnancy
• Having a family history of preeclampsia
• Being pregnant with multiples (twins, triplets or more)
• Being older than 35
• Being overweight or obese

If you’re pregnant and at risk for preeclampsia, talk to your health provider. While the research may be promising, more needs to be done. In the meantime, don’t take any medicine during pregnancy without checking with your health provider first. Learn more about preeclampsia.

IEP reviews in April

09
Apr
Posted by Barbara

meetingIf your child has a disability and has an IEP, you may already know that April is usually the month when mandatory yearly reviews and IEP updates happen.

An IEP is short for Individualized Education Program. It is both a process and a written educational plan for a child with a disability,  age 3 and older. It is a document that lists all of the educational services that your child will receive, if he qualifies. Here is a quick review and resources to help you with the process. (See prior posts, for info on IFSPs for babies and toddlers.)

The IEP is:

INDIVIDUALIZED – specific for your child’s needs. It is not one size fits all.

EDUCATIONAL – it should look at three main areas of your child’s life:  the general education curriculum, extracurricular activities and nonacademic activities.

A PROGRAM or PLAN – all of the services your child will receive are laid out and detailed in writing.

What’s in an IEP?

The IEP may include special education, related services and/or supplementary aids and services. The IEP is first based on your child’s “present levels” which is a snapshot of your child’s function. In other words…what he is able to do now as compared to his non-disabled peers. Then, based on his present levels and his delay or disability, the IEP sets measurable annual goals.

The IEP should specify:

• Who will provide the service (eg. the speech therapist, regular ed teacher, special ed teacher, reading specialist, physical therapist, etc.).

• What kind of service will be provided, such as curriculum modifications or adaptations, the types of related services or aids- (eg. specialized reading curriculum, speech therapy etc.).

• Where the service will be implemented (eg. the regular ed classroom, playground, counselor’s office, etc.).

• When parents will receive reports on how well your child is doing. By law, you need to receive progress reports at least as often as children without disabilities. Often a school system will send home the IEP progress reports with Report Cards.

• When the goal will be achieved (eg. by the end of the marking period or by the end of the year).

• How the goal will be measured and how you will know the goal has been achieved (eg. a benchmark, such as a test score that shows if the goal has been reached).

Remember, an IEP is a living document that can be changed or updated by the IEP team, of which parents are members! It must be reviewed by the IEP team at least once a year, but it can be reviewed and updated more often if necessary.

Need more help?

A great place to go to understand your options and how to prepare for IEP meetings is on NICHCY’s website. In particular, you can find guidance on how an IEP team can write IEP goals. Keep in mind that NICHCY’s site will only be up until September 2014. Fortunately, you can find help by visiting your state’s Parent Training and Information Center (PTI), which is an information resource for parents of children with disabilities. Every state has at least one PTI. Each one has a different name. For example, one of the PTIs in California is named Matrix Parent Network and Resource Center while the PTI in New Hampshire is called the Parent Information Center. Whatever the actual name, each is commonly known as a PTI.

Some states also have Community Parent Resource Centers (CPRCs). CPRCs do the same work as the PTIs, but they focus on reaching underserved parents of children with disabilities, such as those living in a specific area in the state, those with low income, or those with limited English skills. Locate your state’s Centers  and read more about how PTIs and CPACs can help you.

You can also find excellent guidance on how to write IEP goals at Wrightslaw.

Lastly, review previous News Moms Need blog posts to zero in on where you need a refresher. Here is a Table of Contents of many prior posts, including several on IEPs.

Bottom line

April not only brings showers for May flowers; it is the month when most school systems begin reviewing and tweaking IEPs. With the resources in this post, you will be prepared and ready to play an active role in the process.

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). We welcome your comments and input. If you have questions, please send them to AskUs@marchofdimes.com.

Updated guidelines for water birth

07
Apr
Posted by Sara

Water birth is the process of giving birth in a tub of warm water.  A few weeks ago the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) released a joint committee opinion regarding laboring and delivering in water. In it they state that “Undergoing the early stages of labor in a birthing pool may offer some advantages to pregnant women. However, underwater delivery has no proven benefit to women or babies and may even pose a risk of serious health problems for the newborn.”

It is important to understand that the committee does make a distinction between laboring in water and delivering in water.  They acknowledge that there may be some benefits to being in the water during the early stages of labor. For women who have uncomplicated pregnancies, laboring in water may result in decreased pain, reduced use of anesthesia, and shorter labors. However there is no evidence that immersion in water during the first stage of labor otherwise improves perinatal outcomes. And being immersed in water during the first stage of labor should not prevent appropriate maternal and fetal monitoring.

However, the committee did express concerns about a woman actually delivering her baby in water. They found that “the safety and efficacy of immersion in water during the second stage of labor [delivery] have not been established, and immersion in water during the second stage of labor has not been associated with maternal or fetal benefit.”

After reviewing studies on water births they found a risk of severe complications in the newborn, including
•    maternal and neonatal infections, particularly with ruptured membranes;
•    difficulties in newborn temperature regulation;
•    umbilical cord rupture while the newborn infant is lifted or maneuvered through and from the underwater pool at delivery, which leads to serious hemorrhage and shock; and
•    respiratory distress that results from tub-water aspiration (drowning or near drowning).

While these complications of water birth may be rare, they are very serious. Until more thorough studies are done and the benefits of delivering in water to both mother and baby have been proven, both ACOG and AAP suggest that deliveries in water should be done in a research setting with mothers being fully informed about the potential risks and benefits.

C-sections, scheduling births and why healthy babies are worth the wait

04
Apr
Posted by Ivette

We’ve written a lot of posts about labor and, that if your pregnancy is healthy, it’s best to wait for labor to begin on its own. We’re glad that more moms know that having a healthy baby is worth the wait. But sometimes, it doesn’t hurt to have a reminder – not just for moms-to-be, but for everyone.

Both of my babies were late, especially my son. (He’s a true mama’s boy and I sometimes get the feeling that he would climb back in if he could!) I remember all of the frustration and discomfort I felt as I reached and went past my due date. But as uncomfortable as those last weeks were, it was a small sacrifice to make for my baby’s health.

If there are no medical reasons for either you or your baby to have a c-section or schedule your baby’s birth, then it’s best to wait for labor to begin on its own. And unless you have a medical reason for having a c-section, it’s best to have your baby through vaginal birth.

A c-section is major surgery that takes longer to recover from than a vaginal birth. And you’re more likely to have complications from a c-section than from a vaginal birth. A c-section can cause problems for your baby, too. Babies born by c-section may have more breathing and other medical problems than babies born by vaginal birth.

All this is to say that if your pregnancy is healthy and you’re thinking about scheduling your baby’s birth, consider the risks. And even though those last weeks can be very uncomfortable, your baby’s health is worth the wait.

Don’t delay with delays

02
Apr
Posted by Barbara

learning to walkEvery 4 ½ minutes a baby is born with a birth defect. Many other babies experience delays or disabilities as they grow up. In fact, “as many as one in four children through the age of five are at risk for a developmental delay or disability,” according to the U.S. Dept. of Health and Human Services.  The sooner a child is identified as having a condition that requires treatment, the sooner he may start receiving appropriate interventions and begin improving.  This sounds logical, right? Yet, many children with developmental challenges somehow don’t receive the help they need until much later.

When my daughter’s speech delay was evident, I asked her pediatrician “Should we wait a year and see if she grows out of it?” Thankfully, he said “Why would you wait?” His attitude was that if we started right away, there would be a chance that this small problem would not become a bigger problem later.  He was right.

If your child has a broken leg, would you wait to have it set? Of course not. If you did not intervene with the cast and crutches, your child would continue to suffer and perhaps get worse. The same is true with other types of disabilities or delays – early treatment is essential for improvement.

Good news: more help is here

The Birth to 5: Watch Me Thrive!  initiative was launched last week. It is a federal effort to encourage developmental and behavioral screening and support for children, families, and the providers who care for them. Yes, screening and intervention processes have been in place for years in the U.S. However, this initiative features a toolkit with an array of “research-based screening tools” to help pediatricians, parents, social workers, case workers, early care and education providers find help at the local level. The toolkit has resources to raise awareness about healthy development, recommended screening and follow-up practices. The Families page has info on developmental milestones, how to find services in your local area, tips and resources on positive parenting, and other helpful topics.

This initiative comes on the heels of the newly announced increase in Autism Spectrum Disorder (ASD) rates. Last week, the Centers for Disease Control and Prevention (CDC) released data that indicate ASD rates have risen to 1 in 68 children aged 8 years (which is up from 1 in 88). The CDC says that most children with ASD are diagnosed after age 4, even though ASD can be diagnosed as early as age 2.

What’s a solution?

Early diagnosis and early treatment.

As parents, you know your child best. If you have a suspicion that something is not right, don’t wait. Speak up and tell your child’s pediatrician. Learn about developmental milestones and see if your child is on track. If not, say something.

The Early Intervention program in the U.S. is here for babies and toddlers up to their third birthday. The Special Education program takes over for children ages 3 and older. The key is getting babies, toddlers and children identified as early as possible, and starting intervention. Find your local program for children up to their third birthday and request that your baby/child be screened for developmental delays or disabilities without a referral from a provider. And it is free to you. If your child is age 3 or older, request a screening from your child’s school.

Throughout my daughter’s childhood, I heard “Don’t wait” so many times – from doctors and specialists to special educators and therapists. As a result, we jumped on the therapy/intervention path right away, as each issue surfaced, and tackled each problem one by one (or often two by two). I am glad that I had the influence of professionals to prod and guide me along the way. The efforts certainly paid off for my child.

Bottom line

If you need to get help for your child, you now have more than enough resources to get going. The Birth to 5: Watch Me Thrive! initiative is there to set young children off on the right foot, and the Special Education program is there to continue to help kids up to age 21.  Hopefully, your child’s first steps will soon become leaps as you see him thrive. So, don’t delay with delays.

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). As always, we welcome your comments and input – send them to AskUs@marchofdimes.com.

Nacersano.org, our Spanish-language site

31
Mar
Posted by Lindsay

nacersano homepage

Hispanic women have babies at a greater rate each year than any other racial or ethnic group in the United States, making this population the fastest growing group. And now, Spanish-speaking women and families can easily find much-needed information on how to have a healthy pregnancy and a healthy baby online at nacersano.org.

Nacersano.org, the March of Dimes Spanish-language site, offers valuable information on the specific health needs of the Hispanic community, including on the importance of folic acid, a B vitamin that helps prevent serious birth defects of the brain and spine known as neural tube defects (NTDs).

Babies born to Hispanic women are about 20 percent more likely to have a neural tube defect than non-Hispanic white women. While this disparity is not well understood, one reason may be that Hispanic women have a lower intake of folic acid. In the United States, wheat flour is fortified with folic acid, but corn masa flour is not.

The March of Dimes, through its educational print and online initiatives, is working to raise awareness about the need for folic acid among Hispanic women. All women of childbearing age, whether or not they’re planning to get pregnant, should take a multivitamin with 400 micrograms of folic acid every day, beginning before pregnancy and continuing into the early months of pregnancy. This is the best way to get the recommended amount of folic acid to prevent NTDs. Eating foods rich in folate (the natural form of folic acid) or fortified with folic acid is another way to consume this essential vitamin.

Visitors to nacersano.org can find dozens of recipes from various Latin America cultures that provide at least 10 percent of the recommended daily amount of folic acid. Users can also submit their own folic acid rich recipes to the site.

“It’s such an easy thing to make folic acid a part of your daily routine, and it can provide a major benefit to your future family,” says José F. Cordero, MD, MPH, dean of the School of Public Health University of Puerto Rico and a member of the March of Dimes national Board of Trustees. “About half of pregnancies are unplanned, so women should take folic acid daily to give your babies the healthiest start in life.”

Nacersano.org also features hundreds of health articles, ovulation and due date calculators, and educational videos to help Hispanic women and families be healthy before, during and after pregnancy.

Visitors can also ask questions about folic acid and nutrition, preconception, pregnancy and baby health. March of Dimes health experts provide personalized answers by email within 48 hours in Spanish and English. Visitors can also sign up to receive monthly free newsletters on preconception and pregnancy health, read and comment on the blog, and stay connected through various social media channels.

So, if you’re more comfortable with the Spanish language, “like” us on Facebook.com/nacersano and follow us on @nacersano and @nacersanobaby on Twitter.

E-cigarettes, liquid nicotine and poisoning

28
Mar
Posted by Ivette

E-cigarettes from CDCMany things in this day and age have gone digital – even smoking. The latest trend is the fast-growing use of electronic cigarettes, or e-cigarettes. They look like regular cigarettes, but can be used more than once because they use rechargeable batteries. E-cigarettes have nicotine that comes as a liquid and can be refilled. Nicotine is a harmful drug that is found in cigarettes.

There’s been many reports of people, especially children, being poisoned from being in contact with liquid nicotine, either by accidentally drinking it or by spilling it and absorbing it through the skin. Liquid nicotine has powerful toxins and a small amount may be very harmful, even deadly. Liquid nicotine for e-cigarettes is sold in small vials that may be bright and colorful. Sometimes, liquid nicotine may have added flavors, like cherry or bubble gum. All of these things can make it appealing to children and may lead to accidental poisoning.

There isn’t enough research to know if e-cigarettes are safe. If you use e-cigarettes, be sure to keep them and any items used with e-cigarettes, like liquid nicotine, away from children. Store them in a secure place to keep everyone safe.