News Moms Need

The U.S. preterm birth rate dropped for the fifth consecutive year in 2011 to 11.7 percent, the lowest in a decade, giving thousands more babies a healthy start in life and saving billions in health and social costs.
 
Four states – Vermont, Oregon, New Hampshire, and Maine earned an “A” on the March of Dimes 2012 Premature Birth Report Card as their preterm birth rates met the March of Dimes 9.6 percent goal. Although, the US preterm birth rate improved, it again earned a “C” on the Report Card.

The US preterm birth rate peaked in 2006 at 12.8, after rising steadily for more than two decades, according to the National Center for Health Statistics. It dropped to 11.7 in 2011, the lowest in a decade.

All this improvement means not just healthier babies, but also a potential savings of roughly $3 billion in health care and economic costs to society, said Dr. Howse, President of the March of Dimes. About 64,000 fewer babies were born preterm in 2010, when compared to 2006, the peak year.

Dr. Howse attributed the improved rates to an expansion of successful programs and interventions, including actions by state health officials in 48 states, the District of Columbia and Puerto Rico, who formally set goals to lower their preterm birth rates 8 percent by 2014 from their 2009 rate, based on a challenge issued in 2011 by the Association of State and Territorial Health Organizations. On the 2012 Report Card, 45 states, the District of Columbia, and Puerto Rico saw improvement in their preterm birth rates between 2009 and 2011, earning 16 of them better grades.

The largest declines in premature birth occurred among babies born at 34 to 36 weeks of pregnancy, but the improvement was across the board. Every racial and ethnic group benefitted, and there were fewer preterm babies born at all stages of pregnancy.

The March of Dimes “Healthy Babies are Worth the Wait” campaign urges health care providers and patients not to schedule a delivery until at least 39 completed weeks of pregnancy, unless there is a medical reason to do so. Many important organs, including the baby’s brain and lungs, are not completely developed until then. The U.S. Department of Health and Human Services “Strong Start” initiative is partnering with the March of Dimes to raise awareness about the importance of a full term pregnancy through paid advertising support and collaboration with hospitals to improve perinatal care.

The March of Dimes Report Card compares each state’s preterm birth rate to the March of Dimes goal of lowering the rate to 9.6 percent of all live births by 2020. The Report Card information for the U.S. and states is available at this link.

The Apgar Score is well-known, even to those with only passing familiarity of hospital delivery rooms and birthing centers. Yet to summarize Virginia Apgar’s entire career in the scoring system that measures a baby’s heart rate, respiration, muscle tone, reflexes, and color is much like trying to scale Mount Everest from one’s backyard. True, the Apgar Score is a standard clinical procedure that protects the lives of babies, but how does it fit in with Dr. Apgar’s other achievements?

Virginia Apgar, MD (1909-1974) was an obstetrical anesthesiologist who joined the March of Dimes to expand her outreach as an advocate for mothers and babies. She became a pivotal figure in helping to redirect our mission to birth defects prevention in the 1960s. In fact, she was the first medical leader at the March of Dimes to recognize prematurity as a serious problem that demanded a strengthened focus on the importance of early prenatal care.

At a time when fetal monitors were not yet invented and babies were given scant attention after delivery, Dr. Apgar questioned how best to evaluate the newborn infant to improve health and survival rates. With years of experience observing the effects of anesthesia on mother and child, she created a simple five-point scoring method designed to focus attention on the newborn to check its vital signs. Later, at the March of Dimes, she initiated a program for rubella immunization and insisted on making genetic history and pregnancy history a routine part of medical record-keeping on the pregnant mother. And, she always believed it a primary responsibility to remove the stigma of birth defects in her educational outreach.

In 1960, less than a year after joining the March of Dimes, Dr. Apgar participated in a prematurity prevention symposium in Pittsburgh. Thereafter, she continued to educate both the medical and lay communities about prematurity as she brought the problem to the forefront of her work to prevent birth defects. The Apgar Score, as the first clinical method to recognize the newborn as a patient, stimulated research in the prevention of birth defects, but Dr. Apgar’s larger achievement included a holistic perspective on pregnancy and infant health that did not fail to recognize the problem of premature birth. One could easily say that Virginia Apgar was the “founder” of prematurity as an essential part of the March of Dimes mission.

Virginia Apgar was an irrepressible and charismatic champion for babies whose wit and lively personality captivated everyone she encountered in her constant quest for improvements to infant health. She was a caring, enthusiastic physician with super-abundant energy, and she was always ready to explain to anyone who would listen why it is so important “to be good to your baby before it is born.”

About 1 out of every 3 children lives in a home where someone smokes regularly. Children exposed to secondhand smoke are at increased risk of lots of problems like sudden infant death syndrome (SIDS), ear infections, colds, pneumonia, bronchitis, severe asthma, headaches, sore throats, dizziness, nausea, lack of energy, and fussiness. And the younger the child, the greater the risk is.

Secondhand smoke is made up of two things:
• The smoke given off by the burning end of a cigarette, pipe or cigar
• The smoke exhaled by the smoker
Secondhand smoke is also called passive or involuntary smoking. It contains over 250 harmful chemicals; about 50 of these can cause cancer.

What you can do to protect your child from secondhand smoke:
• If you or someone in your house smokes, stop! Talk to your employer or health care provider; they can refer you to a low-cost program that will help you quit.
• Visit the Web site smokefree.gov for tips and tools to help you quit.
• If you smoke and plan to breastfeed your baby, stop smoking. Breastmilk from women who smoke contains chemicals that are dangerous to babies.
• Don’t let anyone smoke in your home or your car, especially when children are present.
• Remove ashtrays from your house. They can encourage people to light up.
• Store matches and lighters out of the reach of children.
• When choosing a baby-sitter or child care worker, be sure he or she does not smoke around your child.
• When you’re in public with your baby, ask others not to smoke around you and your child.
• Don’t go to restaurants that allow smoking.

For more information, read “How can secondhand smoke harm my child?” from the American Academy of Pediatrics.

Before your baby leaves the hospital, she gets her first checkup to make sure she is healthy. Here are some of the tests and treatments she receives.

• Apgar score - At 1 minute and 5 minutes after birth, a doctor or nurse checks you baby for five things: Heart rate; Breathing; Muscle tone; Reflexes; and Skin Color.  Each gets a score of 0 to 2. The total score is called an Apgar score. If your baby has a score of 7 or more, she is in good shape! If she has a score less than 7, she probably is fine but she made need some special care.
• Vitamin K shot. Vitamin K can help your baby’s blood clot and protect her from bleeding problems. She gets this shot right after birth.
• Eye drops or ointment to help protect the eyes from infection.
• Complete physical. A health care provider checks your baby out from head to toe. He listens to her heart and lungs, feels her tummy, checks her eyes, nose, mouth, head, arms and legs. He gives her a hepatitis B shot. This is a vaccine to protect your baby from hepatitis B, a virus that can cause problems in your baby’s liver.
• Blood test – Every state and U.S. territory routinely screens newborns for certain genetic, metabolic, hormonal and functional disorders. 
• Hearing test – A small microphone is put in your baby’s ear and plays soft sounds. Early identification of hearing loss in the newborn allows the baby to be fitted with hearing aids before 6 months of age, helping prevent serious speech and language problems in the future.

During her first year, your baby will see her health care provider regularly for well baby visits.  This is the medical care you get for her when she’s not sick. Her checkups let the health care provider make sure she is growing and developing correctly. In the first year, your baby should get a checkup at 2 weeks, months 1, 2, 4, 6 and 9, and at 1 year.
 
Take your baby for these checkups even if she’s doing great and isn’t sick.

The March of Dimes commends the Institute of Medicine for its thoughtful recommendations in the report released yesterday, “Clinical Preventive Services for Women: Closing the Gaps.” If adopted by the federal government, these recommendations will have a significant impact in improving the health of women, infants and children.

Dr. Jennifer Howse, President of the March of Dimes, said “the March of Dimes is pleased that the panel affirmed our recommendations that insurers be required to cover, without cost-sharing, prenatal and preconception care, as well as all contraceptives approved by the Food and Drug Administration. The March of Dimes also commends the panel for recommending coverage of the services of lactation consultants and rental fees associated with breastfeeding equipment.

“The March of Dimes strongly supports the panel’s recommendations for mandatory coverage of routine prenatal care for pregnant women. Prenatal services should include not only physical examination and specific tests but also counseling on nutrition and tobacco cessation.” Last week, a comprehensive systematic review of all studies over the past 50 years demonstrated that tobacco use during pregnancy is linked to higher rates of birth defects. Given that up to 14 percent of U.S. women report smoking during pregnancy, these counseling services are critical to healthy pregnancies and healthy babies.

With regard to contraception, numerous studies have shown that pregnancies spaced too closely together present a medical risk factor for preterm birth, the principal cause of newborn death. Appropriately spacing pregnancies — for which access to family planning services is critically important — has been shown to reduce the risk of preterm birth. The Institute of Medicine has estimated that the economic cost of preterm birth totaled at least $26.2 billion in 2005, the latest year for which data was available. The medical component of that total was $18.8 billion – 85 percent of which comprised health services provided to infants.

Dr. Howse made it clear that “the March of Dimes looks forward to supporting the panel’s recommendations as the U.S. Department of Health and Human Services considers their adoption.”

A new study has found that a simple saliva test can identify babies born with cytomegalovirus, CMV. Babies born with this common virus are at increased risk for hearing loss, vision loss or learning disabilities.

CMV is the most common congenital (present at birth) infection in the United States. Each year, about 40,000 babies are born with CMV infection. Most babies are not harmed by the virus, but some are. About 90% of babies who are infected with CMV have no symptoms at birth, and most parents aren’t aware that their children have it. However, about 10% to 15% of infected babies develop one or more lasting disabilities during the first few years of life. For this reason, all babies born with congenital CMV infection should have regular hearing and vision tests. An accurate newborn screening test would quickly identify those babies at risk.

According to Suresh Boppana, professor of pediatrics at the University of Alabama at Birmingham and lead author on the new study, somewhere between 20-40% of early childhood hearing loss probably is caused by CMV. The saliva test utilized in the new study, published Wednesday in the New England Journal of Medicine, was easy to perform and highly accurate. The researchers tested about 35,000 babies and the test was 97 percent accurate in identifying babies infected with the virus.

Newborns are screened for dozens of diseases and genetic disorders while still in the hospital. Dr. Boppana recognizes that adding another test to the current roster of newborn screening tests, which are determined by each state, will be no easy matter, but is optimistic.

Want to learn more about CMV? Please join us on Twitter for a live #pregnancychat on CMV on June 22nd at 12 noon, EST. We will be joined by Janelle Greenlee, President and Founder of Stop CMV - The CMV Action Network.  StopCMV.org

Pertussis, whooping cough, is on the rise. It can cause serious illness in infants, children and adults. The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever. But after 1–2 weeks, severe coughing can begin.

Pertussis can cause violent and rapid coughing, over and over, until there is no more air in the lungs and you’re forced to inhale with a loud “whooping” sound. In infants, the cough can be slight or not even there. But Pertussis is most severe for little ones. More than half of babies under the age of one year who get the disease must be hospitalized. About 1 in 5 infants with pertussis get pneumonia, and about 1 in 100 will have convulsions. In rare cases (1 in 100), pertussis can be deadly, especially in infants.

People with pertussis usually spread the disease by coughing or sneezing while they’re around others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by parents, older brothers and sisters, or other caregivers who might not even know they have the disease. (My 34 year old daughter actually had it last November!) Vaccination wears off, so it’s not safe to assume that the vaccine you received when you were young will protect you today.

The Sounds of Pertussis Campaign launched Race to Blanket America, an effort to blanket the country with pertussis education and encourage adults to get vaccinated against pertussis. The centerpiece of the Race to Blanket America is the Sounds of Pertussis Protection Quilt, which symbolizes how those closest to babies can help create a “cocoon” — a blanket of protection — around the tiniest members of their family by getting an adult and adolescent tetanus, diphtheria and acellular pertussis (Tdap) booster vaccination. Learn more and talk with your provider about getting your booster.

You may remember our past posts on the importance of giving babies their vitamin D supplements. This is especially true for breastfed babies or babies that eat less than 1 L/day of infant formula. Vitamin D helps prevent a bone-weakening disease called rickets. Babies can get this important nutrient from vitamin D drops.

The Food and Drug Administration (FDA) wants parents to make sure they’re giving babies the right amount of vitamin D drops. Babies need 400 international units (IU) of vitamin D per day. But some vitamin D supplements may be sold with droppers that could allow for parents to accidentally give too much Vitamin D to their babies. Too much vitamin D may cause things like nausea and vomiting, loss of appetite, excessive thirst, frequent urination, constipation, abdominal pain, muscle weakness, fatigue and other health concerns.

The FDA is working with manufactures to ensure vitamin D supplements for infants are sold with droppers that hold no more than the recommended amount for babies. In the meantime, when giving your baby her daily vitamin D drops, be sure you’ve filled the dropper to no more than 400 international units (IU). Visit the FDA Web site for more information. Learn more about vitamin D and breastfed babies.

The nation’s preterm birth rate dropped for the second consecutive year. New nationwide statistics show a 3 percent decline in the preterm birth rate, according to a report released today by the National Center for Health Statistics. March of Dimes officials say they are encouraged and hope that the decline is a new trend in infant health. The data are based on 99.9 percent of U.S. births and the improvement must be confirmed in the final data.

“We’re beginning to see the benefits of years of hard work by the March of Dimes and its partners.  This decline, although small, is heartening,” said Dr. Jennifer L. Howse, president of the March of Dimes.  “It means about 14,000 babies were spared the health risks of an early birth. We hope that this is just the beginning of what’s possible, and that efforts such as health care reform and our programs to make woman and their doctors aware of things they can do to lower the risk of a preterm birth will continue to bear fruit in years to come.”

Click here to read more.

Kids need vitamins to help them grow strong and healthy. But a new study in this month’s Pediatrics journal finds that nearly 7 out of 10 kids aren’t getting enough vitamin D. This is alarming because vitamin D is an important nutrient in preventing bone-weakening diseases in children as well as other health complications that can occur later in life, like diabetes, heart disease and cancer.

The study examined over 6,000 children aged 1-21 and found that kids who spent more time watching TV, playing video games or using computers and drank milk less than once a week were more likely to have lower levels of vitamin D.

The American Academy of Pediatrics recommends babies, children and adolescents get 400 international units (IU) of vitamin D per day. Babies who are breastfeed can get this nutrient from vitamin D drops.  Your baby’s pediatrician can and should prescribe multivitamin drops containing vitamin D to breastfed babies starting in the first 2 months of life.

Kids can get the right amount of vitamin D by eating foods that are fortified with vitamin D, taking a children’s multivitamin with vitamin D, and by spending some time playing outside in the sunshine (sunlight is a good source of vitamin D).