News Moms Need

Tuesday, March 26, is Diabetes Alert Day. It is designed to teach the public about the seriousness of diabetes, particularly when the disease is left undiagnosed or untreated.

Having gestational diabetes during pregnancy significantly increases a woman’s future chances of developing diabetes. About half will develop diabetes over the next 10 years. And the mom isn’t the only one at risk - her child of that pregnancy may be at an increased risk for developing obesity and type 2 diabetes later in life.

Find out if you’re at risk for type 2 diabetes by taking the Diabetes Risk Test and talking to your family about your family history of diabetes. If left undiagnosed or untreated, diabetes can lead to serious health problems including heart disease, stroke, blindness, kidney disease, amputation, and even death.

For more information and free resources, visit the NDEP Web site at YourDiabetesInfo.org.

There has been an interesting debate in the media lately about New York City’s Mayor Michael Bloomberg’s attempt to regulate the size of sugary soft drinks.  He says he is doing it for health reasons. Well, he is right that there is an enormous (all puns intended) portion of the population that is overweight in this country, and that’s a concern for everyone. 

Obesity leads to significant health problems. Being overweight or obese during pregnancy can cause complications for you and your baby. The more overweight you are, the greater the chances for pregnancy complications. You can read about many of the problems (infertility, miscarriage, stillbirth, high blood pressure, preeclampsia, gestational diabetes…) here.

It’s important to get to a healthy weight before you conceive. This way you’re giving your baby the healthiest possible start. Before you have a baby, take the time to get fit, exercise and eat healthy.  Cutting out the empty calories that do you no good is a good idea. It will be interesting to watch what happens in New York. What do you think?

Overweight and obesity during pregnancy can cause health problems for your baby. You know that it’s not great for your health, but it can affect your baby’s well being, too. While most babies of overweight and obese women are born healthy, problems can include:
• birth defects, including neural tube defects (NTDs) which are defects of the brain and spine
• preterm birth 
• injury, like shoulder dystocia, during birth because the baby is large 
• Death after birth
• Being obese during childhood

Dr. Patrick M. Catalano, a highly renowned obstetrician, professor and researcher has focused on nutrition and metabolic conditions before and during pregnancy and how those conditions affect a fetus’ growth and how much body fat it gains. His research has shown that infants born to obese mothers and mothers who have diabetes are heavier at birth and have a higher risk of developing metabolic disorders, including insulin resistance, a precursor to diabetes.

Dr. Kathleen Maher Rasmussen and her students broke new ground in understanding the threat being overweight at conception has on successful breastfeeding.  We know that breast milk is the best food for babies during the first year of life. It helps them grow healthy and strong. Dr. Rasmussen’s work on over-nutrition found that there is delayed onset of milk secretion and shorter breastfeeding in women who were significantly overweight.

If a woman starts pregnancy at a healthy weight, it can not only lower the risk of preterm birth and birth defects, but can give her baby a healthier start that can have life-long benefits.

Advertisements abound these days for weight loss programs and quick fix diets. Did you eat all your favorite traditional treats over the holidays and have a cup or two of cheer? I certainly did and am now feeling like it’s time to behave – time to swap the cookies for carrots, the fruitcake for fruit.

For those of you thinking about pregnancy, it’s especially important to get your weight under control before you conceive. To know if you’re overweight or obese, find out your body mass index (BMI) before you get pregnant.  BMI is a calculation based on your weight and height.

If you’re overweight, your BMI is 25.0 to 29.9 before pregnancy. Two in 3 women (66 percent) of reproductive age (15 to 44 years) in the United States is overweight.  If you’re obese, your BMI is 30.0 or higher before pregnancy. About 1 in 4 women (25 percent) is obese.

If you’re overweight or obese, you’re more likely than pregnant women at a healthy weight to have certain medical problems during pregnancy. The more overweight you are, the higher are the risks for problems. These problems include:
   • Infertility (not being able to get pregnant)
   • miscarriage (when a baby dies in the womb before 20 weeks of pregnancy)
   • stillbirth (when a baby dies in the womb before birth but after 20 weeks of pregnancy) 
   • high blood pressure and preeclampsia (a form of high blood pressure that only pregnant women get). It can cause serious problems for mom and baby.
   • gestational diabetes 
   • complications during labor and birth, including having a really big baby (called large-for-gestational-age) or needing a cesarean section (c-section).

Some of these problems, like preeclampsia, can increase your chances of preterm birth, birth before 37 completed weeks of pregnancy. This is too soon and can cause serious health problems for your baby. (We’ll talk about how mom’s weight issues can affect her baby’s health in tomorrow’s post.)

For those women who are severely overweight, some are turning to surgery. New studies suggest that weight-loss surgery may help protect obese women and their babies from gestational diabetes, high blood pressure, overly large babies and cesarean delivery during pregnancy.

So think about staying healthy and shedding those unwanted pounds before you get pregnant. Talk with your health care provider, find a plan that’s good for you and stick to it. You’ll have a healthier and more comfortable pregnancy when the time comes.

There can be many reasons why a woman might not get her period. For women who are sexually active and in their 20s or 30s, pregnancy is the first thing that pops to mind. If you’re in your 40s or 50s, it could be the beginning of the transition leading to menopause, or perimenopause. Whatever the reason, it’s important to find out why.

Extreme exercise can be a cause. Did you know that between 5% and 25% of female athletes work out so hard that they stop getting their periods? This is called exercise-induced amenorrhea. I had two friends, both avid runners, who were unable to conceive while they were in training and running marathons. Their intense exercise altered the manufacturing and releasing of reproductive hormones involved in the menstrual cycle. While still remaining active, my friends had to significantly dial back their exercise routines before they were able to have children. But both of them went on to have kids.

Another substantial body stressor that can affect the operation of reproductive hormones is a severely changed eating pattern. Women with eating disorders like anorexia nervosa are greatly altering their hormonal balance by depriving their body of nutrition. This can shut down a normal reproductive cycle.

Women who breastfeed often do not see the return of a normal period for many months. If that happens to you, don’t feel like you’re home-free in the contraception department. This lack of a period does not necessarily mean you’re not ovulating and it is possible to get pregnant during this time.

Medical conditions like problems with your uterus, polycystic ovary syndrome (PCOS), thyroid conditions or pituitary gland disorders, or problems with the hypothalamus can cause amenorrhea. Women who are extremely overweight or obese can lose their period.

If you miss your period for an extended period of time and aren’t sure why, check into it with your health care provider.

Of the four million women who give birth in the US each year, some 3,000 babies are born with neural tube defects, which include certain birth defects of the brain and spinal cord. Folic acid is a critical element needed for proper spinal cord development during the first three weeks of pregnancy. Because this is often before a woman even knows she’s pregnant, it’s important for women of child-bearing age to follow a healthy lifestyle and to include folic acid as part of their diet.

The Grain Foods Foundation has joined with the March of Dimes to remind all women of child-bearing age of the important role folic acid plays in preventing birth defects. Enriched breads – and many other grains such as rice, tortillas, pasta and cereal – are important sources of folic acid. 

• White flour is enriched with three major B vitamins (niacin, thiamin and riboflavin), as well as iron, and is fortified with the B vitamin folic acid.
• Enriched flour contains two times as much folic acid as its whole grain counterpart – making enriched grains the largest source of folic acid in the diets of most Americans. Whole grain products, with the exception of some breakfast cereals, are not fortified with folic acid.
• Since the FDA required fortification of enriched grains, the number of babies born in the U.S. with neural-tube birth defects has declined by 34 percent in non-Hispanic whites, and by 36 percent among Hispanics.

Grain foods are a delicious and nutrient-dense component of a healthy diet and have been shown to help with weight maintenance. In fact, people who consume a medium-to-high percentage of carbohydrates in their diet have a reduced risk for obesity. This is important for women of childbearing age as obese women who are pregnant have a significantly higher risk of needing a Cesarean section delivery, delivering too early, developing pre-eclampsia, and having an exceptionally large baby. They also face double the risk of stillbirth and neonatal death.

For a balanced diet, the USDA recommends at least six one-ounce servings of grains daily. Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain product. Bread, pasta, oatmeal and even tortillas and pretzels are examples of grain foods.

Macrosomia is a term that describes an unusually large baby, weighing more than 9 pounds 15 ounces.  Aside from genetic factors (others in the family are really big), one of the main causes of macorsomia is poorly controlled diabetes during pregnancy.  Increased maternal plasma glucose levels, as well as insulin, stimulate the baby’s growth.  Pregnant women who are obese are at increased risk of having an overly large baby.  If a baby goes way past its due date, it may be overly large.  Interestingly, more male babies are macrosomic than girls, and if you have had one overly large baby you may be at increased risk of having another large baby in a future pregnancy.  I know a guy who is one of four boys, each of whom weighed over 14 pounds!  I kid you not.

With a really big baby, there is the chance of having a difficult birth.  The mother may experience perineal tearing, significant blood loss, and even damage to her tailbone.  The baby’s shoulder may get caught behind the mother’s pubic bone causing a dangerous situation and a threat to both the mother and baby, including possible infant death.
 
Some doctors will plan a cesarean delivery if a woman appears to be carrying a very large baby.  Unfortunately, late third trimester ultrasounds are not particularly accurate at measuring the baby’s size and many planned, cautionary cesarean deliveries turn out to be unnecessary.  It is always important to go over the risks and benefits to both mom and baby when discussing a planned cesarean delivery.

If you are planning for a baby in you future, now is the time to get your weight under control.  If you have diabetes, be sure to manage it carefully so that it is as controlled as possible during your pregnancy.  If you have recently had a very large baby and had gestational diabetes, make sure your doctor tests you for diabetes a few months after delivery.  Up to 20% of women who had gestational diabetes end up with postpartum diabetes and will need to manage it.

It’s important to get to a healthy weight before you become pregnant.  If a woman is overweight or obese before pregnancy, she may face special health risks when pregnant (high blood pressure, preeclampsia or eclampsia, diabetes, problems during childbirth). Babies born to overweight or obese mothers may face their own challenges, too (risk of being born prematurely, certain birth defects, needing care in a NICU, possible obesity in childhood). Ask your doc or health provider for help in losing weight and getting to a safe starting point.

If you watch our video, you’ll learn what you can do if you’re an overweight or obese mom to protect your own health and the health of your baby.  “Pregnancy: The Overweight or Obese Woman” is part of the March of Dimes Healthy Pregnancy, Healthy Baby video series.

In the last few months, I’ve been trying to be more physically active and make healthier food choices. It hasn’t been easy, especially with all the weekend barbeques and summertime desserts (ice cream… yum). My goal isn’t so much to lose weight, but to live a healthier lifestyle so I can lower my chances of developing serious health conditions like diabetes or cardiovascular disease later in life.

Your body needs nutrients to give you the energy you need throughout the day. Most of these nutrients and calories come from the healthy foods you eat. Out of your daily calorie allowance, you also have a certain amount of “discretionary calories” or extra calories that you can use any way you want – maybe an afternoon snack or a small dessert after dinner (Learn more about discretionary calories). However, it turns out that many of us eat too many discretionary calories, and most of these come from drinks with added sugars (colas and other soft drink beverages).

The American Heart Association (AHA) made a new recommendation about the amount of added sugars we eat during the day. The organization recommends that most women have no more than 100 calories per day of added sugar. To give you a better idea, one can of regular cola has about 130 calories of added sugar, which is 30 calories more than recommended.

Instead of cola, why not try some sparkling water with a slice of lemon? That way, you can use your discretionary calories on something yummy.

Pregnancy really did a number on my bod.  My son gave me stretch marks, my daughter brought on spider veins in my legs (but they can appear on the face, neck chest and upper arms, too).  Spider veins are small blood vessels that are close to the surface of the skin.  They are red, purple or bluish and twist into web-like patterns, hence the name.  They don’t hurt, but I’m not crazy about the way they look.

Blood flows through the body in a complex of veins.  The flow is moving in one direction only because of a series of one-way valves. Contracting muscles help pump the blood through the veins to the heart.  If a valve breaks down, blood can pool in an area causing it to weaken, swell and twist.  If the vessels are smaller you may get a spider vein cluster in your smooth skin.  Larger vessels that twist, raise up and stand out like a cord against the rest of your skin are called varicose veins.  Both men and women can have spider or varicose veins, especially if you’re on your feet all day long, are obese, have had surgery to a leg or have family members with these beauties. Pregnancy with its increased blood supply also is a contributing factor and women are twice as likely to get them as men.  Great, huh?

You may not like the way they look but, actually, they don’t usually present a health problem.  It is possible, however, for them (especially varicose veins) to ache, throb, cause leg cramps, slow circulation that could lead to chronic problems and even skin sores.  Occasionally a painful blood clot can form.  In severe cases, varicose veins can be surgically removed.

Unless you have severe symptoms, most spider veins and varicose veins don’t need to be treated.  The easiest way to deal with any discomfort is to wear support hose, available in knee-high or full pantyhose styles.  Check with your pharmacist for brands he recommends.  If you’re overweight, try dropping some of those pounds.  Walking is a good way to do it and it helps with your circulation.  Watch your salt intake, too.  Lots of salt can make your body retain fluid, putting more pressure where you don’t want it.  If you’re sitting at a desk or table, don’t cross your legs because that can intensify circulatory problems.  When you’re sitting reading or watching TV, or if you’re sitting at a desk job for long stretches, be kind to your legs and put your feet up on a stool.

For those of you who really can’t stand the sight of your spider or varicose veins, there are different procedures to help get rid of them: laser therapy; sclerotherapy; vein surgery; endovenous laser treatment; radiofrequency ablation.  Speak with your doc for more info.