Pregnancy

All Articles in the Category ‘Pregnancy’

What Is The Tdap Shot? Seattle Mama Doc 101

Tdap is a shot necessary for all adults and children starting at age 11 that protects against infections caused by Tetanus, Diptheria, and Pertussis (Whooping Cough). Because of increasing reports of Whooping Cough and increased infant deaths in the last 2 years, we are working hard to protect infants, children, adolescents and adults from Whooping Cough (caused by Pertussis). Most importantly we want to protect our newborn babies from being exposed or contracting whooping cough. Whooping cough is most dangerous and most devastating (occasionally fatal) for newborn babies (under 2 months of age) and infants under the age of 6 months. If you are around a newborn baby it’s essential you’ve had a Tdap shot at least once as an adult. Watch the video for more.

Keep in mind, even fully vaccinated adults can get pertussis. If you are caring for infants or young children, check with your health care provider about what’s best for your situation.

What is Whooping Cough & How is it Treated (Link)?

WHEN TO CALL THE PEDIATRICIAN: Pertussis infection starts out acting like a cold. You should consider the possibility of whooping cough if the following conditions are present:

  • The child is a very young infant who has not been fully immunized and/or has had exposure to someone with a chronic cough or the disease.
  • The child’s cough becomes more severe and frequent, or her lips and fingertips become dark or blue.
  • She becomes exhausted after coughing episodes, eats poorly, vomits after coughing, and/or looks “sick.”

How To Protect Your Family From Whooping Cough

  • The best way to prevent Pertussis (Whooping Cough) is to get vaccinated.
  • Children 7 to 10 years old who did not have their full DTP/DTaP series (2,4,6, and 15 months shots) need a Tdap shot.
  • Children with either an unknown or incomplete shot record/history before age 7 years of age need a Tdap shot.
  • All adolescents with an up-to-date record need the Tdap shot at the 11 year old well child check-up/visit.
  • Anyone over age 11 who has not previously received Tdap – when indicated.
  • There’s no minimum interval between Td and Tdap vaccines. Meaning, if you for some reason had a Td (“tetanus booster”) in the last few years, you still need a Tdap now to protect against whooping cough(Pertussis). No 5-10 year interval is required between the shot.
  • Vaccine protection for pertussis, tetanus and diphtheria fades with time, so adults need a booster shot. Experts recommend adults receive a Td booster every 10 years and substitute a Tdap vaccine for one of the boosters.
  • Getting vaccinated with Tdap is especially important for adults who are around infants – new parents, grandparents, babysitters, nannies, and health care providers.

AAP Policy Statement on Using Tdap to prevent Pertussis

CDC: Protecting your family from whooping cough (Pertussis)

Formula, Breast feeding, And Solids

Here’s a response to some of the comments about the post I wrote earlier this week. As I’ve said before, I support parents feeding with breast milk and with formula. Studies like this aren’t designed to alienate parents who feed with formula. Take a listen. Here’s a post I wrote about the juggle/struggle to breastfeed while working. Ultimately, the goal of the Pediatrics study on timing of solids was to illuminate ways to improve obesity prevention. Not divide us or cause us to doubt ourselves.

If It Were My Child: No Baby Food Before 4 Months

Last week news of a study evaluating the timing of solid food introduction for infants emerged. It got a ton of press because the study evaluated the timing of solids on the likelihood of obesity at 3 years of age. Researchers divided babies into 2 groups, those that received partial or full breast milk until 4 months, and those that were weaned from breast milk and received formula exclusively before 4 months of age. Researchers then determined when babies were given solid food (rice cereal, biscuit, pureed “baby” food, etc) of any kind.

The results proved notable. Babies who received exclusive formula and solid foods before 4 months of age were 6 times more likely to be obese as a 3 year-old (defined as BMI over 95%, sum of triceps and subscapular skinfolds). This however, was not true for the babies that were receiving breast milk of any kind. So this study may not be applicable to many babies; in the US for example, 25% of infants are never breastfed and approximately half are breastfed for less than 4 months. Yet still, this sheds light on what we can do to help. Use this data when Grandma Trudy is urging you to feed your infant cereal at 3 months. Or why it’s best to wait until 4 months when you get excited about starting solids. Those of you who didn’t wait? Before you spin your wheels with worry about that bite of rice cereal you gave your baby at 3 1/2 months, read on. Because although, if it were my child, I wouldn’t give baby food before 4 months, there may be more to consider when it comes to timing. Read full post »

RECALL: Baby Monitors, Cords, and Strangulation Risk

The Consumer Product Safety Commission (CPSC) issued a recall on video monitors made by Summer Infant Inc today. Summer Infant makes over 40 models of video monitors. Look at their recall information if you have one, or call their information line Monday through Friday at 1-800-426-8627 for more information about getting a kit to secure the cord properly.

Recalls always make me feel uneasy; the photos accompanying recalls are often terrible to look at and the messages are impregnated with fear. As a mom and doctor, however, I tend to be reminded of things I can do to refresh the layers of safety I have at home for my children. I’m also reminded of the times I messed up. I end most 15, 18, and 24 month-old checks-up talking about our role as parents: to provide a safe and loving home for our children. I mean “home” in the greater sense, but also in the functional one. We need to create a place that allows for exploration. Our infants’ and toddlers’ curiosity is constantly expanding; and most importantly, their judgment lags behind their curiosity.  We have to have a safe place for them to mature. This recall can serve as a great reminder of ensuring your baby, toddler, or preschooler has no cords within 3 feet of their crib, bassinet, or bed. Strangulation can easily be prevented.

After two recent strangulation deaths, and one near strangulation (20 month old was found with cord wrapped around neck), the CPSC announced a voluntary recall of these products. And although most of us don’t have this particular model, most of us have baby monitors. Check your baby monitor (video or not) to make sure the cord is not within 3 feet reach of a crib, changing table, or the floor.

Video and audio baby monitors are designed to work when distant from your baby or child’s crib/bed. You’ll still hear that baby screaming when it’s parked across the room!

The American Academy of Pediatrics says:

Place your baby’s crib away from windows. Cords from window blinds and draperies can strangle your child. Use cordless window coverings, or if this is not possible, tie cords high and out of reach. Do not knot cords together.

As I said, I had MANY lapses in creating a perfectly safe environment for my boys. We moved a number of times during their infant/early toddler years and I remember realizing at one point after a move that I had the baby monitor (we didn’t have a fancy video one) too close to O’s crib. I’d rested it on the top of his crib rail one time after vacuuming. O was about 11 months-old and exploring every corner of the crib at nap time (read: not sleeping). Only when I heard (through the receiver) that O was playing with the monitor did I understand the mistake I’d made! I’d unnecessarily plugged the monitor into the same wall as the crib.  Eeeeps.

I moved the monitor to the other side of the room, about 6 feet away. Of course the monitor still worked fine. And yes, I felt a little stupid but I also wasn’t the only adult caring for my boys in our home. All of us had carelessly been using the monitor in that location. We all can use reminders…

As parents, we change rooms around, particularly with moves and new babies or transitions. Remember that all cords, those from blinds, monitors, and nightlights, need to be at least 3 feet from the crib and up out of reach of the floor. Using cordless blinds can be a great solution, too.

Do you remember a time when you realized you’d lapsed in creating a safe room for your child? Tell me I’m not alone…

Breast Feeding vs Formula: Mommy Sleep

Loved a study published today in Pediatrics. Researchers sought to determine if mothers who breastfed slept less than those who formula fed their babies. I hear lots of talk (at birthday parties to office visits) about how formula or rice cereal creates better infant sleepers. So far, science doesn’t back up these claims. But as every new mom (and dad) knows, sleep is the major commodity during your infant’s first 6-12 months. We really want our babies to sleep through the night. Desperately. Six weeks in, crying is at a peak for infants and mothers are utterly exhausted after a pregnancy, a labor/delivery, and a month or so of very fragmented and dwindling sleep. Not only are we at peace when our babies sleep, we often rest, too. Maternal rest is essential for familial functioning, enjoyment of a baby’s infancy, and simple recovery. Sleep is not just about feeling rested or perceiving that you get more (or less) sleep than the other baby’s mothers on the block. It is about wellness, too. The study asserts that, “a growing body of evidence shows that mothers may not, in fact, do fine with less sleep.” Maternal sleep may affect rates of postpartum depression and an infant’s emotional and cognitive outcome. Getting rest is something we actually CRAVE in the first few months of our baby’s lives. Sleep, at some point, has to be a priority.

Researchers in West Virginia wanted to figure out if mothers of formula fed babies got a better night of sleep compared to those who breast fed or partially breast fed. The motivation behind the study was to dispel any perceived disadvantage of breastfeeding. Before you get up in arms about how bad your night sleep was while breast feeding compared to baby Jane next door who was chugging formula, look at what they did. Sometimes understanding how a study was performed helps you interpret how much weight you put into the results. Read full post »

Why I Hate Sleep Positioners

I hate infant sleep positioners. They are not safe or helpful. If you have one or know a family/friend who uses one for their infant, throw it out. Trash compact it. Stomp on it. Cut it up in bits. This is one rare thing you should feel good about putting in landfill.

When I was first started in practice, I didn’t even know sleep positioners existed; I was shocked at how many parents told me they were using them. We are led to believe (by manufacturers) that positioners confer safety by keeping babies on their back. Since 1994, the Back to Sleep campaign has helped parents become vigilant (yes!) about putting babies to sleep on their backs. But after my sons were born, and while roaming the super-store aisles for bottles, crib sheets, overpriced silicon, and breast pads (oh the glory), I realized why parents get so confused.

In the infant sleep section, I found plenty of products designed for babies I would never recommend. Never. Sleep positioners, head positioners, comforter-like blankets for the crib, bumpers and stuffed animals. Many products went against what I was taught in my pediatric training and what I’ve learned thereafter. Like so many things in life and medicine, less is more. When asked about setting up a safe infant crib I say, “Boring, bare, basic.”

In 2005, the AAP (American Academy of Pediatrics) issued an updated guideline on the prevention of SIDS. Though the message has been effective, sleep positioners have persisted to sell. Two weeks ago, prompted by 12 deaths (over 13 yrs)  due to sleep positioners, the AAP reiterated their position citing the dangers from sleep positioners after the CPSC and FDA (photos seen here) sent out a warning. Even though these positioners go clearly against safety data and medical advice, companies have kept them on the market.

Why? Read full post »

A Spoonful of Bacteria For Baby?

I’m becoming more of a believer in giving children probiotics. Not for everything and not for everyone; I really don’t think we should put them in the water. Probiotics, essentially live “good” bacteria we use to supplement our diet (usually Lactobacillus Acidophilus in the US), are becoming more and more available and recommended by more and more physicians. The role microbes play in our health is a hot topic. Probiotics are thought to improve intestinal health by restoring/elevating levels of  helpful bacteria while concurrently diminishing the population of harmful ones. Bacteria in the intestine are a normal part of our digestive health, but population counts of  bacteria living in our gut may be altered by illness, antibiotic use, ingested/modified foods, or life circumstance. What we eat and where we travel to drink water, change what lives in our gut. Research also finds that which bacteria cohabitate on our bodies may impact other illnesses outside the gut like eczema, allergies, and/or asthma.

In children, probiotic supplements may promote recovery from acute diarrhea by decreasing the number of episodes of diarrhea & the number of days. They also may help prevent the development diarrhea when children are taking antibiotics. The reality is many decisions we make affect our populations of bacteria. This starts on the day of birth. We know for example that babies born by C-section have different populations of bacteria in their poop when compared with those babies born vaginally, within a week after birth. So from the very beginning, the choices we make (or our parents make) may change the environment in our bodies. This ultimately may change our wellness. A set of doctors studied the effect of probiotics on colicky babies… Read full post »

The Juggle: Working And Breastfeeding

ShadowA study in Pediatrics highlighting the importance of breastfeeding and the challenges for working moms was published earlier in 2009. Today, it circulated through a business journal and got some more attention.

I read the study today for the first time. Then I re-read it a number of times. I talk about breastfeeding with moms and parents in clinic on a daily basis. I certainly know the challenges of trying to breastfeed through a transition back to work. I also know how hard it is not to be able to do what you set out to do.

I had my go. With my first son, I saw about 9 lactation consultants in the first week. I am not exaggerating. Me with those women hovering over me trying to help while my little man screamed his head off. The beginnings of motherhood. I breast fed, finger fed, pumped breast milk, finger fed, breast fed, then pumped my way into a sleepless oblivion. Read full post »

Loving Number 2 Just Like Number 1: Prioritizing Your Pregnancy

Home pregnancy test

Before O (my second baby boy) was born I couldn’t really fathom loving him like I did, F (my first born).  I’m not alone in this, I know.  One of my friends recently told me she was so bewildered by the idea of number two that when she, her husband, her first son and her brand new baby were on the way home from the hospital, she leaned over from the passenger seat and whispered, “I’ll always love you best,” to her first born.  Whew.

It happened though.  Just like everybody told me.   I really love number 2. Read full post »