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Nov 29, 2009

Many Women Miscalculate Time to Full-Term Birth

Here is an insightful article written by Jennifer Thomas HealthDay Reporter, on the miscalculation of full term birth. Where 1 in 4 thinks it's as short as 34 weeks, potentially adding to preemie delivery rate.

Recent reports show that the rate of preterm deliveries continues to climb in the United States. Now, a new study suggests one reason why: Many women are confused about what constitutes a full-term birth in the first place.

About one-quarter of new mothers surveyed in the study considered a baby born at 34 to 36 weeks of gestation to be full term, while slightly more than half of women considered 37 to 38 weeks full term.

Though technically speaking, preterm births are babies born prior to 37 weeks, 39 to 40 weeks is optimal, according to the researchers.

Many women interviewed were also unaware that babies born even a little bit premature are at a higher risk of serious health problems compared to babies born at term, the new survey shows.

Misconceptions about what constitutes full gestation and how soon it's safe to schedule an elective induction or cesarean delivery are contributing to increasing numbers of premature births in the United States, said lead study author Dr. Robert L. Goldenberg, professor of obstetrics and director of research at Drexel University College of Medicine in Philadelphia.

"Clearly, the preterm birth rate is going up, as are early deliveries that are at term but are 37 and 38 weeks," Goldenberg said. "The data is becoming more and more clear that the outcomes of births at those earlier gestational ages are not as good as babies that are born at 39 or 40 weeks."

The study, which included 650 first-time mothers ages 21 to 45 from around the nation who had health insurance, is in the December issue of Obstetrics & Gynecology.

When asked, "What is the earliest point in pregnancy that it is safe to deliver the baby, should there not be other medical complications requiring early delivery?", more than half chose 34 to 36 weeks, 41 percent chose 37 to 38 weeks and less than 8 percent chose 39 to 40 weeks.

However, experts warn that any delivery short of 39 weeks puts a baby at higher risk of respiratory distress, sepsis (blood infection) and needing to be placed in the neonatal intensive care unit, according to background information in the study. Only one-quarter of new moms realized 39 to 40 weeks was safest.

Premature births are a growing problem in the United States. In fact, the percentage of babies born preterm rose by more than 20 percent from 1990 to 2006, according to a report released in November by the U.S. National Center for Health Statistics.

Technically, the World Health Organization and other major medical organizations define preterm births as babies born before 37 weeks. But that definition was developed some 50 years ago and is outdated, said Dr. Alan Fleischman, medical director for the March of Dimes.

More recently, studies have shown that babies born even a bit too early -- at 37 or 38 weeks -- have a greater chance of chronic respiratory disease and learning disorders than children born at 39 weeks or later.

Babies born between 34 and 37 weeks are six times more likely to die during their first week or life and three times more likely to die during their first year than babies born at 39 or 40 weeks, Fleishman added.

"Everybody knows a baby who has been born a bit early who has done pretty well," Fleischman said. "But what we've learned is that, going backwards, there is increasing mortality and morbidity for every week prior to 39 weeks of gestation."

Many experts now refer to babies born between 34 and 36 weeks as "late preterm," while babies born at 37 and 38 weeks are "early term."

The American College of Obstetricians and Gynecologists and the March of Dimes recommend against elective inductions or C-sections prior to 39 weeks.

In many situations, there is probably some medical reason for choosing to deliver early -- perhaps the mother has slightly elevated blood pressure, for example, Goldenberg said.

"I call them semi-electives," Goldenberg said. "I believe over the last 15 or 20 years, the practice is evolving to deliver those babies earlier and earlier when there is no evidence of benefits."

TV shows and news reports about very premature babies that survive may also be fueling misconceptions, Goldenberg said. Some women are left with the impression that if babies born before 30 weeks can survive, infants that are just a little bit premature should have no problems.

"Because the shows don't emphasize the bad outcomes at those ages, it's led not only women but doctors to conclude that by the time you get up to 34, 35 or 36 weeks, everything is fine," Goldenberg said. "But the recent research is showing it's not fine."

The last few weeks of gestation are critical to fetal development. All of the organs continue to mature in preparation for moving from the womb to the outside world, Fleischman explained. Between 35 and 40 weeks, the fetal brain grows by about 50 percent.

Educating expectant mothers and their physicians about the risk of preterm births may help women to make more informed decisions about when to schedule elective inductions and C-sections, Goldenberg said. That includes setting up hospital policies that discourage elective deliveries prior to 39 weeks and enforcing it through peer review to help curb the practice.

More information

There's more on preventing premature births at the March of Dimes.

Nov 27, 2009

Do dads belong in the delivery room?

Do dads belong in the delivery room? Here is a story on one doctor's opinion.

Many new fathers are nothing short of awe-stricken by the birth of their child, and cherish their baby's first moments shared with the mother in the delivery room. In fact, ever since Dr. Robert Bradley introduced the concept of husband-coached childbirth in the early 1960s, fathers have been routinely encouraged to be present at their children's births. Yet, now, in what is sure to stir up some fatherly frustration, to say the least, French obstetrician Michel Odent argues that fathers specifically, and men in general, don't have a place in the delivery room.

According to Odent, not only are fathers in the way, but because their presence often makes the laboring mother anxious, they may be interrupting the production of a hormone critical to the birth process. The slowed supply of that hormone, oxytocin, may even increase the chances that a woman will have to deliver by Cesarean section. Odent, who believes that the safest birthing environment involves only the mother and a skilled midwife, told the Daily Mail:
"If she can't release oxytocin she can't have effective contractions, and everything becomes more difficult... Labor becomes longer, more painful and more difficult because the hormonal balance in the woman is disturbed by the environment that's not appropriate because of the presence of the man."

Odent will argue his views this week at a forum hosted by the Royal College of Midwives. He will be challenged in a debate by Duncan Fisher, an advocate for fathers, who believes that men should defer to the women's desire to have them in the room.
Yet, even before the debate, Odent's controversial perspective is likely to generate some opposing views, including those from fellow physicians who suggest that recent increases in C-section deliveries have no correlation with dads being in the delivery room. As Patrick O'Brien of the U.K.'s Royal College of Obstetricians and Gynaecologists told Clare Murphy with the BBC:
"What we do know is that there are many reasons why the number of emergency cesarean sections has risen—including obesity, older mothers, and fear of litigation—none of which have anything to do with the presence of dads."

And while the birthing process has been known to make a few men feel squeamish (or even terrified), whether or not they are in the room should be a decision left to the fathers- and mothers-to-be, O'Brien says. He also told the BBC:
"Having a baby together is an intense, life-changing experience that most couples want to experience together. The father can be an immensely reassuring presence for the mother... And as for the suggestion that men won't cope with the so-called gore - well, most of his role can be carried out at the head-end, talking, mopping her brow, offering sips of water. Of course a man shouldn't feel forced to be there, but I have yet to meet one who said after the birth of his baby - 'I wish I'd stayed at home'."

Toddler Helps His Mom Give Birth.

OLIVE BRANCH, Miss. (Nov. 19) -- A 2-year-old in north Mississippi has done something few toddlers can: He helped his mother give birth to his brother.

Bobbye Favazza told The Commercial Appeal she went into labor Friday and gave birth on the family's living room couch in Olive Branch. She said her toddler, Jeremiha Taylor, got her a towel and caught the baby before firefighters arrived to cut the umbilical cord.

Favazza gave birth to a 7-pound, 4-ounce baby boy, Kamron Taylor. She had been scheduled for a Cesarean section Dec. 6. Not only was Kamron's timing a surprise, but Favazza had been told she was carrying a girl.

City emergency services supervisor Greg Mynatt said the 911 call about Favazza was probably the third this year about a woman in labor, but usually the mother makes it to the hospital before delivery.

Embedded video from CNN Video

Nov 9, 2009

New Study Says Cancer Can Pass from Mom to Womb A new study has provided genetic evidence for the first time that it is possible for a mother to transmit cancer to her unborn child via the placenta.

wikimedia commons
Cases have been reported on rare occasions where a mother and newborn child develop the same cancer, but there has never been proof until now that the mother passed the cancer to the child. In theory it should not be possible, since the infant's immune system should destroy the cancer cells.

The team of British and Japanese researchers studied a case in Japan in which the 28-year-old mother developed leukemia shortly after giving birth to a daughter. Eleven months later the baby developed a cancer with the same genetic markers as her mother's cancer cells.

Using advanced genetic fingerprinting techniques, the scientists were able to prove the leukemia cells in the baby were present at her birth, and that they could only have come from the mother, since the cancer cells had an identical mutation in the cancer gene BCR-ABL1.

They also looked at how the cancer cells from the mother could have avoided being destroyed by the infant's immune system, and discovered that the baby's cancer cells lacked part of the DNA that would have indicated to the immune system the cells were foreign. The leader of the team, Professor Mel Greaves of the Institute of Cancer Research in Sutton, UK, said the cancer cells were in effect invisible to the immune system and therefore were able to implant without being attacked.

The transfer of cancer from mother to unborn child is rare, with only around 30 cases known, and the mother usually has a melanoma or leukemia. Professor Greaves stressed that even if the mother has cancer it is still extremely unlikely she would pass it on to the child, but if pregnant women with cancer are concerned, they should seek the advice of their specialists.

Chief Clinician at Cancer Research UK, Professor Peter Johnson, said the research was important because it shows that for cancers to grow they need to elude the immune system. This means we might be able to develop new treatments that help alert the patient's immune system to the presence of cancer.

The research findings are published in the Proceedings of the National Academy of Sciences.

© 2009

Nov 3, 2009

Dr Oz's Children Will NOT be Receiving H1N1 Vaccine!

Four Perspectives on the H1N1 Virus and Vaccine

The following article is taken from Healthy Child, Healthy World. It has become especially important with the pandemic spread of the H1N1 virus. Parents are scared and I want to help. I don’t have a recommendation for whether you should vaccinate or not, but I do believe you should have easy access to expert insights that can help you make an informed decision. Here are four perspectives you should take into consideration.

Dr. Robert Sears:

Dr. Sears’ position on the issue is emblematic of the entire discussion. He states that in general, he doesn’t “have a recommendation one way or another.” He acknowledges H1N1 to be a serious illness that is potentially life-threatening, noting that “seasonal flu in the U.S. causes about 20 infant and 100 total pediatric deaths each year. The swine flu has so far caused 112 pediatric deaths.” In light of the 36,000 Americans who die of the flu every year, he believes that “the shot helps protect against the flu and lowers this risk.” But he also acknowledges the risk inherent, stating that “there hasn’t been a lot of research on safety and efficacy of flu shots”.

Though that fact is less than a comfort to both patients and physicians, Dr. Sears doesn’t “see any reason to doubt that our immune systems won’t respond to this vaccine the same way they respond to regular flu shots.” He also covers potential side effects, which he doesn’t predict to be any different from those experienced from regular flu shots.

So what really concerns Dr. Sears then?

“(W)hat I DO worry about is that infants will be getting FOUR (count them, FOUR) flu vaccines this year – two doses of the regular one, and two doses of the swine flu vaccine. That’s unprecedented. We’ve never given anyone four doses of a flu vaccine in one year.

There is no way to predict what the side effects might be.” His other major concern is that despite a complete lack of testing to determine if there is any harm to fetuses or young babies, both the regular flu and H1N1 vaccines are recommended unequivocally for pregnant and nursing mothers.

He advises getting the shots alone, as far apart as you can from any other shots. And he urges parents “to delay any vaccines for diseases that don’t pose an immediate danger to a baby’s or child’s life and catch up on those vaccines in February or March, a couple months after finishing the flu vaccines.” Consult your physician for which diseases pose an immediate risk and which can be delayed.

Dr. Jay Gordon:

Dr. Gordon seeks to quell the widespread alarm about H1N1 and discourage a knee-jerk impulse to vaccinate. He advises that winter flues are unavoidable, and integral to strengthening proper long-term immunity. “Children, in particular,” he says, “must suffer through a lot of winter illnesses because their immune systems are so inexperienced. New viruses get more people sick than older ones and this year the H1N1 virus is the newest common infection.”

Dr. Gordon believes the media are responsible for creating more anxiety about winter illness than at any time in recent memory. They are taking advantage of this situation to drive up TV viewership, increase web page visits, and sell more newspapers, he says, citing the SARS scare, the Bird Flu scare, and the West Nile Virus scare as examples.

He also includes the potential mortality risk as part of a broader scare tactic:

“The CDC released fatality data this past week and were quite clear in their assessment of this relatively non-virulent strain of influenza: 75-80% of the 76 children had significant or severe underlying medical problems.

Any child's death creates an extremely difficult public discussion but of the 300,000,000 Americans there are 45,000,000 children and teens and there have been 76 deaths of younger people. About 15 of these deaths occurred in seemingly healthy children and teens.

Please put all of these numbers in the proper perspective and realize that there are many important lifesaving topics for the media to publicize but none which sell papers and create TV viewership quite as well as this new flu…the science is terrible but the publicity is geared towards increasing fear, selling vaccines and Tamiflu and keeping us all on edge.”

He does not predict disaster from this year's pair of flu vaccines, but doesn’t think that they're a good use of our health care dollars, saying, “They are definitely not worth the amount of media and medical attention they've received and continue to receive.”

Jackie Lombardo, Sierra Club National Toxics Committee and

Ms. Lombardo brings up questions about levels of mercury in the vaccine, and the contentious use of the preservative thimerosal. She provides a comprehensive breakdown of all of the ingredients used in the four different manufactured versions of the vaccine, and confirms that some do contain thimerosal, which is 49% mercury by weight.

The dangers, especially the risk of brain damage, associated with mercury are well established in scientific literature. So concerns over mercury exposure for infants, children, and pregnant women are no small matter. She points out that, “reviews in the medical journal The Lancet found a lack of health benefit of the seasonal flu vaccine for children under two and significantly increased rates of vaccine related adverse events in children.”

She recommends reading the package inserts very carefully, paying special attention to risks and safety studies, and insisting on a mercury-free version if you decide to get the shot. Refer to her complete list of ingredients before getting vaccinated.

Dr. Greene:

Dr. Greene emphasizes how little we know about the potential severity of the H1N1 flu, but he does believe it’s likely to be several times worse than usual flu season illness, with children, college and grad-school age adults and pregnant women most vulnerable. Interestingly, he points out that boys who catch H1N1 seem to get a lot sicker than the regular flu.

Overall he feels positively about the prognosis for the vaccine, though he admits that we don’t know the whole story. Though no serious side effects have been noted so far, he warns, “I expect we'll see some side effects emerge when larger populations are immunized. After all, if we gave enough people bananas or spinach we would see a few serious side effects and allergic reactions.” But he does feel that the benefits outweigh any risks.

He also quells a persistent rumor: that people will get the flu from the H1N1 vaccine. Not true, he says: “Unlike some other vaccines, this one is not a live virus; it's bits and pieces that recombine in the body and then prompt it later recognize and attack the flu virus.”

He prefers the versions with no added mercury as a preservative (the ones that come in single dose vials), and he reminds parents that no infants under 6 months should get the vaccine.

What You Can Do:

1. Carefully consider all of the perspectives we’ve presented here. Consider your child’s unique risks (e.g. children in day care are more at risk for catching H1N1 than children who are at home most of the time). Make an informed choice for your child. Unfortunately, the fact of the matter is that you’re taking a risk either way.

2. Stay as healthy as possible during flu season. Use our 10 Tips for Flu Season Super Defense, and practice vigilant but common sense prevention.

3. If you’re feeling ill, use Microsoft Health Vault's at-home tool designed to help people decide whether their symptoms indicate heading to a clinic or hospital or staying home in bed. This may help alleviate the strain on hospital emergency departments and help limit the number of people exposed to this life-threatening illness.

4. Still have more unanswered questions? The New York Times recently ran a comprehensive Q&A that covers more obscure concerns.

Editor's Note: Dr. Greene's quote says that the vaccine does not contain a live virus. This is true for the shot, but not for the nasal mist - which does contain the live virus.

10 flu-fighting foods

Got the sniffles?

Buried in the controversy over whether to get the H1N1 vaccination (or even where to find one), is that one of the best ways to ward off any flu is to build up your overall immunity. Dave Grotto, author of 101 Foods That Could Save Your Life, reveals 10 foods that provide top doses of the vitamins and nutrients you need to protect and defend against illness.

Mushrooms used to get overlooked as a health food, but they possess two big weapons you need this flu season: selenium, which helps white blood cells produce cytokines that clear sickness, and beta glucan, an antimicrobial type of fiber, which helps activate “superhero” cells that find and destroy infections.

Fresh garlic
Strong smelling foods like garlic can stink out sickness thanks to the phytochemical allicin, an antimicrobial compound. A British study found that people taking allicin supplements suffered 46 percent fewer colds and recovered faster from the ones they did get. So start cooking with it daily — experts recommend two fresh cloves a day.

Wild-caught salmon
In a recent study, participants with the lowest levels of vitamin D were about 40 percent more likely to report a recent respiratory infection than those with higher levels of vitamin D. Increase your intake with salmon, a 3.5-ounce serving provides 360 IU – some experts recommend as much as 800 to 1000 IU each day.

Researchers at Harvard University found that drinking five cups of black tea a day quadrupled the body’s immune defense system after two weeks, probably because of theanine. Tea also contains catechins, including ECGC, which act like a cleanup crew against free radicals. Grotto suggests drinking one to three cups of black, green or white tea every day.

The digestive tract is one of your biggest immune organs, so keep disease-causing germs out with probiotics and prebiotics, found in naturally fermented foods like yogurt. One serving a day labeled with “live and active cultures” will enhance immune function according to a study from the University of Vienna in Austria.

Dark chocolate
Nutrition experts agree that dark chocolate deserves a place in healthy diets, and a study published in the British Journal of Nutrition says it can boost your immunity, too. High doses of cocoa support T-helper cells, which increase the immune system’s ability to defend against infection. Sweet!

Zinc is critical for the immune system — it rallies the troupes, or white blood cells, to attack bacteria and viruses like a flu or cold. One medium oyster provides nearly all of the zinc you need for a day, while a portion of six gives you over five times the recommended amount.

Heart-healthy almonds boast immune-boosting antioxidant vitamin E, which can reduce your chance of catching colds and developing respiratory infections according to researchers at Tufts University. You’ll need more than a serving of almonds for your daily dose though, so try fortified cereals, sunflower seeds, turnip greens and wheat germ, too.

Even though vitamin C-rich foods (hello oranges!) are probably the first thing you think of when you feel a cold coming, Grotto says the illness-preventing power of the antioxidant is debatable. That said, some studies show it can reduce the intensity and duration of cold and flu, so it’s worth a try. One cup of strawberries provides 160 percent of your daily needs.

Sweet potato
Beta-carotene improves your body’s defenses. It’s instrumental in the growth and development of immune system cells and helps neutralize harmful toxins. Sweet potatoes and other orange foods like carrots, squash, pumpkin, egg yolks and cantaloupe are top sources.

Prenatal Education and Yoga Series

Pregnancy is a profound journey and a meaningful time to commit to a practice of self-nurturing. Yoga Goddess offers a prenatal class unlike any other because it includes practical labour preparation, prenatal yoga poses, and calming meditations in each class - so you're preparing physically, emotionally and spiritually for childbirth.

The next 4-week sessions begin on:
Tuesday October 20th
Tuesday November 17th
Tuesday January 12th

Classes take place at the gorgeous ravine studio called The Yoga House at Danforth and Coxwell.

Follow this link to learn more and register on line: