Saturday, June 30, 2012

Are You Getting Enough Calcium and Vitamin D?

Calcium and Vitamin D are vitamins that we have been told will prevent osteoporosis when we are older.  However, an "interesting draft recommendation statement" recently made headlines when the U.S. Preventative Task Force (USPSTF) recommended that "evidence is lacking regarding the benefit of daily supplementation with >400 IU of vitamin D3 and 1,000 mg of calcium for the primary prevention of osteoporotic fractures, and the balance of benefits and harms cannot be determined.  The USPSTF concludes with moderate certainty that daily supplementation with ≤400 IU of vitamin D3 and 1,000 mg of calcium carbonate has no net benefit for the primary prevention of osteoporotic fractures."  They based this recommendation due to the lack of studies showing the benefits of calcium supplementation in healthy post-menopausal women in preventing osteoporotic fractures.  There were, however, "adequate evidence that supplementation with ≤400 IU of vitamin D3 and 1,000 mg of calcium carbonate increases the incidence of renal stones. The USPSTF assessed the magnitude of this harm as small."

With this "draft recommendation statement," the USPSTF could not recommend 1,000mg calcium and ≤400 IU of vitamin D supplementation in healthy post-menopausal women due to the lack of evidence showing a benefit in preventing fractures in comparison to the "adequate evidence" that supplementation can increase the incidence of renal (kidney) stones.  This is a "draft recommendation statement" and not a final recommendation and is available for public comment until July 10, 2012.

I think many people are applying this recommendation to groups other than post-menopausal women.  As a pregnant and soon-to-be lactating woman, it is still recommended that I take 1,000mg of calcium and 600 IU of vitamin D daily.  All 1,000mg of calcium should not be taken at one time.  "The percentage of calcium absorbed depends on the total amount of elemental calcium consumed at one time; as the amount increases, the percentage absorption decreases. Absorption is highest in doses ≤500 mg [1]. So, for example, one who takes 1,000 mg/day of calcium from supplements might split the dose and take 500 mg at two separate times during the day."  Vitamin D supplementation is needed along with calcium because "Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts.  Together with calcium, vitamin D also helps protect older adults from osteoporosis."

Unless new information becomes available regarding pregnant and lactating women, I will continue to take my calcium supplements and/or eat my calcium rich foods (like broccoli).  I think maintaining an adequate intake of calcium and vitamin D now will prevent the development of osteoporosis in the future.

Friday, June 29, 2012

A Parent's Worst Nightmare - Forgetting Your Child in the Car

Last night, while wide awake with insomnia, I came across this news story about a father in Kentucky who was arrested after he left his son in his hot car.  This would be my absolute worst nightmare.  The father in the story was lucky in that someone discovered his child in the car before something tragic could happen.  With the weather getting hot outside, these stories are unfortunately, becoming more and more common.

I read a story in the Washington Post 3 years ago that still haunts me to this day.  It is so haunting that I remembered where I read it and could easily find the article.  It is a story that won a Pultizer Prize for feature writing.  The story, titled "Fatal Distraction: Forgetting a Child in the Backseat of a Car Is a Horrifying Mistake.  Is It a Crime?"  I read this story before I had children and it still troubled me.  Now that I am a parent and know first hand how distractions or fatigue can make you go into "autopilot," I can see how parents can make a "mistake" like forgetting their child in a car.  It is one thing to leave your child in a car on purpose (which is unforgivable), like a mother from Danville, California and it is an entirely different story when someone unintentionally forgets their child in the car.  Can you imagine the pain, horror and guilt that will accompany a parent for the rest of their life when they discover such a horrible, tragic mistake?

An organization called Kids and Cars is hoping to bring awareness about children and heatstroke when left in a car.  They say that, "on average, 38 children die in hot cars each year from heat-related deaths after being trapped inside motor vehicles. Even the best of parents or caregivers can overlook a sleeping baby in a car; and the end result can be injury or even death."  So far in 2012, there have already been 7 heat stroke deaths in the US.

Kids left in cars are vulnerable to heat stroke because "a child’s body temperature rises 3‐5 times faster than an adult’s. Even with the windows partially down, the temperature inside a parked car can reach 125 degrees in just minutes. Leaving the windows opened slightly does not significantly slow the heating process or decrease the maximum temperature attained."  

"The most dangerous mistake a parent or caregiver can make is to think it cannot happen to them or their family.  In well over 50% of these cases, the person responsible for the child’s death unknowingly left them in the vehicle. It happens to the most loving, protective parents. It has happened to a teacher, pediatrician, dentist, postal clerk, social worker, police officer, nurse, clergyman, electrician, accountant, soldier, assistant principal, and even a rocket scientist. It can happen to anyone."

The following are safety tips provided by Kids and Cars to prevent this tragedy from happening to you.
Never leave children alone in or around cars; not even for a minute. 
Put something you'll need like your cell phone, handbag, employee ID or brief case, etc., on the floor board in the back seat.
Get in the habit of always opening the back door of your vehicle every time you reach your destination to make sure no child has been left behind. This will soon become a habit. We call this the “Look Before You Lock” campaign.
Keep a large stuffed animal in the child's car seat when it’s not occupied. When the child is placed in the seat, put the stuffed animal in the front passenger seat. It's a visual reminder that anytime the stuffed animal is up front you know the child is in the back seat in a child safety seat.
Make arrangements with your child’s day care center or babysitter that you will always call if your child will not be there on a particular day as scheduled.
- This is common courtesy and sets a good example that everyone who is involved in the care of your child is informed of their whereabouts on a daily basis. Ask them to phone you if your child doesn't show up when expected. Many children’s lives could have been saved with a telephone call from a concerned child care provider. Give child care providers all your telephone numbers, including that of an extra family member or friend, so they can always confirm the whereabouts of your child.
Keep vehicles locked at all times; even in the garage or driveway and always set your parking brake.
Keys and/or remote openers should never be left within reach of children. 
Make sure all child passengers have left the vehicle after it is parked. 
When a child is missing, check vehicles and car trunks immediately.
If you see a child alone in a vehicle, get involved. If they are hot or seem sick, get them out as quickly as possible. Call 911 or your local emergency number immediately.
Be especially careful about keeping children safe in and around cars during busy times, schedule changes and periods of crisis or holidays.
Use drive-thru services when available. (restaurants, banks, pharmacies, dry cleaners, etc.) 
Use your debit or credit card to pay for gas at the pump.  



Thursday, June 28, 2012

Flying with a Toddler

I have been meaning to write this post for weeks now but since I just wrote about changing diapers on a plane yesterday, I thought it would be appropriate to continue with the topic of flying.  For the most part, many of the recommendations that I made in my flying with an infant post still apply to flying with a toddler.  However, it appears that since that post, many airlines are no longer allowing pre-boarding for families with young children.  I think this is especially terrible when traveling with a toddler.  Toddlers are at an age where they're beginning to assert some independence and having extra time to board without too many distractions is a great benefit.  When flying, unfortunately, many of us are at the mercy of the airlines and I hope that my experiences can help some of you have a more enjoyable experience.

Flying with a toddler can be uncomfortable if they are still being held on your lap without their own seat during the flight.  There are two devices that I started flying with to help ease the "pain" of flying with a lap child.  The first was a Baby B'Air Flight Vest.  This is a vest that you can put over the baby and attach to your seat belt.  It is designed to "tether" your baby so they don't go flying out of your arms during turbulence.  It is not FAA approved for take offs and landings but for the cruising portion of the flight.  I have to admit that I was very happy to have this device after we experienced over two hours of turbulence on our flight to Spain.  It wasn't the worst turbulence I ever felt but definitely the longest.  We couldn't get any food, beverages or even use the bathroom during that time.  It just left me a little more at ease knowing my baby wouldn't fly out of my arms during turbulence.

Another device that I always pack in the event of an open seat on our flight is the CARES harness.  It is FAA approved and you can use this in lieu of a car seat for children that weigh at least 22 pounds.  On our way back to the US from Spain, there was an empty seat in our row that we were able to safely secure our toddler to the seat.  It is lightweight and folds compactly and it doesn't take much room in our carry-on luggage.  Since we travel a lot, it is worth the investment since we'll be using it on every flight now that our toddler is over two years old and we are required to buy a seat for him.  It sure beats lugging the car seat around the airport!  We did not have it on our flight to Rome which we regretted.  There was an empty seat on that flight as well but since we checked in his carseat, we had no way to secure him to the seat during the flight.

I think one of the big things with flying with a toddler is to be prepared with lots of distractions.  I pack a separate bag filled with "goodies" for the flight.  I stow that under the seat in front of me so it is easily accessible.  I bring a snack cup and a bag of snacks to put in the cup.  I also use a "secure a toy" to help keep it from falling on the ground.  I also pack his favorite sippy cup and tether that with a strap to also keep it from falling.

I've learned that on shorter flights, they may not always have milk available on board.  If that is the case, it is not a bad idea to buy some milk at the airport before boarding.  I thought I would outsmart the TSA and bring boxed milk with me but they made me open it so they could test a sample.  Lesson learned.  It is easier to just buy it at the airport than trying to bring it from home.  When I was breastfeeding, it wasn't an issue but as my toddler began weaning, having milk available suddenly became very important.  There is nothing like having a screaming toddler on the plane crying for milk when there is none available.

I also buy one new book and bring it out during the flight.  Thankfully my toddler enjoys reading so a good book is always something that can keep him occupied.  I also make sure to pack some of his favorite books to bring something familiar from home to remind him of his usual "routine."  I also make an album of pictures for him.  I buy those cheap plastic picture albums and fill it with pictures of our dog, his grandparents, cousins, friends, etc.  I try to find pictures that I know will bring him comfort in unfamiliar surroundings.  I use a cheap album and prints of digital pictures so he is free to bend pages without fear of damaging important photographs.

I also pack his pajamas so when it is "bedtime," I try to mimic our usual bedtime routine as close as possible.  I change him into his pajamas, read him a book and give him his blanket and stuffed animal to cuddle with.  Luckily he is not "attached" to a specific blanket or stuffed animal so his travel blanket with ties (made by ROSK) and his backpack "child safety harness" doubles as a stuffed animal.

What is a child safety harness?  It is basically a backpack that a child straps to his body that is connected to a strap that a parent can hold.  The purpose is for parents to keep their toddler "attached" to them to avoid them from wandering off and getting lost or hurt.  It can be controversial since many parents oftentimes compare it to a "leash."  I for one, have no problem using them since I know especially when in an different environment, kids can wander off and get lost.  I use it a lot at the airport to prevent him from getting lost amongst the hundreds of travelers.  It is also especially handy when we venture out at home.  Being 35 weeks pregnant, I'm not necessarily as fast as I used to be and chasing after a toddler can be downright dangerous since he outruns me these days.

As an absolute last resort, I also pack our old iPhone.  I load old pictures and videos on it and have his favorite movie on it as well.  He has never really watched a movie other than on an airplane before and even with the limited exposure, he has grown quite fond of the Cars movies.  I can let him play with it without fear of him mistakenly deleting pictures on our phones (which he's done before).  It is also nice to have at our destination since we can use the GPS features without fear of being charged outrageous data roaming prices.

To make my life a little more bearable on the flight, I pack a reusable wide-mouth water bottle.  I've had more than one occasion where my little guy reached for my inflight beverage and spilled it everywhere.  It is easier to just have the flight attendant pour the drink into the cup so a lid can be tightly fastened over it.  It is also handy to have at your destination for filling up on the go.  It was nice to have in Rome with all of their public water fountains.

Eating on the flight with a toddler as a lap child can be quite the challenge.  I pack a bowl with lid and an eating mat along with a bib and utensils.  I always pack the bowl with lid so I can store food and have it ready if he is not ready to eat when they bring food around.  We've also discovered that stacking two trays on top of each other will allow one parent to eat while the other holds the toddler.  It can be tricky but worth it when you're hungry.  Obviously, if you were on a short flight with no food, it is always a good idea to pack food for the flight because kids get hungry quite frequently.  I either bring food from home or buy some at the airport before boarding.  Once again, the bowl with lid is handy for storing food until they're ready to eat.

It's been a few months since our last trip and I am already going through travel withdrawal.  With the baby due in a few weeks, I don't think we're going anywhere anytime soon.  I'm sure I'm probably forgetting something but if I am, I'll just write another post at a later time.  My severe lack of sleep due to pregnancy insomnia is making my thinking a little cloudy at the moment.  Please write a comment if you have any questions or if you have any suggestions.

Wednesday, June 27, 2012

Changing Diapers on a Plane

I stumbled upon an interesting blog post last night while reading a newspaper online.  The post was titled, "Where should parents change diapers on planes?"  The title alone really caught my attention.  As I alluded to on an earlier blog post, "flying with an infant," you never know when you may encounter a "pooplosion" on an airplane.  When that happens, where do you change the diaper?

Back in November, I flew solo with my 18-month old as a lap-child when he decided to poop right as we were taking off.  Since the seat belt sign was illuminated, I could not leave to change his diaper in the bathroom.  I was very aware of the passengers seated next to me and even though I was tempted to change him at my seat, I waited until the seat belt sign was turned off so I could change his diaper in the bathroom.  In the meantime, he was smelly and uncomfortable from his dirty diaper.  All of the squirming made his diaper leak and his pants began to get soiled.  When it was safe to leave my seat, I immediately made a beeline to the bathroom.

As any parent who has tried to change a diaper in an airplane bathroom will tell you, it is not a pleasant experience.  It is tiny, smelly and dirty.  If there is a changing table in the bathroom (which is usually right above the toilet in the line of fire of any airborne particles), it is probably full of bacteria and any curious toddler will try to touch and grab things around him (however disgusting that may be).  To help with some of that, I put several layers of toilet seat covers over the table and my changing pad on top of that.  Despite all of this "prep" work, my toddler refused for me to use the table.

It turns out that my toddler was too freaked out for me to put him anywhere.  He suddenly became very clingy when I tried to put him down to change the diaper.  Since the diaper had to come off, I literally had to hold him against my body with one arm and pull off his clothes and diaper with the other.  I dangled him under his armpits all the while trying clean him and avoid getting any poop on myself.  I also had to balance all of this so as not to touch the toilet or drop anything on that nasty floor.  If this was caught on video, it would have easily made it onto America's Funniest Home Videos.  This was quite the ordeal for both of us but we managed to do it after occupying the restroom for several minutes.

After reading the post last night, I couldn't help but think that it would have been easier if I could have just changed him at my seat.  My fellow passengers could smell him anyway and the friendlier confines of the seat would have made him more comfortable.  By the end of our bathroom ordeal, we were both covered in poop (which it is why I will always pack extra clothes for the both of us going forward) and we were probably smellier after the fact than if we could do it quicker and probably cleaner at our seat. I know it would be considered extremely rude by other passengers but this was a situation that seriously made me think about throwing etiquette out the window.  Frequent travelers are already upset at parents traveling with children and the airlines are making it increasingly difficult to travel with children.  Why not give travelers another experience they won't soon forget?  What do you think?  Would you be offended if a desperate mother who is traveling alone with a toddler changed his diaper at her seat?


Tuesday, June 26, 2012

Just Can't Sleep on my Left Side or Any Other Side...

I am officially suffering from the sleepless, tossing and turning insomnia filled nights of the third trimester.  Apparently, 8 out of 10 women experience insomnia while pregnant.  Don't get me wrong, I am extremely exhausted (especially since I'm still working 40 hours a week and taking care of a toddler at home) but I just can't seem to get any good sleep.  Some of the things that are keeping me awake at night are having to constantly go to the bathroom, the occasional low blood sugar episode where I have to eat (which then causes reflux) and how I am just plain uncomfortable in bed.

It has always been recommended that pregnant women sleep on their left side.  As a pregnant uterus grows, it can exert pressure on the internal vena cava (IVC) which may cause a decrease in blood flow to both the mother and baby.  Sleeping on the left side causes the uterus to rest "against the aorta instead of the IVC. The aorta, which brings oxygenated blood from the heart to the other organs, has thicker walls than the IVC and is better able to withstand the pressure from the uterus."  The American Pregnancy Association recommends against sleeping on your back because "this can cause problems with backaches, breathing, digestive system, hemorrhoids, low blood pressure and decrease in circulation to your heart and your baby. This is a result of your abdomen resting on your intestines and major blood vessels (the aorta and vena cava)."

Maybe its the anxiety of trying to stay on my left side or the pain that all my body weight is placing on my left hip that has made me toss and turn all night long.  I've tried sleeping with a body pillow and a pillow between my legs yet nothing helps me get a good night sleep.  This is getting old (but I am getting a lot of blogging done) and could use some suggestions for a good night sleep.  Anyone have any good ideas??  I've got 5 more weeks and lots of time at night to try them all.

Monday, June 25, 2012

Button Batteries Can be Dangerous and Deadly to Children

I get a lot of information about pregnancy and breastfeeding from reading message boards online.  Some of these message boards are set up so that women can share information based upon their due date.  When you read these boards, you can share pregnancy experiences with women who are going through the same things you are at the same time.  A nice thing about these boards is that once the baby is born, you can still share your experiences or advice as your children grow up.  I started following one of these boards when I became pregnant with my son over two years ago and have followed and made friends with many of the other mommies on the board.  I still keep in contact with and have even met in person a few of the fellow moms on the board that I follow.  The beauty of these boards is there are moms from all over the US and world.  It is interesting to hear about their opinions and experiences based on their different cultural, economic and social backgrounds.  The topics posted are the inspiration for many of my blog posts.  Unfortunately, not all of the topics that I blog about are based upon happy things.

It was through this board that one mom that I've "known" for nearly two years posted that her baby had "died after a short illness."  It was a shock to many of the other moms on the board and we were wondering what would cause her healthy baby to suddenly pass away.  It turns out her baby had swallowed a "button" battery which caused him to suddenly get sick and die.  After hearing her story, I thought that this had to be an isolated "freak" accident.  Unfortunately, it is not and just doing a quick google search, I found that this tragedy has happened again and again and again.  There were 18 fatal cases listed on the National Capital Poison Control Center website.  Even the U.S. Consumer Product Safety Commission issued a warning about button batteries back in 1983.


A study published in the June 2012 edition of the journal Pediatrics looked at "Pediatric Battery-Related Emergency Department Visits in the United States, 1990–2009."  The study found that "an estimated 65,788 patients <18 years of age presented to US Emergency Departments (EDs) due to a battery-related exposure during the 20-year study period, averaging 3289 battery-related ED visits annually.  The number and rate of visits increased significantly during the study period, with substantial increases during the last 8 study years. The mean age was 3.9 years, and 60.2% of patients were boys. Battery ingestion accounted for 76.6% of ED visits, followed by nasal cavity insertion (10.2%), mouth exposure (7.5%), and ear canal insertion (5.7%). Button batteries were implicated in 83.8% of patient visits caused by a known battery type."

How can a tiny button battery cause so much trouble?  According to the National Capital Poison Control Center, "Most button batteries pass through the body and are eliminated in the stool. However, sometimes batteries get “hung up”, and these are the ones that cause problems. A battery that is stuck in the esophagus is especially likely to cause tissue damage. An electrical current can form around the outside of the battery, generating hydroxide (an alkaline chemical) and causing a tissue burn. When a battery is swallowed, it is impossible to know whether it will pass through or get 'hung up'."  According to safekids.org, "Kids can still breathe with the coin lithium battery in their throats. It may not be obvious at first that something is wrong.  Once burning begins, damage can continue even after the battery is removed."

A study published in the May 2010 edition of the journal Pediatrics looked at the clinical implications of battery ingestion and found that "ingestions of 20- to 25-mm-diameter cells increased from 1% to 18% of ingested button batteries (1990–2008), paralleling the rise in lithium-cell ingestions (1.3% to 24%). Outcomes were significantly worse for large-diameter lithium cells (≥20 mm) and children who were younger than 4 years. The 20-mm lithium cell was implicated in most severe outcomes. Severe burns with sequelae occurred in just 2 to 2.5 hours. Most fatal (92%) or major outcome (56%) ingestions were not witnessed. At least 27% of major outcome and 54% of fatal cases were misdiagnosed, usually because of nonspecific presentations. Injuries extended after removal, with unanticipated and delayed esophageal perforations, tracheoesophageal fistulas, fistulization into major vessels, and massive hemorrhage."

A few of the stories mentioned above, the children died as a result of massive hemorrhage.  In the case of the mother on my message board, the battery caused her child's intestines to erode which caused the contents of the intestines to spill into his abdominal cavity resulting in a massive infection.

What are you to do if you suspect your child has swallowed a battery?  According to the National Capital Poison Control Center which operates a National Battery Ingestion Hotline:

"If anyone ingests a battery, this is what you should do:
  1. Immediately call the 24-hour National Battery Ingestion Hotline at 202-625-3333 (call collect if necessary), or call your poison center at 1-800-222-1222
  2. If readily available, provide the battery identification number, found on the package or from a matching battery.
  3. In most cases, an x-ray must be obtained right away to be sure that the battery has gone through the esophagus into the stomach. (If the battery remains in the esophagus, it must be removed immediately. Most batteries move on to the stomach and can be allowed to pass by themselves.)  Based on the age of the patient and size of the battery, the National Battery Ingestion Hotline specialists can help you determine if an immediate x-ray is required.
  4. Don't induce vomiting.  Don't eat or drink until the x-ray shows the battery is beyond the esophagus.
  5. Watch for fever, abdominal pain, vomiting, or blood in the stools. Report these symptoms immediately.
  6. Check the stools until the battery has passed.
  7. Your physician or the emergency room may call the National Button Battery Ingestion Hotline/National Capital Poison Center collect at 202-625-3333 for consultation about button batteries. Expert advice is available 24 hours a day, 7 days a week.
Button batteries may also cause permanent injury when they are placed in the nose or the ears. Young children and elderly people have been particularly involved in this kind of incident. Symptoms to watch for are pain and/or a discharge from the nose or ears. DO NOT use nose or ear drops until the person has been examined by a physician, as these fluids can cause additional injury if a battery is involved."

Button batteries are pretty ubiquitous these days which explains why the incidence of accidental battery ingestion is increasing.  Since they're everywhere, I started looking around the house to make sure the batteries are secure from the prying hands and fingers of my toddler.  Thankfully, many of the batteries today are encased in a compartment which is locked with a screw.  Despite finding many batteries enclosed in a "sealed" compartment, there were a few that could be accessed simply by sliding the cover out of the way.  It is with those electronic devices that I am most concerned about.  I cannot be around my child 24/7 but I am trying my best to make sure the batteries are secured.  In some of the cases that I have read about, the origin of the battery was unknown.  It is the "unknown" sources of batteries that I do not even think about that worry me.  All I can do is hope that most of the batteries are secured and inform my child's caregivers to be aware of the potential dangers of batteries.

Educating people about the hazards are key and families that have experienced first hand the dangers of button battery ingestion are trying to spread the word.  Consumer Reports posted a video showing how a button battery, when left on a piece of ham for three days, burned a hole right through it.  It also showed how singing greeting cards aimed at children, can have easily accessible button batteries.  Energizer batteries also posted a video to educate parents about the hazards of button batteries which included a picture of an x-ray of a child with a button battery lodged in its throat.








Sunday, June 24, 2012

Is it Safe to Drink Alcohol While Pregnant?

I have noticed over the last few days that the topic of "drinking while pregnant" has been a trending topic.  There have been several stories which were published over the last week regarding this topic.  Publications such as US News and World Report, the Huffington Post, and The Week are among many news organizations talking about five new Danish studies published in the BJOG An International Journal of Obstetrics and Gynaecology.

The studies looked at the effects of low, moderate, high and binge drinking by mothers while pregnant.  Their children were evaluated at five years of age to determine if there were any effects caused by the mother consuming alcohol while pregnant.  The researchers found that "low and moderate weekly alcohol consumption in early pregnancy is not associated with adverse neuropsychological effects in children.  Low average weekly alcohol consumption was defined as 1-4 drinks per week, moderate as 5-8 drinks per week and high levels as 9 or more drinks per week. Binge drinking was defined as intake of 5 or more drinks on a single occasion. Participants who did not drink during pregnancy were included as the unexposed reference group."  It is interesting to note that an alcoholic drink in Denmark is defined as 0.4 ounces of pure alcohol while in the US it is 0.6 ounces.

"The papers found that low to moderate weekly drinking in early pregnancy had no significant effect on neurodevelopment of children aged five years, nor did binge drinking. Focusing on children’s IQ and executive functions, no differences in test performance were observed between children whose mothers reported 1-4 or 5-8 drinks/week per week in pregnancy compared to children of abstaining mothers. However one finding showed that high levels of alcohol, intake of 9 or more drinks per week, was associated with lower attention span amongst five year olds."

Despite studies like this, I'm still not sure if I would feel comfortable consuming any alcoholic beverages while pregnant.  I think the risk of fetal alcohol syndrome is real and I'm not sure the small amount of pleasure I'd derive from having an alcoholic beverage is worth the risk.  This also contradicts an earlier study that I first read about in January.  That study published in the journal Alcoholism:  Clinical and Experimental Research found "Higher prenatal alcohol exposure (PAE) in every pattern we examined was significantly associated with an increased risk for having an infant born with reduced birth length or weight or having a smooth philtrum or thin vermillion border or microcephaly.  The most significant associations were seen during the second half of the first trimester; for every one drink increase in the average number of drinks consumed daily, there was a 25 percent increased risk for smooth philtrum, a 22 percent increased risk for thin vermillion border, a 12 percent increased risk for microcephaly, a 16 percent increased risk for reduced birth weight, and an 18 percent increased risk for reduced birth length.  This paper clearly illustrates that drinking alcohol, especially binge drinking, during the first seven to 12 weeks of gestation is associated with four of the most important facial features characteristic of fetal alcohol syndrome (FAS) as well as reductions in birth length and weight that are also characteristic of infants and children with FAS.  This study also illustrates clearly that there is no threshold that triggers these features of FAS. Instead there is variability from woman to woman in the level of drinking that produces these features."

I know that many European women drink throughout pregnancy.  However, it appears more European countries are beginning to encourage pregnant women to abstain from alcohol due to the risk of fetal alcohol syndrome.  I think with many conflicting studies that for the time being, I will abstain from alcohol while pregnant.  It will make that first drink post partum taste that much more wonderful!








Saturday, June 23, 2012

Mandatory Labeling for Genetically Modified Organisms?

I wrote a blog post a few days ago about Genetically Modified Organisms (GMOs) and lamented at the lack of labeling requirements for them.  Well, it turns out that voters in California will get the opportunity to vote on mandatory labeling requirements for Genetically Modified Organisms during the election in November.  The California Secretary of State Certified a ballot measure for voters to decide if manufacturers or producers should be required to indicate if their product contains GMOs.  There are currently no requirements for this on the federal or state level.

The California Secretary of State stated the following about the ballot initiative, "Genetically Engineered Foods. Mandatory Labeling.":
"Requires labeling on raw or processed food offered for sale to consumers if made from plants or animals with genetic material changed in specified ways. Prohibits labeling or advertising such food as “natural.” Exempts foods that are: certified organic; unintentionally produced with genetically engineered material; made from animals fed or injected with genetically engineered material but not genetically engineered themselves; processed with or containing only small amounts of genetically engineered ingredients; administered for treatment of medical conditions; sold for immediate consumption such as in a restaurant; or alcoholic beverages. Summary of estimate by Legislative Analyst and Director of Finance of fiscal impact on state and local government: Potential increase in state administrative costs of up to one million dollars annually to monitor compliance with the disclosure requirements specified in the measure. Unknown, but potentially significant, costs for the courts, the Attorney General, and district attorneys due to litigation resulting from possible violations to the provisions of this measure."

Friday, June 22, 2012

Non-Stress Test

Today, I went in for my first non-stress test (NST) for this pregnancy.  I did it with my son the first time around and doing it again for this baby due to my gestational diabetes.  I will be going in once a week beginning at week 34 and will then go in twice a week beginning at week 36.  I basically sit hooked to a monitor which records the baby's heart rate.  My practitioner wants the baby to move at least twice during the 20 minutes I am hooked up to the monitor.  When the baby moves its heart rate should increase (this is much the same way your heart rate increases when you move).  If the heart rate does not increase or in fact decrease, it could indicate that there is a problem with the baby (like an umbilical cord or placenta issue).  If the baby is lazy or sleeping, then they try different things to get it to move.  Today I had to drink a little bit of cold water and a little prodding to get some movement.  This baby is not a morning person and is definitely more active at night than during the day.

A nice thing about getting the NST is that it is one of the most relaxing times of the day that I can just sit around and do nothing.  With a toddler at home and working full-time, it really is a nice break.  I also get an ultrasound each time to check my fluid levels (high fluid levels are a risk with gestational diabetes) which lets me take a peek at my baby.  It is also always comforting to hear that heart beat knowing the baby is doing well inside.  There is something hypnotic about hearing a fetal heart beat that makes you feel so relaxed.

Here are some video that I took of the ultrasound.  Today was the first time (after many ultrasounds with both of my children), that I could actually see the umbilical cord floating around.

The umbilical cord and baby's face
The baby's heart beat
Hooked up to the monitor.  You can see the baby moving!

Thursday, June 21, 2012

Baby Wash Now Linked to False Positive Marijuana Results in Newborn Drug Screens

I was surprised to read in the news that some commonly used baby wash products have produced false positive marijuana results on newborn drug screens.  A study was recently published in the journal Clinical Biochemistry which found this link.  The danger of having a false positive result is it can cause social services to get involved in cases where there is suspected drug use by the mother while pregnant.

The soaps which were studied that caused a false-positive result were:  Johnson & Johnson’s Bedtime Bath, CVS Night-Time Baby Bath, Aveeno Baby Soothing Relief Creamy Wash and Aveeno Baby Wash & Shampoo.  "Researchers also tested ingredients used widely in soaps and shampoos, including polyquaternium-11 and cocamidopropyl betaine, which both elicited positive marijuana test results.  So far, there is no explanation as to why the chemicals interfere with the test's function, but importantly, they aren't intoxicating; they don't cause symptoms of marijuana exposure in children. The researchers think minute amounts of the substances were simply washing off the babies' skin into their urine samples and confounding the screens."

“Our findings in this study drive home the point that confirmation by more sophisticated methods such as mass spectrometry should be considered before moving ahead with interventions such as child social services or child abuse allegations, which may be false, “ said co-author Carl J. Seashore, MD, associate professor of pediatrics at UNC and director of the Newborn Nursery.  “We wrote this paper to inform care providers and laboratory medicine people in hospitals that this issue is out there and that positive urine screens for THC need to be confirmed.”

This is just another reason for me to not use Johnson and Johnson's baby shampoo.  A few weeks ago, I wrote a post about toxic baby shampoo.   While in this instance, it does no harm to the baby, this is yet more chemicals that may cause issues (although indirectly) for my baby.  I took pictures of the two bottles of Johnson and Johnson's baby wash that I had and they both contained cocamidopropyl betaine.









Wednesday, June 20, 2012

CALIFORNIA GOVERNOR BROWN DIRECTS STATE AGENCIES TO REVISE FLAMMABILITY STANDARDS

I woke up yesterday morning to find this headline in the news.  I could not have been happier!!  The Governor of the state of California "directed state agencies to revise flammability standards for upholstered furniture sold in the state.  Technical Bulletin 117 for flammability standards—will be updated to reflect modern manufacturing methods that can lower the use of harmful chemicals."

Governor Brown went on to say, “Toxic flame retardants are found in everything from high chairs to couches and a growing body of evidence suggests that these chemicals harm human health and the environment,” said Governor Brown. “We must find better ways to meet fire safety standards by reducing and eliminating—wherever possible—dangerous chemicals.”

"Studies show that humans are at risk from exposure to toxic chemicals used as flame retardants in upholstered furniture. A 2008 study by the Environmental Working Group found that toddlers often have three times the level of flame retardant chemicals in their bodies as their parents, and California children have some of the highest levels of toxic flame retardants in their bodies. 


A peer-reviewed study by scientists at Cal/EPA found that California women have much higher levels of toxic flame retardants in their breast tissue than women in other states and countries. Researchers from the University of California, Berkeley found statistically significant associations between flame retardant levels in the blood of California women and reduced fertility. The researchers believe this link may result from alterations in thyroid hormone levels after exposure to the chemicals. 


Numerous studies demonstrate that firefighters have significantly elevated rates of cancer, including non-Hodgkin’s lymphoma and brain cancer. A study published in the Journal of Occupational and Environmental Medicine concluded that firefighters have a significantly elevated risk of cancer that may be attributed to toxic chemicals they inhale, including flame retardants."

It was just four days ago that I wrote about flame retardants and Technical Bulletin 117.  Since many manufacturers were following California's standards for flame retardants, I am happy that the state is doing something to decrease the amount of exposure we have to flame retardants.  Until we have newer standards, the Environmental Working Group has published tips on how to avoid flame retardants.

Tuesday, June 19, 2012

Genetically Modified Organisms (GMO's)

I have been reading a lot lately about Genetically Modified Organisms or GMOs for short.  According to the Human Genome Project, genetic modification (GM) "is a special set of technologies that alter the genetic makeup of organisms such as animals, plants, or bacteria.  Combining genes from different organisms is known as recombinant DNA technology, and the resulting organism is said to be "genetically modified," "genetically engineered," or "transgenic." GM products (current or those in development) include medicines and vaccines, foods and food ingredients, feeds, and fibers."

Why would anyone want to genetically modify an organism?  The following is a list of benefits and controversies as described by the Human Genome Project:

Benefits

  • Crops
    • Enhanced taste and quality
    • Reduced maturation time
    • Increased nutrients, yields, and stress tolerance
    • Improved resistance to disease, pests, and herbicides
    • New products and growing techniques
  • Animals
    • Increased resistance, productivity, hardiness, and feed efficiency
    • Better yields of meat, eggs, and milk
    • Improved animal health and diagnostic methods
  • Environment
    • "Friendly" bioherbicides and bioinsecticides
    • Conservation of soil, water, and energy
    • Bioprocessing for forestry products
    • Better natural waste management
    • More efficient processing
    • Society
    • Increased food security for growing populations

Controversies

  • Safety
    • Potential human health impacts, including allergens, transfer of antibiotic resistance markers, unknown effects
    • Potential environmental impacts, including: unintended transfer of transgenes through cross-pollination, unknown effects on other organisms (e.g., soil microbes), and loss of flora and fauna biodiversity
  • Access and Intellectual Property
    • Domination of world food production by a few companies
    • Increasing dependence on industrialized nations by developing countries
    • Biopiracy, or foreign exploitation of natural resources
  • Ethics
    • Violation of natural organisms' intrinsic values
    • Tampering with nature by mixing genes among species
    • Objections to consuming animal genes in plants and vice versa
    • Stress for animal
  • Labeling
    • Not mandatory in some countries (e.g., United States)
    • Mixing GM crops with non-GM products confounds labeling attempts
  • Society
    • New advances may be skewed to interests of rich countries

This has become a world-wide issue and the World Health Organization has addressed this topic.  From a global perspective, the aspect of having food with an "increased level of crop protection through the introduction of resistance against plant diseases caused by insects or viruses or through increased tolerance towards herbicides" may yield "a product with a lower price, greater benefit (in terms of durability or nutritional value) or both."  However, there is much that is unknown about the long-term consequences of GMOs.  The WHO conducts a "safety assessment" of GM foods which "generally investigates: (a) direct health effects (toxicity), (b) tendencies to provoke allergic reaction (allergenicity); (c) specific components thought to have nutritional or toxic properties; (d) the stability of the inserted gene; (e) nutritional effects associated with genetic modification; and (f) any unintended effects which could result from the gene insertion."  The WHO's main issues for human health regarding GMOs are:

  • Allergenicity. As a matter of principle, the transfer of genes from commonly allergenic foods is discouraged unless it can be demonstrated that the protein product of the transferred gene is not allergenic. While traditionally developed foods are not generally tested for allergenicity, protocols for tests for GM foods have been evaluated by the Food and Agriculture Organization of the United Nations (FAO) and WHO. No allergic effects have been found relative to GM foods currently on the market.
  • Gene transfer. Gene transfer from GM foods to cells of the body or to bacteria in the gastrointestinal tract would cause concern if the transferred genetic material adversely affects human health. This would be particularly relevant if antibiotic resistance genes, used in creating GMOs, were to be transferred. Although the probability of transfer is low, the use of technology without antibiotic resistance genes has been encouraged by a recent FAO/WHO expert panel.
  • Outcrossing. The movement of genes from GM plants into conventional crops or related species in the wild (referred to as “outcrossing”), as well as the mixing of crops derived from conventional seeds with those grown using GM crops, may have an indirect effect on food safety and food security. This risk is real, as was shown when traces of a maize type which was only approved for feed use appeared in maize products for human consumption in the United States of America. Several countries have adopted strategies to reduce mixing, including a clear separation of the fields within which GM crops and conventional crops are grown.

Information about the European Unions' stance of GMOs can be found here.

As far back as 1992, the United States Food and Drug Administration (FDA), "published its "Statement of Policy: Foods Derived from New Plant Varieties" (the 1992 policy) in the Federal Register of May 29, 1992 (57 FR 22984).  The 1992 policy clarified the agency's interpretation of the application of the Federal Food, Drug, and Cosmetic Act with respect to human foods and animal feeds derived from new plant varieties and provided guidance to industry on scientific and regulatory issues related to these foods. The 1992 policy applied to all foods derived from all new plant varieties, including varieties that are developed using recombinant deoxyribonucleic acid (rDNA) technology. This site refers to foods derived from plant varieties that are developed using rDNA technology as "bioengineered foods."  It is "recommended that developers consult with FDA about bioengineered foods under development; since issuance of the 1992 policy, developers have routinely done so.  These procedures describe a process in which a developer who intends to commercialize a bioengineered food meets with the agency to identify and discuss relevant safety, nutritional, or other regulatory issues regarding the bioengineered food and then submits to FDA a summary of its scientific and regulatory assessment of the food; FDA evaluates the submission and responds to the developer by letter."

While the FDA "recommends developers consult with the FDA about bioengineered foods under development", the "FDA has no basis for concluding that bioengineered foods differ from other foods in any meaningful or uniform way, or that, as a class, foods developed by the new techniques present any different or greater safety concern than foods developed by traditional plant breeding.  Although the 1992 policy does not require special labeling for bioengineered foods, the agency advised in that policy that labeling requirements that apply to foods in general also apply to foods produced using biotechnology."

If the FDA does not require bioengineered food to be labeled and you choose not to eat genetically modified food, how can you be certain that a food was not cultivated using GMO?  If a food is certified organic by the United States Department of Agriculture, then it cannot contain any GMO.  "The use of GMOs is prohibited in all ingredients in “organic” and “made with organic (specified ingredients or food groups(s)).” "To be sold or labeled as “100 percent organic,” “organic,” or “made with organic (specified ingredients or food group(s)),” the product must not have been produced with "a variety of methods used to genetically modify organisms or influence their growth and development by means that are not possible under natural conditions or processes and are not considered compatible with organic production. Such methods include cell fusion, microencapsulation and macroencapsulation, and recombinant DNA technology (including gene deletion, gene doubling, introducing a foreign gene, and changing the positions of genes when achieved by recombinant DNA technology)."  There is a great blog post written a few days ago (I'm a little behind in the topics I want to cover) by a former staff writer at Gourmet Magazine that has some great tips for avoiding GMOs in your food.  

I have to admit that I am a little torn regarding this issue.  Sure it sounds weird and almost "Frankenstein-like" to think that humans are "engineering" new plant and animal products by manipulating genes.  However, at the same time, I understand the important advances that have been made using bioengineering.  Especially in areas where there is poor soil or other conditions affecting crop yield, it has been beneficial.  It has also been beneficial in medicine where vaccines and medications used to treat diseases such as autoimmune diseases and cancer have been developed through biotechnology.  Until more information is available about the long-term safety regarding GMOs, I cannot say with absolute certainty that I am completely against it.  However, I do think that consumers need to be given the tools to make informed decisions about these products through mandatory labeling requirements.  I do not think its fair that consumers are not given a choice to avoid GMOs if they are unaware that a product even contains GMOs.  I think the FDA needs to step in and make it mandatory for manufacturers to indicate that a product has a GMO in it.
  

Monday, June 18, 2012

200th Anniversary of the War of 1812

Did you know that today, June 18, is the 200th anniversary of the start of the War of 1812?  I kind of like the fact that there is an anniversary for me to think about this.  I have to admit that this is one war that I didn't really pay much attention to learning about in school.  Apparently, I am not the only one who doesn't remember learning much about this war.  Slate.com wrote an entire article about it.

It was on this date 200 years ago that James Madison signed a declaration of war against Britain.  Some considered this war to be a "second war of independence."  It was through this war that Francis Scott Key wrote the Star Spangled Banner and Washington D.C. was set on fire by the British.  The most unfortunate and biggest "loser" in this war were the Native Americans who lost protection from the British to block the westward expansion of America.

The following are some links to find out more about the history of the War of 1812:
Wikipedia's War of 1812 entry
The History Channel's piece on the War of 1812 
10 things you didn't know about the War of 1812
5 Tips for the War of 1812 Bicentennial Party You're Probably Planning from mentalfloss.com


Sunday, June 17, 2012

Happy Father's Day!!

Happy Father's Day to my dad, my husband and all of the other daddy's out there!  I found a few interesting articles about the origin of Father's Day.  William Jackson Smart was the man who inspired Father's Day.  His daughter wanted to honor him after he raised six children after his wife died in childbirth.  Sonora Smart Dodd got the idea after hearing a sermon about Mother's Day.  It was formally recognized as a holiday in 1972 by Richard Nixon.  It is celebrated the third Sunday in June in the United States.

As many of you know, I enjoy trivia.  Mental Floss published an excellent list of Father's Day "Facts."

1. Halsey Taylor invented the drinking fountain as a tribute to his father, who succumbed to typhoid fever after drinking from a contaminated public water supply in 1896.

2. George Washington, the celebrated “Father of Our Country,” had no children of his own. Researchers believe that childhood illnesses may have rendered him sterile. He did adopt the two children of his second wife, Martha Custis.

3. In Thailand, the King’s Birthday also serves as National Father’s Day. The celebration includes fireworks and acts of charity and honor – the most distinct being the donation of blood and the liberation of captive animals.

4. A.A. Milne created Winnie the Pooh for his son, Christopher Robin. Pooh was based on Robin’s teddy bear, Edward, a gift Christopher had received for his first birthday, and on their father/son visits to the London Zoo, where the bear named Winnie was Christopher’s favorite. Pooh comes from the name of Christopher’s pet swan (of course).

5. Kurt Vonnegut was (for a short time) Geraldo Rivera’s father-in-law. Rivera’s marriage to Edith Vonnegut ended in 1974 because of his womanizing. Her ever-protective father was quoted as saying, “If I see Gerry again, I’ll spit in his face.” He also included an unflattering character named Jerry Rivers (a chauffeur) in a few of his books.

6. Andre Agassi’s father represented Iran in the 1948 and 1952 Olympics as a boxer.

7. In 1950, after the Washington Post music critic gave Harry Truman’s daughter’s concert a negative review, the president came out swinging: “Some day I hope to meet you,” he wrote. “When that happens you’ll need a new nose, a lot of beefsteak for black eyes, and perhaps a supporter below!”

8. The voice of Papa Smurf, Don Messick, also provided the voice of Scooby-Doo, Ranger Smith on Yogi Bear, and Astro and RUDI on The Jetsons.

9. In 2001, Yuri Usachev, cosmonaut and commander of the International Space Station, received a talking picture frame from his 12-year-old daughter while in orbit. The gift was made possible by RadioShack, which filmed the presentation of the gift for a TV commercial.

10. The only father-daughter collaboration to hit the top spot on the Billboard pop music chart was the 1967 hit single “Something Stupid” by Frank & Nancy Sinatra.

11. In the underwater world of the seahorse, it’s the male that gets to carry the eggs and birth the babies.

12. If show creator/producer Sherwood Schwartz had gotten his way, Gene Hackman would have portrayed the role of father Mike Brady on The Brady Bunch.

13. According to a 2005 survey commissioned by TiVo, here are the top ten TV dads of all time: 1. Cliff Huxtable (The Cosby Show); 2. Sheriff Andy Taylor (The Andy Griffith Show); 3. Pa Ingalls (Little House on the Prairie); 4. Howard Cunningham (Happy Days); 5. Ward Cleaver (Leave it to Beaver); 6. Jim Anderson (Father Knows Best); 7. Mike Brady (The Brady Bunch); 8. Tim Taylor (Home Improvement); 9. Reverend Eric Camden (7th Heaven); 10. Danny Tanner (Full House).

14. The Stevie Wonder song “Isn’t She Lovely” isn’t about a woman he’s lusting for; it’s about his newborn daughter, Aisha. If you listen closely, you can hear Aisha crying during the song.

15. Dick Hoyt has pushed and pulled his son Rick, who has cerebral palsy, through hundreds of marathons and triathlons. Rick cannot speak, but using a custom-designed computer he has been able to communicate. They ran their first five-mile race together when Rick was in high school. When they were done, Rick sent his father this message: “Dad, when we were running, it felt like I wasn’t disabled anymore!” Since then, they have run over 66 marathons and 229 triathlons as a team.

Saturday, June 16, 2012

Why I Love Babywearing

What is "babywearing?"  Babywearing is "the practice of wearing or carrying a baby or child in a sling or other form of carrier."  It has been practiced for hundreds of years in many cultures around the world.  I remember growing up seeing my grandmother make her own "sling" to carry my baby brother around on her back.  Babywearing has been talked about more recently due to the Time Magazine Cover about breastfeeding and the "attachment parenting" debate.  I don't believe in all the aspects of attachment parenting (like co-sleeping which I think is dangerous) but I do believe in breastfeeding and babywearing.

Why should we wear our babies?  Wearing our babies has many benefits.  "Carried babies cry less, are able to tune into the rhythm of their caregivers breathing, heartbeat and movements, allows caregivers to become finely attuned to their baby's movements, gestures and facial expressions which is beneficial for mothers who are at risk for postpartum depression,  a great bonding tool for fathers, grandparents, adoptive parents, babysitters, and other caregivers, and you can take care of older children or do chores without frequent interruptions from an anxious or distressed infant—which helps to reduce sibling rivalry. Baby carriers are also wonderful to use with older babies and toddlers; you can save those arms and go where strollers can’t."

I've had people tell me while I have been out "wearing" my baby that they thought it was an unsafe and dangerous thing to do.  The Consumer Product Safety Commission did release a warning regarding sling carriers.  "Slings can pose two different types of suffocation hazards to babies. In the first few months of life, babies cannot control their heads because of weak neck muscles. The sling’s fabric can press against an infant’s nose and mouth, blocking the baby’s breathing and rapidly suffocating a baby within a minute or two. Additionally, where a sling keeps the infant in a curled position bending the chin toward the chest, the airways can be restricted, limiting the oxygen supply. The baby will not be able to cry for help and can slowly suffocate.  CPSC recommends that parents and caregivers make sure the infant’s face is not covered and is visible at all times to the sling’s wearer. If nursing the baby in a sling, change the baby’s position after feeding so the baby’s head is facing up and is clear of the sling and the mother’s body. Parents and caregivers should be vigilant about frequently checking their baby in a sling."  When the CPSC recommendations are followed, baby wearing can be done safely.  It is important to educate yourself about your sling's particular recommendations regarding positioning your baby before using the sling.

The following by Babywearing International are some great tips to safely wear your baby:
ABSOLUTE RULES
1. Make sure your baby can breathe.
2. Never jog, run, jump on a trampoline, or do any other activity that subjects your baby to similar shaking or bouncing motion.
3. Never use a baby carrier when riding in a car.
4. Use only carriers that are appropriate for your baby’s age and weight.
SAFETY GUIDELINES FOR LEARNING NEW CARRIES
1. Practice with a doll or teddy first.
2. It is best to try a new carry with your baby when you are both well rested and generally content.
3. Use a spotter … but only another adult who accepts the responsibility of keeping your baby from falling.
4. Use a mirror.
5. Start low.

Another thing to keep in mind when choosing a sling is proper position of the baby to avoid developmental problems with their hips.  The International Hip Displasia Institute recently issued a statement regarding hip development and infant carrriers.  They state that certain "devices could inadvertently place hips in an unhealthy position, especially when used for extended periods of time. Any device that restrains a baby’s legs in an unhealthy position should be considered a potential risk for abnormal hip development. It is also important to assess the size of the baby and match the device and carrier to the size of the child so that the hips can be in a healthy position during transport."

Baby Harnesses

Not Recommended:

Thigh NOT supported to the knee joint. The resulting forces on the hip joint may contribute to hip dysplasia.


Better:

Forces on the hip joint with thigh-supporting baby harness.
Thigh is supported to the knee joint. The forces on the hip joint are minimal because the legs are spread, supported, and the hip is in a more stable position.

Baby Slings

Not Recommended:
Tightly wrapped baby carriers may contribute to hip dysplasia.
Baby carriers that force the baby’s legs to stay together may contribute to hip dysplasia.
Better:
Baby carriers should support the thigh and allow the legs to spread to prevent hip dysplasia.
Baby carriers should support the thigh and allow the legs to spread to keep the hip in a stable position.


It is also recommended that babies face "inward" rather than "outward" when in a carrier.  "For the first several months, the baby is more than content with being carried in the front position, facing inward towards the caregiver. From a developmental point of view, the baby’s primary tasks are related initially to adaptation to life outside the womb where it certainly does not need excessive stimulation. Quite the contrary, at the “social awakening period at around 2-3 months, the baby’s main interest will be the human face, and here the front facing inward position will continue to be ideal for most babies as they will have a clear view of the caregiver’s hopefully exciting and stimulating face. The baby can also observe the caregiver’s face when she/he is communicating with others, providing the baby with learning experiences."  It is also best for the baby to face "inward" for proper physiologic development.  "The best position to promote a healthy development of spine and hip is the spread squat position or 'frog position', as some call it. In fact, this is the very position that babies are placed in in a brace when hip dysplasia has been diagnosed, because the position stimulates the optimum growth of the hip joints. To have all the weight of the baby placed on the groin and the legs left dangling straight down is simply not optimum from a physiological developmental point of view."

I've had nothing but an amazing experience babywearing.  I used the Moby Wrap from when my baby was a week old (would have used it sooner if I had remembered to use it) until he was four months old.  I wore that thing like a t-shirt everyday.  If it got too hot, I would just wear a bra and keep the baby in only a diaper.  The beauty of the wrap is I got to get a lot of skin to skin contact (also known as kangaroo care) with the baby and I could even breastfeed hands-free while "wearing" my baby.  It also kept my hands free to do chores around the house or while I was out shopping.  It also kept strangers from trying to touch my baby when out in public.  It enabled me to go to places without a stroller.  I didn't have to wait for elevators or squeeze through tight spaces that would have been impossible to get to had I relied on a stroller.

Once my baby turned four months old, he had enough motor development to use the Ergo Baby Carrier.  I had the infant insert for that (for use when the baby was younger than four months) but I didn't like it.  I preferred using the Moby wrap for the first few months and waited until he was bigger to use the Ergo without the insert.  I started using the Ergo at four months and I am still using it with my 2+ year old.  I put him in the piggyback carry position and still get my errands done all while 30+ weeks pregnant.  Like the Moby, I have used it in places that would have never been accessible with a stroller and have been able to comfortably breastfeed hands-free with it.  My favorite memory is using it to carry my baby for 6+ hours to watch a Major League Baseball World Series victory parade.  There was no way I could have seen the entire parade without it!  We also travel a lot and it has been an absolute lifesaver while traveling.  We have used it all over the United States and Europe.

I would highly recommend babywearing to all parents.  When done correctly, it is a great bonding experience.  I cannot wait to do it all over again with my new baby.  I have enjoyed the experience so much that I may even consider wearing two babies at once!


Friday, June 15, 2012

Like it or Not, Flame Retardants are Everywhere.

I am appalled at the amount of things which contain flame retardants.  It seems to be ubiquitous and almost unavoidable these days...  Many of the items around your home probably contain this label (even if you don't live in the state of California):

Label indicating this product meets "Technical Bulletin 117"
What is "Technical Bulletin 117?"  The California Bureau of Electronic Appliance Repair, Home Furnishings and Thermal Insulation "requires manufacturers to make upholstered furniture and bedding products sold in California flame-retardant. In the event of a residential fire, these products act as a significant fuel source and are difficult to extinguish once ignited. The Bureau measures flame retardance in accordance with flammability standards developed by the Bureau or the United States, Consumer Products Safety Commission (CPSC)."  Technical Bulletin 117 requires manufacturers of upholstered furniture and bedding products sold in California to meet "flammability standards."  They "do not prescribe the use of flame-retardant chemicals, manufacturing methods, or specific materials to meet the standards. The Bureau encourages the industry to use innovative solutions and products to achieve flame resistance without compromising the environment."  The bulletin basically requires that products are able to be exposed to an open flame for 12 seconds without igniting.  Since it is impossible to determine if a manufactured item will be sold in California, many manufacturers have adopted this standard to apply to all of their products regardless of where it will be ultimately sold.

While the bulletin does not "prescribe the use of flame retardant chemicals," many manufacturers have turned to brominated flame retardants (BFR).  One of the most common BFR in use are Polybrominated diphenyl ethers (PBDEs).  The Environmental Protection Agency (EPA) is "concerned that certain PBDE congeners are persistent, bioaccumulative, and toxic to both humans and the environment. The critical endpoint of concern for human health is neurobehavioral effects. Various PBDEs have also been studied for ecotoxicity in mammals, birds, fish, and invertebrates. In some cases, current levels of exposure for wildlife may be at or near adverse effect levels.  PBDEs are not chemically bound to plastics, foam, fabrics, or other products in which they are used, making them more likely to leach out of these products."

A study published in the journal Environmental Health Perspectives found that despite the widespread use of brominated flame retardants, "there is clearly a need for more systematic environmental and human monitoring to understand how and where these chemicals are being released into the environment, and what is happening to them once they enter the environment.  Our toxicology database is inadequate to truly understand the risk. Many of the studies that do exist involve the commercial mixtures, which do not represent human exposure. We need studies that focus on the congeners, and potentially their metabolites and/or breakdown products, present in people and wildlife in order to understand the risk from exposure to BFRs."

Despite the lack of studies, it is believed that BFRs may cause "thyroid hormone disruption, permanent learning and memory impairment, behavioral changes, hearing deficits, delayed puberty onset, decreased sperm count, fetal malformations and, possibly, cancer.  Many of the known health effects of PBDEs are thought to stem from their ability to disrupt the body's thyroid hormone balance, by depressing levels of the T3 and T4 hormones, which are important to normal metabolism."  

The Environmental Working Group (EWG) conducted a study on nursing mothers to determine the levels of brominated flame retardants in breastmilk.  The study found that "the average level of bromine-based fire retardants in the milk of 20 first-time mothers was 75 times the average found in recent European studies. Milk from two study participants contained the highest levels of fire retardants ever reported in the United States, and milk from several of the mothers in EWG's study had among the highest levels of these chemicals yet detected worldwide."  Despite these findings, it is still more important to breastfeed your baby than not.    

The problem with Technical Bulletin 117 is that manufacturers have taken things further by treating many things that are not an upholstered furniture item or bedding product with flame-retardant chemicals.  I have found them on my baby's pajamas and even his nursing pillow!

Label on my baby's pajamas indicating it is "flame resistant"  
I was even horrified to find that my "organic" baby mattress contained flame retardants!


I find it upsetting that I am constantly exposing myself and my children to chemicals that have not been proven to be safe and may be causing harm.  After learning more about flame retardants, I read labels on all of the products that I buy to make sure they do not have flame retardants on them.  Why would I want my children exposed to the unnecessary chemicals?  While it may lengthen the time for something to catch on fire, the smoke produced once it does burn is more toxic and can cause more harm than the fire itself since most fire-related fatalities are due to smoke inhalation.  It just makes no sense.  I wish we could have more options that are not treated with flame retardants.