What is Fetal Programming?

By anncowlin | Published January 1, 2012

What is fetal pro­gram­ming? Every per­son liv­ing on earth was first exposed to a uter­ine envi­ron­ment that helped deter­mine their life­time health and devel­op­ment. The term for this phe­nom­e­non is fetal pro­gram­ming. It is a hot topic and deserves attention.

Accept­ing the impor­tance of fetal pro­gram­ming places respon­si­bil­ity on the mother-to-be to do all she can to insure her body pro­vides nutri­ents and oxy­gen to her grow­ing infant while avoid­ing pos­si­ble risks and tox­ins. At the same time, genetic and envi­ron­men­tal fac­tors con­tribute greatly to the poten­tial for some dis­or­ders and prob­lems that arise. Thus, we must be care­ful in assign­ing guide­lines for accept­able behav­ior or blame for poor out­comes to preg­nant women.

On the one hand, we can all see the neg­a­tive con­se­quences of some­thing like fetal alco­hol syndrome…clearly the result of mater­nal behav­ior. Is a preg­nant woman whose baby has been dam­aged in this way guilty of abuse?

But, what if a mother is obese, eats poorly and ends up with an infant with a dis­turbed metab­o­lism. Is this abuse? What if the mother has an infec­tion that results in cere­bral palsy? Or what if she lives near a high­way and invol­un­tar­ily inhales fumes that neg­a­tively affect the placenta?

How do you get a healthy baby? Of course, there are no guar­an­tees. There remain many unknown fac­tors that can affect the course and out­come of a preg­nancy. Some fac­tors we are aware of, such as avoid­ing cer­tain fumes or chem­i­cals.  There are some behav­iors we know can max­i­mize the poten­tial for a good out­come, such as eat­ing ade­quate pro­tein, aer­o­bic con­di­tion­ing and strength train­ing. [Note for new readers…lots of these fac­tors have been cov­ered in our pre­vi­ous posts.]

But, what about all the things we don’t know about?

If these goats eat the wrong grass, will they go into labor?

Here is a cau­tion­ary tale:  There is a species of goat that, if they eat a cer­tain type of skunk grass on day 14 (and only day 14) of preg­nancy, will not go into labor. Why? Plant tox­ins in this grass inter­fere with the devel­op­ment of a small por­tion of fetal brain, the par­aven­tric­u­lar nucleus. This nucleus is involved in the sig­nal­ing cycle of labor. With­out it, the mother will not go into labor!

What are the take-home mes­sages here?

  • Prob­a­bly no one is ever a per­fect fetus…too many pos­si­ble threats.
  • There are some threats we can avoid…being lazy, over-eating, smoking.
  • There are some threats we can­not avoid, so we do the best we can.

Do the best you can by your baby…aerobic fit­ness, good nour­ish­ment, sleep, good hygiene and de-stressing your life.

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Fitness Starts Early!

By anncowlin | Published September 20, 2010

Preg­nancy fit­ness is not only impor­tant for moms, but for the fetus as well. Evi­dence is clear that aer­o­bic fit­ness improves brain, heart, immune and meta­bolic function…at all ages, includ­ing in utero. If con­tin­ued early in life, healthy phys­i­cal adap­ta­tions that occur in the uterus become rein­forced behav­ior, prepar­ing a good foun­da­tion for a healthy lifestyle. Babies are acute observers of move­ment and activ­ity, and learn from each other. A key com­po­nent of a good mom-baby pro­gram is the inter­ac­tion of the babies them­selves. A good teacher will facil­i­tate healthy activ­ity among our small­est class members!

There is grow­ing evi­dence that at all ages, aer­o­bic fit­ness pro­duces the great­est num­ber of ben­e­fits. Recently, researchers deter­mined that aer­o­bic fit­ness in 9 and 10 year olds pro­duced ben­e­fits in the devel­op­ment of two impor­tant brain regions — the basal gan­glia and the hip­pocam­pus — that are sig­nif­i­cant fac­tors in problem-solving intel­li­gence. This is just one of the lat­est reports that tells us the capac­ity to absorb and use oxy­gen (which improves with aer­o­bic fit­ness) is a key to health, qual­ity and length of life…beginning in the womb!

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New Breastfeeding Research: More Baby Protections

By anncowlin | Published August 3, 2010

We have long known that vagi­nal birth and breast­feed­ing are key fac­tors in the devel­op­ment of a healthy immune sys­tem in infants. Pass­ing through the vagina exposes the baby to an array of bac­te­ria that help stim­u­late its unchal­lenged immune sys­tem. Breast-fed babies receive anti-bodies, pro­teins and other mol­e­cules that pro­tect it from infec­tion and teach the immune sys­tem to defend the infant.

Breast­feed­ing is key for long-term health.

Recent research at UC Davis has shown that a strain of the bifido bac­te­ria — acquired from the mother — thrives on com­plex sug­ars (largely lac­tose) that were pre­vi­ously thought to be indi­gestible. The bac­terium coats the lin­ing of the imma­ture diges­tive tract and pro­tects it from nox­ious bacteria.

This com­bi­na­tion of inter­ac­tions affects the com­po­si­tion of bac­te­ria in the infant gut as it matures. Another exam­ple of how evo­lu­tion has “invented” the per­fect nutri­tion for infants, this research con­tributes to the notion that evo­lu­tion has selected for many genes that serve nor­mal birth and breast­feed­ing by pro­tect­ing the new­born. Inter­ven­ing with the nor­mal pro­gres­sion of birth and breast­feed­ing — while occa­sion­ally nec­es­sary — inter­rupts these ben­e­fi­cial adap­ta­tions and con­tributes to aller­gies and autoim­mune disorders.

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More on Preventing Childhood Obesity!

By anncowlin | Published April 19, 2010

Rachael Blum of Santa Mon­ica, CA, has alerted us to an excel­lent arti­cle in the New Eng­land Jour­nal of Med­i­cine con­cern­ing the evi­dence for the role of exer­cise in preg­nancy in help­ing pre­vent child­hood obe­sity:  http://healthcarereform.nejm.org/?p=3321&query=home. Rachael, our newest DTP fam­ily mem­ber, has also alerted us to an LA Times arti­cle on this sub­ject:  LA Times arti­cle.

With the recent empha­sis on the impor­tance of move­ment in the fight against child­hood obe­sity, there is recog­ni­tion that ben­e­fi­cial fetal pro­gram­ming through mater­nal exer­cise can make a big con­tri­bu­tion to this effort. A com­bi­na­tion of proper mater­nal nutri­tion and mater­nal fit­ness may well prove to be most effi­cient and poten­tially effec­tive way to help chil­dren develop an appetite for motion!

One fac­tor in this is the find­ing that reg­u­lar, moderate-intensity exer­cise helps pre­vent obe­sity in the new­born: http://www.nlm.nih.gov/medlineplus/news/fullstory_97212.htmlt. This, may in turn, help pre­vent child­hood obesity.

Recess for everyone!!!

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Twins & Triplets — Exercise & Nutrition Tips

By dancingthrupregnancy | Published August 31, 2009

A detour: We received a ques­tion about nutri­tion and exer­cise for mul­ti­ples. So, here is some infor­ma­tion for those with twins and triplets. Add a com­ment if you have a ques­tion or expe­ri­ence to share on this topic! Next comes birth, we promise!!

If one is a girl and one is a boy, they're fraternal!

If one is a girl and one is a boy, they’re fraternal!

Nutri­tion for Multiples:

The pri­mary thing we tell peo­ple with twins or more is that the pro­tein needs rise about 30 grams/baby/day above the 70 — 90 grams/day needed for a sin­gle­ton. Water intake also needs to rise. Avoid thirst and as much as pos­si­ble, drink until urine runs clear rather than yel­low (as best as you can).

Mul­ti­ples is con­sid­ered a risk fac­tor, and for each risk fac­tor (mul­ti­ples, under­weight, teenage mom, inter-pregnancy period less than a year) an addi­tional 200 calo­ries is often rec­om­mended, with 400 extra calo­ries the upper limit.

Exer­cise with Multiples:

A crit­i­cal fac­tor in suc­cess­ful implan­ta­tion and growth of the pla­centa appears to be aer­o­bic fit­ness in the six months prior to and the first half of preg­nancy. Once bio­me­chan­ics become dif­fi­cult in mid-pregnancy, women with mul­ti­ples can con­tinue activ­ity safely as long as mon­i­tor­ing show the babies are grow­ing appro­pri­ately. A belly sup­port can be extremely help­ful when exercising.

Con­traindi­ca­tions for exer­cise include the dis­cov­ery that one fetus is grow­ing at a sig­nif­i­cantly slower rate than the other(s), that both/all are too small, that the placenta(s) is/are mal­func­tion­ing, or some other con­di­tion occurs, such as an incom­pe­tent cervix or pla­centa pre­via, that would be a fac­tor in any case.

Absolute size dif­fer­ence does not nec­es­sar­ily mean that one baby is grow­ing more slowly, as some fetuses may be a cou­ple weeks younger than their uterus-mate(s) if the mother ovu­lated twice in the fer­til­ity cycle. Or, s/he might be smaller if genet­i­cally des­tined to be a smaller infant at birth. Thus, growth rate is the mea­sur­able fac­tor that helps deter­mine if a fetus is at risk of not receiv­ing ade­quate energy. This can hap­pen when there are two pla­cen­tas and one pla­centa is work­ing more poorly than the other, or for some rea­son there is a flaw in the umbil­i­cal cord of an iden­ti­cal. The com­pe­ti­tion for energy places a slower grow­ing baby at risk.

Pro­tect­ing Mom and Baby:

The pla­centa is designed to nour­ish the baby and will do so at a cost to the mother first if there is inad­e­quate nutri­tion. Thus, activ­ity to the level the mother can tol­er­ate and fol­low­ing nutri­tional guide­lines above — in the absence of med­ical com­pli­ca­tions — pro­duces healthy off­spring. Mul­ti­ples will gar­ner all the same ben­e­fits a sin­gle­ton does.

Note about images:  we strive to use images we own or that are adver­tised as free on the inter­net. We want to thank google, bing and yahoo for mak­ing free images available.

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Pregnancy Pathway, Pregnancy — Behavior: Avoiding Risks

By dancingthrupregnancy | Published August 30, 2009

Some­times it seems like preg­nancy is a time of restric­tions. Avoid­ing risks can be one thing that makes it seem that way. But, bear with us here in an inter­est­ing trip through dan­ger and find­ing you find ways of enhanc­ing your pregnancy!

Risk Fac­tor #1:

Lack of pre­na­tal care. More than any­thing else, be sure you have care. Hav­ing some­one mon­i­tor your health and that of your baby dur­ing preg­nancy is vital to a good out­come.

Risk Fac­tor #2:

Not exer­cis­ing. Seden­tary behav­ior increases the risk for meta­bolic, car­dio­vas­cu­lar and immune disorders.

I know, I know, you don’t have time to exer­cise. Well, pay now or pay later, as they say. Make time to go to a class (make sure it includes 20 –30 min­utes of aer­o­bics) a cou­ple times a week. A class will also pro­vide social sup­port, another fac­tor that enhances your preg­nancy. Take a walk at lunch time. Prac­tice relax­ation techniques.

Risk Fac­tor #3:

Breath­ing dan­ger­ous fumes. Yes, this includes smok­ing and second-hand smoke. But, it also means avoid­ing envi­ron­ments where there is a lot smog (near high­ways), liv­ing with mold or dust, and fancy cleansers that may have dan­ger­ous chem­i­cals in them. Stick with vine­gar, ammo­nia or bleach as cleansers.

Smog can endanger your fetus!

Smog can endan­ger your fetus!

We are learn­ing that com­bus­tion exhaust from cars and trucks can neg­a­tively affect birth weight and pre­ma­tu­rity. If you live or work near a high­way or in an area where smog is preva­lent, what are your options? Can you trans­fer or move? Can you wear a mask? Talk to your care provider and fig­ure out the best pro­tec­tion for you and your fetus.

Risk Fac­tor #4:

Poor Nutri­tion. Yup, just go back one entry and find out how food affects preg­nancy. If you don’t eat enough pro­tein and drink enough water, you don’t make suf­fi­cient blood vol­ume to nour­ish your pla­centa and thus your fetus.

Read labels!

Read labels!

Eat whole foods and learn to read labels when you buy processed foods. What is a “processed” food? Any­thing with more than one ingredient!

Some pro­cess­ing (ex: home­made soup) takes lit­tle nutri­tion away, but some pro­cess­ing (ex: potato chips) takes every­thing good away and replaces it with unsafe sub­stances. Look for low sodium, low sugar, high vit­a­min and min­eral con­tent items with no sat­u­rated or trans fats.

Read the ingre­di­ents; if you don’t know what the words mean, maybe you want to pass it up.

Risk Fac­tor #5:

Alco­hol and Drugs. Com­mon items can be as dan­ger­ous as street drugs, which

There is plenty of time in life for a glass of wine...later.

There is plenty of time in life for a glass of wine…later.

No. No. No. Only meds from your prenatal care provider are okay.

No. No. No. Only meds from your pre­na­tal care provider are okay.

Caffeine? Only one cup & only if you must.

Caf­feine? Only one cup & only if you must.

can severely com­pro­mise you baby’s future. If you have a drug or alco­hol habit, get help.

Risk Fac­tor #6:

Genet­ics. You can have genetic pre­dis­po­si­tions for many preg­nancy issues. How­ever, that does not nec­es­sar­ily mean you will develop a given dis­or­der. For exam­ple, nutri­tion and exer­cise greatly reduce the risk and sever­ity of meta­bolic issues. Some genetic issues are unavoid­able how­ever, and your care provider will alert you to these, if they are relevant.

Risk Fac­tor #7:

Social issues — iso­la­tion, lack of sup­port, abuse, poverty. All of these fac­tors can have neg­a­tive effects.

If iso­la­tion is a sim­ple mat­ter of need­ing to meet other moms-to-be, join an exer­cise pro­gram. That way, you get both sup­port and exer­cise; just be sure it includes aer­o­bics, along with cen­ter­ing, relax­ation and appro­pri­ate strength.

If your sit­u­a­tion is more dire, seek the help of a care provider or social worker at your local hos­pi­tal or clinic. Safety and sup­port are crit­i­cal for you at this time. Get the help you need. There are peo­ple who care. And, if you know of some­one who needs help, help them.

If you have other risk fac­tors to offer, please post them in the com­ments. Thanks!

What’s next?  BIRTH!!

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Pregnancy Pathway — Exercise

By dancingthrupregnancy | Published August 14, 2009

How lucky is this? Just a few days ago, yet another study was released and has been cir­cu­lat­ing on Med­scape and other med­ical sites that indi­cates exer­cise is ben­e­fi­cial in preg­nancy, whether the mother is a pre­vi­ous exer­ciser or not. Just in time for this entry!

Behavior Affects Pregnancy Outcome

Behav­ior Affects Preg­nancy Outcome

Phys­i­cal exer­tion (we call it “exer­cise” nowa­days) is a nor­mal state for healthy humans. Only in the last cen­tury has the desire to rest or the need to store extra calo­ries as fat become more pos­si­ble to achieve than our need to move about to survive.

Preg­nancy is a state in which both of these fac­tors (rest­ing and stor­ing calo­ries) are enhanced through organic changes in body chem­istry, adap­ta­tions that favor fetal sur­vival. The cur­rent seden­tary lifestyle exag­ger­ates these meta­bolic changes and results in syn­dromes that increase the risk for a num­ber of meta­bolic, car­dio­vas­cu­lar and immuno­log­i­cal dis­or­ders of pregnancy.

When con­fronted by the idea that it is coun­ter­in­tu­itive to think exer­cise in preg­nancy might be safe (let alone ben­e­fi­cial) I am dumb­founded. To me, it is coun­ter­in­tu­itive to think that a seden­tary lifestyle in preg­nancy might be safe!

Burning Calories in Pregnancy Improves Outcomes!

Burn­ing Calo­ries in Preg­nancy Improves Outcomes!

What is the evi­dence that exer­cise in preg­nancy is ben­e­fi­cial? Keep in mind that some stud­ies have been exe­cuted more expertly than oth­ers. But, what is com­pelling is that numer­ous well-respected researchers have sought to test the hypoth­e­sis that exer­cise is not safe, but come away with results that indi­cate the opposite!

Here are some of the major findings:

• The pla­centa is larger and has more trans­port sur­face in exer­cis­ers than seden­tary women

• The fetuses of (aer­o­bic) exer­cis­ing moth­ers make ben­e­fi­cial car­dio­vas­cu­lar adaptations

• Women who do aer­o­bic exer­cise are less likely to develop severe preeclamp­sia or ges­ta­tional dia­betes, and the long term health prob­lems that accom­pany these disorders

• Women who are aer­o­bi­cally fit recover from birth 10 times faster than seden­tary women (as mea­sured by time needed to metab­o­lize free rad­i­cals pro­duced in labor)

• Women who exer­cise in preg­nancy are more likely to be phys­i­cally fit in midlife

• Babies of aer­o­bi­cally fit women are at reduced risk for pre­ma­tu­rity and low birth weight
DTP_mover2
So, we have arrived at the take-home mes­sage: MOVE!! Preg­nancy works best when you move and burn calo­ries in a mod­er­ate to vig­or­ous fash­ion. But, alter­nate this activ­ity with rest and good nutri­tion, and be sure to stay well hydrated.
If you want more specifics and resources on this topic, try these:
“Women and Exer­cise” in Varney’s Mid­wifery.
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Pregnancy Pathway, Pregnancy – Exposure to Toxins and Infection

By dancingthrupregnancy | Published August 10, 2009

Hot topic for today: Tox­ins and infec­tions in pregnancy.

Pregnancy Exposure to Toxins and Infections

Preg­nancy Expo­sure to Tox­ins and Infections

A mother-to-be needs to be aware of items that can have adverse effects on the health and devel­op­ment of her fetus, as well as her own health. Two of these fac­tors are tox­ins and infec­tions.

1. Tox­ins can be food, envi­ron­men­tal fac­tors, and med­ica­tions, alco­hol or drugs. Let’s start with food. Inter­est­ingly, many plants have slight tox­ins in them that can have a small neg­a­tive impact dur­ing early fetal devel­op­ment. One the­ory of nau­sea and vom­it­ing in early preg­nancy is that this helps the mother’s body pre­vent these tox­ins from inter­fer­ing with nor­mal devel­op­ment. Pica — espe­cially eat­ing dirt that is largely clay — may be another man­i­fes­ta­tion of how the body strives to counter plant tox­ins, as clay can coun­ter­act some of the effects of these tox­ins. So, plant tox­ins can be one food source in early pregnancy.

Another source is food addi­tives (things you can­not pro­nounce, so read the ingre­di­ents!). We have no idea how many chem­i­cals and hor­mones added to foods affect fetal development.

NIH illustration of reading food label

NIH illus­tra­tion of read­ing food label

Risk-aversion involves avoid­ing items that are risky. If you are not sure, don’t eat it. For up to date infor­ma­tion, look at the FDA site on food safety or the NIH site on read­ing food labels.

Envi­ron­men­tal fac­tors that may affect fetal devel­op­ment can include air pol­lu­tion, house­hold cleansers, mold and other items encoun­tered any­where one goes. Things we breathe can be par­tic­u­larly dan­ger­ous, so be sure to keep cleanser use to sim­ple items such as vine­gar, ammo­nia or chlo­rine bleach. Wear­ing a mask while clean­ing is also a good idea.

Med­ica­tions, drugs or alco­hol that might nor­mally be con­sid­ered safe for a non-pregnant per­son — some­thing as sim­ple as aspirin — can be dan­ger­ous as they affect blood clot­ting fac­tors and threaten the pla­centa. Or, because they cross the pla­cen­tal bar­rier but can­not be metab­o­lized by the imma­ture fetal liver, they are toxic and induce dam­age to the fetus.

2. Infec­tions are of con­cern, as well. It is pos­si­ble that an active infec­tion at the time of fer­til­iza­tion and implan­ta­tion can con­tribute to dys­func­tion in preg­nancy because it inter­feres with the nor­mal immune responses of early preg­nancy. Hyper­ten­sion in preg­nancy may be related to infec­tion in the early days of preg­nancy. Some infec­tions — par­tic­u­lary sex­u­ally trans­mit­ted infec­tions — are known to have detri­men­tal effects on the baby’s health. Preterm pre­ma­ture rup­ture of mem­branes (P-PROM) almost always reflects active infection.

Tak­ing Pre­cau­tions: First, be sure to let your health care provider know about any ill­ness or infec­tion. Sec­ond, take care of your­self. Fol­low rec­om­men­da­tions for fre­quent hand­wash­ing and carry ster­ile hand gel in your purse or back­pack. Avoid places where hygiene might be com­pro­mised. Prac­tice safe sex.

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Pregnancy Pathway, Pregnancy — Maternal Immunological Response

By dancingthrupregnancy | Published July 6, 2009

Today: Mater­nal Immuno­log­i­cal Response…or…the Mother/Fetus Dance!

Maternal Immune Response During Pregnancy

Mater­nal Immune Response Dur­ing Pregnancy

Back to work! Thank you for your fore­bear­ance while we wrote a chap­ter for a nurs­ing textbook!

Dur­ing the course of preg­nancy, the mother/fetus dance is ongo­ing. The mater­nal immune sys­tem and the tro­phoblast cells con­tinue to influ­ence each other even beyond the implantation.

Because the mother’s immune response mod­u­lates near the start of each trimester, the fetus is affected to some degree and mounts a response, as well. For a long time it was thought that mater­nal and fetal DNA mate­r­ial was not exchanged across the pla­cen­tal mem­brane, how­ever recent find­ings indi­cate that there is some exchange of mate­r­ial. Thus, we all carry some por­tion of our mother’s DNA and our mother car­ries some of ours.

What is the impact of this chimeric effect? It depends on how well our DNA gets along!

How does this affect the fetus in utero? The fetus may be affected by clot­ting issues. Depend­ing on mater­nal health sta­tus s/he may be sub­ject to a stronger or weaker immune system.

How does this affect the mother? Women are more likely than men to develop autoim­mune dis­or­ders (preg­nancy play­ing a role here), and those who bear male off­spring are more likely than those who only have girls to have these disorders.

The maternal/fetal dance goes on.…

Be Prepared for Birth!

Be Pre­pared for Birth!

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Pregnancy Pathway, Pregnancy

By dancingthrupregnancy | Published May 11, 2009

Time for an entre: Preg­nancy!!

Up for discussion…

Health Influences in Pregnancy

Health Influ­ences in Pregnancy

Let’s start at the begin­ning…in the first trimester you feel sick and tired, right? Three things:

1) your immune sys­tem is pro-inflammatory (caus­ing nau­sea and fatigue), 2) your body is pro­tect­ing your fetus from some tox­ins (if you eat some­thing not so great for the fetus, you throw up), and 3) you have extreme swings in blood sugar lev­els so that after you eat, the level soars and you feel sick.

Num­ber 3 can be fixed with behav­ior, but you may have to wait out 1 & 2. To fix num­ber 3 eat very small meals fre­quently (6 or 8 times a day) and be sure to eat pro­tein, that is, eggs, meat, fish, fowl, cheese, nuts, rice & beans, soy, etc. with each small meal. This sta­bi­lizes blood sugar and pre­vents dra­matic ele­va­tions that can cause nausea.

In most healthy preg­nan­cies, the immune sys­tem will rebound in the sec­ond trimester so that you feel good; it is pro­tect­ing you again!  But, those wicked tox­ins and infec­tions are still out there in the envi­ron­ment, so the mes­sage is beware bad air (smog, smok­ing, indus­trial air pol­lu­tion), highly processed foods (lunch­meats, things with names you can’t pro­nounce), any drugs or meds not pre­scribed or okayed by your ob or mid­wife, alco­hol, and dan­ger­ous bac­te­ria, viruses and other microbes!

Exer­cise wisely…no sky-diving or scuba div­ing! Eat healthy food and get enough sleep. De-stress through relax­ation and med­i­ta­tive tech­niques. Don’t take risks with your health, but do stay active and start to pre­pare for birth and bring­ing home a baby (or two?).

Third trimester & the immune sys­tem goes on the fritz again — can’t keep this baby in here for­ever; must expel! You may feel sick and tired again. BUT, keep your pre­na­tal care appoint­ments, keep mov­ing, get good nutri­tion, rest and stay focused. Before you know it the real work begins, not to men­tion the 18 years of sleep deprivation.

Get­ting from here…

Being Fully Present in Your Pregnancy...

Being Fully Present in Your Pregnancy…

…to here..

Being Fully Present as Mom

Being Fully Present as Mom.

…is a jour­ney like no other. The adap­ta­tions of your body to the demands of preg­nancy are amaz­ing. If you pay atten­tion, you will learn more about the mean­ing of exis­tence from this than from any­thing else.

BE HERE NOW!!

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