Holiday Contributions That Make a Difference.

By anncowlin | Published May 7, 2011

This is the time of year many of us con­sider where to make our char­i­ta­ble con­tri­bu­tions. We have assem­bled a list of  groups to which you might want to con­sider giv­ing this year. By donat­ing to these orga­ni­za­tions you can help improve the lives of moth­ers, newborns,children and fam­i­lies around the world. Most will also send a card or email mes­sage to a mom in whose honor you give the gift.

UNICEF Inspired Gifts.  You can choose gifts that improve edu­ca­tion, water, health, nutri­tion, emer­gency care and other fac­tors that affect the well-being of women and children.

White Rib­bon Alliance for Safe Moth­er­hood. You can advo­cate for every mother and every child in 152 nations when you give to this organization.

Inter­na­tional Con­fed­er­a­tion of Mid­wives. This group exists to raise aware­ness of the global role of mid­wives in reduc­ing mater­nal and new­born child mortality.

The Fis­tula Foun­da­tion. This group exists to raise aware­ness of and fund­ing for fis­tula treat­ment, pre­ven­tion and edu­ca­tional pro­grams world­wide. Fis­tula is the dev­as­tat­ing injury cause by untreated obstructed labor.

The Preeclamp­sia Foun­da­tion. This orga­ni­za­tion sup­ports research to pre­vent and treat one of the most dan­ger­ous dis­or­ders of preg­nancy, one that accounts for a large per­cent­age of pre­ma­ture births and low birth weight infants. Hav­ing preeclamp­sia is also a risk fac­tor for later heart dis­ease for the mother.

Clean Birth. Clean Birth Kits are designed to pro­vide birth atten­dants and/or expect­ing moms with the tools they need to ensure a clean birthing envi­ron­ment. The Kits ensure the WHO’s “6 Cleans”: clean hands, clean per­ineum, clean deliv­ery sur­face, clean cord cut­ting imple­ment, clean cord tying, and clean cord care.

March of Dimes. The “mother” of all char­i­ties for help­ing pre­vent and treat dis­or­ders and dis­eases that affect children.

Peace, Love and Joy to all.

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High Birth Weight: The New Adverse Outcome

By anncowlin | Published October 6, 2010

While pub­lic aware­ness of low birth weight and pre­ma­ture infants is becom­ing — at long last — inter­est­ing to the main­stream cul­ture and media, another phe­nom­e­non is begin­ning to shake the pro­fes­sional birthing world:  high birth weight. Because it is occur­ring in a more afflu­ent ele­ment of soci­ety, it is alarm­ing. This tells us that you can­not buy your way out of preg­nancy risks that are cre­ated by a seden­tary, toxic food life-style.

Here is the dilemma:

Nor­mal weight and some over­weight women who eat too much in preg­nancy tend to have babies who are, basi­cally, already obese at birth. There­fore, these infants already have meta­bolic and car­dio­vas­cu­lar dys­func­tion. Babies born over 8 lbs. 14 oz. are at increased risk for Type 2 Dia­betes and heart disease.

Inter­est­ingly, the Insti­tute of Med­i­cine  recently issued new guide­lines on preg­nancy weight gain. After nearly 20 years of adher­ing to the “nor­mal” weight gain being 25 to 35 pounds, the Insti­tute rec­og­nized that pre­na­tal BMI plays a role in how much weight gain is nec­es­sary for a healthy pregnancy.

The evi­dence that under­lies this change demon­strates that gains greater than 22 pounds — for all clas­si­fi­ca­tions of pre­na­tal BMI — is the demarka­tion point for increased health prob­lems.  More infor­ma­tion on this is avail­able at:  New IOM Guide­lines.

We have known for a while now that obe­sity in preg­nancy puts mother and infant at risk for a num­ber of prob­lems from car­dio­vas­cu­lar, meta­bolic and immune dis­or­ders to pre­ma­tu­rity, low birth weight, increased need for cesarean birth and slow recov­ery. Add another one:  Obese new­borns with increased risk for heart and metab­o­lism problems.

Ref­er­ence on weight gain and high birth weight:

Lud­wig DS, Cur­rie J. The asso­ci­a­tion between preg­nancy weight gain and birth­weight: a within-family com­par­i­son. Lancet. 2010 Sep 18;376(9745):984–90. Epub 2010 Aug 4.

A good ref­er­ence for issues sur­round­ing obese pregnancy:

Leddy MA et al. The Impact of Mater­nal Obe­sity on Mater­nal and Fetal Health. Rev Obstet Gynecol 2008;1(4):170–178.

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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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Fetal Programming

By anncowlin | Published June 16, 2010

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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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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Weight Gain in Pregnancy — New IOM Guidelines

By anncowlin | Published December 15, 2009

In May 2009, the Insti­tute of Med­i­cine (IOM) issued new guide­lines on weight gain in preg­nancy. You can find this report at the URL listed below. As you may be aware, they are rec­om­mend­ing lower weight gains than previously.

Here is the link to the Guidelines:

IOM Preg­nancy Weight Gain Guidelines

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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 — Nutrition

By dancingthrupregnancy | Published August 28, 2009
Fresh fruit = vitamins & minerals!!

Fresh fruit = vit­a­mins & minerals!!

Ques­tion:

How many extra calo­ries do you need in each trimester to off­set the meta­bolic cost of pregnancy?

Answer:

First trimester — 0; Sec­ond trimester — 300; Third trimester — 500 (source: Insti­tute of Medicine).

Keep in mind that you may also need calo­ries for any fit­ness pro­gram you are doing. If you are con­tin­u­ing a pro­gram, the only change is due to the pregnancy.

If you begin or increase your activ­ity, you need to take that into account. One yoga class = 100 — 150 calo­ries. One aer­o­bics class = 200–400 calo­ries. Walk one mile = 100 calories.

1 slice whole grain bread = 50-100 calories

1 slice whole grain bread = 50–100 calories

Be sure you read food labels so that you can bal­ance your food intake and your calo­rie out­put. A small woman (under 5’3″ & 130 lbs.) prob­a­bly needs about 1200 calo­ries per day as a base. A medium sized woman needs about 1400, and a large woman (over 5’9″ & 160 lbs.) prob­a­bly needs 1600 to 1800 calo­ries. Add your activ­ity and preg­nancy needs to your base amount.

Ques­tion:

What foods are nec­es­sary for a healthy pregnancy?

Answer, part A:

PROTEIN. Lean pro­teins like turkey and those with omega 3 fats like ocean fish and eggs.…yes! EGGS!

Turkey is a good protein

Turkey is a good protein

Ocean fish 1 or 2 times/wk = good protein & omega 3 fat

Ocean fish 1 or 2 times/wk = good pro­tein & omega 3 fat

Eggs are a perfect pregnancy food!

Eggs are a per­fect preg­nancy food!

70–90 grams of pro­tein are nec­es­sary each day, along with  ade­quate water.  These are needed to make an extra 40% blood vol­ume required to sup­port the placenta.

Answer, part B:

WATER. Two (2) quarts of water…more if you are very active…are needed to make extra blood and to pre­vent dehydration.

Ques­tion: What else?

Fresh vegetables also provide fiber

Fresh veg­eta­bles also pro­vide fiber

Answer: CARBS. Fresh, col­or­ful fruits & veg­gies pro­vide nec­es­sary vit­a­mins and min­er­als, as well as fiber. Eat 5 serv­ings a day from all the col­ors:  yel­low, orange, red, pur­ple and green, and you will get live vit­a­mins all day long that help your baby develop prop­erly! Fruits, veg­eta­bles and whole grains are low glycemic index car­bo­hy­drates — the good ones!

Dairy provides calcium

Dairy pro­vides calcium

Ques­tion:

Do I need dairy prod­ucts and red meat? Can I get the needed min­er­als in other ways?

Answer:

Cal­cium is needed in ade­quate amounts for bones and teeth. It is most eas­ily obtained by drink­ing milk or eat­ing cheese, yogurt or cot­tage cheese. Soy, dark green leafy veg­eta­bles and cal­cium for­ti­fied juice are alternatives.

Iron is nec­es­sary for red blood cells to take up oxy­gen. It is found in high amounts in beef,  and lesser amounts in raisins, spinach, and prune juice. Pre­na­tal vit­a­mins are your insur­ance against defi­cien­cies of these essen­tial minerals.

Ques­tion:

Any­thing else that’s essential?

Answer:

Yes! Healthy FAT!!

Avocado is an excellent source of omega 6 fat

Avo­cado is an excel­lent source of omega 6 fat

In addi­tion to omega 3 fats found in fish, wal­nuts and flax seeds, you need also need omega 6 fats, which are found in avo­ca­dos, olive oil and other veg­etable oils. Healthy fats help bal­ance car­dio­vas­cu­lar con­stric­tion and dila­tion, reduc­ing the risk for hypertension.

Last Ques­tion:

What is a healthy weight gain?

Answer:

In 2009, the National Acad­emy of Sci­ences revised its rec­om­men­da­tions. It now bases desir­able weight gain on pre-pregnancy BMI (Body Mass Index…google this!).

BMI less than 18.5 (low) — 28 to 40 lbs.; BMI between 18.5–24.9 (nor­mal) — 25 to 35 lbs.; BMI 25.0 to 29.9 (high) — 15 to 25 lbs.; obese women (BMI over 30.0) — 11 to 20 lbs.

Com­ing Next: Avoid­ing Risks.

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