US researchers confirm Zika causes birth defects

The mosquito-borne Zika virus causes birth defects, including a syndrome in which babies are born with unusually small heads, US health authorities attributing scientists confirmed on Wednesday after months of debate and uncertainty.


"Scientists at the Centers for Disease Control and Prevention have concluded, after careful review of existing evidence, that Zika virus is a cause of microcephaly and other severe fetal brain defects," said a statement from the federal agency.


The decision was based in part on a series of studies in Brazil, where thousands of babies were born last year with birth defects, coinciding with a spike in Zika virus infections among the general public.


"This study marks a turning point in the Zika outbreak," said CDC chief Tom Frieden.


"It is now clear that the virus causes microcephaly."


There was no "smoking gun," or single piece of evidence that offered conclusive proof, said the full report, published in New England Journal of Medicine.


Rather, the decision was made based on "increasing evidence from a number of recently published studies and a careful evaluation using established scientific criteria," said the CDC.


Further studies are being launched to "determine whether children who have microcephaly born to mothers infected by the Zika virus is the tip of the iceberg of what we could see in damaging effects on the brain and other developmental problems," Frieden added.


Zika virus was first identified in 1947 in Uganda, but the virus was poorly understood and symptoms have typically been mild, including rash, joint pain and fever. Most of those infected report no symptoms at all.

Zika was first identified in Brazil in early 2015, and a surge in infants born with microcephaly began nine months later, in September.


Brazil has confirmed 907 cases of microcephaly and 198 babies with the birth defect who have died since the Zika virus outbreak started, officials there said last month.


The Brazilian health ministry said it is still investigating 4,293 suspicious cases.


"The severe microcephaly and other brain anomalies that have been observed in many infants are consistent with an infection occurring in the first or early second trimester of pregnancy," said the report in the New England Journal of Medicine.


Until now, no mosquito-borne virus has been known to cause birth defects, and the last infectious pathogen known to cause an epidemic of birth defects was the rubella virus more than 50 years ago.


Experts reviewing the evidence of microcephaly in Brazil found a similar increase in the birth defects in French Polynesia, which was hit by an outbreak of Zika in 2013 and 2014, though the number of microcephaly cases was small, totaling just eight.


Microcephaly is a rare defect that occurs in six out of every 10,000 births in the United States.


The lack of clarity on whether or not Zika could be established firmly as a cause of birth defects may have contributed to poor public understanding of the virus and its risks, the report said.


A recent poll of Americans found that one in four were unaware of any association between Zika and birth defects, and one in five believed, wrongly, that there was a vaccine to prevent it.


Women who are pregnant or considering becoming pregnant are advised to avoid the more than 30 places in Latin America and the Caribbean where Zika is circulating, and to wear mosquito repellant if they live in those areas.


While is now known to Zika cause microcephaly and other severe fetal brain defects, the actual risk of such birth defects remains unknown.


Indeed, some women who were infected with Zika while pregnant gave birth to apparently healthy children.

The CDC said it would not change it recommendations for women who are or want to get pregnant. They should continue to avoid traveling to Zika infected areas. Their partners should either use condoms or abstain from sexual contact while the woman is pregnant.


"Establishing this causal relationship between Zika and fetal brain defects is an important step in driving additional prevention efforts, focusing research activities, and reinforcing the need for direct communication about the risks of Zika," said the CDC.


"While one important question about causality has been answered, many questions remain."

PREMATURE BIRTHS LINKED TO TOXIC CHEMICALS

The rate of premature births in the U.S. is among the highest in the developed world, with nearly one in 10 babies born in 2014 arriving before 37 weeks of pregnancy.

It’s also the number one cause of infant mortality. Very premature babies who do survive often endure serious problems for the rest of their lives, including diabetes, cerebral palsy, intellectual disabilities and breathing and vision problems, among other issues.

It’s difficult to pinpoint what causes pre-term birth, but many obstetricians as well as federal health authorities strongly urge pregnant women to avoid smoking, alcohol and illicit drugs. Poor nutrition, infection and carrying twins or triplets can also trigger early births. But research indicates the cause of roughly half of all premature births is unknown.

An emerging body of research is connecting pre-term birth to in utero exposure to toxic chemicals. You can learn more in this terrific video, Little Things Matter: The Impact of Toxins on Preterm Birth, by Bruce Lanphear, M.D., Ph.D, one of the world’s leading experts in children’s environmental health.

EWG was a pioneer in investigating industrial pollution in the womb, documenting the presence of toxic chemicals in the bodies of newborns.

EWG co-founder and president, Ken Cook, brought the findings of this landmark research to tens of thousands of people through a widely seen presentation titled 10 Americans. It’s a little over 20 minutes long – worth every second of your time if you’re worried about the impacts of toxic chemicals on our children’s health. 

Author,

Alex Formuzis

7 Ways to Stay Awake During Middle of the Night Nursing Sessions

Nursing mamas, let's get real for a second: the ability to feed your baby by pulling out a boob is pretty convenient, but there's one part that always throws me for a loop: the middle-of-the-night feed. Simply put: getting up to breastfeed in the middle of the night is kind of a drag. Sleeping when you have little ones is highly coveted, so waking up to a crying and hungry baby puts a slight damper on that glorious sleep.

I'm no stranger to the MOTN nursing session; I breastfed my first daughter for 16 months, and I'm currently exclusively breastfeeding my six-month-old baby. I'm not a whiz at math, but I know that combined, that's almost two years of being awake a whole heck of a lot in the middle of the night.

During those early newborn days, especially if you have a baby who likes to nurse forever, staying awake when the rest of the house is fast asleep can be extremely difficult. Sometimes I even have to turn on a light just to keep myself awake, while my precious little one sleeps on the boob, gulping down her midnight (and 2 am, and 4 am) snack in her “dream feed.” (And don't worry, there are plenty of times when she comes into bed with us and I catch some zzz's while nursing her–gotta love the side-laying position!)

I have some tricks up my sleeve that may help you keep your eyes wide open when all they'd rather do is close and go back to sleep.

Here are 7 Ways to Stay Awake During Middle of the Night Nursing Sessions:

#Way 1

Read a Book. It's no secret that moms have very little time to themselves once little ones come around, but one of the things I've missed from my kid-less days is reading. I have a Kindle app on my phone, and during each MOTN feed I pick up right where I've left off. Since the beginning of this year I've already read a dozen books with this method! The books I'm reading aren't super complicated, but they're fun, easy reads that help keep me awake long enough to nurse the baby. The bonus part to this is that I recently joined a book club; so nursing in the middle of the night is essentially helping me make friends! Win/win.

#Way 2 

Clean Out Your Phone Book. In this day and age, it's probably safe to say that your Rolodex is now stored on your phone, and if you're anything like me, you have dozens of numbers stored on there you probably don't need in there anymore. It's also extremely safe to say that you reallydon't have time in your day-to-day life to do something as mundane as looking through your list of contacts for people to delete. Well, now that you're up at oh-dark-thirty, you have plenty of time on your hands to take care of business.

 #Way 3

Play a Game. Nothing can make you doze-off faster than being bored and sleepy. Put that brain to work by playing a game on your phone. Words with Friends, Scrabble, or even that matching game you have on there for your toddler … anything that will make you think. I play games against friends, and you'd be surprised how many other moms are up right around the same time you are. Just don't be surprised if your baby finishes eating and you're still awake trying to get through just one more round. 

 #Way 4

Edit Those Pictures. I typically don't have time to post pictures during the day since I snap around a million photos on my phone just to get that one decent picture of my girls. When I'm breastfeeding I have some extra downtime to scroll through all my pictures, find the ones I like, and get them up on social media or into an email for the grandparents.

 #Way 5

Binge Watch TV. My first daughter was a marathon nurser, meaning she paced herself and was in it for the long haul for each feed. Thankfully, we had a subscription to Netflix, so I binge watched shows in the middle of the night. Consider this an opportunity to catch up on all those shows you've been meaning to watch someday.

 #Way 6

Get Some Food and Pour a Drink. Drinking water is essential to keeping up a good milk supply, so pour a tall glass of water (or keep a water bottle handy on your nightstand), to drink while nursing. During the early days when I was still establishing my supply (and ravenous any time I nursed), I even made some “booby bites” and kept several on my nightstand so I could tame my rumbling tummy during a MOTN feed.

 #Way 7

Get Out of Bed. If you're not keen on cosleeping, and don't want to risk falling asleep with the baby in your bed, get out of your bed and feed her in another room. The act of getting out of bed and walking somewhere else will help wake you up–then use one of the tips above to stay awake.

Author,

Jessica Lynn       

How To Avoid a Caesarian or C-Section Birth

C-Sections are epidemic in the United States. 1 out of every 3 women who is pregnant right now will have one. If you need a C-Section to save the life of your baby, it's nothing short of miraculous, and worth every bit of pain and risk.

Sometimes if your baby is breech and can't be turned, or in some cases with twins, a caesarean tremendously lowers the risk to your baby.

If you and your health care adviser have decided that a C-Section is warranted for safety reasons, you'll be scheduling it. Obviously, you'll want to choose a care-giver who's very experienced with C-Sections and a hospital with an excellent record.

But are you aware that C-sections:

1. Are major abdominal surgery with all the attendant pain and possible complications in the following weeks, just when you want to enjoy your new baby?
2. Increase your risk of hemorrhage and infection?
3. Result in a uterine scar and internal adhesions (scarring) that can cause pain and complications for years?
4. Increase your chances of later ectopic pregnancy and difficulty conceiving?
5. Increase your baby's chances of having asthma later in life?
6. Delay your breastmilk coming in, making it so much more difficult to breastfeed that many women give up?
7. Endanger the health of future pregnancies, increasing the chances of low birthweight, premature delivery and stillbirth?
8. Often leave women with medical complaints six months or a year later?

If you really need a C-Section, they are a miraculous life-saver. If you don't, it's best to avoid it.

Luckily, most C-Sections are not actually medically necessary. 85% of all pregnancies are normal and low-risk, and absolutely do not warrant C-Sections. In fact, there is absolutely no medical evidence that a caesarean is necessary just because you had one last time, or because you're over 40. Even with a multiple birth a C-Section is often more dangerous than a vaginal birth.

Most importantly, do you know that you can tremendously reduce your risk of C-section by picking a care-giver who uses certain kinds of birth practices?

VBAC

(Vaginal birth after caesarean) If you had a C-Section last time, you can still have a Vaginal Birth this time. Do you know the most decisive factor in whether a woman can successfully have a VBAC ? Age. But not the age of the mom, or the term of the baby. The age of the doctor!

That's because doctors used to be educated with the misinformation that uterine rupture was more likely with a VBAC. But the New England Journal of Medicine published a landmark study in 2004 showing that uterine rupture occurs in less than 1% of VBACs. In other words, a woman who had a C-Section is just as likely to be able to have a healthy vaginal birth as any other woman.

Are you over 40?

It's true that women over 40 have a 40% chance of having C-Sections, and it is exhausting and demoralizing to struggle through a prolonged labor only to end up in the operating room having a C-Section. BUT did you know that you can hugely increase your chances of being part of the 60% of over-40 year olds who have normal vaginal births? That's right. Most women over 40 do not need a caesarean, and can avoid having one.

Avoiding a C-Section: 
What every pregnant woman needs to know.

You can significantly reduce your chances of having a C-Section by informed choice of a caregiver and birth place. Here's how:

1. Exercise moderately during pregnancy.

Sedentary women are 4x as likely to deliver via caesarean section as women who did aerobics during the first or second trimester.

2. Find a caregiver who has a low C-Section rate

Find a caregiver who has a low C-Section rate and is experienced with successful VBACs. This is true even if you don't need a VBAC, because it means your caregiver doesn't default to caesareans.

3. Find a caregiver who will give you all the time you need

Find a caregiver who will give you all the time you need rather than rushing your delivery because of staffing issues.

4. Ask your caregiver what she does if your baby is in a breech position

Ask your caregiver what she does if your baby is in a breech position in late pregnancy. You want to hear that she is experienced with turning babies and always tries that before scheduling a C-Section.

5. Check Hospital policies.

If you're considering a VBAC, be sure to use a hospital that allows VBACs.

6. Arrange continuous trained labor support

Arrange continuous trained labor support which studies show keeps labor moving. If you aren't using a midwife, supplement your OB by hiring an experienced labor doula. A 2001 study in the journal of perinatal education showed a 56% reduction in the risk of caesarean in women receiving continuous one to one nursing/doula or midwifery care.

7. Be sure that your caregiver and birth venue encourage practices that support the normal process of labor and keep it moving:

• Arrange to stay upright and moving rather than lying down.
• Stay well-nourished and hydrated to give you energy
• Avoid continuous electronic fetal monitoring
• Avoid hastening labor with pitocin, which increases the severity of contractions and makes other medical interventions much more likely.

Breast or Bottle?

Research shows unequivocally that breastfed babies are healthier and smarter, and that the longer babies are nursed, the healthier and smarter they are. Because the nursing mother experiences hormonal changes that influence how she perceives and relates to her infant, many experts feel that the mother who nurses bonds more strongly with her baby, resulting in a better relationship over time.

1. PLAN to nurse.

Not "If it works out." But "I will do this." And you will. There are lots of times in history when infant formula wasn't available, as, for instance, in London during World War 2. Records show that every mom who gave birth during that time was able to breastfeed her baby successfully -- because there was no alternative.

2. Be Prepared.

The classic nursing hold is to cradle your baby's head in the crook of your arm, turn her whole body to face you so you're belly to belly, and move her to your breast so she can "latch on." That means she needs to be at the level of your breast, which means on a pillow, not on your lap. Many nursing moms say that a good nursing pillow, the kind with the circular cut-out for your belly, is hugely better than an ordinary pillow, which slides around and isn't necessarily the right height or firmness. You don't need most of what they sell for baby (I didn't use changing tables or cribs, for instance, or strollers in the early months), but a nursing pillow is a smart purchase.

3. Know Your Technique.

Good basic technique can tremendously lessen sore nipples, prevent clugged ducts and mastitis, and make the difference in whether breastfeeding works or not. A few helpful rules:

• Be sure your baby opens his mouth wide and gets not only the nipple, but most of the aerola in. This stimulates the full milk let-down as well as preventing sore nipples. Can't get him to open wide enough? Trigger the "rooting reflex" by tickling his mouth or cheek with your nipple.
• Be sure your baby is facing you so he doesn't have to turn his head to nurse.
• Be sure your baby is at breast level so you don't have to hunch over. You can relax better, insuring better milk let-down, and you don't get a sore back and neck.
• Don't know if he's in the correct position? His tongue should be slightly visible between his lower lip and your breast. If not, dis-engage him, tickle his cheek so he opens his mouth wide, and and let him latch on again.
• To save your nipples, dis-engage by inserting your finger at the side of his mouth and breaking the suction so he pops off. (Usually he will fall asleep nursing and the breast will fall out of his slack mouth, that is also fine.)
• Change holds and rotate the baby's position from feeding to feeding. This better drains the breasts and avoids clogged ducts, as well as protecting the nipples from soreness. For example, use the football hold (Baby's feet pointing behind you, hold his head in your hand) or try nursing lying down (prop yourself well with pillows, and if necessary put a folded blanket under baby so neither of you strains).
• Be sure you drink LOTS of water. Just drink water constantly.
• Change your bra daily so any leaked milk (even tiny amounts) doesn't cause a breast infection.
• Wait to introduce a pacifier or bottle until nursing is well-established.

4. Get a good start.

We don't grow up watching moms and aunts nurse their babies, and it isn't second nature to us, so sometimes it isn't as easy to get started nursing as we expect. It's easy to get unbearably sore nipples in the very beginning, or for the baby to have a hard time latching on. And very occasionally, babies are born with a challenge, such as being tongue-tied, which requires a quick snip under their tongue by a doctor.

While you're pregnant, arrange lactation support for that first week. It's a good idea to call your local La Leche chapter in advance just to have a couple of breastfeeding consultants' names handy. Such an expert often makes all the difference in the world. It is absolutely not worth the anxiety of muddling through when one session with an expert can put you and your baby on track.

5. Cultivate family support.

Make sure your partner understands your reasons for choosing to breastfeed. A little education goes a long way to overcome prejudices. Most men, with their wife's encouragement, find breastfeeding a miraculous act, especially once they understand how important it is for their baby. Your partner's support will be critical to your success.

6. Pick a pediatrician who supports breastfeeding.

Virtually all new breastfeeders worry about whether their child is getting enough milk. Most pediatricians are nursing advocates. Get him or her to help you as much as possible.

7. Remind yourself of all the advantages to you.

No middle of the night fixing of bottles. No sterilizing of bottles. No formula expenses. No formula allergies. As much ice cream as you want to eat, while the pregnancy pounds melt away. Diminished chance of breast cancer later. A delay in how soon your period resumes. Pride in the amazing ability of your womanly body.

8. Find other Moms who are breastfeeding to hang out with

...through La Leche or other groups. It makes all the difference in the world.

9. Resist the impulse to supplement with formula.

If you want your baby to take a bottle, pump your milk and have your partner offer it in a bottle once nursing is well established. (Don't wait too long or your baby may turn up her nose at this fakery!) Remember that the answer to too little milk is always to increase the demand by more nursing and/or pumping. Supplementing with formula -- even in an attempt to be sure your baby gets enough -- ALWAYS decreases your milk supply. If your baby needs more food, feed her more often!

10. Take a six month maternity leave

...if at all possible. Then, when you return to work, your child will be ready to supplement his morning and evening feedings with solid food during the day.

11. Relax. Enjoy. And don't be in a hurry to wean.

Don’t worry, she won’t be nursing in high school.

"Well, since you brought it up, when should I plan to wean? When I go back to work?"

 

Many studies confirm that breast milk changes in nutritional value to remain appropriate for babies as they grow into toddlers, maintaining its many health benefits. The National Association of Pediatricians recommends breastfeeding at least until age one, preferably longer. The average age of weaning around the world is four years old. So you might want to plan to nurse for at least a year, maybe two or three. (I'm biased here, I nursed both my kids till they were three. And I was back at work, in both cases, well before they weaned, but not for the first six months.)

So why do most mothers bottlefeed or, at best, wean in the first year?

 

Cultural pressures certainly influence many women. If no one around you is nursing a baby, it may be hard to envision yourself nursing. If your own husband -- or even complete strangers -- begin to chastise you for nursing an eleven month old who is learning to walk, you will probably begin to feel uncomfortable nursing, especially if you don't have support to continue.

But for most mothers, even those convinced of the benefits of nursing for their child, going back to work means the beginning of the end of breastfeeding. Most maternity leaves in this country are disgracefully short, averaging 6 weeks at 2/3 pay compared to an average of a year at full pay in most European countries. Fully half of all American women are not entitled to ANY paid maternity leave!

"Well, I do have to go back to work. What can I do?"

 

Wait as long as you can, so breast-feeding is well-established. By six months, your baby can supplement with solid food while you're gone. Remember that any reduction in demand will reduce your supply, so nurse her as much as you can when you're together, and pump at work.