Multiples in the NICU

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Ob/Gyns Warn Against ‘Vaginal Seeding’ Trend for Newborns

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Special thanks to our friends at HealthDay for providing this story.

 

The U.S.’s leading group of obstetricians and gynecologists is warning against a new trend where babies born by C-section are “seeded” via cotton swabs with vaginal microbes from the mother.”Vaginal seeding” is growing in popularity because it’s thought that babies born through Cesarean-section miss out on certain “helpful” vaginal microbes that might shield the infant from asthma, allergies and immune disorders.

“Vaginal seeding has become a rising trend for patients,” noted Dr. Jennifer Wu, an ob/gyn at Lenox Hill Hospital in New York City. “Patients read about the benefits of a vaginal delivery and hope to replicate these benefits with vaginal seeding.”

As explained by the American College of Obstetricians and Gynecologists (ACOG), it’s thought that contact with healthy vaginal bacteria helps stimulate the infant immune system, prevents the growth of dangerous bacteria and regulates the gut.

That contact doesn’t happen for babies born via C-section, however, so in vaginal seeding, a cotton swab with vaginal fluids from the mother is used to transfer vaginal bacteria to a newborn.

But in a statement issued Oct. 24, ACOG — the nation’s largest ob/gyn organization — said the procedure is not recommended because the known risks outweigh any potential benefits.

“Due to the lack of sufficient data, the very real risks [of vaginal seeding] outweigh the potential benefits,” Dr. Christopher Zahn, ACOG’s vice president of practice activities, said in a college news release.

“By swabbing an infant’s mouth, nose or skin with vaginal fluid after birth, the mother could potentially, and unknowingly, pass on disease-causing bacteria or viruses,” he explained.

Wu agreed. “There are very real risks attached to this practice,” she said. “Certain viruses, such as group B strep and herpes, can cause serious illnesses such as meningitis in newborns.”

And Zahn stressed that there’s a much safer way for a new mom to transfer her helpful bacteria to her newborn: Breast-feeding.

“Breast-feeding for the first six months is the best way to overcome the lack of exposure to maternal vaginal flora at birth,” Zahn said. “The bacteria present in breast milk and on the nipple is sufficient for natural colonization or seeding of the gut. There may be some initial difference in the gut [microbes] of infants based on mode of delivery, but research has shown that difference disappears after about six months,” he added.

If a woman does insist on vaginal seeding, her ob/gyn needs to make sure the patient understands the potential risks, ACOG said.

Dr. Mitchell Kramer is head of obstetrics and gynecology at Huntington Hospital in Huntington, N.Y. He agreed that breast-feeding is a good means of transmitting healthy microbes from a mom to her baby, but that “the jury is still out on [vaginal seeding] and further study is necessary before this is recommended as a routine protocol.”

SOURCES: Jennifer Wu, M.D., obstetrician/gynecologist, Lenox Hill Hospital, New York City; Mitchell Kramer, M.D., chairman, obstetrician/gynecologist, Huntington Hospital, Huntington, N.Y.; American College of Obstetricians and Gynecologists, news release, Oct. 24, 2017.

Pregnancy and Infant Loss Remembrance Day

Today at 7:00 pm in all time zones, families around the United States will light candles in memory all of the precious babies who have been lost during pregnancy or in infancy.  Too many families grieve in silence, sometimes never coming to terms with their loss.

If you or someone you know has suffered a miscarriage, stillbirth or infant loss due to SIDS/SUID, prematurity or other cause, we hope you will join us in this national tribute to create awareness of these tragic infant deaths and provide support to those that are suffering.

More information can be found here.

October 15th, 2017|Infant Multiples, Multiples in the NICU, Preemies|

Hearing Test May Predict Autism Risk Sooner

autism brainA simple hearing test may help identify young children at risk for autism before they’re old enough to speak, a new study suggests.

Researchers from the University of Rochester in Rochester, N.Y., say they’ve identified an inner-ear problem in children with autism that may impair their ability to recognize speech.

“This study identifies a simple, safe and noninvasive method to screen young children for hearing deficits that are associated with autism,” said study co-author Anne Luebke, an associate professor in the departments of biomedical engineering and neuroscience.

“This technique may provide clinicians a new window into the disorder and enable us to intervene earlier and help achieve optimal outcomes,” she said in a university news release.

Autism spectrum disorder is characterized by impaired social-communication skills and restricted and repetitive behaviors. While many signs of autism appear before age 2, most children aren’t diagnosed until after age 4, the researchers said. They suggested that if treatments could start sooner they might have more impact.

For the study, Luebke and her colleagues tested the hearing of children between ages 6 and 17 with and without autism. Those with autism had hearing difficulty in a specific frequency (1-2 kilohertz, or kHz) that is important for processing speech.

The degree of hearing impairment was associated with the severity of autism symptoms, according to the study.

Hearing “impairment has long been associated with developmental delay and other problems, such as language deficits,” said study co-author Loisa Bennetto, an associate professor of clinical and social sciences in psychology.

“While there is no association between hearing problems and autism, difficulty in processing speech may contribute to some of the core symptoms of the disease,” Bennetto said.

If future research confirms the findings, the study authors say the screening could help identify children at risk for autism earlier and perhaps get them services sooner.

“Additionally, these findings can inform the development of approaches to correct auditory impairment with hearing aids or other devices that can improve the range of sounds the ear can process,” Bennetto said.

The hearing test is noninvasive, inexpensive and does not require a child to respond verbally, so it could be adapted to screen infants, the researchers said.

The study was published in the journal Autism Research.

Thanks to HealthDay for covering this topic!

Pregnancy Problems More Likely with Boys?

pregnant womanSerious pregnancy complications are more likely when women are carrying baby boys, new research suggests.

After analyzing more than half a million births in Australia, researchers said the baby’s gender could be linked to the health of both mother and child.

“The sex of the baby has a direct association with pregnancy complications,” said study first author Dr. Petra Verburg, of the Robinson Research Institute at the University of Adelaide in Australia.

Boy babies were more likely to be born early, which sets up infants for more health problems. Also, women carrying boys were slightly more likely to have diabetes during pregnancy (gestational diabetes), and pre-eclampsia, a serious high blood pressure condition, when ready to deliver, the study authors said.

Although it isn’t totally clear why this is so, “there are likely to be genetic factors,” Verburg said.

The findings ring true, said Dr. Querube Santana-Rivas, a neonatologist at Nicklaus Children’s Hospital in Miami, who wasn’t involved in the study. She said she sees the differences in her own practice.

“Male gender is a risk factor for a lot of the complications right after birth, especially in the premature population,” Santana-Rivas said.

The results also echo some findings from previous studies, Verburg said. A potential explanation is that the placenta, the organ that nourishes the developing fetus, is different in boys and girls.

“The placenta is critical for pregnancy success, and it is an organ that technically belongs to the baby, so it is genetically identical to the baby,” said study co-author Claire Roberts, another researcher at the Robinson Research Institute.

In previous research involving normal pregnancies, Roberts’ team found sex differences in the expression of 142 genes in the placenta. The researchers said that defects in how the placenta develops and works are linked with pregnancy complications.

For the new study, Verburg, Roberts and colleagues evaluated more than 574,000 Australian births from 1981 through 2011.

Compared to girls, boys had 27 percent higher odds of preterm birth between 20 and 24 weeks’ gestation; 24 percent greater risk for birth between 30 and 33 weeks; and 17 percent higher odds for delivery at 34 to 36 weeks, the study found. Full-term birth is between 39 and 41 weeks, according to the American College of Obstetricians and Gynecologists.

Moreover, gestational diabetes was 4 percent more likely in women carrying boys, and pre-eclampsia at term was 7.5 percent more likely with boys, the researchers said.

However, women carrying girls had a 22 percent higher risk of getting pre-eclampsia early in pregnancy, requiring preterm delivery, the study found.

Still, the research merely shows an association between gender and birth complications, not a cause-and-effect relationship. The findings shouldn’t alarm mothers-to-be, no matter what the sex of their unborn child, said Roberts.

The advice, for now, is the same as for all women who become pregnant, Roberts said. That means eating a good diet and attempting to maintain a healthy weight before conceiving.

“Even if the pregnancy was unplanned,” Verburg said, “there is still a window of opportunity for a woman to reduce her risks for pregnancy complications.” A woman can stop smoking, not drink alcohol and stay physically fit, she said.

Santana-Rivas agreed. She said the take-home message from the new study is for women to be aware of the potential risks “and to get good prenatal care.”

Depending on what future research finds, prenatal programs for pregnant women might one day vary based on whether they are carrying a boy or a girl, the researchers said.

The study was published online July 11 in PLOS ONE.

Are you ready for RSV season?

Preemie NICUAlthough RSV is the most common cause of respiratory tract infection in children under five years of age, most people are unfamiliar with the disease. RSV can be particularly serious in infants born prematurely, which of course, means most multiple births. Find information and resources on our PreemieCare page.