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Obese expectant mothers at increased risk of preterm birth

Women who are obese during pregnancy may be at increased risk of giving birth too early, a new study from Sweden suggests. In the study, obese women were more likely than normal-weight women to give birth to extremely premature babies those born between 22 and 27 weeks of pregnancy. (Pregnancy typically lasts 40 weeks.) In addition, the more obese a woman was, the greater her risk of preterm birth was, the study found. For women with severe obesity defined as having a body mass index (BMI) between 35 and 39.9 the risk doubled, and for women with extreme obesity (a BMI of 40 or higher), the risk was triple that faced by normal-weight women (those with a BMI between 18.5 and 24.9). Although these increases in risk were considerable, very few babies are born this prematurely. Most obese women in the study did not give birth to extremely premature babies. In the study, extremely premature birth occurred in 0.17 percent of normal-weight women, 0.21 percent of overweight women, 0.27 percent of mildly obese women, 0.35 percent of severely obese women and 0.52 percent of extremely obese women. Still, “considering the high morbidity and mortality among extremely preterm infants, even small absolute differences in risks will have consequences for infant health and survival,” the researchers wrote in the June 12 issue of the Journal of the American Medical Association. The study found an association, and cannot prove a cause-effect link between obesity and premature birth. However, the findings agree with the results of previous studies that have also shown such a link. Obesity is known to increase the risk of “medically indicated” premature birth that is, premature birth that is deliberately initiated by doctors, with a cesarean section or by inducing labor. This is because obesity increases the risk of medical disorders in pregnancy, such as preeclampsia and gestational diabetes. However, the new study also found a link between severe obesity and spontaneous extremely premature birth. The study examined information from more than 1.5 million births in Sweden between 1992 and 2010. Overall, about 5 percent of babies were born prematurely (before 37 weeks of pregnancy), including 4.36 percent who were moderately premature (between 32 and 36 weeks), 0.47 percent who were very premature (between 28 and 31 weeks) and 0.23 percent who were extremely premature. The findings still need to be confirmed in other populations, the researchers said. Because obesity in pregnancy can increase the risk of health problems for the mother and the baby, experts recommend that obese women limit their weight in pregnancy. The Institute of Medicine recommends normal-weight women gain 25 to 35 lbs. during pregnancy, overweight women gain 15 to 25 lbs. and obese women gain 11 to 20 lbs. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/11/obese-expectant-mothers-at-increased-risk-preterm-birth/

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Judge orders second child be put on adult waiting list for donated lungs

PHILADELPHIA – & A federal judge has ordered that a second child at a Philadelphia hospital -- a New York City boy -- be put on the adult waiting list for donated lungs. The ruling from U.S. District Judge Michael Baylson involves 11-year-old Javier Acosta of the Bronx, who has cystic fibrosis. His mother filed a lawsuit Thursday that says he will die soon unless he gets a lung transplant. The decision comes a day after a national organ transplant network complied with Baylson's unusual order to place a dying 10-year-old girl on the list. Children under 12 are currently matched with pediatric donors, which are rare, or wait at the end of the adult list. Medical ethicists question the judge's intervention. But lawyer Stephen Harvey, who represents both families, fears that Javier and Sarah will die while the issue is reviewed.source : http://www.foxnews.com/health/2013/06/06/judge-orders-second-child-be-put-on-adult-waiting-list-for-donated-lungs/

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Public health crisis in Mexico as breastfeeding rates drop, experts claim

Despite the well-known advantages to breast milk and vigorous campaigns around the world championing breast as best, Mexican mothers say the bottle is better. In a dramatic decline over the past six years, today only one in seven mothers in Mexico breast-feeds exclusively in the first six months, the standard recommended by the World Health Organization. That leaves Mexico with nearly the lowest level of breast-feeding in Latin America. Experts call it a public health crisis for a country where millions still live in extreme poverty, dirty water threatens the health of many families and education is poor. Mother's milk is richer in nutrients and antibodies that protect newborns from infections. Mexico has the highest infant mortality rate among the world's 40 largest economies. Between 2005 and 2010, breast cancer deaths increased twice as fast as Mexico's female population, with some experts blaming declining rates of breast-feeding; studies show it cuts a woman's risk of cancer by 50 percent or more. Officials blame an invasion of baby food ads, little regulation of formula companies and the failure of doctors to promote breast-feeding for an overreliance on formula. “Mexico has become the example of what not to do. It's the strongest case of a setback in breast-feeding,” said Marcos Arana Cedeno, a child nutrition expert and health adviser for the state of Chiapas. Feeding newborns with breast milk can save lives in developing nations, where children have higher chances of dying from diarrhea and pneumonia. The WHO has recommended for the past decade that infants be given only breast milk for the first six months. The percentage of Mexican moms who nurse their babies that long fell from 22 percent in 2006 to 14 percent last year, according to a Health Department survey. Only the Dominican Republic has a lower rate of breast-feeding in the region, at 8 percent. Other nations have improved their numbers, led by Brazil and Colombia, which in the past two decades more than tripled the percentage of mothers breast-feeding - to 47 percent in Colombia and 39 percent in Brazil. For many mothers drawn into the urban workforce, nursing a baby while juggling a job is too difficult. “I had to go back to work and I wasn't going to be able to breast-feed him for long. That's why I chose formula,” said Ruth Gonzalez, a clothing company manager. Gonzalez nursed her baby boy, Luis, only at night, after work. He drank formula during the day, and went off breast milk completely after a month. “Formula was just easier,” she said. Yet, even in traditional rural areas, the trend is downward. Breast-feeding fell by half in poor, rural areas, where babies are exposed to more sanitation problems, according to the Health Department survey. Nutritionists complain that Mexico has not adopted laws to meet guidelines adopted by WHO in 1981, which asked countries to restrict companies from providing free samples of formula or approaching new mothers to push their product. “It really is a tragedy,” said Teresa Gonzalez de Cossio, a nutritionist who researches breast-feeding at the National Institute of Public Health. “There is no one making sure we are following international codes. The country is not setting any goals regarding breast-feeding.” Countries such as Brazil and the United States have long stressed the importance of breast-feeding. The U.S. has improved its rate of mothers who exclusively breast-feed for the first six months to 16 percent in 2012 from 11 percent in 2007, according to the U.S. Centers for Disease Control and Prevention. Most New York City hospitals no longer hand out promotional samples of formula and ask new mothers to participate in talks on why human milk is better. Portland, Maine, started a campaign asking businesses to make mothers feel welcome to breast-feed wherever they want. Brazil reversed a decline in breast-feeding in the 1980s by strictly limiting advertising by baby food companies and airing prime-time informational spots with national celebrities to dispel myths, such as that women with small breasts were incapable of nursing. Mexico lets companies self-regulate on following the WHO guidelines. It has rules that say hospitals and doctors should guide new mothers through breast-feeding, but it doesn't enforce them. Dr. Rufino Luna Gordillo, the Health Department's deputy director of maternal and newborn care, said Mexico is renewing periodic checks of breast-feeding practices at public and private hospitals, a policy born in the early 1990s that had fallen by the wayside. “It's clear that these efforts have not been enough to get to the ideal breast-feeding levels,” Luna said in a written statement. “We need to debunk many myths about breast-feeding, limit the abuse of infant formula makers ... and award companies that offer nursing rooms.” Some new mothers say they didn't receive any help on breast-feeding after giving birth and say nurses, without seeking permission, offered formula to newborns at the nursery. In addition, with half of the babies born in Mexico via cesarean-section, many mothers struggle to nurse in the first hours and days after surgery. With little government promotion of breast-feeding, myths proliferate: sagging breasts do not provide healthy milk, or that nursing babies will spoil them. Pediatricians also hear women say that they want to stop breast-feeding so they won't lose their perky breasts. “In Mexico, breast-feeding is not a normative behavior,” said Chessa Lutter, the Pan American Health Organization's regional adviser for food and nutrition. “You are going to see probably walking down the street in Mexico City a lot more bottle-feeding than you are breast-feeding.” Advocates for breast-feeding say big business is to blame. They claim doctors are plied with gifts by formula makers to get them to help introduce infant formula to newborns. Elia Rangel, mother of a 9-month-old girl, Samantha, said a family physician told her not to breast-feed after six months. “We don't have information that is up to date,” she complained. “I came across a doctor at a public hospital who asked me how old Samantha was. She was 7 months. He told me, `Breast milk is no good; it can even harm her.' I was like, `Wow, where did you get this information?'” The government says it discourages the unnecessary use of formula, but Mexico's own Social Security Institute, whose logo shows a mother breast-feeding, provides formula to women even without a medical need if they present a doctor's note. As long ago as 1993, a study warned that Mexico needed to review that policy because of the high cost in both financial and health terms. The government still pays about $35 million a year on cans of infant formula from the Swiss-based food company Nestle, which receives more than 96 percent of the public money spent on formula. Nestle and the U.S.-based Mead Johnson, the two main baby food companies in Mexico, responded in statements that they support the WHO's code for breast-milk substitutes and comply with the law. They say they don't advertise food for babies less than 1 year of age or discourage mothers from breast-feeding. Nestle said it “does not give free supplies of infant formula to hospitals” and cited a 1992 “self-regulatory agreement” that the industry signed with Health Department to end the provisions of formula samples to Mexico's hospitals and doctors. Chris Perille, spokesman for Mead Johnson, said the company tells health professionals about the benefits of their products but doesn't break the rules. “Our work with these experts is conducted in accordance with the highest standards of ethics and integrity, and in compliance with all applicable laws, professional requirements and industry guidelines,” Perille said in a statement.source : http://www.foxnews.com/health/2013/06/06/public-health-crisis-in-mexico-as-breastfeeding-rates-drop-experts-claim/

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Dear Kim Kardashian, read this before you eat your placenta

It never ceases to amaze me how many expectant mothers sensationalize their pregnancies for publicity. And we all know the 'mother' of all publicity seekers’ whose name starts with a “Kim” and ends with “Kardashian.” Perhaps all the bad press she’s been getting about her looks throughout her pregnancy has finally gotten to her. On Sunday's season premiere of “Keeping Up with the Kardashians,” the 32-year-old reality star revealed she might be interested in eating her own placenta after her baby girl is born, in order to help her look younger. Kim, I want to preface this article by reminding you of an old adage that I think applies here: Don't kill the messenger. For years, I’ve been hearing that some patients, after giving birth, request to keep their placentas — though I’ve never actually had this experience in my own practice. Some of these patients desire to keep their placentas for cultural reasons. However, a growing trend is on the rise of new moms that actually want to eat them. A couple of years ago, a feature in New York Magazine called “The Placenta Cookbook,” took an in-depth look at the placentophagia fad from the professional placenta-preparer, to the women who call on her for services. Aside from profiling some of the people who take part in this trend, the article included anecdotal recipes and tips to enjoy the afterbirth delicacy — and even shared step-by-step instructions on how to prepare placental capsules in an attempt to preserve the nutritional value thought to be contained in the tissue. Beyond this particular article, various websites exist where mothers discuss how to drain the blood from the tissue and exchange recipes ranging from roast placenta to placenta lasagne. The growing popularity of this phenomenon has to do with the belief that consuming the placenta may offer a new mother certain health benefits, although there are no scientific studies to back up these claims. For example, some people believe that the placenta can help with the treatment of postpartum depression, or “baby blues.” It has been suggested in the past that postpartum depression in some patients is spurred by the quickly shifting levels of female hormones after giving birth, and that by eating the placenta, the hormones will stabilize and postpartum depression can therefore be prevented. Another thought is that the placenta can offer some degree of pain relief due to certain chemicals contained within the tissue. In ancient Chinese medicine, placental extracts are commonly mixed with herbs taken to relieve pain, stimulate milk production, and even to cure impotence. As it turns out, humans are actually one of the only mammals that don’t regularly eat their own placentas. Some researchers believe it must be because the placenta offers some fundamental biological advantage. It is known to contain high levels of things like iron, vitamin B-12 and certain hormones. But before jumping on the placenta bandwagon, I must admit that I myself have failed to find any concrete benefits to eating your own placenta. The medical community rarely comments on this practice, to be honest. In hospitals, the placenta has always seen as a biohazardous material. Remember that this is human tissue, and in theory, it could carry infectious diseases. However, these days, many hospitals are actively looking into procedures for handling patients who request to take home their placenta after birth. Do the doctors give it to her? Do they package it neatly and present it along with the newborn baby? Surprisingly, it appears that as long as certain medical criteria are met — such as both the patient and placenta being healthy — many hospitals will comply with the growing number of requests. Now, I’m no lawyer, but I don’t think there are any legal implications that would apply to prevent a mother from taking a placenta. Certainly there have been isolated cases where patients have been denied their placentas and challenged the hospitals. In 2007, Anne Swanson took her case to court after a Las Vegas hospital refused to fulfill her request to take home her placenta and won. Actually, Las Vegas seems to be a hotbed of placental-eating activity – so much so that researchers at the University of Nevada, Las Vegas did a small survey of 200 postpartum mothers who consumed their placentas and found that 95 percent of them reported improvements in their recovery and lactation. The researchers admit that the results may be due to the placebo effect, but plan to study the phenomenon more in-depth in the future.  So this is my final take: If you want to eat your placenta because you believe in its supposed health benefits, go right ahead. Just be aware that this material has to be handled with care, and you have to protect those around you from being exposed to any tissue waste that you may find unsuitable for consumption. Finally, please, keep it away from my dinner table.  source : http://www.foxnews.com/health/2013/06/04/placenta-its-whats-for-dinner/

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