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Helping to Reduce the Risk of Childhood Problems
By Lois Thomson


The birth of a baby is a joyous occasion, and in some cases mothers can take precautions to help make sure their child is as healthy as possible, both before and after the baby is born.

SIDS Awareness
The good news is that the rate of SIDS (Sudden Infant Death Syndrome) and other sleep-related deaths has decreased over the years. However, there is still work to do.

More than 1 out of 3 of sudden and unexpected infant deaths that occur in the United States each year are from SIDS. While research shows that unsafe bedding, such as loose blankets in a baby's sleep area, is a leading cause of infant death, there is currently no known way to prevent SIDS. However, following these recommendations reduces the risk of death or injury from suffocation or strangulation:

  • The back sleep position is the safest position for all babies, until they are 1 year old. Babies who are accustomed to sleeping on their backs, but who are then placed on their stomachs – such as for a nap – are at very high risk for SIDS.
  • Never place a baby to sleep on a soft surface, such as on a couch, sofa, pillow, quilt, sheepskin, or blanket, as these can be very dangerous. Do not use a car seat, stroller, swing, infant carrier, infant sling or similar products as a baby's regular sleep area.
  • As there are no known ways to prevent SIDS, avoid products that make claims to help reduce the risk. There is no evidence to show that wedges or other products that claim to keep infants in a specific position are effective. In fact, many of these are associated with injury and death, especially when used in baby's sleep area.
  • Breastfeeding has many health benefits for mother and baby. Babies who breastfeed are at lower risk for SIDS than are babies who were never fed breastmilk. Additionally, a longer duration of breastfeeding leads to lower risk.
  • Give your baby a pacifier for naps and nighttime sleeping. Pacifiers reduce the risk of SIDS for all babies, including breastfed babies.

In addition, mothers themselves can help lower the risk by getting regular prenatal care during pregnancy, and by avoiding smoking, drinking alcohol, and using marijuana or illegal drugs during pregnancy or after the baby is born. (www.webmd.com/parenting/sids-prevention#1)

Spina Bifida
Spina bifida is a type of birth defect in the neural tube that occurs when the spine and spinal cord don't form properly. Normally, the neural tube forms early in pregnancy and closes by the 28th day after conception. In babies with spina bifida, a portion of the neural tube doesn't close or develop properly, causing defects in the spinal cord and in the bones of the spine.

The two most common types are spina bifida occulta, which is the mildest and most common, and myelomeningocele, which is the most severe. Occulta results in a small separation or gap in one or more of the bones of the spine (vertebrae), and many who have it don't even realize it. Children with spina bifida occulta typically don't have any symptoms or complications, so routine pediatric care is usually all that is needed.

In myelomeningocele, the spinal canal is open along several vertebrae in the lower or middle back. The membranes and spinal nerves push through this opening at birth, forming a sac on the baby's back, often exposing tissues and nerves. This makes the baby prone to life-threatening infections and may also cause paralysis and bladder and bowel dysfunction.

Myelomeningocele is usually diagnosed before or right after birth, and these children should be seen by doctors throughout their lives, and families should be educated on the different complications to watch for. Spina bifida may cause either minor or more significant physical disabilities. The more significant ones include walking and mobility problems; orthopedic complications, such as scoliosis, abnormal growth, dislocation of the hip, bone and joint deformities, and muscle contractures; bowel and bladder problems; and accumulation of fluid in the brain.

While doctors aren't certain what causes spina bifida, some of the risk factors they have identified are a family history of neural tube defects, unchecked diabetes, and obesity. Additionally, one of the main problems is folate deficiency. Folate is the natural form of vitamin B-9, and is important to the development of a healthy baby. For that reason, having enough folic acid in your system by the early weeks of pregnancy is critical; however, because many women don't learn they are pregnant during this time, experts recommend that all adult women of childbearing age take a daily supplement of folic acid. Several foods are also fortified with folic acid, including enriched bread, pasta, rice, and some breakfast cereals. (www.mayoclinic.org/diseases-conditions/spina-bifida)

Can Autism be Detected at an Earlier Age?
Despite the fact that many children with autism are not diagnosed until after age 3, the Autism Foundation indicates that a number of symptoms may be detected by 6 months, or even earlier. Some things to look for in children newborn to age 1 would be smiling, looking at people or sounds, babbling or making sounds, responding to their name, crawling, or using their hands and passing things between them.

Between 12 and 18 months, children can be diagnosed more reliably as their behavior has been monitored for a longer period of time. Toddlers in this group should be able to say up to 20 words, know the names of objects like foods or colors, walk upstairs with support, and understand simple requests.

By the time children are 2 years old, they should be able to climb, play games with other children, speak in short sentences, remember the names of objects and point them out, and follow requests such as "Pick that up and give it to me." By age 3, they should express more emotions, show affection for others, be able to dress and undress themselves, speak in short sentences, and be able to turn door handles.

One of the most important things to keep in mind, however, is that all children develop differently, and the ability to not perform all of these functions by a certain does not necessarily mean a problem exists. Any questions you have should be discussed with the child's doctor. (autismdfw.org/how-early-can-an-autism-diagnosis-be-made)

Trying to Prevent Premature Births
According to the CDC, approximately 1 in 10 – or nearly 400,000 – babies are born preterm each year, or before completing the normal 37 to 40 weeks of pregnancy. These babies miss out on aa vital period of growth and development; for example, the brain, lungs, and liver need the final weeks of pregnancy to fully develop.

Premature birth rates did decrease between 2007 and 2014, and this was partly the result of the decline in the number of teens and young mothers giving birth; however, the preterm rate rose each of the next five years. Early birth is a leading cause of infant mortality, and babies who do survive can have short- and long-term health issues, including breathing problems, feeding difficulties, developmental delay, cerebral palsy, or vision or hearing problems.

Preventing early births is a challenge because there can be a number of causes, and those causes may be complex. However, some factors known to increase the risk of preterm birth are: young or advanced age of the mother, cigarette or substance abuse, stress, depression, and carrying more than one baby. The CDC has also identified five important strategies women can employ to help reduce their risk of preterm birth and improve their general health:

  • Aim for an ideal length of time – at least 18 months – between pregnancies
  • If you are between 18 – 44, seek access to health care, before and between pregnancies to help manage chronic conditions and modify other risk behaviors, such as smoking
  • Identify women at risk for giving birth too early and offer effective treatments to prevent preterm birth
  • Discourage deliveries before 39 weeks without a medical need
  • When in vitro fertilization is used, elect to transfer just one embryo, as appropriate, to reduce multiple births


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