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Baby’s tastebuds mirror Mom’s food choices?

Wednesday, November 30th, 2011

You’ve probably heard the claim that exposing a baby in the womb to Mozart will increase his or her IQ. Despite the hype, the research doesn’t support major leaps in smarts (but, if nothing else, it might improve your child’s musical taste, later on).

Now, there’s some evidence showing that you may be able to shape a yet-to-be-born child’s taste in food.

“The flavor and odors of what mothers eat show up in the amniotic fluid, which is swallowed by the fetus, and in breast milk. There is evidence that fetal taste buds are mature in utero by 13 to 15 weeks, with taste receptor cells appearing at 16 weeks, according to researchers.

“’With flavor learning, you can train a baby’s palate with repetitive exposure,” said Kim Trout, director of the nurse midwifery/women’s health nurse practitioner program at Georgetown University.

“Trout recently co-authored a paper that reviews the evidence on prenatal flavor learning and its implications for controlling childhood obesity and diabetes, among the country’s most pressing health problems…”

 

Although I’m just as skeptical of this claim as I am about the one for baby-and-Mozart, I see real benefit in giving this a try, whether it makes your baby want broccoli or not. That’s because, in my practice, I see too many women gaining too much weight during pregnancy, which can not only cause complications for mother and baby, but can be almost impossible to shed once your baby is born.

So, bring on the Brussels sprouts, and eschew the Twinkies. Pass by the apple pie and bite into a nice juicy apple instead. Whether it does a thing to change your baby’s mind about what tastes good later in life, it will do a world of good for you both right now.

– Yvonne S. Thornton, MD, MPH

You are what you eat…and so is your baby

Thursday, October 20th, 2011

We’ve all been told how important it is to eat well in order to stay healthy. Now, new research shows that what you eat when you’re pregnant can be as important for your baby as it is for you.

A study published in the Archives of Pediatrics and Adolescent Medicine shows that when mothers-to-be ate healthful foods, such as those that make up the so-called Mediterranean diet, their babies had fewer birth defects such as cleft palates and neural tube defects.

The Mediterranean diet focuses on vegetables, beans, fruits, grains and fish, and is lower in meat, dairy and “empty” carbs.

Before you panic if you’re reading this while gorging on burgers and fries, no, your baby isn’t going to be born with birth defects just because you’re taking a vacation from your diet. The birth defects researchers looked at in the study are quite rare to begin with. It’s just that they are rarer still among women who eat well.

But the study does hint at something we know: your baby’s development depends, in part, on the nutrients you consume. So, give your little one a head-start on a good future. You’ll be doing a favor for both of you.

– Yvonne S. Thornton, MD, MPH

Moms-to-be: A New Warning Against Smoking

Monday, March 7th, 2011

A study by the CDC, appearing in the journal Pediatrics shows, once again, that smoking cigarettes during pregnancy (with its nicotine and other toxic substances) is a health risk to your baby. Reuters Health reports:

…women who smoked early in pregnancy were 30 percent more likely to give birth to babies with obstructions in the flow of blood from the heart to the lungs, and nearly 40 percent more likely to have babies with openings in the upper chambers of their hearts.

We’ve known for many years of the dangers of smoking during pregnancy, and this study just adds to that knowledge. Mothers-to-be take note: what goes into your body affects your baby—possibly for a lifetime.

– Yvonne S. Thornton, MD, MPH

Time to Deliver? Mother Nature Knows Best

Thursday, December 30th, 2010

For years, I’ve been sounding the alarm about Cesarean delivery on-demand, and have persuaded my patients that childbirth isn’t something you can simply pencil into your schedule when convenient. It’s not just that a baby needs all the time nature gives her within the womb to develop, and that delivering just a few days early can mean that lung development and other functions may be potentially compromised. Cesareans are major surgery, which brings inherent danger to both mom and newborn. Necessary Cesareans are often life-savers. Unnecessary Cesareans can be just the opposite.

And now, at last, the word is spreading.

The San Jose Mercury News reports:


Babies born early through induction or C-section without a medical reason are nearly twice as likely to spend time in the neonatal intensive care unit, researchers say. They also are more likely to contract infections and need breathing machines, according to a 2009 study in the New England Journal of Medicine and a number of other reports.


“We are finding out that the last weeks of pregnancy really do count,” said Leslie Kowalewski, an associate state director for the March of Dimes.


“At 35 weeks, the brain is only two-thirds of what it will weigh at 40 weeks.” Many organizations are responding with programs designed to eliminate early elective deliveries. Most significantly, chapters of the American Congress of Obstetricians and Gynecologists have begun to notify doctors about the serious consequences of performing early elective births.

With luck, as information about potential consequences spreads, expectant mothers and their doctors will decide to let nature take her course, for the sake of the mom’s health and her baby’s.

– Yvonne S. Thornton, MD, MPH

When New Moms – or New Dads – Get the Pregnancy Blues

Friday, May 21st, 2010

Most women are familiar with the term post-partum depression.  Start with all the stresses of adding a new member to the family – not just the financial burden, but the schedule upheaval, the sleep deprivation, and the demands of a tiny person who can only make his or her needs known by wailing. Add the wild surge of hormones flooding a woman’s body, and is it any wonder that she might not be the picture of serenity and assurance? Estimates vary on the prevalence but as many as 25 percent of new moms may experience some level of depression either before or after delivery.

That’s bad enough, but now a study suggests that new fathers, just like new mothers, can find themselves overwhelmed when baby makes three (or more).

“The study, published in the Journal of the American Medical Assn., found that 10.4% of men experienced serious depression at some point between his partner’s first trimester and one year after childbirth, more than double the depression rate for men in general. American men were more likely to experience prenatal or postpartum depression compared with men in other countries, 14.1% in the U.S. compared with 8.2% internationally.”

What can you do when the guy you depend upon to keep you sane is going through his own blue period?

Your most important step –the one you should take if either you or your partner starts to feel sadness, agitation or hopelessness – is to talk to your doctor. Don’t try to tough it out. Reach out for help at the first signs that something isn’t quite right. It’s possible that all you need to get back to your cheery old selves is a good night’s sleep, but sometimes, you need more. The good news is that help is available. But first, you have to be aware of the signs of depression.

Post-partum depression can be debilitating if you let it go, so take steps immediately to get yourself and your new family back into the swing of enjoying things together again.

– Yvonne S. Thornton, MD, MPH

The controversy over male circumcision: facts and falsehoods

Monday, March 1st, 2010

For parents of baby boys, the question of whether to circumcise is likely to come up. You might make the decision to circumcise or not, depending on your religious, family, or cultural traditions. Or your decision might involve considerations about your newborn’s health. Hygiene is easier and urinary infections are less prevalent among boys and men who have been circumcised. Circumcised men are less prone to cancer of the penis. And there is some evidence that circumcised men are at slightly less risk of sexually transmitted diseases, including HIV/AIDS.

Still, you may not wish to have a surgical procedure that isn’t absolutely necessary performed on your baby.

Whatever you decide, that decision should be based on the facts and not the false controversies that have been swirling around the Internet.

Contrary to some inflammatory claims that have appeared on popular websites, there is no similarity whatsoever between male circumcision and the disfiguring procedure done on girls in some Third World countries that’s referred to as female circumcision. Male circumcision is a generally safe, simple procedure that removes only the foreskin of the penis. Female circumcision, by contrast, removes the entire clitoris and sometimes parts of the labia.

Female circumcision is a brutal, abusive act that has a negative lifelong effect on sexual function and pleasure in adulthood. Male circumcision has no effect on sexuality.

So don’t be swayed by false claims, even those made by experts. And, if you’re undecided, discuss the pros and cons of circumcision with your doctor.

– Yvonne S. Thornton, MD, MPH

Compared to white babies, twice as many African-American babies die in their first year of life

Monday, January 18th, 2010

As we celebrate the birthday of one of America’s greatest African-American leaders, Dr. Martin Luther King, and we take pride in the leadership of our first African-American president, Barack Obama, it’s easy to assume that racial disparities are a thing of the past.

But our infant mortality rates tell us that that’s not so.

According to the Centers for Disease Control (CDC), infant mortality among African-American babies is more than twice that of white babies. Among the other troubling statistics in the CDC report:

  • African Americans had 1.8 times the sudden infant death syndrome mortality rate as non-Hispanic whites, in 2005.
  • African American mothers were 2.5 times more likely than non-Hispanic white mothers to begin prenatal care in the 3rd trimester, or not receive prenatal care at all.
  • The infant mortality rate for African American mothers with over 13 years of education was almost three times that of Non-Hispanic White mothers in 2005.

America is still a country where people of color face discrimination at every turn, even if it’s less overt than it was in our past. Bias limits educational opportunities, employment opportunities, and it even limits the opportunity of pregnant women to get access to good healthcare.

If Dr. King could see us today, I know he’d be pleased at how far we’ve come. But if we haven’t provided our youngest and most vulnerable citizens equality in medical care, we still have a long way to go.

– Yvonne S. Thornton, MD, MPH

Pregnancy and Swine Flu: a Dangerous Combination

Friday, December 4th, 2009

The word from the Centers for Disease Control is that women who are pregnant are at high risk from the H1N1 virus, also known as the swine flu.

If you’re pregnant, you need to get vaccinated with both the seasonal and the H1N1 vaccines. It’s the single best way to protect yourself and your baby from the flu. And don’t let the anti-vaccination rumors swirling around the Internet scare you into delaying or avoiding a flu shot. According to the CDC, the seasonal flu vaccine has been administered to millions of women and has not been shown to harm women or their babies. The 2009 H1N1 flu shot is made in the same way and in the same places as the seasonal flu shot.  You may receive both flu shots at the same time; however, they should be given at different sites on your body, e.g., left arm and right arm.

Although recent cases of swine flu have been diminishing, influenza epidemics tend to come in waves. So even if there are few new cases of the flu in your area, it may just be a lull and you could get hit by the next wave. Get vaccinated now, if the vaccines are available in your area. Get everyone in your household vaccinated to prevent the disease from spreading among family members. Babies under 6 months of age are too young to get the vaccine so it’s especially important to their health that other members of the household are vaccinated to protect against family members spreading the virus.

Here are some other ways you can protect yourself from the germs all around us.

  • Wash your hands often with soap and water. Or use small bottles of alcohol-based hand sanitizer you can carry in your purse.
  • If you have flu symptoms, call your doctor immediately. Pregnant women tend to get more serious cases of this flu and it’s important to get treatment. Your doctor can prescribe medicines that will help.
  • Don’t assume that, just because you don’t have a fever, you don’t have the flu. This flu doesn’t always cause fever.
  • Try to avoid contact with others who appear ill. If someone in your family gets sick, ask your doctor to prescribe medications that may prevent you from getting sick, too, such as Tamiflu® or Relenza®.
  • Cover your nose and mouth with a tissue when you cough or sneeze and throw the tissue away immediately. If a tissue isn’t available, sneeze into your sleeve, not your hand.
  • Keep your cabinets well stocked with non-perishable foods as well as other basics and medicine that you might need if you got sick.

The CDC warns that if you are pregnant and experience any of the following, you must call 911 immediately:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Rapid pulse over 100 beats per minute
  • Severe or persistent vomiting
  • A high fever that is not responding to Tylenol®
  • Decreased or no movement of your baby

Just remember, the nasal spray vaccine is not licensed for use by pregnant women because it is a live, attenuated virus. Pregnant women should not receive nasal spray vaccine for either seasonal flu or 2009 H1N1 flu. After delivery, women can receive the nasal spray vaccine, even if they are breastfeeding.

In summary, get vaccinated, practice good hygiene, and call your doctor immediately if you get sick, and you and your baby should come through this flu season just fine.

– Yvonne S. Thornton, MD, MPH

Labor & Delivery: Don’t try this at home

Monday, November 30th, 2009

Most women today have no idea how dangerous it once was for a woman to give birth. The maternal death rate today is about eight per 100,000 births.  When home births were in style, the maternal death rate was 83 per 100,000 births – 10 times the number of deaths.

Women today almost never die in childbirth because, when things go wrong during labor and delivery, medical professionals can step in and prevent emergencies from becoming tragedies.

Which is why I want to scream when I read nonsense like the following, from a website calling itself “Born Free.”


“Welcome to Bornfree! This site is based on the belief that childbirth is inherently safe and relatively painless provided we don’t live in poverty, and do not interfere either physically or psychologically. Drugs, machinery, and medical personnel are not only unnecessary in most cases, they are also no match for a woman’s own intellect and intuition.”

The site quoted above advocates for unassisted childbirth at home. No doctor. No midwife. And no professional help at the ready if something goes wrong.

Ordinarily, I wouldn’t get too exercised over an obscure website. But, it’s how I found this website that has me troubled. It was featured in an article on ABC News.com in the “Entertainment” section. The article mostly extolled the concept of women giving birth at home, with neither a midwife nor a doctor present, giving only the briefest nod to the caveats from an ob-gyn.

In the age of reality TV, maybe a piece about women risking their lives to experience “freebirth” makes good copy. Maybe, because it was in the Entertainment section, this quote from a mother who recently gave birth on her own didn’t raise any eyebrows: “…it is not risky if you do your homework.”

But ask an ob-gyn and you’ll get a much different albeit less entertaining quote.

Yes, so-called “freebirth” is risky. And no, you can’t mitigate the risk by doing “homework.” Approximately 40 percent of high-risk patients appear to be low-risk before labor and delivery. No amount of “homework” can prepare a woman for suddenly finding herself among those 40 percent. If she’s at home, without medical attention, she and her baby could be in serious danger.

Most certified nurse midwives are affiliated with hospitals today precisely because the unexpected can and does happen during childbirth and having medical and surgical teams within shouting distance can mean the difference between life and death. The birthing process is still the 11th leading cause of death in women between 15 and 44 years of age.

When I was in the military, we received a stat call about a home birth gone wrong. The woman lost all muscle tone in her uterus after the birth of her child. By the time the ambulance got her to Bethesda, she had bled to death.

So I’ve seen firsthand how “freebirth” can be a recipe for disaster.

– Yvonne S. Thornton, MD, MPH

Why newborns wear hats in the nursery

Wednesday, May 27th, 2009

When I began my faculty OB practice at The New York Hospital-Cornell Medical Center Lying-In Hospital in 1982, I made sure that all the babies I delivered were outfitted in little Thinsulate® turbans: blue for boys; pink for girls.

At first, some of the other obstetricians thought this looked a bit strange but I wasn’t making a fashion statement. Newborns can have difficulty stabilizing their body temperature when they first leave the womb. There is a precipitous drop in temperature from in utero existence (~99 degrees F.) to room temperature 72 to 75 degrees F. in the delivery room and the nursery. Up to 50 percent of your new baby’s body heat can escape through the head as he or she adjusts to life outside mom’s cozy body. This heat loss differential is lessened by drying the infant, placing him or her under a radiant warmer and covering its head.

Today, almost all hospitals cover newborns’ bald little noggins to compensate for this heat loss. As a side benefit, they do look cute in their blue and pink caps.

– Yvonne Thornton, MD, MPH