After Childbirth Ebook
Getting Back Into Shape After The Pregnancy
Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.
All states require that infants' eyes be protected from this infection immediately after birth. Gonorrheal eye infections were a leading cause of blindness until early in the 20th century, when postnatal treatment of babies' eyes became mandatory. The hepatitis B vaccine can protect infants from any possible contact with this virus. Therefore, your baby may be given this vaccine in the hospital or birthing center shortly after birth. Alternatively, the hepatitis B vaccinations may be given along with other immunizations at two months.
Because of major species differences in phenylalanine metabolism between humans and rodents (Clarke and Bier, 1982 Moldawer et al., 1983), studies in which high doses of L-phenylalanine were fed to rodents could not be utilized in developing a UL for L-phenylalanine. There is one study indicating that high concentrations of L-phenylalanine (3 g kg body weight d) fed to monkeys from a few days after birth until 2 or 3 years of age can produce irreversible brain damage (Waisman and Harlow, 1965). However, this study does not provide any dose-response data to utilize in determining a UL.
The associations between maintenance needs, pregnancy weight gain, and prepregnant fatness indicate that a target weight gain of 12.5 kg is associated with maintenance costs of approximately 160 MJ (38 000 kcal). Although individual women or populations may have lower maintenance requirements, these may be associated with inadequate weight gain and low-birth-weight infants. A major determinant of birth weight is maternal weight gain, and the single most important determinant of infant survival is birth weight. Although birth weight is relatively well preserved at different planes of nutrition, weight alone is an inadequate measure of an infant's overall condition at birth. Even subtle nutritional influences on the fetal environment may have long-term consequences. As mentioned previously, pregnancy weight gain is a critical component of the overall energy costs of pregnancy. The issue of whether pregnancy weight
Toddler behavior is strongly influenced by past experience. Any negative experience with food might result in future food refusal. Transient food refusal may occur after birth of a sibling or other event, in an attempt to redirect attention to themselves (Harrise & Booth, 1992). Refusal to chew due to failure to introduce texture and lumps before 6-7 months of age can result in children rejecting lumpy food later (K & R Minde, 1986).
Even before a child is born, much has occurred in terms of social development. Genetic and prenatal biological factors play a large, persistent role in determining later social behavior. After birth, parents and other family members are the key socializing agents of the preschooler's development.
HHT is characterized by skin, mucosal membrane, and visceral telangiectasias, recurrent epistaxis, and visceral hemorrhages. The recurrent epistaxis is usually the first and most common sign of the disease. The lesions seen on physical exam are small, dark red telangiectases, with ill-defined borders and stellate appearance, occurring most commonly on the face, lips, tongue, palms, and fingers (Fig. 6). The telangiectasias seen on the skin and mucous membranes actually represent small AVMs, which explains their propensity to bleed. Visceral AVMs are found mostly in the lungs, central nervous system (CNS), upper gastrointestinal tract, and liver. The number and location of telangiectasias and AVMs vary widely between individuals and within the same family. The external, visible signs (telangiectasias and frequent nose bleeds) often do not manifest until the second or third decade of life. Internal AVMs in the brain, spinal cord, and lungs are thought to be largely congenital lesions...
Gestational surrogacy A pregnancy carried by a woman who agrees to hand the baby to the commissioning couple after birth. Also known as surrogacy. surrogacy A pregnancy carried by a woman who agrees to hand the baby to the commissioning couple after birth. Also known as gestational surrogacy.
Traditional Medicinal Uses The plant is used to cure indigestion and lumbago. It is used as a tonic after childbirth, to relieve pains in the bone and for treatment of jaundice, dropsy, cachexia and fever. 3,20 Tongkat Ali is one of the most well known folk medicines for intermittent fever (malaria) in Southeast Asia. 16 Decoction of the leaves is used for washing itches, while the fruits are used in curing dysentery. 3 Its bark is used as a vermifuge. 3 The taproots are used to lower high blood pressure, while the root bark is used for the treatment of fever and diarrhoea. 18 The roots of this plant are used as folk medicine for the treatment of sexual insufficiency, aches, persistent fever, malaria, dysentery, glandular swelling and also as health supplements. 18
The first stage, which Freud called the oral stage, occurs during the initial 18 months after birth. During this time, the main sources of pleasure and tension reduction are the mouth, lips, and tongue. You don't have to be around many babies to realize how busy they are with their mouths (e.g., whenever they come across something new, such as a rattle or toy , they usually put it into their mouths first). The main conflict during this stage is weaning, withdrawing from the breast or bottle. This conflict has both a biological and a psychological component. From a biological stand point, the id wants the immediate gratification associated with taking in nourishmen and obtaining pleasure through the mouth. From a psychological perspective, the conflict is one of excessive pleasure versus dependenc , with the fear of being left to fend for oneself. Sometimes a child has a painful or traumatic experience during the weaning process, resulting in a degree of fixation at the oral stage....
Ergometrine causes contractions of the womb and its blood vessels and is used to control heavy bleeding after childbirth or an abortion. For heavy bleeding after childbirth For womb infection after birth (see p. 271), inject 80 mg gentamicin in the muscle, 3 times a day until fever has been gone for 48 hours. For infection after birth (see p. 271), give 400 to 500 mg by mouth 3 times a day until fever has been gone for 48 hours. The baby needs medicine too, starting as soon as possible after birth. These medicines are given in syrups. What to give and for how long depends on what medicine the mother took during pregnancy. engorgement (engorged) When a part of the body is filled with fluid, often blood. Breasts engorged with milk are common after birth and can be very painful.
Progestin-only pills (POPs) are variants of the more commonly used combined (estrogen and progestin) oral contraceptives. Because POPs have no estrogen and only very small amounts of progestin, they are sometimes called minipills. Like Depo-Provera and Norplant, POPs do not contain the estrogen thought to lead to serious cardiovascular complications, such as blood clots and thrombophlebitis. They also are thought to be safer than the combined pill for women who smoke. A POP is taken every day of the month, even during menstrual periods. It can be started as early as a week after childbirth or immediately after a miscarriage or abortion.
When we refer to medicines in this book, we usually mean both modern and traditional medicines, but this part of the book is mostly about the modern medicines that are used for women and babies during pregnancy, birth, and after birth. after oxytocin, misoprostol after ampicillin, gentamicin, For infection after birth (see p. 271), give 2 g by mouth or injected into muscle for the first dose, then give 1 g 4 times a day until fever has been gone for 48 hours. Give other antibiotics too.
In IED TE, massive watery diarrhea develops within the first days after birth in a way similar to MVA MVID. Stool volumes are highly variable (100-200 ml kg body weight day) with stool electrolyte concentrations of sodium of 100-140 mmol l 6, 7 . All children are highly dependent on par-enteral nutrition. There is no past history of hydramnios or other antenatal or neonatal particularities. It is striking that in our experience most children with IED TE have consanguineous parents and or affected siblings and some of them died during the first months of life with severe diarrhea of unknown origin. Upon clinical examination, no malformations are observed however, some children have somewhat rigid hair and a subgroup of patient shows clinical signs of photophobia. Distinct ophthalmologic examination reveals the presence of superficial keratitis in these children. The degree of severity of IED TE is more variable compared to MVA MVID with most children developing a severe course...
A few years ago some colleagues and I carried out a large study of almost 200 women's experiences of pregnancy, childbirth and mothering post-IVF. We followed the women from early in their pregnancies until their children were 18 months old. These women very kindly shared their experiences by completing questionnaires in early and late pregnancy, and three, eight and eighteen months after childbirth.
Programming The idea that nutritional and environmental factors in utero or during early post-natal life can modify gene expression and hence programme metabolism permanently. See also epigenetics. pro-insulin The inactive precursor of insulin, in which the A- and B-chains are joined by the c-peptide the form in which insulin is stored in pancreatic P-islet cells before release. A small proportion of insulin secretion is pro-insulin. A rare variant of insulin-dependent diabetes mellitus is due to genetic lack of the pro-insulin converting enzyme (carboxypeptidase e), so that only pro-insulin is secreted. prolactin Hormone secreted by the anterior pituitary that stimulates milk secretion after childbirth. Also known as lactogenic or luteotrophic hormone, and luteotrophin. prolamins The major storage proteins of the endosperm of cereals, including gliadin (wheat), zein (maize), hordein (barley) and avenin (oats). Characterised by solubility in 70 alcohol, but not water or absolute...
I have had many miscarriages and have no children. Before I was diagnosed with MS, I thought I felt good during pregnancy because of emotions ofjoy and anticipation, and badly after a miscarriage, again because of emotions, albeit ones of grief and loss. Although emotions certainly played a part, I now understand that, as is often the case with MS, I had flare-ups after pregnancy.
At the onset of menstruation the skin may erupt due to the adjustment of hormone levels at that time. During pregnancy, pigmentation changes may occur, but usually disappear after birth. During the menopause the activity of the sebaceous glands is reduced and the skin becomes drier.
Infants are screened for phenylketonuria shortly after birth (by measurement of plasma phenylalanine) treatment is by very strict limitation of phenylalanine intake, only providing sufficient to meet requirements for protein synthesis. Once brain development is complete (between the ages of 8 and 12 years), dietary restriction can be relaxed to a considerable extent, since high concentrations of phenylalanine seem to have little adverse effect on the developed brain. There may, however, be benefits
A very small number of children have been reported who are unable to synthesize molybdopterin they show severe neurological abnormalities shortly after birth and fail to survive more than a few days. As expected from the metabolic roles of molybdopterin, they have low blood concentrations of uric acid and sulfate, and abnormally high levels of xanthine and sulfite. The neurological damage is probably caused by sulfite, because similar abnormalities are seen in children with isolated sulfite oxidase deficiency (Reiss, 2000).
Mothers need care after birth just as babies do . After birth, the mother's body is tired and her womb is open . It is easy for her to get infected, but she can stay healthy by Also, feel the womb to be sure it is going down to its normal size. Just after birth, the womb is about halfway between the pubic bone and the bellybutton. The next day, it grows to the height of the bellybutton, and should shrink every day after that.
The baby should breastfeed every few hours, from the first hour after the birth on . A baby who is breastfeeding enough and who is healthy should urinate and pass stool within the first 24 hours after birth, and regularly after that. She should not have signs of dehydration, and should gain weight. Keep the baby warm and dry, and play with her It is normal for a baby to lose weight for a few days after birth . But she should regain her birth weight by 2 weeks and continue to gain weight steadily. A baby who does not gain weight or grow enough may not be getting enough milk. She may also have an infection, diarrhea, or another health problem . Many babies have a yellow color to their skin or eyes a few days after birth . This is called jaundice . Jaundice is caused when a yellow substance called bilirubin builds up in the baby's body. Normally, a new baby's body breaks the bilirubin down in a few days, and the yellow color goes away.
Two mouse models were previously developed, including a transgenic model (108) and a K14 null model (130). Although both models helped us to understand the disease mechanisms, and the K14 null model also provided important insight into K15 functions, neither mimics EBS-DM at the genetic level and therefore cannot be used to test gene therapy approaches for the diseases. We recently developed a mouse model for EBS-DM, where a wild-type K14 allele was replaced with a mutant allele in the mouse germline (112). The presence of a neomycin-resistance cassette in an intron affected expression from the mutant K14 allele, and the heterozygotes had subclinical phenotypes. But homozygous pups developed extensive blisters and died shortly after birth. When the neo selection cassette was removed by Cre-mediated excision, the resulting heterozygous pups developed large blisters, as was expected for this dominant mutation. To our knowledge, this is the first mouse model that mimics EBS-DM at both...
Determination of the growth component requires knowledge of nutrient accretion with 'normal' growth. Because it is generally agreed that postnatal growth should 'approximate the in utero growth of a normal fetus' 4 , the fetus serves as the model from which nutrient accretion is derived. Beginning in the 19th century, the body composition of stillborn infants and infants deceased soon after birth, including premature infants, has been analyzed by a number of investigators. Sparks 6 and Forbes 7, 8 have provided comprehensive summaries of the chemical analysis of some 160 fetuses. Gestational age was not always available, but because most body constituents change as a function of body size (the notable exception being body fat 7 ), the data can be used to derive accretion rates even when gestational age is not explicitly known 6, 7 . Ziegler et al. 9 used only data from fetuses with known gesta-tional age for the construction of a 'reference fetus' and derivation of fetal accretion...
Glucose and galactose malabsorption Carbohydrate intolerance is a hereditary disorder that occurs infrequently and poses serious health risks. This disorder is caused by a deficiency in a digestive enzyme (e.g., sucrase-a-dextrinase) and defective glucose-galactose transport. Carbohydrate intolerance presents as the development of profuse infant diarrhoea immediately after birth. Gestational diabetes GDM is a form of glucose intolerance that is diagnosed in some pregnant women. It is usually ameliorated after childbirth, but it increases the risk of developing type 2 diabetes in the future.
Finally, a number of pregnancy, labor, and delivery complications have been noted in the histories of children who later turn out to have autism spectrum disorders, such as maternal bleeding during pregnancy, high blood pressure in the mother leading to toxemia, prematurity, and oxygen deprivation during or shortly after birth. What several studies have shown, however, is that these complications are found not only in children with autism, but also in children with other disorders, including cerebral palsy, mental retardation, speech-language disorders, and learning disabilities. Therefore, it appears that obstetrical complications probably cause general differences in brain development, but do not specifically cause autism spectrum disorders.
Bolic rate (BMR) in relation to body and organ weight, and noted that oxygen (O2) consumption increased at a rate greater than that of organ or body weight during the intrauterine and postnatal periods. There is also an increase in O2 consumption during the transition to extrauterine life. After birth, the O2 consumption of these vital organs increases in proportion to increases in organ weight. The contribution of the brain to BMR is exceptionally high in the newborn period (70 percent) and throughout the first years of life (60 to 65 percent). Thermoregulation. In the first 24 hours after birth, thermoneu-trality is reported to be at 34 C to 36 C for the naked infant and falls to 30 C to
Phytoestrogens can cause infertility in some animals and thus concerns have been raised over their consumption by human infants. The isoflavones found in a subterranean clover species (in Western Australia) have been identified as the agents responsible for an infertility syndrome in sheep. No reproductive abnormalities have been found in peripubertal rhesus monkeys or in people living in countries where soy consumption is high. Indeed, the finding that dietary isoflavones are excreted into breast milk by soy-consuming mothers suggests that in cultures in which consumption of soy products is the norm, breast-fed infants are exposed to high levels without any adverse effects. Isoflavone exposure soon after birth at a critical developmental period through breast feeding may protect against cancer and may be more important to the observation of lower cancer rates in populations in the Far East than adult dietary exposure to isoflavones. Although some controversy exists as to whether...
Term-born infants also lose weight after birth and take time to regain it this is not taken in to account in the above calculations. We can calculate the growth rate for a 1,000-gram 27-week infant to catch up with a term-born infant by 44 weeks' postconceptional age, by which time the average weight of term-born males is 4.4 kg 25 . By choosing this time as a target we can account for the initial weight loss that occurs in term infants. The growth rate required for the
The postpartum period has been well established as a time of high risk for women with BD. Nonacs and Cohen 20 reviewed a number of studies, and found that women with BD had a 20-50 risk of relapse during the postpartum period. The risk of postpartum relapse appears to be even higher in women with a past history of postpartum psychosis. The strongest evidence for these findings comes from a well-designed study, in which Kendell et al 21 linked the Edinburgh Psychiatric Case Register to the Scottish maternity discharge database. This study encompassed 54 087 child-births over an 11-year period, and also obtained information about prior psychiatric admissions. Among all women, a psychiatric admission with psychosis during the first 90 days after childbirth was 14.3 more likely than before childbirth. The most striking finding of this study was the degree to which a diagnosis of manic-depressive illness increased the risk of post-partum psychosis. Among the 486 women who had a...
See also anaemia, haemolytic favism. haemorrhagic (hemorrhagic) disease of the newborn Excessive bleeding due to vitamin k deficiency in most countries infants are given vitamin K by injection shortly after birth to prevent this rare but serious (potentially fatal) condition. haemorrhoids (hemorrhoids) Or piles. Varicosity in the lower rectum or anus due to congestion of the veins, caused or exacerbated by a Iow-fibre diet and consequent straining to defecate. haemosiderin (hemosiderin) See iron storage. Hagberg falling number Measure of a-AMYLASE (EC 184.108.40.206) activity of flour based on the change in viscosity of flour paste. haggis Traditional Scottish dish made from sheep's heart, liver and lungs cooked and chopped with suet, onions, oatmeal and seasoning, stuffed into a sheep's stomach. Said to have been originated by the Romans when campaigning in Scotland when breaking camp in an emergency, the food was wrapped in the sheep's stomach. A similar Norman-French dish was...
After birth, new cells move in the direction of the lumen and mitosis continues for two or three more divisions while each cell remains within the crypt. As the enterocyte emerges out of the crypt, proliferation ceases and the process of differentiation proceeds so that the cell, now passing up the outer surface of the villus, reaches functional maturity with a full capacity of membrane-bound brush border enzymes toward the villus tip. On reaching the tip, enterocytes are sloughed off into the intestinal lumen and digested.
In Malaysia, the roots are used to cure boils (10,17,18), wounds, ulcers (10,18,19), fever, as a tonic after birth (10,18), and for intestinal worms (10). They are also used as a paste to relieve headache (10), stomachache (10), pain caused by syphilis (10,19), and bleeding gums (10,20). In Sabah and Kalimantan, a decoction of the bark is drunk to relieve pain in the bones and a decoction of the leaves is used for washing itches (10).
Preterm infants often require more glucose than the term infant secondary to the higher brain to body weight ratio and the need for additional energy for central nervous system energy requirements. Measurements of glucose utilization in the preterm infant range from 6 to 10 mgkg-1 min-1(0.033-0.055 mmol kg-1 min-1). Glycogen stores are very limited in the preterm infant therefore, it requires a large and continuous source of glucose. This should be initiated at a rate of 6mgkg-1 min-1 (0.033 mmol kg-1 min-1) and can be advanced 1-2 mg kg-1 min-1 (0.0055-0.011 mmol kg-1 min-1) each day to an optimum of 12-14 mg kg-1 min-1 (0.066-0.78 mmol kg-1 min-1) as long as the infant does not become hyperglycemic. Above this rate, glucose is not used for energy but rather fat deposition. This is an inefficient process that can result in increased energy expenditure and carbon dioxide production.
Smoked up to the end of pregnancy and continued to smoke after birth. In this subgroup of the cohort, a significantly increased sensitization rate regarding IgE antibodies to food proteins, particularly to hen's egg and cow's milk, was only observed during infancy, whereas sensitization rates later on were not different from children who had never been exposed to tobacco smoke. These observations might be related to the fact that in children the highest urinary cotinine concentrations are detected during the first years of life, when the child spends most of the time close to his or her mother.
The many RAR knockouts illustrate the physiological functions of vitamin A. Disruption of the RARa gene, the RAR with the most widespread, if not ubiquitous, expression in the embryo and adult, does not cause embryonic lethality but reduces the homozygous null population by 60 within 12-24 h after birth and by 90 within 2 months. The RARa null mice that survive 4 or 5 months have severe germinal epithelium degeneration and are sterile. RARfi gene null mice are fertile and viable and show no immediate signs of morphological abnormalities. Nevertheless, complementary data show that RARfi may mediate the antiproliferative function of atRA and as such may serve as a tumor suppressor. Moreover, RARfi null mice have virtually no hippocampal long-term potentiation or long-term depression, the forms of synaptic plasticity that provide a mechanism of short-term spatial learning and memory. This phenomenon can be reproduced by vitamin A depletion. RAR7 null mice have an 86 incidence of skeletal...
Maternal weight gain (kg) Maternal weight gain (kg) Figure 1 The relationship between maternal pregnancy weight gain and birth weight. (Reproduced with permission from the Institute of Medicine, Committee on Nutritional Status during Pregnancy and Lactation (1990) Nutrition during Pregnancy. Weight Gain. Nutrient Supplements. Food and Nutrition Board. Washington, DC National Academy Press.)
The weight gained during pregnancy can be roughly divided into the weight of the fetus, placenta, and amniotic fluid (a total of approximately 5 kg), maternal gain in the uterus, breasts, blood, and fluid (approximately 4 kg), and maternal fat. The latter component is the most variable, accounting for approximately 70 of the variability in pregnancy weight gain. Although average fat gain in different studies is approximately 2-5 kg, values for individual women range from a loss of several kilograms to a gain of approximately 12 kg. Even in a group of women with normal BMIs at conception, the range of fat gain was 0.5-9.5 kg. Fatter women at conception gained less fat during pregnancy, as would be expected from their lower weight gains. The greater fat gain of thinner women is a potential energy store for the fetus and would afford some protection against maternal malnutrition in late pregnancy a situation that is not uncommon in some economically disadvantaged countries.
Early in your pregnancy, your milk-producing (mammary) glands prepare for nursing. By about your sixth month of pregnancy, your breasts are ready to produce milk. In some women, tiny droplets of yellowish fluid appear on the nipples at this time. This fluid is called colostrum. It's the protein-rich fluid that a breast-fed baby gets the first few days after birth. Colostrum is very good for the baby because it contains infection-fighting antibodies from your body. It doesn't yet contain milk sugar (lactose). It's actually the delivery of the placenta that signals your body to start milk production. It clears the way for a hormone called prolactin to start up the mammary glands.
The muscles in your pelvic floor help support your uterus, bladder and bowel. Toning them by doing Kegel exercises will help ease your discomfort during the last months of your pregnancy and may help minimize two common problems that can begin during pregnancy and continue afterward leakage of urine and hemorrhoids. In fact, a recent study found that strengthening your pelvic floor muscles during pregnancy appears to reduce your risk of developing urinary incontinence, both during and after pregnancy.
Newborn's head is often slightly misshapen during the few days or weeks after birth, because the passage through the birth canal often temporarily elongates a baby's soft skull bones. However, a persistent flat spot either in the back or on one side of his head can result from being put to sleep on his back or by problems with the baby's neck muscles. Fortunately, this condition will correct itself by the time the child is one year old. Premature babies are more prone to positional plagiocephaly because their skulls are softer than those of full-term babies, and they spend a great deal of time on their backs without being moved because of their extreme fragility after birth. A baby may even start to develop positional plagio-cephaly before birth, if the baby's skull is pressured by the mother's pelvis or by a twin.
The points of communication between neurons are called synapses, and these begin to form in the brain in the early weeks of gestation. The generation of synapses occurs at different times in different cortical areas. For example, the maximum density of synapses is reached at about four months in the visual cortex but not until about twenty-four months after birth in the prefrontal cortex. This pattern parallels behavioral development, where functions of the visual cortex (such as 3-D vision) develop earlier than some functions of the prefrontal cortex (such as planning for the future).
Pregnancy-induced hypertension (PIH) may appear in otherwise healthy women after the twentieth week of pregnancy. It is more likely to occur in women who are overweight or obese. PIH may be mild or severe, and it is accompanied by water retention and protein in the urine. About 5 percent of PIH cases progress to preeclampsia. Preeclampsia is characterized by dizziness, headache, visual disturbance, abdominal pain, facial edema, poor appetite, nausea, and vomiting. Severe preeclampsia affects the mother's blood system, kidneys, brain, and other organs. In rare cases, the woman can die. Preeclampsia is more likely to occur during first pregnancies, multiple fetuses, in women with existing hypertension, and in women younger than twenty-five years old or over thirty-five years old. If convulsions occur with PIH, it is called eclampsia. PIH disappears within a few weeks after birth.
Manganese is required for bone formation and the normal metabolism of amino acids, lipids, and carbohydrates. The AI for pregnancy, estimated from the manganese content of maternal weight gain, is 2 mg day. The UL is based on avoidance of elevated blood manganese and neurotoxicity, and it is not increased for pregnancy.
The degree to which MR can be prevented has grown with the increased quality and quantity of medical technology, as well as the amount of education presented to expectant mothers. Technology allows medical staff access to the baby in the uterus. The am-niotic fluid can be tested to determine some forms of defect in the fetus. Ultrasound allows the medical staff to see the baby in the uterus and determine if there is a physical defect. If a defect is found through one of these technologies, early intervention can be implemented either while the fetus is still in the uterus or directly after birth.
The regulation of energy balance needs to be explored, including the neuroendocrine factors that control energy intake, energy expenditure, and the differentiation of adipose tissue resulting from excess calories. The genes that are important in human obesity need to be identified. These include those that alter eating and physical activity behaviors, those that affect thermoge-nesis, and those associated with the comorbidi-ties of obesity. The roles of environmental and behavioral influences on metabolic factors important in obesity, as well as gene-environment interactions, need to be studied. Predictive factors should be examined to identify who is most at risk of developing obesity, and whether there are critical periods of life when these factors are most operative. In addition, the influence of the intrauterine environment on the development of obesity needs to be investigated, particularly to determine whether early deprivation leads to a later propensity for overweight and...
During pre- and postnatal development and this accumulation continues throughout the first two years after birth (Martinez, 1992). Evidence from autopsy analysis indicates that accumulation of DHA in the retina is complete by term birth (Martinez et al., 1988). Due to the accumulation of DHA during brain growth, the developing brain is more susceptible to n-3 fatty acid deficiency than the mature brain. However, the presence of DHA within the membrane hydrophobic interior can influence membrane order (fluidity), thickness, domain size, hydration, and permeability and activity of associated proteins and ion channels. Unesterified DHA also regulates the expression of a variety of genes and influences cell signaling mechanisms (Salem et al., 2001 Sinclair et al., 2000). Animal studies have shown that feeding a diet very low in a-linolenic acid results in reduced brain and retina DHA concentration, which is accompanied by reduced visual function and behavior in learning tasks (Benolken et...
The BMI-specific target ranges for pregnancy weight gain are relatively narrow, but a very wide range of gain actually occurs. In a California study, for example, only 50 of the mothers who had an uncomplicated pregnancy with a normal birth-weight infant gained the recommended 12.5-18 kg, with the remainder gaining more or less. Since a substantial amount of the variation in weight gain is due to physiological variability and prepregnancy BMI, deviation from the recommended range may not necessarily be cause for concern. However, it is especially important to assess the dietary patterns and other behaviors of women whose weight gain is unexpectedly high or low. The IOM Implementation Guide for weight gain recommendations provides helpful information on the assessments that should be used.
The mature adrenal cortex in the rodent consists of three concentric steroidogenic zones that are morphologically and functionally distinct the zona glomerulosa (ZG), the zona intermedia, and the zona fasciculata (ZF) reticularis (ZR). The ZG, ZF ZR have unique expression of specific steroidogenic enzymes that defines the specific steroid produced by each zone (Parker et al., 2001). Thus, cytochrome P450 aldosterone synthase (P450aldo) is produced within the glomerulosa to produce the mineralocor-ticoid aldosterone, whereas P450 11 P-hydroxylase (P45011 (3) defines the glucocorticoid producing zona fasciculata reticularis. In many mammalian species the development of the adrenal cortical layers and steroidogenic enzyme synthesis primarily occur during fetal life (Parker et al., 2001). However, cells expressing P45011P clearly resolve into their cortical layer by the third day after birth (Mitani et al., 1997).
Understanding immune regulation and tolerance remains a major challenge in immunology. As an immunosuppressive cytokine, TGF plays a key role in attenuating excessive pathological immune responses. Mice deficient in TGF , developed severe multifocal inflammatory disease and died shortly after birth (Shull et al. 1992). Since TGFg. can be produced by and act on virtually all cell types, the regulatory network invoked by TGF remains incompletely understood. To investigate the role of TGFP signaling in T cells, we engineered a strain of transgenic mice expressing a dominant negative TGF receptor II in T cells (Gore-lik and Flavell 2000). In these mice, T cells were found to differentiate spontaneously into effector T cells, which led to the development of autoimmunity and enhanced tumor immunity and immune responses to pathogens. In addition, we took a gain-of-function approach to study TGFP regulation of autoimmune diabetes by overexpressing this cytokine in the islets of the pancreas...
Gallnuts are used generally in Turkey as an astringent and antidiarrheal. Malay women still uses gallnuts to restore the elasticity of the uterine wall after childbirth. An extract of gallnuts is also used in some Asian countries to blacken gray hairs. In Korea, an aqueous extract of the Chinese gallnut, known as Obaeja, is used for the treatment of patients with so-called So-Gal symptom, typified by excessive urine excretion and water intake (Shim et al., 2003).
An 'early aggressive' approach to nutrition benefits from early introduction of small-volume enteral nutrition (also referred to as MEF) in order to (1) provide trophic benefits of nutrient stimulation to the gut, (2) allow for a more comprehensive package of nutrient administration, and (3) avoid prolonged parenteral nutrition. The most common reason for delayed initiation and limited advancement of enteral feedings in preterm infants is the concern for increasing the risk of NEC. Clearly, there often is reason to cautiously initiate enteral feeding in very preterm infants soon after birth because of the known immaturity of a number of physiological and hormonal systems at early gestational ages. However, early enteral feeding prevents gut atrophy, stimulates maturation of the gastrointestinal system, may actually enhance eventual feeding tolerance, and may reduce the incidence of NEC, especially when colostrum and human milk are used. Most importantly, there is no evidence that MEF...
As noted above, a number of studies over the past 10 years would suggest that postnatal growth failure is unavoidable in ELBW infants. Many of the nutritional intervention studies to date have focused on delivering increased quantities of nutrients in the first 2-4 weeks of life. Clearly, this has decreased the catabolism seen prior to this type of intervention, and in some cases has resulted in improved weight gain. Growth faltering can occur at numerous time points during hospitalization, and solving the postnatal growth failure problem in this population will require different nutritional strategies at different time points. Figure 2 suggests there are at least three phases of growth faltering commonly seen in ELBW infants (1) the several weeks immediately after birth when neonates are the most fragile, (2) the intermediate time period when infants are commonly slowly advanced to full enteral nutrition, but which could potentially represent an opportunity for significant catch-up...
Researchers eager to see a similar mutagenic approach applied to the vertebrate genome have been stymied by the genetic intractability of classical vertebrate developmental models. The mouse is the only vertebrate organism in which large-scale screens for mutations have been performed. These screens have, in the main, been limited to identification of defects in visible morphological traits after birth, since screening for embryonic mutant phenotypes is difficult because development occurs in utero (2). Biologists interested in using a mutagenic approach to study early aspects of vertebrate development have been forced to search for an alternative.
Women who have chlamydia or gonorrhea when they give birth can pass these infections on to their newborn babies. This can cause eye infection leading to blindness, or serious lung problems. A chlamydia or gonorrhea infection in the eyes usually causes a thick yellow discharge from the eyes within the first month. To prevent eye infection in babies, put antibiotic ointment into each baby's eyes after birth (see page 260).
Tetanus (lockjaw) is caused when a germ that usually lives in dirt or stool enters the body through a wound . A woman can get tetanus if something that is not sterile is put into her womb or vagina during or after childbirth or from an unsafe abortion. A baby can get tetanus if the cord is cut with something that is not sterilized, or when anything (like dirt or dung) is put on the cord stump Vaccinations during pregnancy will also protect the baby from tetanus during the first few weeks after birth . But the baby must be vaccinated after birth so that the protection will continue
When you're recovering after pregnancy and childbirth, breastfeeding around the clock, not getting enough sleep and always keeping an ear out for baby, having sex may be the last thing on your mind. Getting back to lovemaking after childbirth can take a long time, and your sexual relationship may be different once you do.
Numerous investigators have explored the benefits of energy and or protein supplementation for pregnancy weight gain and other outcomes. However, relatively few trials have randomly assigned these supplements and used control diets. A statistical analysis was conducted of the 10 such studies that met this criterion in 1995. Most, but not all, of these studies were performed in developing countries. A 5-year controlled trial in The Gambia provided daily prenatal dietary supplements (two biscuits) that contained 4250 kJ energy and 22 g protein. This supplement increased pregnancy weight gain and birth weight during the hungry and harvest seasons. There was a significant but very small increase in head circumference and a significant reduction in perinatal mortality.
Gestational diabetes occurs only during pregnancy and usually resolves after pregnancy. It occurs in 5-10 of pregnancies and most commonly arises after 20 weeks of gestation. Gestational diabetes can be treated largely through nutritional care and moderate exercise to achieve weight control. Nutritional recommendations are to limit protein intake to 15 of total calories, consume 55 of total calories as carbohydrate, and limit fat intake to 30 or less of total calories. Cholesterol intake should be 300 mg day or less, simple carbohydrate intake should be limited, and sodium intake should not exceed 1000mg 1000kcal. Insulin is rarely needed, although blood glucose levels should be monitored daily.
The GI tract is essentially sterile at the time of birth and bacterial colonization begins upon exposure to the environment. Progression of colonization is initially fast, followed by a gradual process of modification over the first few years of life. As the baby passes through the birth canal bifidobacteria and lactobacilli are typically acquired and rapid colonization of mainly enterobacteria occurs. The hospital environment, type of feeding, and type of delivery affect the early colonization of the intestine after birth. Normal vaginal birth permits the transfer of bacteria of the mother as the infant passes through
As described earlier, seasonal climates may affect nutritional status via a combination of reduced dietary intake, increased physical activity, and increased disease incidence, and may occur to a variable extent in different populations and socioeconomic groups. As a result, both energy balance and micronutrient status may be affected, and this is confirmed by the observation of changes in body weight and body composition in adults, growth performance in children, pregnancy weight gain, and birth weight as well as by changes in micronutrient status. Seasonal stress continues after birth for both mothers and children. In The Gambia lactating women lost on average 0.74 kg month-1, at the same rate of nonlactating women. As shown earlier, during the wet season very young children get less attention and less breast milk from their mothers and their growth is affected. In Taiwan, children born in the hot wet summer season were smaller, but could catch-up in the following 3 months, while...
During labor, the health care team caring for you will perform periodic vaginal exams to check how you're progressing. During actual delivery, you're joined by your health care provider, labor coach and, typically, at least one nurse. A pediatrician also may be present to examine the baby right after birth. Who else you have in the labor room or birthing room is largely up to you. Medical professionals who help deliver babies see births almost every day, so they're used to the messy but awesome experience of birth. Some university hospital staffs may
RDS is usually diagnosed within the first minutes to hours after birth. The diagnosis is based on the extent of breathing difficulty and on abnormalities seen on the baby's chest X-ray. A premature baby's lung problems generally improve within several days to several weeks. Babies who still require help with ventilation or supplemental oxygen a month after birth are often described as having Before birth, a chemical compound called prostaglandin-E circulates in the baby's blood, keeping the ductus arteriosus open. In full-term infants after birth, levels of prostaglandin-E fall sharply, causing the ductus arteriosus to close. Then the circulation works properly. Occasionally, especially in premature babies, prostaglandin-E circulates at about the same level after birth as it did before. This causes the ductus arteriosus to remain open, possibly resulting in respiratory or circulation difficulties. Intracranial hemorrhages ranging from minor to significant occur in about one-third of...
When a new baby is born to an HIV-infected mother, however, an antibody test is almost guaranteed to be positive, since babies have their HIV-infected mother's antibodies for up to 18 months after birth. Uninfected infants will gradually lose their mother's antibodies during this time, whereas infected infants generally remain antibody positive. Instead, a diagnosis can be made in early infancy by using a viral culture (PCR polymerase chain reaction), or a p24 antigen test.
Mechanical obstructions that are related to congenital defects include stenosis, hernia and aganglionic megacolon (Hirschprung's disease). Hirschprung's disease is a familial disease affecting 1 in 5000 live births (Wright and WalkerSmith 2000). It results from absent intramural ganglion cells in the nerve plexus, most commonly in a segment of the distal colon. As a result the internal anal sphincter fails to relax and constipation and vomiting can develop shortly after birth.
A higher mean respiratory quotient for both the basal metabolic rate and total 24-hour energy expenditure has also been reported in pregnant women when compared to the postpartum period. This indicates an increased utilization of glucose by the maternal-fetal unit. The increased glucose utilization rate persists after fasting, indicating an increased endogenous production rate as well (Assel et al., 1993 Kalhan et al., 1997) (see Chapter 5). Thus, irrespective of whether there is an increase in total energy expenditure, these data indicate an increase in glucose utilization. Earlier, it was reported that the glucose turnover in the overnight fasted state based on maternal weight gain remains unchanged from that in the nonpregnant state (Cowett et al., 1983 Kalhan et al., 1979).
The memory stores described above are assumed to be universal and present throughout life. Indeed, there is evidence that the capacity to store information in long-term memory begins even before birth. In a well-controlled investigation conducted by Anthony DeCasper and Melanie Spence, the researchers asked pregnant women to read aloud a Dr. Seuss story during the last six weeks of their pregnancies, a point in prenatal development at which fetuses can hear. Shortly after birth, the newborns' recognition memory was tested by comparing their reactions to the familiar passages versus similar but new story excerpts, both of which were read by the babies' mothers. The assessment built on the knowledge that babies can learn to modify the time between bursts of sucking when a change in sucking is followed by the presentation of a stimulus that serves as a reinforcer. The new-borns wore headphones and were given a pacifier that recorded their sucking bursts. They indeed modified the way they...
Prenatal care provides an important opportunity to address the unmet health needs of pregnant women. Although interventions during pregnancy are too late to promote optimal reproductive outcomes for many women, surveillance and care during pregnancy are important for the medical and psychological well-being of both mothers and children. Nutritional, educational, and psychosocial services for women and families are available in comprehensive prenatal care settings. An important role of prenatal care is to engage women in ongoing relationships with health-care providers, so they will have continuing contact with caring professionals after childbirth and during the interval before subsequent pregnancies.
HIV lives in body fluids, such as blood and semen, and transmission occurs primarily through unprotected sex (both heterosexual and homosexual) and the injection of illicit drugs. The virus can also be transmitted from mother to child during pregnancy or at the time of delivery, but medical advances have led to a significant reduction in these cases because pregnant women are now encouraged to undergo voluntary HIV testing. If a woman is found to carry the virus, doctors can begin administering medication to her right away and to her infant after birth. The rate of transmission through contaminated blood or blood products (i.e., via transfusions) was high until 1985 when measures were put into place to ensure the safety of the blood supply in North America, Europe, and some other parts of the world. Transmission still occurs from an unsafe blood supply in some underdeveloped countries.
Women with bipolar disorder who want to have children should work very closely with family support and health care providers when thinking about conceiving. Careful planning and being well-informed are the keys to successful management of bipolar illness during and after pregnancy. Careful planning can help you best manage bipolar disorder by minimizing symptoms and avoiding risks to your unborn child. First, it is important to never stop taking medications before talking with your prescribing doctor. You also shouldn't make sudden
In general, this report does not cover possible variations in physiological need during the first month after birth or the variations in intake of nutrients from human milk that result from differences in milk volume and nutrient concentration during early lactation. In keeping with the decision made by the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, specific DRIs to meet the needs of formula-fed infants have not been proposed in this report. The use of formula introduces a large number of complex issues, one of which is the bioavailability of different forms of the nutrient in different formula types. Where data are available regarding adjustments that should be made for various formulas, they are included in the Special Considerations sections of the nutrient chapters.
Since World War II, the role of maternal nutrition in fetal growth and development has been extensively studied in the context of protein-calorie malnutrition. The role of n-3 fatty acids has only recently come into focus, despite the evidence of its importance having been demonstrated in a series of studies between 1928 and 1930 involving rats and primates. Lipid nutrition during pregnancy and lactation is of special relevance to human development, because brain development in the human takes place during fetal life and in the first 2 years after birth. DHA is found in larger amounts in the gray matter of the brain and in the retinal membranes, where it accounts for 30 or more of the fatty acids in the ethanolamine and serine phos-pholipid. DHA accumulates in the neurons of the brain between weeks 26 and 40 of gestation in humans. with increasing neuromotor activity. The increase in cell size, number, and type requires de novo synthesis of structural lipids, leading to accumulation...
Whole body protein turnover, measured by leucine kinetics, is increased in pregnant women at weeks 24 and 35 compared with pregnant women at 13 weeks or with nonpregnant women (Thompson and Halliday, 1992). Similar observations of increased whole body protein turnover during pregnancy have been made using 15N lysine as a tracer (Kalhan and Devapatla, 1999). A significant reduction in urea synthesis has been shown to occur in the first trimester and is sustained throughout pregnancy (Kalhan et al., 1998). There is general agreement that the amount of nitrogen accreted due to a pregnancy involving 12.5 kg of maternal weight gain (which includes a term infant weighing 3.3 kg) is 148 g (equivalent to 925 g protein if using a conversion factor of 6.25) (Hytten and Leitch, 1971 King, 1975). This amount of protein accumulation is predicted by a summation of the protein components of the fetus (440 g), uterus (166 g), expanded maternal blood volume (81 g), placenta (100 g), extracellular...
Research, current knowledge is limited about the causes of preterm delivery. Risk factors associated with preterm birth include cigarette smoking during pregnancy, prior preterm birth, low prepregnancy weight, and maternal chronic diseases but known risk factors account for less than one-fourth of preterm births. The factors associated with fetal growth restriction are more readily understood than those of pre-term delivery. Cigarette smoking during pregnancy, low maternal weight gain, and low prepregnancy weight account for nearly two-thirds of all fetal growth restriction and seem to be the most promising areas for possible interventions. Other associated factors include multiple births (e.g., twins), infant gender, and several factors relating to the mother, including birthweight, racial or ethnic origin, age, height, infections, history of prior low birthweight delivery, work physical activity, substance use abuse, cigarette smoking, alcohol consumption, and socioeconomic status....
HIV can be transmitted from an infected mother during pregnancy, during childbirth, or after birth through contaminated breast milk. The risk of transmission is approximately 15 percent to 30 percent, even if a mother does not breast-feed her infant. When infected mothers breast-feed, however, the risk of HIV transmission to their babies rises to 25 percent to 50 percent. Approximately six hundred thousand HIV-infected infants are born each year around the world, with over 90 percent of these infections taking place in sub-Saharan Africa. There is hope, however, for curbing MTCT. In fact, through education, counseling, access to antiretroviral drugs, safe delivery practices, and the availability of breast-milk substitutes, MTCT has been virtually eliminated in the developed world. Taking anti-retroviral drugs, including nevirapine and AZT, can reduce the risk for MTCT dramatically when administered during pregnancy, during labor, and soon after birth. In addition, the use of...
Iron Iron is a component of a number of proteins including hemoglobin, which is essential for transporting oxygen to tissues throughout the body for use in metabolic processes. The most well-known consequence of iron deficiency is anemia. A full-term infant normally has a high hemoglobin concentration and a large amount of stored iron. Based on research evidence, this stored iron plus the iron provided in human milk is assumed to be adequate for solely breast-fed infants during the first 6 months after birth. Even though the amount of iron in human milk is low, its bioavailability is greater ( 50 ) than that of the iron in infant formula (
Shortly after birth, most metabolic activity in the brain is in the phylogenetically older parts of the brain the cerebellum, the thalamus, and the motor cortex. At that stage of development, the baby's activity consists only of suckling, startle reactions, and other simple reflex actions. As the child develops, the increasing complexity of behavior is accompanied by increased metabolic activity of neurons, reflected in the FDG accumulation. With maturation of mental functions, one region of the brain after another becomes metabolically active.
The first closely argued explanation for the lateral cradling bias stressed the importance of the lateral position of the heart (Salk, 1960). Lee Salk appears to have first developed the theory when observing a mother rhesus monkey in the Central Park Zoo in New York (see Salk, 1973). Visiting the Zoo repeatedly, Salk observed the mother showing a left-sided cradling preference on 40 of 42 observed occasions. Salk reports wondering whether the phrase 'close to a mother's heart' was more than just an expression (Salk, 1973, p.24), and on this basis proposed a 'cardiac' theory - offering a mechanism that accounted for the role of the heart in the mother-infant relationship. Specifically, Salk suggested that the child developed an association, in utero, between the regular sounds of the mother's heartbeat and the experience of a secure and relatively stress-free environment. When, after birth, the child was distressed, it would be pacified by being re-exposed to these comforting...
Tobacco smoke exposure, both before and after birth, is associated with adverse health effects in children. Other studies have found that secondhand tobacco smoke is linked to the risk of tooth decay in children. In 1993 the Environmental Protection Agency classified secondhand smoke as a cancer-causing toxin to humans. It also has been shown that children of smokers incur a higher risk for blood vessel damage.
TTF-1 is a tissue-specific transcription factor that mediates cell determination and differentiation in thyroid, lung, and brain. It is expressed in thyroid follicular cells, human fetal lung, and alveolar Type II epithelial cells after birth. TTF-1 was detectable in pulmonary adenocarcinomas 33, 34 , SCLCs, LCNECs, carcinoid tumors, and CLCCs but not in pulmonary squamous cell carcinomas 34, 35 . The prognostic value of TTF-1 was evaluated in NSCLCs, and contradictory results were reported. However, TTF-1 positivity is reported to be associated with better survival in NSCLC with meta-analysis 36 . We found that TTF-1 was detectable in 33 of CLCC cases, 28 in LCNEC, 11 in ICNEC, and 77 in SCLC. TTF-1 had a poor prognostic implication in SCLC and in ICNEC in our study.
W W mice have a spontaneous mutation in their c-kit receptor and die shortly after birth due to anemia and cytopenia unless rescued by transplantation with normal WBM (90). Thus, the systemic deleterious effects of lethal irradiation are avoided by using these mice as an in vivo model. W W mice have been used to show that fetal liver contains HSCs capable of repopulating adult WBM (91).
Hearing loss is an uncommon presenting symptom of a systemic infectious disease but may develop during the course of several viral and bacterial infections. Pathogens may infect the inner ear and auditory pathways in utero, resulting in congenital syndromes that often include deafness, or infection may be acquired after birth. As the fluids of the inner ear are not easily accessible for sampling, the implication of viral pathogens as the causes of sensorineural hearing loss has often depended on circumstantial evidence, including an associated viral illness for example, an upper respiratory infection or demonstration of seroconversion during the time of hearing loss. Between 6 and 23 of these infants will go on to develop sensorineural hearing loss. Most cases will be mild, but up to one-quarter will be severe. Hearing loss may be unilateral or bilateral and may develop months or years after birth and be missed on routine audiometric screening. It is thought that asymptomatic CMV...
Pregnancy lasts 40 weeks from the last day of menstruation. Changes in hormonal levels cause symptoms such as nausea in the first trimester, digestion problems and constipation in the second, and, in the third trimester, the growth of the fetus may result in back pain and swelling of the legs. Varicose veins, which can develop in susceptible individuals, may be due to an inherited weakness in the structure of the veins. Blood gathers in pools causing the vein to bulge. Topical application of a cream used in Europe that contains horsechestnut or escin, has shown to be beneficial in affecting venous circulation. A drop in the hormone levels of estrogen and progesterone can cause depression and weepiness after birth.
During the last few years of his life Geschwind became interested in developmental learning disabilities. In Ge-schwind's mind, strict localization theory began to give way to localization with neural plasticity resulting from early extrinsic influences on brain development occurring in utero or soon after birth. These effects were capable of changing standard patterns of brain asymmetry and could lead to developmental learning disorders. His keen clinical acumen led to his noticing that mothers of dyslexic children often reported left-handedness, atopic illnesses such as asthma, and autoimmune diseases such as hypothyroidism. In an epide-miological study carried out with Peter Behan in London, they showed an association between stuttering, dyslexia, colitis, thyroid disease, and myasthenia gravis in left-handers (Geschwind and Behan 1983). This work engendered massive additional research and debate and may constitute Ge-schwind's most creative contribution to new knowledge. Since his...
1 Using donated eggs or sperm, or both If you don't have eggs but the surrogate is fertile and agrees to become pregnant with her own eggs, she can be inseminated with the commissioning father's sperm (if they're suitable) or with donor sperm. However, in this situation the surrogate is the genetic mother of the baby and this can make it harder for her to give up the baby after birth. As a result, the method used in Australia is for the surrogate to carry a baby that isn't genetically hers, using either an embryo formed with eggs from a donor other than the surrogate and sperm from the commissioning father (or a sperm donor), or an embryo donated by another couple.
After birth, most body dimensions, such as stature, body circumferences, and weight, follow a similar pattern of growth a period of very rapid growth in infancy, slower growth during middle childhood, a very rapid growth phase or spurt in adolescence, and a period of rapidly decelerating growth, ending with adult size. Obviously, some body dimensions, such as weight or fatness, can continue to change throughout adulthood. The different phases of postnatal growth can be appreciated more easily by looking at the rates of growth, or velocity, in addition to attained size.
This condition is caused by damage to the central nervous system of the baby during pregnancy, delivery or soon after birth. The damage could be due to bleeding, lack of oxygen or other injuries to the brain. The signs and symptoms of this condition depend on the area of the brain affected. Symptoms include the following
Minimal intravenous lipid intakes should be targeted to prevent essential fatty acid (EFA) deficiency particularly in view of their critical role in postnatal brain development. Preterm infants have very limited endogenous lipid stores 16 . EFA deficiency develops by 4-5 days after birth if exogenous fat is not given and can be prevented with as little as 0.5 g kg day lipid (estimates range from 0.25 to 1.0 g kg day). Other benefits of intravenous lipid include its role as a high-density energy source (which can be provided by the peripheral venous route due to its isotonicity with plasma) and as a vehicle for facilitating delivery of fat-soluble vitamins. Optimal intravenous lipid intake above that which prevents EFA is controversial and has resulted in different lipid administration strategies among neonatal intensive care centers. Early use and or rapid advancement of lipid emulsions in the preterm infant has been
Pregnancy is associated with an increase in insulin resistance and an increase in hormones with actions opposing insulin (i.e. cortisol, progesterone, growth hormone and human placental lactogen). GDM develops at a time when the beta cell reserve cannot cope with the prevailing state of insulin resistance. Therefore by definition after pregnancy when the insulin resistance reduces, then the subject becomes normoglycemic. However, GDM can be considered a pre-diabetic condition with an increased future risk of developing type 2 diabetes during their lifetime approaching 20-50 . The treatment of GDM consists of maintaining strict glycemic control. If dietary intervention fails to achieve normoglycemia, the treatment of choice is insulin.
Since the gastrointestinal tract of the preterm infant is immature, substantive enteral nutrition is not possible in the first 2-3 weeks after birth, especially in those infants whose birth weights are less than 1500 g therefore, the preterm infant is dependent on intravenous fluid for the bulk of fluid needs. Parenteral nutrition (PN) is basically the infusion of a nutrient solution into the circulation. Its development has allowed for the provision of nutrients during the time that enteral nutrition cannot meet nutrient needs. The use of PN has reduced the cata-bolism that occurs until full enteral nutrition can be achieved. PN should definitely be considered in infants whose birth weights are
The maternal weight gain recommendations have been evaluated in a group of Chinese women with good pregnancy outcomes (N 504) to assess the need for an ethnic-specific recommendation for this group. The BMI categories were used at different levels. The recommended total pregnancy weight gain ranges according to BMI for Chinese women were 13-16.7kg for BMI 23.5. Women with weight gain in the lowest quartile had twice the risk of having a low-birth-weight infant, and those with excessive weight gain were in need of assisted delivery (either vaginal or cesarean delivery).
Oral iodized oil Although efficacious, injections of iodized oil have largely been replaced by oral iodized oil owing to the concern over the AIDS pandemic and use of needles as well as the higher cost of supplies (syringes) and personnel (skilled injectors). Oral delivery of iodized oil appears to be as effective as intramuscular injection but is less costly, carries no infection risk (through a contaminated needle), is painless, and can be administered by untrained personnel. Oral iodized oil is considered to be safe for pregnant women and can be given at any time during pregnancy however, it appears to protect against moderate and severe neurological abnormalities in the infant only when given during the first two trimesters. The best outcomes are likely to occur when supplementation is given during the first trimester, but even if it is given in late pregnancy or to the infant after birth slight improvements in brain growth and developmental quotients, but not neurological status,...
Once labor starts, your baby will experience many changes in order to prepare for birth, including a surge in hormones. This may help maintain blood pressure and blood sugar levels after birth. It may also have something to do with communicating to your uterus that the time has come.
Despite the many benefits of breastfeeding, only 64 percent of mothers in the United States initiate breastfeeding, with 29 percent still breastfeeding six months after birth. The U.S. goals for 2000 were to increase to 75 percent the proportion of women who initiate breastfeeding, and to increase to 50 percent the proportion of women who breastfeed for five to six months. In the United States, ethnic minorities are less likely to breastfeed than their white counterparts.
This is another long set of questions that doctors ask and families frequently wonder about. The physician needs to know whether the child has other illnesses or conditions that may be related to the symptoms or relevant to the treatment. You should try to give the doctor as much information as possible. A child might be ten or eleven years old, but the strange problem he or she is having may be the result of something that happened in the neonatal intensive care unit shortly after birth. The physician cannot even begin to suspect that if he or she does not know that the child was in the neonatal intensive care unit. If your physician forgets to ask, it's a good idea to bring it up yourself.
Low blood pressure This is a relatively common complication that may occur shortly after birth due to infection, blood loss, fluid loss, or medications given to the mother before delivery. Low blood pressure is treated by boosting fluid intake or giving medication. Respiratory distress syndrome (RDS) Breathing problems are one of the most common and serious problems of prematurity. With respiratory distress syndrome (RDS), (formerly known as hyaline membrane disease), the infant's immature lungs do not produce enough surfactant, which normally allows the inner surface of the lungs to expand properly when the infant makes the change from the womb to breathing air after birth. RDS is treatable and many infants do quite well. If premature delivery cannot be stopped, most pregnant women are given medication just before delivery to help prevent RDS. Immediately after birth and several times later, artificial surfactant can be given to the infant. Although most premature babies without...
Perinatal (or prenatal ) stroke includes strokes that occur between the 28 weeks of gestation and the 28 days after birth. Stroke occurs more frequently in the perinatal and prenatal age group than in older children. Some perinatal strokes are caused by inherited clotting disorders or coagulation abnormalities that make the infant more likely to have a blood clot. Congenital heart disease and sickle-cell disease are common causes of stroke in children. No cause can be detected in about a fifth of the children with ischemic stroke, but many of these children seem to recover well after birth.
While it may not have an obvious cause, PID often occurs from an untreated sexually transmitted disease such as gonorrhea or chlamydia. It also may occur after childbirth, abortion, or miscarriage. Young, sexually active girls and those who use the intrauterine birth control device are at higher risk.
The APGAR scoring system is used universally in the delivery room to assess the overall health and integrity of the newborn immediately after birth. A score of zero to two is assigned in each of the five areas at one and five minutes after birth. If prolonged resuscitation is needed, scoring continues at five minute intervals until the infant is stabilized. The five areas are Activity from no movement (0) to tone, movement, and flexion (2) Pulse from absent (0) to more than one hundred beats per minute (2) Grimace from no reflex irritability (0) to cough or pulling away (2) Appearance from blue-gray color (0) to normal (2) and Respiration from absent (0) to regular with crying (2). A score of seven to ten is normal. A score of four to seven signals a need for resuscitation. And a score of three or below signals the need for intense, and sometimes prolonged, resuscitation. A low score (less than three) of long duration (greater than ten minutes) may correlate with future neurological...
Hepatic hemangiomas in this context may manifest with coagulopathy, heart failure, and or respiratory distress. Internal hemorrhage is also of significant concern with hemangiomas in hepatic or gastrointestinal locations. Often patients become symptomatic shortly after birth. Therapeutic options for hepatic and gastrointestinal heman-giomas may include surgical resection, emboliza-tion, corticosteroids, and interferon-a 8 . Imaging findings are similar to the findings in adults, although rapid filling is more common in the pedi-atric forms (Fig. 5).
Table 1 presents the most influential models. Some models stress the influence of pathological factors on handedness. Factors such as prenatal problems, perinatal problems, or complications soon after birth may influence normal development of the brain. These pathological influences result in a reorganization of brain anatomy leading to left handedness instead of the normal development leading to right handedness. Intrauterine models propose that prenatal forces are responsible for the distribution of left and right handedness. The prenatal influences are not necessarily pathological. Hormonal mechanisms and intrauterine position may influence the development of handedness in rather subtle ways.