Tag Archive | postpartum

Infant Development Enhanced By Eating Fish While Pregnant

Both higher fish consumption and longer breastfeeding are linked to better physical and cognitive development in infants, according to a study of mothers and infants from Denmark. Maternal fish consumption and longer breastfeeding were independently beneficial.

“These results, together with findings from other studies of women in the U.S. and the United Kingdom, provide additional evidence that moderate maternal fish intake during pregnancy does not harm child development and may on balance be beneficial,” said Assistant Professor Emily Oken, lead author of the study.

The study, which appeared in the September issue of the American Journal of Clinical Nutrition, was conducted by researchers from the Department of Ambulatory Care and Prevention of Harvard Medical School and Harvard Pilgrim Health Care and the Maternal Nutrition Group from the Department of Epidemiology at Statens Serum Institut in Copenhagen, Denmark. These findings provide further evidence that the omega-3 fatty acids found in fish and compounds in breast milk are beneficial to infant development.

The study team looked at 25,446 children born to mothers participating in the Danish Birth Cohort, a study that includes pregnant women enrolled from 1997-2002. Mothers were interviewed about child development markers at 6 and 18 months postpartum and asked about their breastfeeding at 6 months postpartum. Prenatal diet, including amounts and types of fish consumed weekly, was assessed by a detailed food frequency questionnaire administered when they were six months pregnant.

During the interviews mothers were asked about specific physical and cognitive developmental milestones such as whether the child at six months could hold up his/her head, sit with a straight back, sit unsupported, respond to sound or voices, imitate sounds, or crawl. At 18 months, they were asked about more advanced milestones such as whether the child could climb stairs, remove his/her socks, drink from a cup, write or draw, use word-like sounds and put words together, and whether they could walk unassisted.

The children whose mothers ate the most fish during pregnancy were more likely to have better motor and cognitive skills. For example, among mothers who ate the least fish, 5.7% of their children had the lowest developmental scores at 18 months, compared with only 3.7% of children whose mothers had the highest fish intake. Compared with women who ate the least fish, women with the highest fish intake (about 60 grams – 2 ounces – per day on average) had children 25% more likely to have higher developmental scores at 6 months and almost 30% more likely to have higher scores at 18 months.

Longer duration of breastfeeding was also associated with better infant development, especially at 18 months. Breastmilk also contains omega-3 fatty acids. The benefit of fish consumption was similar among infants breastfed for shorter or longer durations.

Women in the U.S. have been advised to limit their fish intake to two servings a week because some fish contains high traces of mercury, which has demonstrated toxic effects. Information regarding mercury levels was not available in this population, but most women consumed cod, plaice, salmon, herring, and mackerel, fish types that tend to have low mercury content. In this study, consumption of three or more weekly servings of fish was associated with higher development scores, so in this case the nutrient benefits of prenatal fish appeared to outweigh toxicant harm.

“In previous work in a population of U.S. women, we similarly found that higher prenatal fish consumption was associated with an overall benefit for child cognitive development, but that higher mercury levels attenuated this benefit,” says Dr. Oken. “Therefore, women should continue to eat fish – especially during pregnancy – but should choose fish types likely to be lower in mercury.” Information on mercury levels in commonly consumed fish is available at the U.S. Food and Drug Administration website (http://www.cfsan.fda.gov/~frf/sea-mehg.html).

Article adapted by Medical News Today from original press release.

Importance of Oral Health During Pregnancy

“Why do my gums bleed so much and so easily?” Oral health is a key component of overall optimal health and wellbeing across a person’s lifespan. During the course of pregnancy, it is very important to obtain treatment for your oral health and it IS safe throughout pregnancy. It is very surprising to find out that 22% of U.S. women reported they never accessed oral health care prior to becoming pregnant, and less than one third of pregnant moms visited their dentist in the postpartum period (between 2 to 9 months postpartum) following the birth of their babies. These statistics were obtained in a 2004 study. Surprising? Yes. Can it be prevented? Absolutely!

Why is oral health so important, especially during pregnancy? The many physiological changes that a woman’s body undergoes during pregnancy can have an undesirable affect on her overall oral health and good oral hygiene. The many hormonal changes that occur in pregnancy can increase the risk of the pregnant mom to be more susceptible to oral infections, such as periodontal disease, and can reduce the body’s ability to repair soft tissues in the mouth. In addition, “pregnancy gingivitis” or mild inflammation of the gums occurs in approximately 60% to 75% of pregnant women. If this condition is left untreated, it can lead to periodonitis, which can lead to bone and tooth loss. Periodontal disease has been associated with cardiovascular disease, stroke, poor diabetes control and adverse birth outcomes. The pain that results from oral disease can also harm nutritional intake and affect a pregnant woman’s self esteem.

While oral health is important to a women’s overall health, her oral health is also important in its relationship to the health of her unborn child. Studies have shown an association between periodontal disease and adverse birth outcomes such as low birth weight, preterm birth and gestational diabetes. More importantly, transmission of bacteria from the mother to her baby is the primary way that children first acquire the disease that causes cavities. Evidence suggests that most infants and most children acquire caries-causing bacteria from their mothers. Cavity-causing bacteria is passed through saliva via activities like sharing utensils, wiping off the baby’s pacifier in the mother’s mouth, and testing food before feeding to your baby. The healthier mom’s mouth, and the longer the initial transmission of bacteria is delayed, the more likely children are to establish and maintain good oral health.

Tips to help promote oral health:
• To help prevent or control tooth decay, brush your teeth with fluoridated tooth paste twice/day, and FLOSS DAILY
• Eat fruit, veggies, whole grain products and dairy products. Limit foods containing sugar to meal times only (watch those carbs!!)
• Drink plenty of water or low-fat/skim milk. AVOID carbonated beverages
• Choose fruit rather than fruit juice to meet the recommended daily intake of fruit (and will have less sugar)
• Obtain necessary oral treatment ideally before pregnancy. Those who have bleeding gums or cavities, should visit a dentist as soon as possible
• Diagnosis (including necessary dental x-rays) and treatment can be provided throughout pregnancy; however, the period between weeks 14 and 20 weeks of pregnancy is the best time to receive treatment.• Delaying necessary treatment could result in significant risk to the mother and indirectly to her baby

If you are dealing with morning sickness or frequent nausea, especially in the first trimester, here are some tips:
• Eat small amounts of nutritious foods throughout the day: the 6 small meals a day rule is important throughout pregnancy, but especially for dealing with nausea
• Chew sugarless or xylitol gum (causes bacteria to lose the ability to adhere to the tooth, stunting the cavity causing process) after meals.
• Rinse your mouth with water and a teaspoon of baking soda (sodium bicarbonate) after vomiting to neutralize acid
• Gently brush teeth with fluoridated toothpaste twice a day to prevent damage to demineralized tooth surfaces
• If you can’t brush your teeth because you feel sick, rinse your mouth with water or a mouth rinse that has fluoride

For mom:
• Maintain good oral health
• Limit foods containing sugar to meal times only (watch sugar intake overall)
• Avoid saliva-sharing behavior, including:
Sharing spoons or other utensils
Cleaning a dropped pacifier or toy by putting it in your mouth

For Baby:
• After the first tooth erupts, wipe your baby’s teeth after feeding with a soft cloth or soft-bristled toothbrush
• Avoid putting your baby to bed with a bottle or sippy cup containing anything other than water
• Ask your baby’s healthcare provider about your baby’s oral health status
• Schedule your baby’s first dental visit for between ages 6 and 12 months

Promoting oral health during pregnancy is the solution to achieving overall health and well-being for pregnant women, their babies and families. Visit your dentist regularly and maintain good oral hygiene.

Article by Jessie Buerlein, MSW, Project Mgr, presented by Angel J. Miller, MSN, CNM
Quickening, Summer 2009. Volume 40, Number 3
Official Newsletter of the American College of Nurse Midwives

Submitted by the Improving Perinatal and Infant Oral Health Project, a joint effort of the American Academy of Pediatric Dentistry and the Children’s Dental Health Project. For more info please visit http://www.cdhp.org