Antidepressant Use During Pregnancy May Raise Autism Risk? A new study!

It is very common for mothers to be taking anti-depressant medication before, during or after a pregnancy. Women with depression who are pregnant or hoping to get pregnant may be alarmed at new research that points to a link between the use of selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, and the occurrence of autism in unborn kids.

In the study, published in the journal Archives of General Psychiatry, researchers led by Lisa Croen of Kaiser Permanente Northern California reviewed the medical records of more than 1,600 children, 298 of whom had autism spectrum disorders (ASDs). Essentially the study stated that children whose mothers take Zoloft, Prozac, Paxil, Celexa or similar antidepressants during pregnancy are twice as likely as other children to have a diagnosis of autism or a related disorder. This study is the first to examine the relationship between antidepressants and autism risk within children. But is this study too early to draw direct links? Or is it a step forward in understanding the links to autism and children?

The study, which was published Monday in the Archives of General Psychiatry, is a small initial investigation into what is likely to become a better-studied area of what causes children to develop the group of developmental and cognitive problems known as Autism Spectrum Disorder.

In my opinion, there are important limitations to the study, and the clinical implications are not entirely clear. In the general population, the researchers wrote, “the fraction of cases of ASD that may be attributed to use of antidepressants by the mother during pregnancy is less than 3 percent…and it is reasonable to conclude that prenatal SSRI exposure is very unlikely to be a  major risk factor for ASD.” However, while they urged caution in interpreting the results, they said they believe the results do suggest a modest link between SSRIs and autism.

“Poor maternal mental health during pregnancy is a major public health issue,” Tim Oberlander, M.D., a professor of developmental pediatrics at the University of British Columbia, in Vancouver, told CNN.com. “Nontreatment is not an option.  While some children might be at risk from an SSRI exposure–and we don’t know who, and how that works–there are many mothers and their children as well who will benefit.”

According to the Archives of General Psychiatry, classes of antidepressants, known as  selective serotonin reuptake inhibitors (SSRIs), may be especially risky early on in a pregnancy. Children who were exposed to the drugs during the first trimester were nearly four times as likely to develop an autism spectrum disorder (ASD) compared with unexposed children, according to the study.

Only 20 of the almost 300 children studied had been exposed to antidepressants in utero, so researchers urged further investigation and study.

Important Note: The study included fewer than 300 children with a diagnosed ASD and does not prove that taking SSRIs during pregnancy directly causes ASDs, which affect approximately 1 percent of children in the U.S. The findings will need to be confirmed in larger studies, and should not dissuade women from starting or continuing to take SSRIs, experts on prenatal drug exposure and mental health say.

I think that it is possible that a very intricate and well-designed study could reveal an even larger association between the use of antidepressants and ASD. Preliminary studies such as this recent one are very influential in research, because they open the door to new ideas and provide a stage for new studies that could provide much better solutions on this issue.

I question — where does this leave women who are pregnant and suffering from depression? I think that those women suffering should seek out help from their doctors and use their judgment in trying to balance the importance of treating depression, while understanding the possibility that using antidepressants could, in some cases, contribute to risk for ASD. All in all? The current research does not provide a definitive answer….but who knows in the future!

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Tips to Stay Cool while You are Pregnant during the Summer!

I was speaking with my friend Jordana last night at my rooftop BBQ and she looks amazing for being 6 ½ months pregnant…my only question was, “HOW are you surviving this heat??” It was 84 degrees in New York City yesterday, no humidity and pure sunshine on the roof deck where we had a BBQ. Here were some of the tips she gave me on how to stay cool in the summer…I added a few of my personal tips for you too!

Tips for a Cool Summer during Pregnancy:

• Ice! Put it in drinks, chew on it or wrap it in a flannel and use it as a cold compress. Soaking your feet in a bowl of iced water can help soothe sore and swollen feet to no end.
• Do outdoor tasks in the morning or evening when the sun is lower and temperatures are cooler.
• When temperatures exceed 90 degrees Fahrenheit, stay indoors in the shade near a fan or air conditioner.
• Wear light-colored clothing.
• Carry a fan! – whether you go for a battery operated or classic hand-powered variety, having a fan on hand can really help to keep you cool when the temperature is rising. If you work on a computer, mini fans that plug into USB ports are now available and these are fantastic for keeping you feeling fresh if you’re office doesn’t have air conditioning.
• Light and airy fabrics. Summer dresses are best for taking advantage of breezes and staying cool. Turn to thin, breathable fabrics and enjoy long flowing dresses that also serve to camouflage swollen ankles.
• Drink plenty of liquids to remain hydrated. Sports drinks with electrolytes can help replace lost salt and retain fluid.
• Sip a cold “mocktail,” like this Pina Colada Smoothie: Combine 6 ounces frozen coconut yogurt, 1/2 a frozen banana, 1/2 of a 20-ounce can of crushed pineapple, and 1 cup milk; blend until smooth.
• Apply sunscreen with an SPF of 15 or higher 20 minutes before going into sun. Reapply throughout the day.
• Take quick showers frequently to keep cool.
• Put feet up to alleviate swelling.
• Minimize salt intake, which will combat water retention.
• Take frequent naps.
• To help you sleep at night keep your bedroom as cool as possible. If your room gets a lot of sun keep the curtains closed during the day, keep the windows open and invest in a rotating fan to place at the foot of your bed.
• Ask for help if you’re too tired to cook, clean, or run errands.
• Beware of typical barbecue foods, such as potato salad and coleslaw that, when left out in the sun, can sour and cause stomach upset.
• Clear your calendar. If it doesn’t absolutely need to be done now, or by you, don’t do it.

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Is it safe to treat your hair during pregnancy?

You’ve just found out you are preggers, but your roots are showing. Is it safe to touch them up? Will it hurt the baby? I know that when I was pregnant this was one of my worries since I was a natural brunette sporting bleach-blonde hair.   

Though there has been minimal scientific research on the subject, this is a frequently asked question. We all know that most hair treatments do involve chemicals and dyes.

Types of hair treatments include:

• Coloring – this includes temporary, semi-permanent and permanent dyes.
• Curling – permanent waves are created by placing two solutions on the hair – first the waving/curling solution then a neutralizer/fixer.
• Bleaching – involves the use of hydrogen peroxide
• Relaxers – are also known as hair straighteners and involve a variety of chemicals.

According to the American College of Obstetricians and Gynecologists (ACOG), “Hair dyes are probably safe to use during pregnancy because so little dye is absorbed through the skin.” This minimal amount is not thought to be enough to make health problems for your baby. There is more concern over the fumes created while processing your hair. It is for this reason that you must use caution. It is recommended by most that you do not treat your hair with anything during your first trimester (when there is a higher risk of problems).

Also semi-permanent dyes or a highlighting process may be considered safer for pregnant women. With highlights, the dye is enclosed in foil and won’t be absorbed into the skin. You can also choose vegetable dyes such as henna that are considered a safer option.

The following safety tips should be followed when chemically treating your hair during pregnancy:

• Wait until the second trimester for hair dye, bleaching, permanents or straightening.
• Treat hair in a well-ventilated area (possibly wear a mask).
• Don’t leave the chemicals on your head any longer than necessary.
• Rinse your scalp thoroughly with water after treatment.
• Wear gloves when applying chemicals.
• Carefully follow product directions.
• Do a patch test for allergic reactions before completing the process
• Never dye or bleach eyebrows or eyelashes. This could cause swelling or increase risk of infection in the eye area.

What about hair treatments while I breastfeed?
It is unlikely that any chemicals would enter the breast milk because so little is absorbed through the skin.

Of course, no one knows for sure the safety of treating your hair during pregnancy. It comes down to what you feel comfortable with. This is just one of many decisions you must make when being a parent. Many moms-to-be choose to go “au-natural” while growing their little-one inside. I chose to bleach my hair beginning my second trimester, but did not bleach directly to my scalp, and always did it in a well-ventilated area. My daughter is extremely healthy. However, I did find that after my baby was born my chemistry changed making it difficult to get the yellow out without over-processing. In the end I decided I looked better as a brunette with highlights.

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Preparing for the Big Day!

At 34 weeks, I am finally getting to the end of what has been, so far, a fantastic first pregnancy! It’s been a long, but easy road and I know the real “hard part” is coming up quickly. 

A very pregnant Kristin standing in front of our Le Top spring and fall 2011 collections

At my doctor’s suggestion, I signed my husband and me up for a four week long Childbirth Preparation class. With my first pregnancy comes a lot of apprehension about the whole birthing process. It doesn’t matter how many people I have talked to about this subject, I know that I can’t go into this based on other people’s experiences and advice alone. After all, I am one of those “prepared” people who has to know what is going on…or at least what is supposed to happen.

I walked in to our first class on Tuesday night, slightly dragging my husband along since he was somewhat reluctant to attend because he said we could learn everything on YouTube! Can you believe that!? Let’s just say that by the time our class was over, my husband had realized that YouTube, may not be the best teacher of childbirth. The benefits, even from the first class, have helped ease my mind a bit. Some of the key things I took away were:

• Stages of labor – understanding what my body would be going through and the duration of each stage in the big picture.
• Defining the terms I had heard so much about, and had not much of a clue as to what they actually meant. Things like “effacing” and “dilating”.
• Pregnancy discomforts – we all share the most common ones (Yay! I am not the only one who has started snoring at night!)
• Pain Management – how to relax

I am really looking forward to the upcoming classes, as I know that my anxiety about this part of the pregnancy should continue to decrease as my knowledge increases.

…Now where did I put that pint of ice cream?

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Mouthwash as a preventative for pre-mature births?

I was surfing the internet yesterday and read about a very interesting new study about pre-mature births and how something as simple as swishing your teeth with mouthwash can help prevent pre-mature births and cut the risk of giving birth to low birth-weight babies. I found this very intriguing and thought I would share it with you…when I first read the article, I thought it was an old wives tale, but the study seems to have some very interesting and relevant evidence to back up this new belief.

The study, presented at the Society for Maternal-Fetal Medicine’s annual meeting, suggests that mothers at high risk for an early birth can cut the risk by about 2/3 simply by using of an alcohol-free antibacterial mouthwash.

Lead author of the study, Dr. Marjorie Jeffcoat, a professor of periodontics at the University of Pennsylvania stated, “Preterm birth is the major cause of perinatal mortality and morbidity worldwide and still difficult to predict and prevent. So, when we found that something as simple as mouthwash could change the outcomes, we were very excited.”

A scary fact is that each year, about 13 million babies around the world are born prematurely, leading to death in some, cerebral palsy, intellectual disabilities, and breathing an developmental difficulties in others.

What is the cause of pre-mature births?
A number of factors can increase the risk of preterm birth, such as a mother’s low weight, smoking and drug abuse, but oral infections can also raise the risk.

The Study:
Researchers enrolled 204 pregnant women at 6-20 weeks gestation. All of them had periodontal disease which can cause the gums and the bone around the teeth to decay. None of them were receiving dental care. A group of 49 women were given a antimicrobial, alcohol-free mouthwash containing cetyl pyridinium chloride (CPC), to be used twice daily.

The rates of preterm birth were two thirds lower in this group than in the control group of 155 women.

The Studies Findings:

• It was noted that only 6.1 percent of the women who used a mouthwash had a premature delivery as opposed to 21.9 percent of those who did not use the rinse.
• Even after factoring age, smoking, and alcohol consumption, women adopting oral hygiene exhibited a two-third reduction in premature deliveries.
• Only 6.1 percent of the mouthwash using women had premature deliveries, compared to 21.9 percent of those who didn’t rinse.

Jeffcoat stated, “These results were so dramatic. There is a public health responsibility, in fact, to know what we found, to repeat it, to find out who should get it.”

So what’s the overall importance? Pregnant women have an extra susceptibility to bacterial infections– if the gums become severely affected, the infection could possibly trigger labor. This study also adds to evidence that dental care in pregnancy is very important! So brush and floss those pearly whites! 🙂

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Was that a kick?

This week I was sitting in a meeting here at Le Top when suddenly I felt something different! Was it just a gas bubble in my tummy or was it the baby moving?! Well it is safe to say at 4.5 months along, it was definitely the baby moving! I read about this feeling in one of my books last week – the gas bubbles or gurgley stomach movements – are usually the baby moving around in there. Since reading  this, I have been really vigilant when I feel something and stop to assess it. Not only did it happen then, but when I went to the dentist later on that day it happened twice while I was in the chair! Though, this time it felt more like something dragging along the front of my stomach.

Then today while I was sitting at my desk I started to feel it again, unlike the dragging at the dentist office, it felt almost like Thumbelina (or Tom Thumb) was doing a flip-flop. I can hardly wait for a real “Mommy I’m HEEEEERRRREEEEE” kick! Ha ha! My husband’s face just lit up when I told him about the movements, like it was the coolest thing ever – which it is pretty close to!

I hit another milestone this past week; it was the ability to rest my hands on this little belly. I was sitting on the couch Saturday night watching a movie, when my husband looks over at me and says “you look so cute!” I looked down and without even thinking about it, my hands were resting atop my bump! I think I like this new place for my hands!

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Can your diet as a prego mom affect your baby’s food habits?

Okay, okay, so us ladies all live in a world where we try to be healthy and stay slender and as soon as you get pregnant, the fear of being unhealthy and gaining weight can get even scarier.  For example, eat your greens and no more ice cream because it is “bad”.  Ha! 

I hear mom’s all the time ponder whether or not the food they are eating while they are pregnant affects their baby’s tastes and food likes/dislikes. Of course every mom knows it is important to think about what they eat during pregnancy as sharing and teaching their future babies how to eat healthy.

During pregnancy, your baby is fed nutrients through the umbilical cord. At the same time, the amniotic fluid, which surrounds the baby, takes on the flavor of the foods you eat. Even though your baby isn’t technically ingesting the amniotic fluid the way you ingest food, the baby is constantly swallowing it and tasting the same flavors that you do. Thus, as a mommy – you have a huge impact on your child’s palette before its even born!

In addition, if you choose to nurse your child, your breast milk will take on the flavors of the foods you eat. Certain flavors come through stronger than others, such as onion, garlic or mint.  My advice? Try to eat a good variety of foods, and your child will get used to experiencing new flavors on an everyday basis, and will be less resistant in the future to trying new foods when he or she is older.

In a 2001 experiment conducted by Julie Menella, a psychobiologist at the Monell Chemical Senses Center in Philadelphia, a group of pregnant women was asked to drink carrot juice during their third trimester; another group of pregnant women drank water instead. Six months later, the women’s infants were offered cereal mixed with carrot juice, and their facial expressions were videotaped while they ate. The offspring of the carrot juice-drinking women consumed more carrot-flavored cereal than babies who had not been exposed to the stuff before birth, and appeared to like its taste more.

What is interesting is that a mother’s eating habits while the baby is in the womb can correlate to various cultures and their cuisines. For example, certain flavors or tastes of particular foods are most likely introduced before birth and can affect a child’s likes towards certain foods. For example, I am half Chinese and as a baby in the womb I tended to eat Chinese food and not much dairy. Today I am allergic to most dairy products and crave Chinese food (ever since I was born).

Menella stated that “when a baby is born, he is not a blank slate. He has already been shaped by a rich array of sensory experiences that we are only now beginning to understand.”

There is no true verdict on whether your diet during pregnancy can affect your baby’s tendency toward food sensitivities or allergies, but the fairest answer is that we don’t really know for sure. However, the American Academy of Pediatrics (AAP) recommends that mothers at high risk of having an infant with food allergies—women with a family history—consider avoiding peanuts, one of the most highly allergenic of all foods, during the third trimester.

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Morning Sickness – The Do’s & Don’ts

Firstly, why “morning sickness”? Who termed it morning? Why not afternoon or evening because it can happen any time of day! Although there is no clear answer why nausea happens during pregnancy, it is believed the cause is hormonal changes.  My friend Chloe is recently prego and voila – nausea just around her 6^th week as most doctors would say. Fortunately she reassured me for when I get pregnant that “it isn’t too bad” and by mid-pregnancy I would be fine.

According to AmericanPregnancy.org, “More than half of all pregnant women experience morning sickness. Many health care providers think morning sickness is a good sign because it means the placenta is developing well.” The good news is that morning sickness doesn’t harm you or your baby, but if you are experiencing excessive nausea or vomiting, then talk to your doc because it may be hyperemesis gravidarum, a rare complication that results in a poor intake of fluids and food (and your wee little one will be quite hungry!).

Here are some DO’s and DON”Ts to help ease your morning sickness:

Do:

• Eat small meals as this will help keep your blood-sugar level steady and will keep your stomach filled
• Drink fluids a ½ hour before after a meal, but not with the meals
• Of course drink fluids also during the day to avoid dehydration
• Eat soda crackers 15 minutes before getting up in the morn (Snacking on easy-to-digest foods, such as whole wheat toast, baked potatoes, pasta and fruit)
• Ask someone to help cook for you or with you and open the windows if the smells are bothering you
• Rest, rest, rest during the day!
• Avoid warm/hot places
• Natural remedies can help – Sniff lemons or ginger, drink lemonade, or eat watermelon to relieve nausea (it works!)
• Eat salty potato chips (they have been found to settle stomachs enough to eat a meal)
• Safely exercise – it helps you sleep at night and relieve stress
• Get out of bed slowly
• Avoid greasy foods

Don’ts:

• Do not lie down after eating
• Do not skip meals
• Do not cook or eat spicy food

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To Caffeine or Not to Caffeine During Pregnancy

The jury has been called to order and whether or not caffeine can actually hurt your fetus – most health-care professional do recommend limiting intake. Sorry Starbucks. Caffeine is a diuretic, meaning it pulls fluids and calcium from both you and baby and will keep you running to the bathroom. Ha! As if you aren’t peeing enough during pregnancy! Caffeine has no nutritional value and can affect your mood, sleep schedule and iron absorption. Remember, caffeine is also found in not just coffee, but most teas, soft drinks and chocolates. Play it safe by totally eliminating caffeine, but If you simply can’t kick the habit, at least cut back. Some studies show that excessive caffeine consumption (more than300 mg or two or three 8-ounce cups a day) can increase chances of miscarriage or premature birth. In the March 2008 issue of the American Journal of Obstetrics and Gynecology that showed that moms-to-be who consumed 200 mg or more of caffeine a day had double the risk of miscarriage compared with those who had no caffeine.

Going cold turkey can be pretty hard, so try lowering your caffeine intake little by little. If you’re a coffee drinker, work your way down to half-caf before becoming a full-fledged decaf drinker. Of course, if you decide to cut out caffeine altogether, you won’t get any arguments from your doctor or midwife.

So which foods and beverages contain caffeine?
Coffee is one. The amount of caffeine in a serving of coffee varies widely, depending on the type of bean, how it’s roasted, and how it’s brewed – and, obviously, on the size of the coffee cup. (Although espresso contains more caffeine per ounce, a full cup of brewed coffee will deliver more caffeine.)

To cut your caffeine intake, though, you’ll need to be aware of other sources like tea, soft drinks, energy drinks, chocolate, and coffee ice cream. Caffeine also shows up in herbal products and over-the-counter drugs, including some headache, cold, and allergy remedies. Read labels carefully.

Caffeine chart: Amounts in common foods and beverages*

Source: http://www.thebabycenter.com

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Pregnancy: How Much Weight Did You Gain?

I was reading a blog entry about Maya Rudolph gaining 70 pounds with her first pregnancy. And I’m thinking, “OMG! That’s a lot of weight.” But I don’t think it’s completely out of the ordinary. A lot of my mommy friends gained around 50 pounds, and some up to 100 pounds. And these women are small and petite.

When I was pregnant (both times), my doctor suggested that I gain no more than 25 pounds. The first time around, I said, “Sure, no problem.” But as the pregnancy progressed, my total weight gain was around 35-40 pounds. It wasn’t like I pigged out on everything, nor was I “eating for two.” But I definitely couldn’t control my weight gain. With my second pregnancy (since I had gestational diabetes), I was put on a low-carb, no sugar diet, and I followed this diet to a T for the health and well-being of my unborn child. Trust me. It was HARD not to give in to my cravings. Yet, I still gained about 30 pounds. My point is, whether I followed a nutritional diet or not, I still gained over the recommended 25 pounds.

Just out of curiosity, how much weight did you gain?

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