Posted on

Pesticide Exposure in Pregnancy Linked to Lower IQ in Kids

pregnant woman

Three studies show a link between pre-birth exposure pesticides widely used on food crops and lower intelligence scores in children.

The effect is especially noticeable in kids from a California farming region. An area where they and their mothers were also potentially exposed to pesticides on local crops.

The pesticides, organophosphates,  kill insects by disrupting their brains and nervous systems. First developed in a more potent form as nerve poisons during World War II, they can disrupt people’s nervous systems as well, according to the U.S. Environmental Protection Agency.

Growing Evidence of Pesticide’s Effects on Pregnancy

The research doesn’t prove that organophosphate exposure is bad for the developing brains of infants and children. That may be impossible to confirm.  Ethical constraints prevent scientists from randomly assigning kids to be exposed to pesticides to see what happens.

Still, “there’s a body of evidence that’s beginning to build” in support of a link, said Brenda Eskenazi, co-author of one of the studies and director of the Center for Environmental Research and Children’s Health at the University of California, Berkeley.

Although organophosphates are no longer used in bug-killing products designed for the home, they remain common in agriculture, the researchers noted.

Exposure to the pesticides in pregnant mothers showed lower IQ scores in their kids by age 7.

Two of the studies, conducted by researchers at Mt. Sinai Medical Center and Columbia University, examined kids in New York City, while Eskenazi’s study looked at 329 kids and their mothers in the Salinas Valley area of central California.

All of the studies found links between exposure to the pesticides in pregnant mothers and lower IQ scores in their kids by age 7.

In the Salinas Valley study, researchers looked at signs of pesticide exposure in urine taken from the mothers during pregnancy and later from their children.

The researchers found that every 10-fold increase in organophosphates detected during a mother’s pregnancy corresponded to a 5.5-point drop in overall IQ scores in her children by age 7.

In fact, the 20% of the children whose mothers appeared to have been exposed to the least pesticides had about a 7-point higher IQ level, on average, than those in the 20% born to mothers with the highest exposure, the researchers reported.

Equivalent to about six months of brain development

The difference is equivalent to about six months of brain development in a typical child, Eskenazi said. And the differences remained even when the researchers adjusted their statistics.

Eskenazi pointed out that the exposure might result in more children in need of special education and other services.

The studies show more of an effect in Salinas Valley than New York City,. Suggesting that the California kids were exposed to more pesticides because they live near farms where these chemicals are used.

How can parents lower their family’s exposure to pesticides?

  • Reducing exposure during pregnancy is important.
  • Take steps to prevent pests from getting into the home, rather than trying to manage them with pesticides.
  • Buy organic produce to avoid pesticides
  •  Wash those fruits and vegetables well. Get a brush to scrub them, especially if they’re hard-skinned fruits and vegetables. If they have a peel, you still need to wash them

Communities should pursue integrated pest management strategies that use a combination of methods and aim to reduce use of chemical pesticides.

Hope for the Future

The pesticides in question may be on their way to becoming less of a risk: Eskenazi said they’re less popular today than in the past. “The industry has been responsive,” she said. “We are definitely seeing a drop, and we’re seeing an increase in organic cropland.”

SOURCES: Brenda Eskenazi, Ph.D., director, Center for Environmental Research and Children’s Health, and professor of epidemiology and maternal and child health, University of California, Berkeley; and Mary A. Fox, Ph.D., M.P.H., assistant professor, health policy and management department, Johns Hopkins Bloomberg School of Public Health, Baltimore; , Environmental Health Perspectives.

Posted on

Why Should I Make Sure My Baby is Screened for Critical Congenital Heart Disease at Birth?

baby girl and dog

New study confirms a dramatic decrease in infant deaths

Infant deaths from critical congenital heart disease (CCHD) decreased when babies were screened for Congenital Heart Disease at birth.

  • a decrease of more than 33 per cent in eight states that mandated screening for CCHD using a test called pulse oximetry.
  • And deaths from other or unspecified cardiac causes decreased by 21 per cent.

Pulse oximetry is a simple bedside test to determine the amount of oxygen in a baby’s blood and the baby’s pulse rate. Low levels of oxygen in the blood can be a sign of a CCHD.

About 1 in every 4 babies born with a congenital heart defect has CCHD and will need surgery or other procedures in the first year of life.

In the U.S., about 7,200 babies born each year have one of seven CCHDs
CCHD screening nationwide could save at least 120 babies each year, according to a new study published in the Journal of the American Medical Association.

This study is the first look at the impact of state policies to either require or recommend screening of infants for CCHD at birth.

The study, Association of U.S. State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Infant Cardiac Deaths, shows that states that required their hospitals to screen newborns with pulse oximetry saw the most significant decrease in infant deaths compared with states without screening policies.

47 states and D.C. now have mandatory screening policies in place and one additional state, California,  requires screening be offered. These results serve as a reminder to hospitals across the country to remain vigilant in their screening for CCHD.

“More families are able to celebrate special milestones in a child’s life thanks to the early identification and treatment of heart defects,” said CDC Director Brenda Fitzgerald, M.D. “Screening newborns for critical congenital heart disease in every state, tribe, and territory will save lives and help babies thrive.”

Without screening by a pulse oximetry reading, some babies born with a congenital heart defect can appear healthy at first and be sent home with their families before their heart defect is detected.

CDC works to identify causes of congenital heart defects, find opportunities to prevent them, and improve the health of people living with these conditions.

For more information on congenital heart defects, visit https://www.cdc.gov/ncbddd/heartdefects/index.html and https://www.cdc.gov/features/congenitalheartdefects/.

Posted on

Ways to reduce baby’s risk of SIDS and other sleep-related causes of infant death.

Parents, grandparents, family members, child care providers, health care providers, and others — are encouraged to learn about the updated recommendations for safe infant sleep.

US Federal agencies and the  American Academy of Pediatrics (AAP) provided this list of actions for safe sleep for infants younger than 1 year of age.

The main ways recommended for reducing the risk of SIDS remains the same:

  • Place babies completely on their backs to sleep for all sleep times, naps and at night. ( most important)
  •  Breastfeeding for at least 6 months,
  • Using a pacifier,
  • Having the baby sleep in or near the parent’s bedroom ( but bed-sharing shows and increases SIDS deaths),
  • Swaddling has been shown to have no impact on SIDS and can be dangerous if done when the infant begins to turn over.

Other important ways to keep baby safe during sleep include:

  • place baby to sleep on a firm sleep surface, such as a mattress in a crib that meets the safety standards of the U.S. Consumer Product Safety Commission.
  • Another advises the removal of blankets, soft objects, toys, crib bumpers, and loose bedding from the sleep area.
  • Couches and armchairs can be very dangerous places for babies this is especially true if adults fall asleep as they feed, comfort, or bond with baby while on these surfaces.

Parents and other caregivers should be aware of how tired they are when feeding, comforting, or bonding with the baby while on these surfaces to avoid falling asleep in such situations.

How to  reduce SIDS and other sleep-related infant deaths:

1. Back to sleep for every sleep.

  1. a.  Preterm infants should be placed supine as soon as possible.

    b. “Skin-to-skin care is recommended for all mothers and newborns, regardless of feeding or delivery method, immediately following birth (as soon as the mother is medically stable, awake, and able to respond to her newborn), and to continue for at least an hour.”

2. Use a firm sleep surface.

Place infants on a firm sleep surface (eg, mattress in a safety-approved crib) covered by a fitted sheet with no other bedding or soft objects to reduce the risk of SIDS and suffocation.

3. It is recommended that infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for the first year of life, but at least for the first 6 months.

There are specific circumstances that, in case-control studies and case series, have been shown to substantially increase the risk of SIDS or unintentional injury or death while bed-sharing and these should be avoided at all times:

    1. Bed-sharing has an increased risk of SIDS.  If parents choose to feed their infants younger than 4 months in bed, they should be especially vigilant to not fall asleep.

4.. Keep soft objects and loose bedding away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment, and strangulation.

5. Consider offering a pacifier at nap time and bedtime.

Studies have shown a protective effect of pacifiers on the incidence of SIDS. The protective effect of the pacifier is observed even if the pacifier falls out of the infant’s mouth.

6. Avoid overheating and head covering in infants.

Although studies have shown an increased risk of SIDS with overheating, The definition of overheating in these studies varies. Therefore, it is difficult to provide specific room temperature guidelines to avoid overheating.

  1. In general, infants should be dressed appropriately for the environment, with no greater than 1 layer more than an adult would wear to be comfortable in that environment.

  2. Parents and caregivers should evaluate the infant for signs of overheating, such as sweating or the infant’s chest feeling hot to the touch.

Things parents and caretakers can do to protect babies from SIDS

7. Breastfeeding is recommended.

  1. Breastfeeding is associated with a reduced risk of SIDS. Unless contraindicated, mothers should breastfeed exclusively or feed with expressed milk (ie, not offer any formula or other nonhuman milk-based supplements) for 6 months,

  2. Breastfeeding has been shown to be more protective against SIDS than no breastfeeding.

8. Avoid smoke exposure during pregnancy and after birth.

9. Avoid alcohol and illicit drug use during pregnancy and after birth.

10. Pregnant women should obtain regular prenatal care.

Pregnant women should follow guidelines for frequency of prenatal visits.

11. Infants should be immunized in accordance with recommendations of the AAP and Centers for Disease Control and Prevention.

There is no evidence that there is a causal relationship between immunizations and SIDS. Indeed, recent evidence suggests that vaccination may have a protective effect against SIDS.

12. Avoid the use of commercial devices that are inconsistent with safe sleep recommendations.

Be particularly wary of devices that claim to reduce the risk of SIDS.

Examples include, but are not limited to, wedges and positioners and other devices placed in the adult bed for the purpose of positioning or separating the infant from others in the bed.

13. Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.

The use of cardiorespiratory monitors has not been documented to decrease the incidence of SIDS.

14. Supervised, awake tummy time is recommended to facilitate development and to minimize the development of positional plagiocephaly.

15. There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS.

Swaddling, or wrapping the infant in a light blanket, is often used as a strategy to calm the infant and encourage the use of the supine position.

There is a high risk of death if a swaddled infant is placed in or rolls to the prone position If infants are swaddled, they should always be placed on the back. Swaddling should be snug around the chest but allow for ample room at the hips and knees to avoid exacerbation of hip dysplasia.

When an infant exhibits signs of attempting to roll, swaddling should no longer be used. There is no evidence with regard to SIDS risk related to the arms swaddled in or out. These decisions about swaddling should be made on an individual basis, depending on the physiologic needs of the infant.

For more information and to see full report go to https://pediatrics.aappublications.org/content/early/2016/10/20/peds.2016-2938