Healthy Habits Best for Babies
Avoiding having a premature baby
By: Lance Chilton
Q: I’m pregnant. What can I do to be sure that my baby is as healthy as possible?
A: To answer this question, I looked to answer a related question, “What factors cause death in American infants?” There are differences between the two questions, of course: Being healthy is not just the absence of being dead!
I wish I could tell you how to avoid having a premature infant. Ending prematurity would be the best thing we could do to prevent infant death and disability. All of the causes of prematurity are not known. According to the Centers for Disease Control, “conditions originating in the perinatal period” caused 13,908 deaths in 2004. Most of these involved tiny premature babies. We know that it is not a good idea to smoke during pregnancy — babies of smokers are likely to be considerably smaller than those of nonsmokers. We know that you shouldn’t drink alcohol while “with child” — infants exposed to alcohol while in the womb are much more likely to be small, to have a set of disorders called alcohol related birth defects or full blown fetal alcohol syndrome. But we don’t know why some women go into labor many weeks before term and deliver infants who are at high risk to die, to have hearing or vision problems, and to have troubles in school later on. Known risk factors include abnormalities of the uterus, smoking, drinking and drug use, previous premature labor and multiple births, so avoid them if you can!
I recently waited with a nurse I know in a hospital up north as the obstetrician examined her daughter-in-law, who had broken her bag of waters little more than halfway through pregnancy. The obstetrician fortunately found it safe to transfer the mother by air to one of three Albuquerque hospitals, Presbyterian, University of New Mexico and Lovelace Women’s, who have the state’s only newborn intensive care units. Mothers are by far the safest “premature baby transfer incubators,” but the infant died after being born too early to have lungs that would breathe for her. What caused this early birth? No one knew; the baby’s mother had done everything right, but the result was devastating to my friend and her family.
The second largest category of deaths in newborns comes from congenital malformations, a term meaning infants born without all of those complex body developments in the womb having gone right. Congenital malformations can be as minor as a malformed ear or a testicle that doesn’t move into its usual place, or as complicated and difficult as a heart with the blood vessels connected in the wrong places, or a whole series of malformations that go together, such as the so-called VACTERL syndrome, where there may be abnormalities of the spinal vertebrae, the anus, the heart, the esophagus, the kidneys, and the legs. Congenital malformations account for more than 5,000 deaths a year.
Most of the time, as with prematurity, no one knows what caused a particular malformation. We do know, though, that taking folic acid even before pregnancy and throughout it reduces the risk of many major malformations.
We know that drinking increases the risk, and we know that certain medications, such as those that combat seizures, markedly increase the risk of malformations. Do you remember thalidomide? That drug, used mostly in Europe to make pregnancies easier, caused babies to be born without limbs. A popular drug for severe acne also causes severe malformations.
Don’t take medicines during your pregnancy unless you’re sure that they’re safe and necessary. Call the New Mexico Poison and Drug Information Center, (800) 222-1222, for advice if you’re not sure about a given medication.
Much has been said about doing exercises or preparing the breasts for breast- feeding during pregnancy. I think the jury is still out on these things, but there’s no doubt that psychological “exercises” are useful in preparing yourself to have the healthiest possible newborn. If you had a childhood marked by parental abuse or neglect, promise to avoid doing the same and talk with your partner and your child’s doctor-to-be about it. Without conscious effort, you’ll be prone to inflict the same on your child. If you have a tendency to depression, please get help: Depressed mothers of newborns can hinder their infants’ development.
Be ready to love and enjoy that newborn — get out the baby books and the books for baby. See what fun it can be to read well- written, colorful and well-illustrated books for kids — you’ll do yourself a favor and help your child develop into a reader. I loved reading “Horton Hears a Who” last night, even though my children are long grown and, sadly, living far away. My best wishes to you for hearing the best whomever ever.
Lance Chilton, M.D., is a pediatrician at the Young Children’s Health Center in Albuquerque, associated with the University of New Mexico.