Food and Nutrition for the Family - on a shoestring budget!

If you don’t have enough money for food, there are many ways of getting help.  An article called "Food and Nutrition for the Family" gives great tips on how to eat better when you are on a shoestring budget.  Read this article with your pregnant daughter and talk to her about these points:

• Learn about WIC (Women, Infants and Children), SNAP (Supplemental Nutrition Assistance Program, formerly the Food Stamps program), the Child Care Food Program, and the School Meals Programs by going to www.fns.uada.gov
• Feeding America (www.feedingamerica.org) has a searchable online directory of food banks in your area.
• For a baby’s first four to six months, breast milk or infant formula provides all the nutrition she needs. Once a baby starts to eat solid foods, consider making your own baby food. Learn more at  www.wholesomebabyfood.com
• Cook at home more.  Find recipes at www.allrecipes.com, www.lowcostmeal.com, or
  www.cookforgood.com.
• Plan menus for a week and buy only the items needed.
• Drink water.

Talk with your pregnant daughter about your current food budget.  What items that are low quality foods can be removed in order to save money or to buy more nutritious foods?

Have questions? Want to talk about this post or other issues? Write a comment, join us on Facebook, or talk with us on our new Grandparent Support Group! 

Health Insurance resource

A pregnant woman needs and deserves prenatal care from the moment she learns she is pregnant. The State Child Health Insurance Program (SCHIP) provides free or low-cost health insurance for children up to age 18 as well as for pregnant women.

The program is designed for families who earn too much to qualify for Medicaid but not enough to afford insurance on their own. Requirements and provisions vary by state. Check insurekidsnow.gov for links to your state’s SCHIP resources, or call 1-877-KIDSNOW (1-877-543-7669).

You may find it helpful to read the chapters “First steps to take” in our book “How To Survive Your Teen’s Pregnancy“.

Have questions? Want to talk about this post or other issues? Write a comment, join us on Facebook, or talk with us on our new Grandparent Support Group!  

28% of US Kids Drank Alcohol in the last month

According to a recent study, "27.6%) of American youth aged 12 to 20 said that they drank alcohol in the past month".

Talk to your kids about not drinking alcohol. Alcohol lowers inhibitions, making it more likely that you will say or do things that you later regret doing, like having sex. Alcohol also affects decision-making skills, making it more likely that you choose to have sex when you otherwise would not have done so.

Statistics indicate that alcohol was involved in more than 97,000 sexual assaults among college students during the years 1998-2001, and more than 100,000 incidents of being too drunk to consent to sex. Was alcohol involved in the sexual activity that lead to your daughter's pregnancy?

"People who start drinking before age 15 are six times more likely to have alcohol problems than those who start drinking at age 21 or older, according to research." Now that your daughter is pregnant, is she still drinking alcohol? Print out this fact sheet about how alcohol affects your daughter's baby while she is pregnant, and talk to her about it. Get her medical help to stop drinking.

The effects of Fetal Alcohol Spectrum Disorder (FASD) vary widely from person to person. Difficulties in an individual’s ability to succeed at home, school, work, and in social situations may arise at different ages. For many people with an FASD, brain damage is the most serious effect. It may result in cognitive and behavior problems. One obvious sign of brain damage in some babies born with FAS is a small head. We call this condition microcephaly. Individuals with FASD may have facial anomalies such as small eye openings, a smooth philtrum (groove under the nose), and a thin upper lip. When a person has all three features, together they are a sign of FASD. Other features, sometimes seen in persons with FAS, include a short nose, a flat mid-face, or a small upper jaw. However, people who do not have FAS can also have these features, so they are not by themselves a sign of FASD.

Due to damage by exposure to alcohol in the womb, babies with an FASD may be born small and underweight. Somehave difficulty nursing or eating and their growth continues to lag, resulting in failure to thrive. Some infants with an FASD may also have tremors, seizures, excessive irritability, and sleep problems. Physical effects of FASD may include heart defects, such as a hole in the wall of the heart that separates its chambers. Other effects are skeletal defects, such as fused bones in the arms, fingers, hands, and toes. People with an FASD may also have vision and hearing problems, kidney and liver defects, and dental abnormalities. Alcohol can damage the developing fetus from the earliest weeks through the end of the pregnancy. Other factors associated with women who drink during pregnancy are poor nutrition and lack of prenatal care. These factors may also affect organ and skeletal development.

Keep healthy during flu season

Remember these simple tips:

1) Wash your hands. Especially before you eat. Use soap and rub for 30 seconds before rinsing.

2) Avoid touching your face.

3) Cover your cough with the crook of your elbow, not your hands.

4) Avoid sick people.

If you get the flu:
1) Stay at home and get rest. The CDC recommends you stay home for 24 hours AFTER your fever is gone.

2) Stay hydrated with water, broth, or drinks like gatorade.

3) Know when to seek emergency medical care. Warning signs include: fast breathing or trouble breathing; bluish or gray skin color; dehydration symptoms such as dizziness when standing, absence of urination; Severe or persistent vomiting; flu symptoms that improve but then return with a fever and worse cough.

Depression affects children

"National Research Council and the Institute of Medicine, estimates that in any given year, 7.5 million U.S. parents are depressed and at least 15 million U.S. children live with a parent who has major or severe depression." A WebMD.com news article summarizes some information from this report.

Was your pregnant daughter depressed before she became pregnant? Is she depressed now that she is pregnant? Make sure she gets medical treatment for her depression! Her depression can adversely affect her child. The report shows that:

Depressed pregnant women may be less likely to get prenatal care.

Depressed moms may be less attentive or less able to respond in a healthy way to their babies' needs.

Parental depression has been linked to children's early signs of, or vulnerability to, having a more "difficult" temperament, including more negativity, less happiness, poorer social skills, more vulnerability to depression, more self blame, less self-worth, and a less effective response system to stress.

William Beardslee, MD, of the psychiatry department at Children's Hospital in Boston notes that
"Early in life, we worry most that somehow the fundamental bond between the mother and father and the infant may be weakened because of depression. A little later on, when children are older, parents are vitally important in providing structure, order, encouragement, support, helping with school, helping with friendships, and those processes tend to be disrupted when a parent is depressed".

Teens with Older Sexual Partners

Child Trends published a fact sheet in April 2008 titled "Long-term consequences for teens with older sexual partners". This research examines whether having sexual intercourse before age 16 with a partner at least three years older was associated with becoming a teen parent or unmarried parent or acquiring a sexually transmitted disease (STD) by young adulthood (post-high school through the early twenties).

Findings:
1) 18% (nearly 1 in 5) middle school and high school girls reported having sex with an partner who who was three or more years older than themselves. Only 4% of boys were in the same position.
2) 55% of girls and 61% of boys reported that they had not yet had sexual intercourse by middle school or high school.
3) Girls who had an older sexual partner were more likely to acquire an STD, and more likely to have had a baby outside marriage by young adulthood.
4) Girls who had sex before age 16 with a partner at least three years older were twice as likely to test positive for an STD in young adulthood.
5) 27% of the girls in the research study reported that they had had at least one nonromantic sexual partner during adolescence.

Talk to your teens and college students about the dangers of dating someone that is more than 3 years older than themselves while they are not yet adults. The maturity and power differences pose serious risks until your children are adults themselves. Read our other blog entries about this topic: "Age differences in dating", "Sexual Behavior in America's Children", and "Teen Dating Abuse".

HELLP Syndrome

A recent news story titled "Miracle baby born months early survives against tremendous odds" tells the story of 24-year old mother Tira and her baby (Brianna) who was born at about 24 weeks of pregnancy. When Brianna was born at about 24 weeks of gestation, she weighed 13 ounces. She stayed in the hospital for nearly five months until she weighed about 5.5 pounds.

Tira, the mother, explained "I was having really bad pressure in my chest and pains, and I let it go for about two or three days and then we went to the hospital and they told me that was my liver shutting down, my blood pressure was skyrocket and if I would have waited 12 more hours they would have lost me and her both."

The symptoms of HELLP include:
Headache
Nausea and vomiting that continues to get worse
Upper abdominal pain
Vision problems
For more information on HELLP, click here.

Conditions like this are why your pregnant daughter needs to get prenatal care as early in her pregnancy as possible and to continue with prenatal care throughout her pregnancy. We talk about the importance of prenatal care in the chapters titled "First steps to take" and "The doctor appointment" in our book "How To Survive Your Teen's Pregnancy."

Depression Treatment during Pregnancy

A new report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists finds that women should talk to their doctors about whether they should continue to take antidepressant medication during pregnancy.

"Pregnant women who experience psychotic episodes, have bipolar disorder, or who are suicidal or have a history of suicide attempts should not be taken off antidepressants, the report concludes."

"Separate studies from Sweden and the U.S. suggested an increased risk for congenital heart defects in babies born to women who took Paxil during pregnancy. But the joint panel found the evidence linking Paxil use during pregnancy to heart problems in newborns to be inconclusive."

Antidepressant "use during pregnancy has also been linked in some studies to an increased risk for miscarriage, low birth weight, and preterm delivery. But once again, the report found no definitive link between the use of the antidepressants and these pregnancy outcomes."

Recommendations in the report include:

"Women who are already pregnant should not attempt antidepressant withdrawal if they have severe depression. Psychiatrically stable women who want to stay on antidepressants during pregnancy should consult with their psychiatrist and ob-gyn about the potential risks and benefits. Women with recurrent depression or those who have symptoms despite drug treatment may benefit from psychotherapy when available."

If your pregnant daughter is taking antidepression medication, talk to her doctor as soon as possible about the risks and benefits of her medication.

Parents: You Matter! Webinar

Boys & Girls Clubs of America and The Partnership for a Drug Free America present a webinar on August 25, 2009 titled

Parents: You Matter!

The webinar will present parent-friendly tools and resources that will give attendees information about why kids use drugs and alcohol, and what parents need to know to help and protect their children. Resources will be made available to all attendees, including the presentation, annotated script and other tools. Sign up here.

Swine Flu Vaccination

The CDC recommends that pregnant women get vaccinated against the Swine Flu (H1N1) as soon as it is available in mid-October.

An article titled "H1N1 flu shots: Pregnant women, health care workers and children first" says:

The first priority group of recipients would be pregnant women, people who live with or care for children younger than 6 months, health care and emergency personnel, people 6 months to 24 years old, and people age 25 to 64 who are at high risk due to chronic health disorders or compromised immune systems.

So get your calendar out and write down a reminder to get your pregnant daughter the vaccination in October.

What is Swine Flu? Learn about the myths and facts by reading this article at Fox News.

Exercise during pregnancy

Watch CBS Videos Online

The above 3.5 minute video from CBS news reminds pregnant women that they should aim for 30 minutes of exercise every day. The related article says that research shows that "exercising during pregnancy can help women lose baby weight quicker and have shorter, less painful labors."

Have your pregnant daughter talk to her doctor about what exercise program would be best for her. Then exercise with her!

Baby's bone health

A Reuter's health article titled "Maternal diet affects infant's long-term bone health" is a good reminder that your pregnant daughter needs your help to plan her diet.

Help your pregnant daughter eat more fruits and vegetables, yogurt, whole wheat bread and breakfast cereals. Help her avoid chips and roast potatoes, sugar, white bread, processed meat, tinned vegetables and soft drinks.

Pregnancy and diabetes

USA Today had an article "Expectant mothers with diabetes face risky challenge" (by Mary Brophy Marcus) that talks about the challenges of pregnancy and diabetes.

"Almost five out of every 1,000 women ages 18 to 44 have diabetes, according to the CDC. Most have Type 2 diabetes, which is linked to obesity."

If your pregnant daughter had diabetes before she became pregnant, you will hear her doctors use the term "pre-gestational diabetes". If she develops diabetes during pregnancy, you will hear the term "gestational diabetes." Most pregnant women are tested for gestational diabetes around the 28th week of pregnancy. About 4% of pregnant women will develop diabetes during pregnancy.

Diabetes during pregnancy "raises the risk of miscarriage, delivery complications, maternal health problems and birth defects" so make sure that your pregnant daughter gets medical attention as soon as possible during her pregnancy.

Your pregnant daughter may be referred to an endocrinologist, who will run a simple blood test called A1C. This test gives an average blood glucose reading over the last 2-3 months. "In June (2009), Diabetes Care published a study by University of Southern Denmark researchers who found that the risk of serious outcomes increased gradually when A1C levels were above 6.9%. Adverse outcomes doubled when A1C's reached 10.3%, and readings 10.4% or greater quadrupled risks."

So what can your pregnant daughter do? Keep her weight under control. Keep her blood sugar under control. Eat a careful healthy diet as directed by her doctor. Exercise as directed by her doctor. Carefully take any medications prescribed by her doctors.

Depression and premature birth

Babies born too early (premature birth), before the 37th week of pregnancy, are at risk for health problems. Researchers do not completely understand why some babies are born too early, but one recent study at the University of Washington indicates that if the the woman was depressed before pregnancy then she might be at risk to give birth too early.

"In the study 18.1 percent of the black women had a preterm birth compared to 8.5 percent of the white women." Researcher Amelia Gavin "believes the higher preterm birth rate among blacks may be the result of declining health over time among black women."

If your pregnant daughter was depressed before she became pregnant, learn with her about preterm labor and talk to her doctor to learn what your daughter can do to take good care of herself during her pregnancy.

Morning Sickness relief

Results of a relatively large research study recently showed that an anti-nausea drug appears to be safe for use during pregnancy.

The Associated Press report says, "The Israeli study, led by researchers at Ben-Gurion University, included pregnant women enrolled in Israel's largest HMO from 1998 through 2007. It compared the health of newborns of 3,458 women who took metoclopramide, for as little as a week to more than three weeks, with 78,245 newborns of women who had not used it. Rates of problems were low and similar in both groups."

According to WebMD, metoclopramide is a pretty powerful anti-nausea drug ... it is used to help chemotherapy patients with their nausea. WebMD has several suggestions for dealing with morning sickness. If these types of home remedies are not working for your pregnant daughter, talk to her doctor about whether she should try metoclopramide.

Pregnancy Weight Gain

New weight-gain guidelines were released recently. Be sure your pregnant daughter talks to her doctor to find out how much pregnancy weight she should gain during each trimester. Research together how she can eat good food that will benefit her growing baby.

The press release from the Institute of Medicine says:
"Healthy American women at a normal weight for their height (BMI of 18.5 to 24.9) should gain 25 to 35 pounds during pregnancy, the new guidelines state.

Underweight women (BMI less than 18.5) should gain more, 28 to 40 pounds.

Overweight women (BMI of 25 to 29.9) should gain less, 15 to 25 pounds.

Obese women (BMI greater than 30) should limit their gain to 11 to 20 pounds."

"For mothers, the ramifications of excess weight gain include increased chances of retaining extra pounds after birth or needing a Caesarean section;

for children the risks include being born preterm or larger than normal with extra fat.

Each of these consequences increases the chances for subsequent health problems -- such as heart disease and diabetes in the case of extra weight, and impaired development in the case of premature birth.

At the same time, adding too few pounds during pregnancy increases risks for stunted fetal growth and preterm delivery."

Pregnancy and smoking

Recent news indicates that the antidepressant bupropion can help pregnant women curb their smoking. A research study was performed by Dr. Margaret S. Chisolm, and she found that women who are drug-dependent tend to continue smoking during pregnancy even though smoking is dangerous to their child just as the illicit drugs are dangerous.

Smoking during pregnancy increases the risk of miscarriage, low infant birthweight, fetal death, and infant death.

So if your pregnant daughter is smoking, ask her doctor if bupropion would be appropriate for your daughter to help her stop smoking.

Exercise can be very beneficial

Make sure your daughter is getting appropriate exercise during her pregnancy. Her doctor will be able to give her feedback on the type of exercise that she may participate in, and for what duration and intensity.

Exercise that is appropriate will benefit both your daughter and her child, both during and after pregnancy.

The American College of Sports Medicine published a report ("ACSM Roundtable Consensus Statement: Impact of Physical Activity during Pregnancy and Postpartum on Chronic Disease Risk") which reviewed the research about pregnancy and exercise in 2006 and offered a summary of the benefits of exercise during pregnancy and after childbirth:

- Exercise Reduces Risk of Preeclampsia. Preeclampsia is a condition marked by high blood pressure, proteinuria (protein in urine) and edema in the mother, which makes her more likely to experience metabolic disturbances during this time similar to those with coronary heart disease and chronic hypertension. One study indicated women who were physically active on a regular basis experienced a 43% risk reduction of preeclampsia as compared to sedentary women. Also, risk appears to decrease as average time spent performing physical activities increased. A reduction in risk has been related to moderate activities most pregnant women can do, such as walking or climbing stairs.

- Exercise Treats or Prevents Gestational Diabetes. Gestational diabetes is a form of diabetes during pregnancy related to a shift in hormones causing insulin resistance and high blood glucose. Physical inactivity and obesity are risk factors. Exercise is considered an adjunctive therapy for this condition. For some women, exercise alone may be sufficient to control glucose levels due to increased insulin sensitivity. The panel noted guidelines for frequency, intensity, duration and type of exercise that will produce optimal outcomes for women at risk or with gestational diabetes are unknown with existing data, and more research is needed.

- Exercise Helps Manage or Alleviate Pregnancy-Related Musculoskeletal Issues. While virtually all women experience some musculoskeletal discomfort during pregnancy, exercise and previous physical fitness can help manage low back pain, pregnancy-related urinary incontinence, abdominal muscle disturbances, and joint and muscle injuries.

- Exercise Links Breastfeeding and Postpartum Weight Loss. Studies performed on breastfeeding women who exercise indicate benefits through improved aerobic fitness, plasma lipids and insulin response. It is the consensus of the panel that weight loss can occur through moderate exercise and calorie restriction without negatively affecting breast milk production and infant growth.

- Exercise Positively Impacts Mood and Mental Health. Most women experience negative mood symptoms during pregnancy and the postpartum period. Exercise has been shown to improve mood, increase vigor, reduce fatigue, stress and anxiety, decrease symptoms of negative mood and depression, and improve self-concept.

- Exercise affects Offspring Health and Development. Evaluation of the many types of exercise and physical activities performed by pregnant women indicate no increased risk of abnormal outcomes to the baby based on their activity. The panel advises that beginning or continuing recreational weight-bearing exercises during pregnancy has both short- and long-term positive effects on offspring growth and development.

So find out what kind of exercise your pregnant daughter can do, and then exercise with her!

Insurance

Does your pregnant daughter not have health insurance?

FoxBusiness.com recently ran an article titled "Women Without Employer Health Plans Pay a Big Price For Pregnancy".

The article says that "One common way insurers handle maternity coverage is to charge a rider on top of the regular monthly premium. The study found riders that ranged from $106 to $1,100 per month, required waiting periods of one to two years with either no or limited coverage during that period and capped total maximum benefits as low as $2,000 to $6,000.
Given that the average cost in 2006 of a hospital-based uncomplicated delivery was $7,488 -- although considerably higher for C-sections and more complicated births -- many women would end up spending less on maternity care if they paid all costs out of pocket instead of buying a rider."

Still want to buy insurance? When shopping for insurance for your pregnant daughter, the article recommends you ask these questions:

1. Is there a maximum out-of-pocket limit for maternity coverage?
2. Is there a waiting period for coverage to kick in?
3. What are cost differences between in-network or out-of-network services?
4. Is my favorite provider (obstetrician or hospital) in-network?
5. Is there a deductible or co-pay for prenatal, delivery and postpartum services?
6. Does the policy pay for a home birth or birth center delivery?

What can you do instead of buying maternity coverage? Do not skip doctors appointments just because you don't have insurance... getting care as early as possible can help make sure that any problems are found before they get out of control.

Apply for medicaid even if you think you're not elligible... let them make the decision.

Talk to your doctor's office and the hospital (in advance of giving birth) to see if you can negotiate a discount or payment plan.

There are a few discount programs (not insurance) that you can explore.

Take the effort to have the healthiest pregnancy possible: research how to eat right, get appropriate exercise, get lots of sleep, and find out what prenatal vitamin is right for you.

Depression and Diabetes

A recent article at Forbes.com was titled "Diabetes linked to depression during and after pregnancy". Here are some points from the article.

• "Low-income women with diabetes who are pregnant or recently gave birth face almost twice the risk of depression compared to women without the blood sugar disorder."
• "It didn't matter whether the women developed diabetes before or during pregnancy, or if they were taking insulin or oral medications. The risk of depression was still much stronger for women with diabetes".
• "Women who'd never been depressed before appeared to be at risk, too. 'One in 10 women who had no indication of prior depression received a diagnosis of depression within a year following delivery'".
• "Post-partum depression affects about 10 percent of new mothers, usually between two and six months after birth, according to background information in the study. If left untreated, post-partum depression can affect the mother-child relationship as well as the child's development."
• "Risk factors for post-partum depression include a history of depression, troubled relationships, domestic violence, stressful life events, financial problems, lack of social or emotional support, a difficult pregnancy or delivery, and health problems with the baby."
• "No matter what your income, if you're expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you're not alone with the baby day after day".

If your pregnant daughter develops gestational diabetes, or had diabetes before her pregnancy, help her learn about postpartum depression and help her develop a plan of how she will get help to cope with a new baby. Ask her doctor to screen her for depression at every visit, both during pregnancy and at checkups after birth.