Monthly Archives: July 2006

Diet affects arteries of foetus

 
Newborn
Heart disease risk may be set in womb, the study suggests.
Babies whose mothers do not eat enough during pregnancy appear to be at risk of clogged up arteries later in life, researchers say.

A study of 200 children found that, on average, the lower the mother’s calorific intake during pregnancy, the thicker the child’s artery walls.

Clogged up arteries – atherosclerosis – can lead to heart disease and strokes.

The University of Southampton team said the reasons for the apparent link were unclear and needed further exploration.

Their study appears in Arteriosclerosis, Thrombosis and Vascular Biology.

“Maternal energy intake in pregnancy may affect the child’s blood cholesterol concentrations”
Dr Catharine Gale

The researchers used ultrasound scans to measure the thickness of the wall of the carotid artery in more than 200 nine-year-old children whose mothers had taken part in a nutrition study during pregnancy.

Experts usually say a pregnant woman needs to eat around 2,500 calories per day.

‘Total calories key’

The researchers said it did not matter what proportion of the calorie intake came from fat, protein or carbohydrate – it was the total calorie intake that was important.

The association between artery thickness and calorific intake remained strong even after taking account of factors such as social class, smoking, exercise habits and sickness in pregnancy.

The study also found that children who were heavier, those who had higher blood pressure or those who took less exercise were more likely to have thicker artery walls.

Researcher Dr Catharine Gale said atherosclerosis was a progressive condition that started early in life.

“Our study provides direct evidence for the first time in humans that the mother’s diet in pregnancy might influence the child’s susceptibility to atherosclerosis.

“Our advice to pregnant women is that a healthy balanced diet is essential to give both mother and baby the best chance of a healthier life”
Judy O’Sullivan
British Heart Foundation

“The exact reasons why lower maternal energy intake in pregnancy was linked to increased arterial wall thickness in the children are unclear.

“We need to do further studies to see if the same findings are present in other groups of mothers and children and to explore explanations for the link.

“One possibility is that maternal energy intake in pregnancy may affect the child’s blood cholesterol concentrations.

“Children who have higher blood cholesterol concentrations are at increased risk of atherosclerosis.”

Judy O’Sullivan, a cardiac nurse at the British Heart Foundation, said: “This study indicates that a low calorie intake during pregnancy affects the thickness of the carotid artery.

“This thickness can be a good indication of athersclerosis in adults but more work needs to be done before we can say the same is true for children.

“Our advice to pregnant women is that a healthy balanced diet is essential to give both mother and baby the best chance of a healthier life.

“A restricted or low calorie diet should not be followed during pregnancy.”

    

Night Time Waking

Ollie has always been quite good at going to bed initially, he cries sometimes but don’t all babies?  A few months ago he was going to bed and then waking up after an hour screaming, really crying tears streaming down his face.  I put it down to teething.  This last week he has started doing it again, I am pretty sure he isn’t teething.  It doesn’t seem to be night terrors as he is fully awake and doesn’t display any of the other signs that Chris put in her article on night terrors.  It could be nightmares….

When I go up to him and calm him down I used to bring him downstairs but then he would be up for a good 1-2 hours.  We decided we didn’t want to encourage him coming downstairs as it would confuse his bedtime even more.  So when he wakes up now I take him in our bedroom and feed him and cuddle him.  He is normally still quite sleepy and lovely.  When he has calmed down and finished feeding I take him back to his cot and lay him down which is fine but the minute I go to leave him he starts really crying again even though I know he is tired.

I have tried not to lift him when he wakes and to comfort him in his cot but he just gets more upset to the point he vomits, then you may as well forget him going to bed for hours.

I leave him when he starts to cry after having put him back down and go downstairs.  I watch him on the monitor he normally just sits or lays in his cot really crying and rubbing his eyes and then eventually drops off.

My question is, is there anything else I could do?  The girls never did this sort of thing once they were in bed and eventually sleeping through the night nothing bar a small bomb would have woken them up.  Ollie still wakes most nights at about 3am for a feed which I don’t mind at all as it normally lasts about 15mins and then he goes straight back in his cot with no bother.

It’s really hard to leave him so upset when he is so lovely and cuddly if I stayed upstairs with him he would be more than happy but I don’t want him to have problems going to bed when he gets older.

Pupils ‘must learn about nappies’

    

 
baby in nappy
Many people have never changed a nappy before becoming a parent.
Teenagers should learn how to bath a baby and change a nappy, a teachers’ union will suggest.

Issues of discipline for toddlers and teenagers should also be covered, the national conference of the Professional Association of Teachers will hear.

Lynn Edwards, outgoing national chair of the association, will call for compulsory parenting classes for 14 to 16-year-olds.

She said many people became parents with little understanding.

‘Unacceptable’

“When I came out of the maternity hospital with a little boy on one arm and a little girl on the other, I had no idea how to put on a nappy,” Ms Edwards said.

“I found it unacceptable that no one had shown me.”

Mrs Edwards said she was lucky because her mother lived nearby.

“Few people now are that fortunate – the extended family no longer occupies a village or urban neighbourhood.”

As a result, few young people learned how to be “good parents on a practical basis” by watching other family members interacting with their offspring.

She said parenting classes should be taught in schools before children could legally become parents.

“It would need to cover the practicalities of caring for a child.

“It would need to give ideas and guidance on how to teach manners, road safety, the handling of money and what constitutes acceptable behaviour to young children within the family setting.”

Feelings of parents

A spokesman for the Department for Education and Skills said: “The government assists voluntary and community sector bodies, through a variety of grant programmes, to support to parents, carers and families where it is needed.

“This includes work in schools and information advice and guidance on adult relationships and parenting.

“In the curriculum – within the personal, social and health education framework – pupils are taught at primary school about relationships in marriage and those between friends and families, and the skills needed for their development.

“At secondary school pupils learn about the role and feelings of parents and carers and the value of family life and good parenting.”

The PAT annual conference takes place in Oxford next week.

Pregnancy Rash

Pregnancy Rash

During pregnancy the female body goes through many, many changes. Some hormonal, some mental and some physical. One of the common changes that can occur is a change in the skin, in form of pigmentation or sometimes rashes. Most of these are completely harmless although occasionally, they may be an indication of something that needs further attention. Here are some of the most common rashes that can occur during pregnancy:

Linea NigraPigmentation changes

Pregnancy causes changes the body’s hormone levels, including an  increase in oestrogen levels and melanocyte-stimulating hormone. Melanocytes are skin cells that determine how much pigmentation there is in the skin. As these levels are increased, dark patches can occur, often on the face and neck and also the common “Linea nigra” line that appears from the belly button downwards during pregnancy. These marks are nothing to worry about and will usually begin to fade within 3 months of the baby’s arrival.

Spots, boils and acne

You wake up one morning, look in the mirror and see that you have gone back to age 14 and teenage ache again! Again, this is down to the hormone levels in the body and can appear anywhere, not just on the face. Try to use a gentle cleanser and oil free moisturiser. You skin should go back to normal within a few weeks of delivery.

obstetric cholestasis rashItchy rashes

Your skin can become more sensitive in pregnancy and so you may find that you react to certain products that have previously caused you no bother, such as washing powders, shower gels etc. Try to work out what you have used that could cause this reaction, and then stop using it for a while. Long soaks in the bath for example can dry out your skin and cause itching, so try to keep these to a minimum and use a little baby oil to keep your skin moisturised.

Wear loose, cotton clothing to keep your body cool and to allow the air to get to your skin. Keep your skin well moisturised. If a rash or irritation does not clear up after a few days, you should see your GP or midwife.

Intense Itching

Occasionally, some pregnant women experience extreme itching all over their bodies, in particularly on their hands and feet. This is most common during the 3rd trimester of pregnancy.  This can be a sign of obstetric cholestasis which affects the liver. This occurs in approx 1 in 1000 pregnancies and in 99% of cases causes no harm to mother or baby. If left untreated, there is a risk of stillbirth. It is therefore essential that you see your doctor if you have such extreme itching.

PUPPPPruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)

Approximately 1% of pregnant women develop red, itchy bumps on their tummies during the 2nd half of pregnancy. This rash can appear to look like hives and usually appears around the stretch marks on the tummy, and then spreads to the thighs and buttocks and occasional to the arms. This is called Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) and is completely harmless to mother and baby, although can be very uncomfortable.

If you have such a rash, you must see your GP or midwife as it can be relieved with treatment. This condition will disappear within a few days of the baby being born and it doesn’t always follow in subsequent pregnancies.

As well as skin rashes and itchiness, pregnant women are more susceptible to urinary tract infections and thrush during pregnancy. If any itching persists for more than 2 days, you should always see your GP or midwife.

This is a members article  written by Dizie

Cloning team’s IVF deal for eggs

 
A human egg
Women having IVF will be able to donate eggs for research.
A UK fertility centre is being allowed to ask women undergoing IVF to donate eggs to therapeutic cloning research for cheap treatment for the first time.

The Human Fertilisation and Embryology Authority has issued a licence to the North East England Stem Cell Institute to permit the practice.

But the HFEA has also announced a consultation on the wider issues around egg donation for research.

There are concerns women could feel pressured to give over their eggs.

“We are helping them to have treatment they may not otherwise be able to afford”
Professor Alison Murdoch, North East England Stem Cell Institute

The Newcastle-based team is investigating stem cell therapies for conditions including Alzheimer’s disease, diabetes and Parkinson’s.

The human eggs which are donated to research will be used in the creation of embryos from which stem cells can be derived.

It will be the first time that payment can be given for IVF eggs used in research.

Until now, the researchers have been permitted to ask women to donate eggs which have not fertilised for research.

It was an egg obtained in this way which was used to create an early-stage cloned human embryo at Newcastle in 2005.

Since last year, the team has also been allowed to ask women having IVF to donate “spare” eggs, if they produced 12 or more eggs.

But the team said the number of eggs this produced was too small.

Altruistic donation

The HFEA licence will now allow researchers to offer couples who need IVF, but cannot afford it, the chance to have some of their care funded in return for donating eggs for research.

Cutting the cost of IVF through egg sharing is currently permitted in the UK, if eggs are donated to another woman undergoing treatment.

However, it will be at last a year before the Newcastle scheme is up and running as researchers now need to apply for funding.

The team also want it to be possible for women not undergoing IVF to donate their eggs.

So-called altruistic donation is already used to help infertile couples conceive.

The HFEA is to consider if Newcastle should allowed to permitted to pursue altruistic donation as part of its consultation.

The three month process, which runs from September to November, will also consider what safeguards are needed to ensure women do not feel coerced into donating their eggs, and how to ensure a patient’s own interests and needs are protected.

‘Evidence-based’ policy

Angela McNab, chief executive of the HFEA, said: “We know there are a wide variety of views on the subject of donating eggs for research and we anticipate a strong response to the consultation from professional groups, scientists, clinicians and patients as well as the public.

“It’s important to capture those views and to understand the issues that are unique to donating eggs for research rather than for treatment so that any policies made as a result of the consultation are well-balanced and evidence-based.”

“The primary concern should be what is in the woman’s best interests”
Josephine Quintavalle, Hands Off Our Ovaries.

Professor Alison Murdoch, who leads the Newcastle team, said the HFEA’s decision was “a step forward for stem cell research and medicine generally”.

She added: “It is of paramount importance to ensure that all donors are not recruited to participate in this research against their best interest by coercion or excessive financial inducement.

“All patients involved in egg sharing need IVF treatment to help them have a baby.

“We are helping them to have treatment they may not otherwise be able to afford.

“There is no additional physical risk to the woman as a result of egg sharing.”

Professor Murdoch said there were many scientific difficulties to be overcome before the research led to stem cell treatments.

And she admitted it was “unusual” for the HFEA to begin a consultation after issuing a licence.

‘Arrogance’

Professor Peter Braude, professor of obstetrics and gynaecology at Kings College London said: “This is a difficult situation because there is a strong need for eggs for research.

“However, this licence surprises me as it is inconsistent with the stance of not paying for eggs for research.

“But the HFEA is about to embark on a consultation, so we will shall wait to see what the public thinks of this issue.”

Dr Gillian Lockwood, chair of the ethics sub-committee of the British Fertility Society, said: “It is unlikely to impact negatively on the availability of eggs for donation to recipients, and some women who need to undergo IVF to achieve a family may indeed prefer to donate anonymously to such important medical research.”

But Josephine Quintavalle, a co-founder of the Hands Off Our Ovaries group, said: “The primary concern should be what is in the woman’s best interests.

“That is to have the most minimally invasive treatment with the minimum use of drugs and the minimum harvesting of eggs.”

Ms Quintavalle said the needs of researchers, who would want as many eggs as possible, would go against that.

And she said she was concerned over how the option of donating eggs in return for cheaper treatment would be presented to women.

“It is coercion under another name.”

She also criticised the HFEA’s handling of the issue, saying it was the “worst example of HFEA arrogance” she had seen.

Delayed PND

    Ive been talking about how I have been feeling with my sister. She thinks I could still be suffering with postnatal depression. I do not remember any of the bad things when Joshua was little. My family tell me he screamed for hours and hours at a time, but I only remember the coo’s and smiles. She also tells me I used to sit on her sofa and cry for no reason, but again I have no memory of this. I do know it is on my notes that my health visitor said I had PND, and I was referred for counselling but the appointment took 2 years to come through and I never went. I have been blaming the endless amount of contraception pills for my moods but my sister said I acted exactly the same way when I had PND. One minute I was high and the next really low. She thinks the pains and stresses and the fact I never faced my PND have all contributed to it coming back.

I know when I am down as I use food against my body. And I am ashamed to admit that this last week and have been doing this again, despite promising everyone of you to get better from it. As I write this I have tears stinging my face, I know things are not right. Ive been happy to blame the pill for so long, I really thought it was the pill. Im finding it very hard to accept that PND can set back in after so long. Im willing to accept there are some levels of depression though. I know I need to sort out my eating problems, but I do not want to do on medication, so even if my sister is right I dont know what I can do. If I see my GP then he will push medication on me.

I thought I had coped so well on my own but now my sister is making me look at myself as a third person, and I can see that Im not doing very well. I feel a bit of a numpty saying all this, I always believed a good cry was good for the tear ducts but lately my poor tear ducts have been working overtime. Im not sure what any one can say to this, I just feel better getting it off my chest. Thanks for listening guys xxxx

MMR deception doctor struck off

 
Dr David Pugh
Dr David Pugh was struck off immediately to protect the public.
A doctor whose clinics gave more than 1,000 children potentially faulty vaccines has been struck off.

The single-dose vaccines against measles, mumps and rubella were given at two private practices run by Dr David Pugh in Elstree and Sheffield.

One doctor told the General Medical Council (GMC) he feared children would be “poisoned” by the vaccines.

The GMC ruled Dr Pugh, who ran Lifeline Care Ltd, was guilty of “a serious breach” of professional standards.

It decided that his name should be immediately erased from the medical register because of the “serious nature” of its findings.

‘Abuse of trust’

The GMC cited four areas in which his behaviour was “fundamentally incompatible” with remaining on the register: failure to provide an acceptable level of care, exploitation of vulnerable patients, repeated dishonesty and abuse of trust.

Dr Pugh had earlier admitted instructing one of his staff on how to prepare multiple doses of the vaccinations despite them having no medical or pharmaceutical qualifications.

He also admitted that the two clinics had decanted individual vaccines into multi-dose containers.

Dr Joel Bonnet, director of public health at Hertsmere Primary Health Trust, previously told a GMC panel he had had a number of meetings with Dr Pugh to discuss concerns about how the clinics administered the vaccines.

Dr Bonnet said Dr Pugh was told he would need to carry out a “recall procedure” for all 1,013 children vaccinated at the clinics since 2003.

The panel found that the letters he sent out to parents made a “number of misstatements” about his actions and the “possible consequences”.

Children at risk

Dr Bonnet told the hearing he had been concerned about the potential for the children to have been “poisoned” or given an infection from the vaccines, and that the youngsters were at “greater risk” of contracting measles, mumps or rubella.

The panel had also heard that a number of parents had asked for tests to be carried out to discover if their children were effectively immunised.

Blood samples were sent to an independent laboratory, but in four of the reports received back Dr Pugh falsified the results and passed them on.

In December 2004, Pugh was sentenced to a nine-month jail term by Cambridge Crown Court after pleading guilty to four counts of using a false instrument with intent.

Dr Pugh, formerly of Bradmore Green, Brookmans Park, Hatfield, Herts, did not attend the hearing and is thought to be living in Runaway Bay, Queensland, Australia. He has 28 days to appeal against the GMC’s decision.

Hope for endometriosis treatment

 
Woman in pain (AJ Photo/Science Photo Library)
Endometriosis affects 10-15% of women at some point in their lives.
Scientists say they have made a crucial step forward in understanding and treating endometriosis.

This painful condition affects between 10 to 15% of women, and is caused by tissue that normally lines the womb growing elsewhere in the pelvis.

Using mice, the team found excess iron promoted the rogue tissue growth.

The discovery that iron-binding molecules reduced cell growth might lead to treatments, say the scientists in the journal Human Reproduction.

“Our findings represent a crucial step in finding the answer to endometriosis”
Professor Jacques Donnez, Catholic University of Louvain.

Endometriosis is an often painful condition.

The menstrual cycle makes the wayward endometrial cells grow and break down as they would usually do in the womb, but the resulting internal bleeding, which has no outlet, can cause pain and scarring, sometimes leading to infertility.

So far, scientists have been puzzled about the causes of the condition.

But a team of scientists at the Catholic University of Louvain, Belgium, believed that iron could be to blame, because of the high-levels of iron found in sufferers pelvises’.

Some scientists believe the excess iron is created as the body breaks down the red blood cells from the monthly internal bleed.

To test their hypothesis, the scientists induced endometriosis in mice.

Future treatments

In some of the mice, they added iron-containing red blood cells, in others they added a molecule, desferrioxamine, which binds to iron and neutralises its effect, and the rest were left with endometriosis alone.

They discovered the numbers of lesions in the mice in the three experiments were approximately the same.

But they found the cell growth in the lesions were much greater in the mice with added iron than in the mice that simply had endometriosis.

By comparison, the mice treated with desferrioxamine had less cell activity than the other mice.

The team concluded that iron was causing increased cell growth in the mice.

Professor Jacques Donnez, lead author on the research and head of the department of gynaecology at the Catholic University of Louvain, said the use of iron-binding molecules might form the basis of future treatment for the condition.

He said: “Our findings represent a crucial step in finding the answer to endometriosis because we are focusing our research more on the origins and causes of the disease in the context of prevention, than on surgical treatment when the disease is already present.

“We really hope that, in the future, genetics will help us to determine the population of young women at high risk of endometriosis, and that treatment, resulting from our findings, may then prevent the development or evolution of the disease.”

‘Important observation’

Tony Rutherford, a spokesman for the British Fertility Society and a consultant gynaecologist at Leeds General Infirmary, UK, said: “Endometriosis is a condition which affects many women and is particularly prevalent in the Western world.

“It can cause a great deal of problems, from pelvic pain to infertility.

“This paper shows that iron may be a factor which stimulates the number of cells in the endometrial tissue.

“It is an important observation, but this is a mouse study, and you cannot always translate animal studies into humans, so further studies are needed to see whether this will truly be of clinical benefit.”

Mums ‘should get tailored care’

 
Mother holding baby
New mothers need to be helped to care for their babies, the guidance says
The NHS must ensure women and their newborn babies do not get “one-size-fits-all” care, a watchdog has said.

The National Institute for health and Clinical Excellence says every woman in England and Wales should get care tailored to their individual needs.

But its guidance for NHS staff also sets out gold standards for key health checks and breastfeeding help.

Child health experts said the guidance was “a step in the right direction”.

“Giving babies the best start in life through good quality post natal care means they are less likely to have health problems during childhood and into adulthood”
Dr David Elliman, consultant in community child health.

The NICE guidelines cover care for the first eight weeks of a baby’s life.

They say health professionals should ensure they only give women the help and advice that is relevant to them – so if they have not had a Caesarean or a birth involving stitches, they do not need any information on those topics.

But there are some key pieces of information which parents need to hear over and over again, the watchdog said.

Each time a new parent comes into contact with a health professional during the first eight weeks of their baby’s life, they should be offered the information and advice to enable them to care for their baby.

They should also be told what signs should prompt them to take their baby to a doctor and which should not.

Health professionals should also ensure women are emotionally well, by checking with them and their family, and that they have adequate social support.

‘Daunting’

Professor Rona McCandlish, who chaired the guideline development group said: “In the past postnatal care has often been considered the ‘Cinderella service’ of maternity care.

“This guideline recognises that women, babies and families deserve highest quality care after birth.

“It establishes clear, much needed national standards for healthcare professionals to help them offer women the support they need in the hours, days and weeks following birth.”

Dr David Elliman, a consultant in community child health, said: “New babies require huge amounts of care and attention, and this can be daunting, particularly for first time parents.

“Helping mothers to know what signs and symptoms could indicate something serious so they know what to worry about and what is normal gives them reassurance and confidence.

“Giving babies the best start in life through good quality post natal care means they are less likely to have health problems during childhood and into adulthood.”

Dame Karlene Davis, General Secretary of the RCM, said: “Good maternity services are the vital building block for long-term health improvement.”

‘Support is crucial’

Rosie Dodds, of the National Childbirth Trust, said: “The development of personalised care plans will help to ensure healthcare professionals provide individually tailored care for each woman.

“And the emphasis on communication between mothers and healthcare professionals is certainly a step in the right direction to ensuring all women are aware of the support available.”

But she added: “These guidelines don’t recommend a minimum number of postnatal care visits.

“We know access to supportive care throughout the first few weeks is essential to emotional and physical well-being of most new parents.

“It would help to work towards an understanding of the amount of care all women should be offered, with additional care available for those who need it.”

SureStart Speech Therapist Appointment

Some of you know that my little boy Max has a problem with speech.  It has been a roller coaster ride of doctors, speech therapists, nurses, teachers and anyone else who has picked up on it, but now we’ve had a stroke of good fortune.

I went to speak to my local SureStart bods today.  A lady called Sam gave me the spiel and tour of the centre and then asked if I had any questions.  Well, I explained that I have actually already enrolled with the centre, but because we live overseas we can’t always attend, which is why I came back to see if it was ok for us to attend while we are over here.  She said of course, and that it didn’t matter if I had forgotten my membership card (doh!).  She was very nice indeed.  So then I pushed the boat out further and asked if it was possible for me to see the Speech Therapist again.  I apologised for being cheeky, but anyway to cut a long story short (too late for that, I know!), I’ve got one coming round to the house this thursday.  Bonus being it was the same lady who came round to see Max when he was 2 and she remembers us!!

So after all that waffling the good news is that we’re actually going to be seeing a Speech Therapist and I’m trying not to feel guilty for seeing one so soon when other people have to wait.

I highly recommend SureStart.  I went to my doctors last week to get a Speech Therapist referral for Max, but he was rubbish.  He told me a letter would be in the post, but guess what?  No, bloody letter.  So I’m well chuffed that SureStart are just round the corner.  They are a Godsend!!