​​Lead is toxic and particularly harmful for developing nervous systems. Lead can be passed through a pregnant woman’s placenta to the fetus, or through breast milk to a baby. 

To minimize the risk to you and your baby from lead, take a moment to educate yourself about making your environment more lead safe.

Is there anything I can do to lower my exposure to lead during pregnancy?

Yes, you can avoid exposure to any known sources of lead before and during pregnancy.

• ​​ If you are working with lead in your job or have a hobby such as making jewelry or stained glass, have your health care provider check your blood lead level.
• ​​ If you are fixing up an older home containing lead-based paint, be sure that the people working it are following safe procedures to protect you and your family from lead exposure. About 75% of homes built before 1978 contain some lead-based paint. The older the home the more likely it is to contain lead-based paint.
• ​​ Water from public sources is regularly tested for lead. You can get information about your drinking water from your local board of health. Houses that use well water should have the water tested regularly for lead and other possible contaminants. See Lead in Tap Water & Household Plumbing: Parent FAQs.
• ​​ Eat frequent and regular meals. Environmental lead is more easily absorbed into your bloodstream and retained in your body if you have an empty stomach.
• ​​ A diet poor in calcium, iron, zinc, vitamin C, vitamin D and vitamin E can be associated with increased amount of lead absorbed into your bloodstream. Therefore, it is important for pregnant woman to eat a well-balanced diet and take prenatal vitamins.

Is there a test to tell how much lead I have been exposed to?

Yes, a blood lead test can be done to see how much lead is present. Although most people will have some lead in their blood, levels greater than 5 micrograms per deciliter (μg/dL) indicate that there is some exposure that needs to be addressed. While there is no clear safe level of lead in the body, the goal is to have the lowest level possible. Women who had exposure to lead in the past should have levels checked.  

The Centers for Disease Control and Prevention (CDC) recommends blood lead testing for pregnant and lactating women with one or more important risk factors for lead exposure and increased blood lead levels:

• ​​ Recent immigration (from an area where lead contamination is high)
• ​​ Living near point source of lead (e.g., lead mines, smelters, battery recycling plants, home remodeling)
• ​​ Pica (i.e., compulsive eating of non-food items)
• ​​ Occupational exposures (e.g., painters, those exposed to batteries or radiators, living with someone who works in lead industry)
• ​​Environmental exposures (e.g., lead-contaminated soil, water, or food)
• ​​Use of lead-containing cosmetics
• ​​Cooking/storing in lead-glazed pottery
• ​​Use of some herbal/alternative medicines

What effects could lead have on my baby?

The most serious effect of high levels of lead during pregnancy can cause miscarriage and stillbirth. Other pregnancy problems such as low birth weight and premature delivery can also occur. Additionally, high maternal lead levels can cause learning and behavior problems in exposed babies. It is unlikely that exposure to lead during pregnancy would significantly increase the chance for major physical birth defects.

Is there concern about lead if I am breastfeeding?

Generally speaking, breastfeeding is safe for women with elevated blood lead levels; however, babies of breastfeeding mothers with very high blood lead levels should be closely monitored.

A blood test should be performed within two weeks of baseline measurement and then at least on a monthly basis:

• ​​For babies with a blood lead level of 5 µg/dL or greater or rising: An environmental assessment is recommended.
• ​​For babies with a blood lead level that stays below 10 µg/dL: Breastfeeding should continue.

Pregnancy is a time of anticipation, excitement, preparation, and, for many new parents, uncertainty. The nine months of pregnancy will give you time to have your questions answered, calm your fears, and prepare yourself for the realities of parenthood. This section contains some guidelines to help you with the most important of these preparations.

5 Tips to Reduce the Risk of Birth Defects

5 Tips to Reduce the Risk of Birth Defects

Not all birth defects can be prevented. But you can increase your chances of having a healthy baby by managing health conditions and by adopting healthy behaviors before and during pregnancy.

Taking care of yourself and doing what’s best for you is also best for your baby!

1. Be sure to take 400 micrograms (mcg) of folic acid every day.

Folic acid is important because it can help prevent some major birth defects of the baby’s brain and spine. These birth defects develop very early during pregnancy when the neural tube—which forms the early brain and the spinal cord—does not close properly. You need to start taking folic acid at least one month before becoming pregnant and continue during pregnancy.

In addition to eating foods with natural folate, you can:

• Take a vitamin that has folic acid in it every day.
• Most vitamins sold in the United States have the recommended amount of folic acid women need each day. Check the label on the bottle to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 mcg.
• Eat fortified foods.
• You can find folic acid in some breads, breakfast cereals, and corn masa flour.
• Be sure to check the nutrient facts label and look for one that has “100%” next to folic acid.

2. Book a visit with your healthcare provider before stopping or starting any medicine.

Many women need to take medicine to stay healthy during pregnancy. If you are planning to become pregnant, discuss your current medicines with a healthcare provider, such as your doctor or pharmacist. Creating a treatment plan for your health condition before you are pregnant can help keep you and your developing baby healthy.

3. Become up-to-date with all vaccines, including the flu shot.

Vaccines help protect you and your developing baby against serious diseases. Get a flu shot and whooping cough vaccine (also called Tdap) during each pregnancy to help protect yourself and your baby.

• Flu: You can get the flu shot before or during each pregnancy. 
  
• Whooping Cough: You can get the whooping cough vaccine in the last three months of each pregnancy.
  

4. Before you get pregnant, try to reach a healthy weight.

Obesity increases the risk for several serious birth defects and other pregnancy complications. If you are underweight, overweight, or have obesity, talk with your healthcare provider about ways to reach and maintain a healthy weight before you get pregnant. Focus on a lifestyle that includes healthy eating and regular physical activity.

5. Boost your health by avoiding harmful substances during pregnancy, such as alcohol, tobacco, and other drugs.

• Alcohol: There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. Alcohol can cause problems for a developing baby throughout pregnancy, so it’s important to stop drinking alcohol when you start trying to get pregnant.
• Tobacco: Smoking causes cancer, heart disease, and other major health problems. Smoking during pregnancy can also harm the developing baby and can cause certain birth defects. Quitting smoking will help you feel better and provide a healthier environment for your baby.
• Other Drugs: Using certain drugs during pregnancy can cause health problems for a woman and her developing baby. If you are pregnant or trying to get pregnant and can’t stop using drugs―get help! A healthcare provider can help you with counseling, treatment, and other support services.

Additional Information:

Simple Steps to Prevent Infections During Pregnancy

​​​​Infections during pregnancy can hurt both the mother-to-be and her baby. 

Making healthy choices and taking a few extra precautions can improve the chances that babies will be born healthy. 

Here are 11 things you can do during pregnancy to protect yourself and your baby from infections.

1. Maintain good hygiene and wash your hands often—especially when around or caring for children. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent infections. If soap and running water are not available, you can use alcohol-based hand gel. Learn how clean hands save lives.
2. Cook your meat until it’s well done. The juices should run clear and there should be no pink inside. Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot. These undercooked meats and processed meats might contain harmful bacteria. Learn more about Listeria.
3. Avoid unpasteurized (raw) milk and foods made from it. Do not eat soft cheeses such as feta, brie, and queso fresco unless they have labels that say they are pasteurized. Unpasteurized products can contain harmful bacteria. Learn more about raw milk dangers.
4. Ask your doctor about Group B streptococcus (GBS). About 1 in 4 women carry this type of bacteria, but do not feel sick. An easy swab test near the end of pregnancy will show if you have this type of bacteria. If you do have GBS, talk to your doctor about how to protect your baby during labor. Learn more about GBS infections.
5. Talk to your doctor about vaccinations. Some are recommended before you become pregnant, during pregnancy, or right after delivery. Having the right vaccinations at the right time can help keep you healthy and help keep your baby from getting very sick or having life-long health problems. Learn more about vaccinations during pregnancy and why the flu and Tdap vaccines are essential for pregnant moms.
6. Get tested for sexually transmitted infections (STIs), such as HIV and hepatitis B, and protect yourself from them. Some people that have HIV, hepatitis B, or an STD do not feel sick. Knowing if you have one of these diseases is important. If you do, talk to your doctor about how you can reduce the chance that your baby will become sick. Learn more about preventing STIs.
7. Avoid people who have an infection. Stay away from people who you know have infections, such as chickenpox or rubella, if you have not yet had it yourself or did not have the vaccine before pregnancy. Learn more about the MMR vaccine and the chickenpox vaccine.
8. Protect against insects known to carry diseases. Stay abreast of developments in Zika virus in your area or places you might be traveling to. When mosquitoes and ticks are active, wear long-sleeved shirts and long pants when outside. Use Environmental Protection Agency (EPA) registered insect repellents with one of the following active ingredients: DEET, picaridin, IR3535, or oil of lemon eucalyptus (para-menthane-3,8-diol). Avoid travel to areas where infections can threaten you and your baby. Learn more about the Zika virus and pregnancy.
9. Do not touch or change dirty cat litter and avoid contact with potentially contaminated soil. Have someone else do it. If you must change the litter yourself, be sure to wear gloves and wash your hands afterwards. Dirty cat litter and soil​ might contain a harmful parasite. Learn more about cats and toxoplasmosis.
10. Stay away from wild or pet rodents, lizards and turtles, and their droppings. Have a pest control professional get rid of pests in or around your home. If you have a pet rodent, like a hamster or guinea pig, have someone else care for it until after your baby arrives. Some rodents might carry a harmful virus. Learn more about lymphocytic choriomeningitis virus (LCMV).
11. Only take vitamins in the doses recommended by your doctor. Your doctor may recommend a daily prenatal vitamin pill, which includes folic acid, iron, calcium and other minerals, and the fatty acids docosahexaenoic acid (DHA) and arachidonic acid (ARA). Make sure your doctor knows about any other supplements you may be taking, including herbal remedies. Learn more about the benefits of folic acid. ​

Marijuana Use During Pregnancy & Breastfeeding FAQs

If you are pregnant, you may have read that marijuana can help with morning sickness. After baby arrives, you might even consider using marijuana to relieve stress. Should you still breastfeed if you smoke marijuana? These are all tricky questions―especially as more states legalize marijuana for adult or medical use.

The American Academy of Pediatrics (AAP) recommends women who are pregnant or breastfeeding avoid marijuana use. The American College of Obstetricians and Gynecologists (ACOG) also recommends that obstetrician-gynecologists counsel women against using marijuana while trying to get pregnant, during pregnancy, and while they are breastfeeding.

No amount of marijuana has been proven safe to use during pregnancy or while breastfeeding. 

How does marijuana effect brain development?

• Studies show marijuana use during pregnancy and breastfeeding may have negative effects on the developing brain. Tetrahydrocannabinol (THC)―the compound in marijuana mostly responsible for its psychoactive effects―has been shown to cross the placenta and enter the brain of the developing fetus during pregnancy. Once in a baby’s system, it can “hijack” normal nerve cell growth that happens in the developing brain. For example, in some studies, prenatal marijuana exposure was linked with increased tremors and startle reflexes in newborns and a possibly higher risk of substance use disorder and mental illness among teens and adults. In other studies, marijuana use during pregnancy was associated with problems in problem-solving skills, memory, visual perception, behavior, attention, executive function, and impulse control in the children especially as they became teenagers and young adults.

Is today’s marijuana stronger than it was years ago?

• The THC concentration in marijuana has quadrupled since the 1980s―when studies linking marijuana use during pregnancy to child growth and behavior differences were conducted. Whether marijuana is smoked, vaped, or consumed in edibles and drinkables, the amount of THC reaching a fetus and newborn may be a lot higher than in the past.

If I smoke marijuana, can it pass into my breastmilk?

• Yes. You may pass the chemicals from marijuana to your baby through breastmilk. A study in the September 2018 Pediatrics confirms earlier findings that THC can transfer into breastmilk. The AAP also reminds that a mother’s ability to care for an infant may be impaired while using marijuana. Bottomline: If you are breastfeeding, don’t use marijuana.

Is marijuana safer than tobacco?

• No. Studies show that between 48% and 60% of marijuana users continue during their entire pregnancy, thinking it’s safer than tobacco. However, research also shows that when marijuana is smoked, carbon monoxide blood concentrations in the pregnant woman are 5 times higher than those when tobacco is smoked. This can mean less oxygen to be available for the fetus.

What should I know about secondhand marijuana smoke?

• Passive or secondhand smoke can be as much a concern with marijuana as it is with tobacco. Studies show people can be exposed to marijuana by inhaling it when the drug is smoked near them. It can cause a positive urine test for THC―which means the THC was in their blood. This means that if a pregnant or breastfeeding woman is exposed to marijuana smoke the THC can transfer to the mother’s blood and then to the fetus or mother’s breastmilk.

Is morning sickness a qualifying condition for medical marijuana?

• No. Chemotherapy-related nausea is a qualifying condition in most states with legalized medical marijuana. Although many women experience nausea during pregnancy, the use of medical marijuana in this specific case has never been studied or determined to be safe.

Are pediatricians mandated to report mothers who are using marijuana while pregnant or breastfeeding to child protective services?

• Yes. The Child Abuse and Prevention and Treatment Act (CAPTA) requires all states to have reporting policies and procedures for when newborns and other children are exposed to illegal substances. Because marijuana is still illegal under federal law, CAPTA applies to marijuana exposure in all states regardless of the legal status of marijuana use by adults in each state.  Individual states may have their own policies about reporting exposure to marijuana through pregnancy and breastfeeding.
  

Remember: If you are pregnant or nursing, the safest choice for your child is to avoid marijuana.

Your pediatrician is a good source of information about potential risks of marijuana use on fetal, infant, and child development. Conversations can happen during discussions about the use of alcohol, other drugs, or contraception. 

Just because marijuana is legal in some areas for medical or recreational use for those ages 21 and above, that doesn’t mean it’s safe―especially for children exposed to it prenatally or while breastfeeding. There’s just too much we don’t know about the ways it might affect children.

The AAP is calling for additional research so that we can better understand how prenatal marijuana exposure affects our children―at every stage of their lives.

​​​All children deserve high-quality medical care. As a parent, it is important to be aware of the most up-to-date treatment guidelines so you can be sure your child is getting the best care possible.

The following information from the American Academy of Pediatrics (AAP) lists some of the most common childhood illnesses and their approved treatments. The treatments discussed here are based on scientific evidence and best practices. However, there may be reasons why your pediatrician has different recommendations for your child, especially if your child has an ongoing medical condition or allergy. Your pediatrician will discuss any variations in treatment with you. If you have any questions about appropriate care for your child, please discuss them with your pediatrician.

1.  Sore Throat

• Sore throats are common in children and can be painful. However, a sore throat that is caused by a virus does not need antibiotics. In those cases, no specific medicine is required, and your child should get better in seven to ten days. In other cases, a sore throat could be caused by an infection called streptococcal (strep throat).
• Strep cannot be accurately diagnosed by simply looking at the throat. A lab test or in-office rapid strep test, which includes a quick swab of the throat, is necessary to confirm the diagnosis of strep. If positive for strep, your pediatrician will prescribe an antibiotic. It’s very important that your child take the antibiotic for the full course, as prescribed, even if the symptoms get better or go away. Steroid medicines (such as prednisone) are not an appropriate treatment for most cases of sore throat.
• Babies and toddlers rarely get it strep throat, but they are more likely to become infected by streptococcus bacteria if they are in child care or if an older sibling has the illness. Although strep spreads mainly through coughs and sneezes, your child can also get it by touching a toy that an infected child has played with.
• See The Difference between a Sore Throat, Strep & Tonsillitis and When a Sore Throat is a More Serious Infection.

2.  Ear Pain

• Ear pain is common in children and can have many causes—including ear infection (otitis media), swimmer’s ear (infection of the skin in the ear canal), pressure from a cold or sinus infection, teeth pain radiating up the jaw to the ear, and others. . To tell the difference, your pediatrician will need to examine your child’s ear. In fact, an in-office exam is still the best way for your pediatrician to make an accurate diagnosis. If your child’s ear pain is accompanied by a high fever, involves both ears, or if your child has other signs of illness, your pediatrician may decide that an antibiotic is the best treatment.
• Amoxicillin is the preferred antibiotic for middle ear infections—except when there is an allergy to penicillin or chronic or recurrent infections.
• Many true ear infections are caused by viruses and do not require antibiotics. If your pediatrician suspects your child’s ear infection may be from a virus, he or she will talk with you about the best ways to help relieve your child’s ear pain until the virus runs its course.
• See Ear Infection Information, Middle Ear Infections, and Your Child and Ear Infections.

3.  Urinary Tract Infection

• Bladder infections, also called urinary tract infections or UTIs, occur when ­bacteria build up in the urinary tract. A UTI can be found in children from infancy through the teen years and into adulthood. Symptoms of a UTI include pain or burning during urination, the need to urinate frequently or urgently, bedwetting or accidents by a child who knows to use the toilet, abdominal pain, or side or back pain.
• Your child’s doctor will need a urine sample to test for a UTI before determining treatment. Your doctor may adjust the treatment depending on which bacteria is found in your child’s urine.
• See Detecting Urinary Tract Infections.

4.  Skin Infection

• In most children with skin infections, a skin test (culture or swab) may be needed to determine the most-appropriate treatment. Tell your doctor if your child has a history of MRSA, staph infection, or other resistant bacteria or if he or she has been exposed to other family members or contacts with resistant bacteria.
• See Boils, Abscess & Cellulitis and Tips for Treating Viruses, Fungi & Parasites.

5.  Bronchitis

• Chronic bronchitis is an infection of the larger, more central airways in the lungs and is more often seen in adults. Often the word “bronchitis” is used to describe a chest virus and does not require antibiotics.
• See Bronchitis (CDC.gov).

6.  Bronchiolitis

• Bronchiolitis is common in infants and young children during the cold and flu season. Your doctor may hear “wheezing” when your child breathes.
• Bronchiolitis is most often caused by a virus, which does not require antibiotics. Instead, most treatment recommendations are geared toward making your child comfortable with close monitoring for any difficulty in breathing, eating, or signs of dehydration. Medicines used for patients with asthma (such as albuterol or steroids) are not recommended for most infants and young children with bronchiolitis. Children who were born prematurely or have underlying health problems may need different treatment plans.
• See Bronchiolitis and Treating Bronchiolitis in Infants.

7.  Pain

• The best medicines for pain relief for children are acetaminophen or ibuprofen. Talk to your pediatrician about how much to give your child, as it should be based on your child’s weight.
• Narcotic pain medications are not appropriate for children with common injuries or complaints such as sprained ankle, ear pain, or sore throats. Codeine should never be used for children as it’s been associated with severe respiratory problems and even death in children.
• See Fever and Pain Medicine: How Much To Give Your Child.

8.  Common Cold

• Colds are caused by viruses in the upper respiratory tract. Many young children—especially those in child care—can get 6 to 8 colds per year. Symptoms of a cold (including runny nose, congestion, and cough) may last for up to ten days.  

• Green mucus in the nose does not automatically mean that antibiotics are needed; common colds never need antibiotics. However, if a sinus infection is suspected, your doctor will carefully decide whether antibiotics are the best choice based on your child’s symptoms and a physical exam.

9.  Bacterial Sinusitis

• Bacterial sinusitis is caused by bacteria trapped in the sinuses. Sinusitis is suspected when cold-like symptoms such as nasal discharge, daytime cough, or both last over ten days without improvement.
• Antibiotics may be needed if this condition is accompanied by thick yellow nasal discharge and a fever for at least 3 or 4 days in a row. 

10.  Cough

• Coughs are usually caused by viruses and do not often require antibiotics.
• Cough medicine is not recommended for children 4 years of age and younger, or for children 4 to 6 years of age unless advised by your doctor. Studies have consistently shown that cough medicines do not work in the 4-years-and-younger age group and have the potential for serious side effects. Cough medicines with narcotics—such as codeine—should not be used in children.

If Symptoms Change:

Occasionally, mild infections—viral or bacterial—can develop into more serious infections.

Call your pediatrician if your child’s illness appears to change, becomes worse, does not go away after a few days, or if you are worried about any new symptoms that develop. If your child’s illness has worsened, or if he or she develops complications, your pediatrician may recommend a new treatment.

Have More Questions?

If you have any questions or concerns about appropriate care for your child, please discuss them with your pediatrician. While it may be tempting to go to a nearby after-hours clinic if your child is ill, your pediatrician knows your child best, has your child’s medical records, and is the best place to start for advice. Ask your pediatrician how he or she would like to be contact when the office is closed.  

In fact, the AAP does not recommend retail-based clinics, telehealth services outside of the medical home, or acute care services without pediatric expertise for children younger than 2 years.

This is an example post, originally published as part of Blogging University. Enroll in one of our ten programs, and start your blog right.

You’re going to publish a post today. Don’t worry about how your blog looks. Don’t worry if you haven’t given it a name yet, or you’re feeling overwhelmed. Just click the “New Post” button, and tell us why you’re here.

Why do this?

• Because it gives new readers context. What are you about? Why should they read your blog?
• Because it will help you focus you own ideas about your blog and what you’d like to do with it.

The post can be short or long, a personal intro to your life or a bloggy mission statement, a manifesto for the future or a simple outline of your the types of things you hope to publish.

To help you get started, here are a few questions:

• Why are you blogging publicly, rather than keeping a personal journal?
• What topics do you think you’ll write about?
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• If you blog successfully throughout the next year, what would you hope to have accomplished?

You’re not locked into any of this; one of the wonderful things about blogs is how they constantly evolve as we learn, grow, and interact with one another — but it’s good to know where and why you started, and articulating your goals may just give you a few other post ideas.

Can’t think how to get started? Just write the first thing that pops into your head. Anne Lamott, author of a book on writing we love, says that you need to give yourself permission to write a “crappy first draft”. Anne makes a great point — just start writing, and worry about editing it later.

When you’re ready to publish, give your post three to five tags that describe your blog’s focus — writing, photography, fiction, parenting, food, cars, movies, sports, whatever. These tags will help others who care about your topics find you in the Reader. Make sure one of the tags is “zerotohero,” so other new bloggers can find you, too.