Ask Bonnie

The good news is, you’re pregnant. The bad news is, you will probably feel sick for at least the first trimester. Morning sickness can happen throughout the day, and it can last throughout your pregnancy, so follow these steps to ease the nausea.
Instructions
STEP 1: Try not to let yourself get hungry; an empty stomach can increase nausea.
STEP 2: Keep a supply of Saltine crackers handy. Have some in the morning before you get out of bed to settle your stomach.
STEP 3: Avoid high-fat foods - especially fried foods - and stay away from spicy and acidic foods.
STEP 4: Eat foods high in B vitamins, which decrease nausea.
STEP 5: Add a bit of ginger to your diet in the form of ginger ale, ginger tea or gingersnaps. Or use ginger in your recipes.
STEP 6: Experiment with natural remedies such as papaya enzyme, vitamin B-6 or acupressure wristbands.
STEP 7: Drink plenty of water between meals. Try sparkling water with a slice of lemon.
STEP 8: Take your prenatal vitamins with food. Your nausea will increase if you take them on an empty stomach.
STEP 9: Avoid taking iron supplements in the first trimester unless you are anemic. Iron can be hard on your stomach.
STEP 10: Utilize the fleeting moments when you feel OK to eat healthful foods and get a little exercise. Tips & Warnings
Nausea can be a sign that everything is going well with your pregnancy. It’s hormonal adjustment that’s making you feel so sick.
For most women, nausea lessens or disappears in the second trimester.
Call your doctor if the nausea becomes debilitating or if you are unable to hold down any food.
If you are suddenly getting sick in your second or third trimester and you weren’t earlier, call your doctor.
If vomiting is accompanied by pain or fever, call your doctor immediately.
This information is not intended as a substitute for professional medical advice or treatment.

A new study suggests that some babies who fail to respond to their name by one year of age may be at heightened risk for an autism spectrum disorder.

Early identification can mean possible early intervention and better outcomes for affected children, say the authors of two studies aimed at early detection, published in the April edition of Archives of Pediatrics & Adolescent Medicine. The issue is devoted to autism research.

A third study finds that every individual with the disorder accrues about $3.2 million in costs to society over his or her lifetime.

Autism spectrum disorder seems to be becoming more prevalent, with the U.S. Centers for Disease Control and Prevention ( CDC) recently announcing that one in every 150 American 8-year-olds have some form of the disorder. That number is higher than prior estimates.

Autism’s causes remain cloaked in mystery, although prior research has pointed to a strong genetic component.

Children and adults with autism experience difficulty with social and language skills and often display repetitive behaviors. However, the disorder is usually not diagnosed until age 3 or 4 — even though as many as half of parents with autistic children report problems with development progress before their child’s first birthday.

The findings announced today may help speed diagnosis. In one study, researchers at the M.I.N.D. Institute at the University of California, Davis, found that one-year-old infants who don’t respond to their names are more likely to have autism or another developmental problem by the time they’re two.

This cue could represent an easy way to spot the disorder early on, experts said.

“One of the challenges has been finding an early exam in the general practitioner’s or pediatrician’s office that can serve as a warning sign or diagnostic indicator,” said Andy Shih, chief science officer for the nation’s leading advocacy group, New York City-based Autism Speaks. “That’s what this paper is getting at. It doesn’t mean that [a non-responsive child] is destined to become autistic, but there seems to be a higher proportion who later go on to develop autism. This, along with many other clues such as language development, eye contact and even head circumference, are potentially simple diagnostic tools that could be used in the general practitioner setting.”

A second study — this time by a team at Vanderbilt University in Nashville, Tenn. — found that younger siblings of children with autism perform below par on tests of social and communication development compared with younger siblings of normal children. These deficits may represent the early indications of an autism spectrum disorder, the researchers said.

“This is demonstrating that even though siblings may not meet the diagnostic criteria of autism, they seem to also have deficits in language and the social domain. They’re not developing as typical, normal children,” Shih said. “This highlights the importance of paying attention to siblings of autistic children in terms of development. It also shows the importance of early diagnosis. If these deficits or delays can be identified earlier, it’s a great opportunity to provide intervention.”

A third study, from researchers at Harvard University and ABT Associates Inc, of Lexington, Mass, found that each individual with autism accrues about $3.2 million in costs over a lifetime, with lost productivity and adult day care making up the lion’s share.

It was already known that autism costs society more than $35 billion annually in direct and indirect expenses, but it hasn’t been clear when these costs occur over a lifetime, the researchers said.

By Amanda Gardner

TORTICOLLIS

What is torticollis?

Torticollis (wry neck) is a congenital or acquired condition of limited neck motion in which the child will hold the head to one side with the chin pointing to the opposite side. It is the result of the shortening of the sternocleidomastoid (neck) muscle. In early infancy, a firm, non-tender mass may be felt in the midportion of the muscle. The mass will go away and be replaced with fibrous tissue. If untreated, there can be permanent limitation of neck movement. There may be flattening of the head and face on the affected side.

How is torticollis treated?

Treatment consists of gentle stretching exercises. The face is turned away from the affected muscle while the head is tilted in the opposite direction with the neck extended. This position is held for a count of 5 and repeated 10 times twice daily. The baby can be placed in the crib or playpen in a way that encourages turning the head away from the deformity in order to observe activities and interesting or favorite toys. When placed in a car seat, padding may be placed on the affected side forcing the head to turn in the opposite direction. Follow up may be necessary in six months with pediatric surgery to assess for the necessity for head molding.

Where can a parent get help and talk with other parents about torticollis?

TorticollisKids www.torticolliskids.org is an organization of parents who have or have had infants with torticollis. The web site has explanations of torticollis and its treatment options, helpful hints on dealing with the condition, and links to obtain support from those who have really “been there”. Interested parents can join an email support group and participate in forums on the condition with other parents.

Long term follow up is important to assess for abnormal head shape.
Torticollis may cause head flattening and asymmetry.This condition can be much worse on one side if a child preferentially sleeps with that side down. Positional (or deformational) plagiocephaly, also known as flattened head syndrome, results from preferentially lying on one side of the head. Deformational brachycephaly is a flattening across the back of the head. The two conditions (plagiocephaly and brachycephaly) often occur together.
If the flattening gets worse anywhere on the child’s head, some parents may opt for further treatment like a cranial helmet that they would seek from a specialist to prevent the baby from sleeping on the flat part of his head.
If you have questions about your child’s head shape you can visit www.plagiocephaly.org