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How To Prepare When You Are Expecting Healthy Twins

If you’re pregnant with more than one baby, a healthy diet and lifestyle will help you cope with your pregnancy and give your babies the best start in life.

The advice for keeping healthy in pregnancy is similar whether you’re expecting twins, triplets or just one baby. Eat well, take gentle exercise, drink lots of fluid and, if you feel stressed, get support from friends and family, or talk to your midwife. It’s also important to attend all your antenatal (*prenatal) appointments so your maternity team can keep a close eye on you and your babies.

Healthy eating with a twin pregnancy

Expecting two babies doesn’t mean you have to eat significantly more than during a single pregnancy. However, it’s normal to put on more weight than a woman who is only carrying one baby.

Aim to eat a healthy, balanced diet that includes plenty of fruit, vegetables and wholegrains. These will help you avoid constipation and provide a range of vitamins and minerals.

You also need some protein foods, such as lean red meat, well-cooked eggs, and nuts and seeds. Dairy foods such as milk, cheese and yoghurt are important for calcium.

If you feel peckish, it’s best to fill up on healthy snacks, such as fresh fruit, low-fat yoghurt or sandwiches filled with grated cheese, lean ham or mashed tuna. Try to avoid foods with empty calories, such as sugary snacks, crisps and fizzy drinks.

You’re more at risk from anaemia during a twin pregnancy. You’ll be offered extra blood tests and may be offered iron supplements. Good sources of iron include lean red meat, leafy green vegetables, beans and fortified breakfast cereals.

Read more about healthy eating in pregnancy and foods to avoid in pregnancy.

Staying active with a twin pregnancy

Gentle exercise will help you tone your muscles and protect you from aches and pains. Exercises that won’t overstress your joints are recommended, such as swimming, walking, antenatal yoga, pilates and tai chi.

Doing pelvic floor exercises regularly will help your pelvic floor get back to normal after your babies are born. Even if you’ve had a caesarean birth, you pelvic muscles can still be weak from your pregnancy.

Read more on how to keep active in pregnancy.

Common pregnancy health worries with twins

  • It’s not necessarily true that you will have more morning sickness if you’re expecting twins.
    • Although some women expecting twins or more report lots of morning sickness, others don’t experience any.
    • If you do experience morning sickness, you may find it helps to eat little and often, and to avoid getting hungry.
  • You’re more likely to experience piles and varicose veins during a multiple pregnancy, because of the weight of your babies pressing on the blood vessels of the pelvic area.
  • Pressure from your womb (uterus) pushing on your stomach may make you more prone to heartburn and indigestion as well.
  • You may also find you have backache and pelvic pain, particularly later in your pregnancy. Speak to your midwife, who may refer you to an obstetric physiotherapist.
  • If you register with Tamba** on their website, you can download their Healthy Multiple Pregnancy Guide for free.

For more information on how to have a healthy pregnancy, feel free to read:

Editor’s Note: * Clarification Provided for our U.S. Readers

**Resources Available Outside the UK

  • Marvelous Multiples: provides links to support organizations throughout the world for expecting parents and families of multiple births.

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September 12, 2018 | Filed Under Community | Leave a Comment 

Your Kids Can’t Catch Cystic Fibrosis- What You Need to Know

Cystic fibrosis is an inherited condition that causes sticky mucus to build up in the lungs and digestive system. This causes lung infections and problems with digesting food.

In the UK, most cases of cystic fibrosis are picked up at birth using the newborn screening heel prick test.

Symptoms usually start in early childhood and vary from child to child, but the condition gets slowly worse over time, with the lungs and digestive system becoming increasingly damaged.

Treatments are available to help reduce the problems caused by the condition and make it easier to live with, but sadly life expectancy is shortened.

Symptoms of cystic fibrosis

The build-up of sticky mucus in the lungs can cause breathing problems and increases the risk of lung infections. Over time, the lungs may stop working properly.

Mucus also clogs the pancreas (the organ that helps with digestion), which stops enzymes reaching food in the gut and helping with digestion.

This means most people with cystic fibrosis don’t absorb nutrients from food properly and need to eat more calories to avoid malnutrition.

Symptoms of cystic fibrosis include:

People with the condition can also develop a number of related conditions, including diabetes, thin, weakened bones (osteoporosis), infertility in males, and liver problems.

Diagnosing cystic fibrosis

In the UK, all newborn babies are screened for cystic fibrosis as part of the newborn blood spot test (heel prick test) carried out shortly after they’re born.

If the screening test suggests a child may have cystic fibrosis, they’ll need these additional tests to confirm they have the condition:

  • a sweat test – to measure the amount of salt in sweat, which will be abnormally high in someone with cystic fibrosis
  • a genetic test – where a sample of blood or saliva is checked for the faulty gene that causes cystic fibrosis

These tests can also be used to diagnose cystic fibrosis in older children and adults who didn’t have the newborn test.

The genetic test can also be used to see whether someone is a “carrier” of cystic fibrosis in cases where the condition runs in the family.

This test can be important for someone who thinks they may have the faulty gene and wishes to have children.

The Cystic Fibrosis Trust has more information on genetic testing for cystic fibrosis (PDF, 130kb).

Treatments for cystic fibrosis

There’s no cure for cystic fibrosis, but a range of treatments can help control the symptoms, prevent or reduce complications, and make the condition easier to live with.

People with cystic fibrosis may need to take different medicines to treat and prevent lung problems.

Physical activity and the use of airway clearance techniques may also be recommended to help clear mucus from the lungs.

Find out more about treatments for cystic fibrosis.

Complications of cystic fibrosis

People with cystic fibrosis also have a higher risk of developing other conditions.

These include:

  • weak and brittle bones (osteoporosis) – medicines called bisphosphonates can sometimes help
  • diabetes – insulin and a special diet may be needed to control blood sugar levels
  • nasal polyps and sinus infections – steroids, antihistamines, antibiotics or sinus flushes can help
  • liver problems
  • fertility problems – it’s possible for women with cystic fibrosis to have children, but men won’t be able to father a child without help from fertility specialists (see a doctor or fertility specialist for more advice)

They’re more likely to pick up infections, and more vulnerable to complications if they do develop an infection, which is why people with cystic fibrosis shouldn’t meet face to face.

The Cystic Fibrosis Trust has more information about complications of cystic fibrosis and preventing cross-infection.

Cause of cystic fibrosis

Cystic fibrosis is a genetic condition. It’s caused by a faulty gene that affects the movement of salt and water in and out of cells.

This, along with recurrent infections, can result in a build-up of thick, sticky mucus in the body’s tubes and passageways – particularly the lungs and digestive system.

A person with cystic fibrosis is born with the condition. It’s not possible to “catch” cystic fibrosis from someone else who has it.

How cystic fibrosis is inherited

To be born with cystic fibrosis, a child has to inherit a copy of the faulty gene from both of their parents.

This can happen if the parents are “carriers” of the faulty gene, which means they don’t have cystic fibrosis themselves.

It’s estimated around 1 in every 25 people in the UK are carriers of cystic fibrosis.

If both parents are carriers, there’s a:

  • 1 in 4 chance their child won’t inherit any faulty genes and won’t have cystic fibrosis or be able to pass it on
  • 1 in 2 chance their child will inherit a faulty gene from one parent and be a carrier
  • 1 in 4 chance their child will inherit the faulty gene from both parents and have cystic fibrosis

If one parent has cystic fibrosis and the other is a carrier, there’s a:

  • 1 in 2 chance their child will be a carrier
  • 1 in 2 chance their child will have cystic fibrosis

Outlook

Cystic fibrosis tends to get worse over time and can be fatal if it leads to a serious infection or the lungs stop working properly.

But people with cystic fibrosis are now living for longer because of advancements in treatment.

Currently, about half of people with cystic fibrosis will live past the age of 40. Children born with the condition nowadays are likely to live longer than this.

Support

Support is available to help people with cystic fibrosis live as independently as they can and have the best possible quality of life.

It can be helpful to speak to others who have the same condition, and to connect with a charity.

The following links may be useful:

Information about you

If you or your child has cystic fibrosis, your clinical team will ask you if you consent to being on the UK Cystic Fibrosis Registry.

This is a secure anonymous registry sponsored by the Cystic Fibrosis Trust that records health information on people with cystic fibrosis.

The registry helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.

Find out more about the registry

**Resources outside the U.K.

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August 22, 2018 | Filed Under Community | Leave a Comment 

Is There a Cure For Common Baby Cradle Cap?

Cradle cap is the greasy, yellow scaly patches that sometimes appear on the scalps of young babies.

It is common, harmless and doesn’t usually itch or cause discomfort. Do not pick at the scales as this can cause an infection.

Cradle cap is not contagious and is not caused by poor hygiene or an allergy.

It usually appears in babies in the first two months and clears up without treatment within weeks to a few months.

What does cradle cap look like?

Cradle cap is easy to recognise by the large, greasy, yellow or brown scales on your baby’s scalp.

The scales flake and may make the affected skin look red. Sometimes the hair will come away with the flakes, but it will grow back.

It usually occurs on the scalp but can also affect the face, ears, neck, nappy area and armpits, and behind the knees.

Treatment for cradle cap

Most cases of cradle cap clear up on their own without the need for treatment within weeks to a few months.

Tips to help reduce the build-up of scales on the scalp:

  • regular washing of the scalp with a baby shampoo, followed by gentle brushing with a soft brush to loosen scales.
  • soften the scales with baby oil first, followed by gentle brushing, and then wash off with baby shampoo.
  • soak the crusts overnight with white petroleum jelly, or vegetable or olive oil, and shampoo in the morning.

If these methods don’t work, speak to your pharmacist about using a greasy emollient or soap substitute, such as emulsifying ointment.

There is usually no need to see your GP (*pediatrician) if your baby has cradle cap. However, you may want to ask them for advice if there is swelling to the scalp or if the cradle cap spreads to other parts of the body.

Special shampoos

You can buy special shampoo for cradle cap from a pharmacy. Always read the instruction leaflet to check it’s safe to use on your child.

Avoid getting the shampoo in your baby’s eyes. If you’re unsure about using it, speak to a pharmacist for advice.

Treating an infection

If these home treatments don’t lead to any improvement, your doctor may recommend an antifungal cream.

A mild steroid cream may also be recommended in some cases where the baby has a nappy rash.

When to see your GP (*Pediatrician)

Picture of baby with cradle capSpeak to your GP if your baby’s cradle cap:

  • itches
  • swells
  • bleeds
  • spreads to the face or body

What causes cradle cap?

It’s not clear what causes cradle cap, although it may be linked to:

  • high levels of an oily substance called sebum on affected areas
  • a reaction to a yeast called malassezia on the skin

Cradle cap is a type of seborrhoeic dermatitis, a common irritation that affects oily skin in children and adults.

Editor’s Note: * Clarification Provided for our U.S. Readers

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August 1, 2018 | Filed Under Community | Leave a Comment 

Video: How to Recognize and Deal with Child Sexual Abuse

It can be difficult to know whether a child is being abused, as the abuser may be secretive about their actions. In this video, aimed at parents and carers, a child sex abuse consultant from the Marie Collins Foundation explains what to do if you think a child is being harmed, and how to discuss the subject of abuse with a child.

Editor’s Note: Video Highlights

Child sexual abuse is any sexual behaviour directed towards children…by adults, male and female, and by young people themselves.

Child Sexual Abuse Involves Activities Ranging from:

  • Voyeurism
  • to rape of children
  • and now involves sexual behavior online

What Do We Need to Know

  • 1 in 6 young adults reported being sexually abused before age 16 (results of recent UK study)
  • Very few (~25%) tell anyone due to extensive guilt
  • Impact can be extensive

Signs to look for

  • Acting out in an inappropriate sexual way with toys/objects
  • Nightmares/sleeping problems
  • Withdrawing or becoming clingy
  • Personality changes or regressing to younger behaviors
  • Unaccountable fear of particular places or people
  • Outbursts of anger
  • Changes in eating habits
  • Physical signs
  • Becoming secretive

How Do We Handle This

  • If someone makes you uncomfortable around your child, and you suspect someone is abusing your child – call a helpline and talk to someone
    • UK: 0808 1000 900
    • US & Canada: 800-422-4453
    • Australia: 1 800 55 1800
  • Talk to your child
    • adjust the conversation to their age
    • try not to act shocked – be reassuring
    • try not to interrupt other than to check that the child is alright
    • let them know you will keep them safe, but you will need to bring in help – the police or children’s services – to do that.

It’s a big step to make that call and accuse someone and we often hesitate – but if you don’t – know that the abuse will continue and the child or children could be affected for the rest of their life.

Additional UK Resources:

  • Childline: 0800 1111
  • NSPCC National Child Protection Helpline: 0800 8005000
  • Child Exploitation and Online Protection: www.ceop.police.uk/report-abuse
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July 25, 2018 | Filed Under Community | Leave a Comment 

Study: HPV Vaccine, Safe and Effective Against Pre-Cancer

“HPV vaccine for schoolgirls gets full marks,” reports ITV News.

Almost all cases of cervical cancer, which usually takes many years to develop, are caused by the human papilloma virus (HPV). HPV causes the cells in the cervix to slowly go through a series of pre-cancerous changes that can eventually turn into cancer.

The HPV vaccine helps protect against cervical cancer by preventing the cells of the cervix from changing into pre-cancerous cells.

In the UK, cervical cancer affects more than 3,000 women a year, with most cases diagnosed between the ages of 25 and 29. In 2016, 815 women died of cervical cancer. A programme began 10 years ago to vaccinate schoolgirls aged 12 to 13 against HPV.

In this latest review, researchers pooled results from 25 trials worldwide involving more than 70,000 girls and young women.

  • After looking at the evidence, the researchers reported that the HPV vaccine provides excellent protection against development of pre-cancerous cells in the cervix.
  • This review found that vaccinating girls before they have HPV works best, cutting their chances of getting pre-cancerous cells linked to the most dangerous strains, HPV16 and HPV18, by 99%.
  • Vaccinating women aged 26 and over, and those who have already been infected, also cuts their chances of pre-cancerous cells but not as dramatically.
  • The researchers found no increased risk of miscarriage or other serious adverse events in the years following vaccination.

Find out more about the HPV vaccine.

Where did the story come from?

The study was carried out by researchers from the Belgian Cancer Centre and the University of Antwerp, both in Belgium, and Lancashire Teaching Hospitals NHS Trust in the UK as part of the worldwide Cochrane Collaboration of research. It was funded by the National Institute of Health Research, European Cancer Network, Belgian Foundation Against Cancer, IWT (a Belgian science and technology institute) and the CoheaHr Network (part of the European Commission).

It was published by the Cochrane Collaboration and is free to read online.

The UK media celebrated the news that the vaccine is safe and works well, with ITV News asking: “Is it now time for boys to get it too?”

Boys are currently not routinely offered the vaccine, although some people have pressed for the programme to be extended. While boys do not get cervical cancer, they can pass HPV on to unvaccinated girls. The virus can also cause less common cancers of the throat, anus and penis.

What kind of research was this?

This was a systematic review and meta-analysis of randomised controlled trials. This is the best way to find out whether a treatment works.

Carrying out a meta-analysis means researchers can pool evidence from smaller trials to come up with a more reliable result.

What did the research involve?

Researchers looked for randomised controlled trials that compared the HPV vaccine with a dummy vaccine (placebo) and measured how many girls or young women had pre-cancerous cells (called cervical intraepithelial neoplasia) at grade 2 or above.

They also wanted to assess the vaccine’s effectiveness against the most dangerous strains, HPV16 and HPV18, which are thought to cause around 70% of all cervical cancers. The UK vaccination programme protects against both.

The 26 studies included 73,428 girls and women, mostly aged 15 to 26, with follow-up periods from 0.5 to 8 years. The researchers looked separately at results for:

  • girls or women who had no HPV infection when vaccinated
  • women aged over 26
  • the 2 different types of HPV vaccine, which protect against different strains

As well as looking for evidence of pre-cancerous cells, they checked for differences in rates of serious adverse events and pregnancy outcomes between women given the HPV vaccine and women given a placebo.

Unfortunately, results for cervical cancer were not available.

All the studies were assessed for risk of bias and, while all but one were funded by the vaccine manufacturers, the review’s authors said most of the trials were at low risk of bias.

What were the basic results?

Results were clearest for girls and young women who had not been infected with HPV at the time they were vaccinated. These findings are likely to be the most relevant for girls in the UK, who receive the vaccine at an age where they are unlikely to have come into contact with HPV.

For non-infected girls and women:

  • chances of having pre-cancerous cells (CIN grade 2) linked to HPV16 or HPV18 reduced from 164 per 10,000 to 2 per 10,000 – a reduction in relative risk (RR) of 99% (RR 0.01, 95% confidence interval [CI] 0.00 to 0.05)
  • chances of having higher-grade pre-cancerous cells (CIN grade 3) linked to HPV16 or HPV18 reduced from 70 per 10,000 to 0 per 10,000 – a reduction in risk of 99% (RR 0.01, 95% CI 0.00 to 0.10)
  • chances of having pre-cancerous cells (CIN grade 2) linked to any strain of HPV reduced from 287 per 10,000 to 106 per 10,000 – a reduction in risk of 63% (RR 0.37, 95% CI 0.25 to 0.55)
  • chances of having higher-grade pre-cancerous cells (CIN grade 3) linked to any strain of HPV reduced from 109 per 10,000 to 23 per 10,000 – a reduction in risk of 79% (RR 0.21, 95% CI 0.04 to 1.10)

The rate of deaths was similar among vaccinated and non-vaccinated women – 11 per 10,000 in the control group and 14 per 10,000 in the vaccine group – and no deaths were linked to the vaccine.

The HPV vaccine did not increase the risk of miscarriage or pregnancy termination. However, there was not enough information to be sure about the risks of stillbirth or babies born with malformations.

How did the researchers interpret the results?

The researchers said: “There is high-quality evidence that HPV vaccines protect against cervical pre-cancer in adolescent girls and women who are vaccinated between 15 and 26 years of age.”

They added that “protection is lower” when women are already infected with HPV at the time of vaccination.

Conclusion

This review provides reassurance for women and girls who have received the HPV vaccine, and for parents of girls due to receive it.

It found the vaccine does a good job of protecting against the most dangerous strains of HPV, which are passed on through sex and skin-to-skin contact of the genital areas.

The majority of the trials included in the review involved girls and women aged 15 to 26, which is slightly older than those vaccinated in the UK programme.

However, what made the key difference for the vaccine’s effectiveness was whether or not women already had HPV when they were vaccinated. By vaccinating girls at age 12 to 13, the chances of them being already infected are lower, which should increase the effectiveness of the vaccination programme.

HPV vaccination has been shown in this study to reduce the chances of women getting pre-cancerous cells in the cervix, but we need to see longer-term results to be sure this translates into a reduced chance of cervical cancer.

Most young women aged 14 to 25 in the UK should now have received the vaccine, meaning rates of cervical cancer may drop in the coming decades. In the meantime, women should continue to attend screening appointments for cervical cancer when invited.

Find out more about the HPV vaccine.

Analysis by Bazian
Edited by NHS Choices

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July 18, 2018 | Filed Under Awareness | Leave a Comment 

How to Plan Activities That Keep Babies & Toddlers On The Move

Ways to get your baby moving

  • Lay your baby down on their back so they can kick their legs.
  • Pulling, pushing, grasping and playing with other people are great ways to practise different kinds of movements.
  • Once your baby has started crawling, let them crawl around the floor, but make sure it’s safe first – see our crawling safety checklist.
  • Playing outdoors helps your baby learn about their surroundings.
  • You can take your baby swimming from a very young age – there’s no need to wait until they’ve been vaccinated.

See Start4Life for more activity tips for babies.

Why tummy time is important

Tummy time helps to build the muscles your baby needs for sitting and crawling. You can start doing tummy time from birth by lying your baby on your chest – but only do this when you’re wide awake and unlikely to fall asleep.

Little and often is best to begin with. Gradually increase the amount of time you do this day by day. Then, when your baby is ready, try doing tummy time on the floor. If your baby has difficulty lifting their head, you can roll up a towel and put it under their armpits. Put some toys nearby for them to reach out to.

Only do tummy time when your baby is awake and alert, and you’re there to keep an eye on them.

Baby bouncers, walkers and seats

It’s important that your baby doesn’t spend too much time in:

  • baby walkers or bouncers – these encourage babies to stand on their tiptoes and can delay walking if your baby uses them a lot
  • baby carriers and seats – long periods in reclining carriers or seats, or seats that prop your baby in a sitting position, can delay your baby’s ability to sit up on their own

If you do use a baby walker, bouncer or seat, it’s best to use them for no more than 20 minutes at a time.

Physical activity for toddlers

Once your child is walking, they should be physically active for at least 180 minutes (three hours) a day, spread throughout the day.

  • Let your toddler walk with you rather than always using the buggy.
  • Toddlers and young children love going to the park, where they can climb and swing or just run around.
  • Toys your child can pick up and move around will help improve their co-ordination and develop the muscles in their arms and hands.
  • Involve your toddler in household tasks like unpacking shopping, tidying or sorting washing.
  • Teach your child songs with actions and encourage them to dance to music.

Watching TV or using a tablet for long periods – or being strapped into a buggy, car seat or highchair – isn’t good for young children.

If you need to make a long car journey, consider taking a break and getting your child out of their seat for a bit.

See physical activity guidelines for children under five.

Enjoy being active together

It’s good to join in with your child’s active play when you can. Have fun showing them how to do new things like running and hopping. Being active together shows your child that activity is enjoyable.

You’re a role model for your child so stay active yourself and try to meet the physical activity guidelines for adults.

There may be activities for parents and children at your local leisure centre or Sure Start Children’s Centre.

Activity for young children with a disability

All babies and young children need to be active, including children with a long-term condition or disability, unless their health professionals give you different advice.

Just like other children, they will enjoy being active and it will help their development. You may need to adapt some activities to suit your child.

Scope has ideas for games all children can play, and the Contact a Family advice service** offers information on caring for a disabled child (in the UK).

Coping with a very active toddler

It can be exhausting keeping up with a toddler who is always on the go. It may help if you:

  • keep to a daily routine – routine can help if your child is restless or difficult; it can also help you stay calm and cope with the strain
  • dedicate time to your child – make sure there are times each day when you give them your full attention
  • avoid difficult situations – for example, keep shopping trips short
  • try to go out every day – go to a park, playground or other safe, open space where your child can run around and use up energy
  • set small goals – help your child to sit still and concentrate for a very short time, perhaps on a book or new toy, then gradually build it up

Does my child have attention deficit and hyperactivity disorder (ADHD)?

At times you may wonder if your non-stop toddler has ADHD. But only about 2% of children in the UK have ADHD**. It’s more likely that your child is just a healthy, energetic toddler.

If you’re worried about how active your child is, talk to your health visitor (*nurse specialist/midwife) or GP (*physician).

Learn more about ADHD or visit ADDISS: National Attention Deficit Disorder Information and Support Service.

Editor’s Note:

* Clarification Provided for our U.S. Readers

** US Reference Information:

  • The American Psychiatric Association (APA) says that 5 percent of American children have ADHD. But the Centers for Disease Control and Prevention (CDC) puts the number at more than double that. The CDC says that 11 percent of American children, ages 4 to 17, had the attention disorder as of 2011.
  • UNICEF-USA is a charity that helps to protect US children and support children with disabilities

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July 11, 2018 | Filed Under Community | Leave a Comment 

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