babies

Doppler ultrasound detects placenta issues in small babies

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A Doppler ultrasound assessing the blood flow in small unborn babies can determine the functionality of the placenta.

Doppler ultrasound gauges placenta function in small unborn babies

Doppler ultrasound gauges placenta function in small unborn babies

Nearly 10 percent of unborn babies are smaller than expected for their stage of development. Pregnancy intervention is not required if these small babies are healthy. However, if small babies have a malfunctioning placenta, it may require action, including the possibility of inducing the baby’s birth.

Based on recent findings, a Doppler ultrasound assessing the blood flow in small unborn babies can determine the functionality of the placenta.

Extra monitoring for small unborn babies is necessary

If there are consistent deviations from these Doppler measurements, it becomes essential to conduct extra monitoring for the unborn baby, according to a statement by Amsterdam UMC. These deviations signify an increased likelihood of oxygen deficiency and other potential health issues for the baby

If there are consistent variations in the Doppler measurements, conducting additional monitoring of the unborn baby becomes essential. These discrepancies suggested an elevated risk of oxygen deficiency and other potential health issues for the baby.

The study was conducted by Amsterdam UMC in collaboration with UMC Groningen and 17 other Dutch hospitals.

The Doppler ultrasound is imperative for initially detecting pregnancies in women carrying babies that are too small due to a malfunctioning placenta. 

It aids in identifying variations in blood flow, indicating a heightened risk of oxygen deficiency and other health problems for the baby.

“This means it is incredibly important to track down which babies are smaller due to the placenta,” stated Wessel Ganzevoort, associate professor of obstetrics at Amsterdam UMC.

Doppler ultrasound assesses resistance of blood vessels in the umbilical cord

In this case, the device evaluated the resistance of blood vessels in the umbilical cord, providing information about the blood flow to the placenta. Additionally, it measured the blood supply to the child’s brain.

The study revealed that repeated deviations from these Doppler measurements indicate a higher risk of oxygen deficiency and other health problems for the baby. 

The research deduced that inducing labor before 37 weeks did not lead to better outcomes, emphasizing the importance of waiting until at least 37 weeks of pregnancy to induce labor for small babies.

Mauritia Marijnen is a PhD candidate at Amsterdam UMC and the study’s first author. Stated:

“What was possible with a Doppler ultrasound was already known, but it is not yet standard practice in all hospitals. This research now shows that this measurement certainly has added value for detecting pregnancies in babies that are too small with a malfunctioning placenta.” 

“By adding this Doppler ultrasound to the care plan of these undersized babies, the higher risk of problems surrounding childbirth can be better detected and monitored. Small babies for whom the measurement is normal can also be monitored less intensively. There is, therefore, a greater chance that the delivery will take place naturally, without intervention,” added Ganzevoort. 

Pandemic challenges may affect babies — possibly in long-lasting ways

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The COVID-19 pandemic has been hard on so many people in so many ways. For babies born during this pandemic, a study published in JAMA Pediatrics suggests that the damage has potential to be lifelong.

The first three years of life are crucial for brain development. And it’s not just the health of babies that matters, but the interactions between babies and their caregivers. Babies need to be touched, held, spoken to, smiled at, played with. As they receive and respond to those interactions, in a “serve and return” kind of way, neural connections are built in the brain. When babies don’t have those interactions, or enough of them, their brains don’t develop as they should — and can even be literally smaller.

When you are a stressed or depressed parent or caregiver, it can be hard to find the time, let alone the energy or interest, to talk to and play with your infant. There are multiple studies showing that maternal depression, poverty, and other family stressors can change the development of a child forever.

How was the study done?

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In this study, part of an ongoing study of mothers and babies, researchers from Columbia University looked at the development of three groups of 6-month-old babies. Two of the groups were born during the COVID-19 pandemic; the mothers of one group had COVID-19, while the mothers of the other did not. The third group was a historical cohort (a group of babies who were born before the pandemic).

Mothers participating in the study used an Ages and Stages Questionnaire (ASQ-3) to record their babies’ development. The researchers noted no difference in the development of the two groups of babies born during the pandemic, suggesting that prenatal exposure to COVID-19 doesn’t affect development, which is great news. But the babies born during the pandemic scored lower in gross motor, fine motor, and social-emotional development than the babies born before the pandemic. Examples of developmental tasks for infants this age are rolling from back to tummy (gross motor), reaching for or grasping a toy with both hands (fine motor), and acting differently to strangers than to parents or familiar people (social-emotional development).

What does it suggest about infant development during the pandemic?

It’s just one study, and we need to do more research to better understand this, but the findings are not really surprising given what we know about infant development. The COVID-19 pandemic has caused a lot of stress — emotional, financial, and otherwise — for so many families. It has also markedly affected the number and kind of interactions we have with other people. Babies are on average interacting with fewer people (and seeing fewer faces because of masking) than they did before the pandemic.

Even though we need to do more research, this study should serve as an alarm bell for us as a society. The children of this pandemic may carry some scars forever if we don’t act now. We’ve been seeing the emotional and educational effects on children; we need to be aware of the developmental effects on babies, too. All of these could permanently change their lives.

What can we do to address these challenges?

We need to find ways to support families with young children, financially and emotionally. We need to be energetic and creative, and work every angle we can. While our government should play a role, communities and individuals can help too.

We need to refer families to and fund early intervention programs around the country that support the development of children from birth to 3 years of age. Because of the pandemic, many of these programs have moved to virtual visits, which can make them less effective. So we need to get creative here, too. We can’t just wait for the pandemic to be over.

And parents and caregivers of infants and toddlers need to know about this research — and ask for help. It’s understandable and natural for parents to think that babies are too small and unaware to be affected by the pandemic. But they are affected, in ways that could be long-lasting. Talk to your doctor about what you can do to help yourself, your family, and your baby’s future.

Babies can see and hear a lot more inside the womb than you might suspect

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We should probably stop swearing…

When my wife became pregnant with our first child, we could barely contain our joy. Then we panicked.

To vanquish our ignorance, we both started reading immediately and obsessively on the latest science behind pregnancy and child development.

A few surprising facts stood out in that torrent of books, studies, articles, and apps.

But the ones I found the most eyebrow-raising had to do with the awareness possessed by babies in the womb: Their hearing and sight develops remarkably early and begins sponging up information far sooner than I expected.

When and what can babies hear?

Every baby, mum, and pregnancy are different, but most of a foetus’ inner ear structures form by week 16, allowing it to hear sound.

By 24 weeks, the cochlea, eardrum, ossicles, and other crucial ear structures are fully formed – and the ‘record’ light is on in the baby studio.

From then on developing babies can easily hear mum’s heartbeat, eating, breathing, walking, talking, exercising, burping, and digestive gurgling.

This may help explain why babies find noise so comforting. There’s also some evidence to suggest babies learn to recognise and react to mum’s voice while inside the womb.

Do loud sounds hurt unborn babies?

The sounds a mum exposes herself to are what a baby is exposed to as well, but babies can’t put in ear plugs.

The CDC says mums should avoid very loud noises exceeding 115 dBA – chainsaws, gunfire, jet engines, blaring music, loud concerts, and so forth.

Consistent loud noise (like heavy machinery) can also damage a baby’s hearing in the womb.

What about loud but non-damaging sounds? Those can surprise babies in the womb, sometimes enough to even make them cry.

When and what can babies see in utero?

Although a baby’s eyes can ‘see’ light starting around week 16, their peepers aren’t recognisable (as we know them) until about week 20.

The eyes first open between weeks 26 and 28, doing so most regularly starting around 32 weeks into a pregnancy. Development of vision is tremendously complicated, so a lot of it continues after birth.

And yet, a foetus can see inside the womb. Their vision is rather blurry, but they sometimes respond (with a flutter of activity) to bright sources of light like the Sun or a flashlight pointed at a woman’s belly.

Getting outside often might even help a baby’s eyes develop and reduce the risk of a few eye disorders.

What does it look like inside there?

Imagine being inside a big, thick, red balloon that’s filled with water. A flashlight projecting through your cheek to create a dull red glow is probably a good (and more practical) example.

 

Babies born by caesarean section are more likely to be obese, study finds

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Obesity is a lot more complex than we think.

Babies born by caesarean section are more likely to experience obesity than children delivered via vaginal birth, a new study has found.

The study suggests that babies from caesarean deliveries don’t only experience greater incidence of obesity as children, but also later on in life – with the effects persisting through teenage years and into adulthood.

“Caesarean deliveries are without a doubt a necessary and lifesaving procedure in many cases,” says nutritionist and epidemiologist Jorge Chavarro from Harvard University.

“But cesareans also have some known risks to the mother and the newborn. Our findings show that risk of obesity in the offspring could another factor to consider.”

The researchers analysed data from more than 22,000 young adults who took part in the Growing Up Today Study (GUTS) – an ongoing project launched in 1996 to examine the factors that influence health and weight as people age.

The participants, who were children aged between 9 to 14 when the study commenced, had their body mass index (BMI) tracked over 16 years. The researchers also collected information on factors that might affect obesity, including their mothers’ pre-pregnancy BMI, smoking status, and age when the participants were born.

Once these factors were accounted for, the data showed that participants born via caesarean deliveries (22 percent of the group) were 15 percent more likely to be obese on average than those who came into the world via vaginal birth (the other 78 percent).

The association showed up in across genders and different age segments, but was at its strongest when the participants were younger.

Participants born via C-section were 23 percent more likely to be obese when aged 9–12; 16 percent more likely to be obese when aged 13 to 18; and 10 percent more likely when aged 19 to 28.

Strangely, the increased risk of obesity was at its highest when pregnant women had elected to have caesarian births without a documented health reason for the C-section, with their babies found to be 30 percent more likely to experience obesity than children delivered via vaginal birth.

Also of note is the fact that participants in the study with siblings – 12,903 of the overall 22,068 group – who were delivered by caesarian had a 64 percent higher risk of obesity than their brothers or sisters from a vaginal birth.

While researchers have previously observed this association between caesarean sections and obesity, this is the largest and most comprehensive investigation yet into the relationship between birthing methods and future weight outcomes.

“I think that our findings – particularly those that show a dramatic difference in obesity risk between those born via caesarean and their siblings born through vaginal delivery – provide very compelling evidence that the association between caesarean birth and childhood obesity is real,” says Chavarro.

“That’s because, in the case of siblings, many of the factors that could potentially be playing a role in obesity risk, including genetics, would be largely the same for each sibling – except for the type of delivery.”

But the question remains, why is this happening?

At this stage, nobody knows for sure, but children born by caesarian section do have less exposure to their mother’s vaginal and gastrointestinal microbiota, and this could play a role in their dietary development and weight as they age.

“Children born via C-section harbour less diverse gut bacteria and these patterns of less diversity have been linked to increased capacity for energy harvest by the gut microbiota,” one of the researchers, Audrey Gaskins, told Hannah Devlin at The Guardian. “You can think of it as a slower metabolism.”

It’s important to remember that, for many women, giving birth via a C-section is a medical necessity to safeguard the health of the mother and her baby – so the researchers are not suggesting that women avoid using this method in a bid to lower their child’s risk of developing obesity.

A definitive biological cause is yet to be identified to explain this correlation, so until the link can be confirmed, we need to wait and see what further evidence reveals. But one thing’s for sure – getting to the bottom of what’s really going on here will be beneficial for all.

“Most often caesarean births are as a result of medical necessity, rather than elective,” biomedical researcher Simon Cork from Imperial College London in the UK, who wasn’t involved with the study, told The Guardian. “[A]s such, this risk would outweigh any concerns mothers should have regarding the possibility of future weight issues.”

Scientists are trying to predict which babies will grow up to become criminals.

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Real-life Minority Report.

Is it possible to predict whether someone will commit a crime some time in the future?

It sounds like an idea from the 2002 science-fiction movie Minority Report, but that’s what statistical researcher Richard Berk, from the University of Pennsylvania, hopes to find out from work he’s carried out this year in Norway.

 The Norwegian government collects massive amounts of data about its citizens and associates it with a single identification file. Berk hopes to crunch the data from the files of children and their parents to see if he can predict from the circumstances of their birth whether a child will commit a crime before their 18th birthday.

The problem here is that newborn babies haven’t done anything yet. The possible outcome of Berk’s experiment would be to pre-classify some children as ‘likely criminals’ based on nothing more than the circumstances of their birth.

This could be the first step in making Minority Report a reality, where people could be condemned for crimes they haven’t even committed.

The art of prediction

Berk’s work is based on machine learning. This involves data scientists designing algorithms that teach computers to identify patterns in large data sets. Once the computer can identify patterns, it can apply its findings to predict outcomes, even from data sets it has never seen before.

For example, the US retail giant Target collected data about the shopping habits of its customers and used machine learning to predict what customers were likely to buy and when.

But it got into hot water in 2012 when it accurately used its pregnancy-prediction model to predict the pregnancy of a high school student in Minnesota.

It is hardly surprising, given the potential use of machine learning to avoid crime, that the field of criminology has turned to machine learning in an attempt to predict human behaviour. It has already been used, for example, to predict whether an offender is likely to be a recidivist.

Predicting criminal behaviour

The ability to use machine learning to inform risk assessments in the criminal justice system has been a focus for Berk for a long time now.

For example, earlier this year he looked at whether a person on bail for alleged domestic violence offences was likely to commit another offence before their next court date.

Whether the algorithms used in machine learning can accurately predict human behaviour is dependent on having as much contextual data as possible. Target used metadata from shopping routines. Berk, on the other hand, uses predictors specific to crime and demographics.

This includes the number of prior arrests of a person, age of first arrest, type of crime or crimes committed and number of prior convictions. It also includes prison work performance, proximity to high-crime neighbourhood, IQ and gender.

In some of his studies Berk has used as many as 36 predictors.

Low-risk and high-risk individuals

In each of Berk’s experiments, the algorithm was able to predict quite accurately who would be a low-risk individual.

For example, he identified 89 percent of those people unlikely to commit domestic violence, 97 percent of inmates unlikely to commit serious misconduct in prison and 99 percent of past offenders unlikely to commit a homicide offence.

The trouble, though, is that the algorithm was nowhere near as accurate in predicting who would be a high-risk individual. There was only:

  • a 9 percent accuracy in predicting which inmates engage in serious misconduct
  • a 7 percent accuracy in predicting which offenders on parole or under community supervision would commit a homicide offence
  • a 31 percent accuracy in predicting which defendants on bail for domestic violence offences were likely to commit another offence before their next court date.

There are two ways of using the results of Berk’s experiments. First, we could divert resources away from low-risk individuals. This might involve placing less onerous supervision conditions on domestic violence defendants who are at low risk of committing another offence.

Alternatively, we could target more resources towards high-risk individuals. This might involve placing inmates at high risk of serious misconduct into higher-security prisons.

But there are two apparent issues with using the data to target high-risk individuals. First, there has been relatively little success in predicting who actually does pose a risk (in comparison to predicting who does not pose a risk), a limitation that Berk himself concedes.

Second, our criminal justice system is premised on the idea that people have free will and might still make the right choice to not commit a crime, even if they only do so at the last possible moment.

How is all this different to what the Australian criminal justice system does when it makes predictions about high-risk individuals?

A lot of the justice system’s work already involves spending a good deal of time making educated guesses about whether someone is an unacceptable threat to public safety or poses a high risk of future danger.

These assessments contribute to officials’ decisions about whether to grant bail, whether to grant parole and how harshly a person should be sentenced.

Prime Minister Malcolm Turnbull recently asked states and territories to push for new legislation to allow ‘high risk’ offenders convicted of terrorism offences to be held in detention even after their sentences have been served.

Generally, though, such decisions are based primarily on past behaviours of a particular individual, not data about past behaviours of other individuals.

Using predictive behavioural tools to decide whether (or for how long) someone should be in prison, based on something that has not yet even happened, would represent a substantial philosophical shift.

We would no longer consider people to be innocent until proven guilty, but would instead see them as guilty by reason of destiny.

Longer paid maternity leave saves babies

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  • Each extra month off linked to 13 per cent fall in infant deaths
  • Paid leave might boost breastfeeding, vaccination and access to health services
  • But it may be unsound to extrapolate findings to all developing nations
   Longer paid maternity leave saves babies

“Based on our analysis, I’m fairly convinced that increasing the duration of paid leave is an effective way of reducing infant mortality.”

More generous policies for paid maternity leave can save the lives of babies in developing countries, a study has found.

The paper estimates that each extra month of maternity leave is linked to about eight fewer infant deaths for each 1,000 live births. This represents a 13 per cent reduction — a “pretty sizable” decrease, says lead author Arijit Nandi, an epidemiologist at McGill University in Canada.

Paid maternity leave improves access to health services before and after childbirth because it provides time, an income and job protection to mothers, helping to reduce anxiety and improve their health, the study says. Maternity leave also increase the likelihood that mothers will breastfeed their child and stick to vaccination schedules, adds the paper, published in PLOS Medicinelast week (29 March).

“Based on our analysis, I’m fairly convinced that increasing the duration of paid leave is an effective way of reducing infant mortality,” Nandi says. He adds that his team controlled for other factors that reduce infant deaths, such as GDP (gross domestic product) and national health spending.

The researchers compared rates of infant deaths in two groups of low- and middle-income countries, covering about 300,000 live births between 2000 and 2008.

The first group comprised Bangladesh, Kenya, Lesotho, Uganda and Zimbabwe, which increased their paid maternity leave over that period. The 15 countries in the control group — including Bolivia, Cambodia and Rwanda — did not change their policies and offered an average 12 weeks of paid leave throughout.

Studies have already demonstrated the benefits of maternity leave on child health in rich countries, but this is the first time a study has focused on developing nations, the researchers say.

However, Zulfiqar Bhutta, a child health researcher at the University of Toronto, also in Canada, says “caution should be exercised in extrapolating this to all low- and middle-income countries”.

While the findings are plausible, “the major limitation here is the assumption that maternity leave policies in a country are universally applied, which they are not”, says Bhutta, who also leads a research centre on woman and child health at Aga Khan University in Pakistan.

In response, Nandi admits: “We look at the impact of changing policies but don’t have good data about implementation.”

But he points to research in other areas, which suggests that policies improving the conditions of employees tend to have spill-over effects, with those working outside formal employment reaping similar improvements. “We can expect the same thing with maternity benefits,” he says.

Mother’s milk made to order for boys, girls.

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Mothers may say they don’t care whether they have a son or a daughter, but their breast milk says otherwise.

“Mothers are producing different biological recipes for sons and daughters,” says Katie Hinde, an evolutionary biologist at Harvard University.

baby eating mother's breast milk

Studies in humans, monkeys and other mammals have found a variety of differences in both the content and the quantity of milk produced.

One common theme: baby boys often get milk that is richer in fat or protein — and thus energy — while baby girls often get more milk.

There are a lot of theories as to why this happens, says Hinde, who spoke at the American Association for the Advancement of Science‘s annual meeting.

Rhesus monkeys, for instance, tend to produce more calcium in the milk they feed to daughters who inherit social status from their mothers.

“It could be adaptive in that it allows mothers to give more milk to daughters which is going to accelerate their develop and allow them to begin reproducing at early ages,” says Hinde.

Reasons unclear

Males don’t need to reach sexual maturity as quickly as females because the only limit on how often they reproduce is how many females they can win over.

The females also nurse for longer than male monkeys, who spend more time playing off on their own and thus need more energetically dense milk.

It’s not yet clear why human mothers produce such different milk for their babies, says Hinde.

There is evidence, however, that the stage is set while the baby is still in utero.

Hinde co-authored a study published last week in PLOS One that showed that the sex of the foetus influences the milk production of cows long after they are separated from their calves — typically within hours of the birth.

The study of 1.49 million cows found that, over the course of two 305-day lactation periods, they produced an average of 445 kilograms more milk when they had female calves than when they had males.

They also found no difference in the protein or fat content of the milk produced for heifers than for bulls.

Improving milk formula

Much remains to be understood about how breast milk impacts infant development in humans, says Hinde.

Knowing more could help improve the baby milk formulas sold to mothers who are unable or unwilling to nurse their infants, she says.

“While the food aspects of milk to some extent are replicated in formula, the immuno factors and medicine of milk are not and the hormonal signals are not,” she says.

Getting a better understanding of how milk is personalised for specific infants will also help hospitals find better matches for breast milk donated to help nourish sick and premature infants in neo natal units, she adds.