Environmental toxins are seen as posing risks during pregnancy

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Leading up to and during pregnancy, women are told to avoid alcohol and cigarettes, to make sure they get enough folate and omega-3 fatty acids, and to get adequate sleep and exercise. Most are told little or nothing about reducing their exposure to chemicals despite evidence suggesting that ingredients in plastics, vehicle exhaust and cosmetics additives can have profound impacts on babies’ health.

In recent years, the field of ­maternal-fetal medicine has started to respond. In 2013, the American College of Obstetricians and Gynecologists issued a committee opinion, reaffirmed this year, “calling for timely action to identify and reduce exposure to toxic environmental agents while addressing the consequences of such exposure.” The International Federation of Gynecology and Obstetrics voiced a similar opinion in 2015, and the following year nearly 50 prominent U.S. doctors and scientists created Project TENDR: Targeting Environmental Neuro-Developmental Risks to call for reducing chemical exposures that can interfere with fetal and children’s brain development.

Yet, a recent survey suggests that most doctors don’t discuss exposure to pollutants with their pregnant patients.

“Fetal development is a critical window of human development, and so any toxic exposure during that time, during pregnancy, doesn’t only have a short-term effect at that moment, but really an effect that lasts the entire lifetime,” said Nathaniel DeNicola, who was on the committee that reaffirmed the ACOG opinion.

In 2011, University of California at San Francisco (UCSF) researcher Tracey Woodruff and colleagues reported finding traces of dozens of harmful chemicals in 99 percent or more of the 268 pregnant women whose urine they analyzed; among them were organochlorine pesticides, perchlorate, phthalates and cancer-causing compounds found in vehicle exhaust and smoke.

Click here to read full article!

Drink, drank, drunk: what happens when we drink alcohol in four short videos

Alcohol is a depressant, a diuretic, and a disinfectant. These generally aren’t pleasant attributes, but people have been drinking alcohol for thousands of years – some of the earliest written texts mention or contain recipes for beer, and pottery shards from China show people may have been making alcohol as far back as 7,000BCE.

So what is this special chemical that we’ve loved to drink for so long?

Well, there are many types of alcoholic drinks – fizzy and flat, hot and cold, fermented and distilled – but all of the alcohol we drink as humans is ethanol based.



The process of how ethanol gets from the glass into your brain is not straight forward. And how quickly it gets to your brain (and whether or not it’s quickly broken down by your liver) is down to a variety of factors, one of which it’s actually very easy for us to control: whether or not we’ve eaten.

Let’s take a look at what happens after that first sip of alcohol.



The organ that takes on the biggest burden of processing ethanol in our body is the liver.

The liver is one of our largest and most important organs and it performs hundreds of functions, including converting the nutrients in food into something our bodies can actually use.

But there’s a reason we apologise to our livers if we’ve a big night: the liver’s other job is processing any toxic substances we ingest into something harmless, or removing them from the body altogether. Which makes it the perfect organ to deal with ethanol.

Most – about 90 to 98% – of the ethanol we consume is processed in the liver, with the remainder either removed in our urine, sweat or when we exhale.

The liver processes alcohol in two distinct steps. The first involves an enzyme called alcohol dehydrogenase (ADH), which breaks down ethanol into a chemical called acetaldehyde. Unfortunately acetaldehyde is actually a toxin, which is why there’s a second stage to the process.

Another enzyme – aldehyde dehydrogenase (ALDH) – quickly breaks down acetaldehyde into acetate, which is harmless. It’s then either excreted, used to make other molecules or broken down into water and carbon dioxide.

And it’s while your liver is slowly processing the ethanol in your system (as quickly as it can) that the remainder makes its way to your brain.



A complicating factor for determining how drunk we’re likely to feel after a certain amount of alcohol is that different people will process alcohol at different speeds.

There are many things that impact how quickly the body processes alcohol, including your weight, body composition and hormones, the number of drinks you’ve had and how quickly you drank them.

But roughly, the liver can effectively process about 1 standard drink in an hour, give or take. Women and men do process alcohol at different speeds, which is why alcohol campaigns often suggest women consume fewer drinks in the first hour than men.

The problems start when you consume more than a standard drink per hour – which is not hard to do, given an average bottle of beer has 1.2 to 1.4 standard drinks, and a restaurant sized glass of wine is about 1.5 standard drinks.

While it can be hard to match up exactly how many drinks equate to how intoxicated you’ll feel, your blood alcohol concentration (or BAC) gives a pretty good indication of what most people will feel as they ingest escalating amounts of alcohol.

So what does that actually look like?



Alcohol makes us feel increasing pleasure and relaxation as we drink more, while simultaneously hampering both our ability to make decisions and even move capably, which can lead to dangerous consequences.

The actual recommended intake for adults is just two standard drinks a day, which is less than a pint of beer. Realistically, people often drink more than this. So the important thing is to be aware of your limits, plan for how much you intend to drink, eat a meal before you begin drinking, and drink responsibly.

Retrieved from http://theconversation.com/drink-drank-drunk-what-happens-when-we-drink-alcohol-in-four-short-videos-100206

Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function

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imageShahani Noor* and imageErin D. Milligan

Retrieved from https://www.frontiersin.org/articles/10.3389/fimmu.2018.01107/full

In utero alcohol exposure is emerging as a major risk factor for lifelong aberrant neuroimmune function. Fetal alcohol spectrum disorder encompasses a range of behavioral and physiological sequelae that may occur throughout life and includes cognitive developmental disabilities as well as disease susceptibility related to aberrant immune and neuroimmune actions.

Emerging data from clinical studies and findings from animal models support that very low to moderate levels of fetal alcohol exposure may reprogram the developing central nervous system leading to altered neuroimmune and neuroglial signaling during adulthood.

In this review, we will focus on the consequences of low to moderate prenatal alcohol exposure (PAE) on neuroimmune interactions during early life and at different stages of adulthood. Data discussed here will include recent studies suggesting that while abnormal immune function is generally minimal under basal conditions, following pathogenic stimuli or trauma, significant alterations in the neuroimmune axis occur.

Evidence from published reports will be discussed with a focus on observations that PAE may bias later-life peripheral immune responses toward a proinflammatory phenotype. The propensity for proinflammatory responses to challenges in adulthood may ultimately shape neuron–glial-immune processes suspected to underlie various neuropathological outcomes including chronic pain and cognitive impairment.

Click to read full report

FASD Day 2018 Interview #1: Jeff Noble

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Every year on September 9, the international community celebrates FASD Day. September 9 is chosen to represent the 9 months that women should abstain from alcohol consumption while pregnant. This year, in preparation for FASD Day, we have interviewed some amazing people to learn a bit about how their lives have been affected by FASD. They include caregivers, researchers, policy makers, and people who have FASD.

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First up, we have Jeff Noble! After confronting the challenges associated with being a caregiver, he started a company called Noble Initiatives. Noble Initiatives provides online and in person FASD training for caregivers and front-line workers across the country. Jeff has created a community of caregivers in Canada and internationally that provide support and best practices to learn and grow together.

 

 

Can you tell us a bit about what you do?

I run a company called Noble Initiatives. We provide online and in person FASD training for caregivers and front-line workers. I also give keynotes at conferences.

So, part of this is that you’ve created virtual community to support caregivers, what inspired you to create this space?

Having been a caregiver myself, I found it very isolating and lonely. I also understand the power of community. I knew that if I was going through this, there must be others going through it as well. Seeing as FASD is so prevalent, I was right. We have created an online community that is all over the world. The biggest feedback I get is that caregivers get energy and strength from knowing they’re not alone.

How has digital media allowed you to offer support to people across the world? In your experience, what has been the best platform for you to share your messages?

Social media has allowed me to send caregivers daily reminders that we understand how hard their job is and to let them know that they are not alone. It allows the caregiver to receive training on FASD directly from their phone or computer, so they don’t have to spend money on airfare/hotels or secure child care.

What have people benefited from most from your programs?

The major benefit is the renewed energy in helping advocate for their loved ones on the spectrum. They will have brand new ideas and feel recharged and ready to go. They no longer feel like they are bad parents and their kids are successful and can have a positive future. They also make lifelong friends with other caregivers going through the exact same situation and they feel acknowledged and supported.

What is the most important thing for caregivers to remember while caring for their loved ones with FASD?
That nobody is trying to be a jerk on purpose. Their kids want to please them and do well. The problem is no matter how hard they try, sometimes their brain won’t let them.  It’s also important for caregivers to realize that they are not bad parents – it’s a hard job!

Find out more about Jeff and Noble Initiatives here:

Website: FASD Forever

Facebook: FASD Caregiver Success

Twitter: @Jeffjnoble

Training: Caregiver Kick Start!

 

 

CBC: The lonely road to recovery: How isolation can hurt people trying to overcome addictions

Cutting social connections and challenges making new ones can lead people back to using, experts say

Phil Goss is now a peer advocate at Winnipeg’s Main Street Project, the organization where he sought help for a meth and heroin addiction when he was struggling. (Aidan Geary/CBC)

 

Phil Goss’s road to recovery started on the highway, in the passenger seat next to a 23-year-old Manitoba pig farmer who offered him a joint.

Goss was 37 or 38, “hopeless and helpless” and at the end of his rope as he tried to kick a heroin habit he started when he was 15. He was hitchhiking from Vancouver, where he’d been living, back to Toronto, where he’s from, when the pig farmer gave him a ride and suggested he smoke the joint.

“I didn’t want to do that, because I was on the highway and I didn’t have a lot of money and I wanted to keep my wits about me somewhat,” Goss recalls years later, sitting in his cozy, cluttered office at Winnipeg’s Main Street Project.

“And I declined, and the conversation went from there to addiction, alcoholism, blah blah blah.”

Suddenly, the pig farmer was telling Goss about his dad, his alcoholism and how he got help at the Alcoholism Foundation of Manitoba — now the Addictions Foundation of Manitoba.

Then he was driving Goss there, and dropping him off at the front doors. He didn’t have Manitoba health insurance, so staff gave him cab fare to get to Main Street Project — a low-barrier shelter with addictions services where he now works as a peer advocate.

“Luck happened for me,” he says.

With help, Goss stopped using. But without drugs, he had nobody: not his family, who were a province away and estranged besides, and not friends — he didn’t know how to talk to people sober, and all his old friends still used.

“Near the end, I got pretty down. Pretty low,” he says. “I’m sure that if I kept on doing what I was doing, I would be dead.”

Rick Lees, executive director of Main Street Project, says he hopes to foster an increase in social programs that aren’t just structured around therapy, like a women’s spa day spearheaded by a former client earlier this year.(CBC)

 

Goss’s experience isn’t unique. Experts say isolation is a critical barrier to recovery for many with addictions, and some say they want to see more programming to help people deal with it and recovery in general.

“The general society could look at the substance being the problem, but I think often feeling isolated, feeling alone, is such a strong feeling that there could be relapse or a return to old patterns,” says Melissa Piper, the supervisor of the women’s in-house program for the Addictions Foundation of Manitoba.

“Not necessarily the substance being the first reason, but because, as humans, we need attachments, we need social connections, we need relationships.”

‘Constant feeling’ of fear

A long-awaited review of Manitoba’s mental health and addictions services released in May describes a “perfect storm” of poorly co-ordinated, underfunded services in the province that lag behind the rest of the country.

The Virgo report noted that in the past five years, the number of people whose methamphetamine use was noted by emergency room health-care workers rose dramatically, shooting up from about 10 per month in 2013 to 190 per month in 2017.

It called for increased funds for mental health and addictions services, as well as greater crisis supports and collaboration between primary and community-based treatment services.

Goss says he felt those gaps. When he wasn’t using, he had a “constant feeling” of fear, and fear kept him alone.

“You can only be isolated for so long and then you want to get into the action again, and there’s only one way you know how to do it,” he says. “You start drinking or using drugs again.”

For many people who use, the substance they’re using can become a pervasive part of their social groups, Piper says. Trying to quit often means leaving social connections behind.

“We see that in our detox all the time.… Clients will come to detox for their addiction, but they get drawn back to the people outside, right?” says Rick Lees, executive director of Main Street Project.

“They miss their friends.”

Rick Lees, executive director of the Main Street Project, says he wants to see more community-building and mental health groups to help people with addictions. (CBC)

 

And Lees says finding new friends is easier said than done.

“You manage to make the transition out, but now what? How do you create a new community for yourself?” Lees says.

“You’re alienated on both sides: you’re neither a non-user nor a user. You’re a person who’s now in recovery for the rest of your life.”

Michael Ellery, a clinical psychologist who specializes in dealing with addictions, says building new connections is “essential.”

“Connectedness really seems to be the antidote to addiction,” he says.

Filling up the hole

Many treatment programs, such as short-term detox, create isolation intentionally, based on the principle of “changing your playpen, your playmates and your playthings,” Ellery says.

“What that seems to be based on is that it recognizes this need to completely reorganize your social group,” he says. “It can be isolating, at first, because you don’t know how to socialize, necessarily, without your drug of choice.”

Ellery attributes the success of programs such as Alcoholics or Narcotics Anonymous — or non-religious versions like Smart Recovery — not simply to the techniques taught there, but also to the group meeting structure that brings people together.

Goss says he met the woman who turned it around for him at an AA meeting. They later got married, and Goss says his relationship gave him the purpose he needed to leave drugs and alcohol behind for good.

“What are we all looking for? We’re looking to fill up that hole or fix the hole,” he says.

“Basically, it all stems around the same thing, that hole you have to fill up in your heart, somehow.”

‘Hope is a big thing’

To create connectedness, experts say a broad range of community-based resources should be developed, and some of them already exist.

In the past two years, Piper has seen more services along those lines pop up in Winnipeg, including Refuge Recovery — a Buddhism and mindfulness-based program — and Crystal Meth Anonymous, which started last fall. She’s optimistic that momentum will continue.

“I think that developing different community support including aftercare programs and meetings in the community and even counselling and mental health supports are important,” she says.

Melissa Piper, supervisor of the women’s in-house program for the Addictions Foundation of Manitoba, says community support and aftercare programs are key to addressing addictions. (Submitted by the Addictions Foundation of Manitoba)

 

At Main Street Project, Lees says he’s hoping to foster an increase in social programs that aren’t just structured around therapy, like a women’s spa day spearheaded by a former client earlier this year.

But Goss says there are too many gaps in the system as people move through social services, and Ellery says there aren’t enough resources to fill them.

“In general, addiction and mental health treatment and resources across the country are under-resourced. We have a severe shortage of psychiatrists and psychologists. Manitoba in particular has an especially bad shortage of both,” he says.

“There’s just not enough resources for everybody. It can be difficult sometimes to even access medically supervised detox, for instance.”

He’d also like to see the development of more non-religious treatment groups like Smart Recovery, which he helped get off the ground in Manitoba.

For Goss, offering people struggling with substance abuse a chance to have social success is a way to offer them a crucial element in recovery: hope.

“Hope is a big thing,” Goss says.

“[They’re wondering,] ‘OK, so now I’m sober — what am I going to do now?’ Keep your arms around them and then offer them something to do.”

Drinking while breast-feeding may dampen child’s brain development

ResearchKey

(July 30, 2018 by Serena Gordon, Healthday Reporter)—Sorry, new moms, although you’ve already waited at least nine months, it’s not time for a glass of wine just yet: New research suggests it might be best for baby’s brain to wait until you’ve stopped breast-feeding.

That’s because exposure to alcohol in breast milk was linked to a reduction in thinking and reasoning skills when kids were tested at ages 6 and 7.

The effect might not be lasting, however. When the children were retested between 10 and 11 years old, the link was no longer apparent.

The Australian researchers also noted that smoking while breast-feeding didn’t seem to effect youngsters’ thinking and reasoning abilities.

“The more alcohol women drank, or the riskier their drinking patterns—binge drinking—while breast-feeding, then the lower the child’s abstract reasoning ability at age 6 to 7 years,” said study author Louisa Gibson, a doctoral student in neuropsychology at Macquarie University in Sydney.

It’s important to note that while the study found an association, it didn’t prove a cause-and-effect relationship.

However, Gibson said there was no decline in thinking and reasoning skills seen in children of mothers who consumed alcohol but didn’t breast-feed.

“This lack of association in babies who had never been breast-fed suggests that the reduction in [thinking and reasoning] abilities was a direct result of the alcohol in the breast milk, and not because of other social aspects related to drinking,” she explained.

Dr. Michael Grosso, chair of pediatrics at Northwell Health’s Huntington Hospital in Huntington, N.Y., said the findings should still be interpreted cautiously, “as the association between the risk factor and the outcome may be the result of something unmeasured.”

Still, he said, avoiding alcohol while breast-feeding is likely the safest option for babies.

Gibson agreed. “The safest option is to abstain from alcohol completely during both pregnancy and breast-feeding. This study suggests that there is no safe level of alcohol consumption, with every extra drink causing a little bit more harm,” she said.

Gibson pointed out that while the study didn’t find an effect from tobacco use while breast-feeding, she said it might just be that this study wasn’t able to capture those effects.

She said she suspects smoking probably has some detrimental effects during breast-feeding, as there’s evidence that it does in pregnancy. She also suggests abstaining from smoking while breast-feeding.

The study included more than 5,000 babies and mothers from Australia. They were recruited in 2004. The researchers conducted assessments of the children every two years.

Gibson said there are a number of factors that could explain how alcohol while breast-feeding could affect a child’s reasoning skills many years later.

One may be that alcohol may directly damage brain cells. Another is that alcohol may somehow change the nutritional content of breast milk, causing an early nutritional deficiency. Another is that alcohol in breast milkmay affect the feeding and sleeping patterns of a baby, which could affect the infant’s environmental stimulation, Gibson suggested.

Dr. Ron Marino, associate chair of pediatrics at NYU Winthrop Hospital in Mineola, N.Y., said that infancy is a time when the brain’s synapses—the connections between brain nerve cells—are forming at a remarkable rate.

“The human brain is an extremely active organ in both prenatal and early postnatal life,” he said.

Previous studies have also shown that exposure to alcohol or tobacco smoke during this time can have a negative impact, he added.

“The take-home message is quite clear: Do not smoke and avoid alcohol while breast-feeding,” Marino said.

The study was published online July 30 in the journal Pediatrics.

Explore further: Mom’s marijuana winds up in breast milk

More information: Louisa Gibson, M.S., doctoral student, Macquarie University, Sydney, Australia; Michael Grosso, M.D., chair, pediatrics, Northwell Health Huntington Hospital, Huntington, N.Y.; Ronald Marino, D.O., associate chair, pediatrics, NYU Winthrop Hospital, Mineola, N.Y.; July 30, 2018, Pediatrics, online

The U.S. Centers for Disease Control and Prevention has more about alcohol and breast-feeding.
Journal reference: Pediatrics

Retrieved from https://medicalxpress.com/news/2018-07-breast-feeding-dampen-child-brain.html

Indigenous elder mentorship program leads to healthier babies in Wetaskiwin area

Elder Margaret Montour was an important support for Lacey Hoffman when she was pregnant with her son Aziel. (CBC)

Lacey Hoffman was nervous about attending her prenatal appointments by herself. As a teen expecting her first baby, she worried that others were judging her.

“It wasn’t fun being the youngest one,” recalled Hoffman. “I felt like people were looking at me, thinking that was sad or something like that.”

Now 18, Hoffman said she had the support of her mother and sister but they weren’t always able to join her for appointments at the Wetaskiwin Primary Care Network.

On those days, she had support from Elder Margaret Montour. 

“It was nice to have someone to talk to, to not be alone,” Hoffman told CBC News. 

Montour has been offering support and companionship to pregnant women since 2016 as part of The Elder’s Mentoring Program, a community-based program organized through a partnership between the Maskwacis community and the University of Alberta. 

“You have to be sure that a mother is attending her appointments,” explained Montour, who is from the Samson Cree Nation in Maskwacis, about 20 kilometres south of Wetaskiwin.

“That’s one way that I encourage them when I sit down to talk with them one-on-one.”

Connecting through culture

Elder Muriel Lee, from the Ermineskin Cree Nation in Maskwacis, joined the program in 2015 when it was first established as a pilot project.

“I welcomed the opportunity to contribute to the life of a mother that’s expecting, that is going to bring life into this world,” said Lee. “I wanted to be a part of that.”

Lee connects with pregnant women by sharing teachings and stories from her Cree culture.

“I tell them stories that were told to me about who the child is, about raising that child in our way,” she said. 

Lacey Hoffman’s son Aziel is wrapped up in a moss bag, a traditional Indigenous baby carrier that supports the spine. (Lacey Hoffman)

 

Lee and Montour both say that taking part in the program has been a fulfilling experience.

“It makes me feel good, being acknowledged,” said Montour. “I enjoy it.”

The elders offer to teach mothers about moss bags, a traditional Indigenous baby carrier that supports the baby’s spine and legs while keeping the child snugly wrapped.

It’s a gesture that Hoffman appreciated, since she was looking for a moss bag herself. It’s a tradition she wants to share with her young son Aziel.

“That moss bag was honestly a lifesaver for getting him to sleep at night,” she said with a laugh.

Hoffman doesn’t have her legal Indigenous status, but wants her son to grow up surrounded by his culture. 

“I just want him to be aware of it.”

Building trust 

The Elder’s Mentoring Program is offered on Tuesdays and Thursdays, when obstetrician Mohammad Badawi sees his prenatal patients.

He said the elders help foster better communication, which in turn leads to a greater trust between the medical team and the patients. 

“If we can’t get information, or we can’t deliver the care that we are hoping to deliver, we find that the elder is the avenue to get to that point,” said Badawi.

Badawi has noticed that his patients are more engaged in their prenatal care since the program has been introduced.

“We saw more compliance, more followup and more adherence to health care and being seen in the prenatal course,” he said.  

The elders have also taught the staff to be more understanding and culturally sensitive, said Badawi.

Elders Margaret Montour, left, and Muriel Lee demonstrate how to wrap up a baby in a traditional moss bag.(CBC)

Research component 

The program was developed over several years of community engagement, led by U of A associate researcher Richard Oster.

“Following that course, believing that if we were to build those relationships, that the program would thrive from that, I think that’s been the key to our success,” he said.

Oster’s research is qualitative and looks at how culturally sensitive care leads to healthier outcomes in pregnancy and after birth.

The feedback has been positive, said Oster. 

“This program offers a platform for enhanced support, which is exactly what we intended,” he said. 

The program’s current funding, through Alberta Innovates Health Solutions (AIHS), will run out at the end of the year.

Oster is looking for other financing options to keep the program going, including the possibility of receiving funds from the PCN clinic. 

For Hoffman, the program’s value is obvious. 

“It’s a good idea, not just for Indigenous women but anyone who is alone in their pregnancy,” said Hoffman. “It’s not fun having no support, it’s kind of lonely.”

Retrieved from https://www.cbc.ca/news/canada/edmonton/indigenous-elder-mentorship-program-leads-to-healthier-babies-in-wetaskiwin-area-1.4759996

 

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