When it comes to increasing positive outcomes for families, research shows that the following five strengths play a major role in engaging parents and building the best outcomes for children.
Jade Elliott spoke with Trisha Reynolds, Child Abuse & Neglect Prevention Services Administrator, Division of Child and Family Services, about what parents can do.
Parental Resilience: Resilience is the ability to bounce back in difficult times. It means having good coping skills and self-care strategies.
Social Connection: Parents who have more support are more responsive to their kids, have better overall moods, and experience less depression, anxiety and anger.
Knowledge of Parenting & Child Development: There is always room to improve our knowledge and parenting skills. No parent knows everything about parenting children.
Social & Emotional Competence of Children: Children’s social skills and emotional skills are just as important as academic skills.
Concrete Supports: Services that can assist with things like housing, child care, and medical care will help your family function well, especially in difficult times like we are facing right now. Knowing where to find help and taking the step to ask for it will make you and your family stronger.
Links to websites or resources:
Free Community Resources Available for Pregnant Women and Families with Children Ages 0-11 (All services below are provided at no cost to families)
Utah Association of Family Support Centers: Family Support Centers strengthen Utah families by supporting parents, protecting children, and preserving families. Seventeen locations across Utah provide 24-hour crisis and respite nursery, information and referral services, and parenting and youth education programs. https://utahfamilies.org/
The Office of Home Visiting: The Office of Home Visiting works with local agencies to provide home visits to pregnant women and young families who would like to know more about being parents. Home Visitors are well-trained and can provide information about breastfeeding, toilet training, nutrition, home safety, child development and much more. https://homevisiting.utah.gov/home
Help Me Grow Utah: Help Me Grow Utah is an information and referral helpline that helps parents, physicians and providers find ways to help children grow and develop. Get help tracking your child’s development for every stage of growth from pregnancy and to age eight. https://www.helpmegrowutah.org/, (801) 691-5322
Prevent Child Abuse Utah: Prevent Child Abuse Utah provides home visiting in Weber, Davis, and Box Elder counties. Parent Educators provide support, education, and fun, connective activities for families with young children. Our statewide education team offers diverse trainings on Protective Factors, Digital Safety, Bullying, and Child Sex Trafficking. We are available for in-person or virtual trainings and offer free online courses for the community at pcautah.org.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
After a woman has had a baby and is recovering at home, she might be concerned about her abdominal muscles and if they’ll return somewhat to their pre-pregnancy shape and how and when to return to exercising those abs.
Jade Elliott spoke with Janelle Hayes, a physical therapist with Intermountain Healthcare, to help new moms be patient with themselves, set realistic expectations and know the exercise do’s and don’ts for getting your abdominals back in shape safely.
After a vaginal delivery
First, it’s important to talk a little about postpartum recovery in general. After childbirth, gradually returning to exercise is the best strategy. For regular vaginal births, doctors and midwives who deliver babies, typically recommend that for the initial two weeks after childbirth, postpartum women limit their exercise to gentle walking as they feel up to it.
As a general guide, OB providers and midwives typically recommend women pay attention to their postpartum bleeding and not over-exert. And from two to six weeks postpartum, women can slowly integrate exercise like longer walks and gentle stretching or yoga.
“During pregnancy and childbirth, your uterus, abdominals, pelvic floor muscles and vaginal tissues have to stretch out to accommodate the baby. It takes time for a woman’s body and those various muscles to recover. An incremental increase in exercise over the first six weeks postpartum is preferred to being sedentary for six weeks and then abruptly beginning exercise,” said Janelle Hayes, DPT a physical therapist with Intermountain Healthcare who has helped treat women with postpartum conditions.
“Even if you exercised regularly before getting pregnant and during pregnancy, you should take a gradual approach to returning to exercise postpartum. For women who exercise frequently, it may take some mental discipline, to take it back a notch those first few weeks,” she added.
Every woman’s body and medical conditions are different, and every childbirth experience is unique. Be sure to go to the recommended postpartum check-ups. Typically, an OB/Gyn doctor or midwife will suggest a six-week postpartum visit and do an exam to assess healing. This is a great time to ask questions about resuming physical activities.
After a Caesarean delivery
OB/Gyn providers say women who deliver via Caesarean section need to keep in mind, it’s a major abdominal surgery that involves an incision with either staples or stitches. And they typically recommend no heavy lifting of over 20 pounds for six weeks. Women with a C-section need to take care of their incision site and call their provider if they have signs and symptoms of infection, including foul odor at site, excess bleeding, severe abdominal pain and fever.
Start with breathing exercises
Until a woman’s provider gives the ok for a full return to exercise, Hayes said simple breathing exercises are a good precursor to returning to exercise at their previous level.
“Sometimes pregnancy breathing habits – such as shallow breathing – stick around postpartum. Remember to breathe from the diaphragm, which helps to activate the deep abdominals and the pelvic floor muscles. Breathe from the belly, not the chest. When you breathe deeply, you can feel and see the lower part of your rib cage move when you breathe in and out,” she added.
Diastasis Recti
She said another condition to be aware of is the overstretching of the connective tissue that hold the abdominal muscles together or separation of the abdominals known as Diastasis Recti, that persists longer than 12 weeks postpartum.
“Diastasis Recti occurs in most pregnant women by the end of the third trimester. That’s the body’s normal way of accommodating the growing uterus and baby. At six weeks postpartum about 60 percent of women still have some degree of abdominal separation. Sometimes those abdominal muscles can take months or a year or longer to return to normal,” said Hayes.
Hayes said there are many factors that affect whether or not you have Diastasis Recti that persists, such as: genetics, pre-pregnancy level of strength and fitness, and what movement habits you have during pregnancy. Giving birth to a baby with a large birth weight may be a factor as well.
Women should ask their provider or a physical therapist to examine their abdominals if they notice a bulge form down the midline of the abdomen when they get up out of bed or change positions, or if they notice a gap in the middle of their abdomen that they can sink their fingers into.
For diastasis recti that doesn’t resolve on its own over time or with regular return to exercise, visit a physical therapist with experience treating postpartum women for an assessment and recommendations to see if therapy could help.
As far as what abdominal exercise to start with postpartum, there’s not a one-type fits all answer.
“If you are doing an exercise and you see or feel a bulging or a gap in your abdominals, you may need to modify the exercise by breathing deeply, moving through a smaller range of motion, or using less resistance,” said Hayes.
“Women should continue to monitor their abdominals for progress, and gradually progress the difficulty of the exercises based on how they’re feeling and how well they are able to control the abdominal muscles,” she added.
When to see a physical therapist
Hayes said women might want to see a physical therapist postpartum if they experience persisting diastasis recti, pelvic pain, back pain, feel weakness in the core muscles, or notice weakness in the pelvic floor muscles, such as urinary stress incontinence when they sneeze, cough, jump, run or do sudden movement.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
The Division of Services for People with Disabilities provides a wide range of services to help those with disabilities participate more fully in their communities and lead self-determined lives.
Jade Elliott spoke with Jamie Douglas, Department of Human Services, about how parents of children with disabilities can apply for disability services.
The Community Supports Waiver is available from birth throughout your life. The types of services that can be provided through this waiver include:
Behavior consultation: Behavior supports address serious behavior problems for people with disabilities. By focusing on sound principles of applied behavior analysis and on positive behavior supports, these services provide personalized behavior consultation to families and staff who support people with a range of serious to the most complex behavior problems that a person may exhibit.
Chore services: Chore services help maintain a clean, sanitary, and safe living environment for persons with disabilities who are unable to complete chore activities on their own
Companion services and personal assistance
Day supports: This is a non-medical care, supervision, and socialization service for functionally impaired adults. Companions assist or supervise such tasks as meal preparation, laundry, and shopping, but do not perform these services as discrete services.
Environmental adaptations: Environmental Adaptation services allow families to make physical alterations and adaptations to their home as needed to ensure the health and welfare of the individual, or enable the individual to function with greater independence in the home.
Financial management services: Financial Management Services are provided by a Fiscal Agent in connection with the Self-Administered Services Model. A Fiscal Agent is a company contracted with DSPD to handle employee payroll, including state and federal tax deductions. The fiscal agent will issue paychecks to employees who are delivering services based on approved timesheets
Non-medical transportation: DSPD provides a number of transportation options to help a person gain access to waiver and other community services, activities and resources. These may come in the form of UTA passes or paratransit to name a few and can often be modified to meet a person’s individual needs.
Respite care: Respite care is care provided by a trained person that temporarily relieves parents or caregivers from the day-to-day care they provide to the individual with disabilities. It can be provided in the family’s home, in the home of the respite provider or in a specialized facility, depending on the needs and preferences of the family or individual
Supported employment: Supported Employment includes job development, placement, intensive on-the-job training, and supervision by a job coach. It is intended for those people who may not be able to work in the community without some form of support, but does not rise to the same level of supervision as Day Services.
Supported living: Supported living provides support, supervision, socialization, personal care, training and assistance in order to help people live as independently as possible. This service is often for those who live alone in their own homes, with roommates, or a spouse and includes help with various activities of daily living necessary for an individual to maintain a self-directed life within the community.
And more.
Waitlist
The most important thing for parents to know is to get on the waitlist as soon as possible. The waitlist is NOT first-come, first served—it’s based on need. However, you can’t just call and get on the waitlist. You have to complete your intake packet and be approved before you will be added to the waitlist.
Important things to know about the waitlist:
The waitlist is based on need. It’s not first-come, first served. People are placed on the waitlist according to a needs assessment— those with the most need for services are given priority, no matter when they apply.
The quicker you apply for one of these waivers, the better.
Getting on the waiting list is the first, most important step to be able to get these services.
If your application is approved, you’ll be placed on the waitlist.
Eligibility – Who can apply?
The Community Supports Waiver provides services for people with an intellectual or developmental disability or a related condition, like Autism, Cerebral Palsy, Down Syndrome, and Fetal Alcohol Syndrome.
To qualify for a Community Supports Waiver, you must have a medical diagnosis from a medical doctor, or an MD.
If your child has a diagnosis of Intellectual Disability (ID) or Autism Spectrum Disorder (ASD), the diagnosis must show the condition began during the developmental period. You must have testing to support the diagnosis or a diagnosis from a medical professional with a PhD or PsyD.
Have at least 3 out of 6 functional limitations, or things that make it harder to live a full life:
Self Care : An applicant who requires assistance, training, and/or supervision with eating, dressing, grooming, bathing or toileting.
Expressive or receptive language: An applicant who lacks functional communication skills , requires the use of assistive devices to communicate, or does not demonstrate an understanding of requests or is unable to follow two-step instructions.
Learning: An applicant who has a valid diagnosis of an Intellectual Disability based on the criteria found in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Mobility: An applicant with mobility impairment who requires the use of an assistive device to be mobile and who cannot physically self-evacuate from a building during an emergency without the device.
Self-Direction: An applicant who is significantly at risk in making age appropriate decisions. A person who is a significant danger to self or others without supervision.
Capacity for Independent Living: An applicant who is unable to locate and use a telephone, cross streets safely, or understand that it is not safe to accept rides, food or money from strangers.
• Your child may also be eligible if he or she has a medical diagnosis with an additional condition that would result in a developmental delay.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
A woman’s body goes through all kinds of physical changes during pregnancy and childbirth. Some of those changes are to the pelvic floor muscles, which support the increasing size and weight of the baby during pregnancy. After pregnancy and childbirth, it can take some time for those muscles to recover and get back in shape.
Jade Elliott spoke with Jessica Woodman, a physical therapist with Intermountain Healthcare who specializes in pelvic floor physical therapy, about what those pelvic floor muscles do and some common post-pregnancy symptoms and problems that involve the pelvic floor muscles, and how physical therapy can help.
Where the pelvic floor muscles are and what they do
The pelvic floor muscles are like a “hammock” on the inside of the pelvis. They run from the pubic bone in front back to the tailbone. There are three layers of the pelvic floor, which provides support for internal organs, controls function for your openings, and helps with sexual function.
“Before pregnancy, those without pelvic floor symptoms may not specifically pay much attention to this region. After pregnancy, it can be very common for several different pelvic floor symptoms to begin. This can be due to a possible weakness, or tightness, of the pelvic floor muscles, interfering with proper function,” said Jessica Woodman, a physical therapist with Intermountain Healthcare who specializes in pelvic floor physical therapy.
Pelvic floor conditions are common
National studies show between one fourth to one-third of U.S. women have a pelvic floor condition.
According to Woodman, pelvic floor symptoms can be especially common for women who have given birth more than once or to twins or multiples. Utah’s high birthrate means many Utah women are in this category.
Common symptoms of pelvic floor muscles not functioning properly
Urinary stress incontinence: leaking urine, when you cough, sneeze or do exercise that involves running or sudden movement.
Urinary urge incontinence: leaking urine when trying to get to the bathroom
Increased urinary frequency, or difficulty emptying bladder
Pain in the pelvis, abdomen, low back or tailbone
Pain with intercourse or sexual dysfunction
Constipation or fecal leakage
Pelvic organ prolapse: when one or more internal organs is not supported well
“Stress incontinence, or leaking urine when you cough, sneeze or exercise can occur after childbirth. It’s common, but it’s very important for women to know this can be treated. There are many women out there dealing with urinary leakage, not knowing they can get help and see improvement. I want women who have these symptoms to know they don’t have to accept the status quo or just live with these symptoms forever.”
“It’s also not uncommon for women to experience pelvic pain, which can include pain with intercourse. This can stem from tightness of the pelvic floor, which can be treated in a specific way. Pelvic floor physical therapy can be a truly life-changing intervention for many women,” added Woodman.
In addition to pregnancy and childbirth, other factors that contribute to pelvic floor conditions include aging, obesity, tailbone injuries, chronic coughing, chronic constipation, hip weaknesses, and pelvic/abdominal surgery. So even if a woman hasn’t had a baby, she could still have some pelvic floor issues.
Woodman said women with these symptoms can talk to their doctor or see a physical therapist specializing in post-pregnancy issues for an assessment. Pelvic floor symptoms can often be improved with physical therapy, especially if treated early on, but sometimes surgery may be recommended. It’s a good idea to start with the least invasive option of physical therapy first.
Kegels exercises may help some conditions if done properly
Many women have heard of doing Kegel exercises to help strengthen pelvic floor muscles. Kegel exercises are the repeated tightening and releasing of the pelvic floor muscles for a few seconds. Pelvic floor muscles are the same muscles used to stop urination midstream. Kegels can be done while standing, sitting or lying down. They were developed in the 1940’s by Dr. Arnold Kegel.
“Pelvic floor symptoms may be due to weakness or tightness of those muscles. Kegels can help with weakness, but may exacerbate the problem in patients with tightness. Kegels sound kind of simple, but there’s a right way to do them and a specialized therapist can help you know how to do them properly,” said Woodman.
“It’s not just squeezing those muscles, but also involves breathing and movement. Complete pelvic floor therapy involves not just Kegels, but working to stabilize the whole pelvis and help restore normalized function,” she added.
Therapists use different visualization techniques to help patients do pelvic floor exercises correctly. Each patient is unique, so different techniques work for different patients. Therapists can give patients a treatment plan for the type and frequency of exercises to do at home.
When to see a pelvic floor P.T.
You can see a therapist during pregnancy or postpartum. There are delivery positions that protect the pelvic floor. And you want to make sure you’re breathing when exerting. There are some foundation deep core exercises you can start while pregnant.
Postpartum visits are best after a woman’s six-week appointment with her doctor or midwife to ensure healing has gone well and there are no other concerns.
What to expect at your first appointment
Your first appointment will begin with a thorough history of a patient’s symptoms and personal goals. If the patient is comfortable, a pelvic floor muscle assessment can be performed with a pelvic exam in a closed private room. This is the best way to assess muscle weakness or muscle tightness, coordination or pain, so that treatment can be customized. Pelvic floor physical therapy can still be very beneficial without an exam. Physical therapists can also help with whole-body considerations to help patients learn the best practices and exercises to improve their physical conditions.
Pelvic floor treatments
Therapy and treatments may include strengthening and coordination, relaxation exercises and manual techniques varying from: scar mobilization, to joint mobilization, to muscle release.
Pelvic floor physical therapy is effective
According to medical studies, pelvic floor muscle training combined with bladder training effectively resolved urinary incontinence in women.
Studies also show pelvic floor therapy can also help reduce pelvic pain.
Finding a pelvic floor physical therapist
Intermountain has 12 pelvic floor physical therapy locations across Utah. For more information visit intermountainhealthcare.org to find a physical therapy location close to you and ask for a pelvic floor physical therapist.
The Orthopedic Specialty Hospital in Murray, Utah also offers online Pilates classes with a focus on pelvic floor muscles, which teaches control, strength and relaxation.
Classes are held twice weekly with daytime or evening options. Cost is $40 for one month of eight classes. Call TOSH at 801-314-2210 to register.
There are national websites where you can search for a registered pelvic floor physical therapist by zip code such as Pelvic rehab.com.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
Most people feel comfortable talking about health topics like nutrition and physical activity. They’re part of our everyday conversations. Since talking about physical health is such a normal part of our conversations, we’re also usually comfortable talking about times we’re just not our best or are struggling in these areas. We do lots of things to make sure we and those we love are physically healthy.
Jade Elliott spoke with Brook Dorff, MA, CHES Maternal Mental Health Specialist at Utah Department of Health, about what you can do to improve your mental health on this episode of the Baby Your Baby Podcast.
We support those around us in their efforts to make time to focus on their health every day. We encourage those we love to get help if they need extra support or can’t seem to be their best on their own. We cheer people on when they get help from a nutritionist, hire a personal trainer, find a workout buddy, or join a support group, so they can get healthier and feel better. However, mental health isn’t part of our normal, everyday conversations like physical health is.
Why is that?
We know our mental health is every bit as important to our overall health and well-being as our physical health. Throughout the pandemic, mental health issues have been all over the news and social media. However, many people still have a hard time talking about mental health issues because there is still a lot of stigma surrounding mental health conditions or mental illness. We often wait until something is really bad to talk about our mental health, instead of talking about it at the first sign we’re struggling. Talking about mental health like we do physical health, as just another part of our overall health and well-being, can make it easier to talk about.
How many Utah parents are affected by mental health conditions?
Data from the 2020 Pregnancy Risk Assessment Monitoring Survey (PRAMS) show almost half of Utah parents with new babies experienced mental health conditions (like depression or anxiety) before, during, or after pregnancy. Utah PRAMS data also show the number of people who experienced anxiety and depression before and during pregnancy increased in 2020.
When people think about maternal mental health, or mental health conditions that affect women during pregnancy or after they’ve had their baby (postpartum), the first thing that comes to mind is usually postpartum depression. However, it’s important for parents to know they can experience other mental illnesses during the entire perinatal period, which is from the time you get pregnant up until a year after you give birth. Some examples of other mental health conditions parents can experience during the perinatal period are: depression, anxiety, OCD, bipolar disorder, post-traumatic stress disorder (PTSD), and psychosis.
What can you do if your mental health is suffering?
1. Know the signs.
We are have been living in a pandemic for almost two full years. Add on the fatigue and seasonal blues that often set in during the winter months, and many parents are left wondering if what they are experiencing is just “normal” burnout, or a mental illness. If you are wondering if you should seek help…you probably should. Knowing the signs of mental illness can help you decide if you should seek help or not. Signs of mental health issues include, but are not limited to:
Sleeping too much or too little
Eating too much or too little
Not enjoying the things you used to enjoy
Body pains
Anger
Brain fog
Heart palpitations
Avoiding loved ones
Feeling overwhelmed, even with simple tasks
2. Know what works.
Several strategies and treatments have been shown to improve mental illness during pregnancy and postpartum. Some of these include:
Therapy
Medication
Support groups
Getting enough sleep (at least four hours in a row)
Getting 10 minutes of movement (like a walk)
Proper nutrition
Drinking enough water
Taking a prenatal vitamins during pregnancy and for an entire year after you give birth
Talk to your doctor or medical professional about what would work best for you. It’s often a combination of strategies and treatments. For more information on what’s known to help, visit our website at: https://mihp.utah.gov/maternal-mental-health.
This is a searchable directory that includes many types of providers throughout the state. Results can be narrowed down by insurance type, location, specialty, and whether or not providers can accommodate virtual visits.
Additional education, information, links, and daily reminders that parents are doing better than they know can be found on our social media channels.
What is the most important thing for parents to remember if they are suffering with mental illness?
Experiencing mental illness during pregnancy and postpartum can feel overwhelming. We want parents to remember to reach out. You don’t need to suffer alone.
Our Instagram page is filled with information to help you recognize the signs of mental illness during the perinatal period.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
Gestational diabetes is a type of diabetes that happens during pregnancy. Like other kinds of diabetes, gestational diabetes affects how the body processes glucose or sugar, causing glucose levels to be higher than they should be.
Jade Elliott sits down with Emily Hart Hayes, a Certified Nurse Midwife with Intermountain Healthcare, on this episode of the Baby Your Baby Podcast. Together they discuss how to prevent gestational diabetes and how to manage it.
How common is gestational diabetes?
According to the Centers for Disease Control, between 2 and 10 percent of pregnancies are affected by gestational diabetes.
Why does it happen during pregnancy?
Pregnancy hormones can make it harder for insulin to move glucose from your blood into other cells in your body.
Is there any new research about gestational diabetes? What causes it?
There is some new research on the different causes of gestational diabetes – one recent study looked at the cause being in the pancreas, where insulin is made, versus at the level of the cells in the body and how they’re able to use that insulin. Currently, people with diabetes are treated similarly, but in the future, we may have more information about how to best treat pregnant women based on where the source of the disease originates.
How can diet and exercise help you prevent or manage gestational diabetes?
We know gestational diabetes is caused by the body’s inability to process glucose normally. Maintaining a healthy weight, eating a balanced diet low in sugar, and getting regular exercise all help the body keep blood sugar under control. Exercise is especially important because it helps the body be more sensitive to insulin (the hormone that allows cells to use blood sugar for energy).
Is gestational diabetes routinely tested for during pregnancy? When and how?
Yes, most women will be tested for gestational diabetes. Typically, we test for this between 24- 28 weeks gestation (at the end of the 2nd trimester or beginning of the 3rd trimester). This usually involves drinking a sugary drink with a set amount of glucose in it, then measuring the blood glucose level an hour later to see how the body is able to process that sugar. For women who have risk factors, they may be tested early in pregnancy during the 1st trimester.
What happens if the screening test comes back positive? Does that mean you have gestational diabetes?
A longer, more comprehensive test is recommended to determine if you have gestational diabetes.
What are the warning signs for gestational diabetes?
Most people with gestational diabetes don’t have any symptoms, which is why it’s so important to test for this during routine pregnancy care.
What are the risk factors?
Being overweight or obese
Family history of type 2 diabetes
Have previously given birth to a baby who weighed more than nine pounds
Have had gestational diabetes in a previous pregnancy
Women who are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander
If a pregnant woman doesn’t manage her gestational diabetes what can happen?
Increased chance of preeclampsia, a condition that causes high blood pressure. If it becomes severe it can be life-threatening for mother and baby.
Increased chance of needing a Caesarean delivery
Higher risk of developing regular diabetes
If you have gestational diabetes are you more likely to develop regular diabetes later?
Women who have gestational diabetes have about a 50 percent chance of developing Type 2 diabetes later in life. That’s one reason why it’s important to follow up with your midwife or doctor after your baby is born to check for diabetes, and to get regular check-ups in the years after you’ve had your baby.
The good news is a healthy diet, regular exercise, and weight loss can help reduce the chances of developing diabetes later in life. Sometimes people are able to make lifestyle changes when they learn they have gestational diabetes during pregnancy which can help them stay healthy later in life.
What is the effect on the baby if you have gestational diabetes?
These babies are at increased risk of preterm delivery, and can experience low blood sugar after they are born.
Uncontrolled diabetes can even increase the chance of stillbirth, so it’s really important to know about it so we can manage it and prevent these things from happening.
Babies of women with gestational diabetes are at risk for being larger than normal, greater than nine pounds, which can make birth more difficult or increase the chances a Cesarean section is needed.
These babies have a higher chance of developing Type 2 diabetes themselves later in life.
Women considering pregnancy can help start the pregnancy out as healthy as possible by eating healthy and exercising to help reduce the chances of developing this disease and give their baby the best possible start in life. For women who have a body mass index in the obese or overweight category, they may reduce their risk of diabetes by losing weight prior to pregnancy.
If you have diabetes or gestational diabetes, it’s important to go to your prenatal visits so your provider can help you know how to best manage this condition and improve your and your baby’s outcome.
For more information on gestational diabetes, click here.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
Pre-term births can happen to any expectant mother. Doctors say right now, they do not know all of the causes of pre-term birth, but there are some risk factors that can increase the chance of one.
Jade Elliott sat down with Sean Esplin, MD, Maternal Fetal Medicine Specialist, Intermountain Healthcare, to discuss pre-term birth, the causes and how technology is helping doctors learn more about it.
Common causes or risk factors that increase the chance of pre-term birth:
Infection is most common. There are different types of infections and it depends on how the body responds to that infection.
Smoking or substance abuse during pregnancy
Short time between pregnancies
Expecting multiples, twins, triplets, etc. This is becoming more common. Identical twins who share a placenta are especially risky. 50 percent of twins come early.
Abnormal vaginal bleeding
Abnormal shape of the uterus or a cervix that is short or weak.
Maternal and fetal stress
What kinds of symptoms of preterm labor should a woman call her doctor about?
Call your obstetrician or other health care professional right away if you notice any of these signs or symptoms:
Change in type of vaginal discharge (watery, mucus, or bloody)
Increase in amount of discharge
Pelvic or lower abdominal pressure
Constant low, dull backache
Mild abdominal cramps, with or without diarrhea
Regular or frequent contractions or uterine tightening, often painless
Ruptured membranes (your water breaks with a gush or a trickle of fluid)
For more information on symptoms and risk factors, click here.
Why is it so difficult to prevent pre-term birth?
Of every 100 women, 10 percent will deliver pre-term. Doctors don’t know which 10 percent. When they have a heads up it’s easier to prevent. There’s a 30-40 percent recurrence rate if a woman has previously had a pre-term birth. In most cases doctors have no prior knowledge that a woman will have pre-term labor or deliver prematurely. Sometimes they can do surgery to stitch the cervix together if it’s opened prematurely. At 20 weeks gestation, it’s standard practice to look at the cervix in an ultrasound. Sometimes doctors insert a pessary device that helps holds the cervix closed. Sometimes doctors do everything we can, but we can’t stop the labor.
Doctors at Intermountain Healthcare are changing their focus to actively identify those at risk for preterm birth
They are looking at genetics. They are working to identify women who are at high risk demographically. Checking up on women and giving them reminders about taking care of themselves and symptoms to watch for can help.
What is the Prevent Preterm Birth study that started in May of 2018? How long has it been going and when will you have results?
Intermountain Healthcare is just finishing the study. The last babies were born in June and will leave the hospital soon. Doctors will have results in about two months. The study involved 1200 women. There are some blood markers of preterm birth we’re identifying.
Intermountain is working in partnership with U of U. It involves a new Mom to Be Network of 10,000 women in U.S. at eight sites.
What are the different ways Intermountain is using technology to help prevent pre-term birth?
Intermountain is using an app that sends nudges or reminders to pregnant moms that helps them follow through to get pre-natal care and take care of themselves while they’re pregnant
During the study the app gives pregnant women reminders about what they can do at home and to remind them to go to their prenatal visits and seek care when they have certain symptoms. The app uses Nudge Theory.
What is nudge theory and why does it work especially well with expectant mothers?
The idea behind Nudge Theory is basically that when people are gently reminded and given positive reinforcement they’re more likely to follow through with good behaviors. Pregnant women are motivated. They want the best outcome for the baby. People want to stop smoking. Being pregnant gives them a reason. Pregnancy is a temporary condition, they’re more likely to succeed at doing the recommended behaviors short term.
How does the app work?
The App is live, so patients have access to a caregiver right when they have symptoms. The app was only available to women in the study. It was through Care Centra, My MoBe. It includes a 30 question survey that assesses their strengths and motivations, healthcare literacy, how tech savvy they are and their physical activities. The app then tailors the nudges to be something they respond to. Knowledge is power. The app provides them with more access to ask questions. The purpose of the app is to allow the physician to motivate people to do specific things. Doctors then give them more information about why those behaviors are important.
There’s also a postpartum part of the app that we’re unrolling. It provides reminders about breastfeeding, contraception, depression screening etc.
What other ways is Intermountain using technology?
Intermountain is using artificial intelligence and algorithms to prevent preterm birth
Intermountain is using machine learning and AI driven “nudges” sent directly to patients. The solution generates a personalized motivational/behavior map (called a MoBE map) for each patient, helping their care team to know when and how to work with that patient to help them do the behaviors that will improve their health.
This information, coupled with a personalized care plan, connects the patients to their care team 24/7 through personalized nudges and communication delivered according to the patient’s preference (calls, texts, emails, video visits, mobile phone app, etc.).
Preliminary results:
In Intermountain’ first efforts with this program, 124 women were identified as being at high risk for a pre-term birth through a patented genomic lab test. Each of these women were invited to participate in the program. 93 percent engaged in the program and 89 percent completed the program. Only one woman out of this group delivered her baby prior to week 37 of her pregnancy. All other deliveries were full term.
They’re studying and using genetics to learn how to predict preterm birth through Intermountain’s Heredigene population study. They want pregnant women and their partners to participate. Can they find the gene? Researchers wants 30,000 samples to have enough data to make predictions to prevent pre-term birth.
Intermountain has a partnership with Sera diagnostics to use a patented genetic lab test to predict risk of preterm birth.
There may be certain genes some women carry that mean they’re more likely to deliver prematurely. The test analyzes protein in the blood. There are some markers associated with pre-term birth, like having a shorter cervix.
Intermountain is using Instagram to reach out to expectant moms and see what kind of nudges moms will respond positively to. The Instagram account @imamom2be, is helping to bring together moms and expectant moms.
The feedback on Instagram helps us determine what kind of nudges will work best. Having weekly contact with patients helps. The patients have a sense that they’re supported. Their questions are answered. The demographic most benefited by high intensity care management are those that don’t have strong social support. They can share symptoms, connection, and a community feeling when they realize other people have the same concerns.
How is Intermountain leading the way in this field?
Intermountain is using technology and genetics to help predict preterm birth. Intermountain is constantly involved in monitoring outcomes and providing better care. Over 25 years they’ve been part of research networks and asking the most important questions. The volunteer ethic here is unique. People are interested in family history and genetics. 85-90 percent of people want to help. They want to participate and help serve even if it’s not directly benefiting them.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
When you have young kids, sleep is an essential part of your survival as a parent. When your kids sleep well, you sleep well. Thankfully, a bedtime routine can help your kids sleep better. Instead of letting your kids fall asleep whenever and wherever, a bedtime routine can bring structure and security to your child’s day. You and your child will get more sleep when they feel safe and secure.
Jade Elliott sat down with pediatrician Tyson Tidwell, DO, Intermountain Healthcare, on this episode of the Baby Your Baby Podcast to discuss the dos and don’ts of sleep routines.
Bedtime routines with your child can help everyone sleep better
So how can you make it happen? A bedtime routine doesn’t have to be difficult or drawn out. A routine is just something that you do every time your child goes to bed. Your child’s bedtime routine will help them form positive sleep associations. Here are some tips for forming a positive bedtime routine for your child.
Recommended sleep guidelines for babies and children by age
1 to 4 weeks old- Newborns sleep about 16-17 hours a day with periods of wakefulness lasting 1-3 hours. However, most newborns have not developed a night/day sleep cycle, so their sleep time can vary to all hours of the day.
1 to 4 months old- Babies of this age still tend to sleep about the same amount of hours, but their night/day sleep cycles begin to kick in, allowing them to sleep longer at night, although they still wake for feedings and changes.
4 months to 1 year- Babies of this age still require between 14-15 hours of sleep every day. Many of them are able to sleep the night, and take up to three naps during the day and evening. During this period, it’s very important to establish healthy sleep habits.
1 to 3 years- Most toddlers need about 12-14 hours of sleep, but often get less due to the schedules of parents and older children in the house. They will more than likely lose their early morning nap and early evening nap and tend to only take one nap a day.
3 to 6 years- Approximately 11-12 hours of sleep. Younger children of this group may still require a short nap during the day, but the need to nap usually diminishes by the time they enter the first grade.
7 to 12 years- Children of this age group tend to need about 10-12 hours of sleep, but often only get about 9-10 hours.
13 to 18 years- Teens require about 8-10 hours of sleep, but rarely get the full amount. The demands of schoolwork and after-school activities often cut into their sleep. Most teens report getting about 6-8 hours of sleep.
Start the bedtime routine early
Your child’s bedtime routine doesn’t have to happen right before bed. In fact, you should actually start your child’s bedtime routine at least 30 minutes before it’s time to start getting ready for bed. Start to wind down. Put an end to raucous games. Move slower. Dim the lights. Turn off the TV and electronic devices. Talk softer. Prepare your child’s mind and body for their upcoming bedtime routine and sleep.
Your child’s bedtime routine
No matter what you do, pick an easy and predictable routine that happens every time your child goes to bed. Try not to draw out your child’s bedtime routine. Fifteen minutes or so should be plenty of time for a good bedtime routine. Decide what is going to help your child fall asleep, and stick with it. Consistency is much more important that what you actually do during your routine. Some examples of bedtime routine elements include:
Bath
Reading books
Telling stories
Singing a song
Saying prayers
Brushing teeth
Putting on pajamas
Goodnight kisses and hugs
Diaper change or going to the bathroom
Snuggling together or tucking them in
Set the stage for good sleep
You’ve prepped your child for a good night of sleep. Don’t just leave them in a space that isn’t going to help them sleep. Don’t leave TVs, tablets, computers or phones in their bedroom. Keep the space dark enough for good sleep, while still comfortable for those who are scared of the dark. Night lights can help. Make the bed up comfortably. Check the temperature so it’s cool enough to sleep without leaving your kids cold. Invest in a white noise machine or fan.
Bedtime Routine Do’s and Don’ts
Avoid poor sleep associations
A sleep association happens when your child learns to fall asleep using certain tools or methods. Most of the time, poor sleep associations sneak in when parents try to get their kids to sleep in sheer desperation. A poor sleep association is one that can harm your child, or is unsustainable so that your child can’t fall asleep on their own. Examples of poor sleep associations include:
Going to sleep with a bottle
Falling asleep to the TV or music
Being rocked to sleep
Falling asleep to a backrub
Sleeping somewhere other than their own crib or bed (usually a parent’s bed)
Safe sleep for infants to help reduce the risk of sudden infant death
1.Always put your baby to sleep on his back until he can roll over.
2.Never bed-share with a newborn. It’s best for baby to sleep in their own crib within earshot of parents for first six months. If mom is sleepy, put baby in bassinette or crib.
3.Crib mattress should be firm, keep soft objects and loose bedding out of crib.
4.Do not overdress baby for sleep.
At what age can you start letting your baby fall asleep on their own or cry it out?
There are many different opinions on this. It’s really about parent preferences. Infants under 3-4 months won’t learn to put themselves to sleep. They need soothing. You can start sleep training at 4-5 months of age. Sleep routines are important for both naptime and bedtime.
When nursing or bottle-feeding, leave the lights on. Then turn off the lights and lay your baby down in their crib and say goodnight or sing or rub their back for just 60 seconds. Wait five minutes. Lay child back down and rub their back again and reassure them. Then, step out of the room for 10 minutes. If they’re still crying. Repeat and reassure them, this time stepping out of the room for 15 minutes. If your baby or toddler is hysterical or very upset you’ll want to console them briefly. They’ll figure it out in 2-3 days.
With a consistent and positive bedtime routine, your child will fall asleep faster and happier. Leaving you plenty of time to get your own shut eye.
Dr. Tidwell suggests these books and websites: Happiest Baby on the Block by Harvey Karp, M.D. and the website Taking Cara Babies, https://takingcarababies.com/ especially the section called The ABC’s of Sleep.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
Screens and media are everywhere and can be a powerful tool for your child’s learning and play. However, nothing can replace face-to-face interaction and play with your child.
Jade Elliott sat down with Kaitlin Carpenter, MD, a pediatrician with Intermountain Healthcare, on this episode of the Baby Your Baby Podcast to discuss screen time guidelines for your kids.
The American Academy of Pediatrics (AAP) has issued several recommendations regarding screen time for children:
Under 18 months: Avoid screen time other than video-chat.
18-24 months: Limit screen time to high-quality programming.
Over 2 years old: Limit screen time to 1 hour per day of high-quality programming created for young children, like Sesame Street and other PBS shows such as Daniel Tiger.
Make sure you are watching and discussing shows with your child. They can be great ways for you and your child to learn together.
The most powerful thing parents can do is be a “media mentor” and show children how to appropriately interact with phones, tablets, and TVs.
Co-watch shows and videos or co-play games with kids.
Try to avoid constant use of your phone around your child. You are your child’s best role model. They will do what you do, so if you are constantly on your phone, your child will be too.
Designate times and places that are phone- or screen-free, like dinner time or bedtime.
Like anything else in a child’s life, children do well with consistent limits. Encourage playtime up and away from screens after the limits are up.
It can be tempting to use media as an emotional pacifier (think crying toddler at the doctor’s office). While that is a nice solution that can be used sometimes, try not to make it a habit. Kids need to learn their own coping strategies (like a hug from mom or dad) or another way to channel those emotions.
Here are some additional ideas and AAP resources for families:
When considering whether to get paper books or eBooks, choose paper books. Research has shown that children learn better and interact more with paper books.
There seems to be a relationship between increased media use in young children and obesity, research has shown.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
A newborn screening is a mandatory screening for all of our Utah babies. Currently, the Utah Department of Health tests for over 40 different disorders. If these disorders aren’t caught and treated, then they can lead to health issues, brain damage, or possibly death.
Jade Elliott sat down with Kari Weiss from the Utah Department of Health, to discuss newborn screenings, what they test for and how they work.
What if my family’s health history is healthy? The disorders we screen for are called autosomal recessive and do not appear in every generation. Many times these disorders are the first in a family. That is why screening is so important.
When is it collected and by whom? Utah is a two screen state. The first screen is 24-48 hours after birth. This is either done in the hospital or with a midwife. The second one is 7-16 days after birth. The hospital or midwife will give you the 2nd card to take to your baby’s health care provider for collection at the 2 week checkup.
How much does it cost? The kit is $118. This fee funds 100% of our program. We do not receive any general State funds to operate the program. Typically this fee is rolled into the hospital’s laboratory fee. If you are having a home birth, you will need to work with your midwife to purchase a kit.
What if I can’t pay this? Call us and talk with us.
What does the cost cover? This covers all the testing (1st, 2nd and any necessary repeats), confirmatory (diagnostic) testing and follow-up.
How is the test done? Baby will have a simple heel prick where several drops of blood that are placed on the screening card (one drop in each circle).
How do I get my results? They are sent to the baby’s health care provider or midwife.
What if the results come back abnormal? We will contact your doctor’s office or midwife for further testing.
What happens to the card after? The dried blood spot is kept for a minimum of 90 days to ensure all testing is complete and nothing needs repeating. After this the sample may be used for quality assurance/quality control purposed that are related to newborn screening. Space is limited therefore we only have sample that are a few years old.
Can I request to have the blood sample destroyed? Yes, the left over specimen can be destroyed after 90 days and by completing a “Request for Destruction” form.
What if I want to refuse the test? In the interest of your baby’s health, Utah law requires newborn screening. An exception can only be made for a religious objection [Statute 26-10-6 (1)]. Visit the Objections section of our website for more information.
How is this tracked? Each baby is assigned a Kit number. This is like a medical record number. The first, second and any additional samples have the same kit number but a different accession numbers.
What do we do if the collection screen is unsatisfactory or untestable multiple times? We offer on-site training. Call us and we can schedule a time where we will come out and help with trainings.
What can I do as a parent? Ensure your baby’s card is filled out completely and accurately. We need to know the correct health care provider in order to send and communicate your baby’s results. Also, if we cannot reach the provider, we need to know how to contact you if we have urgent information to communicate. Also, make sure two screens have been completed at the right time.
What about adoption or foster care? Fill out the card with the person who will be taking care of baby. We need to know who the guardian is in case we need to contact them with medical instructions.
What if my baby was born out of state? Do not start a Utah screen, contact the state the baby was born in, request the result and inquire if additional follow-up is needed. Some states only have one screen while others, such as Utah, screen twice. If this is not possible, a Utah kit will need to be purchased.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.
