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Learning to read at a young age is important for the development of the child. It helps them develop a better understand of their surroundings, allows them to gather information from printed materials, and provides them with a wonderful source of entertainment when they read stories and rhymes. Children develop at different rates, and some children will develop reading skills quicker than other children; however, what’s important is that as the parent, you are keenly aware of your child’s maturity and reading level to provide them with appropriate books and activities to help them improve.
As parents, you are the most important teacher for your children. You will introduce your child to books and reading. Below we have some tips to help you teach your child to read.
Teach Your Child How to Read Tip #1
Teach your child alphabet letters and sounds at the same time. Studies have shown that children learn best when they are taught the letter names and letter sounds at the same time. In one study, 58 preschool children were randomly assigned to receive instructions in letter names and sounds, letter sound only, or numbers (control group). The results of this study are consistent with past research results in that it found children receiving letter name and sound instruction were most likely to learn the sounds of letters whose names included cues to their sounds. 
When teaching your child the letter sounds, have them slowly trace the letter, while saying the sound of the letter at the same time. For example, if you were teaching your child the letter “A”, you would say:
“The letter A makes the /A/ (ah) sound.”
Then have your child say the /A/ sound while tracing the letter with his or her index finger.
Teaching a Child How to Read Tip #2
When teaching your child to read, always emphasize with them that the proper reading order should be from left to right, and top to bottom. To adults, this may seem so basic that anyone should know it. However, our children are not born with the knowledge that printed text should be read from left to right and top to bottom, and this is why you’ll sometimes see children reading from right to left instead – because they were never explicitly taught to read from left to right. When teaching your child how to read, always emphasize this point with them.
Teach Your Child How to Read Tip #3
Teach final consonant blends first. Teaching words such “at” and “and” can lead your child directly to learning words that rhyme with these. For example, for “at”, you can have:
For “and”, you can have these rhyming words:
and so on…
You can start teaching blends once your child has learned the sounds of some consonants and short vowel sounds. You don’t need to wait until your child has mastered the sounds of all the letters before teaching blends.
Learning to read is a long process, but it doesn’t have to be a difficult process. Broken down into intuitive and logical steps, a child as young as two years old can learn to read, and older children can accomplish even more.
Click here to for a simple, step-by-step program that can help your child learn to read, and watch a video of a 2 year old child reading Click here to for a simple, step-by-step program that can help your child learn to read, and watch a video of a 2 year old child reading
FORT LAUDERDALE, Fla. – The state of Florida is asking thousands of young women some intimate questions their sex lives and is giving them a $10 gift card in return — but some who received the survey are offended.
The South Florida Sun Sentinel reported Sunday that the Department of Health sent surveys to 4,100 women between 18 and 24, giving participants a CVS gift card.
Officials say the survey will help them understand women’s need for and approach to family-planning services.
The state spent $45,000 on the 46-question survey, which was sent out in September and October, and 782 have been returned. Participants were asked how many men they had sex with over the last year and how they felt emotionally the last time they had unprotected sex. A November batch weren’t mailed after it was found that some of the surveys were sent to girls under 18.
“We obviously offered an apology sent back in writing and will work to ensure that moving forward, this never happens again,” state Surgeon General Dr. John Armstrong told the paper.
He added that participation is voluntary.
“If somebody sees something they don’t like, they can rip it up and throw it in the garbage can,” he said.
The state says the names of those surveyed will be kept private, but some who received it questioned whether that would be true and how their answers would be used.
David Brown, a Broward County political consultant, said he was given the survey by a woman who was offended when she received it.
“Some of the questions are incredibly offensive and invasive,” Brown told the Sun-Sentinel. “She thought that it was an unconscionable invasion of her privacy. There wasn’t enough information to tell her who really did this and where the budget was for it, whether the information was going to be kept private, and really, what are they talking about in terms of how does this information in any way help?”
The paper reported several questions from the survey:
– How old were you when you first had sex? The last time you had sex with a man, did you do anything to keep from getting pregnant? If not, why not?
– Has a sexual partner ever “told you he would have a baby with someone else if you didn’t get pregnant?”
– Are you depressed? Have you ever been physically abused? What’s your religion? Do you smoke? How much do you weigh?
Armstrong said the survey was created using questions that have appeared in other surveys used nationally and that it was vetted by review boards at the state health department and Florida AM University.
The state says Florida has one of the lowest rates of contraceptive use among women of child-bearing age.
The results will be used to design the state’s service offerings, including pamphlets and counseling. Women can receive contraceptives at the health department for a fee that’s based on income.
Armstrong said that without a survey it is difficult to understand gaps and disparities in women’s use of services.
“It’s really important to emphasize,” Armstrong said, “that we want people to be informed so that they can manage their health.”
A 7-year-old girl suffering from leukemia is one of Oregon’s youngest medical marijuana patients.
Her mother says she gives her daughter marijuana pills to combat the effects of chemotherapy, but her father, who lives in North Dakota, worries about the effects of the drug on her brain development.
Mykayla Comstock was diagnosed with leukemia last spring. Her mother treats her with a gram of cannabis oil daily, The Oregonian reported.
Mykayla’s mother credits the drug for the leukemia’s remission. “As a mother, I am going to try anything before she can potentially fall on the other side,” said Erin Purchase, 25, who with her boyfriend administers Mykayla’s cannabis.
The girl says the drug helps her eat and sleep but also makes her feel “funny.”
“It helps me eat and sleep,” Mykayla said. “The chemotherapy makes you feel like you want to stay up all night long.”
Mykayla’s father, who is divorced from the girl’s mother, was so disturbed by his daughter’s marijuana use that he contacted child welfare officials, police and her oncologist. The father, Jesse Comstock, said his concerns were prompted by a visit with Mykayla in August.
“She was stoned out of her mind,” said Comstock, 26. “All she wanted to do was lay on the bed and play video games.”
Comstock, who works in a North Dakota oil field, pays child support to Purchase and covers Mykayla’s health insurance. He said he observed strange behavior during an August visit and took Mykayla to a private lab, where technicians detected THC levels of an adult daily marijuana user.
Gladstone police contacted the girl’s mother, examined Mykayla’s medical marijuana paperwork, then told Comstock there was little they could do.
Comstock, who used pot in the past, said he doesn’t object to people over 16 using medical marijuana.
But he worries about his daughter’s well-being and the potential for addiction.
“She’s not terminally ill,” Comstock said. “She is going to get over this, and with all this pot, they are going to hinder her brain growth.
“It’s going to limit her options in life because of the decisions her mother has made for her,” he added.
Oregon law requires no monitoring of a child’s medical marijuana use by a pediatrician.
The law instead invests authority in parents to decide the dosage, frequency and manner of a child’s marijuana consumption.
Many doctors worry about introducing a child to marijuana when they say other drugs can treat pain and nausea more effectively. Purchase believes marijuana heals, and credits the drug for curing her stepfather’s skin cancer.
She herself is an Oregon medical marijuana patient, and her boyfriend is Mykayla’s grower. She is so convinced of the drug’s safety that she consumed it during the pregnancy and while breastfeeding her second child.
When her symptoms are especially bad, Mykayla’s mother and her mother’s boyfriend will feed her cannabis-infused food. She’s had up to 1.2 grams of cannabis oil in 24 hours, the rough equivalent of smoking 10 joints.
Purchase said Mykayla’s first oncologist called the marijuana use “inappropriate.”
With marijuana, Purchase said her daughter has been able to fight past the chemotherapy and return to a sense of normalcy.
“She’s like she was before,” her mother said. “She’s a normal kid.”
Men and women can suffer from hair loss for a variety of reasons. Genetics is often to blame for hair loss, and in many cases, it is the root cause. However, there is a large percentage of the population that experiences hair loss as a side effect of another condition or medication. Everything from poor nutrition to chronic stress to a hormonal imbalance can lead to hair loss.
The key to finding a solution to thinning hair or baldness is determining the root of the problem and seeking treatment accordingly.
Your hormones regulate nearly every function in the body. Your thyroid produces several of these hormones that regulate your metabolism and energy levels. When your thyroid hormones –TSH, T3, T4, rT3 – are out of balance, it can also cause hair loss. Getting these hormones back in balance can correct the problem, stopping hair loss and allowing your hair to grow back.
The constant fluctuations that occur following pregnancy and childbirth can lead to thinning hair or loss in patches. This is normal and can last up to three months after the birth of your child. Your body will recover from the loss and your hair will grow back.
Several types of medications can cause your hair to fall out. Blood thinners, birth control, SSRI, NSAIDs and beta-blockers are just a few that many people may not be aware of. Chemotherapy is also classically associated with hair loss. When you stop taking these medications or are no longer undergoing treatment, your hair will grow back,
The body reacts in various ways to physical trauma. Anything from surgery to a major accident to a grave illness can cause shock to the hair follicles and cause up to 75 percent of your hair to fall out. The severity of the trauma and the treatment plan can impact when and if the hair will grow back.
Emotional disturbances such as a divorce, serious financial woes or death of a loved one can disrupt hair growth. However, once the gravity of these emotions has lifted and these stressors have been controlled, the body often returns to it normal state and your hair will grow back.
When your body is missing essential nutrients, it will do its best to reserve energy for all that is vital. Your hair does not make the top of this “vital” list. Crash diets, severely restrictive fad diets and failure to eat a variety of foods can lead to nutrient deficiencies, which can cause hair loss or poor hair growth. Make sure your diet is balanced to care for your precious locks.
Believe it or not, all that work you do to make your tresses look fabulous can bring some serious damage to your hair and the number of strands that remain on your head. Harsh chemicals, like strong dyes; overuse of heated styling tools, such as blow dryers, curling irons, curlers and straightening irons; or even a too tight ponytail can cause hair loss. Handle your hair with care to keep it healthy.
Skin fungal infections, bacterial infections and other internal infections can cause balding or thinning of the hair. You must treat the source of the infection to restore hair growth and prevent further loss.
Diabetes and lupus are just two autoimmune diseases that have been linked to hair loss. In many cases the hair loss caused by these conditions may not be reversible; however medications or hair restoration surgeries may help compensate for the loss.
Alopecia is the medical term for hair loss. There are two main types: alopecia areata and androgenic alopecia. Alopecia may cause hair loss exclusively on the scalp or all over the body. It may result in patches of hair loss, balding or thinning hair, which may be permanent or temporary. There are numerous causes, particularly genetics or autoimmune disorders as mentioned above. Treatments may be available to aid in hair growth, but a “cure” for patterned baldness has not yet been discovered.
Dr. Jennifer Landa is Chief Medical Officer of BodyLogicMD, the nation’s largest franchise of physicians specializing in bioidentical hormone therapy. Dr. Jen spent 10 years as a traditional OB-GYN, and then became board-certified in regenerative medicine, with an emphasis on bio-identical hormones, preventative medicine and nutrition. She is the author of “The Sex Drive Solution for Women.” Learn more about her programs at www.jenlandamd.com.
A growing trend I’m seeing in many of my pregnant patients has me concerned – especially those from Latin American countries who often don’t realize that many cultural traditions, when it comes to food, can put their unborn children in danger.
When these patients either return to or have family members visit from their respective countries, who bring food that may not be properly processed, the potential for foodborne bacterial infections is increased. Once ingested, bacteria can cause complications in pregnancy that lead to miscarriage, severe intrauterine infection, or even stillbirth.
Certain infections like Listeria and E. coli are prime examples of those bacteria that you can get from unpasteurized cheeses, cold cuts, raw milk, undercooked meats and contaminated produce.
The CDC estimates that about 2,500 people contract listeriosis in the United States every year – with about a third of those cases occurring in pregnant women. Odds are, if you contract listeriosis, it will not make you seriously ill. But that doesn’t mean it can’t have a serious impact on the health of your developing baby.
Other infections like toxoplasmosis can be acquired by handling soil or cat litter that contains feces infected with the parasite, or by eating unprocessed or undercooked meats. About half of pregnant women infected with toxoplasmosis can transmit the infection to their unborn baby, which can cause severe problems either during or after birth.
I remember in medical school, we were taught about these infections in pregnant women, but you hardly saw them – especially here in the U.S. Now, more and more cases are being documented and personally, I have treated too many to say that it’s a coincidence, but rather a problematic trend that needs to stop.
Of course, there are other restrictions pregnant women need to observe when it comes to things like sushi and other fish, but I’ll answer those questions tomorrow.
So pay attention, and don’t consume homemade dairy products – especially those that are unpasteurized or unprocessed, if you want to have a healthy pregnancy.
When 15-year-old Kali Gonzalez became pregnant, the honors student considered transferring to an alternative school. She worried teachers would harass her for missing class because of doctor’s appointments and morning sickness.
A guidance counselor urged Gonzalez not to, saying that could lower her standards.
Instead, her counselor set up a meeting with teachers at her St. Augustine high school to confirm she could make up missed assignments, eat in class and use the restroom whenever she needed. Gonzalez, who is now 18, kept an A-average while pregnant. She capitalized on an online school program for parenting students so she could stay home and take care of her baby during her junior year. She returned to school her senior year and graduated with honors in May.
But Gonzalez is a rare example of success among pregnant students. Schools across the country are divided over how to handle them, with some schools kicking them out or penalizing students for pregnancy-related absences. And many schools say they can’t afford costly support programs, including tutoring, child care and transportation for teens who may live just a few miles from school but still too far to walk while pregnant or with a small child.
Nearly 400,000 girls and young women between 15 and 19 years old gave birth in 2010, a rate of 34 per 1,000, according to the Centers for Disease Control and Prevention.
Those statistics have led child advocates to push for greater adherence to a1972 law that bans sex discrimination in federally funded education programs and activities, according to a new report by the National Women’s Law Center.
Fatima Goss Graves, the center’s vice president of education and employment, says offering pregnant teens extra support would ultimately save taxpayers money by helping them become financially independent and not dependent on welfare.
But budget cuts have eaten into such efforts.
California lawmakers slashed a successful program for such students in 2008, ruling it was no longer mandatory, and allowed school districts to use the money for other programs.
More than 100,000 pregnant and parenting students have participated in the program that helps them with classwork and connects them with social services. It boasted a 73 percent graduation rate in 2010 – close to the state’s normal rate – and advocates said participants were less reliant on welfare and less likely to become pregnant again. That compares to several counties where only 30 percent of pregnant and parenting teens graduated.
“It’s unfortunate that this effective program fell prey to the enormous budget challenges we are facing as a state,” said State Superintendent of Public Instruction Tom Torlakson.
Three years ago in Wisconsin, cost-cutting lawmakers dropped a requirement for school districts to give pregnant students who live within two miles of a school building free rides to school. The requirement had been part of an effort to improve access to education and reduce infant mortality rates.
Less than half of the states have programs that send home assignments to homebound or hospitalized student parents, according to the study.
In almost half of the states, including Idaho, Nevada, Nebraska, South Dakota and Utah, the definition of excused absences is not broad enough to include pregnant and parenting students. That typically results in a patchwork of policies where some school districts don’t excuse absences even if the student is in the hospital giving birth, according to the study.
But a few states have developed programs to help improve graduate rates among pregnant girls and young mothers.
In Washington, D.C., caseworkers in the New Heights Teen Parent Program often stand by the school entrance or text pregnant students and young moms to make sure they are attending classes.
When students do miss school, caseworkers take them homework assignments. About 600 students participate in the program which also helps students with housing, child care and parenting skills. But the $1.6 million federal grant funding the program runs out next year and officials said they don’t have a clear future funding source.
Roughly 4,500 male and female student parents participated in a Pennsylvania program last year where case workers helped them balance school and child care. Nearly 1,300 graduated or received an equivalent, state officials said. The ELECT program, which started in 1990 as a partnership between state child welfare and education officials, monitors students’ attendance, coordinates summer programs and links them with support systems in the community.
Florida allows pregnant and parenting students to receive homebound instruction and lays out a clear process to make up missed work. The state also gives those students the option of taking online classes.
In St. Johns County, where Gonzalez lives, the school district provides free day care for teen moms and bus transportation for students and their children.
Pregnant students are often stereotyped as low-achievers, but advocates say pregnancy actually motivates some to do better in school.
Gonzalez, whose daughter is now 2, said her grades improved after she became pregnant.
“I did push myself a lot harder and I made sure that I wasn’t going to be that statistic,” said Gonzalez, who is now married and pursuing a nursing degree.
Children whose mothers took antibiotics while they were pregnant were slightly more likely than other kids to develop asthma in a new Danish study.
The results don’t prove that antibiotics caused the higher asthma risk, but they support a current theory that the body’s own “friendly” bacteria have a role in whether a child develops asthma, and antibiotics can disrupt those beneficial bugs.
“We speculate that mothers’ use of antibiotics changes the balance of natural bacteria, which is transmitted to the newborn, and that such unbalanced bacteria in early life impact on the immune maturation in the newborn,” said Dr. Hans Bisgaard, one of the authors of the study and a professor at the University of Copenhagen.
Those effects on the immune system could lead to asthma later on, although it’s still not clear how, said Anita Kozyrskyj, a professor at the University of Alberta who also studies the antibiotics-asthma link but wasn’t involved in the new study.
Previous research has linked antibiotics taken during infancy to a higher risk of asthma, although some researchers have disputed those findings (see Reuters Health stories of May 17, 2011 and February 3, 2011).
To look for effects starting at an even earlier point in a baby’s development, Bisgaard and his colleagues gathered information from a Danish national birth database of more than 30,000 children born between 1997 and 2003 and followed for five years.
They found that about 7,300 of the children, or nearly one quarter, were exposed to antibiotics while their mothers were pregnant. Among them, just over three percent (238 kids) were hospitalized for asthma by age five.
In comparison, about 2.5 percent, or 581 of some 23,000 kids whose mothers didn’t take antibiotics were hospitalized for asthma.
After taking into account other asthma risk factors, Bisgaard’s team calculated that the children who had been exposed to antibiotics were 17 percent more likely to be hospitalized for asthma.
Similarly, these children were also 18 percent more likely to have been given a prescription for an asthma medication than kids whose mothers did not take antibiotics when they were pregnant, according to findings published in The Journal of Pediatrics.
In an email to Reuters Health, Bisgaard said he expected to see a higher risk of asthma “because the mother is a prime source of early bacterial colonization of the child, and antibiotics may (have) disturbed her normal bacterial flora.”
Bisgaard’s team also looked at a smaller group of 411 kids who were at higher risk for asthma because their mothers had the condition and found these children were twice as likely as their peers to develop asthma too if their mothers took antibiotics during the third trimester of pregnancy.
Kozyrskyj, who is research chair of the Women and Children’s Health Research Institute, said it’s also possible that something other than the antibiotics are to blame for the findings in both groups of children – such as the illness that caused the mothers to take antibiotics.
“This study, it doesn’t tell us whether it’s the antibiotic use or whether it’s the infection. That’s one thing we can’t decipher,” she told Reuters Health.
The results don’t suggest that women should avoid taking antibiotics to try to reduce their kids’ risk of asthma, Kozyrskyj emphasized.
Some infections can be quite dangerous to a fetus, and “there are very good indications for these antibiotics,” she added.
Bisgaard agreed that women should be treated, “but we see 1/3 of pregnant women in our region receiving treatments (often for urinary tract infections), which may reflect an uncritical use,” he wrote in an email.
Bisgaard said his group is also studying the types of bacteria in pregnant mothers and newborn children to get a better understanding of their role in asthma.
Kozyrskyj said Bisgaard’s study suggests that the development of asthma might start before birth, something researchers hadn’t studied very closely.
“We’re beginning to appreciate that some of the origins of asthma and changes to the immune system, maybe they start earlier than right after birth. It might be happening in utero,” she said.
No prescription or doctor’s exam needed: The nation’s largest group of obstetricians and gynecologists says birth control pills should be sold over the counter, like condoms.
Tuesday’s surprise opinion from these gatekeepers of contraception could boost longtime efforts by women’s advocates to make the pill more accessible.
But no one expects the pill to be sold without a prescription any time soon: A company would have to seek government permission first, and it’s not clear if any are considering it. Plus there are big questions about what such a move would mean for many women’s wallets if it were no longer covered by insurance.
Still, momentum may be building.
Already, anyone 17 or older doesn’t need to see a doctor before buying the morning-after pill – a higher-dose version of regular birth control that can prevent pregnancy if taken shortly after unprotected sex. Earlier this year, the Food and Drug Administration held a meeting to gather ideas about how to sell regular oral contraceptives without a prescription, too.
Now the influential American College of Obstetricians and Gynecologists is declaring it’s safe to sell the pill that way.
Wait, why would doctors who make money from women’s yearly visits for a birth-control prescription advocate giving that up?
Half of the nation’s pregnancies every year are unintended, a rate that hasn’t changed in 20 years – and easier access to birth control pills could help, said Dr. Kavita Nanda, an OB/GYN who co-authored the opinion for the doctors group.
“It’s unfortunate that in this country where we have all these contraceptive methods available, unintended pregnancy is still a major public health problem,” said Nanda, a scientist with the North Carolina nonprofit FHI 360, formerly known as Family Health International.
Many women have trouble affording a doctor’s visit, or getting an appointment in time when their pills are running low – which can lead to skipped doses, Nanda added.
If the pill didn’t require a prescription, women could “pick it up in the middle of the night if they run out,” she said. “It removes those types of barriers.”
Tuesday, the FDA said it was willing to meet with any company interested in making the pill nonprescription, to discuss what if any studies would be needed.
Then there’s the price question. The Obama administration’s new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.
If the pill were sold without a prescription, it wouldn’t be covered under that provision, just as condoms aren’t, said Health and Human Services spokesman Tait Sye.
ACOG’s opinion, published in the journal Obstetrics Gynecology, says any move toward making the pill nonprescription should address that cost issue. Not all women are eligible for the free birth control provision, it noted, citing a recent survey that found young women and the uninsured pay an average of $16 per month’s supply.
The doctors group made clear that:
-Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth.
-Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill.
-Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen.
-And there’s no need for a Pap smear or pelvic exam before using birth control pills. But women should be told to continue getting check-ups as needed, or if they’d like to discuss other forms of birth control such as implantable contraceptives that do require a physician’s involvement.
The group didn’t address teen use of contraception. Despite protests from reproductive health specialists, current U.S. policy requires girls younger than 17 to produce a prescription for the morning-after pill, meaning pharmacists must check customers’ ages. Presumably regular birth control pills would be treated the same way.
Prescription-only oral contraceptives have long been the rule in the U.S., Canada, Western Europe, Australia and a few other places, but many countries don’t require a prescription.
Switching isn’t a new idea. In Washington state a few years ago, a pilot project concluded that pharmacists successfully supplied women with a variety of hormonal contraceptives, including birth control pills, without a doctor’s involvement. The question was how to pay for it.
Some pharmacies in parts of London have a similar project under way, and a recent report from that country’s health officials concluded the program is working well enough that it should be expanded.
And in El Paso, Texas, researchers studied 500 women who regularly crossed the border into Mexico to buy birth control pills, where some U.S. brands sell over the counter for a few dollars a pack. Over nine months, the women who bought in Mexico stuck with their contraception better than another 500 women who received the pill from public clinics in El Paso, possibly because the clinic users had to wait for appointments, said Dr. Dan Grossman of the University of California, San Francisco, and the nonprofit research group Ibis Reproductive Health.
“Being able to easily get the pill when you need it makes a difference,” he said.
For all the miracle stories of tiny preemies who survive, the sad reality is that scientists know far too little about what triggers premature birth and how to prevent it. And despite some recent progress, the U.S. has a far higher rate of preterm births than other similar nations.
On Thursday, an international coalition said there are a handful of proven protections – and if the U.S. and other developed countries do a better job of using them, together they could keep 58,000 babies a year from being born too soon.
That’s a blip in the global epidemic of prematurity: About 15 million preterm babies are born every year, most of them in Africa and parts of Asia where the priority is to improve care of these fragile newborns. More than 1 million premature infants die, mostly in developing countries, and survivors can suffer lifelong disabilities.
But in wealthier countries, where sophisticated medical care already keeps most preemies alive, the focus is shifting to how to prevent these births in the first place. Nearly 1 in 10 births across the developed world are preterm, and about 1 in 8 in the U.S. Only recently have rates begun leveling off or dropping in many of these countries after years of steady increases.
Thursday’s report makes clear just how hard additional progress on that front will be – projecting an average 5 percent drop in preterm birth rates across the highest-income countries by 2015, if they follow the new advice.
“Shockingly, very little reduction is currently possible,” specialists with the World Health Organization, Save the Children, U.S. National Institutes of Health, March of Dimes and other groups reported in The Lancet.
But even that improvement would translate into about $3 billion in annuals savings from medical bills and lost productivity, the group calculated. Nearly half that savings would be in the U.S.
The bigger message: It’s time for a major scientific push to figure out the causes of preterm birth and find some better ways to intervene.
“I don’t think it’s hopeless at all,” said report co-author Dr. Catherine Spong, a maternal-fetal medicine specialist at NIH who points to clues that infections and inflammation affecting the mother play a yet-to-be-understood role.
Because healthier babies grow into healthier adults, “if you could improve pregnancy outcomes, you could improve the health of the nation, quite honestly,” she added.
Over half a million U.S. babies are born premature, before completion of the 37th week of pregnancy. That’s 11.7 percent of the babies born in 2011, the lowest rate of preterm birth in a decade and down from a peak of 12.8 percent in 2006, the March of Dimes reported earlier this week.
Contrast that with Japan and Sweden, where fewer than 6 percent of births are premature, or Canada and Britain where fewer than 8 percent are.
Last spring, this same international coalition provided the first country-by-country estimates of preterm births and recommended some inexpensive steps that developing countries could take to improve preemie survival. Thursday’s follow-up analyzed trends in developed countries, to come up with advice on preventing prematurity.
The report recommends:
-Nearly eliminating the practice of inducing labor and C-sections scheduled much ahead of mom’s due date unless they’re medically necessary. Much of the recent U.S. improvement comes from reducing elective early deliveries, leading to a drop in “late preemies,” babies born a few weeks early.
-Helping women to quit smoking. Smoking at some point during pregnancy varies widely, from 10 percent in Canada to 23 percent in the U.S. and 30 percent in Spain, the report found.
-Providing regular injections of the hormone progesterone to certain women at high risk, largely because of a prior preterm birth. A recent NIH survey of obstetricians found just 21 percent of eligible patients received the shots.
-Putting a stitch into the cervix of certain high-risk women, those who have what’s called a short cervix.
-Using just one embryo, not multiples, when in vitro fertilization is used.
The impact would vary. The U.S. could see an 8 percent drop in its preterm birth rate by 2015 if it fully implemented these steps, the report estimated, while countries such as Sweden that already have far fewer preemies would see their rates inch down only slightly more, by about 2 percent.
Having one preemie greatly increases the risk for another. Other risk factors include pregnancy before age 17 or over 40, and the mother’s own health conditions, such as being underweight or overweight, or having diabetes or high blood pressure. That’s why it’s so important for women to have good care, not only early in pregnancy, but before they conceive, said the March of Dimes’ Christopher Howson.
But all those factors explain only a portion of preterm birth. NIH’s Spong pointed to efforts to understand how vaginal infections and inflammation may help trigger preterm labor.
Another mystery: Why African-American women are at higher risk, with a preterm birth rate of about 17 percent compared to under 11 percent among white women, Howson said.
Still, many women don’t know that there are some protections, said Nikki Fleming of suburban Charlotte, N.C., who benefited from two of the steps recommended in Thursday’s report and tries to spread the word.
Fleming’s first baby, Lauren, was born at 26 weeks, weighing just over 2 pounds and spending her first five months in the hospital. Fortunately Lauren, now a healthy 8-year-old, fared well. But Fleming’s next pregnancy ended in a miscarriage.
Her doctor determined that she would benefit from that cervical stitch as well as the progesterone shots. The result: two healthy full-term babies.
“I appreciate that they didn’t treat it like an isolated incident,” Fleming said.