Number of women with gestational diabetes underestimated

A new study claims that twice as many women as previously thought develop gestational diabetes during pregnancy.

The research shows that 16 per cent of women develop gestational diabetes during pregnancy compared to previous estimates that only 8 per cent develop the condition.

The findings of this international research involving 23,000 women in nine countries will be published in the March issue of Diabetes Care, a journal of the American Diabetes Association.

Welcomed results

Cathy Moulton, Care Advisor at Diabetes UK, said: “Diabetes UK welcomes the long-awaited results of this multi-national study. The research shows that the blood glucose levels of pregnant women, which were once deemed to be in the normal range, are now seen to be those of a person with gestational diabetes. This means that two to three times more pregnant women could be diagnosed with gestational diabetes than at the present moment.

“These blood glucose levels, if left undetected, have the potential to produce large babies and lead to an increased risk of injury during delivery, which causes many women to have a caesarean section.”

“Diabetes UK, who funded the Manchester and Belfast arm of this study, awaits the publication of the full study next month and the consequences it could have in the detection and treatment of gestational diabetes.”

About gestational diabetes

Gestational diabetes arises during pregnancy – usually during the second or third trimester. In some women, it occurs because the body cannot produce enough insulin to meet the extra needs of pregnancy. In others it may be found during the first trimester of pregnancy, and in these women the condition most likely existed before the pregnancy.

In the majority of cases, gestational diabetes comes to light during the second trimester of pregnancy. The baby’s major organs are fairly well developed at this stage and the risk to the baby is lower than for women with Type 1 or Type 2 diabetes.

However, babies of women who had blood glucose problems that were undiagnosed before pregnancy have a higher risk of malformations. The degree of risk depends on how long blood glucose levels have been high and on how high the levels have been.

Visit the pregnancy and diabetes secion of our website for more information.

Pregnancy and alcohol – a dangerous cocktail

Learning difficulties, physical disabilities and behavioural problems are all part of fetal alcohol spectrum disorders [FASD].  These lifelong conditions can drastically impact on the lives of the individual and those around them. BMA Scotland said today (Monday 1 March 2010) that the reality is that these conditions are completely preventable by not drinking any alcohol during pregnancy.

There is proven risk that heavy drinking by pregnant women can cause these disorders in their children. However, evidence is continuing to emerge on the effects of low or moderate prenatal alcohol exposure and until there is clarification the only message is that it is not safe to drink any alcohol during pregnancy or when planning a pregnancy.

Dr Brian Keighley, Chairman of the British Medical Association in Scotland said: “We need to raise awareness of the emerging evidence on FASD among healthcare professionals so that children are diagnosed quickly and get the help they need. The lack of awareness and research in the UK on this subject, together with the complexity of the syndrome itself is leading to delays in diagnosis and referral.

“Healthcare professionals also need to get the message across to expectant mothers that consuming alcohol can cause irreversible harm to their unborn child. It’s about giving people the right information so that they can act responsibly – and save children from completely preventable life-long disabilities.”

The BMA published a report on FASD in June 2007.  Recommendations in the report include:

There is an urgent need for further UK and international research on FASD.

Research should be undertaken to examine the relationship between different levels of prenatal exposure and the range of conditions associated with FASD.

The UK health departments should implement guidance and training programmes for healthcare professionals on the prevention, diagnosis and management of FASD.

Women who are pregnant, or who are considering a pregnancy, should be advised not to consume any alcohol.

Research should be undertaken to identify the most effective ways to educate the public about FASD and to alter drinking behaviour. This requires systematic studies that compare various universal strategies and their impacts across the different social groups.

All healthcare professionals should provide clear and coherent advice for expectant mothers and anyone planning a pregnancy on the risks of maternal alcohol consumption. Members of the antenatal care team should provide continued advice and support to expectant mothers throughout pregnancy.

Any woman who is identified as being at high-risk of prenatal alcohol exposure should be offered referral to specialist alcohol services for appropriate treatment. Any referral should be followed up and assessed at regular intervals.

Notes:

Each time the acronym FASD is used it refers to the full range of disorders that fall within the umbrella term FASD, unless otherwise stated. These disorders range in diversity from the most clinically recognisable type; Fetal Alcohol Syndrome (FAS), to a set of conditions – including Partial Fetal Alcohol Syndrome (PFAS), Alcohol-Related Birth Defects (ARBD) and Alcohol-Related Neurodevelopment Disorders (ARND) – that show some, but not all of the features of FAS. The severity of the abnormality depends on the level and pattern of alcohol consumed as well as the stage of pregnancy at which alcohol was consumed.

The BMA report ‘Fetal alcohol spectrum disorders’, a guide for healthcare professionals’; can be accessed on our website at: http://www.bma.org.uk/health_promotion_ethics/alcohol/Fetalalcohol.jsp

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Foods Standards Agency reminds parents of advice on making up infant formula

The Agency is reminding parents and childcarers who use powdered infant formula to use hot water to make up a feed. Formula powder isn’t sterile, so occasionally it could contain harmful bacteria, which could make babies ill. Using water that is 70°C, or higher, will kill any harmful bacteria in the powder.

In practice, this means boiling at least 1 litre of water in a kettle and leaving it to cool for no more than half an hour.

Recent research funded by the Agency has confirmed the importance of using hot water to make up powdered formula. But some parents aren’t aware of this advice and may use cold water, or boiled water that has been cooled for longer than half an hour.

Ready-to-feed liquid formula, sold in cartons, doesn’t need to be mixed and is sterile. But it is more expensive to buy than formula powder.

If you are making up powdered infant formula, follow the manufacturer’s instructions on how much powder and water to use for each bottle. You should also do the following:

Clean and sterilise bottles and teats before you use them.
Use fresh tap water (don’t use water that has been boiled before).
Fill the kettle with at least 1 litre of water.
Boil the water.
Then leave the water to cool for no more than half an hour.
Always put the water in the bottle first, before the powder.

Cool down the milk by holding the bottom half of the bottle under cold running water, with the cap covering the teat. (This is to avoid scalding the baby.)

Test the temperature of the formula milk on the inside of your wrist before giving it to a baby. It should be body temperature, which means it should feel warm.

If there is any made-up formula milk left after a feed, throw it away. You should also throw away any milk that has been at room temperature for more than two hours.

The Government advises mothers to breastfeed exclusively until their babies are six months old and then to continue after introducing solid foods. For more information about feeding babies, talk to your GP or health visitor, or read the advice on our eatwell site.

For information on breastfeeding, call the National Breastfeeding helpline on 0300 100 0212 to speak to the nearest trained volunteer in your area.

View report

Bacteriocidal preparation of powdered infant milk formulae

://www.foodbase.org.uk/results.php?f_category_id=&f_report_id=395

BLISS CHARITY AND NEONATAL CARE IN ENGLAND

House of Commons Early Day Motions

Bob Spink [R]
Peter Bottomley
Bob Russell
Andrew George
Mr Gregory Campbell
Mr David Drew
	Dr Rudi Vis	Dr William McCrea	Ms Katy Clark

That this House notes that 70,000 babies were admitted to neonatal care in England in 2008, almost 20,000 of those being admitted to intensive care; further notes that Bliss is the only UK charity that helps care for premature and sick babies; congratulates Bliss on 30 years of campaigning that has resulted in an NHS neonatal taskforce conducting the most comprehensive review of neonatal care ever undertaken in England; and calls on the Government to implement fully the Taskforce’s recommendations in order to make a lasting improvement in the way babies and their families are cared for.

Departmental Public Expenditure – Health

Mrs. Maria Miller:

To ask the Secretary of State for Health how much his Department has allocated to Maternity Matters programmes in (a) 2009-10 and (b) 2010-11.

Ann Keen:

In January 2008, the Department announced an additional £330 million for maternity services to help support the implementation of Maternity Matters over the three years 2008-09 to 2010-11. This funding has been included in primary care trusts (PCT) baseline allocations. It is for PCTs to determine how best to use based on the needs of local maternity services.

Mrs. Maria Miller:

To ask the Secretary of State for Health how much his Department has allocated for NHS Baby Lifecheck in (a) 2009-10 and (b) 2010-11.

Gillian Merron:

Expenditure on NHS Baby Lifecheck in 2009-10 is expected to be approximately £1.3 million. The allocation for NHS Lifecheck in 2010-11 is still under consideration.

Improvements to care for sick and premature babies in Wales

 Health Minister Edwina Hart today [Monday, 7 December] accepted the recommendations of an expert group on improvements to care for sick and premature babies in Wales.

The group, led by Dr Jean Matthes, Consultant Neonatologist at Abertawe Bro Morgannwg University Health Board, has produced a plan to improve neonatal services. Priorities include introducing dedicated neonatal transport services, improved information systems, and the establishment of a Neonatal Managed Clinical Network for Wales. The network should be operational in February.

The group’s recommendations outline how the additional £2million a year of Assembly Government funding announced by the Minister for neonatal services will be spent.  Planned improvements include:

Two neonatal transport services, one in south Wales and one in north Wales. The transport services will ensure rapid and safe transport to specialist centres. The services will operate 12 hours a day in the first instance, with planned progress towards a 24-hour service in the future as staff resources are developed. The new service should be operational from spring next year.

Specialist Neonatal services concentrated in three centres in South Wales – Swansea, Cardiff and Newport – and one in North Wales, yet to be determined.

Recruitment to begin for additional Neonatal Consultants and Neonatal Nurses at each centre to deliver the new service.

A single Neonatal Database enabling the standardised collection of data across Wales.

Dr Jean Matthes, Chair of the Expert Group, said: “I am absolutely delighted with the development of the neonatal transport services, database and network.  This will significantly help to improve the services for newborn babies and their families throughout the whole of Wales.”

Dr Huw Jenkins, Consultant Paediatrician at University Hospital of Wales, Cardiff, added: “This is a very welcome announcement and I am pleased that the hard work of the clinicians and others involved in developing the neonatal standards and service models is coming to fruition.”

Home birth figures remain static across UK

Across the UK in 2008, 21, 211 (2.7%) of all births (787,032) took place at home, compared with 20,548 (2.68%) in 2007. This shows no rise in the home birth rate.

In England 18,933 women (2.8%) had a home birth, from 665,779 births.

Wales has the highest proportion of women having home births, 1,314 (3.7%) from 35,256 births.

In Scotland, 881 women (1.5%) had a home birth, from 60,366 births. And in Northern Ireland, 83 women (0.3%) had home births from 25,631 births.

In many areas community midwifery services are not being developed to increase access to home births and birth centres, and women are not being given balanced information to make well-informed choices. Low midwifery staffing levels mean home birth is either not being offered, or withdrawn at short notice. Every trust and board should ensure that choice of place of birth is available to all women.

Local administrative areas with highest and lowest home birth rates include:-

		HIGHEST		LOWEST
England		South Hamms – 13.6%		Alnwick 0.0%
Scotland		East Lothian – 5.0%		Eilean Siar – 0.4%
Wales		Bridgend – 9.5%		Merthyr Tydfil – 1.3%

New data provided by the Office of National Statistics, The General Register Office for Scotland and the Northern Ireland Statistics and Research Agency. Statistics analysed by BirthChoiceUK – available at www.BirthChoiceUK.com/HomeBirthRates.htm

Back after the bump: Mums face a challenging return to the workplace

Returning to work after maternity leave is still a hugely daunting and difficult experience for many mothers, according to new survey published today (30 November) by the NCT.

One in three women (39 per cent) said they found going back to work after having a baby ‘difficult’ or ‘very difficult’, with 31 per cent saying their relationship with their boss had deteriorated since they had become pregnant. Despite a host of legislation and HR policies aimed at successfully welcoming mothers back into the workplace, many say they’re still not receiving the support they need.

The study, which surveyed over 1,500 mothers who have recently gone back to work, also found that one in three (32 per cent) felt their promotion prospects had been reduced since having a baby, while 13 per cent said they have reduced seniority since returning to work.

Currently, employees with caring responsibilities for children aged 16 and under have the statutory right to request to work flexibly, enabling them to adjust their working pattern to suit their needs. The vast majority (88 per cent) of mothers who were surveyed for the NCT’s report wanted to work flexibly on their return to work. However, one in six (16%) of those said their request for flexible working practices had gone nowhere.

Emma, a bank office clerk, found her return to work extremely frustrating: “I told the HR department and also my line manager when I’d be coming back, but still nobody was expecting me when I returned. I’ve also seen the same happen with two other colleagues. It’s a bit disappointing really and makes you feel as if you’re not wanted.”

Renata, a shop floor supervisor, also experienced difficulties, particularly when it came to a request for flexible working:

“Before my maternity leave, I decided that when I returned to work I would work part time. I completed all the necessary paperwork and it was formally confirmed with my manager. However, a week before my return, he informed me that no part-time work was available. It was completely unprofessional; they shouldn’t have made false promises.”

To help guide both mothers and employers through a smooth return to the workplace, the NCT and the charity Working Families have published two free downloadable guides available : click here: www.nct.org.uk/returningtowork

or www.workingfamilies.org.uk.

Sarah Jackson, Chief Executive of Working Families, says: “Returning to work when you have a new baby can be very difficult for the new mother and her manager. But the good news is that problems can be avoided by good communications and good planning together. These new guides take mother and manager step by step from early pregnancy, through maternity leave and a successful return to work”

Top tips on maternity leave for mums:

– Prepare a handover plan – discuss with your boss the options for handing over responsibilities and when it is appropriate to do this
– Remember, you are entitled to 52 weeks maternity leave, regardless of length of service or the number of hours you work
– Keep a record of everything and try to get agreements in writing
– Start thinking about your return to work early on
– Anything can be flexible working – it doesn’t have to be a reduction in hours, it could be home working, compressed hours, job sharing or term time only working

Notes:

The online survey was completed by 1,541 mothers from 1 September – 31 November 2008.

The experiences of women returning to work after maternity leave in the UK – This report seeks to understand experiences of mothers returning to work after maternity leave in the UK

BPA in plastic bottles

Breast Cancer UK today launches a campaign calling on the Government to take action to end the use of controversial chemical, Bisphenol-A (commonly abbreviated to BPA), in baby bottles.

This call is backed by NCT (National Childbirth Trust), UNISON, The Women’s Environmental Network, the Cancer Prevention and Education Society and CHEM Trust.

Already voluntarily withdrawn from shelves in Canada and the USA, polycarbonate baby bottle made with BPA are still available in the UK, despite our view being that clear and compelling scientific evidence in lab experiments have linked even low level exposure to increased risk of breast cancer and other chronic conditions.

In the first survey of its type ever conducted, just under four in of five (79%) of the public either strongly agree (50%) or agree (29%) ‘that it is important that the UK Government acts in a precautionary way when it comes to protecting babies and very young children from BPA’.

Women feel even more strongly, those agreeing or strongly agreeing rises to just under 17 in 20 (84%).  While 61% of the public think the UK Government should ‘act to end the use of BPA in baby bottles’ 61% and only 10% think the Government ‘should follow the current FSA guidelines and leave things as they are’.

The No More BPA campaign is being launched just a day after an expected announcement on BPA, due on the 30th of November 2009, from the US Food and Drug Administration, that have similar regulatory authority on food contact products and public health as do the UK Food Standards Agency.

Baby bottle manufacturers, anticipating the Canadian ban as well as expected regulatory action in the US, have already withdrawn baby bottles made with BPA from shelves.

The plastic recycling number 7 is sometimes imprinted on polycarbonate plastics, but as the number 7 code is used as the catchall for ‘other plastics’, even this limited labelling is very unclear.

Doulas – a help for mums

Commenting on BMJ.com, a doctor today says that the presence of doulas during labour may alter the doctor-patient dynamic and can compromise communication and therefore patient care.

Furthermore, the need for doulas implies a failing of medical and midwifery services and also the support provided by family and friends, says Dr Abhijoy Chakladar who was working at Worthing Hospital in West Sussex when he first encountered a doula.

Background

There are two types of doula – birth and postnatal – and some cover both areas. A birth doula is there to offer physical and emotional support to you (and your partner) during labour and for your birth. They don’t do anything medical but are a continuous, reassuring presence.

Most (but not all) doulas are mothers themselves and may or may not have done additional training. Those recognised by Doula UK will have completed an approved training course and will have de-briefed and reflected on what birth means for them. A birth doula will usually cost between £200 and £600. Postnatal doulas are there to support you at home after the birth – ‘mothering the mother’ so you can mother your baby.