Pregnancy After Preemie: Reducing Premature Births

If your baby was born prematurely, you may be concerned the same thing could happen with your future children. What does preterm labor and preterm birth look like? What factors typically trigger labor prior to 37 weeks gestation? And what can you do to minimize those risks?

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Preggie Pals
Pregnancy After Preemie: Reducing Premature Births
Episode 61, July 1st, 2013

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[00:00:00]

[Theme Music]

Sunny Gault : If your baby was born prematurely, you may be concerned the same thing could happen with your future children. But are you really more at risk? What factors typically result in preterm births? And what can you do during your pregnancy to make it full term? Vicky Lombardo, Associate State Director of Program Services for the California Chapter of the March of Dimes is joining us today. We are discussing ways you can reduce premature births. This is Preggie Pals, episode 61.

[Theme Music/Intro]

Sunny Gault : Welcome to Preggie Pals, broadcasting from the Birth Education Center of San Diego. Preggie Pals is your weekly online, on the go support group for expecting parents and those hoping to become pregnant. I'm your host, Sunny Gault. Are you looking for an older episode of Preggie Pals? Be sure to visit the episode link on our website and check out the episode guide for links to all of our shows. And thanks to all of our loyal listeners who have joined our Preggie Pals Club. Our members get access to all of our archived episodes, bonus content after each new show, plus special giveaways and discounts. You'll also get a one year free subscription to Pregnancy Magazine. Visit our website, PreggiePals.com, for more information, and to sign up. And another way for you guys to stay connected is by downloading our free Preggie Pals app, it's available in the Androind and iTunes marketplace. So, let's meet all the ladies joining us here in the studio. Molly, let's start with you, tell us a little bit about yourself.

Molly Riffel : Hi, my name is Molly Riffel, I am 32 years old, I am a teacher, my due date was May 16th, and I have two little girls, one is two and a half years old and the other one is now eleven weeks. I had vaginal births with both, and with my second one I had preterm labor, started out with a little bit of cramping and throughout the day it just got more intense cramping, but by the end of the day it got intense non-regular, like I wasn't on the regular contracting. I went to the hospital and they tried giving me magnesium, that didn't work, and hours after I got to the hospital and she was out. It was really quick, very intense, very unexpected.

Sunny Gault : I remember I met you and I thought you were only around 30 weeks, and then I saw something on Facebook about you having the baby, and I thought, “Oh my gush! What just happened? Did I totally loose track of timing?”

Molly Riffel : It was really quick, even the doctors told me when I first went there that it will stop and I'll have a couple more weeks, and after about two hours on the magnesium, my contractions were getting more regular, they were spacing at three minutes and they would get very very intense. I think my labor from start to finish was 12 hours.

Sunny Gault : It was fast, really fast! OK, Stephanie is joining us here in the studio, Stephanie is our producer of Preggie Pals, and she is our social media guru, who is checking out Twitter and Facebook, if you guys want to join our conversation you can join our little Twitter party by following #PreggiePalsVP, which stands for Virtual Panelist. So Stephanie is going to be checking that out throughout the episode. Stephanie, tell us a little bit about yourself.

Stephanie Saalfeld : Hi, I'm Stephanie, I'm 30 years old, I have an almost six month old daughter, and like Sunny just said, I'm a producer for Preggie Pals.

Sunny Gault : OK, a little bit about myself, I've got some interesting news recently, I am pregnant, I thought I was going in for a routine appointment, this was a prescreening test, first trimester stuff, and I discovered that we are having twins! So I got this news a couple weeks ago, I thought we were going to be a family of five, but we are now going to be a family of six, so I have two older children, one is three, my oldest is three, and my youngest is one, and we've got two other babies on the way. We are due in December, I hope I make it to December, gush, this pregnancy is just off the wall, I don't even know what's going to happen. With a single kid you know what's going on, you know what to expect, I've been through this a couple of times already, and now I just don't know what's going on, it's totally crazy. But anyway, regarding today's topic, I am really interested in this, because, of course, with twin pregnancy, premature births happen all the time, I'm really glad we're doing it, so we will be right back.

[Theme Music] [Featured Segment: Ask the Experts]

[00:04:54]

Sunny Gault : We have a question from one of our listeners, Karie writes to us, on our Facebook page, and Karie says, “I've been putting together my birth plan, I'm a little torn about whether to do a natural or managed placenta delivery” - wait, before I continue with this question, Karie, we never want to say torn, and birth in the same sentence, that's bad karma! No tearing during birth. Anyway, she continues, “I'm doing hypnobirthing, which recommends no pitocin, and no cord traction. I discussed this with my midwife, and she is totally fine with that, if that's what I want. However, she would typically administer pitocin right after birth. I've been trying to research both choices and it seems like there is pros and cons for both routes, so I really don't know what to do.”

Care Messer : Hi Karie! My name is Care Messer and I'm a doula and hypnobirthing educator. Good for you for doing research on whether or not a managed placenta delivery is right for you. It's good to know both sides so you can make an informed decision. The reasons for giving pitocin after birth is to prevent postpartum hemorrhage, by helping the placenta to eject faster and help the uterus cramp down and stop the bleeding quickly. Only 1 out of 100 women have a postpartum hemorrhage, and that's one percent of moms. In my own birth, I felt that those odds were pretty good, so I asked my OB why they always gave pitocin. She said that it's for safety measures, if they have ten moms on the floor, they all get pitocin and prevent what could have been a postpartum hemorrhage. She said at a home or birth center birth, you have a midwife by your side a lot longer to monitor your bleeding and blood pressure, so automatic pitocin would not be so necessary. I followed up with a question about natural birth, if I chose not to get pitocin at the hospital, what would happen? She said, “Oh, you just get a nurse in the room monitoring you like a midwife, she never leaves your sight”. Pitocin helps you get out of the room faster as well, as it helps the placenta delivery faster and it will take less time than waiting for the placenta to naturally come off. It was great information to have and I am so glad that I asked. Keep in mind that in natural birth, some awesome hormone exchanges are going on between mother and baby. When the baby is placed on your chest right after birth, and you're allowed to remain there skin to skin, it will help with breastfeeding behaviors. The baby moves towards your nipple, they come around it with their hands and their mouth, it stimulates a lot of oxytocin, the love hormone, that naturally begins to contract and clamp down on your uterus. Then the baby natural's step in reflex is that they use to craw up towards the breast. It also encourages the uterus to clamp down and stop bleeding. Then, once they latch and begin to suck, it increases the oxytocin release, and that's when the cramping may become more intense, when breastfeeding starts. All these our your body's natural safety measures that have worked for hundreds of thousands of years all over the world, and still work today. Our bodies are amazing, and pretty powerful, if we just let them do their thing. It's nice to know that you do have a back up plan though, if we are the 1%. But if we are the 99%, our baby and body will work together just fine. You can read more about the hormonal exchange between baby and parents during pregnancy and birth, on SarahBuckley.com, and you can download her free ebook called “Ecstatic Birth”. Hope that helps!

[Theme Music]

[00:08:20]

Sunny Gault : Today's episode is all about pregnancy and preemies. It's a topic that was submitted by Cathy, one of our Facebook friends, and Cathy writes, “Hi Sunny! I love the show, I've been listening since the beginning, even before I was pregnant. I'm 27 weeks with my third, I have seven year-old twins who were born at 30 weeks. I'm really nervous that I will have another preemie, and would love to hear from you about pregnancy after a preemie, and how others cope with it. Keep up the great work!”. Well, Cathy, thank you so much for this email, for suggesting it, I think it's a fantastic topic, and something that really isn't talked about that much. So, joining us on the phone is Vicki Lombardo, she is the Associate State Director for Program Services for the California Chapter of the March of Dimes, that is a mouthful! I'm glad I got it out! And for those of you who don't know, the March of Dimes is a non-profit organization focused on reducing premature births and birth defects. Vicki, welcome to Preggie Pals!

Vicki Lombardo : Good morning!

Sunny Gault : Good morning, how are you doing?

Vicki Lombardo : I'm doing great, thank you for having me on the show!

Sunny Gault : Oh, absolutely. Vicki, let's kick things off by defining what a premature birth is.

Vicki Lombardo : Everyone needs to know, first of all, that a normal pregnancy is 40 weeks long. So a premature birth is any birth that happens before the completion of 37 weeks of pregnancy.

Sunny Gault : OK, and then what factors typically lead to a preterm birth?

Vicki Lombardo : Well, when you're talking in terms of researchers, they grouped them in about four categories of causes. 40% of the causes when it happens, we don't know why it happens. But here are the four groupings and one is infections and inflammation. And whether that or the fetal membrane might be even dental or peridental disease, it's an infection the body is fighting and may lead to preterm birth. The second grouping is maternal or fetal stress. And that can be a chronic stress, for instance a woman that's not living in a safe environment, or it could be stressful for the baby, because they're not getting enough nourishment for some reason. The body releases hormones that then cause the uterus to contract. The third grouping is bleeding. And that is often associated with the placenta not wanting to let go from the uterus, and that will cause the uterus to contract and the force of stretching – we're talking about twins this morning, when there is more than one baby, the uterus begins to stretch. It's nothing bad about having twins, 75% of those pregnancies go on to term, so it can be done, but when you get to triplets and quadruplets, and the higher order multiples, those are always born preterm. The second thing I wanted to focus on now is that your lifestyle affects your risk for preterm birth. And there is a comprehensive list on the March of Dimes website, at MarchOfDimes.com, but some of those are no prenatal care, smoking, drinking alcohol, domestic violence, extreme levels of stress, working long days and standing long periods of time. And then the mothers' health is the other thing. So the March of Dimes encourages women to see a doctor before you get pregnant, to make sure you're healthy. For instance, you don't have an infection, you don't have diabetes, your blood pressure is normal, and there are several other things that they will check you for and talk to you about.

Sunny Gault : I want to toss this over to Molly, first of all, there is probably a question of yours about why is this happening, did they give you a reason or were able to break stuff down for you?

Molly Riffel : We were moving prior to the birth, so it was probably a lot of bending over, standing up, packing, unpacking, so that's what the doctor thinks. Because I didn't have any other complication. With my first one, I had a hypertension towards the end, but had no problems with this one whatsoever, and I think it was probably from moving, and I had the flue two weeks prior, so that might have softened my cervix, 'cause I threw up so many times. So a combination between getting sick and then the stress of moving, actually physically, bending over and doing stuff.

Sunny Gault : I feel like, going over through that list of things that can lead to it, there are a lot of things that can lead to it, it's a little bit scary.

Vicki Lombardo : Not all of them are direct causes, but all add to your risk, and that's what we're trying to do, reduce that risk. And of the risks that I did not list is – if you're African-American, your risk of having a preterm birth is twice as high than if you were a caucasian. That's the groups that we don't know about.

Sunny Gault : That's amazing. One of the other things I wanted to discuss is elective interventions, and how those can lead to premature birth. Can you tell us a little bit about that?

Vicki Lombardo : They can lead to complications with the baby, primarily. We seem to be an impatient society, we want our food cooked fast instead of slowly in the oven, so we don't want to wait until 40 weeks of gestation, or we don't want to wait until we deliver spontaneously. It seems to be an increasing trend that women are asking for induction, or elective C-sections, they just don't want to go through labor. And when those were being done before the completion of 39 weeks of pregnancy, that's two weeks longer than spontaneous labor, those babies were getting in trouble, and were sent to the intensive care unit. So the March of Dimes is working very hard with doctors, nurses and the general public to get them to understand that unless there is a medical indication, we should not cause a delivery to happen either by C-sections or by induction.

Sunny Gault : And sometimes, we hear about this a lot in the birth community here in San Diego, we're making a big push for this not to happen as much, but it's not always just the moms that want this, but we're finding that the doctors are pushing for this, they have their schedules and everything too, so it's a little bit of a two-way street here, but the point is the same, and that is keep these babies in as long as you possibly can, right?

Vicki Lombardo : Yes, and I would encourage the moms that if the doctor suggested, “Hey, want don't you come in on Friday for an induction?”, and that frequently is the conversation. “I'm going on vacation, I can probably induce you safely on Friday”, something like that. One of the things the mom needs to know is not only there is a risk for the baby, but also it's an elective induction before 39 weeks increases her risk of having a caesarean birth by 50%. And we're encouraging women to ask the doctors some questions, the first one is, “What is the risk to me, and what's the risk to my baby of doing this?” and the second question is, “What's the benefit to me, and what's the benefit to my baby in doing this?” So if you ask those four questions, that's a nice way to begin that conversation with the doctor. The last question is, “How is my pregnancy dated?” Sometimes, there are lots of ultrasounds done, and there is a timeframe when the dating of a pregnancy by ultrasound is accurate, and then those later ultrasounds, when we're so tempted to change the due date, those aren't as accurate. And so we want to make sure that he is following the right criteria of dating the pregnancy.

Sunny Gault : I feel like that's all over the map sometimes, too, I know when I went in for my eight week ultrasound, believe it or not, the ultrasound showed a single kid, which was obviously off, and it also showed that the baby was measuring small. So it totally threw off the due date, which honestly I don't even know when it is anymore, I don't know if they changed it, this whole twin is new for us. But I feel like more and more moms that come on Preggie Pals say, “You know what? One person gave me this due date, another person gave me this, and I don't really know what it is”. That's kind of scary, because if you don't know when the baby is really supposed to come, then if they try to take it early, they could really be taken in early.

Vicki Lombardo : Yes. The safest way to know which time for the baby to deliver is to go into spontaneous labor. That's the safest way. But there is also the American Congress of Obstetrics and Gynecologist, that's the professional organization, set standards for that for all the doctors to use, so it's a researched thing for dating pregnancy and you're going to have the most accurate estimation of your due date.

Sunny Gault : Vicki, I feel like we've been talking about preterm labor, but a lot of the people that listen to our show are pregnant for the first time. And they may not know what labor even feels like, or even preterm labor, what some of the signs are, so can we go over that a little bit, I know everybody's pregnancy is different and what they feel, going into labor may be different, but what are some of the common signs of preterm labor?

Vicki Lombardo : Some of the common signs are a feeling of tightening of the uterus, that's one of them, called contraction, it tightens like a cyst, and it would do that on a regular basis, that's one way, but not everybody feels that. The second would be a change in vaginal discharge – it feels like you're leaking a fluid, there may be a little bleeding from your vagina, whether it's brownish or reddish, because the cervix is starting to stretch. The third is pelvic pressure, feeling like the baby is pushing down, it's not feeling hard, it just feels different. A fourth one is low or dull back ache. Everyone who's pregnant has a back ache, but this one seems to come and go. Another way to describe is just that women feel menstrual cramps differently, the same thing is true with labor. So if it feels like you have menstrual cramps in the second half of your pregnancy, that could be preterm birth. And some women will describe it like they are having intestinal cramps, like diarrhea or something like that. And that may be what you're actually having, so those are all signs that you should call your doctor and talk to them about that.

Molly Riffel : I know that when I had my first child, I was cramping everywhere, all over my belly, everything. And with my second one I was cramping just from the bottom. That's why I didn't think I was going into labor, 'cause it was just at the very bottom, just the base of my pelvic bone, that's the only place I was having the cramps, and the doctor was like, “Well, you know, it could be preterm labor”. I had eggs before, and that was all over, so that's why I thought this was no big deal, something different, I just strained myself, and the doctor said that no, it could be preterm labor, come on in, let's check you. I let it go for probably six hours before I even called the doctor, because it wasn't a big deal to me.

Sunny Gault : Could you time them at all?

Molly Riffel : No. And that's the thing, it was coming and going and there where times when I would go for 40 minutes and no contractions, there were times when I would go for like consecutively for two minutes and there was no apparent reason in what was going on, that's how I thought that something is happening. And then I also had the spotting, and that's what kind of scared me, I didn't have that at all with my first one.

Vicki Lombardo : So these were brand new symptoms, you hadn't experienced them before.

Molly Riffel : Right.

Sunny Gault : I think it's helpful to have already had a pregnancy, you kind of know what to expect, and then yes, they can be different across the board, of course, but we get more red flags, “This isn't the same”

Vicki Lombardo : Right.

Sunny Gault : So Vicki, for listeners that are listening to this episode right now and have had a premature baby in the past, I know they have a lot of questions about this, we will dive into that a little more in the second half of this show, but what are your odds of having another premature baby if you've already had one?

Vicki Lombardo : Overall in the United States everyone has a 5% chance of having a preterm baby, whether they've had one or not. And if you've had one preterm baby, than you increase those chances to 15%, it's not excruciatingly high, you can certainly have one preterm baby followed by a term baby. If your first baby was term and your second baby was preterm like Molly's, the odds are increasing to 24% for the third baby. So you think about that as you plan your future. If you've had two preterm babies, then you're kind of on the track for preterm birth, and you're up to 33%.

Sunny Gault : So it really does kind of build on your previous pregnancies, right?

Vicki Lombardo : Yes. Again, remember, just as Molly had one term birth and then had a preterm birth, we can't tell you when it's going to happen for sure, we do know, in studying all of the data of that that there is an increased risk in the predictor of a woman having a preterm birth if she had one already. So we watch them much more closely.

Sunny Gault : Alright, well when we come back, we're going to discuss what options moms-to-be have in reducing their odds of having another premature birth, plus, what should parents know if their baby is born preterm? We'll be right back.

[Theme Music]

[00:22:04]

Sunny Gault : Welcome back, today we're talking about pregnancy and premature births, and our expert is Vicki Lombardo, with the California Chapter of the March of Dimes. So Vicki, what medical options do parents have to try and prevent another premature birth? Or even stop labor, if they happen to go into labor?

Vicki Lombardo : I'll get to stopping labor later, but as far as the options that you have right now, the biggest most important thing you can do is to see your doctor when you start thinking about getting pregnant. When you stop using birth controls, and you're actually trying to get pregnant you want to see the doctor first. Because your health care practitioner can help make sure that you are as healthy as possible. That's one of the pieces that are still very important. So you're the right weight, your blood pressure is in control, you don't have high blood sugar, they've checked you for everything else and you've stopped smoking. That's the first thing. For the women that are listening that have had a preterm birth, a single baby, and it was delivered preterm, then we have a medication now that the doctor can give you during this second pregnancy that will decrease your risk of having a second preterm birth by up to 70%. It's a great medical known as 17P, it's a progesterone that's given to the moms, and is successfully helping moms that have single pregnancies, one baby, to go on to term in much larger numbers now.

Sunny Gault : It's a shot, Vicki? Is that what you said it was?

Vicki Lombardo : It's a shot, and you get it weekly from your doctor. And they know you're at risk and then they give it throughout your pregnancy.

Sunny Gault : But you would already had to have a premature baby in order to get that?

Vicki Lombardo : Yes, you wouldn't give it to someone that you have no indication that will have a preterm birth. The doctors will go deeper, and I do not have the expertise of a doctor, I'm a nurse, but there are certain things that they use if your cervix is getting short, and there are other conditions going on, so all hope is not lost for everyone, but we do know that this 17P has been very effective, and we're encouraging all the doctors to use that with their patients. Regarding stopping preterm labor, the bad news is that if a woman is truly in preterm labor, she can't be stopped, we don't know how to stop it yet. There are several different drugs that we can give a mom to slow down the contractions. If you weren't in true preterm labor in the first place, those medications will stop those contractions, but if you're really in preterm labor, your body has decided it's time to deliver, we can't stop it, but we can slow it down and it gives us an opportunity to give you two shots of a medication that will help the baby's lungs mature. Because the biggest risk to the baby is that their lungs won't be developed enough and we'll have to give them oxygen or something after they are born. So we give you these two injections. The second thing that's slowing down that contractions is a chance for the doctor to asses what level hospital you are presently being cared for where you are. If you're going to have a premature baby and there's not a NICU in that hospital, then you should be moved before you deliver to the next level hospital where there is one to care for your preterm baby.

Molly Riffel : I have a quick question, so if I could have been gotten to the doctor sooner on the day that I started having contractions – 'cause I only got one of the steroid shots, because everything happened so fast, is there a possibility that if I would have gone earlier, they might have prolonged my labor a little bit longer than the 12 hours?

Vicki Lombardo : It's possible. Yes. It's possible, but don't feel guilty about it.

Molly Riffel : No, I'm just thinking about for the next one, if we do have a next one, I've learned that if I feel anything, get to the doctor, if there is anything we can do, we'll do as much as we can.

Vicki Lombardo : That's what you would want to do and it's best for the baby, it decreases the baby's respiratory complication risks if you can get both of those shots.

Sunny Gault : Vicki, and actually, this is a question for Molly too, I kind of want to give our audience an idea of what it's like, especially within the first – and I guess it depends on how early you end up delivering your baby, but in those initial days and weeks, what parents can expect with a premature baby? We've been talking about the NICU, and again, I know everything depends on how old the baby is at the time of birth, but, Molly, let's start with you. Can you tell us a little bit about your experience, I know your baby just got out yesterday, so this is very fresh on your mind. If you have advice to give to parents of premature babies, what would it be based on your experience?

Molly Riffel : Well, our daughter was born with Down syndrome, and also a congenital heart defect, so we pretty much knew that she was going to have to be in the NICU to be monitored, and so she was early and we were worrying about her lungs. Luckly, her lungs came out fine, but the first few weeks were tough to know that she is here, something is going wrong, she had a heart failure early on as well. We were trusting our doctors in what they were saying and we got to the point were we realized we needed to start to ask questions, “Why are you doing this? What's the reason behind giving her this?”, lots of questioning, they are there to help her, but they are also there to – it seemed like they were making decisions on comparing her to other preemies, which she wasn't, she wasn't just another preemie. So we had to look at her medical condition and say that she's special, she's different than what you're used to working with, so how can you treat her as an individual, instead of comparing her across the board to a preemie? So for us it was asking questions, we would try to get second opinions, our hospital kind of couldn't help us very much, so we ended up moving her actually, because she needed the care that she needed, so we took her out of the hospital she was and went to another one, which is the hospital that everybody goes to, and we talked to them and told them she has Down syndrome and has a heart condition. We learned to ask questions, find out why they are doing what they are doing, get involved, be as involved as you can, because you know your baby the best. Because you can't rely on nurses, they have a 12 hour shift and they usually work two, three days a week.

Sunny Gault : So you have to be your baby's advocate.

Molly Riffel : Yes. You have to know, “Is this what my baby normally looks like?”, you have to know your child so that you can say that something is wrong. So you have to be as involved as you can be. Luckly, we were able to be there all the time, we had somebody to help out with our other daughter and we were able to be there all the time, so we were able to watch her and be on top and say, “No, this isn't normal”, and step in and say that something is happening, or “why are you doing this? Do you really need to do that now?” So questioning was the one thing we learned.

Sunny Gault : And she was at the NICU for how long?

Molly Riffel : She was in there for 79 days. Very long time. We kind of pushed towards the end to get her out, because it just came down to the fact that she needed to eat. Because most preemies don't eat for a while, 'cause when they are born at first they don't know how to eat, so they have to learn to eat, and for her, with her complications and her heart condition, she couldn't eat for an extended do, so she wasn't getting as much nutrients as she needed through the milk. She's on a feeding tube now that they've put into her belly, so she is able to eat, but they were just waiting to make sure she could handle it and we can do it at home, where we are all comfortable. When they finally said, “Yeah, let's send you home”. We were like, “Yes!” It was a relief. Very big relief to be home.

Sunny Gault : I am so glad. OK, Vicki, is anything you would add to that? I know there is probably a lot we could discuss, but any big tips for parents out there?

Vicki Lombardo : Molly hit the biggest ones parents can do for the babies, because you do know your baby the best. But the things we advise parents to do, when a parent walks in, often the NICU is the very first experience that they have in a hospital, and it's a scary place. There's lots of tiny babies, there's lots of equipment, everything is different. So being patient with yourself, know that this is a new world, you have to learn about it, ask questions, tell people how you're feeling, give yourself permission to cry and be sad, because you didn't have that term baby that you've been hoping and dreaming for. Knowing that your baby does need you, even though you're not making the decisions that parents of term babies are making, such as, “This is my feeding schedule, I'm going to bath my baby now and this is how I am going to dress my baby”, you can be there for your baby by touching your baby, talking quietly to your bab, putting a cloth in your baby's bassinet or isolette at the incubator the baby stays in, all of these things help the baby to calm down, and actually respond much better to the treatment that the doctors and nurses are doing.

Molly Riffel : That's one of the things I would also suggest, finding support. The NICU we were in, we weren't able to talk to other parents, because each baby had their own room, so we were very isolated. For the first few weeks I was severely depressed, my baby was struggling, we were having problems, my family was broken up, so to be able to talk to somebody else – somebody who's been through it and who's experienced being in the NICU, 'cause you can't talk to people who haven't been there, they don't understand. And it's nice to have somebody else go, “Oh, yeah, I remember that, I understand what you're going through”. And then the sleeping with the blanket, I slept with the blanket every night and then put it in my daughter's isolette so that she could smell me. If I would forget to do it, my husband would do it, just so she could smell us, so she knew we were there. 'Cause we would spend the night with her, we were able to, but just having her smell us was a huge thing, 'cause she wasn't able to breastfeed, so having her know that I'm still there. And then, for moms who aren't able to breastfeed, a lot of NICUs won't allow you to breastfeed, 'cause they need to monitor how much the baby is getting in milk. We would do skin to skin and I would sit there with my breast out and she would be able to lick it, smell it, so that she knows that it's comfort as well as nutrients. That was huge. I talked to a couple of moms in the NICU once I was able to talk to them, until then it has never been suggested, because the doctors never thought about it.

Sunny Gault : They wouldn't let you pump, even? I know that they measure how much...

Molly Riffel : I was able to pump, so she was getting breast milk, but she wasn't able to latch on, and plus, the heart condition, to latch on breastfeeding is a hard thing for her to do, so she wasn't able to go very long, she did it, and it was great, she was able to latch on and nurse, but they want to monitor how much they are getting, so they pushed into bottle feed.

Sunny Gault : Vicki, before we wrap up our conversation, I wanted to give you an opportunity to tell people a little bit more about the March of Dimes, I think we all have heard of them already, but I don't know if we really know all the efforts and struggles you guys are making in this area of premature births.

Vicki Lombardo : Molly touched on something that's very important to parents in the NICU, and that's connecting with other parents. In addition to Preggie Pals, the March of Dimes hosts an online community of NICU parents, and you get there by going to shareyourstory.org, and that is where you can see all of the parents' stories and you can actually become interactive, you can find someone to talk to, and we just updated that website, and now you can find other parents in your geographic area. So that is very helpful. The March of Dimes' mission is to improve the health of babies by preventing birth defects, premature birth and infant mortality. We fund research, we do professional and public education, we fund community services and we also have a very special program called “The NICU family support program” that's active in over 100 NICUs across the country, where we actually have a March of Dimes employee in the NICU, and their sole role is to help parents through this experience, and to find their role in taking care of their baby. And then last but not least, we do advocacy, we change laws so that we improve access to care, and we get newborn screening tests done on baby centers, we can identify problems that can be treated before the baby gets into trouble.

Sunny Gault : We're certainly glad this organization has been around, and for how long? 75 years, is that what I saw on your website?

Vicki Lombardo : Yes, 75 years.

Sunny Gault : That's fantastic!

Vicki Lombardo : We're 75 years old this year, we were founded in 1938 to find a cure for polio, and no one sees polio in the Western hemisphere because of the work of March of Dimes.

Sunny Gault : That is so wonderful! So awesome. Well, Vicki, thank you so much for being with us today and sharing your expertise and knowledge with our audience.

Vicki Lombardo : You're welcome!

Sunny Gault : For more information on our expert as well as our panelists, you can visit the episode page on our website. This conversation continues for members of our Preggie Pals Club, after the show, Vicki will share some important questions you should ask your medical care provider if you think you're at risk for a premature birth.

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Sunny Gault : Before we wrap today's show, here's some maternity fashion trends, from Krystal Stubbendeck, of Borrow for your Bump.

Krystal Stubbendeck : Hello Preggie Pals! I am Krystal Stubbendeck, maternity fashion expert, and founder of Borrow for your Bump, where you can buy or rent maternity items for a monthly rate. Today we are going to talk about the upcoming fall fashion trends for moms-to-be. These little ideas and wardrobe essentials are stylish and versatile as your bump grows and can easily transform any look as the new season approaches. Trend number on is the long sleeve mini. The key to this dress is to show skin in some areas, while keeping other covered up. We love long sleeved styles that show off more leg. The trick is to keep this fit loose and flowing. Add a belt to tie over the bump which will create curves. We love the colors of condiments. Think olive greens and mustard yellow. To tie this look together, avoid a skinny heel and try comfy wedge boots. Trend two is sexy stipes. Whether you are more on the hippy side or if you want to create curves, stripes is one detail that works for many body types. Stick with thinner stripes and dark colors. Wider stripes can make your bump and backside appear larger. Focus on a fit that hugs your curves and has ruched sides. This type of dress looks good on many body types whether you want to create curves or even balance wide hips. Tie the look together with some flat knee high boots. For our third trend, prints all the hype this fall. Have fun with different styles but make sure that the colors match. We love a silky print dress for a more dressed up look with purple and aqua tones. Dress prints down by taking a fun print blouse and pair with skinny jeans. For colors we love orange, navy and cream with a tan boot. You are probably seeing this next trend everywhere… Leather! We love this look for moms-to-be. Pair a comfy pair of stretch leather leggings with a basic gray sweater or for a retro look try a navy polka-dot blouse and fun rusty colored heels. Add a fun hair piece like a bird cage for a sleek style. Our final trend for fall is dressed up details. An incredible cocktail dress is a must have for all seasons. Spice up the standard Little Black Dress and find a style with beaded detail on an empire waist. An LBD with a little bit of lace is also chic and season less. Many of these fall trends can be found at BorrowforyourBump.com. Enter promo code “PreggiePals” to save 20% on your entire order. Thanks for listening to today's fall fashion trend, and be sure to listen to Preggie Pals for more great pregnancy tips.

[Theme Music]

Sunny Gault : That wraps up our show for today, we appreciate you listening to Preggie Pals, don't forget to check out our sister show, Parent Savers, for parents with newborns, infants and toddlers, and our show The Boob Group, for moms who breastfeed their babies. Next week, we're launching a new series on Preggie Pals, called “Childbirth choices”, which explores some non-traditional options for birthing your baby, and we are kicking things off with an episode on home births. So this is is Preggie Pals, your pregnancy, your way.

[Disclaimer]

This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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