- PediatricsGeneral Page Tier 3BlogSleep-related deaths claim about 3,500 infants each year in the U.S., according to the American Academy of Pediatrics (AAP). Locally, we have seen an increase. In 2016, eight infants died in Anne Arundel County as a result of unsafe sleeping practices. This is up from two deaths in 2015 and three in 2014, according to statistics from the Anne Arundel County Department of Health. Health department officials say all deaths were linked to unsafe sleeping practices, such as infants sharing a bed or sleeping under blankets. But you can take steps to prevent this type of tragedy by being mindful of how you put your baby to sleep, using the right sleep surface and avoiding bed sharing. Know your ABCs AAP urges all caregivers to follow the ABCs to make sure babies are sleeping safely. Always place your infant to sleep alone, on his or her back, and in a crib or bassinet with a firm surface. “If you don’t do anything else follow the ABCs,” says Debbie Wasem, supervisor of Women’s Education for AAMC. Wasem says experts used to tell parents to place babies to sleep on their stomachs, believing that if the infants were choking or throwing up, there would be less chance of suffocation. But that’s not true. “When you look at the anatomy of a newborn it makes sense to place babies on their backs,” she says. Source: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Use a firm sleep surface You should place your baby to sleep on a firm sleep surface, covered by a fitted sheet, with no other bedding, pillows or toys, to reduce the risk of suffocation. Soft mattresses, including those made from memory foam, could increase the chance of rebreathing in carbon dioxide or suffocation if the infant rolls over. Use the right crib You should look for cribs with slat spacing less the 2 3/8 inches, snug fitting and firm mattresses, and no drop sides. You should not use a crib with missing hardware. Experts also caution against the use of bumper pads in cribs. Maryland banned the sale of these items in 2013. Be careful with swaddling If you swaddle your infant, you should always put the baby to sleep on his or her back. You should stop swaddling once the infant shows signs of trying to roll over. Big bulky blankets could also potentially cover an infant’s face leading to breathing problems, Wasem says. Consider using a pacifier Several studies indicate a pacifier may reduce the chances of a sleep-related death, though it’s unclear why. You should use a pacifier when putting the baby to sleep. Never hang a pacifier around an infant’s neck. You should also wait to use a pacifier until breastfeeding is well established. The National Institute of Child Health and Development broke down some of the studies here. Infants should sleep close to your bed — but not in it There is evidence that sleeping in the parents’ room – but on a separate surface – decreases the risk of sleep-related deaths by as much as 50 percent. “One of the big things mothers say is ‘when I breastfeed, it’s so much easier to have the baby right next to me,’” Wasem says. “We tell them have the crib or bassinet right beside your bed so you can easily reach the baby for feedings. That is safer than risking falling asleep with the baby in bed with you.” Learn more about how to care for the new addition to your life at AAMC’s Newborn Care class. Originally published April 5, 2017. Last updated June 13, 2019.0
- General Page Tier 3BlogMany of us are still working and learning virtually from home. That’s why this is a good time to take a closer look at your child’s (and your own!) relationship with snacking. A good rule of thumb is to keep it simple. To do that, ask the four ‘w’s’ – why, when, where and, most importantly, what. Why is your child looking for a snack? Snacks are important to help your child meet nutritional needs for overall health. But, if they are seeking snacks more frequently, it’s fine to ask them if they might be feeling something other than hunger. For example, feelings of stress or anxiety, boredom or loneliness, thirst or fatigue can bring about food cravings. If one is an issue, be sure to address the underlying problem. When does a snack make sense? Snacks are important to help children meet their nutritional needs. It helps them stay focused and gives them energy to get through a busy day. In general, children and teens need to eat every three to four hours during the day. Younger kids need at least two snacks a day. Older kids/teens need at least one (two or more if they are participating in sports or going through a growth spurt). The timing of snacks is important, too. You want your child to have an appetite for their meals and not get in a habit of grazing throughout the day only to refuse food at mealtime. Consider offering a snack a few hours after one meal ends and an hour or two before the start of the next meal. Offer meals and snacks at predictable times. Where should you eat a snack? Make snacking an eating event. Have specific areas in your home where snacking takes place. For example, the kitchen table, the counter or a table outside during nice weather. Research shows that when kids snack while doing other things, such as watching TV or studying, it can lead to overeating. And when your child eats all over the house, you’re less likely to be aware of what or how much they are eating. What to eat as a snack? The nutritional choices you and your children make are crucial. Good nutrition is essential to good health. Parents need to think about food choices as health decisions for their children. Think of snacks as “mini meals.” Try to make 50% of a snack a fruit or vegetable. Add in a high fiber grain, like whole grain cereal or bread. Or add in lean protein, like sliced turkey or peanut butter. This will keep their tummies happy until the next meal or snack. Additional tips for healthy snacking Involve your children in age-appropriate meal and snack planning and preparation. Keep produce in plain sight. For example, a bowl of fruit on the counter or table. Have cut veggies and fruit in baggies or on a plate in the refrigerator. Purchase frozen fruit for a quick smoothie. Prepare small portioned containers of trail mix or dry cereal. Keep small yogurts and cheese sticks on hand. Try baked chips with homemade salsa or bean dip. Roast some chickpeas or kale chips. Prepare mini bagels with nut butter and a banana. Your turn! Prepare a yogurt parfait with your child Set up a yogurt parfait bar. Place all the ingredients on the table and have your children make their own yogurt parfaits. It can be a fun and nutritious snack activity. You will need: Greek yogurt or non-dairy coconut yogurt Granola or your favorite dry cereals Mixed, cut fresh fruit Pumpkin, sunflower seeds or nuts (for older children) Start with yogurt in the bottom of the glass or bowl and alternate layers of cereals, fruit, seeds and nuts. Enjoy! Authors Ann Caldwell is a nutritionist and registered dietitian at Anne Arundel Medical Center. To reach her, call 443-481-5555.0
- Women's HealthGeneral Page Tier 3BlogMaintaining good health during pregnancy involves more than just watching your weight and taking your prenatal vitamins and folic acid. It also includes managing your blood pressure. Blood pressure is the force of the blood pushing against the artery walls. The force is created with each heartbeat as blood is pumped from the heart into the blood vessels. If the pressure in your arteries becomes too high, you have high blood pressure, also called hypertension. Sometimes high blood pressure is present before pregnancy. In other cases, high blood pressure develops during pregnancy. SEE MORE: Are you at risk for high blood pressure? Take this quiz! While there is no exact cause of hypertension during pregnancy, there are many factors that increase your risk of having it. Your risk may be higher if you’re: Pregnant for the first time Overweight or obese Over 40 years old African American Giving birth to multiples Have a history of hypertension Hypertension is known as the silent killer because those who have it often do not have symptoms. “This is why it’s so important to come to all of the prenatal care appointments,” says Laura Merkel, MD, a board-certified obstetrician and gynecologist at Annapolis OB-GYN. “Even if you’re feeling great, we want to see you, measure your blood pressure and check on your baby.” While many women with high blood pressure deliver healthy babies, hypertension can affect the kidneys and increase your risk of heart disease, kidney disease and stroke. Other complications include: Fetal growth restriction: High blood pressure can decrease the flow of nutrients to the baby through the placenta. The baby may have growth problems as a result. Preterm delivery: If the placenta is not providing enough nutrients and oxygen to your baby, your provider may decide that early delivery is better for your baby than allowing the pregnancy to continue. Placental abruption: This condition, in which the placenta prematurely detaches from the wall of the uterus, is a medical emergency that requires immediate treatment. Cesarean delivery: Women with hypertension are more likely to have a cesarean delivery than women with normal blood pressure. A cesarean delivery carries risks of infection, injury to internal organs, and bleeding. Your health care provider may also test your urine for protein because hypertension during pregnancy may lead to preeclampsia. This is the most serious form of hypertension during pregnancy. Along with high blood pressure, there are signs that some organs may not be working properly. Preeclampsia is a serious condition characterized by the following signs and symptoms: High blood pressure. Swelling of face/hands. Protein in urine. Changes in vision. Call your doctor if you are experiencing any of these symptoms. Preventing High Blood Pressure During Pregnancy There isn’t a magic pill or one single medication that prevents high blood pressure during pregnancy. The good news is there are some simple ways to keep your blood pressure down. You can: Reduce salt intake. Limit intake of caffeine. Avoid tobacco entirely. Get lots of rest. Drink at least 10 glasses of water every day. Do not drink alcohol. Reduce stress levels. Elevate your feet when possible. After the birth of your baby, your care team will closely monitor your blood pressure. Your gynecologist and nurses will watch for any symptoms of preeclampsia. Typically, blood pressure falls back into normal and safe levels within a few weeks of delivery. However, we encourage all new moms to continue monitoring themselves once they’ve arrived home, especially as it relates to high blood pressure. Signs your blood pressure may still be high are: A headache that won’t go away. Irregular vision (spots, blurry vision). Nausea or vomiting. Very little urine output. You just don’t feel well overall. “If you notice any of these symptoms, contact your health care provider right away,” says Dr. Merkel. “Don’t attribute a bad headache to being a normal pregnancy symptom, it could be something more serious.” Originally published April 4, 2018. Last updated April 26, 2019.0
- Behavioral Health, Heart CareGeneral Page Tier 3BlogJuggling multiple commitments during the holidays might bring out the best in you. Or it might leave you feeling stressed, anxious or depressed. These feelings go well beyond your mental health. They can have short-term and long-term effects on your whole body, especially your heart. Boaz Rosen, MD, a cardiologist at Anne Arundel Medical Center, says it is important to find ways to manage the emotions the holidays bring out. “Stress and anxiety can affect the heart in a variety of ways, such as increasing blood pressure,” he explains. Tips to Relieve Holiday Stress When it comes to the holidays, finding the right balance between celebration and healthy habits will serve your heart well. Recognize your hot buttons. Think about the things that made you anxious or sad during previous holiday celebrations and develop a plan to cope with those stressors. Carve out some time for yourself. Exercise, meditation, yoga, prayer or time with a favorite book or movie can help you relieve stress. Practice moderation with sodium and alcohol. Repeated use of large amounts of sodium or alcohol can cause heart problems. More importantly, Dr. Rosen says, people may try to use food, smoking or alcohol to relieve stress, anxiety or depression. Weight gain from overeating can affect blood pressure and contribute to an increased risk of diabetes. Tobacco use has well-known short- and long-term effects on the heart and lungs. And while moderate intake of red wine (not more than one glass a day) can be beneficial, excessive alcohol use can affect heart, brain and liver function. Dr. Rosen also warns that it’s important to know the signs of a heart attack and to take any symptoms seriously. “A lot of people will ignore chest pain symptoms thinking it’s indigestion,” he says. “They describe a gassy feeling of pressure or discomfort in the chest. If there is any concern or if antacids don’t take care of that discomfort in minutes, think ‘heart’ and call 911. Even if it turns out to be indigestion, it’s better to be safe than sorry. On a positive note, I wish you and your family a happy, healthy holiday season!” Learn your “heart age” and risk for heart disease with AAMC’s free online heart risk assessment. Author Boaz Rosen, MD, is a cardiologist at Anne Arundel Medical Center. Originally published Dec. 5, 2016. Last updated Dec. 12, 2019.0
- Behavioral HealthGeneral Page Tier 3BlogAbby Forbes was in drug rehabilitation for the second time when she had to overcome an unexpected hurdle. By the time she was in her mid-twenties, Abby had been battling addiction for nearly a decade. She began consuming alcohol at 15, drinking to the point of blacking out. She later began experimenting with marijuana and ecstasy before moving on to heroin. Her addiction led her to Pathways, Anne Arundel Medical Center’s drug and alcohol treatment facility, where she was determined to get clean for good. But a new obstacle stood in her way. This time, it was in the form of adventure therapy, Pathways’ hands-on outdoor activities course designed to challenge patients’ problem-solving skills. Abby remembers standing on a wooden platform with about 15 other people. Each person had to climb up a rope and swing to another platform several yards away. As Abby struggled with the rope, the others tried to help. Still, she was determined to do it herself, insisting to the group that she could handle it despite falling twice. Mark Sakraida, Pathways’ adventure therapy coordinator, walked over to her. His words remain clear in Abby’s mind, 16 years later. “How is that like recovery?” he asked her. It was as if a lightbulb went on in Abby’s mind. “I learned to ask for help,” she says. “I couldn’t do it alone” Abby first came to Pathways in 2000, after her parents had kicked her out of their home. “I was in a very child-like state,” she recalls. “I wanted what I wanted, when I wanted it.” She briefly moved in with a boyfriend, living in his family’s basement in squalid conditions. After a few days, she called her parents. They told her she could come back home – as long as she went to rehab. She remembers having a chip on her shoulder the first day at Pathways, though she felt better after receiving treatment for drug withdrawal symptoms. Abby stayed at Pathways for 15 days. She loved the supportive community there, but didn’t know what to expect upon being discharged. “I was scared,” she says. “I left with knowledge of coping skills. And then it somehow evaporated.” Abby says she got back in touch with other users, and fell back into her old habits. Seven months later, she returned to Pathways. This time, she was in a different place mentally. “I wasn’t as nervous. I was excited about who I was going to meet and learn from,” she says. Abby had been through adventure therapy when she was at Pathways the first time, when she learned the importance of teamwork. Yet it wasn’t until she was back for a second round, standing on that platform and working hard to climb up the rope, that the lessons hit home. “I couldn’t do it alone,” she says. READ MORE: The benefits of play: Why the playground is essential to a child’s development The benefits of adventure therapy Now 42, Abby has been sober since 2001. She works as a peer support specialist with the Anne Arundel County Department of Health, connecting addicts with community resources such as Pathways. Abby says Pathways gave her a strong foundation that has served as the basis for her successful recovery. She regularly attends 12-step meetings, where she met her husband. And she’s still not afraid to ask for help when she needs it. Mark, who has served as adventure therapy coordinator since 1994, cites an ancient Chinese proverb when explaining why adventure therapy works. “Tell me, I’ll forget. Show me, I’ll remember. Involve me, I’ll understand,” he says. “I tell patients that my job is to take them out of their comfort zone – and I think I do a pretty good job of that.” More than a decade and a half after leaving Pathways, Abby finally got the chance to thank Mark. She was at a work meeting at Pathways this summer when she walked past him in the hallway. She stopped and told him how she still thinks about the lessons she learned so many years ago. “He has a special place in my heart,” Abby says. Mark says he relishes every chance he gets to give his patients a dose of Vitamin A – “pure adrenaline.” “Every day I do this is a blessing,” he says. Ask questions, find resources and learn more at askAAMC.org/HealthyMinds.0
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