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Pediatric Pregnancy & Child birth

Baby Development & Care from Birth to Three Months

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It is very difficult to know  what a newborn baby is capable of. In the early days and weeks after birth, to the naked eye, not much. Eating, crying, sleeping, and pooping seem to take up the majority of her day, with a few moments of alertness thrown in for good measure. But recent research has shown that she’s doing a lot more than that. “Even in the first minutes of life, babies are a wonder,” says Naomi Steiner, MD, a developmental and behavioral pediatrician at Tufts-New England Medical Center, in Boston. “The newborn has a superactive brain and is primed to learn.”
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Recent research, much of which relies on high-tech advances in intrauterine photography and brain imaging, now offers empirical proof of what parents have known all along: Babies are smart. What’s more, each baby is born with a unique personality that becomes readily apparent within the first few weeks of life. “Babies come into the world as themselves,” says Dr. Steiner. “It’s our job to get to know them.”

Baby’s Ability

Even though your baby can’t care for herself, what she is capable of at birth may surprise you. She’s born with 70 innate reflexes designed to help her thrive, some of which are truly remarkable. “Reflexes like the tonic neck reflex — in which your baby turns his head to one side, straightens one arm, and holds the other out — are critical to labor and delivery, helping your baby squirm around during the birth process, stimulating the uterus to keep contracting,” says Dr. Brazelton. In essence, he’s helping your labor progress.

Other reflexes are less subtle to a new parent. If left on his mother’s abdomen in a dim, quiet room after birth, a healthy newborn “will rest for about 30 minutes and will gaze at his mother’s face on and off,” reports Marshall Klaus, MD, who wrote the first textbook on neonatology and has coauthored a number of popular books for new parents, including Your Amazing Newborn (Perseus). Then he’ll begin smacking his lips and moving toward the breast completely unaided, using a powerful stepping reflex and bobbing his head up and down to gather momentum. Once at the breast, a newborn will open his mouth wide and place his lips on the areola, latching on all by himself for his first feeding. From that point on, these inborn responses will affect your newborn’s every move. The rooting reflex, for example, helps your baby seek nourishment. However, seemingly random, reflexive movements may be more intentional than we first thought. “When in a quiet, alert state, and in communication with a caregiver, some babies will reach out to try and touch something,” says Dr. Klaus.

Normal newborns at birth apparently have the underlying potential to reach for things, he explains, but their strong neck muscles are linked to their arms, so that a slight neck movement moves the arms as well. This connection protects the baby’s head from suddenly dropping forward or backward.

Baby’s Thinking

It depends upon how you define thought; of course, a newborn can’t share ideas. But some researchers believe that babies do put concepts together (albeit on a primitive level), evidenced by the fact that they remember and recognize their mother’s voice from birth, and express and respond to emotions before and immediately after birth. One could argue that memory and emotion are inextricably linked to thought. “A baby’s brain grows very differently depending on what sorts of experiences the baby has both in utero and after birth,” says Wendy Anne McCarty, PhD, the founding chair and faculty of the Prenatal and Perinatal Psychology Program at the Santa Barbara Graduate Institute, in California. “During gestation, birth, and early infant stages, we learn intensely and are exquisitely sensitive to our environment and relationships. From the beginning of life, we’re building memories.” Other experts say that a baby’s brain is too undeveloped to do more than orchestrate vital body functions. One fact remains clear: Newborns learn every day and apply that knowledge to their growing repertoire of skills. So can a newborn really think? Watch your baby, and judge for yourself!

Yopu may find the following:-In the first three months, your baby will learn to raise his or her head, smile, kick, move both arms and legs, roll over and make babbling noises. You will also learn to distinguish your baby’s cries, which will help you determine what your baby wants from you. Baby may also learn to wake up less as his or her stomach grows bigger and takes more in at a feeding.

Dr. Klaus discovered that newborns instinctively reach out until about 3 weeks of age, when this ability apparently disappears until about 3 months of age. This coincides with the time it takes your baby to start learning how to integrate his senses and gain control over his muscles. This is a prime example of how your baby’s need to learn so much, so quickly, means he must set aside some tasks while focusing on other, more important ones, such as regulating his sleep-wake cycles and figuring out how to focus his brand-new eyes on all the new sights around him.

So why do all these useful survival instincts seem to disappear so early — some as early as the 2-month mark? A baby spends the first few months of his life reacting to the world around him. But once he starts to understand where he ends and the world begins, which is partly a matter of brainpower, and partly a matter of practice, some behaviors that were once reflexive become active, as gradually baby learns that he can make things happen on his own and affect his environment. And, says Dr. Brazelton, “Just watching a baby learn is enough to give you hope for the human race.”

Baby’s Senses and Sensibility:-
Touch:
Your newborn’s skin is his largest and most highly developed sensory organ. At birth, your baby can respond to variations in temperature, texture, pressure, and pain. Your newborn’s lips and hands have the largest number of touch receptors, which may account for why newborns enjoy sucking on their fingers.

Smell:
By the 28th week of pregnancy, your baby can use her nose. One piece of evidence: Newborns placed between a breast pad from their mother and one from another woman most often turn toward the one with the alluring Mom-smell.

Taste:
In your womb, your baby gets a sampling of flavors as he swallows amniotic fluid. Studies have shown that fetal swallowing increases with sweet tastes and decreases with bitter or sour tastes.

Hearing:
Although your baby’s middle ear is still somewhat immature at birth, as are the sound processing centers of his brain, your newborn can hear you and will prefer human speech over any other sounds, especially if the voice is yours.

Vision:
By the time you actually meet your baby, her eyes are capable of excellent vision; however, her brain is still too immature to distinguish between different shades of color. By the time your baby is 3 months old, she will want to look at the world around her. She’ll prefer bright colors or sharp contrasts, and her favorite thing to look at will be faces.

Resources:

http://www.parents.com/baby/care/newborn/your-baby-from-birth-to-3-months/?page=5
http://www.thebabydepartment.com/babycare/baby-development.aspx

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Foe Turns Friend

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A-beta, a protein implicated in Alzheimer’s, may be the brain’s shield against germs.
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For years, a prevailing theory has been that one of the chief villains in Alzheimer’s disease has no real function other than as a waste product that the brain never properly disposed of.

The material, a protein called beta amyloid, or A-beta, piles up into tough plaques that destroy signals between nerves. When that happens, people lose their memory, their personality changes and they stop recognising friends and family.

But now researchers at Harvard suggest that the protein has a real and unexpected function — it may be part of the brain’s normal defences against invading bacteria and other microbes.

Other Alzheimer’s researchers say the findings, reported in the current issue of the journal PLoS One, are intriguing.

The new hypothesis got its start late one Friday evening in the summer of 2007 in a laboratory at Harvard Medical School. The lead researcher, Rudolph Tanzi, a neurology professor who is also director of the genetics and aging unit at Massachusetts General Hospital, said he had been looking at a list of genes that seemed to be associated with Alzheimer’s disease.

To his surprise, many looked just like genes associated with the so-called innate immune system, a set of proteins the body uses to fight infections. The system is particularly important in the brain, because antibodies cannot get through the blood-brain barrier, the membrane that protects the brain. When the brain is infected, it relies on the innate immune system to protect it.

That evening, Tanzi wandered into the office of a junior faculty member, Robert Moir, and mentioned what he had seen. As Tanzi recalled, Moir turned to him and said, “Yeah, well, look at this.”

He handed Tanzi a spreadsheet. It was a comparison of A-beta and a well-known protein of the innate immune system, LL-37. The likenesses were uncanny. Among other things, the two proteins had similar structures. And like A-beta, LL-37 tends to clump into hard little balls.

In rodents, the protein that corresponds to LL-37 protects against brain infections. People who make low levels of LL-37 are at increased risk of serious infections and have higher levels of atherosclerotic plaques, arterial growths that impede blood flow.

The scientists could hardly wait to see if A-beta, like LL-37, killed microbes. They mixed A-beta with microbes that LL-37 is known to kill — listeria, staphylococcus, pseudomonas. It killed eight out of 12. “We did the assays exactly as they have been done for years,” Tanzi said. “And A-beta was as potent or, in some cases, more potent than LL-37.”

Then the investigators exposed the yeast Candida albicans, a major cause of meningitis, to tissue from the hippocampal regions of brains from people who had died of Alzheimer’s and from people of the same age who did not have dementia when they died.

Brain samples from Alzheimer’s patients were 24 per cent more active in killing the bacteria. But if the samples were first treated with an antibody that blocked A-beta, they were no better than brain tissue from non-demented people in killing the yeast.

The innate immune system is also set in motion by traumatic brain injuries and strokes and by atherosclerosis that causes reduced blood flow to the brain, Tanzi noted.

And the system is spurred by inflammation. It’s known that patients with Alzheimer’s have inflamed brains, but it hasn’t been clear whether A-beta accumulation was a cause or an effect of the inflammation. Perhaps, Tanzi said, A-beta levels rise as a result of the innate immune system’s response to inflammation; it may be a way the brain responds to a perceived infection. But does that mean Alzheimer’s disease is caused by an overly exuberant brain response to an infection?

That’s one possible reason, along with responses to injuries and inflammation and the effects of genes that cause A-beta levels to be higher than normal, Tanzi said. However, some researchers say that all the pieces of the A-beta innate immune systems hypothesis are not in place.

Dr Norman Relkin, director of the memory disorders programme at New York-Presbyterian / Weill Cornell hospital, said that although the idea was “unquestionably fascinating”, the evidence for it was “a bit tenuous”.

As for the link with infections, Dr Steven DeKosky, an Alzheimer’s researcher at the Virginia School of Medicine, noted that scientists have long looked for evidence linking infections to Alzheimer’s and have come up mostly empty handed.

But if Tanzi is correct about A-beta being part of the innate immune system, that would raise questions about the search for treatments to eliminate the protein from the brain.

“It means you don’t want to hit A-beta with a sledgehammer,” Tanzi said.

But other scientists not connected with the discovery said they were impressed by the new findings. “It changes our thinking about Alzheimer’s disease,” said Dr Eliezer Masliah, who heads the experimental neuropathology laboratory at the University of California, San Diego.

Source : New York Times News Service

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Remedy for Strokes

Mild electrical stimulation shows promise in reviving stroke-damaged brains:-

Shova Paul, a 55-year-old housewife, was rushed to the emergency unit of a hospital after she was found lying on the floor of the toilet well past midnight. A quick examination and a subsequent brain scan revealed an awake and alert patient unaware of her illness (anosognosia). She had lost senses on the left side of the body (hemiplegia) and the brain image showed tell-tale signs of damage in the movement and language centres (sensorimotor cortex and Broca’s area). While recording the obvious signs of a severe cerebral stroke the doctor could apprehend what was coming: even after the best possible medical care, she wouldn’t be able to move, speak, read, write or comprehend what others were saying.

Now, two years after that incident, Paul leads a hemiplegic’s life. Like countless other hapless stroke survivors, she can’t move on her own, speaks with a slurred accent and has an impaired vision. To regain some control of the damaged muscles and relearn simple chores she undergoes a rehabilitation regime, which includes prolonged physiotherapy and psychological counselling.

Yet the lives of hundreds of thousands of stroke survivors like Paul can be dramatically transformed by a simple, inexpensive technique developed many decades ago, but largely forgotten. According to a new study reported last week, electrical brain stimulation — a procedure that delivers mild electric current to the brain non-invasively — has been shown to help severely affected stroke patients recover their ability to move and speak. In the therapy, known as transcranial direct current stimulation (tDCS), a mild electrical jolt is passed to the brain through the scalp and skull of the patient — perceived as a slight tingle in the head. “The concept of using therapeutic electricity on excitable tissue such as that of the brain is not new, considering the attempts to cure epileptic disorders with electric catfish as early as in the 11th century (by an Arab physician called Ibn-Sidah),” writes Gottfried Schlaug, the principal investigator of the study which appeared in the journal Archives of Neurology. He also points out that in the late 19th century physicians had used mild electrical stimulation to treat patients with depression. According to Schlaug, a neurologist at the Beth Israel Deaconess Medical Center (BIDMC) at Harvard Medical School in Boston, non-invasive brain stimulation using tDCS is “fast re-emerging as an interventional tool to modulate the effects, and possibly treat the symptoms, of several neurological and psychiatric disorders.”

However tDCS should not be confused with its controversial cousin electroconvulsive therapy (ECT), or electro shock, used for the treatment of severe depression. Unlike shock therapy — which is more drastic, giving a giant 600 milliampere (mA) buzz and affecting the entire brain, causing a seizure and memory loss — tDCS is much gentler (2mA) and more selective in the sense that it excites or inhibits brain regions directly underneath the positioned electrode. Moreover, ECT always requires the use of anaesthesia and is more invasive.
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Schlaug and his collaborators at the BIDMC tested tDMC on 20 patients who had suffered a stroke about two-and-a-half years back and still had moderate to severe impairments. Patients performed 60 minutes of routine rehabilitation procedures each day for five days while also receiving a 30-minute session of either active electrical stimulation or a placebo (‘sham’ treatment designed to mimic electrical stimulation). A simple nine volt battery connected to a piece of moistened sponge was used to deliver the mild electrical jolt. Within a week, patients given the real treatment were found to perform better in basic motor tests such as grasping a cup. A brain scan showed that activity in the injured part of the brain increased after the treatment. Schlaug presented the findings of the research at a conference at San Francisco last week.

Although it is not yet clear exactly how tDCS works, Sclaug believes that the electrical stimulation augments recovery in stroke patients by re-establishing communication between the damaged and unaffected halves or hemispheres of the brain. In other words, a stroke creates an imbalance in the normal communication of the brain’s hemispheres such that the unaffected hemisphere becomes functionally dominant and inhibits the damaged hemisphere.

“There is no denying that tDCS has an immense potential for repairing the stroke-damaged brain, but the problem is that it is still in an experimental stage,” says Dr J.N. Roy, a stroke neurologist at the Advanced Medicare Research Institute (AMRI) in Calcutta, who had attended to Paul two years ago. “Unless there is a huge trial involving a large number of patients, and the underlying neurophysiological changes are properly explained, one can’t put it into use in a routine rehab programme,” he adds. In fact, Schlaug’s team is trying to understand better the changes that take place in the brain as patients recover.

Countless neurologists like Roy and patients like Paul around the world are waiting for their results.

Source:Thje Telegraph (Kolkata, India)

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Science meseum

The Neurostimulation Technology Portal

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Coffee Can Lower Stroke Risk for Women

Women who enjoy drinking coffee may be lowering their risk of suffering a stroke, a new study suggests.
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Women who drank five to seven cups of coffee a week were 12% less likely to have a stroke than were those who downed just one cup a month, the study among 83,000 American women revealed.

The survey was carried out over a 24-year period by Harvard Medical School and Harvard School of Public Health in Boston and the findings published in the March issue of the journal Circulation.

According to the German experts on stroke prevention in Berlin, the benefit does not appear to come from caffeine. Those who drank tea and other caffeinated drinks did not experience the same reduction in stroke risk, said Martin Grond of the German Stroke Society.

It seems the positive health effects of coffee-drinking come from antioxidants in the beverage which lower inflammation and improve blood vessel function.

Taking into consideration factors such as cigarette and alcohol consumption, researchers found that healthy women who drank two to three cups of normal caffeinated coffee a day had, on average, a 19% lower risk for any kind of stroke than did women who drank less than one cup a month. Drinking four or more cups a day lowered the risk by 20%.

At the same time, the study confirmed that the beneficial effects of coffee only apply to otherwise healthy people. Those with complaints such insomnia, anxiety, high blood pressure and cardiac complications should be aware that coffee consumption was likely to worsen their condition, said Grond.

Sources: The Times Of India

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Do Some Fish Oil Supplements Contain Mercury?

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Fish oil supplements are increasingly popular, but it has sometimes been suggested that they could also expose you to the harmful pollutants found in some species of fish.
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However, studies have found that most of the widely available supplements contain little or no mercury, dioxins or PCBs.

Most companies use species of fish that are lower on the food chain, like cod and sardines, that accumulate less mercury. Many companies also distill their oils to help remove contaminants.

A report by ConsumerLab.com, which conducts independent tests of supplements, examined 41 common fish oil products and found none contaminated with mercury or PCBs. Another report, by researchers at Harvard Medical School and at Massachusetts General Hospital, studied five popular brands of fish oil and found that the brands had “negligible amounts of mercury.”

Resources:
New York Times March 23, 2009
Archives of Pathology and Laboratory Medicine Dec 2003;127(12):1603-5 (Free Full Text Article)

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