Battling Nausea? Use Zofran with Caution

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Posted by vera | Posted in Birth, Health, Twins or Multiple Birth Pregnancy | Posted on 20-10-2017

shutterstock_261399308Today’s post is contributed by guest blogger Jen Holmes from zofranlawsuitguide.com

Carrying twins comes with the added risk of double the nausea and vomiting. As result, many women carrying twins and multiples may benefit from medical intervention to help them battle severe morning sickness.

One such drug sometimes prescribed to combat prenatal nausea is Zofran, a cancer drug. GlaxoSmithKline (GSK), the makers of Zofran, saw an open market in pregnant women and began offering kickbacks to physicians who prescribed the medication to expectant mothers.

Potential Negative Effects of Zofran

Unfortunately, GSK didn’t perform enough necessary studies on Zofran before promoting it to pregnant women. In fact, GSK admits that it never did an in-depth study on the medication before it started marketing it to pregnant women. Yet, numerous studies have been conducted by researchers and scientists, including in-depth research published by the National Institutes of Health (NIH), that indicated infants exposed to Zofran are at heightened risk of developing:

  • Cleft lip and cleft palate
  • Heart defects
  • Musculoskeletal defects
  • Kidney defects
  • Jaundice, and more

There have been at least two cases of infants deaths and more than 20 cases of babies born with serious heart defects after women in Canada alone were prescribed Zofran during pregnancy. In an in-depth report conducted in 2012, The Star revealed the information, that was otherwise publically unavailable by Health Canada.

Consequently, there are more than two dozen Zofran lawsuits currently pending against GSK, and as more women learn about the company’s alleged false marketing practices, this number is expected to grow.

If You’re Expecting Twins

If you’re expecting twins and are currently battling nausea, it’s important to understand the risks involved in taking certain medications. Although Zofran may help you battle devastating morning sickness, the research suggests that the end results are generally not worth it and the risks to your infants are too great to ignore.

While some women will take Zofran and go on to have healthy babies, others may not be as lucky. Be certain to discuss alternative options with a trusted physician in battling morning sickness before taking a prescription medication. For example, the Mayo Clinic suggests the following remedies to help mom battle nausea and vomiting prior to resorting to prescription drugs:

  • Take prenatal vitamins in the evening, followed by a light snack (sometimes taking vitamins in the morning causes additional nausea)
  • Increase your intake of Vitamin B6 (with physician’s recommendation)
  • Add ginger to your diet, including ginger ales, candies, and tea
  • Get additional rest
  • Avoid restaurants and other places where scents may make you queasy
  • Consider pregnancy-safe, over-the-counter nausea medication
  • Ask your doctor about anti-nausea wristbands, which trigger pressure points to help reduce nausea 

In Summary 

Canada health officials have repeatedly expressed concern with the prescription medication Zofran (ondansetron) and its effect on unborn infants. Although the drug is only approved for use by cancer patients and those undergoing surgery, many doctors across Canada continue to prescribe it for off-label use for pregnant women expecting twins, who generally experience difficult bouts of morning sickness.

Thanks to Jen Holmes at zofranlawsuitguide.com for alerting us to the dangers of Zofran

Tips for Choosing the Right Prenatal Class – Part 2 of 2

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Posted by vera | Posted in Health, Parenting, Travel, Triplets, Twins or Multiple Birth Pregnancy | Posted on 05-09-2013

PPL_logoOur previous blog post, by  Alba Aguanno, RN, BScN, LCCE and Director of Childbirth Education at Port Perry Lamaze investigated how best to consider credentials and more when choosing the best twins prenatal class for you – here are four more tips on choosing a multiple births prenatal class.  Thanks, Alba!

In addition to credentials and experience of the instructor, location of class and testimonials of other clientele, consider also convenience, content, currency and instructional style before selecting your twins or triplets prenatal class:

5.  Convenience

Most prenatal instructors offer their classes as a series of 6 to 8 weekly sessions, each running 2 to 3 hours.  Typically, these are offered after dinner on weeknights, or sometimes on weekends. Ask what nights are offered and make sure that your calendar can accommodate all of the sessions – plan ahead.

phone prenatal course instructorFor shift workers, commuters, professionals, those who need to travel for business, and those with either lots of commitments or unpredictable schedules, a 6 or 8 week commitment may not be feasible.  In this case, consider instructors who offer the content delivered in 2 full-day sessions.  You’ll get the same content, but delivered over one or two weekends.  For many, this is a much more convenient option.

For those who find such a condensed format challenging, or who can’t attend an on-site childbirth class due to work schedules, time constraints or medical conditions, online classes may offer a convenient alternative.  Be sure to find an online class that is multiples-specific, taught by a qualified instructor, and one who is willing to respond to individual questions either by email or telephone throughout the class.

6. Class Content

Ask for – and carefully examine – an agenda or course outline.  Look at the topics to be covered. 

Some classes just focus on labour and delivery, while others spend equal time on what happens after the babies are born, such as feeding, diapering, bathing, settling crying babies, caring for the birth mother immediately after birth, postpartum depression, changes in the family, and other related topics.  This is an especially important consideration when you will be bringing home two or more babies!

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For labour and delivery, make sure classes include a range of options for pain management including breathing, positioning, and relaxation techniques plus drugs and other interventions you may be faced with during labour and birth.  Caesarean section births should be covered in detail, as this is a birthing reality that families pregnant with twins and higher-order multiples must be ready to face.

A good twins-specific prenatal course provides couples with the knowledge and motivation they need to advocate for their childbirth health decisions and to provide care for their newborn children. This is supported through:

• Helping women realize their inherent abilities to give birth.

•  Providing current evidence-based knowledge on childbirth procedures and outcomes in the multiples context.

• Increasing the confidence of both women and their support persons that birth is a normal, natural process and encourages you to work with your body’s natural abilities.

• Helping couples understand their childbirth options and their role in the childbirth decision-making process in the multiples pregnancy context

• Teaching couples how to communicate their childbirth decisions to healthcare providers through verbal and written means

• Providing information on post-partum parenting and baby care of more than one baby

7.  Current Information and Resources

Ask what resources are being used, and try to determine how up to date these are.  Many instructors purchase videos and other resources and continue to use them year after year, without investing in refreshing the resources as new versions come available.  You may be learning with outdated information.

Pamphlets and other handouts should also be assessed for their currency and relevancy to the multiple births context.  Recommendations change over time as the results of new medical research come available.  Try to determine whether or not your instructor is keeping up to date with the latest developments.  

Some professionals, such as registered nurses, are required to stay current to maintain their nursing license, while Lamaze-certified instructors are required to take a number of continuing education courses each year to help them stay current.  Even a non-certified instructor, if she is a professional, will attend conferences and classes and keep up to date with reading.

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Find out when your instructor last held a set of twins or triplets in his arms.

8. Teaching Style

What is your learning style?  Do you learn best by reading, listening to lectures, watching demonstrations, or participating in activities?  

The best instructors use a variety of teaching techniques to ensure that all participants leave the class with the required information, regardless of their preferred learning style.  Ask your potential instructor what techniques they use to teach the class.

Conclusion 

Participation in childbirth classes has been known to decrease physical complications during labour and delivery and also to improve physical and mental health in the postpartum period.  

Following the tips outlined above will help you choose the right childbirth class for you.

Infant Massage with Multiples

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Posted by vera | Posted in Health, Nannies, Twins or Multiple Birth Pregnancy | Posted on 12-06-2013


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Recently, I had the good fortune of sharing an evening of infant massage with two other families who had 11-week-old twins.

Infant massage is something I address in Class Four of our Twins Prenatal Course, and since it had been a while since I’d done it myself with newborns, I decided to offer a free class through our local twins club.

There is quite possibly nothing cuter than four little babies all lined up on the floor; the sheer sight of them brought a smile to everyone’s face before we even got started!

The benefits of infant massage are well-documented: From soothing fussy babies to helping relieve gas pains, to boosting muscle development and circulation, infant massage is becoming a more and more mainstream way for parents to support the overall health of babies everywhere.

One-On-One Connection with Multiples

One challenge with having twins, triplets or more is how to effectively bond with each baby. Incorporating infant massage into your daily bath-time or bedtime routine can help you connect with each of your babies individually. For the 10-15 minutes you massage your newborn each day, she’ll have your undivided attention as you look into her face and tell her how much you love her, with your voice and your hands.

For our “class”, both partners came with their twins, so there was one adult per baby. But going to a group infant massage session is a great way for single parents with twins, or two parents with triplets or higher order multiples to get an extra hand with the additional babies. Your instructor or class helpers or volunteers are often happy to take one baby while you take the rest.

Infant Massage & Language Development

There is some evidence to suggest that twins, triplets or more can exhibit language delays. Talking to each baby about what you are doing while you are doing it can help “front load” language input.

For example, while taking a little arm in your hand and rubbing oil on it, you can tell your baby, “Now I’m going to put some oil on your left arm, see? Doesn’t that feel nice? I’m going to rub it together to make it nice and warm first, then I’m going to massage your left arm, one – two – three, and now your hand, like this, and each little finger, 1 – 2 – 3-4 – 5…” and so on.

Consider how many full, rich sentences your little ones are hearing, in context, as you gently describe what you are doing, in a soft, soothing voice.

Grumpy Clientelle

It wasn’t long into our group infant massage session that most of the babies were fussing and crying, but we’re pretty sure that’s because they were hungry… Fortunately, both mothers were breastfeeding their twins, so that problem was quickly and easily solved!

Different philosophies exist about what to do when a baby complains during massage: Some people believe it’s best to stop the massage for now, and give baby a break, while others persevere, using gentle tones to soothe their babies while introducing them to this new and not-yet-familiar sensation. (The thinking goes that once they get used to it, babies will learn to anticipate and enjoy their daily massage routine; that was certainly true of my now-9-year-old twins.)

As parents, you know your babies best, and can decide if or how to proceed when one or both twins decide let you know they’re not yet enamoured with this massage business!

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Healthy Teeth and Gums… Healthy Twins, Triplets and More?

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Posted by vera | Posted in Health, Parenting, Teeth | Posted on 21-08-2010

We are proud to share this guest blog, co-authored with Erika King, Dental Hygienist. Enjoy!

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A sometimes overlooked health factor when pregnant is… Dental Health!

Carrying  multiples in particular impacts the health of your gums and teeth; both can be affected by your pregnancy, and in turn your pregnancy can be affected by how well you take care of your mouth.

Some women find their gums become puffy or swollen and bleed more when they are pregnant.  This is due to the increased production of estrogen (normal during pregnancy and particularly increased for moms pregnant with twins, triplets or more), and is called pregnancy gingivitis.  For some women the increased estrogen causes their gums to become extra sensitive to plaque (bacteria) that accumulates on their teeth.  Women who experience this need to be extra diligent in their oral care at home, and it is usually recommended they also see their dental hygienist during this time for additional cleaning and/or guidance.

One of the early signs of multiples pregnancies is more extreme than normal morning sickness.  Women who experience morning sickness also need to pay special attention to their dental health. Frequent vomiting or regurgitation can lead to acid erosion of the teeth. When stomach acid frequently comes into contact with teeth, the outer enamel covering can wear down, weakening the tooth and increasing sensitivity.  After an incident of vomiting, the best thing to do is to rinse out your mouth with water or mouth wash, and avoid brushing your teeth for at least 45 minutes.   Brushing your teeth right after vomiting actually increases the rate of erosion as you are scrubbing the acid into your teeth.

Many pregnant women, particularly those pregnant with more than one, also experience nausea or an increased gag reflex, making it difficult to take proper care of her teeth/gums.  Using non-foaming toothpaste often helps (i.e. no sodium laurel sulphate– these toothpastes may be hard to find, try looking in health or naturopathic stores, or online.  Some examples of brands are: Tom’s of Maine, Therabreath, the Natural Dentist, Nature’s Gate, CloSYS, Squigle, Sapphire Toothpaste ), as well as leaning over the sink while brushing your teeth, allowing the toothpaste to drain out of your mouth instead of building up.  (Yes, this becomes a bit tricky towards the end of the second and into the third trimester, when your belly is full of big babies!)  Other women may find it helpful to take a deep breath and then hold it while brushing the teeth at the back of the mouth. Using a smaller toothbrush, as well as using floss holders may also help.

So why is gum health so important during pregnancy? Scientific studies have found women with severe gum disease are seven times more likely to have pre-term, low birth-weight babies. This is due to the labour-inducing hormone called progesterone, which is present in oral bacteria.  When your gums are unhealthy, the bacteria in your mouth can enter your blood stream, increasing the circulating progesterone. This becomes especially significant for women pregnant with multiples, as they are often already at risk for pre-term labour.

Seeing your dental hygienist for regular dental cleanings can help you have a healthy pregnancy. She will give you advice and guidance for your specific situation. She will also teach you important preventative tips for your growing family.

Erica King, RDH

www.ericasmobilesmiles.ca