Minimizing Risks
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Emerging research points to the effects of the gestational and perinatal environment on the developing neural and immune systems as they may pertain to autism. Watch Dr. Judy Van deWater, of the MIND Institute at University of California at Davis, present current theories regarding the influence of environmental exposures, including xenobiotic exposures and infection during gestation, as well as the effects of maternal microflora on development. The presenation also touches on the role of maternal immune function in neurodevelopment during gestation and the potential effects of perturbations in maternal immune status on behavioral outcome.

Editorial: What Can Be Done to Prevent Autism Now?

By Maureen McDonnell, RN

If a woman is considering becoming pregnant, one of the best things she can do is give herself six months or even a year to improve her diet and make better lifestyle choices. She should consume organically grown grains, vegetables, fruits, nuts, and lean sources of protein. Laying the foundation by putting herself in optimal shape prior to conceiving will go a long way in minimizing the chance of miscarriage, or developing other complications of pregnancy and delivery.

Because gastrointestinal problems are so common in children with autism, in addition to reducing or eliminating the white foods (sugar, white bread, pasta, pizza, bagels), chemical preservatives and processed foods, some women I’ve worked with choose to address their own GI-related conditions prior to conceiving. If a woman has a history of candida (yeast), for instance overgrowth, or digestive problems, gluten intolerance, food allergies, bloating, constipation, or parasites, they treat these conditions before becoming pregnant. Reducing sugar consumption, minimizing the use of antibiotics, taking probiotics, and using specific diets and herbs for intestinal pathogens such as yeast and parasites can all be helpful in optimizing health; all of these greatly enhance the likelihood that her child will not be prone to GI problems.

  • Reduce or eliminate alcohol and caffeine, and eliminate tobacco.
  • A 2006 report from the CDC found that the average American had 116 of the 148 synthetic compounds tested for, including the infamous dioxin, polycyclic hydrocarbons, and organochlorine pesticides. These same substances were also found in human milk, placental tissue, umbilical cord blood, and the blood and body fat of newborns. The average American home contains 3-10 gallons of hazardous materials, and 85 percent of the chemicals that are registered have never been tested for their impact on the human body. See the Green This! series of books by Deirdre Imus.
  • Prior to conceiving, a woman should switch to green cleaning and personal care products (e.g., shampoo, toothpaste, body lotion, facial cream).
  • Begin or continue an exercise routine.
  • If a woman has mercury-based amalgam dental fillings, she may want to have these removed by a dentist familiar with safe procedure for the removal of dental mercury (www.holisticdental.org) Safely remove mercury-based amalgam fillings with a dentist associated with The American Holistic Dental Association (www.holisticdental.org) at least 6 months before becoming pregnant, and not while breastfeeding.
  • Also in anticipation of conception, it makes sense to begin taking a good comprehensive multivitamin/mineral supplement.
  • Adding a source of animal-based Omega-3s is essential. Krill oil is suggested by many, or a mercury-free source of high-quality fish oil.
  • Find a “green” dry cleaners (the chemical used in most dry cleaning facilities, perchlorethylene (PERC), is a known carcinogen.
  • Use a stainless steel water bottle to carry and consume filtered water. Heated or not, the soft plastic bottles will release phthalates. Antimony, a heavy metal, can also be released from polyethylene terephthalate.
  • For more information about water filters, call 1-800-673-8010 or see NSF International’s Web site at www.nsf.org/Certified/DWTU, or the Natural Resources Defense Council Web site at www.nrdc.org/water/drinking/gfilters.asp.
  • Minimize consumption of large fish (for mercury levels of fish, check: www.gotmercury.org).
  • To build beneficial microflora, take high quality probiotics (in addition to improving levels of beneficial intestinal flora, these have been shown to decrease intestinal absorption of certain chemicals by facilitating their excretion), and consume more fermented foods. See BodyEcologyDiet.com.
  • Improve indoor air quality by opening the windows when you can, and creating cross ventilation.
  • Check vitamin D levels and add additional Vitamin D3 if necessary. Many studies are supporting the use of higher levels of Vitamin D than what was previously recommended to support immune, cardio, and neurological function.
  • Eating a diet rich in colorful, organically grown vegetables will provide an adequate intake of antioxidants to fight off the damaging effects of free radicals. Juicing organic vegetables is a great alternative if you can’t seem to consume the recommended 4½ cups of veggies and fruit per day.
  • If anticipating pregnancy, I would also suggest avoiding the flu shot and any other vaccine for one year prior to conception.
  • Computers, TVs and cell phones emit Electro Magnetic Radiation (EMFs), so you should not sleep with these in the bedroom.
  • Use cell phones only when necessary and keep the phone in your pocketbook as opposed to in your pocket.
  • Do what is reasonable to green your home and to minimize exposure to toxins in your food, cleaning products, EMFs, water etc. If remodeling is planned, and/or a new home is being constructed, try to select no VOC paints, sustainable wood as opposed to composites and resin-based products, minimize exposure to building materials, and allow for outgassing of new materials etc..

During Pregnancy

  • Continue a high-quality organic diet that eliminates or greatly reduces sugar and other processed foods.
  • Continue to take a good comprehensive, natural, and easily absorbed multivitamin.
  • If possible, avoid dental work while pregnant, especially the removal or insertion of amalgam fillings.
  • If possible avoid antibiotics and other OTC and prescription medication. There is no pharmaceutical drug on the market that has been proven safe for pregnancy. A new study shows antidepressants are especially dangerous to take during pregnancy (13)
  • Continue an exercise program to improve circulation and stimulate peristalsis (intestinal motility slows as a result of pregnancy hormones. So in order to continue having good bowel movements, daily exercise is essential). In addition, take good sources of fiber like ground flax seed, psyllium husks, bran, nuts, whole grains, seeds etc.
  • Eat at least 80 gms of protein per day. Get high-quality organic lean sources of protein including turkey, chicken, nuts, whey protein powder for smoothies, meat, and eggs, and divide into 4-5 2 oz. servings.
  • Always have a protein-rich snack on hand for those low blood-sugar dips.
  • If Rhogam is needed because you are RH negative, then ask to see the package insert to make sure there is no thimerosal in the vaccine.
  • If sick, rest; drink lots of hot water with lemon, take extra Vitamin C and possibly use Echinacea drops (not goldenseal) during pregnancy.
  • Interview midwives and/or obstetricians until you find one that makes you feel comfortable and empowered. Home birth is an option that is not right for everyone. However, a study published in the British Medical Journal in 2005 found that natural birth at home with certified midwives is safe for low-risk mothers and their babies. The study followed 5,000 mothers in the US and Canada, finding that these home births with low-risk mothers had much lower rates of medical interventions when compared to the intervention rates for low-risk mothers giving birth in hospitals.
  • Avoid unnecessary ultrasounds-- which may include all ultrasounds. There are no conclusive studies showing that ultrasounds are safe in pregnancy; of even more concern is that there are studies showing that prenatal ultrasound affects brain development. Even standard, routine ultrasounds are not medically necessary, and have not been shown to improve birth outcome. Pathways magazine, issue # 22, has an informative article on the potential relationship between ultrasound and autism.
  • Minimize intrusive procedures during labor (induction with Pitocin, pain meds, epidurals, forceps, C-section, early cord-clamping, etc.) by researching them and discussing with your midwife or doctor which procedures you wish to avoid if possible, and which ones you wish to be part of your labor and birth experience. Pathways issue #21 has an article that relates many of these often-unnecessary procedures with an increased risk of autism. A large study published in the British Medical Journal attested to the benefit of delaying cord clamping for at least three minutes.
  • Choose your birth-care providers wisely. Rather than selecting a provider or place of birth because of insurance coverage, select providers who will support your philosophical core beliefs about birth. Decisions made about “necessary treatment” vary drastically between homebirth midwives, birth-center midwives and obstetricians. Define your values and beliefs and then seek a provider accordingly. In this issue of Pathways there is a very informative article about choosing your provider.
  • In preparation for labor, delivery, and parenthood, start childbirth classes early. Seek classes outside of the hospital, with independent groups that offer support and knowledge about natural birthing. Additionally, finding a birth-support doula is essential for better birth outcome. The perceived need for medication can be eliminated with proper breathing and relaxation techniques and adequate support during birth. For additional information on natural labor and birth procedures read Pathways issue #24.
  • There is a higher risk of autism in cesarean-delivered babies. So although it is tempting to think of skipping labor, it is actually Mother Nature’s way of preparing the child for life outside the womb. The baby’s neurological function is enhanced by naturally passing through the birth canal, and through cranial molding.
  • Walking during labor and being in an upright position or on all fours for pushing and delivery will greatly maximize your pelvis’ ability to open and give birth with greater ease. This will then minimize the forceful use of doctor assisted pulling, forceps and vacuum extraction. Any form of pulling and rotation to the baby’s delicate spine in labor may have a lasting affect on future nerve system function.
  • Interview several pediatricians during the pregnancy to find one who accepts your views on health. Today, many parents are seeking providers outside of the typical allopathic model, choosing integrative practices that offer safer, more natural options to achieve health and wellbeing.

During the newborn and infant stages

  • Bond with your baby as much as possible. You will need your sleep and so you need to rest when you can. But be sure to hold and talk to your infant as often as possible. Co-sleeping is an option many parents are adopting to insure continued contact with their babies.
  • Breastfeeding is the best way to not only provide optimal nutrition but to ensure there is a good amount of bonding time with mother and child. While breastfeeding, keep up your excellent dietary habits of 6-9 servings of colorful antioxidant-rich veggies and fruit, 80-100gms of high quality protein sources divided up into 4-5 2 oz servings per day and plenty (6-8 glasses) of filtered water per day.
  • Wear your baby as often as possible, utilizing various baby carriers. Having your baby held close gives them comfort, emotional ease, and very importantly, constant motion. These factors all contribute to strengthen and enhance neurological development in your baby.
  • Take in extra fiber to ensure a bowel movement each day.
  • Purchase an organic crib and/or bed mattress for you. Be aware of bedding and clothing with flame-retardants, as they contain high levels of antimony and other toxic substances.
  • Continue multivitamin and fish oil supplements, with extra Vitamin D if your blood work showed level below 50.
  • Unless a mother is positive for Hepatitis B, there is no need for her newborn to receive the Hep B vaccine in the nursery or within the first few months of life.
  • To minimize the possibility that your child will develop food allergies, postpone the introduction of solids for at least 6 months. When it is time to introduce them, only use organic vegetables (wait a few weeks before introducing fruits), steam them, and puree them in a food processor. You can make batches of these and freeze in ice cube trays. Introduce each new food no sooner than 4 days apart to make sure there is no reaction. Grains should not be introduced until the baby has teeth; prior to then, they do not have the digestive enzymes to assimilate them. If you have a family history of eczema, food allergies, celiac or autism, avoid dairy, soy, and gluten grains (wheat, barley, oats, rye, kamut, etc.)
  • Continue breastfeeding for at least one year, preferably two. A child’s own immune system does not kick in until they are about 18 months of age, and your breast milk offers the best immune-system support available. Contact your local La Leche league for support and knowledge before and during the breastfeeding period.

Regarding vaccines

  • Parents are choosing which vaccines to give after careful consideration of the child’s history and genetic background. For instance, if a child was born prematurely or has had recurrent ear infections, or if the parents have a history of autoimmune disorders or allergies, then these are indicators that the infant or toddler might not respond well to a vaccine (and certainly not when several are given at one time).
  • If you decide to give a vaccine, make sure your child has not been ill recently or is not coming down with something. You also do not want to give a vaccine if the child has been on antibiotics or if they recently came off antibiotics. Ask for single-dose vials, and give one at a time, i.e., per visit. There are no long-term studies showing that giving multiple vaccines at once is a safe practice. I would also suggest priming your child’s immune system with immune-protective nutrients prior to vaccinating. You can give 250mg of Vitamin C, 2 or 3 Echinacea drops and ½ tsp. cod liver oil for a few days before and after the vaccine.
  • Summary: We don’t have all the answers. No one does. But let us consider the research that has already be done, the stories of improvement and recovery from parents who have traveled this difficult path, and let’s apply common-sense precautionary principles as we prepare for, and enter motherhood. None of them can harm you or your baby.
  • Maureen McDonnell has been a registered nurse for 33 years in the fields of childbirth education, clinical nutrition, labor and delivery, newborn nursery, and pediatrics.  Since the late 70s Maureen has been a vocal advocate and frequent lecturer promoting whole foods, green living and preventive health measures as the most logical and cost-effective methods for minimizing complications associated with pregnancy and birth, and reducing chronic illnesses in children. In 2008 Maureen co-founded Saving Our Kids, Healing Our Planet Green Expos www.SOKHOP.com and established the blog Raising Healthy Kids Naturally at www.RaisingHealthyKidsNaturally.blogspot.com.

References:

Buie, Timothy, et al., Evaluation, Diagnosis and Treatment of Gastrointestinal Disorders in Individuals with ASDs; A Consensus Report and Recommendations for Evaluations and Treatment of Common Gastrointestinal Problems in Children with ASD, Pediatrics, 1-4-2010

Vargus, DL, Nascimbene, C, et al., Neuroglial activation and neuroinflammation in the brain of patients with autism, Ann Neurolo 2005 Jan:57(1):67-81

Li, X, Chauhan, A, et al., Elevated immune response in the brain of autistic patients, J Neuroimmunol 2009 Feb 15:207(1-2):111-6 Epub 2009 Jan 20
James, S.J., et al.. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. Am J Clin Nutr. Dec. 2004; 80(6):1611-7.

Johnson, K et al., Outcomes of planned home births with certified professional midwives: large prospective study in North America, BMJ 2005:330-1416 (18 June)

Landrigan PJ, Schecter CB, Lipton JM, Fahs MC, Schwartz J., Environmental Pollutants and Disease in American Children: Estimates of Morbidity, Mortality and Costs for Lead Poisoning, Asthma, Cancer and Developmental Disabilities. Environ Health Perspect 2002; 110 (7):721-728.

Smith, Bob, Organic foods vs. supermarket foods: Element levels. J of Appl. Nutrition, 45 [1], 1993 35-39.

Day, Jasperse, et al., Prenatal Exposure to Alcohol: Effect on Infant growth and morphologic characteristics, Pediatrics Vol 84 No.3 September 1989 pp.536-541

Body Burden – The Pollution in Newborns; Environmental Working Group, July 14, 2005

Consumer Reports study in 1996 concluded 1/6700 will get cancer from wearing PERC-cleaned clothing once per week. Dry Cleaning Alternatives online; http://consumerreports.org accessed March 16, 2007.

Kenji, et al., Effect of probiotics bifidobacterium breve and lactobacillus casei on bisphenol A exposure in rats; Biochem 72.2008, 70672-1-7

Lapillonne, A, Vitamin D deficiency during pregnancy may impair maternal, fetal outcome. Med Hypotheses 2010 Jan:74(1) 71-5 Epub 1009 Aug 08

http://www.vitalvibesusa.com/health_risks/

Lund N, Pedersen LH, Henriksen TB. Selective serotonin reuptake inhibitor exposure in utero and pregnancy outcomes. Archives of Pediatrics & Adolescent Medicine. 2009; 163: 949-954.

Emma J. Glasson, BPsych, BSc (Hons), PhD; Carol Bower, MBBS, MSc, PhD, FAFPHM, DLSHTM; Beverly Petterson, MSc, PhD; Nick de Klerk, BSc, MSc, PhD; Gervase Chaney, MBBS, FRACP; Joachim F. Hallmayer, MD, Perinatal Factors and the Development of Autism, Arch Gen Psychiatry. 2004;61:618-627.

Andersson O, Hellström-Westas L, Andersson D, Domellöf M. Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial. BMJ 2011; 343 doi: 10.1136/bmj.d7157