April 7, 2015

By Shelly Lopez-Gray

First, let me say that there is no such thing as “eating for two.” I know this is a huge disappointment, as many people out there would love to use their pregnancy as an opportunity to eat every single thing that they ever thought tasted good (I know, I’ve been there). But let me fast forward through your pregnancy a bit – it’s unhealthy for you, it’s unhealthy for your baby, and the pregnancy weight is not going to magically fall off.

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As you begin your pregnancy, I wanted to share some key things to remember:

  • You need about 300 extra calories a day during pregnancy to support your baby’s growth and development.
  • Most doctors suggest women gain a total of 1 to 4 pounds total during the first three months of their pregnancy.
  • Women who gain too much are more likely to have a large baby or a premature baby.

A premature baby is born before 37 weeks of pregnancy. These mothers may also have health conditions like diabetes and high blood pressure that can cause problems during pregnancy.

The total amount of weight gain during your pregnancy depends on your weight when you become pregnant. Talk to your physician or midwife for more information.

Tips to help you create better eating habits:

Watch how much juice you drink. Even all-natural and 100 percent juice is full of sugar and empty calories. If you find it impossible to cut out these sweet drinks, treat yourself to a small glass once a day. If you are gestational diabetic, you should cut these out from your diet.

  • Anything canned or frozen is full of salt. Even if it’s a “healthy meal,” it’s still full of salt.
  • Try snacking on something healthy every two hours or so.
  • If you can pick the food up in a drive-through, it’s probably unhealthy.

Here’s a list of fruits, vegetables, dairy, grains and protein foods that are great for women to eat throughout their pregnancy.

Vegetable Group

  • Carrots
  • Sweet potatoes
  • Pumpkin
  • Spinach
  • Cooked greens (such as kale, collards, turnip greens, and beet greens)
  • Winter squash
  • Tomatoes and tomato sauces
  • Red sweet peppers

These vegetables all have both vitamin A and potassium. When choosing canned vegetables, look for “low-sodium” or “no-salt-added” on the label. Vitamin A helps with postpartum tissue repair and helps to fight infection. Potassium helps to maintain fluid and electrolyte balance in your body’s cells.

Fruit Group

  • Cantaloupe
  • Honeydew melon
  • Mangoes
  • Prunes
  • Bananas
  • Apricots
  • Oranges
  • Red or pink grapefruit
  • 100 percent prune juice or orange juice

These fruits all provide potassium, and many also provide vitamin A. When choosing canned fruit, look for those canned in 100 percent fruit juice or water instead of syrup.

Dairy Group

  • Fat-free or low-fat yogurt
  • Fat-free milk (skim milk)
  • Low-fat milk (1 percent milk)
  • Calcium-fortified soymilk (soy beverage)

These all provide the calcium and potassium you need. Make sure that your choices are fortified with vitamins A and D. A vitamin D deficiency during pregnancy can cause growth retardation and skeletal deformities. It also may have an impact on birth weight. Some researchers believe that a vitamin D deficiency during pregnancy can affect your baby’s bone development and immune function throughout your baby’s life.

Grain Group

  • Fortified ready-to-eat cereals
  • Fortified cooked cereals

When buying ready-to-eat and cooked cereals, choose those made from whole grains most often. Look for cereals that are fortified with iron and folic acid. Iron is essential for making hemoglobin, a protein in red blood cells. During pregnancy, the amount of blood in your body increases almost 50 percent, so you need more iron to make more hemoglobin.

Protein Foods Group

  • Beans and peas (such as pinto beans, soybeans, white beans, lentils, kidney beans, chickpeas)
  • Nuts and seeds (such as sunflower seeds, almonds, hazelnuts, pine nuts, peanuts, and peanut butter)
  • Lean beef, lamb and pork
  • Oysters, mussels, crab
  • Salmon, trout, herring, sardines, and Pollock

Some types of seafood can contain high levels of mercury. Too much mercury can damage your baby’s developing brain and nervous system. Shark, swordfish, king mackerel and tilefish can contain high levels of mercury.

The Food and Drug Administration and the Environmental Protection Agency say pregnant women can safely eat up to 12 ounces (340 grams) of seafood a week. Similarly, the 2010 Dietary Guidelines for Americans recommend 8 to 12 ounces of seafood a week for pregnant women – or about two average meals.

Talk to your provider if you have any questions about safe foods during pregnancy.

March 10, 2015

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By Dr. Steven Abrams

I arrived at Texas Children’s Hospital from Ohio as a newly minted fellow in neonatology in the summer of 1985. At the time, Texas Children’s was one building, now called “Abercrombie,” and was a seven story hospital with a 24-bed Level 3 neonatal intensive care unit (NICU) and another 50 or so Level 2 NICU beds in three separate nurseries. I began research on bone health in infants at the Children’s Nutrition Research Center (CNRC), then housed on a few floors of what is called the Medical Towers building on Fannin Street.

I stayed at Texas Children’s and Baylor College of Medicine for nearly 30 years, except for a brief sojourn in the Washington, D.C. area in the late 1980s for research training at the National Institutes of Health. I returned to Texas Children’s and Baylor as a faculty member in 1991.

Now, it is time to embark on a new and exciting opportunity. Next month, I will be the Chair of the Department of Pediatrics at Dell Medical School at the University of Texas at Austin. This is a new medical school and a new Department of Pediatrics with its primary pediatric teaching hospital being Dell Children’s Medical Center of Central Texas. Both challenges and opportunities abound, and I am grateful for them and for the opportunity to continue to serve the children of Texas in this unique way.

Leaving after three decades is not easy and I wanted to say goodbye with this blog post. I leave Houston with many fond memories of my experiences at Texas Children’s and the incredible importance of Texas Children’s to the city of Houston.

I met my late wife Judy in Houston at Congregation Emanu El where she served as a junior assistant Rabbi. We shared more than two-and-a-half decades together being part of the Houston community, and ultimately I said goodbye to her here. She always told me and our three children to do what we are supposed to do with our lives, and that the pathway would be clear forward. She and I were very proud of being part of Texas Children’s and having our children expertly cared for here.

The most remarkable part of being a faculty member at Texas Children’s is seeing what we can do for children by relying upon the strengths of the people who work here. I was recruited to Texas Children’s by the incredible Dr. Arnold J. Rudolph. Dr. Rudolph was a legendary leader of our field for many years. He taught us to always focus on doing what we knew was the right thing, which was not necessarily the easiest thing, for our young patients, every time, every day. He focused on families and the dynamics of an infant within a family. He never stopped teaching even into his last years of life. His teaching showed us what pediatrics education was about and he made it clear that education should go along with patient care and research as our passions as pediatricians.

Through most of my time here, our department chair was Dr. Ralph Feigin. We all have Dr. Feigin stories, but here is my personal favorite. After the tsunami hit Sri Lanka in late 2004, I wanted to lead a team of neonatologists and staff members (nurses, respiratory therapists and others) to go there and help them rebuild their NICUs. I had identified medical and research connections in Sri Lanka who were anxious for us to make such a trip. I emailed Dr. Feigin with my plan to lead a 10 person team from Texas Children’s to Sri Lanka. I emailed him at 6:30 a.m. At 6:45 in the morning, he called me at home to tell me it was a great idea and by 11 a.m., he met with the Texas Children’s Hospital Board of Directors and the money was approved. So much for months of haggling! We went to Sri Lanka and hopefully accomplished something in that difficult setting. Dr. Feigin’s approach was to quickly and decisively take action on behalf of children everyone and he taught by example every day.

Other memorable moments include waking up one Sunday in 1998 to be told to head in on-call to Texas Children’s for the delivery of octuplets. That was quite a delivery and experience taking care of them! Also, I am proud to watch the incredible work Texas Children’s has done internationally in many settings and the Texas Children’s unending support for the rights of children throughout the world, especially those in Africa and Latin America. I hope that my advocacy for new forms of therapy for children with liver disease, for good nutrition for children, and for health care for newborns throughout the world can be a legacy I’ve provided to the Texas Children’s community that will continue forward.

I want to express my tremendous appreciation to our department chair, Dr. Mark W. Kline, and many others at Texas Children’s and Baylor including Dr. Dennis Bier and Dr. Steven Welty, my section heads at the CNRC and Neonatology, respectively, for their support over the years and their assistance in helping me make a smooth transition to Dell Medical School.

I also want to express my appreciation to the Baylor and Texas Children’s public relations departments for their assistance in teaching me how to do a better job of advocating for children in the media and with the public. These are skills I will need in my new position.

In the end, I am saddened to leave the friend I call Texas Children’s behind, but happy to be able to transmit the skills and values I have learned here over the last 30 years to help develop an outstanding new Department of Pediatrics.

Don’t be strangers if you come to Austin! I hear they have decent barbecue there.

March 3, 2015

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I felt compelled to share the story of my late son, Anthony Jaxon Llanas, who was born at Texas Children’s Pavilion for Women on October 16, 2014. Alongside his two older siblings, he was my pride and joy. I only knew him for one month, but in those 29 days, we developed a strong, unbreakable bond.

Anthonyand MommyUnlike my previous pregnancies, this pregnancy was complicated. At 32 weeks, I was hospitalized at the Pavilion for Women. During my two-week stay, many of the nurses were wonderful and made me feel comfortable. Because of polyhydramnios (excessive amniotic fluid), I had an emergency C-section and delivered a handsome 4 pound, 7 ounce baby boy.

While still in my womb, I knew Anthony’s chances for survival would be uncertain. When I was 20 weeks pregnant, Anthony was diagnosed with esophageal atresia – a congenital defect where the upper esophagus does not connect with the lower esophagus and stomach – and tracheoesophageal fistula, an abnormal connection between the esophagus and the trachea. Two weeks later, doctors discovered he had coarctation or narrowing of the aorta. Anthony was also diagnosed with CHARGE syndrome which was not confirmed until after my son passed away peacefully in my arms.

Despite Anthony’s lengthy list of health problems, I was overjoyed to see his precious little face staring right at me, but at the same time, I was nervous about his prognosis. My Little Angel was wheeled away to the Neonatal Intensive Care Unit (NICU) at Texas Children’s Newborn Center where many of the NICU nurses took excellent care of him and answered all of my questions. He spent two weeks in the NICU before he was transferred to the Cardiovascular ICU, where a team of physicians and nurses closely monitored him.

As I struggled to stay positive while my baby was courageously fighting for his life, Anthony’s health problems quickly stacked up, one after another. Shortly after birth, Anthony was diagnosed with choanal atresia which prevented him from breathing through his nose. At 10 days old, doctors diagnosed him with severe immune system deficiency. His T-cells were lower than most normal babies at birth.

JuliaWhen Anthony was one week old, he had his first surgery to correct esophageal atresia, and two days later, he had surgery to treat choanal atresia. Anthony underwent bypass open heart surgery a few days later to repair the narrowing of his aorta, which eventually caused his heart rate to increase and be off rhythm. He was placed on an Extracorporeal Membrane Oxygenation (ECHMO) machine because his lungs and heart were too weak to function on their own. While he was on the ECHMO machine, his left lung collapsed. The day after his bypass, he was taken off the machine, but since his heart could not tolerate it, he was placed on the ECHMO machine for a second time. Sadly, Anthony’s extremely weak heart and lung were not cooperating.

On Wednesday, November 12, 2014, doctors told us Anthony’s heart rate was steadily dropping and that his body was not recovering from the multiple surgeries. He was getting sicker and they felt there was nothing more that could be done.

After hanging on for so long and enduring all of the surgeries to save his life, he passed away in my arms in a room full of people who loved him. He was by far the strongest and the most beautiful baby boy I’ve ever met. As all parents who’ve dealt with a loss of a child, I wish I could have done things differently to prevent his death, but with the support of Zoey’s Angels, they’ve helped me understand that I did as much as a parent could do and that his memory is not erased. If anything, it has just begun.

Four months after the tragic loss of my baby, I am back at work. While it’s been a difficult road for me and my family, my colleagues and manager, Lindi Stegeman, have been so supportive and I am so grateful to be working with such wonderful people.

February 3, 2015

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By Amy Puglia

Have you ever heard the line: “I am not from Texas, but I got here as fast as I could?” Well that statement certainly applies to my husband and me. Between the two of us, we have lived in no less than 12 states! So we may not have gotten here all that fast, but we are really happy that we’re here now. And we’re even more happy that our daughter, Vivian, was born right here in Houston at Texas Children’s Pavilion for Women six months ago.

bump2In these few short months, we have had a great time showing Vivian around “her” state. We traveled to the Hill Country where we took in the scenery, saw a live glass-blowing demonstration, went to a county fair, and shopped at a huge outdoor crafts festival. We visited Austin where we toured the State Capitol, showed Vivi the famous bat bridge, and ate at a popular Mexican restaurant. In San Antonio, we explored a few of the historical mission sites, walked around the Riverwalk and listened to some live music. We’ve enjoyed spending a few days in Galveston where we watched the sunrise over the Gulf each morning and visited a large aquarium. For a couple quick trips out of town, we shopped in charming Old Town Spring. And, of course, Houston has offered plenty of great sites to visit and explore each day with our new addition including the zoo, Museum of Natural History, and several great parks.

As our baby grows older, we look forward to going on many more Texas adventures. There is so much to offer here and so much to do! We have already picked out some “country” clothes to wear for her very first Houston Rodeo and we can’t wait to take her!

What kind of fun do you like to have with your family in this great state?

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Amy Puglia is the manager of emergency management at Texas Children’s. She and her husband, Steven, are the proud parents of 6-month-old, Vivian.

January 13, 2015

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The look on people’s faces when I tell them our news is always hilarious and always the same: wide eyes, open jaws and nodding heads shaking back and forth in disbelief. If this isn’t the look we receive right away then I immediately know they haven’t heard me correctly. So I restate the facts: “Twins, again. Only 20 months a part. Four kids under the age of 2.” And then I wait for the reaction. And it’s always spot on and always the same.

11415BWelizabeth640-2Most people would classify my husband, Scott, and I as nothing short of crazy. Yes, four kids under the age of 2 is going to be extremely challenging, and yes, I’m aware of how I will rarely have any time left for myself. But in all reality, I consider us to be the luckiest people in the world. How many families do you know that are blessed with two sets of twins? How many people get to grow their family in such a unique way? I come from a large family (I’m the second of five children), and so I’m welcoming the chaos with open arms. My childhood home was always full, always loud and always busy. But above all, it was fun. As a child, I used to crave silence, but now as an adult I can’t imagine anything better than to give our children siblings and to introduce them to the world I knew growing up.

The chaos will increase at the end of January when we welcome babies no. 3 and no. 4. Since our first set of twins are a boy (Charlie) and a girl (Caroline), my husband and I decided to let the next set be a surprise. We’ve had the envelopes revealing their genders for several months, but somehow we’ve managed not to open them. My friends and family ask me all the time how we have the willpower to not rip them open and find out the surprise, but it honestly hasn’t been that hard for me. The only focus we have is on healthy children. As long as they arrive healthy and strong, we couldn’t care less what their genders are. We already feel blessed beyond measure and can’t wait to become a family of six in just a few weeks!

January 6, 2015

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By Dr. Gail Demmler-Harrison

Congenital cytomegalovirus (CMV) is the most common virus that most people have never heard of. Most everyone will catch CMV at some time in their lives and never know they have it.

If a woman gets CMV for the first time while she is pregnant, she can be in a potentially dangerous situation. CMV infects almost 1 out of every 100 newborns in the United States and is the most common congenital infection.

The virus is passed to the unborn baby from the mother and can cause serious complications in the newborn, like platelet problems, liver disease and lung disease. It can also cause long-term effects on hearing, vision, growth and development by invading the brain, eyes and ears.

What makes CMV even more dangerous is that most people, including pregnant women, have never heard of CMV. Since CMV does not cause a rash like its cousin, chicken pox, you do not know who is infected and shedding the CMV.

The good news is CMV infection is potentially preventable.

If a pregnant woman is aware of CMV, she can take simple hygienic precautions to reduce her exposure to the virus. Toddlers are a “hot zone” for CMV, and by slightly modifying your behavior while pregnant, you can reduce your risk of catching this silent virus.

CMV is present in saliva and urine, so…

  1. Do not share food or drink with your toddler — no more “one for mommy one for baby” mealtime games while you’re pregnant.
  2. Do not kiss your toddler on the lips or cheek, rather hug them and give them a loving kiss on the top of the head while you’re pregnant.
  3. Wash your hands carefully after changing diapers and wiping your toddler’s nose and face.

An ounce of CMV awareness and three simple hygienic precautions while you’re pregnant are all it takes to save your unborn baby from a potentially devastating infection.

But, what if you contract CMV during pregnancy? I’ve put together a list of questions and answers with basic information that I hope you’ll find helpful. Click here to read my other blog.

December 23, 2014
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Eden McCleskey’s kiddos, Austen (9 months) and Jess (almost 2).

Bump Watch thanks everyone who contributed adorable pictures capturing memorable moments of their kiddos this holiday season.

As we ring in the New Year, the smiles on these tiny faces spread plenty of holiday cheer!

Caroline Nakamura's 6-month-old son, Luke, loves his festive green suit.
Caroline Nakamura’s 6-month-old son, Luke, loves his festive green suit.

xDr. Susan Leong-Kee's 15-month-old twins, Daniel and Abigail, love to entertain.
Dr. Susan Leong-Kee’s 15-month-old twins, Daniel and Abigail, love to entertain.

 

Harper with mom
Harper (who will be 2 in May) poses with her mom, Veronika Javor.

 

Keno Okiomah Xmas Portrait 2014
Ujiro Okiomah’s 10-month-old son Keno is looking handsome as ever!

Anabelle Boudrea
Annabelle (9 months) is fascinated with holiday lights. Her dad is Warren Boudrea.

 

Cameron Griffith
Julie Griffith’s 5-month-old son, Cameron, enjoys the radiant spotlight.

 

Yamil Torress
Mercedes Sleiman’s son, Yamil Torres (2), is happy to meet Santa Claus.

 

Madison Beasley
Rachel Beasley’s daughter, Madison, dawns her festive knit cap while she snoozes.

 

Goudys
It’s holiday photo time for Lord-Rudy Goudy’s kids: Zariya (12), Zion (6) and Zachary (1).

 

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Natasha Curtis’ kids, Arden Monroe and Chandler Curtis, hang out with Santa’s reindeer.

 

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Amy Puglia’s daughter, Vivian (4 months old), doesn’t mind being held by Santa Claus.

 

Emmy and Presley Cohen
Jennifer Cohen’s girls, Emmy (6 months) and Presley (3), are ready for the holidays!

 

Berss
Kaylan Berss’ son, 16-month-old Brantley, has a special holiday announcement!

 

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Krystal Hall’s 6-year-old son, Dezzmone, untangles the holiday lights to decorate outside.

 

Christian Jacques
Christian (3) can’t wait to open gifts from his parents, Brian and Samantha Jacques.

 

Cadence Picture
Maria Dahl’s daughter, Cadence (4), smiles for the camera!

 

Zachary Goudy
One-year-old Zachary Goudy wishes everyone a blessed holiday season!