"Nearly 80% of all child deaths in the United States occur under one year of age."

Baby's Breath is a campaign to help increase your child's chance of survival their first year of life and beyond that critical period. This information is being provided as a resource to offer useful advice on prenatal, postnatal, and infant care. Not all child deaths are predictable or preventable. This information is intended to help increase your child's chance at a healthy, injury-free infancy and toddlerhood. This information should, by no means, replace the medical attention and advice of your doctor. If you have any questions please contact your physician or email info@missfoundation.org.

El Aliento del Bebé en Español

1. MISS Foundation's Safe Nursery-Safe Home Checklist (.doc)
2. Stillbirth: What Every Woman Needs to Know (.pdf)
3. Expanded Newborn Screening
4. Twin-to-Twin Transfusion: What You Need to Know
5. Breast Feeding May Shield Cancer
6. Washing Machine Danger
7. Count your baby's kicks during your last trimester.
8. The Safe Nursery
9. Practice Baby Wearing and Attachment Parenting
10. Watch your nutrition before, during, and after pregnancy.
11. Take prenatal vitamins before conception, during pregnancy and while breastfeeding.
12. Watch your environment and the baby's!
13. Make sure your physician tests for GBS (Group B Strep).
14. During pregnancy, watch for signs of pre-term labor.
15. Breastfeeding is the gift that lasts a lifetime.
16. Breastfeeding: good for babies, mothers, and the planet
17. Risk factors for co-sleeping with your infant
18. Exercise special care when co-sleeping.
19. Keep a baby's environment, before and after birth, smoke free.
20. Healthy babies should sleep on their back.
21. Be temperature sensitive.
22. Get a second opinion.
23. Know your baby!
24. Educate yourself on fire and burn prevention.
25. Watch your child around water at all times.
26. Use Infant/Child Car Seats.
27. Cough and Cold Medicines: Concerns Raised for Use with Infants
28. Safe Sleeping with Pampersack (tm)

IMPORTANT NOTICE - If your child experiences any symptoms out of the ordinary which concern you, especially things like blood or rust-colored streaks or mucous in the urine or bowel movements, difficulty arousing, stiff or painful neck, unusual rash or lumps or anything else that worries you, contact your physician immediately. If you are not able to reach anyone or are unsatisfied with the explanation, seek another opinion.

Did you know that that approximately one out of every 1,500 US babies will be born with a disease detectable through new born screening? Most routine newborn screening tests do not screen children for the disorders that have been linked to Sudden Infant Death Syndrome (an estimated 3 to 4% of SIDS cases are actually one of these 55 screen able disorders). Because these children appear normal and healthy, it is not suspected that they have an underlying disorder that could cause sudden unexplained death. Even after death, many times these children are undiagnosed and said to be cases of SIDS. Proper comprehensive screening would allow diagnosis and treatment of these disorders, thus allowing most of these children to avoid early death and to live normal lives. States offer newborn screening, but it is a bare minimum. Many only screen for 5 or six out of 55 screen able disorders. Many people, INCLUDING MEDICAL PROFESSIONALS have never even heard about expanded newborn screening. You need to check out what your state screens for. You will be shocked and made to feel sick when you realize how easy it is to perform the mass spectrum test (one extra drop of blood on filter paper in addition to blood spot the medical professionals draw for PKU screening) You send the filter spot into a private lab where they test for 55 screen able disorders in less the 24 hours and they let you know immediately if there is a problem.

Please check out the website www.savebabies.org and www.neogen.com for more information about this VERY important test.

  Twin-to-Twin Transfusion: What You Need to Know

Every couple experiencing a multiple gestation needs to be aware of the condition known as Twin to Twin Transfusion Syndrome (TTTS). This is a disease of the placenta which occurs in identical twin pregnancies, but may also affect higher order multiples (Triplets, Quads, etc.) if there are identicals present within it. It does not occur in Fraternal Twins. However, unless you know the twins are boy/girl, it would be best to assume they are identical and monitor for TTTS unless it is proven otherwise before delivery. While considered rare, this is a highly lethal condition which affects up to 6000 documented cases a year, and without treatment may be 80-100% likely to result in the death or major disability of one or both twins. Treatments that are currently available can increase the odds of survival for both twins to as much as 60-70%, but are useless if the condition goes undiagnosed. More...

WASHINGTON (AP) - Breast-fed infants may have up to a 30 percent lower risk of developing some forms of childhood leukemia when compared to babies who are bottle-fed, according to a new study. More...

In addition to being aware of any standing water in or around your home, making sure your children do not have access to your washing machine is vital. A child can drown if he or she falls into a washing machine. Please read "An Open Letter From Amber's Parents" and make sure that your children can not open or access your washing machine especially when it is in use.

Your baby moves many times a day. Your baby’s kicks are the best sign of its health. We ask that you count the number of times your baby moves once a day. The baby may kick or roll during the time you are counting count all movements. You will know when your baby is most active and at what time of day.

YOU NEED TO:

1. Pick one quiet time in your day, when you can count how many times the baby moves. Some babies move most in the evening.
2. You may want to sit with your feet up or lie on your side.
3. Count all baby movements until you reach 10. DO NOT count for more than 2 hours.
4. Write own the time it took for the baby to move 10 times. Example: SUNDAY = 45 min.
5. If your baby does not move at least 10 times in the two hours, you must call your obstetric provider.

"The Safe Nursery" - Information and Safety Advice from the CPSC

Wear your baby! Research has shown that Dr. William Sears' method of AP helps babies develop physically, emotionally, and spiritually. Baby wearing reduces infant stress and relieves colicky baby tears. This method of attachment parenting helps the baby's development, thriving, and interdependence.
- Baby Wearing Info: http://www.askdrsears.com/html/5/t051100.asp#T051103
- Benefits of Attachment Parenting: http://www.askdrsears.com/html/10/t130100.asp

Nutrition is a most important factor in your pregnancy outcome. The Institute of Medicine-National Academy of Science has published new guidelines that show the risk of low birth weight can be decreased if the mother gains more weight. Underweight women should try to gain 28 to 40 pounds; normal weight women, 25 to 35 pounds; and overweight women, 15 to 25 pounds. Weight gain for women carrying twins or triplets should be 40 pounds or greater.

Birth defects can be caused by inadequate diet from insufficient vitamins and minerals. Folic acid is very important! Even if you are eating regular meals each day, you and your growing baby may still be inadequately nourished. According to the U.S. Public Health Service, all women considering pregnancy should supplement their daily diet with multivitamins. To reduce the incidence of spina bifida, the number one disabling birth defect, and other neural tube defects (NTD's), take 0.4 mg of folic acid (one of the B vitamins) every day.

Beware of household, and environmental hazards, including contact with chemicals, radiation, and other harmful substances.

Screen for Group B Strep before delivery. Group B Streptococcus (GBS) bacteria, not to be confused with the variety which causes strep throat, are the most common life-threatening infections in newborn babies. One in three women carry this bacteria in their lower intestinal tract. There are no symptoms. Most often, GBS infects babies during labor or during delivery as they pass through the birth canal. The American Academy of Pediatrics recommends testing for GBS between 35-37 weeks in pregnancy. If at any time,even during the last weeks of pregnancy. If positive, you can be treated with antibiotics during delivery to prevent infection of your baby. For more information on Group B Strep, visit www.groupbstrep.org.

Premature birth can be a serious danger to a newborn. Ask your obstetrician to review the symptoms of preterm labor at your next visit; labor occurring prior to 37 weeks gestation. For more information contact your physician or the hospital immediately.

Preterm labor contraction are sometimes painless occurring every 15 minutes or closer. If, after changing position, emptying your bladder, or a period of rest or change in activity, the contractions continue, contact your doctor immediately or go directly to the hospital. Also watch for lower, dull backache, pelvic pressure, intestinal cramping, increase or change in vaginal discharge, and even a general sense of something 'not being right.' Any one or combination of the above should precipitate a call to your doctor. If you experience any bright red blood, a rupture of the membrances, whether a rush or steady trickle, or severe stomach pain this may indicate a medical emergency. Contact your physician immediately! (courtesy of Matria Healthcare)
- More information on pre-term labor

Breast milk has special properties which strengthen a baby's immune system. It is the perfect food, and saves thousands of dollars in health care and food cost. The American Academy of Pediatrics recommends exclusive breastfeeding for a minimum of six months; breastfeeding at least one year; and breastfeeding past one year as long as it is mutually satisfying to mother and baby. New data suggests it may even prevent cancer. For more information contact La Leche League at www.lalecheleague.org or (847)519-7730.
- Deadly Virus Infects More Babies
- Community Breastfeeding Promotions Lower Infant Illness Rates
- August 1-7 is National Breastfeeding Week!

Click here to learn more about Human milk's nutritional benefits, breastfeeding and the Immune System, infant growth and development, and much more.

• Nicotine/Cigarette use - Never sleep with an infant if you are a smoker.
• Alcohol - Do not sleep with a baby if you have had even moderate amounts of alcohol.
• Drugs, recreational or prescription, including cough syrup - All of these substances can put your child at risk for overlay/positional asphyxia.
• Overtiredness - A parent who is too tired may not arouse when or if the baby's sleep position become compromised.
• Bed overcrowding - The infant should not sleep in a crowded bed.
• Multiple siblings sharing bed - Infants should not share their sleeping locations with other siblings.
• Waterbeds - Infants should never be placed to sleep on waterbeds.

Please do not sleep with your infant under any of the above circumstances.
Source: BMJ, 4 December, 1999 CESDI SUDI research group, Royal Hospital for Children.

A parent should never sleep with their child under the influence of prescription or recreational drugs, or if any alcohol has been consumed. Mothers who smoke cigarettes should not sleep with their infants. Be aware of safe sleeping practices. Never place pillows, comforters, stuffed toys, bean bag cushions, sheepskins or other extraneous items in a baby's bed. For more information visit the American Academy of Pediatrics at www.aap.org

Even second hand smoke can significantly compromise a baby's delicate immune system. Smoking increases the severity and occurrence of upper respiratory, ear infections, pneumonia and asthma. It increases the risk of S.A.D.S., early stillbirth, SIDS/other infant death. Article: At the AAP site www.aap.org/. or the American Academy of Pediatrics
- S.A.D. Syndrome - The last great mystery of obstetrics

This significantly reduces the risk of sudden infant death. There has been a 30% decline of SIDS deaths since the 1994 American Academy of Pediatrics support of the Back to Sleep Campaign. For more information contact the SIDS Alliance at 1.800.221.7437 or visit www.sidsalliance.org.
- Safe Sleeping Newsletter

A baby should be dressed in loose fitting, comfortable clothing. Do not layer clothing unless weather requires it. Overheating a baby can compromise an infants developing and delicate autonomic nervous system. Article: www.parentsoup.com.

Do not hesitate to get a second or a third opinion if you suspect something is wrong during your pregnancy or early infancy. Most physicians understand a parent's need for peace of mind.

Use the count method to keep track of your baby's movement patterns. If you have any concerns, call your healthcare professional immediately. S.A.D.S. can occur during the last few weeks of pregnancy and decreased movement is sometimes a precursor.
- S.A.D. Syndrome - The last great mystery of obstetrics
- Pregnancy Institute Website

Never keep matches or lighters near children, young or old. Talk to your children about the dangers of fire, matches, ovens, curling irons, and other 'hot' items. Always test the water on yourself before bathing baby. The water should be less than warm as baby's skin is more sensitive.
- Foundation for Burns & Trauma Website

Toilets, buckets, sinks, and swimming pools can be deadly for a child. Learn CPR and take all precautions if you have a pool and also when visiting friends and relatives with a pool. Even seasoned swimmers can drown so don't let even older children swim alone!
- Drowning Prevention Website

Motor vehicle crashes are the leading cause of death in children over age one.₁ Here are some current guidelines for proper child seat use₂:

• Keep babies rear-facing as long as possible. One year and 20lbs is the minimum rear facing limit, but it is now recommended that babies rear face until the limits of a convertible seat are met at 30-35lbs. When a baby outgrows an infant seat, they should be moved to a rear-facing convertible seat. The harness needs to be at or below the shoulders and there should be no slack in the material.
• When a child is too big to rear-face, they should be moved to a forward facing carseat with a harness. The harness should be snug and at or above the shoulders.
• When a child outgrows a forward facing carseat, they need to be moved to a belt positioning booster seat. This type of seat uses the lap and shoulder belt to secure the child.
• Never use anything with your carseat that did not come with the seat or was not made by the manufacturer of your seat for the seat that you have. This voids the warranty and could put your child in danger.
• After market devices such as head rests, inserts, seatbelt tightening devices and adjusters should not be used. There are no federal regulations for these and they could cause your carseat to fail.
• As plastic tends to weaken over time, it is advised that you replace a carseat that is older than 6 years. Also, older carseats may not meet current crash testing standards.
• Always check you manual to insure proper installation. 4 out of 5 carseats are installed incorrectly. You can find a certified child passenger safety technician in your area here: www.safekids.org They can check your seat for recalls and proper installation and this is usually a free service.
• A child is ready for an adult seat belt only when all five of the following are met:
  1. The child can sit all the way back in the seat.
  2. While sitting this way, the knees bend comfortably over the edge of the seat.
  3. The lap portion of the belt fits across the lower legs or hips.
  4. The shoulder strap rests between the neck and shoulder.
  5. The child is mature enough to sit this way for the entire trip.

₁National Highway Traffic Safety Administration. www.nhtsa.gov
₂“Car safety seats: A guide for families.” AAP. www.aap.org/family/carseatguide.htm

According to Robert Cohen, the author of "Experts denounce kids' cold elixirs," an article printed in The Star-Ledger © on March 18, 2007, concern has been raised regarding the use of over-the-counter cough and cold remedies in children. He specifically states:

The issue came to the fore earlier this month when a group of prominent pediatricians and public health officials filed a petition with the FDA urging the agency to ban drug companies from marketing OTC cough and cough medicines to children under 6 because the products are "ineffective and pose a risk to health." The FDA, in response to the petition, said it had been re-examining the safety and effectiveness of children's cough and cold remedies for several months.

Though the review is ongoing, FDA officials acknowledged they have very little reliable testing data on children. They said the recommended doses for children are little more than a guess based on what can be tolerated in adults.

While the doctors' petition to the FDA grabbed headlines, they were just the latest in a long line of researchers and medical groups who have been raising red flags for more than a decade.

The article goes on to detail some of the concerns brought forth in the last ten years, including comments from a member of the pharmaceutical industry.

Upon further research into this issue, the Department of Health and Human Services - Centers for Disease Control website offers this Synopsis (January 11, 2007) on its Morbidity and Mortality Weekly Report page:

Infant Deaths Associated with Cough and Cold Medications
United States, 2005 Press Contact: CDC - Division of Media Relations, (404) 639-3286

Cough and cold medicines can be harmful and should be used with caution in children under 2 years of age. Although it is very rare, we identified three infants who died from the toxic effects of cough and cold medicines in 2005. In addition, in 2004 and 2005, over 1,500 children less than 2 years old were treated in U.S. emergency rooms for adverse events from cough and cold medicines. While these drugs are effective in older children and adults, there is little evidence these drugs help in children under 2 years old. Parents should always consult a healthcare provider before giving cough or cold medicine to kids under 2 years old. Healthcare providers should use caution when giving cough and cold medicines to children under 2 years old.

Cohen's article ends with tips for parents whose young children are suffering from cough and cold, gleaned from The American Academy of Pediatrics' Website. This information can be found at:
http://www.aap.org/patiented/coldsandyoungchild.htm

Given the serious nature raised by these concerns, parents might find it prudent to consult with their physicians before providing over-the-counter cough and cold medicines to their young children. In addition, parents should take preventative measures by helping to reduce exposure to cough and colds for the very young.

Earthwalk Design LLC – home of the PamperSack™ sleep sack - is proud to partner with the MISS Foundation to promote safer sleep for babies. “Sleep bags are wearable blankets that cannot be kicked off or cover a baby’s face,” states Christina Alborn, owner of Earthwalk Design and mother of three. “Our PamperSack™ sleep bags are not a garment, but are worn over pajamas. They keep a baby warm like a blanket would, but won’t cover a baby’s face like soft, loose bedding can.” Soft bedding has been linked to a condition called “rebreathing.” Rebreathing occurs when bedding molds around or covers a baby’s face as they sleep, creating a stale pocket of expired air eventually reduced to carbon dioxide. Many agencies, including the American Academy of Pediatrics (AAP) recommend removing all soft, loose bedding from the crib. Sleep sacks have been used extensively in Europe for the last thirty years. 15% of the proceeds will be donated back to the MISS Foundation to support their advocacy programs and education efforts by visiting http://www.pampersack.com/miss/index.htm to place your order.

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NOTE - The information on this website is not intended to replace your doctor's advice or offer medical advice. This is for informational purposes only. Please call your physician if you have any other questions.