Mothers, keep your babies safe

Someone must have written a press release because this story in the news wasn’t news.... no new study had come out and nothing had happened. But, perhaps it’s given readers the idea that something had.

That’s called publicity. But it has very real potential to harm innocent babies and pregnant women who may believe it is anything more than that.

Yesterday, the Associated Press reported that an idea is being floated to lower the weight recommendations for pregnant women in order to address “the country’s obesity epidemic.”

Review set for pregnancy weight advice

...An influential U.S. medical panel is considering changes to the medical guidelines for how much weight a woman should gain during pregnancy. It's acting on the insistence of doctors who say heavy moms are gaining too much weight and the current recommendations do not factor in the country's obesity epidemic.

Carrying too much weight while pregnant increases the risk of complications for mother and baby, including birth defects, labor and delivery problems, fetal death and delivery of large babies, according to the March of Dimes. A revision is long overdue, said Dr. Raul Artal of the Saint Louis University School of Medicine. "This has been one factor in causing the epidemic of overweight and obesity that we see in our country."

This fall, the Institute of Medicine, a private organization that advises the federal government, is expected to begin the lengthy process of gathering scientific evidence to decide if the guidelines should be changed, said spokeswoman Christine Stencel [Media Relations Officer for IOM]...

A study in the April issue of the American Journal of Obstetrics and Gynecology suggested that the current guidelines may raise the risk of mothers having overweight toddlers. Women in the study who followed the IOM's recommendations ran four times the risk of having a child who was overweight at age 3, compared to women who gained less than the advised amount....

Dr. Patrick Catalano of Case Western Reserve University in Cleveland, said an obese woman has nutrients stored away and doesn't need to gain weight to provide for the baby...

A nearly identical press release, also quoting Dr. Artal, had been released in June by the press office at St. Louis University. St. Louis University will probably sound familiar to readers who remember the St. Louis University Obesity Prevention Center funded by RWJF, the NIH and NCI and directed by Debra Haire-Joshu Ph.D., a RWJF Health Policy Fellow and an advisor on obesity and chronic disease for the Health, Education, Labor and Pensions Committee of Senator Edward Kennedy. It had received a $3.5 million grant, for instance, to address weight gain in pregnant teens.

Perhaps that may explain the marketing, but the scientific evidence and what’s best for babies and mothers is what’s most important. Most readers probably read last week’s review of the study being used to support the claim that fat women risk having babies with birth defects. The actual evidence in that study and studies to date has shown that maternal “obesity” is not associated with higher risks for birth defects.

But some readers may have missed the look at research appearing to support the claims that even a modest increase of 7 pounds could raise a woman’s risk for pregnancy-related complications, such as gestational diabetes by 30% and pregnancy hypertension 40%; and warned women that “gaining 3 or more units of BMI raises the risk of a stillbirth by 63%, pre-eclampsia and gestational hypertension by 78% and 76%, and could double her risks for gestational diabetes.” The study actually found only nonfindings.

And most importantly, the April study in the news again this week was carefully examined here and I hope concerned readers will read it. There is no evidence to support that pregnancy weight gain is to blame for the obesity epidemic. In fact, this notion of restricting pregnancy weight gain has been tried before, by U.S. public health officials in the 1950s, but medical professionals quickly recognized that this advice was endangering babies. Among mothers following their weight gain restrictions, their babies had poorer chances for survival and more health problems. That finally led to a reversal in the 1970s and the guidelines we have today. The research has continued to show these recommendations help to ensure a safe pregnancy, optimal fetal growth and healthy babies.

It’s not babies with healthy baby fat that there is evidence for serious concern, but the growing numbers of babies without enough. In April, we also looked at the latest CDC statistics on the more recent rise of premature and small babies. Low birthweight babies are now at the highest levels reported since 1968. Among the things known to play a role is low weight gain during pregnancy. The recent surge in underweight babies being born in British Columbia has health officials there so concerned that they recently began telling mothers that it’s not what they eat, but how much that’s important to having a healthy baby.

“Low birth-weight babies may be associated with ... heart problems, lung problems, digestive problems, sometimes even into learning disabilities later on in life,” said Paul Hasselback, senior medical health officer with Interior Health.... Just as disturbing, said Shelly Inglis Allan, a low-birth-weight prevention officer in B.C.'s Interior, some women intentionally avoid gaining weight. “It often came back to societal pressures around being thin,” she said.

Babies born to mothers of all sizes deserve to enjoy a healthy start from mothers eating well. Mothers and babies deserve public health guidelines based on the very best and most careful, sound and objective medical evidence. The welfare of children and improving their chances for healthy futures should be the concern, not whether they or their mums are fat.