Aspen Birth Center Blog

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COVID-19 Children's Health

March 26, 2020



Coronavirus Disease 2019 (COVID-19) Information for Children’s Health Advocates

Updated March 24th, 2020   

Coronaviruses are a family of viruses that cause symptoms similar to the common cold, like a runny nose, cough, and sore throat. They can also lead to more serious respiratory diseases, like pneumonia.

The 2019 Novel Coronavirus (COVID-19) is a new coronavirus. It first appeared in China in 2019 and is now a global pandemic, with an increasing number of cases spreading across the U.S. COVID-19 can be fatal, though symptoms range from mild to severe. More severe cases seem to be associated with specific high-risk populations, including the elderly and those with serious pre-existing conditions. According to the CDC, COVID-19 is likely spread through close contact with an infected person. When an infected person sneezes or coughs, others nearby can contract the virus by inhaling their respiratory droplets.

Knowledge about the outbreak, including who is most at risk and how it spreads, is constantly evolving. Below, is a summary of key information related to children’s health and links to information references.

Pregnant women

There is currently no information on whether pregnant women are more susceptible to COVID-19 or have a higher risk for illness, morbidity, or mortality. However, generally, pregnant woman may be more susceptible to viral respiratory infections, including COVID-19. In other related coronavirus infections, pregnant women have been at higher risk than the general population for developing severe illness. Currently the CDC does not know whether COVID-19 would cause problems during pregnancy or affect the health of the baby after birth. 

Find out about facts and recent updates here: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-faq.html

COVID-19's Impact on Families With Less Resources

It is important to acknowledge that families living in poverty will be disproportionately affected by COVID-19. Low-income populations may be more likely to have chronic health conditions, which put them at a heightened risk of adverse outcomes from COVID-19. Moreover, important safety measures will likely hit them harder: closed schools means a loss of school breakfasts and lunches for children; closed businesses and quarantines means fewer paychecks to buy basic necessities; and seeking medical care if symptomatic is more difficult for someone without health insurance or easy access to care. In the coming months, national, state, and local efforts will continue to seek solutions to address COVID-19. During this time, we urge our network to keep under-resourced families top of mind and consider how to mitigate the added burden COVID-19 places on their health. 

Placental Transmission

Currently, health officials do not know whether a pregnant woman infected with COVID-19 can transmit the virus to her fetus or baby before, during or after delivery. Find out about facts and recent updates here: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-faq.html

Breastfeeding

Currently, the virus that causes COVID-19 has not been found in the breastmilk of infected women. There is also no information on whether the virus can be transferred through breastmilk. For other infectious diseases, like the flu, the CDC recommends that a mother continue breastfeeding while taking precautions to spread the virus to her baby. The CDC does not have specific guidance for breastfeeding for other, more similar viruses, like SARS-CoV or Middle Eastern Respiratory Syndrome (MERS-CoV).

While breastfeeding supports the health of moms and babies, it is important to recognize that there is still much information needed about breastfeeding and COVID-19. Families should talk with their health care providers when deciding to breastfeed, as there may be a medical reason to separate mom and baby. If a mother with COVID-19 or who is under investigation because she has COVID-19 symptoms chooses to breastfeed, the CDC recommends important precautions, including: 

  • Washing her hands before touching the infant and, if expressing breast milk with a breast pump, washing her hands before touching the pump or bottle parts
  • Wearing a face mask, if possible, while feeding at the breast
  • If expressing breast milk, following recommendations for proper cleaning after each use and considering having someone who is well feed the breast milk to the baby

Find out about facts and recent updates here: https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy-breastfeeding.html

Pediatric Disease

While children have been affected by COVID-19, they currently appear less likely to have severe symptoms when infected by the virus. However, children with underlying health conditions may be at an increased risk for complications.

Find out about facts and recent updates here: https://www.cdc.gov/coronavirus/2019-ncov/prepare/children-faq.html

Sickle Cell Disease

Information about how COVID-19 will affect those living with sickle cell disease is evolving constantly. Individuals with sickle cell disease have weakened immune systems, so maximizing the prevention of infections is important. The Sickle Cell Disease Association of American has put together pertinent COVID-19 information for families and providers: 

Asthma

There is not enough information yet to determine whether COVID-19 will have a more severe impact on children with asthma. However, in adults, we do know that COVID-19 affects the respiratory tract and can cause an asthma attack, which may lead to pneumonia or acute respiratory disease.  Therefore, families with children with asthma should be extremely vigilant in following their current asthma regimens (e.g., regularly scheduled medicines) and practicing hand-washing as well as social distancing.  

Additional references

American Academy of Pediatrics tips for parents about COVID-19: https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/2019-Novel-Coronavirus.aspx


Article from: National Institute for Children;s Health Quality, March 24, 2020
Posted by Heather Knott, RN-IBCLC
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COVID-19 Community Hotlines

March 26, 2020


COVID-19 help hotlines/ línea comunitaria:


Aspen to Parachute COVID-19 community hotline 970-429-6186 (English or Español)

Garfield County Public Health call line: 970-945-1377, ext. 8120 (English or Español)

CO-HELP 1-877-462-2911 or COHELP@RMPDC.org (multiple languages)
 
Provided by:
Garfield County Public Health Department- working to promote health and prevent disease
 
 
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Celebrate International Women's Day March 8, 2020

March 9, 2020


How do we ensure that a woman's right to breastfeeding support is realiised in the era of generation equality?

The solution includes:
  • more equal sharing of care work within the parenting team,
  • enhanced community understanding of existing inequalities,
  • engaging with men and boys to support women’s needs and rights,
  • improving women’s access to health services,
  • and last but not least gender-equitable parental social protection (PSP) policies and legislation.
Policies that promote more flexible and parent-friendly workplaces, allowing equitable and efficient distribution of time, will attract more women to the workforce and reduce constraints on women’s time and child health. Equitable implementation of maternity protection policies to include women working in the large informal sector will be required for all the benefits of breastfeeding to be maximized.

With an estimated 47.2% of women in the labour force in 2019, the civil and private sectors are playing an essential role in women’s right of support to breastfeed. The World Breastfeeding Week (WBW) 2019 called for the implementation of PSP, which includes public-funded paid leave policies, legislation, and parent-friendly or family-friendly workplaces. There is a large difference of the rights of breastfeeding mothers between countries worldwide. The Parents at Work Advocacy Tool was developed to showcase the level of support parents are currently receiving worldwide.
For Women’s Day this year, we call upon governments, UN agencies, health systems, workplaces, communities and civil society organisations to:
  • Implement gender-equitable social protection that will enable breastfeeding and greater gender equality.
  • Enact and monitor national legislation and policies that uphold the rights of women and their children in diverse contexts.
  • Enact paid parental leave and workplace breastfeeding policies for women in the formal and informal economy.
  • Create a warm chain of support for breastfeeding across healthcare, workplace and community from pregnancy until the child's second birthday. 
  • Invest in interventions such as support for breastfeeding as a means to improve the health and survival of women and children.

For more information, contact:

Thinagaran, thina@waba.org.my
Revathi Ramachandran, revathi@waba.org.my
 
 
 
Posted by article: World Alliance for Breastfeeding Action
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FDA on Marijuana, THC, CBD-Breastfeeding and Pregnancy

November 14, 2019



New Alert from the FDA on Marijuana, THC, CBD

Now that the sale and use of marijuana is legal in many states for medical use and in some states for recreational use, do you discuss the use of cannabis and cannabis-derived products with your pregnant and breastfeeding patients? These products have become much more common in recent years and many new parents are confused as to whether they are safe to use.

In response to a flood of new cannabis-containing products on the market, the Federal Drug Administration (FDA) recently released a statement strongly advising against the use of cannabidiol (CBD), tetrahydrocannabidiol (THC) and marijuana in any form during pregnancy or while lactating. There are many unanswered questions as to exactly how these substances affect the developing fetus, breastfeeding infants and even mothers’ milk supplies.

People are often confused by all the terms used to describe additives, supplements and oils. Cannabis is a plant that contains over eighty biologically active chemical compounds. THC and CBD are the two most commonly known compounds. Marijuana is one type of cannabis plant which contains varying amounts of THC, the compound that causes a person to feel "high." Hemp is another type of cannabis plant which contains very low amounts of THC. CBD, a compound which does not produce a "high," can be derived from either marijuana or hemp. The FDA says there may be serious risks to pregnant or breastfeeding mothers using cannabis products, including those containing CBD.

Research suggests that there are potential negative effects from using marijuana and THC-containing products. The U.S. Surgeon General recently cautioned that THC can enter the fetal brain through a mother’s bloodstream and may increase the risk of low birth weight. https://www.hhs.gov/surgeongeneral/reports-and-publications/addiction-and-substance-misuse/advisory-on-marijuana-use-and-developing-brain/index.html.

Premature birth and potential stillbirth may also be linked to marijuana use. Breast milk can contain THC for up to six days after use and may affect the baby’s brain development resulting in hyperactivity, poor cognitive function and other long-term effects.

There is not a large body of research on the effects of CBD in pregnancy and while breastfeeding, but the FDA is continuing to look at the research and collect data. High doses of CBD in animal models has shown an adverse effect on the reproductive systems of developing male fetuses. There is also potential for contamination from other substances and concern about side effects, drug interactions and long-term use.

Discussions about marijuana, THC, and CBD use are important when interacting with preconceptual or pregnant patients and new parents. Not only should they make informed decisions regarding the use of cannabis-containing products, they need to be aware of state regulations regarding their use.

Some things to consider and discuss include:

• THC enters breast milk and has the potential to affect the baby.
THC is stored in body fat and remains in the body for a long time. Babies have a high percentage of brain and body fat.
The American Academy of Pediatrics states that marijuana should not be used while breastfeeding.
Not much is known about the amount of THC in breast milk, the length of time it remains in the breast milk, and the effects on the infant.
Since THC is stored in fat and stays in the body a long time, it’s not known how long a mother would need to "pump and dump" to wait for THC to be eliminated from breast milk.
Marijuana is legal in some states in the U.S., but this doesn’t mean it is safe for pregnant moms or babies. Some hospitals test babies after birth for drugs and may notify child protective services if they test positive.

For more information, check out the resources below.

Resources:

1. https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about-using-cannabis-including-cbd-when-pregnant-or-breastfeeding

2. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/marijuana.html

3. https://www.colorado.gov/pacific/sites/default/files/MJ_RMEP_Factsheet-Pregnancy-Breastfeeding.pdf

Article Information collected from: Human Milk Insights, Medela, November 2019

Heather Knott, RN-IBCLC

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