Science proves becoming a parent sucks the happiness out of life

Someone recently told me I changed 5 years ago, for the worse. I wondered what could have happened that would have turned me into a horrible person, when it dawned on me- 5 years ago I had a kid!

The reality of parenthood, Thanksgiving 2012

That was the end of sleep/sleeping in/getting enough sleep, having nice things, cleaning only your own poo, leisurely meals, peaceful car trips, etc. The lack of sleep alone is enough to make people irritable and irrational, never mind the crying. I think most parents would agree that having a kid was a profound, and possibly irreversible, life change.

Et voila! Science proves it.

It turns out parenthood is worse than divorce, unemployment — even the death of a partner

Life has its ups and downs, but parenthood is supposed to be among the most joyous. At least that’s what the movies and Target ads tell us.

In reality, it turns out that having a child can have a pretty strong negative impact on a person’s happiness, according to a new study published in the journal Demography. In fact, on average, the effect of a new baby on a person’s life in the first year is devastatingly bad — worse than divorce, worse than unemployment and worse even than the death of a partner.– The Washington Post

Parenthood is, in its way, worse than getting divorced, losing your job, or the death of a partner. Read it and weep (or perhaps I should say keep weeping if you’re already there).

I can’t imagine being a single parent, or not having the choice whether or not to have a child. Even at the lowest points, at least Mac and I could fall back on, “We got ourselves into this mess.”

It may be a choice to procreate, the end result may be positive, and parents may not choose to change anything, but parenting is freakin’ hard. Especially that first one.

So, on behalf of parents everywhere, apologies that we couldn’t be sunshine and roses when sleep-deprived and devoid of free time. Sincere thanks for folks who tolerated us and supported us during that transition.

Coffee: Gatorade for parents and scientists

Everyone who drinks coffee knows that it makes you have to pee, right?

You may also be aware that scientists are heavy coffee drinkers.

Thus, when I am in meetings that run longer than an hour and a half, starting around the 50min mark, people start taking ‘bio breaks.’

My “Pessimist’s Mug”

This anecdata would support the idea that coffee/caffeine dehydrates you by acting as a diuretic.

Well, this is why anecdata is dangerous to rely on.

I heard it on NPR (who did good by linking to the original PLoS study in their article!) that, caffeine, “when consumed in moderation by caffeine habituated males provides similar hydrating qualities to water.” (Source: Killer, Blannin, and Jeukendrup PLoS 2014 since PLoS stands for Public Library of Science, the article is freely available for all to read!).

It’s practically a health drink!  It’s like Gatorade for parents and scientists!*

 

Check it out on NPR here: “Coffee Myth-Busting: Cup Of Joe May Help Hydration And Memory”

At PLoS here: “No Evidence of Dehydration with Moderate Daily Coffee Intake: A Counterbalanced Cross-Over Study in a Free-Living Population”

*Disclaimer:  DO NOT dump an urn of hot coffee over the head of anyone as a celebratory gesture as is frequently done with Gatorade. Coffee is hot and can result in severe burns.

Your brain on coffee

The other day my IRL friend Christi (who also happens to have a blog at Three Mugs To The Wind) posted a link to this piece in from the New York Times Well Blog:  This Is Your Brain on Coffee.

Grab a cup of java and check it out for a short read on all the wonderful things coffee does for your brain.

It reminded me of this infographic which I’ve shared before, here.

Source.

I have documented my coffee habit, scientifically proven to be common among scientists, add in parenting two small humans, and I am reliant.

Another unremarkable reaction to vaccinations

My friend and fellow Evidence-Based Parenting blogger, Tara Haelle shared her story of her son’s unremarkable reaction to his childhood vaccinations, here.  She also dissected a recent study from Pediatrics, the journal of the American Association of Pediatricians, on the impact of religious exemptions on  pertussis rates.  You can read Tara’s post here.  You can also join the Evidence-Based Parenting community on Facebook and discuss it, share your stories, here.

I’ve written before about the importance of vaccinations.  I’ve even written about a case of measles that hit WAY to close to home for me, here.  In light of that, the study which Tara wrote about is concerning to me.  The crux of that paper from Pediatrics?  “Counties with higher exemption rates had higher rates of reported pertussis among exempted and vaccinated children when compared with the low-exemption counties.” (Source).

If you think that choosing NOT to vaccinate your child doesn’t impact anyone else in your community, you are WRONG!

Parents are lying about their religious beliefs to score immunization waivers on the basis of a religious objection.  Those lies, that failure to vaccinate is having real and measurable impacts on their communities, in the form of increased cases of pertussis.  Vaccination is important.  Vaccines save lives.  We all have to do our part to keep our communities safe and healthy.

Today, I’ll join Tara and I’ll add my voice to the chorus of vaccine stories.

I have two children, Mable is 3.5 and Nemo just turned one.  Both children have been vaccinated according to the standard schedule recommended by the CDC, AAP, AMA, etc.

While I have done a lot of reading on the topic of childhood vaccinations, we relied heavily on the decades of schooling and practice that our pediatricians and nurse practitioners had, in deciding how to vaccinate our kids.

Both of my remarkable children have had only unremarkable reactions to their vaccinations.

Just last week Nemo recieved his first dose of the MMR vaccine and the Varicella vaccine.

I could not even tell you what happened after each and every vaccination.  I have a recollection of Mabel sleeping through the night for the first time after getting several vaccinations at her 8 week well child visit.  I have a recollection of Nemo having a slight fever after some shots- I don’t remember which ones or how old he was.

My experience has been completely unremarkable.  Other than expected tenderness at the injection site or being sleepier than usual, maybe a fever, neither of my kids have had any reactions.  And, as is clear from my inability to recall details, those reactions aren’t even memorable enough for me to recall.

That’s my unremarkable vaccine reaction story.  What’s yours?  Share it here or with other Evidence-Based Parents on Facebook.

Adverse Effects of Pitocin in Newborns

OMG!  “Pitocin Side Effects:  Harm to Newborns Found in Child Labor Drug Study Triggers mommy-Blog Firestorm!”

I wasn’t really sure what the problem was from the headline.  Were mommy-bloggers upset over child labor?  Were newborns put to work on a drug study?  What’s going on?!

Apparently the moms at Babble and The Stir have their granny-panties in a knot reporting, sensationally*, on a press release from the American College of Obstetricians and Gynecologists. (*meaning they are sensationalizing the results for clicks, not that they are doing a sensational job reporting on the study)

All the hubbub is over Poster #74 at ACOG’s Annual Meeting.  Title:  “Oxytocin Usage for Labor Augmentation and Adverse Neonatal Outcomes” by Dr. Michael S. Tsimis et al.

What the study looked at?

…a  retrospective analysis of deliveries that were induced or augmented with oxytocin. The study included more than 3,000 women delivering full-term infants from 2009 to 2011. The researchers used the Adverse Outcome Index, one of several tools used to measure unexpected outcomes in the perinatal setting and to track obstetric illness and death rates. (Source)

What the data showed?

Researchers found that induction and augmentation of labor with oxytocin was an independent risk factor for unexpected admission to the NICU lasting more than 24 hours for full-term infants. Augmentation also correlated with Apgar scores of fewer than seven at five minutes. The Apgar is a test that evaluates a newborn’s physical condition at one and five minutes after birth based on appearance (skin coloration), pulse (heart rate), grimace response (medically known as “reflex irritability”), activity and muscle tone, and respiration (breathing rate and effort). A baby who scores eight and above is generally considered to be in good health. (Source)

What the authors concluded?

The analysis suggests that oxytocin use may not be as safe as once thought and that proper indications for its use should be documented for further study. “However, we don’t want to discourage the use of Pitocin, but simply want a more systematic and conscientious approach to the indications for its use.” (Source)

The take home message?  The study (as far as I can ascertain from the ACOG press release) did not establish a causal link between pitocin use and adverse effects in newborns, it showed a correlation.  Like any drug, pitocin isn’t without side effects.  Doctors and patients must exercise their judgement in using it- adverse effects from pitocin may be preferable to outcomes of NOT using it and complications of delayed delivery of a baby.

Keep in mind, since this is a poster and not a published paper, the data hasn’t been peer reviewed, actually, unless you are actually AT that meeting, you can’t see the data, because it’s on a poster. My search for the abstract was fruitless, leading me in circles back to the press release.

So, as always, talk to your doctor, ask questions, make informed choices.  Don’t just listen to some random mommy-blogger (or in this case, #scimom blogger/Evidence Based Parenting blogger) on the internet.

How to calm a baby and/or a baby mouse

Saw this article in The New York Times: “In Parents’ Embrace, Infants’ Heart Rate Drops”

As I mom, I can attest to the fact that there have been numerous occasions where my children were crying- either in their bed, on the floor, or in the arms of another person- and the moment I took them into my arms, the crying ceased.  It’s often insulting to the person who has been holding them, but that is what they’ve done.

I’ve written before about research showing just how calming a mom can be for children of all ages- even just that mom’s voice, here.

It’s always oddly fascinating to me when research proves what we’ve always known/felt/believed to be true.

Turns out that human babies, and lots of other mammalian babies, respond similarly to being carried by their mother (or perhaps caregiver in the case of humans), by calming down.

Image from Esposito et al of the ‘behavioral task of maternal rescue’ wherein Mother Mouse rescues her pups from a cup.  This is similar to humans rescuing an infant from under the coffee table or a toddler from the monkey bars at the park.

A recent paper by Esposito et al entitled “Infant Calming Responses during Maternal Carrying in Humans and Mice” published in Current Biology looked at the responses of babies (of the human and murine variety) as well as dissecting what signals actually contribute to those responses (in the murine babies).

By monitoring babies movements, crying, and heart rates (electrocardiograms) the researchers found that within seconds of being carried (not just held, but picked up and moved around) by their moms, infants’ heart rates declined, their movements slowed, and their crying diminished.  Compared to an infant laying alone in a crib, just holding the infant while the mother was seated did elicit some calming effects, but not as strongly as carrying the infant.  (I’m pretty certain that further study would show this is primarily responsible for many a parent pacing up and down the aisles of an airplane to placate a cranky baby)

The same happens to mice, and since we can do experiments on mice that we can’t on babies, researchers looked further into the murine response to see how it worked.

Turns out, mice babies cry too (Ultrasonic Vocalizations, USVs).  Just like humans, when a mouse mom carries her pup, it calms down.  In a mouse, that means the pup stops crying/making USVs, adopts a compact posture (drawing up its hind legs and being still), and its heart rate drops.  The researchers used several different techniques to figure out what cues were causing these behaviors and figured out that it was a combination of actually feeling the mother grasping its skin and proprioception (basically sensing that it is being carried).

It’s fascinating to me how behaviors and responses are shared between species. It also reminds me how primal newborns are.

However, the paper had one CRITICAL flaw.  MAJOR.  As in I don’t know how the reviewers and editor missed it.

See here:

A scientific understanding of this physiological infant response could prevent parents from overreacting to infant crying. Such understanding would be beneficial to parents by reducing frustration, because unsoothable crying is a major risk factor for child abuse [26]. Source.

To this I say, “HAHAHAHA!  Are any of you even parents?!  At 3 am when you haven’t gotten any sleep and your kid just WILL NOT SHUT UP- does the knowledge that “the identified effects of carrying on parasympathetic activation and cry reduction were significant and robust” make one damn bit of difference?!*  I think not.

If I had been the reviewer, I might have responded, “If you want those two sentences in the paper, you gotta include a figure on whether that knowledge actually mattered to any parent in the dead of night with a colicky infant.”

 

 

*I’m only partly joking.  When my kids were infants and being difficult/impossible to soothe, I did remind myself that they weren’t intentionally trying to piss me off.  I suppose this understanding of what soothes them might similarly serve as a reminder that babies aren’t out to get you on a personal level at 3am by refusing to sleep and/or let you stop pacing around and/or nursing them.

From The Annals of the Obvious: HPV vaccination does not make girls more promiscuous

Yesterday it was all over the news what anyone with a brain cell might have been able to figure out on their own- vaccinating girls against Human Papilloma Virus does not make them whores.

Here’s the study:  Sexual Activity-Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year Olds, by Bednarczyk et al.

To briefly borrow a summary for the NYTimes:

They selected a group of 1,398 girls who were 11 or 12 in 2006 — roughly a third of whom had received the HPV vaccine — and followed them through 2010. The researchers then looked at what they considered markers of sexual activity, including pregnancies, counseling on contraceptives, and testing for or diagnoses of sexually transmitted diseases.

Over all, in the time that the girls were followed, the researchers did not find any differences in these measures between the two groups.  Source:  Anahad O’Connor, NYT.

When I was a tween and got vaccinated against hepatitis, I didn’t run out and spread my legs either.  I don’t think I even realized that hepatitis could be sexually transmitted at that age- or even paid close attention to what I was being vaccinated against.

I’m not sure why people think that being vaccinated against an STD would make a child more promiscuous, but apparently that’s the most cited reason given by parents for not vaccinated against HPV!

I can’t understand the reasoning, “Hmm.  Should I vaccinate my daughter against cervical cancer?  Give her protection against oral cancers as well?  All with this simple vaccination?  Oh, wait!  It’s an STD?!  Heck no.  I’d rather a daughter who died of cervical cancer than a daughter who engaged in premarital sex- because I know my precious little angel would never do that otherwise!”

Look.  HPV is an STD that causes genital warts.  It also causes cervical cancer.  It’s also now been linked to oral cancers as well, see here.  The HPV vaccine could guard your children, female and male (it causes penile cancer as well) against infection.  That means your daughters won’t get cancer and neither will your sons (they also won’t pass it on to your future daughter in law*).  Even if your precious little angel saves him/herself for marriage, who’s to say their spouse did the same?  Newsflash:  Almost one third of 14- to 19- year olds are infected with HPV!  Those are not odds I want to take with the health of my kids.

Just as I do with every other vaccine, I’m going to follow the CDC guidelines when it comes to the HPV vaccine.  Mabel and Nemo will both be vaccinated.

That said, I’m not going to turn them loose without a healthy dose of info on sexuality and sexual health.  I hope they always make the wisest of decisions when it comes to sex.  I would be happy if they waited until they were married.  Do I know the odds of that are slim?  Yes.  Are young people inherently unable to make decisions based on the long-term consequences of their actions?  Heck yeah. That’s why this vaccine is so important-  I don’t want a single bad decision to result in a cancer diagnosis down the road- for them or for their future partners.

Also note, all of this is assuming that children only engage in consensual sexual relations.  We know that this is not the case.  Children should be protected from predators, but they should also be protected from being victimized twice- first at the hands of an abuser, and second from any STD that abuser might transmit to them.

_______________________________________________

*Pardon the hetero-normative language, but I’m guessing a person who fears a vaccine causing their daughter to have premarital sex, and that chance trumping her healthy, is NOT considering the possibility that their son or daughter could possibly ever be homosexual.

A near miss.

On my 4th wedding anniversary last week I wrote about how Mac and I spent our 3rd anniversary- frightened I may have been losing a much wanted pregnancy.

Well, as I was writing that post, an article was published in the British Medical Journal.  I came across it on Thursday, looking for citations to back up the information I was including in the post.  It shook me, but I didn’t have time to read it until today, and I don’t link to any information that I haven’t read for myself.

Well, I read it today.  It made me realize just how close we came to losing that baby, our Nemo who, as the article would suggest, really beat the odds to be born.  So scary.

The article, “Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding:  meta-analysis of cohort studies” by Verhaegen et al looked at the data compiled by 26 previous studies of women who were less than 14 weeks pregnant and experiencing abdominal pain or bleeding.

This article does a pretty good job of reviewing the data in laymen’s terms if you would like to know.

The finding that made me catch my breath was that in women with progesterone levels below 10ng/ml, the probability of the pregnancy being non-viable was 96.8%.  That meant only 3.2% of pregnancies with that low of a progesterone level were viable.

If you remember what I wrote last week, when my progesterone levels were checked at 7 weeks, it was only 6ng/ml.  (Even after the supplementation with Prometrium, the highest my levels ever got were 12ng/ml.)  At that point I had only a 3.2% chance of a happy ending.

I’m glad this study wasn’t out there for me to find when I was going through that.  As it was, at that time, the worry made me feel so uncertain.

I’m also glad that the ultrasound technician was as stellar as she was.  I’m glad she didn’t give up after the first pass when she saw no heartbeat and an embryo measuring weeks behind where it should have been.  I’m glad that she noticed my tipped uterus, that she persisted, tried something different, and managed to detect a heartbeat and get measurements that reassured us (we even got a picture, see below).  If she hadn’t been as diligent as she was, Mac and I would have left the office with news that I was losing the pregnancy- low progesterone, embryo measuring small, no heartbeat- that would have been the conclusion.

Nemo at 7w3d. Only a few millimeters long on September 27, 2011.

Unlike with Mabel, we didn’t ‘go public’ with news we were expecting Nemo until just before Thanksgiving- at which point I was already 15 weeks pregnant.  I didn’t tell anyone at work until I was over 17 weeks along.  Most parents-to-be can’t wait to shout it from the rooftops that they are expecting.  With Mabel, I felt nervous announcing, like we might jinx ourselves.  With Nemo, knowing that things had been complicated or tenuous or whatever they were, made Mac and I even more reluctant.  Even once we did announce, it was only on Facebook- not the video we sent out via email and posted on Facebook to announce Mabel’s impending arrival.  The picture above- we didn’t share it with anyone (until today).

At one point, once things had settled down and the pregnancy was progressing normally, the midwife actually said to me, “I hope you don’t feel like there’s a cloud over this pregnancy.”

She hit the nail right on the head.  I did feel like there was a pall over me and Nemo, and I think Mac felt it too.  The uncertain start gave me a worry that was hard to shake.

If I had gotten that first phone call from the midwife’s office telling me my progesterone was only 6ng/ml and I’d found the Verhaegen study, I would have been certain things would end badly.  I’m glad it wasn’t out there back then.

I also hope that women who find this post by doing the same Google search I did last September find some answers and some hope.

NSAIDs and miscarriage risk

I was shocked to read this MSNBC headline:  Miscarriage risk doubles with use of anti-inflammatory drugs.  I immediately tracked down the actual research article in the Canadian Medical Association Journal to read for myself:  Use of nonasprin nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy and the risk of spontaneous abortion.

I’ll cut to the chase.  Bottom line- I would not take NSAIDs while pregnant without a frank discussion with my doctor/midwife about the risks.  I will advise my friends and family likewise and encourage them to talk with their doctor/midwife.

The research does not show a direct causal relationship between NSAIDs and miscarriage.  However, the data are compelling, necessitate further research, and in the meantime warrant avoidance of NSAIDs during pregnancy.

The MSNBC article did a good job of accurately summarizing the research-

The Canadian study compared the medical records of 4,705 women who had a miscarriage during the first 20 weeks of gestation with records of 47,050 women who became pregnant and delivered a child. The women in the study were aged 15 to 45 when they became pregnant.

[The authors] considered a woman to have been exposed to an NSAID if she had a prescription for the drug filled before she became pregnant or during early pregnancy. Most NSAIDs in Canada are available through prescription rather than over-the-counter, the authors said.

Among women who had miscarriages, 352 had taken NSAIDs, compared with 1,213 of the women who did not experience pregnancy loss.

Taking all those factors into account, Berard and her colleagues determined that women who took prescription NSAIDs early in pregnancy were 2.4 times as likely to have a miscarriage as those who did not. The rate of miscarriage in women who took NSAIDs was about 35 percent, compared with the normal rate of miscarriage, which is about 15 percent.       Source: MSNBC

Reading the original journal article the authors are well aware of the limitations of their study- for instance, they did not have data on the use of over the counter (OTC) NSAIDs by study subjects (although they note that ibuprofen is the only OTC NSAID available in Quebec, where the study was conducted, and prescriptions for OTC medications were available to subjects through their health plan).  Information on why NSAIDs were prescribed to patients was not available, thus it is not possible to know if there was an underlying illness that contributed to miscarriage risk.  The authors also assumed that study subjects took prescribed NSAIDs as directed.  There were also a litany of confounding factors that had to be corrected for- other illnesses, socioeconomic status, etc.  The authors also did not have information on whether the patients smoked during pregnancy.

The mechanism by which NSAIDs might contribute is unknown, but speculated to be due to their ability to modulate prostaglandins.  Prostaglandins are lipid (fat) molecules that control certain cell behaviors.  They can induce muscle contractions and inflammation. NSAIDs inhibit the productions of prostaglandins, quieting inflammation and cramping.  The ability to reduce cramping is why NSAIDs are included in drugs like Midol for treating cramps associated with menstruation.  During pregnancy, the levels of prostaglandins in lining of the uterus decrease over time.  If NSAID treatment causes a more rapid drop in prostaglandin levels or fluctuation in the levels, it may contribute to miscarriage risk.  However, this is speculative and there is no definitive evidence that this it the case.

Increasing the risk of miscarriage from 15% to 35% is a staggering amount.  However, I cannot stress enough that correlation does not equal causation, and this study does not prove causation.  Further, pregnant women with underlying conditions will have to work with their medical providers to balance the potential for increased risk of miscarriage from NSAIDs with the risks of forgoing NSAID treatment.

When I was pregnant with Mabel, I avoided taking anything that wasn’t necessary.  I cannot recall exactly, but I’m pretty sure I avoided taking any kinds of pain killers (NSAID or otherwise) the entire time I was pregnant.  I do remember using Mucinex and nasal decongestant spray due to a nasty cold with massive congestion that left me unable to sleep.  I also took a prenatal vitamin as well as some OTC allergy meds deemed safe for use during pregnancy by my allergist (chlorpheneramine maleate and Benedryl).

Bottom line- I would not take NSAIDs while pregnant without a frank discussion with my doctor/midwife about the risks.  I will advise my friends and family likewise and encourage them to talk with their doctor/midwife.

Remember, NSAIDs are sold under lots of names and are ingredients in a lot of cold/flu remedies:  Advil, Aleve, Midol, Motrin, Dayquil,  Sudafed, etc.  For a comprehensive list, see here.