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This is a guide to help parents like you stay informed and make the best healthcare decisions for yourself and your new family. Your health is in your hands. Copyright ©2017 Generation Rescue 1 Safe Pregnancy Guide 3 Before Pregnancy 4 Pre-Pregnancy Actions 5 Prenatal Testing 6 Food Allergies & Intolerances 8 Vitamins 10 Uncover & Treat Yeast, Bacteria, & Viral Infections 12 Live a Non Toxic Lifestyle 15 During Pregnancy 20 Diet, Nutrition and Supplements 21 Lifestyle Changes 23 Vaginal Delivery vs. C-Section 28 Post-Pregnancy 30 Supplements, Nutrition, and Constipation 31 Post Delivery Topics 32 Vitamin K, Eye Ointment, & Cord Clamping at Birth 33 Vaccines Following Delivery 35 Breastfeeding & Early Nutrition 35 Copyright ©2017 Generation Rescue 2 Safe Pregnancy Guide In the United States, developmental disorders affect as many as 1 in 6 children.1 Not surprisingly, prevention of developmental disorders is paramount for parents. This guide aims to arm you with the knowledge and tools to do so to the greatest extent possible. The most concerning developmental disorder for most parents today is autism, which is characterized by a wide range of physical and psychological symptoms. In fact, because of the wide variety of symptoms and severity, it is now referred to as Autism Spectrum Disorder. In spite of shared symptoms, no two people with an autism spectrum disorder will present the exact same way. Although the cause of Autism is still not well understood, the prevailing thinking is that it is caused by a genetic predisposition and an assault on the immune system either during gestation or after birth. Prevention, therefore, begins before conception. Through a protocol of eliminating environmental toxins, strengthening the immune system and understanding your family history the risk of autism can be minimized. More specific autism risk factors include parental and sibling history of autism, ADHD, OCD, some psychiatric illnesses, genetic disorders, allergies, asthma, poor immune system (either hyper-immune or low-immunity), learning and language difficulties, advanced maternal age, poor nutrition, low essential fatty acids, chronic infections, poor periodontal hygiene, before conception and during pregnancy exposures to toxic metals through environment, fish and vaccinations.2 Given the severity of developmental disorders, there is a lot of information to consider before, during and post pregnancy to be used as resources and guides for parents. Boyle, Coleen et. al. (2011). Trends in the Prevalence of Developmental Disabilities in US Children, 1997-2008. Pediatrics, 127: 1034-1042. doi:10.1542/peds. 2012-2989 1 2 Laake, D. (2009). Comprehensive Prenatal Nutrition. Defeat Autism Now Conference (pp. 131-142). Dallas: ARI, Autism Research Institute. Copyright ©2017 Generation Rescue 3 Before Pregnancy Planning for a healthy baby occurs well before a family is ready to conceive. Those who are considering pregnancy should investigate up to one year in advance the steps needed to ensure the healthiest possible pregnancy. Copyright ©2017 Generation Rescue 4 Pre-Pregnancy Actions UNDERSTAND YOUR MEDICAL HISTORY A parent’s medical history can be a significant indicator of Autism risk. Many studies indicate that individuals with a history of autoimmune disorders, diabetes, infections or allergies are at a greater risk of having a child on the autism spectrum. In one study, 46% of families with autistic children have two or more of their family members with autoimmune diseases. These diseases consisted of Type 1 diabetes, adult-onset rheumatoid arthritis, hypothyroidism and lupus.3 Most autoimmune diseases cause inflammation and controlling inflammation can help prevent possible damage to the fetus. Medical history is a critical component to pre-pregnancy, pregnancy and the future child’s health. In addition, the parent’s medical history should be shared with the pediatrician to identify symptoms that may indicate problems with the newborn's immune system. FIND THE RIGHT MEDICAL PROVIDER There are many types of medical providers for expecting parents ranging from OBGYN, Nurse Practitioner, and Certified Nurse Midwife to a Licensed Midwife. To find the right fit research should include a background check, speaking with former clients (if available) and interviews. It’s also possible to form a team of providers across all disciplines. A recommended and vetted listing of medical professionals is available at generationrescue.org. LOWER YOUR BMI Obesity in pregnancy can carry multiple risk factors that endanger the baby. Women should try to have a BMI of 21-29 prior to conception. It is not Comi A, Zimmerman A, Frye V, et al. Familial clustering of autoimmune disorders and evaluation of medical risk factors in autism. J Child Neurol 14:388-394, 1999. 3 Copyright ©2017 Generation Rescue 5 recommended to diet directly before conceiving but to work with a nutritionist or registered dietitian (RD) well in advance to lose the weight in a healthy, nutrition building fashion.4 STOP USING THE PILL Discontinue use of the contraceptive pill at least 3 months before pregnancy because it can interfere with absorption of Vitamin B6 and Zinc. A deficiency in B6 can cause anemia, neuritis, depression, dermatitis, renal calculi and possibly convulsions. Zinc is helpful in cell development, bone growth, wound healing, protein metabolism and unlocks stored vitamin A. Zinc requirements increase over 30% during pregnancy. Inadequate Zinc intake can increase severity of morning sickness and their babies can have low birth weight, born premature and have impaired immunity. With adequate Zinc levels the risk of stillbirth due to deficient nutrition decreases.5 Prenatal Testing These tests can be performed by a healthcare provider or purchased via an online lab test provider, such as MyMedLab.com. Online providers liaise with local doctors to verify the lab tests and provide prescriptions for testing. Results are available in a secure online environment with the ability to fax to your chosen doctor or get medical advice from a doctor or nurse on call. Genetic testing, TORCHS panels (detection of toxoplasmosis, rubella, cytomegalovirus, Herpes Simplex, HIV and syphilis) and obstetric exam is part of a regular prenatal visit with your physician or other medical professional.6 This testing should not replace good prenatal care. Burden & Jones (2011). Preconception Care. In S. Macdonald & J.Magill-Cuerden (Eds.), Mayes' Midwifery 14th Edition(Chapter 20). London, UK: Bailliere Tindall Elsevier. 4 Burden & Jones (2011). Preconception Care. In S. Macdonald & J.Magill-Cuerden (Eds.), Mayes' Midwifery 14th Edition(Chapter 20). London, UK: Bailliere Tindall Elsevier. 5 6 Laake, D. (2009). Comprehensive Prenatal Nutrition. Defeat Autism Now Conference (pp. 131-142). Dallas: ARI, Autism Research Institute. Copyright ©2017 Generation Rescue 6 These suggested Prenatal Testing Panels were designed to help find and target illness and nutritional deficiencies that could create complications during pregnancy. Testing is for the father and mother including blood type, nutritional deficiencies, thyroid status, and exposures to toxins/medications. These tests can be done anywhere between 3 months to 1 year before conception.7 ▪ Journal of Neurological Sciences, Roman 2007 talks about Thyroid Deficiency in Pregnancy: "transient intrauterine deficits of thyroid hormones result in permanent alterations of cerebral cortical architecture reminiscent of those observed in brains of patients with autism" which suggested that the “current stage of autism could be related to transient maternal hypothyroxinemia resulting from dietary and/or environmental exposure to antithyroid agents.” These agents include mercury, fluoride, coal derivatives and PCB's. 8 ▪ The American Journal of Clinical Nutrition, Hollis and Wagner’s 2006 editorial discusses Vitamin D deficiency in pregnancy as an "ongoing epidemic" that isn't linked just to bone formation. Studies have shown that "vitamin D is linked to fetal “imprinting” that may affect chronic disease susceptibility later in life as well as soon after birth". This vitamin D deficiency has also been linked to several autoimmune diseases like MS and rheumatoid arthritis. To correct a deficiency the nutritional intake of vitamin D must reach equal to or greater than 2000 IU/d.9 ADDITIONAL SUGGESTED PANELS For Both Mother and Father Pre-conception (3 months to 1 year prior): ▪ CBC, Chem Panel ▪ Serum Ferritin ▪ Serum Iron ▪ Vitamin D3 25 hydroxy ▪ Blood type ABO/Rh (cont.) 7 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. Roman, G. (2007). Autism: Transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents . Journal of Neurological Sciences, 262(1-2), 60-70. 8 9 Hollis & Wagner (2006).Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutrition, 84(2), 273. Copyright ©2017 Generation Rescue 7 ▪ If diabetes risk: HbA1C, GGT ▪ If cardiac risk: CRP For Mother Pre-conception (3 months to 1 year prior): ▪ Thyroid, Free T3, Free T4, TSH ▪ Vaccine Titers: Rubella, Varicella ▪ Genetic testing is done thru your physician according to state ▪ Hep B, Syphilis, HIV ▪ Blood Type ABO Rh ▪ Diabetes screen HbA1c Nutrition Testing Pre-pregnancy ▪ Zinc ▪ Organic Acid Test (OAT) ▪ Comprehensive Stool ▪ Food Allergy IgG, IgE ▪ Celiac Blood Panel ▪ Porphyrin Urine ▪ Serum A, D, E, K ▪ RBC mineral panel ▪ Opiate Peptide Urine ▪ Adrenal profile for cortisol and DHEA Food Allergies & Intolerances Allergies are sensitivities to one or more substances that can be eaten touched or inhaled and are often times referred to as allergens. Allergies are inherited or a predisposition to an allergen is passed down from the parent to the child. The more allergic a parent, the sooner the onset of the symptoms of allergies. Studies have shown that if the parents are allergic to a substance, the child will have a 75 to 100 percent chance of having the same allergy. If neither parent has allergies the chanced of the child having allergies drops to 10 percent.10 Nambudripad, D. (2002). Say Goodbey to Illness, A Revolutionary Treatment for Allergies & Allergy Related Conditions (3rd ed.). Buena Park, CA: Delta Publishing Company. 10 Copyright ©2017 Generation Rescue 8 In some cases the child still has severe allergies with both parents having no history or allergic reactions. This can be explained by several factors. The parents had an illness or disease, the mom was exposed to poor nutrition, drugs or alcohol, radiation, contracted a virus or bacterial infection or suffered from severe stress. These factors can cause the genes to mutate instead of developing normally, so what should have been a low allergy genetic code was changed into an imbalanced genetic code that creates high rates of allergies, sensitivities that can lead to a variety of other disease states.11 Allergies occur because the immune system has been weekend at some point in utero or after birth. There are multiple studies showing that certain vaccines can alter the immune response causing an allergic reaction response to increase.12 Testing and treating allergies can be accomplished prior to conception. A healthcare provider can perform a food allergy IgG, IgE panel for common food allergies. Once allergens are known, eliminating allergies from the diet can be accomplished. A nutritionist or other health care provider can also create a plan to eliminate allergies from the diet while treating with NAET. Removing allergic foods from the diet will decrease the amount of inflammation leading to a healthier mother. NAET, Nambudripads Allergy Elimination Techniques, is a non–invasive allergy elimination technique that uses all avenues of medicine, from all over the world to reduce inflammation, improve health and can reduce or eliminate food allergies or intolerances if done correctly by a qualified NAET certified practitioner. As with any treatment, outcomes are dependent on the skills of the provider, the compliance of the patient and many other variables. Research and information along with providers can be found on www.naetautismtreatmentcenter.com. Nambudripad, D. (2002). Say Goodbey to Illness, A Revolutionary Treatment for Allergies & Allergy Related Conditions (3rd ed.). Buena Park, CA: Delta Publishing Company. 11 12 Imani, F. & Kehoe, K. (2001). Infection of human B lymphocytes with MMR vaccine induces IgE class switching. Clinical Immunology, 100(3), 355-361. Copyright ©2017 Generation Rescue 9 Recently NAET was published in Integrative Medicine Vol. 10, No. 5 Oct/Nov 2011 issue about a research study showing the success of recovery in allergy induced autism.13 Another good resource for elimination diets is Julie Matthews, a Certified Nutritionist, books and prenatal seminars found at http://nourishinghope.com/. EAT HEALTHY & KEEP GOOD NUTRITION After determining the allergens and foods that need to be eliminated based on the results of the IgG and IgE allergy panels, as well as knowing vitamin and supplement deficiencies, a good nutrition plan should be implemented. Food choices vary by person, and nutrition plans will vary, but all will include eating a "clean" diet, free of chemicals and preservatives, organic fruits and vegetables and grass-fed meats. Most will also limit fish due to mercury content. Consider consulting with a nutritionist and or Registered Dietician (RD) as they are very important in this phase of prevention. A great nutrition course, called Nutrition for Pregnancy by Julie Matthews focuses on prevention of autism is available online here: http://nutritionforpregnancy.com/ In addition to a good nutrition program, a supplement protocol should also be considered. Necessary amounts vary by patient and health history and a consultation with a medical practitioner is highly recommended. Vitamins Prentatal Vitaimins: Prenatal Vitamins, a vegan/organic source is best. They are usually free from food dyes, wheat, gluten, milk, eggs, toxins and other allergens. A multi-dose option (1 capsule 2 times per day or 1 capsule 3 times per day read the label), helps to Jacob Teitelbaum, MD; Devi S. Nambudripad, MD, PhD, DC, LAc; Yvonne Tyson, MD; Ming Chen, MD; Robert Prince, MD; Mala M. Moosad, RN, LAc, PhD; Laurie Teitelbaum, MS. (2011) Improving Communication Skils in Children with Allergy Related Autism Using Nambudripads Allergy Elimination Techniques A Pilot Study. Integrative Medicine, 10(5), 36-43. 13 Copyright ©2017 Generation Rescue 10 absorb the water soluble vitamins better and the levels stay more consistent in your system.14 Calcium and Magnesium: Calcium and Magnesium are very important in bone growth and hormone regulation. Magnesium in general can help with sulfation and detoxification while eliminating constipation and muscle fatigue or cramping.15 Fish Oils Fish Oils, Omega 3's or essential fatty acids (EFA's) contribute to brain cell function, hormones and healthy neurotransmitters like serotonin.16 Vitamin D Vitamin D is good for bone formation, hormone regulation, immune modulation and prevention of allergy and other inflammatory conditions. Additional vitamin D should be supplemented with prenatal vitamins because the RDA of 400IU is generally too low to maintain healthy levels.17 Probiotics Powerful Probiotics of at least 50 to 100 billion CFU's help to build healthy bacteria to increase immune defense.18 Zinc Zinc can help with digestion, cognitive function and immune regulation. Zinc is often thought of as "No Zinc, No Think". 9In addition, Zinc is important in preventing viral replication.19 14 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. Bock, K., & Stauth, C. (2008). Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergies, The Ground Breaking Program for the 4-A Disorders. New York: Ballantine Books. 15 Bock, K., & Stauth, C. (2008). Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergies, The Ground Breaking Program for the 4-A Disorders. New York: Ballantine Books. 16 17 Hollis & Wagner (2006).Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutrition, 84(2), 273. 18 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. 19 Korant, B., Kaurer, J., & Butterworth, B. (1974). Zinc ions inhibit replication of rhinoviruses Nature, 248 (5449), 588-590 DOI: 10.1038/248588a0 Copyright ©2017 Generation Rescue 11 SUPPLEMENTS TO AVOID OR LIMIT Some supplements should be avoided during pregnancy. Please consult with your medical practitioner on the following: Vitamin A Vitamin A is very important for the health of the mother and the baby but should be limited to no more than 8000IU – 10000IU per day.20 Any medications that contain sources of A like retinols (acne treatments) should be discontinued. Talk to your medical professional about all of your medications and supplements you are taking to make sure they are safe before, during and after pregnancy. Visit the Teratology Society to learn more about possible side effects and research. http://teratology.org/ Uncover & Treat Yeast, Bacteria, & Viral Infections Consult a medical practitioner to discover and treat any infections at least six months to a year before conceiving. The body's inflammatory process should be evaluated before pregnancy with a simple stool test for yeast, bacteria and parasites. In addition with an immune panel blood test that looks for any present viruses and parasites. A healthcare practitioner will build a treatment regime based on the panel results. THE YEAST BEAST Yeast is commonly seen as a vaginal yeast infection, but yeast can be in all parts of the body causing damage and inflammation. Yeast overgrowth in the gastrointestinal tract can cause "leaky gut syndrome" which hinders the body's ability to digest foods correctly causing malabsorption, food intolerances, and nutritional deficiencies.21 20 (1987) Teratology Society Position Paper: Recommendations For Vitamin A Use During Pregnancy TERATOLOGY 35:269–275 21 Prescott. (2010) Proceedings of the Nutrition Society, 69, 366-372 Copyright ©2017 Generation Rescue 12 The Central Nervous System communicates with the GI tract via nerves sending important messages using neurotransmitters. Some research shows that 90% of serotonin (a very important neurotransmitter) is located in the GI tract. Serotonin maintains a balanced mood and enhances the sleep cycle as a precursor to melatonin. Yeast, bacteria and other infections may damage nerves regulating serotonin causing mood destabilization that may result in depression, aggression and anxiety. With 80% of the immune system in the gastrointestinal tract yeast overgrowth can lead to autoimmune conditions.22 A yeast fighting plan usually consists of 1) A candida fighting diet such as the Specific Carbohydrate Diet (not to be used during pregnancy, just while fighting yeast) 2) Anti-fungal medications (either Rx or naturals) 3) Replenish the GI tract with a powerful probiotic at least 50-100 Billion cfu's. When treated, yeast may release toxins during "die-off" and can be uncomfortable at times including loose stools, headaches, body aches, vomittig, and stomach pains. To help prevent this, slow down the yeast control program. CLEAR UP THE BACTERIA Maternal bacterial infections such as a UTI or infection of the placenta can cause an inflammatory response in the mother. Damage to the placenta can harm the fetal brain and can cause subsequent fetal mortality or neurodevelopmental defects.23 24 25 Treating any underlying bacterial infections present in a stool test before pregnancy is very important. During pregnancy the immune system is lowered so that the body does not reject the baby. While protecting the fetus, this may lead to complications for the mother if she has unresolved infections. Bacterial 22 DeFelice, K. (2006). Enzymes: Go with Your Gut, Nore Practical Guidelines for Digestive Enzymes. Bound, Minnesota:ThunderSnow Interactive. 23 Shalak, L.F. et al. (2002). Clinical chorioamnionitis, elevated cytokines and brain injury in term infants. Pediatrics, 110, 673-680 Back, S.A. (2006). Perinatal white matter injury:the changing spectrum of pathology and emerging insights into pathogenetic mechanisms. Mentally Retarded Developmentally Disabled Res. Rev.,12, 129-140. 24 25 Volpe, 18 Claire, J.J. (2009). Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurology, 8, 110-124. R., Martin, J. & Taylor, T. (2012). Fight Autism and Win, Biomedical Therapies That Actually Work!. Rochester, NY: JRT Publishing. Copyright ©2017 Generation Rescue 13 infections may be treated with antibiotics or natural remedies, such as Goldenseal.26 FIND & TREAT PARASITES Similar to other infections, parasites can be very dangerous to the fetus and one's general health. There are a variety of parasites that can be found on a comprehensive stool test. Treatment is laid out according to type of parasite. Natural anti-parasitic medications like Humaworm, Wormwood or eating a Garlic Clove.27 A parasite called toxoplasma gondii causes the disease toxoplasmosis. Most that become infected don't even know it because their immune system keeps them from showing side effects. This disease can be acquired anywhere in the world by eating undercooked meat, cat stool transmission, from child to parent. The CDC recommends testing before becoming pregnant. A positive test prior to pregnancy indicates previous infection and no further treatments or testing needs to be done for toxoplasmosis. If the test is negative, precautions such as hand washing, avoiding cat litter box cleaning, cooking foods to safe temperatures, washing fruits and vegetables well, avoiding raw fish, wearing gloves during gardening and having younger children wash their hands well may prevent infection. Toxoplasma testing is part of a routine prenatal blood test panel. Treatment is not usually needed before pregnancy, as it will clear on it's own. A doctor will treat toxoplasmosis during pregnancy only when a positive blood test is found with a prior negative result.28 THE VIRAL DANGER One proposed etiology for autism is prenatal or early infantile viral infections. The Central Nervous System (CNS) is not fully developed at birth and is more 26 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. 27 Claire, R., Martin, J. & Taylor, T. (2012). Fight Autism and Win, Biomedical Therapies That Actually Work!. Rochester, NY: JRT Publishing. 28 Center of Disease Control. (2013). Parasites Toxoplasmosis General Information. Retrieved from http://www.cdc.giv/parasites/toxoplasmosis/gen_info/faqs.html Copyright ©2017 Generation Rescue 14 susceptible to viral damage.29 Viruses have been shown to hinder the development of the CNS in fetuses. "Viral infections in pregnancy are major causes of maternal and fetal morbidity and mortality.”30 These viruses can infect the fetus via the placenta during gestation, during the birthing process from blood or other secretions and from breast milk after the baby is born. The infection risk is related to the virus itself and the age when the baby was exposed, indicating the need for testing.31 There are routine viral panels to test for these diseases. Preventing viral infections is complicated. Hand washing, diligent testing and good immune status can help. Speaking with a medical professional about ways to find, treat and prevent viral infections is recommended. Live a Non Toxic Lifestyle Achieving a non-toxic life in today's world is almost impossible. Understanding what is toxic, how the particular toxins are harmful and how to avoid toxins will help reduce toxic intake. Reasonable home health improvements include: non-toxic paints, carpets, bedding, cleansers, aluminum free deodorants, soaps, non-aluminum cooking utensils and pans, stainless vs. plastic water bottles, decrease electronic frequencies that contain radiation (EFMs) no cell phones next to bed or in your pocket, and decrease electronics in the bedroom.32 Use common sense, read labels and research the ingredients. Studies have shown genes that each parent gives to the baby in the first early days of development, during "genomic imprinting" can be changed by 29 Prescott. (2010) Proceedings of the Nutrition Society, 69, 366-372 30 Marino et.al., Medscape Reference. (2012). Viral Infections and Pregnancy. Retrieved from http://emedicine.medscape.com/article/235213-overview 31 Marino et.al., Medscape Reference. (2012). Viral Infections and Pregnancy. Retrieved from http://emedicine.medscape.com/article/235213-overview Evironmental Working Group. (2009). Pollution in Minority Newborns: 11 Healthy Pregnancy Tips. Retrieved from http://www.cdc.giv/parasites/toxoplasmosis/ gen_info/faqs.html 32 Copyright ©2017 Generation Rescue 15 environmental factors, altering the function of the gene for the fetus. This is called epigenetics. Epigenetics is when a gene in our body is altered by an environmental factor that changes the function of the gene but not the actual DNA sequence. 33 Genes can be changed due to a toxic environment, stressors, infections and other factors. Thus meaning it is not always the parent's genetic make-up that influenced the predisposition to autism or other developmental delays, it could be many other controllable factors. 34 In the 1950's there were many papers on the role of early development, pregnancy, birth and it's effects on mental health, development and behavior of the child through their lifetime. These ideas weren't used again until the late 1990's where they showed a link between prenatal environment and metabolic and cardiovascular disorders.35 Additional information can be found on the following websites: The Environmental Working Group is the nation’s most effective environmental health research and advocacy organization. They offer information on the latest research in the fields of environmental health as well as listings for families to make safer choices in skincare, foods and household items. www.EWG.org Healthy Child Healthy World is a nonprofit organization that empowers parents to take action and protect children from harmful chemicals. They offer easy steps and resources towards healthier living. www.healthychild.org Studies have shown that risks for potential off gassing and toxic chemicals may be linked to overall health issues, that concern led the makers of Intellibed to create a nontoxic mattress and pillows including the IntelliGEL technology. To learn more and read the research visit www.intellibed.com/ 33 Bressan FF, et al., (2009). Unearthing the Roles of Imprinted Genes in the Placenta, PlacentaJournal doi:10.1016/j.placenta.2009.07.007 34 Groom A, Elliott HR, Embleton ND, et al. (2010). Epigenetics and Child Health Basic Principles. Archives of Diseases in Childhood doi:10.1136/adc.2009.165712 35 Barker, D.J., (1995). The fetal origins of adult disease. Proc. R. Soc. Lond. B Biol. Sci. 262, 37–43. Copyright ©2017 Generation Rescue 16 AVOID MERCURY There is a lot of focus on mercury and its role in autism and other developmental disorders. Reasons for this are clear: Mercury has detrimental effects on the immune system, internal organ function and the brain. This has been proven in several instances including Pink's Disease caused by mercury based tooth powder. 36 Mercury is the world's second most neurotoxic element. Mercury is naturally occurring in the environment, but also occurs in man made sources such as the preservatives in vaccines, mercury in fish and dental amalgams. During our history mercury was not properly disposed and it is now present in the soil and the ocean. Mercury that cannot successfully be discarded by the body accumulates in fatty tissue and disrupts many of the body's natural functions. Symptoms of mercury toxicity range from sensory disorders, speech and hearing problems, cognitive issues, and unusual behaviors.37 Avoidance of all known sources of mercury is vital prior to conception. It’s often suggested to avoid fish, any new dental amalgams with mercury or improper removal of them. Removal of amalgams should be done at least one year before pregnancy.38 Mercury chelation can be done a few years in advance of becoming pregnant. Mercury chelation done safely and effectively in low-doses with proven medications that have documented half-lives (the time the medication stays at the same level in the body) is not a quick and easy process. For more information and to talk with an expert in the field of chelation, go to www.noamalgam.com. Dr. Cutler will work with any medical doctor or other medical professional to help clarify treatments and help achieve safe and accurate removal. 36 Claire, R., Martin, J. & Taylor, T. (2012). Fight Autism and Win, Biomedical Therapies That Actually Work!. Rochester, NY: JRT Publishing 37 Cutler, A. (1999). Amalgam Illness diagnosis and treatment, What you can do to get better, How your doctor can 38 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. Copyright ©2017 Generation Rescue 17 For a listing of safe dentists go to www.holisticdental.org/find_holistic_dentist FLU SHOT The influenza vaccine has been shown to be ineffective in a large study of pregnant women.39 In an ongoing study published in 2009 and updated this year entitled "Vaccines for preventing influenza in healthy adults," scientists said they found no plausible substantiation that the flu vaccine prevented death or hospitalization from flu-related complications and only marginally reduced the number of days of lost work attributed to the illness.40 Many integrative medical practitioners recommend avoiding the flu shot for at least a year prior to getting pregnant.41 Research for yourself and make an informed decision. Safe Minds created a good resource for vaccine information awareness: www.smartvax.com STOP USING FLUORIDE In the 1940's and 50's fluoride was added to drinking water believing it would help prevent tooth decay. Modern research has since proven that fluoride has minimal benefit when taken internally and its ability to fight cavities when applied to teeth is being questioned. In fact, it has been shown to cause multiple problems including reducing intelligence in children, causing tooth defects called dental fluorosis and transporting other toxins such as lead from the water pipes across the blood brain barrier.42 Fluoride is an endocrine disruptor and can cause reduction in thyroid function in many individuals.43 A study demonstrated that "transient" thyroid deficiency in pregnancy can result in permanent changes in the brain similar to those seen in Black SB, Shinefield HR, France EK, et al. (2004). Effectiveness of the influenza vaccine during pregnancy in preventing hospitalizations and outpatient visits for respiratory illness in pregnant women and their infants. 21:333-339 39 SmartVax.com. (2013). Vaccine Decisions to Make During Pregnancy. Retrieved from http://www.smartvax.com/index.php? option=com_content&view=article&id=143 40 41 Autism Research Institute. (2013). Minimizing Risks. Retrieved from http://www.autism.com/index.php/prevention 42 Xiang Q, et al. (2003a). Effect of fluoride in drinking water on children’s intelligence. Fluoride 36: 84-94; 198-199. 43 National Research Council. (2006). Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. National Academies Press, Washington D.C. p. 189-224 Copyright ©2017 Generation Rescue 18 autistic brains. The study goes on to suggest that the rise in autism cases could be linked to hypothyroidism of the mother due to environmental exposure of thyroid toxic agents.44 Not only does fluoride damage teeth it can harm the nervous system, thyroid and multiple body systems. Use filtered water and find a fluoride free toothpaste. Read more about fluoride on these links: http://slweb.org/ftrc.html http://www.fluoridealert.org/ http://nofluoride.com/ http://www.earthclinic.com/fluoride_questions_and_answers.php Roman, G. (2007). Autism: Transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents . Journal of Neurological Sciences, 262(1-2), 60-70. 44 Copyright ©2017 Generation Rescue 19 During Pregnancy Pregnancy is such a vulnerable and exciting time for families. It is also a time to be vigilant about toxin exposure, lowered stress, good nutrition and adequate rest. It is important to continue the pre-pregnancy protocol during pregnancy. Copyright ©2017 Generation Rescue 20 Diet, Nutrition and Supplements Continue to forgo known allergic foods from the diet according to the IgG and IgE allergy panels, plus what vitamins and minerals you are deficient in, while maintaining a good nutrition plan. Food choices vary by person, and nutrition plans will vary, but all will include eating a "clean" diet, free of chemicals and preservatives, organic fruits and vegetables and grass-fed meats. Most will also limit fish due to mercury content. Consider consulting with a nutritionist and or Registered Dietician (RD) as they are very important in this phase of prevention. A great nutrition course, called Nutrition for Pregnancy by Julie Matthews an Autism Nutrition Consultant focuses on prevention of autism is available online here: http:// nutritionforpregnancy.com/ In addition to a good nutrition program, a supplement protocol should also be considered. Actual amounts needed vary by patient and condition and consultation with a medical practitioner is recommended. Increase caloric intake as the baby develops according to individual needs. It is important to not take in empty calories but make each one count. Weight gain depends upon the mother's diet, amount of activity she engages in, what types of foods are available to her, blood sugar status or diabetes status and whether she has been ill or having multiples. Obesity in pregnancy, a body mass of 30 or more is associated with diabetes, hypertension, infection, bleeding risk and fetal abnormalities. Most of which are known risk factors for autism.45 Foods to avoid that may cause infections during pregnancy are non-pasteurized milk, soft cheeses, pates of meat or veggies, undercooked frozen 'ready to eat' meals, raw eggs, partially cooked meats, eggs or mayonnaise.46 45 Autism Research Institute. (2013). Minimizing Risks. Retrieved from http://www.autism.com/index.php/prevention 46 Tiran, D. (2011). Nutrition. In S. Macdonald & J.Magill-Cuerden (Eds.), Mayes' Midwifery 14th Edition(Chapter 17). London, UK: Bailliere Tindall Elsevier. Copyright ©2017 Generation Rescue 21 VITAMINS Prentatal Vitaimins: Prenatal Vitamins, a vegan/organic source is best. They are usually free from food dyes, wheat, gluten, milk, eggs, toxins and other allergens. A multi-dose option (1 capsule 2 times per day or 1 capsule 3 times per day read the label), helps to absorb the water soluble vitamins better and the levels stay more consistent in your system.47 Calcium and Magnesium: Calcium and Magnesium are very important in bone growth and hormone regulation. Magnesium in general can help with sulfation and detoxification while eliminating constipation and muscle fatigue or cramping.48 Fish Oils Fish Oils, Omega 3's or EFA's essential fatty acids contribute to brain cell function, hormones and healthy neurotransmitters like serotonin.49 Vitamin D Vitamin D is good for bone formation, hormone regulation, immune modulation and prevention of allergy and other inflammatory conditions. Additional Vitamin D should be supplemented in additional to prenatal vitamins because the RDA of 400 iu is too low to help most people maintain healthy levels.50 Probiotics Powerful Probiotics at least 50 to 100 billion CFU's help to build healthy bacteria to increase immune defense.51 47 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. Bock, K., & Stauth, C. (2008). Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergies, The Ground Breaking Program for the 4-A Disorders. New York: Ballantine Books. 48 Bock, K., & Stauth, C. (2008). Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergies, The Ground Breaking Program for the 4-A Disorders. New York: Ballantine Books. 49 50 Hollis & Wagner (2006).Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutrition, 84(2), 273. 51 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. Copyright ©2017 Generation Rescue 22 Zinc Zinc can help with digestion, cognitive function and immune regulation. “No Zinc, No Think.”52 Zinc is also important in preventing viral replication. SUPPLEMENTS TO AVOID Some supplements should be avoided because they could be dangerous for the baby. Vitamin A Vitamin A is very important for the health of the mother and the baby but should be limited to no more than 8000iu – 10000iu per day.53 Any medications that contain sources of A like retinols (acne treatments) should be discontinued. Talk to your medical professional about all of your medications and supplements you are taking to make sure they are safe before, during and after pregnancy. Visit The Teratology Society to learn more about birth defects research. http:// teratology.org/ Lifestyle Changes DESCREASE STRESS Stress has been shown to alter the hormones in the body, which can affect development of an unborn baby. Acupuncture, Yoga or some quiet time can make a world of difference in the health of a pregnancy. What the newest studies have shown is that stress among other common risk factors like smoking, drugs, alcohol, poverty, poor nutrition, can influence the mental health, development and behavior throughout the child's lifespan.54 Bock, K., & Stauth, C. (2008). Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergies, The Ground Breaking Program for the 4-A Disorders. New York: Ballantine Books. 52 53 (1987) Teratology Society Position Paper: Recommendations For Vitamin A Use During Pregnancy TERATOLOGY 35:269–275 54 W. Schlotz, D.I. W. Phillips. (2009). Fetal origins of mental health: Evidence and mechanisms.Brain, Behavior, and Immunity. 23 905–916 Copyright ©2017 Generation Rescue 23 NO VACCINES DURING PREGNANCY With the danger of toxic adjuvants in the vaccines and the downgraded state of the mother's immune system during pregnancy, vaccines are generally not recommended. "The flu shot has the highest levels of Thimerosal of all vaccines—as much as 25 micrograms of mercury, more than 10 times the safe limit for an infant. Its package insert has this disclaimer, “It is also not known whether influenza virus vaccine can cause fetal harm when administered to a pregnant woman...” These blatant inconsistencies in our public “health” policies are frightening.”55 The influenza vaccine has been shown to be ineffective in a large study of pregnant women.56 In an ongoing study published in 2009 and updated since entitled "Vaccines for preventing influenza in healthy adults," scientists said they found no plausible substantiation that the flu vaccine prevented death or hospitalization from flurelated complications and only marginally reduced the number of days of lost work attributed to the illness.57 Research for yourself and make an informed decision. Safe Minds created a good resource for vaccine information awareness: www.smartvax.com AVOID MERCURY & DETNAL AMALGAMS There is a lot of focus on mercury and it's role in autism and other developmental disorders. Reasons for this are clear: Mercury has detrimental effects on the immune system, internal organ function and the brain. This has been proven is several instances including Pink's Disease caused by mercury based tooth powder.58 55 Ohm, J. (2009). Common Obstetrical Procedures and Their Link to Autism. Pathways Magazine, Pregnancy Issue 21. Black SB, Shinefield HR, France EK, et al. (2004). Effectiveness of the influenza vaccine during pregnancy in preventing hospitalizations and outpatient visits for respiratory illness in pregnant women and their infants. 21:333-339. 56 SmartVax.com. (2013). Vaccine Decisions to Make During Pregnancy. Retrieved from http://www.smartvax.com/index.php? option=com_content&view=article&id=143 57 58 Claire, R., Martin, J. & Taylor, T. (2012). Fight Autism and Win, Biomedical Therapies That Actually Work!. Rochester, NY: JRT Publishing. Copyright ©2017 Generation Rescue 24 Mercury is the world's second most neurotoxic element. Mercury is naturally occurring in the environment, but also occurs in man made sources such as the mercury used as a preservative in vaccines, and mercury in fish and dental amalgams. Historic mercury use was not properly disposed and it is now present in the soil and the ocean. Mercury that cannot successfully be discarded by the body accumulates in fatty tissue and disrupts many of the body's naturally functions. Symptoms of mercury toxicity range from sensory disorders, speech and hearing problems, cognitive problems, and unusual behaviors.59 Avoidance of all known sources of mercury is vital prior to conception, during pregnancy and when breastfeeding. Avoid fish, High Fructose Corn Syrup,60 61 vaccinations, getting any new dental amalgams with mercury or improper removal of them. Removal of amalgams should be done at least one year before pregnancy. Do not have ANY dental work done to disturb the mercury during pregnancy if you have silver amalgams.62 Dental amalgams (silver fillings) consist of 50% mercury along with a combination of other metals. Mercury vapor from amalgams can vary from 1 3 micrograms/day to 27 ug/day. According to the Occupational Safety and Health Administration with continuous exposure at the higher level it is extremely unhealthy. The World Health Organization (WHO) has stated that the exposure to mercury vapor can increase to over five times those levels when you add in teeth grinding, gum chewing, and drinking sodas.63 Cutler, A. (1999). Amalgam Illness diagnosis and treatment, What you can do to get better, How your doctor can help. (1st ed.). Sammamish, WA: www.noamalgam.com. 59 Green Right Now, Sustainable Living. (2009). List: Foods with Detectable Mercury. Retrieved from http://www.greenrightnow.com/welcome/2009/01/30/listfoods-with-detectable-mercury/ 60 Institute for Agriculture and Trade Policy. (2009). High fructose corn syrup's not-so-sweet surprise: mercury!. Retrieved from http://www.iatp.org/blog/2009/01/ high-fructose-corn-syrups-not-so-sweet-surprise-mercury 61 62 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. Levine, J. The Doctor Oz Show. (2013). Toxic Teeth: Are our dental amalgams safe?. Retrieved from http://www.doctoroz.com/videos/toxic-teeth-are-ouramalgam-fillings-safe 63 Copyright ©2017 Generation Rescue 25 Common sense actions you can take to decrease these levels are using a softer toothbrush, ceasing to chew gum, and using a straw when drinking acidic foods or carbonated beverages. For a listing of safe dentists go to www.holisticdental.org/find_holistic_dentist For more information on vaccine content go to www.smartvax.com or download our Safe Vaccine Guide at generationrescue.org STOP USING FLUORIDE In the 1940's and 50's fluoride was added to drinking water believing it would be beneficial to preventing tooth decay. Modern research has since proven that fluoride has minimal benefit when taken internally and its ability to fight cavities when applied to teeth is being questioned. In fact, it has been shown to cause multiple problems including reducing intelligence in children, causing tooth defects called dental fluorosis and transporting other toxins such as lead from the water pipes across the blood brain barrier. 64 Fluoride is an endocrine disruptor and that it can cause reduction in thyroid function in many individuals.65 A study demonstrated that "transient" thyroid deficiency in pregnancy could result in permanent changes in the brain similar to those seen in autistic brains. The study goes on to suggest that the rise in autism cases could be linked to hypothyroidism of the mother due to environmental exposure of thyroid toxic agents.66 Not only does fluoride damage teeth it can harm the nervous system, thyroid and multiple body systems. Use filtered water and find fluoride free toothpaste. Read more about fluoride on these links: http://slweb.org/ftrc.html http://www.fluoridealert.org/ http://nofluoride.com/ 64 Xiang Q, et al. (2003a). Effect of fluoride in drinking water on children’s intelligence. Fluoride 36: 84-94; 198-199. 65 National Research Council. (2006). Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. National Academies Press, Washington D.C. p. 189-224. Roman, G. (2007). Autism: Transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents . Journal of Neurological Sciences, 262(1-2), 60-70. 66 Copyright ©2017 Generation Rescue 26 AVOID HIGH FRUCTOSE CORN SYRUP In January of 2009, the Institute for Agriculture and Trade Policy published a listing of several foods used by many Americans that showed 17 out of the 55 foods that contained High Fructose Corn Syrup also contain the neurotoxin mercury. This included Coca Cola Classic, Nutrigrain Cereal Bars and multiple other common foods. Since then, Yoplait yogurt has removed their content of High Fructose Corn Syrup. Read labels, if a product is questionable, call the manufacturer, research any testing that has been done on the product. Labels are not just for calories anymore. Knowledge of the ingredients listing is very important in keeping a clean, nutritious diet.67 68 LIMIT ULTRASOUNDS Limit the number of Ultrasounds to those that are medically necessary. Some studies have shown a reason to believe that ultrasounds can interfere with brain development and may lead to speech issues. The safety and efficacy remains unknown. Even the U.S. Food and Drug Administration (FDA) says, “While ultrasounds have been around for many years, expectant women and their families need to know that the long-term effects of repeated ultrasound exposures on the fetus are not fully known.” 69 RHOGAM RHO(D) IMMUNE GLOBULIN INFORMATION The Rhogam shot works by stopping the production of antibodies to the Rh positive blood of a baby. If these were not blocked then the antibodies would cross the placenta into the baby's bloodstream and damage the blood cells, which can be fatal. Green Right Now, Sustainable Living. (2009). List: Foods with Detectable Mercury. Retrieved from http://www.greenrightnow.com/welcome/2009/01/30/listfoods-with-detectable-mercury/ 67 Institute for Agriculture and Trade Policy. (2009). High fructose corn syrup's not-so-sweet surprise: mercury!. Retrieved from http://www.iatp.org/blog/2009/01/ high-fructose-corn-syrups-not-so-sweet-surprise-mercury 68 69 Ohm, J. (2009). Common Obstetrical Procedures and Their Link to Autism. Pathways Magazine, Pregnancy Issue 21. Copyright ©2017 Generation Rescue 27 Rh incompatibility occurs when the mother is a negative blood type such as O Negative or A Negative and the developing baby has a positive blood type such as O Positive or A Positive. This happens when the father is a positive blood type. If the father is a negative blood type then the baby cannot have a positive blood type or Rh incompatibility so you won't need the Rhogam injection. If the mother has a negative blood type and the husband is positive, then the mother must get the Rhogam injection.70 The Rhogam formula no longer contains mercury in the United States but in other countries please read the label to check for Thimerosal. When mercury was in the Rhogam it usually had at least 25mcg of mercury per shot, if you had multiple pregnancies through the years, that is a considerable amount of mercury intoxication for the mother and the fetus that is trying to grow critical brain cells. If getting a Rhogam injection, be sure check the injection packaging information to confirm it is mercury free.71 PITOCIN RISK Pitocin, an artificial form of the labor hormone oxytocin can be used during labor. It has been shown to increase blood pressure in both mother and baby and decrease the blood supply to the placenta due to strong overlapping contractions. There are many in the medical field that believe it is a potential risk for autism.72 Vaginal Delivery vs. C-Section Cesarean sections (c-sections) vs. vaginal labor: Studies have shown the benefits of vaginal labor go further than just being an easier recovery for the mother. 70 Kendrion Biopharma. (2013). Understanding Rh-Negative. Retrieved from http://www.rhogam.com/understanding-rh-negative 71 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. 72 Ohm, J. (2009). Common Obstetrical Procedures and Their Link to Autism. Pathways Magazine, Pregnancy Issue 21. Copyright ©2017 Generation Rescue 28 Often times a c-section is associated with higher risk of allergies, diabetes, gastrointestinal problems, asthma and leukemia.73 74 Labor helps the baby transition successfully from inside to outside the womb by "triggers lung-liquid re absorption" which helps with air breathing after birth.75 This process activates the innate immune response in the newborn making labor "immunologically beneficial to the newborn.”76 Cardwell CR, Stene LC, Joner G, Cinek O, Svensson J,Goldacre MJ, et al. (2008)Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: ameta-analysis of observational studies. Diabetologia, 51, 726–35. 73 Pistiner M, Gold DR, Abdulkerim H, Hoffman E, Celedon JC. (2008). Birth by cesarean section, allergic rhinitis, and allergicsensitization among children with a parental history of atopy. The Journal of allergy and clinical immunology, 122, 274–9. 74 75 Olver RE, Walters DV, Wilson SM. (2004). Developmental regulation of lung liquid transport. Annu Rev Physiol, 66, 77–101. Chung-Min Shen, Shih-Chang Lin, Dau-Ming Niu, Yu Ru Kou. (2009). Labour increases the surface expression of two toll-like receptors in the cord blood monocytes of healthy term newborns. Acta Paediatrica, 98(6), 959-962. 76 Copyright ©2017 Generation Rescue 29 Post-Pregnancy Copyright ©2017 Generation Rescue 30 Supplements, Nutrition, and Constipation Nutrition guidelines are similar to when pregnant. Continue to forgo known allergens from the daily diet according to the IgG and IgE allergy panels. Continue to take the vitamins and minerals in which you are deficient, while maintaining a good nutrition plan. If breast-feeding, it is important to increase daily caloric intake over pregnancy levels. The number of total calories per day will depend on post pregnancy weight and other factors. Consult with your medical providers, nutritionists or registered dietician, as they can help establish a solid nutrition plan that can help maintain milk supply and consistent energy levels. The following supplements can be helpful: VITAMINS Prentatal Vitaimins: A vegan and organic source is best. Free from food dyes, wheat, gluten, milk, eggs, toxins and other allergens. A multi-dose option (1 capsule 2 times per day or 1 capsule 3 times per day) helps to absorb the water-soluble vitamins better and the levels stay more consistent in your system.77 Calcium and Magnesium: Calcium and Magnesium are important in bone growth and hormone regulation. Magnesium in general can help with sulfation and detoxification while eliminating constipation and muscle fatigue or cramping.78 Fish Oils Fish Oils, Omega 3s and essential fatty acids contribute to brain cell function, hormones and healthy neurotransmitters like serotonin. 77 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton. Bock, K., & Stauth, C. (2008). Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergies, The Ground Breaking Program for the 4-A Disorders. New York: Ballantine Books. 78 Copyright ©2017 Generation Rescue 31 Vitamin D Vitamin D is supports bone formation, hormone regulation, immune modulation and prevention of inflammatory conditions. Vitamin D should be supplemented in addition to prenatal vitamins because the RDA of 400iu, typically found in prenatals, is too low to help most people maintain healthy levels. 79 Probiotics Powerful Probiotics at least 50 to 100 billion CFUs help to build healthy bacteria to increase immune defense. Zinc Zinc supports digestion, cognitive function and immune regulation. “No Zinc, No Think.” Zinc is also important in preventing viral replication. Post Delivery Topics Constipation and Hemorrhoids Constipation and hemorrhoids are common in pregnancy due to increased progesterone production. Progesterone affects the smooth muscles surrounding the intestines causing a slowdown in the bowels. Constipation and hemorrhoids usually remain an issue after giving birth. Increasing fluid intake, adding soft fiber, taking magnesium citrate and vitamin C increase regularity. Consult a doctor or nurse about constipation and any discomfort associated with hemorrhoids or incontinence.80 Additionally, probiotics may help regularity during pregnancy and after birth.81 Hepatitis B Hepatitis B is a virus that affects the liver and may lead to liver cancer. The Hep B virus is transmitted through blood, body fluids, contaminated needles, and unprotected sex with Hep B-infected persons. 79 Hollis & Wagner (2006), Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutrition, 84(2), 273. 80 Mayes Midwifery, A Textbook for Midwives, 14th Edition (2011) Publisher: Elseivier 81 Mayes Midwifery, A Textbook for Midwives, 14th Edition (2011) Publisher: Elseivier Copyright ©2017 Generation Rescue 32 A Hep B positive mother can give Hep B to her baby. If the mom tests positive for the Hep B surface antigen (HbsAg) within 12 hours after birth, current recommendations are to administer the Hep B vaccine to the baby along with the Hepatitis B Immune Globulin (HBIG). This prevents the baby from becoming sick with the Hep B virus. If the mother is Hep B positive, consult with a medical professional about only giving the HBIG at birth instead of both the Hep B vaccine and HBIG. The vaccine itself can be postponed and administered at a later date if warranted. If the mother tests negative for the Hepatitis B surface antigen, or other Hep B negative results then the baby does not need the Hep B vaccine after birth. Please read the vaccine insert itself or in the post marketing report found on the manufacturer’s website to further research the ingredients and possible side effects. For those wishing to vaccinate on an alternative schedule that doesn't include the newer vaccines such as Hep B, visit www.askdrsears.com to find information and connections to medical professionals that use alternative vaccine schedules.82 Vitamin K, Eye Ointment, & Cord Clamping at Birth Along with the Hep B vaccine, there are three other interventions that are generally given to every baby directly after birth. The Vitamin K injection, eye ointment antibiotic, and immediate cord clamping. Each of these is a choice and can be planned according to one's beliefs in advance of giving birth. Vitamin K is the first injection that a nurse gives the baby directly after birth. It is given to prevent an uncontrolled bleeding disorder called "hemorrhagic disease" of the newborn. 1 in 100,000 are born with poor levels of vitamin K that may lead to bleeding. The injection itself is either 0.5mg or 1mg of Vitamin K that is administered into the thigh of the newborn. Studies have shown that the amount of Vitamin K in this injection can increase the risk of leukemia.83 Ask Dr.Sears. (2013). Find a Vaccine Friendly Doctor Near You. Retrieved from http://www.askdrsears.com/topics/vaccines/find-vaccine-friendly-doctor-nearyou 82 83 Golding J, Paterson K, Greenwood R, Mott M. (1992). Intramuscular Vitamin K and Childhood Cancer. BMJ; 305: 341-346 Copyright ©2017 Generation Rescue 33 Those who refuse the Vitamin K injection can request the waiver forms from the nurse prior to birth and can be included as part of the birth plan. Vitamin K can be supplemented as part of the diet (high sulfur foods like broccoli and cauliflower). With the advice of your medical professional there are also vitamin K drops that can be given in smaller doses to the newborn. Additionally, an erythromycin antibiotic treatment is applied to the eyes to protect from chlamydia, gonorrhea and syphilis. Side effects do not usually occur, however, the most important to be aware of are blurry vision, eye irritation and or hindered eyesight in the newborn. Some parents may choose to put breast milk in the eye as an antibiotic instead. As always, speak with medical professionals and include all choices in your predetermined birth plan.84 CORD CLAMPING Another procedure to research prior to giving birth is cord clamping. Before birth, the cord and placenta “breathe” for the baby. Humans and all other mammals have evolved over millions of years a very safe mechanism for closing umbilical cords at birth without interrupting “breathing,” and ensuring optimal survival of their offspring.85 Studies have shown that early cord clamping can lead to increased incidences of brain impairment due to lack of oxygen from the hypervolemia and anemia. More insight through studies on this topic needs to be accomplished before this can be proven or disproven.86 Emerging research on the subject shows some benefit to delaying cord clamping for a few minutes or until the cord has stopped pulsating.87 Alternatives to immediate cord clamping can be discussed with your medical practitioner as they vary with each professional and medical facility guidelines. 84 McNinch C, et. Al. (1985). Plasma concentrations after oral or intramuscular vitamin K1 in neonates. Archives of Disease in Childhood; 60: 814-818 85 Morley, G. (2002) How the Cord Clamp Injures Your Baby’s Brain. Retrieved from http://www.whale.to/a/morley1.html#6 86 Linderkamp, O. (1982). Placental transfusion: determinants and effects. Clinics in Perinatology; 9: 559-592 McDonald SJ, Middleton P. (2008). Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews (2): CD004074. 87 Copyright ©2017 Generation Rescue 34 Vaccines Following Delivery Vaccines after delivery should be seriously discussed with your medical provider and researched for all risks and side effects. Vaccines introduce live viruses to the mother and if breastfeeding, they may pass on to the newborn. Dr. Kartzinel said it best in his book Healing and Preventing Autism: "If the baby is going to breastfeed, I would not want any of the live virus vaccines passed to her child in her breast milk.” In Mark and Hilary Butler's book Just a Little Prick, she states, "Some older studies show that colostrum and breast milk carry specific IgG and IgA antibodies to four organisms: whooping cough, Haemophilus B, Streptococcus pneumoniae and Neisseria meningitides.88 This is an educated choice that should be planned for months before giving birth and included in the birth plan as discussed with a practitioner so the proper actions are taken. Breastfeeding & Early Nutrition BREASTFEEDING Breast milk is considered the "Gold Standard" for infant nutrition and immunity support for newborns. Breast milk contains important nutrients of cholesterol, Omega-3s and taurine,89 all of which are known to be deficient in autism.90 The colostrum in breast milk is uniquely tailored to help the newborn's metabolism, giving it enzymes that aid in the digestion of proteins, fats and carbohydrates. Breast milk Lactoferrin helps decrease bacterial overgrowth by limiting the nutrients bacteria need to flourish. Breast milk also promotes iron absorption by the intestines.91 88 Butler, P. & Butler, H. (2006). Just a Little Prick. New Zealand: Robert Reisinger Memorial Trust. 89 Lawrence RA, Lawrence RM. (2005). Breastfeeding: a guide for the medical profession (6th Ed). USA: Elselvier. Pangborn, Baker, Rimland. (2005). Autism: Effective Biomedical Treatments (Have We Done Everything We Can For This Child? Individuality In An Epidemic). San Diego: Autism Reseach Institute. 90 91 Riodin, J. (2008). Breastfeeding and Human Lactation (4th Ed) Revised. Boston: Jones & Bartlett. Copyright ©2017 Generation Rescue 35 Breastfeeding is the best way to increase immunity for a baby. Studies have shown that breastfeeding helps to shift a baby’s immune system to a more protective, less inflammatory state. Breast milk may reduce gastrointestinal infections and their severity with protective factors given to the baby's mucosal surfaces. Breastfeeding may decrease the chance of infection caused by viruses, protozoa and bacteria.92 Breast milk contains secretory IgA, which has anti-toxin, anti-allergic properties. A low secretory IgA is extremely common in autism and leads to greater infections and lower immunity to viruses and other organisms. Pediatricians recommend new mothers breastfeed for as long as possible for at least 1 year or more. If that isn't possible due to work, time constraints and other circumstances mothers may pump and store the breast milk so the baby will have the benefits of the breast milk. In the event that the mother cannot produce milk or there are complications and the newborn is in intensive care, breast milk can be ordered through Prolacta Bioscience. The milk is donated, screened and filtered. Breast milk banks only donate to neonatal intensive care units through the recommendation of a neonatologist. It is a viable option for a sick newborn when the mom cannot breastfeed herself.93 Formula can also be considered. Choose a clean, organic, chemical-free formula that contains high levels of DHA and ARA. If a newborn doesn't tolerate a formula, an allergic reaction may be possible. Consider changing the formula to an allergen-free version; there are GFCF formulas such as Neocate but it is cornbased and not organic, which can be problematic. Nutritionists can help create a coconut milk, goat milk or other non-dairy source based formula as well. Talk with a doctor or nurse for recommendations.94 If a child is showing allergic signs, a Nambudripad’s Allergy Elimination Technique (NAET) practitioner may help reduce or eliminate the allergy. Adding 92 Isaacs, C. (2005). Human Milk Inactivates Pathogens Individually, Additively and Synergistically. The Journal of Nutrition; 135, 5;1286. 93 Prolacta Bioscience. (2013). Milk Banking FAQs. Retrieved from http://www.milkbanking.net/faqs.php 94 Nutricia Neocate. (2013). You are not the first to ask. Retrieved from http://www.neocate.com/help-for-parents/faqs Copyright ©2017 Generation Rescue 36 in a probiotic made for infants, DHA drops that contain essential fatty acids and vitamin A may also assist with digestion. A charcoal based colic product like "Colic Calm" can help with gas, bloating and upset stomach. 95 Whether one breastfeeds or formula feeds, good nutrition is essential while watching for signs of intolerance, allergic reactions or a compromised immune system. Discuss any interventions with a doctor or nurse for what is best for the baby. "NURSERY WATER" OR FLUORIDATED WATER Fluoride is thought to have minimal benefit when taken internally and its ability to fight cavities when applied to teeth has been questioned. Fluoride has been shown to cause multiple problems including reducing intelligence in children, causing tooth defects called dental fluorosis and transporting other toxins such as lead from the water pipes across the blood-brain barrier.96 DELAY GRAINS Delay grains in the baby's diet as long as possible. Some experts are suggesting until the baby is almost two years old. Others say to wait until the baby has most of her teeth, which almost always coincides with the 2nd birthday. A baby's digestive system can tolerate fats and proteins much easier than carbohydrates. Infants do not produce sufficient amylase enzyme necessary to digest grains. One of the main enzymatic deficiencies in ADHD and Autism is amylase and the ability to digest carbs.97 One way to check if a baby has proper digestion or may need some intervention is to monitor if they frequently fall asleep directly after a meal even if they weren't tired before or it wasn't close to bedtime. Solid foods should be introduced at 6 months if there are known allergies in family. This can help to prevent further allergic response by giving the child Nambudripad, D. (2002). Say Goodbye to Illness: A Revolutionary Treatment for Allergies & Allergy Related Conditions (3rd ed.). Buena Park, CA: Delta Publishing Company. 95 96 Xiang Q, et al. (2003). Effects of Fluoride in Drinking Water on Children’s Intelligence. Fluoride, 36, 84-94;198-199. 97 DeFelice, K. (2006). Enzymes: Go with Your Gut, More Practical Guidelines for Digestive Enzymes. Bound, Minnesota: ThunderSnow Interactive. Copyright ©2017 Generation Rescue 37 enough time to get a functioning GI tract that is capable of digesting solid foods with the correct type of enzymes and normal flora. Start slowly with veggies and work up to other foods.98 INTRODUCE PROBIOTICS Probiotics are extremely important in the health of newborns and as they grow. When choosing a probiotic, look for a product that is made for infants up to 2 years of age that dissolves well in liquid or foods and is free from allergens. Breast milk supplies these normal flora (good bacteria found in the gastrointestinal tract) but when the probiotic environment is disrupted with a cold virus, ear infection, diarrhea, or shows signs of a yeast infection (diaper rash or cradle cap) then a multi-strain probiotic should be used. They can be used daily as well. Klaire Labs and Jarrow brands both have infant formulas that work well. Both contain Lactobacillus Strains (found in the small intestine) and Bifidobacterium (found in the colon). To find out more about probiotics: Visit http://www.klairelabs.com/ and http:// www.customprobiotics.com/. AUGMENTIN ANTIBIOTIC DANGER IN INFANTS AND CHILDREN Augmentin has been a popular antibiotic for ear infections since the 1980s. It has worked wonders because of the ingredient clavulanate potassium that is added to the amoxicillin. The clavulanate potassium makes it possible for the child to be given the medication over time during multiple ear infections without the bacteria becoming resistant to the amoxicillin. During the process of making Augmentin, the fermentation process of clavulanic acid involves massive amounts of ammonia. When a child ingests ammonia it could injure the intestinal tract, brain, and nervous tissue. Ammonia Cmablee-McBride. (2010). Gut and Psychology Syndrome, Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia, Revised and Enlarged. United Kingdom: Mediform Publishing. 98 Copyright ©2017 Generation Rescue 38 has been shown in small amounts to cause brain inflammation or even abnormalities.99 A study from 2005 implicated the antibiotic Augmentin TM as a possible trigger in the formation of autism. This study looked at 206 children under 3 with an autism diagnosis. They found that these children had a very high number of ear infections as compared with the general pediatric population. Each of these children were given 12 courses of antibiotics that totaled 2480 courses together. 893 of these courses were with the antibiotic Augmentin and 362 of those courses were given to children under the age of 1 year. The high levels of ammonia from the doses of Augmentin could be another factor in the increase in autism diagnoses.100 Further research needs to be undertaken to determine if clavulanic acid in pharmaceuticals can cause neurotoxicity in children and the effects that toxicity can bring. High occurrence of ear infections can be a sign of poor immunity or immune dysfunction in children. If your child has frequent ear infections, talk with your practitioner about alternatives to prescription antibiotics that can disrupt normal gut flora and cause ammonia toxicity, such as garlic oil used topically in the ear, probiotics and other natural remedies to boost the immune system. Be sure to use natural supplements and remedies under the care of a physician, as even natural substances have toxic levels.101 Disclaimer: None of the information presented here should be considered medical advice or a "cure" for autism. The information presented represents strategies for dealing with autism that have been reported as successful by professionals and/or families with autism. While we believe this information to be accurate we are not in a position to independently verify it and cannot guarantee that it will work in any particular case. No treatment for autism should be attempted without prior consultation with a physician familiar with autism spectrum disorders. 99 Devaraj, S. (2013). Ammonia. MedScape. Retreived from http://www.emedicine.medscape.com/article/2054408-overview#a30 Fallon, J. (2005). Could one of the most widely prescribed antibiotics amoxicillin/clavulanate "augmentin™" be a risk factor for autism? Medical Hypotheses, 64(2), 312-315. 100 101 Marks, D. (2010). Garlic. Livestrong.com. Retrieved from http://www.livestrong.com/article/326569-garlic-oil-for-sinus-ear-pain-infections Copyright ©2017 Generation Rescue 39 YOU are in control of YOU and your child’s health. YOUR voice is the one your child is counting on. Educate yourself fully and make the best decision for YOU. The life you are bringing into this world is counting on it. Copyright ©2017 Generation Rescue 40