A seeming relationship appeared to exist between eating salmon and the incidence of a specific mental health disorder. The earlier research, omega-3, indicated it could lower schizotypy because people who ate more fish when they were 3 to 5 years old had lower rates of schizotypal personality disorder when they were 23 years old. New research has tested that idea.

A community group of 290 11–12-year-olds who met the criteria for conduct disorder, oppositional defiant disorder, or high aggression scores on a standard test were included in the intention-to-treat, single-blind study. Three groups were entered into the study: omega-3 alone, CBT alone, and omega-3 and CBT together. Schizotypy was down 25.7% in the omega-3-alone group and 36.6% in the omega-3-plus-CBT group three months after treatment.

Compared to the CBT group 9 months after treatment, the interpersonal schizotypy factor showed stronger effects in both omega-3 groups. Reductions in schizotypy were much stronger in people who ate a lot of omega-3 nutrients. The results have indications for benefit not simply to patients, but to society in general.

The high costs these behaviors have for society make finding ways to stop them important, if cost is the sole purpose of such research. I tend to dispute a dollars-and-cents approach and prefer the benefit shown to the patients.

One type of intervention is adding nutrients to the food. Research shows a link between insufficient nutrients and acting aggressively or antisocially. For instance, not getting enough food when you are 3 years old has been linked to acting aggressively and unsocially when you are 8, 11, and 17 years old. Also, randomized controlled trials (RCTs) have shown that taking multivitamins and mineral supplements can help lower antisocial behavior.

Children not getting enough nutritional food are more likely to have problems with their brains and thinking, which can lead to behavior problems that appear in public throughout childhood and youth. The results show that cutting malnutrition in children may help lower antisocial and violent behavior later on. We know the need for specific nutrients for proper brain development at an early age, yet nutrition has received insufficient attention.

Many studies have been done over the years on the biological and social factors that make kids more likely to be aggressive. Still, surprisingly, little is known about how poor nutrition can lead to aggressive behavior in kids. It is not often that a nutrition shortage is looked at in terms of externalizing behavior. Still, many studies have shown that food additives, hypoglycemia, and, more recently, cholesterol, can change how people act. Why salmon and omega-3; how does it work?

Getting more omega-3 may help make up for the structural and functional problems seen in people who are aggressive and antisocial. This is because omega-3 helps control the activity of membrane enzymes, protects neurons from cell death, encourages neurite outgrowth, and improves synaptic functioning and dendritic branching. When viewed in these terms, salmon and its omega-3 seem like wonder drugs you can easily buy in the fish department of the market.

If most research points toward these supplements or salmon, one major problem remains even in the face of research singling out these supplements and salmon in particular. What is it? Finance plays a major role in household incomes; supplements and salmon can be expensive, ergo inaccessible, items to add to any shopping list.

Should local groups or the government begin to provide the supplements (we know they won’t give out fish vouchers) to help kids in terms of brain development and functioning? But the case must be viewed in the face of how violence, either proactive or reactive, adds to the local budgets, instills fear in the community, and may relegate young people to lives of despair or imprisonment. What is cheaper, a bottle of supplements or maintaining someone in a prison cell for years? It’s patently clear which is preferred.

The time for dietary medicine would seem to have come, and we have to wonder why it’s not being emphasized more.

The post Salmon Is Taking Center Stage in Kids’ Personality Disorders appeared first on Medika Life.

1. Inform kids about the importance of fear and how it keeps them safe. Inform them that fear is a normal reaction to perceived danger and that it can aid them in making wise decisions.

2. You can convey the concept of dread using age-appropriate novels, films, or articles, for instance. For instance, Todd Parr’s “The Emotions Book” offers a vivid and interesting introduction to several emotions, including dread.

3. Promote free communication by creating a secure setting where kids can voice their anxieties without fear of repercussion. Pay close attention to their worries, and then reassure and support them.

4. Take the fear of the dark as an illustration. When your child shares this worry, listen to their worries and talk about ways to deal with it. Parenting for Brain and other websites provide guidance on how to foster open communication with kids.

5. Healthy examples of how to handle fear are best illustrated by handling your own fears and worries in a calm manner. In this way, you can show others how to respond to fear appropriately. This encourages kids to follow your lead and learn positive coping skills. Unfortunately, many adults fail to see the effect they have on kids. I know someone who learned to fear even ladybugs because her mother became so upset at seeing one.

6. Take one thing that many people fear, such as spiders or other bugs. If you’re frightened of spiders, you should gently remove the spider or call for help rather than freaking out. This demonstrates to kids that worries can be addressed without having to take drastic measures.

7. Exposing children to their concerns in a controlled way while utilizing age-appropriate techniques is known as “gradual exposure.” This method of systematic desensitization aids in children’s resilience development and helps them get over unreasonable anxieties. A parent I know took his young son to a pet park, where the boy learned that even large snakes (such as a yellow python) can be harmless. They took photos with the snake to have at home as a reminder that some snakes are harmless, and others need to be avoided.

If a youngster is afraid of dogs, start by showing them photographs of dogs, then go on to movies of dogs, and lastly, expose them to a nice, calm dog in a safe environment. This is a well-known behavioral technique used in therapy for dog phobia. A young boy, who received a pet mouse, grew to love the little creature so much that he became a veterinarian when he reached adulthood.

8. Teach relaxation skills to assist children in learning how to handle their anxiety and terror. Exercises that involve deep breathing, visualization, and progressive muscle relaxation can all help reduce anxiety.

Another website that is useful and contains helpful exercises for kids is “Calm Kids”, which provides children with guided breathing exercises and mindfulness exercises that are age-appropriate.

9. Encourage a positive outlook by helping kids avoid concentrating on their worries by encouraging them to focus on the positive aspects of their experiences. Encourage them to adopt a growth attitude by stressing that failures and errors are opportunities to improve.

For instance, if a youngster is fearful of failing, acknowledge their effort and perseverance in overcoming difficulties, reinforcing the notion that failures are a normal part of learning.

10. Create a welcoming social atmosphere to provide children with friends and classmates who react to fear in a healthy way as positive role models. Promote relationships that foster empathy, teamwork, and emotional health.

A sports team or a volunteer organization are two examples of groups or activities that expose kids to positive social settings and promote collaboration and teamwork. And, remember, that teamwork later in their adulthood will be useful in whatever work or creative activities in which they engage. Teams are valuable in this way.

Last, of all, keep in mind that every child is different, so it’s crucial to adapt these strategies to each one’s specific demands and phases of development. You may support children’s resilience and mental well-being by encouraging appropriate fear reactions and avoiding modeling phobias.

The post Raising Children With Appropriate Fear Responses, Not Modeling Phobias appeared first on Medika Life.

We often hear that women’s rights are human’s rights: this most definitely also applies to healthcare.

Improving women’s health depends on improving their rights and vice versa. This calls for widespread commitment on both fronts, involving health professionals, institutions, politicians, and NGOs. The aim is to remove the economic, ideological, and socio-cultural obstacles to implementing actions that can change women’s lives. “The health of women and girls is of particular concern because, in many societies, they are disadvantaged by discrimination rooted in sociocultural factors.” said the World Health Organization (WHO).

Among said factors are unequal power dynamics between men and women, inequality towards education and employment opportunities, an exclusive focus on women’s reproductive roles and increased vulnerability to physical, sexual, or emotional violence. Women also face increased vulnerability in less privileged parts of the world.

Regarding health-related inequalities, in sub-Saharan Africa, women, for example, represent a significant majority of HIV/AIDS victims (63% of new infections in 2021). Every two minutes, a young woman between 15 and 24 gets infected by HIV. These women (aged 15-24) are three times more likely to contract HIV than young men of the same age.

We need urgent and long-term care for women around the globe. Prioritizing women’s health to make a difference everywhere and around the world is our mission at FIGO.

Founded in 1954, FIGO brings together 135 learned societies of gynecology and obstetrics on every continent whose aim is to improve the status of women, girls, and families to enable them to reach their full educational, sexual, and reproductive potential in harmony with their professional fulfillment and personal well-being.

In its fight for women, FIGO is also partnering with Professor Denis Mukwege, a Congolese gynecologist and winner of the 2018 Nobel Peace Prize, to support the “Red Line Initiative,” which bans the practice of rape as a weapon of war and leads on global programme activities, with a particular focus on sub-Saharan Africa and Southeast Asia. We strive to promote women’s health and rights through four fundamental pillars: education, training, research, and advocacy.

To that end, health professionals and experts from all over the globe will come together at FIGO’s upcoming congress in Paris from October 9 to 12 to share their knowledge and learn about new progress that has been made for women’s health, and the goals that we all have yet to achieve.

One excellent example is the elimination of cervical cancer.

This aim, which will considerably impact women’s lives, is one of FIGO’s priorities. Today, a woman dies of cervical cancer every two minutes worldwide, even though it can be prevented. Prevention is based on vaccinating boys and girls, ideally, before they begin sexual activity, and on screening. Cervical cancer is caused by papillomaviruses, or HPV, a family of sexually transmitted viruses. Eighty percent of the sexually active population will encounter HPV at least once, but in 90% of cases, the human body will naturally fight it and eliminate it within two years. If not, the persistent virus can lead to precancerous lesions and invasive cancer. Vaccination can prevent 90% of HPV infections that cause cancers other than cervical cancer (ENT, vulva, anus, penis).

Recommended by all learned societies and the World Health Organization, implementation varies from country to country. Australia, for example, is a good role model with a rate of 90% of vaccinated young girls, and cervical cancer is expected to be eliminated by 2035. In the US, 63,8% of young girls and 59,8% of young boys are fully vaccinated.  Rwanda became the first African country with an HPV vaccination implementation strategy and now realizes that vaccination coverage reached 99% of those born in 2002.

After an initial catch-up campaign that targeted school grades and included older girls, the programme transitioned to an age-based approach, with routine vaccination of only girls aged 12 from 2015 onwards. More than 1.15 million girls in Rwanda received their first dose of the HPV vaccine in 2011–2018 as part of this programme. Population-level HPV vaccination coverage increased from 6% for girls born in 1993 to 99% for those born in 2002.

Other countries need to catch up for several reasons. In addition to some reluctance toward vaccination, smear screening progresses slowly, often due to a need for more awareness and information. Smear screening is essential to eradicating cervical cancer: the WHO recommends screening 70% of women in all countries.

Improving prevention and women’s health understandably requires deploying resources on a par with the expected ambitions and progress. Political commitment is imperative to remove the cultural and economic obstacles to improving women’s health.

Healthy women are the cornerstone of healthy societies.

Women often provide for their families, communities, and the people around them. If women are healthier, it impacts everyone around them and eventually leads to healthier newborns, children, families, households, and communities. Leaders who prioritize women’s health can overcome gender inequality and improve the overall population’s health.

To register for the FIGO Congress, Paris, 9-12 October 2023: https://figo2023.org/registration/

[Medika Life is honored to feature this exclusive Q&A feature authored by Jeanne Conry, MD, president, The International Federation of Gynecology and Obstetrics]

The post Why Improving Women’s Health Around the World is Urgent appeared first on Medika Life.

“Children significantly preferred food products packaged in red. This is in line with our hypothesis that red exerts greater attraction than green for children when associated with food because, as in previous literature, food items with a red-packaged color are presumably associated with more pleasant tastes.” In fact, color has been found to have a profound, assumed, bias regarding the taste of that item.

These marketing techniques aim to seize their interest, arouse favorable feelings, and ultimately influence consumers to make unhealthy food selections.

Food marketers use vivid and eye-catching images to grab kids’ attention. A child’s interest can be captured right away through appealing branding, colorful packaging, and appealing food imagery. The products appear more appealing and desirable thanks to these exciting images, especially when one item is included with favored characters.

Marketers frequently link their food goods to beloved characters from well-liked children’s cartoons, movies, or TV series. Food corporations build an emotional connection with kids by using these characters on the packaging, in ads, and in promotional efforts. Children are encouraged to choose these products because of their association with their favorite characters.

Food manufacturers may pay additional fees to have their products intentionally arranged on store shelves at eye level so that kids can easily reach and see them. Also, they purposefully place unhealthy goods on end displays or specific types of materials close to checkouts, where kids are more likely to ask for them. These strategies are designed to entice parents and kids to make impulsive purchases. Have you ever seen a child holding an item and begging the parent to buy it while the parent insists that it’s not a good choice?

Commercials have a significant impact on kids’ eating preferences. The catchy jingles, entertaining animations, and intriguing stories featured in advertisements frequently capture children’s attention. These commercials make unhealthy food products seem irresistible by emphasizing the flavor, thrill, and delight they offer.

Research on the subject is revealing. “Research examining the effects of television food advertising on children has shown that children exposed to advertisements prefer branded foods at much greater rates than children not similarly exposed. Television advertising impacts food consumption and eating behaviors as well.” The push, as has been shown, is toward choices that are heavily advertised but not equally heavy in nutrition.

Incentives and promotions also draw kids to products. Toys, games, competitions, and tie-ins with well-known films or franchises are a few examples of these.

There is also the issue of peer pressure to want certain food products that their friends have, and here we have more stress to make poor choices. Remember, these are children without sufficient control over peer pressure. If other kids have them, they want to be included in the group and not seen as modern pariahs.

What is the solution to this constant barrage of advertisements for poor food choices by children? Parents need to have candid discussions with their kids about advertising and equip them to make better dietary decisions about healthy food options by fostering media literacy skills in children and teaching them to think critically.

Enticing images, character branding, product placement, engaging advertisements, incentives, and promotions in marketing have a significant impact on children’s eating preferences. Children are continually exposed to persuasive messages beyond traditional platforms. If we want children to develop into healthy adults, we need to give them the skills to make healthy choices, no matter the color, placement, or characters in ads.

The post Clever Choice of Colors Draws Children Into Poor Food Choices appeared first on Medika Life.

Nutrition

Due to its unrivaled nutritional profile, breast milk is frequently referred to as “liquid gold.” It has the ideal ratio of vitamins, minerals, and other critical components to satisfy the unique requirements of a developing newborn. This nutritional benefit is extremely important for a child’s cognitive development, including brain function and growth. Breast milk contains a special combination of fatty acids, including DHA (docosahexaenoic acid), which has been associated with enhanced cognitive function and higher academic achievements later in life.

Breastfeeding significantly contributes to a child’s brain development throughout the crucial first few years of life. Growth factors, hormones, and antibodies found in breast milk are among the bioactive substances that help synaptic connections and the development of brain circuits. These elements encourage the development of strong cognitive capabilities, including memory, concentration, and problem-solving ability, and facilitate optimal brain development. As a result, kids who breastfeed for longer periods of time may have a neurological edge that improves their ability to learn in school.

A unique supply of immune-stimulating nutrients, breast milk helps shield infants from illnesses and infections while promoting brain development. The antibodies in breast milk strengthen a child’s immune system, reducing the risk of infections that could impede their academic development.

Here we find a factor that may contribute to academic performance apart from breastfeeding: absences from school. So, it wouldn’t be exclusively the breastmilk but the fact that the child doesn’t miss school and, therefore, backslide in their performance. Breastfeeding may contribute to improving academic performance by reducing absences due to illness and protecting against common infections. This unbroken presence in the classroom has the potential to promote consistent learning and academic success.

Breastfeeding also promotes a strong emotional attachment between mother and child, in addition to providing nutrition for the baby. The mother-child relationship fosters closeness, comfort, and a sense of security that support a child’s healthy emotional growth, resulting in the child’s feeling of security, stronger self-esteem, social skills, and mental health.

Motherly Influence

The benefits of breastfeeding are mutual for the mother and the child. Breastfeeding mothers frequently make deliberate lifestyle decisions. These mothers frequently adopt healthier behaviors, such as eating a balanced diet, getting regular exercise, and getting enough sleep, which can improve their mental faculties, emotional stability, and parenting abilities. A mother’s healthy state of mind and active participation in her child’s education can help create a welcoming home atmosphere, nurture a love of learning, and pave the way for academic success.

Empirical evidence firmly supports the conclusion that prolonged nursing is associated with improved academic performance. The mother’s influence as well as the nutritional advantages, enhanced brain development, immunological protection, bonding and emotional support, and nutritional advantages of breastfeeding all affect a child’s academic success.

The post Longer Breastfeeding Results in Better School Achievement: Why Might That Be? appeared first on Medika Life.

The clinics, spread over two floors and 180 sqm, will house a resident OB-GYN and pediatrician with access to the latest medical technology. Expectant mothers will also benefit from on-site birthing facilities in a country with high maternal mortality.  The pilot clinics will be built in Albay, a rural region of Luzon, the Philippines’ largest island. The Philippines is home to approx. 140 million people, many of whom still live below the poverty line.

“Statistics tell the relentless story of needless suffering and death,” reflects Clinics IV Life Founder. Robert Turner.  “For decades we’ve thrown billions of dollars in aid each year at the problem. It remains and, in many instances, worsens year to year. Historical charitable models are flawed.”  Turner adds: “Clinics IV Life was launched by seasoned health professionals who seek to address these shortcomings in novel ways. Our hybrid clinic model removes the need for continued donor funding and integrates into local healthcare systems, removing the dependencies created by historical charitable efforts.”

Each clinic aims to treat 1000 indigent patients annually, making inroads on the high maternal and infant mortality levels plaguing developing nations. The first of the three clinics earmarked for Luzon will open in 2024, followed by openings in late 2024 and 2025. Access to care remains one of the critical reasons mothers die in childbirth.  The leading causes of maternal mortality in the Philippines – like in many emerging nations – include challenges that can be prevented with medical oversight, such as bleeding, infection, unsafe abortion, hypertensive disorders and obstructed labor.

A NEW ECONOMIC MODEL FOR SUSTAINABILITY

Their clinic model relies on a unique shared practice agreement that ensures its clinics are self-sustaining, removing the need for the continued use of donor funds beyond construction and equipping a site. The Not-for-Profit plans to extend its reach into India, Africa and other Asian countries during the next three years.

Unlike traditional charitable models, Clinics for Life will not seek funding from the general public. 

“We form close corporate partnerships with companies that serve the maternal and newborn health markets and share our vision. Our clinic model offers the best ROI in terms of corporate giving. We pair each clinic with a corporate partner and for a single donation a company can generate more than 30 years of health impact in a community. It’s a gift that keeps on giving; both for the patients and the donors,” says Kemi Olugemo, chair of Clinics IV Life’s Fundraising Board, on their approach to funding.

ABOUT MATERNAL AND INFANT MORTALITY 

Every minute, around the globe, four newborns die; every two minutes, an expectant woman dies, often in childbirth. It is estimated that 85% of these deaths, primarily occurring in developing countries, are avoidable with access to proper medical care. In India alone last year, 2.7 million babies were stillborn, and nearly 600 thousand died in their first month.

Historically, women suffer more from health inequalities and require more complex medical interventions than their male counterparts on a more frequent basis. Access to procedures taken for granted in developed nations, like ultrasounds and fetal monitoring, are luxuries in developing countries, only affordable to those with money. 

ABOUT CLINICS IV LIFE 

Clinics IV Life was created specifically to address these health inequities that are commonplace in emerging nations. Their hybrid clinic model overcomes continued reliance on donor funding by creating self-sustaining businesses, obviating the need for financial donor support to ensure the ongoing success of each clinic. Donor funds are only utilized for the construction and equipping of a clinic.

Clinics IV Life views every element of the patient-provider ecosystem as being of equal value, and places great emphasis on ensuring its doctors, nurses and staff can serve their patients in a safe, secure and welcoming environment while having access to the latest medical technology and training and a global network of knowledge provided by colleagues who selflessly volunteer their time and skills.

The Clinics IV Life board of directors includes physicians, pharmacists, psychologists, public health professionals and business leaders who have brought their knowledge, connections and resources to this needed cause.  

Find out more by visiting: https://clinics4life.com/

Clinic IV Life Board members and industry advisors include: 

• Robert Turner – Founding Board Member
• Kemi Olugemo MD FAAN – Chair, Fundraising and Board of Directors
• Shazia Ahmad
• Gil Bashe – Board of Directors
• Grace Delerme
• Hesham Hassaballa MD
• Sharon Handelman-Gotlib
• Karie Hudson MS
• Viveca Livezey MD FAAN
• Jeff Livingston MD, Board of Directors
• Kellie Lease Stecher MD
• Dr. Soojin Jun
• Tom Krohn
• Teresita Pulgarin 
• Bianca Rose Phillips LLB. BComm. GradDipLP. LLM 

Media Contacts:

Kemi Olugemo, MD, FAAN
Board Chair, Fundraising
Tel: +1 (781) 226 0429
Email: kemi.olugemo@clinics4life.com

Gil Bashe
Board Chair, Executive
Cell: +1 (732) 371-0922
Email: gil.bashe@finnpartners.com

The post Clinics IV Life Launches a New Clinic Model to Change the Face of Charitable Maternal Care, Delivery to Impoverished Communities appeared first on Medika Life.

As a fetus, Charlie endured hearing his mother gasp for life during three heroin overdoses, heard the constant fighting and screaming between his birth mother and my son, endured severe malnutrition second to his parents’ homelessness, felt the poisonous effects of multiple substance abuse, and was the victim of the subsequent, injurious, powerful negative stress hormones pulsing through his mother’s veins.

The Origin Of A New Trauma-related Diagnosis

Addiction and overdose result in deep shame, guilt, and fear for persons suffering from addiction.

Most addicts report a heavy burden of anger and disgust for themselves for their addicted state. Subsequently, they acknowledge an absence of self-worth, which perpetuates hopelessness, low initiative for self-care, and an outward disregard for their lives and health as a way to offset dealing with the deep trauma roots of addiction.

A drug-addicted lifestyle is harder on the soul and body of an addict than on the people who love them, although family and friends suffer inexplicably living with and observing a loved one’s addiction.

However, there is a significant other victim of addiction who is most often never even acknowledged until the damage done to them is permanent. This person receives every spiritual, psychological, and physical impairment that the person in addiction experiences in active addiction and overdoses, but is incapable of processing or recovering from the events.

These lives helplessly experience repetitive, excessive drug use, and very often, overdose, in their body and mind. They can not escape the experiences or the source of those experiences and are unable to tell anyone or ask for protection from the effects of another’s drug abuse.

This is because they are not yet born.

How Excessive Prenatal Exposure To Drugs and Overdose Physiologically Affect A Newborn:

An addict’s excessive drug use is an overt sign of self-rejection. The user may not perceive initially that this is an originating factor of their addiction because there are many other valid facets to addiction.

However, a tragic consequence of addiction-related self-rejection is the destruction of innocence, both of the using individual and of any child growing in the womb of a pregnant addict.

A fetus has every capability to perceive love, affection, and its hopeful birth as it does to receive the innate rejection, disregard, and neglectful abuse occurring in substance abuse overdoses and drug abuse during its womb experience.

What transpires physically to the child through the onslaught of poisonous substances in-utero creates the intrinsic knowledge or perception that it is unwanted, alienable, and dismissible as being worthy of concern and love.

This is how addictive drug use causes any addict to feel. This deep trauma belief is transferred to the unborn through brain synapses, hormones, and the connective spirituality between mother and child.

My own grandson has been born from a severely multi-substance exposed pregnancy. Once home from the NICU, this tiny human being wore the look of the sadness and devastation of his intra-uterine experience in his countenance. I had never seen anything like it. It scared me to the core.

My experience with the result of a loved one’s addiction leads me to educate readers on the tragedies of prenatal opioid and substance abuse.

In my work as a NICU nurse, what always struck me about our “drug babies” was their direct inability to readily accept the human touch. I recognized that although sensory and neurological issues were a major component of that born trait, the inability to want or accept human touch was also resultant of the prenatal rejection occurring through pregnancy drug use and overdose.

They would grimace from touch first, as it appeared to hurt. Watching a new child recoil from another human being’s affection is heartbreaking.

An initial diagnosis of NAS or NOWS is not the separative long-term condition that these children go home with. Most NAS symptoms, some of which initially coincide with PORS symptoms, dissipate after several few weeks.

Most times, these babies were discharged home screaming, red-faced, uncomfortable, and heavily medicated. Their parent(s) would never have the patience and wherewithal to care for them, while still in active addiction or early recovery.

These children begin their fragile lives with both a biological and physical understanding/belief that life is pain, an intrinsic search to end that pain (which becomes a future central focus of existence), an inability to independently stop the physical and emotional pain of rejection (which creates a subhuman existence) and a disconnect from intimacy and self that permanently alters their perspective on self-worth, purpose, and trust for humanity.

Why Medical Intervention is Imperative in PORS and Active Parental Addiction

There are now new trauma classes for foster families accepting children from homes of drug use and other abuses, but few are well versed, if at all, on the subject of prenatal exposure to excessive substance use and overdose-related PTSD or the resultant rejection component in the newborn.

This is because the conditions in this delicate population are not yet medically recognized, documented, and treatable pediatric diagnoses.

It is especially not yet widely recognized that these brand new lives have severe PTSD.

Few professionals have or seek research on this.

Even with today’s recent increased trauma research, both the medical community and society seem to pull a sheet over both the inevitable and unexplainable realities occurring to a human being from prenatal drug exposure.

When medical professionals happen to note both the discord in the addict’s parental dynamics and in how prenatal and postnatal drug addiction (at home) affects those babies conceived in addiction, it is common to see the multitudinous signs and symptoms in a child who is suffering from PORS, dismissed as non-related diagnoses.

CPS can and will not intervene in most cases where a mother does not show up positive for substances at birth or just before. Addicts know to circumvent the system. Who confirms that she is sober a few days prior to the test and several days or weeks after discharge?

For the most part, no one.

An addict traditionally does not get sober during pregnancy just because an innocent life is at stake during or after childbirth.

Overall, there is little intervention from the medical community to acknowledge the delicate situation these children are born into or to actually protect their vulnerable and damaged lives from further damage.

Many times, it seems that this lack of response may stem from willful and/or fearful ignorance to address addiction and an age-old stigma that since an “addict begats an addict,” why intervene?

Few medical providers understand the devastating and insidious nature of the addicted mind. Many do not comprehend the further and continuing damage that occurs to a child who goes home to addiction in a post-exposure crisis medically, emotionally, and physically.

As a result, the formation of special parenting techniques is not addressed through counseling/therapy and things such as specialist referrals are not made or followed through with, compromising the child’s health and safety further.

Persons with an addiction can get better and someday give good care to and parent their child well but, in my experience and opinion as a nurse and observant custodial grandmother, the formative years of the child should not be under the care of addicts (even “functioning” ones) or newly recovered ones.

When an addict is in recovery, they learn that they must focus on themselves and their sobriety first and always to keep themselves in check to stay sober. Decisions must be made that leave out other members of that addict’s family and other life priorities in lieu of the priority of sobriety.

Only time, maturity, and experience weaving the recovery program’s requirements into all aspects of the addict’s life will eventually allow for that addict to be able to properly care for others, and achieve the self-awareness and discipline to do so while maintaining sobriety.

My professional and personal experience so far is the observation of the passive omission of the medical community to take initiative to reach out and engage these parents in any appropriate discussion or intervention of the care of their PORS-affected newborn, or the desperate need for addiction services.

Addressing Latent Effects of PORS and An Addicted Parental Response

A healthy baby whose pregnancy is free of substance abuse requires full-time, attentive, round-the-clock care.

A newborn who is riddled with the physical, mental, and emotional after-effects of prenatal substance abuse requires scrutiny and intervention in every aspect of care and an intimate understanding that their responses to everything around them are woven with distrust, fear, and disconnect.

In most cases, the obvious emotional and physical problems cannot be handled safely or appropriately either by addicts who remain in their addiction or by recovering addicts who are less than 1–2 years stable into their sobriety.

Beginning in the early months after birth, it takes a gentle hand, a calm demeanor, an overly attentive approach, and an excess of undistracted care to settle and restructure these children’s spirit after their womb trauma.

Keep in mind, rejection is a foundational component of their physical, mental, and emotional makeup.

The latent effects of this condition pose further danger to a child as they grow and age as most parents in recovery or in active addiction, will not recognize or understand prevailing and insidious symptoms such as the presence of sensory deprivation/overload, general sensorial problems, neurological delays, night terrors, processing disorders, speech/choking swallowing disorders and other serious maladaptations resulting from prenatal drug use and overdose.

Some of these diagnoses could take months or a few years to become visibly evident, although many are present right after birth.

This places the child in yet another traumatic situation because the uneducated, (uneducated to the problems associated with the diagnosis) addicted or sober parent is again, not traditionally sought out by the baby’s or mother’s medical professionals as an interventional risk or for the teaching of the probable issues to come.

Addicted or recovering parents are prone to getting angry easily (which is a result of their complicated mental and emotional condition in addiction) at the distracting crying, incessant need to eat and be soothed, or the refusal to eat and be held, as well as frequent illnesses.

What commonly happens in the manifestation of symptoms, is the parent(s) will react to the “irrational,” confusing behavior and excessive needs of the child and not to the cause of either. Subsequently, several types of abuse are common to occur, as the baby or older child’s behavior is intrinsically misunderstood.

Parents in active addiction or early recovery will usually misunderstand telltale signs that the baby is in need of a different kind of intense and patient parenting. The parents also do not have the ability in their current state to process or act on the needs of their child.

In one particular NICU environment I was employed in, the staff would read the city’s newspaper weekly on the unit to note which of our discharged babies had died by abuse or neglect. It was that common.

Others ended up in our emergency room completely malnourished and in active severe dehydration. Some made it, some did not.

The medical community as a whole must urgently re-examine the entire and intricate phenom of addiction. We must seriously re-examine sending a drug and overdose-exposed infant home to the people who had damaged them in utero, despite their “cleaned up” appearance and promises, and even despite any recent positive recovery status.

The menace that is relapse is an overshadowing, lurking danger, historically, and must be monitored very closely for a newly sober parent.

Self-coined Prenatal Overdose Rejection Syndrome Diagnosis.

Separate from my extensive nursing experience, I have gathered an immense amount of professional and personal expertise in managing, caring for, and in raising a child born into a heroin and meth addiction.

I noticed the symptoms of PORS in my professional career, but it was not until Charlie, my own grandson, was born from severe addiction that I could pen an actual name for the postnatal (and beyond) symptoms that I was seeing.

I have had legal custody of him since his fifth month of life. Charlie grew in-utero in my home from 28 weeks, was born at 38 weeks, and subsequently endured a month-long NICU stay and then was discharged to my home under the care of his birth mother and my youngest son, his father.

Both Charlie’s parents continue to struggle today with their recovery from heroin and meth, but for all their positive efforts (five years later) neither are in any kind of emotional or physical condition to parent Charlie and will not be for a long time, if ever.

During the pregnancy, in a rescue attempt to get help for her and for Charlie, I insisted that my grandson’s birth mother inform all her doctors and prenatal specialists of her heroin and meth addiction.

However, her specialists were not concerned.

They did not intervene and did not question her or even address her obvious positive drug screens occurring before her 28th week.

Not only was she not flagged as a risk to the baby at and after the birth, but the delivering ob/gyn actually told her that heroin and meth were not known to hurt a baby, so he “should be fine.”

This ridiculous and irresponsible line of thinking and under-education on this doctor’s part is reprehensible and did prove to be tragically wrong. Charlie was born with Gastroschisis, requiring immediate surgery after birth, and was subsequently diagnosed with 12 independent diagnoses.

Now, Prenatal Overdose Rejection Syndrome is an additional, undocumented and unrecognized problem I manage in his care and a focal point of intervention in his life.

Symptoms:

Charlie displays a constant need for reassurance of each family member’s role and connection with each other and to secure the idea that he and everyone “go together.” He continually looks for his proper place in the family, as it is clear he feels “out of place,” in general.

He is now almost five years old. Until very recently, he was inconsolable if I was not within sight and behaved as though he believed I was gone for good. This fear of abandonment began at birth. The few months his parents cared for him only cemented his fears as they did not know how and were not focused on meeting his needs…and they had both secretly returned to using just after he came home.

Charlie additionally had sudden, unexplained fevers, frequent illnesses (every 3 weeks almost on the dot) including pneumonia, RSV, strep, and other general maladies. He woke six to seven times a night, screaming inconsolably much of the time.

When a little older, he would hit himself when even gently corrected or if any situation seemed to place him in the spotlight for any reason. These issues are still present but improved now.

Charlie screams and talks angrily in his sleep often, now and seems to have dreams in which he is being threatened or attacked, as evidenced by this sleep speech and cries.

I sincerely believe this has to do with his prenatal and post-birth experiences with substance abuse, overdose, and the irresponsible, incomplete care he received from his parents in the first few months of his life.

For all the physical, neurological, and emotional difficulties (there are many more diagnoses), the most noted after effect of his prenatal exposure and trauma is his noticeable sense of rejection.

I am very careful in my one on one handling of his body when he walks and moves, as any accidental brush, scrape, or slight knock (think of getting a child into a car seat, dressing, or just moving about in general in the home) to his person sends him into a screaming fit, hitting himself.

The expectation of rejection and mistreatment is in his eyes, despite all my expressed care and love for him. I have also seen the same look in the eyes of other special needs children, both in my pediatric career and presently in other children attending therapy appointments at our therapy clinic.

Many things in a human being’s life can cause the rooted belief of unworthiness. It is incomprehensible that a developing fetus can be so poorly treated in the womb that this kind of root would begin before a first breath in the world, but it is an unfortunate reality.

Signs of PORS: (some can be characterized under other diagnoses as well)

If the caregiver/parent/grandparent of a child who suffered prenatal drug abuse and overdoses recognizes some or any of the following signs, immediate PCP’s therapy and developmental delay referrals needs to be made:

• excessive separation anxiety
• frequent night terrors
• social distancing from peers (can be observed as early as 12–18 months)
• delayed or difficult speech and conversation
• frequent, unexplained illnesses
• any purposeful self-injury
• the appearance of being persistently sad, aloof, disengaged or if they appear overexcited, excessively talkative ie: like the Energizer bunny and they are in a noticeable state of stress)
• anything else that appears to be “odd” or out of sorts with their communication methods, thought processes, and reactions to everyday activities and stressors.
• subtle and overt signs of problems processing daily communication and information, discipline, and social expectations. *
• Congenital mobility problems: weaknesses in various parts of the body showing as imbalance, toe-walking, odd gait, frequent falls, weak extremities, etc.

As a fetus, Charlie endured hearing his mother gasp for life during three heroin overdoses, heard the constant fighting and screaming between his birth mother and my son, endured severe malnutrition, felt the effects of multiple substance abuse, and was the victim of the negative stress hormones pulsing through his mother’s veins caused by the distinct chaos of another’s addiction.

Again, I continue to observe that the PORS phenomenon with all its nuances is not considered even when clinicians do work with addicts and their children. The effect of an addict’s life and abuse on the fetus is not addressed head-on.

Medical providers are bound to the search and research of best care and we are trained to unturn every stone for solutions and resolutions. If this is not accomplished, there are dire consequences for a patient who has experienced prenatal exposure to drugs, and especially, severe cases.

This type of unborn life, this type of prenatal rejection, affects the child’s whole physical, mental, emotional and spiritual makeup.

It is a permanent, invisible disfigurement.

Suggesting Further Solutions:

As with any health problem in our world, one effective and necessary solution is education, which is the purpose for my piece on this under-recognized and hugely epidemic medical and social problem.

Active and sober addicts, the parents and caregivers of the affected babies and children, and other involved (and medical) parties affected by Prenatal Overdose Rejection Syndrome need to be educated on the signs and symptoms of this not-yet-diagnosed condition.

Immediate, compassionate and consistent intervention should unequivocally begin at the positive test for pregnancy in an addict. As much as we, the medical community, can do to help that mother obtain permanent sobriety, we should do.

All parties affected by and involved in the care of Prenatal Overdose Rejection Syndrome also need a voice as a way to heal, educate, and be educated to implement treatments and cares and advocate for new research into this devastating issue. This begins by assessing, triaging, monitoring, and providing the utmost, loving and creative care are for these populations, as we are capable of.

This happens through the willful and purposeful engagement of physicians and other medical providers to swiftly address the symptoms of addiction in the parent and those of the child born out of that addiction. Researching and documenting these mental health and physical conditions and presentations is most imperative.

To summarize

Unborn babies in the womb of an active addict are the most at-risk type of patients in society and the medical community due to the inability of this type of patient to advocate for themselves and the inability of the addicted parent (s) to advocate appropriately for either of them.

The lives and health of these babies are severely compromised before birth. They are discarded and rejected prior to life outside the womb through the use and overdosing of substances, whether intentionally or neglectfully done.

Until research on the full psychosocial, psychological, and coinciding physical and emotional prenatal effects of drug use and overdose is addressed thoroughly, and protective measures for the unborn experiencing this abuse are put into effect, many an unborn child in the womb of an active addict will be plagued with a consciousness of intrinsic and lasting rejection before they are even seen or held.

This is unacceptable for our children and grandchildren and for any new human being.

The post Prenatal Overdose Rejection Syndrome appeared first on Medika Life.

Laura has been given an amazing opportunity to work as a mental health technician in a home for children who have been victimized and are too disturbed to enter the local foster care system. This center will provide her with four weeks of paid training — which sounds wonderful to me, but very scary to her. I have tried to convince my daughter that they will teach her appropriate techniques to use in managing and helping psychologically and physically injured children.

She recently asked me and my husband how we ever got used to seeing the effects of child abuse, hearing those tragic stories, and interacting with the parents or family members who injured the child. My husband is a retired pediatric nephrologist, and I am a retired neonatologist. We both experienced excellent pediatric residency training in large city-county hospital systems in which we saw everything, including horrific child abuse cases.

We told Laura that you can care deeply about the kids who are injured, and care for them medically, but you cannot let yourself become so shocked or disturbed as to be nonfunctional in providing their care. We told her that we learned to harden ourselves in those situations and to provide safety and medical care for the child. The busyness and necessity of getting the medical things done were great distractions.

Our daughter is a highly empathetic and sensitive person who fears that she might feel the child’s pain too deeply to be able to care for them. She is anxious that she will be incapacitated by the horror of what she might see or hear about the children she will care for.

We each shared with her our first experience of encountering severe child abuse and finding ourselves capable of dealing professionally with each dreadful case:

I was an intern in the Parkland General Hospital pediatric emergency room in Dallas, Texas, when I was confronted with a four-year-old girl who was obtunded and had scalded hands and feet. Her severe burns were in the pattern of stockings-and-gloves burn from being dunked into boiling hot bath water. She had old and new cigarette burns scattered over her tiny body and bruises in various sizes and stages. Her mother originally told me that she fell off the couch.

While I stabilized this child and carefully noted all her injuries in my History and Physical exam (even drawing pictures), I seethed with anger at what lay before me. The child clearly had been severely abused. We stabilized her and transferred her to the pediatric intensive care unit (PICU) at Dallas Children’s Hospital where she underwent heroic intensive care and support until her death four days later from a massive cerebral hemorrhage. Her head trauma most likely resulted from her being battered against a wall.

After the child was transferred to the PICU, I went back to pressure the mother into giving me a more accurate history. When I pleaded with the mother to tell the truth, she finally, and tearfully, confessed that her boyfriend had been hurting her daughter. Afterwards, I walked over to the Pediatric ICU and added that statement into my original note, hoping that someone would notice and turn him in to the authorities. Of course, seeing this darling little girl so injured made everyone around the child just sick at the possibility of such severe physical abuse. Witnessing that kind of brutal and senseless abuse can be nauseating.

Three years later, while I was in my neonatology fellowship training, I gladly accepted the opportunity to testify against the man who injured that child. In fact, he had been arrested and charged with murder after the child died. After much delay, his trial was scheduled to take place and I was subpoenaed to testify.

While in court on the witness stand, I eagerly answered questions about how the girl had presented and was able to use my extensive handwritten note and pictures to review her physical findings and to recount what the mother had told me. I enjoyed glaring at the defendant once I had completed my descriptions of her physical findings to the jury. I especially relished hearing from the district attorney, some days later, that the man was convicted of murder and sentenced to life imprisonment. His guilty verdict would not bring that child back, but I was happy that he got what he deserved.

My husband told our daughter the story of his experience as an intern, when he admitted a two-year-old child in a coma to the PICU at Texas Children’s Hospital in Houston, Texas. Astonishingly, this was not her first admission with coma. She had previously been admitted with coma two times before! Thankfully, after each of these previous admissions to the PICU with a coma, she recovered.

My husband related her presentation with vomiting, muscle weakness, seizures, and obtundation which progressed into a coma. Unfortunately, this time, while he was one of her doctors, her neurological instability could not be reversed by the PICU staff and pediatric neurologists. Not only could they not save her, but they were unable to determine the cause of her coma. This beautiful toddler died in a coma of unknown etiology.

Of course, all the residents and staff felt miserable that they could neither bring her around, nor ascertain the cause of her repeated admissions for coma. Her death created a shared and defeating jumble of sadness and loss for the whole team. It is tragic when you lose a patient, when you are unable to save them, but it is even worse when you cannot determine why they died.

Months later, in another city in Texas, a general pediatrician cared for the sibling of the child who had died at Texas Children’s Hospital. Her younger sister was admitted to his hospital with coma of unknown origin after presenting with vomiting, muscle weakness, and seizures. Happily, this child recovered.

Soon thereafter, the perplexed and thoughtful pediatrician attended a national meeting of the American Academy of Pediatrics in another city. This is a meeting of expert instructors who provide continuing medical education. During the break in between meetings, the pediatrician chanced to meet with a pharmacologist and described to him how his little patient, the second sibling, had presented. The pharmacologist opined that the child could have been poisoned by ergotamine, a medication that is given for migraines.

The next time the child presented to the PICU with coma, the pediatrician made sure that serum and urine drug toxicology panels were obtained and that they included ergotamine. It turned out that the child had been poisoned with ergotamine! This was a medication that the mother was supposedly taking for her migraines. Afterwards, the mother was arrested for child abuse and charged with attempted murder. The pediatrician called the PICU doctors in Houston to share the news of his uncovering the probable etiology of the coma that each girl had suffered through.

This was a case of Munchhausen’s by proxy (now called factitious disorder) in which a caregiver, usually the mother, who is mentally unstable, attempts to sicken her child by any means — in these cases with medication overdose and poisoning — to bring attention to herself. It is a rare and severe form of maternal mental illness, one in which a mother intentionally sickens and harms her own child.

Our daughter listened to these stories from our early days in training and could not imagine how we were able to persevere in those cases. We told her that you do what you can, what you are trained to do, and you always try to help and protect the injured child. You control your emotions while you are doing the actual work, and then deal with your feelings later when you can process the horrible thing that you have seen executed on a child.

We reassured Laura that she would be able to do this, too. She would learn to harden herself to witness the incredible offense that is child abuse. She would learn to do what she could to comfort and care for those abused children, and deal with her feelings, too.

The post How do you harden yourself to the witness of child abuse? appeared first on Medika Life.

Lara was born in January of 2022, into a household infected with Covid. Both my wife and I had caught it only days before her birth and it was inevitable she would contract it. Omicron was circulating and I suspect that was what we had contracted. At a week old, I could see she was struggling and took her in to our A&E, suspecting the worst. A few hours later she was admitted to an isolation ward, where she would spend the next ten days.

I could see the doctors were at a loss in terms of treatment protocols for the young infants in the ward. The gold standard at that stage was to pump the infant full of antibiotics and hope for the best. I refused the treatment, arguing she was not febrile and that she should be monitored rather than medicated. Ignoring my request, they pressed ahead and she spent the next seven days on a drip.

She was discharged after a week, her little system somehow had managed to fend off the virus without any ill effects. My wife was overjoyed, but I harbored concerns and I still do. There is absolutely no research done on young infants and the long term impact of the virus on their systems. Babies are notoriously difficult to treat and even harder to enroll in any form of meaningful trial. This results is a wait and see scenario, which, if you’re the parent, is far from ideal.

She’s made it, almost uneventfully – aside from a few minor incidents, mostly involving the cat and her desire to separate it from it’s tail – to her first birthday and first steps and on the surface, all appears well. It’s the rest of her journey that concerns me, and it’s a concern all new parents should share, post Covid.

We cannot unsee the last three years

Particularly if you’ve been invested in the saga of Covid, and I have, writing copiously on the pandemic, the lockdowns, masks, mandates and then, the vaccines. We’ve seen both the best of healthcare (in terms of dedicated doctors and nurses tirelessly running the gauntlet) and the worst. We’ve been lied to, locked down, manipulated, terrified and then coerced, sometimes at gunpoint, into rushed vaccines and experimental medical technology.

Now, we have to witness the last act of the Covid saga, of a triumvirate not even Shakespeare could have envisaged. The lead players, science, politics and medicine, trying to extend their flawed narrative just that little bit longer, and to play out their final scene they’ve conscripted our children. We are living out the vaccines swan song and they’re singing it to our babies.

There is some benefit for some children, those for whom the risk of the vaccine is outweighed by their medical conditions or predisposition to developing serious Covid symptoms. For most other children, Covid is not life threatening. There is simply no logical reason to expose them to the risks of a growing number of serious adverse events linked to the mRNA vaccines, some of which prove fatal.

There is not one shred of serious, robust clinical evidence to support the CDC’s Covid vaccination campaign for children.

Given what I know and what I’ve witnessed over the last three years, I now face a conundrum as a parent. One that I am certain many other parents also face. How can we ever again trust public health, and the science that drives it. As the person responsible for ensuring my baby daughters wellbeing, I now have to weigh up the risks (often unquantifiable) of each medical intervention she is exposed to, before consenting to it. I know that in many instances I will now decline these interventions.

Is the reputation of the vaccine irreparably damaged?

It may very well be in the minds of many parents, as evidenced by diseases we had once eradicated, making a slow and determined return. Small outbreaks of measles, polio and other childhood ailments are telling signs of our distrust in a system that is supposed to protect us, and which, under ideal conditions, does.

mRNA has issues, perhaps not the actual idea, but the particles we use to deliver the enveloped instruction in, the production, which exposes the vaccines to impurities with E.coli present in a number of tested samples, and then of course, the fact that the products don’t perform as advertised. The body does not, in some individuals and for reasons unknown, stop producing the protein the vaccine instructs, as we’d been assured. There are numerous other issues, to complex for this article and therein lies the rub.

Much of what is currently under development in terms of cutting edge medicine blithely assumes we’ve got mRNA all figured out, when truth be told, we are still stumbling to understand all the subtle nuances of the technology. Vaccines, flu shots, cancer treatments and other rare diseases will, in the future, all be delivered with mRNA technology.

My young daughter now faces medical choices that didn’t exist, pre-Covid. Am I going to expose her to these new treatments. Absolutely not. I will wait, as should responsible science, to see what emerges from our global clinical trial involving nearly two thirds of the worlds population. I pray I am wrong, but emerging evidence suggests otherwise.

In the meanwhile, old fashioned polio drops and measles, mumps and rubella vaccines will have to suffice.

The post Born into the age of Covid appeared first on Medika Life.

I worked with Allison to develop an individualized treatment plan that addressed nutrition (she wanted to adopt the Mediterranean diet since it seemed sustainable), exercise (we identified several forms of physical activity she enjoyed that fit her schedule) and behavior modification (for example, we shifted her meal timing earlier and discussed techniques to avoid stress-eating). As part of this plan, we also started on metformin, a great option in cases like hers, because it can help with weight loss, it can help restore ovulation, and it is generally considered safe to take during pregnancy.

After a few months, Allison had lost 20 pounds and she began to ovulate; however, she had not yet conceived so she elected to start fertility treatment.

This meant her weight management program would be even more critical.

Weight gain associated with fertility treatment

Since hormones affect weight, hormonal therapy to enhance ovulation (whether pills or the multiple shots that the in vitro fertilization process entails) often leads to weight gain. This gain can be significant, especially for patients with insulin resistance and patients who, like Allison, have overweight or obesity.

While we don’t want to add to patients’ anxiety during the stress of fertility treatment, it is important for us as providers to be mindful of the potential for weight gain. Fertility-treatment-related weight gain can have a long-term impact because successful treatment means pregnancy — and thus pregnancy weight gain — and it’s often difficult to lose the cumulative excess pounds afterward. For women with multiple pregnancies, the extra weight can add up quickly. One of my patients, for example, gained 70 pounds with her first pregnancy and then lost only 20 pounds before conceiving again. She presented to me during her second pregnancy, and we’re working on strategies to avoid excessive weight gain this time.

Excess weight is associated with various health complications during pregnancy, including hypertension, diabetes, obstructive sleep apnea and preeclampsia, as well as an increase in the child’s risk of congenital anomalies. Women’s healthcare providers often hesitate to bring up the topic of weight, but both mother and baby could benefit significantly if more fertility specialists and OB-GYNs (nonjudgmentally) asked patients’ permission to discuss the issue — and then monitored their weight at appointments and took appropriate action as needed.

Managing weight during fertility treatment

Cases like Allison’s are extremely common, so it’s important for women’s healthcare providers of all kinds to be aware of the options and limitations of weight management during fertility treatment. Most anti-obesity medications are off the table for patients during this time, but there are still a number of steps practitioners can take to help their patients avoid excessive weight gain:

• Optimize lifestyle interventions. Dietary strategies, physical activity and recommended behavioral modifications may be more effective when tailored to the patient’s specific lifestyle. Referrals to outside resources, such as a dietitian or behavioral therapist, for instance, can be great options if additional support is needed.

• Address other contributors to weight gain. Stress, lack of sleep and many factors unrelated to the conventional diet-and-exercise combo contribute to weight gain, and all of these contributors may be in play during fertility treatment. Patients benefit from a personalized plan that addresses these as well.

• Assess for drug-induced weight gain. Many medications are known to promote weight gain, so consider pausing these medications or reducing the dose during fertility treatment, if possible, when substitution with weight-neutral agents isn’t an option. Critical medications obviously need to be maintained, but a risk-benefit analysis might suggest that others should be discontinued.

• Consider prescribing metformin. Some gynecologists and reproductive endocrinologists may be comfortable prescribing the diabetes medication, metformin, for patients with overweight, obesity or insulin resistance, or for those at high risk of weight gain. In addition to improving insulin sensitivity and helping to balance hormones, metformin is a weight-loss-promoting medication and can thus help decrease weight gain associated with fertility treatment.

• Refer to an obesity medicine specialist. While we generally can’t use anti-obesity medications during fertility treatment, patients may benefit from a comprehensive medical evaluation and a personalized treatment plan. A thorough plan is particularly important when a patient is unable to conceive quickly and undergoes fertility treatment for a prolonged period. (I currently have one patient, for example, who has gained 40 pounds over the course of seven months of fertility treatments and still isn’t pregnant.)

Supporting better outcomes for mother and child

Women with overweight or obesity who plan to become pregnant are often counseled to lose weight before trying to conceive, both to enhance fertility and to reduce the risk of health complications for themselves and their babies. This recommendation often becomes more explicit before a woman begins fertility treatment — and obesity medicine specialists like me receive many referrals at this juncture.

The more time we have to treat a patient’s obesity beforehand, the more we can do, of course, but we can still help even after treatment begins. While managing weight during fertility treatment is a challenge, it’s not a lost cause. Taking steps to counteract the potentially weight-promoting effects of hormone therapy can significantly impact the health of the woman and her future child. This is a challenge that impacts many generations to come. We can do this together!

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