1. Special Topics # 1

2. Pre-Natal Issues

3. Factors Affecting The Fetus §Food Ingestion l PKU l Over the counter drugs: Aspirin: Rye Syndrome l Vitamins; C, B Complex, D,E & K l Vitamin overuse: A,D,K l Maternal Nutrition Protein: Bone & Brain development §Drugs §Thalidomide §DES

4. Drugs ( includes Alcohol) Cocaine/ Crack §Recreational Drug l Most dangerous ( March of Dimes) l Devastating effect on baby l Fetal brain damage l Poor infant reflexes l Lack of responsiveness: attention span l Irritability l Increased occurrence of miscarriage

5. Drugs & Alcohol l Restrict nutrients in utero( constricted) l Low Birth weight l O2 deprivation l Pre-maturity l SIDS ) sudden infant death syndrome) l Shorter l Smaller head l 1985 long tern effect of school ?

6. Marijuana §Cannabis §400 different chemicals §THC ( tetra hydrocannibal) §Data Long term effect §Common sense §Smoking in general

7. Smoking & Pregnancy §History / Facts l Known about negative effects since 1935 l 1964 “ adverse effect of fetus” l 2,200 different ingredients in smoke l 40% of females smoke l Most common cause of pre-mature birth l Characteristics/ effects

8. Smoking §Higher rate of infant mortality §Increases number of miscarriages §Double rate of SIDS §Nicotine poisoning/ breast feeding §Second Hand Smoke l Advertisements l Result

9. Second Hand Smoke §Small child §Decrease lung capacity §Decreased oxygen carrying capacity of the blood §Brain development §Adults §Restaurants: California/ New York

10. Alcohol & Pregnancy §Warnings: Everywhere §Advised / law suits §Legal drug §Societal values §Drinking during pregnancy l Some or none ?? l No safe dose

11. Alcohol & Pregnancy §Growth deficiencies: l Birth weight l Birth length l Microcephaly l Increased risk of congenital abnormalities §CNS Dysfunction Weak sucking reflex

12. Alcohol & Pregnancy §IQ lower §Myopia §Sensory-motor loss §Irritability §Hyperactivity §Hypotonia §Increased risk of seizures

13. Alcohol & Pregnancy Delayed motor & language development Poor fine motor skills Clumsiness FAS: Fetal Alcohol Syndrome

14. Pre-NatalConsiderations §Breast Feeding §Genetic Counseling l History l Choices §La Maze method §Le Boyer §Midwives