Showing posts with label pregnancy. Show all posts

Friday, April 1, 2011

Vaccines Are Not A Piece Of The Autism Puzzle

As we celebrate Autism Awareness Month in April, I want to mention a common controversy: vaccines. Here at the Pregnancy Risk Line in Utah, we hear from callers who are concerned about vaccine use during pregnancy. Some moms are so concerned that they do not want to be vaccinated.

Much of the concern by parents has come from one poorly-done research study. The study, published back in 1998 in Lancet, made false claims about the measles, mumps, and rubella (MMR) vaccine and the preservative thimerosal. The preservative thimerosal contains a very small amount of mercury, causing some concerns. Since that time, the medical journal that published the study has publicly stated the research did not show any link between the vaccine and its preservative thimerosal and autism.

Vaccines are one of the most important medical advances in modern times. We have seen worldwide control of devastating diseases like polio and smallpox and are making progress in reducing other diseases, like chicken pox, hepatitis, pertussis, and other illnesses. Vaccines keep our children healthy and reduce disabilities that have lifelong consequences.

Even with all the evidence supporting the safety and effectiveness of vaccines, some parents are still concerned. In response to those concerns, vaccine manufacturers have reduced or eliminated the preservative thimerosal from vaccines. Most children’s vaccines do not have the preservative. Some of the current influenza, or flu, vaccines contain thimerosal at low levels that are safe for pregnancy and breastfeeding (see the Vaccines and Pregnancy fact sheet link below). Preservative-free flu vaccines are available for anyone who still may have concerns. Even with the reduction and elimination of the preservative, the rates of autism continue to increase, further showing that neither vaccines nor preservatives were the cause.

What is autism and what causes it? Autism spectrum disorders (ASD) are a range of conditions that include developmental delays, autism, and Asperger syndrome. Children typically have problems with communication, behaviors, and social skills. Currently, researchers think parents may pass on genes that may lead to ASD or that may become active after being exposed to something in the environment. Some researchers also believe the drugs thalidomide and valproic acid may increase the risk for ASD. Some of the symptoms of ASD, including communication and behavior problems, begin to be noticed as developmental delays when a child is about 18 months to 2 years old.

There is no cure for ASD, but early detection and treatment can help improve language, behavior, and social skills. Parents can learn about developmental milestones and ask their primary care provider (medical home) if they have any concerns.

Autism is still a puzzle, but parents can track their children’s growth, take them for regular check-ups, and read to them to give them the best start possible.

Alfred Romeo, RN, PhD, works at the Pregnancy Risk Line, a partnership between the Utah Department of Health and the University of Utah. His experiences include working as a nurse in newborn intensive care units, training medical homes in improving services, and training young adults with disabilities in leadership and advocacy.

The Pregnancy Risk Line is an affiliate of the Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. Utah women with questions or concerns about pregnancy or breastfeeding exposures can call 1-800-822-2229. Outside Utah, please call OTIS at 1-866-626-6847. OTIS is conducting several studies, including vaccine studies for influenza, meningitis, and the human papillomavirus (HPV). Women who have received these vaccines during their current pregnancy can call OTIS to volunteer to participate in the studies or learn more by visiting OTISPregnancy.org.

References:

http://www.otispregnancy.org/files/vaccines.pdf

http://www.bmj.com/content/340/bmj.c655.full

http://www.cmaj.ca/cgi/reprint/182/4/E199

http://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html

http://www.pregnancyriskline.org/

All opinions expressed in this review are my own and not influenced in any way by the company. Any product claim, statistic, quote or other representation about a product or service should be verified with the manufacturer or provider. Please refer to this site's Disclaimer for more information. I have been compensated or given a product free of charge, but that does not impact my views or opinions.

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Tuesday, March 1, 2011

It May Be March, But A Nutritious Pregnancy Diet Shouldn’t Force You Into Madness

By Sharon Voyer Lavigne, MS, CPEIS Teratogen Information Specialist

We have all heard this before from our mothers and grandmothers before them, but here it is again, “what we put into our bodies really affects our health and well being.” What better time to delve into that saying than during the month of March - National Nutrition Month. For women, proper nutrition becomes especially important during our childbearing years. When planning a pregnancy, newly pregnant or breastfeeding, good nutrition is key to healthy outcomes.

So how does a woman go about getting “nutritionally” healthy? First, we need to look at our diet. Yes the dreaded four-lettered word D-I-E-T. Let’s first focus on the version of this word that is positive, instead of it’s negative connotation that makes us think of deprivation and cravings. What kind of food do you consume? Fruits, vegetables, proteins, grains and fats should all be on the list. During pregnancy and breastfeeding, vegetarians and vegans need to be more creative at getting in enough protein and healthy fats, but it is doable. A consultation with a dietician or nutritionist may help you round out your intake properly. Women with medical conditions like Crohns disease or ulcerative colitis (see fact sheet- http://www.otispregnancy.org/files/IBD.pdf) may also benefit from consulting an expert to cater to their needs. These conditions may limit what you can eat or effect how you absorb nutrients. In some cases, supplements are helpful. For example, Vitamin K (the clotting vitamin) may be deficient in someone with inflammatory bowel disease.

Another group that needs to be aware of their diet is those individuals with diabetes. Diabetics need to eat the right balance of carbohydrates in order to keep their blood sugar level in a healthy range (See fact sheet: http://www.otispregnancy.org/files/diabetes.pdf). This is especially true prior to conceiving, since elevated blood sugar levels can cause birth defects and pregnancy complications. A diabetic’s glycosulated hemoglobin levels (HbA1c) should be as close to normal (below 6 ug/ml) as possible prior to and during pregnancy. Some women who had been previously able to control their diabetes with diet and exercise alone may need insulin during pregnancy. In many cases, using insulin makes it easier for a woman to be in control of her blood sugar levels.

Now lets look at supplements. Vitamins and minerals can be supplemented to round out our nutritional intake. In the perfect world, prenatal vitamins would be started prior to conception. However, since 50% of pregnancies are unplanned, vitamin and mineral intake often starts after conception. Vitamin and minerals typically have a predetermined Recommended Daily Allowance (RDA) for pregnancy and for breastfeeding. Women should stick to these guidelines unless their health care provider has determined that they are deficient in something specific. Then an additional amount of what vitamin or mineral is lacking can be supplemented. More is not always better, so heeding the guidelines of the RDA is safest.

One vitamin that most women have heard about is folic acid or folate. This B vitamin has been shown to reduce risks for certain birth defects, so all women planning to conceive or who are already pregnancy should be taking at least 600mcg of folic acid. Women who have taken medications recently or need to continue to take medication that decrease folic acid will need more- 4-5 mg per day. This is not a typical dose in a prenatal vitamin, so a separate supplement of folic acid will be necessary.

Any supplement that also contains herbal products should be avoided. Natural herbs are not always safe to use during pregnancy. While the majority may not cause birth defects, very little data exists on their safety in pregnancy and breastfeeding. Some herbs interfere with hormones, which may affect fertility. Some herbs may cause uterine contractions and cause pregnancy loss. A supplement without additional herbal ingredients is best.

Okay, now what about Omega 3 fatty acids, fish and methyl mercury? Yes, fish is found in a healthy diet. Fish does contain omega 3’s which are important for your health and the growth and development of your baby. Some prenatal vitamins contain Omega 3 fatty acids now. Fish can also contain methyl mercury, a toxic form of mercury that may affect your baby’s developing brain. Avoiding types of fish that may contain high level of methyl mercury is best. These include shark, swordfish, King mackerel and tilefish (See fact sheet: http://www.otispregnancy.org/files/methylmercury.pdf). The FDA suggests consuming no more than 12 ounces of fish per week of most types of cooked fish. If you prefer to eat fresh water fish from local waters, the Environmental Protection Agency or your state or local health department should be able to advise you on what fish are currently safe to eat.

Finally, we cannot ignore the negative connotation of the word D-I-E-T. Trying to get down to a healthier weight is a good idea prior to pregnancy. However, once you conceive, you should strive for the healthy balance we have discussed so far. Weight loss during pregnancy may put you at greater risk for having a child with birth defects or pregnancy complications. Leave those thoughts and plans of weight loss until after you have had your baby.

Good ‘ol grandma was right…”You are what you eat!” So, eat right, monitor your health, and you’ll be rewarded when a healthy, bouncing baby’s toothless smile is gleaming up at you!

Sharon Voyer Lavigne is a Teratogen Information Specialist and coordinator of the Connecticut Pregnancy Exposure Information Service (CPEIS), a non-profit based at the University of Connecticut Health Center that aims to educate women about exposures during pregnancy and breastfeeding. She’s also been a genetic counselor for the past 20 years.

CPEIS is an affiliate of the Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. Connecticut women with questions or concerns about pregnancy or breastfeeding exposures can be directed to (800) 325-5391. Outside of Connecticut, please call OTIS counselors at (866) 626-OTIS (6847).

Friday, February 4, 2011

An Unexpected Treat If You’re Expecting On This Valentine’s Day

By Nadia Mohamedi, OTIS Teratogen Information Specialist

Whether you think Valentine’s day is a great opportunity to cherish the love in your life, a nauseating marketing ploy, or a form of torture for single people, there’s one thing we all can agree on: chocolate will be eaten…lots of it! Pregnant women, on the other hand, are sometimes told that chocolate is yet another treat they should not eat in pregnancy. Although a low amount, chocolate does contain caffeine. Many studies have been conducted on the effect of caffeine on a pregnancy and the developing baby, however, some pregnant women hear varied and unclear advice about caffeine consumption. Do pregnant womenreally have to spend their Valentine’s Day watching their kids enjoy their fancy chocolate-dipped strawberries?

Caffeine has been studied extensively in pregnancy and to date no studies have suggested that caffeine intake in pregnancy is associated with an increased risk for birth defects. However, there have been conflicting results regarding the contribution of caffeine intake to an increased risk for miscarriage and preterm birth (delivering before 37 weeks).

In 2008, the American College of Obstetrics and Gynecology (ACOG) reviewed the literature to date on the effect of caffeine intake on pregnancy outcome. To determine if caffeine increases one's risk for a miscarriage, they reviewed two large studies of more than 3,000 pregnant women. They concluded that this data showed caffeine intake of less than 200mg per day, or "moderate" caffeine intake, was not associated with an increased risk for miscarriage. Similarly, they reviewed two large studies of about 2,000 babies and found that moderate caffeine intake did not contribute to preterm birth. Thus, ACOG concluded that moderate caffeine intake, no more than 200mg of caffeine per day, during pregnancy does not seem to be a factor in increasing a women's risk for having a miscarriage or a preterm delivery.

So, a pregnant woman can have some chocolate. But wait, how much is 200 mg of caffeine? Here is a list of some common caffeinated treats with their average milligrams of caffeine defined by the US Department of Agriculture:

Dark Chocolate 1.45 oz = 30mg
Milk Chocolate 1.55 oz = 11mg
Coffee 8oz = 137mg
Tea 8oz = 48mg
Soda 12oz= 37mg
Hot Cocoa 12oz= 8-12mg

Given these recommendations, pregnant women should feel reassured that they can share a latte with their valentine or indulge in a few pieces of dark chocolate this Valentine's Day without the worry of adversely affecting their developing baby. Sweet!

* Committee Opinion #462, "Moderate Caffeine Consumption During Pregnancy," published in the August 2010 issue of Obstetrics & Gynecology.

Nadia Mohamedi is a teratogen information specialist and also serves as a research assistant/interviewer for OTIS studies in San Diego, CA. She holds a BA in neurobiology and a minor in psychology from Harvard College. In addition to her work with OTIS, Nadia has worked for the Alcohol and Drug Abuse Treatment Program at McLean Hospital as well as served as a teacher’s assistant at a school for children with disabilities in Lima, Peru.

OTIS is a North American non-profit dedicated to providing accurate evidence-based information about exposures during pregnancy and lactation. Questions or concerns about alcohol during pregnancy or breastfeeding can be directed to OTIS counselors at (866) 626-OTIS (6847) or online at OTISPregnancy.org.

Monday, January 24, 2011

NON-PROFIT LAUNCHES 'CHAT COUNSELING' FOR PREGNANT WOMEN IN HONOR OF BIRTH DEFECTS PREVENTION MONTH

Beginning January 19th, a non-profit that's traditionally been a telephone hotline-only counseling service for pregnant and breastfeeding women seeking information about medications and other exposures will expand to offer counseling in both English and Spanish through private instant messaging chat on its website, www.CTISPregnancy.org. The California Teratogen Information Service (CTIS) Pregnancy Health Information Line, which is housed at the University of California, San Diego, has been planning the addition of the web chat counseling service for the past 6 months as well as an entirely new, interactive website. Those behind the project hope it will propel the service into the 21st century-way of communicating with moms all over the world.

"We are proud and very excited to be able to use this technology as an option for women who need our services, and look forward to demonstrating how valuable this is," said Dr. Christina Chambers, associate professor of pediatrics at UCSD and program director of CTIS Pregnancy Health Information Line. "One of our goals at CTIS is to build on advances in technology to bring our free services to more women of all different backgrounds who have questions about the safety of exposures in pregnancy and while breastfeeding. This will help us achieve that goal," she added.

Dr. Chambers explained the new chat service launch was chosen to coincide with National Birth Defects Prevention Month, which is honored every year during the month of January. Nationally, some 160,000 babies are still being affected by birth defects each year. Approximately 3% of the babies born each year in California are born with birth defects.
The chat service will be monitored by several highly trained, bilingual (English/Spanish) CTIS counselors who specialize in answering questions regarding medications, environmental, chemical and illicit substances, as well as other exposures, during pregnancy and breastfeeding. Some of the most common questions pregnant women ask CTIS counselors include:

· "Can I color my hair during pregnancy?"
* "I have allergies, what can I take?"
* "Can I have a glass of wine with dinner?"
* "I'm trying to get pregnant, should I get a flu shot"
* "Do I have to quit taking my antidepressant now that I'm pregnant?"

Women will be able to log on and chat with a counselor directly and privately. The counselor instant messaging service will be the first of its kind in the nation for pregnant and/or breastfeeding women. "This will be for women who feel like they don't have time to call us on our traditional hotline and prefer to use their computer or laptop," said Sonia Alvarado, a CTIS Pregnancy Health Information Line supervising counselor. "This option will also be ideal for women who are uncomfortable talking to someone on the phone, although our services are provided confidentially and can be provided anonymously, whether by phone or chat," she explained.

The new chat feature will be a major component in the non-profit's overhaul of its website. While a strong portion of the new CTISPregnancy.org continues to be the library of evidence-based fact sheets geared for moms and healthcare professionals, it also features blogs, news articles, improved forums, and a chance for women to build profiles and exchange information among each other, as well as with experts.

"We're aiming to make the website as interactive as possible so it's a gathering place for moms and healthcare providers alike," said Alvarado. "The quality of the information is evidence-based regardless of the method we use to communicate it, so women and providers can be sure that however they reach out to us, professionalism is not compromised," she added.

All opinions expressed in this review are my own and not influenced in any way by the company. Any product claim, statistic, quote or other representation about a product or service should be verified with the manufacturer or provider. Please refer to this site's Disclaimer for more information. I have been compensated or given a product free of charge, but that does not impact my views or opinions.

Saturday, January 15, 2011

Guest Post - The Bad Daddy Factor

The Bad Daddy Factor

Drinking, smoking, taking prescription meds or failing to eat a balanced diet can influence the health of men’s future children.

By Emily Anthes

The fathers weren’t supposed to matter. But in the mid-1960s, pharmacologist Gladys Friedler was making all sorts of strange findings. She discovered that when she gave morphine to female rats, it altered the development of their future offspring — rat pups that hadn’t even been conceived yet. What’s more, even these rats’ grandchildren seemed to have problems. In an effort to understand the unexpected result, she made a fateful decision: She would see what happened when she put male rodents on the opiate. So she shot up the rat daddies with morphine, waited a few days, and then mated them with healthy, drug-free females. Their pups, to Friedler’s utter shock, were profoundly abnormal. They were underweight and chronic late bloomers, missing all their developmental landmarks. “It made no sense,” she recalls today. “I didn’t understand it.”

For the next several decades, Friedler tried to understand this finding, ultimately assembling a strong case that morphine, alcohol and other substances could prompt male rodents to father defective offspring. There was only one problem: No one believed her. Colleagues questioned her results — her former adviser urged her to abandon the research — and she struggled to find funding and get her results published. “It didn’t occur to me that you’re not supposed to look at fathers’ roles in birth defects,” Friedler says. “I initially was not aware of the resistance. I was one of the people who was actually naïve enough to work in this field.”
Over the last half-century, as scientists learned more and more about how women could safeguard their developing fetuses — skip the vodka, take your folate — few researchers even considered the possibility that men played a role in prenatal health. It would turn out to be a scientific oversight of significant proportions. A critical mass of research now demonstrates that environmental exposures — from paints to pesticides — can cause men to father children with all sorts of abnormalities. Drinking booze, smoking cigarettes, taking prescription medications and even just not eating a balanced diet can influence the health of men’s future kids. In the several decades since Friedler started her work, the idea that chemicals in a man’s environment can influence the health of his future children has, she says, “moved from lunatic fringe to cutting edge.”
So why don’t we ever hear about it?

As an andrologist, Bernard Robaire has spent his career studying the functions and dysfunctions of the male reproductive system. In the early 1980s, he was giving grand rounds at the McGill University Health Center in Montreal when an oncologist approached him with a question. The oncologist had been treating men with testicular cancer; chemotherapy and radiation were generally expected to render the patients infertile. But lo and behold, tests were showing that, even after the cancer had been licked, some of the men still had viable sperm. The patients had concerns, however: Were the sperm defective? Was it safe for them to have kids? The oncologist, surprised that reproduction was even an option for his patients, had no idea. He put the question to Robaire.

Robaire was equally stumped. He combed through the scientific literature but couldn’t find a clear answer. So he decided to research the question himself. He paired up with a specialist on birth defects, and together they put together an application for a grant to study whether cancer drugs might damage sperm in ways that put men’s future children at risk. They submitted their application to the Medical Research Council, Canada’s equivalent of the National Institutes of Health. “And I had the absolute worst ranking on a grant I’ve ever had in my life,” Robaire recalls today. The scientists reviewing the application rejected it outright. “This makes no sense,” they had written. “How can you expect drugs given to the male to affect the progeny?”
It wasn’t an unreasonable question. There was no obvious physiological mechanism that could explain the connection. It’s the woman who makes her body home to a developing fetus, and damaged sperm were widely thought to be too weak to successfully fertilize an egg. The conventional wisdom, among oncologists, was that anti-cancer drugs would kill sperm, but after stopping treatment, sperm production would begin again — and the germ cells would be normal.

But that’s not what Robaire found. In his early rodent studies, he discovered that chemotherapy agents could degrade the quality of sperm. These sperm were still capable of fertilizing eggs, but the embryos would often spontaneously abort themselves. Among those that actually survived to term, the rodent pups had abnormally slow development. Since then, Robaire has continued to study the effects of chemotherapy drugs on sperm in rodents and humans; some of his most recent work reveals that some men continue to manufacture damaged sperm — with abnormal numbers of chromosomes and breaks in DNA — for as long as two years after their last dose of chemo. “The chemo causes really dramatic damage,” Robaire says.

While Robaire was slogging away, other scientists were quietly accumulating similar evidence. Some of the early work showed that women had more miscarriages when their male partners worked in manufacturing jobs where they were exposed to heavy metals, such as lead and mercury. Men exposed to pesticides were more likely to have children who developed leukemia. (For years, studies have linked Agent Orange, an herbicide used during the Vietnam War, to birth defects in the offspring of veterans, but a causal link has not been definitively established.) Other research suggested that men who worked with solvents, cleaning solutions, dyes and textiles, paints and other chemicals were all more likely to father kids with birth defects or childhood cancers.

Scientists also showed that it didn’t require industrial-strength chemicals to wreak havoc on men’s sperm. Smokers seemed to produce sperm with the wrong number of chromosomes, a DNA error that could lead to miscarriages or Down syndrome. (A stunning 2008 paper revealed that men with deficiencies in folate, that superstar maternal vitamin, had the same problem.) Paternal smoking has also been linked to childhood cancer, and even alcohol and caffeine can cause sperm abnormalities that derail child development.
We now know that what started as an inconceivable mystery — how could men’s environments and lifestyles possibly affect the children they would later father? — has not just one but several answers. Certain substances interfere with the earliest phase of sperm production in the testes, prompting errors in cell division that lead to genetic mutations in immature sperm cells. Chemicals can also cause what are known as epigenetic mutations, which don’t change the DNA sequence itself but alter how the body reads these genetic instructions. Essentially, an epigenetic change involves turning certain genes on or off, telling the body to pay more or less attention to the code they contain. (If genetic changes are akin to changing the lyrics of a song, epigenetic changes are like fiddling with the volume.)

Drugs can also interfere with sperm transport. A 2009 study revealed that a standard dose of paroxetine — the active drug in the antidepressant marketed as Paxil — causes a fivefold increase in the number of men who show evidence of “sperm fragmentation,” which can increase the chances of miscarriage. Researchers have known that certain antidepressants can influence ejaculatory response; it turns out that they seem to slow the transportation of sperm through the male reproductive system, causing the cells to age prematurely. “Sperm are being damaged because they’re not traveling properly through the body,” says Peter Schlegel, who led the study and is a urologist at New York’s Weill Cornell Medical College.

And these findings are just the beginning. Consider, for instance, that there are some 84,000 chemicals used in American workplaces, says Barbara Grajewski, a senior epidemiologist at the National Institute of Occupational Safety and Health. Only 4,000 of these have even been evaluated for reproductive effects in men or women, and males are particularly understudied. “There’s a whole range of effects in men that really are not being given attention or are well understood,” Grajewski says. “The whole area of men’s reproductive health is way behind women’s health.”

The implications of this research deficit are huge. Some 60 percent of all birth defects today are of unknown origin; tracing even a small fraction of these back to men’s environmental exposures would constitute a major public health advance.

Despite the accumulating findings, the idea that fathers can somehow contribute to birth defects has gained little traction in the public sphere. Cigarette packs have no warnings about the association between male smokers and birth defects. A woman who drinks while she’s pregnant can be prosecuted, but most men have no idea that drinking in the months before conception is risky.

“Why would we not look at the paternal side of the equation? To me that’s really a social and political puzzle,” says Cynthia R. Daniels, a political scientist at Rutgers who studies gender and reproductive politics. “We seem to politically be in a place where we overprotect and over-warn women, but where men and fathers remain almost completely invisible. You’re not likely anytime soon to see signs in bars that say, ‘Men who drink should not reproduce.’”

We still assume that men are secondary partners in reproduction, that their biological contribution to a child is fleeting and ultimately less important than women’s, Daniels says. What’s more, both men and women can find the research threatening. After Friedler organized a scientific symposium on the paternal-fetal connection, she found herself in the elevator with two male colleagues. They turned to her and said, “Why are you picking on men?” On the other hand, when Friedler later had a fellowship at an institute for female scholars, some of the women there challenged her, demanding to know why she was spending so much time researching men. She couldn’t win.

Even when the science is unambiguous, policy seems to lag. For decades, only women were banned from the lead trade, though the evidence suggested the metal could cause stillbirths and fetal problems regardless of which parent had been exposed. Today, federal occupational and health standards protect men from lead, but there are lots of regulations missing for other dangerous compounds.

Consider the well-documented hazard presented by anesthetic gases. The female partners of men who work as dentists, operating room technicians or anesthesiologists are more likely to experience miscarriages. On its website, the Occupational Safety and Health Administration has a lengthy document devoted to the hazards presented by anesthetic gases and how companies can protect their workers. But, in a prominent message at the top of the page, the agency comes straight out and says, “These guidelines are not a new standard or regulation, and they create no new legal obligations. The guidelines are advisory in nature. …”

By law, employers are required to provide what are known as “material safety data sheets” that outline the hazards involved in any chemicals their workers might encounter. A team of researchers discovered that these sheets were 18 times more likely to mention risks to female reproduction than male reproduction. To be fair, it’s harder to figure out what to do to protect men. With women, it’s obvious — keep them away from these chemicals during pregnancy. But what do you do with men who are constantly making sperm and could contribute to a pregnancy at any point?

Well, we should start with a thorough review of the evidence, Daniels says, and then establish a commission to develop appropriate policy. It’s also clear more research is needed — particularly research that asks the right questions. The FDA requires that new drugs be tested in rodent models for any potential effects on sperm production. But while these sorts of analyses will reveal whether a drug drastically affects sperm count, they may not show more subtle changes, says Schlegel, who conducted the study on antidepressants. Unless a chemical has “a huge and dramatic effect on sperm numbers, it often can be missed,” he says.

An obvious step toward better fetal health would have obstetricians and gynecologists consider fathers’ chemical exposures when trying to ensure healthy pregnancies and children. Ideally, men would be engaged even earlier, with the government issuing guidelines for young men that deal with environmental toxins and lifestyle choices that might jeopardize the health of future children. The time may be right for more engagement; many occupational health and safety guidelines, for men and women, were loosened by the Bush administration. “I think there’s a great opportunity now to rebuild standards to include risks to male reproductive health,” Daniels says.

There’s a generational opening, too, she says. In recent years, she’s noticed a change in the reaction male college students have to learning about the risks they face. “I’ve found, especially among young men, a sense of outrage and alarm,” Daniels reports. “They say, ‘How could this be? How could it be that no one has ever suggested to me that alcohol might have an impact on my ability to have healthy children?’ They’re angry that they don’t know about this.”

All opinions expressed in this review are my own and not influenced in any way by the company. Any product claim, statistic, quote or other representation about a product or service should be verified with the manufacturer or provider. Please refer to this site's Disclaimer for more information. I have been compensated or given a product free of charge, but that does not impact my views or opinions.

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