How do public health experts detect emerging risks to pregnancies before they become widespread crises? In this episode of The MotherToBaby Podcast, host Chris Stallman, genetic counselor, mom of four, and teratogen information specialist, sits down with Dr. Amanda Elmore, Assistant Professor of Maternal & Child Health at the University of South Florida, to explore the powerful role of birth defect surveillance.

Dr. Elmore shares how her career in public health began during the Zika virus epidemic—reviewing medical records of exposed infants to help the CDC understand the real-world impact of in-utero exposure. She explains how surveillance systems track structural and functional birth anomalies, serve as early warning systems for new and emerging exposures, and shape everything from clinical care and referral services to national public health policy.

The conversation also dives into:

• How surveillance led to rapid public health responses during the Zika crisis
• What neonatal abstinence syndrome (NAS) reveals about opioid exposure during pregnancy
• The push for real-time data using electronic medical records and health information exchanges
• How machine learning and natural language processing may transform how cases are identified
• Why a life-course perspective matters for children born with birth defects
• How surveillance data supports funding, prevention efforts, and long-term family services

Dr. Elmore also shares her vision for the future: a more standardized, timely, and integrated national system that can better support prevention, research, and lifelong care for affected children and families.

This episode offers a behind-the-scenes look at how data quietly powers some of the most important protections for moms and babies.

💡 Have questions about exposures during pregnancy or breastfeeding?
You can contact MotherToBaby for free, confidential, evidence-based information:
📞 Call: 866-626-6847
📱 Text: 855-999-3525
💻 Visit: https://mothertobaby.org/

The weeks after delivery (often called the fourth trimester) can raise just as many questions as pregnancy itself. From pain management and supplements to beauty treatments and mental health medications, many parents are unsure how different exposures may affect breastfeeding.

In this episode of The MotherToBaby Podcast, host Chris Stallman, MS, CGC, is joined by Kirstie Perrotta, MPH, and Angela Messer, MS, Teratogen Information Specialists from MotherToBaby California, to discuss some of the most common postpartum questions they receive from parents and healthcare providers.

Together, they explain how exposure information is evaluated during breastfeeding and how factors like dose, timing, and route of exposure influence what may reach breast milk.

In This Episode, You’ll Learn:

• What the fourth trimester is and why exposure questions continue after delivery
• Common postpartum concerns, including pain medications, stool softeners, and laxatives
• How prescription pain medications, including opioids, are evaluated during breastfeeding
• Why route of exposure matters when considering topical products
• What to know about hair dye, Botox, manicures, facials, and salon treatments
• Why supplements, herbal products, and proprietary blends raise additional questions
• Which over-the-counter medications are often discussed in the breastfeeding period
• How medication guidance can differ between pregnancy and lactation
• Why addressing postpartum mental health conditions is essential
• Common breastfeeding myths and misconceptions
• Practical tips to reduce direct infant contact with topical products

Key Takeaways:

• Many medications have data available for use during breastfeeding
• Topical products are typically evaluated based on how they are applied and absorbed
• High-dose supplements and proprietary blends often lack breastfeeding data
• Postpartum pain, mental health, and chronic conditions deserve appropriate treatment
• Feeding decisions are personal, and there is no single approach that works for everyone

Resources Mentioned:

• MotherToBaby.org – evidence-based fact sheets, Baby Blogs, podcasts, and educational resources
• Over 300 fact sheets in English and Spanish on medications, exposures, and health conditions
• One-on-one support via phone, chat, text, or email
• MotherToBaby Pregnancy Studies – helping expand knowledge about medications, conditions, and exposures in pregnancy and lactation

Can some alcohol be ok during a woman’s pregnancy? Has it been researched well? What about opioid use in a birth mom if one is considering an adoption? Will the baby born have problems? Sarah Obican, MD, a maternal-fetal high-risk pregnancy subspecialist from MotherToBaby’s Florida affiliate at the University of South Florida in Tampa joins host Chris Stallman, a certified genetic counselor and mom. Together, they answer one caller’s questions about a possible adoption that may have been exposed to alcohol and opioids.