Spring break is often associated with young college students flocking to the beaches to take a break from their studies. However, it is now embraced by a diverse crowd, including families with pregnant and breastfeeding women. Spring break typically takes place between March and April each year, leading to masses of people traveling by planes, trains, and automobiles. Fun times are possible for everyone, and we have guidance to increase the chances that your travels and experiences will be comfortable and safe for you and your baby.

Check-In with Your Doctor

For most pregnant women, traveling by airline, train, car, or bus is generally safe until close to their due date. Regardless of your trimester, a quick check-in with your doctor is essential to ensure you are cleared to travel.

• First Trimester: If you are experiencing pregnancy-related nausea, prepare ahead with needed medications and a plan to stay hydrated.
• Second Trimester: If you are healthy, this is a great time to travel.
• Third Trimester: You should be fine to travel, but keep in mind that if you go into early labor, you don’t want to be far from high-quality obstetrical care. Check for hospital locations at your destination.

Check for Infectious Disease Warnings

If you are traveling outside of the U.S., check for disease warnings or recommended vaccines for your destination on the CDC Travelers’ Health page. Additionally, if your destination has mosquitoes, use insect repellants to reduce the risk of exposure to infectious diseases.

Sun Exposure and Heat

Prolonged sun exposure can lead to overheating and dehydration, and in severe cases, heat stroke. High fever is a potential concern for pregnant individuals in any trimester. Prevention is key:

• Keep hydrated.
• Protect against direct sun for prolonged periods (sit under an umbrella or go indoors).
• Use sunscreen.
• Drink plenty of water.
• Avoid alcohol and limit caffeine, as they can increase dehydration.

Sunscreen

Everyone, including pregnant and breastfeeding women, should use sunscreen year-round. While there is some evidence that chemical sunscreens can penetrate the body in very small amounts, the American College of Obstetricians and Gynecologists (ACOG) recommends the use of effective sunscreen. For breastfeeding women, remember that sun exposure does not provide enough vitamin D for your baby; the American Academy of Pediatrics recommends 400 IU of vitamin D daily for breastfed babies.

Dietary Concerns

One of the highlights of travel is enjoying local food. For pregnant women, the risks from food-borne illnesses remain the same whether at home or on vacation. Avoid unpasteurized milk products, undercooked meats, and fish from risky categories.

Alcohol

Alcoholic beverages may be a destination goal for many, but pregnant and breastfeeding women are urged to continue following the warnings:

• Pregnant Women: It is crucial to avoid alcohol, as there is no known safe amount to drink. The risks to the developing baby are significant and can be devastating. Increasingly, restaurants are creating delicious and inviting mocktails (non-alcohol) and other beverages, offering an alternative that does not single out a person from the crowd.
• Breastfeeding Women: Limiting alcohol is beneficial as it can decrease the amount of breastmilk produced. It is recommended to breastfeed after two hours per drink to reduce the risk of exposure to the baby and developing brain.

Following these recommendations and reminders can help prevent exposures and experiences that could later cause grief and anxiety. Prepare well and enjoy your holiday! Ideally, a well-planned spring break will lift your spirits, provide a mental health break, allow you to enjoy new or favored foods, and create new and wonderful memories.

References and Additional Information:

CDC:

https://wwwnc.cdc.gov/travel/page/sun-exposure

https://www.cdc.gov/niosh/heat-stress/about/illnesses.html

https://wwwnc.cdc.gov/travel/page/sun-exposure

https://www.cdc.gov/breastfeeding-special-circumstances/hcp/diet-micronutrients/vitamin-d.html

https://wwwnc.cdc.gov/travel

ACOG

https://www.acog.org/womens-health/faqs/travel-during-pregnancy

A statement issued by the MotherToBaby Public Affairs Committee

Recently, the issue of lead in drinking water has become a topic of great concern nationally. While there is much news coverage of this issue and of the experts working toward ensuring that these communities have safe drinking water, there has been very little data reported or resources identified specifically for women who are pregnant or breastfeeding.

Here is what we do know: Lead can get into your body through the gut if you swallow or inhale tiny particles of paint chips, medications, soil, water, or other items that contain lead. Because lead is naturally found in many places in the environment, most people have small amounts of lead in their blood and do not usually experience problems. When a person is exposed to lead over a long period of time or at a high level, the body will store lead in the bones and teeth. Lead can stay in the bones and teeth for many years. During pregnancy and breastfeeding, lead can leave bone and move back into the bloodstream. A blood lead test can be done to see how much lead is present in the blood. Although most people will have some lead in their blood, levels greater than 10 micrograms per deciliter (μg/dl) indicate that there is some exposure at home or in the workplace that needs to be addressed. While there is no clear safe level of lead in the body, the goal is to have the lowest level possible. Women who had exposure to lead in the past should have levels checked before and during pregnancy. The Centers for Disease Control and Prevention recommend that public health actions (such as a search for the source of the lead) be initiated when blood lead levels are above 5 μg/dL. Lead can cross into the baby starting at about the 12th week of pregnancy. The amount of lead in the blood of the mother and baby are almost the same, as are the levels in breast milk. Lead may also be found in infant formulas prepared at home, particularly if the local water supply contains high levels of lead. A mother should not stop breastfeeding unless her blood lead levels are above 5 μg/dL. Be sure to talk to your health-care provider about all your choices for breastfeeding.

MotherToBaby Creates Zika Fact Sheets, Launches New Media (Scroll down for additional resources, video)

BRENTWOOD, TN – As information surrounding the Zika virus continues to evolve, MotherToBaby, a service of the international non-profit Organization of Teratology Information Specialists (OTIS), unveils new tools to bring the most accurate, evidence-based information to pregnant and breastfeeding women. Easy-to-understand fact sheets regarding Zika, as well as insect repellant use during pregnancy, are now available on www.MotherToBaby.org. Additionally, teratogen information specialists (experts trained in the field of birth defects) have begun taking questions about exposures from the general public and health care providers beyond its traditional telephone line – through private, live chat, text messaging and e-mail.

MotherToBaby, a suggested resource by many agencies including the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration’s (FDA) Office of Women’s Health, recognizes the urgent need for providing pregnant women, those planning a pregnancy, as well as breastfeeding moms with the most up-to-date information about the Zika virus and other potential causes of preventable birth defects. MotherToBaby is an official supporter of World Birth Defects Day, which is recognized by more than 50 international organizations each year on March 3rd.

“With the information and research about Zika changing on an almost daily basis, it can be confusing and, potentially, cause unnecessary anxiety for a pregnant woman,” said Stephen Braddock, MD, incoming president of MotherToBaby who serves as the Director of Medical Genetics at Saint Louis University. “That’s why MotherToBaby’s specifically-trained teratogen experts are here to sift through and interpret the evolving Zika-related research, putting it into perspective so a woman can make informed health decisions in collaboration with her health care provider,” added Dr. Braddock.

The challenges of staying up-to-date on the changing Zika information are lessened since OTIS, the professional society which provides the MotherToBaby service, includes members and researchers currently in the thick of the Zika outbreak. Lavinia Schuler-Faccini, PhD, lead author of one of the first ground-breaking studies to examine the association between the Zika virus in pregnant women and microcephaly (small head and brain) in their babies, is part of the MotherToBaby/OTIS network. Dr. Schuler-Faccini is President of the Brazilian Society of Medical Genetics (Sociedade Brasileira de Genetica Medica).

“Being based in Brazil, one of the countries where Zika has been declared an ‘outbreak,’ has allowed me to communicate the very latest research to my American colleagues,” said Dr. Schuler-Faccini. “For example, I was able to provide region-specific information where infected mosquitos are currently located to a worried American traveler who had contacted MotherToBaby,” she added.

More about Zika
On February 1, 2016 the World Health Organization (WHO) declared a global public health emergency over Zika virus, due to its suspected ability to cause microcephaly in unborn babies. Zika virus was first identified in Africa in 1947. In 2013, there were outbreaks in islands in the Pacific, and now outbreaks are being reported in many Central and South American countries. Isolated cases have also been reported in the U.S. in people who have recently traveled to South American countries, and in Puerto Rico, over the last few weeks. Additionally, just last week, federal health officials reported strong evidence that more than a dozen people have caught the virus through sexual transmission.

About MotherToBaby
MotherToBaby provides free, evidence-based, personalized risk assessments, education and counseling regarding the effects of exposures during pregnancy and while breastfeeding. Examples of exposures include the Zika virus, prescription and over-the-counter medications, alcohol, tobacco, illicit drugs, vaccines, beauty products, herbal supplements, chemicals and more. The public, as well as health care providers, can be connected with a MotherToBaby expert through its traditional toll-free phone line, 866-626-6847, via text message at 855-999-3525, or through live chat and email on www.MotherToBaby.org.

More than 100,000 women and their health care providers seek information about birth defects prevention from MotherToBaby every year. MotherToBaby has been able to launch new outreach efforts to reach underserved populations and launch new communication technologies through a cooperative agreement with the U.S. Health Resources and Services Administration.

About World Birth Defects Day
Along with more than 50 birth defects-related organizations around the world, MotherToBaby is helping to raise awareness of this critical global issue by participating in World Birth Defects Day, which is observed yearly on March 3. The commemorative day not only helps to raise awareness of the problem of birth defects, but also the importance of improving prevention strategies and research that will ultimately lead to fewer birth defects and a healthier society.

More Resources

• Health care providers interested in viewing the recording of a National Society for Genetic Counselors joint webinar on research surrounding Zika, click here.
• MotherToBaby’s Dee Quinn, MS, CGC provides the latest Zika research on “The Vibrant Gene” program:
  
• MotherToBaby’s Public Affairs Committee has also issued an official statement about the Zika virus, which can be read here.
• Our sister society, the Teratology Society, has recently published a blog looking closely at the science needed to learn more about Zika as well. Read its latest Birth Defects Insights blog here.

# # #
Media Contact: Nicole Chavez, 619-368-3259, nchavez@MotherToBaby.org. Interviews in Spanish can also be arranged.

Concerned about medication use during pregnancy? You’re not alone. 
In this episode of The MotherToBaby Podcast, host Chris Stallman, MS, CGC (genetic counselor, mom of four, teratogen information specialist) sits down with Dr. Judy C. Morrow of Harvard Medical School to break down how FDA REMS (Risk Evaluation and Mitigation Strategy) programs help reduce the risk of birth defects and protect pregnant patients.

Together, they discuss:
✔️ What REMS programs are and why they exist
✔️ How REMS programs support safe medication use
✔️ The role of manufacturers, prescribers, and pharmacists
✔️ Common medications with REMS programs (including isotretinoin/Accutane)
✔️ Pregnancy testing requirements & pharmacy restrictions
✔️ Why some drugs don’t have REMS (even if risks exist)
✔️ What patients should ask if they’re prescribed a REMS-covered medication 

Dr. Morrow shares how researchers use real-world data to identify medication-related adverse events in pregnancy, how REMS programs try to prevent exposed pregnancies, and why communication between patients, providers, and pharmacists is essential. 

If you’re pregnant, planning a pregnancy, breastfeeding, or support patients in these settings, this episode offers clear, practical insights to help guide informed decision-making.

🔎 Key topics: pregnancy, REMS, FDA, teratogens, isotretinoin, Accutane, birth defects, pharmacy programs, medication safety, pregnancy data, registries

🎧 Listen now to learn how REMS programs help protect pregnant women and their babies.

By Robert Felix, MotherToBaby Past President

I’ll never forget the panic in her voice. “The web said, ‘stay away from cats when you’re pregnant because your baby can be mentally retarded!” It was the first thing this soon-to-be mom could get out the second I picked up the phone. “It is true? I got rid of my cat immediately because I was so worried and I feel terrible about it,” she breathlessly explained. As a teratogen information specialist (someone trained to answer questions about exposures during pregnancy and breastfeeding), I knew her concern was shared by many. She was worried about something called “toxoplasmosis,” and after calling her doctor’s office, a nurse she spoke with didn’t say much or educate her about the infection. The nurse just reaffirmed that by getting rid of her cat, she had done “the right thing.” She was beyond frustrated. Not to mention, she missed her family’s feline!

After hearing her frustration, I asked her some basic questions relative to the cat.
• How long has she had the cat?
• Was the cat only indoor, outdoor, or both?
• Did she feed the cat any raw meat?
• Who changed the cat litter?
• Did she do any gardening?

Based on what she described, there was nothing to indicate that she was at an increased risk. “But I’m sure I’ve harmed my baby,” she said anxiously. So, I broke down the basics about toxoplasmosis. January is Birth Defects Prevention Month, what better time to revisit facts about infection?

Toxoplasmosis infections can occur by eating undercooked, infected meat, or handling soil or cat feces that contain the parasite. Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. Although most adults have no symptoms, swelling of the lymph nodes, fever, headache or muscle pain may be seen. In most cases, once a person gets toxoplasmosis, he/she cannot get it again. About 85% of pregnant women in the United States are at risk for toxoplasmosis infection.

Women who have recently gotten a cat or have outdoor cats, eat undercooked meat, garden, or who have had a recent mononucleosis-type illness are at increased risk. In Europe where far more undercooked meat is eaten, there is a higher prevalence of toxoplasmosis. Toxoplasma gondii can be found in raw or undercooked meat, raw eggs and unpasteurized milk. Cats that eat raw meat or rodents can become infected, and the parasite lives in the cat’s feces for two weeks. Toxoplasma gondii eggs can live in cat feces buried in soil up to 18 months.

To avoid infection:
• Cook meat until it is no longer pink and the juices run clear.
• Wear gloves while gardening.
• Wash all fruits and vegetables.
• Wash hands carefully after handling raw meat fruit, vegetables, and soil.
• As for furry friends… Pregnancy’s not the time to be on litter box duty, but is a good time to get your partner to do it for you!
• Also, don’t feed cats raw meat.

Taking simple precautions to avoid infection during pregnancy will keep you healthy and keep kitty from landing in a homeless shelter. In addition, it’s very important for women to get prenatal care, talk to their healthcare providers, eat healthy and take their prenatal vitamins (including folic acid) during pregnancy. Remember, #Prevent 2Protect.

Robert Felix is a teratogen information specialist at MotherToBaby California, a non-profit affiliate of the international Organization of Teratology Information Specialists (OTIS). Robert is the past president of MotherToBaby and is based at UC San Diego’s Center for Better Beginnings.

MotherToBaby is a service of OTIS, a suggested resource by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about toxoplasmosis, please visit our toxoplasmosis fact sheet, call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding.