One of the most common Zika-related questions we get at MotherToBaby is, “What is the risk of Zika if I travel to Country X?” Or, a variation of the same: “We just got back from Country X. Do we really need to wait 3 months before we try to get pregnant?”

Back when the Zika epidemic was sweeping the western hemisphere, answering these travel-related questions was fairly straightforward. It was easier to know where there was a risk for Zika infection as governments and public health organizations around the world collaborated to identify and report cases. Since then, the number of reported Zika cases has fallen dramatically, but sporadic, low-level transmission continues to happen in some areas. Systems for detecting and reporting cases vary widely from country to country now, making it difficult to know the exact level of risk in any given area.

So, what’s a traveler to do?

First and foremost, all travelers should avoid mosquito bites to help prevent not only Zika, but also other diseases spread by mosquitoes. Preventing bites is important for everyone, especially those who are pregnant or planning a pregnancy and their partners. The best way to prevent mosquito bites while traveling is to use an Environmental Protection Agency (EPA)-registered insect repellent with one of the following active ingredients:

• DEET
• Picaridin (also known as KBR 3023 and icaridin)
• IR3535
• Oil of lemon eucalyptus (OLE)
• Para-menthane-diol (PMD)
• 2-undecanone

Other ways to help prevent bites during travel include wearing loose-fitting, long-sleeved shirts and pants, and sleeping in areas free of mosquitoes (such as accommodations with window and door screens or air conditioning, or sleeping under a mosquito net).  

Second, consider your destination.

Check for active Zika Travel Health Notices from the Centers for Disease Control and Prevention (CDC). Travel Health Notices indicate areas with known current transmission of Zika.

After checking for Zika Travel Health Notices, visit the CDC interactive Zika map. The map uses different shades of blue to broadly classify Zika risk in countries and territories around the world:

• Dark blue areas have reported Zika transmission in the past and there could be current sporadic or low-level transmission in some areas. As in any area, there could be delays in detecting and reporting any new outbreaks.
• Medium blue areas have the kind of mosquitoes that most commonly spread Zika, but they have not reported Zika cases in the past.
• Light blue areas are not known to have the kind of mosquitoes that most commonly spread Zika, and they have not reported Zika cases in the past.

Third, learn the recommendations.

Learn the recommendations related to pregnancy based on your destination (summarized below). Depending on where you’re thinking of going, CDC might advise that you avoid travel, take steps to prevent passing the virus to a partner through sex (sexual transmission), and/or delay pregnancy if you or your partner are planning to become pregnant. Preventing sexual transmission of Zika means using condoms or dental dams, not sharing sex toys, or not having sex for 2 months after travel (for biological females) or 3 months after travel (for biological males). If delaying pregnancy after travel, follow these same timeframes (2 months after travel for biological females and 3 months after travel for biological male partners).

Recommendations for areas with a Zika Travel Health Notice:

• If you are pregnant, avoid travel to these areas.
• If your partner is pregnant and you must travel to these areas, prevent mosquito bites and sexual transmission during and after travel according to the guidelines and timeframes above.
• If you or your partner are planning a pregnancy and you choose to travel to these areas, prevent mosquito bites, prevent sexual transmission, and delay pregnancy after travel according to the guidelines and timeframes above.

Recommendations for areas with current or past transmission (dark blue on the map):

• If you or your partner are pregnant and you choose to travel to these areas, be sure to prevent mosquito bites. If you are concerned about Zika, prevent sexual transmission during and after travel according to the guidelines and timeframes above.
• If you or your partner are planning a pregnancy, be sure to prevent mosquito bites. If you are concerned about Zika, prevent sexual transmission during and after travel and consider delaying pregnancy according to the guidelines and timeframes above.

For travel to all other areas with mosquitoes, take steps to prevent bites.

Lastly, talk to your healthcare provider.

Talk to your healthcare provider about any questions or concerns. They can help you consider the nature of your travel, your ability to prevent mosquito bites and sexual transmission, the risks associated with a potential Zika infection, your pregnancy plans, and any other factors specific to you, your partner, and your circumstances. 

MotherToBaby specialists are also available to talk with you about Zika or other travel-related exposures before or during pregnancy. Safe and happy travels!

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.

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 is joining the cause to increase awareness of the risks of drinking alcohol while pregnant as September’s Fetal Alcohol Spectrum Disorders (FASD) Awareness Month kicks off. It is estimated that 40,000 babies are born each year with FASDs, which describe a range of effects that can happen to a fetus when a woman drinks alcohol during her pregnancy.¹ The U.S. Surgeon General advises pregnant women and women who are considering becoming pregnant to abstain from alcohol consumption to eliminate FASD.²

When alcohol is consumed during pregnancy, the mother’s blood passes the alcohol to the baby through the placenta and the umbilical cord. There is no known safe amount or type of alcohol to drink during pregnancy. There is also no safe time to drink during pregnancy, including before a woman knows she is pregnant. FASDs can impact children’s physical, mental, behavioral, or cognitive development. It considered the most preventable form of mental retardation.

To prevent FASDs, a woman should not drink alcohol while she is pregnant or if she might be pregnant. “There is a huge number of women that don’t know that they’re pregnant so they are behaving in that period of time the same way they would behave if they weren’t pregnant,” said Kenneth Lyons Jones, MD, MotherToBaby president and one of two doctors who first identified the most severe form of FASD, Fetal Alcohol Syndrome (FAS), in 1973. “It’s a major problem when it comes to FASD, but it’s important to note that it’s never too late to stop drinking.” Because brain growth takes place throughout pregnancy, the sooner a woman stops drinking, her baby’s chances for a healthier outcome increases.

For a personalized risk assessment, as well as resources about the effects of alcohol during pregnancy, contact MotherToBaby toll-FREE from anywhere in North America at 866-626-6847. We also have a Fact Sheet on alcohol in pregnancy available in English and in Spanish. You’re also encouraged to read information from our partners at the Centers for Disease Control and Prevention.

¹May PA & Gossage JP. Estimating the prevalence of fetal alcohol syndrome: A summary. Alcohol Research & Health 2001;25(3):159–167.

²US Department of Health and Human Services. US Surgeon General releases advisory on alcohol use in pregnancy. Washington, DC: US Department of Health and Human Services; 2005.