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REACTION PAPER (RESEARCH/UPDATES ON CARE OF PREGNANT MOTHERS) Lorenzo Angelo G.

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http://www.telegraph.co.uk/health/healthnews/9593862/Eating-fish-in-pregnancy-may-protectchild-from-ADHD-research.html Eating fish in pregnancy may protect child from ADHD: research

High levels of mercury during pregnancy may increase the risk of children with ADHD, a study has found, while eating fish reduces chances of the disorder. Researchers found that women with the highest levels of mercury were between 40 per cent and 70 per cent more likely to have children showing symptoms of ADHD eight years later. The authors, from Boston University, in America, said that the primary source of mercury was from eating fish. However, children born to women who ate more than two portions of fish per week were 60 per cent less likely to have attention and hyperactivity symptoms. This showed the 'difficulties of balancing the benefits of fish intake with the detriments of lowlevel mercury exposure in developing dietary recommendations in pregnancy', the researchers said. It may be that women with the highest levels of mercury were consuming fish high in the heavy metal, such as swordfish, shark and marlin, where as most women ate fish with relatively low levels such as sardines and mackerel. Other experts suggested that the women may have been exposed to another source of mercury. Experts praised the research for being rigorous and said it added important information about mercury in the environment. It is the first time that eating fish in pregnancy has been linked to a lower risk of ADHD in children. It is thought up to 12 per cent of children could suffer from attention deficit hyperactivity disorder and links have already been made with women smoking and being exposed to lead during pregnancy.

The researchers took hair samples of 421 mothers around the time of giving birth, in New Bedford, Massachusetts, and asked them about their consumption of fish while pregnant. Then eight years later they assessed the children for signs of ADHD. They found that one microgram of mercury per gram of hair or more was associated with a rise in the likelihood of the child having ADHD symptoms. This was a level slightly lower than the current recommended safe limit, the team wrote in the journal Archives of Pediatrics and Adolescent Medicine. Jean Golding, Professor of Paediatric and Perinatal Epidemiology at University of Bristol, said: This is an important paper that should be considered carefully. "For me the most important take home message is that a mother eating more than 2 helpings of fish a week appears to reduce the risk of hyperactivity in her child by a considerable amount. "The other message is that high levels of mercury in the mother have some adverse consequences for the child's behaviour but this must imply that it is not the mercury from seafood that is the culprit. This is a complex field, but important to untangle. Meanwhile the take home message for pregnant mothers is that eating fish is good for the future behaviour of her child. A spokesman for the Food Standards Agency, said: Were aware of the paper which needs to be considered alongside the existing literature on this issue. "The European Food Safety Authority is currently reviewing the risks to health from mercury and methylmercury and is expected to publish its preliminary opinion later this year. "The FSAs advice remains that risks from mercury in fish are mainly an issue for pregnant women and women who intend to become pregnant. "This is because of the possible risks to the developing nervous system of the unborn child. Our advice is that pregnant women and women intending to become pregnant shouldnt eat more than four medium-sized cans or two fresh tuna steaks per week. They should also avoid shark, marlin and swordfish.

REACTION Having been working in a Birthing-Home and handling pregnant mothers, I can safely say that reading the research update about the effects of mercury on pregnant women has been of great help for my plans of care in my patients. In the Health Teaching part, mothers usually ask stuff about Unsay likayan namo ug kaon pagmamabdos man gani mi?. The information provided in this update (or should I say article), helps greatly in my answers for the mother. The last part of the article was particularly important and straight to the point about what foods high in mercury that pregnant mothers should avoid to lessen risks of ADHD on their children. Since the article was very particular in the types of fish that have high mercury content, I guess all I need to do after that is to translate some of them into the vernacular term. The research update also opened up my eyes as a review towards my previous lessons in Maternal and Child Care Nursing. It seems that the nutritional aspect of the mother during her pregnancy months has some certain dos and donts. I know for particular that high-contents of Vitamin A could be bad for the baby, but high mercury content on fishes such as tuna streaks, sharks and marlins were a bit lost in my cognition. At least I now have something to add. It also made me realize the importance of being kept up to date about the nutritional values of other foods, (not just fish), and what their effects are on the pregnant mother. Fishes are not the only types of food out there high on mercury or any other harmful mineral there is to the pregnant mother. We, as nurses should be good nutritionists as well, and should be well aware of the nutritional facts of certain types of foods. The list of fishes towards lower chances of ADHD on children was also a bit particular regarding fishes about sardines and mackerel. It seems that to be effective in my health teaching on the nutritional facts of the pregnant mother, I need to specify the types of fishes that should be avoided and/or encouraged in pregnant mothers. This type of actions seems to root in deeper towards the actions of a nurse as a teacher towards his/her patients. Having to go that extra-mile, just to be more specific in the care of the pregnant woman is likely seen by me as an upgrade on a nurses actions. Perhaps the lower the chances of ADHD part didnt particularly catch my attention as I was browsing for research articles I should put in my reaction paper. But then again, there was also an added information about the mercury and its risks on pregnant mothers (which wasnt really included in the title of the research article). And having read through it, I was enlightened by the facts that there were still many things I needed to learn in the care of pregnant mothers. I wanted it to be something not just anyone else knew of, something I myself could contribute to the health institution besides my other professional colleagues. But I also wanted it to be simple and easy to understand. Let me just end my reaction with the statement that I am very much thankful to GOD that I was allowed to have a better look at the things involved in the care of pregnant mothers. I hope that I am able to apply these things that I have learned soon on my care. Theres just that issue about trying to translate those fishes in the vernacular. Lets seesalmon, mackerel, marlin, shark (pagi?), tuna etc.

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