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Key facts

Congenital heart disease (CHD) are a group of different heart problems that are present at birth.

They can include problems with: the structure of the heart, the heart valves or the major blood vessels.

CHD can be caused by a mix of environmental and genetic factors.

Some cases of CHD can be seen with an ultrasound scan during pregnancy.

Your baby's treatment will depend on the type and severity of their heart problem.

What is congenital heart disease?

Congenital heart disease (CHD) is a term used to cover any problems with the heart that are present at birth. CHD is the most common group of congenital disorder s.

CHD can include problems with the:

heart itself

heart valves

major blood vessels leading to or from the heart

Congenital heart disease can change the flow of blood and the way your heart works.

It's possible to have more than one problem in the same heart. Heart problems can occur together with other health problems.

CHD can range from simple to complex.

CHD is also sometimes called:

childhood heart disease

congenital heart conditions

congenital heart defects

congenital cardiac defects

Globally, about 9 in every 1,000 babies are born with CHD.

What are the main types of congenital heart disease?

There are many types of congenital heart disease. The main ones are listed below:

Aortic coarctation - narrowing of the aorta.

Aortic stenosis - a problem with the aortic valve where it is blocked or narrowed, which means blood flow out of the heart is reduced.

Atrial septal defect (hole in the heart) - a hole in the wall between the right and left atria.

Hypoplastic left heart syndrome - the left ventricle is too small to work properly.

Patent ductus arteriosus - the connection between the aorta and pulmonary artery doesn't close after birth.

Pulmonary atresia - there is no pulmonary valve and no blood flow to the pulmonary artery.

Transposition of great vessels - the aorta and pulmonary artery are in the wrong positions.

Ventricular septal defect (hole in the heart) - a hole in the wall between the right and left ventricles.

The Tetralogy of Fallot is a rare condition where there are four different heart problems at once:

ventricular septal defect

pulmonary valve stenosis - a narrowing of the pulmonary valve

an enlarged aorta

right ventricular hypertrophy - thickening of the muscle wall

A hole in the heart (atrial or ventricular septal defect).

What are the symptoms of congenital heart disease?

Your doctor may suspect CHD in your baby if they:

have blue lips, fingers or toes (cyanosis)

are breathless or having trouble breathing

had a low birth weight

have difficulty feeding or gaining weight

their legs, tummy or around the eyes is swollen

have a heart murmur that the doctor can hear

In older children, the symptoms of congenital heart disease include:

being very tired

shortness of breath during exercise

fainting during exercise

swelling in the hands, ankles or feet

Sometimes congenital heart disease does not cause any symptoms until your child is a teenager or adult.

What causes congenital heart disease?

CHD is caused by a mix of environmental and genetic factors. Only 1 in 3 babies born with CHD have a known change to their genes or chromosomes.

Down syndrome is an example of a genetic syndrome associated with heart problems.

Any family history of congenital heart disease can mean it's more likely to happen with your baby too.

If the pregnant mother had certain problems during pregnancy it can increase the chance of CHD:

Check with your doctor or pharmacist before you take any over-the-counter or prescription medicines. Make sure you tell your health provider that you're pregnant when seeking advice. It's important to take care with medicines during pregnancy.

How is congenital heart disease diagnosed during pregnancy?

Some cases of congenital heart disease can be found during pregnancy. During your second-trimester ultrasound, your doctor will look for signs of heart problems.

If they suspect CHD, your doctor will arrange a foetal echocardiogram (an ultrasound of your baby's heart). This will help diagnose the exact problem before your baby is born.

A foetal echocardiogram may also be organised if you have a family history of CHD.

How is congenital heart disease diagnosed after birth?

Most cases of CHD are found soon after birth.

If you doctor suspects your baby has CHD they may organise tests, such as:

cardiac catheterisation - measures blood pressure and flow

a chest x-ray

an echocardiogram - an ultrasound of the heart

an ECG - shows how the heart's electrical system is working

an MRI scan - to take pictures of the heart and measure heart function

pulse oximetry - measures oxygen levels in the blood

For babies with mild forms of CHD, they may only be diagnosed when they're older.

How is congenital heart disease treated?

Treatment which can reduce the impact of CHD is available for most heart problems.

Managing congenital heart disease during pregnancy?

If your baby is diagnosed with congenital heart disease during pregnancy, your doctor may refer you to a foetal cardiologist (specialist).

Finding your baby's heart problem early allows your health team to prepare for your baby's birth. They can also plan for your baby's treatment.

Managing congenital heart disease after your baby is born?

Management of congenital heart disease after birth depends on the type and severity of the problem.

After your baby is born their health will be closely monitored. They may be connected to a pulse oximetry device, which measures blood oxygen levels.

Your baby may need medicines either straight after birth, or when they're older.

Some babies may need cardiac catheterisation. This is where a thin flexible tube is put into an artery in the leg. It's then slowly moved towards the heart.

This procedure can be used to help diagnose CHD. It can also be used to treat certain heart conditions by:

stretching a narrow vessel or valve

implanting a stent

closing a hole

If your baby has a complex heart condition, they may need surgery. This often occurs before their first birthday.

Avoiding the complications of congenital heart disease

Children with CHD have an increased chance of having other problems:

developmental problems - they may take longer to start walking or talking

learning difficulties - such as memory, concentration and language problems

pulmonary hypertension - high blood pressure in the arteries connecting the heart and lungs

respiratory tract infections (chest infection) - infections of the lungs and airways

Babies with complex CHD have an increased chance of problems with their brain development.

Children with CHD also have an increased chance of having problems with their heart and blood, such as:

Can congenital heart disease be prevented?

There is no evidence for things you can do to prevent congenital heart disease.

However, there are some things that you can do to reduce your chance of having a baby with congenital anomalies or birth differences. Before pregnancy:

take folic acid to help prevent neural tube defects

include an iodine supplement to support thyroid function

avoid alcohol and smoking or vaping

have a healthy diet

maintain a healthy weight

if you have diabetes, make sure that it's well managed

get vaccinated against rubella and chickenpox if you're not immune

If you are planning a pregnancy and are already taking medicines for existing conditions, discuss this with your doctor.

Find out more about planning for your pregnancy.

During pregnancy continue to:

take folic acid and iodine

avoid alcohol and smoking or vaping

have a healthy diet

maintain a healthy weight

get vaccinated against the flu

if you have diabetes, make sure that it's well managed

You can also:

limit your exposure to environmental hazards

check that any medicines you take are safe in pregnancy

don't travel to areas with outbreaks of infections that can cause congenital disorders

Resources and support

Your doctor or midwife will give you information about CHD. They will also explain what treatment your baby will need.

To read more about your child's condition, visit the Royal Children's Hospital Melbourne website. They have information on specific heart conditions, and how each condition is managed.

HeartKids provides support for people with congenital heart disease. You can call their helpline on 1800 432 785.

Find out more about other congenital disorders.

Last reviewed: February 2025

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Congenital heart differences or defects (CHD) are a group of different heart problems that are present at birth. Learn more about the types of CHD.

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USMLE® Step 1: Neuroscience: Development of CNS Animation

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Neural Tube Defect - Overview (signs and symptoms, pathophysiology, treatment)

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During pregnancy, the energy of kilojoules you need doesn't increase too much, but your requirements for many nutrients do change. This is an important time for you to make good food choices. In this presentation we take a look at what you should aim to eat from the five food groups each day to help you have the healthiest pregnancy possible.

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If you are more of a visual learner, these short, practical and informative videos about how to meet your nutrition needs in pregnancy are for you: You may have been wondering if there is any special diet to follow that may help you fall pregnant.

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What is vision impairment?

Vision impairment means lots of different things. It can range from no vision - blindness - or very low vision to not being able to see particular colours.

Vision impairment can happen at any age. Most vision conditions in children will stay the same throughout their lives. Some conditions might result in vision problems for only a short time, but others might get worse over time, resulting in much poorer vision or blindness as the child gets older.

What is low vision?
Low vision is when your child can't see all the things he should be able to see for his age. Your child might have low-to-no vision, blurred vision or loss of side vision. Or his eyes might not be able to see some colours - this is called colour blindness.

What is blindness?
A child is considered legally blind if she can't see at 6 m what a child with normal vision can see at 60 m, or if her field of vision is less than 20° in diameter (a person with normal vision can see 180°).

Causes of vision impairment

Babies might have vision impairment at birth. It can also happen later as a result of disease, injury or a medical condition.

The most common causes of vision impairment are:

neurological conditions that affect the parts of the brain that control sight (cortical vision impairment)

genetic conditions like albinismand retinitis pigmentosa

illnesses that happen to some very premature babies or babies that have particular problems during their birth

conditions like paediatric glaucoma or cataracts and cancers like retinoblastoma

infections with particular viruses during pregnancy - for example, rubella, cytomegalovirus, sexually transmitted infection, toxoplasmosis and so on

structural problems with the eyes that limit vision - for example, microphthalmia or anophthalmia

damage or injury to the eye, to the pathways connecting the eye to the brain, or to the visual centre of the brain.

Early signs and symptoms of vision impairment

Children who have vision impairment might have normal-looking eyes. Often, it will be something about a child's behaviour or the way he uses his eyes that makes you think there might be a problem with the way he sees.

Most babies start to focus on faces and objects by 4-5 weeks of age. By about 6-8 weeks, most babies will start smiling at the familiar faces and things they see. But if a baby has a vision impairment, you might notice she has trouble doing this.

Other signs that a baby might have a problem with his vision are if his:

eyes move quickly from side to side (nystagmus), jerk or wander randomly

eyes don't follow your face or an object, or he doesn't seem to make eye contact with family and friends

eyes don't react to bright light being turned on in the room

pupils seem white or cloudy rather than black

eyes don't appear straight but turn towards the nose or drift outwards.

An older child might:

hold things up close to her face

say she is tired or rub her eyes a lot

turn or tilt her head or cover one eye when looking at things up close

get tired after looking at things up close - for example, reading, drawing or playing handheld games

seem to see better during the day than at night

seem to have crossed or turned eyes or a squint (lazy eye)

seem clumsy - for example, she might knock things over or trip often.

Diagnosis of vision impairment

Getting a diagnosis is the first step to the right intervention.

If you're worried about your child's vision, you might want to see a GP or paediatrician to get your child's eyes checked. Your GP or paediatrician can send you to a children's eye specialist - a paediatric ophthalmologist. The ophthalmologist will examine your child and do tests to work out what the problem is.

If your GP or paediatrician doesn't think there's a problem but you're still worried, it's OK to get a second opinion.

Effects of blindness

Blindness can affect lots of areas of your child's development, some of which you might not expect.

Your child might have extra challenges with:

communicating - for example, your child might not see someone waving and smiling at him or not be able to make eye contact

playing and socialising with others - for example, your child might be clumsy, not be able to read non-verbal cues and gestures, get lost in a crowd or have trouble making friends

talking - for example, your baby might not point to objects, so that the people around him won't name these objects, and he'll miss the chance to learn the names

telling the difference between day and night

sitting, crawling and walking - for example, your child might not try to move because he can't see the interesting objects you put out for him

learning to read and write

playing - for example, your child might be afraid to touch certain textures or explore areas he can't see.

Severe vision loss or blindness can mean that some parts of your child's development and learning will be slower than for other children. For example, you might notice that your child is slower in learning to roll over, crawl, walk, speak and be social with others. Your child's ability to do all these things should come with time.

Early intervention services for children with vision impairment

Once your child has a diagnosis of vision impairment, you can get access to early intervention services and specialists.

Children with all kinds of vision loss can get a lot out of early intervention. Early intervention services can do further assessments and help your child learn new skills. And they can help you learn how to do things to support your child's development in your everyday play and communication together. Children learn the most from the people who care for them and with whom they spend most of their time.

There are several specialists who are trained to work specifically with children who have severe vision loss. These might include orthoptists, physiotherapists, orientation and mobility specialists, occupational therapists and special education teachers.

Engaging your child in exploring her environment using whatever vision she has - and linking the vision she has with all of her other senses - will help spark her curiosity about the world around her.

Financial support for children with vision impairment

If your child has a confirmed diagnosis of vision impairment, he might be able to get support under the National Disability Insurance Scheme (NDIS). The NDIS helps you get services and support in your community, and gives you funding for things like early intervention therapies or one-off items like guide dogs.

Looking after yourself and your family

Although it's easy to get caught up in looking after your child, it's important to look after your own wellbeing too. If you're physically and mentally well, you'll be better able to care for your child.

Some agencies offer child and family counselling to help you work through the challenges and celebrate the triumphs that you'll encounter in your life as the parent of a child with vision impairment.

Talking to other parents can be a great way to get support. You can connect with other parents in similar situations by joining a face-to-face or online support group.

If you have other children, these siblings of children with disability need to feel that they're just as important to you - that you care about them and what they're going through. It's important to talk with them, spend time with them, and find the right support for them too.

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Vision impairment means lots of different things. It can range from no vision - blindness - or very low vision to not being able to see particular colours. Vision impairment can happen at any age. Most vision conditions in children will stay the same throughout their lives.

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Learning that your child has cerebral palsy can be devastating news. Yet, by educating yourself, including learning about treatment options and how to help manage the disorder, your child can still live a productive life.

What is Cerebral Palsy?

Cerebral palsy (CP) is a neurological disorder that affects a child's movement, motor skills, and muscle tone. In most cases, cerebral palsy is caused by brain damage that develops while the baby is still in utero or during or shortly after birth.

Cerebral palsy is a congenital disorder, affecting around 500,000 in the U.S. There is currently no cure for cerebral, but there are numerous treatment options that can help babies and children live quality lives that turn into successful adult lives.

Unfortunately, cerebral palsy can lead a number of other medical conditions, depending on the severity of the disorder. Other medical issues associated with cerebral palsy include:

Speech problems

Learning disabilities

Problems with hearing and vision

Types of Cerebral Palsy

The severity and type of cerebral palsy a child has can vary.Some children may just have some muscle spasms, while others are unable to walk. Some may have seizures and some may have cognitive disabilities. The condition can affect any muscles in the body, so possible complications include trouble with balance, eye problems, bladder or bowel problems, poor range of motion in joints, and difficulty swallowing. Cerebral palsy does not get worse with time.

There are different types of cerebral palsy that affects babies and children in different ways:

Spastic Cerebral Palsy

Spastic cerebral palsy is the most common type of the disorder, affecting around 76.9% of all people with CP. Spastic cerebral palsy differs from other types of CP due to it distinct symptoms and characteristics. Common symptoms and characteristics of spastic CP include:

Failure to reach milestones in walking, crawling, and sitting up

Abnormal movement

Movement inhibition

Stiff muscles

Muscles tend to become stiffer the more the child moves

Difficulties with controlling individual muscles

Difficulties moving from one position to another

Spastic quadriplegia is the most severe form of spastic CP. This type of cerebral palsy can affect a child's entire body, placing them at risk of limb deformities. Many children with spastic quadriplegia will also experience chronic seizures, so it's important to work with a healthcare team to figure out the best treatment options.

Another form of spastic CP is spastic diplegia. It's not as severe as spastic quadriplegia, as children are still able to walk. However, they often walk on their toes and have issues with balance and coordination. Other symptoms of spastic diplegia include delayed milestones, fatigue, seizures, "flexed knees," and a crouched gait. Legs are often affected more than arms.

Dyskinetic Cerebral Palsy

Dyskinetic cerebral palsy (also known as dystonic and athetoid) is the 2nd most common form of cerebral palsy, although it only affects around 2.6% of all cases of the disorder. Symptoms of dyskinetic cerebral palsy include:

Repetitive, twisting motions (dystonia)

Slow, writhing movements (athetosis)

Unpredictable, irregular movements (chorea)

Awkward posture

Movements can range from slow to rapid and can be accompanied by pain

Ataxic Cerebral Palsy

Ataxic cerebral palsy is named after the word ataxia, meaning "without order." It's the least common type of cerebral palsy, marked by poor balance, incoordination, tremors, and shaky movements.

Mixed Cerebral Palsy

Mixed cerebral occurs when the child has two or more types of the aforementioned types of cerebral palsy. Spastic-dyskinetic cerebral is the most common type of mixed cerebral palsy. When children have mixed cerebral palsy, they may exhibit a combination of symptoms, matching each type of the disorder they have.

What If I Notice Symptoms of Cerebral Palsy in My Child?

If you see obvious symptoms of cerebral palsy, you should consult your child's pediatrician right away. Even if you notice things that might not be the more obvious signs of cerebral palsy (such as muscle spasms, stiff muscles, and abnormal movements), you should always take your concerns to your child's doctor. Early intervention is key when helping children with cerebral palsy.

Also keep in mind that there is no need to panic. In some cases, it will turn out that the child doesn't have CP. In other instances, parental instincts are spot-on, and treatment can begin shortly after.

What Causes Cerebral Palsy?

In some instances, the cause of cerebral palsy remains unknown. However, research indicates that the disorder can be caused during pregnancy when the baby's brain fails to develop correctly or gets damaged. Brain damage can occur from maternal illnesses and diseases, genetic factors, or using illegal drugs while pregnant Cerebral palsy can also happen during childbirth. Infants born too early are at risk of developing the disorder. Premature infants run the risk of oxygen loss and a host of other medical issues that can lead to brain damage, which may eventually lead to cerebral palsy.

Cerebral palsy doesn't always occur during pregnancy or childbirth. In some instance, children may have an accident during childhood that can lead to brain damage and cerebral palsy. Additionally, babies or toddlers may develop a severe medical condition, such as meningitis, that can lead to brain damage and cerebral palsy.

Another possible cause of cerebral palsy is brain damage caused by medical negligence. When the baby is deprived of oxygen during birth, the damage can be enough to cause cerebral palsy. Improper use of forceps and other tools during delivery can also cause damage.

A doctor may also be at fault for failing to do something, like delaying a Cesarean section or failing to perform one altogether, not properly monitoring the health of the fetus, or not detecting and treating infections. Many parents have started lawsuits against doctors and hospitals when negligence was suspected in a cerebral palsy case.

Is Cerebral Palsy a Disease?

No, cerebral palsy isn't a disease. As aforementioned, it's a neurological disorder which affects movement and muscle control. Cerebral refers to the brain and palsy refers to movement.

Will My Child Have an Intellectual Impairment?

There's a huge misconception that all children with cerebral palsy are intellectually impaired. Not only is this myth untrue, but many children with cerebral palsy have above average intelligence. There are doctors, attorneys, teachers, and more, who live with cerebral palsy yet carry out demanding careers. Remember, the part of the brain that's damaged is the part that controls movement only.

Some children, however, will develop some form of cognitive impairment, due to the injury that caused CP in the first place. The National Institute of Neurological Disorders and Stroke (NINDS) reports that around 2/3 of all people with cerebral palsy have some form of intellectual impairment. The degree of the impairment depends on individual circumstances. Healthcare professionals will be able to work with your child to determine what level, if any, of cognitive impairment exists.

How is Cerebral Palsy Diagnosed?

In many instances, cerebral palsy isn't diagnosed until the child reaches the age of walking and talking. If parents suspect a problem with lack of muscle control and coordination, they'll usually find out from the child's physician if he/she has cerebral palsy.

In other instances, especially if a baby is born prematurely or has a heightened risk of developing the disorder, there is a chance that the infant will get a diagnose in the first few months of life.

When diagnosing cerebral palsy, doctors look for poor coordination skills, spastic movements, uncontrolled muscle movements. Based upon a muscle movement test and the child's medical history and a physical exam, a doctor will be able to ascertain whether your child has cerebral palsy or not.

Physicians will also perform development screenings on the infant or child. A development screening test will allow doctors to see if the patient has motor movement delays or any other type of developmental delays.

It's important to remember that diagnosing cerebral palsy is not done in one day. It will take time to get a proper diagnosis, although premature infants may get a quicker diagnosis than a toddler.

Can Cerebral Palsy Be Prevented?

Most cases of cerebral palsy cannot be prevented because most causes of the disorder are still unknown. However, there are always steps you can take while pregnant to help lower your risk of having a baby with cerebral palsy.

If you're not pregnant yet, make sure you're eating healthy, wholesome foods and that any pre-existing medical problems are under control. If you're already pregnant, it's crucial to continue to eat healthy while taking prenatal vitamins and avoiding drinking alcohol and smoking.

Unfortunately, no one knows when an infant will suffer brain damage at the hands of a physician. As mentioned earlier, pulling too hard on an infant, especially while using birth-assisting tools (forceps) can result in severe injuries, including brain damage.

On the other hand, infants who are not pulled out in time during childbirth run the risk of being deprived of oxygen, so doctors must extremely careful not only when pulling the infant out, but ensuring the infant doesn't get hurt when a quick delivery is needed.

Sometimes an emergency C-section is needed if an infant is not progressing as he/she should during a normal delivery. If the C-section isn't ordered and carried out in time, the infant may suffer brain damage, which can lead to cerebral palsy.

If you already have an infant or toddler at home, be certain to "baby proof" your home. This includes making sure cleaning supplies and other toxic substances are out of reach.

What Are the Treatment Options for Cerebral Palsy?

Currently there's no cure for cerebral palsy, but a variety treatment options can provide help and improve the quality of life of babies and children.

Therapy is common for almost all children with cerebral palsy as it helps them with the crucial aspects of growth and development. Therapy is usually started shortly after a diagnosis and can include both physical and speech therapy. Therapies help patients learn techniques for movements, stretching, hearing, eating, drinking, learning, speech, hearing, and social development.
Medications
Generally, medications are used to help control spastic movements, seizures, and control pain. Your physician will go over what kind of medication your child will need, depending on his/her symptoms. The following medications may be prescribed to help with cerebral palsy symptoms include:

Baclofen

Diazepam

Anticonvulsants

Anticholinergics

Stool softeners/laxatives

Dantrolene (Dantrium)

Surgery
Surgery, in some cases, may be a treatment option. Surgery for cerebral palsy is usually to help children have better orthopedic functions. Common surgery for cerebral palsy patients include repairing hip dislocations, as well as scoliosis surgery. Surgery also may include nerve root repair, tight/stiff muscle repair, and surgery to reduce spasticity.

Leg braces, wheelchairs, communication boards, and other assistive devices may also be a part of the treatment care plan. In addition, your child may have numerous healthcare professionals assisting him/her, including physical therapists, physicians, counselors, social workers, nurses, special education teachers, and more.

Surgery in the upper extremities is also common, especially on the arms and shoulders.
Therapy
Therapy, provided in various forms, help people with cerebral palsy with physical, mental, social, and academic benefits. If it's started early enough after diagnosis, many forms of therapy for cerebral palsy can reduce impairment and the risks of developing other conditions associated with cerebral palsy.

Therapy is usually combined with other treatments, such as drug therapy, surgery, and assistive technology, which help benefit the child even further. When physicians determines the child's medical goals, they can then develop an individualized therapy plan.

Keep in mind that therapy can also be extremely beneficial to parents and caregivers. For example, nutritional therapy can help people understand specific dietary needs, while behavioral therapy can help teach parents the benefits of positive reinforcement.

Common types of therapy used to help children with cerebral palsy include:

Is Cerebral Palsy Fatal?

Prior to the mid 20th century, many children with cerebral palsy didn't live through adulthood, but that was before today's medical advancements. Cerebral palsy is not a fatal disorder, but it generally requires early intervention and good medical care, especially for children with severe forms of the disorder. Today, the odds of reaching adulthood are much more favorable for children with cerebral palsy.

It's important to note that some of the conditions of cerebral palsy can be life-threatening if not treated in time or correctly, such as breathing and swallowing difficulties (which can lead to pneumonia or malnutrition), chronic seizures, or life-threatening pressure sore infections.

What Are the Associated Conditions of Cerebral Palsy?

Associated conditions, also known as associated disorders, are medical conditions that co-exist with another medical condition. However, associated conditions shouldn't be confused with secondary conditions, which are caused directly by the primary condition (cerebral palsy).

For instance, a secondary condition of cerebral palsy could be the inability chew and swallow directly, skin problems due to drooling, or bowel issues. In other words, secondary conditions happen because of cerebral palsy itself, while associated conditions are different medical issues altogether that some children with cerebral palsy will develop.

There are a number of cerebral palsy associated conditions. It doesn't mean that every child with cerebral palsy will develop these, but generally, kids with CP have at least one co-existing medical disorder. The most common associated conditions of cerebral palsy include:

Hearing and/or vision impairment

Seizures

Cognitive issues

ADHD

Behavioral, emotional issues

Autism

Sleepdisorders

What is Life Like for Someone with Cerebral Palsy?

The prognosis for cerebral palsy depends on each individual, but most people with the disorder have a typical life expectancy, no different from anyone else. Many children with cerebral palsy have average or even above average intelligence measures, although many may have some form of cognitive issues that will require additional educational assistance. Yet, most kids can go to school with their peers, but may need adaptive equipment for physical needs, to communicate, or for mobility.

Some children have "light" cerebral palsy, as mentioned earlier, and aside from muscle spasms and muscle tightness, they may be able to carry on as non-disabled child, with no associated disorders. Other cases of cerebral palsy, are of course, more severe, and a child with severe CP may have a number of associated conditions. The associated conditions are typically what cause many medical problems, which, in some cases, can affect lifespan, especially without early intervention.

What Do I Do If I Can't Afford My Child's Expenses?

Children with special needs often need additional medical care and other requirements that can become quite costly. According to the Morbidity and Mortality Weekly Report (MMWR), the average cost to raise a child with cerebral palsy, including direct and indirect medical costs, is around $921,000 (this doesn't include out-of-pocket expenses, lost wages, or emergency room visits). If you find yourself struggling to keep up with expenses, there are several options that you and/or your child may qualify for.

For example, kids with motor dysfunctions qualify for cash assistance from the government. This falls under section 111.000 of the Social Security Disability Evaluation. There is a process you need to follow to get your child qualified, including gathering pertinent medical information, labs and tests results, social security number, birth certificate, etc. Those approved for cash assistance from the Social Security Administration (SSA), generally qualify for full medical insurance at little to no charge.

Additionally, you may qualify for free or reduced child care for special needs children under the Americans With Disabilities Act (ADA) and educational assistance under the The Individuals with Disabilities Act of 2004.

Last but not least, if your child's cerebral palsy was caused due to negligent medical mistakes, you have the option to file for compensation against the responsible party. Negligent medical mistakes can happen in a variety of different ways.

How Do I Know if My Child's Disorder Was Caused by Medical Errors?

As previously mentioned, medical errors occur when a doctor or another healthcare professional make careless and negligent mistakes during the mother's pregnancy, or during or shortly after childbirth. The following are some of the common ways that medical errors occur:

A doctor failing to diagnose a maternal condition that could lead brain injuries (which can cause cerebral palsy)

A doctor, nurse, or healthcare professional failing to monitor, detect, and treat maternal or fetal distress

Improper use of birth-assisted tools

A doctor failing to schedule and carry out an emergency C-section

A doctor failing to detect and treat infant jaundice (which can lead to brain damage, and in turn, cerebral palsy)

Malpractice is a tricky area, however, because not only does there have to be enough proof in place to file a case, but there are also certain rules in place that must be met. For example, most states require that a patient/doctor relationship must have existed when the medical negligence took place. Additionally, you'll need to ensure that injuries did indeed come from the negligent mistakes of a healthcare provider (s). However, if the case is valid, a successful legal suit can help you take care of your child for life.

What is the United Cerebral Palsy?

The United Cerebral Palsy (UCP) is a non-profit organization dedicated to helping people with cerebral palsy. Assistance from UCP comes in many different ways from over 80 nationwide affiliates, and can include help with transportation, housing, recreational activities, traveling, health awareness, assistive technologies, and much more. According to the official UCP site,
"UCP educates, advocates and provides support services to ensure a life without limits for people with a spectrum of disabilities. UCP works to advance the independence, productivity and full citizenship of people with disabilities through an affiliate network that has helped millions."
Is There a Cure For Cerebral Palsy?

Currently, there is no cure for cerebral palsy. However, the disorder itself doesn't get worse as someone ages (although associated medical conditions of CP can sometimes increase in severity). That being said, scientists and researchers conduct ongoing studies in hopes of one day finding a cure.

Some of the current cerebral palsy research includes studies on stem cells, which has shown promise. In a study done by Dr. Evan Snyder, a neurologist at Harvard Medical School, mice injected with stem cells had damaged brain cells replaced with healthy ones. It's still unclear whether this method will work with children, but scientist continue to research to determine if there is a safe and proven way for damaged brain cells to repair themselves or replenish with new cells.

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Cerebral Palsy | Answers to Top Questions

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Learning that your child has cerebral palsy can be devastating news. Yet, by educating yourself, including learning about treatment options and how to help manage the disorder, your child can still live a productive life. Cerebral palsy (CP) is a neurological disorder that affects a child's movement, motor skills, and muscle tone.

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Centers for Disease Control and Prevention

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About 1 in every 4 babies born with a heart defect has a critical congenital heart defect (critical CHD, also known as critical congenital heart disease). Babies with a critical CHD need surgery or other procedures in the first year of life. Learn more about critical CHDs below.

What are Critical Congenital Heart Defects (Critical CHDs)?

In the United States, about 7,200 babies born every year have critical CHDs. Typically, these types of heart defects lead to low levels of oxygen in a newborn and may be identified using pulse oximetry screening at least 24 hours after birth. Some specific types of critical CHDs are listed in the box to the right. Babies with a critical CHD need surgery or other procedures in the first year of life. Other heart defects can be just as severe as critical CHDs and may also require treatment soon after birth.

Importance of Newborn Screening for Critical CHDs

Some CHDs may be diagnosed during pregnancy using a special type of ultrasound called a fetal echocardiogram, which creates pictures of the heart of the developing baby. However, some heart defects are not found during pregnancy. In these cases, heart defects may be detected at birth or as the child ages.

Some babies born with a critical CHD appear healthy at first, and they may be sent home before their heart defect is detected. These babies are at risk of having serious complications within the first few days or weeks of life, and often require emergency care. Newborn screening is a tool that can identify some of these babies so they can receive prompt care and treatment. Timely care may prevent disability or death early in life.

How Newborn Screening for Critical CHDs is Done

Newborn screening for critical CHDs involves a simple bedside test called pulse oximetry. This test estimates the amount of oxygen in a baby's blood. Low levels of oxygen in the blood can be a sign of a critical CHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby's skin. The test is painless and takes only a few minutes.

Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect a critical CHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination.

Timing of Critical CHD Screening

Screening is done when a baby is at least 24 hours of age, or as late as possible if the baby is to be discharged from the hospital before he or she is 24 hours of age.

Pulse Oximetry Screening Results

Pulse oximetry screening is most likely to detect seven of the critical CHDs. These seven defects are hypoplastic left heart syndrome, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Other heart defects can be just as severe as these seven and also require treatment soon after birth. However, pulse oximetry screening may not detect these heart defects as consistently as the seven listed above.

Pass

If the baby passes the screen (also called "negative" or "in-range" result), it means that the baby's test results did not show signs of a low level of oxygen in the blood. A baby that passes the screen is unlikely to have a critical CHD. However, not all babies with a critical CHD will have a low level of oxygen in the blood that is detected during newborn screening. Thus, it is possible for a baby who passes the screen to still have a critical CHD or other CHD.

Fail

If the baby fails the screen (also known as "positive" or "out-of-range" result), it means that the baby's test results showed low levels of oxygen in the blood, which could be a sign of a critical CHD. This does not always mean that the baby has a critical CHD but could mean that more testing is needed. There may be other causes, such as breathing problems, for low levels of oxygen in the blood. The baby's doctor might recommend that the baby get screened again or have more specific tests, like an echocardiogram (an ultrasound picture of the heart), to diagnose a critical CHD.

References

1. Oster M, Lee K, Honein M, Colarusso T, Shin M, Correa A. Temporal trends in survival for infants with critical congenital heart defects. Pediatrics. 2013;131(5):e1502-8.

2. Adapted from Reller, MD, Strickland, MJ, Riehle-Colarusso, TJ, Mahle, WT, Correa, A. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;153:807-13.

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About 1 in every 4 babies born with a heart defect has a critical congenital heart defect (critical CHD / critical congenital heart disease).

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Centers for Disease Control and Prevention

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What is Diaphragmatic Hernia?

Diaphragmatic hernia is a birth defect where there is a hole in the diaphragm (the large muscle that separates the chest from the abdomen). Organs in the abdomen (such as intestines, stomach, and liver) can move through the hole in the diaphragm and upwards into a baby's chest. When an organ pushes through the hole, it is called a hernia. A diaphragmatic hernia can prevent the baby's lungs from developing completely, causing breathing difficulties for the baby at birth.

How Many Babies are Born with Diaphragmatic Hernia?

Researchers estimate that about 1 in every 3,600 babies is born with diaphragmatic hernia in the United States.About half of all newborns who have diaphragmatic hernia also have other conditions, including birth defects of the brain, heart, and intestines.

Causes and Risk Factors

While the causes of diaphragmatic hernia in most infants are unknown, researchers believe that some instances of diaphragmatic hernia may be caused by abnormalities in the baby's genes.

Understanding the factors that are more common among babies with a birth defect will help us learn more about the causes. CDC funds the Centers for Birth Defects Research and Prevention, which collaborates on large studies, such as the National Birth Defects Prevention Study (NBDPS; births 1997-2011) and the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS; began with births in 2014), to understand the causes of and risks for birth defects, such as diaphragmatic hernia.

If you are pregnant or thinking about becoming pregnant, talk with your doctor about ways to increase your chances of having a healthy baby.

Diagnosis

During pregnancy, there are screening tests to check for some birth defects and other conditions. Doctors can usually diagnose diaphragmatic hernia before the baby is born. Doctors use an ultrasound to create a picture of the diaphragm and lungs to look for abnormalities.

In some cases, ultrasounds during pregnancy do not show the diaphragmatic hernia. However, once the baby is born, doctors may diagnose the condition after noticing that the baby has trouble breathing. A chest x-ray can show that organs normally in the abdomen are in the chest, and the lungs look smaller than normal or are pushed to one side.

Management and Treatment

Surgery is necessary to repair a diaphragmatic hernia soon after the baby is born. After surgery, the baby will need continued assistance to breathe until the lungs recover and expand.

References

1. Mai CT, Isenburg JL, Canfield MA, Meyer RE, Correa A, Alverson CJ, Lupo PJ, Riehle‐Colarusso T, Cho SJ, Aggarwal D, Kirby RS. National population‐based estimates for major birth defects, 2010-2014. Birth Defects Research. 2019; 111(18): 1420-1435.

2. Pober BR, Russell MK, Ackerman KG. Congenital Diaphragmatic Hernia Overview. 2006 Feb 1 [Updated 2010 Mar 16]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2016. Available from: http://www.ncbi.nlm.nih.gov/books/NBK1359/external icon

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national center on birth defects and developmental disabilities

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Diaphragmatic hernia is a birth defect where there is a hole in the diaphragm (the large muscle that separates the chest from the abdomen). Organs in the abdomen (such as intestines, stomach, and liver) can move through the hole in the diaphragm and upwards into a baby's chest.

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What Is Hydrocephalus?

Hydrocephalus is a buildup of cerebrospinal fluid (CSF) in the hollow places inside the brain. These hollow places are called ventricles. The buildup of CSF can put pressure on the brain.

Treatments for hydrocephalus (hi-droh-SEF-eh-less) usually can lower the amount of CSF.

What Are the Signs & Symptoms of Hydrocephalus?

Signs and symptoms of hydrocephalus in babies and children can include:

fussiness

tiredness

poor appetite

vomiting

eyes that stay looking down

slowed development

Babies younger than 1 year old still have their "soft spot" because their skull bones have not fully grown together yet. In them, hydrocephalus usually leads to bulging at the soft spot, increasing head size, and large scalp veins.

Older children with hydrocephalus usually complain of headache.

Who Gets Hydrocephalus?

A child can:

be born with hydrocephalus (called congenital hydrocephalus)

get it later (called acquired hydrocephalus)

Hydrocephalus can run in families.

How Does Hydrocephalus Happen?

Cerebrospinal fluid is saltwater that's made inside the ventricles. It flows around the brain and spinal cord, cushioning them. It also sends nutrients to the brain and takes away waste. Then it's absorbed into the bloodstream, and new, fresh CSF takes its place.

Hydrocephalus can happen if:

The flow of CSF is blocked (called obstructive hydrocephalus).

Not enough CSF is absorbed into the bloodstream (called communicating hydrocephalus).

What Causes Hydrocephalus?

Causes of hydrocephalus include:

spina bifida: when a baby's spinal cord does not fully develop

aqueductal stenosis: when CSF flow between the ventricles inside the brain is blocked

infection during pregnancy

complications of prematurity (being born early)

bleeding in the brain (from a stroke or brain injury)

a brain tumor

infection in the brain

How Is Hydrocephalus Diagnosed?

Doctors diagnose hydrocephalus by:

How Is Hydrocephalus Treated?

Treatment for hydrocephalus depends on the child's age and what's causing the hydrocephalus.

Treatments may include one of these surgeries:

Ventriculoperitoneal (VP) shunt surgery: Doctors place a tube from the brain's ventricles to the peritoneal cavity, the space inside the belly where the stomach and the bowels sit. The tube is all inside the body under the skin. After it gets to the belly, the extra CSF is absorbed into the bloodstream. Shunts are replaced:

over time as a child grows and needs a bigger shunt

if they get infected or stop working

Endoscopic third ventriculostomy (ETV) surgery: A tiny hole made in the bottom of the ventricle lets the extra CSF drain out of the brain. Then, it's absorbed into the bloodstream.

Kids also might need therapy for slowed development, such as:

How Can Parents Help?

Your child needs your care and support. Treatment for hydrocephalus is successful in many children. But most need more than one surgery and ongoing medical care.

To help your child get the best treatment:

Take your child to all doctor visits.

Follow all medical recommendations, such as taking prescribed medicines.

If needed, take your child to:

early intervention programs

physical therapy

occupational therapy

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Hydrocephalus is a buildup of cerebrospinal fluid (CSF) in the hollow places inside the brain. These hollow places are called ventricles. The buildup of CSF can put pressure on the brain. Treatments for hydrocephalus (hi-droh-SEF-eh-less) usually can lower the amount of CSF.

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Cleft Palate Facts

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Centers for Disease Control and Prevention

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Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly during pregnancy. Together, these birth defects commonly are called "orofacial clefts".
What is Cleft Lip?

The lip forms between the fourth and seventh weeks of pregnancy. As a baby develops during pregnancy, body tissue and special cells from each side of the head grow toward the center of the face and join together to make the face. This joining of tissue forms the facial features, like the lips and mouth. A cleft lip happens if the tissue that makes up the lip does not join completely before birth. This results in an opening in the upper lip. The opening in the lip can be a small slit or it can be a large opening that goes through the lip into the nose. A cleft lip can be on one or both sides of the lip or in the middle of the lip, which occurs very rarely. Children with a cleft lip also can have a cleft palate.

What is Cleft Palate?

The roof of the mouth (palate) is formed between the sixth and ninth weeks of pregnancy. A cleft palate happens if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. For some babies, both the front and back parts of the palate are open. For other babies, only part of the palate is open.

Other Problems

Children with a cleft lip with or without a cleft palate or a cleft palate alone often have problems with feeding and speaking clearly and can have ear infections. They also might have hearing problems and problems with their teeth.

How Many Babies are Born with Cleft Lip/Cleft Palate?

About 1 in every 1,600 babies is born with cleft lip with cleft palate in the United States.

About 1 in every 2,800 babies is born with cleft lip without cleft palate in the United States.

About 1 in every 1,700 babies is born with cleft palate in the United States.

Causes and Risk Factors

The causes of orofacial clefts among most infants are unknown. Some children have a cleft lip or cleft palate because of changes in their genes. Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy.

Like the many families of children with birth defects, CDC wants to find out what causes them. Understanding the factors that are more common among babies with a birth defect will help us learn more about the causes. CDC funds the Centers for Birth Defects Research and Prevention, which collaborate on large studies such as the National Birth Defects Prevention Study (NBDPS; births 1997-2011) and the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; began with births in 2014), to understand the causes of and risks for birth defects, including orofacial clefts.

Recently, CDC reported on important findings from research studies about some factors that increase the chance of having a baby with an orofacial cleft:

Smoking―Women who smoke during pregnancy are more likely to have a baby with an orofacial cleft than women who do not smoke.

Diabetes―Women with diabetes diagnosed before pregnancy have an increased risk of having a child with a cleft lip with or without cleft palate, compared to women who did not have diabetes.

Use of certain medicines―Women who used certain medicines to treat epilepsy, such as topiramate or valproic acid, during the first trimester (the first 3 months) of pregnancy have an increased risk of having a baby with cleft lip with or without cleft palate, compared to women who didn't take these medicines.

CDC continues to study birth defects, such as cleft lip and cleft palate, and how to prevent them. If you are pregnant or thinking about becoming pregnant, talk with your doctor about ways to increase your chances of having a healthy baby.

Diagnosis

Orofacial clefts, especially cleft lip with or without cleft palate, can be diagnosed during pregnancy by a routine ultrasound. They can also be diagnosed after the baby is born, especially cleft palate. However, sometimes certain types of cleft palate (for example, submucous cleft palate and bifid uvula) might not be diagnosed until later in life.

Management and Treatment

Services and treatment for children with orofacial clefts can vary depending on the severity of the cleft; the child's age and needs; and the presence of associated syndromes or other birth defects, or both.

Surgery to repair a cleft lip usually occurs in the first few months of life and is recommended within the first 12 months of life. Surgery to repair a cleft palate is recommended within the first 18 months of life or earlier if possible. Many children will need additional surgical procedures as they get older. Surgical repair can improve the look and appearance of a child's face and might also improve breathing, hearing, and speech and language development. Children born with orofacial clefts might need other types of treatments and services, such as special dental or orthodontic care or speech therapy.

With treatment, most children with orofacial clefts do well and lead a healthy life. Some children with orofacial clefts may have issues with self-esteem if they are concerned with visible differences between themselves and other children. Parent-to-parent support groups can prove to be useful for families of babies with birth defects of the head and face, such as orofacial clefts.

References

1. Mai CT, Isenburg JL, Canfield MA, Meyer RE, Correa A, Alverson CJ, Lupo PJ, Riehle‐Colarusso T, Cho SJ, Aggarwal D, Kirby RS. National population‐based estimates for major birth defects, 2010-2014. Birth Defects Research. 2019; 111(18): 1420-1435.

2. Little J, Cardy A, Munger RG. Tobacco smoking and oral clefts: a meta-analysis. Bull World Health Organ. 2004;82:213-18.

3. Honein MA, Rasmussen SA, Reefhuis J, Romitti P, Lammer EJ, Sun L, Correa A. Maternal smoking, environmental tobacco smoke, and the risk of oral clefts. Epidemiology 2007;18:226-33.

4. Yazdy MM, Autry AR, Honein MA, Frias JL. Use of special education services by children with orofacial clefts. Birth Defects Research (Part A): Clinical and Molecular Teratology 2008;82:147-54.

5. Correa A, Gilboa SM, Besser LM, Botto LD, Moore CA, Hobbs CA, Cleves MA, Riehle-Colarusso TJ, Waller DK, Reece EA. Diabetes mellitus and birth defects. American Journal of Obstetrics and Gynecology 2008;199:237.e1-9.

6. Margulis AV, Mitchell AA, Gilboa SM, Werler MM, Glynn RJ, Hernandez-Diaz S, National Birth Defects Prevention Study. Use of topiramate in pregnancy and risk of oral clefts. American Journal of Obstetrics and Gynecology 2012;207:405.e1-e7.

7. Werler MM, Ahrens KA, Bosco JL, Michell AA, Anderka MT, Gilboa SM, Holmes LB, National Birth Defects Prevention Study. Use of antiepileptic medications in pregnancy in relation to risks of birth defects. Annals of Epidemiology 2011;21:842-50.

8. American Cleft Palate-Craniofacial Association. Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial anomalies. Revised edition, Nov 2009. Chapel Hill, NC. P. 1-34. https://acpa-cpf.org/wp-content/uploads/2017/06/Parameters_Rev_2009_9_.pdf

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Facts about Cleft Lip and Cleft Palate | CDC

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Cleft lip and cleft palate (orofacial clefts) are birth defects that occur when a baby's lip or mouth do not form properly during pregnancy.

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Spina Bifida and Neural Tube Defects | Children's National Research Institute

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Learn about Children's National Hospital's progress in one of its many prime research areas: spina bifida and neural tube defects.

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University of Massachusetts Medical School

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What is Crohn's Disease

Crohn's disease is a chronic condition of the gastrointestinal tract that is associated with an imbalance in the microbiome. Diet can rapidly affect the microbiome and may play a role in the pathogenesis and treatment of Crohn' s disease.

Healthier Immune System in Infants Born to Mothers with Crohn's Disease

Accumulating evidence suggests that maternal health and diet during pregnancy and early life have an impact on the baby's microbiome composition and immune system development, with long-term health consequences, including establishing predisposition to Crohn' s disease and other immune-mediated diseases.

By modulating maternal microbiome during pregnancy through diet, we, researchers at the UMass Medical School, hope to be able to promote healthier immune system development in infants born to mothers with Crohn's disease.

Trial to Evaluate the Efficacy of a Diet

The MELODY Trial, conducted by the University of Massachusetts Medical School and the Icahn School of Medicine at Mount Sinai, will test whether a noninvasive diet intervention implemented during the third trimester of pregnancy can beneficially shift the microbiome, or the bacterial flora of the body, in patients with Crohn' s disease and in their babies.

We are currently enrolling expecting mothers with or without Crohn's disease, and in their third trimester (<27 weeks). Participation involves the collection of stools, saliva, health status, and dietary questionnaires and others from pregnant women, as well as stool samples from their infants during the first year after birth. Women with Crohn's disease will be allowed to select whether they participate in the diet intervention, which has been adapted for pregnancy.

If you are interested in the MELODY trial or know someone who may be, please visit or share our trial page!

About Ana Maldonado-Contreras

Ana is an Assistant Professor at UMASS Medical School, part time microbiologist, and part time science advocate. She is a clinical translational researcher focused on understanding the interaction of diet, microbiota, and disease. According to her research, microbiota provides tremendous benefits to the body, including protecting us for malicious bacteria (pathogens) and helping train our immune system to respond properly to viruses.

Ana's lab investigates how manipulation of the microbiota, through diet, can benefit patient outcomes, particularly those suffering from inflammatory bowel diseases.

You can find Ana on Twitter @almaldonxx.

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Learn how to Enhance Baby's Immune System While Pregnant With Crohn's

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Crohn's disease is a chronic condition of the gastrointestinal tract that is associated with an imbalance in the microbiome. Diet can rapidly affect the microbiome and may play a role in the pathogenesis and treatment of Crohn' s disease.

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[Put in your recipe to see how you measure up, compare these values to pregnant women's RDI's.

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Recipe calorie calculator - get personalized and detailed nutrition facts for any recipe. Just copy & paste a list of ingredients from any website of your choice or see sample recipe report.

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Your browser does not have JavaScript enabled. Many features will not work. Recipe calorie calculator - get personalized and detailed nutrition facts for any recipe. Just copy & paste a list of ingredients from any website of your choice or see sample recipe report.

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We've all heard them - if you're craving sweets you're having a girl, if you're craving savoury foods you'll be having a boy. Old wives tales aside and whether you're carrying high or low we've put together our favourite pregnancy recipes for you and your special one.

Latest in Ultimate pregnancy recipe collection

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Ultimate pregnancy recipe collection - Recipe Collections - delicious.com.au

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We've all heard them - if you're craving sweets you're having a girl, if you're craving savoury foods you'll be having a boy. Old wives tales aside and whether you're carrying high or low we've put together our favourite pregnancy recipes for you and your special one.

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If you're pregnant and confused about what you can and can't eat, you're not alone. Find out what the dos and don'ts are.

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Most moms-to-be mean to eat well - but the thing about pregnancy is that it makes you really hungry. What with needing a few more calories, dealing with crazy cravings, and trying to keep up with your normal busy schedule, sticking to healthy habits can be a commitment. But loading up on good ingredients is one of the best things you can do for you and your baby.

Get inspired with these delicious recipes, which are easy enough to tackle on a weeknight and will satisfy even the most voracious of appetites. You'll feel great knowing that they're packed with lots of protein, nutrients, and other benefits for you and your baby. From tender salmon and steak to flavorful dark greens and sweet potatoes, eating well has never tasted so good.

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15 healthy recipes for pregnancy | BabyCenter

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Most moms-to-be mean to eat well - but the thing about pregnancy is that it makes you really hungry. What with needing a few more calories, dealing with crazy cravings, and trying to keep up with your normal busy schedule, sticking to healthy habits can be a commitment.

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Healthy quinoa mushroom and chicken risotto

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Healthy quinoa mushroom and chicken risotto

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myvmc.com-Vitamin and Mineral Requirements and Supplements During Pregnancy