Hear from a Pediatrician

Q. Tell us about your current work and background and the role you play in caring for women and children. 

A. I am a Pediatrician/Neonatologist who connects with mothers of children, while caring for children. In Particular I work at the interface of delivery of a baby, providing antenatal counseling to expectant mothers about their future baby's health and what to expect. I care for babies when born, helping them transition from intra-uterine to extra-uterine life and ongoing care should they need it, primarily in the neonatal intensive care unit. However, my research is focused on early life exposures and the impact on the immediate and long term outcome of the offspring. So I am very focused on this topic and its impact on the health of the baby, child and adult offspring.

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Q. From your perspective, what are the most discussed issues affecting maternal and child health? What topics contain the most amount of education for parents? And what topics do you feel parents are most worried about?

A. All parents want healthy babies and children. They are always worried about having a normal pregnancy with the birth of a normal baby and child. This could range from nutrition, diet, exercise and exposures to various things, as simple as air pollution to drugs necessary for maternal health. 

Q. What do you think are the most effective methods of educating parents about children’s health topics?

A. I think parents are very attentive to aspects of children’s health much more than their own health at times. They are always concerned about a healthy diet, reduction of screen time, proper exercise and preventive measures of any disorders. They also worry about ensuring their child reaches the normal milestones during development including making the transition to school and ensuring normal social interactions and behaviors.

Q. As you may know, our project is focusing on the effects of EDCs on pregnancy. During your training, were EDCs taught or discussed? Currently, are EDCs discussed in your work with your colleagues or with the patients you serve? 

A. EDCs are not routinely discussed with patients unless there may be some potential exposures that are possible. We know that EDCs exist in multiple exposures that vary from traffic related air pollution, fertilizers on the farm, toxic exposures in factories, in plasticizers, hormonal exposures, and certain specific drugs. Generally upon taking a history of the occupation, living conditions, habits etc., it becomes evident if there could be the potential of exposures, it is then that such items are discussed. This is of particular importance to a developing fetus during the mother's pregnancy, and to the developing child. The effect could vary from feminization of a male fetus, to masculinization of a female fetus, towards much greater congenital malformations with major consequences. Also certain exposures can lead to DNA damage and genetic disorders. Any such consistent exposures can lead to altering the life course of a baby.

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Q. How have you noticed discourse on EDCs, both as a general topic and in relation to pregnancy, changing over time? 

A. Over time the awareness has increased substantially in the medical profession but also in the lay public, given discussions at times by media in the form of television or other platforms. There is more information and knowledge available regarding the topic and  its effects during pregnancy and on a child’s life. It can be as simple as unhealthy dietary consumption to high levels of toxic exposures.

Q. Do you ever advise parents and patients on avoiding specific ingredients in their personal care products?  

A. Yes, cosmetics and other personal care products are brought up by parents for discussion, and we talk about such exposures particularly in children. This is why it is strictly advised not to have children use make up, deodorants, etc.

Q. Do you think the responsibility of EDC exposure education should be placed on maternal and child health care providers? 

A. It is generally not possible for the health care providers, namely physicians, to cover the multitude of topics in addition to screening for various health conditions timing wise. However, other health care educators should routinely take this on in addition to discussing the side effects of various exposures. Sometimes it is very hard, e.g. gas stoves within homes can cause toxic pollution in homes, yet not easy to change overnight. However, exposures to smoking and illicit drugs are routinely discussed towards ensuring against exposures.