Breast Feeding - USPSTF Recommends Primary Care Interventions to Promote Breast-Feeding
USPSTF recommendation statement in Annals of Internal Medicine (Free)
USPSTF evidence review in Annals of Internal Medicine (Free)
USPSTF's 2003 recommendations (Free)
The U.S. Preventive Services Task Force now recommends primary care interventions during pregnancy and after childbirth to encourage and support breast-feeding (grade B recommendation).
In Annals of Internal Medicine, the task force cites evidence that breast-feeding is associated with lower risks for:
- breast and ovarian cancers in mothers;
- ear, respiratory, and gastrointestinal infections in infants;
- asthma, type 2 diabetes, and obesity in young children.
Strategies that may increase breast-feeding initiation, duration, and exclusivity include:
- formal breast-feeding education of mothers, partners, family members, and friends;
- direct support of women during breast-feeding, such as consultation with lactation specialists and peer counseling;
- training of primary care staff in techniques to offer support.
Florida Tobacco Quit-For-Life Counseling Program 
The Florida Tobacco Quit-For-Life Line is a free cessation service offering individualized counseling and support to any Florida resident who is ready to quit. The Quit-For-Life Line can provide the counseling component of tobacco dependence treatment without added time or costs to health care providers or insurers.
Folic Acid Research
Folic Acid Fortification and Supplementation—Good for Some but Not So Good for Others, Young-In Kim, MD, FRCP(C) 2007
Evidence has established the protective effect of folic acid (FA) fortification and periconceptional supplementation on neural tube defects (NTDs). Folic acid fortification and periconceptional supplementation of women may reduce the risk of certain childhood cancers in their offspring. However, recent human studies have suggested that FA supplementation and fortification may promote the progression of already existing, undiagnosed, preneoplastic and neoplastic lesions, thereby corroborating earlier observations from animal and in vitro studies. Following the success of mandatory FA fortification on the reduction of NTD rates in the United States and Canada, several countries are currently considering whether or not, and at what dose, to institute FA fortification. More
Body Mass Index and Serum Folate in Childbearing Age Women, Ramin Mojtabai, Department of Psychiatry, Beth Israel Medical Center, New York, NY, USA Accepted in revised form 12 August 2004
Higher pre-pregnancy body mass index (BMI) is associated with increased risk of neural tube defects (NTDs) and possibly other negative birth outcomes in the offspring. More
Reassessing folic acid consumption patterns in the United States (1999–2004): potential effect on neural tube defects and overexposure to folate1–3, Eoin P Quinlivan and Jesse F Gregory III
In the United States, folic acid fortification of cereal grain foods has significantly increased folate status. However, blood folate concentrations have decreased from their post fortification high as a result, in part, of decreasing food fortification concentrations and the popularity of low-carbohydrate weight-loss diets.
The objectives of the study were to quantify changes in folate intake after folic acid fortification and to estimate the effect on neural tube defect (NTD) occurrence. More
Greater Maternal Weight and the Ongoing Risk of Neural Tube Defects After Folic Acid Flour Fortification, Joel G. Ray, MD, MSc, Philip R. Wyatt, MD, PhD, Marian J. Vermeulen, BScN, MHSc, Chris Meier, BSc, and David E. C. Cole, MD
Maternal obesity is likely a risk factor for neural tube defects (NTDs). By late 1997, it became mandatory in Canada that all refined wheat flour be fortified with folic acid. Because overweight women may consume greater quantities of refined wheat flour, we questioned whether their risk of NTD changed after flour fortification. The risk of open NTD
was evaluated across maternal weight quartiles and deciles,
and an interaction between greater maternal weight
and the presence of flour fortification was tested using
multiple logistic regression analysis. More
Food Fortification with Folic Acid: Has the Other Shoe Dropped? Noel W. Solomons, M.D.
Folic acid (FA) supplementation effectively reduces the rates of children born with neural tube defects (NTDs). Currently, 42 nations practice mandatory FA fortification to combat NTD. In addition to NTD, FA fortification may also have salutary effects on the incidence of orofacial cleft birth defects and have secondary benefits in reducing serum homocysteine concentrations and stroke mortality. However, a recent note of caution has been raised concerning a possible negative effect of mandatory FA fortification on the incidence of colorectal cancer. More
Health Information in Multiple Languages
Click here to view the MedlinePlus multilingual feature, providing access to high quality health information in languages other than English and Spanish. This new service benefits people who prefer to read consumer health information in their native language. It also helps supply information to professionals and health care providers who serve them. The new collection contains 2,500+ links to information in more than 40 languages and covers nearly 250 Health Topics.
Medical Information and Professional Development - Medscape
- Physician optimized MEDLINE
- Free Online CME
- 25+ medical specialty sites
- 100+ online medical journals
- Conference Coverage
- Daily Medical News
Medical Provider Survey
The goal of Healthy Start is to reduce infant mortality, increase
access to maternal and child health care
and support services and improve the health
and developmental outcomes of children
in our community. This initiative includes
ongoing collection and assessment of information
regarding the services available
to the maternal and child populations.
We are asking maternal and child health
care providers in Flagler and Volusia counties
to please take a few minutes to complete
the survey below so that we can better
assess what medical services are currently
available to our target population. Thank
you in advance for helping us gather this
data.
Medical Provider Survey (pdf file) click here to
download free pdf reader
HIPPA Act Information
HIPPA Act allows release of protected health information, without
specific client consent, for public health
investigations. Click the letters below for HIPPA Act information from the Florida Department of Health.
HIPPA Letter regarding FIMR (Fetal Infant Mortality Review)
HIPPA Letter regarding PAMR (Pregnancy Associated Mortality Review)
HIPPA Letter regarding MomCare - Prenatal choice counseling and care management women who are eligible for Medicaid through the Sixth Omnibus Budget Reconciliation Act (SOBRA)
Surgeon General's Report on the Health Consequences of Involuntary Exposure to Tobacco Smoke
Those of you interested in reading The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General (including the full report, the executive summary, or the consumer-oriented publication}. click here.
A Safe Haven for Newborns
Safe Haven provides an alternative to a frightened girl/woman, who, in a moment of desperation, may do something drastic, destroying two lives, hers and her babies.
There is now a Florida Law which allows a mother/ father an alternative to infant abandonment with their confidentiality protected. Parents may call the Safe Haven 24-hour, multi-lingual, confidential hotline at 1-877-767-2229. The result will be:
- A child’s life is saved.
- A mother/father is saved from a lifetime of guilt and criminal prosecution.
- The hopes and dreams of parents waiting to adopt are fulfilled.
Many Hospitals and all staffed 24/7 Fire and Emergency Medical Service stations have signs with the Safe Haven logo and help line # posted outside of their facility. For more information, visit the Safe Haven web site. For a brochures in English, Spanish and Creole, click here. To contact Save Haven for Newborns, call 305-882-1304 Ext. 103, or email safehaven@asafehavenfornewborns.com
Nutrition
Click here to find: vegetable consumption surveillance data; information on various 5 A Day pilot programs; internet and legislative resources; more about the 5 A Day program; and help encouraging others to eat a colorful variety of fruits and vegetables.
National HIV/AIDS Clinicians' Consultation Center
The National HIV/AIDS Clinicians' Consultation Center (NCCC) is a component of the AIDS Education and Training Centers (AETC) program funded by the Ryan White CARE Act, administered by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau, in partnership with the Centers for Disease Control and Prevention (CDC). Click here to visit the web site. See services offered below:
Warmline - National HIV telephone consultation service offers healthcare providers expert clinical consultation on antiretroviral treatment options, drug interactions and toxicity, resistance testing, prophylaxis and management of opportunistic infections, and primary care of persons with HIV/AIDS. 1-800-933-3413, Monday-Friday, 8 am to 8 pm EST, Voicemail 24 hours a day - 7 days a week.
Perinatal Hotline - National perinatal HIV consultation and referral service provides 24-hour advice from HIV experts on indications and interpretations of HIV testing as well as consultation on treating HIV-infected pregnant women and their infants. 1-888-448-8765, 24 hours a day - 7 days a week.
PEPline - National clinicians' post-exposure prophylaxis hotline offers healthcare providers around-the-clock advice on managing occupational exposures to HIV, and hepatitis B and C. 1-888-448-4911, 24 hours a day - 7 days a week.
HIV/AIDS Testing Paid for During Pregnancy and Delivery
From: Harrelle, Nita
Sent: Monday, June 15, 2009 3:13 PM
Subject: Payment for HIV testing during labor and delivery
Hello all. We had some feedback that even though Florida Administrative Rule 64D-3.042 states that pregnant women are to be tested for HIV at:
Their initial prenatal care visit,
Again at 28 - 32 weeks, or
At L&D if no test after 27 weeks,
some hospitals are not testing during L&D because they believe Medicaid will not pay for the test. We have researched this, and Medicaid will pay for an HIV test at L&D, if it is ordered by the physician. Attached you will find a link to a list of tests covered by Medicaid. The CPT codes for rapid HIV tests can be found on page 28 of this document. http://www.cms.hhs.gov/CLIA/downloads/waivetbl.pdf We also polled the larger private insurers and they all told us the same thing. They will pay for the test if it is ordered by the physician.
The majority of hospitals are following the current recommendations and testing at L&D if there is no documentation of HIV status when the patient presents at L&D. At this juncture, I would like for you to be our eyes and ears in the community. If you are aware of a facility that does not routinely do an opt-out HIV test for a woman with undocumented HIV status at L&D, please call me at the number below or send an email, and we can provide one-on-one technical assistance to that facility. There are only a handful of birthing hospitals that are not complying with 64D-3.042, and this is probably just an education issue.
Thank you so much for all you do on behalf of mothers and babies in Florida.
Nita Harrelle
Florida Department of Health
Linkage Team Leader
Perinatal Prevention Coordinator
phone: 850-245-4444 ext. 2565
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Prenatal Screen. This collaboration and teamwork certainly shows in the 30% increase we have experienced in our Service Area Prenatal Screening Rate from FY06-07 to FY07-08! 
We also thank