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Coffee "raises miscarriage risk"

Pregnant women should consider avoiding caffeine, say researchers who found even moderate consumption in early pregnancy raises the miscarriage risk.

Currently, the Food Standards Agency sets an upper limit during pregnancy of 300mg - or four cups of coffee a day. But an American Journal of Obstetrics and Gynaecology study found more than 200mg of caffeine a day doubled the risk compared to abstainers.

Experts said they would review the data to see if advice needed changing.

Pat O'Brien, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecologists, said based on the findings he would now be advising women in their first 12 weeks of pregnancy to abstain from caffeine altogether.

"The first 12 weeks is a very vulnerable time for the baby. It's when most miscarriages occur," he explained.

He said most women in early pregnancy went off the taste of caffeinated drinks anyway and so should not find abstaining from them too difficult. But he said it was unclear whether pregnant women needed to avoid caffeine in later pregnancy. More

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Book deals with joy and grief of twins

Book deals with joy and grief of twins
Frisco: After losing one daughter, mother chronicles feelings
12:00 AM CST on Thursday, December 27, 2007
By DAN X. McGRAW / Special Contributor to The Dallas Morning News


Jennifer Hander plays with daughters Alexa, 2, and Addison, 13 months, at their home in Frisco. Ms. Hander has published a book, A Place of Peace, about the loss of Alexa's twin, Alysa.
They show her first day and her last, and what could have been for the Hander family's first pregnancy.

But 28 days after she was born, Alysa died because of complications of twin-to-twin syndrome. Her sister, Alexa, survived.

"We thought we were having the perfect pregnancy," Jennifer Hander said. "We were scared and shocked when we found out."

As Ms. Hander cared for Alexa during the first year of her life, she chronicled her feelings of losing one of her twin daughters. This year, the Frisco mother published a book, A Place of Peace, that documents that journey.

The twins' condition was diagnosed six months into the pregnancy. The syndrome causes twins to share blood vessels throughout the pregnancy, and at some point, one baby transfers its blood to the other, Ms. Hander said.

The cause of the syndrome, which occurs only in identical twins, is not known, Ms. Hander said.
Like many new parents, the Handers were unaware of the syndrome. The twins were delivered an hour after their parents were told about it.

Doctors who delivered the twins predicted that the Handers had a 90 percent chance of losing one child and an 80 percent chance of losing both.

"We just hoped that things would be OK," Ms. Hander said.

Because of the sudden transfer of blood, Alysa was left with very little blood in her body, while Alexa had too much blood. Doctors at the Medical Center of Plano worked to correct both problems.

However, 28 days later, Alysa died in her mother's arms. During those days, Alysa suffered bleeding in her brain that proved fatal.

"You are living the two extremes," Ms. Hander said. "You are mourning the loss of one twin but celebrating the life of another. The other twin serves as the reminder of what you might have had."

Because of the critical condition of Alexa, doctors ordered Ms. Hander to remain at home for the first four months of Alexa's life, and visitors had to be diligent about washing their hands to avoid getting the baby sick, said Lex Hander, their father.

"We had to be very strict," Mr. Hander said. "It was definitely a time she [Jennifer Hander] surrendered herself."

As Ms. Hander watched Alexa, she jotted down her feelings and thoughts of losing Alysa. She began to confront her feelings head on. The journal eventually evolved into a book about her experience.

"I was hesitant to publish it at first, because it has my deepest, darkest thoughts," Ms. Hander said. "But I was able to get over that, and my hope is that people can see me as an example."
Ms. Hander said she hopes people who read the book can use it to confront their feelings of losing a twin or become educated about the syndrome.

"If I can help only one person, it was worth it."

As Alexa grows up, Ms. Hander is teaching and reminding her of her sister. Ms. Hander refers to Alysa as the other sister who is an angel to Alexa, and it isn't something she is about to give up.

"It is just something that I intend to raise her with," Ms. Hander said. "I don't want it to be something she would be distraught about later."