WINTER 2014
sanity for sleepless mommies
pampering for preggos
Orlando
“Lylah will
always be
perfect
to us”
how mother Mariah Garces learned about & lives with her daughter’s spina bifida
what do you do...
When “High-Risk” Hits Close to Home
LOW
HIGHRISK???
impact
exercising during pregnancy
Winter 2014
is
by
Subscribe online at www.babyourself.com
Connecti ng Or l a nd o M om s
Introducing the
new baby to other sibblings
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h i gh r i s k?
is
ADVANCED MATERNAL AGE – Is 35 high-risk?
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babyourself winter 2014
CONTENTS
The Winter Issue
Special Features 8 – Cover Story – Mariah’s high-risk pregnancy, learning her daughter has spina bifida
12 – Advanced Maternal Age – Is 35 high-risk?
The Moms Give Back Guide
15
15 – Cradle to College – A guide to giving back to our community
MOMS GIVE BACK A guide to giving back to our community
Expert Advice 18 – Move of the Month – Low impact exercises
20 – Ask the Pediatrician –
Introducing the new baby
8
18
LOW IMPACT Ways to stay active when your doctor tells you to take it easy
ON THE COVER
At a routine prenatal visit, Mariah learned that her unborn baby Lylah had spina bifida. She transferred to a high-risk obstetrician for the remainder of her pregnancy. Even though they knew Lylah’s life would be full of uncertainties, they embraced her challenges with grace and laughter.
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babyourself.com • Winter 2014
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ASK THE DOC What’s the best way to introduce the new baby to the family?
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babyourself LETTER FROM THE EDITOR
editor interview:
When “High-Risk” hits close to home During a content planning session, the Babyourself editorial team discovered high-risk and high-stress topics resonated deep within Babyourself owner, Kristi Corley. When we began brainstorming our featured articles for the Winter issue, Kristi could immediately relate to many of the topics. “Some of my stories are health related, and A LOT are emotionally related.” Kristi shared. “I've always known there would be an opportunity to tell my story, I just didn't know when." So we decided that, in lieu of a traditional “Letter from the Editor,” Placenta previa occurs we would give you a glimpse into the when the placenta either partially conversation of our planning meeting – since this has been the inspiration for or totally covers the cervix. It can sometimes occur as early as everything you’ll find in this issue of the first trimester, but is usually Babyourself Magazine. found during the second or BY Team: Let's start from the beginning. third. It can cause severe bleeding When were you first labeled "High-Risk"? before or during delivery and presents a serious complication Kristi: Oh my! That goes back 15 years, during birth. However, it is possible for the placenta to move when I was 13 weeks pregnant with during pregnancy, so being Alexandria. One day I had a lot of diagnosed with placenta previa bleeding, and I immediately feared I had miscarried. During the ultrasound, early in your pregnancy does not mean it will stay that way. I discovered that I hadn't miscarried but instead had placenta previa. I was given instructions not to lift anything heavier than 10 pounds and to “take it easy.” The placenta eventually did "migrate" to a normal position, and I delivered naturally. However, for unknown reasons, I went into labor nearly six weeks early.
BY Team: Were there any complications? Kristi: No, no health issues related to Alex coming early. Thankfully, we went home only two days later with my petite little 5 pound girl! She did, however, have an unrelated deformity with her fingers. The middle two fingers on each hand were webbed together. But it had nothing to do with my pre-term labor. Alex had surgery when she was seven months old to separate her fingers, and she's had many “scar release” surgeries since then to try and straighten her fingers. We were advised to wait until her hands were fully grown before doing cosmetic surgery to straighten the bones, so we will be looking into that within the next year or two. BY Team: How about your other pregnancies? Did you have more health issues? Kristi: My second pregnancy was fairly easy, other than the fact that we literally moved across the country, from Nebraska to Florida, within the WEEK after Drew’s birth. Talk about crazy!
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babyourself.com • Winter 2014
My third pregnancy with Kaitlyn was tough. I had multiple gallbladder attacks throughout my pregnancy. They were awful. Then, just six days after she was born, I had surgery to remove my gallbladder. I couldn't nurse her for 24+ hours, but thank God for my trusty breast pump!
BY Team: How about other health issues your family has had to face? Kristi: When my firstborn, Alex was a year old, it became evident that she
had epilepsy. It started with one seizure, and then a couple weeks later, she had another. We found a good neurologist and eventually figured out what medication would help her. But when she was three years old, her seizures took a serious turn for the worse, and we found ourselves in the hospital with a grim diagnosis. The doctors couldn't find any anti-seizure medications to control her seizures, which had escalated to more than 40 per day! That was definitely a low point for me – leaving the hospital without any answers, and hearing the news that there was a less than a 10 percent chance that any medicine would help her.
babyourself Volume 5, Issue 1 ~
Winter 2014
www.babyourself.com www.OrlandoMomsBlog.com www.facebook.com/babyourself www.twitter.com/babyourself
EDITOR IN CHIEF kristi corley
MANAGING EDITOR elisabeth myrick
CREATIVE DIRECTOR elisabeth nixon
BY Team: So what happened next? Kristi: Well, I am a Christian, and I love sharing that God can work with a 10
percent diagnosis! In fact, the very first medication that we tried worked! It became our "liquid gold,” as we called it. Since then, she has had plenty of ups and downs – an occasional seizure in school and frequent seizures when she sleeps. But about three years ago, she had major surgery to remove a mass in her brain, which was discovered to be at the location where her seizures were originating. The surgery was successful in eliminating her seizures, but it left her unable to speak – and her right side was "stroke-like” and almost paralyzed. Talk about stress! We immediately started intense in-patient therapy. And thankfully – after more than five weeks – she regained a lot of her mobility and speech, although it has not completely returned to "normal.” That's the hardest part for me as a mom. Every mom wants their child to be "normal.” To be able to run, play, have friends – to not be bullied. In the middle of everything, I felt I needed an escape from it all. That was right at the dawn of online games and social media, where I could hide behind my computer and pretend that "everything was okay.” I pulled away from my husband. Wait. That's an understatement. There became a canyon emotionally between me and my husband. Gradually, I couldn't find anything that I liked about him. The grass not only looked greener on the other side, it was like an irresistible MUSTHAVE pasture of heaven. (Sacrilegious, I know!) I eventually asked for a divorce, but instead agreed to a guided separation. I went to a counselor to talk through all of the issues going on in my marriage, and why I couldn't see myself staying. The separation lasted a year. It was hard. I lost A LOT of friends (because they didn’t think they could be friends with someone who was having marriage problems). It was tough on me, tough on my kids and it seemed impossible. There was little hope. It was kind of like that 10 percent chance that my daughter faced. At the time, I insisted that God had nothing to do with the grim chance of us getting back together. In fact, I was keeping God at arm’s length. But looking at it all now, I can see how He was with me all the while. We DID get back together. My marriage isn't society's "normal,” but like my daughter, we are looking better every day. I've grown a lot as a mom and as an individual over the last 15 years. Raising kids is hard. Maintaining friendships is hard. Being a good wife is hard. Sometimes we fall into the category of “high-risk”. Sometimes our struggles are kept hidden and sometimes they are a flashing neon sign. I personally know that every day I need to try and do the right thing – try to be a good mom, try to love my man, try to understand that my high-risk life is an opportunity to live with high hopes that something great can happen, even in the face of grim 10-percent chances.
Kristi Corley
editor in chief kristi@babyourself.com
CONTRIBUTING WRITERS greg gordon, m.d. gene krishingner jr., m.d. elisabeth myrick kristen scruggs eryn vargo
PHOTOGRAPHY elisabeth nixon photography
WEB AND DESIGN andy corley
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(both magazine and online)
advertise@babyourself.com
MAGAZINE SUBSCRIPTIONS AVAILABLE @ babyourself.com BLOG: www.OrlandoMomsBlog.com
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babyourself.com • Winter 2014
“Lylah will
always be
perfect
to us”
By Elisabeth Myrick
Photography by Elisabeth Nixon Photography
For most expectant parents, early ultrasounds are a formality. Heartbeat? Check. Baby is growing on schedule? Check. And the most pressing question for many parents: is there any clue to the gender? Ha! Then there’s the “routine” bloodwork. However, for Mariah Garces, her 12-week blood test turned out to be anything but “routine” or normal. “My doctor called to follow up a few days later and warned me that my tests came back positive for Spina Bifida,” Mariah explains. “It was the first time I heard the words ‘I’m sorry’ associated with my pregnancy and baby.” Devastated, Mariah recalls spending the next two days crying and wondering what life would be like for her daughter, if she survived. After subsequent testing and, ultimately an amniocentesis, the diagnosis of spina bifida with “no other defects” was confirmed and Mariah was transferred to a high risk obstetrician for the remainder of her pregnancy. Though she was babyourself.com • Winter 2014
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spina bif·i·da
(bĭf′ĭ-də)
n. A congenital defect in which the spinal column is imperfectly closed so that part of the meninges or spinal cord may protrude, often resulting in neurological disorders. Also called hydrocele spinalis. The American Heritage® Medical Dictionary
then took Lylah away to be examined. The breathing issues were quickly corrected. Then, less than 24 hours after she was born, Lylah underwent major surgery to close her spine. “The hardest part of all of it, other than the trauma of her delivery, was leaving the hospital while my baby stayed there,” Mariah said. Mariah and Juan finally took Lylah home from Winnie Palmer Hospital two weeks after she was born, a short stay compared to many other children. But, each time Lylah was hospitalized for six surgeries and countless procedures over the past two-and-a-half years, they were met with the same sentiment: “I’m sorry.” “Hearing someone apologize for your child stings every time you hear it,” Mariah says. “But Juan and I have so much to be thankful for.”
Life Today Today, daily life with a thriving, nearly three-year-old, keeps Mariah and Juan on their toes... 6:30 a.m. Wake up, Mariah and Juan take turns getting ready. considered high risk, the OB only cautioned her against lifting anything greater than 1015 pounds, due to the amniocentesis, which can cause pre-term labor. “Other than the lift restriction, things were pretty boring,” Mariah said. As they proceeded with the standard new baby preparations, Mariah and her husband Juan were also interviewing neurosurgeons and lining up the many doctors who would treat their daughter, who they named Lylah, after she was born.
Lylah’s Birth and First Surgery While Mariah’s pregnancy was relatively uneventful after Lylah’s diagnosis, her birth heralded a new chapter for the Garces
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babyourself.com • Winter 2014
family. The delivery room for her scheduled C-section was filled with nurses, doctors, even medical students. The neurologist who would perform surgery on newborn Lylah was not in the delivery room, but on standby at the hospital. “Lylah was breech, so it took nearly 30 minutes to complete the C-section,” Mariah recalls. “The doctors had to push with a lot of force on my stomach to get her out. At one point, I remember them asking for a stool so they could get more leverage. I actually had to ask them to stop for a minute because I couldn't breathe with all the force they were putting on my diaphragm. I had bruises all along my stomach.” When Lylah was born, she was purple from the waist down, and was not breathing on her own. The doctors showed her to Mariah, and
7 a.m. Lylah’s awake! Her nighttime diaper is changed and her catheter is inserted for the day. She picks out her outfit and Mariah helps her put on her pink rhinestone-bedazzled leg braces. 7:30 a.m. Breakfast! 8 a.m. The family heads out the door, sometimes to a doctor appointment, but most often Juan and Mariah proceed to work and school after dropping off Lylah at medical daycare, which is very similar to any other daycare, except the staff is trained to care of children with a wide variety of disabilities. Lylah averages at least one doctor appointment per week, either for a regular check-up, or especially if she is sick or has fallen down and injured herself (even the smallest bumps and bruises need to be checked out).
“Lylah will always be perfect to us. We love her no matter what!” “It is a little different than other children, as the process to learn a new skill takes a lot longer,” Mariah explained. “The first time she stood, it was amazing! But it was probably another six to eight months before she was able to do it regularly. So every time, it was a celebration.” “Even though the hard times may seem to overshadow the good days, we choose to embrace our ’normal’ with grace and laughter,” Mariah says. “Lylah will always be perfect to us. We love her no matter what!” While no parent would wish a lifetime of challenges on their child, Mariah and Juan choose each day to celebrate the daughter God gave them.
6 p.m. Everyone is home for the evening. Juan makes dinner while Lylah and Mariah play. Recently, she’s been working on stringing colorful beads for fun and therapy. 6:30 p.m. Dinner as a family. 7-8 p.m. Bath, books and bedtime for Lylah. Seems like a typical day for a family of three? It is. While Spina Bifida presents challenges at times, Lylah walks confidently with the help of twister cable braces and a walker or crutches when needed. She talks and plays just like other children her age and the Garces home is full of laughter. And even though they still hear “I’m sorry” from nearly everyone they meet, the Garces continue to celebrate the smallest joys with Lylah: from eating and standing on her own, to new leg braces that transformed her ability to move around their home and daycare. All typical things to celebrate with a new baby and growing toddler, however for a child with Spina Bifida, these moments are important milestones. babyourself.com • Winter 2014
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35
h i gh r isk ?
is
BY DR. GENE KRISHINGNER
So you just hit your mid 30s healthy, vibrant, happy and now pregnant with your second child. You arrive at your OB/ GYN office excited about the new addition to your family but leave an hour later with frustration and anxiety as you find out you have just been labeled “Advanced Maternal Age.” Your doctor informed you that you are now considered high risk and need a consult to the Maternal Fetal Medicine specialists!
Here are the facts. At age 35 the chance of having a baby with Down Syndrome is 1 in 240, and at age 40 the chance is 1 in 109! In addition to genetic concerns, there are several other risks that increase at the mid-30 mark. These include increased risk of miscarriage, pre-eclampsia, fraternal twins, stillbirth, placental problems and hemorrhage, stroke, gestational diabetes and several other very concerning conditions. As the age increases beyond 35, so does the risk!
Advanced Maternal Age is a term that frustrates many mothers-to-be, and often I find myself explaining, almost apologizing, for making someone think I am calling them old! Trust me when I say that 35 is young from my perspective. However, in the world of OB/GYN it marks the turning point where some important risk factors in pregnancy begin to increase significantly.
Despite these concerns, women in the modern era can reduce their risks by a huge margin if they manage their pregnancy with a careful approach and consultation to the Maternal Fetal Medicine Specialist. That is why it is so important to get this additional assessment and evaluation and why your general OB/GYN will insist upon it. The evaluations for genetic abnormalities now often involve dedicated ultrasound studies and specialized blood or saliva tests instead of the more invasive studies like amniocentesis or chorionic villous sampling. The referral to the MFM doctor also ensures that you have someone who is highly specialized in the medical and clinical concerns unique to Advanced Maternal Age and pregnancy. They will comanage your pregnancy along with your general OB/GYN and give you the best chance at a safe and healthy experience.
The term “Advanced Maternal Age” comes from an era when women married in their teens and began having children at a much younger age. Now we live in a time where a large proportion of moms are busy with new careers and the professional workforce. These moms certainly don’t feel old and sometimes they are just getting to a point in life where they are considering a family for the first time.
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babyourself.com • Winter 2014
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Dr. Gene Krishingner Jr. is proud to announce the opening of his new OB/GYN practice located at the RDV Sportsplex in Maitland with an additional office in Oviedo. His compassionate and friendly approach to women’s health, along with his reputation as an experienced and skillful doctor, has made him one of Orlando’s top OB/GYNs. Dr. Krishingner is board certified with over 14 years of experience. He specializes in minimally invasive gynecological surgery and delivers both natural and high risk OB patients at the Dr. Phillips Baby Place at Winter Park Memorial Hospital. Dr. “K”, as he is known by his patients, has been in private practice in the Orlando Area since 2006, and is excited for the opportunity opportunity to take care of your health and pregnancy needs for the moments in life that matter most!
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babyourself ’s
Guide
a busy mom’s guide to incorporating
volunteerism, healthy living, & quality time Live a more meaningful life!
a busy mom’s guide to incorporating...
volunteerism
Guide Did you know there are hundreds of non-profit organizations right here in Central Florida? Each one impacts our community in their own unique way. The Moms Give Back Guide is your resource to learn more about these non profit organizations and discover information on how you can get involved with your children and live a more meaningful life! “Be the change you wish to see in the world” ~Gandhi
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babyourself.com • Winter 2014
i (this issue)
healthy living
quality time
Cradle to College is an upscale children’s consignment event and expo which showcases gently loved children’s items. You can save for the future by consigning and shopping Cradle to College! Consignors receive 70% of their total sales (no matter what!) ... one of the highest payouts in all of Florida! Consign and volunteer and be afforded an opportunity to shop early, and have your name entered in a drawing to win 100% of your total sales. Allow Cradle to College to display and sell your items in a professional, department-like store setting. Volunteers are a vital part of the team and will be rewarded by having their name entered in a drawing to win a gift basket donated by an expo vendor, as well as be able to shop early. The event expo will feature local, family-friendly businesses.
Consign. Shop. Save. Give Back. The Moms Give Back Guide is excited to highlight Cradle to College! There are several ways you can give back to Orlando families and our community at each sale location! FOOD DRIVE All shoppers are asked to bring at least one non-perishable food item, which will be distributed to local charities in each sale’s community. TOILETRY/HYGIENE DRIVE Shoppers are asked to bring at least one toiletry/hygiene item to be donated to charity. Some of these items are distributed locally as well as to needy villages in Honduras. BE A BLESSING BY CLEANING OUT THE KIDS CLUTTER A portion of every consignor registration fee will be donated to local Missions and Scholarship Funds. Also, when entering inventory, Consignors can choose to donate any unsold items; of which will be distributed to local charitable organizations.
Volunteerism
babyourself MOVE OF THE MONTH
LOW
impact By Kristen Scruggs
I’m a very active person and I love, enjoy and NEED exercise in my life! I am addicted to running. However, when I was four months pregnant with my daughter, my doctor asked me to stop running. I was devastated. It looked like I had placenta previa, and he wanted to be on the safe side. He told me to stick with low impact activity. This was quite new for me, so I had to find new ways to be active with my growing belly!
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babyourself.com • Winter 2014
Here are some examples of low-impact activity to try if you find yourself in a similar situation: •
30-45 minutes on the Elliptical/Stairmaster
•
Walking on the treadmill or outside
•
Swimming/Aqua-Jogging
•
Basic weight training using 5 pound weights to get/keep your arms toned
•
Pilates/Yoga for Pregnancy DVDs
The benefits of staying active during your pregnancy are numerous. It helps reduce back aches, constipation, bloating and swelling. It improves your mood, energy and posture while promoting muscle tone, strength and endurance needed for labor. Staying active even helps you sleep better! A few points to remember: Do not exercise on your back after your first trimester. Avoid exercise in hot, humid weather – and drink plenty of water to prevent dehydration and overheating. Wearing a supportive sports bra and comfortable clothing will help you remain cool. If you’re just starting an exercise routine, begin with as little as five minutes a day, and add five minutes each week until you can work up to 30 minutes a day, or even break it up into two 15 minute chunks. Make sure you consume up to an extra 300 calories per day as needed for your pregnancy. You should stop exercising immediately if you have any of the following symptoms during activity: uterine contractions, headache, chest pain, dizziness, vaginal bleeding, increased shortness of breath, or feeling faint. Call your doctor immediately if you experience any of these symptoms. If you are exercising during pregnancy, the extra weight on the front of your body shifts your center of gravity and places stress on joints and muscles, especially those in your pelvis and lower back. Investing in a good maternity support belt will really help. Here are some good choices: •
Gabrialla Elastic Maternity Belt, $32, available from Amazon
•
Motherhood Maternity Support Belt, $39, available from Motherhood (online only)
I was very active through most of my pregnancy, but due to my daughter’s small measurements, I was induced at 38 weeks. So my level of exercise those final weeks was significantly less. However, my daughter was born perfectly healthy at 5 lbs, 12 oz. And soon after my checkup, I resumed running. It was much easier for me lose the weight and get back to my level of fitness since I exercised during most of my pregnancy. So before you get worried when your doctor deems you high risk, remember that high risk doesn’t always mean bed rest! Take it one day at a time and listen to your body – and if needed, slow your activity some and go low impact! Editor’s Note: This article is not intended to treat, diagnose or otherwise replace medical care. Always consult your doctor, especially if you are pregnant, before beginning any exercise program.
Kristen E Scruggs is the Chapter Leader for the East Orlando chapter of Moms RUN This Town, a free running club for Moms with close to 400 members. She recently ran her first full marathon, the Space Coast Marathon! She is married with a one year old daughter and wants 2-3 more children in the near future. You can see what her busy group of Moms is up to at www.momsrunthistown.com/EastOrlando/.
babyourself.com • Winter 2014
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babyourself ASK THE PEDIATRICIAN
Introducing the new baby By Dr. Gregory Gordon
One of the most commonly asked questions from readers and patients centers around introducing a new sibling to a family. What’s the best way to introduce a young toddler to your new baby and how can you make the first weeks/months go smoother? Preparing for another child is always an exciting time for a family. Fortunately, most older siblings adjust well to the birth of a new baby. A few tips to make the transition better:
due date. To avoid the toddler claiming ownership of the crib, pack it up. When you bring out the crib closer to your due date, it will now be the “baby’s bed.”
Get the child involved. Talk to them about
taking away from their first born by “daring” to have a second. This simply isn’t the case. Your children’s relationship should last beyond your lifetime and help them in life’s rough times. When your son has girlfriend trouble in college he won’t call you, but he may call his brother.
the baby and your changing body. Ask them if they want to feel the baby kick. Refer to it as their baby or our baby. Take them to doctor visits (when possible) and let them hear the baby’s heart and see the ultrasound images.
Read up! When we were pregnant with our second, we found the book Zaza’s Baby Brother by Lucy Cousins. It is a great book to prepare an 18-month to 3-year-old for a second child. Dr. Gregory Gordon grew up in Gainesville, Florida. He attended the University of Florida for both his undergraduate and medical degrees. After he completed his pediatric residency at the University of Alabama at Birmingham, he joined Pediatric Associates of Orlando. Dr. Gordon is the proud father of eight children. He is the Vice President of “The Gift of Swimming” (a local charity that provides swim lessons to Orlando’s needy children). In early 2010 Dr. Gordon started gregorygordonmd.com to share his pediatric and parenting experience.
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babyourself.com • Winter 2014
Get a gift. After the birth of your newborn, have
the new siblings exchange presents. On the way to the hospital to meet their new baby, have Dad take the older sibling to pick up a simple present for the baby. When they give their gift to the baby have the baby give them a present (perhaps something to keep them busy in the hospital) as well.
Get them involved. Let them hold their new baby. To make this as safe as possible, try a “double wrap.” Swaddle the newborn in a cotton swaddling blanket and then again in a fleece blanket. This gives the baby’s head padding and stability. Don’t blame the baby. Try not to say things
like, “Mommy can’t read you a book since she has to feed the baby.” Do say things like, “Let’s read a book right now and then Mommy will come upstairs and give you a kiss goodnight.”
Prepare, prepare, prepare. Get your older child ready. If the plan is to move the two-year-old to a big-boy bed, do it at least a couple months before your
Be positive. Many parents feel like they are
Passionate about our community and the moms who live here! Connect with your local Moms Blog!
Not a Mom’s Blog in your city? Start one! Visit CityMomsBlogNetwork.com
babyourself.com • Winter 2014
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Stronger, healthier babies. Every day, we do all we can to make sure every baby is born healthy. Find out how we’re helping a baby you love at marchofdimes.com.
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