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Book Note: Just How Guilty Should a Mother Feel?

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Written by the excellent science writer Annie Murphy Paul (read her brilliant salon.com takedown of the "emotional intelligence" industry), it explores the still-murky but growing research into how the environment in the womb can affect a baby's life ever after.

Now, not to get overly provincial, but one of my favorite parts of "Origins" is its depiction of a local fetal-origins luminary, Dr. Matthew Gillman of Harvard Medical School. His team's "Project Viva" began recruiting pregnant women in 1999, and has been running ever since, seeking the "early-life origins" of health outcomes including asthma, obesity and brain development.

Annie Paul runs through several of their findings: Children of women who get more vitamin D during pregnancy appear less inclined to get asthma. Children of women who eat more low-mercury fish during pregnancy tend to be smarter. Children of women who gain less weight during pregnancy are less likely themselves to be overweight as children.

I asked Dr. Gillman if he had any updates to share since "Origins" went to press. I knew he'd been working of late on rapid weight gain in infancy, which makes a child more likely to become obese later, and exploring whether the hormonal milieu in a mother's womb might affect it.

He replied:

I don't know exactly what went into the book, but we've been on the trail of rapid infant weight gain for some time. Here are some bullets:

1. Even in the first few months of life, an infant who gains more rapidly than others has a higher risk of obesity (and blood pressure, and other adverse consequences like higher insulin, lipids, etc).
2. It doesn't seem to be all explained by infant feeding. After all, breastfed babies actually gain weight faster than formula fed babies for the first few months before slowing down later in infancy.
3. We've published a few things recently on how hormone levels around the time of birth, perhaps especially leptin, might be important in programming this phenomenon. Animal studies suggest that leptin at a critical period around birth matures neurons in the hypothalamus that are important for appetite regulation.
We have grants in to measure more hormones in cord blood--insulin, insulin-like growth factors--that could round out this story nicely.

We're also doing lots of stuff with other risk factors--gestational weight gain, gestational diabetes, infant sleep, introduction of solids, TV, etc., and starting in on a number of interventions to try to change these factors.

I can't wait for the sequel. (Also known as: Just How Guilty Should I Feel?)

This program aired on October 6, 2010. The audio for this program is not available.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.

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