Category Archives: Public Health Education

Decrease Your Risk of Preterm Birth


Decrease Your Risk of Preterm Birth


Rachel Heitman

Director of Injury Prevention, Infant Mortality Reduction and Death Review

Tennessee Department of Health

Did you know that 1 in 10 babies are born too early in Tennessee? In Memphis, 13.7% of all babies are born prematurely or before 37 weeks gestation. Preterm birth is one of the leading causes of infant mortality. When a baby is born prematurely, he/she might need special care in the hospital. The baby is also at risk for life long disabilities or death. Some steps that you can take to reduce your risk and improve your overall health when pregnant include:

1. Avoid alcohol and illicit drug use.

There is no safe level of alcohol use during pregnancy. Alcohol can affect the fetus throughout pregnancy. It is best not to drink at all while you are pregnant. If you did drink alcohol before you knew you were pregnant, you can reduce the risk of further harm to the baby by stopping drinking.
Illicit drug use includes use of any illegal drugs in addition to the use of prescription drugs for a nonmedical reason. Drug use can interfere with the growth of the fetus and cause preterm birth and fetal death.

2. If you smoke, STOP.

Cigarette smoke contains more than 4,000 chemicals. When you smoke during pregnancy, those chemicals build up in your blood stream, which is the source of oxygen and nutrients for your baby. If you need help with quitting, call the quit line at 1-800-QUIT-NOW (1-800-784-8669).

3. Get early prenatal care and attend all of your scheduled appointments.

Some of the largest risk factors for premature birth include high blood pressure, infections, abnormal uterus or cervix, and stress. By going to your provider early and often, these types of conditions can be tracked and monitored and possibly lead to preventing a preterm birth.
4. Learn the signs and symptoms of preterm labor.

The signs of preterm labor include pain in the belly, painful urination, decreased movement from the baby, backache, contractions, cramping, leaking fluid, increased abdominal pressure, increased vaginal discharge, vaginal bleeding, and fever. If you experience any of these symptoms, be sure to check in with your provider.

5. Ask your provider if you are a candidate for 17P.

If you have already had a preterm birth, you might be eligible for a medication called 17P. This medication is a weekly injection starting around the 16th week of pregnancy and continuing until 37 weeks pregnant. There are no known side effects for the baby. This medication has shown to lower the risk of delivering a preterm baby by as much as 33% for women that have had a previous preterm birth. If you would like more information about 17P, please talk to your OB provider.

6. Wait at least 18 months between pregnancies.

Take your time between pregnancies. Another high-risk factor for preterm birth is having less than 18 months between pregnancies. Infants conceived less than 6 months after giving birth have a 40% chance of being born premature. A longer time between pregnancies is important to help your body heal. To prevent pregnancy for at least 18 months, talk with your provider or local health department about birth control options. If you do become pregnant within this period, be sure to get early care from your provider.

7. Manage stress.

Increased stress puts you and your baby at risk for a preterm birth. Figure out what’s making you stressed and talk to your partner, a friend, family member or your health care provider about it.

8. Lead a healthy lifestyle before becoming pregnant.

If you are considering becoming pregnant, start your healthy lifestyle now. This includes exercising, eating healthy, taking a multivitamin, seeing your physician for a check-up, and getting any illnesses or chronic diseases under control
The following links provide more information on prematurity.


Zika Virus & Pregnancy


Zika Virus & Pregnancy


Ture Carlson and Tyler Zerwekh, DrPH

Shelby County Health Dept., Environmental Health Services Bureau

There has been a lot of news coverage on Zika virus the past couple months. Most of this media coverage has been based on a potential link between Zika virus and a congenital condition or birth defect called microcephaly.

Zika virus is not new. It was first discovered in 1947 in the Zika Forest, located near Entebbe, Uganda. In the following year, mosquitoes in the Zika Forest were found to be infected with the virus, and that was when it was thought to be a mosquito-transmitted virus. Research several years later confirmed this assumption.

In May of 2015 health authorities in Brazil reported cases of Zika in which the patients had no international travel history, indicating the virus was being locally transmitted. Local transmission means mosquitoes in that area are infected with Zika virus and are spreading it to people. In November of 2015, about six months after Zika was first detected, Brazilian authorities began to notice an increase of babies being born with below normal head sizes.

Microcephaly is a condition in which the head size remains small because the brain does not develop properly. Microcephaly has been associated with other infections like cytomegalovirus, chicken pox, and rubella if the mother has contracted them during pregnancy. Zika is just another potential infection an expecting mother may contract during pregnancy (in areas where there is risk of viral transmission).

It is important to note, current research demonstrates Zika virus has not been clinically proven to cause microcephaly. However, some evidence has led to concern for pregnant women living in or traveling to areas where Zika virus is actively circulating:

  1. Increase in microcephaly where Zika is being detected
  2. Increase in microcephaly started showing up about six months after Zika started being detected
  3. Zika has been found in the amniotic fluid
  4. Zika has also been found in the brain tissue of newborns with diagnosed microcephaly

Pregnant women planning to travel outside the U.S.A. should visit the U.S. Centers for Disease Control and Prevention’s website at to find out current health issues for their specific destination. Also any pregnant women returning from international travel should inform their physician about their travel history.

Currently, there is no available vaccine for Zika virus so it is important to take precautions and avoid contact with mosquitoes.

  • Wear loose fitting long-sleeved shirts and long pants.
  • Use EPA-registered insect repellents containing DEET, IR3535, picaridin, or oil of lemon eucalyptus. The U.S. Environmental Protection Agency does not recommend any additional precautions for repellent use by pregnant or nursing women. Use insect repellents as directed.
  • Sleep and stay in air-conditioned and/or screened-in rooms.

Currently all of the cases of Zika virus being reported in the United States have been found in travelers returning from foreign countries. There is the potential for a traveler to return to Shelby County and infect the local mosquito population with Zika. In Shelby County there is one mosquito species out of the 48 different species currently known to be able to spread Zika to people, and that is the Asian Tiger mosquito.

Although the Asian Tiger mosquito can be found throughout Shelby County, it is more common in urban areas. It is a black mosquito with very visible white-sliver stripes on the legs and body. This mosquito has a couple of important behaviors.

  1. It is active during the day. The Asian Tiger mosquito is one of the few mosquitoes that will try to bite people and animals during the day. Most mosquitoes will only be active at dusk and dawn.
  2. Containers, Containers, Containers!!! The Asian Tiger mosquito will only lay eggs and grow in containers that can hold water. This includes but is not limited to tires, cans, buckets, gutters, bottle caps, and sometimes small ornamental ponds that are not working properly. The Asian Tiger mosquito will not lay its eggs or grow in large areas of standing water like swimming pools, flood plains, or ditches.
  3. The Asian Tiger mosquito is active late April/ early May until late October. It will not be found during the winter months no matter how warm it may get.
  4. The Asian Tiger mosquito does not fly far from where it developed. Odds are if it is biting you in your yard it came from your yard. It is very important, especially after a rain, to check your yard for anything holding water. Encourage your neighbors to do the same.

Healthy Eating Before, During and After Pregnancy

Betty Marrero Public Health Coordinator - Chronic Disease

Healthy Eating Before, During and After Pregnancy

by Betty Marrero

Public Heath Coordinator- Chronic Disease

Shelby County Health Department

Maintaining a healthy lifestyle throughout pregnancy, as well as before and after, is key for both baby and mother. A healthy pregnancy actually begins before you become pregnant. It’s important to know how health conditions and risk factors can affect you or your unborn baby if you become pregnant. For example, some foods, habits, and medicines can harm your baby — even before he or she is conceived. Some health problems, such as diabetes, also can affect pregnancy. The five most important things you can do for preconception health are:

  1. Take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day if you are planning or capable of pregnancy to lower your risk of some birth defects of the brain and spine, including spina bifida.
  2. Stop smoking and drinking alcohol.
  3. If you have a medical condition, make sure it is under control. Some conditions that can affect pregnancy or be affected by it include asthma, diabetes, oral health, obesity, or epilepsy.
  4. Talk to your doctor about any over-the-counter and prescription medicines you are using. These include dietary or herbal supplements.
  5. Avoid contact with toxic substances or materials that could cause infection at work and at home. Stay away from chemicals and cat or rodent feces.

Important steps to a healthy pregnancy include eating a balanced diet; gaining the right amount of weight; enjoying regular physical activity; taking a vitamin and mineral supplement if recommended by a physician; and avoiding alcohol, tobacco and other harmful substances.

When you’re pregnant, what you eat and drink is the main source of nourishment for your baby. Eating well during pregnancy is more than simply increasing how much you eat. You must also consider what you eat.

A healthy diet includes proteins, carbohydrates, fats, vitamins, minerals, and plenty of water. The U.S. government publishes dietary guidelines that can help you determine how many servings of each kind of food to eat every day.

Scientists know that your diet can affect your baby’s health — even before you become pregnant. For example, recent research shows that folic acid helps prevent neural tube defects (including spina bifida) from occurring during the earliest stages of fetal development — so it’s important to consume plenty of it before you become pregnant and during the early weeks of your pregnancy.

Even though many foods, particularly breakfast cereals, are fortified with folic acid, doctors now encourage women to take folic acid supplements before and throughout pregnancy (especially for the first 28 days).

Calcium is another important nutrient. Because your growing baby’s calcium demands are high, you should increase your calcium consumption to prevent a loss of calcium from your own bones. Your best food sources of calcium are milk and other dairy products. However, if you have lactose intolerance or dislike milk and milk products, ask your doctor about a calcium supplement.

No level of alcohol consumption is considered safe during pregnancy. And although many doctors feel that one or two 6- to 8-ounce cups per day of coffee, tea, or soda with caffeine won’t harm your baby, it’s probably wise to avoid caffeine altogether if you can. High caffeine consumption has been linked to an increased risk of miscarriage and other problems, so limit your intake or switch to decaffeinated products.

Fish and shellfish can be a healthy part of your pregnancy diet because they contain beneficial omega-3 fatty acids and are high in protein and low in saturated fat. Some types of fish contain high levels of mercury, which can cause damage to the developing nervous system of a fetus. Almost all fish and shellfish contain small amounts of mercury, but you can safely eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury, such as salmon, shrimp, clams, Pollock, catfish, and tilapia.

As a new mom, or even if this is your second or third child, you’ll need plenty of energy to take care of baby. Choosing the right foods — fruits, vegetables, whole grains, lean protein and dairy — is especially important if you are breast-feeding. To ensure adequate milk supply, you’ll need to meet your energy needs and include essential nutrients in your diet. For most post-partum women, calorie intake should be in the 1,800 to 2,200 range with an extra 300 to 400 calories more per day while lactating, depending on how much milk the mother is producing.

6 Tips for Mom’s Healthy Meal Plan

  • Don’t skip meals.
  • Drink at least 6 to 8 glasses of water. If breast-feeding, get into the habit of filling a tall glass of water to keep with you all day.
  • You need 1,000 milligrams of calcium daily. You can get this easily by consuming three servings of low-fat or fat-free dairy throughout the day.
  • Consume at least 2 cups of fruits and 2½ cups of vegetables.
  • Include protein at each meal.

For more information, follow these links:

Everyone Loves HUGS—Have you had YOUR HUG today?


Everyone Loves HUGS

By: Linda Busby,RN

Shelby County Health Department


Everyone Loves HUGS

Have you had your HUG today?

As we know there are many different kinds of hugs ranging from the polite hug to the never-ending rocking side to side embrace hug. And just as there are so many ways to hug there are endless reasons why hugs are wanted and needed. Today I want to share HUGS with you!

What is HUGS?

HUGS is an acronym which stands for Help Us Grow Successfully. HUGS is a home-based care coordination program developed by the Tennessee Department of Health. Home visitation provides a way to help decrease infant mortality. The Shelby County Health Department HUGS program provides assessment of family needs, assistance to seek solutions for these needs, and also includes client centered education.

In an effort to reduce the infant mortality rate one of the specific focus areas for the HUGS program is educating families on the risk of Sudden Infant Death Syndrome (SIDS) by providing a safe sleep environment for infants.

Who qualifies for these services?

  • Families living in Memphis and Shelby County
  • Prenatal/postpartum women
  • Children through 5 years of age
  • Parent/guardian of the client referred to the program.
  • Families who have experienced the loss of a child less than 2 years old (due to SIDS, prematurity, etc.) 

How does the HUGS program help a family?

A health care professional is assigned to each family. These services are provided at no cost to the families. The care coordinator encourages a healthy pregnancy to promote positive birth outcomes. Families are assisted in accessing health care and other social and educational services. Attention is placed on enhancing family strengths. Education is provided regarding pregnancy, growth, development, and parenting education. Emphasis is placed on SIDS counseling and ways to decrease the risk of SIDS.

Who can I contact if I am interested in the program or to make a referral to HUGS?

Linda Busby, RN

HUGS Supervisor

Phone: 901-222-9703

Fax:  901-222-7976


Benefits of Social Support of Breastfeeding

Shenika Holmes

Shine Bright like a BF STAR: Benefits of Social Support of Breastfeeding

By: Shenika Holmes, Public Health Intern (BF STARS)

Shelby County Health Department

Hi, my name is Shenika Holmes, and I am a proud supporter of breastfeeding!

How many children do I have? Zero.

Am I expecting? No.

Yet, I am a young, African-American woman in the child bearing years of 15-35 from a neighborhood in Memphis- Shelby County, Tennessee characterized by low socioeconomic status, high rates of infant mortality and low breastfeeding rates. This snapshot of me is not just to further introduce myself but to shine light and even challenge us, warriors of public health, to dually engage the “soon-to-be mothers” as well as the “could-be mothers.”

This summer, I worked with the Shelby County Health Department, Community Health Bureau, and Maternal Child Health Section in accomplishing start-up operations for the BF S.T.A.R.S (Breastfeeding Sisters That Are Receiving Support) Program. BF STARS aims to reduce disparities in breastfeeding in Shelby County through professional and peer lactation support. My time with the program has allowed me, a “could be mother”, to gain more knowledge about breastfeeding and its importance to a baby and its mother.

Breastfeeding is a natural, nutritionally balanced and cost effective way to feed a baby and also provides greater health benefits for the mom and baby such as:

  • Reducing risk of cold and infections
  • Promoting healthy brain development and cognitive skills
  • Reducing the risk of chronic diseases such as Type 1 diabetes and obesity
  • Lowering the risks of respiratory conditions such as Asthma and Allergies
  • Improving Mom’s postpartum weight
  • Providing a positive emotional and mental benefits, to include the decreased likelihood of depression

My biggest take away from my experience is that a greater antidote to the present disparities of breastfeeding could lie within support and support systems reflective of BF S.T.A.R.S. Support aids in dispelling breastfeeding myths, buffers stress and increases the success of the breastfeeding experience when faced with barriers.

A community of healthier babies really starts with healthy, empowered mothers and women.

For more information about breastfeeding, please contact the Shelby County Health Department’s Clinical Services Section at 901-222-9847.