Sudden Infant Death Syndrome and Secondhand Smoke

October has been designated as Sudden Infant Death Syndrome (SIDS) Awareness Month and the North Dakota Department of Health (NDDoH) encourages residents to understand the relationship between SIDS and secondhand smoke. According to Katie Bentz, director of the SIDS program for the NDDoH, SIDS is the leading cause of death in the nation and in North Dakota for infants between 1 month and 1 year. Every year about 2,000 infants in the United States die from SIDS.

“While the direct cause of SIDS is unknown, we do know that breathing secondhand smoke or having a mother who smoked during pregnancy are risk factors for causing SIDS,” said Bentz. “Other ways to reduce the risk of SIDS are having your baby sleep on his or her back, never letting anyone smoke around your baby, and offering a pacifier at all sleep times once breastfeeding is well established.”

Secondhand smoke is a mixture of gases and particles that come from the burning end of a cigarette, cigar or pipe, along with the smoke breathed out by smokers. According to the 2014 Surgeon General’s Report, tobacco smoke contains more than 7,000 chemicals, including at least 69 that can cause cancer.

The 2006 Surgeon General’s Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, reports the following facts:

  • Babies who breathe secondhand smoke after they are born are more likely to die of SIDS
  • Mothers who smoke during pregnancy are more likely to have their babies die of SIDS
  • Smoking and exposure to secondhand smoke during pregnancy can lead to a low birth-weight baby and can reduce a baby’s lung function
  • During pregnancy, many of the compounds in secondhand smoke change the way a baby’s brain develops
  • Babies who breathe secondhand smoke have weaker lungs; their breathing problems can continue as they grow older and even when they become adults

According to Kara Hickel, health promotion coordinator for the North Dakota Tobacco Prevention and Control Program, there is help available for those who would like to quit smoking.

“NDQuits is a free service for North Dakotans to help them quit smoking and tobacco use,” said Hickel. “NDQuits offers advice and encouragement from quit coaches and free nicotine replacement medications, like nicotine patches, gum and lozenges for those who qualify. Quitting smoking and protecting your baby from secondhand smoke are two of the most important things you can do to give your baby the healthiest start possible.”

If you would like help quitting smoking or tobacco use, contact NDQuits by calling 1.800.QUIT.NOW (1.800.784.8669) or logging on to

For more information about SIDS, log on to or call Katie Bentz at 701.328.4538.

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Inflammatory Breast Cancer Awareness

Inflammatory breast cancer (IBC) represents 1 to 5 percent of all diagnosed breast cancers, and is far more aggressive and more difficult to diagnose than other breast cancers.

IBC is a relatively rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast.  This type of cancer is called “inflammatory” because the breast often looks swollen and red or “inflamed.” Because the symptoms of IBC are so different from other forms of breast cancer, accurate diagnosis is often difficult, and may result in delaying timely treatment, which is essential to survival. IBC does not present with a lump but with a red rash that often is mistaken for mastitis or other skin conditions. IBC usually grows in ‘nests’ or ‘sheets,’ rather than a tumor that causes a lump. Some women also experience thickening of the skin, pain and itching. As the cancer grows, it can result in dimpling of the skin, a condition called ‘peau d’orange.’

With the introduction of systemic chemotherapy, the five-year overall survival rate with a diagnosis of IBC has improved from 0 to 5 percent in the 1990s to a current five-year survival rate of 40 percent.  With the advancements in targeted therapy, many women with IBC are now living longer with a better quality of life.

Because IBC tends to be more aggressive (it grows and spreads much more quickly) than other types of breast cancer, it is at least stage IIIB when diagnosed (locally advanced with cancer cells in the skin). Unfortunately, it is often diagnosed at stage IV (metastatic) because it has already spread to distant parts of the body.

The advanced stage of IBC, along with the tendency to grow and spread quickly, makes it more difficult to treat successfully than other types of breast cancer. This is why it is very important for women to recognize the signs and symptoms of the disease.

Symptoms of inflammatory breast cancer include:

  • A breast that appears discolored (red, purple, pink or bruised)
  • A tender, firm and enlarged breast (sometimes overnight)
  • A warm feeling in the breast (or may feel hot/warm to the touch)
  • Persistent itching of the breast (not relieved with cream or salve)
  • Shooting or stabbing pain
  • Ridged or dimpled skin texture, similar to an orange peel
  • Thickened areas of breast tissue
  • Enlarged lymph nodes under the arm, and/or above or below the collarbone
  • Flattening or retraction of the nipple
  • Swollen or crusted skin on the nipple
  • Change in color of the skin around the nipple

If one or more of these symptoms continue for more than a week, talk to a health-care provider.  Because tenderness, redness, warmth and itching are more common than IBC, a health-care provider may first suspect infection to be the cause and treat with antibiotics.  However, if the systems do not get better in seven to 10 days, further evaluation is needed.  It is important that women become their own best advocate when it comes to ruling out inflammatory breast cancer.

More information about inflammatory breast cancer can be found by visiting For more information about Inflammatory Breast Cancer Awareness Month, contact Barbara Steiner, North Dakota Department of Health, at 701.328.2389.

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Breastfeeding Expert to Lead Conference in Fargo

Tackling the most common questions of breastfeeding is the goal of the “Solving Breastfeeding Mysteries” conference on Thursday, Oct. 23, at the Ramada Plaza Suites in Fargo.

Breastfeeding expert and co-author of The Breastfeeding Mother’s Guide to Making More Milk, Lisa Marasco, will lead the conference which will focus on the following topics:

  • Identifying tongue tie issues and latching,
  • The role of hormones in lactation,
  • Strategies for working with  “high need” mothers, and
  • Nutrients essential for milk production and lactogenic foods.

Kim Vance, director of the Women, Infants, and Children Nutrition Program at Fargo Cass Public Health says, “This conference will enable attendees to learn and share information and techniques on how to help moms have a successful breastfeeding experience.”

Nurses, dietitians, nutritionists, lactation experts, students and the public are welcome to attend this conference. The general registration fee is $75 and $35 for students. Pre-registration is required.

For more information and registration information for the conference, go to, or call 701-277-1455.

Continuing education hours were approved by: North Dakota Board of Nursing 5.75 contact hours and IBCLE  6.0 CERPs,  Commission on Dietetic Registration hours are pending.

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September is Gynecologic Cancer Awareness Month

According to the American Cancer Society, 94,990 new cases of gynecologic cancers will be diagnosed in 2014, resulting in approximately 28,790 deaths.  That is why it is important for womento take care of their health, not just in September, but every day of the year.

Gynecologic cancers include cervical cancer, ovarian cancer, uterine/endometrial cancer, vaginal cancer and vulvar cancer. Uterine cancer is the most common (more than 52,500 new cases per year), while ovarian cancer is the deadliest due to late stage diagnosis.
Cervical cancer is almost totally preventable given the availability of a vaccine for both boys and girls, and a wide-spread primary screening program using both the Pap test and HPV test (HPV is the cause of almost all cervical cancer).

There are specific steps that women can take to reduce their risks and even prevent these cancers. More than half of all cancer deaths could be prevented by staying at a healthy weight, eating right, keeping active, and getting recommended screening tests.

The Fargo Cass Public Health Clinic offers physical examinations for women including: pelvic exams, pap smears, urinalysis, and blood work. Fees are based on a sliding fee scale. Women age 40-64 may qualify for Women’s Way which may help pay for cervical and pelvic exams.

For more information or to schedule an appointment, call Fargo Cass Public Health at 701-241-1383.

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Support for Moms Who Breastfeed on the Rise

Breastfeeding mothers in North Dakota can more easily identify where to find support in both local hospitals and workplaces thanks to two designations developed by the North Dakota Department of Health’s Division of Nutrition and Physical Activity.

The newest designation allows North Dakota hospitals to provide crucial support to new mothers by earning a breastfeeding-friendly designation. The “North Dakota Breastfeeding-Friendly Hospital Designation” is a five-step program that has been developed from research-based best practices in hospitals to help mothers who breastfeed get off to the right start. “We are thrilled that many hospitals across the state are interested in this designation and are willing to take the right steps in supporting breastfeeding mothers from the start,” said BriAnna Wanner, Division of Nutrition and Dietetics.

Two hospitals that are the first to apply for the designation are:

  • West River Health Services, Hettinger
  • Sanford Health, Bismarck

“Breastfeeding is natural, but is a skill that must be learned,” said Wanner. “The first few days of life are the most crucial in predicting duration and exclusivity for breastfeeding. That is why it is important to have the right practices in place in the hospital.”

For four years, the Department of Health has given the designation of “Infant Friendly” to North Dakota businesses if they adopt a policy that supports nursing mothers in the workplace.

The following 13 North Dakota employers have been designated as infant-friendly in the last year:

  • Bismarck – City of Bismarck
  • Dickinson – Southwestern District Health Unit
  • Emerado- Ascension Lutheran Church
  • Fargo- Discovery Benefits
  • Grand Forks – Altru Family YMCA, Amazing Grains, Kidney & Hypertension Center, Kidney Institute of North Dakota, Aurora Dialysis, Grand Forks Public Library, 1101 Dental, PLLC
  • Northwood- Valley Community Health Centers
  • Rolla- Presentation Medical Center

Businesses interested in becoming “Infant Friendly” can find resources for supporting their employees and the simple application at

The designation of these businesses coincides with Gov. Jack Dalrymple’s proclamation of Breastfeeding Week, Aug. 1-7, 2014, in North Dakota, which mirrors the annual global celebration event that draws attention to the health impacts of breastfeeding for both babies and mothers. The theme this year is “Breastfeeding: A Winning Goal For Life.”

For more information about the infant friendly designation or Breastfeeding Week in North Dakota, contact BriAnna Wanner, North Dakota Department of Health, at 701.328.4529.

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Community Forum on Alcohol Misuse Prevention

On Wednesday, August 6, Fargo Cass Public Health (FCPH) will host the Community Forum on Alcohol Misuse Prevention to reveal findings from a community assessment and discuss effective strategies to prevent adult binge drinking and underage drinking in Cass County. The forum will be held two times: 1-2 p.m., and 7-8 p.m. at the Fargo City Commission Room, 200 3rd St. N., Fargo.

Fargo Cass Public Health has been awarded the Strategic Prevention Framework State Incentive Grant (SPG SIG) for Cass County. The purpose of the grant is to build our prevention infrastructure. The SPF SIG focuses on the prevention of adult binge drinking and underage drinking and consists of three phases: assessment, planning and implementation.

Fargo Cass Public Health will begin the planning phase which will include learning about effective prevention strategies, aligning them with what will work in Cass County, and using the data from the needs assessment as a guide. The public is invited to become involved in our community prevention efforts through this grant.

The community forum will address:

  • the problem of alcohol misuse in our community
  • the SPF SIG project
  • how to provide input or suggestions
  • how to apply for funding to implement strategies

If you are unable to attend personally, please send an agency/organization representative and feel free to share this information with anyone else who may be interested in attending.

For more information on the event contact Robyn Litke Sall at 701-241-1341, or


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Practice Safety Tips during Extreme Heat

Summer events are in full swing and Fargo Cass Public Health would like to remind everyone to take the necessary precautions during this heat wave to avoid dangerous health conditions. Those most vulnerable to the effects of heat include infants and young children, the elderly and those with existing medical conditions. Dangers we face during periods of very high temperatures include:

Heat Cramps: These are muscular pains and spasms due to heavy exertion. They are an early signal that the body is having trouble with the heat.

Heat exhaustion: This typically occurs when people exercise heavily or work in a hot, humid place where body fluids are lost through heavy sweating. Blood flow to the skin increases, causing blood flow to decrease to the vital organs. This results in a form of mild shock. If not treated, the victim may suffer heat stroke.

Heat stroke (sunstroke): Heat stroke is life-threatening. The victim’s temperature control system, which produces sweating to cool the body, stops working. The body temperature can rise so high that brain damage and death may result if the body is not cooled quickly. 

During a heat wave practice these safety tips:

  • Slow down and avoid strenuous activity,
  • Stay indoors as much as possible,
  • Wear lightweight, light-colored clothing,
  • Drink plenty of water regularly and often. Do not drink liquids that      contain alcohol or large amounts of sugar–these actually cause you to lose more body fluid. Also, avoid very cold drinks, because they can cause stomach cramps.
  • Eat small meals and eat more often,
  • If you have to be outside, take frequent breaks in the shade,
  • Limit your outdoor activity to morning and evening hours,
  • Do not leave anyone or pets in a parked vehicle. Even with the windows cracked open, vehicles can still get 15-20 degrees hotter than outside temperatures,
  • Check on elderly neighbors, and
  • Keep infants and young children well hydrated.

Finally, never leave your pet in a hot car, not even for a minute, even with the air conditioning running. According to the Humane Society of the United States, temperatures inside a vehicle can rise rapidly to dangerous levels. For example, on an 85-degree day, the temperature inside a car, with the windows open slightly, can reach 102 degrees within 10 minutes, which may cause your pet to suffer irreversible organ damage or die.  Also, make sure all animals have plenty of cold water available.

For more information and videos on heat safety, go to

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North Dakota Observes National HIV Testing Day

Department of Health Urges Testing for At-Risk People

In observance of National HIV Testing Day on June 27, the North Dakota Department of Health is urging people at risk for HIV/AIDS to get tested, according to Gino Jose, HIV Prevention Coordinator for the Department of Health.

The Centers for Disease Control and Prevention (CDC) estimates that over 1 million people 13 and older are living with HIV infection, including about 200,000 who are unaware of their infection. Over the past decade, the number of people living with HIV has increased, while the annual number of new HIV infections has remained relatively stable. Still, the pace of new infections continues at far too high a level— particularly among certain groups.

As of June 20, 2014, 365 people are currently living in North Dakota with HIV/AIDS. It is estimated that about one-fourth of the people infected with HIV are unaware they have HIV; as a result, these people may be unknowingly spreading their infection to others. That is why it is important for people to learn their HIV status by getting tested.  Advances in medicine have made it possible for people who have HIV infection to live long healthy lives, and knowing your status sooner can help prevent poorer health outcomes.

HIV testing is available at testing sites throughout the state, and results are available in 20 minutes. The test sites are staffed by trained personnel who offer free and confidential HIV testing, counseling and referrals to those at risk. HIV can be prevented by avoiding or not engaging in risky behaviors, such as unprotected sex, needle-sharing for drug use, or tattooing and body piercing at unlicensed facilities.

Fargo Cass Public Health offers Rapid HIV testing. For more information go to and click on STD/HIV testing.  To make an appointment, call 701-241-1383.  Residents can also visit a website where they can identify their risk factors through an anonymous survey at .

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Documentary Focuses on Under-Vaccinated Society

Fargo Cass Public Health and the Fargo Public Library invite area residents to a free screening of the documentary “Invisible Threat” (not rated) which explores the science behind disease and the risks facing a society that is under-vaccinated. Following the screening, there will be a Q&A session with Dr. Mauriello, Sanford Pediatric Infectious Disease Specialist. This film and Q&A event is set for Saturday, June 28, starting at 1 p.m. at the downtown Main Library. Contact Nicole at (701) 241-1472 or the Main Library Information Desk at (701) 241-1492 for more information. Watch the trailer at:

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Pool Season Hygiene and Safety Reminders

It is that time of year again, time for swimming lessons, fun with friends and family, and getting some much needed relief from the heat by cooling off in pools. Fargo Cass Public Health (FCPH) would like to remind area residents to take the following precautions before and after using public pools, to help prevent bacterial illnesses like Cryptosporidia, Norovirus, and “Swimmer’s Ear”:

  • Avoid the Pool:  If you do not feel well or if you have any cuts or open wounds 
  • Rinse off in the showers using soap before you start swimming
  • Take children on regular bathroom breaks and check diapers every 30-60 minutes
  • Wash hands after using the bathroom
  • Do not swallow pool water
  • Obey all pool rules
  • Wash your swimsuits after each pool visit

Another reminder is that all pools in Cass County with a circulation system and/or 2 feet of water need a fence at least 5 feet in height that completely encircles the pool.

According to FCPH environmental health director Grant Larson, “Practicing these tips helps cut down on the number of reported illnesses and injuries in and around public pools.”

For more information swimming pool rules and regulations in Cass County, call the Fargo Cass Public Health Environmental Health Division at 701-476-6729.







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