Pregnancy Heartburn
   Symptoms, Treatment & Prevention

Your Cutting-Edge heartburn during pregnancy Information Resource

heartburn during pregnancy Article

Acid Reflux During Pregnancy
Heartburn During Pregnancy
Heartburn Early Pregnancy
Heartburn In Early Pregnancy

Anti-Hypertensive Drugs To Enhance Esophageal Contraction
Nifedipine, a calcium-channel blocker, was shown to decrease lower esophageal sphincter pressure and increase esophageal acid exposure time, while atenolol, a b1 blocker, was shown to inhibit relaxation of the smooth muscle of the esophagus...
New Endoscopic Treatment May Spare Barrett's Esophagus Patients From Surgery
Early tumor formation in Barrett's esophagus (BE) can be effectively and safely treated with radiofrequency ablation (RFA), in combination with prior endoscopic removal of visible lesions, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute...
Shape Of Barrett's Epithelium Effects Prevalence Of Erosive Esophagitis
Barrett's epithelium is recognized as a complication of erosive esophagitis and is the pre-malignant condition for adenocarcinoma of the esophagus. A research team from Yokohama City University School of Medicine hypothesized that some macroscopic features of Barrett's epithelium might be useful for identifying a subgroup with a high risk for the development of esophageal adenocarcinoma...
New Hope For Therapy In Heartburn-Related Cancer
Cancer of the gullet, or oesophagus, is one of the ten most common cancers in the Western world, and there have been recent alarming increases in the number of cases each year in the US and UK. There is no good treatment, and sufferers frequently face a short, painful battle which ends all too quickly in death. Many of the cancers diagnosed are in people with a long history of heartburn...
Development Of ADX10059 Ended For Long-Term Use
Addex Pharmaceuticals (SWISS: ADXN) announced that based on preliminary review of the unblinded data from study 206, it has terminated development of ADX10059 for chronic indications, including long term treatment of gastroesophageal reflux disease and migraine prophylaxis...
Amneal Receives FDA Approval For Nizatidine Oral Solution, The First Generic Oral Solution For Axid(R) In The Market
Amneal Pharmaceuticals is pleased to announce that it has received U.S. FDA approval to manufacture Nizatidine Oral Solution in the 15 mg/mL strength effective November 18, 2009. It is an AA-rated, therapeutically equivalent alternative to Axid® Oral Solution (a licensed trademark of Braintree Labs)...
Are Manometric Findings Different Between Patients With Erosive And Nonerosive Disease?
Gastroesophageal reflux disease (GERD) is defined as the pathological retrograde movement of gastric contents into the esophagus. Various esophageal motility disturbances which may be important in reflux are observed in patients with GERD. The main esophageal motility disorder in these patients is ineffective esophageal motility (IEM)...
Why Does Percutaneous Endoscopic Gastrostomy Fail To Eliminate Gastroesophageal Reflux?
Gastroesophageal reflux (GER) is a common problem in mechanically ventilated patients and contributes to the development of esophageal mucosal injury and even erosive esophagitis. The relationship between percutaneous endoscopic gastrostomy (PEG) and subsequent development of GER is complex and not well understood...
Strengthening Sphincters In Animals Via Muscle Cell Infusion
A new study shows that muscle cells grown in the lab can restore an intestine's ability to squeeze shut properly. The work, performed in dogs and rats, might ultimately help treat patients with conditions such as gastric reflux and fecal incontinence. This technique may be used to strengthen sphincters, which are the bands of muscle that separate the major sections of your intestinal tract...
FDA Approves ZEGERID OTC(TM) For Over-the-Counter Treatment Of Frequent Heartburn
Merck & Co., Inc. announced that the U.S. Food and Drug Administration (FDA) has approved ZEGERID OTC(TM) (omeprazole 20 mg/sodium bicarbonate 1100 mg capsules), for over-the-counter treatment of frequent heartburn. ZEGERID OTC will be marketed over-the-counter by Schering-Plough HealthCare Products, Inc., the consumer healthcare division of Merck & Co., Inc...
News From The November Issue Of GIE: Gastrointestinal Endoscopy
"Screening for Barrett's esophagus in asymptomatic women" Barrett's esophagus is a condition where the lining of the esophagus changes due to chronic inflammation, generally from gastroesophageal reflux disease (GERD). Barrett's esophagus is important to recognize as it may increase the risk of developing esophageal cancer...
Reflux Esophagitis Due To Immune Reaction, Not Acute Acid Burn
Contrary to current thinking, a condition called gastroesophageal reflux disease (GERD) might not develop as a direct result of acidic digestive juices burning the esophagus, UT Southwestern Medical Center researchers have found in an animal study. Rather, gastroesophageal reflux spurs the esophageal cells to release chemicals called cytokines, which attract inflammatory cells to the esophagus...
Addex ADX10059 Monotherapy Is Effective On GERD Symptoms In Phase IIb Clinical Trial
Addex Pharmaceuticals (SWISS: ADXN), the allosteric modulation company, announced that it achieved statistically significant efficacy on the primary endpoint, increasing the number of symptom free days in the Phase IIb trial of ADX10059 as a monotherapy in patients with gastroesophageal reflux disease (GERD), the cause of heartburn and other symptoms...
Mylan Receives FDA Approval For Generic Version Of Prevacid® Through Its Subsidiary Matrix Laboratories
Mylan Inc. (NASDAQ: MYL) announced that its privately held Indian subsidiary, Matrix Laboratories Limited, has received final approval from the U.S. Food and Drug Administration (FDA) for its Abbreviated New Drug Application (ANDA) for Lansoprazole Delayed-release (DR) Capsules, 15 mg and 30 mg. This product is shipping immediately and will be sold under the Mylan Pharmaceuticals brand...
Open Wide: Incisionless Surgery To Treat GERD
Every day, more than 20 percent of the U.S. population experiences the painful burning symptoms of gastroesophageal reflux disease (GERD). For these 20 million Americans, the first line of defense is medication...
FDA Approves New Salix Product Exclusively In Catalent's Zydis(R) Fast Dissolve Technology
Catalent Pharma Solutions, one of the leading advanced drug delivery technology providers to the pharmaceutical industry, announced that the U.S. Food and Drug Administration (FDA) has granted marketing approval for Metozolv™ ODT (orally disintegrating tablets) metoclopramide HCL utilizing Catalent's Zydis® fast dissolve technology...
Unexpected Consequences Of Proton Pump Inhibitor Use In Reflux Disease
Despite being highly effective and beneficial for many patients, unexpected consequences are emerging in patients who are prescribed proton pump inhibitors (PPIs) for reflux diseases. Physicians are warned to monitor these effects and prescribe these medications carefully, according to a new commentary published in the November 2009 issue of Otolaryngology -Head and Neck Surgery...
New Procedure For Acid Reflux/GERD
Boston Medical Center (BMC) surgeons are now offering patients an incisionless alternative to laparoscopic and traditional surgery for treatment of acid reflux or GERD. Using the new procedure known as EsophyX TIF (Transoral Incisionless Fundaplication), surgeons can repair or reconstruct the valve between the esophagus and stomach, effectively stopping GERD...
New Studies Explore Connection Between High Stress And High Exposure Jobs And GI Disorders
In two new studies, presented at the American College of Gastroenterology's (ACG) 74th Annual Scientific meeting in San Diego, researchers explored the connection between high stress, high exposure occupations and long-term gastrointestinal disorders...
New Study Results Analyzed The Use Of KAPIDEX(TM) (dexlansoprazole) For Nighttime Heartburn In Adults With Non-Erosive GERD
New data being presented at the American College of Gastroenterology (ACG) 2009 Annual Scientific Meeting in San Diego showed that treatment with KAPIDEX(TM) (dexlansoprazole) delayed release capsules over a four-week period resulted in a statistically significant greater percentage of nights without heartburn in subjects with non-erosive gastroesophageal reflux disease (GERD),...
Possible Weight-Gain From Long-Term Treatment With Proton Pump Inhibitor
Gastroesophageal reflux disease (GERD) is the most common esophageal disorder, and frequently encountered in the primary care setting. Accumulating evidence has confirmed the excellent efficacy and safety of proton pump inhibitor (PPI) therapy in patients with all grades of GERD, making these agents the mainstay of treatment...
XenoPort Announces Initiation Of A Phase 2b Clinical Trial Of Arbaclofen Placarbil In Patients With Gastroesophageal Reflux Disease
XenoPort, Inc. (Nasdaq:XNPT) announced today that it has initiated a Phase 2b clinical trial of arbaclofen placarbil (AP), also known as XP19986, in patients with gastroesophageal reflux disease (GERD) who remain symptomatic despite treatment with a proton pump inhibitor (PPI)...
Heartburn Drugs Deemed Safe For Fetuses According To Ben-Gurion University Researchers
H2 Blocker drugs, such as Famotidine, Cimetidine and Ranitidine, approved in the U.S. for acid reflux (heartburn), pose no significant risks for the fetus according to a large collaborative cohort study by researchers at Ben-Gurion University of the Negev...
Addex Completes Enrollment Of First Mid-Stage Clinical GERD Trial
Addex Pharmaceuticals (SWISS: ADXN), the allosteric modulation company, announced the completion of enrollment in the Phase IIb trial of ADX10059 as a monotherapy in patients with gastroesophageal reflux disease (GERD), the cause of heartburn and other symptoms...
Mayo Clinic Researchers Lead National Clinical Trial Testing New Treatment For Chronic, Severe Indigestion
Could medicines used for depression also treat chronic, severe indigestion? Scientists at Mayo Clinic suspect they can and, backed by funding from the National Institutes of Health (NIH), they are testing that premise in a nationwide clinical trial...

Below, you'll find extensive information on leading heartburn during pregnancy articles and products to help you on your way to success.

Pregnancy Heartburn, Remedies During Pregnancy That Can Help Relieve Your Heartburn Pregnancy Misery!
By Hannah Bajor, C.N.M.,M.S.N. Pregnancy Success Coach
Pregnancy heartburn relief during pregnancy is a common concern many pregnant women have. Read on to see what you what remedies can be used to help relieve heartburn during pregnancy.

What causes pregnancy heartburn?
Heartburn in early pregnancy is a common complaint. The hormone progesterone is released as soon a woman becomes pregnant and can cause many early pregnancy symptoms which include pregnancy heartburn. Progesterone causes relaxation of the cardiac sphincter of the stomach which is the muscle between the stomach and the esophagus (food pipe). Relaxation of this muscle allows for some gastric acid and food to flow backwards and re-enter the esophagus (food pipe). Gastric acid irritates the lining of the esophagus causing a burning sensation in the center of the chest called pregnancy heartburn.


As your baby grows bigger and takes up more room in the abdominal area, the stomach itself is displaced and squashed. The growing uterus can permanently press on the cardiac sphincter of the stomach and allow gastric juices and food to constantly leak back into the esophagus (wind pipe) which may cause severe heartburn during pregnancy.

Heartburn pregnancy remedies that can help alleviate some of your heartburn during pregnancy:
Pregnancy heartburn relief can be achieved by eating yogurt or drinking a glass of milk.

Try a tablespoon of honey in a glass of warm milk can help with pregnancy heartburn.

Eat smaller more frequent meals throughout the day rather than three large meals.

Avoid spicy, greasy, fatty foods, peppers and tomatoes produce extra gastric acid causing pregnancy heartburn.

Avoid foods that relax the cardiac sphincter of the stomach such as alcohol, peppermint, garlic, and chocolate as they can add to pregnancy heartburn.

Sleeping with extra pillows under your

Anti-Hypertensive Drugs To Enhance Esophageal Contraction
Nifedipine, a calcium-channel blocker, was shown to decrease lower esophageal sphincter pressure and increase esophageal acid exposure time, while atenolol, a b1 blocker, was shown to inhibit relaxation of the smooth muscle of the esophagus...
New Endoscopic Treatment May Spare Barrett's Esophagus Patients From Surgery
Early tumor formation in Barrett's esophagus (BE) can be effectively and safely treated with radiofrequency ablation (RFA), in combination with prior endoscopic removal of visible lesions, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute...
Shape Of Barrett's Epithelium Effects Prevalence Of Erosive Esophagitis
Barrett's epithelium is recognized as a complication of erosive esophagitis and is the pre-malignant condition for adenocarcinoma of the esophagus. A research team from Yokohama City University School of Medicine hypothesized that some macroscopic features of Barrett's epithelium might be useful for identifying a subgroup with a high risk for the development of esophageal adenocarcinoma...
New Hope For Therapy In Heartburn-Related Cancer
Cancer of the gullet, or oesophagus, is one of the ten most common cancers in the Western world, and there have been recent alarming increases in the number of cases each year in the US and UK. There is no good treatment, and sufferers frequently face a short, painful battle which ends all too quickly in death. Many of the cancers diagnosed are in people with a long history of heartburn...
Development Of ADX10059 Ended For Long-Term Use
Addex Pharmaceuticals (SWISS: ADXN) announced that based on preliminary review of the unblinded data from study 206, it has terminated development of ADX10059 for chronic indications, including long term treatment of gastroesophageal reflux disease and migraine prophylaxis...
Amneal Receives FDA Approval For Nizatidine Oral Solution, The First Generic Oral Solution For Axid(R) In The Market
Amneal Pharmaceuticals is pleased to announce that it has received U.S. FDA approval to manufacture Nizatidine Oral Solution in the 15 mg/mL strength effective November 18, 2009. It is an AA-rated, therapeutically equivalent alternative to Axid® Oral Solution (a licensed trademark of Braintree Labs)...
Are Manometric Findings Different Between Patients With Erosive And Nonerosive Disease?
Gastroesophageal reflux disease (GERD) is defined as the pathological retrograde movement of gastric contents into the esophagus. Various esophageal motility disturbances which may be important in reflux are observed in patients with GERD. The main esophageal motility disorder in these patients is ineffective esophageal motility (IEM)...
Why Does Percutaneous Endoscopic Gastrostomy Fail To Eliminate Gastroesophageal Reflux?
Gastroesophageal reflux (GER) is a common problem in mechanically ventilated patients and contributes to the development of esophageal mucosal injury and even erosive esophagitis. The relationship between percutaneous endoscopic gastrostomy (PEG) and subsequent development of GER is complex and not well understood...
Strengthening Sphincters In Animals Via Muscle Cell Infusion
A new study shows that muscle cells grown in the lab can restore an intestine's ability to squeeze shut properly. The work, performed in dogs and rats, might ultimately help treat patients with conditions such as gastric reflux and fecal incontinence. This technique may be used to strengthen sphincters, which are the bands of muscle that separate the major sections of your intestinal tract...
FDA Approves ZEGERID OTC(TM) For Over-the-Counter Treatment Of Frequent Heartburn
Merck & Co., Inc. announced that the U.S. Food and Drug Administration (FDA) has approved ZEGERID OTC(TM) (omeprazole 20 mg/sodium bicarbonate 1100 mg capsules), for over-the-counter treatment of frequent heartburn. ZEGERID OTC will be marketed over-the-counter by Schering-Plough HealthCare Products, Inc., the consumer healthcare division of Merck & Co., Inc...
News From The November Issue Of GIE: Gastrointestinal Endoscopy
"Screening for Barrett's esophagus in asymptomatic women" Barrett's esophagus is a condition where the lining of the esophagus changes due to chronic inflammation, generally from gastroesophageal reflux disease (GERD). Barrett's esophagus is important to recognize as it may increase the risk of developing esophageal cancer...
Reflux Esophagitis Due To Immune Reaction, Not Acute Acid Burn
Contrary to current thinking, a condition called gastroesophageal reflux disease (GERD) might not develop as a direct result of acidic digestive juices burning the esophagus, UT Southwestern Medical Center researchers have found in an animal study. Rather, gastroesophageal reflux spurs the esophageal cells to release chemicals called cytokines, which attract inflammatory cells to the esophagus...
Addex ADX10059 Monotherapy Is Effective On GERD Symptoms In Phase IIb Clinical Trial
Addex Pharmaceuticals (SWISS: ADXN), the allosteric modulation company, announced that it achieved statistically significant efficacy on the primary endpoint, increasing the number of symptom free days in the Phase IIb trial of ADX10059 as a monotherapy in patients with gastroesophageal reflux disease (GERD), the cause of heartburn and other symptoms...
Mylan Receives FDA Approval For Generic Version Of Prevacid® Through Its Subsidiary Matrix Laboratories
Mylan Inc. (NASDAQ: MYL) announced that its privately held Indian subsidiary, Matrix Laboratories Limited, has received final approval from the U.S. Food and Drug Administration (FDA) for its Abbreviated New Drug Application (ANDA) for Lansoprazole Delayed-release (DR) Capsules, 15 mg and 30 mg. This product is shipping immediately and will be sold under the Mylan Pharmaceuticals brand...
Open Wide: Incisionless Surgery To Treat GERD
Every day, more than 20 percent of the U.S. population experiences the painful burning symptoms of gastroesophageal reflux disease (GERD). For these 20 million Americans, the first line of defense is medication...
FDA Approves New Salix Product Exclusively In Catalent's Zydis(R) Fast Dissolve Technology
Catalent Pharma Solutions, one of the leading advanced drug delivery technology providers to the pharmaceutical industry, announced that the U.S. Food and Drug Administration (FDA) has granted marketing approval for Metozolv™ ODT (orally disintegrating tablets) metoclopramide HCL utilizing Catalent's Zydis® fast dissolve technology...
Unexpected Consequences Of Proton Pump Inhibitor Use In Reflux Disease
Despite being highly effective and beneficial for many patients, unexpected consequences are emerging in patients who are prescribed proton pump inhibitors (PPIs) for reflux diseases. Physicians are warned to monitor these effects and prescribe these medications carefully, according to a new commentary published in the November 2009 issue of Otolaryngology -Head and Neck Surgery...
New Procedure For Acid Reflux/GERD
Boston Medical Center (BMC) surgeons are now offering patients an incisionless alternative to laparoscopic and traditional surgery for treatment of acid reflux or GERD. Using the new procedure known as EsophyX TIF (Transoral Incisionless Fundaplication), surgeons can repair or reconstruct the valve between the esophagus and stomach, effectively stopping GERD...
New Studies Explore Connection Between High Stress And High Exposure Jobs And GI Disorders
In two new studies, presented at the American College of Gastroenterology's (ACG) 74th Annual Scientific meeting in San Diego, researchers explored the connection between high stress, high exposure occupations and long-term gastrointestinal disorders...
New Study Results Analyzed The Use Of KAPIDEX(TM) (dexlansoprazole) For Nighttime Heartburn In Adults With Non-Erosive GERD
New data being presented at the American College of Gastroenterology (ACG) 2009 Annual Scientific Meeting in San Diego showed that treatment with KAPIDEX(TM) (dexlansoprazole) delayed release capsules over a four-week period resulted in a statistically significant greater percentage of nights without heartburn in subjects with non-erosive gastroesophageal reflux disease (GERD),...
Possible Weight-Gain From Long-Term Treatment With Proton Pump Inhibitor
Gastroesophageal reflux disease (GERD) is the most common esophageal disorder, and frequently encountered in the primary care setting. Accumulating evidence has confirmed the excellent efficacy and safety of proton pump inhibitor (PPI) therapy in patients with all grades of GERD, making these agents the mainstay of treatment...
XenoPort Announces Initiation Of A Phase 2b Clinical Trial Of Arbaclofen Placarbil In Patients With Gastroesophageal Reflux Disease
XenoPort, Inc. (Nasdaq:XNPT) announced today that it has initiated a Phase 2b clinical trial of arbaclofen placarbil (AP), also known as XP19986, in patients with gastroesophageal reflux disease (GERD) who remain symptomatic despite treatment with a proton pump inhibitor (PPI)...
Heartburn Drugs Deemed Safe For Fetuses According To Ben-Gurion University Researchers
H2 Blocker drugs, such as Famotidine, Cimetidine and Ranitidine, approved in the U.S. for acid reflux (heartburn), pose no significant risks for the fetus according to a large collaborative cohort study by researchers at Ben-Gurion University of the Negev...
Addex Completes Enrollment Of First Mid-Stage Clinical GERD Trial
Addex Pharmaceuticals (SWISS: ADXN), the allosteric modulation company, announced the completion of enrollment in the Phase IIb trial of ADX10059 as a monotherapy in patients with gastroesophageal reflux disease (GERD), the cause of heartburn and other symptoms...
Mayo Clinic Researchers Lead National Clinical Trial Testing New Treatment For Chronic, Severe Indigestion
Could medicines used for depression also treat chronic, severe indigestion? Scientists at Mayo Clinic suspect they can and, backed by funding from the National Institutes of Health (NIH), they are testing that premise in a nationwide clinical trial...

head to keep your stomach lower than your esophagus (food pipe) works very well to give you a better start to the day and a better nights sleep and minimize night time pregnancy heartburn.

Avoid eating for at least two hours before going to bed is also a great suggestion to minimize pain associated with night time heartburn during pregnancy.

Do not lie down after eating to prevent the food from the stomach flowing back into your esophagus causing pregnancy heartburn.

Mild over-the-counter antacids such as Mylanta or Tums may prove helpful in relieving heartburn during pregnancy.

If your symptoms are severe or accompanied by headache or swelling (especially if you are later on in pregnancy) consult with your health care provider immediately as you may have pre-eclampsia of pregnancy.

One of the most effective ways to deal with is to try to prevent heartburn developing in the first place. The healthier you are prior pregnancy and the healthier you eat during pregnancy can have a direct correlation to the amount of pregnancy symptoms you have. Supplement with a high quality vitamins, mineral and antioxidants prior and during pregnancy will correct many misalignments within the body, and encourage the stomach to produce the right amount of gastric acid that you body needs for digestion.

Pregnancy can be an extraordinary experience for a woman. It is far more than growing a baby and dealing with issues like heartburn. Pregnancy has a huge emotional, mental, spiritual, and energetic side to it. The more you understand these aspects, the easier and less symptomatic your pregnancy will be. Learning how to connect with the emotions of your unborn child will allow you to enhance your pregnancy experience and surrender to its normal physiological process of pregnancy heartburn
Learn more how you can communicate with the emotions of your unborn child and pick up a FREE GIFT to support you during your pregnancy visit click on www.PregnancySuccessCoach.com.

We strive to provide only quality articles, so if there is a specific topic related to pregnancy heartburn that you would like us to cover, please contact us at any time.

And again, thank you to those contributing daily to our heartburn during pregnancy website.

Chinese medicine 'no help to get pregnant' (AFP)
AFP - Couples who use acupuncture and Chinese medicine to try and increase their chances of having a baby were warned there was no evidence it worked by British fertility experts Wednesday.
Home abortion drug use effective, safe for most (Reuters)
Reuters - Medication-induced home abortions are safe for women who are 50 to 63 days pregnant, a new study from Sweden shows.
Hoped-for drop in childbirth deaths not happening (AP)
AP - Eleven days after her son Benjamin's birth by C-section, Linda Coale awoke in the middle of the night in pain, one leg badly swollen. Just as her doctor returned her phone call asking what to do, she dropped dead from a blood clot.
1 in 5 At-Risk U.S. Babies Doesn't Get Hepatitis B Vaccine (HealthDay)
HealthDay - MONDAY, March 8 (HealthDay News) -- About one in five babies born to mothers with hepatitis B aren't getting treatments that have been shown to prevent the infection in newborns, a new study finds.
HIV among newborns could be 'eradicated by 2015' (AFP)
AFP - Within five years, the world could shield all newborns from HIV, while making strides in reducing deaths from malaria and tuberculosis, the Global Fund to fight the three diseases said Monday.
World could soon shield "most newborns" from HIV (AFP)
AFP - Within five years the world could shield all newborns from HIV, while making strides in reducing deaths from malaria and tuberculosis, the Global Fund to fight the three diseases said Monday.
World could soon shield "most newborns from HIV" (AFP)
AFP - Within five years the world could shield all newborns from HIV, while making strides in reducing deaths from malaria and tuberculosis, the Global Fund to fight the three diseases said Monday.
World could soon shield "all newborns from HIV" (AFP)
AFP - Within five years the world could shield all newborns from HIV, while making strides in reducing deaths from malaria and tuberculosis, the Global Fund to fight the three diseases said Monday.
World could soon shield "all newborns from HIV" (AFP)
AFP - Within five years the world could shield all newborns from HIV, while making strides in reducing deaths from malaria and tuberculosis, the Global Fund to fight the three diseases said Monday.
Protect Your Baby's Smile (HealthDay)
HealthDay - SATURDAY, March 6 (HealthDay News) -- The best way to give your children's teeth a healthy start is to begin dental care early in life, and the American Dental Association has tips for keeping kids' teeth in tip-top shape: Visit the dentist for regular checkups. Set up an appointment within six months of the eruption of a child's first tooth, but no later than the first birthday. Routine exams, cleanings and fluoride treatments can catch problems early before they get worse and require significant care. ...