Health Headlines

ABC(NEW YORK) -- Radio icon Delilah opens up about her life off-air and the inspiration behind her new book, "One Heart at a Time."

Delilah recently spoke out about embracing her faith following the death of her son two years ago.

The much-loved radio personality's 18-year-old son Zachariah died by suicide in October 2017. She also lost her 16-year-old son Sammy in 2012 from complications from sickle-cell anemia.

While appearing on "The Dr. Oz Show" on Friday, Delilah said she did not think her son Zachariah was suicidal and opened up on his death.

"He [gave me permission] to call his doctor and I did call. I called twice and I said, 'My son's talking about weird space travel and weird time loop continuums' and his doctor never returned my call," she told Dr. Mehmet Oz about her son.

She went on, "And, he spent Saturday and Sunday at his dad's house, they had his favorite food, they watched 'Star Wars' then Monday night, he came home from his dad's house. He spent a few hours in the barn with our cats. We had four kittens...he came in and ate dinner with our family. Went up to his room and played video games, and then at 10:30 he came down. I was in Africa, and he said to my husband, 'I'm going to go for a walk.'"

She explained that he left a nine-page letter that focused on "time travel." Delilah also shared what she missed most about him: "He had more energy than all my other kids added up -- just larger than life."

Her healing process largely revolved around her faith, she explained.

"There’s a man named Rory Feek, who is a country songwriter who lost his wife to cancer,” she said. "And he called me, and he said, 'Delilah, your boys are much more a part of your future than they are of your past.'”

"We share the same faith and I just, I was in this rage, and I said, how can you say that? I don’t get to go to their weddings, I don’t get to see their babies, I don’t get to be a grandma, I don’t get to see them graduate, both of them," she said. "And he said, 'Because you know where they are, and you know you’ll be with them in the future.'”

The mother of 13 previously spoke out about her son's death by suicide in 2018 while discussing her memoir "One Heart at a Time" with "Good Morning America" co-host Robin Roberts.

"I couldn't write, I couldn't talk about it," she said of Zachariah's death.

Delilah said her sister offered to step in and her write a book about Zachariah.

"I'm like, 'Oh, no, no, no, no. Nobody's telling Zack's story but me,'" she said. "I do want parents to know...we need to talk about teenage suicide."

"And we need to start having open conversations as painful as they are," she added. "Because it's epidemic."

If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741-741.

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Ceneri/iStock(NEW YORK) -- Parents have all sorts of parties to celebrate, well, parenting.

When baby showers for any child beyond the first became taboo, then came the "sprinkle" -- a baby shower celebrating children born after the first child. The next parent party trends included the "gender reveal," the "babymoon," the "hatchelorette" ... and now, there is the weaning party.

A significant difference with the weaning party is that it's a celebration of the end of having children, as opposed to the celebration of a birth. On the Bravo series Real Housewives of Orange County, Braunwyn Windham-Burke threw herself a weaning party to celebrate the end of breastfeeding her seventh and last child.

The party appeared similar to a rowdy bachelorette party: strippers, a nipple cake and X-rated gifts.

The earliest reference ABC News' Good Morning America could find for a weaning party was from 2007, but it had a very different connotation. On the blog Journey to Here, the author wrote about planning a party to ease the transition of weaning her daughter.

"A party complete with cupcakes, balloons and a birthday song sung to the words of 'No more nee nee’s for you, no more nee nee’s for you. No more nee nee’s for Camden. No more nee nee’s for you.' I then made her a chart that would help her countdown to her party and also help her visually see how many times she had left to nurse," the blog reads.

Breastfeeding advocacy group La Leche League International also mentions a weaning party on its website.

It appears Windham-Burke may have invented her version of the party. The reactions on social media were mixed.

"I love her but a weaning party ... they really throw a party for anything huh?" wrote one.

"Sorry but kind of strange behaviour for a mother of 7 & women over 40 but as Tamra Judge would say 'that’s just my opinion,'" wrote another.

And while Windham-Burke appeared to have the time of her life at the party on the show, her emotions were raw during an after-show interview.

She pointed out that she had been having and nursing children for 20 years and it was the end of an era.

"I'm not having any more kids," she said, choking back tears. "I would have 30 kids if I could. All I ever wanted in my entire life was to be a mom. It was a fun party, but nobody at that party realized what a big deal that [the end of her time having children] was to me. But I wasn't really celebrating."

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Adene Sanchez/iStock(NEW YORK) -- The children of low-income mothers who benefit from the federal government's Special Supplemental Nutrition Program for Women, Infants and Children are one-third less likely to die during their first year of life than babies born to mothers without WIC benefits, according to a new study.

The study, published in the Journal of American Medicine, comes as many federal programs for low-income populations face increasing scrutiny.

"All safety net programs are being scrutinized under a magnifying glass," Dr. Samir Soneji, one the study's authors, told ABC News. "There is a legitimate question as to the benefit of WIC."

The study analyzed the birth certificates of babies born to more than 11 million women between 2011 and 2017. Those certificates included data on a mother's participation in WIC, which includes vouchers for foods rich in protein and iron, including dairy.

"The study shows that WIC works," said Soneji, adding that the U.S. still has one of the highest infant mortality rates in the world despite a robust economy.

WIC, according to the program's website, "provides federal grants to states for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk."

Dietitians who work with pregnant women said that the study is consistent with what they see in practice.

"I'm not surprised," said Liz Weinandy, lead outpatient dietitian at Ohio State University's Wexner Medical Center.

Weinandy, who counsels pregnant patients who receive WIC benefits, noted that sometimes pregnant women are unaware of needing more iron and other nutrients during pregnancy.

"WIC has a profound impact on patients," she added.

Even public policy organizations that have been critical of other similar programs, such as the Supplemental Nutrition Assistance Program, which saw additional restrictions enacted this week, said they supported results of the WIC study.

"This is generally a good study and is suggestive of the positive benefits of WIC," Angela Rachidi, a research fellow at the American Enterprise Institute. "I do think WIC enjoys bipartisan support, it has integrity. Public money from WIC is being spent on nutritious food, and the food bought with SNAP isn't always considered healthy."

According to data from the U.S. Department of Agriculture, which administers the WIC program, more than 6 million Americans receive monthly benefits, with more than 3 million of those being children and 1 million being infants.

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Hailshadow/iStock(WASHINGTON) -- More than 140,000 people around the world died of measles last year, most of them children under the age of 5, according to a report published by the World Health Organization and Centers for Disease Control and Prevention Thursday.

This year is shaping up to be even worse, as deadly outbreaks continued to sweep the globe in 2019. As of mid-November, the number of measles cases countries reported to WHO was three times higher than the number of cases reported at this time last year.

This week, officials in Samoa advised the public to hang red flags outside their homes to indicate that they have an unvaccinated family member living there. The flags appear to be a twist on a disease-control practice dating back to the Middle Ages, when people marked homes and businesses affected by the Black Plague.

In Samoa, the flags are intended to make it easier for health workers who are going door-to-door and vaccinating a community in the throes of a measles outbreak. At last count, 62 people have died, on an island nation of 200,000 residents. Almost all of those deaths were among young children.

Samoa's story is one sliver of a larger narrative about a measles spike following more than a decade of progress toward eliminating the disease. In 2000, there were roughly 28,000,000 estimated measles cases worldwide. By 2017, that number had fallen to fewer than 8,000,000 cases.

Last year, progress ground to a halt.

2018 saw nearly 10,000,000 estimated cases of the infectious disease spread around the world.

"In other words, we're backsliding," warned Dr. Kate O'Brien, director of immunization, vaccines and biologicals at WHO.

"There's been an increase in both the cases and the deaths that have occurred from measles," she said.

In 2018, Albania, Czechia, Greece and the United Kingdom, lost their coveted measles elimination status, meaning they've had continuous measles transmissions for more than a year after previously declaring the disease eliminated. The United States, which this year logged the highest number of measles cases in more than two decades, barely clung to its own status. Outbreaks in Brooklyn and New York State that lasted for nearly 12 months threatened to end nearly 20 years of having the elimination designation.

Why measles is rebounding around the world

The best defense against the measles is the measles vaccine, but despite being safe, effective and in use for half a century, there are still large gaps in immunization coverage around the world.

In poorer countries, access to the vaccine is a problem, according to WHO. The vaccine isn't reaching everyone who needs it, especially in parts of sub-Saharan Africa, which has the greatest disease burden. As it stands, five countries -- the Democratic Republic of Congo, Liberia, Madagascar, Somalia and Ukraine -- accounted for nearly half of worldwide measles cases in 2018.

Richer countries have a different problem.

While access to the vaccine isn't an issue, confidence in the measles vaccine is falling precipitously.

"We're seeing a surge in misinformation around vaccines in general, and in particular, around measles vaccine," O'Brien said. "This is a very high concern for us, because families, parents, are really vulnerable to misinformation."

In the United States, spreading misinformation about the measles vaccine has been the domain of a group of prominent anti-vaccine advocates who have permeated communities, such as the Orthodox Jewish community in New York and the Somali community in Minnesota, distributing false information claiming vaccines are dangerous.

Misinformation about vaccines has similarly proliferated online, largely fueled by the same small group of anti-vaccine advocates. A study published last month in the journal Vaccines, found that 54% of advertisements spreading misinformation about vaccines on Facebook were funded by just two anti-vaccine groups, one of which is led by Robert Kennedy Jr., a known anti-vaccine advocate.

"If you're not somebody who understands where the information is coming from, [it's difficult] to discern accurate, credible scientific information from misinformation," O'Brien said.

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milanfoto/iStock()SAN DIEGO) -- Seven people in San Diego have died from a flesh-eating bacterial infection linked to black tar heroin use, according to local health officials.

Over the last two months, nine people were admitted to San Diego hospitals for severe myonecrosis infections. All but two of those cases proved fatal.

The soft tissue infection, which starts as pain or swelling around a wound or injection site, can cause people to go into shock if left untreated, according to San Diego County Health and Human Services Agency. It can also lead to amputations or death, as it did in the San Diego cases.

Health officials also confirmed one case of wound botulism in a patient in October, adding to the 13 confirmed and probable wound botulism cases that have been reported in Southern California this fall.

“People who use black tar heroin are not only at higher risk of dying from an overdose, but also more prone to developing myonecrosis and wound botulism,” Dr. Wilma Wooten, a San Diego county public health officer, said in a statement.

Wound botulism occurs when Clostridium botulinum, the same bacteria that causes botulism in food, gets into a wound and forms a toxin, according to the Centers for Disease Control and Prevention. The condition is rare, with roughly 20 cases reported each year, typically among injection drug users.

According to provisional estimates from the CDC, more than 15,000 people died from heroin overdoses in 2018.

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Chainarong Prasertthai/iStock(NEW YORK) -- As cellphones became an omnipresent part of life over the past two decades, head and neck injuries associated with the devices spiked dramatically, according to a new study.

Injuries were infrequent until 2007, but as cellphones became more popular -- and more distracting -- injuries soared. In 2016, there were 9,431 cellphone-related injuries, compared with 2,709 injuries in 2007.

"The biggest point isn't the objective numbers, it's the change you see around 2007," said Dr. Boris Paskhover, co-author of the new study, which was published Thursday in the journal JAMA Otolaryngology.

During the last 10 years, the way we use our phones has drastically changed. Apple launched its first iPhone in 2007, and since then, cellphones are used more like computers than like landline devices they replaced.

"We're not using them as phones anymore," said Paskhover, who is also a surgeon at Rutgers New Jersey Medical School. "We're not paying attention to our surroundings."

The most common forms of self-reported cellphone injury were lacerations and abrasions, followed by internal organ injuries, which includes traumatic brain injuries. Many of these injuries were caused by people using their phones while doing other activities, such as texting while walking or driving.

Researchers analyzed a national database of 2,501 patients who went to the emergency room for cellphone injuries and found that teenagers and young adults between the ages of 13 and 29 were most likely to report cellphone-related injuries occurring because they were distracted.

It's also likely that cellphone injuries are under-counted, according to Paskhover, since there can be legal ramifications to admitting to texting while driving for example. Importantly, as our social behavior changes, "We have to be more aware of our surroundings," he added.

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whitemay/iStock(WASHINGTON) -- More than 100 people across the U.S. have been infected with E.coli linked to romaine lettuce, according to federal officials.

The Food and Drug Administration, Centers for Disease Control and Prevention, and state health authorities say evidence indicates that romaine lettuce from the Salinas, California, growing region is "a likely source of this outbreak."

There have been 102 cases reported in 23 states, according to the CDC.

"Consumers should not eat romaine lettuce harvested from Salinas, California. Additionally, consumers should not eat products identified in the recall announced by the USDA on November 21, 2019," the FDA said in a press release.

Of those who have been infected with the outbreak strain of E. coli, 58 have been hospitalized and 10 have developed hemolytic uremic syndrome, a type of kidney failure, the CDC said.

There have been no reported deaths as a result of the outbreak.

The warning included all types of romaine lettuce grown in the Salinas area, including whole heads of romaine, organic romaine, hearts of romaine and romaine in salad wraps.

Consumers are advised if they have lettuce that was grown in Salinas to throw it away or return it to the place of purchase. Anyone ordering salad containing romaine at a restaurant or a salad bar should ask the staff if the lettuce came from Salinas, officials said.

The public should also stay away from packages of pre-cut lettuce and salad mixes that contain any romaine, according to the CDC.

Wisconsin has reported the most ill people, with a total of 31. Arizona, California, Colorado, Florida, Idaho, Iowa, Illinois, Maryland, Michigan, Minnesota, Montana, Nebraska, New Jersey, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, South Dakota, Texas, Virginia and Washington have also reported people infected.

The CDC first issued an advisory last month after 67 people became ill.

Most people infected with that strain of E. coli can experience diarrhea, which is often bloody, and vomiting. Many of those infected recover within a week, but, in rare cases, a person can develop a severe infection.

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iStock(WASHINGTON) -- For the first time in decades, the House of Representatives is shining a light on making cosmetics safer.

On Wednesday, the Subcommittee on Health of the Committee on Energy and Commerce held a hearing entitled "Building Consumer Confidence by Empowering FDA to Improve Cosmetic Safety."

The hearing focused on legislation being introduced to help protect cosmetics users, including the Safe Cosmetics and Personal Care Products Act of 2019 and the Cosmetic Safety Enhancement Act of 2019.

"Consumers today assume that the cosmetic products they purchase are safe and appropriately regulated, but unfortunately that isn’t always the case," Rep. Frank Pallone Jr., D-N.J., the chairman of the Energy and Commerce Committee, said in his opening statement. "The truth is that Congress has not updated FDA’s authority to regulate the multi-billion-dollar cosmetic industry in over 80 years."

M. Isabelle Chaudry, a senior policy manager of the National Women's Health Network, explained in her testimony the issue at hand.

"There are several critical issues and loopholes in federal cosmetic regulation that allow manufacturers to use dangerous ingredients in their products and evade full disclosure of the chemicals contained in those products, and then sell those products to the American public, all of which puts consumers' health at risk," Chaudry said.

She highlighted the importance of understanding the safety of ingredients in cosmetics to the overall health of users, as they can significantly impact their long-term health and potentially create a risk for infertility in women and girls.

On average, women use 12 products a day containing a total of 168 unique ingredients, while men use six products daily with 85 unique ingredients, according to an Environmental Working Group. However, almost none are tested for safety.

In 2011, the National Toxicology Program at the Department of Health and Human Services declared formaldehyde a known human carcinogen that has been found to cause cancer of the lymphatic system, head, nose and neck, as demonstrated by animal and human studies. Yet, nearly one-fifth of cosmetic products contain this potentially harmful ingredient in product formulations, according to the Food and Drug Administration.

Additionally, other risky ingredients such as phthalates and parabens, were banned from hand soaps by the FDA in 2016 because of their potential to be linked to cancer, impaired reproductive ability and compromised neurodevelopment in children, according to a 2017 Scientific American article. But they are still often found in cosmetics such as makeup, hair and moisturizers, according to the same report.

Chaudry also shed light on how women of color are disproportionately affected by environmental chemical exposures.

"Black women and women of color are particularly at risk because the cosmetic and personal care products marketed and sold to them often contain the most harmful ingredients," she said.

According to the Environmental Working Group Skin Deep Cosmetics Database, a free online resource for finding less-hazardous alternatives to personal care products, an analysis of ingredients in 1,177 beauty and personal care products marketed to black women found about one in 12 was ranked as "highly hazardous."

Beautycounter founder and CEO Gregg Renfrew, who also testified at Wednesday's hearing, spoke on behalf of her community of advocates.

"I am one person, but I represent the many who have been fighting hard for cosmetic reform," she wrote in an Instagram caption. "It is time. Congress has the opportunity to act to help us fulfill our mission of getting safer products into the hands of everyone."

Renfrew also pointed out in another post, that the U.S. has not passed a major federal law governing the cosmetics industry since 1938.

"I knew this effort would require the education of our lawmakers by a movement of people committed to transparency and consumer safety," she wrote.

"By amplifying our collective voice over the past seven years through calls, texts, and meetings with representatives, it's clear that we have been heard."

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iStock(WASHINGTON) -- The Trump administration unveiled a new program to provide HIV prevention medication to people without prescription drug coverage as a part of the president's ambitious effort to eradicate the virus in America by 2030.

The government's Ready, Set, PrEP program will provide about 200,000 uninsured Americans annually with free access to daily pre-exposure prophylaxis, or PrEP, medications that prevent those exposed to the virus from contracting it.

The medications, which can reduce the chances of getting HIV through sex by more than 90%, will be donated by Gilead Sciences, which manufactures Truvada and Descovy -- the only HIV prevention drugs currently approved by the federal government. A 30-day supply of the drugs can cost as much as $2,000 without insurance.

"Ready, Set, PrEP is a historic expansion of access to HIV prevention medication and a major step forward in President Trump’s plan to end the HIV epidemic in America," U.S. Department of Health and Human Services Secretary Alex Azar said in a statement Tuesday. "The Trump Administration recognizes the vital role of prevention in ending the HIV epidemic in America, and connecting members of vulnerable communities to prevention services and medication is an important part of the President’s initiative."

To qualify for the program, participants must test negative for HIV, have a valid on-label prescription for PrEP and not have any prescription drug coverage.

The introduction of PrEP helped cities like New York, once the at heart of the nation's deadly AIDS crisis, bring new infections to their lowest level on record last year. Researchers said NYC's success is the result of a three-part plan implemented by the city, which stresses the importance of identifying, tracking and treating residents infected with the virus. The plan relies heavily on the use of PrEP and antiretroviral drugs, which suppress HIV to untransmittable levels. Health care experts believe the strategy could help bring the disease below epidemic levels if implemented nationwide.

President Donald Trump pledged to eliminate HIV transmission within 10 years during his State of the Union address earlier this year, noting that science had "brought a once-distant dream within reach."

"We have made incredible strides, incredible,” Trump said in January. "Together, we will defeat AIDS in America and beyond."

More than 1.2 million Americans are at risk for HIV, but only about 220,000 had received a prescription for PrEP in 2018, according to the Centers for Disease Control and Prevention. Coverage was especially low among young gay and bisexual people of color who could benefit from PrEP the most, according to the CDC. White people are between four and seven times more likely to be covered by PrEP than their black and Latino counterparts, according to CDC data.

About 14% of people with HIV are unaware that they are infected and another 37% are aware, but not receiving treatment, the CDC said.

"PrEP is highly effective in preventing HIV infection when taken as directed," HHS Assistant Secretary for Health Brett Giroir said in a statement Tuesday. "It is a critical tool for ending the HIV epidemic, but to make an impact it has to be available for people who need it most."

Potential recipients can go to www.getyourprep.com or call the toll-free number, 855-447-8410, to sign up for the program.

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MilosStankovic/iStock(NEW YORK) -- The use of hair dye and chemical hair straighteners may be associated with a higher risk of breast cancer, according to a new study.

The study, published Tuesday in the International Journal of Cancer, is making headlines but it does not mean that all women need to immediately stop using hair dyes and straightening products, according to ABC News chief medical correspondent Dr. Jennifer Ashton.

"It’s not as simple as the headline, as usual, but this is something that potentially affects a lot of people," Ashton, a board-certified OBGYN, said Wednesday on Good Morning America. "You must interpret this headline with a massive amount of caution."

The study looked at more than 46,000 women ages 35 to 74 over a span of six years.

Overall, the study found that regular use of permanent hair dye was associated with a 9 percent increased risk of developing breast cancer. The study also broke down the results by race and found that for white women in the study there was a 7 percent increased risk of developing breast cancer.

For black women, the risk could be as high as 45 percent which the study suggests is likely due to different chemicals in hair products specifically for black women’s hair texture. For heavy use of hair dye (defined as once or more every five to eight weeks) the risk increased to 60 percent for black women and 8 percent for white women.

Now to the caveats.

Each woman in the study had a sister with breast cancer, making them part of a high-risk population, which makes the results of the study hard to extrapolate across the general population, according to Ashton.

In addition, the study showed association, not cause and effect, so it does not show a "direct causal link" between hair dye and breast cancer, noted Ashton.

Other studies have also shown no increased risk of breast cancer due to the use of hair dye.

"We don’t know the absolute risk here," said Ashton. "We don’t know the absolute number of cases that could be tied to these findings."

Ashton said men and women should continue to focus on the things they can control that are proven to lessen the risk of breast cancer.

"We know the things that can lower the risk of breast cancer, things like exercise, keeping your weight in a healthy range, minimizing alcohol consumption if you are in a high-risk group and, if possible, breastfeed," she said. "We have to control the controllables."

The U.S. Federal Drug Administration (FDA), the agency that oversees the regulation of hair dyes, says on its website it does not "have reliable evidence showing a link between cancer and coal-tar hair dyes on the market today." Coal-tar hair dyes, according to the agency, includes permanent, semi-permanent, and temporary hair dyes.

The National Cancer Institute of the National Institutes of Health (NIH) also states on its website that studies looking at possible links between breast cancer and hair dye have "produced conflicting results." The institute notes the International Agency for Research on Cancer (IARC) Working Group concluded in 2010 that "personal use of hair dyes is 'not classifiable as to its carcinogenicity to humans.'"

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Liliboas/iStock(NEW YORK) -- "Rockin' around the Christmas tree" or going to a "Christmas party hop" make for good holiday song lyrics but are the stuff of holiday nightmares for people who identify as introverts.

A night out making small talk at a holiday party would require at least one night or more of solitude to recharge for an introvert, who find time alone as nourishing for their bodies as eating or sleeping.

That's hard during the holiday season when there is seemingly, for most people, an endless calendar of events, parties and the social pressure to charge full force ahead with holiday spirit.

"I joke that you can tell the extroverts from the introverts by how long they stay at a party," said Laurie Helgoe, Ph.D., a clinical psychologist and the author of Introvert Power: Why Your Inner Life is Your Hidden Strength. "The introvert may have a good time and enjoy a mood boost initially and then just get worn out and need to go home, while an extrovert is going to get more and more energized by the action."

Introverts -- people who thrive in smaller gatherings of people and need alone time to recharge -- don't have to go in full Grinch mode though and hibernate for the holidays.

Helgoe points out that introverts are not shy or anti-social people, they just don't get the same stimulation from being the center of attention that extroverts do. There are ways then for introverts to both enjoy the holiday season and preserve their sanity.

Try these six tips from Helgoe and Elizabeth Lombardo, Ph.D., also a clinical psychologist and the author of Better Than Perfect: 7 Strategies to Crush Your Inner Critic and Create a Life you Love:

1. Check your calendar: Right now, take stock of all the holiday commitments and invitations you have through the New Year, recommend both Helgoe and Lombardo.

Make sure you include everything from going shopping for gifts to family get-togethers, office parties and time with friends. Then, be proactive about making your schedule work for you.

"The problem with the holidays is we feel like we have to take what is presented to us, either take it or leave it, and we can’t choreograph our own holiday season, but if we do think ahead we can do just that," said Helgoe. "Ask yourself, 'What do I enjoy most during the holiday season and what do I hate?'"

"If you hate going to the mall, figure out how much can you order online, or if the work party stresses you out, figure out a plan to make it less stressful or plan out an alternative," she said. "Use your planning capacities to pre-think through scenarios and think about what you would like this holiday to look like."

Helgoe also recommends planning recovery time for yourself, so if you have a work party on a Thursday night, make sure you carve in extra me-time on Friday.

2. Feel good about saying no: Though this can be difficult for introverts who feel guilty, start by saying no -- no to holiday parties and no to events that are going to leave you drained.

Then, if you change your mind and feel able to attend, it's a bonus for both you and the person doing the inviting.

"A trap introverts can get into is we say yes to something that is really a no and then make excuses or just don’t show up and then feel more guilty," said Helgoe. "People will feel more happy that you changed your mind and want to come."

3. Reframe the holiday season:
Yes the holiday season means social events and gatherings, but it also can mean one-on-one time with friends, sipping hot cocoa and staying inside because it's cold out.

"Winter months draw us inward so they are more introverted in a way," said Helgoe. "The spirit of reflection, the twinkling lights and hot beverages and sitting by the fire, all those aspects of the season are very appealing to introverts."

Helgoe suggests saying yes to those aspects of the holidays, like walking and looking at Christmas lights with a friend, going to a movie with family or having a small group over for a dinner party.

4. Think before, during and after: Lombardo has clients think through what they will do before, during and after an event to help themselves manage any stress or discomfort.

Ask yourself what you can do before the event to make sure your stress level is as low as possible, whether that is spending time alone, going on a walk or meditating.

Then, think about what you can do during the event to reduce stress, like finding a spare room for some alone time. Also seek out jobs that will both be helpful and give you time alone, like volunteering to pick up a family member at the airport, volunteering to take photos, taking the dog for a walk or driving to the grocery store for last-minute ingredients. At a party outside the home, see if there is a task the host will let you take on, like mixing drinks or handing out name tags at the entrance.

If you are hosting an event, think of an activity like a game to play or a craft or food to make that can be something to focus on.

Lastly, think about your reward for after the event.

"If you’re at a party and you know when this is over you’re going to have time to yourself, you can enjoy yourself more," said Lombardi. "Have that carrot waiting for you."

5. Memorize this phrase: "Tell yourself, 'This is who I am and I’m going to do the best I can,'" said Lombardo.

The best thing introverts can do is embrace who they are because there is nothing wrong with who they are or the way they are wired to socialize, she explained.

6. Keep up your self-care: Self-care is something that can get tossed aside during the holidays, but for introverts especially it's critical to keep your routine, according to Helgoe.

"Whatever you do to replenish yourself, not only make sure that that's in place but you may need more of that," she said. "Giving that up during the holidays is giving up something that helps you cope better."

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ABC(NEW YORK) -- Abrea Hensley and her miniature therapy horse, Flirty, are quite the sight. Whether at the grocery store or in the park, Flirty attracts a lot of attention.

"Going out with Flirty is definitely one of the most interesting parts of my life at this point," said Hensley. "I get a lot of questions."

This year, the duo even took a flight together after the Federal Aviation Administration cleared miniature service horses to fly.

"It was the first time Flirty had ever flown," Hensley told ABC News. "Everybody at the airport was really nice and really welcoming and helpful. The experience itself was really and truly one of the most freeing experiences I’ve had recently."

But don’t expect to run into Flirty on a plane anytime soon; Hensley doesn’t plan on making a habit with her flying horse. "It’s not something I plan on doing a lot, just because it is a lot to ask of Flirty," she said.

Hensley said she battled post-traumatic stress disorder and severe anxiety for years before her care team suggested a service animal might help her symptoms.

"I [am] allergic to dogs so I couldn’t get a service dog," she said, "Miniature horses are the only alternative to dogs that are allowed under the ADA [Americans with Disabilities Act]."

That was two and a half years ago, and now Flirty goes everywhere with Hensley. "We just immediately had a connection that you don't find very often with an animal. You know it's kind of a once-in-a-lifetime type bond that we have," Hensley said.

Flirty assists Hensley in a multitude of ways: "Before I actually have an anxiety attack she can predict based on my rising heart rate and cortisol levels that an anxiety attack is going to happen. She also helps me to get through them faster. She will sit there and nudge me and lick me until I start to calm down."

Hensley also has some mobility issues so Flirty "assists me with some walking ... as well," she said.

The use of service animals has expanded over the years. Once reserved for the vision and hearing impaired, service animals are now commonly seen on college campuses to provide stress relief during exams, in courtrooms to assist children during difficult testimonies and by the sides of veterans who experience PTSD.

A service horse is a natural choice for some.

"There are a number of reasons that somebody might choose a service horse besides just dog allergies," Hensley said. "Horses are much better suited for mobility assistance … [and] there is also the issue of the lifespan. A miniature horse will live to be approximately 35 years old, so that's about the lifespan of two to three service dogs. So that's a huge advantage there."

ABC News chief medical correspondent Dr. Jen Ashton, said there is a difference between service animals and emotional support animals.

"Generally, when we hear the word service animal or service dog, those are specifically trained animals to carry out a very specific task for a specific problem," she said. "When you talk about just an emotional support animal, that's usually an animal for whom a relationship exists with that person and the presence of that animal is soothing and comforting for that person."

Ashton addied, "Anyone who owns a pet knows how soothing and calming a pet [can] be."

The use of "comfort" animals on flights has skyrocketed lately. United Airlines saw a 77% increase from 2016 to 2017, and Delta has seen its numbers double in the recent past. Most of these emotional support animals are dogs, but other ponies may soon join Flirty in the ranks of flying horses after the recent FAA rule change.

Some say, however, that the allowances have gone too far. Last year a woman was banned from a flight after she tried to bring her emotional support peacock on the plane, and many airlines have weight and breed restrictions.

"Unfortunately, I think the influx of all kinds of animals on planes and public transportation in general has possibly swung the pendulum a little bit too far," said Ashton. "Just because a physician or health professional can certify a person as potentially benefiting from an animal is very different than going through the often very rigorous steps, selection and training process that many people who have service animals or support animals have to go through."

In upstate New York, a different kind of emotional support animal is providing moving experiences for many visitors to Mountain Horse Farm, home to Bella and Bonnie the comfort cows.

Suzanne Vullers and her husband, Rudi, own and operate Mountain Horse Farm, in Naples, New York, which doubles as a bed and breakfast and spa. But many guests come here for one specific service that’s generated a lot of buzz: cow cuddling.

"It naturally relaxes you," said Suzanne Vullers. "A lot of people are looking for mindfulness. They’re looking for ways to calm down their head and their body. When you are with a large animal like that, they command your presence. ... There's no way you can be somewhere else when you're with them because they're so big. And that creates a natural mindfulness."

It's a practice Vullers said hails from her native Netherlands called "koe knuffelen," which translates to "cow hugging," and it’s meant to get people back in touch with nature.

"Touching a living being kind of relaxes you and it's very similar to you getting a massage," she said. "The benefits are very similar as well."

When visitors come to the farm they are led out to the pasture to meet the animals while they relax in the shade. Then the cuddling commences. Suzanne said seeing people lie down next to her animals is "her favorite moment" of the experience.

"It makes you go so quiet, and it’s so relaxing, and it’s such a joy that they want to connect with you in that way," she said.

Sheryl and Brandon Hertel, from Buffalo, New York, visited Mountain Horse farm late last summer. They came to celebrate Sheryl’s birthday.

"I thought she was kidding at first," Brandon Hertel said of his wife. "She wants to pet the cows."

"I just hope they like me," said Sheryl Hertel. "As weird as that sounds!"

The duo set out with Vullers, entering the pasture as Bonnie and Bella relaxed. Vullers instructed the couple on how to sit with the cow so that her head would lay in their laps.

The session was a success.

"It was amazing," said Sheryl Hertel. "Everything I thought it would be ... you felt like they could actually understand you. ... My heart was ready to explode. I loved it."

"It was surprisingly relaxing," added her husband. "You’d think interacting with a big animal wouldn’t be relaxing, but it is shockingly relaxing."

For some, it’s about more than a stress-free afternoon. Hensley said her connection to Flirty saved her life.

"My treatment team was very concerned that I wouldn't live more than a year or two without having a service animal," she said. "So because of Flirty I am still here. I am still able to go out and function in society. And she's just been a huge lifesaver and complete life changer for me. I'm very grateful to have her."

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iStock/Adene Sanchez(NEW YORK) -- Warmer temperatures wrought by climate change could put women at risk for giving birth early, according to new research.

The research adds to existing knowledge on health complications tied to extreme temperatures. High air temperatures have been linked to heat stroke, as well to higher pollen levels, which can trigger asthma, according to the World Health Organization.

The study, published in the journal Nature Climate Change this week, found that in the United States, the birthrate increased by 5% on days in which the temperature exceeded 90 degrees.

Researchers analyzed country-level birthrates over 20 years to make their projections, and estimated that heat exposure translated into 25,000 infants born earlier than predicted each year, approximately 150,000 hours of lost gestational time.

Although the researchers described the average length that gestation was shortened -- approximately 6.1 days -- as "modest," some babies were born two weeks earlier.

In the United States, about 1 in 10 babies is born prematurely, before 37 weeks of pregnancy, according to the Centers for Disease Control and Prevention. The earlier a baby is born, the higher the risks of health problems or death.

If current climate change trends continue unabated, the researchers project that there will be 250,000 lost gestational days per year by the end of the century.

Despite mounting evidence about climate change harming human health, the global community has not made significant strides to fix the problem. Of the 101 countries surveyed by WHO, only half had plans in place to address climate change-related health problems. Fewer than 20% had put those plans into action.

Still, the new study should be considered with caveats. The researchers used a spike in birth rate on days hotter than 90 degrees as a proxy for early births, rather than counting the length of pregnancy recorded on birth certificates. Although previous studies have found an association between hot weather and shorter gestation periods, it has not yet been established whether the birth rate method is an accurate way to determine an association between higher temperatures and early births.

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St. Elizabeth Healthcare(NEW YORK) -- There must be something in water at St. Elizabeth's Healthcare in Kentucky, as 22 labor and delivery hospital staffers were all pregnant at the same time this year.

Among the group of physicians, nurses and administrative workers, 18 of the women are now mothers.

Two of the little ones arrived on the same day, Sept. 25, and four more women are still to give birth, with the last mom expected to deliver in January 2020.

Kristy McDowell, a labor and delivery nurse, was the first to have her baby on May 13. At 32 weeks, McDowell welcomed a girl, Priscilla, who weighed 4 pound, 8 ounces.

Priscilla spent 34 days in the NICU but is now thriving, McDowell told "GMA."

"She's [now] the biggest out of all of them," McDowell said of her daughter. "She's very happy, always smiling -- doesn't cry unless she's hungry."

McDowell said each day she'd come into work and more and more of her colleagues would reveal their pregnancies.

"We had a list at the nurse's station and somebody was always adding their name to it," she said.

Sarah Dixon, a secretary in the labor and delivery unit, welcomed a girl, Jensyn, on Sept. 11 weighing 5 pounds, 10 ounces.

"She's a double rainbow baby and [myself] and her older three siblings, we hold her all the time," Dixon said. "She's very special."

Assistant nurse manager Jocelyn Laake said the hospital is one big family.

"Then to get to share this moment in the lives of so many people you work with...is truly a blessing."

The women said they are excited to see their children grow up together.

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The fall finale of ABC's "Grey's Anatomy," aired on Nov. 21, 2019. - Kelsey Mcneal/ABC(New York) -- A Grey's Anatomy episode that aired in March made headlines for its focus on sexual assault. According to a new study, it had a societal impact, too.

The study, published by JAMA Network and conducted using Google Trends and data provided by the Rape, Abuse, and Incest National Network (RAINN), revealed that inquiries for the term 'RAINN' increased 41 percent. The search for "rape" was up 8 percent and according to the organization, calls to RAINN increased 43 percent in the 48 hours after the episode aired.

"Silent All These Years" ended with a public service announcement from Grey's Anatomy star Ellen Pompeo, who provided viewers with the number for RAINN.

"Increasing accurate portrayals of sexual assault in the media, coupled with increased awareness of organizations similar to RAINN, may positively affect public health," the study concluded. "Hollywood may be poised to help put the public back into public health."

"Silent All These Years" documented one woman's experience with sexual assault, from reporting the incident to grappling with the intense emotions surrounding it. The character, played by actress Khalilah Joi, blamed herself for the assault, and was reluctant to undergo a rape kit, fearing to do would only lead to more stress.

Showrunner Krista Vernoff told The Hollywood Reporter at the time that the episode was "the most powerful hour of TV I've ever been a part of in my 20-year career," and added that it was inspired by the testimony of Christine Blasey Ford. Blasey Ford accused Supreme Court Justice Brett Kavanaugh of sexual assault before he was confirmed -- Kavanaugh has denied her allegations.

"It was a pretty powerful moment to watch all of that," Vernoff said of Blasey Ford's testimony. "I felt that the most damaging thing that happened in all that is that young women and men everywhere were told that consent was irrelevant."

"I wrote to the writers and said, 'We have to find a way to come at this through character. We have to do something about consent and try to do our part to explain what consent is and how impactful rape is and how it can damage people for years, decades and generations,'" she added. "We had to use our platform to do something."

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