Epsom Salts and Cerebral Palsy

Dr. Greene’s thoughts on cerebral palsy…

Before we talk about Epsom salt baths, here’s the news: giving pregnant women an IV infusion of magnesium sulfate (Epsom salts) cut the risk of their preterm baby developing cerebral palsy by about half, according to a study in the August 28, 2008 New England Journal of Medicine. Women who were in labor or whose water had broken before 32 weeks of pregnancy were included in the study. Half got the “mag” (as pediatric residents often call this strong IV medicine) and the other half got a placebo infusion. The results of the study were impressive and make sense to me. The magnesium could improve blood flow, calm brain cells, and help them get the oxygen they need. Although the idea of using “mag” to prevent the brain damage of cerebral palsy has been around for a decade, the evidence is still preliminary. I would suggest, though, asking your doctor what she thinks about it if you go into labor before 32 weeks.

What about Epsom salt baths? Or foot soaks? Most people don’t connect this gentle home remedy from Epsom, England in the days of Shakespeare to the powerful IV drug used today, among other things, to prevent seizures in women with preeclampsia. But the substances are the same; it’s the dosages and methods that are different.

Epsom soaks have been used to try to ease stress, lower blood pressure, and to provide relaxed, increased energy. They have been claimed to improve sleep, boost the mood, reduce inflammation, speed the healing of aches and bruises, and help improve the functioning of nerves and muscles – all while softening and exfoliating the skin. Firm scientific evidence for the benefits of soaks is hard to come by, but we do know that the magnesium sulfate is absorbed through the skin when soaking, and raises magnesium levels on blood and urine tests. Magnesium is important in hundreds of processes throughout the body, and many people don’t get enough in their diets. For basically healthy adults the soaks have an excellent track record of safety extending back for hundreds of years.

What about Epsom soaks during pregnancy? I wish I knew. Perhaps they are a wonderful gentle way to help improve sleep, prevent high blood pressures, stave off depression, et cetera – good for you and for your baby. I suspect this is the case. A warm bath can be safe and wonderfully relaxing, and the Epsom salts may make it all the better. But perhaps the Epsom baths – or maybe even the foot baths – are a risky idea. I haven’t been able to find good evidence one way or the other.

If you hear of any evidence, please let me know. In the meantime, if this is something you choose to try, I would certainly talk with your doctor or midwife first. Just because something is safe when not pregnant, doesn’t mean that it is safe during pregnancy. And anything strong enough to help is strong enough that it could potentially have other effects.

Rouse DJ, et al. A Randomized, Controlled Trial of Magnesium Sulfate for the Prevention of Cerebral Palsy. New England Journal of Medicine. August 28, 2008; 359:895-905.Hirtz DG and Nelson K. Magnesium sulfate and cerebral palsy in premature infants. Current Opinion in Pediatrics. April 1998; 10:131-7.