Nutrition & Health During Pregnancy

 Your unborn child gets its nutrition from what you eat. So, eating habits of the mother before and during pregnancy is a very important factor affecting the health of the unborn child. Good nutrition during pregnancy will go a long way in having a healthy baby. Be knowledgeable about the constituents of good nutrition, for you and your unborn baby. You may improve your eating habits at any stage you want to. Your baby will benefit from the improvements you make even late in pregnancy.

 

What you eat before and during your pregnancy can affect the health of your growing baby. Even before you start trying to get pregnant, you should take special care of your health. Eat healthy meals and snacks and take a multivitamin every day. While you are pregnant, you will need additional nutrients to keep you and your baby healthy. But, that does not mean you need to eat twice as much. You should only eat an extra 300 calories per day. A baked potato has 120 calories. So getting these extra 300 calories doesn`t mean you have to consume a lot of food. Pregnant women should consume a total of 2,500 to 2,700 calories every day. These calories should come from a variety of healthy foods.

Make sure not to restrict your diet during pregnancy either. If you do, your unborn baby might not get the right amounts of protein, vitamins, and minerals. Low calorie diets can break down a pregnant woman`s stored fat. This can lead to the production of substances called ketones. Ketones can be found in the mother`s blood and urine and are a sign of starvation. Constant production of ketones can result in a mentally retarded child.

To get enough nutrients, pregnant women should take a multivitamin and eat healthy foods from the four basic food groups everyday. 

There is no established formula to determine how much weight you should put on during pregnancy. Weight gain is dependant on a variety of factors notably, your pre-pregnancy weight and stature, the size of your baby and placenta and the quality of your diet before and during pregnancy. Pre-1970, North American Physicians limited weight gains to between fourteen and seven-teen pounds. They thought that this weight gain would result in easier labors and less postpartum obesity, assuming that the fetus always managed to extract the necessary nutrients. However, around 1970 researchers studying the correlation be-tween weight gain and the health of the baby, found that a higher weight gain during pregnancy led to more full-term pregnancies, with healthier and larger babies.. This led, the National Research Council`s Committee on Maternal Nutrition in 1970 to recommend higher weight gains with some allow-ance for individual circumstances.


Weight Gain during Pregnancy



If you were underweight during your pre-pregnancy days, it is advisable for you to gain more weight than women who are normal or overweight. You would gain more weight if your baby is large (more than eight pounds) than if your baby is of average or small size.

If you are on a well balanced diet and the quality of your diet is normally excellent and you and your baby are of average size, you will probably gain about twenty-five pounds.

Alternatively, if you are obese, accustomed to high calorie, non-nutritious foods before your pregnancy you may not gain twenty-five pounds after you make adjustments, like eating a well balanced diet full of nutrients. That is to say, by replacing the high-calorie, Non-nutri-tious foods with better quality foods, you may gain less weight, while benefiting your baby.

Your weight gain is of secon-dary importance to the quality of your diet. If you are on a well balanced diet, you need not bother about weight gain.

Your weight will be recorded at each prenatal visit. A chart of your weight gain is maintained. You will gain weight slowly early in the pregnan-cy picking momentum with the growth of the baby and its support system. A sudden spurt or fall in your weight between two consecutive prenatal visits indicates sign of illness or problems in your pregnancy. It could also indicate starvation or food binge between visits.

Most women do not mind the increase in weight during pregnancy, especially when they realize that it is lost either during birth or shortly thereafter. They do not consider that it will be very difficult to remove the extra five or more pounds of fat being accumulated. Many weight-conscious women dislike putting on fat during pregnancy since it takes months to disappear.

A part of your weight gain will be fat deposition on your body. You possibly cannot gain only the weight related to the growth of the baby and the placenta without adding the fat to your own body. You cannot say I will gain only 20 lbs and not the 5 lbs of fat. In fact, fat is produced gradually along with the other components of the weight gain. Avoiding fat will deprive you and your baby of essential nutrients.

Most women are able to shed their extra weight gradually over a period of five to six months after the birth of the baby, provided they eat sensibly. If you breast feed your baby, you would requires 900 to 1.000 calories per quart. The stored fat provides some of these calories; the rest comes from an additional 500 calories a day that should be taken in by the breastfeeding mother.

Pregnancy is the time when you concentrate on a high-quality diet. This is not an appropriate time to keep a watch on your weight.

Foods for Pregnant Women

All the nutrients the unborn child needs are supplied by the mother during pregnancy. The baby will weigh about seven pounds at birth. The baby`s life-support system consisting of the placenta, uterus, membranes, fluid and maternal blood volume also grows during pregnancy, facilitating the growth of the fetus. Your body also gets ready to give birth and nourish the baby through breastfeeding. Your pregnancy may de-plete you of important nutrients if you do not nourish yourself adequately. All these added demands require that you develop a good eating habit. You need about 300 calories per day more than you did when you were not pregnant. These amounts to a total of about 2.100 to 2.400 calories per day .These additional calories should come from high protein, high calcium and iron rich foods. Three hundred calories is not much actually. It could be obtained from 2 tall glasses of milk or a bowl of hearty soup, a serving of meat or fish. Do not add lots of high calorie non nutritious food such as cakes or dessert. A good daily pregnancy diet should consist of a variety of food containing plenty of fresh fruits and vegetables, whole grains, dairy products, pro-tein foods (such as meat, fish, nuts, eggs, and legumes), some fat and about two quarts of fluid a day. To get enough nutrients, pregnant women should take a multivitamin and eat healthy foods from the four basic food groups everyday including: Fruits and Vegetables - Pregnant women should try to eat 7 or more servings of fruits and vegetables combined (for example: 3 servings of fruit and 4 of vegetables) daily. Fruits and vegetables are rich sources of fiber, vitamins and minerals. Fruits and vegetables also contain vitamin C which will help you and your baby to have healthy gums and other tissues. Vitamin C also helps your body to heal wounds and to absorb iron. Examples of fruits and vegetables with vitamin C include strawberries, melons, lemons, oranges, papaya, tomatoes, peppers, greens, cabbage, and broccoli. Fruits and vegetables also add fiber and minerals to your diet to give you energy. Plus, dark green vegetables have vitamin A, iron, and folate, which are important nutrients during pregnancy. One Serving Fruit = 1 medium apple, 1 medium banana, 1/2 cup of chopped fruit, 3/4 cup of fruit juice One Serving Vegetable = 1 cup raw leafy vegetables, 1/2 cup of other vegetables (raw or cooked), 3/4 cup vegetable juice. Whole-grains or Enriched Breads/Cereals - Pregnant women should eat 6 to 9 servings of whole-grain or enriched breads and/or cereals every day. Whole-grain products and enriched products like bread, rice, pasta, and breakfast cereals contain iron, B vitamins, minerals, and fiber. Folic acid has been shown to help prevent some serious birth defects. Eating breakfast cereals and other enriched grain products that contain folic acid is important before and during pregnancy. One Serving Cereal/Bread = 1 slice bread, 1/2 cup of cooked cereal, rice, or pasta, 1 cup ready-to-eat cereal Dairy Products - Pregnant women should try to eat 4 or more servings of low-fat or non-fat milk, yogurt, cheese or other dairy products every day. Dairy products provide the calcium you and your baby need for strong bones and teeth. Dairy products are also great sources of vitamin A and D, protein, and B vitamins. Vitamin A helps growth, fight infection, and vision. Pregnant women need 1,000 milligrams (mg) of calcium each day. Other sources of calcium include dark green leafy vegetables, dried beans and peas, nuts and seeds, and tofu. One Serving Dairy = 1 cup of milk or yogurt, 1 1/2 oz. natural cheese, 2 oz. processed cheese. Proteins - Pregnant women and their growing babies need 10 grams of protein more than non-pregnant women. Pregnant women should eat 60 grams of protein every day. Two or more 2-3 ounce servings of cooked lean meat, fish, or poultry without skin, or two or more 1 ounce servings of cooked meat contain about 60 grams of protein. Eggs, nuts, dried beans, and peas also are good sources of protein. Protein builds muscle, tissue, enzymes, hormones, and antibodies for you and your baby. Protein-rich foods also have B vitamins and iron important for your blood. One Serving Protein = 2-3oz. of cooked lean meat, poultry, or fish, 1 oz. meat also = 1/2 cup cooked dried beans, 1 egg, 1/2 cup tofu, 1/3 cup nuts, 2 T. peanut butter. Folic acid: Pregnant women need 400 micrograms (400 mcg) of folic acid every day to help prevent birth defects. Folic acid is a B vitamin that helps prevent serious birth defects of a baby`s brain or spine called neural tube defects. Getting enough folic acid can also help prevent birth defects like cleft lip and congenital heart disease. An easy way to get enough folic acid is to take a multivitamin every day. Orange juice, spinach and legumes are also good sources of folic acid. Iron: Pregnant women need twice as much iron - 30 mg per day - than other women. Pregnant women should also eat lots of iron-rich foods. Some good sources of iron include lean red meat, fish, poultry, dried fruits, whole-grain breads, and iron-fortified cereals. Pregnant women need extra iron for the increased amount of blood in their bodies. Iron helps keep your blood healthy. Plus, your baby will store iron in his body to last through the first few months of life. Too little iron can lead to a condition called anemia. If you have anemia, you might look pale and feel very tired. If your doctor finds that you have anemia, she will give you a special iron supplements to be taken once or twice a day. Calcium: Pregnant women aged 19 to 50 years should get 1,000 mg/day of calcium. Younger pregnant women need even more - 1300 mg/day. Low-fat or non-fat milk, yogurt, cheese or other dairy products are great sources of calcium. Eating green leafy vegetables and calcium-fortified foods like orange juice and breakfast cereal can also provide calcium. If your diet is does not provide you with 1,000 mg/day of calcium, talk to your doctor about taking a calcium supplement. Water: Pregnant women should drink at least six eight-ounce glasses of water per day. Water plays a key role in your diet during pregnancy. It carries the nutrients from the food you eat to your baby. It also helps prevent constipation, hemorrhoids, and excessive swelling, and urinary tract or bladder infections. Drinking enough water, especially in your last trimester, prevents you from becoming dehydrated. Not getting enough water can lead to premature or early labor. Food Groups Food can be classified into four basic groups: 1. Dairy products 2. Meat and protein foods 3. Fruits and vegetables 4. Breads and cereals However, you may not get all the necessary nutrients even if you consume food from the above groups. Further sorting of foods is necessary to cover all the necessary nutrients. Hence, food items are further sorted into seven basic groups: 1. Dairy products 2. Eggs and meat 3. Green and yellow vegetables 4. Citrus fruits and vitamin C-rich foods 5. Potatoes and other vegetables and fruits 6. Grain products 7. Fats Two other food categories are also important: 8.liquids 9. sugar Pregnant women should drink about eight cups of liquid per day. The body has no requirement for sugar foods. Excessive intake of sugary food may cause excessive weight gain, and also it may take the place of nourishing foods. Nutrients & Vitamins Some nutrients however deserve special mention for their particu-lar importance in pregnancy. Protein Protein is the basic ingredient of a cell. Your protein requirements increase by about 60 percent over your normal requirement, in the period of rapid growth of the unborn baby and its support system (placenta, uterus, volume of blood and amniotic fluid). Calcium Mineralization of the fetal skeleton and teeth is promoted by calcium. The fetus requires approximately 66 percent more cal-cium than normal during the last trimester, when the teeth are forming and skeletal growth is most rapid. You will store Calcium in your bones as a reserve for later milk produc-tion. Iron Iron is a major component of hemoglobin, the oxygen-carrying protein in the blood. , During pregnancy the maternal blood vol-ume increases by 50 percent, so there is increased demand of hemoglobin and the other components of blood. On top of it the fetus, during the last six weeks of pregnancy, accumulates enough iron in her liver to supple-ment her needs for the first three to six months of life. This is nature`s way of ensuring that the baby gets enough iron, since the main food during that period being breast milk or formula food, only partially fulfills an infant`s iron require-ments. A healthy person is able to absorb about 5 to 10 percent of the iron he ingests. The National Research Council`s Commit-tee on Maternal Nutrition recommends thirty to sixty milligrams of iron supplement daily to ensure absorption of the iron needed each day. Though iron is a major component for good nutrition, it is known to upset the digestive tracts in many people. The side effects like nausea, heartburn, diarrhea, or constipation-are related to the amount of elemental iron ingested and how an individual reacts to the iron supplement and not to the type of preparation. That is to say it does not matter if you take ferrous sulfate, ferrous fumerate, or ferrous gluconate than how much iron you take at a time. To relieve the unwanted side effects, your physician may advice you to decrease the dosage or ingest it with food. Eat foods that are rich in iron content, like liver and other organ meats, red meat, egg yolk, dried fruit, apple juices, dried peas, spinach lentils, spinach, beans and back-strap molasses and walnuts. Absorption is easiest when it is taken in natural form. Vitamins Life functions are impaired in the absence of vitamins. They are classified by their solubility: Water soluble vitamins like C and B complex and fat soluble vitamins like A, D, E, and K. Cooking destroys the vitamin content of the water soluble ones. Foods high in these vitamins should preferably be eaten raw or cooked briefly in little water, steamed or stir fried. Folic acid is a water-soluble vitamin in the B-complex group. Folic acid is essential for the normal growth of all cells. RNA & DNA synthesis cannot take place in the absence of folic acid. Hence the requirement for folic acid doubles during pregnancy. The usual recommendation is a daily supplement of 400 micrograms during pregnancy. The supplement needs to be maintained as folic acid is destroyed by long storage and overcooking. To make sure that you get all the essential vitamins and minerals, you must eat a varied diet. Your supplements should be augmented from your prime source that is from food itself. Vitamin preparations contain only some of the essential nutrients that have been identified and there are undoubtedly some essential nutrients that have not yet been discovered or whose functions are not yet fully understood.   Common Concerns Due to changes in hormone production and the increased size and weight of the uterus, some common nutrition related problems arise during pregnancy. We will discuss some causes of and treatments for these ailments Nausea and Vomiting Nausea and vomiting are sometimes referred to as "morning sickness" though usually not restricted to morning only. Pregnant women frequently feel nauseated and need to vomit when they are on an empty stomach, or they smell certain odors, like that of cigar. Smell especially triggers these attacks. The cause may vary from person to person but the problem remains the same. You may think that your baby`s health will be affected if you vomit frequently as vomiting may deplete you of nutrition. Be reassured that recent studies indicate that women, who are healthy at conception, have enough reserves to supply the growing embryo and fetus, even if they eat poorly for the first two or three months. Another study indicates that the pre-sence of nausea is associated with a favorable pregnancy out-come. Nausea is neither abnormal nor a sign of uncon-scious rejection of the baby as is sometimes suggested. Nausea is probably related to the increased production of twenty six hormones, added to the four other hormones produced only during pregnancy. Some of these hormones act to delay the emptying of the stomach. While others, when present in large quantities, upsets the body and the body takes time to adjust. Treatment You need to change your eating habits. You will have to eat several (five or six) small meals a day to avoid an empty stomach. Some protein should be included in each of these meals. Eating toast or crackers before getting up in the morning is helpful to some women. It is advisable to have your breakfast in bed in the morning. Drinking liquids between meals instead of during meals is also often beneficial. Increased consumption of Vitamin B6 (Pyridoxine) helps some women. You do that by eating more foods high in this vitamin (whole grains and cereals, wheat germ, nuts, seeds, legumes, corn). You can discuss with your physician whether you should take vitamin B6 supplements. You should not self medicate during pregnancy. You have to bear with it for three to four months. Have a sense of humor. Do not make throwing up a part of the morning schedule. Take it as it comes.. Sometimes, nausea can become so severe that a woman actually becomes dehydrated and lose a great deal of weight by being unable to hold any food down. This condition is called hyperemesis gravidarum. This condition may necessitate medica-tion or even hospitalization if the nausea and vomiting en-danger either the mother or the baby`s health. Medications relieve the symptoms of nausea and vomit-ing. They are prescribed either when the nausea and vomiting are so severe that it may cause dehydration or more commonly, the woman is upset or inconvenienced and requests medication. You should understand that these medications cross the placenta to the fetus and that they are never guaranteed to cure you of the symptom. These medicines are not safe for the unborn child. Since these are used during the formative stage of the fetus. It would be wise to not use them. Until recently, Bendectin was widely used. Researchers found out that there is an association between Bendectin and birth defects (cleft palate and heart deformities) Heartburn Heartburn is a feeling of fullness with some regurgitation of acid from the stomach. It is more prevalent in late pregnancy. The hormones relax the muscular opening at the top of the stomach and cause the stomach to empty more slowly. Added to this is the increased pressure from the growing uterus. Fatty foods and large meals may also contribute to the condition. Treatment Avoid fatty food and gas producing foods. Eat several small meals instead of a few large ones through the day. Some women find that eating slowly and keeping a gap between the last meal and bedtime also help reduce heartburn. . Antacids or other drugs are sometimes used to control heartburn. They should be used only if necessary. Be aware of the undesirable side effects. Constipation During pregnancy, food passes through the intestines very slowly. Though this causes better absorption of nu-trients and water, it also tends to cause constipation. The growing uterus puts pressure on the large intestine magnifying the problem. Treatment Drink plenty of fluids and eat foods with high-fiber content (raw or dried fruits and vegetables, whole grains and prune juice) which encourage elimination. Exercise regularly. Exercise is an often neglected but ef-fective aid to regularity. Laxatives can and should be avoided. Exercise and proper diet helps to relieve of the condition. Preventing constipation will also reduce the severity of discomfort of hemorrhoids, another common problem during pregnancy,

Special Concerns

Drugs Until the early 1960s, it was thought that the placenta pro-tected the fetus from harmful substances. The Thalidomide tragedy of the sixties proved otherwise. Thalidomide effective in controlling nausea in early pregnancy was considered harmless to the unborn child. Shortly after its introduction, an epidemic of babies born without limbs led to an exhaustive investigation that linked these birth defects to the drug. This prompted the Scientists to investigate whether other birth defects might be linked to other drugs and medications used during pregnancy. It is difficult to trace the connection be-tween drugs and birth defects. The causes of birth defects may be several. Experimentation becomes difficult since humans have to be used as experimental subjects, and high risk is also involved. While the information gained from animal studies is valuable, it cannot necessarily be applied to humans. Isolating a single agent is difficult since most women consume numerous drugs and medications during their pregnancies. Finally, when the drug is being taken is important. It may be harmful if used in conjunction with other agents. Tracing the specific effects of particu-lar drugs is a complex one, but it is a known fact that virtually all drugs and medications taken by a pregnant woman cross the placenta and reach the fetus. The effect of the drugs on the fetus is possibly greater than their effect on the mother at the time of the fetus` rapid growth and development. Do not be worried by what to do and what not to do. We will try to explain about some of the most common drugs and provide some guidelines on their applications and best times of usage with respect to the progress of your pregnancy as also suggest any alternative drug if possible. As a thumb rule, drugs should be used judiciously if you are pregnant. No drug has been proven totally safe for the fetus though many drugs are taken to be safe or at least not harmful. It is important for you to weigh the possible risks against the possible benefits. Use the drug only if the benefits outweigh the risks, otherwise try alternative treatments. Alcohol AlcoholUntil the mid-l970s, it was believed that alcohol was harmless to the fetus. The assumption was that alcohol, by itself, even if consumed in large quantity by the pregnant woman, will not harm the fetus. Alcoholism was felt to be a problem because an al-coholic pregnant woman might tend to neglect her diet resulting in malnutrition in the fetus. We now know that alcohol has a direct toxic effect on the developing fetus. Alcohol quickly crosses the placenta and enters the fetus` blood in the same concentration as in the mother`s blood. Babies born of alcoholic mothers are at substantial risk for suffering from Fetal Alcohol Syndrome, a cluster of disabilities that in-cludes mental and physical retardation, tremors, and peculiar facial characteristics. Alcohol, even in small measures is now associated with some fea-tures of Fetal Alcohol Syndrome. Even an occasional binge drinking may have lasting harmful effects depending on its timing during pregnancy. Even moderate social drinking (about two drinks per day) may lead to lower birth weights. If you are pregnant, it would be wise for you to give up drinking altogether - earlier the better. While drinking in early pregnancy is more likely to be associated with birth defects, drinking later in preg-nancy is more likely to be associated with smaller fetal size. Stopping at any time, therefore, will allow your baby the oppor-tunity to catch up in growth before birth. There is no safe dose for alcohol If you consume alcohol the baby receives it in his blood. Do not consume Beer and wine thinking that they are less harmful than hard liquor. The quantity of alcohol is the same in a four-ounce glass of wine or a can of beer as in a mixed drink. If you were not aware of the harmful effects of alcohol, have drunk too much during your pregnancy it is but natural that you would be concerned about the health of your baby. You need not panic because the fetus probably benefits from the day you stop drinking. Remember that the fetus is remarkably strong and resilient. Babies handle difficulties very well. A high percentage of Mothers give birth to healthy babies who took drugs or medicines or had illnesses or other problems during their pregnancies. Do not get carried away thinking the fetus will be strong enough and deliberately abuse drugs. In case you have unknowingly used drugs, be reassured that the fetus has resources to help her combat their effects. It is normally seen that pregnant women commonly de-velop an aversion to alcohol (as well as smoking and caffeine). Many women cut down on their use of alcohol simply because it loses its appeal. Perhaps this is nature`s way to safeguard the baby. Circumstance may make demand, on you like, say you are in a party, and forced to accept a drink. In this situation it is always advisable to opt for fruit juice, tomato juice or bottled water with a twist of lemon. Tobacco TobaccoThe adverse effect of Tobacco smoking has been explored in detail. It is recommended that if you have the habit of smoking, you should cut down, if not stop altogether, your smoking before you plan to become pregnant. Cigarette smoke contains tars, nicotine, carbon monoxide, lead that are harmful to both you and your unborn child and it has been observed that women who smoke give birth to underweight babies and have greater chances of premature rupture of the membranes, premature birth, prenatal death, placental abnormalities and bleeding during pregnancy. The chances of these above complications occurring increase if you are a regular smoker. Your smoking also has a long-term ill effect on the child. It has been observed that in a family where one or both the parents smoke, the child may suffer from respiratory illness, may have a less developed IQ and are three to five months behind the children of non smokers. Children of smoking par-ents will be more inclined to smoke than the children of nonsmoking parents. You may not be smoking, but you may be breathing in the smoke from your colleagues, friends or family. You are what is called a passive smoker. Passive smoking is harm-ful to your unborn child. You should try to avoid people who smoke as well as identified smoking areas. Sometimes you have to be assertive and forbid people to smoke near you. Marijuana The effect of marijuana smoking has not been researched conclusively till date. The fetus is affected by marijuana smoke as much as the mother, if not more. The amount of tar and nicotine in marijuana are considerably greater than in cigarettes as it has not been commercially viable to reduce these substances in marijuana. Carbon monoxide, which is present in all smoke, restricts the capacity of the blood to transport oxygen. The long term effects of the additives of marijuana and the active ingredients of marijuana on the fetus are still not fully known. Caffeine CaffeineYou will find caffeine in Coffee, tea, colas and other soft drinks (read the labels). Choco-late and some over-the-counter drugs contain caffeine. It has been found in some animal studies that caffeine con-sumption resulted in certain birth defects. While, another study in humans found that drinking coffee leads to abortion, stillbirth, prema-ture delivery, and low birth weight. The added effect of smoking has not been considered here. As many people who drink excessive amounts of coffee also smoke, it is difficult to distinguish the real cause of the problem. A study of over 12,000 women who had babies in a three-year period found that birth problems were more common among heavy coffee drinkers (those who consume more than four cups per day). When, the only coffee drinkers were eliminated from the heavy smokers who also drank coffee the ill effects disappeared. You might be reassured with this finding, if you are a coffee drinker, but "pru-dent and protective" expectant mothers should limit caffeine use. Other than birth defects and pre-maturity, Caffeine causes an increased production of "stress" hormones--epineph-rine (adrenalin) and norepinephrine (noradrenalin). According to National Academy of Sciences report if you drank one to two cups of coffee, or two to three cups of tea per day these stress hormones concentrations increase. The availability of oxygen to the fetus decreases due to the effects of these hor-mones as they constrict peripheral blood vessels, including those in the uterus. The consumption of caffeine is directly proportional to the deprivation of oxygen of the fetus. Caffeine readily enters the fetal blood stream. If the baby has caffeine in her circulation at birth, it takes a much longer time to clear her system than it would take an adult. It would be wise if you reduce, if not eliminate altogether, caffeine intake during pregnancy.

Pregnancy always demands good nutrition. You need to be scrupulous about your diet. If your pregnancy is a "special pregnancy" or if you are on a special diet, your nutritional requirements will be greater than normal. Seek nutritional counseling under these special circumstances. Your physician or a nutritionist will be able to plan your diet in a practical way. Special Pregnancies Multiple pregnancies You need to consume more calories if you are carrying two or more babies. Your nutritional requirement also increases. Adolescent pregnancy A teenager is in the growth phase and has greater-than-adult requirements for most nutrients. She needs to eat particularly well when she is pregnant to maintain her own growth while providing nourishment for her fetus. Pregnancies in rapid succession Pregnancy de-pletes your reserves of certain nutrients like calcium and iron. Your body makes up for this deficit in due course. So if your successive pregnancies are properly timed, no nutritional deficiency occurs. If you become pregnant in quick succession, your reserves may be depleted and you may need extra calories and nutrients. The length of time needed between successive pregnancies to correct deficien-cies depends on your overall health, your age, the quality of your diet and your nutritional status. Special Diets A vegetarian diet If you are a vegetarian and consume milk and eggs you can, with know-ledge and careful planning, provide adequate nourishment for yourself and your unborn baby. Your prime concern is the need to take in sufficient calories, to supplement B12 found mostly in animal meats and to combine protein-rich foods to obtain all the essential proteins. Milk intolerance Milk intolerance may lead to calcium deficiency. Try cultured forms of milk such as acidophilus milk and yogurt, which are often well tol-erated by people who are not able to digest milk.. Alternatively eat other foods high in calcium, such as, cheese, whole grains vegetables, egg yolk and whole canned fish. If you simply do not like the taste of milk try cooking with dry powdered milk or eating cream soups. These alternatives will give you the benefits of milk without its taste. If you are unable to meet your requirements through your diet, you may need calcium supplements .Your physician will offer you the best advice in this matter. Allergies If you have significant food allergies, you need to be guided by a nutritionist, who will plan a proper diet for you, so that you do not lack in any nutrients. Eliminating problem foods may lead to an inadequate diet. Medical problems If you are pregnant and have a medical prob-lem, such as diabetes, anemia, heart or lung disease, you will need to take care of your illness along with the growing needs of the developing fetus. You must be monitored closely by your physician and your diet should be charted by a qualified nutritionist.
Drugs and PregnancyUntil the early 1960s, it was thought that the placenta pro-tected the fetus from harmful substances. The Thalidomide tragedy of the sixties proved otherwise. Thalidomide effective in controlling nausea in early pregnancy was considered harmless to the unborn child. Shortly after its introduction, an epidemic of babies born without limbs led to an exhaustive investigation that linked these birth defects to the drug. This prompted the Scientists to investigate whether other birth defects might be linked to other drugs and medications used during pregnancy. It is difficult to trace the connection be-tween drugs and birth defects. The causes of birth defects may be several. Experimentation becomes difficult since humans have to be used as experimental subjects, and high risk is also involved. While the information gained from animal studies is valuable, it cannot necessarily be applied to humans. Isolating a single agent is difficult since most women consume numerous drugs and medications during their pregnancies. Finally, when the drug is being taken is important. It may be harmful if used in conjunction with other agents. Tracing the specific effects of particu-lar drugs is a complex one, but it is a known fact that virtually all drugs and medications taken by a pregnant woman cross the placenta and reach the fetus. The effect of the drugs on the fetus is possibly greater than their effect on the mother at the time of the fetus` rapid growth and development. Do not be worried by what to do and what not to do. We will try to explain about some of the most common drugs and provide some guidelines on their applications and best times of usage with respect to the progress of your pregnancy as also suggest any alternative drug if possible. As a thumb rule, drugs should be used judiciously if you are pregnant. No drug has been proven totally safe for the fetus though many drugs are taken to be safe or at least not harmful. It is important for you to weigh the possible risks against the possible benefits. Use the drug only if the benefits outweigh the risks, otherwise try alternative treatments. Alcohol Until the mid-l970s, it was believed that alcohol was harmless to the fetus. The assumption was that alcohol, by itself, even if consumed in large quantity by the pregnant woman, will not harm the fetus. Alcoholism was felt to be a problem because an al-coholic pregnant woman might tend to neglect her diet resulting in malnutrition in the fetus. We now know that alcohol has a direct toxic effect on the developing fetus. Alcohol quickly crosses the placenta and enters the fetus` blood in the same concentration as in the mother`s blood. Babies born of alcoholic mothers are at substantial risk for suffering from Fetal Alcohol Syndrome, a cluster of disabilities that in-cludes mental and physical retardation, tremors, and peculiar facial characteristics. Alcohol, even in small measures is now associated with some fea-tures of Fetal Alcohol Syndrome. Even an occasional binge drinking may have lasting harmful effects depending on its timing during pregnancy. Even moderate social drinking (about two drinks per day) may lead to lower birth weights. If you are pregnant, it would be wise for you to give up drinking altogether - earlier the better. While drinking in early pregnancy is more likely to be associated with birth defects, drinking later in preg-nancy is more likely to be associated with smaller fetal size. Stopping at any time, therefore, will allow your baby the oppor-tunity to catch up in growth before birth. There is no safe dose for alcohol If you consume alcohol the baby receives it in his blood. Do not consume Beer and wine thinking that they are less harmful than hard liquor. The quantity of alcohol is the same in a four-ounce glass of wine or a can of beer as in a mixed drink. If you were not aware of the harmful effects of alcohol, have drunk too much during your pregnancy it is but natural that you would be concerned about the health of your baby. You need not panic because the fetus probably benefits from the day you stop drinking. Remember that the fetus is remarkably strong and resilient. Babies handle difficulties very well. A high percentage of Mothers give birth to healthy babies who took drugs or medicines or had illnesses or other problems during their pregnancies. Do not get carried away thinking the fetus will be strong enough and deliberately abuse drugs. In case you have unknowingly used drugs, be reassured that the fetus has resources to help her combat their effects. It is normally seen that pregnant women commonly de-velop an aversion to alcohol (as well as smoking and caffeine). Many women cut down on their use of alcohol simply because it loses its appeal. Perhaps this is nature`s way to safeguard the baby. Circumstance may make demand, on you like, say you are in a party, and forced to accept a drink. In this situation it is always advisable to opt for fruit juice, tomato juice or bottled water with a twist of lemon. Tobacco The adverse effect of Tobacco smoking has been explored in detail. It is recommended that if you have the habit of smoking, you should cut down, if not stop altogether, your smoking before you plan to become pregnant. Cigarette smoke contains tars, nicotine, carbon monoxide, lead that are harmful to both you and your unborn child and it has been observed that women who smoke give birth to underweight babies and have greater chances of premature rupture of the membranes, premature birth, prenatal death, placental abnormalities and bleeding during pregnancy. The chances of these above complications occurring increase if you are a regular smoker. Your smoking also has a long-term ill effect on the child. It has been observed that in a family where one or both the parents smoke, the child may suffer from respiratory illness, may have a less developed IQ and are three to five months behind the children of non smokers. Children of smoking par-ents will be more inclined to smoke than the children of nonsmoking parents. You may not be smoking, but you may be breathing in the smoke from your colleagues, friends or family. You are what is called a passive smoker. Passive smoking is harm-ful to your unborn child. You should try to avoid people who smoke as well as identified smoking areas. Sometimes you have to be assertive and forbid people to smoke near you. Marijuana The effect of marijuana smoking has not been researched conclusively till date. The fetus is affected by marijuana smoke as much as the mother, if not more. The amount of tar and nicotine in marijuana are considerably greater than in cigarettes as it has not been commercially viable to reduce these substances in marijuana. Carbon monoxide, which is present in all smoke, restricts the capacity of the blood to transport oxygen. The long term effects of the additives of marijuana and the active ingredients of marijuana on the fetus are still not fully known. Caffeine You will find caffeine in Coffee, tea, colas and other soft drinks (read the labels). Choco-late and some over-the-counter drugs contain caffeine. It has been found in some animal studies that caffeine con-sumption resulted in certain birth defects. While, another study in humans found that drinking coffee leads to abortion, stillbirth, prema-ture delivery, and low birth weight. The added effect of smoking has not been considered here. As many people who drink excessive amounts of coffee also smoke, it is difficult to distinguish the real cause of the problem. A study of over 12,000 women who had babies in a three-year period found that birth problems were more common among heavy coffee drinkers (those who consume more than four cups per day). When, the only coffee drinkers were eliminated from the heavy smokers who also drank coffee the ill effects disappeared. You might be reassured with this finding, if you are a coffee drinker, but "pru-dent and protective" expectant mothers should limit caffeine use. Other than birth defects and pre-maturity, Caffeine causes an increased production of "stress" hormones--epineph-rine (adrenalin) and norepinephrine (noradrenalin). According to National Academy of Sciences report if you drank one to two cups of coffee, or two to three cups of tea per day these stress hormones concentrations increase. The availability of oxygen to the fetus decreases due to the effects of these hor-mones as they constrict peripheral blood vessels, including those in the uterus. The consumption of caffeine is directly proportional to the deprivation of oxygen of the fetus. Caffeine readily enters the fetal blood stream. If the baby has caffeine in her circulation at birth, it takes a much longer time to clear her system than it would take an adult. It would be wise if you reduce, if not eliminate altogether, caffeine intake during pregnancy.   Medications during Pregnency Herbal Teas Hundreds of herbs are available commercially as herbal teas. Herbal teas are said to have various curative or restorative properties, helpful for most discomforts. However, their effects on the fetus are not well studied. The active ingredients of the herbal teas that produce the benefits have not been properly identified. Herbs are also known to cause undesirable side effects in some adults. For instance, teas made from juniper berries, buckthorn bark, senna leaves, duck roots and aloe can irritate the stomach and intestinal tract, sometimes severely. Drinking camomile tea can trigger allergic reactions in some people allergic to rag-weed and related plants. A popular ingredient of tea -licorice root, if used in large quantities, leads to water retention and loss of potassium. Sassafras root contains safrole known to cause liver cancer in rats. The Food and Drug Administration recently ruled that safrole is unsafe for human consumption. Another herb, Ginseng con-tains small amounts of estrogen. Swollen and painful breasts have been reported after its use. These ingredients almost certainly reach the fetus and affect the baby at least as much as they do the mother. You should use herbs with caution because their risks and benefits have not been studied properly. Medicines Drugs such as aspirin, acetaminophen, sedatives and tran-quilizers, antihistamines, antacids and antiemetics (to control nausea and vomiting) are widely used during pregnancy. These drugs do relieve the symptoms such as pain, headache, nervousness, sleeplessness, runny nose, heartburn and nausea. However, they do not cure the illness. Medications, such as an-tibiotics, insulin and steroids either cure or control an illness. The benefits of these drugs are surely greater than those drugs that merely relieve symptoms. Medication is advisable only when the benefits greatly outweigh the potential risks. Your parents, physician will advise you on the judicious intake of medications. Strong medications in some conditions are unavoidable. Conditions such as epilepsy, pneumonia, asthma, strep throat, high fever, arthritis, dia-betes and heart disease may require treatment with strong medications even during pregnancy. Leaving these types of disease untreated would be far more harmful to mother and fetus than the medications. Consider the risks of the symptoms if left untreated, the benefits of the treatment, the seriousness of the condition, other possible treatments and their benefits and the risks of both condition and treatment. Two widely used drugs are generally considered to be harmless - aspirin (Anacin, Bayer, Bufferin, Empirin etc.) and acetaminophen (Datril, Tempra, Tylenol etc.). These drugs reduce pain and fever but both readily cross the placenta and enter fetal circulation. We will focus on each of these drugs. Aspirin One tablet of aspirin is enough to alter the body`s ability to clot blood and prolong the bleeding time. The usual adult dose is two tablets, which will double the bleeding time. The effect of aspirin lasts from four to seven days after a single dose. Aspirin, taken towards the end of pregnancy, is more harmful be-cause normal bleeding after birth may be increased and pro-longed. It is not safe either to take aspirin even earlier in pregnancy, as it could worsen any bleeding you have during your preg-nancy. Aspirin present in the baby`s circulation at birth also prolongs bleeding time for the newborn and it increases the likelihood of jaundice. It is advisable therefore that you should avoid aspirin dur-ing pregnancy, except when it is necessary for controlling cer-tain diseases like arthritis where its benefits outweigh these risks. Acetaminophen Acetaminophen is potentially less harmful than aspirin. The moderate use of acetaminophen does not adversely affect the fetus. The consistent use of more than the recommended dosage would lead to kidney damage in the fetus. If you normally tolerate acetaminophen well, it would be advisable to use acetaminophen in modera-tion rather than aspirin and only if you really need a pain or fever medi-cation during pregnancy. Home Remedies
Opt for home remedies before resorting to medications. In this portion we suggest some alternatives to the medical treatment of common ailments. You should consult your physician if any of these discomforts persist or seem harmful to your well-being. Headache Headache is relieved by a warm relaxing bath, a massage, tension -reducing exercises (such as shoulder circling) and relaxation routines. Hot packs on the back of the neck or shoulders and cold packs on the forehead also help relieve headache for many people. Try not to use aspirin or acetaminophen or a combination drug. Cold, hay fever, runny nose and cough You can get relief from these symptoms by trying a cool mist vaporizer, handkerchief, rest, liquids and honey and lemon. These are safe and effective treatments than decongestants, aspirin, and cough syrups. Remember that these drugs treat the symptoms and does not cure them. Backache Backache is a common problem for pregnant women. You can get respite from backaches with massage, hot or cold packs, and exercises to strengthen the abdominal muscles and to decrease the curve in the low back. You should avoid aspirin and muscle relax-ants unless the condition is severe. Sleeplessness This condition is especially common in late pregnancy. Take a brisk walk each day; this will help release tension that might keep you from sleeping. Before going to bed, try a warm bath, a glass of warm milk, a massage, or listening to soothing music. Do not use sleeping pills or alcohol even if you find yourself wide awake in the middle of the night. Try reading (a dull book is more likely to help you get to sleep) or take the help of yoga.