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It May Be March, But A Nutritious Pregnancy Diet Shouldn’t Force You Into Madness

By Sharon Voyer Lavigne, MS, CPEIS Teratogen Information Specialist

We have all heard this before from our mothers and grandmothers before them, but here it is again, “what we put into our bodies really affects our health and well-being.” What better time to delve into that saying than during the month of March – National Nutrition Month. For women, proper nutrition becomes especially important during our childbearing years. When planning a pregnancy, newly pregnant or breastfeeding, good nutrition is the key to healthy outcomes.

So how does a woman go about becoming “nutritionally” healthy? First, we need to look at our diet. Yes the dreaded four-lettered word D-I-E-T. Let’s first focus on the version of this word that is positive, instead of it’s negative connotation that makes us think of deprivation and cravings. What kind of food do you consume? Fruits, vegetables, proteins, grains and fats should all be on the list. During pregnancy and breastfeeding, vegetarians and vegans need to be more creative at getting in enough protein and healthy fats, but it is doable. A consultation with a dietician or nutritionist may help you round out your intake properly. Women with medical conditions like Crohns disease or ulcerative colitis (see fact sheet- http://www.otispregnancy.org/files/IBD.pdf) may also benefit from consulting an expert to cater to their needs. These conditions may limit what you can eat or effect how you absorb nutrients. In some cases, supplements are helpful. For example, Vitamin K (the clotting vitamin) may be deficient in someone with inflammatory bowel disease.

Another group that needs to be aware of their diet is those individuals with diabetes. Diabetics need to eat the right balance of carbohydrates in order to keep their blood sugar level in a healthy range (See fact sheet: http://www.otispregnancy.org/files/diabetes.pdf). This is especially true prior to conceiving, since elevated blood sugar levels can cause birth defects and pregnancy complications. A diabetic’s glycosulated hemoglobin levels (HbA1c) should be as close to normal (below 6 ug/ml) as possible prior to and during pregnancy. Some women who had been previously able to control their diabetes with diet and exercise alone may need insulin during pregnancy. In many cases, using insulin makes it easier for a woman to be in control of her blood sugar levels.

Now, let’s look at supplements. Vitamins and minerals can be supplemented to round out our nutritional intake. In the perfect world, prenatal vitamins would be started prior to conception. However, since 50% of pregnancies are unplanned, vitamin and mineral intake often starts after conception. Vitamin and minerals typically have a predetermined Recommended Daily Allowance (RDA) for pregnancy and for breastfeeding. Women should stick to these guidelines unless their health care provider has determined that they are deficient in something specific. Then an additional amount of what vitamin or mineral is lacking can be supplemented. More is not always better, so heeding the guidelines of the RDA is safest.

One vitamin that most women have heard about is folic acid or folate. This B vitamin has been shown to reduce risks for certain birth defects, so all women planning to conceive or who are already pregnancy should be taking at least 600mcg of folic acid. Women who have taken medications recently or need to continue to take medication that decrease folic acid will need more- 4-5 mg per day. This is not a typical dose in a prenatal vitamin, so a separate supplement of folic acid will be necessary.

Any supplement that also contains herbal products should be avoided. Natural herbs are not always safe to use during pregnancy. While the majority may not cause birth defects, very little data exists on their safety in pregnancy and breastfeeding. Some herbs interfere with hormones, which may affect fertility. Some herbs may cause uterine contractions and cause pregnancy loss. A supplement without additional herbal ingredients is best.

Okay, now what about Omega 3 fatty acids, fish and methyl mercury? Yes, fish is found in a healthy diet. Fish does contain omega 3’s which are important for your health and the growth and development of your baby. Some prenatal vitamins contain Omega 3 fatty acids now. Fish can also contain methyl mercury, a toxic form of mercury that may affect your baby’s developing brain. Avoiding types of fish that may contain high level of methyl mercury is best. These include shark, swordfish, King mackerel and tilefish (See fact sheet: http://www.otispregnancy.org/files/methylmercury.pdf). The FDA suggests consuming no more than 12 ounces of fish per week of most types of cooked fish. If you prefer to eat fresh water fish from local waters, the Environmental Protection Agency or your state or local health department should be able to advise you on what fish are currently safe to eat.

Finally, we cannot ignore the negative connotation of the word D-I-E-T. Trying to get down to a healthier weight is a good idea prior to pregnancy. However, once you conceive, you should strive for the healthy balance we have discussed so far. Weight loss during pregnancy may put you at greater risk for having a child with birth defects or pregnancy complications. Leave those thoughts and plans of weight loss until after you have had your baby.

Good ‘ol grandma was right…”You are what you eat!” So, eat right, monitor your health, and you’ll be rewarded when a healthy, bouncing baby’s toothless smile is gleaming up at you!

About the Author

Sharon Voyer Lavigne is a Teratogen Information Specialist and coordinator of the Connecticut Pregnancy Exposure Information Service (CPEIS), a non-profit based at the University of Connecticut Health Center that aims to educate women about exposures during pregnancy and breastfeeding. She’s also been a genetic counselor for the past 20 years.

CPEIS is an affiliate of the Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. Connecticut women with questions or concerns about pregnancy or breastfeeding exposures can be directed to (800) 325-5391. Outside of Connecticut, please call OTIS counselors at (866) 626-OTIS (6847).

Stopping Back Pain During Pregnancy

It is estimated that two-thirds of American women will experience lower back pain by the 36th week of pregnancy. Why is this such a common problem? And what is causing this pain? One of the reasons low back pain during pregnancy is so common is because of a general lack of awareness of proper care for the spine prior to and during pregnancy. As a Boise Chiropractor and Meridian Chiropractor I see a wide range of patients. Among those, I often see pregnant women who are suffering from back pain. One of the most common causes of back pain during pregnancy has to do with the internal biochemistry which actually has an effect on the spine and pelvis. During the pregnancy the body produces a hormone known as relaxin which is designed to help loosen ligaments, particularly in the low back and pelvis. This is primarily to help better facilitate movement and shifting of these joints in preparation for the birthing process. This is good for labor, but not so good for the low back. What inevitably happens as a result of this release of relaxin is shifting and misalignment of various structures in the low back and pelvis causing abnormal tension in these areas resulting in pain and irritation.

A Simple But Effective Solution

So what can be done to help with these problems? Well unfortunately many physicians feel as though there isn’t much that can be done. You obviously can’t use any sort of pharmaceutical intervention during pregnancy. What many people still are unaware of is how powerful and effective chiropractic care can be for pregnant women. The reason why chiropractic care helps so much is because it addresses the fundamental cause of back pain during pregnancy. Chiropractic adjustments help to restore proper alignment of the spine and pelvis which in turn helps to relieve tension and irritation of the surrounding muscles and ligaments. In addition to chiropractic adjustments, your chiropractor might also prescribe some simple stretching and strengthening exercises to help prevent any further problems.

But is it Safe for You and Your Baby?

The number one concern that most pregnant women have when seeing a chiropractor for the first time is whether or not chiropractic is safe. Rest assured, chiropractic care is extremely safe and effective. Numerous studies have demonstrated the effectiveness and safety of chiropractic care. In addition to this however chiropractic malpractice insurance rates are lower than any other physicians treating pregnant patients. This is a direct reflection of safety.

Preventing Back Pain During Pregnancy

Without reservation I always recommend that any woman that is pregnant or is considering getting pregnant seek out a trusted chiropractic physician as part of their healthcare team. Regular preventative chiropractic care should be a part of everyone’s health and wellness strategy, especially women who are pregnant. Ensuring that the spine and pelvis are correctly aligned and functioning properly ahead of time can help prevent problems that could creep up. If you are pregnant or are considering getting pregnant, contact your chiropractor today to see how they can help you.

About the Author

Dr. Chad Woolner is a Chiropractic Physician is Boise, Idaho. He can be reached through his blog at www.Alignwellnessblog.com or his clinic website www.BoiseChiropracticGroup.com.

Pregnancy: No Excuse For Ditching Your New Year’s Resolution To Get Fit

By Sonia Alvarado, CTIS Pregnancy Health Information Line Counselor

It’s a New Year, which for many people also means a renewed commitment to personal improvement – also called “New Year’s resolutions.” High on the list of New Year’s resolutions is either exercising more or starting an exercise routine. If you are not pregnant, most people take it for granted that maybe you should hop on the treadmill or dance your way to better health in rumba class (or another trendy exercise craze), but what about pregnant women?

It was not that long ago that pregnant women in the U.S. were seen as delicate, weak, sensitive creatures that could not – or should not – lift grocery bags, children, exercise, or work. Pregnant women were seen as human incubators that could be harmed by too much exertion or physical stress. In fact, many people still hold on to these types of ideas, some of which are also culturally-based. At one time, the American College of Obstetrics and Gynecologists (ACOG) also had a view that exercise should be low impact, and that the heart rate should not exceed 140 bpm. This recommendation was a source of irritation to many healthy pregnant women who exercised regularly and did not appreciate having to cut down on their normal routines.

Recommendations for pregnant women

ACOG currently recommends pregnant women continue an exercise routine if they already have one. They also recommend that sedentary pregnant women see their doctors about getting started on appropriate exercises. Pregnant women are recommended to exercise daily, or at least, on most days of the week for 30 minutes or more. Certain women may have health issues that make it risky for them and in those cases the doctor may have other suggestions for strengthening muscles during pregnancy.

The ACOG Education Pamphlet AP119 — Exercise During Pregnancy reports that exercise has a positive impact on pregnancy and reduces common complaints such as backaches, constipation, bloating, and swelling. More specifically, it reports that exercise “may help prevent or treat gestational diabetes, increases your energy, improves mood and posture, promotes muscle tone, strength, and endurance, and helps you sleep better.”

What do the studies show?

A review article published in 2010 in the journal Sports Medicine, looked at studies specific to pregnant women and cardiovascular adaptations during exercise, compliance with current recommendations and the effects of exercise on pregnancy outcomes.

The authors report that regardless of whether pregnant women exercise or not, there is a change in heart rate that takes place from as early as two weeks of pregnancy and continues into the third trimester. There is an increase in blood volume that starts at between 10 and 20 weeks. This change, as well as others, however, has not been reported to be a barrier or disadvantage to exercising in pregnancy. Data suggests that pregnant women who exercise have a lower resting heart rate compared to non-exercising pregnant women and aerobically fit pregnant women have an improved V02, which means they take in more oxygen and use it better during exercise.

When women exercise their heart rate increases, and so does the fetal heart rate. However, this has not been reported to be a risk to the development of the baby and may have advantages for the baby during delivery and after. Studies suggest that women who regularly exercise have tend to have infants that are leaner, however, this has also not been reported to be a disadvantage. Very fit women also have advantages in labor, including a decreased risk for c-sections.

What about yoga and Qi?

Qi gong (pronounced chee guhng) and yoga are both gentle exercises with a focus on stretching, breathing and bringing calmness of mind to the practitioner. Qi is also reported to have an additional emphasis on “energy life force.”

There have been a few studies looking at the benefits of yoga on sleep during pregnancy, Qi and yoga on depression or anxiety in pregnancy, yoga on delivery-related stress and labor. The data on these exercises has been reassuring. The studies are generally interview-based and reflect how participants feel about their experience. For women who are interested in getting “fit,” but may not be interested in other types of exercise, this may be another option.

Which exercises should be avoided?

The ACOG Education Pamphlet AP119 — Exercise During Pregnancy, recommends avoiding contact sports, downhill snow skiing and scuba diving during pregnancy. Sports with a higher risk for falling are generally not recommended.

Whether your 2011 resolutions include walking, running, swimming, yoga, or Qi, I say, increase your chances of being successful! Try it with friends, your pets, include your significant other and your mother! Just make it fun and you’re more likely to still be at it in 2012!

About the Author

Sonia Alvarado is a bilingual (Spanish/English) Teratogen Information Specialist with the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, a state-wide service that aims to educate women about exposures during pregnancy and lactation. Along with answering women’s and health professionals’ questions regarding exposures during pregnancy/lactation via CTIS’ toll-free hotline and email service, she’s provided educational talks regarding pregnancy health in community clinics and high schools over the past decade. In addition, Sonia contributes to the service’s website, develops training materials for new CTIS staff, and is the supervising Teratogen Information Specialist trainer. Sonia attended San Diego State University and has worked in Tuberculosis Control for San Diego County’s Public Health Department. Sonia’s work has also been published through several tuberculosis studies. In her spare time, she loves to volunteer with the March of Dimes as an expert speaker on themes related to pregnancy.

CTIS Pregnancy Health Information Line is part of the The Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. Questions or concerns about the flu shot can be directed to (800) 532-3749 or by visiting CTISPregnancy.org. Outside of California, please call OTIS counselors at (866) 626-OTIS (6847).

References:

The ACOG Education Pamphlet AP119 — Exercise During Pregnancy

Melzer et al: Physical Activity and Pregnancy – Cardiovascular Adaptations, Recommendations and Pregnancy Outcomes.Sports Med 2010;493-507.

Eun Sun Ji and Hae-Rae Han: The Effects of Qi Exercise on Maternal/Fetal Interaction and Maternal Well-Being During Pregnancy.AWHONN 2010;310-318.

*Image provided by Gaiam.*

Avoiding Your Inner Pregnancy ‘Grinch’ This Holiday Season

By Nadia Mohamedi, OTIS Teratogen Information Specialist

If “holiday” means an exemption from work, the holiday season should be a time of relaxation and comfort. For many of us, however, the holiday season can be an overwhelming blur of bright lights, packed malls, uncomfortable work parties, financial heartache and family drama. Add some crazy pregnancy hormones and fatigue in the mix and the holiday season no longer seems like a winter wonderland. As my then pregnant sister said one Christmas, “My fat body may make me look like Santa but I feel more like the Grinch with anxiety problems.” Because, at that point I was not a pregnancy health counselor and not equipped with pregnancy information to help my sister, I hope to share what I know now and encourage all soon-to-be or repeat mamas to have a real holiday this year for both their well-being and that of their babies.

Stress is the body’s way of reacting to something that is unknown, disturbing or dangerous, also called a “stressor”. For example, if you were just waltzing around walking in the woods and all of a sudden saw a big black bear, your body would produce hormones like cortisone or adrenaline that gets your heart rate up and your legs running…fast. Once you are in a safe place, these levels of hormones would go down and you would start to relax. This kind of stress is protective – it keeps us safe, energized and even improves our immune system and memory.

However, repeated stress or stress that remains long after the “stressor” goes away or stress that is extreme can contribute serious damage to your own health. Chronic stress can lead to hypertension, heart disease, diabetes, lower immune function and memory problems. Extreme stress can also lead to a worsening of existing health conditions – like throwing a diabetic’s glucose levels out of control.

In general during pregnancy, the healthier the mom is, the better chance she has of having a healthy baby. Increased stress during pregnancy can affect the pregnancy outcome in many different ways:

• As mentioned above, stress can worsen existing conditions like diabetes. Poorly controlled diabetes in pregnancy is associated with increased risk for birth defects, preterm delivery (delivering before 37 weeks), and a cesarean birth. Stress can also increase blood pressure, which can lead to pregnancy-induced hypertension.

• Stress can cause emotional problems like feelings of anxiety, sadness and irritability. Women who have a mental illness in pregnancy are twice as likely to develop post-partum depression, which can negatively affect maternal bonding and, consequently, the baby’s development and behavior.

• Some women alleviate stress by eating poorly, smoking cigarettes, drinking alcohol or using illicit drugs. Stress can cause women to forget to take their prenatal vitamins or prescribed medication. These behaviors can be extremely detrimental for a developing baby such as causing poor fetal growth, birth defects preterm delivery, or neonatal withdrawal.

Measuring the effects of stress itself on a pregnancy is difficult. Numerous studies have been done to find out if increased stress alone can cause adverse pregnancy outcomes. The studies, so far, have shown that it is unlikely that stress alone can cause an increased risk for birth defects. However, some studies have shown that severe stress alone is associated with an increased risk for preterm delivery and low birth weight. Some studies have not shown this effect. In clinical practice, many doctors prescribe bed rest, which can vary from taking it easy around the house to total bed confinement, for pregnant mothers who are at risk for having an early delivery or other complications.

If you’re still reading this, you might be a little stressed out right now. Take a deep breath… phew! I hope to increase awareness about how important it is to stay healthy and relaxed this holiday season, not to contribute to anxiety. If you are pregnant and are feeling the nerves rise, take a break to find out what might help you keep them down. For once, pass on heading the next big project at work. Master that downward-facing dog. Sip some hot cocoa while you mouse-click your way through all your holiday shopping. That party tonight where 50 strangers will be rubbing your belly? Skip it. Take advantage of all the “holiday spirit” enthusiasts by making them listen to you vent for hours. Seek professional help as soon as you think you might need it. If you know someone who is pregnant, ask her what she wants this holiday – like a pregnancy massage or a big pillow. Don’t assume she only wants presents for the future baby. And lastly, if every year you attend a huge dinner hosted by the fabulous Aunt Linda, who is pregnant this year, offer to have it at your place instead. It can be hard to break tradition, but remember, the holiday season happens every year. This year, focus on the most important present you can give – the brightest future possible for you (or your pregnant friend) and the newest addition to the family. Happy Holidays!

We all come home, or ought to come home, for a short holiday – the longer, the better – from the great boarding school where we are forever working at our arithmetical slates, to take, and give a rest. – Charles Dickens

*Nadia Mohamedi is a teratogen information specialist and also serves as a research assistant/interviewer for OTIS studies in San Diego, CA. She holds a BA in neurobiology and a minor in psychology from Harvard College. In addition to her work with OTIS, Nadia has worked for the Alcohol and Drug Abuse Treatment Program at McLean Hospital as well as served as a teacher’s assistant at a school for children with disabilities in Lima, Peru.

OTIS is a North American non-profit dedicated to providing accurate evidence-based information about exposures during pregnancy and lactation. Questions or concerns about alcohol during pregnancy or breastfeeding can be directed to OTIS counselors at (866) 626-OTIS (6847) or online at OTISPregnancy.org.*

*Image provided by Bamboobies, maker of the Butterfly Wrap.*

Counselors at the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, a non-profit based at the University of California, San Diego that aims to educate women about exposures during pregnancy and breastfeeding, have compiled a list of the most common holiday foods to avoid during pregnancy.

“It’s crucial we spread the word during this time of year, especially about avoiding alcohol in pregnancy,” said Dr. Christina Chambers, professor of pediatrics at UCSD and program director of CTIS Pregnancy Health Information Line. “In fact, it’s during this time of year when we receive the most number of calls from women who overindulged, found themselves pregnant and are now concerned about the amount of alcohol they consumed during the first few weeks of their unplanned pregnancies,” she added.

Fetal Health Experts List Top 10 Seasonal Foods To Avoid During Pregnancy

Counselors who provide California women answers to questions about exposures during pregnancy and lactation through a toll-free hotline (800) 532-3749, said many drinks and foods commonly served as appetizers or main courses during the holidays can lead to pregnancy problems, including:

1. Spiced Cider

Many spiced ciders will contain alcohol. Spiced wine is also a commonly served drink around the holidays. If you’re not sure if there is alcohol in what’s being served to you, just ask. Also, avoid those drinks that might contain wine, beer or liquor. “Drinking alcohol during pregnancy is a leading cause of mental retardation,” explained Laurel Prince, a CTIS teratogen information specialist.

2. Eggnog

Eggnog lattes are coming soon to a coffee shop near you, but so are punchbowls full of eggnog and brandy. It’s okay to enjoy the first (as long as it’s decaf), but make sure to avoid the second! Pasteurized eggnog can be a delicious treat, but alcohol should be avoided.

3. Rum Balls

Delicious? Yes. A good idea during pregnancy? No. Unfortunately rum balls actually do contain some alcohol. If craving chocolate, reach for something that doesn’t contain alcohol. “It’s great to indulge a little bit when it comes to chocolate,” explained Prince. “Just also be aware that chocolate contains caffeine and pregnant women shouldn’t consume more than 300mg of caffeine per day,” she added.

4. Soft Cheeses (Panela, Cotija, Queso Fresco, Blue-Veined Cheeses, Brie, Feta, Camembert)

Unless it’s labeled as “made with pasteurized milk,” it should be avoided. Unpasteurized milk can contain the bacteria listeria monocytogenes. This bacteria can cause listeriosis, an infection that can harm a developing baby and increase the risk of miscarriage, stillbirth, uterine infection, premature labor, and death in the newborn. To avoid this problem, make sure to look for the “made with pasteurized milk” label.

5. Hot Dogs and Luncheon Meats

Hot dogs and luncheon meats are also places listeria monocytogenes bacteria like to hang out. Make sure to reheat them until they are steaming hot. Otherwise, choose another delicious deli treat.

6. Pate

Refrigerated pates or meat spread can also cause listeriosis, so it’s best to avoid them during pregnancy. If you’re craving the spreading sensation, try peanut butter, almond butter or pasteurized cream cheese.

7. Imported Candies

Lead has been found in some consumer candies imported from Mexico. Lead has also been found in the wrappers of some imported candies. To be safe, stick to non-imported candies this holiday season. High levels of lead during pregnancy can cause low birth weight, premature delivery, miscarriage, and even stillbirth.

8. Undercooked Turkey & Ham

Food poisoning can affect everyone, including pregnant woman. Be sure that meat is cooked at the correct temperature for the correct amount of time. Using those meat thermometers will help do the trick! If you aren’t cooking the meat yourself, make sure you check with the chef to ensure its cooked all the way through.

9. Tuna

For all of you tuna tar-tar lovers, just remember the recommendation for fish consumption during pregnancy is no more than 12 oz. of large predator fish (tuna, shark, tilefish, king mackerel) per week since it contains methylmercury. In addition, large predator fish are more likely to contain higher amounts of methylmercury. High levels of methylmercury can lead to birth defects such as cerebral palsy, mental retardation, and blindness.

10. Smoked Seafood

Remember that pesky bacteria listeria monocytogenes that makes those delicious soft cheeses off-limits? It turns out it can live in smoked seafood too. Don’t eat refrigerated smoked meats unless they are ingredients in a dish that has been cooked, such as a casserole. Examples of refrigerated smoked seafood include salmon, trout, whitefish, cod, tuna, and mackerel, which are most often labeled as “nova-style,” “lox,” “kippered,” “smoked,” or “jerky.”

More information on the exposures mentioned can be found on www.CTISPregnancy.org.

CTIS Pregnancy Health Information Line is the California affiliate of OTIS, a North American non-profit dedicated to providing accurate evidence-based, clinical information to patients and health care professionals about exposures during pregnancy and lactation through its toll-free hotline and website, www.OTISPregnancy.org. Nearly 100,000 women seek information about birth defect prevention from OTIS and its affiliates every year.

Searching for a meaningful and unique gift for the expecting mom this holiday season? Bellybuds® are a safe and convenient option for sharing music, voices and/or sound with the baby-to-be via their “bellyphones” that adhere to the belly with medical-grade, reusable and skin-safe hydrogel rings. They’re easy to wear (they can go right under your clothes) and affordable at under $50! They have just launched a NEW innovative VoiceShare™ application that allows mom to share unique audio with baby. Friends and family (no matter where their location) can record a message for baby to be played via Bellybuds. This is a great gift option for military families, adoptive parents, surrogates, etc. this holiday season!

What’s the buzz about the buds? The inspiration for Bellybuds® is Jama Williamson of NBC’s “Parks and Recreation.” Williamson is the co-founder’s wife and pregnant with her second daughter. What does she have to say?

“A few weeks ago we went to our OB/GYN and found out that our baby was in the breech position. Before our next visit a couple weeks later, I used my bellybuds several times and put them very low on my abdomen in hopes that she would turn downward. Well, when we went back in, sure enough she had turned! My best friend did the same thing with her buds and her baby turned downwards within 24 hours!”

To learn more or to purchase Bellybuds®, visit www.bellybuds.com.

*Company generously provided information and images for this review.*

This versatile salve from Motherlove is an absolute must for every home! A little definitely goes a long way with this remedy. Certified USDA Organic, the Green Salve soothes and heals baby’s sensitive chapped skin, relieves the sting from insect bites, bee stings, poison ivy and poison oak, and helps with the irritation and redness caused by eczema. The salve makes a great “boo-boo” remedy, as well, as it aids in wound healing with minimal scarring!

Motherlove offers a full line of products for pregnancy, breastfeeding, and babies. You will find some delightful gift ideas for the mom-to-be and her newborn cherub! In addition, Motherlove gives over 10% of after-tax profits to the Nurturing Life Foundation.

To learn more about this amazing eco-conscious company, or to order the Green Salve and other fabulous organic products for mom & baby, please visit their website.

*Company generously provided a sample and images for this review.*