Healthy Pregnancy

Staying Healthy and Safe

Eat this. Don't eat that. Do this. Don't do that. Pregnant women are bombarded with do's and don'ts. Here is help to keep it all straight.

Eating for Two

Eating healthy foods is more important now than ever! You need more protein, iron, calcium, and folic acid than you did before pregnancy. You also need more calories. But "eating for two" doesn't mean eating twice as much. Rather, it means that the foods you eat are the main source of nutrients for your baby. Sensible, balanced meals combined with regular physical fitness is still the best recipe for good health during your pregnancy.

Weight Gain

The amount of weight you should gain during pregnancy depends on your body mass index (BMI) before you became pregnant. The Institute of Medicine provides these guidelines:

• If you were at a normal weight before pregnancy, you should gain about 25 to 30 pounds.
• If you were underweight before pregnancy, you should gain between 28 and 40 pounds.
• If you were overweight before pregnancy, you should gain between 15 and 25 pounds.
• If you were obese before pregnancy, you should gain between 11 and 20 pounds.

Check with your doctor to find out how much weight gain during pregnancy is healthy for you.  

You should gain weight gradually during your pregnancy, with most of the weight gained in the last trimester. Generally, doctors suggest women gain weight at the following rate:

• 2 to 4 pounds total during the first trimester
• 3 to 4 pounds per month for the second and third trimesters

Where does the added weight go?

• Baby – 6 to 8 pounds
• Placenta – 1½ pounds
• Amniotic fluid – 2 pounds
• Uterus growth – 2 pounds
• Breast growth – 2 pounds
• Your blood and body fluids – 8 pounds
• Your body's protein and fat – 7 pounds

FYI:

• Recent research shows that women who gain more than the recommended amount during pregnancy and who fail to lose this weight within six months after giving birth are at much higher risk of being obese nearly 10 years later.

• Findings from another large study suggest that gaining more weight than the recommended amount during pregnancy may raise your child's odds of being overweight in the future.

If you find that you are gaining weight too quickly, try to cut back on foods with added sugars and solid fats. If you are not gaining enough weight, you can eat a little more from each food group.   

Calorie Needs

Your calorie needs will depend on your weight gain goals.

Most women need 300 calories a day more during at least the last six months of pregnancy than they do pre-pregnancy.

Keep in mind that not all calories are equal. Your baby needs healthy foods that are packed with nutrients — not "empty calories" such as those found in soft drinks, candies, and desserts.

Although you want to be careful not to eat more than you need for a healthy pregnancy, make sure not to restrict your diet during pregnancy either.

If you don't get the calories you need, your 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 cause your body to make 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 child with mental deficiencies.

Foods Good for Mom and Baby

A pregnant woman needs more of many important vitamins, minerals, and nutrients than she did before pregnancy.

Making healthy food choices every day will help you give your baby what he or she needs to develop.

The MyPyramid for pregnant and breastfeeding women can show you what to eat as well as how much you need to eat from each food group based on your pre-pregnancy BMI and activity level.

Use your personal MyPyramid plan to guide your daily food choices. Here are some foods to choose often:

• Grains – fortified, cooked or ready-to-eat cereals; wheat germ
• Vegetables – carrots, sweet potatoes, pumpkin, spinach, cooked greens, winter squash, tomatoes, red pepper
• Fruits – cantaloupe, honeydew melon, mangoes, prunes or prune juice, bananas, apricots, oranges or orange juice, grapefruit, avocado
• Dairy – nonfat or low-fat yogurt; nonfat milk (skim milk); low-fat milk (1 percent milk)
• Meat and beans – cooked beans and peas; nuts and seeds; lean beef, lamb, and pork; shrimp, clams, oysters, and crab; cod, salmon, polluck, and catfish

Talk to your doctor if you have special diet needs for these reasons:

• Diabetes – Make sure you review your meal plan and insulin needs with your doctor. High blood glucose levels can be harmful to your baby.
• Lactose intolerance – Find out about low-lactose or reduced-lactose products and calcium supplements to ensure you are getting the calcium you need.
• Vegetarian – Ensure that you are eating enough protein, iron, vitamin B12, and vitamin D.
• PKU – Keep good control of phenylalanine (FEN-uhl-AL-uh-NEEN) levels in your diet.

Food Safety

Most foods are safe for pregnant women and their babies. But you will need to use caution or avoid eating certain foods.

Follow these guidelines:  

Clean, handle, cook, and chill food properly to prevent foodborne illness, including  listeria and toxoplasmosis.

• Wash hands with soap after touching soil or raw meat.
• Keep raw meats, poultry, and seafood from touching other foods or surfaces.
• Cook meat completely.
• Wash produce before eating.
• Wash cooking utensils with hot, soapy water.  

Do NOT Eat:

• Refrigerated smoked seafood like whitefish, salmon, and mackerel
• Hot dogs or deli meats unless steaming hot
• Refrigerated meat spreads
• Unpasteurized milk or juices
• Store-made salads, such as chicken, egg, or tuna salad
• Unpasteurized soft cheeses, such as unpasteurized feta, Brie, queso blanco, queso fresco, and blue cheeses
• Shark, swordfish, king mackerel, or tile fish (also called golden or white snapper); these fish have high levels of mercury.
• More than 6 ounces per week of white (albacore) tuna
• Herbs and plants used as medicines without your doctor's okay. The safety of herbal and plant therapies isn't always known. Some herbs and plants might be harmful during pregnancy, such as bitter melon (karela), noni juice, and unripe papaya.
• Raw sprouts of any kind (including alfalfa, clover, radish, and mung bean)

Fish Facts

Fish and shellfish can be an important part of a healthy diet. They are a great source of protein and heart-healthy omega-3 fatty acids. What’s more, some researchers believe low fish intake may be linked to depression in women during and after pregnancy. Research also suggests that omega-3 fatty acids consumed by pregnant women may aid in baby's’ brain and eye development.  

Women who are or may become pregnant and nursing mothers need 12 ounces of fish per week to reap the health benefits. Unfortunately, some pregnant and nursing women do not eat any fish because they worry about mercury in seafood. Mercury is a metal that at high levels can harm the brain of your unborn baby — even before it is conceived. Mercury mainly gets into our bodies by eating large, predatory fish. Yet many types of seafood have little or no mercury at all. So the risk of mercury exposure depends on the amount and type of seafood you eat.  

Women who are nursing, pregnant, or who may become pregnant can safely eat a variety of cooked seafood, but should steer clear of fish with high levels of mercury. Keep in mind that removing all fish from your diet will rob you of important omega-3 fatty acids. To reach 12 ounces while limiting exposure to mercury, follow these tips:

Do NOT eat these fish that are high in mercury:

• Swordfish
• Tilefish
• King mackerel
• Shark

Eat up to 6 ounces (about 1 serving) per week:

• Canned albacore or chunk white tuna (also sold as tuna steaks), which has more mercury than canned light tuna

Eat up to 12 ounces (about 2 servings) per week of cooked * fish and shellfish with little or no mercury, such as:

• Shrimp
• Crab
• Clams
• Oysters
• Scallops
• Canned light tuna
• Salmon
• Pollock
• Catfish
• Cod
• Tilapia  

* Don’t eat uncooked fish or shellfish (such as clams, oysters, scallops), which includes refrigerated uncooked seafood labeled nova-style, lox, kippered, smoked, or jerky.

Check before eating fish caught in local waters. State health departments have guidelines on fish from local waters. Or get local fish advisories at the U.S.Environmental Protection Agency. If you are unsure about the safety of a fish from local waters, only eat 6 ounces per week and don’t eat any other fish that week.

Eat a variety of cooked seafood rather than just a few types.  Foods supplemented with DHA/EPA (such as “omega-3 eggs”) and prenatal vitamins supplemented with DHA are other sources of the type of omega-3 fatty acids found in seafood.  

Vitamins and Minerals

In addition to making healthy food choices, ask your doctor about taking a prenatal vitamin and mineral supplement every day to be sure you are getting enough of the nutrients your baby needs. You also can check the label on the foods you buy to see how much of a certain nutrient the product contains. Women who are pregnant need more of these nutrients than women who are not pregnant:

Women who are pregnant also need to be sure to get enough vitamin D. The current recommendation for all adults younger than 71 (including pregnant and breastfeeding women) is 600 international units (IU) of vitamin D each day. Talk to your doctor about how you can be sure to get enough vitamin D and other important vitamins and nutrients.

Keep in mind that taking too much of a supplement can be harmful. For example, very high levels of vitamin A can cause birth defects. For this reason, your daily prenatal vitamin should contain no more than 5,000 IU (International Units) of vitamin A. Some supplements contain much more. Only take vitamins and mineral supplements that your doctor recommends.

Don't Forget Fluids

All of your body's systems need water. When you are pregnant, your body needs even more water to stay hydrated and support the life inside you. Water also helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Not getting enough water can lead to premature or early labor.

Your body gets the water it needs through the fluids you drink and the foods you eat. How much fluid you need to drink each day depends on many factors, such as your activity level, the weather, and your size. Your body needs more fluids when it is hot and when you are physically active. It also needs more water if you have a fever or if you are vomiting or have diarrhea.

The Institute of Medicine recommends that pregnant women drink about 10 cups of fluids daily. Water, juices, coffee, tea, and soft drinks all count toward your fluid needs. But keep in mind that some beverages are high in sugar and "empty" calories. A good way to tell if your fluid intake is okay is if your urine is pale yellow or colorless and you rarely feel thirsty. Thirst is a sign that your body is on its way to dehydration. Don't wait until you feel thirsty to drink.

Alcohol

There is no known safe amount of alcohol a woman can drink while pregnant. When you are pregnant and you drink beer, wine, hard liquor, or other alcoholic beverages, alcohol gets into your blood. The alcohol in your blood gets into your baby's body through the umbilical cord. Alcohol can slow down the baby's growth, affect the baby's brain, and cause birth defects.

Caffeine

Moderate amounts of caffeine appear to be safe during pregnancy. Moderate means less than 200 mg of caffeine per day, which is the amount in about 12 ounces of coffee. Most caffeinated teas and soft drinks have much less caffeine. Some studies have shown a link between higher amounts of caffeine and miscarriage and preterm birth. But there is no solid proof that caffeine causes these problems. The effects of too much caffeine are unclear. Ask your doctor whether drinking a limited amount of caffeine is okay for you.

Cravings

Many women have strong desires for specific foods during pregnancy. The desire for "pickles and ice cream" and other cravings might be caused by changes in nutritional needs during pregnancy. The fetus needs nourishment. And a woman's body absorbs and processes nutrients differently while pregnant. These changes help ensure normal development of the baby and fill the demands of breastfeeding once the baby is born.  

Some women crave nonfood items such as clay, ice, laundry starch, or cornstarch. A desire to eat nonfood items is called pica (PYE-KUH). Eating nonfood items can be harmful to your pregnancy. Talk to your doctor if you have these urges.

Keeping Fit

Fitness goes hand in hand with eating right to maintain your physical health and well-being during pregnancy. Pregnant or not, physical fitness helps keep the heart, bones, and mind healthy.

Healthy pregnant women should get at least 2 hours and 30 minutes of moderate-intensity aerobic activity a week. It's best to spread your workouts throughout the week. If you regularly engage in vigorous-intensity aerobic activity or high amounts of activity, you can keep up your activity level as long as your health doesn't change and you talk to your doctor about your activity level throughout your pregnancy.  

Special benefits of physical activity during pregnancy:

• Exercise can ease and prevent aches and pains of pregnancy including constipation, varicose veins, backaches, and exhaustion.
• Active women seem to be better prepared for labor and delivery and recover more quickly.
• Exercise may lower the risk of preeclampsia and gestational diabetes during pregnancy.
• Fit women have an easier time getting back to a healthy weight after delivery.
• Regular exercise may improve sleep during pregnancy.
• Staying active can protect your emotional health. Pregnant women who exercise seem to have better self-esteem and a lower risk of depression and anxiety.
• Results from a recent, large study suggest that women who are physically active during pregnancy may lower their chances of preterm delivery.

Getting Started  

For most healthy moms-to-be who do not have any pregnancy-related problems, exercise is a safe and valuable habit. Even so, talk to your doctor or midwife before exercising during pregnancy. She or he will be able to suggest a fitness plan that is safe for you. Getting a doctor's advice before starting a fitness routine is important for both inactive women and women who exercised before pregnancy.  

If you have one of these conditions, your doctor will advise you not to exercise:

• Risk factors for preterm labor
• Vaginal bleeding
• Premature rupture of membranes (when your water breaks early, before labor)

Best Activity for Moms-to-Be

Low-impact activities at a moderate level of effort are comfortable and enjoyable for many pregnant women. Walking, swimming, dancing, cycling, and low-impact aerobics are some examples. These sports also are easy to take up, even if you are new to physical fitness.  

Some higher intensity sports are safe for some pregnant women who were already doing them before becoming pregnant. If you jog, play racquet sports, or lift weights, you may continue with your doctor's okay.  

Keep these points in mind when choosing a fitness plan:

• Avoid activities in which you can get hit in the abdomen like kickboxing, soccer, basketball, or ice hockey.
• Steer clear of activities in which you can fall like horseback riding, downhill skiing, and gymnastics.
• Do not scuba dive during pregnancy. Scuba diving can create gas bubbles in your baby's blood that can cause many health problems.

Tips for safe and healthy physical activity

Follow these tips for safe and healthy fitness:

• When you exercise, start slowly, progress gradually, and cool down slowly.
• You should be able to talk while exercising. If not, you may be overdoing it.
• Take frequent breaks.
• Don't exercise on your back after the first trimester. This can put too much pressure on an important vein and limit blood flow to the baby.
• Avoid jerky, bouncing, and high-impact movements. Connective tissues stretch much more easily during pregnancy. So these types of movements put you at risk of joint injury.
• Be careful not to lose your balance. As your baby grows, your center of gravity shifts making you more prone to falls. For this reason, activities like jogging, using a bicycle, or playing racquet sports might be riskier as you near the third trimester.
• Don't exercise at high altitudes (more than 6,000 feet). It can prevent your baby from getting enough oxygen.
• Make sure you drink lots of fluids before, during, and after exercising.
• Do not workout in extreme heat or humidity.
• If you feel uncomfortable, short of breath, or tired, take a break and take it easier when you exercise again.

Stop exercising and call your doctor as soon as possible if you have any of the following:

• Dizziness
• Headache
• Chest pain
• Calf pain or swelling
• Abdominal pain
• Blurred vision
• Fluid leaking from the vagina
• Vaginal bleeding
• Less fetal movement
• Contractions

Kegel Exercises

Your pelvic floor muscles support the rectum, vagina, and urethra in the pelvis. Toning these muscles with Kegel exercises will help you push during delivery and recover from birth. It also will help control bladder leakage and lower your chance of getting hemorrhoids.  

Pelvic muscles are the same ones used to stop the flow of urine. Still, it can be hard to find the right muscles to squeeze. You can be sure you are exercising the right muscles if when you squeeze them you stop urinating. Or you can put a finger into the vagina and squeeze. If you feel pressure around the finger, you've found the pelvic floor muscles. Try not to tighten your stomach, legs, or other muscles.

Kegel exercises

• Tighten the pelvic floor muscles for a count of three, and then relax for a count of three.
• Repeat 10 to 15 times, three times a day.
• Start Kegel exercises lying down. This is the easiest position. When your muscles get stronger, you can do Kegel exercises sitting or standing as you like.

Your Solution

Begin doing all of what is written above ideally, before you get pregnant.  This will help to prepare your body for pregnancy and will allow you to have minimal issues during your pregnancy.  

Dr. Huntoon has always offered information and treatment for women who are pregnant.  Having a Consultation with Dr. Huntoon BEFORE conceiving to get your health in order is vital for a healthy baby.  Working with him for 12 months before choosing to get pregnant offers great benefits for a healthy pregnancy.

Woman who experience Morning Sickness need to appreciate the following:

• Your baby has developed an allergy to something you are eating.  This allergic response is not particularly harmful to the baby, and is something that can be fully addressed in the office.  Dr. Huntoon does an Allergy Treatment to the offending allergy for the baby while in utero.  Once done, the morning sickness stops immediately and the two of you can go forward with your pregnancy. 
• Working with Dr. Huntoon for a year before conceiving will set you up for a healthy and event free pregnancy.

If you have not done that before getting pregnant, after a thorough examination with Dr. Huntoon, begin incorporating any and all of this throughout your pregnancy as you are able.

Remember, everything you are doing affects both you and your baby.  This is important to keep in mind.  

As you move through your pregnancy, continue to develop a healthy appreciation for your health and what a positive effect it has on your mood and the overall sense of wellness.  And habits you start now will sustain you after the pregnancy is over and you begin raising your healthy child.  

If you need any insights or advice in maintaining your health while adjusting to your pregnancy and the bodily changes you are/will experience, regular visits throughout your pregnancy is essential.  This will help make your pregnancy health challenge free and will make both you and your baby all the more healthy.