Your healthy pregnancy

December 19, 2008 7:46:44 PM PST
While excitement and joy are common emotions for the newly pregnant, they are often accompanied by fear and misgivings as well. At the top of their list of worries? Making sure baby is healthy while minimizing the negative effects of pregnancy on your own body. However, it's no secret that moderate exercise and good nutrition keeps both mom and baby healthy while ensuring that baby grows and develops properly.

Foods to eat

For many, the dos and don'ts of eating for two may seem overwhelming, but with a bit of knowledge and common sense, it can be as simple as pie. Well, maybe not pie because it's loaded with sugar, but pregnant women should make sure to get plenty of calcium, folic acid, grains, fruits and vegetables, and protein. Some calcium rich foods like cheese and milk can count as a serving of calcium and protein, which makes the daily goal of 1200mg of calcium and three servings of protein easy to remember. As for fruits and vegetables, four to five servings a day is adequate but make sure at least one serving includes a green leafy vegetable like spinach and one fruit that is rich in vitamin C. Every day, expectant moms should include about six servings of grains, especially whole grains, and a small amount of healthy fats such as olive oil. Lastly, as most pregnant women know, taking a daily prenatal vitamin is important, one that includes DHA, or omega-3 fatty acids, is good for the formation of the baby's brain and eyes. DHA often comes from fish oil, but is also found in flaxseed.

Foods to avoid

Besides making sure to eat a variety of nutritious foods, it is imperative for moms-to-be to avoid foods that can cause harm in the pregnancy. Undercooked meats and unpasteurized dairy products along with caffeine and sugar should be consumed in small doses, if at all. Raw fish and undercooked meats, including deli meats, can carry a type of bacteria that can cause the baby to become very ill. Women wanting to eat deli meats should consider microwaving it for a minute first. And although some fish, especially salmon, is a great source of omega-3 fatty acids, too much fish is not good since even cooked fish can carry mercury, which can cause blindness, mental retardation and seizures in a baby. While it is okay to have tuna or salmon in moderation (once or twice a week) swordfish, king mackerel and shark should be avoided.

All dairy and juice products should be pasteurized to reduce the levels of bacteria present. Most milk products and hard cheeses bought in grocery stores are pasteurized, but some soft cheeses, such as brie or goat cheese may not be. Read the labels carefully because unpasteurized dairy products can carry the bacteria listeria, which has potential to make the baby very sick, while unpasteurized juice products can be contaminated with E. Coli.

Other foods to avoid while pregnant are caffeinated drinks, alcohol and sugar. Although it's okay to drink up to two cups of small coffee a day, large amounts of caffeine have been linked to miscarriages, and it is best to avoid alcohol as no amount of it has been proven safe. Lastly, while a sweet snack or junk food is okay to have once in awhile, remember that they do not significant nutritional value for the baby.

While many women are careful about watching their weight before they become pregnant, confirmation that they are pregnant often causes them to consume more than necessary. Pregnancy isn't really "eating for two." To maintain a healthy pregnancy, a woman only needs 300 additional calories per day, the equivalent of a snack such as cheese with an apple or part of a bagel. The key is to make sure that additional calories are rich in nutrients to help the baby grow. Nutrition, exercise and weight gain go hand in hand. Every woman's body and every pregnancy is different, but guidelines are in place regarding appropriate ranges for weight gain during pregnancy.

Weight gain and exercise

The amount of weight gained during pregnancy affects both mom and baby. Women who gain more than the recommended amount are more likely to develop obesity, to have difficulty breast feeding and to deliver via c-section. On the flip side, gaining too little weight can lead to growth restriction of the baby and premature delivery.

Twenty-five pounds is a normal weight gain for most pregnant women, but for a woman who starts her pregnancy underweight, her doctor may recommend she gain more. Conversely, an overweight or obese women's doctor may recommend she gain 15 pounds or less. A recent study shows that gaining 22 pounds or less may be the ideal for most women, and obese women should gain very little weight. Some doctors are starting to take this new study seriously even though the American College of Obstetrics and Gynecology has not yet changed its recommendations.

In the first trimester, most women gain three to four pounds, but that can fluctuate from one woman to another. Weight gain in the first trimester varies because morning sickness can cause some women to lose weight and others to gain. By the third trimester, weekly weight gain will be between 0.5 and 1.5 pounds per week. Women who start to gain too much weight, however, should refrain from dieting and focus on making healthy food choices instead.

In addition to tweaking food choices, exercise is highly recommended for uncomplicated pregnancies. Studies show that exercise in pregnancy can deter excessive weight gain and help prevent heart disease, diabetes and obesity in the child when he or she is an adult. Safe forms of exercise include power walking, stationary bikes, elliptical machines and swimming. Women who exercise regularly before pregnancy may be able to continue their previous routine with some exceptions.

While prenatal yoga or strength training -- using the body's own weight -- are excellent forms of exercise, activities to avoid include those with a high risk of falling, getting hit or lifting heavy weights. Also avoid exercises that require lying on one's back because this decreases blood flow to the baby. If spotting, bleeding, cramping, pain or a fall occurs, stop and call the doctor immediately.

Physicians used to recommend pregnant women keep their heart beat under 140 beats per minute while exercising. Now many doctors think that a particular heart rate isn't as important as oxygenating the baby, which can be gauged by whether or not mom can have a conversation with someone while exercising. Keep in mind that some days will be easier than other in terms of the amount of exercise that can be done, so it is important for women to listen to their bodies and drink plenty of fluids.

Following these simple guidelines can keep both expectant mothers and their babies healthy throughout pregnancy. Due to specific medical conditions, however, it's essential for women to discuss nutrition, exercise and weight gain with their doctor, as a physician may alter the standard recommendations as needed.

Dr. Rakhi Dimino is a board-certified OB/GYN practicing at The Woman's Hospital of Texas since 2006. Raised in Ohio, Dimino completed medical school at Ohio State University and her residency at Washington University and Barnes Jewish Hospital in St. Louis prior to moving to Texas. She passionately supports women's issues in and out of the office serving on the Board of Directors and Education Committee for the Houston Affiliate of Susan G. Komen for the Cure.

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