Sections
 |
 |
 |
 |
|
|
 |
 |
 |
|
|
A developing baby is hooked into the mother's blood supply by two weeks after conception. By this time, the mother is expecting her period and likely does not yet know that she is pregnant. In the first eight weeks after conception, all the organ systems of the baby are formed, from the heart, kidneys and bony structures right down to the hair follicles.
This is the most critical period of development where, in general, the baby is most at risk from harmful agents. Once the first two months have passed, the baby continues to grow and mature. The baby's brain grows and develops throughout the pregnancy and into childhood, and so continues to be at risk for damage.
Age
These days, many couples delay pregnancy. They may wait until they feel they can afford a house and a car, and have the ability to raise children in good financial circumstances. Sometimes pregnancy is delayed as women establish careers, or because couples wish to travel and experience other opportunities in life first. Each couple is unique and has to decide what is best for them. However, few people realize that delaying pregnancy may make it more difficult to conceive and have a healthy pregnancy and baby.
Although there is no perfect age for pregnancy, women in their twenties have the best outcomes in general. The chances of becoming pregnant decrease and most complications of pregnancy increase with age.
Preconception (before pregnancy)
Half of all pregnancies are not expected or planned. As a result, many women have not prepared adequately for pregnancy. To get ready for pregnancy, a woman should try to be at her healthiest. It is best if she is as close to her ideal body weight as possible. She should be physically active or exercising regularly, and have good sleep habits. Her diet should be balanced with all the food groups and she should not be skipping meals. She should also avoid things that could be harmful to a developing baby, such as smoking, alcohol and certain chemicals including illegal drugs.
A woman who has chronic medical conditions such as asthma, epilepsy or diabetes should see her doctor to make sure her condition is stable and that she is taking medications appropriate for pregnancy. Ideally all women should discuss preconception planning with their physician.
All women planning a pregnancy, or who could possibly become pregnant, should take folic acid supplements of at least 0.4 milligrams each day. Folic acid occurs naturally in leafy green vegetables and has been added to flour products. Most multivitamins and all prenatal vitamins have folic acid.
Nutrition
During pregnancy, women need about 300 more calories each day, but do not need to 'eat for two.' In early pregnancy many women develop cravings for certain foods, often because their diet is inadequate in that area.
Developing babies need all the nutrients found in a quality diet. They need essential fatty acids for brain development as well as the calcium found in milk and dairy products or substitutes. They need calories and vitamins found in whole grains along with multiple vitamins and minerals found in vegetables and fruits.
Pregnancy is not a time to go on a diet that limits these food groups. Prenatal vitamins help to make sure the vitamins and minerals in greater need in pregnancy are available, but vitamins cannot replace a good diet.
In early pregnancy, women tend to prefer foods that are the least likely to be contaminated. Beef, pork and fish often do not appeal to women early in pregnancy. These foods come from animals high on the food chain. These animals will have eaten grains and possibly animal proteins that may have been contaminated with pollutants. Such pollutants will be concentrated in the meat.
Early in pregnancy, women often like to eat small amounts of carbohydrate-rich foods such as breads, cereals, pastas and rice. It is not as critical to be eating all the food groups early on if nausea is a problem. There will be plenty of time later in pregnancy to balance the diet.
Many food scare stories have been aimed at pregnant women. Unfortunately, it is difficult to tell whether women should be overly concerned with these issues.
Fish - Fresh tuna, shark and swordfish have been identified as sources of mercury contamination, which is harmful to a baby's developing brain. As these are big fish, they are high on the food chain, and can concentrate mercury in their flesh if their environment is contaminated. Still, mercury levels in canned light tuna are well within acceptable guidelines and so canned light tuna is safe to eat in pregnancy. Other possible contaminants include PCBs and dioxins, so local fish advisories should be observed. Fresh large fish should be limited to one meal per month. Fresh sport fish, caught in freshwater lakes and listed as safe in provincial guides, should be limited to four meals a month. Salmon is considered safe in pregnancy.
Other seafood - Raw seafood such as sushi and raw shellfish like oysters may carry infections that can be harmful in pregnancy.
Listeriosis - Listeria is a rare bacteria found in unpasteurized milks, soft cheeses and deli meats. Pregnant women are much more likely to get sick when exposed to Listeria, and the infection can be deadly for the baby. If these foods are eaten in pregnancy, they should only be served steaming hot.
Food poisoning - E. coli, salmonellosis and toxoplasmosis are all infections that can be spread through foods that have not been cooked adequately. Raw eggs, meat and poultry can all be sources. Avoid eggnog and caesar salads made with raw eggs or even partially cooked soft eggs. Cook ground meats until no pink is left. When preparing raw meats, be careful to wash hands and kitchen surfaces well. Raw sprouts and unwashed fruits and vegetables can also lead to these infections.
Evidence suggests that unborn babies may be able to actually taste the amniotic fluid in which they float. It is possible that the types of food a mother eats in pregnancy prepare her baby's tastebuds for the type of food she likes to eat. This is very early role modeling indeed!
Smoking, alcohol and other toxins
Smoking can lead to higher chances of miscarriage, growth disturbance, preterm birth (baby born too early), stillbirth (baby born dead) and crib death (SIDS), among other things. Problems with the placenta (the life support connection between baby and mother), which the baby uses to take in oxygen and get rid of carbon dioxide and other waste, can also develop. Reducing the amount smoked or, better still, quitting at any time in pregnancy is always encouraged for the health of both baby and mother.
Alcohol is one of the strongest toxins (poisons) we know of, and it can cause damage throughout the entire pregnancy. The more alcohol consumed, the greater the chance of damaging the baby's developing brain and other organ systems. Drinking during pregnancy can cause fetal alcohol spectrum disorder, a lifelong condition that can have devastating effects on a baby's future. There is no known safe level of alcohol in pregnancy. However, women who had a drink or two before realizing they are pregnant should not worry. Just take care to avoid further alcohol in pregnancy.
Understandably, the use of illegal substances, such as marijuana, cocaine and crystal meth, are all considered hazardous to pregnancy and should be avoided completely.
Many other toxins are present in our environment, including dry cleaning fluids, cleansers, and industrial solvents. If a woman is exposed to fumes or chemicals at work, she should record the information from the chemical label and discuss it with her doctor or midwife, preferably before pregnancy. If fumes cause nausea or sickness, listen to Mother Nature's instincts and avoid exposure. If someone else in the family is working with chemicals such as pesticides, it may be wise to wash work clothes separately to keep the unborn baby safe.
Medications
Medications include prescription and over-the-counter medications available without prescription. Pills, elixirs, lotions and patches are all types of drugs. Although many people think any medication is unsafe in pregnancy, a large number of medications are considered safe.
Some medications have known ill effects, but may still be used if the condition they treat could cause worse problems. For instance, untreated depression can lead to a loss of appetite, disturbed sleep, reduced activity and exercise, and in severe cases, attempted suicide. All of these can lead to an unhealthy environment for the baby. Each medication and medical condition must be assessed for its potential benefits and risks. The doctor or midwife should be consulted about all medications taken in pregnancy.
Herbal products and teas
Herbal products and teas are a separate topic, as they are not regulated like medications. They may not be pure, may have varied concentration, and may harm a baby even though they are 'natural.' Echinacea, garlic (in normal cooking amounts) and ginger are probably all safe to use in pregnancy. Anything else should be discussed with a pregnancy care provider.
Dental hygiene
It may be surprising to learn that women with good dental health have the best pregnancy outcomes. Although ideally all dental care should be done before pregnancy, a pregnant woman should not be afraid to have routine dental check-ups. It is probably best to wait until the back of the teeth can be brushed without gagging to make the dental visit tolerable. Avoid having routine dental x-rays taken at this time.
Exercise
Fatigue often leads women to stop exercising during early pregnancy. Women are encouraged to resume activities once energy levels return. Activities that could lead to trauma (such as rock climbing or contact sports), are associated with rapid acceleration or deceleration (like bungee jumping or carnival rides), or involve dramatic pressure changes (scuba diving and paragliding) should be avoided.
Exercise should not be overly strenuous. A target heart rate of 140 beats per minute and the talk test can be used to keep the level appropriate. To pass the talk test, the woman should be able to carry on a conversation or talk aloud during exercise without feeling winded or short of breath. As well, air circulation is necessary to avoid overheating during physical activities. Avoid using hot tubs and saunas. For the last half of the pregnancy, try not to exercise in positions that involve lying flat on the back, as this may interfere with the blood supply to the baby.
Illness
A woman should make sure she is immune to certain diseases before trying to conceive. The illnesses include rubella (German measles) and varicella (chickenpox). Vaccinations are available for these conditions, and ideally should be given before pregnancy begins. She may also wish to check on CMV (cytomegalovirus) and toxoplasmosis, to discover if she is at risk for these infections. Since toxoplasmosis is often spread in the litter of outdoor cats, changing litter boxes should be avoided.
In pregnancy, testing for sexually transmitted infections (STIs), HIV and hepatitis B is done. A woman can still develop an STI while pregnant, and condoms should be used if her sexual partner could possibly pass on an STI.
Other infections in the community can be harmful to a developing baby. In general, pregnant women should stay away from anyone ill with a fever and those undergoing radiation therapy for treatment of cancer.
Most pregnancies go very well. By listening to Mother Nature when she tells you what and when to eat, what to avoid and when to sleep, you will be well on your way to the healthiest pregnancy possible. Starting to be the ideal role model for your baby from the moment of conception gives your child the best start possible. Consider it the beginning of true parenting - providing food to baby, removing wastes (just like changing diapers), and protecting baby from the hazards of the world.
FAMILY HEALTH is written with the assistance of |
 |
 |
Articles in the Diabetes section of Family Health OnLine are sponsored by:
|
