Tag Archive | Nutrition

Is it safe to continue breastfeeding if I’m pregnant with another child?

Many mothers choose to continue breastfeeding throughout pregnancy, while others decide to wean. The following ipregnantwithsonkissinnformation may help you decide what is best for you and your family.

Generally, it’s possible to safely continue breast-feeding while pregnant — as long as you’re careful about eating a healthy diet and diligently drinking plenty of fluids. There’s an important caveat, however. Breast-feeding can trigger mild uterine contractions. Although these contractions aren’t a concern during an uncomplicated pregnancy, your health care provider may discourage breastfeeding while pregnant if you have a history of preterm labor. In an uncomplicated pregnancy there is no evidence that continuing to breastfeed will deprive your unborn child of necessary nutrients. In addition, according to the LeLeche League International Breastfeeding Answer Book, 3rd Edition 2003, page 407. “Although uterine contractions are experienced during breastfeeding, they are a normal part of pregnancy. Uterine contractions also occur during sexual activity, which most couples continue during pregnancy.” if you are having a difficult pregnancy and are at risk for preterm labor and birth, and in particular, have been advised to avoid intercourse during pregnancy, then weaning would probably be advisable.

It is important to have a healthy diet if you plan to breastfeed during pregnancy. Depending on how old your nursing child is, you may need an additional 650 calories a day if your breastfeeding child is under the age of six months, or about 500 if your child is now eating other foods. This is in addition to the 350 (second trimester) and 450 (third trimester) calories you need during your pregnancy. (No additional calories are needed during the first trimester as you work your way through morning sickness and some healthy foods are just not palatable. In malnourished populations, pregnant, nursing mothers do have lower weight gain and lower weight babies, as well as lower weight nursing siblings, than those who wean.

If you’re considering breastfeeding while pregnant, be prepared for changes your nursing child might notice. Although breast milk continues to be nutritionally sound throughout pregnancy, the content of your breast milk will change — which may affect the way your milk tastes. In addition, your milk production is likely to decrease as your pregnancy progresses. These factors could lead your nursing child to wean on his or her own before the baby is born.

Your comfort may also be a concern. During pregnancy, nipple tenderness and breast soreness are common. The discomfort may intensify while breast-feeding. Pregnancy-related fatigue may pose challenges as well. If you want to continue breast-feeding while pregnant — or breast-feed both the baby and the older child after delivery — you may need additional support from loved ones or other close contacts. Also check with your health care provider about taking supplemental prenatal vitamins.

Info provided from LeLeche League International, Breastfeeding Answer Book, 3rd Edition, 2003.

Sara Walters, B, Breastfeeding During Pregnancy, Carmathen Wales UK; from New Beginnings, Vol. 25, No. 1, January-February 2008, pp. 32-33

Benefits of Daily Probiotics

goodbacteriaProbiotics are beneficial bacteria that help maintain the natural balance of organisms (microflora) in the intestines between harmful and beneficial bacteria and work to remove toxins from the body. The normal human digestive tract contains about 400 types of probiotic bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system. The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus, found in yogurt with live cultures, is the best known. Yeast is also a probiotic substance.

Probiotics promote healthy digestion by providing beneficial bacteria to recolonize and balance the GI tract, and hinder the growth of harmful, toxic bacteria, while also promoting a healthy immune system.

Probiotics may seem new to the food and supplement industry, but they have been with us from our first breath. During a vaginal birth while the newborn passes through the birth canal, a newborn picks up bacteria from his/her mother. These good bacteria are not transmitted when a Cesarean section is performed and have been shown to be the reason why some infants born by Cesarean section have allergies, less than optimal immune systems, and lower levels of gut microflora.

What are probiotics used for?
Some people use probiotics to prevent diarrhea, gas, and cramping caused by antibiotics. Antibiotics kill “good” (beneficial) bacteria along with the bacteria that cause illness. A decrease in beneficial bacteria may lead to digestive problems. Taking probiotics may help replace the lost beneficial bacteria. This can help prevent diarrhea.

A decrease in beneficial bacteria may also lead to other infections, such as vaginal yeast and urinary tract infections, and symptoms such as diarrhea from intestinal illnesses.

Probiotics may also be used to:

• Help with other causes of diarrhea.

• Help prevent infections in the digestive tract.

• Help control immune response (inflammation), as in inflammatory bowel disease (IBD).

Poor food choices, emotional stress, lack of sleep, antibiotic overuse, other drugs, and environmental influences can all shift the balance in favor of the bad bacteria.

When using probiotics, the idea is not to kill off all of the bad bacteria. Our body does have a need for the bad ones and the good ones. The problem is when the balance is shifted to have more bad than good. An imbalance has been associated with diarrhea, urinary tract infections, muscle pain, and fatigue.

Maintaining the correct balance between the “good” bacteria and the “bad” bacteria is necessary for optimal health.

When the digestive tract is healthy, it filters out and eliminates things that can damage it, such as harmful bacteria, toxins, chemicals, and other waste products. On the flip side, it takes in the things that our body needs (nutrients from food and water) and absorbs and helps deliver them to the cells where they are needed.

The other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn’t function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn’s disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, Helicobacter pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it’s never too late.

Probiotics convert the fiber in food into healthy fatty acids that nourish the cells that line the intestines. They also help the intestines make short-chain fatty acids, which contribute to the overall health of the body.

Benefits of Probiotics in Pregnancy
Many women suffer from digestive issues, such as heartburn, diarrhea, constipation and intestinal cramps, during pregnancy. Probiotics help relieve constipation and other intestinal issues by improving gastrointestinal function. The healthy bacteria can also improve the immune system of both the mother and baby during pregnancy. Probiotics can help you fight off or avoid colds and other illnesses, which is essential during pregnancy due to a suppressed immune system. Taking probiotics during pregnancy may also help prevent allergies and eczema in both mothers and infants.

A study performed by the Norwegian University of Science and Technology discovered a lasting impact on babies whose mothers took probiotics during pregnancy. According to this study, babies and toddlers up to 2 years old were 40 percent less likely to suffer from eczema compared to babies whose mothers did not drink probiotics. Additionally, babies who did experience eczema had less severe cases. This study, which was published in the “British Journal of Dermatology,” highlights the effectiveness in preventing eczema in children and did not indicate any adverse risks to the mother or baby.

References
Parenting; Ask Dr Sears: Probiotics During Pregnancy?; William Sears;
http://alturl.com/354h8
Pregnancy Today; Probiotics and Pregnancy; Teri Brown
Colorado State University Extension; Food Safety During Pregnancy; J. Dean & P. Kendall; December 2006
San Mateo Medical Center; Acidophilus and Other Probiotics; 2011

The Benefits of Red Raspberry Tea

Red Raspberry leaf tea is one of the safest and commonly used tonic herbs for women wanting to get pregnant or for women who are already pregnant. Red Raspberry Leaf (Rubus idaeus) tones the uterus, improves contractions and decreases constipation. Most tonics need to be used regularly, for a tonic is to the cells much like exercise is to the muscles; it is not much help when done irregularly . But you will still  benefit even from occasional use of tonics during pregnancy, since they contain nourishing factors. The herb comes in forms of leaves to make teas or tonics as well as pill like capsules you can swallow. Most of the benefits given to regular use of Red Raspberry leaf tea throughout pregnancy can be traced to the strengthening power of fragrine, an alkaloid which gives tone to the muscles of the pelvic region, including the uterus itself; and to the nourishing power of the vitamins and minerals found in this plant. There is rich concentration of Vitamin C, the presence of Vitamin E and the easily assimilated calcium and iron. Raspberry leaves also contain vitamins A and B complex and many minerals, including phosphorus and potassium.

When to use: There are two basic points of view on the subject. There is agreement among many
clinicians that in the 3rd trimester frequent (2- 3 cups per day of tea or 1 – 2 cups per day of infusion) isred raspberry leaf tea
beneficial to the uterine and pelvic muscles.

The more radical point of view is that drinking one cup of tea per day in the 1st trimester and 2 cups in the 2nd trimester and switching to the infusion in the 3rd trimester ensures a strong uterus, is good for you nutritionally and prevents miscarriage. Some say it is advised to not use it in the first trimester, particularly if you have a history of miscarriage. If a mother is prone to miscarriages she may feel safer avoiding raspberry until the third trimester. This is an herb with centuries of safe use behind it, there is usually little cause for concern, but check with your healthcare provider before using.

According to Susun Weed, author of “Wise Woman, Herbal for the Childbearing Year,” the benefits
listed below for drinking a Raspberry leaf brew before and throughout pregnancy are as follows:

  • Increasing fertility in both men and women. Red Raspberry leaf is an excellent fertility herb when
    combined with Red Clover.
  •  Preventing miscarriage and hemorrhage. Raspberry leaf tones the uterus and helps prevent
    miscarriage and postpartum hemorrhage from a relaxed or atonic uterus.
  • Use raspberry leaf infusion to help facilitate placenta delivery. Chips of frozen raspberry leaf infusion
    sucked throughout labor help keep the uterus working strongly and smoothly.
  •  Easing of morning sickness. Many women attest to raspberry leaves’ gentle relief of nausea and
    stomach distress throughout pregnancy. Drink a cup or two of raspberry leaf tea or infusion each day.
    Sipping the infusion before getting up or sucking on ice cubes made from the infusion increases the
    strength of this remedy.
  •  Reducing pain during labor and after birth. By toning the muscles used during labor and birth,
    Raspberry leaf eliminates many of the reasons for a painful birth and prolonged recovery. It does not
    counter the pain of dilation of the cervix.
  • Red Raspberry Leaves do not start or encourage labor. It can help the contractions to be productive
    once true labor has begun because it strengthens the uterine and pelvic muscles but it is not an oxytonic
    herb (one that would induce labor). That being said, it’s important to talk with your midwife,
    obstetrician or herbalist before beginning drinking red raspberry leaf tea or taking a supplement. Some
    will recommend you wait until you are 36 weeks along before incorporating the tea into your health
    regime while others may encourage you to begin right away. Each situation and pregnancy is different
    so it’s best to get other’s opinions before beginning red raspberry leaf tea.

Tea recipe: To make a tea, pour 1 cup boiling water over 2 teaspoons of herb and steep for ten minutes. Strain. During the first two trimesters, drink 1 cup per day. During the final trimester, drink 2-3 cups per day.

Excerpts from Weed, Susun. “Wise Woman Herbal Childbearing Year.”http://www.motherandchildhealth.com/Prenatal/raspberry.html

Presented by Angel J. Miller, MSN, CNM

www.midwiferycareassociates.com

https://www.linkedin.com/in/angeljmiller

The Importance of Healthy Nutrition Throughout Your Pregnancy

Adequate nutrition during your preconception and prenatal periods is important for a healthy pregnancy and healthy baby. Achieving a normal body mass index (BMI) prior to your pregnancy as well as improving your nutritional status prior to and during your pregnancy can lower your risk of pregnancy complications such as gestational diabetes and pre-eclampsia. Remember, you are not eating for two; you only need to increase your calorie intake by 300-500 calories. You should gain weight gradually during your pregnancy, with most of the weight gained in the last trimester.

Read your food labels! What are you consuming to help with your baby’s growth?  Food labels will tell you what nutrients are in the foods you eat. The letters RDA, which you find on food labeling, stand for recommended daily allowance, or the amount of a nutrient recommended for your daily diet. When you’re pregnant, the RDAs for most nutrients are higher.

Pregnant women need a balanced diet including:

  • Whole grains: Breads, cereals, pastas and brown rice.
  • Fruits: All types of fruits, fresh, frozen or canned without added sugar.
  • Vegetables: Eat a variety of colorful vegetables, fresh, frozen or canned with no added salt. Raw sprouts should be avoided.
  • Lean protein: Choose lean protein from meat, poultry, fish, eggs, beans and peas, peanut butter, soy products and nuts. Pregnant women should avoid eating tilefish, shark, swordfish and king mackerel, and limit white (albacore) tuna to 6 ounces per week. Deli, luncheon meats and hot dogs should be reheated if consumed.
  • Low-fat or fat-free dairy: This includes milk, cheese and yogurt. Unpasteurized milk and some soft cheeses that are made from unpasteurized milk should also be avoided.
  • Healthful fats: Vegetable oils including canola, corn, peanut and olive oil are good choices.

Avoid extra calories from added sugar and fats, which can lead to unhealthy weight gain. Cut down on foods such as regular soda, sweets and fried snacks. These are empty calories and of no nutritional value.

Key Nutrients for Healthy Pregnancy

  • Folate/Folic Acid: Folic acid reduces the risk of birth defects that affect the spinal cord. All women of childbearing age and pregnant women should consume 800 micrograms of folic acid each day. Sources include fortified foods such as cereals, pastas and breads, supplements and natural food sources of folate, including legumes, green leafy vegetables and citrus fruits.
  • Iron: Maternal iron deficiency is the most common nutritional deficiency during pregnancy.  A pregnant woman needs 27 milligrams a day. Your body uses iron to make hemoglobin, a protein in the red blood cells that carries oxygen to your tissues. During pregnancy your blood volume expands to accommodate changes in your body and help your baby make his or her entire blood supply, doubling your need for iron.

If you don’t get enough iron, you may become fatigued and more susceptible to infections. The risk of preterm delivery and low birth weight also might be higher.

Foods with high and moderate amounts of iron include red meat, chicken and fish, fortified cereals, spinach, some leafy greens and beans. For vegetarians and women who do not eat a lot of meat, increase iron absorption by combining plant-based sources of iron with vitamin C-rich foods. For example, try spinach salad with mandarin oranges or cereal with strawberries.

  • Calcium: During pregnancy, calcium is needed for the healthy development of a baby’s teeth, bones, heart, nerves and muscles. When a pregnant woman does not consume enough calcium, it is taken from her bones for the baby. It is important to consume adequate amounts of calcium daily before, during and after pregnancy. The recommended amount of calcium during pregnancy is 1,000 milligrams per day for adolescents 14 to 18 years old and 1,300 milligrams per day for women aged 19 to 50. That means at least three daily servings of calcium-rich foods such as low-fat or fat-free milk, yogurt or cheese or calcium-fortified cereals and juices.

Vitamin D Promotes bone strength and helps build your baby’s bones and teeth.  Fatty fish, such as salmon, is a great source of vitamin D.  Other options include fortified milk and orange juice.

There has been many studies recently revealing how common it is women of childbearing age are either insufficient or deficient in their levels of Vitamin D. This can cause an adverse outcome in pregnancy if not addressed.  Your vitamin D3 level should be > 40 ng/ml for a healthy pregnancy and for breastfeeding. Ask your healthcare provider to include your 25-OH-D concentrations of your Vitamin D level in your initial prenatal lab work.

Prenatal vitamins currently contain only 400 IU of Vitamin D3 which is inadequate.

 Protein is crucial for your baby’s growth, especially during the second and third trimesters. You need 71 grams/day. Good sources of protein include: Lean meat, poultry, fish and eggs are great sources of protein. Other options include dried beans and peas, tofu, dairy products, and peanut butter.

When you look at your food choices on your plate, you should have a variety of color!

Fine-tuning your eating habits to ensure you are receiving adequate nutrition for the health of you and your baby is key. Healthy eating during pregnancy is critical for a healthy pregnancy, healthy mom and baby!

Shelia L. Kirkbride,  MS, NC, VE.

 

colorfulplate

References:

Mayo clinic.org-Nutrients in pregnancy

maternal vitamin D supplementation reduces the risk of premature birth

http://tinyurl.com/q83koe6

https://www.vitamindcouncil.org/newsletter/newsletter-pregnancy-and-gestational-vitamin-d-deficiency/

TIME – the Most Precious Commodity of All

breastfeeding momMost mothers are stressed when they have a new baby. I absolutely remember how tiring it is to be a mother – and especially when you’re a breastfeeding mother. Being tired is on my mind right now, because in the midst of working with a new breastfeeding mother of a six-day-old, she flat-out told me that, “this breastfeeding thing is taking way too much of my time.” I was left flabbergasted and flap-jawed. What I wanted to say and what I did say were two very different things. What I wanted to say was “Well, what were you expecting? Did you think you were going to drop the baby in the umbrella stand on the way in and out of your front door?” What I actually said is “Tell me how I can help you.”

The mom went on to explain that nursing every two hours was beginning to grate on her nerves. I went on to explain that babies had tummies the size of golf balls and that breast milk was a “perfect food” that made it digest and move through the stomach very rapidly. I quoted how each DROP of colostrum had 3 million cells (the majority being immune cells). Breastfeeding is as much nurturing as nourishing (hoping the old adage would help). I also described cluster feeding as being analogous to a camel getting ready to cross the desert; feed, feed, feed and then you get the big sleep (maybe 4-5 hours max). In my first book “Start Here; Breastfeeding and Infant Care with Humor and Common Sense” I tried to call the hours between 6-10PM the “arsenic hours,” but the publisher opted for something safer like “the witching hours.” I guess that “every hour on the hour” cluster thing is what put this new mother “over the edge.”

So, here are some suggestions I’ve come up with to help you save time during your busy breastfeeding days.

  • If you have an exceptionally sleepy baby (or just have to get the show on the road once in a while), I find that you can feed on one side while you simultaneously pump on the other: Tarzan Pumping (at least that’s what I call it). That trick alone can save you up to a half hour per feeding and maximize your milk supply. Your body will react as it you’re feeding twins (because both sides are going at the same time) and perhaps even increase supply a bit. It will also expedite your feeding and have your baby feel as though a bigger, stronger twin was on the other breast helping him or her out. Now you’ll want to feed that milk to your baby at some point (perhaps during cluster feeding time), as when I previously instructed another mom to do this, she was giddy with her new frozen stash; problem was the baby hadn’t gained any weight in a week…whoops; I should have been more clear with my instructions.
  • Anyone who tells you to sleep when the baby sleeps probably doesn’t shower, do laundry, use the bathroom, open the mail or eat; I never understood that suggestion. I mean, that’s the only time you have to do ANYTHING, isn’t it? So, ALLOWING others to do things for you will help put time back in your day. You shouldn’t feel as though you’re not a good mother if you don’t do everything and do it well (do as I say, not as I do/did). I remember 28 years ago how I came creeping out of my house to get the mail and was spotted by my neighbor. She promptly sent her “nanny” over to my house with instructions to “help that poor woman out.” Problem is that I wouldn’t let the well-meaning nanny in! As I look back on it, I was afraid that I’d be found out; that I’d be “exposed” and my neighbor would know how I wasn’t really holding things together as a mother “should.” In my experience, many mothers feel that same way. They’re overwhelmed but think that they’re the only mother experiencing that. I’m here to tell you that MOST mothers feel overwhelmed in the beginning and if they tell you otherwise, I’d be wary.
  • Remember the saying “time is fleeting,” so are these stages!  Many times these cluster feeds will pass quickly and after a couple days you’ll have an entirely new baby.  It’s important to keep in mind that babies patterns change quickly and you won’t always be feeding around the clock. 

When I heard this mother complaining about time, as I think more about it, I’m suspicious there might be something else going on. Is she depressed? Is she lonely and needs to get out of the house for companionship, does she simply have cabin-fever, or are her expectations unrealistic as to how much time infants take out of a mothers day? What do you think?

Blog written by  Kathleen F. McCue, DNP, FNP-BC, IBCLC-RLC, 

Owner of Metropolitan Breastfeeding

Building a Strong Foundation for Your Pregnancy

Contemplating pregnancy?  Nutritional and optimal health should be priority number one!  Women contemplating pregnancy must keep in mind that healthy eating habits and healthy lifestyle behaviors should be established before pregnancy to make sure proper nutrient levels for early embryo development and growth.

Eating a balanced diet that includes the proper amount servings of protein, grains, fruit, and vegetables is key. Protein is essential to the very foundation of your baby’s growth. Eating enough protein ensures that your little one, from the very beginning, is getting adequate food stores to support cell growth and blood production.  Regular exercise should also be incorporated in your daily routine to prepare your body for the demands of pregnancy. Habits such as drinking or smoking must be avoided to allow for optimal health and development of the child during pregnancy and after birth.  Good habits should  include taking a daily multivitamin or a daily prenatal vitamin.  Even if you are consuming healthy foods daily, you can miss out on key nutrients.  A daily prenatal vitamin — ideally starting three months before conception — can help fill any gaps.  A quality, fast absorbing prenatal vitamin is necessary for all the basic micronutrients needed during pregnancy.eat-well-teaser

Through the course of pregnancy there is an increased need for nutrients and calories to make sure proper fetal growth. The increased need for vitamins and minerals such as folate, calcium and iron is necessary to prevent birth defects, ensure proper bone formation/retention, and to reduce the risks of preeclampsia or anemia. Folic acid intake increases to a daily amount of 800 mcg, calcium to 1200 mg, and iron to 30 mg. Your Vitamin D levels should be checked with your initial prenatal labs to be sure you levels are not insufficient or deficient.  Fetal needs for vitamin D increase during the latter half of pregnancy, when bone growth and ossification are most prominent. Vitamin D travels to the fetus by passive transfer, and the fetus is entirely dependent on maternal stores. Your body needs vitamin D to maintain proper levels of calcium and phosphorus, which help build your baby’s bones and teeth. A vitamin D deficiency during pregnancy can cause growth retardation and skeletal deformities. It may also have an impact on birth weight.  Therefore, maternal status is a direct reflection of fetal nutritional status.

Researchers believe that a vitamin D deficiency during pregnancy can affect bone development and immune function from birth through adulthood.

Blog by Shelia Kirkbride

Best Exercises for Your Pregnancy

yogamomCongratulations on your pregnancy! Now you can sit back, relax and put your feet up for the next nine months, right? Not so fast! Attitudes and beliefs about prenatal exercise have drastically changed over the past twenty years. No longer is pregnancy viewed as a time to sit, watch TV and each chocolate. These days, moms can actually maintain and improve their fitness levels while pregnant. And exercise provides many numerous benefits such as a boost in your mood and energy levels, helps you sleep better, helps prevent excess weight gain and increases your stamina and muscle strength. You cannot lose!

Regular exercise during your pregnancy can improve not only your heart health and boost your energy, but improve your overall health. Maintaining a healthy body and healthy weight gain can help reduce common pregnancy complaints and discomforts like lower back pain, fatigue and constipation and can even help with shortening your time during labor by strengthening your endurance.

First, consult your health care provider if it is okay to exercise. If you have been participating in a regular exercise regimen and are having a healthy pregnancy, there should not be a problem continuing with your regimen in moderation. You may have to modify your exercise according to your trimester of pregnancy.

If you have not participated in an exercise regimen three times a week before getting pregnant, do not jump into a new, strenuous activity. Start out with a low-intensity activity and gradually move to a higher activity level.

The best type of exercise during pregnancy:
• Increases your heart rate steadily and improves your heart circulation
• keeps you flexible and limber
• manages your weight gain by burning calories
• prepares your muscles for labor and birth
• won’t cause you to push your body too hard

Research shows that healthy pregnant women who exercise during their pregnancy may have less risk of preterm labor and birth and a shorter labor process, are less likely to need pain relief, and recover from childbirth faster.

Regular, moderate exercise not only gives you a healthier pregnancy, it may give your baby a healthier start. Research shows that when pregnant women exercise, their developing babies have a much lower heart rate. Babies of active moms may also have a healthier birth weight. Experts recommend that you exercise for 30 minutes a day, on most days. Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do not overdo it.

Your pregnancy exercise regimen should strengthen and condition your muscles. Always begin by warming up for five minutes and stretching for five minutes. Following your choice of exercise, finish your regimen with five to ten minutes of gradually slower exercise that ends with gentle stretching.

The safest and most productive activities to perform during your pregnancy are brisk walking, swimming, indoor stationary cycling, prenatal yoga and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until the birth of your baby. Other activities such as jogging can be done in moderation. You might want to choose exercises or activities that do not require great balance or coordination, especially later in your pregnancy.

Use common sense:
• Avoid exercising that involves lying on your stomach or flat on your back after the first trimester of pregnancy.
• Stay well hydrated and drink plenty of fluids before, during and after you exercise.
• Avoid overheating and humidity, especially during the first trimester when the fetus is undergoing its most important growth and development.
• Stop exercising if you feel fatigued, develop persistent pain or experience any vaginal bleeding; check with your healthcare provider if regular contractions occur more than 30 minutes after exercise (possibly a sign of pre-term labor).
• Avoid heavy weightlifting and any activities that require straining.
• Avoid exposure to extremes of air pressure, as in high altitude exercise (unless you’re accustomed to it) or scuba diving.
• Do not increase the intensity of your workout beyond pre-pregnancy intensity level
• Eat small, frequent meals throughout the day. Sedentary pregnant women need about 3,000 calories per day during the second and third trimesters; if you are physically active, your caloric needs will be higher to make up for the calories burned up during your exercise regimen.

Basic exercise guidelines:
• Wear loose-fitting, comfortable clothes, as well as a good support bra
• Choose shoes that are designed for the type of exercise you choose. Proper shoes are your best protection against injury
• Exercise on a flat, level surface to avoid injury
• Finish eating at least one hour before exercising
• Get up slowly and gradually to prevent dizziness
• Never exercise to the point of exhaustion. If you cannot talk normally while exercising, you are probably over exerting yourself, and you should slow down your activity.

Physical changes during your pregnancy will create extra demands on your body. Keeping in mind the changes listed below, remember you need to listen to your body and adjust your activities or exercise regimen as necessary.
• Your developing baby and other internal changes require more oxygen and energy.
• Hormones (relaxin) produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.
• The extra weight and the uneven distribution of your weight alters your center of gravity. The extra weight also puts stress on joints and muscles in the lower back and pelvic area, and makes it easier for you to lose your balance

If you have any medical condition, such as asthma, heart disease, hypertension or diabetes, exercise may not be advisable. Again, consult with your health care provider before beginning any exercise regimen.

Exercise may also be harmful if you have a pregnancy-related condition such as:
• vaginal Bleeding or spotting
• Low placenta (low-lying or placenta previa)
• Threatened or history of recurrent miscarriage
• Previous premature births or history of early labor
• Weak cervix

Talk with your health care provider before beginning any exercise program. Your health care provider can also suggest personal exercise guidelines, based on your medical history.

Stop exercising and consult your healthcare provider if you:
• Feel pain
• Have abdominal, chest, or pelvic pain
• Notice an absence of fetal movement
• Feel faint, dizzy, nauseous, or light-headed
• Feel cold or clammy
• Have vaginal bleeding
• Have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily (when your bag of “water” breaks, also called rupture of the amniotic membrane)
• Notice an irregular or rapid heartbeat
• Have sudden swelling in your ankles, hands, face, or experience calf pain
• Have increased shortness of breath
• Have persistent contractions that continue after rest
• Have difficulty walking

Regular exercise will keep you and your baby healthy while staying fit, and enjoying your pregnancy!

Written by: Angel J. Miller, MSN, CNM, certified nurse-midwife, Midwifery Service Director, Washington, D.C. Area and co-author: Nine Months In ~ Nine Months Out.
References
Miller, Angel, Kelly, Stacia, Kirkbride, Shelia, Matthews, Corry. Nine Months In ~ Nine Months Out. Sterling, Va. Ironcutter Media, 2011.
http://www.webmd.com/baby/exercise-during-pregnancy
http://kidshealth.org/parent/index.jsp?tracking=P_Home
http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/in-depth/pregnancy-and-exercise/art-20046896

Water, Water Everywhere-How Much should you Drink?

Your water needs depend on many factors, including your health, how active you are and where you live.
Most individuals seem to know that drinking water is good for them, but maybe don’t know exactly why and have a hard time reaching their intake goals each day. We know all the excuses:

– I don’t like the taste
– I simply forget
– I can’t drink that much
– Who has time for that many bathroom breaks!

Well, we are going to inform you on why you should always have a water bottle nearby, how much you really need to drink and some tips to help you reach that goal.

Why You Should Be Downing That Water

Water is the most important nutrient for your body. From flushing out toxins, transporting nutrients throughout your body, and other vital actions, water necessary for every single system in your body needs water to function.

On average, water makes up 60% of our body weight. Even slight dehydration can prevent your body from carrying out normal bodily functions, draining your energy or even causing a headache.

5 reasons why you should have a glass of cool, refreshing H20:

1. Drop a few pounds: Remember just a moment ago when we said water is necessary for every function in your body. This includes breaking down fat for weight loss. Also, water is calorie free and is often an appetite suppressant. In fact, most people often confuse hunger for thirst.

2. Drink for your health: Drinking the right amount of water improves the health of your heart, and can even lower your risk of a heart attack. Also, increasing your water intake can improve digestive health by aiding in the breakdown of food. And, most of you probably already know that drinking water is one of the best things you can do for healthy skin – giving it a glow from the inside out.

3. Energy: The first all natural energy drink is water! Test it out next time you’re feeling a little sluggish by having a couple glasses of water.

4. Headache prevention: Know those dull headaches that come in the afternoon, especially after sitting at your desk all day? You’d be surprised how many of those headaches are caused by a slight dehydration.

5. Cleansing: Flush out all those unhealthy toxins!

Now that you’re sold on why to drink more water, let’s talk about how much – and how!
For years we’ve been told to follow the “8 by 8” rule – drink eight 8-ounce glasses of water per day, but for some people that just is not enough water. Here’s a new formula to use when calculating how much water you need. Simply divide your weight (in pounds) by two to give you the number of ounces of water you should strive to drink each day. For example, if you weigh 160 lbs., strive to drink 80 ounces of water daily.

Dietary recommendations: The Institute of Medicine advises that men consume roughly 3 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.

If you drink a lot of caffeine, exercise or your job requires a lot of physical activity, you may need to consume even more water to replenish your body.

Whoa, that’s a lot of water!

Need some help reaching your new water intake goal? Try these tips:

1. Get a reusable bottle and figure out how many times you must empty it through out the day to reach your goal.

2. Have a glass of water before (and with) every meal.

3. Keep a pitcher of water in your office, at your desk or in the fridge – this will also help track how much you’ve already had for the day.

4. Add lemon or lime slices, or mint leaves to give your water a light, refreshing taste. (Hint: the mint may need to soak in the water up to 12 hours to give it any flavor.)

5. Set a daily alarm on your cell phone to remind you of your water intake goal.

6. Go slow. If you rarely drink water and just the thought of your recommended intake makes your bladder a little uneasy, take a few days or even a week to work your way up to that magical number.

Even apart from the above approaches, if you drink enough fluid so that you rarely feel thirsty and produce 1.5 liters (6.3 cups) or more of colorless or slightly yellow urine a day, your fluid intake is probably adequate.

Factors that influence water needs
You may need to modify your total fluid intake depending on how active you are, the climate you live in, your health status, and if you’re pregnant or breast-feeding.

Environment. Hot or humid weather can make you sweat and requires additional intake of fluid. Heated indoor air also can cause your skin to lose moisture during wintertime. Altitudes greater than 8,200 feet (2,500 meters) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves, thus increasing your fluid intake needs.

Illnesses or health conditions. Signs of illnesses, such as fever, vomiting and diarrhea, cause your body to lose additional fluids. In these cases you should drink more water and may even need oral rehydration solutions, such as Gatorade or Powerade. On the other hand, some conditions such as heart failure and some types of kidney, liver and adrenal diseases may impair excretion of water and even require that you limit your fluid intake.

Pregnancy or breast-feeding. Women who are expecting or breast-feeding need additional fluids to stay hydrated. Large amounts of fluid are used especially when nursing. The Institute of Medicine recommends that pregnant women drink 2.3 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.1 liters (about 13 cups) of fluids a day

Other Sources of Water
Although it’s a great idea to keep water within reach at all times, you don’t need to rely only on what you drink to satisfy your daily fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.
For example, many fruits and vegetables, such as watermelon and tomatoes, are 90 percent to 100 percent water by weight. Beverages such as milk and juice also are composed mostly of water. Even beer, wine and caffeinated beverages — such as coffee, tea or soda — can contribute, but these should not be a major portion of your daily total fluid intake. Water is one of your best bets because it’s calorie-free, inexpensive and readily available.

Staying safely hydratedIt’s generally not a good idea to use thirst alone as a guide for when to drink. By the time you become thirsty, it’s most likely you are already dehydrated. Further, be aware that as you get older your body is less able to sense dehydration and send your brain signals of thirst. Excessive thirst and increased urination can be signs of a more serious medical condition. Talk to your healthcare provider if you experience either.

To ward off dehydration and make sure your body has the fluids it needs, make water your beverage of choice. Nearly every healthy adult can consider the following:
 Drink a glass of water with each meal and between each meal.
 Hydrate before, during and after exercise.
 Substitute sparkling water for alcoholic drinks at social gatherings.
If you drink water from a bottle, thoroughly clean or replace that bottle often.

Though uncommon, it is possible to drink too much water. When your kidneys are unable to excrete the excess water, the electrolyte (mineral) content of the blood is diluted, resulting in low sodium levels in the blood, a condition called hyponatremia. Endurance athletes, such as marathon runners, who drink large amounts of water, are at higher risk of hyponatremia. In general, though, drinking too much water is rare in healthy adults who consume an average American diet.

If you’re concerned about your fluid intake, check with your healthcare provider or a registered dietitian. He or she can help you determine the amount of water that’s best for you.

Posted by Living Well Today on June 17, 2009
Excerpts from Mayoclinic.com/health/water

Eating Safely in Pregnancy

During your pregnancy, the body lowers its internal defenses against bacteria to accommodate the baby. Unfortunately, a less effective immune system puts mom and baby at a greater risk of food-borne illnesses. This leads expectant moms to become confused about food safety.
Coffee: For those women who would not be the same without their cup of morning coffee, take heart — coffee is considered safe during pregnancy. Because caffeine can cross the placenta and affect your baby, it is smart to limit your coffee to 2 to 3 cups per day, maximum. Pregnancy hormones and metabolism can wreak havoc on your digestive system, so coffee may make you a bit more jittery than usual. If you find yourself having a hard time dealing with coffee, try to cut back even more, or go half-decaf.
Caffeinated Soda: The same rules dealing with coffee pertain to caffeinated soda — moderation is key, so try to limit your intake of soda to no more than 24 ounces(680 g) per day. Since it has no nutritional value, try replacing it with water, milk( 2% of lower) or a healthy juice (watch the sugar content!)
Diet Soda: The Food and Drug Administration (FDA) has deemed artificial sweeteners such as aspartame and Splenda® safe to eat during pregnancy. However, it is artificial, and Splenda® hasn’t been around long enough to research long term effects. Unless you’re diabetic, it may be worth just splurging on an occasional non-diet soft drink, and avoid artificial sweeteners altogether.
Tea: A cup of tea can be a relaxing part of your day, and some teas can have added health benefits as well. Be sure to watch caffeine content.
Chocolate: Some women who fear consuming too much caffeine while pregnant and limit their intake of chocolate will be happy to know that because the amount is negligible, they can indulge in this favorite craving. Beware — chocolate during pregnancy is a notorious cause of heartburn! (watch the calories too!)
Vegetarian or Vegan Diet: because these diets tend to be very well balanced and healthy, most healthcare providers will not advise against a vegetarian or vegan diet. However, studies have shown that pregnant women on these types of diets may suffer from a B12 deficiency which can lead to serious anemia. Be sure to get extra calcium and protein if on these diets and your Vit. B complex.
Fish:women should avoid certain types of large fish that contain high levels of mercury. There are many other types of fish and shellfish that will give them the benefits of omega-3s: Shrimp, flounder, scallops, catfish and crab are all examples of fish that are safe to eat during pregnancy. Just be sure that they are fully cooked.
Spicy Foods: While spicy foods may wreak havoc on your digestion, and cause searing heartburn, it’s safe to eat during pregnancy. Interestingly enough, certain strong tastes can cross the placenta and babies learn to have a taste for what their mom likes.
Livestock with antibiotics: Because the levels of antibiotics in livestock are so
minute, red meat is safe to eat during pregnancy. If you’re concerned, eat organic, free-range meat to ease your worries. Be sure to cook your red meat medium to well done during pregnancy.
Sugar: Pregnant women can safely consume regular sugars, in moderation. These sugars include granulated sugar, honey and brown sugar.

Foods that Aren’t Safe to Eat During Pregnancy
Alcohol: Alcohol in any amount is unsafe for the health and development of your baby.
Un-pasteurized Juices: Un-pasteurized juice can harbor bacteria that can affect you and your baby. Unless you’ve washed, squeezed and bottled the juice yourself, you have no idea how it was handled before it got to you. The process of pasteurization should kill all bacteria, making it a safe during pregnancy.
Smoked/Cured Meats and Deli Meats: Cold cuts and smoked meats can harbor bacteria like E. coli and listeria, which can be very dangerous for a pregnant woman and her baby. Avoid them during pregnancy, as well hot dogs — even the ones you make at home.
Fish: although fish is generally safe to eat during pregnancy, certain large fish which prey on smaller fish may have unsafe levels of mercury in their flesh. Avoid shark, swordfish, tilefish and king mackerel during pregnancy. Limit tuna to smaller types of tuna, and canned tuna, to about 6 ounces (170 g) per week.
Soft Cheeses: Certain soft cheeses can harbor bacteria as well — stick with hard or pasteurized cheese

Is it safe to each sushi during pregnancy?
From http://pregnancychildbirth.suite101.com/articles.cfm by Jody Morse
Why Eating Sushi During Pregnancy is Okay
According to the American Pregnancy Association, there are a few reasons why sushi should not be avoided entirely. Remember that fish offers numerous health benefits. The vitamins and nutrients which can be found in sushi can actually be beneficial to the growth and development of the baby. Keep in mind that sushi is also often cooked, so the risk of bacteria is not quite as high as one may think.

Sushi to Avoid or Limit During Pregnancy
Keep in mind that there are certain types of fish which should be avoided by pregnant women, no matter how they are cooked. Kajiki (swordfish), Saba (mackerel), shark, and tilefish are the four types of sushi that should be avoided during pregnancy. While most people are recommended to only eat these types of fish once a month, women who are pregnant are advised to avoid them altogether.

There are other types of fish would do not need to be avoided entirely, but should be limited because they are higher in mercury than other types of fish. It is recommended that pregnant women do not eat any more than three six-ounce servings a month. This list of sushi includes shiro, hamachi, makjiki, toro, inada, meji, buri, kanpachi, masu, ahi, katsuo, and maguro. The types of fish which are used in these sushi dishes include yellowfin tuna, albacore tuna, yellowtail, bonito, bluefin tuna, bluefin, big eye, trout, and blue marlin.

Types of Sushi Women Can Enjoy While Pregnant
Although women should avoid the above mentioned types of sushi at all times during their pregnancy, there are other types which are lower in mercury. These types of fish can be enjoyed by women who are pregnant on a more regular basis.

Preconceptional Counseling and Care

Becoming a parent is a major commitment in life. It can be met with challenges, rewards and informed choices. Before you conceive, be sure to incorporate a healthy life-style to ensure optimal health for mom and baby. Receiving pre-conceptional counseling and care can lay the ground work for a healthy lifestyle and healthy pregnancy. Good health before pregnancy can help you cope with the stress of pregnancy, labor and birth. Obtaining good health care before you conceive will help you throughout your pregnancy. It also provides you with the opportunity to find out your risks, treat any medical problems that may affect the outcome of your pregnancy and adopt or continue a healthy lifestyle.

If you are planning to conceive, schedule a pre-conceptional visit with your healthcare provider. Included in your visit is a comprehensive history of your health including: Family history and risk factors, your medical history, surgical history, medications that you are presently taking including vitamins, supplements, OTC (over-the-counter) meds; your diet and lifetstyle and any past pregnancies.

Your preconception visit is a time for you to ask questions. Do not hesitate to seek advice, discuss your concerns and your options. Your healthcare provider is there to provide information and guidance to help you make informed choices in your healthcare to help you obtain and maintain a healthy pregnancy.

Women who are planning to conceive should stop their form of birth control several months in advance. Even though methods vary in use, it may affect when your menses resumes and becomes regular. During this time you may also want to start taking a prenatal vitamin daily to ensure you are getting added vitamins and increased folic acid.

Your lifestyle includes diet, exercise, weight, substance use, living/working environment and infection history. Current immunizations are important to prevent any infections during your pregnancy that can harm you and your baby, even if you were vaccinated as a child (measles, mumps, rubella, polio, tetanus), you may not be immune now. If you are vaccinated prior to conceiving, you will be protected. The vaccine for mumps, measles and especially rubella should be given at least 3 months
prior to conceiving. During this period of time, you should use a reliable method birth control.

Optimal health at any time during your lifetime involves a healthy diet and the proper amount of exercise. Ideally, you should be in good physical shape and follow a regular exercise regimen before your conceive. If you are not used to being active, you should start an exercise program gradually.

Tobacco, alcohol and recreational (illegal) drug use is addictive and can harm you and your baby that can last a lifetime or even result in death. They can have detrimental affects on the organ formation, causing damage. The misuse of prescription medication can also harm the fetus. For the sake of your own health and that of your baby, now is a good time to cut back on smoking and alcohol and quit all recreational drugs. It takes time and patience to quit a habit, especially if you have had that particular habit for a long time. Ask your healthcare provider to suggest ways to get through the withdrawal state or quitting and to refer you to support groups. Your decision to quit may be one of the hardest things you have ever done, but it will be one of the most worthwhile.

Does your work environment impose any hazards? If you are trying to conceive, it is a good idea to look closely at your work place and surroundings. Are you exposed to toxic substances, chemicals, or radiation? Discuss your level of exposure to specific substances with your employee health division, personnel office or union representative.

Exposure to lead or certain solvents, pesticides or other chemicals can reduce your partner’s fertility by killing or damaging sperm. Unlike women, who are born with a complete supply of eggs for their entire lifespan, men make new sperm on a daily basis for most of their lives. Unless the damage to a man’s reproductive system is very serious, he will probably be able to make healthy sperm against a short time span after his exposure to the harmful material stops.

Questions to Consider…
• Do I or a member of my family have a disorder that could be inherited?
• Do I need to gain or lose weight to prepare for pregnancy?
• Should I make any changes in my lifestyle?
• Could any medications I am taking cause problems during my pregnancy?
• Can I continue my present exercise program?
• Does my work expose me to things that could be harmful during pregnancy?
• Do I need to be vaccinated for any infectious diseases before I try to conceive?