Tag Archive | Pregnancy

ZIKA VIRUS and PREGNANCY

mosquitoZika Virus: Answers for Pregnant Women

What is Zika virus?

Zika is a virus that’s been around for actually dozens of years; it generally causes a mild viral syndrome and is prevalent in the Tropics—South America, the Caribbean islands, and Pacific islands.

Zika virus is a mosquito-borne illness.  Most people who are infected with Zika virus have no symptoms. If they have symptoms, they are usually very mild such as fever, rash, red eyes, muscle pain or joint pain. People usually do not get sick enough to be hospitalized and they very rarely die.

Is there a link between the Zika virus and birth defects? Infection during pregnancy can be harmful to the fetus or the newborn. Zika virus has been associated with microcephaly, a birth defect in which the size of a baby’s head and brain is smaller than expected. This birth defect is associated with developmental delays including trouble speaking, problems with movement and balance, hearing loss, and vision problems.

How is Zika virus transmitted? Women can be infected with the Zika virus directly by mosquito bite in an area where there is active Zika transmission or by sexual transmission from an infected male partner.

How can I prevent catching the Zika virus? The Centers for Disease Control and Prevention (CDC) has recommended that pregnant women, or women who may potentially become pregnant, avoid travel to countries that have been affected by the virus, including a large number of countries in South America, the Caribbean and the Pacific Islands. Check the CDC website http://www.cdc.gov/travel/page/zika-travel-information for a complete list of affected countries. Both pregnant women and their partners should avoid mosquito bites, particularly if traveling to a country that has been affected by Zika. If your sexual partner has recently visited an area with the Zika virus or is infected with the Zika virus, abstain from sex or use condoms throughout the pregnancy.

 If I am going to travel to an affected area, what should I do to prevent catching the virus? Travel to an affected area is not recommended for pregnant women. If travel is completely unavoidable, talk to your healthcare provider and take precautions to avoid mosquito bites. This should include use of EPA-registered insect repellents, wearing long-sleeved shirts, long pants, and hats to cover exposed skin, and maximizing time spent indoors in air-conditioned or screened rooms.

The recommendations for people contemplating pregnancy are a little bit different. If the woman has been exposed to Zika and gotten sick—meaning she has flu-like symptoms, runny nose, sore throat, low-grade fever, red or itchy eyes—it is possible that it is due to the Zika virus and, currently for people who have symptoms that have been exposed, they can be tested to see if that is true.

For a woman who has been exposed and been sick from Zika, it is recommended  waiting 8 weeks before tyring to conceive. There’s concern for men that the virus can remain in their bodies and be spread through sexual contact. And so for a man who has been sick from Zika, again, been exposed, been in an area and had a viral syndrome, the man can now be tested and, if he’s been sick or tested positive, the current recommendation is that he not have unprotected intercourse with a pregnant woman or try to conceive for 6 months.

If I catch the Zika virus before my pregnancy, is my baby at risk? We do not yet have recommendations about the safe period between infection and conception. However, once the virus is cleared from the blood, prior Zika infection is not thought to affect future pregnancies.

For more information about Zika virus, visit www.ChildrensNational.org/Zika

If you are concerned that you have been exposed to the Zika virus, please talk to your doctor. The Fetal Medicine Institute at Children’s National can work with your doctors directly.

http://childrensnational.org/departments/fetal-medicine-institute

Phone number:  202-476-7409

*SOURCES: Information provided by Children’s National Health System Centers for Disease Control and Prevention

*Excerpts from The Zika Virus and Getting Pregnant, Eric A. Widra, Medical Director,  Shady Grove Fertility

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

What is a Perinatal Mood Disorder?

Recently, the media has reported several stories relating to perinatal mood disorders (more commonly considered to be post-partum depression, but are not limited to depression). Guidelines around who should get screened and when have taken center stage. Despite this attention, many don’t realize what perinatal mood disorders are or whether or not they are at risk for one.

black-and-white-person-woman-girl-mediumQuite simply, a perinatal mood disorder is a mental health concern that occurs either during pregnancy or post-partum. This can include depression, anxiety, obsessive thoughts, paranoid thinking, and thoughts to harm yourself or your baby. While these concerns exist prior to pregnancy for individuals, they can be exacerbated during pregnancy and after for several environmental reasons: changes in hormones and lack of sleep are two prevalent factors. Of course, not everyone who has a baby experiences changes in mood, and certainly, some people seem to be more resilient during this transition.

Common symptoms of a perinatal mood disorder may include:
*Changes in sleep (not being able to sleep at all, even when the baby is or
oversleeping)
*Irritability
*Fears of something happening to the baby (being dropped, not
breathing, etc)
*Concerns (despite weight gain) that baby isn’t eating enough
*Uncontrollable crying
*Disinterest or lack of connection to the babypexels-photo-48566-medium
*A feeling of not being yourself

Nearly 1 in 8 women (and 1 in 10 men) experience a perinatal mood disorder. Treatment is simple and can range from therapy, medication, or both. However, without treatment, there can be long-term consequences that are dangerous for both mother and baby, as studies of depressed mothers have shown difficulties in their children as they age. There is a simple screening that you can opt to take to see if you might be experiencing a perinatal mood disorder and it can be found here. People who are are risk for developing a perinatal mood disorder include those that have experienced depression or anxiety during pregnancy; those that have a family member who had a perinatal mood disorder; those with a history (or family history) of depression or anxiety; those that have suffered a pregnancy loss; those that conceived through infertility; those with a baby that was in the NICU; teenage mothers; those that are having financial/housing/medical concerns; and those that do not have a social support system or a limited one. Certainly, this is not an exhaustive list, but is inclusive of many “red flags”.

 

If you are concerned about you or someone you know that might be having difficultly adjusting to life postpartum, you can contact your OB-GYN/Midwife/Primary Care Physician about a mental health referral. It is important that the clinician you meet with has experience and training in treating perinatal mood disorders as it is not something that most graduate programs cover.

By Julie Bindeman,  Psy-D

http://www.greaterwashingtontherapy.com/

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/

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

Limiting Weight Gain during Pregnancy

How much weight should I gain?
Gaining the right amount of weight during pregnancy by eating a healthy, balanced diet is a good sign that your baby is getting all the nutrients he or she needs and is growing at a healthy rate.

Weight gain should be slow and gradual. In general, you should gain about 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy, unless otherwise directed by your healthcare provider.

Your healthcare provider will tell you how much weight you should gain during pregnancy. A woman of average weight and height and/or normal BMI before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your healthcare provider recommends.

It is not necessary to “eat for two” during pregnancy. It’s true that you need extra calories from nutrient-rich foods to help your baby grow, but you generally need to consume only 200 to 300 more calories than you did before you became pregnant to meet the needs of your growing baby.

Follow the guidelines below if you are gaining weight too quickly during pregnancy.

What if I have gained too much weight?
If you have gained more weight than recommended during the beginning of your pregnancy, DO NOT try to lose weight. It is never safe to lose weight during pregnancy — both you and your baby need the proper nutrients in order to be healthy.

Be sure to eat a variety of foods to get all the nutrients you and your baby need. Follow the guidelines and serving recommendations on The Food Guide Pyramid to avoid further excess weight gain. Think about the foods you eat and avoid those foods that will not give you and your baby the nutrition you both need. Follow the glycemic index,which is simply a measurement of the impact carbohydrates have on your blood sugar levels. Check out http://tinyurl.com/8vqbtv. Make sure you are active and getting adequate time in for exercise.

Keep in mind that you will lose some weight during the first week your baby is born. You’ll be surprised at how quickly you lose the remaining weight by following a balanced diet and exercising.

If you are gaining weight too fast during pregnancy…

When eating out at a fast food restaurant, choose lower fat items such as broiled chicken breast sandwich with tomato and lettuce (no sauce or mayonnaise), side salad with low-fat dressing, plain bagels or a plain baked potato. Avoid fried foods such as french fries, mozzarella sticks or breaded chicken patties.Avoid whole milk products. You need at least 4 servings of milk products every day. However, using skim, 1 or 2 percent milk will greatly reduce the amount of calories and fat you eat. Also choose low-fat or fat-free cheese or yogurt.Limit sweet or sugary drinks. Sweetened drinks such as soda, fruit punch, fruit drinks, iced tea, lemonade or powdered drink mixes provide many calories with little nutrients. Choose water, club soda, or mineral water to avoid extra calories.

Do not add salt to foods when cooking. Salt causes your body to retain water.

Limit sweets and high calorie snacks. Cookies, candies, donuts, cakes, syrup, honey and potato chips provide many calories with little nutrition. Try not to eat these types of foods every day. Instead, try fresh fruit, low-fat yogurt, angel food cake with strawberries, or pretzels as lower calorie snack and dessert choices.Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream and cream cheese. Try the lower fat substitutes that are available for these foods.Prepare meals using low-fat cooking methods. Frying foods in oil or butter will increase the calories and fat of that meal. Baking, broiling or boiling are healthier, lower fat methods of cooking. Read Labels of food you purchase!

Exercise. Moderate exercise, as recommended by your healthcare provider, can help burn excess calories. Walking or swimming is safe, effective exercises for pregnant women. It is perfectly safe for you to walk 30 to 60 minutes every day. Wear comfortable shoes and clothes. Open your front door and walk away from your house for 15 minutes as fast as you can. If you can sing while you walk, you are not walking fast enough.

Be sure to talk to your healthcare provider before starting an exercise program.