Nutrition and Weight Gain during Pregnancy

In order to bring a healthy child, a high nutrient diet is recommended during pregnancy. As pregnancy progress it’s important to understand the requirements as weight gain is different during different stages of pregnancy.

• During pregnancy the mother is encouraged to gain 3 Kg over the first 20 weeks and 0.5 Kg every week until term.
• During the second trimester, much of the weight gained is used to increase the mother’s blood plasma volume and laying down of fat stores.
• During the third trimester, weight gained is used to increase the weight of the fetus.
  So therefore, an average of 10-13 kgs is required to be gained during pregnancy.
  
  Maternal weight gain
  Fetus 3-4 Kg
  Placenta 0.5-1 Kg
  Extracellular fluid 1-1.75 Kg
  Amniotic fluid 1.0-2 Kg
  Uterus + Breast 0 .75 Kg + 0.5 Kg
  Other tissue + fat stores 2-2.5 Kg
  Blood 1-1.5 Kg
  Total 10-13 Kg
  
  
  Food groups
  Grain products - 4 to 6 serves per day
  Sample Foods +Sample Serves
  -2 slices of bread-1 cup of porridge-1 cup breakfast cereal flakes-1 cup cooked rice, pasta, noodles
  
  Vegetables - 5 to 6 serves per day
  Sample Foods +Sample Serves
  -1 medium potato-1 cup of salad-½ cup of peas, lentils, green beans. Tomatoes, lettuce, capsicum, cucumber, sweetcorn, celery, sprouts etc.
  
  Fruits - 4 serves per day
  Sample Foods +Sample Serves
  -1 piece medium sized fruit e.g. apple, orange, mango, mandarin, pear, peach etc.-2 pieces of small fruit e.g. apricots, kiwi fruit, plums etc.-1 cup chopped or canned fruit-½ cup fruit juice-¼ medium melon-Approx 20 grapes or cherries-1 ½ tablespoons sultanas
  
  Milk and milk products - 2 serves per day
  Sample Foods +Sample Serves
  -250 ml glass or 1 cup of milk (fresh, long life or reconstituted milk)-40g (2 slices) of cheese-50ml (1 cup) custard-200g of yoghurt-1 cup almonds-½ cup of pink salmon with bones-A cup of calcium-fortified soy milk
  
  Meat and protein foods - 1.5 serves per day
  Sample Foods +Sample Serves
  -2 small eggs-65-100g cooked meat or chicken (e.g. ½ cup mince, 2 small chops or 2 slices roast meat)-80-120g cooked fish fillet-1/3 cup cooked dried beans, lentils, chick peas, split peas or canned beans-1/3 cup peanuts or almonds
  
  
  For more information contact:
  The Environmental Health Officer at your local council Environmental Health Service, Department of Health WA Food standards Australia & New ZealandCentre for Disease Control
  

Breast Care during Pregnancy

As the pregnancy begins the breast changes and prepares itself for 9 months for the arrival of baby. The hormones cause these changes and you may experience a few more than others. These changes include :

• Growth and enlargement
• Tenderness and hypersensitivity
• Darkening of nipples and areolas (the skin around your nipples), due to hormones that affect pigmentation of the skin
• Darkened veins along your breasts (due to increased blood supply to your breasts)
• Your breasts may start leaking a yellowish, thick substance known as colostrum
• Nipples stick out more; the areolas and nipples will grow larger
• Small glands on the surface of the areolas called Montgomery's tubercles become raised bumps

Sensitive and tender breasts:
Hormones in your body are preparing your breasts for lactation. The milk ducts are growing and being stretched as they fill with milk early in pregnancy. All this causes your breasts to be more sensitive, particularly your nipples.

Colostrum:
This is known as pre-milk, which is a sweet and watery fluid that is easy to digest. During your second trimester your breasts will begin to produce colostrum. Colostrum appears thick and yellow at first, and as birth draws near, it becomes pale and almost colorless. There is no need to be alarmed when this happens, and there is no need to worry if it does not happen. Women who do not experience discharge in pregnancy still produce and provide milk for their baby.

Breast Care :

• Buying a good supportive cotton bra can help a lot to stabilize your breasts. Lovable brand is one the best supportive bras recommended by docs.
• Massage your nipples with pure olive oil and areolas in a circular movement after bath. It will help ease the sensitiveness and prevents cracks on nipples.

Foods to avoid during 1st Trimester of Pregnancy

• Avoid alcohol and smoking during pregnancy. Alcohol has been linked to premature delivery, mental retardation, birth defects and low birth weight babies.
• Limit caffeine to no more than 300 mg. per day. The caffeine content in various drinks depends on the beans or leaves used and how it was prepared
• The use of saccharin is strongly discouraged during pregnancy because it can cross the placenta and may remain in fetal tissues. But, the use of other non-nutritive or artificial sweeteners approved by the FDA is acceptable during pregnancy. These FDA-approved sweeteners include aspartame (Equal or NutraSweet), acesulfame-K (Sunett) and sucralose (Splenda)
• Decrease the total amount of fat you eat to 30% or less of your total daily calories. Limit cholesterol intake to 300 milligrams (mg) or less per day
• Do not eat shark, swordfish, king mackerel, or tilefish (also called white snapper), because they contain high levels of mercury
• Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese. These cheeses are often unpasteurized and may cause Listeria infection. Hard cheese, processed cheese, cream cheese, cottage cheese, or yogurt need not be avoided

Morning Sickness- Eat crackers, cereal or pretzels before getting out of bed; eat small, frequent meals throughout the day; avoid fatty, fried and greasy foods.
Constipation- Eat more fresh fruit and vegetables. Also drink 6 to 8 glasses of water a day.
Diarrhoea - Eat more foods that contain pectin and gums (two types of dietary fiber) to help absorb excess water. Examples of these foods are: applesauce, bananas, white rice, oatmeal, and refined wheat bread.
Heartburn-Eat small, frequent meals throughout the day; try drinking cold milk before eating; and limit caffeinated foods and beverages.

Myths ! DOs and DONTs in 1st Trimester of pregnancy

I am 3 months pregnant and want to do everything right for my unborn but at the same time overwhelmed with conflicting information. Now that I have gone through 3 months its just that each pregnancy is unique with unique challenges. I want to do everything to deliver a healthy baby and my health professionals are important resource. But its first time that too with Hypothyroid and PCOS so I cant just keep calling my doctor to double check everything ? I surveyed internet , my friends and families but you really get confused. 1st trimester is a very delicate period of pregnancy because its all about foundation and formation of vital organs of a fetus and at the same time challenging to a body which is facing a flush of hormones to deal with. All of us must be acknowledged with the small things that have to be taken care of during these 3 important months. Now that I have completed my three months I feel that we don’t have to worry of causing harm to fetus for nine months , especially when vast majority of routine pregnancies produce normal, healthy babies.

Although nausea and vomiting, gastritis, heart burn are the few things which make everything impossible but eating healthy would ensure your daily intake required.

Here are my specs:

The Right Start to Pregnancy

Prenatal vitamins
These are specially formulated vitamins needed that make up for any nutritional deficiencies in the mother's diet during pregnancy. While the supplements contain numerous vitamins and minerals, their folic acid, iron, and calcium content are especially important.

• Folic acid can reduce your risk of having a baby with a serious birth defect of the brain and spinal cord, called the "neural tube." A baby with spina bifida, the most common neural tube defect, is born with a spine that is not closed. The exposed nerves are damaged, leaving the child with varying degrees of paralysis, incontinence, and sometimes mental retardation. There are natural sources of folic acid: green leafy vegetables, nuts, beans and citrus fruits. It's also found in many fortified breakfast cereals and some vitamin supplements.
• Calcium during pregnancy can prevent a new mother from losing her own bone density as the fetus uses the mineral for bone growth.
• Iron helps both the mother and baby's blood carry oxygen.
  While a daily vitamin supplement is no substitute for a healthy diet, most women need supplements to make sure they get adequate levels of these minerals.

Look for one that contains approximately:
4,000 and 5,000 IU (international units) of vitamin A
800 and 1,000 mcg (1 mg) of folic acid
400 IU of vitamin D
200 to 300 mg of calcium
70 mg of vitamin C
1.5 mg of thiamine
1.6 mg of riboflavin
2.6 mg of pyridoxine
17 mg of niacinamide
2.2 mcg of vitamin B-12
10 mg of vitamin E
15 mg of zinc
30 mg of iron

Fruits & Vegetables
There are daily 5 recommended servings of fruit but you can make it to you at having a good proportion of apples, bananas, oranges, kiwi, peach, melons, grapes, pine apple, pomegranate, dates, lime, litchi etc. accordingly. The best approach is to eat different kind of fruits and vegetables and nuts to obtain nourishment. As you will progress you will hear a big no to Papaya. Although a fully ripe papaya is not considered dangerous, a papaya that is at all unripe contains a latex substance that acts like prostaglandin and oxytocin that triggers uterine contractions. Contractions of the uterus could lead to miscarriage .
Other healthy foods are coconut water, lettuce, honey, peanuts, almonds, green leafy vegetables etc.

Ingesting milk is one of the major problems faced during 1st trimester of pregnancy. High level of hormones or medications causes the stomach valves to remain open which brings back partially digested food back to oesophagus and thus vomit occurs. To prevent this, one may take alternative forms of milk eg Soy milk, curd, ice cream, milk shakes or cold milk whichever you feel your stomach can digest. As the pregnancy progresses you will get used to the needs of body and can make better choices for your eating habits. Eat small portions of food and drink lots of fluid. If you feel sick of water the best is lime water, rose water, juices. Make sure not to have much carbonated drinks ,spicy oily food because they tend to increase your heart burn.

My PCOS Pregnancy

I am 30 years old hypothyroid and married for last 1 year. I am diagnosed with PCOS which was almost borderline. Both Hypothyroid and PCOS are fairly common problems among women. With PCOS infertility is due to ovulatory dysfunction commonly characterized by polycystic ovaries depending upon severity. I started to feel like phoenix. Tired and worn of reading about the consequences and the fear that will I ever bear my own child. The world seems like flames but a good guidance and consultation brought a new purpose….and we could rise stronger than before. The first truth is PCOS manifests itself differently in each woman it afflicts. Every woman wonders …Am I the one with infertility? Is it so that her medication will help me ? Am I the one frustrated and alone ? Doctor told me that my ovary has a large no. of follicles which remain immature never growing to full development or ovulating to produce a good quality egg capable of being fertilised. In addition other features are irregular periods , excessive hair growth and fat depending upon individual. These symptoms are related to several internal changes.

Hormonal abnormalities, including: raised luteinising hormone (LH) in the early part of the menstrual cycle, raised androgens (male hormones usually found in women in tiny amounts), lower amounts of the blood protein that carries all sex hormones (sex-hormone-binding globulin) , a small increase in the amount of insulin and cellular resistance to its actions.

Characteristic changes in the appearance of the ovaries on ultrasound scan. The ovaries are polycystic, with many small follicles scattered under the surface of the ovary (usually more than 10 or 15 in each ovary) and almost none in the middle of the ovary. These follicles are all small and immature, generally do not exceed 10mm in size and rarely, if ever, grow to maturity and ovulate.

Most women with PCOS will have the ultrasound findings, whereas the menstrual cycle abnormalities are found in around 66 per cent of women and obesity is found in 40 per cent. The increase in hair and acne are found in up to 70 per cent whereas the hormone abnormalities are found in up to 50 per cent of women. After blood tests on 3rd day of cycle I was on the most effective medication of Letrazole for 5 days in continuation with Metformin (most efficient updated drug for PCOS) , folic acid and ecosprin ( supports pregnancy). With the series of ultrasound my ovulation was enhanced by GMH 150 IU injections.

We finally got our miracle on second month of treatment through IUI. I constantly think about a phase which we passed through which most of my fellow women pass and it made me realize that how a women can feel so alone in their quest to get a handle on this confusing disorder PCOS. Find everything that’s on your mind bcos PCOS can be managed with proper treatment and diagnosis as in my case. I am on a new journey towards life. I wish to continue sharing experiences of my pregnancy in PCOS. Please feel free to ask

Music during pregnancy

For a pregnant couple most of the time it’s all about Do’s and Don’ts. We are always looking for ways to bring more joy to the pregnancy. As one of those efforts we realized that the music can have huge impact there. It can have tremendous healing effect. Good and correct music brings forth positive vibrations in the nerves of the listeners. It is observed that during the early stages of pregnancy, music given to mothers to be does very good effect for the fetus.

There are studies indicating that fetuses can hear and react to sound by moving. Some studies says that newborns can recognize music their parents played for them when they were in the womb and even perk up or fall asleep when they hear a familiar song. Music Therapy enhances the concentration level of children; it helps to clear the mind- which leads to have a positive frame of mind.

List of Music that we found very helpful and soothing (Please feel free to share your experiences)

• Dinner In Greece - Primary Artists: Rouly AntonopoulosLabel: Avalon (Somerset Entertainment)
• Natural Stress Relief - Primary Artists: David Bradstreet Label: Solitudes (Somerset Entertainment)