February 27, 2017 2916
We told you we read your mind, we spoke to Dr Bheena Vysali, Consultant Obstetrician & Gynaecologist at Columbia Asia Hospital Petaling Jaya and we demystify those questions you may have. Read on to find out what would be Dr Bheena’s advices.
If the following conditions are seen/detected/occur during the pregnancy, they are termed as high risk pregnancy:
• Bleeding during pregnancy
• Low lying placenta (placenta praevia)
• Growth restricted babies
• Previous history of pre-term birth
• Any signs of going into preterm labour/early contractions
• Twin pregnancies
• Patients with heart diseases
• High blood pressure/pre-eclampsia
• Gestational Diabetes Mellitus
**Do check with your doctor before using this guide.
1. Food and Beverages – Do’s and Don’ts
Food – Portion sizes
When you get pregnant, there are a few changes that you must do to your lifestyle. You cannot follow your regular routines. The first thing I always talk to to-be-moms is about exercise and food.
Talking about food, we Malaysians are food lovers, there is no denying that. However, our diet are too carbohydrate based . Your daily serving should include 2-4 servings of fruits, 4 or more servings of vegetables and three servings of protein sources.Choose at least one good source of vitamin c such as oranges honeydew or strawberries and one good source of folate such as dark green leafy vegetable , black beans or chickpeas.
Well on the other hand, I always also advise my patients not to eat for two. The pregnant mum has to just meet the calorie intake prescribed per day – 300 extra calories per day. Three small but balanced meals and 3 light snack throughout the day are a good rule of thumb to ensure the nutritional need are met.
Mothers whom are underweight from early pregnancy can gain weight up to 16 kgs while those of normal BMI can gain uptill 11-13 kg. Unfortunately mothers who are obese or overweight have the flexibility to only gain about 5-7 kgs . In such people the amount of food consumed has to be tailored.
Food – raw or cooked?
Let us consider eating basically cooked meat, any raw meat is a no-no – uncooked seafood and rare or under cooked beef and poultry contains coliform bacteria , toxoplasmosis and salmonella which can cause gastrointestinal upset.Having that said, unfortunately sushi is a big no – no for pregnant lady.
Fish that contain high mercury should also be avoided as it has been associated with developmental delay and brain damage.Some of the fish that contain high mercury include shark,swordfish and king mackerel.
There is nothing better than eating a bowl fresh salads.But remember they could also be a war zone for unhealthy bacteria and also pestisides. Wash them with clean water before consuming.Salad buffets are probably not a good idea as there is no way to be certain that the greens , fruits and vegetables have been washes or cross contaminated by other food on the salad bar.
Food - Dairy products
Moms will definitely need to increase their dairy products as it is good source of calcium and essential for the development of their little ones bones, teeth, muscle, heart and nerves.It is important not just for baby’s bones but you will also need this mineral to strengthen your own bones and prevent bone loss ( osteoporosis ) later in life.But be sure to stay away from unpasteurized milk and all foods that is made from it including soft cheeses like feta, Brie and blue veined cheese.
How much dairy product will you need?Aim to get at least 2-3 cups of dairy product a day.On an average a glass of milk contains about 300 mg of calcium. Mother require around 1000-1200 milligrams of calcium a day.If your taking prenatal vitamins, your probably already taking 150 mg - 500 mg calcium a day.
Food for Vegetarian Pregnant Women
You can be a vegetarian while pregnant and still get all the proteins, vitamins, minerals and other nutrients that you need. I usually advice pregnant mothers who are vegetarians to take a variety of nuts and legumes to keep up with the protein requirement.
Food - Supplements
If the food intake is well balanced, you actually do not need supplements. But its also a good idea during pregnancy to take prenatal vitamins to help cover any nutritional gaps in mothers.
Folic acid helps prevent neural tube defect which affect the brain and spinal cord.Pregnancy can deplete a mothers iron stores.Low iron levels have been linked to premature birth and low birth weight babies.Iodine is also as essential mineral.Iodine deficiency can result in learning difficulties and affect development of motor skills and hearing.
Beverages - Do’s and Don’ts for Mothers
There is a myth that you can’t drink coffee since it is said to cause miscarriage. Well, not really. But any caffeinated drink has to be consumed in moderation – limit the amount of caffeine to 300mg only. Remember decaffeinated cofee doesnt mean caffeine free.It still has 12-25mg of caffeine.Pregnant women have a higher heart rate as a baseline, so consuming more caffeine can increase these further causing palpatations in some sensitive mothers. Moderation is key.
Diet sodas come under the same category. I am asked by my patients if they can consume sodas that fall under the “Diet” category, again in this case as well, moderation is important. Saccharin is the artificial sweetener that is still used in these drinks and many foods as a replacement for sugar. It is said that saccharin can pass through the placenta so it is not clear how much of it is safe or unsafe.Its is said to be associated with an increased risk of preterm delivery.Another reason to limit its intake is that many of it also contain caffeine. It is always better to keep it to a minimum.
For patients who develop Gestational Diabetes
The diet restrictions are similar to that of a diabetic patient. They have to avoid sugary food and drinks in their diet and no added sugars.Aim for food that have low glycemic index(GI).What is glycemic index? Basically its a food measure as to how quickly sugar is released into your bloodstream after you have eaten it.Low GI foods take longer time to digest .Glucose is released more slowly into your blood stream.Examples of low GI food include food that are made of wheat flour, brown rice, apples, oranges, pears and sweetcorn. Example of high GI food include white rice, baked potatoes , cornflakes ,grapes and durian .High GI food are best mixed together with low GI for better control.
Why is control important?This is mainly due to its effect on the baby. The babies can become larger causing prolonged labour, a necessity for an instrumental delivery ( vacuum/ forceps) or even require a C-section. Control is very important for diabetes during pregnancy.
2. Exercise and activities for Pregnant ladies
Exercise is important and safe during pregnancy. We tend to neglect exercise during pregnancy. The aim would be just 30 minutes per day .It helps us control your weight gain during pregnancy, improves mood, helps you sleep better and infact helps to improve your ability to cope with labour .For those who have been in a regular exercise activity prior to becoming pregnant, please go ahead! If your looking to lose weight during pregnancy . now is definitely not the time!
You would want to avoid the following types of exercise: exercise that may cause trauma to your tummy, contact sports ,any activity that may cause you to fall , activities that require intense jumping/ hopping/skipping or bouncing. I would recommend swimming, brisk walking, prenatal yoga.
Loose fitting clothes and constant hydration is very essential during exercise. Choose also well fitting shoes that are designed for your exercise. There is a theory that when your core body temperature increases during 1st trimester, it can lead to neural tube defects in the baby.
Make sure you eat well with healthy calories through your pregnancy and try eating at least one hour before exercise. Mums in the high risk category are usually not advised to do any exercise. Underweight mums also need to check with their doctor to adjust their calory intake.
3. Beauty and Hygiene for Pregnant Ladies
Basically majority of pregnant women are still worried about their appearance during pregnancy. Lots of hormonal changes and lots of bodily and skin changes.
Commonly asked question would be the safety of going for hair coloring.Coloring requires chemical applied to the scalp which can be absorbed and enters the bloodstream to the unborn child.The best advise would be to wait until the baby is born but that would mean that you might have plenty of white hair!Most obstetrician will want you to wait till after the first trimester.A healthy alternative would be to use products not containing chemicals.
Facials are safe during pregnancy as long as you stick to a basic cleansing facial.No chemical peels, laser treatment or other electrical currents during pregnancy .Be sure to know the producets thatbeing used by your beautician.
Massages during pregnancy is safe .It relaxes your muscle tension , improves lymphatic and blood circulation, reduces stress and anxiety and infact helps reduced those dreadfull backaches.Do avoid massaging you growing belly!It is important to seek certified prenatal massage therapist as they are well aware of positions that are safe for you to prevent strain as well as watch for symptoms of varicose veins and blood clots in your legs.Again if your high risk please seek advise from your doctor first.
4. Medication for Pregnant Ladies
If you are planning to take any medications, please talk to your doctor first.This also includes over the counter medications as well as dietary and herbal products.Many internet websites also post lists of medication that are safe in pregnancy but dont make decisions based solely on this.
On the other hand ,some pregnant women require medication to treat their health conditions.For example diabetics, epileptic patients, depression and asthmatic patient.They will require to continue the medications as without treatment it could be harmful to both mother and baby.Balancing the benefits and risk will be the aim of your doctor including adjusting the medication to its proper dosage.
Whether pregnant or not, a simple rule will be never to self - medicate.
5. Home Cleaning for Pregnant Ladies
Well, actually it is perfectly alright to do all the cleaning work. Some of the no-no would include avoiding moving heavy furniture or carrying heavy weighted objects around,using bleach or toilet cleaners , using pesticides and also cleaning the cats litter box( its associated with an infection called toxoplasmosis).Use gloves when your cleaning and keep a window open to improve ventilation.
Maybe pregnant women can take this as an excuse to get the cleaning work done by someone else in the household ;)
6. Education and empowerment for Pregnant Ladies
I always maintain that it is advisable to check with your doctor in case of any doubts. The doctor is the best person to help you clarify your doubts, right? Knowledge is power, hence I would definitely encourage mothers to read up and educate themselves on any information that can help them.
There are hospitals worldwide such Royal College London that publish information for general public to understand about the condition, diseases, pregnancy etc. Those are legitimate, you can very well read them up and also discuss with your doctor. You can also enrol in antenatal classes, breastfeeding classes, breathing technique lessons. Such classes give you a broader outlook and you can anticipate things that can occur during the journey such as before labour or during labour, post-partum pelvic exercises etc.
Hospitals such as Columbia Asia Hospital Petaling Jaya conducts antenatal classes regularly. Whether it is your first or second or third pregnancy you can very well enrol in these classes, might act as a refresher for you.
That was quite a lot of information; if your question is not yet answered, and you would like to find out more, join the antenatal class: 'The Wonderful Journey', happening on 5th March 2017!
Qian's interest in healthcare industry came about after her father was diagnosed with bladder cancer. This experience has led her to become a strong believer in empowering individuals to take charge of their own health. View all articles by Qian.