Pregnancy Advice

This advice is not a substitute for any instructions your doctor has previously given you in the office. This is routine pregnancy advice, in normal low risk pregnancies.

Nausea

Nausea is caused by hormone changes with increased stomach acid in the pregnant woman. Usually 50-75% of pregnant women experience nausea anytime during the day, but usually the symptoms resolve after 12 weeks. You may find relief by taking Vitamin B6- 100mg twice daily, using “Seabands” or eating candied ginger.

To help reduce your nausea:

• Avoid empty or overloaded stomach
• Eat small, frequent meals
• Avoid greasy, fried, rich or spicy foods
• Keep crackers, popcorn, or dry cereal at the bedside. Eat something when you first wake, but before you get out of bed. This starts the digestive process that will remove excess stomach acid and relieve nausea.
• Have your breakfast after the nausea subsides
• Get up slowly- sudden movements can aggravate nausea
• Eat a high protein snack before bedtime
• Limit coffee. Coffee stimulates stomach acid secretion
• Stop smoking. Smoking increases the secretion of stomach acids

Heartburn / Indigestion

Heartburn and indigestion are caused by increased stomach acid and pressure of the uterus on the stomach.

To help reduce these symptoms:

• Bland diet
• Frequent small meals
• Antacids

Constipation and Gas

Constipation and Gas is caused by pressure from the uterus on the bowel and less room for proper digestion.

Medication you can take:

• Constipation: Citrucel, Senokot, Metamucil, Colace, Milk of Magnesia, or Miralax
• Indigestion: Antacids, such as Mylanta, Gaviscon, Tums, or Maalox;
• After the first trimester: Zantac or Pepcid over the counter.

To help reduce these symptoms:

• Exercise, such as walking- 30 minutes daily
• Increase fiber in the diet, such as fruits, vegetables, and whole grains
• Increase water intake
• Avoid salt intake

Backache

Backaches are caused by poor posture, poor body mechanics, breast enlargement, or strain on muscles as the uterus enlarges.

To help you feel better:

• Try a Maternity Belt for lower abdominal support
• Work to correct your posture
• Get regular exercise
• Wear low-heeled shoes with good support
• Take frequent rest periods
• Wear a supportive bra
• Massage Therapy (Prenatal Massage)

Lower Abdominal Cramping (Round Ligament Pain RLP)

Round Ligament Cramps are felt on either side of the abdomen, where the groin meets the leg. They are worse upon getting out of bed or chair and upon walking. These cramps are caused by increased pressure from growing uterus, pressure on nerves from uterusor fetal position, or pressure from softening and movement of pelvic bones.

To help reduce cramping:

• Exercise regularly
• Apply heat to area, but not directly on the abdomen
• Do stretching exercises
• Change positions frequently
• Soak in a bathtub if able to get out on own. Remember to avoid hot tubs
• Massage

Hemorrhoids

Hemorrhoids are caused by constipation, pressure from the uterus, lack of exercise, or familial tendency.

You may find relief by:

• Avoiding constipation or straining
• Kegels exercises
• Cold compresses
• Sitz baths
• Over the counter Preparation H

This advice is not a substitute for any instructions your doctor has previously given you in the office. This is routine pregnancy advice, in normal low risk pregnancies.

Urinary Tract Infections

A Urinary Tract Infection, or UTI is an infection in either the kidneys or the bladder.

• Symptoms include but are not limited to pain or burning with urination, frequency and urgency, blood in the urine, or foul smelling urine
• Pregnant women are more susceptible to urinary tract infections

Fortunately, there are some preventions.

• Drink plenty of water, at least 8-10 glasses of water daily. Drink cranberry juice, that is 100% juice without added sugar or corn syrup, at least 2-3 glasses daily.
• Avoid sodas, tea, coffee, and alcohol intake. Bacteria love sugar and caffeine.
• Urinate immediately after intercourse to flush out any bacteria.
• Empty your bladder every 4 hours or as needed to prevent bladder distention.
• Do not take frequent bubble baths. Wipe the perineum from front to back after urinating. Keep the perineal area clean and dry. Wear cotton underwear and no douching.
• If your doctor has prescribed antibiotics for you, take the complete course even if you are feeling better. All of the medicine should be taken to prevent a recurrent UTI.

Toxoplasmosis

Toxoplasmosis is an infection caused by a parasite that can harm an unborn baby.

• Avoid handling cat litter, it’s ok to pet your cat and hold him
• Wear gloves when gardening
• Do not eat undercooked meats

LCMV

Lymphocytic choriomeningitis virus is carried by rodents, including pet hamsters and guinea pigs. LCMV can cause abnormalities in pregnancy.

• Avoid all rodents
• Do not handle rodent urine, droppings, or nesting materials
• Wash your hands if you must handle rodents, and avoid touching your mouth or eyes

Listeriosis

Listeriosis is an infection caused by bacteria in unpasteurized or undercooked foods. It can be treated with antibiotics, but it is best to prevent the infection first.

• Cook raw foods thoroughly, such as beef, pork, poultry, and fish
• Wash all vegetables / fruits before eating
• Avoid unpasteurized milk
• Avoid soft cheeses, such as brie, camembert, and blue veined cheeses
• Cook hot dogs before eating
• The risk of deli meats being contaminated with listeriosis is extremely low, as long as the deli is clean. To be safe you can microwave any deli sandwiches.

Food safety is important for everyone — but it is especially important for you and your unborn child. That is why the U.S. Department of Agriculture’s Food Safety and Inspection Service prepared this booklet. It is designed to provide practical guidance on how to reduce your risk of foodborne illness. You can read or download the booklet here.

This advice is not a substitute for any instructions your doctor has previously given you in the office. This is routine pregnancy advice, in normal low risk pregnancies.

Swollen Ankles and Leg Cramps

Swollen ankles and legs are caused by increase in blood volume, heat, gravity, pressure on blood vessels and supply from uterus.

Treatment measure include:

• Elevate feet above heart level frequently
• Wear support hose to waist, not thigh high
• Lie on left side when resting/sleeping
• Soak in the bathtub; water pressure decreases swelling
• Massage
• Magnesium and Potassium supplements can decrease leg cramps

Shortness of Breath

Shortness of Breath is caused by pressure on the diaphragm in the last few months of pregnancy.

To find relief:

• Use complete breath
• Correct posture

Frequent Urination

Frequent Urination is caused by pressure of uterus on bladder in the first 3 months and when baby drops.

Treatment includes:

• Cut down fluid one hour before bedtime
• Avoid Caffienated Beverages

This advice is not a substitute for any instructions your doctor has previously given you in the office. This is routine pregnancy advice, in normal low risk pregnancies.

Medications

Abstinence from all medications is preferred during pregnancy, except prenatal vitamins. However, the following medications may be taken:

• Cough — Robitussin DM
• Headache — Tylenol (regular or extra-strength)
• Diarrhea — Imodium
• Sleep — Benadryl 25mg at bedtime
• Constipation — Citrucel, Senokot, Metamucil, Colace, Milk of Magnesia
• Indigestion — Antacids, such as Mylanta, Gaviscon, Tums, or Maalox Pepcid after the 1st trimester
• Nausea — Vitamin B6 25mg every 6 to 8 hours as needed, and 12.5mg of Unisom Sleep Tabs (one-half tablet) orally once or twice daily as needed, Sea bands, candied ginger or peppermint tea.
• Sleep — Benadryl 25mg at bedtime.
• Gas — Simethicone
• Allergies — Benadryl 25mg. Zyrtec or Claritin after the 1st trimester (13weeks)

This advice is not a substitute for any instructions your doctor has previously given you in the office. This is routine pregnancy advice, in normal low risk pregnancies.

Nutrition & Pregnancy

It is recommended that during pregnancy, each woman should intake a well-balanced healthful diet.

We recommend that you:

• Eat at least 3 servings of fruits and 4 servings vegetables a day. Which includes all dark green, orange, and yellow leafy vegetables and all fruits. Kool-aid or fruit drinks do not count as your daily fruit and vegetable intake. An 8oz. glass of 100% fruit juice without corn syrup counts.
• Eat 4 servings of whole grains, such as whole wheat, oats, and brown rice. White bread is not a whole grain.
• Eat 2 eggs daily. Eggs are rich in omega3 fatty acids, protein, and iron.
• Eat 4-5 servings of dairy products, such as milk, cheese, or yogurt.
• Eat 3-4 lean meats such as chicken, beef, or pork. Or meat substitutes, such as peanut butter, tofu, or soybeans.

Important Food Sources:

IRON

• Beef, Pork, Veal, Chicken, Fish, Shellfish
• Grains, Cereals, Fruits, Beans, Legumes
• Dairy Products
• Carrots, Corn, Lettuce, Molasses
• Tofu, Peanut Butter

POTASSIUM

• Bananas, Tomatoes, Potatoes, Oranges, Cantaloupe, Melons, Peaches, Prunes, Apricots, Raisins, Watermelon, Beets, Green Vegetables, Soybeans, Squash, Mushrooms, Nuts, Salt Substitute, Buttermilk or Low fat Milk, Citrus / Prune / or Tomato Juice

MAGNESIUM

• Fortified Cereals, Legumes, Whole Grains (such as whole wheat), Wheat Germ
• Seafood, Shellfish, Fish

CALCIUM

• Cheeses, Yogurt, Cottage Cheese, All Milks, Sardines, Salmon, Beans, Oysters
• Tofu, Collards, Kale, Mustard Greens, Turnip Greens, Waffles, Cornbread, Pancakes
• Blackstrap Molasses, Custard

FOLIC ACID

• Enriched grains, such as cereal, bread, rice and pasta
• Orange juice
• Green leafy vegetables, broccoli, asparagus, peas, lentils, beans and peanuts

FOODS & CHEMICALS TO AVOID

• Avoid fish with high levels of mercury, such as shark, tile fish, swordfish, and king mackerel. Albacore tuna is higher in mercury than regular light tuna. Eat albacore tuna only 12 ounces monthly. It is better to eat light tuna packed in spring water 12 ounces weekly.
• Avoid exposure to toxic chemicals and substances. Take special care with cleaning products and always read the label. Clean in a well ventilated area.
• Avoid lead based paints, indoor shooting ranges, and using dishes that contain lead.

Fluid Intake

It is very important that you drink at least 8-10 glasses of water daily. Avoid caffeine, caffeine dehydrates you. Do not count sodas, teas, juice, or milk as part of your daily water intake.

The best fluids for you are:

• Water
• Milk
• Juice
• Sports Drinks (such as Gatorade, Powerade)

Exercise

• Physical activity during pregnancy can benefit both you and your baby by lessening discomfort and fatigue, making labor easier and increasing the likelihood of early recovery after delivery.
• Light to moderate exercise strengthens the abdominal and back muscles, which help improve posture and decrease aches and pains.
• Practicing yoga, Pilates, walking, swimming and cycling on a stationary bike are safe for pregnant women.
• It is best to exercise at least 30 minutes each day, drink plenty of water when exercising and rest after.