Because each year over a half million babies are born prematurely or with birth defects, it’s especially important for a woman to know how best to prepare herself for a healthy pregnancy, how can she continue to maintain health while pregnant, and what should do after the baby is born.
After all, mom’s lifestyle and nutrition BEFORE pregnancy influences WHETHER she can become pregnant and maintain a pregnancy. And CERTAINLY what she does during pregnancy can affect the outcome of the baby. Once the baby is out, we, as pediatricians, take over to ensure baby is healthy and safe, but we also take on the added responsibility of making sure that the family environment is safe and free from hazards.
If you are fortunate enough to really plan the timing of your pregnancy (and we know those best laid plans can easily go sideways) there are a few things you can do to prepare your body:
· Start taking a prenatal vitamin (they are now over the counter)
- 600 mcg of folic acid prevents neural tube defects
- Vitamin D keeps your bones strong and helps keep a pregnancy going, and allows your body to absorb much needed calcium.
- Calcium is essential for growing teeth and bones
- Vitamins B & C are essential for tissue development and the machinery of cell and tissue development
· Nature forces the BEST from mom to flow into the baby, so it’s important to make sure both of you get good nutrition. Start by improving your own diet ahead of pregnancy – more greens and fiber, fruits and veggies are a good start. Look to learning how to prepare and eat healthier sources of protein and eat less packaged food, and more fresh food. Embracing rich sources of dietary calcium and vitamins, by enjoying dairy, nuts, dark leafy greens and a variety of healthy oils and fats will round out a perfect diet for you and your baby. Face it, the changes you make before the baby hopefully will stick so that your baby will grow up with a healthier diet.
· Smoking – definitely something you want to quit before getting pregnant. Nicotine in any form (vaping or smoking) is unhealthy for you and baby, and it’s ideal to cut down and quit before conceiving. Mothers who smoke during pregnancy have a higher risk of losing their babies to SIDS. Encourage others in the household to either quit, or learn to smoke OUTSIDE so that second hand smoke is not part of your baby’s airspace.
· Drinking and other recreational substances – experience and good science clearly demonstrates that your baby’s behavioral and intellectual future is negatively affected by drinking alcohol during pregnancy. And babies born to mothers who regularly take pain pills, opioids, stimulants and other medications often give birth to babies who go through withdrawal, and have future issues with learning and behavior. With the recent legalization of marijuana in many states, what we DON’T have is solid science, pro or con, for the effects of using THC before or during pregnancy. So, prior to conceiving, if you are concerned about medications that you are taking, or that you may have trouble stopping drinking, have that honest conversation with your doctor. Your baby will thank you for taking steps ahead of time to grow him safe!
· Physical activity – keeping physically active is terrific for many things – your emotional good health, your cardiovascular health, and reducing the chances you will develop weight-related complications from pregnancy. So aiming to be a bit more fit can only help move you towards a healthier pregnancy.
· This is one area that receives less attention than it should but can have a very negative impact on a baby’s intellectual development – and that is LEAD in the environment
- A good example is a family renovating a home built in the 70’s or before. That home, no doubt, has lead paint in its depths. During the process of demolition, painting and sanding, your body can absorb that lead through inhalation and swallowing contaminated air and that lead can accumulate silently in your bones. During pregnancy, it can be released to your baby without you knowing, and potentially cause permanent neurologic and/or cognitive damage. So mask off those rooms, have professionals sand, paint, and safely discard construction waste – or if you are a DIYer, wear an approved mask and goggles, and after your construction day, put contaminated clothing right in the washer, shower off, and mask off the areas being worked on.
- The same goes with the lead that may be present in those old pipes or the solder that is used to weld together brass or copper pipes. If contemplating a pregnancy, get your blood lead level tested FIRST, and then to reduce your chances of accumulating lead while trying to get pregnant, drink water through an approved filter that removes lead and other impurities from the water. Make sure to replace or change filters according to the manufacturer’s instructions.
- If you live in a newer home or apartment, make sure you check your local water department’s annual report to ensure that your city’s water supply has no lead within.
- If you enjoy a high risk hobby that exposes you to lead risk (like ceramics or stained glass), time to switch gears to reduce your potential lead exposure. If you work in an occupation that exposes you to lead (like a battery plant or car repair) you may want to have your lead level checked, and if any is present, consider a re-assignment to another area to reduce your risks.
· It’s always a good idea to see your family doctor or OB/GYN BEFORE getting pregnant; a good history and physical, along with a few carefully chosen labs can set you off onto a path of a healthier pregnancy. And if you are trying to get pregnant, are under 35, and have been trying for a year, best to see a gynecologist if you haven’t already. If you are over 35, and can’t get pregnant within 6 months, see an OBGYN sooner rather than later.
· If you struggle with depression, anxiety or other emotional states, best to discuss these frankly with your therapist, psychiatrist and OBGYN. Your doctors can assess the safety of your medications during pregnancy and can make any adjustments ahead of time, if warranted.
NOW YOU ARE PREGNANT!
Advice, no doubt, is hitting you from several directions – sometimes welcomed, often unsolicited. Try not to take on the emotional burden of others’ stories – it creates so much unnecessary anxiety, and time. So it’s important to stay focused on you, your story, and what is happening in your body as your baby grows.
· What we do know about what we eat during pregnancy is that foodborne illness from certain germs can actually cause fetal loss, fetal illness, prematurity and even newborn illness or death. And MERCURY, eaten from food sources, can cause both maternal and fetal side effects. So here are some NO NO’s the minute you know you are pregnant:
- The FDA recommends women who are pregnant or breastfeeding and young children avoid these seven varieties: king mackerel, marlin, orange roughy, shark, swordfish, tilefish from the Gulf of Mexico, and bigeye tuna.
- Unpasteurized dairy/soft cheeses as well as lunch meats, pates, meat spread, smoked seafood, nova/lox/smoked/jerky increase risk of contracting LISTERIA - a germ notorious for causing prematurity, sepsis and death in newborns.
- Undercooked protein including shellfish, raw eggs, cookie dough, as well as sprouts and unwashed veggies and fruits and unpasteurized juices can increase the risk of other food-borne illness that can impact both mother and baby.
· Creating and maintaining a smoke-free environment, and encouraging your partner and family members to reduce or eliminate substances makes for a family and partner who are more sober, attentive, and mindful of the little one who is to come.
· Keeping up with exercise, getting fresh air and some sunshine, helps keep blood sugar and weight down, and mood and endurance up.
· Making sure you listen to your body so that you get enough sleep is so important
· Checking in on your relationship with your partner/family members is key – it’s very hard to bring a baby into the world if there is discord or strife – often a little tune-up with a therapeutic partner before baby comes can make a huge difference in everyone’s stress levels
· As discussed before, renovations during pregnancy can continue to expose a pregnant woman to toxins like lead. And, if mom has already accumulated lead in her bones, the state of pregnancy actually releases more lead from her bones and funnels it across the placenta where it can cause cognitive and developmental delays in the baby. And, if you happen to move to a new place during pregnancy, take the same steps to avoid environmental lead as before – especially when it comes to checking your water supply and having any peeling or chipping paint removed and repaired before moving in. Remember, we are advised to drink so much more water during pregnancy – so make sure you use a good filter at home, and make sure your bottled water has an “NSF STAMP OF APPROVAL” to make sure that it is lead and contaminant-free.
· Your doctor will have you on a schedule of regular pre-natal care checkups, and extra visits if necessary. It’s key to check in regularly with your OB, and contact him/her if you feel something isn’t just right. Follow your gut instincts, and make that call, if you feel it’s necessary.
· If you see an alternative health practitioner and are taking herbs or supplements, clear these with your OBGYN. Herbal teas are caffeine-free, but their safety is unclear when you’re expecting. There are no reliable human studies on the safety of herbal preparations, including supplements such as Echinacea and St. John’s wort, during pregnancy. The FDA does not routinely monitor the quality of dietary supplements. pregnant women should avoid large quantities of herbal tea, and completely avoid herbal supplements.
· Women who are pregnant, or who could become pregnant, should not take 10,000 or more IU per day of vitamin A because of the risk of birth defects.
AND THE BABY HAS COME!
· It’s best to keep up your healthy diet after baby is here, whether you are breastfeeding or not. You need energy to keep up with your little one, and it’s advised to continue your prenatal vitamin for several months post-partum to replenish your personal stash of nutrients.
· A small amount of caffeine is ok, and follow your doctor’s advice re: medications and alcohol.
· A diet rich in fiber and vitamins will help you poop better, and heal faster, especially after episiotomy or a C/Section
· There’s no better exercise than picking up your baby 100 times a day, taking walks, playing and getting outside. You can’t spoil a newborn, and babies, even young ones, often sleep better and calm easier with a trip or two outside daily.
· Make sure you keep your home 100% smoke free, and that includes the car too! If grandparents or other family smoke, have them visit your home, and if they want to smoke, do so outside. Don’t visit homes where there are indoor smokers.
· The stress of a baby can easily stress those trying to stay sober or more healthy. Create opportunities for everyone to catch a break on a regular basis and keep conversations about these challenges open and non-judgmental.
· If you are breastfeeding, key to make sure your personal water supply is safe. Your water and fluid intake, as far as keeping milk supply up, is critical. We know that lead can cross from mom to baby via breastmilk, so stay vigilant with your clean water. And if you are formula feeding your baby, he or she will drink and absorbs tons more of your tap water – so make sure it’s safe. NEVER run hot water from the tap into baby’s bottle, especially if you have old pipes or lead in your system. Run cold water for at least 30-60 seconds in the morning before filling that first bottle. Heat safely in a pan of hot water or in a bottle warmer. (You should collect that first morning water and use it to water your plants or grass)
· When your child receives gifts, make sure that toys are manufactured in the US or in Europe. Exchange or discard painted toys made in China or other parts of the world. Discard any beads, bracelets or necklaces that are not stamped with silver or gold – many decorative children’s beads, chew beads and other decorations often contain lead. Shiny things and little mouths are inseparable – and those beads are also a choking risk!
· Make sure your baby sleeps in an approved crib that contains just a bottom sheet. Bumpers, toys, quilts and blankets are suffocation risks. Dress baby in layers to keep warm and make sure air is circulating in the baby’s room.
· Make sure to use an approved car seat, rear-facing in the backseat, at least until age 2. You can utilize local resources like fire departments, or hospital educators, to make sure your car seat is installed properly.
· Establish a trusted relationship with your pediatrician or family doctor and do your best to keep up on timely visits for well care and vaccinations. It’s a big, crowded world out here, and we have so many ways to keep our babies healthy and prevent many illnesses. Keep a dialog going between you and your baby’s doctor so that any fears or questions you have are answered in a timely fashion. We’re all here to help.
For more information about healthy water and lead toxicity prevention – go to:LeadcareII on Facebook…
For more information about pre-pregnancy planning go to www.marchofdimes.org
For more information about vaccines go to www.chop.org
It's important to talk to your doctor about what both you and your baby need to eat and avoid in order for the two of you to thrive during pregnancy. This can vary greatly from person to person, especially if you have a chronic healthcare condition that requires adjustments from the “norm”, are on medication or have dietary restrictions that are a result of faith or allergies. Talk to your doctor about a strategy that is right for you specifically.