Mayo Clinic: Foods to Avoid While Pregnant

When it comes to pregnancy, what you don't eat can be as important as what you do.

According to an online article by the Mayo Clinic, here are some foods that all pregnant women should avoid:

• Seafood:
  

Seafood contains protein, iron, and omega-3 fatty acids that aid in a fetus' brain development. Some studies even suggest that skimping on seafood can cause poor verbal skills and slow development in a child. However, seafood should be eaten with caution during pregnancy because of the high levels of mercury in some fish. Merucury is a neurotoxin and will damage the fetus' developing nervous system. Fish that contains higher levels of mercury include swordfish, shark, king mackerel, and tilefish. Also avoid any raw seafood, like oysters or clams, and refrigerated, smoked seafood. Shrimp, salmon, pollock, and catfish are safer choices for seafood; however, pregnant women should only consume up to 12 oz. a week. Pregnant women can eat tuna, but are advised to eat no more than 6 oz. a week.

Click here to read another Mayo Clinic article about beneficial effects of eating fish while pregnant.

• Meat/Poultry: Changes in metabolism during pregnancy increases the chance that expectant mothers will develop food poisoning. With severe reactions, even a developing fetus can get sick. Pregnant women are advised to eat only meats that are steaming hot and to skip any meats that are cooked medium or rare. Deli meats should be avoided entirely due to the risk of developing listeriosis.

• Dairy: Pregnant women should not eat anything made with unpasteurized milk. Common dairy products to be avoided are cheese such as brie, camembert, blue cheese, and mexican-style cheeses like queso blanco, queso fresco, queso de hoja, queso de crema, and queso asadero.
  

• Caffeine: Women who consume caffeine while pregnant have higher rates of miscarriages and stillbirths. Caffeine can cross the placenta and increase the fetus' heart rate to dangerously high levels. Some reports suggest that up to 200 miligrams of caffeine can slow fetal growth. A doctor is the best person to recommend safe caffeine levels during pregnancy. Some doctors may advise women to avoid it entirely throughout pregnancy.
  

• Herbal Tea: There is little data on the effects of specific herbs on the developing fetus, thus, women are cautioned to drink herbal tea only in moderation. Red Raspberry Tea is known to cause contractions and should be avoided entirely.
  

• Alcohol: No level of alcohol is safe. Women who consume alcohol while pregnant put their babies at risk of developing fetal alcohol syndrome, which can cause facial deformities, heart problems, low birth weight, and mental retardation. Alcohol should be avoided entirely. Women who consumed alcohol before they knew they were pregnant should consult with a physician.
  

Harvard News Release: Weight Gain in Pregnancy Linked to Overweight Kids

A study by Harvard's Department of Ambulatory Care and Prevention of Harvard Medical School and Harvard Pilgrim Health Care released a report showing that pregnant women who gain too much weight or are overweight during pregnancy are four times more likely to have an obese child (click here to read Press release). The study examined 1,044 women throughout their pregnancy and recorded their children's weights at age 3. Overweight was defined as having a body mass index (BMI) greater than the 95th percentile for an average weight. Like obese adults, obese children are at a higher risk of developing high blood pressure, diabetes, and high cholesterol.

The author of the study, Emily Oden, MD, MPH, said that because finding a long-term solution for obese children remains elusive, it is important to look for avenues of preventing childhood obesity before it happens. Oden recommends that The Institute of Medicine, which released guidelines for pregnancy weight gain 17 years ago, should revise their guidelines given the nation's obesity epidemic.

The current guidelines recommend that women with a prepregnancy BMI between 19.8 and 26 kg/m2, (considered normal by the IOM guidelines) should gain 11.5 to 16kg (25 to 35 pounds); that women with a BMI of less than 19.8 kg/m2 (considered underweight by the IOM guidelines) should gain 7 to 11.5 kg (15 to 25 pounds); and that women with a BMI of more than 29 kg/m2 (considered obese by the IOM guidelines) should gain at least 6 kg (13 pounds).

Click here to read an article by BabyCenter.com about how to manage weight when pregnant.

DeseretNews.com : Should Utah revise sex ed?

An article in the Deseret Morning News reports on a CDC study revealing that after fourteen years of steady declines in teen pregnancy rates, rates increased 3% for the first time from 1995 to 1996. The previous high was 61.8 birth per 1,000 girls aged 15 - 19 in 1991. In 1995, there were 40.5 births per 1,000 girls. In 1996, that figure increased to 41.9 birth per 1,000 teenage girls. The rise is not surprising given the catastrophic increase in cases of sexually transmitted diseases like syphilis, gonorrhea, and chlamydia over the past few years.

Although the CDC study did not evaluate state-by-state numbers, statistics from the Utah Department of Health suggest that Utah is contributing to the problem. 18 of the 61 monitored regions have teen pregnancy rates higher than the national average. The regions with the highest rates are Rose Park (96.5 birth per 1,000 teenage girls), downtown Ogden (83 birth per 1,000 teenage girls), and Glendale (79.8 births per 1,000 teenage girls).

Missy Larsen, the Executive Director of the Planned Parenthood Action Council agrees that sex education focusing on abstinence-only programs are to blame and that sex education in Utah needs reform. She says, "These kinds of statistics force us to ask ourselves if we are doing the best for our young people to help them prevent unintended pregnancies and to arm themselves against these diseases that could prevent them from ever having children...Kids want to talk about it and they overwhelmingly want to talk about it with parents. If we can have a comprehensive approach with abstinence as the foundation and provide medically reliable information about contraception we would be doing the most we can to keep teens healthy."

What are your opinions on sex education? Is an abstinence-only approach responsible for the increased in teen pregnancy nation-wide? Should Utah's sex ed programs be reformed?

CNN.com: Fertility treatments linked to certain birth defects

A new article from CNN.com reports on a study performed by the CDC's National Center on Birth Defects and Developmental Disabilities. The report concludes that babies born with assisted reproductive technology (ART) are two to four times more likely to have certain birth defects. ART technology includes in-vitro fertilization, and fertilization through donor eggs. It does not include artificial insemination. The authors of the study caution however, that the overall risk for birth defects remains low.

The study compared 281 babies born through ART to 14,000 babies conceived naturally. Of the 18 categories of birth defects studied, only four were found to be statistically significant. Babies born using ART were found to be twice as likely to develop septal heart defects (a hole in the heart) and cleft lip. Babies were four times more likely to develop two certain gastrointestinal defects.

In 2005 134,000 ART procedures were performed, resulting in 52,000 births. The numbers of women turning to ART and other fertility treatments is steadily rising. The authors of the study caution that as more women turn to technology to resolve infertility problems, they become aware of the potential risks involved.

CNN.com: U.S. gets 'D' on premature birth report card

CNN.com reported on November 12th that the nation is not on track to meet its federal goal of having no more than 7.6% of babies born before the 37th week. According to data from 2005, the most recent available, 1 in 8 babies is born premature in the United States. This figure has risen steadily over the past two decades. States with low premature rates are Vermont and Oregon, with 9% of babies being born premature. Other states have higher figures. In West Virginia 14.4% of babies are born premature. In Kentucky and South Carolina that figure rises to 15% of babies of born premature. The state with the worst statistic is Mississippi, where a whopping 18.8% of babies are born prematurely.

The March of Dimes outlined three possible reasons why the national figure continues to worsen despite federal attention. First, states with high premature birth rates also have high rates of people lacking health insurance. In Mississippi for example, estimates suggest that 1 in 5 women do not have health insurance and subsequently do not seek prenatal care. The second factor affecting the rise in premature births is smoking rates. In states with higher levels of premature births, more women smoke. The third factor are births occurring between 34 - 37 weeks, also called "late preemies." Advanced medical has allowed babies born prematurely the opportunity to survive. However, even babies born a few weeks before reaching full-term are at risk for developmental, learning, and behavior delays.

Click to view the March of Dimes' interactive state-by-state map of premature birth rates.

NYTimes: Weight Loss Surgery Helps Obese Women Have Healthier Babies

An recent article in the New York Times reported that women who become pregnant after weight loss surgery have healthier babies than obese women in general. The study reviewed 75 separate studies of women who delivered babies after having bariatric surgery. These women reported less incidence of gestational diabetes, preeclampsia, low birth weight, and premature delivery. The babies were also healthier in general.

Reports estimate that 50,000 women each year have bariatric surgery to induce weight loss. One-third of American women are obese. Obese mothers have higher rates of neural tube defects, stillborn infants, and premature births. The article quotes Dr. Laura Riley, the medical director of labor and delivery at Massachusetts General Hospital. Dr. Riley feels it is important that obese women understand these risks. Dr. Riley says, “I often see women who come in who are morbidly obese, and they say they’ll try to lose 10 or 15 pounds. That’s nice, but the majority don’t lose the weight and just come back pregnant. With this kind of data, it’s easier to say, ‘You are better off having bariatric surgery and losing 100 pounds and then getting pregnant.’”

Click here to review the CDC's guidelines on obesity and see if you are at a healthy weight.

Frequently Asked Questions about Health & Pregnancy

How important is it to eat a healthy diet? Can I still eat chips, candy, and soda?

A nutritious diet is an important component of a healthy pregnancy. In 1950, a precursory study identified an important link between nutritious foods and pregnancy. Babies born to women who ate minimally during an eight week period suffered a higher rate of morality and defects than women who ate regularly. Similarly, babies born to malnourished mothers have a higher rate of neurological disorders and handicaps, and are at a greater risk to develop degenerative diseases later in life than babies born to women who eat a nutritious diet.

Ideally, nutritious food should be a part of a woman’s life before she becomes pregnant. Many key developmental processes occur very early on in pregnancy – often before a woman knows she is even pregnant.

The problem with a diet rich in chips, candy, and soda is that these foods do not supply the vitamins and minerals necessary to support both the health of the baby and the mother. An occasional soda or handful of chips is not a problem so long as these types of foods do not form the basis of an expectant mother’s diet.

What level of exercise is OK? When should I start exercising? When should I stop?

Regular physical activity has many benefits and is recommended throughout pregnancy in moderate amounts. Some benefits of regular exercise are less discomfort and fatigue, a sense of well-being, stronger abdominal and back muscles to improve posture and reduce strain, and an increased likelihood of early recovery after delivery. Moderate yoga, walking, swimming, and cycling on a stationary bicycle are usually safe exercises for expectant women.

Because appropriate exercises can change as a pregnancy progresses, pregnant woman should always check with their doctors before starting a new exercise. Pregnant women should immediately stop exercising if they experience any of the following: pain, strong cramps, uterine contractions at 20-minute intervals, vaginal bleeding, leaking of amniotic fluid, dizziness, fainting, shortness of breath, palpitations, tachycardia (rapid heartbeat), constant nausea and vomiting, trouble walking, edema (swelling around joints), or if the baby is less active than normal.

How much weight should I gain? How can I control weight gain?

Pregnant women need to eat more calories than non-pregnant women to ensure proper development of the fetus; however, the amount of weight gained will vary from woman to woman (click to view WebMDs useful website on pregnancy and weight gain). The National Health Service recommends that women who begin pregnancy at a healthy weight should gain between 22 – 26 pounds. Both insufficient weight gain and gaining too much weight pose risks to the health of the mother and the fetus. Still, pregnancy is also not the time to be dieting! Women who are prone to being overweight and those with eating disorders should check with professionals before becoming pregnant to mitigate potential risks. Try to be within 15 pounds of your ideal weight before pregnancy.

Can I drink alcohol or caffeine when I am pregnant? What levels are safe?

Alcohol should be avoided entirely. Women who drink alcohol during pregnancy put their babies at risk to develop fetal alcohol syndrome – a disorder characterized by growth retardation, facial abnormalities, and central nervous system dysfunction. Caffeine should be avoided as well, or at least limited. Be sure to check food labels. Along with coffee, tea, soft drinks, energy drinks, and chocolate, caffeine is now found is more than 200 foods, beverages, and over-the-counter medications.

Are vaccinations safe while pregnant? Are certain vaccinations recommended?

As with many other health issues during pregnancy, it is better to go over your vaccination history with a doctor prior to becoming pregnant. Some vaccinations are safe to recieve during pregnancy and others are not. Pregnant women should not recieve vaccines of live viruses, even if they are attenuated. An example of this type of vaccination is the measles, mumps, rubella (MMR) vaccination. However, rubella poses a serious threat to the health of a mother and unborn baby if contracted during pregnancy. A woman who is hoping to become pregnant should check to make sure she has recieved this vaccination. Safe vaccinations to recieve during pregnancy include the flu shot, tetanus, hepatitis A, hepatitis B, polio, and pneumococcus. Vaccinations derived from genetically engineered forms of viruses or toxoids are also considered safe for pregnant women. . Some vaccinations are safe and others are not. Click here to read a DiscoveryHealth webpage specifically about pregnancy and vaccinations.

Is it safe to have sex when I am pregnant?

As For most women, it is safe to have sex all throughout pregnancy, though not necessarily comfortable. However, sex should be avoided if a pregnant woman is at risk for pre-term labor because semen contains substances that cause the uterus to contract. Sex should also be avoided in cases of unexplaines bleeding or a history of pre-term labor, the pregnant woman has placenta previa (a condition where some of the placenta covers the cervix), water has broken, or in cases where a pregnant woman is carrying multiple babies and is in her ninth month. A doctor should be contacted immediately if a woman bleeds bright red blood after sex, especially if it is accompanied by a fever, or if a pregnant woman is leaking any fluid. This Parents.com article explains in greater detail when sex during pregnancy could be risky.

What Environmental Hazards should I be aware of?

The March of Dimes estimates that there are four million chemical mixtures in homes and businesses. Many of these chemicals have not been tested to discern whether or not they pose health risks to pregnant women and unborn babies. The majority of exposure to environmental hazards occurs in the workplace. Many routes of exposure are possible. Chemicals can be inhaled, ingested, or absorbed through the skin. For pregnant women to experience deleterious effects of the known environmental health hazards however, exposure needs to be constant and in high doses. Chemicals pregnant women should be concerned about are: lead, mercury, arsenic, cadmium, pesticides, and organic solvents like alcohols, degreasers, paint thinners, and varnish removers. Pregnant women should contact their worksites to become aware of areas of risks and ask to be removed from these areas. Click here to learn more from the March of Dimes' website about Environmental Health Risks to Pregnant Women.

What is morning sickness? Can it be avoided?

The extent to which an expectant woman experiences morning sickness differs with every woman. That said, up to 70% of pregnant women experience some type of morning sickness. Common symptoms include queasiness and an upset stomach. More rare symptoms include nosebleeds and bladder infections. Foods that a woman loved before becoming pregnant may cause sickness now. It is useful to substitute five or six small meals a day instead of three large meals to avoid exacerbating the symptoms. By the fourth month, most women overcome morning sickness. Medical professionals can prescribe medication that can ease some of the symptoms of morning sickness. Click here to read more in Mayo Clinic's health library about morning sickness.

I have heard about Folic Acid before but I don't know what it is. Is it important?

Folic Acid is a B vitamin that makes new cells. It is very important that pregnant women take the recommended amount of 400 micrograms daily. In the developing fetus, folic acid prevents birth defects affecting the neural tube (also called Neural Tube Defects, or NTDs). A well-known example of a neural tube defect is spina bifida. Folic Acid is also important for the development of the baby's spine, brain, organs, skin, and bones. The developmental processes that require folic acid occur very early on in pregnancy, often before a woman knows she is pregnant. Thus it is important even for women who do not think they are pregnant now but would like to be pregnant in the future to regularly take folic acid supplements. Click here to read the CDC's webpage about folic acid and to learn what cereals contain added folic acid.

When should I see a doctor once I know I am pregnant? What happens at a prenatal visit?

Once a woman finds out that she is pregnant, she should call a doctor, midwife, or other health professional right away. Although prenatal visits may seem like a waste of time if the pregnant woman is feeling fine, these visits are important for the long-term health of the mother and baby. The goal of these visits is to monitor the progress of the developing fetus and identify problems before they become serious health risks. Women who take advantage of prenatal care options tend to have healthier babies and are less likely to deliver prematurely. At prenatal visits, women are taught about pregnancy, their doctors or health professionals monitor chronic health conditions, tests are performed to monitor the health of the mother and baby, and expectant mothers are introduced to support groups or government programs, like WIC which can help ensure their baby is healthy. The is the typical schedule for prenatal visits:

• 4 - 28 weeks: 1 visit per month (every 4 weeks)
• 28 - 36 weeks: 2 visits per month
• 36 weeks - birth: 1 visit a week

Click here to watch Dr. Siobhan Dolan describe the importance of prenatal care