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Is It Safe To Take Lexapro During Pregnancy?

Dr. HelloDox Care #
HelloDox Care

What Is Lexapro (Escitalopram)?

Lexapro (escitalopram) belongs to a group of drugs known as selective serotonin reuptake inhibitors (SSRIs) that alter the serotonin levels in the brain. Serotonin influences the mood and eases depression. The drug is, therefore, used to treat panic disorder, anxiety disorder, and obsessive-compulsive disorder. Lexapro is a brand name of the generic drug escitalopram.

Can You Take Lexapro While Pregnant?

No, it is not safe to take Lexapro during pregnancy as it can affect the mother and the baby. The US Food and Drug Administration (USFDA) ranks Lexapro under category C, which means animal studies have shown adverse effects on the unborn baby, and there are no well-controlled studies in humans.

Lexapro is prescribed for pregnant women only when its potential benefits outweigh the possible risks to the mother or the unborn. The doctor will also consider your gestational age before recommending this drug.
In short, this drug can be taken when there is no other option.

What If You Have Already Taken Lexapro (Escitalopram) During Pregnancy?

If you have been on Lexapro before your pregnancy or have taken it during pregnancy but without any prescription, let your doctor know about it. She can decide whether you can continue or require any other alternative.

Do not stop taking the medication abruptly as it could be dangerous for both you and the unborn. Always take your doctor’s advice before withdrawing from the medicine.

Problems Associated With Weaning Off Lexapro While Pregnant:

Abrupt termination of the medication could result in withdrawal symptoms such as :

Mood changes
Numbness or tingling sensation in the hands and feet
Difficulty falling asleep

What Are The Side Effects Of Taking Lexapro During Pregnancy?

Recent studies conclude that Lexapro could result in several birth defects in the newborn baby. Some of them are discussed next.

1. Neonatal persistent pulmonary hypertension (PPHN):
According to a public health advisory issued by the USFDA in 2006, antidepressants such as Lexapro and other SSRIs can cause PPHN in babies.

With this condition, the baby will not be able to breathe once outside the mother’s womb and will have to be put on a ventilator, under intensive care. A severe case of PPHN can lead to death as well .

2. Premature birth:
Studies showed that intake of drugs post the first trimester can lead to pregnancy-induced hypertension, an increased risk of miscarriage and even premature birth. It was also found that babies born before 37 weeks of pregnancy are likely to experience health concerns .

3. Autism spectrum disorder:
Use of SSRIs such as Lexapro increases the risk of Autism spectrum disorder, which can impair the child’s ability to interact with people, communicate and develop language skills as they grow .

4. Newborn behavioral syndrome:
The intake of Lexapro and other SSRIs during pregnancy could cause the newborn behavioral syndrome in infants. The symptoms are feeding difficulties, constant crying, jitteriness, breathing problem and seizures .

5. Cleft lip:
According to the Cleft Lip and Palate Foundation, one of the common birth defects that result from SSRIs is facial malformations such as cleft lip and palate.

While cleft lip leaves a gap in the upper lip, the cleft palate creates a gap in the palate when parts of the baby’s face do not join properly during development .

6. Omphalocele:
Although early studies do not suggest that SSRI intake during pregnancy increases the risk of Omphalocele, recent studies indicate otherwise.

Omphalocele is an abnormality in the abdominal wall where the bowel and intestines are outside the baby’s belly. It, therefore, leads to damage of abdominal cavity, organ, and infections .

As you have seen, most of the complications have serious and long-term effects on the baby. And the baby has to suffer for no fault of theirs.

Who Is Liable If Lexapro Leads To Birth Defects?
Studies in the past have linked the use of SSRIs to birth defects in newborns. It, therefore, becomes the moral and legal responsibility of the doctor to inform the pregnant woman about the negative effects of taking Lexapro or any other SSRIs.

In fact, doctors also ask the patients to sign a statement of agreement stating that they understand all the potential risks of using SSRIs during pregnancy.

Also, the pharmaceutical companies, such as Forest Laboratories in the case of Lexapro, hold the obligation of informing the customers about the risks associated with the drugs.

If the doctor fails to inform the patient about the drug’s side effects, and a child is born with birth defects, you have a right to file a legal case against the manufacturer as well as the practitioner who prescribed it.

A healthy diet with the right supplements and an active lifestyle can help ward off depression as well. But if you still think you need to take antidepressants like Lexapro, do so only if your doctor prescribes it. The bottom line is to follow the specific suggestions and take only the prescribed medications as advised by your doctor.


What Type Of Diet Is Beneficial During Pregnancy?

Dr. HelloDox Care #
HelloDox Care

Pregnancy is a life-changing experience, and you've got to be armed with the right nutrition to take it on!

For many moms-to-be, pregnancy is the time to rest, relaxation, and pampering and while for some, it may be stressful, especially if the pregnancy involves medical complications. Either way, it is a turning point in your life, physically, mentally, and emotionally. And food is an important part of this journey which requires a lot many changes in the diet, which has to be rightly balanced so that you are eating right for your belly and your baby.

A nutritious, balanced diet through pregnancy is important not only to maintain maternal nutritional needs, but also for the development of a healthy fetus. Remember, nutrition at this time needs to cater to the continuous adjustments in maternal body composition and metabolism.

The number of calories you will need to consume in addition to your regular diet is just 150 Kcal in the first trimester and 350 Kcal in the second and third. These surely need to be healthy calories, not empty calories. A clinical dietician will help you navigate the distribution of calories, but do keep them in check, as your maternal obesity puts you at risk for other serious medical conditions such as gestational diabetes. It may also put your baby at risk for future obesity and
other diseases.

Similarly, if you have morning sickness, you may not feel the urge to eat, and you may be underweight. In this case make each calorie count check, with nutritionally rich foods. Ensure that total weight gained throughout your pregnancy is between 12 and 14 kg. Cut down on refined sugar, and while ghee and butter are okay if you are not already overweight, avoid binging on them.

When it comes to pregnancy diet, there are certain foods that need to be definitely avoided. Foods that are too high in mercury or Vitamin A can pose a health risk to your baby, as can foods that are known to cause food borne illness such as Listeriosis and Salmonella poisoning. List of foods that are right for you and your baby.

For Boosting Your Baby Brain And Your Own Health:

Eat: fish, vegetable oils, nuts (especially walnuts), flax seeds, flax seed oil, dark leafy vegetables

Why: These are rich sources of Omega-3 fatty acids, an important component in boosting the development of the brain formation in the fetus, especially in the second half of pregnancy. According to the Harvard School of Public Health, US, Omega-3 is an integral part of the cell membranes and forms the building blocks of the fetal brain. While fish does contain mercury, US guidelines stipulate that two servings of fish in a week is safe. If you are not able to eat fish, ask your doctor if you should have a fish oil supplement. The two most beneficial forms of Omega-3s come from aquatic sources. But if you are vegetarian, you could try the other sources as well. This essential fatty acid is also known to reduce cholesterol, hence blood pressure.

For The Building And Strengthening Of Bones, For The Baby And You:

Eat: milk and dairy products, ragi (finger millet), broccoli, spinach

Why: To fulfill its own bone development requirement, the fetus will derive its calcium from the mother, whether or not the mother is getting adequate calcium herself. The National Institute of Nutrition has set the calcium needs for pregnant women and nursing mothers as double compared to non-pregnant women. You will need 1,200 mg per day. Two glasses of milk will give you approximately half the requirement. You can derive the rest from the other sources. Also make sure you get some sun, preferably in the morning, when it is not too warm, to help create vitamin D, necessary for good bone health.

Up Your Immunity:

Eat: colourful fruits and vegetables; probiotic foods such as yogurt

Why: Pregnancy is a time when you want to be safe and not catch any infections, especially those that can harm the fetus. Fruits and vegetables are antioxidant-rich. They have phytochemicals that naturally occur in plants, protecting them against infections. They'll help you do the same. Each colour gives a different benefit, so eat the rainbow through the week. Probiotic foods help maintain gut health. Set your own yogurt, as this contains many more 'good, healthful' bacteria than store-bought varieties.

For The Prevention Of Birth Defects In Baby:

Eat: legumes, green leafy vegetables, citrus fruits, nuts, beans

Why: Legumes include lentils, peas, beans, chickpeas, soybeans, and peanuts. The group is a rich source of folic acid, which helps in prevention of neural tube defects (birth defects of the brain, spine or spinal cord). Folate is one of the B-vitamins (B9), especially important in the first trimester. Your doctor will provide you with supplements, but you can also make sure you get the vitamin in your diet. Folic acid works closely with vitamin B12, to make red blood cells and make iron work properly in the body. If possible, eat organic, so you're not taking in too many chemicals.

For Overall Growth And Development:

Eat: small amounts of red meat, chicken, spinach

Why: Iron is an essential nutrient, and is needed for fetal and placenta growth, as well as for the development of the mother's own tissue. About 50-70% of Indians are anemic, and this is a cause of serious concern. Your doctor will prescribe additional iron in the form of a supplement; however, you can also get it in the diet.

Foods to be avoided when you're pregnant:

Avoid unpasteurized milk.

Avoid Alcohol.

Avoid raw or undercooked meat, fish and eggs.

Avoid unwashed vegetables and fruits.

Avoid raw sprouts (Eating raw sprouts increases your risk of salmonella poisoning, which causes fever, vomiting and diarrhea. Be sure to cook sprouts thoroughly.)
oid excess of caffeine.


Moms-to-be beware! Taking stress during pregnancy may affect baby's brain

Dr. HelloDox Care #
HelloDox Care

Mothers-to-be please don't take stress during pregnancy as it may harm your baby's brain. A new study has found that stress during pregnancy is not good for the unborn child and remaining stress-free during this period helps the brain development of the baby.

According to the study presented at a meeting of the Cognitive Neuroscience Society in Boston, Massachusetts, a mother's stress during pregnancy changes neural connectivity in the brain of her unborn child.

One of the researchers Moriah Thomason of Wayne State University in the US said,"We have demonstrated what has long been theorised, but not yet observed in a human, which is that the stress of a mother during her pregnancy is reflected in connectional properties of her child's developing brain."

Research in newborns and older children to understand prenatal influences has been confounded by the postnatal environment, Thomason explained.

But recent advancements in foetal imaging allowed the researchers to gain insight into a critical time period in brain development never previously accessible.

Using foetal resting-state functional magnetic resonance imaging (fMRI), they examined functional connectivity in 47 human foetuses scanned between the 30th and 37th week of gestation.

The researchers recruited the participating mothers from a low-resource and high-stress urban setting, with many reporting high levels of depression, anxiety, worry and stress.

They found that mothers reporting high stress had foetuses with a reduced efficiency in how their neural functional systems are organised.

The data suggest that the brain does not develop in a sequence from the simplest systems to more complex high-order systems, but perhaps instead first develops the areas that will be most critical in bridging across systems.

The researchers found that the cerebellum played a central role in the observed effects, suggesting it may be especially vulnerable to the effects of prenatal or early life stress.


Passive smoking dangerous for pregnant women

Dr. HelloDox Care #
HelloDox Care

In developing countries around the world especially in Asia, secondhand smoke causes thousands of stillbirths every year. Exposure to secondhand smoke during pregnancy increases the risk of stillbirth, congenital malformations, low birth-weight and respiratory illnesses.

In a recent study, researchers found that 40% of all pregnant women in Pakistan are exposed to secondhand smoke - causing approximately 17,000 stillbirths in a year.

The team from the University of York looked at the number of pregnancies alongside smoking exposure data in 30 developing countries from 2008 to 2013. The analysis revealed that in Armenia, Indonesia, Jordan, Bangladesh and Nepal more than 50% of pregnant women reported exposure to household secondhand smoke.

In Indonesia alone, 10,000 stillbirths take place every year. In Pakistan, only 1% of stillbirths are attributed to women actively smoking during pregnancy, but for secondhand smoke, the figure is 7%, largely due to the high numbers of pregnant women exposed to tobacco smoke in the home.

In five of the 30 countries, household secondhand smoke exposure was twice as common as active smoking."This is the first study which provides national estimates for 30 developing countries on secondhand smoke exposure in pregnancy and it reveals a huge problem, a problem which is not being addressed," said a lead researcher Kamran Siddiqi.

"We have shown for the first time that secondhand smoke during pregnancy is far more common than active smoking in developing countries, accounting for more stillbirths than active smoking.

Protecting pregnant women from secondhand smoke exposure should be a key strategy to improve maternal and child health," he added.

They also say further work is needed to develop effective interventions to reduce household exposure to secondhand smoke. The study appeared in the BMJ Tobacco Control Journal.


9th Month Pregnancy Diet - Which Foods To Eat And Avoid?

Dr. HelloDox Care #
HelloDox Care

It is time for you to relax and enjoy the few days that you have before you deliver your baby!

When you are in your 9thmonth of pregnancy, you will find that there are quite a few challenges that need to be faced. Since it is the last month, you will no doubt feel heavy any more often than not, quite uncomfortable. There is also the excitement and anticipation of the coming bundle of joy! Could there be a more exciting time than this stage of your pregnancy?

What Should Be Included In Your 9th Month Of Pregnancy Diet:

At this stage, your baby’s development is almost complete. Her weight will increase rapidly and her brain and lungs will continue to mature. While you can still indulge in some guilty pleasures at this stage, it is important for you to remember to be cautious about what you eat. Your digestive system can be affected due to the rapid weight gain, which is why you should continue with the balanced and nutritious diet you followed in the early months but in larger servings. Here is a list of foods that should be in included in your 9th month of pregnancy diet:

Grains And Whole-Grain Breads: 6 to 11 servings per day
Fruits: 2 to 4 servings per day
Vegetables: more than 4 servings per day
Dairy Products: 4 servings per day
Foods Rich In Protein: 3 servings per day
Hydration: Minimum 2 litres of pure water every day

Foods To Eat During This Stage Of Your Pregnancy:

When you eat healthy and nutritious foods, you guarantee yourself a problem-free pregnancy. Discomforts like constipation and heartburn are prevented when you eat a balanced diet. This in turn helps in your baby’s proper development and growth, resulting in a healthy baby who has no complications. Include the following in your diet:

Fiber-Rich Foods: Such as land and sea vegetables, fruits, whole grain breads, cereals, dates, etc.
Iron-Rich Foods: Such as fish, chicken, egg yolk, broccoli, lentils, peas, spinach, berries, soybeans and dried fruits like prunes, raisins, etc. Do consume a minimum of 3 servings of iron-rich foods on a daily basis.
Calcium-Rich Foods: Calcium retention peaks during this stage of your pregnancy which is why it is important for you to eat plenty of calcium-rich foods. Such foods include collard greens, dairy products, oatmeal, almonds and sesame seeds.
Vit C-Rich Foods: Foods rich in vitamin C are also important during your 9th month of pregnancy. Eat plenty of citrus fruits, tomatoes, strawberries, broccoli and cauliflower.
Folic Acid-Rich Foods: To avoid birth defects such as spina bifida, consume foods that are rich in folic acid content. Green leafy vegetables and legumes like lima beans, chickpeas and black-eyed peas should be a part of your daily diet.
Vit A-Rich Foods: Spinach, carrots, sweet potato, cantaloupe and other rich sources of vitamin A should also be included in your diet during this stage of your pregnancy.

Foods To Avoid During The 9th Month Of Your Pregnancy:
The foods that you have avoided throughout your pregnancy are the same as what you should omit from your diet during ninth month of pregnancy. Here are the foods that you should definitely stay away from during this time:

Caffeine: Should be avoided. However, if you do drink it in any form, do not exceed 200 mg daily. Chocolate also contains caffeine, so limit your intake of it as well.
Alcohol: It is widely known to be dangerous during pregnancy. To prevent mental retardation, premature delivery as well as a wide range of birth defects, it is important that you abstain from it completely throughout your pregnancy.
Saccharine: It is a sweetener that should be completely removed from your diet during your pregnancy. Indulge in your sweet tooth by opting for organic fruits and homemade candies.
Soft Cheeses: These are still a non-no. This type of cheese is normally not pasteurized and could lead to an infection, so stay away from it.
Raw Sea Food: It is also important to remember to avoid sushi (most of which is prepared with raw fish as the main ingredient). Also other seafood that is served raw, such as oysters.
Tobacco: It is dangerous during pregnancy. If you are a smoker or if you chew tobacco, it is important that you give it up not only in the 9th month pregnancy diet but throughout your pregnancy. Your child’s development and growth can be adversely affected if you take tobacco.

Supplements That Can Be Taken During Pregnancy:
Your nutritional requirements will be met when you eat a healthy and balanced diet. If you are not getting enough nutrients, your doctor will prescribe the following supplements to meet your needs:

Calcium Supplement: If you are not getting enough calcium from your daily diet, this supplement will be prescribed to you. It is also given to those who suffer from lactose intolerance.

Multi-Vitamin And Multi-Mineral Supplement: This supplement will help in providing you with all the vitamins and minerals that your body needs during this stage of your pregnancy.

Folic Acid Supplement: Folic acid is important to produce healthy red blood cells and also to prevent birth defects. If you are not getting enough of it from the foods you eat, your doctor will prescribe this supplement for you.

Iron Supplement: Experts recommend an iron supplement that contains 27 mg of iron for all pregnant women when they are at the second and third trimesters of their pregnancy.

As you know, the various nutrients that you consume at this time will have a direct effect on your baby’s development and growth. Since you are eating for two, you have a responsibility to eat only the healthiest of foods. This way, you ensure that your baby gets all the required nutrients to be healthy and you also stay strong for labour when the delivery day comes.

So, eat right, preferably organic so that you keep pesticide/fertilizer intake to the barest minimum, and make sure that you get all the proper nutrients that you need for a healthy pregnancy and a strong baby!

Dr. Akshay Choudhari
Dr. Akshay Choudhari
MS/MD - Ayurveda, Ayurveda Infertility Specialist, 2 yrs, Pune
Dr. Pradnya Shirke
Dr. Pradnya Shirke
MS/MD - Ayurveda, Gynaecologist Infertility Specialist, 17 yrs, Pune
Dr. Meghana Karande
Dr. Meghana Karande
MS/MD - Ayurveda, Ayurveda Panchakarma, 1 yrs, Pune
Dr. Palavi Gholap
Dr. Palavi Gholap
BAMS, Ayurveda Family Physician, 9 yrs, Pune
Dr. Dr.Monica Rathod
Dr. Dr.Monica Rathod
BDS, Cosmetic and Aesthetic Dentist Dental Surgeon, Thane