Health Tips
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Being pregnant is amazing. During the 40 weeks of the pregnancy calendar your body experiences incredible change. Read on to find out what to expect during the three stages of pregnancy (trimesters), plus, learn some good tips to keep you and your baby healthy.

Pregnancy Tips

1. First Trimester (weeks 1-12)
There’s a lot going on inside your body right now. Every bit of you is beginning to discover what it means to be pregnant. This can include:

- Extreme tiredness
- Morning sickness
- Tender or swollen breasts
- Food cravings
- Mood swings
- Weight gain

2. Second Trimester (weeks 13-28)
You may find this trimester easier than the first. As morning sickness and tiredness fade, your bump will begin to show more. Before long, you’ll feel your baby move. You’ll also experience:

- Aches in your back, tummy and groin
- Stretch marks
- Numb or tingling hands
- Slight swelling of the ankles, fingers and face

3. Third Trimester (weeks 29-40)
You’ll now have a football ball sized bump. You’ll feel discomfort as your baby presses against your organs. As well as the need to go to the toilet more often, you also notice:

- Shortness of breath
- More pronounced swelling of the ankles, fingers and face (If this becomes extreme, contact your health care professional immediately)
- Tender breasts, which may leak a watery pre-milk fluid (colostrum)
- Trouble sleeping

##Top tips to prevent illness during pregnancy
Don’t ignore your body’s changes – a little person is growing inside you. Use these pregnancy tips to make some changes too:

- Go to bed earlier and get more sleep (while you can!).

- Eat a healthy nutritious diet.

- Avoid unpasteurised dairy products, mouldy cheeses, cold meats and soft boiled eggs which can carry bacteria. Consult your doctor for a full list of foods to avoid.

- Take folic acid supplements until your 12th week of pregnancy to help prevent your baby being born with harmful conditions such as spina bifida.

- Avoid cat faeces as it can contain an organism that causes toxoplasmosis (an infection that, in severe cases, can cause serious eye and brain damage to the baby).

- Clean and disinfect commonly touched surfaces around the home Dettol Hygiene Liquid or

- Dettol Antiseptic Liquid which kill 99.9% of germs

- Wash your hands often with soap and water.

- In case water is not readily available, use Dettol Wipes to disinfect your hands

Wherever you are on the pregnancy calender, enjoy it – the time will fly.

Hypertension during pregnancy can be a problem for both baby and the mother. Thus it is of utmost importance that during pregnancy a good health should be maintained along with controlled blood pressure and cholesterol levels. With an increase in multiple births and women of older age the risk of hypertension during pregnancy has increased. But if proper care is taken it can be avoided.

Types of Pregnancy Hypertension:

There are three prominent forms of hypertension that can be seen during pregnancy. The pregnant ladies should be aware of the same. These are:

- Preeclampsia - This is the most common and serious hypertension during pregnancy. This hypertension can only be controlled by delivering the fetus which usually involves complications like death of the mother or child. This occurs 20 weeks after pregnancy.

- Gestational Hypertension - This form is only prevalent during pregnancy and is not a problem for the mother or baby after delivery. This usually occurs in the last leg of the pregnancy

- Chronic Hypertension - This form forms either prior to the pregnancy or before 20 weeks of the pregnancy.

Management of Pregnancy Hypertension:

Hypertension during pregnancy can be handled by the following:

- In case of severe hypertension, blood pressure medication should be continued during pregnancy

- If you are on ACE inhibitor-type medication, then the medication is changed to one that is even safe for the baby

- Your doctor might like to monitor you daily and can advise hospitalization for a few days

- If medication is missed, it might lead to uncontrolled life-threatening hypertension. Thus the medication should not be missed at any time

- In case of mild hypertension and absence of other diseases like diabetes and kidney disorders, the doctor might stop the medication or reduce the dose. Also, being off medicine does not cause any problem in mild hypertension.

- Irrespective of the hypertension being mild or severe, the prenatal appointments should not be missed, so that the doctor can monitor you and the baby. If any problems, like rise in blood pressure, poor fetal growth, and signs of preeclampsia can be spotted and steps can be taken for the same.

- In case there is some form of hypertension present the prenatal visits and lab tests will be more

- Apart from the usual second trimester ultrasound, there will be periodic ultrasounds in the third trimester to monitor the baby's growth and the amniotic fluid.

- Also regular fetal tests and Doppler ultrasounds will be done to track the baby's growth.

- Lifestyle changes should be made. Salt intake should be limited, fresh food instead of processed food should be consumed.

- If blood pressure is high then doctor might ask you to avoid exercise especially if you never did before pregnancy.

Gestational diabetes is a kind of diabetes that happens during pregnancy. Diabetes is referred to a condition where your blood glucose or blood sugar is very high. Although, glucose is good as it used by your body for energy, but excessive glucose in your blood can be harmful for both you and your child. Gestational diabetes is mostly diagnosed in the later stages of pregnancy. If gestational diabetes is diagnosed in the early stages of pregnancy, then it is quite possible that you may have had diabetes before you became pregnant. Treating gestational diabetes can help both you and your baby stay fit and healthy. You can protect both, yourself and your baby by controlling your blood glucose levels.

Problems with gestational diabetes in first 3 months prem can lead to abortion or congenital authorities in baby. Mid trimester abortions, urinary and vagina infection can occur. Preeclampsia , chorioamnionitis also possible. In 3rd trimester preterm Labour, intrauterine death, large baby or small for dates can happen. Neonatal hypoxia, respiratory distress are common. So it has to be controlled strictly throughout pregnancy with diet, exercise and medicines.

Here are 7 things that you need to know about Gestational diabetes:

Every three to eight out of 100 ladies tend to develop diabetes during pregnancy, a condition known as gestational diabetes. Fortunately, it can be dealt with and even kept away by maintaining healthy lifestyle choices. Eating leafy foods and avoiding sugar-rich things, is a vital step for both control and counteractive action. Exercise, after consulting your doctor can guarantee that you have a healthy pregnancy.

In diabetes, when your body's glucose or sugar levels get so high that the carbohydrates and sugars cannot be converted into energy, the excess starts accumulating in your body. This additional glucose can harm the vessels in your kidneys and all through your body, particularly in organs like eyes.

Two or three factors might cause danger for creating gestational diabetes, both inside and outside of your control. If you are overweight before you get pregnant or while you are pregnant or your family history shows that you are hereditarily inclined to the sickness, you will probably build up the condition.
nsulin goes. Your specialist may prescribe that you require diabetic pills or insulin to help you control your glucose levels.

Your weight can bring about complexities during the delivery in case of gestational diabetes. So it is best to keep your weight in check in order to have a smooth sailing pregnancy and delivery.

Gestational diabetes can likewise put ladies at risk of contracting preeclampsia, which can bring about a number of side effects and complexities. Side effects brought on may start from swollen feet, legs, fingers, and hands to hypertension and even seizures or strokes.

Apart from the risks of having gestational diabetes during your pregnancy, it might affect the child later on. Your baby may have a higher danger of obesity as it develops, both in the teenage years and youth. Youngsters who are overweight may suffer from type 2 diabetes in the long run.

The ability to create life and give birth is one of the greatest miracles of nature. Pregnancy can be tough, don’t let anyone tell you otherwise. It is uncomfortable and comes with a long list of dos and don’ts. However, it is also one of the most amazing experiences a woman can go through.

A common piece of advice expecting moms get in India is that they should ‘eat for two’. This along with plenty of advice about topping their food with ghee (so that the baby ‘slips out!!’), eating gond ke laddoo and many such traditions confuse the new-age woman. Given that there is a lot of wisdom hidden in age-old traditions and old-wives tales. However, with so much information available on your fingertips, it is a good idea to read more and gather expert advice.

I have always been very conscious of my dietary habits. After years of eating healthy, I was worried about letting go and making ill-informed dietary choices when I got pregnant. However, it was also very important to me that I got all essential nutrition for my own as well as my baby’s health. A baby’s only source of nutrition in the womb is from the mother, thus it is imperative to eat healthy and ensure that a recommended diet plan is followed.
The importance of eating healthy during pregnancy

Ideal Diet Plan for Pregnancy

How much should you eat?

‘Eat for two’ – this is probably one of the most damaging inputs you can get. No, you do not need to eat for two, for the better part of your pregnancy. The other ‘person’ you’re eating for, is a tiny foetus, the size of a peanut in the first trimester.

• An average woman leading a sedentary life requires around 1900 calories per day.
• In the first trimester of pregnancy, you do not require any additional calories. Instead, you should make a conscious effort to shift your dietary habits such that your entire calorific intake ensures you get all essential nutrients required in this critical phase.
• In the second term, you need 300-350 additional calories per day.
• The third term requires your intake to be 500 calories over your normal diet.

What should you eat?

It is critical that these additional calories do not come in the form of junk food or unhealthy and non-nutritious foods. Many people think of pregnancy as a free pass to indulge themselves and load up on all sinful and calorie-laden foods. That large bar of chocolate or burger is not really helping you send nutrition to your baby. It is only helping you gain weight and inches, not the foetus. Make healthy food choices, eat fruits, vegetables, dairy products, etc.

Dark chocolate

Important nutritional requirements

There are four things that are very important and must be included in your diet:

• Folic Acid – Folate or folic acid is essential for preventing brain defects in the baby and it also helps support the placenta. Recommended allowances are Folate 500µg/day. Best sources include Amaranth leaves, ambat chukka, mint and spinach dals like Bengal gram, black gram, green gram and red gram.

• Calcium – The baby’s bones and teeth formation requires calcium. If your diet lacks calcium, the body will automatically take this mineral from your own bones for the baby. Thus, one must ensure that a calcium-rich diet is followed. Calcium is essential for maintaining the health of mother’s bones and to ensure proper bone and teeth development of the baby. Recommended dietary intake for calcium is 1200mg/day. Milk and milk products are the best source of bio available calcium. Some other foods rich in calcium are ragi, Bengal gram, whole dals like horse gram, rajma, and soya bean. Green leafy vegetables, nuts, oil seeds and fish are some other sources of calcium.

• Iron – Studies have stated that as high as 59% of Indian women are anaemic. During pregnancy, it is important to keep an eye on your HB count and ensure that you get enough iron through your diet. Both mother and child need iron to meet the needs of red blood cell formation. The recommended allowance for iron intake is 35mg /day. Green leafy vegetables are the best sources of Iron. Something as simple as a mint and coriander chutney can help meet your needs. The richest sources are amaranth, Bengal gram leaves, radish leaves and cauliflower greens. Vitamin C helps iron absorption in the body.

Spinach, a good source of iron

• Protein - A ‘builder nutrient’, it is essential for the baby’s organ development. Proteins are essential for maintaining the integrity of the mother’s body and for the baby’s growth and development. An additional 6.9 gm in the second and 22.7 gm in the third trimester is advised. Good quality protein sources include eggs, fish and low fat meats, however vegetarians can achieve their protein targets by a combination of cereals and millets with dals, paneer, cheese, besan, nuts and milk.

Expert Speak: Dr.Rupali Datta, Chief Clinical Nutritionist at Fortis-Escorts

An ideal weight gain for a mother-to-be is about 10-12 kg. A healthy birth weight for a baby is 3kgs. To achieve this, you do not need to eat for two but additional requirements of the body have to be met.

Starting with total calories, the first trimester does not require any additional intake so the RDA of 1900Kcal is adequate (for a sedentary woman). From the second trimester, an additional 350Kcal are recommended. To achieve this goal, intake of nutrient dense foods like whole grains, millets should be promoted. Oils are a concentrated source of energy, additional oil calories can be included from natural sources like nuts and seeds. Traditional gond ladoo, besan and dal pinnis could also help. But they must be taken in moderation so that they provide the additional calories and proteins yet prevent excessive and unnecessary weight gain.

Ladoo

If all this sounds like a mammoth task, relax. The way you can achieve these goals is by eating a variety of foods, using seasonal variations to guide you along. Eating a balanced meal is the best way to receive nutrients. Supplements, as the word means, are a supplement to your food. These should be taken only under medical care.

One of the first changes a woman makes when she learns about her pregnancy is almost always diet related. Expecting mothers are surrounded by many relatives and friends who all offer so many different perspectives on what a pregnant woman should and should not eat that it can be very confusing for the mother-to-be. While our loved ones mean well, mothers-to-be should not follow any advice blindly when it comes to their diet.There are several myths and misconceptions about the kind of food expecting moms should consume and avoid. Here are five common pregnancy diet related myths that are usually spread through word of mouth and often have no scientific rationale:

Myth #1: A Pregnant Mother Should be Eating for Two

It is very common for family members, friends and colleagues to tell a new mother-to-be that she now needs to eat for two because of which pregnant women tend to vastly increase their appetites. This misconception is one of the leading causes of excess weight gain during pregnancy, combined with an inactive or sedentary lifestyle.

As per the recommended requirements, pregnant women only need 300 extra calories a day, which is equivalent to a banana milkshake, a dry fruit milkshake or a two-slice multigrain vegetable paneer sandwich a day. This is definitely not the same as eating for two. The quality of food choices is more important than the quantity of food consumed during pregnancy.

Myth #2: Pregnant Women Should Avoid Fish

Most mothers-to-be avoid consumption of fish due to concerns about toxin build-up, excess heat, skin reactions, etc. However, fish is an excellent source of protein, omega-3 and other important nutrients, which are vital for brain and eye development of the foetus. Pregnant women should avoid fish with a high mercury content such as shark, tuna and mackerel. However, sardines [mathi], anchovies [nethili/natholi], salmon and river fish like rohu and catla can be consumed in moderate amounts to meet dietary needs. If you are a fish lover, consult your nutritionist to see how the right amount of fish can be incorporated into your diet.

Myth #3: Saffron Will Make the Baby's Complexion Fairer

This is one of the most common beliefs and quite an expensive one at that! There are a lot of families that believe that if a pregnant woman has saffron with milk, her baby will have a fair complexion. The truth is that no food can influence the baby's complexion, as the skin colour is entirely determined by the genes of the parents.

Myth #4: Papaya and Pineapple Can Cause Abortions or Miscarriages

These two fruits are completely forbidden in a pregnant woman's diet due to the belief that they can cause abortions and miscarriages. The assumed scientific basis of this myth is that both these fruits in their raw form contain certain enzymes, which if consumed in large quantities, can cause uterine contractions.

However, consumption of well-ripened papaya or pineapple does not cause any adverse reaction, if taken in moderate amounts in a well-balanced diet. However, many gynaecologists refrain from freely recommending it for two reasons - first, moderation is a widely misunderstood term and second, most fruits nowadays are artificially ripened, which can alter the amount of enzymes in the fruits and what is left behind is often unclear.

When pregnant, always check with your nutritionist before consuming papaya or pineapples.

Myth #5: Pregnant Women Can Catch a Flu with Cold and Sour Food Items

Mothers-to-be are often told to avoid citrus fruits, juices, limes, lemons, curd, buttermilk, etc. due to an age-old belief that these foods will cause them to develop cold and cough that will affect the baby too.

But the fact is these foods are loaded with nutritional benefits for the mother and the growing baby. For instance, the entire range of citrus fruits provides Vitamin-C, a very important vitamin for iron-absorption in the mother and skin development of the growing baby.

Curd and buttermilk provide probiotics, which keep the mother's gut healthy and also helps in digestion along with providing gut immunity. Both Vitamin-C and probiotics are two core immunity-boosting nutrients which are required in a pregnant mother's diet, so inclusion of these foods is important.

Dr. Kalpana Dongre Ladde
Dr. Kalpana Dongre Ladde
BAMS, Ayurveda Family Physician, 11 yrs, Pune
Dr. Aniket Amrutkar
Dr. Aniket Amrutkar
BAMS, Family Physician Physician, 8 yrs, Pune
Dr. Mahesh Gupta
Dr. Mahesh Gupta
MS/MD - Ayurveda, Ayurveda Family Physician, 4 yrs, Pune
Dr. Ashish Babel
Dr. Ashish Babel
BHMS, Family Physician, 8 yrs, Pune
Dr. sandeep shivekar
Dr. sandeep shivekar
BHMS, 10 yrs, Pune
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