Articles on symptoms and discomforts of pregnancy

Pregnancy Diet

Ms. Swati Kapoor, Dietitian/Nutritionist
Pregnancy is the most beautiful phase in a woman's life. It brings both emotional and physiological changes as well as it also poses extra demands on the body. In this phase the body needs extra nutrition for the developing fetus, for pregnant woman herself and also the lactation period to follow. Pregnancy Diet must be full of nutrition and healthy also.Importance of Nutrition in The Diet in PregnancyThese nutritional demands have to be met for a healthy child and mother because as the week progresses the organs and other system of the fetus start developing in mother’s womb and thus the energy used to create these systems (which actually comes from the energy and nutrients in the mother's circulation, and around the lining of the womb) also starts to increase. The table below highlights the nutrients, its importance and food sources which should be included in a women's pregnancy diet -NUTRIENTSIMPORTANCEFOOD SOURCES Protein cell growth and blood productionlean meat, fish, poultry, egg whites, beans, tofuCarbohydrates daily energy productionbreads, cereals, rice, fruits, vegetablesCalcium strong bones and teeth, muscle contraction, nerve function milk, cheese, yogurt, spinachIronred blood cell production (to prevent anemia)All green leafy vegetables e.g. spinach, methi and whole-grain cerealsVitamin A healthy skin, good eyesight, growing bonescarrots, dark leafy greens, sweet potatoesVitamin C healthy gums, teeth, and bones; assistance with iron absorption citrus fruit, broccoli, tomatoes, amla, guavasVitamin B6 red blood cell formation; effective use of protein, fat, and carbohydratespork, ham, whole-grain cereals, bananasVitamin B12 formation of red blood cells, maintaining nervous system healthmeat, fish, poultry, milk(Note: vegetarians who don't eat dairy products need supplemental B12)Vitamin D healthy bones and teeth; aids absorption of calcium fortified milk, dairy products, cereals, and breadsFolic acid blood and protein production, effective enzyme function green leafy vegetables, dark yellow fruits and vegetables, beans, peas, nutsFatbody energy stores meat, whole-milk dairy products, nuts, peanut butter, margarine, vegetable oils(Note: limit fat intake to 30% or less of your total daily calorie intakeRecommended Nutrients in The Diet in PregnancyNutrientRecommendation (Extra = Above RDA)EnergyIncrease by 300 kcal (840 kJ) per day. Certain guidelines according to trimester.1st trimester (1 to 12 weeks) - 10 kcals/day 2nd trimester (13 to 27 weeks) - 90 kcals/day 3rd trimester (27 to 40 weeks) - 200 kcals /day.ProteinsExtra 15 gms per dayThiaminIncrease in line with energy; increase by 0.1 mg per dayRiboflavinNeeded for tissue growth; extra 0.3 mg per dayNiacinRegular supplementation/diet of substance. No increase required.FolateMaintain plasma levels; extra 100 µg per dayVitamin CReplenish drained maternal stores; extra 120 mg per dayVitamin DReplenish plasma levels of vitamin 10 µg per day.CalciumNeeds no increaseIronExtra 3 mg per day neededMagnesium, zinc, and copperNormal supplementation or consumption.IodineExtra 100 µg per day.Foods To Avoid During Pregnancy- Skip aerated or caffeine based beverages like coffee, tea and colas. Too much caffeine may affect the growth of baby. A recent study said that pregnant women who consume even about a cup of coffee everyday are at a higher risk of giving birth to an underweight baby.- Avoid eating foods that have been prepared with maida.- Try and cut down on eating foods that are high in sugar content.- Sea-food that is high in mercury should be strictly avoided. Swordfish, shark and king mackerel are among these. Raw fish may contain listeria, a bacteria that can cause food poisoning. While canned seafood is considered safe, skip smoked or frozen seafood like oysters, sushi, sashimi, and smoked salmon.- Unpasteurized milk may contain listeria, which can cross the placenta and lead to infection or blood poisoning in the baby. Ensure that the milk you drink is pasteurized.- Stay away from mould-ripened cheese (cheese that has a blue vein in it) like brie or camembert. Make sure you cook raw eggs. When the eggs are cooked, see that the yolk and white are firm.- Avoid the consumption of smoking and drinking in day to day routine.Healthy Pregnancy Diet Tips:-- Have a piece of fresh fruit for a mid-morning or afternoon snack, instead of reaching for chocolates or biscuits.- By carrying a small bottle of water when you are out ensures you are well hydrated, and not tempted by sugary soft drinks.- Each week, prepare a couple of meals using beans, lentils and pulses.- Add in your diet different healthy grains, such as barley, couscous or brown rice, in order to give variety to your favorite recipes.- Choose low-fat dairy productsIt is important to note that being pregnant doesn't indicate that the mother to be has to consume food for two individuals, as she is supporting a life within her. The key to a healthy pregnancy is to consume a balanced diet with light and frequent meals throughout, and to regularly take the supplements or medicines prescribed by the doctor. One should also try, and be active, for e.g., go for walks or light swimming or do pregnancy specific yoga [under supervision].

Oral Health Complications During Pregnancy

Dr. B.N. Prasad, Dentist
Recent findings have reported that oral bacteria and their by-products can possibly pass the placental barrier keeping oral health at prime importance during pregnancy. An awareness related to oral health during pregnancy cannot be neglected or avoided in order to minimize the complications.This article focuses on few points related to the necessity of oral health during pregnancy. Pregnancy comes with many responsibilities making expecting mothers more concerned about their health. However, many pregnant women may not be aware of oral health and its effect on the developing child.  Negligence of oral health is quite common during pregnancy due to lack of alertness of oral hygiene and its effect on systemic health.Moreover, pregnancy discomforts like frequent bouts of nausea, increased physical demands, weight gain or certain dental problems like pregnancy gingivitis or inflammation of gums may be dangerous to developing fetus.  Risk of oral problems during pregnancy:-Few common oral problems associated with pregnancy are as follows. Pregnancy Gingivitis: Hormonal changes during pregnancy leads to pregnancy gingivitis. It is a condition of bleeding gums, redness. Moreover inflammation, swelling and tenderness are also observed. Ignorance of such problems may lead to serious gum disease.  Frequent cleaning can avoid such dental issues. Progesterone levels are elevated during pregnancy which stimulates the production of prostaglandins and leads to inflammation of blood vessels in gums.Tooth Decay:Diet during pregnancy is of high importance. It is designed to nourish both mother and unborn baby. Diet rich in carbohydrates actually increases the risk of tooth decay. The morning sickness increases acid secretion in the mouth which is harmful to enamel. Pregnancy tumors: Overgrowth of tissue on gums in pregnant women are called as pregnancy tumors. They are noncancerous and generally observed in the second trimester of the gestation period. It is nothing but swollen gums between teeth. The bleeding and reddening of gums observed in such conditions.  Periodontal disease and preterm birth:untreated gum disease or periodontal problems can development periodontitis characterized by inflammation and infection of the gums and supporting structures of the teeth. This ultimately leads to loss of supporting material and finally the teeth themselves. A study result has revealed that there is a relation between preterm birth and presence of gum diseases in the pregnant women. The reason is not yet known. However, research study findings have evidence that oral bacteria or their byproducts can pass placental barrier. This initiate inflammatory response leading to preterm birth. Another correlation exists between the gum disease and the increased rate of pre-eclampsia, a condition of high blood pressure during pregnancy. The positive correlation suggests that gum disease may cause stress to the blood vessels of the mother, placenta and the fetus.The basic periodontal therapies like oral hygiene instructions, scaling, root planing and prophylaxis can substantially decrease the level of prostaglandin responsible for inflammatory response. The regular treatment and follow-up in pregnant women can maintain good oral health and minimize the risk of preterm birth. Dental treatment during pregnancy: The dental procedures mostly include the use of X-rays and use of anesthesia. In the case of pregnancy, these procedures can be used with precaution. Therefore, before sitting on dental chair patient should declare her pregnancy to the physician. Untreated dental infections can harm fetus as well as the mother. The emergency situations request use of dental radiographs which can’t wait. The radiation of dental x-ray is generally very low and precaution is always taken for lowest radiation exposure. A leaded apron including collar, shields can be used to prevent abdominal exposure to the x-ray radiation. Use of dental X-ray is not at all contraindicated in pregnancy when used with precaution. The use of local anesthesia is also not contraindicated in the pregnancy. A clinical trial result showed that there is no harm in the use of local anesthetics during pregnancy. It is not linked with increased risk for major medical problems like cerebral palsy, cleft lip and heart defect in newborns. The medication prescribed during dental treatment mainly includes local anesthetics, analgesics, and antibiotics. Most of them can be used with safety precautions. Each drug has its own pregnancy category which should be considered during its use. The antibiotic like tetracycline can permanently cause discoloration of developing teeth.  Prevention: Dentists can educate patients with following points to avoid problems associated with oral hygiene. The patient should declare the pregnancy to  the Dentist Follow routine oral checkup. Undergo all elective and emergency procedures. Follow good oral hygiene practice ask for a better toothpaste.In the case of morning sickness avoid sweets and snacks which increase the risk of tooth decay. Have healthy and balanced diet. Awareness of oral health during pregnancy is a must to avoid complications.

Abdominal Sagging After Pregnancy: Causes And Treatment

Dr. Radhika Bharath, Physiotherapist
Diastasis Recti / Recti Split/ Abdominal separationDiastasis Recti is a disorder usually seen in ladies during and post pregnancy. It is defined as the separation of the rectus abdominis muscle into right and left halves. Normally the two sides of the muscle are joined at the linea alba (a fibrous structure that runs down the midline of abdomen) at the midline of the body. (Tupler Techniques, 2013)Diastasis of the muscle occurs:• In newborn, when the abdomen is not fully developed. Usually seen with pre-mature births.• In pregnancy or postpartum women due to stretching of the rectus abdominis by the growing uterus. It occurs more commonly in multiparous women (carrying more than one foetus) due to episodes of stretching of uterus.• Women are more likely to develop diastasis recti when above the age of 35, high birth weight of the child, multiple pregnancies, and multiple birth pregnancies.• Additional causes can be due to excessive abdominal exercises during the first trimester for pregnancy. Signs & Symptoms:• Excessive abdominal sagging• A persistent gap between the rectus abdominis muscle (3 finger space or more)• Abdominal pain• Abdominal discomfort.• Umbilicus protrusion.• Flabby abdomen.Treatment:• It is one of the most commonly seen disorders, often mis-diagnosed as umbilical hernia.• Adequate manual testing and physiotherapy exercises are proven to be most effective.Exercises like:- Core contractions- Seated squeeze- Head lift- Upright push up- Squats against the wall- Kegels exercise are proven to be most effective• In extreme cases, corrective surgeries can be opted for cosmetic purposes.

How to Cope With Skin Changes During Pregnancy

Dr. Karuna Soni, Dermatologist
You're positively glowing! You must be pregnant! While it is flattering to receive compliments like these from everyone during pregnancy, what's not so great are the other visible changes your skin undergoes when you are pregnant. Skin changes during pregnancy can be rather noticeable, but the good news is that most of these can just as easily be managed with a few simple home remedies.Here are a few for you to try out yourself:Stretch MarksThis one definitely tops the list of the skin changes pregnant women experience. There are many creams and lotions that will claim to reduce or eliminate the appearance of stretch marks entirely. However, the truth is that there is very little substance to their claims. Instead of these, you can try applying aloe vera pulp to reduce the appearance of stretch marks. You will not be able to get rid of them completely. But these marks are usually known to go away by themselves after you deliver. Being patient is the key.The Mask of PregnancyPregnant women are often known to develop dark spots, or even black patches on their face. This is also commonly known as 'the mask of pregnancy.' Using a sunscreen daily, even if you mostly stay indoors, can help you fix this problem. You can also apply things like cucumber, tomato or lime juice mixed with milk on the darkened areas for results.AcneIf you thought you were done with acne in your teenage years, think again! Many pregnant women have a relapse of acne as their hormone levels change during pregnancy. You should cleanse your skin regularly with a mild soap or face wash, using lukewarm water. If you have dry skin, use an oil free moisturizer. Avoid using topical acne creams as they are usually unsafe during pregnancy.Spider veinsThese are the small red. blue or purple veins that are easily visible through our skin. They usually appear on legs or faces. To reduce the chances of spider veins appearing, protect yourself from extremes of cold or heat. Continuous exposure to either of these can make the problem of spider veins worse.While you might also experience several other changes in your skin during your pregnancy, you can take comfort in the fact that almost all these conditions will automatically sort themselves out once you have given birth. You have exciting days ahead of you, you should keep your energies focussed on that!

5 Reasons - Why Your Wife May Seem Cranky During Pregnancy and Why You Should Just Smile

Dr. Himani Gupta, Gynecologist/Obstetrician
The fact that you're here means you have been through or are currently in a similar situation. During pregnancy, your partner will change, as I'm sure most of you have already noticed by now. Coming home from work and opening that main door has become a game of potluck, you do not know what's on the other side of it. And I'm sure you have heard this from a lot of people but here it is- it's not her fault, it's the hormones! Hormones are chemicals our glands secrete into our body that get to control things, all kinds of things. When a woman becomes pregnant, these hormones go into hyper drive to create the perfect environment for the baby. And while they are at it, they also cause the following changes- Nausea and vomiting This is the earliest symptom of pregnancy. Hormonal changes of pregnancy are again responsible for it. It usually subsides by the 4th month. At times it may be prolonged due to which women will require to take medicines for many months.Word to the Husband Remember the last time you had to take an antacid as you were having nausea and vomiting as a result of eating outside? Now imagine your wife having the same feeling for a period of 2-3 months.Pain 'No pain, no gain.'  This age old saying is absolutely true for pregnancy. Whether delivery is normal or Cesarean some amount of pain will be experienced even with our newest medicines. She needs to undergo repeated blood tests, gynecological check ups, and has to get numerous vaccinations.Word to the HusbandHow many of us keep postponing health check ups, dental treatment for fear of pain?Change in Eating and Sleeping Habits When a woman gets married, she may enter a new realm of eating and cultural habits. What is eaten, the way it is cooked, eating time table, all may be entirely different from what she is used to since her birth. Add to that the increasing demands of pregnancy. She may experience craving for odd food items at times. Her sleeping habits may also change. Increasing abdominal girth makes it difficult for her to adopt a comfortable posture. Baby movements may keep her awake or wake her up frequently during sleep.All these things will overwhelm her.Word to the Husband You can start by acknowledging the fact that she still keeps smiling despite all these changes. Get her one meal per day of her choice. The way she has always liked and share it with her. Make sure you do whatever you can to get her comfortable when she wants to sleep.Weight gain As pregnancy advances she is bound to gain weight. Growing fetus, placenta, uterus and many other factors are responsible for this. During each doctor visit, first thing that will be asked of her 'Have you gained weight?' Healthy weight gain is necessary for a healthy pregnancy. Then again it comes with its own discomforts. Feeling of bloating, backache, swelling in legs, all are part of the package. Even after delivery, returning to pre-pregnancy weight may not be easily achievable for many women.Word to the Husband Empathy, sympathy and understanding will work for you. Accept the changes in her and help her do the same.Pregnancy MarksPregnancy is going to leave its tell tale signs behind. Things like loss of hair will recover, pigmentation on face will also disappear with time and treatment. But stretch marks is the main concern. With our newer skin treatments it is possible that they appear less and can be made to go away to a certain extent. But even for a short period, her appearance and way of dressing may change.Word to the HusbandInner beauty and qualities of a person matter most in journey with your life partner. Tell her that she is the most beautiful woman that has walked in to your life at every opportunity that you get.Put all this together & you’ve got someone who needs your help & support, however difficult it might be for you at times. So you’ll have to bite your lip, do a lot of agreeing & apologising, and keep telling yourself that she’s literally out of control. This is a hard time for her too. Things will get less confusing once you slowly learn to gauge her mood. Remember to always ask her what she needs.Talk to her. Be with her. Support and love her. 

Common Problems in Pregnancy and How to Tackle Them

Ms. Raminder Kaur Deshmukh, Dietitian/Nutritionist
Pregnancy doesn't treat everyone equally while some women might face severe pregnancy symptoms like nausea, backache, and constipation, others may be lucky and have a cake walk like pregnancy.Some of the common problems are:1. MORNING SICKNESSThere is no denying that nausea or morning sickness can haunt you throughout the day, so be prepared to visit restroom during the 1st trimester. It is your hormones that are creating havoc. Also, pregnancy increases sensitivity in the area of the brain which triggers nausea.HOW TO TACKLE IT:Stay in bed for few minutes after you wake up.Do not have fluids like fruit juices first thing in the morning. Start your day with biscuit or toast instead.Keep yourself hydrated throughout the day.Avoid overeating and have six small meals throughout the day.Avoid your triggers. Every pregnant woman suffering from morning sickness becomes arise to certain odors like that of onion, garlic or other fragrances. If you know to stay away from them.Ask for modification from your doctor if it becomes difficult to ignore.One can have ginger flavored candyInhale fresh air Remember not to stop eating as it will worsen the sickness.2. CONSTIPATIONBowel movement slows down during pregnancy. this happens due to increased level of progesterone in the body. Also, iron supplements taken during pregnancy can lead to constipation with fatigue, nausea, backaches,constipation would be the last thing yo want to deal with.HOW TO TACKLE IT:Increase fiber intake. ask your doctor for modification and don't reach out of laxatives on your own.Don't miss your 8 glasses of water and keep sipping other fluids also.Pick your plate with fruits and vegetables.Walk, light exercise can help to aid digestion and relieve constipation symptom.Avoid refined flour and it's products.3. HEARTBURN AND INDIGESTIONDuring pregnancy as your belly bulges out your stomach is pushed upward and this aggravates heartburn. Also going empty stomach for too long can increase acid levels and cause heartburn, indigestion and slows down your bowel movements too.HOW TO TACKLE IT:Eat small and frequent meals.Avoid spicy or fried food as that can aggravate acidity.Do not lie down for at least half an hour after your meal.Avoid tea/coffee/aerated drinks and too much of fruit juices.An occasional ice cream or cold milk can work as an antacid.

"I never thought i will be ever comfortable in bikini, thanks to Tummy Tuck "

Dr Deepali Agarwal
"STOP WAITING FOR THINGS TO HAPPEN,GO OUT AND MAKE IT HAPPEN"Loose,wrinkled abdominal skin and excess fat in the lower abdomen can be the result of substantial weight loss,muscle weakness following pregnancy  or heredity.If you have loose skin and lack of tone in the abdominal area then tummy tuck is a good option for you.It has become one of the most popular procedures.Every woman desires for a figure she had prior to childbearing and wants to wear fitted clothing ,looking beautiful and appealing while standing and sitting as well.The procedure tightens the loose stomach muscles.This is a wonderful surgery for women who following pregnancy have developed loose abdominal skin and abdominal wall weakness.This surgery helps you to get rid of the excess skin of the stomach that is unaffected by diet and exercise.It helps you to get back the beautiful shape of the abdomen that looks great in slacks and swimwear.The effects of pregnancy on the abdomen are fairly obvious.The uterus is usually about the size of an orange.During pregnancy the growth of the baby stretches the uterus which in turn presses the muscle wall of the abdomen.The two vertically placed rectus muscles get pulled apart and seperate.This condition cannot be reversed by exercise and diet,only surgery can help and correct the condition.The procedure leaves the skin tighter making the body look leaner and more youthful.Fast Facts:The surgery takes two to five hours.It is usually done under general anesthesia.Overnight stay is recommended.Pain medications are prescribed for 14 days and one can go back to work in 1 to 4 weeks.Scars are usually undetectable.Serious complications while possible are unlikely if you are in expert hands.

Antenatal Exercises and Its Importance Fit for Two

Dr. Rakesh Kumar, Physiotherapist
Pregnancy is a state of health,not of illness so,a well conditioned body will perform better during the stress of advances pregnancy and delivery.Pregnancy can significantly affect your overall daily functioning.A woman body goes through incredible physical and hormonal changes before and after delivery.For years,discomfort associated with pregnancy has been accepted as a normal part of the process.Today,many physicians recommend physical therapy to relieve the discomfort experienced by pregnant women and help prepare the pregnant body for an easier delivery and recovery process.Pregnancy and Physiotherapy CombinedAs Physiotherapy is a profession treating problems associated with muscles,joints, bones and circulation, it an be used to work collaboratively with pregnancy to ensure stronger, healthier core stability muscles and posture throughout.Many if not all of the exercises recommended by the Physiotherapist can be done at home on a regular basis for a fitter,more birth prepared Pregnancy.‘Even regular tasks such as sitting, walking, standing and working can be difficult when pregnant.Almost all women experience musculoskeletal discomfort during pregrancy.This is due to the tremendous changes undergone by the body during any healthy pregnancy.With physiotherapy,techniques can be learned to help relieve the following conditions:Lower backpain caused by a shift in the mother’s centre of gravity as the baby growsNeck pain and headaches due to changes in postureTightness and pain in the hamstrings and heel cords caused by a flattening of the feetArm pain or tingling caused by nerve compression associated wtth an increased chest diameterBladder leakage during pregnancy and after delivery due to strained pelvic musclesStretching of the abdominal walls leading to back pain and difficult delivery due to ineffective abdominal contractionsANTENATAL CLASSES & EXERCISESThese antenatal classes are designed especially for pregnancy and child birth.Each class addresses a specific pregnancy related issues and help you prepare for child birth and beyond.Exercises are blended with education to give you a better understanding of your body and how to keep”pregnant fit”and “birth fit”.BENEFITS:Why exercising in pregnancy may be good for you and your baby?Keep your heart, lungs and muscles as fit as possible.Keep your weight within the healthy range.Improve your posture,balance and co-ordination.Improve your circulationIncrease your strength and staminaFeel better in body and mindBe prepared for labour and deliveryReduce minor ailments of pregnancyBecome fitter and may ar more help you to recover more quickly after birthEXERCISES AND FACTS:The American college of OBS/GYNAE 2002:in the absence of medical and OBS complications 30 min or more moderate exercise a day on most, if not all days of week, is recommended for a Pregnant Women.

12 Tips to Reduce Period Cramps!

Dr. Amar Deep, Homeopath
Drink lemon water every morning after you wake up. This will have an alkalizing effect on the body and keep the body hydrated and mineralized. Stay hydrated throughout the day,Your must include vitamin D3 in your diet. Especially if you live is a colder climate where sunlight is reduced during the winter season.Increase consumption of leafy greens to ensure enough B vitamins, fiber and mineral supply in the body. You will get a lot of calcium, magnesium, iron, B vitamins and other minerals through leafy greens. Swiss chard, collard greens, yogurt, pumpkin seeds, sesame seeds, spinach contains these minerals.Eat fatty fish, fish or flax oil every day to get relief from hormonal imbalances.My most favourite remedy to get relief from cramps is an Ayurvedic home remedy using cinnamon and ginger to make tea. Just use ¼ tsp. of ground cinnamon and a pinch of ground ginger or couple of thin slices of half an inch of fresh ginger to a cup of hot water. Wait and let it steep for 5 minutes. Strain and drink the tea. Vitex or chaste berry is a herb that eases menstrual cramps,Evening primrose oil or borage oil are rich in anti-inflammatory omega-6 fatty acids and are known to reduce breast pain and tenderness as well as PMS symptoms.Dietary intake of calcium and magnesium is crucial for balancing the hormones.Using heating pads or hot water bags around the area relaxes the stiff muscles and reduces pain by bringing oxygen in the area.One of the most important things to address is relaxation through 7-8 hours of sound sleep and stress reduction. Meditation and breathing exercises (pranayama) also assists in reducing stress.If you eat a lot of nuts, seeds and grains then increase aerobic exercises. Aerobic exercises releases endorphin hormones or “feel good” hormones in the body. The presence of this hormone works like a natural pain killer.Apply natural progesterone cream or wild yam cream. Apply this cream on stomach, lower abdominal area, buttocks, things, breasts and upper arm area. Best time to apply this cream is a week before the start of your period.