Pregnancy is such an exciting time for a woman and her family and usually, women pay particular attention to their activities, diet and overall health. A healthy lifestyle and avoidance of potential risks for the mother-to-be and her baby is the ultimate goal. Here are some evidence-based recommendations for supporting a healthy lifestyle and optimal outcome for the pregnancy.  Seven pregnancy do’s and don’ts that you should discuss with your obstetrician.

Prenatal Vitamins

Prenatal vitamins provide supplemental micronutrients which may be decreased in some diets. Fortunately, in the United States, most women with a well-balanced diet may not have any deficiencies except iron, Vitamin D and folic acid (often listed on the label as folate or L-methylfolate). Over the counter and prescription prenatal vitamins are similar in the content, except there is a little more folic acid in the prescription vitamin. Over the counter, preparations are normally sufficient for supplementation.

The vitamin recommendations for women are:

• Folic acid 400-800 micrograms starting prior to pregnancy and continued through at least the first trimester.
• Iron 30mg and if the initial lab work done at the OB visit indicate anemia, an additional iron supplement may be recommended.
• Vitamin D 600international units
• Calcium 1,000mg. Taking calcium in food may be less constipating that the tablets.

Weight Gain

Weight gain will happen! The National Academy of Medicine recommends that weight gain goals are based on the starting body mass index (BMI). Most babies will weigh 1 pound around 20-22 weeks. The rate of baby’s growth is fastest in the third trimester.

• Women who are in the normal weight range will gain 25-35
• Women who are over their ideal body weight may gain 15-25
• Women who are underweight may gain 28-40 pounds

Dietary Changes

Most women will continue with their normal diet but there are a few things to avoid. The amount of alcohol that may cause harm to the baby is unknown and therefore it should be avoided in pregnancy. Caffeine in low amounts does not seem to be a concern, therefore keeping the total daily amount to less than 300mg is encouraged. The average cup of coffee, 8 ounces of regular brew has 130mg of caffeine and a cup of tea or 12-ounce soda has approximately 50mg. Artificial sweeteners can be used in pregnancy, but as in life, moderation is the key.

A well-balanced diet will include fresh vegetables and fruit that is washed prior to eating, protein, and limited carbohydrates. Deli meats that are prepackaged and have preservatives are probably low risk, and the deli meats from a restaurant or grocery store counter may be warmed before eating, although the risk for Listeria contamination is very low. The most recent outbreak from food source infections involved other foods, so be aware of any food recalls in your area. Fish are a good source of DHA and are encouraged as a menu choice 2-3 times weekly. The type of fish should have lower mercury content. Sushi consumed in a reputable restaurant is unlikely to be a concern.

Smoking

Smoking and vaping are associated with increased risk for complications of pregnancy. There is an increased risk of miscarriage, preterm delivery, growth-restricted babies and stillbirth. Vaping actually has more nicotine content and although long term studies are not available, it is thought that the risk is at least the same for cigarettes.

Exercise

Exercise is encouraged throughout the pregnancy but may have to be modified by tolerance and endurance. Hydration is key so keep up with the water intake! Bedrest has not been shown to be of benefit in pregnancy and may actually increase the risk of clots in the legs. High impact activities are not recommended such as skiing, horseback riding, boxing to name a few.

Travel

Many women travel throughout pregnancy for business and pleasure. Be aware of any infectious risks such as Zika, at the planned destination. Balancing the potential risk for complications that may need to be addressed at a distant location, especially in the third trimester, should be considered when making travel arrangements.

Summer Considerations

Summertime means lots of outdoor activity and sunshine. Take care of your skin with sunscreen. DEET insect spray is encouraged to avoid mosquito bites, and enjoy the water. Swimming in the pool, lake, river or beach is safe but avoid hot tubs that may increase your core body temperature.

Pregnancy Do’s and Don’ts

These are a few pregnancy do’s and don’ts and of course, there may be specific questions or situations you may have which should be discussed with your obstetrician. Our goal is your goal—happy healthy mom and baby!  Connect with one of our physicians to learn more.