Aanchal....

Exercise during a twin pregnancy

2008-12-29T22:35:00.005+05:30

Is it safe to exercise if I am carrying twins?

It is safe to exercise if you're expecting twins, but there are a few things to bear in mind. You will obviously increase in size faster than someone who is only expecting one baby, which will make some forms of exercise uncomfortable earlier on in your pregnancy. Most experts recommend that you should not undertake any vigorous or aerobic exercise after 28 weeks. (SOGC 2003) The last three months of a twin pregnancy are especially tiring, and around half of twins are born before 37 weeks. (HFEA 2006)

If you wish to carry on exercising after 28 weeks, discuss it first with your doctor or midwife.

What type of exercise is best for a twin pregnancy?

Swimming, yoga and Pilates are all ideal forms of exercise. Pelvic floor exercises are also important in any pregnancy, so don't forget to do these. As long as you find it comfortable, and providing you are not suffering from pelvic or back pain, walking is another good form of exercise during pregnancy.

Ideal forms of exercise when expecting twins

Swimming and aqua-natal classes
Swimming will feel more comfortable than land-based exercise, as the buoyancy of the water helps to support the extra weight you are carrying. The water supports your joints and ligaments as you exercise, preventing injury, and can protect you from overheating. Swimming can also help with swelling and the discomfort caused by varicose veins, a common side-effect of a twin pregnancy.

If you suffer from backache or pelvic pain, talk to your midwife or a physiotherapist before you start swimming. You may find that breaststroke is uncomfortable, and she will be able to advise you of alternative strokes or exercises in the water.

Aqua-natal classes are becoming increasingly popular in many areas and are usually run by midwives. Ask your midwife for details of classes near to where you live.

Yoga
Yoga can be useful if you are carrying twins as it is a gentle way of maintaining fitness. It can also help with flexibility and muscle toning. Avoid upside-down poses while you are pregnant and any movements which require you to lie flat on your back. This decreases blood flow to the uterus (womb). Never force or strain during any pose or stretch, especially during movements that stretch the tummy muscles. If you experience back or pelvic pain, you may have to modify some of your postures. After 28 weeks, some of the poses may prove difficult. Check that your doctor and yoga teacher are happy for you to carry on with your classes after this point.

Pilates
Pilates is an ideal form of exercise for a twin pregnancy because it targets the tummy and pelvic floor muscles, which are placed under a lot of strain when you are carrying more than one baby. Many Pilates exercises are performed on a "hands and knees" position, and this is a good position to exercise in, as it helps to take a lot of stress off your back and pelvis and may help to position your babies ready for birth.

Before trying Pilates, make sure that you can perform a strong pelvic floor contraction by squeezing in your pelvic floor muscles and holding it for at least 10 seconds. If you can't maintain a "stable core" by tightening your pelvic floor and lower tummy muscles then you may overstress your joints, ligaments and pelvic floor.

Certain positions, especially those lying on your tummy or back are not appropriate for you. If you can, find a Pilates class specifically designed for pregnant women, or make sure that your Pilates instructor is qualified to teach pregnant women and is aware that you are expecting twins.

Pelvic floor exercises
Because of the extra weight you are carrying and because you have more pregnancy hormones in your system, you may find that you begin to leak urine
when you cough or sneeze. Exercising your pelvic floor muscles regularly should help to prevent or treat this problem, and if it doesn't, ask your midwife or doctor to refer you to a physiotherapist.

How much should I push myself when exercising while carrying twins?

In general, you shouldn't go for the burn, push yourself or exercise to exhaustion when you are carrying twins. Exercise at a comfortable level to be safe. You should be able to have a comfortable conversation with someone while you are exercising. Some women like to monitor their heart rate while exercising. However, don't rely on this as heart rates in pregnancy can vary widely. It is safer to be guided by how you are feeling. (Artal & O'Toole 2003)

Are there any signs that I am overdoing things or should stop exercising?

Stop exercising and seek medical advice if you have any of the following symptoms

• vaginal bleeding
• blurred vision
• nausea
• dizziness
• fainting
• breathlessness
• heart palpitations
• increased swelling in your hands, feet and ankles
• sharp pain in your abdomen or chest
• leaking of amniotic fluid
• you feel unwell
(Artal and O'Toole 2003).
as a result of exercising:

Are there any reasons why I should not exercise when carrying twins?

Always talk to your GP or obstetrician before exercising if: • you are more than 27 weeks pregnant • you are anaemic or feel very weak and tired • you have a chest problem i.e. bronchitis or asthma • you have experienced bleeding during your pregnancy • you have previously had a premature baby • you have shown any signs of premature labour during this pregnancy • you have cervical weakness • you have a low-lying placenta (placenta praevia) • you have low or high blood pressure • you have any medical conditions i.e. heart problems, diabetes, epilepsy or thyroid disease • you have been told that your babies are small for their dates or are not growing properly (fetal growth restriction) • you are very underweight or overweight • you have never exercised before or want to increase your exercise level significantly

20 reasons why it's great to have twins

2008-12-29T22:26:00.003+05:30

Finding out that you're pregnant with twins is often a shock. But there are lots of reasons to be excited about bringing two babies into the world at the same time. Here are just some of them.

1.

Knowing that you are only going to have to go through the birth process once to end up with two children.

2.

Enjoying the fun of choosing two baby names that fit together perfectly.

3.

Being able to hold one baby in each arm and feeling a huge rush of love and pride.

4.

Watching your babies sleeping peacefully side by side.

5.

Having to establish only one routine.

6.

Getting all the sleepless nights over and done with in one go.

7.

Watching them carve out their own identities as they grow.

8.

Knowing that they are going to have a best friend in each other for life.

9.

Enjoying the attention that twins inevitably attract.

10.

Feeling confident that they can help each other on their first day of school.

11.

Discovering all their amazing little differences.

12.

Watching them create their own secret language and games.

13.

Knowing that they will never be lonely.

14.

Loving the fact that they are constant playmates and can entertain each other.

15.

Feeling special because you've joined the exclusive club of twin mums – together with the likes of Jennifer Lopez and Julia Roberts.

16.

Only having to buy one of every must-have toy and not having to give baby number two (by a few minutes!) hand-me-downs.

17.

Only having to bake one birthday cake and throw one party a year.

18.

Seeing them learning and encouraging each other to reach their milestones.

19.

Watching them taking care of each other when one is upset or hurt.

20.

Knowing that their shared history means they have one of life's most unbreakable bonds. Are you a mum of twins?

Why not add your favourite thing about it by writing in the Comment box below?

7 Dos and Don'ts for Pregnant Commuters

2008-10-14T16:36:00.004+05:30

Commuting during pregnancy isn't always easy. Here are a few suggestions to make the trip more bearable.

Mary Anna Clemons remembers being in the far left lane of the highway when the urge came to use the bathroom. At eight months pregnant, Clemons was used to frequent potty breaks along her 40-mile trek from her rural home to her job in Colorado Springs, Colorado. When she finally made it to a gas station restroom, the door was locked. In panic, Clemons went to the front of a line of customers and demanded the key from a surprised gas station attendant.

"Three people asked me if I 'made it OK' after I emerged from the bathroom," recalls Clemons, whose son is now nine months old. Her advice to other pregnant commuters: "Stay in the right lane for easier access to getting off the main drag." For the last few weeks of her pregnancy, Clemons gave up highway driving altogether in favor of town roads that had easier access to bathrooms and emergency rooms.

No doubt other pregnant commuters can identify with Clemons' woes. And for many, commutes are getting longer. According to the Transportation Research Board, from 1990 to 2000, the number of workers with commutes lasting more than 60 minutes grew by almost 50 percent. If you're commuting while pregnant, you need to take extra precautions to keep yourself—and your baby—healthy and comfortable.

Clothing

DON'T: Wear constrictive clothing or high heels.

DO: Wear comfortable clothes and sneakers. A comfortable commute starts before you get in your car or on the train, explains Susan Bellinson, a certified nurse midwife at the Montefiore Comprehensive Family Care Center in the Bronx. "Because so many women get dressed in a hurry, they may not think about how constrictive clothing or high heels might affect them." Tight clothing, knee-high stockings, and ill-fitting shoes constrict blood flow, causing increased swelling and discomfort, especially in your legs and feet.

Dr. Jennifer Ashton, MD, an OB-GYN in private practice in Englewood, New Jersey, gives another reason to forego heels: "During your pregnancy you have a different center of gravity. You're more prone to slip or trip going down stairs." Her solution? Wear sneakers.

Eating Breakfast

DON'T: Skip breakfast before you leave for work.

DO: Grab at least a quick bite to eat.Passing on breakfast is dangerous, warns Bellinson. "Morning starvation is bad for mother and baby. Not eating enough can make you dizzy and weak."

If you're running to catch a bus or train (or even sitting in a car), you need food to keep you going and alert. Bellinson recommends a balanced breakfast with a glass of milk, toast, and fruit. If you can't sit for a meal, opt instead for quick, healthy snacks such as a granola bar or fruit. Once you get to the office, make sure to eat something more.

Drinking Water

DON'T: Drink too much water or other liquids before your commute.

DO: Drink a small glass of milk, juice, or water before you leave and drink up once you get to the office.Your pregnant body needs plenty of fluids, yet you don't want to be on a long commute with a full bladder and no restroom. "Not only is a full bladder uncomfortable," says Bellinson, "but it can lead to bladder infections, which can then lead to kidney infections."
Instead of drinking a full glass of water at the beginning of the day, Bellinson advises commuters to drink a small amount before work and then to bring a water bottle.

Before you get to the office, start drinking (when you know a bathroom is nearby). When you get to work, keep drinking.

Managing Nausea

DON'T: Ignore nausea symptoms.

DO: Stash snacks in your pockets.You may experience moderate to severe nausea at the beginning of your pregnancy—and a commute certainly doesn't help. Some pregnant women avoid eating hoping to escape an upset stomach. That's a mistake, says Bellinson. Instead she suggests keeping your symptoms in check with nuts such as almonds or cashews whose essential oils help reduce nausea. If nuts don't appeal to you, try other pregnancy staples such as saltines or graham crackers. Keeping something in your stomach, says Bellinson, is more soothing than traveling on empty.

Posture and Position

DON'T: Lock your legs or stay in the same position for your entire commute.

DO: Try simple stretches or any sort of movement to keep your blood flowing. "I can't tell you how many patients have told me how they've fainted on the bus or subway," comments 20-year veteran Bellinson, whose practice draws many pregnant women from the Manhattan area. Pregnant women who stand in the same position for a long time are susceptible to dizziness and fainting because blood pools in the lower part of their bodies, depriving the brain of oxygen and putting pregnant women at risk of blacking out. Dr. Ashton equates the blood flow to the sand in an hourglass.

The longer you stand, the more likely that the blood will pool in the lower part of your body, just as sand drains to the bottom of the hourglass. While your baby is not at risk from lack of blood flow or oxygen, you are at risk of serious falls.

To alleviate blood-flow problems, make sure to move around as much as possible. If you're stuck in traffic try wiggling your toes, moving your feet, or stretching your calf muscles to get your blood circulating. Bellinson also recommends maternity support stockings to help maintain adequate blood flow.

Seating

DON'T: Wait to be offered a seat on the subway or bus.

DO: Ask for someone to give up a seat if none are available."You can't always count on a polite person to give up a seat," says Dr. Ashton, "but you shouldn't hesitate to ask for one." Sitting will make your commute much more comfortable, and you'll be less likely to fall or black out.

Driving

DO: Drive safely.

DON'T: Drive without a safety net.If you're exhausted or drowsy at the end of the day, consider taking a break at work before heading home, carpooling with coworkers, or using public transportation. Bellinson explains that pregnant women can "safely drink a cup of tea or coffee with caffeine in the morning if they are concerned about fatigue."

Beyond your own driving habits, you should also be vigilant with general safety strategies such as always taking your cell phone with you and letting someone know what route you'll be taking, in case of an emergency. (You may also want to stash pepper spray in your purse, as pregnant women can be targets for robberies.)

Commuting pregnant can be uncomfortable, but by following a few simple suggestions, your commute can be a lot smoother and safer.

2008-10-12T15:20:00.003+05:30

Traveling while you're pregnant can raise some questions. Find out what you need to know if you're planning a trip during your pregnancy.

International Travel and Pregnancy

Travel abroad while pregnant can be fun and rewarding, but you should take some precautions before you go.
Whether you're traveling abroad while pregnant for business or pleasure, you should take steps to ensure your health and that of your unborn baby—before you ever set foot on the plane.

When to Travel

Your second trimester is the best time to travel, according to Dr. Robyn Horsager-Boehrer, MD, medical director of Obstetrics and Gynecology at University Hospital-St. Paul, which is part of the UT Southwestern Medical Center in Dallas, Texas. "In the first trimester many women are not feeling well due to nausea or fatigue," explains Dr. Horsager-Boehrer, while "the third trimester brings along the risk of preterm delivery."
In fact many airlines won't let you fly past 36 weeks, says Dr. Bob Wheeler, MD, an emergency medicine specialist, a cruise ship medical consultant, and the medical director for On Call International, a company that provides medical insurance for over seven million travelers. "After all, you don't want to be having a baby at 45,000 feet."

Where Should You Go?

You're much more likely to get sick in a developing or newly-industrialized country, such as Mexico, India, Brazil, or the Philippines, which may not adequately treat its water and food, versus countries like Canada or Europe. According to Dr. G. Richard Olds, a travel-disease specialist and chairman of medicine at the Medical College of Wisconsin, 35 percent of travelers will get sick during a standard two-week stay in a developing country. Some studies, reports Dr. Olds, put the rate much higher at 85 percent.

While you might not be traveling for two weeks, Dr. Olds says pregnant women need to be especially careful because during pregnancy you're body is already partially immuno-suppressed to accommodate your growing baby.

Be a Picky Eater

Germs that make you sick can come from a variety of sources, but certainly food is top on the list, especially in developing countries. When it comes to food choices, "think about how the food has been prepared," says Dr. Olds. Baking, frying, or boiling the food kills most germs. Fresh foods, however, like salads, can be harder to clean. Dr. Olds gives the recent spinach scare—right here in the US—as an example of how difficult it is to get fresh vegetables and fruits clean.
That's not to say you should avoid fresh fruits and veggies altogether. Opt for peelable fruits, like oranges or mangoes, says Dr. Olds, and avoid fruits with high water content like watermelon.
Tom Kime, chef and author of Street Foods: Exploring the World's Most Authentic Tastes, has visited—and eaten—food in developing countries around the world. He says travelers often make mistakes about food choices because they go for something familiar instead of the local fare.
"You're much more likely to get sick from the hotel's all-day buffet, which has been sitting out in the air conditioning gathering bacteria, than the food on the street, which is cooked right in front of you," offers Kime.

Kime points out that food might be making you sick simply because it's different than what you're used to, not necessarily because it's contaminated. "I once felt ill in Thailand but it wasn't from food poisoning, I'd just eaten too much chili," says Kime, who dined on bananas the rest of the day. Bananas are his secret remedy for calming an upset stomach. According to Kim, other starchy, bland foods, such as noodles or rice, are also good stomach soothers.
But there are local foods to be wary of. Watch out for unpasteurized cheeses, meats and fish that may not be prepared fresh (or may have a high level or mercury or pesticides), and dishes with undercooked eggs (steer clear of soft-boiled eggs) or meats (sorry, no steak tartar!).

Be Careful with Water

If you're traveling in Europe you probably won't have a problem drinking tap water, but if you're traveling in Mexico or Jamaica, you need to be careful about drinking local water, which may not be treated properly for germs.
"Most people make common mistakes," says Dr. Olds. For example, drinking bottled water, but then using local ice or brushing their teeth with local water. He points out that even if you're on a luxurious cruise ship and your boat is docking in developing countries, chances are it's taking on local water.
But don't avoid drinking water—staying hydrated during pregnancy is important. Instead, buy it bottled—as often as you can.

A Word about Bugs

Mosquitoes carry a variety of serious illnesses such as malaria and dengue fever. While many luxury resorts spray their properties to keep mosquitoes at bay, you should bring along bug spray (and even a mosquito net for sleeping) if the area you're visiting is prone to the flying pests.

Before you depart, talk with your OB-GYN about what types of bug spray are safest for you to use during your pregnancy.

Talking to Your Healthcare Provider

Discuss your plans with your OB-GYN before you travel. If you are taking any medications, makes sure to bring along enough to cover your trip (and even a little extra just in case).
You may also consider bringing along a copy of your basic pregnancy records, advises Dr. Horsager-Boehrer. "If something should happen and you need medical care, a copy of the prenatal record with your lab and sonogram results makes it much easier for a physician to understand how the pregnancy has progressed thus far."

Traveler's First-Aid Kit

Avoid purchasing medications in another country, where pharmacies may offer over-the-counter medications that are prescription-only in the US. Pack your own obstetrician-approved survival kit, including medications to treat common travel complaints, such as "an antacid for indigestion, Tylenol for aches and pains, Claritin or Benadryl for allergies, Sudafed or its generic for cold symptoms," says Dr. Horsager-Boehrer.

If You Get Sick

Before you travel, call you healthcare provider to make sure you know about your coverage. "You can get sick whether you're walking down the beach in Jamaica or sitting in your living room," says Dr. Wheeler. "A common complaint in pregnancy is spontaneous bleeding or spotting, which can happen anywhere."

A guide to INFANT MASSAGE

2008-09-21T00:50:00.002+05:30

Babies simply love to be touched. In fact, they thrive on it — it's a critical part of growth and development. All that skin-to-skin contact not only helps you and your baby bond, it can comfort your baby when he's upset and ease colicky behavior. This simple six-step "I Love You" massage can help you get started.

P R E P A R A T I O N

Find a warm, flat surface to lay your baby on — a blanket on a carpeted floor is fine. Pour a little baby oil or pure vegetable oil in your palms and rub your hands together to warm them and the oil. Try to look into your baby's eyes, and sing or talk to him as you do the massage. And pay attention to your baby's response: If he doesn't seem to be enjoying himself, try a lighter touch, or simply stop.

1. While facing your baby, use two or three fingers to trace the letter "I" on the right side of his abdomen with firm but gentle movements. Start under his ribs and go straight down to his hip joint, using the oil to smooth your way.

2. Next, stroke from left to right across your baby's abdomen, forming the long side of a sideways "L."

3. Use a short downward stroke on the right side of his stomach to complete the "L."

4. To begin the last letter, the upside-down "U," stroke up from your baby's hipbone, on the left side of his tummy.

5. For the middle segment of the "U," move your fingers along the top of your baby's tummy.

6. And for the final part of the "U," stroke down your baby's right side

Baby Body Care

2008-09-04T21:30:00.004+05:30

Why newborns look so funny ?

Few newborns look like beauty contest winners, which isn't surprising when you consider what they've been through. But is it really normal for their heads to be so pointy and their genitals so swollen? Here's the top-to-toe scoop on why newborns look so, well, strange.

Head

If you gave birth vaginally, you may take a look at your baby's head and think, "No wonder!" It's big compared to the rest of your baby's body!Your baby's head may also look a little misshapen or kind of pointy. This is called molding, and it happens as babies squeeze through the birth canal. Your baby's head should return to its original shape in about a week.C-section babies don't come through the birth canal, so they have an edge in the looks department. Their heads come out nice and round because they don't get squeezed.The soft spots on your baby's head, called fontanels, are diamond-shaped openings in the skull covered by a thick layer of skin. These openings — one in front and one in back — allowed the bones of your baby's skull to compress during his trip through the birth canal, and now they'll allow for the quick growth of his brain.The rear fontanel will take about four months to close. The front one will take between nine and 18 months.

Arms and legs

After spending so much time curled up in the tight space of your uterus, your baby needs time to adjust to his new freedom and stretch out a bit. His arms and legs will uncurl within a week or two. When he does begin to stretch out, he'll probably appear a bit bowlegged.Some babies find swaddling — being wrapped snugly in a blanket — to be comforting because it mimics the tighter quarters of the womb.

Belly

Your baby might lose a little weight in his first week, but he should regain it during the second week and continue to put on the ounces and pounds at a fast clip in the following months, quickly filling out his belly.After ten to 14 days, your baby's umbilical cord stump will fall off, leaving an adorable little belly button.

Genitals

Your newborn's genitals and breasts (whether you have a boy or a girl) may be swollen from the extra dose of hormones just before birth. A little milky substance may leak from your baby's nipples as well. Girls may also have a little white discharge or blood-tinged vaginal mucus. All of this will go away in the first few weeks.

Skin

Newborn skin varies in appearance according to how far along your baby is at birth. Premature babies have thin, almost transparent skin that may be covered with a fine, downy hair called lanugo. You'll also see vernix, a cheesy white substance that protects a baby's delicate skin from the amniotic fluid. The farther along your pregnancy is when you deliver, the less lanugo and vernix your baby will have.Babies of all races and ethnicities are born with reddish-purple skin that changes to pinkish-red within a day or so. The pink tint comes from the red blood vessels that are visible through your baby's still-thin skin. Because your baby's blood circulation is still maturing, his hands and feet may be bluish for a few days. Over the next six months, your baby's skin will develop its permanent color.If your baby's skin takes on a yellowish tinge in the first few days of life, he may have a slight case of jaundice. More than half of healthy newborns show signs of jaundice, which happens as the body breaks down extra red blood cells.Jaundice usually goes away within a week for full-term babies, but often hangs around slightly longer in preemies.

It's usually nothing to worry about, but you should mention it to your healthcare provider.About 30 to 40 percent of all babies are born with milia, small white or yellow dots on their face that look like tiny pimples. They usually disappear within three or four weeks without any special treatment.If your baby has small pus-filled bumps that leave dark brown marks when they burst, it's probably pustular melanosis, a newborn rash more common in African American babies.

There's no need to treat this condition. The marks will disappear by the time your baby is 3 or 4 months old.Acne isn't unusual in new babies, either. About a fifth of newborns have a case of acne during their first month. Newborn acne is most likely to show up on the forehead and cheeks. It should disappear on its own within a few months.Birthmarks — including Mongolian spots, angel kisses, and stork bites — are also common. They come in a wide range of shapes, sizes, and colors and can show up anywhere on a baby's body. Certain types of birthmarks may not appear for several days or weeks after birth.Most birthmarks are harmless. Many go away on their own in the first few years of life, although some are permanent.

Hair

Be prepared for some surprises when it comes to your baby's hair. Dark-haired Caucasian couples have been thrown for a loop by children born with bright red or blond hair, and fair-haired couples have been presented with Elvis Presley look-alikes. And then there are the parents who wonder what color that peach fuzz is, exactly.That said, newborn hair doesn't tend to have much bearing on what your child's hair will eventually look like. Even if your baby was born with a full head of hair, he may begin to lose some or all of it in the first few weeks or months.Don't worry — the hair will come back, although it may not look the same when it does. Babies born carrot tops can turn into blonds, raven-haired newborns can sprout fair tresses, and blonds often turn into brunettes.Hair texture frequently changes in the first six months, too. You may find coarser, tighter ringlets growing in place of your baby's loose, fine curls, for example.

Eyes

Most Caucasian babies, though certainly not all, are born with dark gray-blue eyes that can take months — even years — to reveal their permanent color. Many African American, Asian, and Hispanic babies are born with dark gray-brown eyes that don't change color significantly, but some may start out with hazel eyes that get darker as they approach 6 months.Most often, the eye color you see at 6 to 9 months will be the one that sticks around.EarsYour baby's ears may be soft and floppy, and one of the edges may be bent over a bit. As the cartilage in your baby's ears becomes harder, his ears will become more defined.

Nose

Your baby's nose may look swollen from the pressure on it during delivery. It may also be a little flattened or even off-kilter. (He'll look less like a prizefighter in just a few days.)

How to buy: A baby bathtub

2008-08-09T11:01:00.001+05:30

The lowdown on baby bathtubs

Rub-a-dub-dub — ready for the tub? Maybe not. Until your baby can sit up on his own, usually at around six months, bathing him in an adult-sized tub can be more trouble than it's worth. Many parents love to get right in the tub and bathe with their babies, but that can be dangerous, too — your baby could bonk his head on a hard surface or even drown if he slips out of your grasp. If you try to bathe him without getting in the tub, your back won't appreciate all the leaning over.You may find it easier to keep your baby clean by bathing him in an infant bathtub, designed to make washing a wee body safe and fun. In addition to saving your back (baby tubs are designed for use in kitchen and other big sinks), baby bathtubs make it easier for you to handle a slippery, squirming infant by holding him safely in place.

What to look for when buying

You have a lot of choices these days: hard plastic tubs, foldable tubs, even inflatable tubs. Many tubs are contoured for comfort. Some are lined with a soft sponge interior.There are many models to choose from, but this is one baby product decision you don't have to lose sleep over. If it holds water, you're in business. Of course, that hasn't prevented manufacturers from coming up with a multitude of designs and value-added features. Here are some points to consider:
• Look for thick plastic that won't buckle from your baby's weight or the weight of the water.
• Foldable tubs are more convenient for storing and carrying, while non-foldable types may be a bit more solid and sturdy.
• An infant-to-toddler tub may serve you longer, because it has adjustable features to accommodate a growing baby.
• A plug at the base of the tub makes for easy draining.
• Make sure it doesn't have any rough edges that can chafe delicate baby skin.
What it's going to cost you Most baby bathtubs cost between $15 and $30.

How to bathe your baby

2008-08-09T10:15:00.000+05:30

How often should I bathe my baby?

Although some parents bathe their babies every day, until yours is crawling around and getting into messes, a bath isn't really necessary more than once or twice a week. (Just wash his face frequently and thoroughly clean his genital area after each diaper change.) When you do bathe him, you may find it a little scary to handle your wiggly little one when he's all soapy and slippery, so keep a good grip. Most babies find the warm water very soothing.

Where should I bathe my baby?

Instead of using a standard bathtub, which requires you to kneel or lean awkwardly over your baby and gives you less control over his movements, it makes sense to use the kitchen sink or a small plastic baby tub.

What's the best way to give my baby a bath?

Here's how to do it and what you'll need to make baby-bathing easy. With any luck, his bath will become one of the most enjoyable parts of your days together:

1. Assemble all necessary bath accessories.
2. Fill the tub with 2 to 3 inches of water that feels warm but not hot, about 90 degrees Fahrenheit (32 degrees Celsius).
3. Bring your baby to the bath area and undress him completely.
4. Gradually slip your baby into the tub, using one hand to support his neck and head. Pour cupfuls of bath water over him regularly during the bath so he doesn't get too cold.
5. Use soap sparingly (it dries your baby's skin) as you wash him with your hand or a washcloth from top to bottom, front to back.

Wash his scalp with a wet, soapy cloth. Use a moistened cotton ball to clean his eyes and face. As for your baby's genitals, a routine washing is all that is needed. If dried mucus has collected in the corner of your baby's nostrils or eyes, dab it several times with a small section of a moistened washcloth to soften it before you wipe it out.

6. Rinse your baby thoroughly with a clean washcloth.

7. Wrap your baby in a hooded towel and pat him dry. If his skin is dry, or if he has a bit of diaper rash, you may want to apply a mild lotion after his bath.

Bathing basics

2008-07-27T12:30:00.000+05:30

Baby bath seats

The lowdown on baby bath seats and rings

Once your little one is old enough to sit up on her own, usually between 4 and 7 months, she's really too big for a baby bathtub. One option is to graduate to a bath seat or ring. These can help keep slippery babies in an upright position, which is handy when your baby is just learning to balance on her bottom and topples easily. But bath seats and rings aren't essential. Many parents manage the precarious job of bathing babies by climbing into the tub with them.Bath seats and rings are a bit controversial. Many argue that they aren't safe because they give a false sense of security about leaving a baby alone in the tub for a few moments to answer the phone or run to the linen closet.

And older designs of bath seats, with suction cups and larger leg holes, can tip over or allow a baby to slide underwater, even with a parent close by.Some public groups have asked the U.S. Consumer Product Safety Commission (CPSC) to ban baby bath seats and rings, but the CPSC has instead been working with voluntary standards groups and manufacturers to create safer designs. And, more important, they've been working to make it clear to the public that even in a bath seat or ring, a baby should never be left without a capable adult at arm's reach. Bath seats are bathing helpers, not safety devices."Baby bath seats are not babysitters," says Patty Davis, spokesperson for the CPSC. "Never walk away, even to answer the phone — your child can tip over in seconds, and drown in just a few inches of water."

How to use them safely Because newer designs are safer, Davis recommends that parents avoid older-model, secondhand bath seats (such as those with suction cups and larger leg holes). The older models' suction cups could give way, causing the seat to tip your baby face-first into the bathwater. And the larger leg holes can allow babies to "submarine," or slide underwater, where they might become trapped.Newer models have an arm that fits over the side of the tub, but Davis notes that these don't work well on sunken tubs, and the seat can still tip or even break. Follow the manufacturer's instructions when installing the seat, she advises.Bath rings are inflatable circles that can help your baby stay upright in bathwater.

But these may require much more water in the tub to be effective. Safety groups advise keeping the water shallow to minimize the risk of babies drowning.Most important, no matter which bath seat you choose, never be more than an arm's length away from your baby. Leaving an older, seemingly capable child with your baby isn't safe either. Davis notes that most baby drownings happen while the baby is either unattended or left in the care of an older child.

What to look for when buying

Because of the controversy surrounding bath seats and rings, few new models are on the market these days. But there are some general things to look for when buying:

• Make sure the seat has a T-bar or strap that runs between your baby's legs.
• Check out display models in a store — do they seem sturdy and well-made? Might they tip easily?
• If it's a model that clamps to the side of the tub, measure the thickness of your tub's wall to make sure the clamp will fit.
• Will your baby fit into it? Bath seats come in one size, but not all babies are built alike — yours may not fit comfortably into it, or be able to be pulled from it without difficulty.
• Consider a seat that comes with spinning toys to make bath time fun.
• Watch out for any rough edges that might scrape your baby's skin when you pull her in and out of the seat.
• As with any children's product you buy or receive as a gift, check our product recall page regularly to make sure it hasn't been recalled.

What it's going to cost you

Bath seats tend to cost between $15 and $20.

Just after delivery- Caring for your newborn's umbilical cord stump

2008-07-13T12:17:00.002+05:30

Caring for your newborn's umbilical cord stump

What's the purpose of the umbilical cord?

Babies receive nourishment and oxygen in the womb through the placenta, which is connected to the inner wall of the mother's uterus. The placenta is connected to your baby by the umbilical cord through an opening in the baby's abdomen. After your baby is born, the umbilical cord is clamped and cut close to the body in a painless procedure, leaving an umbilical stump.

How long will my baby have an umbilical stump?

In about 10 to 21 days, the stump will dry up and drop off, leaving a small wound that may take a few days to heal.

Does the stump require special care?

It must be kept clean and dry. Fold the baby's diaper below the stump (or buy newborn diapers with a cut-out space for the cord) so it's exposed to the air and not to urine. When the stump falls off, you may detect a little blood on the diaper, which is normal. Avoid giving your baby tub baths until the stump falls off.In warm weather, have your baby wear just a diaper and loose T-shirt to let air circulate and speed the drying process. Avoid bodysuit-style undershirts until the cord has fallen off. And never attempt to pull off the cord, even if it looks like it's hanging by a little thread.Sometimes after the stump falls off some bits of lumpy flesh remain, which may disappear on their own or may need to be treated by your child's doctor.

These "umbilical granuloma" are not serious and contain no nerves, so if treatment is required, it's painless for your baby.As for the time-honored practice of swabbing the stump with rubbing alcohol, the waters have become murky. To prevent infection, your doctor or midwife will swab the cord with dye or another antiseptic when she clamps and cuts the cord. And for at-home care afterward, healthcare practitioners have long recommended cleaning the base of the stump with a cotton swab or gauze pad dipped in a little bit of rubbing alcohol once or twice a day.Many pediatricians still support that practice, but others now suggest that it's more effective to let the cord dry naturally.

That's because a 1998 study by the Hamilton Health Sciences Corporation in Ontario, Canada, found that untreated cords healed in eight days, while it took ten days for alcohol-swabbed cords to fall off. (None of the 1,800 newborns in the study developed an infection.)Pediatrician Carol A. Miller, a clinical professor of pediatrics at the University of California in San Francisco, says she still recommends the alcohol cleaning because many parents don't like the odor and "goopiness" that sometimes result from not using the alcohol. "It's questionable whether the one- or two-day benefit of natural drying is worth it," she says.If you're not sure which method to use, talk to your baby's doctor.

What are the signs of infection?

Consult your healthcare provider if:
• Your child develops a fever or appears unwell.
• The navel and the surrounding area become swollen or red.
• Pus appears at the base of the stump.

Just after delivery-Bonding with your newborn

2008-07-13T12:03:00.002+05:30

Bonding with your newborn

What is bonding?

When experts talk about bonding, they're referring to the intense attachment you develop with your baby. It's the feeling that makes you want to shower them with love and affection, or throw yourself in front of a speeding truck to protect them.For some parents, this takes place within the first few days — or even minutes — of birth. For others, it may take a little longer. In the past, researchers who studied the process thought it was crucial to spend a lot of time with your newborn during his first few days to seal the bond right away. But now we know that bonding can take place over time. Parents who are separated from their babies soon after delivery for medical reasons or who adopt their children when they're several weeks or months old can also develop enormously close, loving relationships.

What if I don't bond with my baby right away?

Breathe easy. Parent-baby bonding is complicated and often takes time to gel. As long as you take care of your baby's basic needs and cuddle with her regularly, she won't suffer if you don't feel a strong bond at first sight."There's so much discussion about bonding with a new baby that mothers often feel guilty if they don't feel some incredible attachment to their new baby immediately," says Edward Christophersen, a pediatric psychologist in Kansas City, Missouri. "But bonding is truly an individual experience, and it's just as reasonable to expect the bond to develop over a period of time as it is for it to develop instantaneously."Your baby may be cute and cuddly, but she's also an entirely new person, one you'll have to get used to before you become enmeshed. You can't force yourself to bond. There's no magic formula.A true parent-child bond is a byproduct of everyday caregiving. Over time, as you get to know your baby and learn how to soothe her and enjoy her presence, your feelings will deepen. And one day — it may be the first time you see her smile — you'll look at your baby and realize you're utterly, ineffably filled with joy and love for her. Now that's bonding.

When should I worry?

If, after a few weeks, you find that you don't feel more attached to and comfortable with your baby than you did the first day, or if you actually feel detached and resentful of her, talk to your baby's pediatrician and your own doctor or midwife. Postpartum depression is real and can hamper bonding, in which case it's best to seek help as soon as possible.Early intervention can prevent your relationship with your child from deteriorating. The longer you wait, the harder it will be to win back your baby's trust and affection.

Newborns 101

2008-07-11T22:23:00.003+05:30

Just After Delivery

Big Story: How love blossoms between you and your child

During her pregnancy, people warned Jen Harrington that she was about to fall in love like never before. But she didn't understand what they meant until her son, Joshua, was born. The feeling of adoration hit as soon as she saw him."It was like I wasn't even living before I looked at my baby," Harrington says.The bond between parent and child is one of the strongest connections in nature.

Romances come and go, but once you've bonded with your baby you're probably hooked for life, and not because you enjoy the prospect of changing thousands of diapers.The love you feel for your child isn't just intellectual or cultural — it's a basic part of your makeup. Whether you're a mom or a dad, an adoptive parent or a stepparent, you're primed to form strong bonds with your child, and your child is equally ready to connect with you.

Over the years, scientists and child development experts have uncovered fascinating details about the connection between parents and children. Their findings help explain why babies are so addictive and why we deeply love our kids when they get older, too — tantrums, arguments, and all. Your bond with your child will change over the years, but its importance never fades.

Pregnancy: Love before first sight

Don't be surprised to find yourself loving your baby before you even meet. Soon-to-be parents are often hit by a potent mix of emotions and anticipation — and these feelings help set the stage for your relationship with your child.If you're a pregnant mom, powerful mommy hormones also lay the groundwork for your connection with your baby. These kick in during pregnancy, growing stronger as the weeks go by.

As your due date nears, your brain starts producing more and more oxytocin, a hormone that literally helps bring out the mother in you. Also known as the love hormone, oxytocin is responsible for maternal behavior like nuzzling and grooming in animals from rats to monkeys. For pregnant moms, its main job is to ease feelings of stress while fueling anticipation for the new arrival.

Oxytocin has attracted serious scientific interest in recent years. Animal studies suggest that it plays a huge role in all sorts of social behaviors, from raising babies to forming long-term relationships. Animals that don't produce oxytocin ignore their offspring and find different mates every season. Species that do make the hormone tend to be doting parents that form lasting bonds with their mates. So when your body starts pumping out oxytocin during pregnancy, it's as if love is coursing through your veins.

Your baby is also developing a bond with you, even in the womb. Studies show that his heart will beat a little faster at the sound of your voice. It's something that will excite and comfort your child now and for years to come.If you're a dad, the second parent in a same-sex couple, or an adoptive parent expecting a new baby, you won't experience the same hormonal boost and physical closeness with your developing child that pregnant moms do.

But don't worry, your bond with your child won't suffer.Babies and older children have the capacity to form tight bonds with any caregiver who responds to their physical and emotional needs. Attachment theory — the guiding psychological principle of human relationships — says that people of all ages become deeply connected with others who provide a sense of security and support.People never outgrow their ability and desire to form these connections, so it's never too late to bond with a child, says Carol Wilson, a psychologist at Franklin & Marshall College in Lancaster, Pennsylvania. "Any caregiver can become an attachment figure," she explains.

You and your baby: Addicted to love

As labor progresses, the stream of oxytocin in a mom-to-be's brain and bloodstream becomes a torrent. Among its many other jobs, the hormone causes contractions and gets breast milk flowing. (It works so well that doctors routinely pump pitocin, a synthetic form of oxytocin, through an IV to induce labor.)As a brand-new mom, you'll be practically swimming in oxytocin when you finally get to hold your baby. The hormone can break through the exhaustion and pain of labor to give you a feeling of euphoria and intense love.

According to pediatrician and child development expert Marshall Klaus, the potency of oxytocin helps explain why babies are almost never abandoned in hospitals that allow mothers to hold and nurse them in the first hour after birth.New fathers aren't immune to the bewitching nature of babies — or the effects of oxytocin — either. Like mothers, dads get a rush of the love hormone when they see their baby for the first time. That may help explain the unexpected emotions that sometimes overwhelm dads in the delivery room.

Steve Bradley says he never gave much thought to fatherhood, even as his wife entered the last stages of pregnancy. He certainly didn't expect to cry when his daughter was born, but the waterworks started as soon as he saw Olivia. "I was pretty much in denial until she started to crown," he says. "She came out face up, looking at me first."New dads experience other dramatic biological changes, too. A Canadian study in 2001 found that men's testosterone levels tend to plummet (for a couple of months anyway) after they become dads for the first time. Even more intriguing, some men start to produce extra estrogen, perhaps the clearest sign of the transformative power of fatherhood.

According to Diane Witt, a neuroscientist with the National Science Foundation, estrogen makes the brain more sensitive to oxytocin, presumably helping fathers become more loving and attentive.Oxytocin isn't the only love chemical. Dopamine, the main currency of pleasure in the brain, plays an important role in early bonding, too — for you and for your baby. As you hold, rock, or nurse your child, you both get a rush of this "reward" chemical.While you're savoring the high, dopamine is helping your baby attach emotionally to you.

In 2004, Italian researchers put this together by observing baby mice: Those that couldn't sense dopamine didn't especially care whether or not their mom was around. It's the strongest evidence yet that dopamine plays a crucial role in mother and infant bonding.Adoptive parents also enjoy hits of the feel-good chemicals oxytocin and dopamine when they're around their children, according to Witt. And their offspring, like all children with healthy attachments to their caregivers, get regular rushes of dopamine from spending time with their parents.Incidentally, dopamine is what gives drug users a feeling of well-being when they're high on heroin or cocaine.

In a very real sense, addicts who get hooked on drugs are simply chasing the feeling that ideally flows between parent and child. Parental love just happens to be infinitely healthier.

What if we don't bond immediately?

About 30 percent of mothers don't fall in love with their babies right away, often because their child or the birth process isn't what they expected. Disappointment, stress, or exhaustion can be enough to drown out the strong hormones of love, but only temporarily. The vast majority of parents grow attached to their babies in the first few months.Carrie Hook, a child-abuse prevention counselor and mother of three, didn't get the chance to bond with her first child right after birth. After Hook's long and excruciating labor, baby Madison was born with a small amount of meconium in her lungs, and the nurses in the hospital immediately whisked her away.

Hook couldn't nurse or even hold Madison for at least eight hours. Even then, she had trouble connecting with the screaming bundle in her arms. "I just figured that your baby is born and you fall in love," she says. "I never thought I'd need impulse control to keep from throttling her." Suddenly, she wasn't sure if she was ready to be a mother.Hook often tells her story to mothers who are worried about connecting with their babies. The story ends on a happy note: Eventually Madison stopped screaming, Hook started to feel more confident, and the lovefest began.If you can't hold your baby right away after birth, don't despair. There isn't a magic "window of opportunity" for bonding, says Witt, the National Science Foundation neuroscientist.

Adoptive parents, parents of preemies, moms who have birth complications, and others who aren't always able to spend extended time with their babies right away still have plenty of time to fall in love.However, if your baby is born prematurely and has to spend a few days or weeks in an incubator, push to spend as much time with him as possible, as soon as you can, for your sake and your baby's. Recent studies show that skin-to-skin contact with a parent, often called kangaroo care, is one of the best therapies for preemies.

A father's touch can be just as calming as a mother's. A study of premature babies in neonatal intensive care units found that attention from Dad can have profound, long-lasting benefits. The babies who received regular visits from their dad gained more weight in the hospital. They also showed better emotional development 18 months later, probably because they continued to get lots of parental attention after they came home.Likewise, if you have a cesarean section and can't hold your baby right away, have your partner step in. A 2007 study of babies delivered by c-section found that skin-to-skin time with Dad cut down on crying and encouraged babies to start their first nap in the outside world.Love develops over time — for you and for your baby.

If you're together during your child's first hour of wakefulness, he may look you in the eye and memorize your face, or at least a blurry version of your face. Later, his early smiles can help the two of you connect. A study published in Pediatrics in 2008 found that when moms looked at pictures of their own smiling baby, their brain lit up in areas associated with the pleasure-connected chemical dopamine.

But it won't be until 7 or 8 months old that your baby will develop strong emotional attachments to you and other important people in his life, says Julia Braungart-Rieker, an associate professor of psychology at the University of Notre Dame.Your baby will care deeply about the people who hold him when he cries and feed him when he's hungry. He'll miss you when you leave the room, and he'll be happy when you come back. It's not exactly "love" as adults define it, but it's one of the strongest emotions he knows.

Note: It's impossible to "spoil" a baby with love, attention, and affection, says Emma Adam, a developmental psychologist at Northwestern University. When you comfort your child, you're building a foundation of trust and affection that will last a lifetime.

Toddlers: Are tantrums a sign of affection?

The bond between you and your child grows stronger in the toddler years, even if he spends much of the time stomping and screaming. In fact, those fits are a testament to your closeness.Tantrums from toddlers are a bit like lover's quarrels, according to Adam. "They're only capable of that meltdown because they love you so much," she says. In other words, your child couldn't be so disappointed or angry unless he trusted you deeply in the first place.

Even when you're incredibly frustrated with your toddler, don't worry that you'll stop loving him. Again, you have biology on your side. British researchers recently scanned the brains of 20 mothers who were looking at pictures of their own young children. The part of the brain that controls pleasure — the same part involved in romantic love — lit up like a slot machine hitting the jackpot. The part that judges and criticizes, however, practically shut down.Mom Jen Harrington certainly has trouble seeing any shortcomings in her son, even now that he's a big 5-year-old. He was one of those angelic, no-hassle kids that other parents envy. ("When he was a baby, we would sometimes joke that we should poke him just to see if he could cry," she says.)

But she and her husband are equally crazy about their daughter, Abigail, a crier and screamer who's as strong-willed as her brother is mellow."Before she was born, I was worried that I couldn't love another child as much as I love Josh," Harrington says. "But I do."Your toddler has a rich range of emotions. (If you spend 15 minutes with him in a grocery store, there's a good chance you'll see every one of them.) But he still doesn't understand the concept of "love" as you know it. Toddlers often throw the word around loosely: They may say they love you, but they'll also say they love their books or their toys or their third-favorite cereal. (Remember, these are the same people who like to call all four-legged animals "doggies.")

Even so, you don't have to worry about your place in your toddler's universe. He's keenly aware that you're important, and when he gets hurt or wants to cuddle, he doesn't run to his toys or the cereal cupboard. "Children want help from the people they trust the most," says Braungart-Rieker, the University of Notre Dame psychologist.

Preschoolers and big kids: A more refined love

As your child gets older, he'll start keeping more of his emotions hidden, partly because of peer pressure and partly because the toddler method of expressing every passing feeling can be exhausting.Still, some older children are extremely generous with their affection. Harrington's son Josh acts as if his mom and dad need constant reassuring. "When I drop him off at school, I can't leave without him saying 'I love you,'" Harrington says.Even if your child doesn't hug you at every opportunity, the signs of love will still be there. Some kids are very confiding and will tell you everything, while others are by nature more likely to keep things inside. But as long as you're there when your child needs you and are ready to listen, love will still flow in two directions.

The needy, clingy love of early childhood is starting to become more rich and complicated. Your child now feels empathy for you and others, and he'll start to love you as a person, not just a caregiver.As a preschooler, he may enjoy spending one night at Grandma's house, but it won't be long before he's begging to come home. At the same time, he's starting to push for more independence, which means he needs your love and support now more than ever.

"It seems contradictory, but the more security you give your child, the more independent he can become," says Adam, the Northwestern University psychologist.Even as your child strives to become his own person, he can't break the bond he has with you. You have a connection that goes back to before he was born, one that's propped up by affection, memories, and, yes, hormones.When a mom holds her 8-year-old or watches him in a school play, she gets a little hit of oxytocin, a literal reminder of the first hours with her baby. And when dads, stepparents, or adoptive parents kiss an "owie" or help out with homework, they're cementing an attachment that will last for years. It's enough to make you fall in love all over again.

Seven Signs that your child loves you

1. Your newborn stares into your eyes — he's actually working hard to memorize your face. He doesn't understand anything else about the world, but he knows you're important.

2. Your baby thinks about you even when you're not around. Between 8 and 12 months old, he'll start to scrunch his face and look around when you leave the room — and he'll smile when you return.

3. Your toddler throws wicked tantrums. Nope, those screaming fits don't mean he's stopped loving you. He wouldn't be so hurt and angry if he didn't trust you so deeply.

4. Your toddler runs to you for comfort when he falls down or feels sad. Kids this age may not truly understand the meaning of "I love you," but their actions speak louder than words.

5. Your preschooler gives you a flower picked from the garden, a finger-painted heart, a sparkly rock, or another gift.

6. Your preschooler wants your approval. He'll start to be more cooperative around the house, and he'll look for chances to impress. "Look at me!" will become a catchphrase.

7. Your grade-schooler trusts you with secrets, like his first crush or his most embarrassing moment. You're his confidante, even if he shies away from your hugs in public.

2008-07-09T20:47:00.002+05:30

Weight gain, weight loss, hormone surges, and powerful urges -- they're all in a week's work for your changing body. What's going on?

Let us help. Learn what's happening to your body and you can maintain your health and feel your best. For you. And for your family.

How to take care of yourself after a tough labor

What causes a difficult labor

A difficult labor (also know as dystocia in medical terminology) can be caused by a number of specific complications or by nothing in particular. Babies who are in breech position, for example, or who can't fit through the birth canal because they're too big or the mother's pelvic bones are too close together often cause difficult labors. And sometimes nature simply takes its sweet time and there's no one cause for the slowdown.

What you may be feeling after a long labor

Even an uncomplicated pregnancy that culminates in a relatively easy birth is an emotionally and physically exhausting experience. But if your labor was longer or more difficult than you expected, or if you experienced complications, you may feel particularly worn out. Not to mention confused and anxious about what to expect from your recovery. You might also have some questions about what exactly happened, and why; and you may be wondering about future pregnancies and how this labor experience may affect your health.

"Be sure to communicate your concerns to your physician," says Carol L. Archie, an obstetrician-gynecologist and professor of medicine at the University of California at Los Angeles School of Medicine. Even if the doctor explained to you what was happening during the delivery, you may not remember everything that was said -- you were a little distracted, after all! Don't be shy. Ask again now that you're able to listen to and think about the information.

Tips for a faster, easier recovery

"The most basic advice -- sleep when the baby sleeps, ask for help, eat nutritiously, and drink lots of fluids -- is even more important if you experienced difficulties during labor or afterward," says Archie. This is also no time to be stoic. "Accept all offers for help with cooking, cleaning, childcare, whatever friends and family offer," says Archie. Even under the best circumstances, labor is mentally and physically exhausting. If you lost a lot of blood, became dehydrated during labor, or are anemic after childbirth, it may take you a few extra days or weeks before you start feeling remotely like yourself again.

If no one offers to pitch in during the early days, or if you live far from family, consider hiring a doula, a specially trained "mother's helper." Many people think of a doula as someone who assists during labor, but a doula can also help out after delivery with light housekeeping duties, cooking, and whatever else you need once you're home so you can rest and bond with your newborn. For information about doulas and how to find one, click here. Some women find that talking, particularly with others who've experienced similar difficulties with labor, helps them feel better.

What you need to know for future pregnancies

If you plan to have more children, ask your physician if you have a physical problem, such as a narrow pelvis, that may have made your labor unusually difficult. Ask if there's anything you can do to shorten future labors. Unfortunately, most long labors are random occurrences, and there may not be anything you can do to make the next one easier besides being mentally and physically prepared to be patient while nature takes its course. It might also help to know that many mothers say labor gets easier with subsequent births, so you may not have such a tough time the next go-round.

BEDREST

2008-07-06T11:56:00.001+05:30

What is bedrest?

Nearly one in five women in the United States is put on bedrest at some point during pregnancy. That is, she's told to spend much or all of her time lying in bed. This can last anywhere from a few days to a number of months. And while that may sound good if you're exhausted, most moms-to-be find that being confined to bed, even for a few days, is uncomfortable, boring, and inconvenient. When days become weeks, it may feel more like torture than relaxation.

Are you supposed to stay in bed all the time?

It depends. There's no standard definition of bedrest, so it's something you'll need to work out with your caregiver. In general, complete bedrest means spending 24 hours a day in bed, getting up only to use the bathroom, if that. (Some women are told to use bedpans instead.) You'll be told to lie on your side most of the day because this position takes the pressure of your heavy uterus off the vena cava, a large vein that returns blood from your lower body to your heart.

Alternatively, some caregivers prescribe less restrictive forms of bedrest, sometimes known as modified or partial bedrest. You may be told to stay home and rest in bed, but be able go out occasionally in the car (usually to see your caregiver) and get up to make yourself lunch or to take a shower. Or you may just be asked to curtail your normal activities and take it easy, resting in bed only a few hours each day.

Why is bedrest prescribed?

Bedrest has been prescribed for various pregnancy complications for decades. It's often prescribed if you're carrying twins (or more) or are otherwise at risk for preterm labor, including if you have a weak cervix. Your caregiver may also recommend bedrest if she suspects that your baby isn't growing properly in the womb (intrauterine growth restriction), or if you have placenta previa (when your placenta is lying unusually low in your uterus, next to or covering your cervix).

Finally, you may be put on bedrest at home if you have mild gestational hypertension or preeclampsia, in the hope that it can help you keep your blood pressure in check.Few well-designed studies have been done on bedrest, however, so no one knows whether it's really useful for many of these problems. We have no good data to confirm or disprove the benefits of bedrest for women with placenta previa, mild hypertension or preeclampsia, or cervical insufficiency, or for women who are at risk for preterm labor and carrying one baby.

On the other hand, several good studies have looked at hospital bedrest for twin pregnancies, and none found that it reduced the risk of preterm birth. In fact, in two of the studies, being on hospital bedrest was actually linked to a higher risk for early delivery. (Unfortunately, there are no good studies on bedrest at home for twin pregnancies.) Only one small, well-designed study to date has looked at the effect of bedrest on intrauterine growth restriction, and it found that bedrest didn't seem to help.

The bottom line is that more good scientific studies are desperately needed. In the meantime, experts disagree on when and how to prescribe bedrest. Many caregivers say that until there's good evidence to the contrary, bedrest is worth a try. Others argue that bedrest itself can have negative effects and that women should not be subjected to it until we know that it does more good than harm. These caregivers tend to believe that the use of complete bedrest should be curtailed, and that some women would be better off just taking it easy — restricting their activity level, cutting back on work, avoiding heavy lifting or prolonged standing, and resting for a few hours each day, for example.

How can resting in bed be harmful?

Bedrest can be hard on your health. Being on complete bedrest for an extended period increases your risk of blood clots. (In some circumstances, a practitioner may prescribe heparin to help prevent clots.) What's more, because you don't use your muscles, heart, and lungs the way you would if you were moving around as usual, they lose strength, leaving you weak and extremely tired.You may also suffer from insomnia, changes in your metabolism, bone loss, and aches and pains.

The boredom and isolation you're likely to feel can take a toll on your mental health. When your bedrest order is eventually lifted, it can take many weeks to get your strength back, which makes it harder to care for a newborn.What's more, being confined to your bed can be a logistical nightmare and a financial hardship for you and your family. You may have to stop working sooner than you planned or find someone to care for your children. If you're on complete bedrest, you'll need someone to wait on you 24 hours a day, bringing you food and anything else you need.

What should I do if my practitioner wants me to go on bedrest?

Ask her to discuss the pros and cons with you. For more information on bedrest, check out this list of frequently asked questions compiled by Judith Maloni, a nursing professor and bedrest researcher at Case Western Reserve University.If you and your practitioner do decide that bedrest is a good idea for you, find out exactly what level of activity is allowed — whether you're supposed to stay in bed 24/7 or just take rest periods throughout the day, or something in between. Then talk to your family, friends, and employer and make a plan. You'll need to line up a support system to help you get through the days.

You can also contact Sidelines, an organization that provides support and advice for women on bedrest.If you're going to be on prolonged bedrest, you may want to line up more professional support. Ask your practitioner for a referral to a physical or occupational therapist, who can teach you simple exercises to do in bed to improve your circulation and help keep up some muscle tone. This person may suggest ways to reposition yourself in bed so that you're more comfortable. You may also benefit from counseling, since you're likely to feel torn between your obligation to your unborn child and your family or job. Counseling can be helpful for your partner as well if your bedrest is putting a strain on your relationship.

Deciphering expectant dads' dreams

2008-06-29T21:24:00.003+05:30

Have you dreamt about sleeping with someone besides your partner? Maybe you're worried that pregnancy will damage your sex life. Dreaming about your grandparents? Pending fatherhood can make you think about your family's roots. As a soon-to-be dad, your feelings of excitement, anticipation, anxiety, and worry may open a floodgate of dreams.

Here's something else your dreams might reveal: With all the attention centered on your wife and her bulging belly, you might feel left out. Your reaction is normal, says psychologist and dream expert Patricia Garfield. "Sharing your dreams and feelings throughout the pregnancy can help you both feel loved and needed," she says.To help you figure out what your dreams might be telling you, read on. The following excerpt from Garfield's book Women's Bodies, Women's Dreams describes three types of dreams from dads-to-be and their possible interpretations.

Fear that fatherhood will compromise your masculinity

During the first few months men with pregnant mates are likely to have many more sexual dreams than usual, according to an intriguing study conducted by psychologist Alan Siegel in Berkeley, California: Early in their wives' pregnancies, the fathers-to-be in his study dreamed of having sex with their wives, with other women, with prostitutes, or sometimes with homosexuals.

Siegel speculates that the protective feelings a man develops toward his wife and unborn child may be threatening to his masculinity. His sexual dreams and other macho visions (such as triumphs on the football field) may be expressing a need to be more "masculine." They offer reassurance.
At the same time he is having an unusual number of sexual dreams, an expectant father often dreams of protecting and caring for his wife. The sexual dream theme usually drops out as the pregnant wife moves into her second trimester.

Feeling left out

During the second trimester, an expectant father's dreams become less dominated by sexuality and more protective and nurturing. He may find himself thinking and dreaming about his family of origin. In other dreams, the expectant father might see himself being pregnant and giving birth. Although he recognizes his mate's unique role as childbearer, he wants to share in the pregnancy experience.
Expectant fathers often feel left out at this stage of their wife's pregnancy. More than half of subjects studied dreamed of being excluded and alone. Confiding troublesome dreams to one's mate can help men overcome feelings of loneliness and keep partners in touch, while trading happy dreams can increase confidence and intimacy.

Anticipating fatherhood

A father-to-be anticipates the birth of a child in his dreams just as his pregnant wife does. Often fathers dream of finding babies or of being given them, sometimes during elaborate ceremonies or rites. While a woman may be dreaming of the work involved in her forthcoming labor, her mate may be concentrating on dream celebrations of the baby's birth. Dreams of this kind indicate acceptance and valuing of the child whose arrival is imminent.

How and why does pregnancy affect dreams?

2008-06-28T22:04:00.002+05:30

Expert Answers

Mary O'Malley, sleep consultant

Dreams reflect your emotional state, so it's only natural that during pregnancy — a time of many mixed emotions — your dreams seem more intense and stranger than usual. Hormonal changes (specifically, a surge in progesterone) also make you dream more frequently and vividly. And you may be remembering more of your dreams if you're regularly waking up during the night, interrupting phases of dream-filled REM sleep.

Experts have found that moms-to-be often dream about such things as water, talking animals, sex, and large buildings during their first, second, and third trimesters. As you find out more about your pregnancy and your growing baby, your dreams will probably be affected. Soon after I learned that my pregnancy was high-risk and that I could hemorrhage during delivery, for instance, I had several very bloody anxiety dreams. Try not to be disturbed by your dreams — they simply reveal your apprehension and excitement about the huge changes taking place in your life.

If you'd like to, record your dreams and what you think they mean in your personal, printable dream journal. Share your nocturnal adventures with your spouse, and while you're at it, find out what expectant-father dreams he might be having, too.

How can I sleep well during bedrest?

2008-06-25T22:28:00.002+05:30

Expert Answers

Mary O'Malley, sleep consultant

Bedrest, whether you're on it for most of your pregnancy or just the final weeks, can be tough both emotionally and physically. Of the many challenges you'll face, getting a good night's sleep is high on the list. Why? Because spending weeks or months in bed can wreak havoc on your circadian rhythms — your natural sleep / wake cycles — and your sense of time may start to erode as a result.

Here are a few steps you can take to sleep better during bedrest.

• Maintain a normal day / night routine. Even though you'll be spending most or all of your time in bed, try to keep up with regular daytime activities such as taking a shower in the morning (if your doctor says it's okay) and putting on makeup if that's what you usually do. Swap your PJs for comfortable daytime clothes — sweatpants and a loose shirt are a good choice.

• Get some sunlight. If you can, move your bed or a chair close to a window so you can enjoy the daytime light. It will boost your spirits and help keep your internal clock on track, too.

• Create a daytime schedule and stick to it. Maybe you'll decide to read the newspaper and make phone calls in the morning and watch a movie or read a book in the afternoon. Whatever you choose to do, follow your schedule as closely as possible.

• Nap, but not too much. You're on bedrest because you need to rest. Go ahead and nap during the day, preferably at a scheduled time. If you snooze too late in the day, though, you may find yourself having a hard time falling asleep at bedtime.

• Eat meals at roughly the same time every day. Ask a friend or relative to drop by and join you for a breakfast or lunch. Having meals at the same time will help keep your body on a schedule.

Does what I eat or drink affect my sleep?

2008-06-25T22:25:00.001+05:30

Expert Answers

Jodi Mindell, pediatric sleep expert

Certainly. If you drink caffeinated beverages such as tea, coffee, or soda in the afternoon or evening, you may not sleep well that night. Smoking and drinking alcohol — which you really shouldn't be doing while you're pregnant, anyway — can also interfere with sleep. Eating a lot of sugar or sugary snacks such as chocolate, cookies, or candy before bed may leave you feeling revved up or restless.

On the other hand, if you go to bed with an empty stomach, you may wake up hungry or nauseated. Have some crackers, a banana, or a granola bar before you hit the hay. If you get heartburn or indigestion, stay away from spicy, heavy, or acidic foods (such as tomato products), especially within two or three hours of bedtime. If you find that dairy products upset your stomach, avoid them, too.

Do sleep patterns before birth predict sleep patterns afterward?

2008-06-25T22:16:00.001+05:30

Do a fetus's sleep patterns in the womb predict his sleep schedule after he's born?

Expert Answers

Mary O'Malley, sleep consultant

You've probably heard that if your baby is most active in the womb at night, he'll be a night owl once he's born. Some moms — as well as a few sleep experts — swear this old wives' tale is true, but no scientific evidence bears it out.

That doesn't contradict the fact that your baby is developing a sleep/wake cycle before he's born. At the beginning of your third trimester, he'll start having active or REM (rapid-eye-movement) sleep, the phase of sleep in which we dream. He'll add non-REM sleep — also known as quiet sleep — a month or so later.

Just like newborns, babies in utero don't have our typical day/night schedule; they rest for a few hours, and then are awake for a few hours. So don't worry about disturbing his sleep routine — you'll have to wait until a month or two after he's born for him to even have one!

Does what I eat or drink affect my sleep?

2008-06-23T21:55:00.001+05:30

Expert Answers

Jodi Mindell, pediatric sleep expert

Certainly. If you drink caffeinated beverages such as tea, coffee, or soda in the afternoon or evening, you may not sleep well that night. Smoking and drinking alcohol — which you really shouldn't be doing while you're pregnant, anyway — can also interfere with sleep. Eating a lot of sugar or sugary snacks such as chocolate, cookies, or candy before bed may leave you feeling revved up or restless. On the other hand, if you go to bed with an empty stomach, you may wake up hungry or nauseated. Have some crackers, a banana, or a granola bar before you hit the hay. If you get heartburn or indigestion, stay away from spicy, heavy, or acidic foods (such as tomato products), especially within two or three hours of bedtime. If you find that dairy products upset your stomach, avoid them, too.

Can sleep patterns predict postpartum depression?

2008-06-23T21:44:00.001+05:30

Expert Answers

Jodi Mindell, pediatric sleep expert

According to one study, there is a link between the quality of sleep during the final weeks of pregnancy and postpartum depression. Researchers in Massachusetts followed 34 pregnant women and analyzed the quality of their sleep at three stages: four weeks before giving birth, three weeks postpartum, and four months postpartum. The results? If the quality of their sleep plummeted during the final weeks of pregnancy, the women were more likely to feel depressed after giving birth. Another finding: Women of all ages sleep more — and better — at three weeks postpartum than at the end of pregnancy or four months after giving birth.

Having a positive plus-size pregnancy

2008-06-22T14:35:00.004+05:30

When Adrienne Erazo, a researcher at a newspaper in Orange, California, got pregnant the first time, the excitement over building her family was immediate and profound. As her baby started to grow, she felt a sense of purpose, like this was what she was supposed to do her whole life. But hanging over that joy was a pall of doubt and shame: Was she doing something wrong? Was she hurting her baby?

She wasn't drinking alcohol, smoking, or taking drugs — she was simply overweight, a size 22W at 5 feet 4 inches tall. She'd been overweight most of her life.She kept hearing the concerned voices of her husband and family telling her, months earlier, that she should really "get her weight under control" before she got pregnant. She kept thinking about all the warnings she'd read in the news about plus-size women having gestational diabetes and their babies having birth defects.

"When I got pregnant, at first I was sad because I was so worried," says the 27-year-old. "I should have been happy." Unfortunately, Erazo's not alone.Guidelines from the American College of Obstetricians and Gynecologists urge healthcare professionals to counsel plus-size women to lose weight before pregnancy, limit weight gain during pregnancy, and lose baby weight quickly after pregnancy. The U.S. Centers for Disease Control and Prevention ranks being overweight or obese during pregnancy nearly at the same risk level as uncontrolled high blood pressure, diabetes, smoking, or drinking.With all the warnings out there about how dangerous it is to be overweight — and the phrase "obesity epidemic" appearing regularly in the news — it's no surprise that women like Erazo feel anxious and guilty about their pregnancies and spend at least part of the time feeling bad about themselves.

A more positive outlook

Luckily for Erazo and countless other plus-size women, the truth is not nearly so frightening. After nine months of a complication-free pregnancy, Erazo gave birth to Orion, a 9-pound baby boy with soft brown hair and his daddy's chocolate brown eyes.Now pregnant with her second child, Erazo wants you to know something: "I'm fat and pregnant and I'm just fine," she says simply. "It's important for other moms to know that you're not a bad mom and you won't be a bad mom just because you're plus-size."In fact, if you're a plus-size woman, you're part of a growing sorority. Today, one in three pregnant women is considered obese — having a body mass index (BMI) of 30 or more. And half of women of childbearing age are considered overweight — having a BMI of 25 to 29.9. And while plus-size women face increased risks of complications, the majority of these are manageable if they occur, and being overweight doesn't mean you're destined for a troubled pregnancy."Most plus-size women have completely normal pregnancies and normal babies.

We're currently making a lot of fuss about maternal size. This only magnifies the risks and scares women," says Cornelia van der Ziel, a clinical instructor in obstetrics at Harvard Medical School and an oby-gyn in private practice."The odds are, plus-size women are going to have healthy pregnancies," says Brette McWhorter Sember, a mom of two and coauthor of Your Plus-Size Pregnancy. "The odds often sound like they're against plus-size women, but the truth is that you're most likely to have a perfectly healthy pregnancy, nothing wrong with the baby, and a wonderful delivery. It doesn't have to be that big of a deal."As the women profiled below can attest, your weight truly doesn't have to be that big of a deal — and it is possible to have a healthy pregnancy and healthy baby.

Adrienne: Overcoming gestational diabetes

Erazo and her husband, Marcelo, decided to try for a second baby on her husband's birthday. Two weeks later, she was pregnant. They were thrilled and were hoping this pregnancy would also be complication-free. This time, however, Erazo developed gestational diabetes. You can hear the edge of tension in her voice as she talks about the future and worries about her baby being affected by gestational diabetes.

She doesn't know what will happen, of course, with the delivery or the baby's health, but she's trying not to blame herself. Instead, she's focusing on approaching food in a different way. Rather than interpreting her gestational diabetes diagnosis as a sentence or a judgment of herself as a plus-size woman, she's being positive and embracing a new, healthier way of eating. She feels better already."This pregnancy is completely different," she says. "It's a really positive experience because of all the realizations I've been making about how I eat and how this diet makes me feel. I feel healthier." She adds, "I truly believe that I'll eat this way the rest of my life."She loves her body when she's pregnant — a shift she didn't expect. She spent many years hiding her body from people, overwhelmed by the negative attention her large size sometimes attracted. She sucked in her stomach. She hid behind baggy clothes. But being pregnant, she says, makes her feel beautiful, even sexy."I'm so proud of my belly," she says. "It's okay for me to be big for once, because I'm pregnant. Plus, I just feel so special when I'm pregnant. The fact that I can grow this beautiful being inside my body is a blessing. I feel like I have a purpose."

Amie: Complication-free pregnancy

When Amie Blasi got pregnant in 2004, it was a surprise. A pet store employee in Lakeland, Florida, Blasi was finalizing a divorce from her first husband and making plans for the future with her fiancé, Nathaniel. Her first hint that she was pregnant came while she was at work. "I was cleaning a cage out after a mess, and the smell made me sick to my stomach," she recalls. "It had never really bothered me before, and I was sick the rest of the day. I just suspected it was because I was pregnant."

As soon as she learned she was carrying a baby, she worried she was hurting her baby by being overweight. At 5 feet 5 inches with long red hair down her back, the 27-year-old Blasi weighs about 280 pounds today and is a stay-at-home mom. Before getting pregnant, she had lost 60 pounds and was down to a size 22, but the weight loss didn't loosen the grip of her fears.As it turned out, everything was fine: After a complication-free pregnancy and a simple delivery, she gave birth to a healthy baby girl with fuzzy ears and a dark patch of hair on her head that, she recalls, "was as soft as a kitten." She weighed in at 8 pounds, 13 ounces, and has her mom's eye shape and her daddy's dark brown eye color.

Mechelle: Moving past negativity

Mechelle Lehman was taking a break from getting her degree in secondary education when she found out she was pregnant the first time. She and her husband, Jon, had just moved to a new town. She says she worried briefly about her weight affecting her pregnancy. Instead, her pregnancy was easy. But that didn't stop the occasional negative comments about her weight from strangers and acquaintances.

Lehman, now a 28-year-old stay-at-home mom of two in DeKalb, Illinois, stands 5 feet 6 inches tall and vacillates between a size 16 and a size 24. During her pregnancies, she says, people couldn't tell she was pregnant until she was quite far along. "I didn't change too much during my pregnancies," she says. "The only difference was that my large hourglass shape — which I call an infinity glass! — turned a little bumpier around the middle."Still, people occasionally made negative comments about her weight — assuming she wasn't pregnant — even when she was wearing what she thought were her "most pregnant-looking" outfits. But she figures that's more their problem than hers."This is how I look at it: I've worn a size 16 to 24 most of my life," she says, matter-of-factly. "You get used to those comments. You can choose to let them make you angry, or you can choose to try to ignore them. That's what I do. Seems to me the most important thing about your pregnancy is that you just eat healthy and surround yourself with nice people."She adds, "You need to try to enjoy being pregnant. It's an experience of a lifetime."

And Lehman did enjoy her pregnancies. Her first yielded a happy, healthy baby girl, Mallora. Her second pregnancy was complication-free, and she gave birth in July 2006 to 8-pound, 6-ounce Thorsten.

Jennifer: An "easy" pregnancy

When Jennifer Mountain, a 29-year-old mom of one and a real estate contractor in Haslet, Texas, got pregnant in 2005, the last thing on her mind was how her weight would affect her baby. She was finishing her master's degree in social work, working part-time at a real estate office, and interning at a day resource center for the homeless. Plus, she and her husband had just filed for bankruptcy.

Jennifer Mountain andher little pumpkin"My biggest surprise with the pregnancy has been how easy it was. It's been a blessing," says the Texas native, who, at 5 feet 5 inches, weighed 245 before getting pregnant.She gained 10 to 15 pounds during the pregnancy without changing her diet, and she tested negative for "everything you're 'supposed' to get as a plus-size pregnant woman" — such as gestational diabetes and preeclampsia.Ironically, it's been her friends and family — not the medical professionals — who keep predicting dire outcomes for her pregnancy."You can be healthy and overweight, and it's been nice having medical professionals support me in that," she says. "It was a little disconcerting sometimes having my family react so poorly, though. I just didn't listen to them."

Elisha: Winning out over medical skeptics

At 32, Elisha Mitchell has two beautiful girls — and she had both as a plus-size woman. Unlike many other women, she didn't worry about her weight affecting her babies.

"Overall, I knew I was healthy — maybe more so than some skinny people," she says. "I ate healthy, avoided caffeine, didn't smoke, stayed out of smoke-filled places, didn't drink, didn't do drugs, ate low-fat and high-protein foods, and exercised. So even though I was overweight, I actually felt quite healthy. Heck, the day before I delivered Zöe [her first child], I went on a two-mile hike!"Mitchell, a web designer who was living in Nashville, Tennessee, at the time of her first pregnancy, found healthcare providers who didn't patronize her because of her weight — and left one who did — and, she says, ate healthier as a pregnant woman than she does as a mom. "If only I cared about myself as much as I cared about my girls!" she jokes.She gave birth to 8-pound, 2-ounce Zöe after a 12-hour labor, and the only complication was that she needed an episiotomy.Her second daughter, Bella, was a different story, however.

"That pregnancy was complicated from conception!" she says. "I was diagnosed with gestational diabetes, but I was borderline, meaning I fell over into that category by like only two points. So I had to come in weekly for fetal heart tests."When she was diagnosed with gestational diabetes, Mitchell admits to becoming mad at herself, convinced that she wouldn't be borderline for gestational diabetes if she weighed less. Still, she had no complications and was religious about keeping her doctor appointments, taking a pill every morning to regulate her blood sugar, and testing her blood sugar three times a day.

The worst part about her second pregnancy, she says, was how the medical community treated her. Having moved from Tennessee to Ohio, she had to change healthcare providers and deal with a new medical system — an impersonal one that treated her, she says, as a "number, not a person."Her delivery was frustrating, too. Convinced Bella would be a large baby because of the gestational diabetes, her doctor induced her a week early. Things went downhill from there: Medical residents tried for almost an hour to give her an epidural before an anesthesiologist came in and injected it in a few minutes, the umbilical chord wrapped itself around Bella's neck when Mitchell's water was artificially broken, and both the baby's and Mitchell's heart rates began to drop.Eventually, a doctor came in and suggested they refill Mitchell's uterus with fake amniotic fluid. Bella relaxed, both heart rates returned to normal, and Mitchell delivered vaginally within an hour with no further problems.

Bella, it turned out, wasn't a large baby after all — she weighed in at 7 pounds, 8 ounces, with normal blood sugar."I really think that if I were able to stay with my first ob-gyn for my second pregnancy, I would have had a normal delivery just like I did with Zöe," Mitchell says. "But who knows? The bottom line is that they are both healthy!"

Understanding and managing health risks

2008-06-22T14:28:00.002+05:30

Most plus-size women can expect a healthy pregnancy. But as with any journey as complex as having a baby, the ride may get a little bumpy from time to time.Women with a body mass index (BMI) above 25, considered overweight, are more susceptible to certain pregnancy conditions such as gestational diabetes. This risk climbs higher if your BMI is 30 or above, considered obese. Not sure where you fall on the spectrum? Find out what your BMI is.

Risk reality check

The fact is, doctors and researchers still don't know exactly why weight matters. And it's just one piece of the puzzle — age, genetics, and even ethnicity factor in."The impact of obesity is different for every ethnic group," says Gladys Ramos, an ob-gyn and coauthor of a 2006 study in the American Journal of Obstetrics and Gynecology on race, weight, and pregnancy complications. "

For example, Latina women have a higher rate of gestational diabetes and preeclampsia, compared to Caucasian women. African-American women have a higher rate of c-section than do heavier Caucasian women. Caucasian women tend to form bigger babies, where African-American women do not."The good news is that most of the health conditions and situations mentioned below are manageable and in some cases they're preventable — and you may not experience any of them. You could have a perfectly healthy pregnancy and delivery.It's important to keep in mind that "most plus-size women have completely normal pregnancies and normal babies," says Cornelia van der Ziel, a clinical instructor in obstetrics at Harvard Medical School and a private-practice ob-gyn.

"You can be overweight and have a fit pregnancy. Any obese pregnant woman can modify her risks by eating well, exercising, and adhering to weight-gain guidelines," notes van der Ziel, a coauthor of Big, Beautiful, and Pregnant: Expert Advice and Comforting Wisdom for the Expecting Plus-Size Woman.Sujatha Reddy, an ob-gyn in Atlanta, says the most important thing to do is have a conversation with your healthcare provider about your individual risk factors. Do you have a history of high blood pressure? Do you have a history of uncontrolled blood sugar? What about a family history of larger babies?

Once you know your personal risk factors, work with your healthcare provider to make sure you're having the healthiest baby you can. (Do you think your healthcare provider is treating you with respect? If not, read about how to find a plus-size-friendly healthcare provider.) And don't panic: As Reddy says, "It's not a doom-and-gloom scenario at all."

Health conditions and situations

Here are the conditions and situations your healthcare provider may need to be mindful of as you go through your pregnancy:Neural tube defects — Neural tube defects (NTDs) are problems with how a baby's brain and/or spinal cord develop. Overweight and obese women have a higher risk of having a baby with NTDs, although the risk is still very small: around 0.1 percent of births, according to the Duke University Center for Human Genetics.

What you can do: Researchers still don't know why obese women have higher rates of NTDs, which makes it hard to create specific recommendations, but the most commonly recommended prevention for all women is to take folic acid supplements before and during pregnancy. If you're plus-size, you may have lower blood folate levels than smaller women, according to one study. Although it's still unclear what the connection may be between weight, lower folate levels, and NTDs, it doesn't hurt to start taking 1,000 micrograms (mcg) of folic acid in a supplement form before you conceive (since these defects start early in pregnancy) and keep it up throughout your pregnancy.

You can also ask your healthcare provider for a triple-screen blood test at 15 weeks to detect NTDs; ultrasound and amniocentesis can confirm diagnosis.Gestational diabetes — Gestational diabetes is causes elevated blood-sugar levels during pregnancy. Your healthcare provider will evaluate your blood sugar during glucose screening and tolerance tests. Uncontrolled levels of high blood sugar can cause a variety of problems, including a large baby and hypoglycemia in your baby after birth.

According to the National Institute of Child Health and Human Development, about 2 percent of women with a BMI of 19 to 24 develop gestational diabetes, while about 6 percent of overweight women and a little more than 9 percent of obese women develop the condition.What you can do: Learn about what gestational diabetes is, and how you can manage it with nutrition. You can also get more information from the American Diabetes Association. Even if you have gestational diabetes, you can have a healthy pregnancy if you follow your healthcare provider's advice and attend all your prenatal appointments.Gestational hypertension — If you develop high blood pressure (a reading of 140 over 90 or higher — even if only one of the numbers is elevated) after 20 weeks of pregnancy but don't have protein in your urine, you'll be diagnosed with gestational hypertension, sometimes called pregnancy-induced hypertension. (High blood pressure with protein in the urine indicates preeclampsia.)

If you had high blood pressure before pregnancy, or are diagnosed with it before 20 weeks of pregnancy, that's called chronic hypertension. Chronic hypertension is a heart risk, but gestational hypertension is usually mild and likely won't cause any overt problems for you or your baby. However, it does puts you at higher risk for preeclampsia, intrauterine growth restriction, preterm birth, placental abruption, and stillbirth.Several studies have shown that roughly 10 percent of obese women (BMI of 30 or above) will have gestational hypertension, versus around 4 percent of women with a BMI of 19 to 25.What you can do: Show up for your prenatal appointments — your healthcare provider will take your blood pressure at each visit. If you have either type of hypertension, she will monitor your health closely, and possibly put you on blood-pressure-lowering medication.

Learn more about gestational hypertension and how it's managed.Preeclampsia — Preeclampsia, also known as toxemia, is a complex disorder that's diagnosed if you have high blood pressure and protein in your urine after 20 weeks of pregnancy. It causes blood vessels to constrict, which raises your blood pressure and lessens blood flow throughout your body. Preeclampsia can range from mild to severe, and can progress slowly or rapidly. In severe cases, this can cause organ damage for you and problems for your baby, such as poor growth, decreased amniotic fluid, and placental abruption.

Severe cases can lead to seizures, a condition called eclampsia. Women with severe preeclampsia are given antiseizure medication."[Weight] is a major risk factor, but [it's] not primary," says Reddy. "Preeclampsia is much more common in women under 20 and women older than 35. If you're under age 35 and overweight, you're at a lower risk for preeclampsia than a woman at a healthy weight who's 35 or older." Studies have shown that about 9 to 12 percent of overweight and obese women will be diagnosed with preeclampsia, while 4 to 5 percent of women with a BMI in the 19 to 25 range will be diagnosed.

What you can do: Make sure to attend all your prenatal appointments, where your healthcare provider will check your blood pressure. If your blood pressure is high, your provider will test your urine for protein. Call your healthcare provider right away if you experience puffiness or swelling in your face; swelling in your extremities; a severe or persistent headache; rapid weight gain; intense pain or tenderness in your upper abdomen; or vision changes such as double vision, blurriness, seeing spots or flashing lights, light sensitivity, or temporary loss of vision. Learn more about preeclampsia and how it's managed.Large baby — While most plus-size women will have perfectly average-size babies (around 7 pounds, 8 ounces), obesity is considered a risk factor for having a large baby — 9 pounds, 15 ounces, or more — known as macrosomia. About 5 to 10 percent of babies are macrosomic.

Your baby is more likely to be large if you have undiagnosed or poorly managed gestational diabetes, or have a family history of large babies, or go past your due date. If your fundal measurements indicate you're measuring large for dates, that may indicate you're carrying a large baby, but it could also be due to a large amount of amniotic fluid (and fundal measurements are more likely to be inaccurate in plus-size women). An ultrasound is a more accurate estimate of fetal size; however, the only real proof of a macrosomic baby is the post-birth weigh-in.

What you can do: If you have gestational diabetes, make sure to keep your blood sugar levels in check. If your healthcare provider suspects your baby is large, talk with her about your options. While some providers recommend a c-section, most will opt for a trial of labor to see if vaginal delivery is possible before turning to a cesarean. Learn more about macrosomia and talk to your provider.Longer labor — A 2004 study in the journal Obstetrics and Gynecology found that overweight women were in active labor an average of 80 minutes longer and obese women 105 minutes longer than thinner women. But these are averages — it doesn't necessarily mean you will be in labor longer, says van der Ziel.What you can do: Exercising, eating a sensible diet, and gaining the appropriate amount of weight may affect the length of labor, says van der Ziel.

Prepare yourself for labor with childbirth preparation classes and exercises that can ease labor, and consider hiring a labor coach. A positive mindset helps, too — go into it with confidence in your body's ability to handle labor, adds van der Ziel.Cesarean — A number of studies have shown that overweight and obese women are more likely to have a cesarean delivery, from 26 to 35 percent of deliveries, versus around 20 percent in women with a BMI in the 19 to 24 range. This is likely due to the other factors that can be associated with being plus-size and pregnant: If you're in labor for a long time, or have preeclampsia, gestational hypertension, or other health complications, your healthcare provider may be more likely to recommend a c-section, either prescheduled or as an intervention during labor if there are problems.What you can do: Talk to your healthcare provider.

Does she consider you at high risk for a c-section, and if so, why? Ask about her c-section rate and her philosophy about c-sections in general. If you have no serious health problems, is she fine with trying vaginal delivery? During a vaginal delivery, what might cause her to order a c-section intervention?Also, you may decrease your odds of having a c-section by following your doctor's weight-gain recommendations, exercising during pregnancy, and taking childbirth preparation classes

How to manage your weight during pregnancy

2008-06-22T13:56:00.002+05:30

If you started off your pregnancy overweight for your height — with a body mass index (BMI) of more than 25 — you're far from alone. More than half of women in the United States are considered overweight.You're considered overweight if your pre-pregnancy BMI — the relationship between your height and weight — is between 25 and 29.9. You're considered obese if your BMI is 30 or greater. (Not sure where you fall? Find out what your BMI is.)

If I'm overweight, how much weight should I gain during pregnancy?

You should gain between 15 and 25 pounds by the end of your pregnancy, at a rate of approximately 2 to 3 pounds a month, primarily in your second and third trimesters. (Experts advise women with a healthy BMI — 18.5 to 24.9 — to gain between 25 and 35 pounds.) It's normal, however, not to gain any weight at all during the first trimester, when morning sickness is most pronounced.

Is it okay to lose weight during pregnancy?

Pregnancy is definitely not the time to go on a weight-loss diet: Restricting your food intake is potentially hazardous to you and your developing baby. But many plus-sized women do experience weight loss without dieting during pregnancy.In the first trimester, it's common to lose weight as the result of morning sickness: The nausea can diminish your appetite, and the vomiting can cause you to lose calories. But don't worry, your baby your baby will still get all the calories he needs. Overweight women have an extra reserve of calories in stored fat, so as your baby grows, it's okay for you to maintain or even lose a little weight.

How can I stay on track with weight gain?

Your best strategy is to eat healthily and to incorporate exercise into your daily life.Eating well for pregnancy takes a bit of researching, planning, and tracking. Learn how to eat well during pregnancy, and follow the seven principles of pregnancy nutrition.Use our handy pregnancy food diary to make sure you're getting enough nutrients and drinking plenty water every day. The diary's also useful for tracking your mood and hunger levels, so you can spot patterns you may need to change.If you're a relative exercise newbie, start with Pregnancy Exercise for Beginners. You can enjoy low-impact exercise such as walking, swimming, and low-impact aerobics. Never start a new exercise regime without first talking to your healthcare provider. And always follow the 13 rules of safe pregnancy exercise

Mother's obesity and PROM a risky mix for newborns

2008-06-21T13:58:00.002+05:30

Fri, Nov 16, 2007 (Reuters Health) - Obese women are at increased risk of having their infant die soon after birth, especially if premature rupture of membranes (PROM) occurs before full-term, according to a report in the journal Obstetrics & Gynecology.

These findings may indicate there is a problem in how obese women with preterm PROM births are treated, Dr. Ellen A. Nohr from University of Aarhus, Denmark told Reuters Health. It is also possible that "preterm infants of obese mothers may be more susceptible when they are not protected by the membranes."

PROM occurs when the membranes rupture before labor begins, which is usually followed by labor and delivery. Umbilical cord compression is the primary risk for the fetus, while infection within the uterus is the major complication in the woman.

Nohr and colleagues used the Danish National Birth Cohort to investigate the association between prepregnancy obesity and infant mortality, with focus upon different types of preterm births.

The infant mortality rate was higher in infants of overweight and obese mothers than in infants of normal-weight mothers, the authors report, even after consideration of other maternal and infant risk factors.

Mortality in infants born after preterm PROM was more than tripled in infants of overweight women and was increased nearly six-fold in infants of obese women, the report indicates.
High body mass index was not, however, associated with mortality in infants born after spontaneous preterm births without preterm PROM.

The results were similar in infants with or without malformations and after exclusion of infants born to women with obesity-related diseases or infants born to subfertile women, the researchers note.

"This is the first study indicating an elevated mortality in infants of obese mothers after preterm PROM, and it is therefore too early to suggest changes in the management of pregnancies in obese women," Nohr said.

"However, if these findings are causal and we understand the mechanisms behind them, it may be possible to suggest preventive measures," she added.What you can do:If you're plus-size and pregnant, learn how to:

• eat well during your pregnancy,
• safely manage your weight, and
• have a positive plus-size pregnancy.

You can also reduce your risk of premature birth by eating a healthy diet, exercising regularly, and visiting your healthcare provider for every scheduled prenatal visit.

High blood sugar in pregnancy may lead to obese offspring

2008-06-21T13:54:00.001+05:30

Tue, Sep 18, 2007 (Reuters Health) - Children born to mothers who developed diabetes during pregnancy are more likely to be overweight or obese than their peers, according to a new study.
However, treatment of so-called gestational diabetes reduces the risk.

Dr. Teresa A. Hillier and her colleagues studied nearly 10,000 mother-child pairs enrolled in Kaiser Permanente plans in Hawaii and in the Pacific Northwest during the period from 1995 to 2000. Women with preexisting diabetes were excluded.

Follow-up with the children 5 to 7 years later revealed a significant association between their weight and their mothers' blood glucose levels when tested during pregnancy, the researchers report in the medical journal Diabetes Care.

Specifically, a child was 28 percent more likely to be overweight or obese when the glucose level of the mother during pregnancy was in the top range rather than the lowest.

According to Hillier's team, the trend remained significant after factoring in maternal weight gain, maternal age, number of pregnancies, ethnicity, and birth weight.

However, further analysis showed that the risk of obesity was not significantly increased among children born to mothers with treated gestational diabetes.

"Our results suggest that 'metabolic imprinting' of the future child for obesity occurs with one or more abnormalities on an oral glucose tolerance test," Hillier and her associates conclude. "The risk is modifiable by treating gestational diabetes."

Plus-size and pregnant: Eating well

2008-06-21T13:44:00.002+05:30

Pregnancy's an important time to focus on eating well. You need to make sure your baby's getting enough nutrients to grow — and that you're getting enough nutritional support to grow a baby!

This isn't the time to diet or cut back on calories. But it's a great time to take a close look at how and what you eat and to figure out what's best for you and your baby. It's useful to keep in mind how much weight you should gain during pregnancy as you make healthy food choices.

Top tips for eating well

• Eat a good breakfast. Here's where you set the stage for your day. A breakfast with protein, fat, carbohydrates, and fiber will make you feel better the rest of the day.

• Eat small meals with snacks in between, rather than three bigger meals.

• Include protein in every meal and snack, and avoid foods with refined sugar or processed white flour. This helps your blood sugar levels stabilize and keeps hunger at bay.

• Work fruits and veggies into your meals in creative ways: Toss assorted chopped vegetables into your breakfast eggs, or sprinkle shredded zucchini or carrots into low-fat quick breads. Apple and cucumber slices make great additions to sandwiches. Add apple chunks, dried cranberries or currants, or chopped dried apricots to salads.

• Focus on folate: Plus-size women, according to a study, may need more folic acid than smaller women, so it's essential to take a daily prenatal vitamin with 1 milligram of folic acid both before and during pregnancy.

• Choose unsaturated good fats (olive, canola, peanut oils) over saturated and hydrogenated bad fats (animal fats, palm oil, margarine).

• Use our pregnancy food diary to keep track of your food and nutrient intake so you can make sure you're getting enough good stuff. It's also useful for tracking your mood and hunger levels so you can spot patterns you may need to change.

• Follow the seven principles to eating well during pregnancy.

• Discover 11 "fast" foods a pregnant woman could love — and five to avoid.

Snack and drink ideasHere are some healthy ways to satisfy between-meal hunger pangs:

• An apple and a palmful of almonds or walnuts

• A slice of whole-grain toast spread with 1 tablespoon of a protein-packed almond butter

• A 6-ounce glass of skim milk and a banana

• 1/2 cup of plain yogurt, sweetened with a touch of honey

• Six whole-grain crackers with an ounce or two of low-fat cheese

• A hard-boiled egg and some snackable veggies, such as celery, carrot sticks, and cut-up peppers

Watch what you drink — anything with refined sugar (juice with added sugar, sugar-sweetened lattes, sweetened sodas) can make your blood sugar levels fluctuate and contribute to hunger and headaches. Even sugar-free soda can play funny tricks with your hunger levels. Try these instead:
• Low-sodium vegetable juice

• Sparkling water with a splash of pomegranate juice and a few sprigs of mint

• Carrot juice with a splash of orange juice

• Vanilla- or chocolate-flavored sugar-free soy milk over ice

• Skim milk over ice with a splash of sugar-free flavoring — like vanilla or hazelnut — which are readily available, thanks to our national fancy coffee craze

If you have eating problems

If you need support to get and stay on track, a nutritionist can help redesign your ways of eating to be healthier and more fulfilling for both you and your baby, without making you feel deprived. You can find a nutritionist (also called a dietitian) on the American Dietetic Association website — just click on Find a Nutrition Professional.If you have problems with emotional and/or compulsive overeating, you're not alone — and you'll find good company and lots of support and recovery help at a local Overeaters Anonymous or Food Addicts Anonymous meeting.Before making any changes to your regular food routine, run them by your healthcare provider to make sure they're safe for your baby.

Finding a size-friendly healthcare provider

2008-06-21T13:31:00.000+05:30

When Mechelle Lehman got pregnant for the first time three years ago, she had just moved to a new town and didn't know anyone. She also didn't have an obstetrician. She started her search and hunkered down for a fight."I've never had good luck with doctors," she says. "When I got pregnant, I was expecting [the doctor hunt] to be bad."Lehman, a mom of two in DeKalb, Illinois, has been plus-size her whole life — between a size 16 and a size 24 — and knows how rude some doctors and nurses can be about weight.

They weigh you in the middle of the hallway and tsk-tsk when they read your weight. They lecture you about weight loss even if you're just there for a sore throat.And they make assumptions about your eating habits and lifestyle based on your weight. Lehman, for instance, is a vegetarian, but as a plus-size woman, her healthcare providers often assume she eats massive quantities of hamburgers and steaks. It's gotten to the point where she only goes to the doctor when she has to.

A common problem

Unfortunately, Lehman is far from unique when it comes to her distaste for doctors. A 2005 study published in the American Journal of Public Health found that women who are considered medically overweight (with a body mass index of 25 or more) are less likely to have routine cervical and breast cancer screenings regardless of their income, age, or health coverage.Another study, released the same year in the International Journal of Obesity, offered a reason: Women like Lehman feel such a strong anti-fat stigma from their medical professionals that they stop going to the doctor."Some physicians don't feel comfortable with plus-size moms. They're afraid," says Brette McWhorter Sember, a plus-size mother of two and author of Your Plus-Size Pregnancy.So what's a plus-size woman to do when she finds out she's pregnant and wants to have the healthiest baby possible? I

f you're like Lehman, you audition doctors the way you'd test-drive a car. As someone who's moved around a lot, Lehman has had more than her share of experiences with doctors, and she knows it's possible to find great ones."I know medical professionals can have a good bedside manner," she says. "I figure they know I'm overweight. I know I'm overweight. Don't treat me like a leper."

The importance of finding the right healthcare provider

Pregnancy creates its fair share of stress around tests, vitamins, food restrictions, and the rest, but get the right healthcare provider, and your stress level may decrease, says Sember. A good provider will note your weight during pregnancy and occasionally talk about it — it's necessary as your baby grows. And a good provider can monitor your risk factors, based on family and personal history, but without harping on weight, she adds.Finding the right doctor is key during pregnancy, says Sujatha Reddy, an ob-gyn in Atlanta. "A more relaxed approach is best for most women. If there are problems, you want the doctor to help, but you don't want to constantly be worrying that you've gained one too many pounds," she says."The line I always use is, 'This is not about you looking like Britney Spears. It's about being healthy,'" says Reddy. "There's no reason to stay with a doctor you don't connect with. You form a relationship with a doctor just like you do with anyone else."

Consider a midwife

Jennifer Mountain, a real estate contractor and mother of two in Haslet, Texas, had a first pregnancy that was free of complications. It was made all the easier because her midwives were so supportive of her ability to have a healthy baby at 5 feet 5 inches and 245 pounds. But that didn't happen by accident. After too many doctors lectured her about weight loss when she came in with the flu, she's learned to be up-front and picky about her doctors in all cases, including her obstetrician."I don't make any bones about the fact that I don't want to hear [medical professionals] say anything negative about my weight," she says. "I'm very clear that they aren't going to deliver my baby. I'm going to deliver the baby. I'm the mom.

They are there to deal with any medical issues that come up. I'm choosing them and making them work for me."For Lehman, it took two tries to find a good doctor for her first pregnancy. Her first doctor "didn't have a very caring attitude." So she looked around again. Luckily, the wife of one of her husband's co-workers had just had a great experience with an obstetrician. He was two hours from her home, but Lehman was willing to travel to have a great pregnancy. She did: In 2003, she gave birth to Mallora, a healthy baby girl.Her second pregnancy in 2005-2006 yielded the same doctor drama.

She and her husband had just moved again. She had heard good things about one doctor, so she made an appointment. Unfortunately, she never met the doctor. She did meet the nurse-practitioner and the nurses — and the nurses sealed her decision to leave."The nurse-practitioner was nice, but the nurses were horrible in the way they talked to me, in the comments they made when I got on the scale," she recalls. "I'm overweight. I know that. You don't have to make a big deal about the fact that you have to move the scale over another 100 pounds."

How to find a healthcare provider you like

Do you need help finding a great doctor? Follow these tips from our experts — and moms who've been there:
• Stick together. Ask other plus-size moms in your area for recommendations for size-friendly obstetricians. They'll have the inside line on practices that offer great care for plus-size moms — and those that don't.

• Gauge experience. Before you make an appointment at a new practice, ask whether the doctor and nursing staff have experience working with plus-size moms. If the doctor has never done, say, a c-section on a plus-size mom, you don't want to be his first.

• Case the joint. Does the practice have gowns large enough to fit you and large-size blood pressure cuffs? That's a sign of a practice that's welcoming to plus-size women.

• Trust your gut. Watch how the doctor and his staff talk to you. Do they use a condescending tone? Knowing that your doctor will want to talk to you about weight as your baby grows, see if the way he does it is sensitive and nonjudgmental.

• Consider a midwife. Many plus-size women have good experiences with midwives who don't instantly see their weight as a medical problem. "I felt defective in my doctor's office, like my pregnancy was a ticking time bomb, but my midwife never made a fuss about my weight — she trusted my body to be able to do what it's designed for," says Emily James, an architect and mother of two in Bergen, New Jersey.

How to leave a healthcare provider you don't like

If you decide your doctor doesn't measure up, you can always leave. Consider these tips from Sember and moms who've made the switch:

• Get a second opinion. Before you notify your doctor that you're leaving, Sember recommends you tell your insurance company you need a second opinion and then start auditioning different doctors. That way, there's never a gap in your care.

• Time it right. Get prenatal care early, so that if you decide to make a change, you can do it before the end of the first trimester, notes Sember. After that, some doctors will be hesitant to take you.

• Plan your exit based on comfort level. The way you leave the practice depends on what you feel comfortable doing. Lehman told the nurse-practitioner in her second pregnancy to say, "I don't think this is going to work out." You can also secure a new ob-gyn and have your records transferred without any explanation. Some women want their former doctor to know why they're leaving and so write a letter or tell their doctor directly. Do what feels right for you.

• Remember: You don't have to explain. You don't need your ob-gyn's permission, either. You also don't have to tell your new doctor why you're changing. Simply follow the above advice to find a doctor who fits your criteria. Then have a great pregnancy!

Holiday foods to avoid during pregnancy

2008-06-20T15:09:00.005+05:30

Even if you've always had a stomach of iron, pregnancy weakens your immune system and makes you more vulnerable to food-borne illnesses that could make you sick and harm your baby. So it's important to avoid certain foods during pregnancy — even on special occasions."The risks are real, and need to be taken very seriously," says David Acheson, director and chief medical officer of the Center for Food Safety and Applied Nutrition at the U.S. Food and Drug Administration (FDA).

Dangerous bacteria and parasites like listeria, toxoplasma, salmonella, staphylococcus aureus, and E. coli can lurk in improperly prepared, cooked, and stored foods. And listeria and toxoplasma can cross your placenta and affect your baby even if you never feel symptoms of the illness yourself.So if you've always licked the spoon clean of cookie dough, enjoyed Caesar salads with raw egg in the dressing, and ordered your burgers medium rare, pregnancy is a time to rethink these practices and err on the side of food safety, experts say.Here are some tips to get you through the barbecues of the summer and the holiday buffets of the winter without feeling deprived — or endangering your baby.

Valentine's Day

• Chocolates: If your Valentine brings you a box of chocolates, feel free to dive right in. But to be on the safe side, avoid candies filled with alcoholic liqueurs like Grand Marnier or Amaretto.
Memorial Day, Fourth of July, and Labor Day

• Pre-made salads: Steer clear of store-bought salads and side dishes that contain mayonnaise or egg-based dressings, like potato salad, some pasta salads, and coleslaw. They may have been improperly stored, and can harbor salmonella and listeria. Homemade salads with mayo and egg-based dressings are okay, as long as you know they've been properly prepared (with pasteurized or cooked eggs) and refrigerated, and haven't been left out in the sun.

• Hot dogs: It's safe to enjoy a hot dog, provided it's fresh off the grill or has otherwise been cooked until steaming hot (to at least 165 degrees Fahrenheit) to kill bacteria that may be present. But because hot dogs are generally high in nitrates, as well as fat and sodium, they're best as an occasional treat

• Burgers and other grilled meat or fish: If you're offered a burger or other grilled or barbecued meat, chicken, pork, or fish, make sure it's cooked well done and not pink in any areas. E. coli and toxoplasma can lurk in undercooked meats.

Note: Because of concerns about mercury in fish, the FDA recommends limiting yourself to 12 ounces (about two servings) of fish a week, and avoid some kinds of fish altogether. For more information, see our article on eating fish safely during pregnancy.

• Raw sprouts: Don't garnish your burger or salad with alfalfa or other raw sprouts. They can be an E. coli hazard.

Halloween

• Raw cookie dough or cake batter: If you're preparing Halloween cookies or cupcakes, resist the temptation to sample the batter. The raw eggs in cookie dough and cake batter could contain salmonella or other bacteria harmful to you and your baby. Stick with store-bought goodies or bake your treats without tasting the uncooked batter.

Thanksgiving

On Turkey day (as on every other day) it's important to be vigilant against germs and bacteria in the kitchen. Wash your hands frequently when preparing meals and be careful to clean any surface that's come in contact with raw meat or eggs before using it again. Use separate cutting boards for poultry and produce, and keep uncooked poultry and meat chilled in the refrigerator and separate from other food items.Don't leave leftovers out for more than two hours, and store them in shallow containers so they'll cool quickly. Make sure your refrigerator is set between 35 and 40 degrees F and your freezer at or below zero to keep cold foods from going bad.

• Turkey and stuffing: Cook the turkey until it reaches an internal temperature of 180 degrees F (use a meat thermometer to check it). If you're preparing stuffing (also known as dressing), cook it outside the turkey in a separate baking dish to 165 degrees F. The inside of a stuffed turkey's cavity doesn't get hot enough to kill off harmful bacteria.

• Unpasteurized cider: If hot or cold apple cider is served, make sure it's pasteurized. Unpasteurized juices — including cider — are unsafe during pregnancy because they can contain bacteria like E. coli. (Note: Almost all juice sold is pasteurized — and unpasteurized juice sold in containers is required to carry a warning label.)

• Smoked meats and meat spreads: If you're serving meat spreads like pâté, or smoked meats such as smoked salmon, make sure they're canned, not from the refrigerated section of the grocery store. Refrigerated meat spreads and smoked meats can contain listeria.

Winter holidays

• Unpasteurized soft cheeses: Fruit and cheese platters are a party staple, and a relatively healthy way to fill up, but stay away from soft cheeses made with unpasteurized milk. Unpasteurized or "raw milk" cheeses may contain listeria, which is killed during the pasteurization process.Before eating soft cheeses, the FDA recommends checking the label to make sure it says "made with pasteurized milk." If you can't check the label — for example, if you're at a party — avoid soft cheeses (including Brie, Camembert, goat cheese, Limburger, Montrachet, Neufchâtel, Pont L'Evêque, and Mexican-style cheeses like queso fresco) and semi-soft cheeses (such as Asiago, Bel Paese, bleu, brick, Gorgonzola, Havarti, Muenster, Port Salut, Taleggio, and blue-veined cheeses like Roquefort). If you're not sure which cheeses are safe, stick with hard cheeses like cheddar, Swiss, and Monterey Jack.

• Sushi: Avoid sushi trays with raw fish — especially if it has been sitting out on a buffet for any period of time — because it may contain parasites and bacteria. Although raw fish poses little direct risk to your baby, if you get ill from sushi you'll likely suffer from vomiting and dehydration, which can affect your unborn baby.

• Carving stations: If your party features a carving station with roast beef or turkey, make sure the meat is cooked well-done and is still steaming hot. Avoid sauces like bearnaise, hollandaise, and aioli, which can contain uncooked eggs.

• Eggnog: Homemade eggnog is generally off-limits, because it's usually made with raw, unpasteurized eggs — and alcohol. But you can make a virgin, pregnancy-safe version at home with a pasteurized egg product or an egg alternative like Egg Beaters. Or try store-bought eggnog — just check the label to make sure the eggs are pasteurized. You might consider "soy nog," which doesn't contain eggs or any other dairy products. You can find it during the winter holidays in most large grocery stores as well as specialty health-food stores.

• Fruitcake and other alcoholic food items: Fruitcake and other desserts that use alcohol as an ingredient are generally okay, because most of the alcohol burns off during cooking. If the fruitcake has been soaked in rum or other liquor after being baked, however, little of the alcohol will have evaporated, and you should probably steer clear.

New Year's Eve

• Raw oysters and other shellfish: Stay away from uncooked shellfish, including oysters, clams, mussels, and scallops. Cook shellfish until the shell opens to ensure that any bacteria or parasites have been killed.

• Champagne and other alcoholic beverages: Check with your doctor or healthcare provider about whether it's okay to have a sip of champagne at midnight. But if you're like most moms-to-be, you'll be asleep long before the ball drops, so toast an early New Year's with a glass of sparkling water or soda, and then head to bed.

Pregnancy-safe cocktail recipes

2008-06-20T14:24:00.008+05:30

Being pregnant doesn't mean you have to miss out on having a drink with friends. The good news is that most bartenders can easily whip up a virgin version of your favorite cocktail — just ask!

If you're hankering for a yummy cocktail at home, whip up one of these alcohol-free classics:

White Sangria

This refreshing and tasty recipe is perfect for your next dinner party, or just whip up a pitcher to have on hand whenever you need a bubbly beverage break.

Ingredients:

4 cups white grape juice

1 cup pink grapefruit juice

1 tablespoon lime juice

1 bottle club soda (750 milliliters)

Pink grapefruit slices

Preparation

In a large pitcher, combine all three juices. Refrigerate. Just before serving, add the soda water and grapefruit slices (and other fruit, if you'd like). Makes about 12 servings.

Nonalcoholic Champagne

If you're in the mood to celebrate but want something besides sparkling apple cider, why not try mixing up a batch of your own alcohol-free champagne? This concoction is ideal for elegant baby showers or any festive occasion during pregnancy.

Ingredients:

2/3 cup sugar

2/3 cup water

1 cup grapefruit juice

1/2 cup orange juice

3 tablespoons grenadine syrup

28 ounces chilled ginger ale (about 2 1/3 soda cans' worth)

Preparation:

Combine sugar and water in a saucepan over low heat. Stir until sugar is dissolved. Bring to boil and boil ten minutes. Cool. Add sugar syrup to grapefruit and orange juices. Chill thoroughly. Add grenadine and ginger ale just before serving. Makes about 1½ quarts.

Virgin Strawberry Daiquiri

The perfect drink for a hot summer day, a virgin daiquiri (strawberry or whatever fruit suits your fancy) is tangy and thirst-quenching. Plus, because it's fruit-flavored and blended, you're less likely to notice the missing alcohol. Go for fresh strawberries over frozen; the flavor will be much better.

Ingredients:

1 ounce fresh lime juice

3 ounces frozen strawberries in syrup (or fresh, if available)

1 teaspoon sugar

Cracked ice

Preparation:

Fill a blender with cracked ice. Add lime juice, strawberries, and sugar. Blend until smooth, then pour into a chilled glass. Garnish with an extra strawberry (if you have one) or an orange slice.

Piña Colada

Another summer classic, the piña colada, is cool and refreshing. With its smoothie-like consistency, it can be gentler on a mom-to-be's stomach than other, more lively concoctions.Of course, if citrus fruits — with their acidic qualities — have been playing havoc with your digestion, you may want something even milder. Although pineapple isn't technically part of the citrus family, its juice, like that of the orange, lime, or lemon, can be quite tart. For a sweeter, less tangy drink, use pineapple canned in syrup rather than its own juice.

Ingredients:

2 ounces coconut milk

1½ ounces crushed pineapple

1 ounce pineapple juice

1/4 cup crushed iceBrown sugar to taste (no more than one tablespoon)

Preparation:

Put all the ingredients in a blender and blend until smooth (about 30 seconds). Pour into chilled glass. Garnish with an orange slice, a pineapple wedge, or a maraschino cherry.

Virgin Bloody Mary

If you're heading out to brunch anytime soon, this is the drink to order. Spicy and tangy, a virgin Bloody Mary will satisfy you almost as well as a regular one.

Ingredients:

4 ounces tomato juice

½ ounce lemon juice

½ teaspoon Worcestershire sauce

A dash of hot sauce

A pinch of celery salt (add to taste)

A pinch of salt (add to taste)

A pinch of pepper (add to taste)

Cracked ice

Ice cubes

Preparation:

Combine tomato juice, lemon juice, Worcestershire sauce, hot sauce, and seasonings in a mixing glass. Shake with ice and strain into glass filled with ice cubes. Garnish with a celery stalk and a wedge of lime.

Herbal teas during pregnancy

2008-06-20T14:19:00.002+05:30

Is it safe to drink herbal teas while I'm pregnant?

Many pregnant women carefully avoid caffeine, alcohol, nicotine, and unnecessary medications but think nothing of drinking cup after cup of herbal tea. If this sounds like you, take heed: Herbal teas can be harmful, especially if you drink too much of them. Most of the ingredients in herbal teas are safe, but many are not. Herbs are drugs and thus can be as potent as some medications. What's more, only a few of the herbs used for teas have been studied in pregnant women.

How can I tell which herbal teas are safe to drink during pregnancy?

Although no U.S. regulations specifically address herbal teas, most of the herbs the Food and Drug Administration (FDA) considers safe for food use are presumed safe for teas as well. For example, teas made from ginger, lime blossom, peppermint, roasted barley, rose hips, and thyme are probably safe to drink occasionally in small amounts while you're pregnant or nursing. However, drinking excessive amounts of any teas can cause health problems for you and your developing baby.

Which teas are not safe?

Many of the herbs used for teas, when taken in large or medicinal amounts, can potentially stimulate the uterus and induce miscarriage. These include anise, catnip, chamomile, comfrey, ephedra (called ma huang in traditional Chinese medicine), European mistletoe, hibiscus, horehound, Labrador, lemongrass, licorice root, mugwort, pennyroyal, raspberry leaf, rosemary, sage, sassafras, stinging nettle leaf, vetiver, and yarrow.Although some midwives use raspberry leaf (also known as red raspberry leaf) to aid delivery, its effectiveness hasn't been proven. In any case, it should be used only near term and under the supervision of a healthcare professional. Avoid the rest of the herbs in this list during pregnancy and lactation.Note: You can still eat food that contains herbs like rosemary and sage, because the amounts used in food are generally much smaller than those used in tea — and not as potent (the brewing process for making tea concentrates the chemicals of the herbs).Among other reasons to avoid certain herbs used in teas:
• Coca (also known as mate de coca) contains small amounts of cocaine.
• Comfrey, kava root, skullcap, valerian, and woodruff may damage your liver.
• Lobelia contains nicotine.
• Mate (or yerba mate) can contain as much caffeine as coffee.None of these herbs should be taken while you're pregnant or nursing.

What about the herbal teas that are marketed for pregnant women?

The same cautions apply to teas touted for pregnant women, which are sold in supermarkets and health food stores. While the makers of pregnancy teas promote their products as healthy for expectant moms, no clinical studies support these claims and the safety of the ingredients are not regulated.Pregnancy teas usually include ingredients such as alfalfa, fennel seed, lemongrass leaf, lemon verbena, nettle leaf, rosehips, and strawberry leaf. Not all of these are safe to take during pregnancy. For example, nettle leaf (also known as stinging nettle leaf), which stimulates the uterus and can cause miscarriage, and fennel (including the fruit, seed, and oil) should not be used in tea during pregnancy and lactation due to its potential estrogen-like effects.

How can I choose a safe herbal tea?

If you enjoy herbal teas, check the packaging labels and steer clear of unsafe or unfamiliar ingredients. Or consider making your own concoction. Add honey, fruit juices, lemon rinds, cinnamon, or cloves to boiled water or decaffeinated black or green tea. Never make a tea from any plant unless you're 100 percent sure what it is and that you can safely take it while you're pregnant.

Drinking alcohol during pregnancy

2008-06-20T14:08:00.002+05:30

How much alcohol is too much during pregnancy?

Alcohol and pregnancy don't mix. No one knows exactly what harmful effects even the smallest amount of alcohol has on a developing baby.All public health officials in the United States recommend that pregnant women, as well as women who are trying to conceive, play it safe by steering clear of alcohol entirely. So do experts at the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

What effects could alcohol have on my baby?

When you drink, the alcohol quickly travels through your bloodstream, crosses the placenta, and reaches your baby. Your baby breaks down alcohol more slowly than you do, so she may end up with higher levels of blood alcohol than you have.Drinking endangers your growing baby in a number of ways: It increases the risk of miscarriage and stillbirth. As little as one drink a day can raise the odds for low birth weight and raise your child's risk for problems with learning, speech, attention span, language, and hyperactivity.

And some research has shown that expectant moms who have as little as one drink a week are more likely than nondrinkers to have children who later exhibit aggressive and delinquent behavior."Fetal alcohol spectrum disorders" (FASD) is the term experts use to describe the range of problems related to alcohol exposure before birth. The most severe result of alcohol use is fetal alcohol syndrome (FAS), a lifelong condition characterized by poor growth (in the womb, after birth, or both), abnormal facial features, and damage to the central nervous system.Babies with FAS may also have abnormally small heads and brains, as well as heart, spine, and other anatomical defects. The central nervous system damage may include mental retardation, delays in physical development, vision and hearing problems, and a variety of behavioral problems.

Frequent drinking (seven or more drinks per week, including mixed drinks, wine, and beer) or binge drinking (four or more drinks on any one occasion) greatly increases the risk that your baby will suffer from FAS. But babies whose moms drink less can also develop this syndrome. And babies exposed to alcohol before birth — even if they don't have full-blown FAS — may still be born with some of these birth defects or later exhibit a number of mental, physical, or behavioral problems.According to the U.S. Centers for Disease Control and Prevention, fetal exposure to alcohol is one of the main preventable causes of birth defects and developmental problems in this country. More than 10 percent of women in the United States drink during pregnancy, and as many as 1 in 30 pregnant women drinks frequently or binge drinks. The babies of all these women are at risk.

How to get help

Whether you have a severe drinking problem or a more moderate one, if you find yourself unable to completely give up alcohol, it's vital to get help as soon as possible. If you need help, here are some options:

• Talk to your healthcare provider about counseling and treatment.

• Call your local chapter of Alcoholics Anonymous (AA), listed in the white pages of the phone book and on the organization's website.

• Call a local crisis intervention helpline (listed in the yellow pages under "crisis intervention").

• Find a substance abuse treatment facility near you on the website of the U.S. Department of Health and Human Services.

What about "nonalcoholic" beer and wine?

The term "nonalcoholic" is a bit misleading when it comes to the supposedly alcohol-free versions of beer and wine. In fact, all "nonalcoholic" beers and many nonalcoholic wines do contain some alcohol, typically less than half a percent. Drinks labeled "nonalcoholic" can contain trace amounts of alcohol, while those labeled "alcohol-free" can't.While few would say that the trace amount of alcohol in an occasional glass of nonalcoholic beer is going to harm your baby, it's something to be aware of — especially if you drink these beverages often or in large amounts. So before you drink up, read labels carefully and remember that "nonalcoholic" and "alcohol-free" aren't interchangeable terms.

What if I had a few drinks before I knew I was pregnant?

If you had a drink or two before your period was due, don't panic. It's not likely that it harmed your baby. The most important thing to focus on is staying as healthy as you can from now on — and that should include swearing off alcohol for the rest of your pregnancy.

Caffeine during pregnancy

2008-06-19T23:33:00.002+05:30

Now that I'm pregnant, should I cut back on coffee and other sources of caffeine?

There's general agreement that pregnant women and those trying to conceive should avoid consuming large quantities of caffeine, but after decades of controversy and conflicting evidence, there's still no real consensus on how much caffeine is safe to consume during pregnancy.The March of Dimes advises women to limit their caffeine intake to 200 mg per day.

This recommendation was prompted by the results of a study published in the March 2008 issue of the American Journal of Obstetrics and Gynecology, showing that moms-to-be who consumed 200 mg or more of caffeine a day had double the risk of miscarriage compared to those who had no caffeine.Not all studies show a link between caffeine consumption and a higher risk of miscarriage. Still, it may be smart to err on the side of caution and stick to the March of Dimes recommendation. (See chart below to get a sense of the caffeine content of various types of coffee, teas, and other drinks.) And, of course, if you decide to cut out caffeine altogether, you won't get any arguments from your doctor or midwife.

Are there other possible risks besides miscarriage?Yes.

Because caffeine can cause blood vessels to constrict, it may reduce blood flow to the placenta. And because it easily crosses the placenta and reaches your baby (who then very slowly metabolizes it), caffeine may directly affect his developing cells.A study in Denmark found that the risk of stillbirth more than doubled in women who drank a great deal of coffee per day — eight cups or more — compared with non-coffee drinkers. And some studies suggest that high levels of caffeine consumption by Mom may slightly reduce a baby's birth weight, but other research has shown no association

One study found a link between maternal caffeine consumption equal to three cups of coffee per day and an increased risk of having a son born with undescended testes. This happens when the testes don't move from the pelvis into the scrotum as they usually do in late pregnancy.Other research has shown that babies whose mothers consumed more than 500 mg. of caffeine a day had faster heart rates and breathing rates and spent more time awake in the first few days after birth.One thing's for sure: You'll feel better if you cut back on caffeine. It's a stimulant, so it raises your heart rate and may raise your blood pressure slightly, too. Plus, it can make you feel jittery and cause insomnia.

Caffeine can also contribute to heartburn (something you probably don't need help boosting!) by stimulating the secretion of stomach acid.These effects may be more pronounced or last longer than usual as you approach your due date, because your body breaks down caffeine more slowly as your pregnancy progresses. And that means a higher level of caffeine in your bloodstream and in your baby's.There's one more reason to cut back on coffee and tea during your pregnancy, whether it's caffeinated or not. These beverages contain compounds called phenols that make it harder for your body to absorb iron. This is particularly important because many pregnant women are already low on iron. If you drink coffee or tea, have it between meals so it'll have less of an effect on your iron absorption.

Which foods and beverages contain caffeine?

Coffee always comes to mind, but to cut your intake for the day you'll need to be aware of some of the other sources, like tea, soft drinks, "energy" drinks, and chocolate. It's also in some herbal products and over-the-counter drugs, including some headache, cold, and allergy remedies. Check the chart below for caffeine amounts in some common foods and beverages.

1. Item - Brewed coffee, drip method
Amount-8 ounces
Caffeine- 100-300 mg

2. Brewed coffee, percolated
Amount- 8 ounces
Caffeine- 65-275 mg

3.Instant coffee
Amount-8 ounces
Caffeine-50-190 mg

4. Espresso
Amount-2 ounces
Caffeine- 40-70 mg

5. Cappuccino
Amount- 2 ounces
Caffeine- 40-70 mg

6. Decaffeinated coffee
Amount- 8 ounces
Caffeine- 1-8 mg

7. Brewed tea
Amount- 8 ounces
Caffeine- 35-175 mg

8. Green tea
Amount- 8 ounces
Caffeine- 8-30 mg

9. Instant tea
Amount- 8 ounces
Caffeine- 40-80 mg

10. Iced tea
Amount- 12 ounces
Caffeine- 65-75 mg

11. Coffee ice cream or frozen yogurt
Amount- 1 cup
Caffeine- 8-85 mg

12. Soft drinks
Amount- a 12-ounce can
Caffeine- 30-60 mg

13. Hot cocoa
Amount- 8 ounces
Caffeine- 3-30 mg

14. Chocolate milk
Amount- 8 ounces
Caffeine- 2-7 mg

15. Milk chocolate
Amount- 1 ounce
Caffeine- 1-15 mg

16. Dark or semisweet chocolate
Amount- 1 ounce
Caffeine- 5-35 mg

17. Baker's chocolate
Amount- 1 ounce
Caffeine- 26 mg

18. Chocolate syrup
Amount- 1 ounce
Caffeine- 4 mg

I'd like to kick the caffeine habit while I'm pregnant. Any tips?

You may find your taste buds doing the cutting back for you. Many women's fondness for a cup of joe evaporates during the first trimester when the queasies strike. Otherwise, consider switching to decaffeinated tea or coffee. (Decaffeinated beverages may contain some caffeine, but it's usually a small amount.).If you're a devoted java junkie or cola guzzler, caffeine withdrawal won't be easy.

To minimize symptoms — which may include headaches, irritability, and lethargy — ease off gradually. Start mixing decaf with your caffeinated coffee. Or reduce the caffeine in homemade hot beverages by brewing them weaker or for a shorter time. If you love a soothing cup of Earl Grey, steeping your tea bag for just one minute instead of five reduces the caffeine by as much as half.One more thing: Although herb teas often have no caffeine, be sure to read the ingredients list and consult your practitioner before trying anything new. Certain herbs and additives aren't safe during pregnancy.

Is it safe to get my heart rate over 140 beats per minute during pregnancy?

2008-06-19T23:18:00.001+05:30

Expert Answers

Raul Artal, chair of the department of obstetrics, gynecology, and women's health, St. Louis University School of Medicine

Instead of trying to keep your heart rate below 140 beats per minute, I recommend that you not engage in strenuous activities that could raise your core body temperature to over 103 degrees Fahrenheit during the first four to six weeks of pregnancy. That's because a very high body temperature early in pregnancy could theoretically cause birth defects.
Later in pregnancy, if you're not well hydrated or have an elevated body temperature, you risk premature labor. If you're exercising to keep your heart and lungs in shape, moderate exercise is all you need.

Jeanne-Marie Guise, associate professor of obstetrics and gynecology, Oregon Health Services Center, Portland

You don't want your heart rate to go too high for too long or to exercise so hard that you get overheated. If you're healthy, you generally shouldn't raise your heart rate over 140 beats per minute while pregnant. You need enough time between beats to get blood to the baby, and as the heart rate goes up you don't squeeze out quite as much blood each time and the blood is not as well oxygenated.

You want to avoid getting too hot for a different reason: There's some concern that if you get overheated during the first trimester, it affects the baby's development; there's a slightly increased risk of problems like the baby's abdominal wall not closing all the way. Plus, as your body diverts blood to your skin to help you cool off; it's taking some of the blood flow away from your baby. It's also harder to cool down when you're pregnant, so if you get overheated, you're more likely to pass out. You'll know you've probably gotten too hot if you break a sweat and continue sweating. To keep this from happening, take frequent breaks and drink a lot of water.

Is it safe to drink diet soda during pregnancy?

2008-06-19T23:11:00.001+05:30

Expert Answers

Russell Turk, ob-gyn and founder of the Riverside Obstetrics & Gynecology in Riverside, CT

Diet sodas often contain both caffeine and an artificial sweetener. Aspartame (NutraSweet) — the most common sweetener — seems to be okay when consumed in moderation (the amount found in one or two 12-oz servings of soda per day). Certain other sweeteners, such as saccharin, have actually been found to cause birth defects when consumed in very high amounts by laboratory rats. Because the safety of this product in smaller amounts is hard to prove, I would advise avoiding it. Sucralose (Splenda), a modification of regular table sugar appears to be safe, but because this new sweetener hasn't been extensively studied, it's best used in moderation.

Jeff Hampl, registered dietitian and professor, Arizona State University, Mesa

Most diet sodas are made with aspartame (i.e., Nutrasweet or Equal), which is approved by the Food and Drug Association (FDA) as safe for pregnant women. There's a whole lot of buzz out there about the risks associated with aspartame, but not much documented fact. But the FDA weighed all the evidence and said pregnant women can safely consume aspartame and that it does not get through the placental barrier to the fetus. The one group of women who should not have aspartame is those with the disease phenylketonuria or PKU because they aren't able to digest it.

Is it safe to do sit-ups or abdominal crunches during pregnancy?

2008-06-19T11:23:00.000+05:30

Expert Answers

Raul Artal, chair of the department of obstetrics, gynecology, and women's health, St. Louis University School of Medicine

That's fine. The only problem is that lying flat on your back tends to lower your blood pressure, which could inhibit the blood supply and oxygen to the fetus. About 6 to 10 percent of pregnant women experience rapid drops in blood pressure when they lie down — even if it's only for a few minutes. The problem can begin in early pregnancy, though it's more likely to occur after 20 weeks.

If you really want to work your abdominal muscles, a better exercise would be to get on the floor on your hands and knees and alternate arching your back up and relaxing it.
Jeanne-Marie Guise, associate professor of obstetrics and gynecology, Oregon Health Services Center, Portland

Sit-ups and crunches are fine in your first trimester. But by your second trimester, you'll need to avoid lying on your back because as your uterus grows, its weight can compress the blood vessels leading to your heart, potentially depriving your developing baby of oxygen. Of course, by that time in your pregnancy, you'll most likely find that sit-ups are almost impossible to do anyway.

Is it safe to diet during pregnancy?

2008-06-19T11:12:00.002+05:30

Expert Answers

Jennifer Shu, board-certified pediatrician in Atlanta, Georgia, and coauthor of Heading Home With Your Newborn

I don't recommend it — pregnancy is not the time to diet. Normally, you should gain about 25 to 30 pounds during pregnancy. If you're overweight, you may want to shoot for the lower end of that range. The recommendation for women who are morbidly obese is to gain only 15 pounds. Some gain is inevitable given the weight of the baby, the enlarged uterus, the placenta, and the amniotic fluid.

But that's weight that should disappear quickly once the baby is born. On average you should be getting about 2,500 calories a day (that's up from about 2,100 when you're not pregnant). You need those calories and your baby does, too. Plus, your physiology changes. Your blood sugar between meals drops to very low levels, which is why so many pregnant women have the feeling that they're starving and need to eat between meals. If you go into pregnancy thinking you need to lose weight, you'll find yourself incredibly hungry.

Babies are pretty efficient at getting what they need, so it's more a threat to your health than your baby's if you don't eat enough, but there's a risk that the baby will grow poorly if you're really malnourished.

My approach is to think of these eight months as part of a larger piece. Any weight you think you should lose, you probably put on during the years and decades before you got pregnant. So instead of trying to lose weight while you're pregnant, use this time to develop the healthy eating habits that will carry you through the rest of your life.

Mary Lake Polan, chair emeritus of the department of gynecology and obstetrics, Stanford University School of Medicine, CA

No, because if you diet, you starve the fetus as well as yourself. The standard recommendation is to gain 25 to 27 pounds during pregnancy, and even women who are morbidly obese shouldn't try to lose weight during pregnancy. If you look at other species, including whales, walruses, and seals, they put on a lot of fat to feed back to their babies.

The 25 to 27 pounds you need to gain are not just from the baby, the placenta, the enlarged uterus, and the enlarged breasts — it's the amount needed for the baby to reach an optimal weight and for you to develop enough fat to feed the baby afterward.

Your pregnancy food diary

2008-06-19T11:02:00.003+05:30

Keeping a food diary may sound like a hassle, but you'll be amazed at how easy it is to get a real look at your eating patterns in just a few days, and make changes for the better.

Click here for food journal.. It will really help..

Some basic guidelines

• Write as you eat. Don't depend on your memory at the end of the day — or worse, the end of the week.

• Write it all down. Keep the diary in your bag and write down everything you eat or drink, from a can of soda to a handful of pretzels from your co-worker's desk. Those "little eats" are easiest to forget, but they can make a big impact on health.

• Be specific. Indicate whether there's mayo on your bread, cheese on your burger, or crackers in your soup.

• Be honest. No one's judging you on this — it's for your eyes only — so don't worry about trying to look like a more healthy eater.

Daily recommendations

To help your baby grow and feed your body during pregnancy, you need a variety of important nutrients. Among these are protein, fiber, omega-3 fatty acids, and vitamins and minerals such as calcium, iron, vitamin C, and folic acid.

Read our chart of important nutrients and their food sources to help you pick the right foods for your daily intake.You also need at least six to eight 8-ounce glasses of water a day. Find out how water really benefits you during pregnancy.

Your week in review

At the end of the week, take a look at your diary. What eating habits can you now see? How often did you eat when you weren't that hungry, or because your mood was low? Did you manage to check off all the items in the nutrient checklist? Did you get in some exercise at least a few days a week?Ask yourself what you did well this week, and what you'd like to improve. Then write down your goals for next week: what you might do more or less of, do differently — or do just the same!

Meal planning during pregnancy

2008-06-17T23:13:00.000+05:30

Overwhelmed by pregnancy nutrition advice?

Feeling like your diet will never measure up? Before you give up completely and eat whatever you want, learn how the Food Guide Pyramid can quickly help you figure out if you're getting the nutrients you need during pregnancy.

What is the Food Guide Pyramid and how can it help me during pregnancy?

The illustrated Food Guide Pyramid highlights how many servings of different types of food you should eat every day. Although the guide is intended to show what the average person should eat daily, it's also the foundation for healthful eating during pregnancy. It's updated every five years, and is the basis for most dietary recommendations in the United States.The pyramid divides food into six groups. Here's a quick look at those groups and how many servings a day from each group you should aim for:

• Bread, Cereal, Rice, and Pasta (6-11 servings a day): Choose whole grain varieties like whole-wheat bread or unprocessed brown rice over white whenever possible; they contain the most fiber, vitamins, and nutrients.

• Fruit (2-4 servings a day): Vary the color of the fruit you eat and choose fresh over canned — most prepackaged varieties are preserved in sugary liquid. Bonus: The fiber in fruit will help you head off constipation and hemorrhoids — two common pregnancy symptoms.

• Vegetables (3-5 servings a day): As with fruit, fresh is best for fiber, folate, and other important vitamins. Broccoli, for example, is packed with folate, calcium, and B vitamins — all essential nutrients for your growing baby.

• Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts (2-3 servings a day): Choose lean meats and eat fish sparingly (some varieties may be harmful to your baby).

• Milk, Yogurt, and Cheese (2-3 servings a day): Low-fat varieties give you all the nutrients you need without the extra fat. If you can stomach them, dairy products, in general, are a great source of calcium and protein.

• Fats, Oils, and Sweets (use sparingly): Some fats are better than others. It's okay to indulge your sweet tooth every now and then, but try to substitute healthy alternatives when a craving for junk food hits.

How large is a serving of each food?

What's in a serving depends on what you're eating. For example, 1/2 cup of raw fruit or hard vegetables is considered a serving; if you're eating raw leafy vegetables, a serving is 1 cup, and 2 to 3 ounces of meat, fish, or chicken (about the size of a deck of cards) is one serving. And while it's generally accepted that one slice of bread equals one serving, the serving sizes for packaged food and breads can vary. Read the label to find out for sure.

How many servings of each food should I aim for?

It depends on your size, your appetite, and your activity level. But don't go crazy trying to hit the perfect serving number. If you aim for servings within the following ranges (and you're taking a daily prenatal vitamin), you and your baby will be well nourished. During pregnancy, you should try to eat seven or more servings of fruits and vegetables a day (three servings of fruit and four of vegetables), between six and 11 servings of grains, two to three servings from the legume family, three to four servings of dairy products, and at least three servings of meat, fish, eggs, or nuts.

The food pyramid recommends a range of servings because people have different calorie needs. For example, nutritionists recommend that the average woman get around 2,200 calories a day, an amount that falls into the mid-range of servings. But the average pregnant woman generally needs about 300 more calories a day, an amount in the higher serving range.

Do all nutrition experts consider the USDA pyramid the gold standard?

Not everyone agrees that the USDA pyramid is a good nutrition model. Researchers at the Harvard School of Public Health have created their own eating guide, called the Healthy Eating Pyramid, which they say better reflects recent thinking about a balanced diet. Their pyramid puts greater emphasis on whole grain foods, vegetable oils, fruits, vegetables, nuts, legumes, and fish, plus it highlights the importance of daily exercise.

Red meats and refined grains such as white bread and white rice make up the top part of the pyramid, indicating that they should be used "sparingly." And the researchers believe the pyramid should mention alcohol, in light of recent studies highlighting the benefits of moderate alcohol consumption in reducing the risk of heart disease and stroke (though alcohol is clearly not recommended during pregnancy).View the Harvard Healthy Eating Pyramid.

Which model is best to follow during pregnancy?

You can't go wrong following either version. Because experts don't completely agree, you can expect to find slight variations in what constitutes a healthy diet, at least until the pyramid is updated again.Even if you don't follow the pyramid to the letter, it gives you something to strive for, says Kathy Church-Balin, director of maternal health information at the March of Dimes. Eating nutritiously during pregnancy pays huge dividends for the rest of your baby's life. "We know that a simple dietary change — getting 400 micrograms of folic acid a day — significantly reduces a baby's chances of being born with a neural tube defect," says Church-Balin.

"Inadequate nutrition during pregnancy has long-term effects in other areas, too, especially on brain development and intellectual capacity. It's more important to make wise food choices during pregnancy than practically any other time in life," says Church-Balin.Get more information on the USDA Food Guide Pyramid.

See a sample menu for a pregnant womanHere's an example of a daily menu from the USDA (with a few extra snack suggestions to boost your calcium intake):Breakfast:1/4 cantaloupe2 whole-wheat pancakes with blueberry sauce1 cup skim milkLunch:Chili-stuffed baked potato topped with low-fat, low-sodium cheddar cheese1 cup spinach-orange salad6 wheat crackers1 cup skim milk

Dinner:

Apricot-glazed chicken, 1 breast half3/4 cup rice-pasta pilaf1 cup tossed salad w/ reduced-calorie Italian dressing2 small hard rolls1/2 cup vanilla ice milkSnacks:6 oz nonfat plain yogurt1/2 cup fat-free cottage cheese1/2 medium apple1 large soft pretzel

Food cravings and what they mean

2008-06-17T22:57:00.001+05:30

What do pregnant women crave?

We took a survey of BabyCenter users and discovered that most (almost 40 percent) said "Give me something sweet." Slightly fewer (33 percent) opt for salty snacks. Fans of Mexican food and other spicy cuisine came in third (17 percent). Trailing behind (at 10 percent) are those who crave citrus fruit, green apples, and other lip-puckering tart or sour foods.What does it all mean? Here's what the experts say:

Food jags: Cheese Whiz sandwiches, anyone?The yearning for a particular type of food is an undeniable part of carrying a baby: About 85 percent of women report at least one food craving during pregnancy. And not all of these cravings can be neatly cataloged — or stomached.You confessed to wanting pickles wrapped in cheese, salsa spooned straight out of the jar, and yes, even steak fat.

And where in the spectrum of sweet, salty, spicy, and sour does one woman's passion for black olives on Sara Lee cheesecake lie? Another reader told us she ate a steady diet of Cheese Whiz sandwiches, which she now (postpartum) can't bear the sight of. Eggplant, particularly on pizza, was another reader's obsession.Many of these cravings seem to come out of nowhere, with a ferocity that's overpowering. Where do they come from? Hormones, right?Maybe, says Elizabeth Somer, author of Nutrition for a Healthy Pregnancy.

The extreme hormonal changes women go through during pregnancy can have a powerful impact on taste and smell. (This would help explain why women going through menopause can also experience strong food cravings and aversions.) But the bottom line, says Somer, is that no one really knows for sure.

Some experts are skeptical about the idea that food cravings can be attributed simply to hormones. Ronald Chez, a professor of obstetrics and gynecology at the University of South Florida, notes that pregnancy has a similar effect on every woman's body, while cravings vary widely from person to person."No one really understands what causes cravings," says Chez. "No absolute cause has been scientifically established."

What do food cravings mean?

As to what a particular craving signifies, the answer depends on whom you ask. Some nutritionists and healthcare practitioners believe that certain cravings may be meaningful.For example, cravings for ice and bizarre substances such as laundry starch and cigarette butts (a condition called pica) have been linked to an iron deficiency — even though none of these items contain significant amounts of iron.

In fact, a number of our readers reported consuming large quantities of ice, which they had never craved before, during their pregnancies.San Francisco midwife and herbalist Cindy Belew says other food cravings may be worth paying attention to as well. For example, alternative medicine practitioners believe that a shortage of B vitamins can trigger a craving for chocolate. Belew has also found that many of her patients need more essential fatty acids in their diet; when they start taking flax oil, their food cravings disappear.

Similarly, a craving for red meat seems like a transparent cry for protein. And the reader who consumed great quantities of peaches may have been responding to her body's need for beta carotene. Still, Somer doesn't see much of a link between a pregnant woman's cravings and what her body needs."People think their cravings are significant, but studies show no link between cravings and nutritional requirements," she says. "If people craved what the body needs, we would all eat more broccoli and less chocolate."

What to do about your cravings

In the end, the experts we consulted agreed that you should pay attention to your pregnancy cravings — indulging the healthy ones and coming up with alternatives to the less healthy cravings."Most cravings and aversions are more interesting than serious and, for the most part, can be indulged in moderation," Somer says. "A healthful diet should be one that meets your nutritional and your emotional needs, as well as your preferences." She recommends that pregnant women humor their cravings rather than fight them by, say, substituting nonfat frozen yogurt for ice cream.

Other ways to curb unhealthy cravings: Eat breakfast every day (skipping breakfast can make cravings worse), get plenty of exercise, and make sure you have lots of emotional support. This last is particularly important, says Somer."The ebb and flow of emotions that accompanies pregnancy can cause you to turn to food," she says, "when what you really need is a hug."

Copper: Essential for forming blood cells

2008-06-17T22:50:00.000+05:30

Why do I need copper?

Copper, a trace mineral found in all plant and animal tissues, is essential for forming red blood cells — especially important during pregnancy, when your blood supply doubles. Copper also boosts your body's ability to mend tissue, break down sugars, and keeps your hair growing and looking healthy. Most important, it also helps form your baby's heart, skeletal and nervous systems, arteries, and blood vessels.

How much do I need?

You'll need 1 mg per day during pregnancy. While breastfeeding, you should get about 1.3 mg per day.

Should I take a supplement?

If you eat a healthy, varied diet, you'll probably get enough copper. It's present in organ meats (like liver), seafood, nuts, seeds, wheat bran cereals, whole grain products, and cocoa products. If your diet doesn't include these foods, a good prenatal multivitamin usually includes an adequate amount.

What are the best food sources?

Organ meats (such as liver), seafood, nuts, seeds, wheat bran cereals, whole grain products, and even cocoa products, are all good sources of copper. Here are some typical amounts:

• 3 oz. liver (about the size of a deck): 2.4 mg
• 3 oz. steamed oysters: 2.3 mg
• 3 oz. canned crab meat: 1.1 mg
• 1 cup cooked brown rice: 0.51 mg
• 1 medium baked potato: 0.47 mg
• 1 cup cooked kidney beans: 0.56 mg
• 1 cup cooked pinto beans: 0.44 mg
• 1 cup cooked black beans: 0.36 mg
• 1 cup boiled spinach: 0.31 mgFYI Don't cook food in uninsulated copper pots; unlike iron pots, which enhance your body's ability to absorb vitamin C, copper ones react with food and destroy vitamin C, as well as vitamin E and folic acid — and may increase the copper in your diet to toxic levels.

Chromium: A little bit is all you need

2008-06-17T22:48:00.000+05:30

Why do I need chromium?

Chromium is a mineral necessary for regulating your body's blood sugar levels (it's a component of insulin, the hormone that breaks down glucose), and it stimulates the synthesis of protein in your growing baby's tissues.

How much should I get?

During pregnancy, you'll need about 30 mcg a day — a fairly easy amount to get through your diet. If you ate one slice of whole-wheat bread, one apple, and a cup of spinach, you'd be just over the recommended daily allowance (RDA).

Do I need a supplement?

You don't need — and shouldn't take — supplements of chromium picolinate, the form of the mineral commonly sold in drug stores. New research suggests that the supplements may cause damage to the body's cells, and there's no evidence that they can reduce cholesterol levels, aid in weight loss, or control diabetes, as some anecdotal evidence may lead you to believe.

What are the best food sources?

Whole-grain breads and cereals, wheat germ, asparagus, and brewer's yeast are good sources. Others include:
• 1 slice American cheese: 48 mcg
• 1 tablespoon peanut butter: 41 mcg
• 1 cup boiled spinach: 36 mcg
• 3 oz. broiled skinless chicken: 22 mcg
• 1 cup button mushrooms: 20 mcg
• 1 slice whole-grain bread: 16 mcg
• 1 medium apple: 15 mcg

Chart: Nutrients you need to help your baby grow

2008-06-15T14:40:00.008+05:30

1. Calcium

Daily amount :- 1000 mg

Do you need a supplement? :- No

Benefit to your baby :- Grows strong bones and teeth, healthy nerves, heart, and muscles. Also develops heart rhythm and blood clotting
Food source :- 8 oz. skim milk: 302 mg, 8 oz. calcium-fortified orange juice: 300 mg, 1/2 cup rice: 300 mg, 3 corn tortillas: 150 mg

2. Chromium

Daily amount :- 30 mcg

Do you need a supplement? :- No

Benefit to your baby :- Regulates blood sugar levels; stimulates protein synthesis in developing tissues

Food source :- 1 tablespoon peanut butter: 41 mcg, 3 oz. broiled skinless chicken: 22 mcg, 1 slice whole-grain bread: 16 mcg

3. Copper

Daily amount :- 1 mg daily

Do you need a supplement? :- No

Benefit to your baby :- Helps form heart, skeletal, and nervous systems, arteries, and blood vessels

Food source :- 2.4 mg, 3 oz. canned crab meat: 1.1 mg, 1 cup cooked kidney beans: 0.56 mg, 1 cup cooked brown rice: 0.51 mg

4. Fluoride

Daily amount :- 3 mg daily considered safe

Do you need a supplement? :- No

Benefit to your baby :- Needed when teeth begin to form at ten weeks; later, in the second and third trimesters, needed to develop primary incisors, molars, and permanent teeth

Food source :- Drink some amount of fluoride-fortified water. Also, 1 cup cooked kale: 0.205 mg, 1 medium apple: 0.093 mg

5. Folic Acid

Daily amount :- 400 mcg (before conceiving), 600-800 mcg (during pregnancy)

Do you need a supplement? :- Yes

Benefit to your baby :- Is a critical part of spinal fluid and helps close the tube housing the central nervous system; also helps synthesize DNA and normalize brain function

Food source :- 1/2 cup lentils: 179 mcg, 1/2 cup cereal (fortified): 146-179 mcg, 4 spears steamed or boiled asparagus: 88 mcg

6. Iodine

Daily amount :- 220 mcg daily

Do you need a supplement? :- No

Benefit to your baby :- Regulates metabolism, helps develop nervous system

Food source :- Salt is fortified with iodine; also in fluoridated drinking water.

7. Iron

Daily amount :- 27 mg (almost double the RDA for nonpregnant women)

Do you need a supplement? :- Yes; a daily ferrous iron supplement (30 to 60 mg) in the second and third trimesters

Benefit to your baby :- Makes red blood cells, supplies oxygen to cells for energy and growth, and builds bones and teeth.

Food source :- Combine heme (in animal sources) and nonheme iron (in plants): 3 oz. beef sirloin, about 1.9 mg; 1/2 cup lentils: 3.3 mg, 1/2 cup boiled spinach: 3.2 mg, 3/4 cup iron-fortified cereal: 1.8 mg

8. Magnesium

Daily amount :- Between 350 and 360 mg

Do you need a supplement? :- No

Benefit to your baby :- Helps build strong bones and teeth, regulates insulin and blood-sugar levels, builds and repairs tissue

Food source :- 1 oz. dried pumpkin seeds: 151.9 mg; 3 oz. halibut: 91 mg; 1 cup spinach spaghetti: 86.6 mg

9. Manganese

Daily amount :- 2 mg daily

Do you need a supplement? :- No

Benefit to your baby :- Aids bone and pancreas development and synthesis of fats and carbohydrates
Food source :- 1 cup cooked brown rice: 6.93 mg; 1 cup cooked whole-oat oatmeal: 0.95 mg; 1 cup cooked black beans: 0.76 mg

10. Pantothenic Acid

Daily amount :- No RDA; 6 mg considered safe

Do you need a supplement? :- No

Benefit to your baby :- Regulates adrenal activity, antibody production, growth and metabolism of protein and fat.

Food source :- 1 medium hard-boiled egg: 1.1 mg; 1/2 medium avocado: 1.1 mg; 1 cup nonfat milk: 1.0 mg

11. Phosphorous

Daily amount :- 700 mg

Do you need a supplement? :- No

Benefit to your baby :- Builds strong bones and teeth; develops blood clotting and normal heart rhythm

Food source :- 3 oz. canned salmon (including bones): 279 mg; 1 cup cooked pinto beans: 273 mg; 1 cup nonfat milk: 247 mg; 1 cup cooked black beans: 241 mg

12. Potassium

Daily amount :- No RDA; 2,000 mg per day considered safe

Do you need a supplement? :- No

Benefit to your baby :-Aids muscle activity and contractions, energy metabolism, and nerve function

Food source :- 1 medium baked potato: 844.4 mg; 8 oz. prune juice: 706.6 mg; 1 cup raisins: 575 mg; 10 dried apricots: 482 mg

13. Riboflavim

Daily amount :- 1.4 mg

Do you need a supplement? :- No

Benefit to your baby :- Promotes growth, good vision, and healthy skin. Essential for baby's bone, muscle, and nerve development

Food source :- 1 cup nonfat yogurt: 0.5 mg; 3 oz. skinless duck: 0.4 mg; 1/2 cup boiled mushrooms: 0.2 mg; 1/2 cup part-skim ricotta cheese: 0.2 mg

14. Thiamine

Daily amount :- 1.4 mg daily

Do you need a supplement? :- No

Benefit to your baby :- Converts carbohydrates into energy; essential for brain development. Also aids heart and nervous system growth.

Food Source :- 1 tablespoon brewer's yeast: 1.3 mg; 3 oz. pork tenderloin: 0.8 mg; 1 cup enriched spinach noodles: 0.4 mg; 1 cup split peas: 0.4 mg

15. Vitamin A

Daily amount :- 770 mcg RAE (retinol activity equivalents) OR 2,565 IU (international units)

Do you need a supplement? :- No

Benefit to your baby :- Important for cell growth, eye development, healthy skin and mucous membranes, infection resistance, bone growth, and fat metabolism

Food source :- 1 baked sweet potato: 1,403 mcg RAE; 1 cup boiled spinach: 1,146 mcg RAE; 1 raw carrot: 433 mcg RAE

16. Vitamin B6

Daily amount :- 1.9 MG

Do you need a supplement? :- No

Benefit to your baby :- Aids metabolism of protein, fats, and carbohydrates. Helps form new red blood cells and develop the brain and nervous system.

Food source :-1 medium banana: 0.7 mg; 1 medium baked potato: 0.7 mg; 1 cup chickpeas: 0.6 mg; 3 oz. chicken breast: 0.5 mg

17. Vitamin C

Daily amount :- 85 mg

Do you need a supplement? :- No
Benefit to your baby :- Essential for tissue repair and collagen production. Aids proper growth and strengthens bones and teeth.
Food source :- 8 oz. orange juice: 124 mg; 1 cup strawberries: 84.5 mg; 1/2 cup boiled broccoli: 58.2 mg; 1 tomato: 23.5 mg

18. Vitamin D

Daily amount :- 10 mcg

Do you need a supplement? :- No

Benefit to your baby :- Helps build bones and teeth.

Food source :- 3 oz. herring: 35 mcg; 3 oz. salmon: 8 mcg; 1 cup milk: 2 mcg

19. Zinc

Daily amount :- 11 mg

Do you need a supplement? :- Yes
Benefit to your baby :- Helps form organs, skeleton, nerves, and circulatory system.

Food source :- 3 oz. beef blade roast: 8.7 mg; 3 oz. Alaskan king crab: 6.5 mg; 1/3 cup toasted wheat germ: 4.7 mg

Charlie's diet: Bridget Swinney's analysis

2008-06-14T00:18:00.002+05:30

Bridget Swinney, a registered dietician and author of Eating Expectantly: A Practical and Tasty Guide to Prenatal Nutrition and the upcoming Baby Bites sat down with Charlie's diet and came up with nutrition advice helpful to every mom-to-be.Kudos to Charlie for allowing her diet to be analyzed for everyone to see.

She's doing a lot of things right: She takes long walks, which helps to keep weight gain under control, increases and maintains muscle mass, and offsets stress and boredom. It also looks like she's at 2,500 calories a day: right on target. However, there's still room for improvement with her portion sizes; her intake of whole grains, fruits, and veggies; and the types of fat she's eating.

What Charlie can improve on:

Weight gain

Although Charlie's calorie goals and exercise are great, her weight gain is still higher than it should be, at about 12 pounds at 16 weeks. She is not alone. Many women gain more than the recommended three to four pounds in the first trimester. (Sometimes it's the curse of the "eating for two" mentality.) Charlie should gain about a pound a week for the rest of her pregnancy. Here's some advice to help her — and you — stay on track.

Portion distortionLike many of us, Charlie finds it tough to estimate portions. We are so used to eating huge servings at restaurants that we've lost sight of what a normal one is. Here are a few ways to cut down on amounts:

• Keep a daily food diary to monitor calories.
• Weigh your regular portions for one week. This can be a real eye-opener, especially when you count up all those calories.
• It's easy to overdue it with pasta. Try halving your normal serving and mixing in loads of veggies. You'll be eating the same amount of food while boosting your veggie intake.
• Take a smaller serving first. If you're still hungry, go back for seconds.
• Trick your eye — and stomach — by eating from a smaller plate.

Eating regularly

Charlie's smart to eat six or so small meals a day, but she needs to make healthier choices. Instead of nibbling while she's making dinner or feeding her son, she should be sitting down and focusing on eating a complete meal.Eating your child's foodIt's easy to pick at your child's food. A bite here, a bite there, and soon you've had an entire meal. Here are some great tricks to avoid mindless nibbling:
• Before feeding your kid, brush your teeth or pop in some sugar-free gum.
• Down a big glass of water with a slice of lemon, orange, or cucumber instead of your child's chicken nuggets.
• Cut your child's sandwich in quarters, not halves. Feed him one piece at a time, and stash the leftovers in the fridge right away.
What Charlie can improve on: Adding more nutrientsIn general, Charlie is eating balanced meals with a decent carb-protein-fat ratio.

And she's getting at least 100 percent of the recommended amounts for many nutrients. But she can benefit from boosting her vitamins D, A, and E, plus folic acid, fiber, iron, manganese, and selenium.

Here are a few things Charlie can do to increase these levels: More DVitamin D — made in the skin by the sun's rays — is important for developing and maintaining a baby's bones. During the winter, fortified foods (milk and cereals) and a calcium supplement are other ways to get this valuable vitamin. Favor fruits and veggiesAim for at least two cups of fruit and two cups of veggies a day.

Charlie is averaging about half that, causing a shortfall in fiber, vitamin A, and folic acid. Try these suggestions:
• Eat a whole orange instead of a glass of juice; it has fewer calories and more fiber.

• Keep baby carrots, celery sticks, and precut veggies on hand for snacking. Grated carrots, spinach, chopped tomatoes, avocado, and sliced red peppers are great in sandwiches and wraps.

• Sneak veggies into your diet in a pureed soup or pasta sauce. Even salsa — especially homemade — can up the veggie intake.

• Trade white potatoes for the sweet kind, which are high in fiber and vitamin A. Another trick: Add flavor (instead of fat) with salsa.

• Eat a cooked or raw veggie at every lunch and dinner.Satisfy your sweet toothFruit can curb your cravings:

• Keep fresh berries, cut-up melon, and other fruit on hand for no-fuss snacking.

• A handful of raisins, dried cranberries, or cherries often does the trick.

• Microwave an apple with cinnamon sugar — easy (and yummy) as pie.

• Toss berries or peaches on sherbet or low-fat frozen yogurt.

• A fruit smoothie is a perfect midafternoon snack: Just blend a cup of fruit with a cup of milk or yogurt. Sweeten to taste with honey or sugar. (Using canned or bagged frozen fruits off-season works, too.) Get great whole grainsWhole grains contain fiber to help the digestive tract work smoothly, plus provide antioxidants and minerals — iron, manganese, selenium, and vitamin E — that are hard to find in other foods. Try to reach a goal of three varieties a day in these simple ways:

• Choose whole-grain pasta and brown rice. Experiment with lesser known grains such as quinoa and bulgur, too.

• Choose whole-grain cereal for a quick morning meal or an afternoon snack.

• Use whole grains for baking carrot cake, zucchini muffins, or banana bread.

Squelch the Saturated Fat

Charlie eats a lot of cheese and pizza, both of which are high in saturated fat. However, she's not getting enough omega-3 fat, a good fat that boosts her baby's brain and eye development. Savor these suggestions for improving the good-to-bad fat ratio:

• When eating out, ask for low-fat mozzarella or Swiss cheese on sandwiches. Both contain less fat than many other cheeses.

• Use extra-lean ground beef (drain the extra fat before adding other ingredients) in homemade chili or spaghetti sauce.

• Pick a soft margarine with oil or water listed as the first ingredient.

• To boost omega-3 fats, eat salmon once or twice a week, choose DHA-fortified eggs, and sprinkle ground flaxseed on cereal.

• Reduce trans fats — known to stunt your heart's health and your baby's growth — by avoiding bakery goods, fried foods, and other treats made with shortening or partially hydrogenated oils.

Comforting your Baby

2008-06-13T18:18:00.001+05:30

Burping, Bathing, and Bathroom Basics

2008-06-13T18:16:00.000+05:30

Pick Up and Holding Baby

2008-06-13T18:15:00.002+05:30

Health Matters: New Born Infant Care

2008-06-13T18:15:00.001+05:30

Calcium: Why it matters during pregnancy

2008-06-13T17:28:00.000+05:30

Why do I need calcium?

Your developing baby needs calcium to grow strong bones and teeth, a healthy heart, nerves, and muscles, and to develop normal heart rhythm and blood clotting abilities. If you don't get enough calcium in your diet, your baby will leach it from your bones, which may impair your own health later on.

How much do I need?

Before, during, and after pregnancy you need 1,000 mg a day, because your body can't absorb much more than that amount. Most American women don't get nearly enough of this important mineral. Aim for four servings of dairy or other calcium-rich foods a day (see our list of suggestions below).FYI Even after your baby's born and you're finished nursing, keep paying attention to your calcium intake — you need the mineral to help ward off osteoporosis (bone loss) later in life.

What are the best food sources of calcium?Milk, especially skim, and other dairy products are top sources, as are calcium-fortified foods and canned fish.

• 1 cup low-fat yogurt: 414 mg
• 8 oz. skim milk: 302 mg
• 2 cups cottage cheese: 300 mg
• 8 oz. calcium-fortified orange juice: 300 mg
• 2 slices calcium-fortified bread: 300 mg
• 3 oz. sardines: 300 mg
• 1 oz. Gruyere cheese: 283 mg
• 3 oz. canned salmon: 211 mg
• 1 oz. cheddar cheese: 202 mg
• 4 oz. firm tofu: 166 mg
• 3 corn tortillas: 150 mg
• 1/2 cup boiled turnip greens: 98 mg

Should I take a supplement?

A good multivitamin or prenatal vitamin should include at least 150 to 200 mg of calcium. You can also try a calcium supplement. Look on the label for calcium carbonate, the type most easily absorbed by the body. Or do this test: Place the supplement in a glass of vinegar and time how quickly it dissolves. If ten minutes pass and it hasn't dissolved, try another brand.Look for tablets that say they're lead-free. Recent studies have found that some "natural" calcium supplements contain a small amount of lead, which can be harmful to your growing baby.

Parenting Tips

2008-06-13T17:13:00.001+05:30

11 "fast" foods a pregnant woman could love (and five to avoid)

2008-06-13T17:07:00.000+05:30

One of the luxuries of modern living is that it's easy to buy convenience foods that taste good — it's just too bad they're full of preservatives and other ingredients you should steer clear of during pregnancy. But there are "fast" foods that are genuinely good for you, especially if what you really need are light meals or snacks that will tide you over until your next meal.

Here are 11 quick and tasty foods to love — and five to avoid — all recommended by Heidi Reichenberger, a spokesperson for the American Dietetic Association and Elizabeth Somer, registered dietician and author of Nutrition for a Healthy Pregnancy: The Complete Guide to Eating Before, During and After Your Pregnancy.

Healthy fast foods

1. Single-serve fruit bowls.

Handy little 4-ounce fruit cups that count as a serving of the daily recommendation for fruits and vegetables. Choose varieties packed in their own juice rather than in sugary syrup.

2. Soy milk.

Available in 8-ounce servings of plain, chocolate, and vanilla flavor. Stash one in your purse or briefcase (they don't need to be refrigerated). One bottle can supply one-third of your daily calcium and vitamin D needs during pregnancy.

3. Raisins.

A 1-ounce box provides 2 grams of fiber, 4 percent of the daily recommended amount of iron, and even 1 gram of protein.

4. Yogurt.

The classic nutritious-and-convenient food can provide you with 25 percent of your daily calcium requirement, protein, fiber, and several other necessary vitamins and minerals.

5. Easy-to-make trail mix.

Mix a handful of shredded wheat-type cereal with a handful of dried cherries and almonds. Keep a zip-lock bag full in your desk or car for a handy, crunchy snack.

6. Salad bar.

Some fast-food restaurants and many grocery stores have salad bars where you can serve yourself practically the whole day's worth of fruits and vegetables. Load up on spinach, carrots, tomatoes, celery, cucumbers, zucchini, raisins, and nuts. Add chickpeas and kidney beans for a protein boost.

7. Baby carrots.

Carrots are full of vitamin A and fiber and you can find them in single-serving bags. Dip them in nonfat yogurt mixed with a little bit of ranch dressing for an extra dose of nutrition. Look for other prewashed and prepacked veggies like broccoli, cauliflower, and spinach, and stir-fry them together for dinner.

8. String cheese.

If you don't know about string cheese now, just wait until your baby is a toddler — this food will become a snack staple. Low-fat mozzarella sticks are chock-full of calcium and have some protein.

9. Boxed, calcium-fortified orange juice (now available in many grocery stores).

A 4-ounce serving provides half the daily requirement of vitamin C and about 15 percent of your calcium needs.

10. Single-serve boxes of cereal (not the sugar-coated kind) or packages of instant oatmeal.

Stash a few in your desk at work for a snack. Almost all breakfast cereal is now fortified with essential vitamins and minerals.

11. Single-serve cottage cheese bowls (available in the dairy section of most grocery stores). Cottage cheese is a good source of protein and calcium.

Foods to avoid

1. Ramen noodles. Packed with salt, fat, and little else.

2. Sodas. Fill up on empty calories and sugar and you won't have any room for more nutritious drinks. Low-fat milk, carbonated water, and juices are a good substitute.

3. Prepackaged commercial lunches. Sure, they'd be a quick fix for hunger pangs, but preservatives, salt, and fat make them a bad choice.

4. Almost all prepared, frozen meals. They tend to have astronomical amounts of salt and fat. Instead, pop a potato in the microwave, and top it with cheese and steamed broccoli for a fast, healthy meal. If you can't avoid the occasional frozen meal, look for organic brands, or those low in salt and fat.

5. Iceberg lettuce. If you're going to eat a salad, choose a green such as romaine that's full of fiber; A, B, and C vitamins; folic acid; calcium; and potassium. Iceberg lettuce has only trace amounts of these nutrients.

Complete Baby Care - Instructions for New Parents

2008-06-10T14:47:00.001+05:30

How To Take A Pregnancy Test

2008-06-10T14:42:00.001+05:30

Pregnancy Massage

2008-06-10T14:38:00.001+05:30

Week 1-4

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The 13 rules of safe pregnancy exercise

2008-06-08T20:09:00.000+05:30

Exercise has great benefits, but during pregnancy you need to approach it with extra caution. Whether you're a regular exerciser looking to continue your regime during pregnancy, or a former couch potato looking to get moving, follow these 13 rules to keep yourself and your baby safe.
1. Check with your healthcare provider first

If you exercised regularly before getting pregnant and your pregnancy is problem-free, you can most likely continue working out as before — with modifications as noted below. There are exceptions to this general rule, so talk to your doctor or midwife about your fitness routine to make sure your activities don't put you or your baby at risk.If you're starting from scratch as a non-exerciser, see our exercise guide for beginners, and talk to your healthcare provider.

2. Take in extra calories

Get the 300 to 500 additional calories a day you need during pregnancy, especially if you're exercising. Make sure to eat well to help nourish and strengthen your body.

3. Steer clear of dangerous sports

Avoid contact sports, as well as activities that might throw you off-balance, such as horseback riding or biking. Even if you're normally graceful, keep in mind that the increased levels of the hormone relaxin during pregnancy, which relax pelvic joints in preparation for childbirth, loosen all ligaments and joints, making you more susceptible to sprains and injury from falls. See our list of safe sports and those to avoid.

4. Wear the right clothes

Wear loose-fitting, breathable clothing. Dress in layers so it's easy to peel off a layer or two after you've warmed up (or if you simply feel too hot). Make sure your maternity bra offers enough support, and choose athletic shoes that fit your feet properly and offer good support. If your shoe size has changed because of mild swelling, stash away your pre-pregnancy sneakers and buy a new pair.

5. Warm up

Warm-ups prepare your muscles and joints for exercise and build your heart rate up slowly. If you skip the warm-up and jump into strenuous activity before your body is ready, you could strain your muscles and ligaments and experience increased post-workout aches and pains.

6. Drink plenty of water

Drink water before, during, and after exercising. Otherwise, you can become dehydrated, which can cause contractions and raise your body temperature, sometimes to levels that are dangerous for you and your baby. James M. Pivarnik, Ph.D., of Michigan State University, says that while there's no official recommendation for how much water pregnant women should drink while exercising, a good guideline is to drink one cup (8 ounces) before you exercise, one cup for every 20 minutes of exercise, and one cup after you finish your workout. In hot and/or humid weather, you'll need more.

7. Don't lie flat on your back

Avoid lying flat on your back after the first trimester. This position puts pressure on a major vein called the vena cava, which will diminish blood flow to your brain and uterus, and can make you dizzy, short of breath, or nauseated. Some women are comfortable in this position well into their pregnancies, but this isn't necessarily a good gauge of whether blood flow to the uterus is affected. Placing a pillow under your right hip or buttock will allow you to be almost supine without compressing the vena cava.

8. Keep moving

Standing motionless for prolonged periods — as when you're lifting weights or doing yoga poses — can decrease blood flow to the uterus and cause blood to pool in your legs, making you dizzy. Keep moving by switching positions or walking in place.

9. Don't overdo it

Don't exercise to exhaustion. A good rule of thumb: Slow down if you can't comfortably carry on a conversation. In general, the best guideline is to listen to your body. When something hurts, that means something's wrong, so stop. You should feel like you're working your body, not punishing it.

10. Don't get overheated

Avoid letting yourself get too hot, especially during the first trimester when your baby's major organs are developing. Although there's no proof of a danger to humans, some animal studies suggest that overheating can cause birth defects.Increased blood flow and a higher metabolic rate mean you'll feel warmer than usual when you're pregnant, and doubly so when you exercise. And since feeling warm is common in pregnancy, you may get overheated much faster than you normally would, even before your belly is big.Signs of being overheated are largely individual, but pay attention if you're sweating a lot, feel uncomfortably warm, or feel dizzy or short of breath. On hot and/or humid days, skip your workout or exercise indoors in a well-ventilated, air-conditioned room. Wear loose, non-binding clothing and drink plenty of water.To cool off quickly, stop exercising, take off layers, and change your environment: seek out air conditioning or step into a cool shower. Hydrating is key, too, so drink lots of water.

11. Get up from the floor slowly

As your belly grows, your center of gravity shifts. That's why it's important to take great care when you change positions. Getting up too quickly can make you dizzy, and may cause you to lose your footing and fall.

12. Cool down

At the end of your workout, take a few minutes to walk in place and then stretch. Heart rate increases during pregnancy and it may take as long as 15 minutes for your heart to return to its resting rate following a workout.

13. Make it a habit

Make a commitment to work regular exercise into your schedule. Keeping up a routine is easier on your body than periods of inertia interrupted by spurts of activity. According to the American College of Obstetricians and Gynecologists, you can safely engage in 30 minutes or more of moderate exercise on most, if not all, days of the week as long as you have your healthcare provider's go-ahead.

Seven great benefits of pregnancy exercise

2008-06-08T19:58:00.000+05:30

Does exercising sound too much like a chore? We've got seven fantastic reasons why you'll actually love it!

1. Boost your energy

Pregnancy can sap your energy, but regular bouts of exercise will help you get through your daily tasks or cope with a demanding schedule: Exercise strengthens your cardiovascular system, so you don't tire as easily. With muscles that are strong and toned, you need less effort to engage in any activity, whether that means grocery shopping or sitting through meetings at the office.

According to the American College of Obstetricians and Gynecologists (ACOG), you can safely take part in 30 minutes or more of moderate exercise every day, as long as you don't have a medical condition or complication that your doctor or midwife has told you rules out exercise or limits your activity level.Before you hop on the treadmill or into the pool, make sure you follow these safety guidelines and see our tips on starting an exercise program.

2. Sleep better

When you're carrying an extra 15 pounds (or more!) in front of you, finding a comfortable sleeping position can be a real challenge. But exercise will help you work off any excess energy and tire you enough to lull you into a deeper, more restful slumber. (Get more tips for sleeping well during pregnancy.)

3. Reduce pregnancy discomfort

Overall, regular exercise stretches and strengthens your muscles, which helps your body cope better with the aches and pains of pregnancy. Stretches ease back pain, walking improves your circulation, and swimming can strengthen your abdominal muscles.Learn more about these and other exercises recommended throughout pregnancy.

4. Prepare for childbirth

It makes perfect sense: The better shape you're in, the stronger you'll be come labor and delivery time. Giving birth is akin to running a marathon — it requires stamina, determination, and focus. Though it hasn't been well researched, training for childbirth through exercise may ease labor and even shorten the time it takes to deliver your baby.

5. Reduce stress and lift your spirits

Having a child is a life-changing, momentous experience that can leave you feeling simultaneously ecstatic, overwhelmed, and anxious. One study found that exercise boosts levels of serotonin, a brain chemical linked to mood, putting you in better spirits.Learn how to tell the difference between true prenatal depression and normal pregnancy moodiness.

6. Improve your self-image

Watching the scale inch its way up to numbers you've never seen before can be disheartening. Staying active helps you feel better about yourself and improves your odds of gaining a healthy amount of weight.

7. Get your body back faster after childbirth

This alone is motivation enough for many women to embark on a pregnancy exercise regimen. When you've maintained your strength and muscle tone all through your pregnancy, your body will have an easier time bouncing back after you give birth.

Pregnancy exercise for beginners

2008-06-08T19:24:00.000+05:30

Good news: You can safely start an exercise program during pregnancy even if you've been an avid couch potato until now. If you were sedentary before you became pregnant, it's important to review your exercise plan with your healthcare provider before you begin.Pregnancy isn't the time to try to lose weight or begin a vigorous exercise routine, but if you aren't in any of the high-risk categories, you can pursue an exercise regimen at a mild to moderate level.

Start slowly and wisely

Beginners should start by exercising 15 to 20 minutes at a time, three days a week —preferably with a day of rest between workouts. Don't go for the burn and don't exercise to exhaustion. A good rule of thumb: Slow down if you can't comfortably carry on a conversation.Be careful to eat properly and get enough fluids. Being pregnant means you need approximately 300 extra calories a day, depending on your prepregnancy weight.Always stay cool while exercising. Wear a sun hat and layers of loose, comfortable clothing when working out in hot, humid weather. Keep a bottle of water handy to replenish lost fluids.

Safe exercises

If you're pregnant and new to the joys of physical fitness, consider:

• Walking: This activity gets top honors for expectant mothers because it's safe, easy to do, and improves your cardiovascular fitness — in short, it's the perfect way to get started if you didn't exercise before pregnancy.

• Low-impact aerobics classes or fitness DVDs: Look for ones that cater to pregnant women.

• Swimming: This is a great form of exercise because it uses your whole body and puts little strain on your joints. An added bonus: The water supports your weight, giving you a temporary reprieve from feeling ungainly as your belly gets bigger.

• Prenatal yoga and stretching: Both ease tension and help keep you flexible and strong.

Activities to avoid

• High-risk sports, such as scuba diving, and activities with a potential for hard falls, such as horseback riding, downhill skiing, snowboarding, and waterskiing, are off-limits to pregnant women.

• Certain other forms of exercise, such as bike riding, should be pursued more cautiously or postponed until after the baby's born. While biking enthusiasts may disagree, some experts say that biking during your second and third trimesters is dangerous because your balance isn't what it usually is, making falls more likely.

• Pregnancy isn't the time to start running, either, although it's fine if you jogged regularly before getting pregnant.

• After the first trimester, avoid sit-ups and other exercises done while lying flat on your back — they can make you dizzy and decrease the blood flow to your uterus.

• Weight lifting and other exercises that involve standing in place for long periods can also decrease the blood flow to your baby. Keep moving by changing positions or simply by stepping back and forth.

Warning signs

If you have any of the following symptoms while you're exercising, stop immediately and contact your doctor or midwife:
• pain anywhere, but especially in your back or pelvic region
• excessive fatigue
• dizziness or feeling faint
• shortness of breath
• vaginal bleeding
• difficulty walking
• contractions
• fluid leaking from your vagina
• decreased fetal movement (learn how to monitor your baby's movements, but bear in mind that the baby's often most quiet when you're exercising)
• rapid heartbeat while at rest

2008-06-08T19:20:00.000+05:30

Great pregnancy exercise: Walking

The benefits of walking during pregnancyWalking is one of the best cardiovascular exercises for pregnant women because it keeps you fit without jarring your knees and ankles. It's also a safe activity to continue throughout all nine months of pregnancy and one of the easier ways to start exercising if you haven't previously been active.If you've been walking, keep it up. If you were fairly inactive before you got pregnant, start with a slow walk and build up to brisk 20- to 30-minute jaunts. According to the American College of Obstetricians and Gynecologists, you can safely do moderate exercise for 30 minutes or more most days of the week, provided you've gotten the go-ahead from your doctor or midwife.

First-trimester tips

You probably won't need to change your normal walking habits very much. Make sure you have walking shoes that support the ankles and arches. Protect your skin with sunscreen, no matter what the season; in summer, wear a sun hat and carry a spray bottle filled with water for cooling off. Bring drinking water with you to avoid dehydration, which can cause contractions and raise your body temperature, sometimes to levels that are dangerous for you and your baby. And if it's very hot and humid outside, go for a walk in an air-conditioned mall or on a treadmill at the gym or at home.

Second-trimester tips

Continue to wear supportive shoes, protect your skin from the sun, and avoid dehydration. Your gait may now be more ungainly, so pay attention to your posture to avoid straining your back: When you walk, keep your chin level, your hips tucked under your shoulders to avoid a sway in your back, and look ahead. Swing your arms for balance and to intensify your workout. You may want to find a buddy to join you on your walks and keep you motivated. Don't walk outside after dark unless the area is brightly lit — you're at increased risk of stumbling and falling if you can't see where you're going.

Third-trimester tips

Keep up your walking regimen as long as you can, but avoid hiking trails or any uneven terrain that could put you off balance. As you get closer to your due date, you might also want to consider walking on a track. Not only is the surface easier on your body, but you might feel safer knowing that you won't get stuck far from home or your car in case of an emergency.

Warning signs

Never walk to the point of exhaustion or breathlessness. Pushing yourself to the limit forces your body to use oxygen that should be going to your baby.Stop walking immediately and call your healthcare provider if you have any of the following symptoms: vaginal bleeding, difficulty breathing, dizziness, exercise, chest pain, muscle weakness, calf pain or swelling, preterm labor, decreased fetal movement, apparent leakage of amniotic fluid, or contractions.

Your pregnancy: 14 weeks

2008-06-08T18:29:00.000+05:30

How your baby's growing:

This week's big developments: Your baby can now squint, frown, grimace, pee, and possibly suck his thumb! Thanks to brain impulses, his facial muscles are getting a workout as his tiny features form one expression after another. His kidneys are producing urine, which he releases into the amniotic fluid around him — a process he'll keep up until birth. He can grasp, too, and if you're having an ultrasound now, you may even catch him sucking his thumb.In other news:

Your baby's stretching out. From head to bottom, he measures 3 1/2 inches — about the size of a lemon — and he weighs 1 1/2 ounces. His body's growing faster than his head, which now sits upon a more distinct neck. By the end of this week, his arms will have grown to a length that's in proportion to the rest of his body. (His legs still have some lengthening to do.) He's starting to develop an ultra-fine, downy covering of hair, called lanugo, all over his body. Your baby's liver starts making bile this week — a sign that it's doing its job right — and his spleen starts helping in the production of red blood cells. Though you can't feel his tiny punches and kicks yet, your little pugilist's hands and feet (which now measure about 1/2 inch long) are more flexible and active.

How your life's changing:

Welcome to your second trimester! Your energy is likely returning, your breasts may be feeling less tender, and your queasiness may have completely abated by now. If not, hang on — chances are good it will soon be behind you (although an unlucky few will still feel nauseated months from now).

The top of your uterus is a bit above your pubic bone, which may be enough to push your tummy out a tad. Starting to show can be quite a thrill, giving you and your partner visible evidence of the baby you've been waiting for. Take some time to plan, daydream, and enjoy this amazing time. It's normal to worry a bit now and then, but try to focus on taking care of yourself and your baby, and having faith that you're well equipped for what's ahead.

Your pregnancy: 13 weeks

2008-06-08T18:03:00.000+05:30

How your baby's growing:

Fingerprints have formed on your baby's tiny fingertips, her veins and organs are clearly visible through her still-thin skin, and her body is starting to catch up with her head — which makes up just a third of her body size now. If you're having a girl, she now has more than 2 million eggs in her ovaries. Your baby is almost 3 inches long (the size of a medium shrimp) and weighs nearly an ounce.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

This is the last week of your first trimester, and your risk of miscarriage is now much lower than earlier in pregnancy. Next week marks the beginning of your second trimester, a time of relative comfort for many women who see early pregnancy symptoms such as morning sickness and fatigue subside. More good news: Many couples also notice a distinct libido lift around this time. Birth is still months away, but your breasts may have already started making colostrum, the nutrient-rich fluid that feeds your baby for the first few days after birth, before your milk starts to flow.

Your pregnancy: 12 weeks

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How your baby's growing:

The most dramatic development this week: Reflexes. Your baby's fingers will soon begin to open and close, his toes will curl, his eye muscles will clench, and his mouth will make sucking movements. In fact, if you prod your abdomen, your baby will squirm in response, although you won't be able to feel it.

His intestines, which have grown so fast that they protrude into the umbilical cord, will start to move into his abdominal cavity about now, and his kidneys will begin excreting urine into his bladder.Meanwhile, nerve cells are multiplying rapidly, and in your baby's brain, synapses are forming furiously. His face looks unquestionably human:

His eyes have moved from the sides to the front of his head, and his ears are right where they should be.

From crown to rump, your baby-to-be is just over two inches long (about the size of a lime) and weighs half an ounce.

How your life's changing:

Your uterus has grown to the point where your healthcare provider can now feel the top of it (the fundus) low in your abdomen, just above your pubic bone. Though you probably won't need maternity clothes for several more weeks yet, you've no doubt noticed that your waist is thickening and that you're more comfortable in loose, less restrictive clothing.

You may begin to experience heartburn (also called acid indigestion), a burning sensation that often extends from the bottom of your breastbone to your lower throat. Many women get heartburn for the first time during pregnancy, and those who've previously had bouts of heartburn may find that it worsens.

During pregnancy, the placenta produces a large amount of the hormone progesterone, which relaxes the valve that separates the esophagus from the stomach. Particularly when you're lying down, gastric acid can seep back up the pipe, which causes the uncomfortable burning sensation. For many women the problem doesn't begin (or worsen) until later in pregnancy, when your growing uterus starts to push up on your stomach. The discomfort may range from mildly annoying to intense and distracting.