Pregnancy Channel - Coastal Perinatal Center

Why is Non-toxic, Safe Makeup in Pregnancy Important?

May 15, 2014/in Pregnancy Channel/by coastal

Congratulations!! You are pregnant! This is one of the most exciting and special times in a woman’s life. Now it’s time to plan for a safe pregnancy.

Everybody is concerned about toxins. Pesticides, cigarette smoke, pollution, bisphenol A (BPA), organic, gluten-free…these phrases are thrown at us countless times per day in magazine ads, news reports and commercials.

What about in pregnancy? What should you do? Does it matter?

In 2004, and 2009, two different studies from the Environmental Working Group examined newborn’s blood, and found over 200+ toxins in newborn’s blood! Some of these toxins were pesticides, Bisphenol A, mercury, some are known to cause cancer, and some are known to be neurotoxic. The babies were exposed in utero to these chemicals directly from the mother’s exposure.

Some of these toxins can have an immediate affect, such as low birth weight. But some cause problems later in the child’s life. There is a phenomenon called bioaccumulation,where small amounts of toxin are absorbed, but as the baby grows, these small amounts build up and become toxic to the child.

These toxins can come from multiple sources; food, air, and even makeup.

A healthy environment is important during pregnancy. In a recent study released in February 2013, it was found that pregnant women who were living in cities with higher pollution were more likely to give birth to underweight babies. Clearly, exposure to a high toxin burden, can adversely affect your babies growth.

What about toxin exposure through skin? Is your makeup safe for your pregnancy?

In March 2013 the Safe Cosmetics and Personal Care Products Act was introduced in the US Congress. It aims to ensure that all personal care products are safe by establishing a system to assess the safety of makeup and cosmetic ingredients and to phase out the most harmful substances that are suspected of causing cancer, reproductive harm or other adverse health effects. Toxin exposure in makeup has got the attention of the US Government!

Did you know that there is lead in many brands of makeup in the USA today!The lead content comes from the use of dyes to give color. The FDA tested commonly used lipsticks and reported their findings in this detailed report:
http://www.fda.gov/cosmetics/productandingredientsafety/productinformation/ucm137224.htm

This report will surprise you!! There is no safe level of lead. Lead should not be in any of our products. Even though the individual amounts in each lipstick maybe small, a phenomenon of bioaccumulation occurs. This is when repeated levels of low amounts,build up over time, and can become toxic levels. In pregnancy, lead can be transferred to the fetus as early as the first trimester, and is associated with neurodevelopment delay.

We carefully choose every ingredient to ensure that there is no lead in any of our products.

How can a fetus get exposed to toxins in makeup? This is described as transdermal absorption or across the skin absorption.

Figure 1: Chemical Absorption by Fetus

After the chemicals pass through the skin, they get absorbed into the bloodstream. The mothers blood directly goes to the baby along with nourishment, oxygen etc. The mother’s blood goes to the placenta which is the interface between the mom and the baby. Nourishment, oxygen and other substances get transferred to the placenta, and then from the placenta to the baby via the umbilical cord.

Figure 2: Fetal blood circulation

Chemicals found in cosmetics have been found to affect both the mother and the baby in a number of ways. Most commonly, they interfere with hormonal balance amounting to what is commonly known as endocrine disruption. This can occur in the mother, and the baby. For instance, in pregnancy, exposure to parabens, and phthalates may be associated with reproductive anomalies in the baby later in life. For the mother, prolonged exposure to certain chemicals such as parabens may be associated with breast cancer. The European Union classifies pthalates as a suspected endocrine disruptor on the basis of evidence that it interferes with hormone function, and as toxic to reproduction on the basis that it may cause harm to the unborn child and impair fertility. As well, Health Canada notes evidence suggesting that exposure to phthalates may cause health effects such as liver and kidney failure in young children when products containing phthalates are sucked or chewed for extended periods. Parabens can mimic estrogen, the primary female sex hormone. They have been detected in human breast cancer tissues, suggesting a possible association between parabens in cosmetics and cancer. Parabens may also interfere with male reproductive functions.

You probably have parabens and a number of other toxins in your makeup, and aren’t even aware! Check the labels of your cosmetic products.

Pregnancy is the most important time to protect yourself agains toxin exposure. Limit yourself from pesticides by washing all produce, don’t expose yourself to pollution and cigarette smoke, and try to choose safe makeup.

Now there is a safe makeup alternative for pregnant women. To give women a choice in their makeup, I have created the world’s only safe, non-toxic makeup exclusively for pregnancy. I have removed potential toxins, lead,allergens, and irritants from our ingredients. This is the world’s safest makeup for the mother AND the baby. We feel that our makeup is the best natural, and toxin free makeup that is safe in pregnancy. Go to www.VSACHARMD.com to get more information.

Perfect Gift for a Baby Shower

May 14, 2014/in Pregnancy Channel/by coastal

A baby shower is a time of joy and celebration for every expectant mother. The original intent for a baby shower was for women to share wisdom and lessons on the art of becoming a mother. It has now become a festive occasion celebrating the pending arrival of the new baby. Mothers and friends get together to give gifts to the expectant mother, tell stories and have fun. Traditional gifts include diapers, maternity clothes, blankets, baby bottles, clothes, and toys.

What About Cosmetics??

Traditionally this is not a common gift, but now there is a new product on the market that every pregnant woman will need: safe, non-toxic makeup for use during pregnancy. Dr. Vik Sachar is a double board certified Obstetrician/Gynecologist and High Risk Pregnancy Specialist who has created the world’s first makeup exclusively for pregnancy. Traditional makeup has many chemicals which are known to be toxic. Many of these chemicals are called Endocrine Disrupting Chemicals. The World Health Organization and the United States Congress are addressing toxins in many products including cosmetics. They are concerned about the short term and long term effects on people. Many diseases such as obesity, breast and prostate cancer, infertility and others may be associated with toxin exposure. The concern is that these exposures start early, maybe even during pregnancy, and over time the levels accumulate and may cause disease; this phenomenon is known as bio accumulation.

One of the most susceptible populations to these toxins are women who are pregnant.

“Whatever a woman is exposed to during pregnancy, it gets absorbed, and travels to the baby through the bloodstream and can affect the baby later in life” says Dr. Sachar. “Today it is known that babies are born with over 200+ toxins in their blood. I created this line to give pregnant women a choice for safe, non-toxic makeup during pregnancy.”

You can find more information about Dr. Sachar’s line V.Sachar MD at his website, www.VSACHARMD.com, www.facebook.com/VSACHARMD, and follow him @VSACHARMD.

Anxiety During Pregnancy

May 13, 2014/in Pregnancy Channel/by coastal

With so many things going on during your pregnancy, it is not uncommon that some women experience Anxiety during pregnancy. In fact about 20-30% of women may experience some form of anxiety during their pregnancy.

This post is brought to you by VSacharMD.com The world’s first and only cosmetic company devoted to safe, non-toxic cosmetics for pregnancy. Toxin exposure during pregnancy is a real concern, and can place your baby at risk for future diseases such as cancer, diabetes, and more.

What is Anxiety Disorder?

Anxiety is a common phenomenon among during pregnancy and among new mothers too. Many physicians consider anxiety during pregnancy to be a normal phenomenon. This may manifest with racing thoughts, insomnia, and mild depression. For some women, this normal anxiety can escalate and can become an anxiety disorder. Anxiety disorder is severe enough to cause you distress and interfere with your daily ability to function

Insomnia during pregnancy may be a sign of anxiety

socially. It is estimated that about 5% to 16% of women suffer from anxiety disorder either during pregnancy or postpartum.

Anxiety during pregnancy can range from normal worry and anticipation to severe incapacitating fear. Many symptoms do not meet formal diagnostic criteria but definitely affect their ability to function normally. Not much is known about the complex interplay of factors involved in the development of anxiety disorders during pregnancy and not many obstetricians screen their patients for anxiety disorders.

History of anxiety in the past is the single-most best predictor of anxiety during pregnancy. Factors like perfectionism and the desire to become a supermom may contribute to the development of anxiety disorder during pregnancy. Life experiences such as frequent miscarriages, separation, loneliness, and other impactful life events may also lead your way to anxiety disorder and depression.

How it affects Pregnancy

Anxiety disorder may seriously interfere with your day-to-day activities during pregnancy. Your risks of developing postpartum depressions are three times higher with a history of anxiety disorder. Anxiety regarding pain involved with vaginal delivery may play a role in some women requesting a primary cesarean section. Women with anxiety may have more physical complaints compared to other pregnant women and chances of developing posttraumatic stress reactions are higher after childbirth.

How it affects Mom & Baby

The impact of mental health disorders on the fetus are just beginning to be understood. Anxiety disorder in mothers are associated with an increase in the risk of preterm birth, low birth weight, low APGARS in the newborn. There are also long term infant outcomes associated with maternal stress and anxiety. These include increased baby fussiness, problems with attention, emotional reactivity, as well as lower scores on measures of mental development. Postpartum anxiety and depression may also play a role in inhibited
mother-baby bonding.

There are no direct maternal-fetal neural pathways between mother and baby. Maternal anxiety is believed to affect baby through stress hormone interactions that can affect neural pathways in the developing baby.

Treatment

Where once anxiety was considered chronic and untreatable, there are now some effective forms of anxiety treatment. Cognitive behavioral therapy (CBT) is a form of psychotherapy that can have some reduction in maternal anxiety. Relaxation techniques have also been shown to significantly reduce anxiety during pregnancy. In addition, giving women information about anxiety and management strategies for self-management have been found to be effective. The best advantages of cognitive behavioral therapy that it does not include any medications. However, medications such as antidepressants and anti-anxiety medications are also used sometimes as CBT may not be a viable option for all mothers because of time and insurance constraints. A combination of CBT and medication can also be used to treat anxiety disorders. These therapies complement each other and effective in result. For women experiencing mild anxiety during their pregnancy but who do not wish to seek treatment, exercise is an excellent modality to help stabilize stress hormones. This alone or in combination with stress reducing teas, meditation and other medications may be sufficient to help pregnant mothers experiencing stress, and anxiety during
pregnancy.

This post was presented to you by VSacharMD.com The World’s first and only cosmetic company devoted to safe, non-toxic cosmetics in pregnancy. Toxin exposure in utero is associated with adult diseases as the child grows such as cancer, diabetes, and more. Prevent exposure to toxins by using safe, non-toxic
cosmetics.

Antibiotics in Pregnancy

May 12, 2014/in Pregnancy Channel/by coastal

Several times per week I am approached by a patient regarding which antibiotics are safe for her to use in pregnancy. Usually this question comes from their dentist who wants to perform a dental procedure, and ants to use an antibiotic for prophylaxis. The concern is that some antibiotics are known teratogens. Teratogens cause malformations in the developing embryo or fetus. Teratogens can be antibiotics, viruses, and other substances. Examples of known teratogens include: ACE inhibitors,radiation, cytomegalovirus, rubella virus, alcohol, cocaine, lead etc.

Most of the information regarding safety of antibiotics in pregnancy are obtained from women who took the drug “by accident” or when they didn’t know they were pregnant, and then they were followed to see the outcome of the baby. These are called retrospective studies. Because of safety concerns about risks to the developing baby, pregnant women are excluded from most drug studies. The FDA has assigned a letter category to all drugs that is used to rate a drug’s safety in pregnancy. It is generally accepted that Category A, and B drugs are safe in pregnancy.

An excellent resource from the FDA is here: (http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118567.htm). Known drugs that are teratogens are given a Category X.Frequently encountered infections in pregnancy include, urinary tract infections, pyelonephritits (kidney infection), bladder infection, pneumonia, cold, bronchitis, sinusitis, among others. A few of the commonly used antibiotics include Amoxicillin, Ampicillin, Clindamycin, Erythromycin, Penicillin, Keflex,Augmentin. These are category B.

In May 2011, the American College of Obstetricians and Gynecologists issued a monograph stating that most antibiotics are safe during pregnancy(http://www.acog.org/About%20ACOG/News%20Room/News%20Release/2011/Most%20Antibiotics%20Are%20Safe%20During%20Pregnancy.aspx).

There are many conditions that require that a pregnancy category C drug be taken. This includes anti-seizure medications, and some mood stabilizer medications among other. If you are prescribed ANY antibiotics you should have a discussion with your practitioner to assess the benefit vs risk of taking these medications during pregnancy.

This pregnancy post was presented to you by VSacharMD.com The world’s first and only cosmetic company created by a High Risk Pregnancy Specialist devoted to safe, non-toxic cosmetics in pregnancy. Toxin exposure during pregnancy is associated with the development of diseases later in life such as cancer, diabetes, Alzheimer’s and more. Find more information at www.VSacharMD.com

Herpes Virus Infection in Pregnancy

May 11, 2014/in Pregnancy Channel/by coastal

If someone says the word “Herpes”, everyone cringes. Surprisingly, about 2/3 of you reading this now, may have had HSV 1 (the type that causes cold sores), and about 20% of you may have had the genital type of Herpes (HSV2). Most people who get exposed to herpes are asymptomatic and may not even know they had it. The way we can tell if you have been exposed to this virus before is to measure your immunoglobulins (IGG) against the herpes virus.

Most episodes of HSV during pregnancy are recurrent, and are a very low risk to affect the baby. Transmission occurs through mucous membranes or open or abraded skin. The virus lives in the neurons where it entered near the spine. Recurrent clinical outbreaks occur infrequently, and may involve trauma, UV radiation, change of temperature, pregnancy,stress, immunosuppression or hormonal changes.

Infection presents with papules, pustules, vesicles and ulcers that last 2-6 weeks

The fetus becomes infected by a virus shed from the cervix or lower genital tract. It either invades the uterus during membrane rupture or is transmitted by contact with the fetus during delivery. Neonatal herpes is caused by both herpes simplex types 1 and 2, although herpes simplex type 2 infection predominates. Most infected infants are born to mothers who have no reported infection.

How it affects You/Pregnancy?

The risk of neonatal infection correlates with the presence of HSV in the genital tract, the stage of maternal infection and invasive obstetrical procedures. If the pregnant woman acquires a new infection near the time of delivery the infant has a 30- to 50- fold increased risk of infection due to higher viral load and the lack of protective antibodies. While women with recurrent HSV have less than a 1-percent risk of neonatal infection.

How it affects the mother?

Only 1/3 of newly acquired Herpes infections are symptomatic. The incubation period of 2-10 days followed by eruption that is papular with itching and tingling, which then becomes painful and vesicular. Transient flu-like symptoms are common. Although very rare, life threatening herpes infection may develop in the mother (disseminated disease) with encephalitis, hepatitis and pneumonia may develop. All signs of infection disappear in 2-4 weeks. Many women do not present with the typical lesions, some may have pruritic or abraded areas others may have knife-slit lesions that may sting, or be itchy.

How it affects the baby?

Neonatal transmission occurs during pregnancy in about 5% of cases, during labor and delivery around 85% and after delivery around 10%.

The most concerning HSV infection during pregnancy occurs in those with a primary/first episode infection in early pregnancy. These are associated with an increased risk of preterm labor, IUGR (intrauterine growth retardation), spontaneous abortion or stillbirth. Premature infants account for 2/3 of the cases of neonatal HSV.

Late-pregnancy infection has been associated with preterm labor and delivery. 80% of mothers of infected infants have no reported infection. This often occurs because the mother is unaware that she was infected, or exposed to a partner with HSV. Epidemiologic studies suggest that most sexual transmission of genital herpes occurs when persons shed virus but lack lesions. Both men and women can shed the virus, without visible lesions on their genitals.

Primary/first episode infection during pregnancy is associated with microcephaly and neonatal chorioretinitis; rarely skin lesions. The risk of fetal transmission with HSV primary infection is about 60%. 20% of those with neonatal HSV have long-term neurologic sequelae.

Treatment and Prevention

Specific antiviral medications have been used successfully to attenuate the infection and reduce viral shedding. In those women with a history of prior HSV (recurrent HSV), and recurrent outbreaks, suppressive therapy with daily antiviral treatment has been used successfully to reduce outbreaks, decrease viral shedding, and decrease neonatal HSV.

Antiviral treatment with medication such as Acyclovir appears to be safe in pregnant women.

If women at term with a history of HSV, present with prodromal symptoms of HSV infection such as vulvar burning or itching, and careful examination of the vulva, vagina and cervix should be done to evaluate for the presence of lesions. Cesarean section is indicated for those with only active genital lesions or prodromal symptoms. However even after cesarean section, some infants are born with HSV. Postnatal treatment with antiviral medications are
given for neonatal herpes infection.

This post was presented to you by VSacharMD.com The World’s first and only cosmetic company devoted to safe, non-toxic cosmetics in pregnancy. Toxin exposure in utero is associated with adult diseases as the child grows such as cancer, diabetes, and more.Prevent exposure to toxins by using safe, non-toxic cosmetics.

Choosing Your Hospital for Labor & Delivery

March 24, 2014/in Pregnancy Channel/by coastal

You have many decisions to make during your pregnancy: choosing your doctor, choosing your baby name, and of course choosing your hospital. It is quite common that your physician may deliver at different hospitals. You should find out if they have admitting privileges at other hospitals and assess all of your options.

Quite often, patients want to deliver at a particular hospital because of convenient location, a NICU, or personal preference. Insurance plans often have defined plans with which hospital they are contracted; check with your insurance plan early in your pregnancy to see which hospitals you are restricted to, if any.

If you are set on a particular hospital, then call your insurance company for a list of doctors that are in your plan that deliver at that particular hospital. Although these decisions seem trivial, find out early about these details, as it will affect you later.

Labor and Delivery
Some hospitals have Labor and Delivery Recovery and Postpartum suites, or LDRP. These are the most convenient for the patient and the family. You labor in the same room that you deliver in, then you stay there for the postpartum and recovery period (2-3 days depending on route of delivery).
The other more common option is Labor and Delivery and Recovery suite. With this type of room, you labor and delivery and recover in the same room, then you get transported to a different ward for postpartum period.
Both options are available, but obviously the LDRP are the most convenient.

Neonatal Intensive Care Unit (NICU)
Pregnancy is a critical time for your babies’ development. During pregnancy, your baby depends on you for nourishment, oxygen, getting rid of waste, and protection from harm. After the baby is born, it no longer has that protection that you gave. Immediately after birth, your child has to learn how to breathe, take its first breath, has to process food and waste, and their immune system has to start working to protect against bacteria and viruses. Most babies can make this transition fairly easily, but occasionally some babies have difficulty making the transition and need special attention. Babies that are born prematurely, often need assistance in some, or all of these areas as well. Other babies that often need the specialized care that a NICU offers include those with congenital birth defects; for instance cardiac, or spinal.
A NICU offers highly specialized nursing and medical care by a staff that is trained for this special group of patients.
Only about 9% of all newborns need NICU care, so most babies do not need their services, but some patients want the assurance if something comes up unexpected for their newborn, that a NICU is available. If your hospital does not have a NICU, as most don’t, they may need to be transferred to a facility with a NICU after birth.

Next, set up tours to visit all of the hospital birthing units. Most hospitals will have tours available a few times a month. Many will not only give you a tour of the unit, but will also answer questions, and even give you a goodie bag at the end. This tour will allow you to view the facilities first hand, visit with some of the nursing staff, and get a first hand look at the security features the hospital offers. Pay attention to details and ask many questions. Take detailed notes about your visit. After touring several hospitals you may start to get them mixed up. Not only will touring the birthing centers help you to make the wisest decision, knowing exactly where to enter the hospital upon arrival when you are actually in labor is a great thing to know.

While visiting the hospitals you should also ask for a list of any prenatal classes that are offered. If a hospital offers a large number of classes, such as labor and delivery, infant CPR, breastfeeding, etc, it is more likely that their birthing unit is of higher importance in the overall scheme of the hospital.

If you have a lot of trust in the doctor who is seeing you for your prenatal visits, you may ask him or her for a recommendation. Your doctor may even only perform deliveries at certain hospitals. If you really want to make sure your doctor is there with you for labor and delivery, make sure you know ahead of time what hospitals he or she will deliver in.

Having a baby is a frightening, wonderful, and completely exhausting experience. Dealing with negative nurses, a cramped delivery room, and less-than-secure facilities only adds to your already overwhelmed state. Doing a little research ahead of time, and choosing the best hospital for you and your baby, will allow you to have the best experience with your labor and delivery as possible.

Antiphospholipid Syndrome in Pregnancy

October 28, 2013/in Pregnancy Channel/by coastal

What is it?

Antiphospholipid Syndrome (APS) has been associated with a variety of medical problems in pregnancy;

blood clots in arteries and veins (deep vein thrombosis), low platelets and both early (<12wks) and later fetal loss. This syndrome occurs secondary to the presence of maternal antiphospholipid antibodies: B2 glycoprotein 1, Lupus anticoagulant, and anticardiolipin. There are blood tests that can check for the presence of these maternal antibodies. Obstetric complications that have been associated with antiphospholipid antibodies include: preeclampsia (<34 wks), intrauterine growth restriction, placental insufficiency, and preterm delivery. Some patients have all three antibodies, some only have one. The diagnosis requires 2 positive tests at least 12 weeks apart (because sometimes the presence of these antibodies is transient).

The most common medical complication with APS is a blood clot and the most likely location is in the leg (calf). Recurrent pregnancy loss <10 wks is also associated with APS.

Who should be tested for APS?

Women with any history of a blood clot.
Women with a history of >3 miscarriages less than 10 wks, consecutively (not sporadic), after maternal hormonal abnormalities, maternal anatomical abnormalities, and abnormal parental chromosomes were ruled out.
Women with a history of a fetal loss after 10 weeks gestational age.
Women with a history of preterm delivery <34 weeks secondary to severe preeclampsia or eclampsia, or placental insufficiency.

How it Affects You

Pregnant women with APS are at risk for blood clots. Usually the blood clot occurs in the deep veins of the calf. This can present as a painful swollen leg. If this occurs, there is a risk that the clot could spread to the lungs where it becomes a pulmonary embolus and is associated with maternal death. The purpose of the treatment of APS is to prevent clot formation.

How it Affects the Baby

Smaller clots occur in the placenta, and are associated with preeclampsia, growth restriction, and subsequent preterm delivery.

Treatment

Women with APS should be treated with both low-dose Aspirin and subcutaneous heparin injections. Third trimester fetal monitoring is recommended; discuss the timing of this with your physician. Treatment should continue through pregnancy and continue until 6 weeks postpartum.

Because women with APS are at a lifelong risk for thrombotic events and stroke, they should consult with their physician or a specialist regarding need for treatment after pregnancy.

Why Gluten Free Makeup

August 26, 2013/in Pregnancy Channel/by coastal

We are always in a state of change. Our bodies change, our mind changes, our hair changes, and even our sensitivity to different products changes. After the birth of our first son, my wife became sensitive to perfume of any kind.

Some people have a gluten sensitivity, and most don’t even know it. Many women are told they have irritable bowel syndrome, and have to figure Gluten is a protein from wheat and related grains. It is used in many different products in different industries because it acts like a filler. It is used in pastries, whip cream, bread, pasta, cereal, chocolate, crab meat in sushi (not the fish though), even beer.

Maybe you notice if you eat pizza, you get a little bloated and “uncomfortable” after. This may last the whole day. You may think this is a normal reaction to the food, however this may be a gluten sensitivity.

As we are all different, everyone’s reaction to this is different. Personally, I can’t eat pizza, or drink beer, or anything mentioned above without feeling kind of sluggish and lousy for the rest of the day. So I don’t.

How does this apply to makeup??

Our bodies are not isolated, everything is connected. Our skin is an organ, and it absorbs. Lipstick gets ingested (yes it’s true!). Eyeliner, foundation, blush…your skin absorbs some molecules of everything. Some people may get a rash, acne, or itchy red eyes, or a puffy face, lips and think it’s ok AND then apply more makeup which compounds the problem!

In pregnancy this may be a little more complicated. Any reaction in the mother, may be carried to the baby. The reactions in the mom trigger inflammation, and this may be carried to the baby. This phenomenon is still being studied, however we do know that inflammation and its triggers are concerning. One possible cause of colic in infants is believed to be gluten sensitivity in the baby.

Our mineral cosmetics are a safe alternative for pregnant patients. Note our entire line is Gluten Free!!

Weight Gain in Pregnancy: A Big Topic

August 25, 2013/in Pregnancy Channel/by coastal

How many of you have had this reaction??

Not every topic on this blog will be about cosmetics. In fact most will be about pregnancy and life in general.

“I’m eating for two!!”

“I can’t help it, I have cravings for a half dozen Krispy Kreme Donuts!”

Kim Kardashian gains 65lbs and is only 6 months pregnant!!

Everyone is talking about weight gain and weight loss: Biggest Loser, Celebrity Trainers, Weight Watchers…the list is endless. But that’s because obesity is a GLOBAL epidemic.

And it is even bigger in pregnancy.

In the good old days, when a woman became pregnant, she was given a platinum card to eat whatever she wanted!

“Ice cream and anchovies…..Sounds good!”

“A full Pizza at 3am for a snack because THE BABY woke me up!……Go For It!”

But now we are smarter. We know that when you are pregnant you need to have your weight gain INDIVIDUALIZED. It’s not an open 30-40 lbs for everyone. We are all different, and need individualized healthcare recommendations.

But so what?? So what if you gain 70lbs during your pregnancy?? We all know someone who did, the baby did fine…what’s the big deal?

Pregnancy is a unique situation in which there are two patients, the mother and the baby. It’s not just all about the baby. If you gained 70lbs during your pregnancy, you would probably lose about 25 immediately after, but that still leaves an excess 45 lbs. Those extra pounds turn to fat, and then they cause reactions in your body; the first is insulin resistance, and increasing your risk of becoming a diabetic. The second is the excess weight can lead to increased blood pressure. Increased weight also places stresses on your joint, and can lead to arthritis, and joint injury. These changes won’t occur immediately after delivery, but the process gets started, and becomes a problem for you a few years down the line. This has been recognized in medicine through observation and now we are addressing this issue.

Body Mass Index (BMI) is used as a screening tool to identify possible weight problems. You can enter your weight and height on any website BMI calculator and it will give you a number (http://www.nhlbisupport.com/bmi) . If you are 25kg/m2 or less then you are appropriate. If you are 25-30 kg/m2 then you are considered overweight. And if you are 30-40kg/m2 then you are considered obese. You may want to ignore those numbers, but beware, the higher your BMI, the higher your risk of developing Gestational Diabetes (diabetes in pregnancy). This occurs because of insulin resistance, and with it comes a 50-60% chance you will develop true diabetes in the future. Even more concerning to the baby, is that the babies of diabetic mothers have a higher chance of developing childhood obesity and diabetes later in life.

So let’s assume that you went to the website, and entered your height and weight and got a number…now what?? What does it mean? How much weight should you gain??

The Institute of Medicine (IOM) released a statement about weight gain in pregnancy for the first time in 2009. (http://www.iom.edu/~/media/Files/Report%20Files/2009/Weight-Gain-During-Pregnancy-Reexamining-the-Guidelines/Report%20Brief%20-%20Weight%20Gain%20During%20Pregnancy.pdf). This was the first any medical advisory board addressed the issue of weight gain in obese women. Their recommendations were based on BMI and divided into underweight, normal weight and obese. Although their recommendations were individualized, their recommended weight gain was considered excessive by some. The American College of Obstetricians and Gynecologists (ACOG) issued a recent statement this year in which they stated for the overweight pregnant woman who is gaining less than the recommended amount BUT has an appropriately growing fetus, no evidence exists that encouraging increased weight gain to conform with the current IOM guidelines will improve maternal or fetal outcomes (http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/Weight%20Gain%20During%20Pregnancy.aspx) . I too restrict my obese patients’ weight gain to less than the IOM recommendations, but I ensure their diet is adjusted to maximize nutrition, and minimize “empty” calories. We also ensure appropriate vitamin supplementation. Simple prenatal vitamins do not appropriately give all the vitamins and nutrients needed for an adult let alone for a pregnant woman with the additional needs of the fetus. But that is another topic for a blog!!!I

Note: As always have a discussion with your obstetrician before embarking on any intervention that may affect your pregnancy!

Vitamin D & Pregnancy

August 24, 2013/in Pregnancy Channel/by coastal

Sunscreen, sunburn, SPF 1000…we have all been told to protect ourselves from the deadly sun since we were kids.

“Wear a hat, stay in the shade!”

Sunblocks, our fear of skin cancer, and processed food diets all contribute to a deficiency of Vitamin D.

We recently saw a comedian who was an ex-Marine (really!) who was telling us how he broke his ankle and found out he was Vitamin D deficient; he was 27!!

Vitamin D used to be believed to be important for bones and bone health only. Now we know that Vitamin D really works like a hormone, and it has wide reaching effects all over the body.

Vitamin D is associated with: bone health, helps prevent against diabetes, prevents against Alzheimer’s disease and dementia, helps prevent depression, helps prevent against colds and viruses, and may help protect against certain cancers….

What about pregnancy?

The list is impressive, Low Vitamin D in pregnancy is associated with: autism, behavioral problems, schizophrenia, low birth weight, poor motor skills, possible low IQ. In terms of the pregnancy itself, low Vitamin D is associated with gestational diabetes, pre-eclampsia, and premature delivery.

What about the prenatal vitamin?

The standard amount of Vitamin D in prenatal vitamins is 400IU. This amount is used in every standard regular vitamin, and is probably insufficient for pregnancy. Some studies suggest 10X this level is probably the correct dose. Your dose should be individualized to your Vitamin D level.

What should I do?

Talk to your doctor, get your Vitamin D level checked (Vitamin 25-OH level) checked, and if low, start supplementation. And remember Vitamin D is a fat soluble vitamin which means you need to take it with food to be absorbed.

As always make sure you check with your physician before making any changes to your health care during pregnancy.