Nutrition During Pregnancy – Three Key Nutrients

 

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Nutrition During Pregnancy
Image: americanpregnancy.org

Max Izbicki DO Chicago Il Obstetrician and Gynecologist provides comprehensive care to women at all stages of their pregnancy from the first prenatal consultation through delivery and beyond. Good nutrition is especially important during pregnancy. The following vitamins and minerals are of particular importance.

Folic acid, or folate, is a B vitamin. Current guidelines suggest that women who are pregnant get at least 600 micrograms of folic acid daily to prevent birth defects and encourage proper brain and spine development. Folate-dense foods include beans, asparagus, and spinach.

Calcium is a mineral that helps build bones and teeth. All women should get at least 1,000 milligrams of calcium daily, pregnant or not. Women who are pregnant should consume at least 1,300 milligrams. Calcium-fortified cereals and juices are good sources, as are dairy products, salmon, and spinach.

Iron makes hemoglobin, a crucial component of red blood cells. Women who are pregnant need to double their iron intake to create the red blood cells that deliver oxygen to babies. This amounts to about 27 milligrams of iron daily. Fortified oats, meat, spinach, and beans are high in iron.

Pre-natal vitamins contain all of the vitamins and minerals listed above as well as others. If seeing Dr. Max Izbicki for prenatal care, he will advise you as whether additional supplementation is recommended.

Exercise During Pregnancy

 

Obstetrician and gynecologist Dr. Max Izbicki treats patients in Chicago, Illinois. Dr. Izbicki offers personalized care to patients through each stage of pregnancy.

Most healthy women experiencing normal pregnancies may safely exercise. In fact, the Centers for Disease Control and Prevention recommends that women who are pregnant get at least 150 minutes of aerobic exercise weekly. This exercise can alleviate some pregnancy-related pains and may help prevent or improve conditions such as gestational diabetes. Women who are already active typically can continue their exercise regimens, making adjustments as needed.

Sports and activities that could cause a fall should be avoided. Physicians also suggest that women avoid exercises such as hot yoga that lead to overheating as well as activities at very high or very low altitudes, such as scuba diving.

Brisk walking is one low-risk way to get exercise during pregnancy. Swimming and water aerobics are also safe, low-impact workouts for women who are pregnant and may be experiencing lower back or joint pain.

Yoga and Pilates are also good choices. Modified forms of these exercises are suitable for pregnancy and can improve flexibility.

Women who are pregnant should drink water before, during, and after exercise to avoid dehydration. Wearing loose clothing and exercising in climate-controlled spaces can help avoid overheating. If seeing Dr. Izbicki for prenatal care in Chicago, he will discuss activity in pregnancy with you in detail.

Post partum Depression

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Post partum Depression
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About 2–3 days after childbirth, some women begin to feel depressed, anxious, and upset. They may feel angry with the new baby, their partners, or their other children. They also may cry for no clear reason, have trouble sleeping, eating, and making choices and question whether they can handle caring for a baby. These feelings, often called the postpartum blues, may come and go in the first few days after childbirth.The postpartum blues usually get better within a few days or 1–2 weeks without any treatment. Women with postpartum depression have intense feelings of sadness, anxiety, or despair that prevent them from being able to do their daily tasks. Postpartum depression can occur up to 1 year after having a baby, but it most commonly starts about 1–3 weeks after childbirth.

Postpartum depression probably is caused by a combination of factors. These factors include the following: Changes in hormone levels—Levels of estrogen and progesterone decrease sharply in the hours after childbirth. These changes may trigger depression in the same way that smaller changes in hormone levels trigger mood swings and tension before menstrual periods. A history of depression is also a risk factor. Women who have had depression at any time—before, during, or after pregnancy—or who currently are being treated for depression have an increased risk of developing postpartum depression. Emotional factors include feelings of doubt about pregnancy are common. If the pregnancy is not planned or is not wanted, this can affect the way a woman feels about her pregnancy and her unborn baby. Even when a pregnancy is planned, it can take a long time to adjust to the idea of having a new baby. Parents of babies who are sick or who need to stay in the hospital may feel sad, angry, or guilty. These emotions can affect a woman’s self-esteem and how she deals with stress. Fatigue may also play a role. Many women feel very tired after giving birth. It can take weeks for a woman to regain her normal strength and energy. For women who have had their babies by cesarean birth, it may take even longer.

If you think you may have postpartum depression, or if your partner or family members are concerned that you do, it is important to see your health care provider as soon as possible. Do not wait until your postpartum checkup. Postpartum depression can be treated with medications was well as talk therapy. Dr. Max Izbicki Chicago Il OB/GYN cares for women with a wide range of pregnancy complications including post partum depression and may offer both of these options if you are diagnosed with this condition. If you have a history of depression at any time in your life or if you are taking an
antidepressant, tell your doctor early in your prenatal care. He or she may suggest that you begin treatment right after you give birth to prevent postpartum depression.

Breast Feeding

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Dr. Max Izbicki DO Chicago IL OB/GYN cares for pregnant patients from the first prenatal consultation through the delivery and beyond and supports breast feeding in new moms. Exclusive breastfeeding is recommended for the first 6 months of a baby’s life. Breastfeeding is best for your baby for the following reasons: Breast milk has the right amount of fat, sugar, water, protein, and minerals needed for a baby’s growth and development. As your baby grows, your breast milk changes to adapt to the baby’s changing nutritional needs. Breast milk is easier to digest than formula. Breast milk contains antibodies that protect infants from certain illnesses, such as ear infections, diarrhea, respiratory illnesses, and allergies. The longer your baby breastfeeds, the greater the health benefits. Breastfed infants have a lower risk of sudden infant death syndrome (SIDS). Breast milk can help reduce the risk of many of the short-term and long-term health problems that preterm babies face.

Breastfeeding is good for you for the following reasons: Breastfeeding triggers the release of a hormone called oxytocin that causes the uterus to contract. This helps the uterus return to its normal size more quickly and may decrease the amount of bleeding you have after giving birth. Breastfeeding may make it easier to lose the weight you gained during pregnancy. Breastfeeding may reduce the risk of breast cancer and ovarian cancer.

Drinking caffeine in moderate amounts (200 mg a day) most likely will not affect your baby. Newborns and preterm infants are more sensitive to caffeine’s effects. You may want to consume a lower amount of caffeine in the first few days after your baby is born or if your infant is preterm. If you want to have an occasional alcoholic drink, wait at least 2 hours after a single drink to breastfeed. The alcohol will leave your milk as it leaves your bloodstream—there is no need to express and discard your milk. Drinking more than two drinks per day on a regular basis may be harmful to your baby and may cause drowsiness, weakness, and abnormal weight gain.

Most medications are safe to take while breastfeeding. Although medications can be passed to your baby in breast milk, levels are usually much lower than the level in your bloodstream. The latest information about medications and their effects on breastfed babies can be found at LactMed, a database of scientific information, at http://www.toxnet.nlm.nih.gov/newtoxnet/lactmed.htm. If you are breastfeeding and need to take a prescription medication to manage a health condition, discuss this with your health care team and the health care professional caring for your baby.

Painful Intercourse

Dr. Max Izbicki Chicago Il OB/GYN cares for women with a wide range of obstetric and gynecologic conditions including painful intercourse. Pain during intercourse is very common. Nearly 3 out of 4 women have pain during intercourse at some time during their lives. For some women, the pain is only a temporary problem; for others, it is a long-term problem. Pain during sex may be a sign of a gynecologic problem, such as ovarian cysts or endometriosis. Pain during sex also may be caused by problems with sexual response, such as a lack of desire or a lack of arousal.

Women may feel pain in their vulva, in the area surrounding the opening of the vagina, or within the vagina. The perineum is a common site of pain during sex. Women also may feel pain their lower back, pelvic region, uterus, or bladder. If a woman has frequent or severe pain during sex, she should see a health care provider. It is important to rule out gynecologic conditions that may be causing the pain.

Pain during sexual intercourse can be a warning sign of many gynecologic conditions. Some of these conditions can lead to other problems if not treated. Some skin disorders may result in ulcers or cracks in the skin of the vulva. Contact dermatitis is a common skin disorder that affects the vulva. It is a reaction to an irritating substance, such as perfumed soaps, douches, or lubricants. It may cause itching, burning, and pain. Treatment of skin disorders depends on the type of disorder. Vulvodynia is a pain disorder that affects the vulva. When pain is confined to the vestibule (the area around the opening of the vagina), it is known as vulvar vestibulitis syndrome (VVS). There are many treatments available for vulvodynia, including self-care measures. Medication or surgery may be needed in some cases.

During perimenopause and menopause, decreasing levels of the female hormone estrogen may cause vaginal dryness. Hormone therapy is one
treatment option. Using a lubricant during sex or a vaginal moisturizer also may be helpful. Vaginitis, or inflammation of the vagina, can be caused by a
yeast or bacterial infection. Symptoms are discharge and itching and burning of the vagina and vulva. Vaginitis can be treated with medication. Vaginismus is a reflex contraction (tightening) of the muscles at the opening of your vagina. Vaginismus may cause pain when women try to have sexual intercourse. Vaginismus can be treated with different forms of therapy. Women who have had an episiotomy or tears in the perineum during childbirth may have pain during sex that may last for several months. Treatments include physical therapy, medications, or surgery. Pelvic inflammatory disease, endometriosis, and adhesions are all associated with pain during sex.

Influenza Vaccines in Pregnancy Not Linked to Autism

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influenza vaccine

 

Chicago Il Obstetrician and gynecologist Dr. Max Izbicki cares for pregnant women through all stages of pregnancy, delivery, and postpartum. Dr. Izbicki cares for women with low and high-risk pregnancies.

According to a study recently published in the Journal of the American Medical Association (JAMA) Pediatrics, receiving an influenza vaccine during pregnancy does not increase a child’s risk of autism. Researchers also found no increased risk among those women who received an influenza vaccine during pregnancy, particularly when the expectant mother received the vaccination during her second or third trimester. The study does present clinically insignificant data for higher risk when mothers received a flu vaccination during the first trimester, though researchers note that this may be attributable to chance.

The findings stem from an examination of data regarding a cohort of nearly 197,000 children born at Kaiser Permanente from the beginning of 2000 to the end of 2010. All children were born at 24 weeks gestation or later. After reviewing participant families’ medical records, which included maternal influenza and vaccination as well as autism spectrum disorder (ASD) diagnosis in their children, researchers recommended no change in existing recommendations that pregnant women receive the flu shot.

Because women in pregnancy are particularly vulnerable to infection, a flu shot during pregnancy is currently the recommendation of the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, and all relevant obstetric and pediatric medicine societies. However, more research will likely occur to further examine any increased risk during the crucial first trimester.

Vaginal Birth after Cesarean

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Dr. Max Izbicki Chicago, IL OB/GYN offers patient with a previous delivery by cesarian section the opportunity for a vaginal delivery. Vaginal birth after cesarean delivery, commonly referred to as VBAC, is a delivery option for patients who have had one prior c-section. Recently the technical terminology has changed a bit, referring to the labor process as TOLAC (trial of labor after cesarean), and successful completion of a vaginal delivery as VBAC. However, the term VBAC still tends to be the most widely used and understood abbreviation.

VBAC allows an option for experiencing a vaginal birth, and successful VBAC avoids additional abdominal surgery and provides a quicker post-partum recovery. For those planning large families, VBAC enables one to avoid multiple repeat c-sections and the associated surgical risks.

Who is a candidate for VBAC?

TOLAC is a reasonable option for many women who have undergone one previous low transverse cesarian. The term “low transverse” refers to how the incision was made on the uterus, not the skin. For patients interested in VBAC, your provider will request a copy of your prior operative report to confirm that the incision on your uterus is indeed, low transverse.

What are the risks of VBAC?

It is important to remember that both repeat cesarean delivery and VBAC have risks associated with them, and the highest risks are associated with a failed VBAC. Either of these may be associated with maternal hemorrhage, infection, and hysterectomy. However, the risk most commonly associated with VBAC is uterine rupture, meaning that during the labor process the uterus ruptures , or breaks open, on the prior uterine scar line. In rare instances uterine rupture may occur with a routine scheduled c-section. Uterine rupture is associated with both maternal and fetal complications. The risk of uterine rupture in a patient who has had one prior low transverse cesarean delivery undergoing TOLAC is 0.7-0.9%.

What is the success rate for VBAC?

For any woman considering VBAC, the indication for your prior c-section impacts the likelihood of successful VBAC. For example, a patient who had a prior c-section for arrested labor (ie the cervix stopped dilating or one reached 10 cm but pushed for a few hours without making progress), has the lowest likelihood of VBAC. On the other hand, someone who has had a prior successful vaginal delivery has the highest likelihood of success. The overall success rate for VBAC is 60-80%. There are a number of other factors that make a trial of labor after cesarian more or less likely to result in a successful VBAC. Women should only make the choice for a TOLAC after close consultation with a supportive obstetrician experienced with VBAC deliveries.