Here are the answers to all your pregnancy nutrition worries.

As you go through your pregnancy, no doubt the unsolicited advice from everyone and their mother have put you in a conundrum—for every fact, you will find a contradictory one. We demystify common misconceptions and help you tell apart fact from myth.

Your officemates say: Eat up, you’re eating for two.


Sorry, you need to put back that extra serving of  pudding. The biggest myth is that it is okay to eat more during pregnancy because you are eating for two.  Chef, cookbook author, and food, health and travel writer Catherine Jones and perinatal nutritionist and dietician Rose Ann Hudson, authors of the newly updated book Eating For Pregnancy, stress that you are carefully eating for one, and you should increase calorie intake to 300 calories a day – the equivalent of one cooked chicken breast. Remember that you are eating primarily for you, and just a little bit more for a tiny someone, who at full-term, is small enough to fit in the crook of your arm.

Your Mom says: Forget the salt – you don’t want to swell up.

Normal sodium intake of 2,300 mg daily does not make you swell up, but excessive consumption can cause water retention and swelling, particularly in the ankles. And while a little swelling is normal in pregnancy, swelling combined with high blood pressure can be a symptom of preeclampsia and requires immediate medical attention. Rule of thumb – salt your food to taste. It is still and essential nutrient.

Your best friends say: It’s ok to eat a little less, because your baby will just feed off your fat stores.

Pregnancy is NO time to diet. Adequate calories, vitamins, minerals, fats, and protein ensure healthy fetal development and delivery. Depriving your baby of essential nutrients can result in low-birth weight and other complications. Inadequate protein will force your body to break down tissues (muscle) to feed the baby, and your health will suffer. The only source of protein your baby has is from the food you eat.

Your favorite aunt says: Eat a low-fat diet to keep the extra weight off.

Low-fat diets can be extremely dangerous in pregnancy, because most foods considered “fatty” are good sources of protein, such as eggs, meats and cheese. During pregnancy, it’s important to eat a balanced diet that includes plenty of good fat. For instance, DHA omega-3 fatty acids from fish and supplements form the building blocks of your baby’s brain, particularly during the third trimester. Be sure your diet includes mono- and polyunsaturated fats from plant oils and fish sources.  

Your dear grandmother says: A fish diet will ensure a perfectly healthy baby.

Maybe in your grandma’s time, yes. If only our waters weren’t so polluted today and the resulting mercury content in some fish weren’t toxic to babies.  Methyl mercury, primarily found in large fish (such as tuna, swordfish, tilefish, and king mackerel), can contain high levels of mercury. Smaller fish, like salmon and grouper (lapu-lapu) are all safe to eat during pregnancy. Fish high in omega-3s (such as salmon, sardines, trout, herring, and halibut) are essential for healthy brain development. Bottom line: Don’t eliminate fish from your diet, but make smart choices.

Oh no… can we really handle another one?

My second daughter came to us sooner than expected. My son had not even reached his second birthday… and surprise! …we were pregnant again. Maybe the hormones were also to blame, but while the “good news” made my husband ecstatic it made me cry and panic. Apparently, my reaction is not unusual. If you’re feeling overwhelmed about that new baby on the way, I offer some comforting words.

True, taking care of two versus one is more complicated. There’s a transition phase that will entail some struggle and a few mistakes here and there. But that transition phase will eventually pass.

It hit me the moment I saw my son playing with his sister and her finding joy in being with her big brother. Eventually, I realized I was no longer at my son’s beck and call for entertainment. Now they have their own games and language that mom and dad are not part of… and it melts my heart when I see them relishing each other’s company.

There are fights of course. But what’s great about that is, I let them settle things on their own as much as possible. In the end, they’re better at dealing with other people in general.

Another upside of adding to your family: You’re an expert now, and you can kiss all that constant questioning good-bye. You’ve already raised one baby so you know what’s coming with sleep, feeding, and setting limits. In my experience, nursing the second time around was so much easier.

Transition Smoothly

With two kids you will definitely need to streamline your life. Set a systematic schedule for chores, shopping and errands. I really can’t imagine how a laissez faire approach can work.

When it comes to kids, you’ll find that setting and sticking to routines is key. As soon as you can, get your new baby on a regular nap and bedtime schedule; everyone will be in a better mood. Eventually, both kids will go to bed around the same time and eat regular meals together, which will make your life a lot easier.

A few more important tips:

Spend one-on-one time with each child. Set aside time for just hanging out with one kid at a time. This was especially helpful with my older son. He hardly felt like his sister was taking his mom away from him.

Indulge in date night. One night a week mom and dad deserve to spend some time together without the kids. It’s good for your marriage and sanity. You’ll take better care of your kids if you’re happy.

I laugh at myself now recalling those panic-stricken tear-filled days when I was surprised to find out baby number two was on it’s way. Today I consider my baby girl to be the best surprise ever.

Can we really suffer from pregnancy brain?

Since I delivered my children with epidural anesthesia, I call it epidural brain. Others call it momnesia. Some say pregnancy brain. A new Australian study says, physical changes of pregnancy and motherhood do not cause women to have memory lapses or other cognitive problems.

”When focused on a task, women who are pregnant or new mothers do not have ‘cognitive deficits,’ and perform as well as their non-pregnant contemporaries,” says the study’s lead author Dr. Helen Christensen, PhD, a researcher at The Australian National University in Canberra. Her study is published in The British Journal of Psychiatry.

The momnesia theory is so widely accepted that many pregnancy guides even warn women about the possibility of short-term memory problems during pregnancy.

Dr. Christensen point out that biologically, there is nothing that happens to a woman’s brain when she’s pregnant or after giving birth to mess with her faculties. It’s just that, new mothers may exhibit lapses in memory or some absent-mindednes because they are focused on the new child or an upcoming major life change that is giving birth.

Well, of course! Makes complete common sense. It wasn’t my epidural, it was me focusing all my attention on my kids. It’s good to know my brain has not suffered any physical degradation! Here’s how Dr. Christensen’s team figured out their contention that mommy brain is a myth:

Researchers evaluated women who had joined the Personality and Total Health (PATH) Through Life Project, a large community-based study in 1999 that focused on health and well-being. She compared the women and their cognitive test results at four-year intervals, in 2003 and 2007.

Christensen tested 1,241 women (age 20-24) at the start, in 1999, to provide a baseline result. Over the eight years of the study, after subtracting dropouts, 76 women were pregnant at follow-up interviews, either in 2003 or 2007; 188 became moms but were not pregnant at the time of the interview. Another 542 didn’t become pregnant. Only first-time moms and women pregnant for the first time were included.

No significant differences were found in those who were pregnant or new moms and those who weren’t.

Late pregnancy was associated with poorer performance on a test of mental speed, the researchers found. But overall, no substantial differences were found.

”We will continue to follow the sample, with 542 non-mothers, and an age range of 28 to 32 now,” Dr. Christensen says.

Another good point against momnesia was raised by Dr. Ros Crawley PhD at the University of Sunderland, UK. They had a 2008 study that produced the same results — pregnant and non-pregnant women fared equally in cognitive tests.

”We have suggested that it may be that pregnant women have internalized a societal stereotype that suggests they will become more forgetful and absentminded,” according to Crawley. If you believe the myth, you can make it real. So pregnant women and new moms… your brains are fine. Believe that!

Can’t get pregnant? A few lifestyle changes may be in order.

Like we said, it’s never really as simple as have sex, get pregnant. Even a few lifestyle factors can mean boost or bust if you want to have a baby. If you’ve decided you’re ready to be a parent, consider our fertility don’ts. If you want to get pregnant and have a healthy head-start for your baby, time to start kicking some bad habits — or a least practice some self-control.

Here are our pre-pregnancy don’ts:

Cigarettes

We all know cigarettes are bad for our health, but you may be surprised that it can also diminish your fertility. Cigarettes bring toxins to your body that can damage your eggs — interfering with fertilization and implantation. They can also cause ovaries to age prematurely. Dr. Robert Barbieri OB-GYN at Brigham and Women’s Hospital Boston and co-author of the book 6 Steps to Increased Fertility explains, “the ovaries of a 35-year-old smoker function as if they belong to a 42-year-old and are therefore less fertile.” The good news is, when you quit smoking, ovarian function can normalize or improve.

Alcohol

More research indicates that alcohol over consumption diminishes a woman’s chances of getting pregnant. Alcohol can affect estrogen levels and also interfere with egg implantation. A glass of wine over dinner every so often shouldn’t be cause for concern, but binge drinking can lower your chances of getting pregnant. And of course, too much alcohol can definitely harm a growing fetus in the event that you find yourself already pregnant.

Caffeine

You should also consider cutting back on caffeine while trying to conceive and during your pregnancy. A recent study published in the American Journal of Obstetrics and Gynecology found that women who drank the equivalent of caffeine found in two cups of coffee were twice as likely to miscarry as those who didn’t consume any. The bottom line: If you’re thinking about getting pregnant, limit your daily caffeine fix. Consider that caffeine can also be found in soda and chocolate… so limit where you’re getting your fix for the day.

His health matters too. The same things that harm your fertility can do a number on your husband’s reproductive health as well. Cigarettes, alcohol, a poor diet — any of these can contribute to lower sperm count or motility — the sperm’s ability to swim to fertilize an egg. Studies have traced chromosomal damage in sperm to cigarettes and heavy alcohol intake. Getting enough nutrients every day — particularly vitamins E and C and the mineral selenium — helps men produce healthy sperm. Dr. Christopher Williams, reproductive endocrinologist and author of The Fastest Way to Get Pregnant Naturally says, “it takes almost three months for a man to make new sperm, so he needs to think ahead too.”

What’s good and safe about pregnancy massage?

Massage offers many benefits for pregnant women. Done properly by a trained therapist, prenatal massage can help alleviate the aches and pains of pregnancy, improves circulation and relieves tension and fatigue. You might hear people tell you to skip massages while pregnant because it can harm your baby. That’s a misconception!

The truth is, wether you are pregnant or not, massage can only be as good as the person giving it to you. If you need to de-stress and think you could use a massage while pregnant — ask for referrals for properly trained massage therapists. An OB-gynechologist, midwife or a friend who’s had it before can point the way.

Here’s more reason why indulging in that massage can be good for you:

• Pressing certain acupuncture pressure points can minimize or completely relieve first trimester nausea.
• Stress relief on weight bearing joints such as ankles, neck, lower back and pelvis.
• Reduces swelling in hands and feet by stimulating blood and lymph circulation.
• Helps with relaxation and insomnia. Even if you don’t have insomnia, massage helps you get better quality sleep.
• Helps eliminate lactic acid from the body, helping your body’s circulatory and lymphatic systems.

I had regular weekly massages when I was pregnant and for me the best part… it just felt good and relaxing. I’m a believer in touch therapy.

There are still misconceptions that should be cleared concerning prenatal rubs. Massage, done properly, does not cause miscarriages. Rubbing the lower back or stomach will not dislodge the placenta. However, there are some guidelines to follow to make a prenatal massage session safe for you and your baby:

• Do not massage open wounds, areas with rashes or distended varicose veins.
• After 20 weeks of pregnancy, never lie on your back for a massage as this can compromise blood flow to the uterus. Note: you’re not even supposed to be sleeping on your back anymore at this stage.
• Massage of the abdomen must strictly be done by a professional massage therapist trained in prenatal massage.
• Avoid applying pressure between the ankle bone and heel. There are pressure points here that are connected to the uterus and can induce labor.

Go ahead and indulge on a pregnancy massage. But do note, now more than ever, it’s important that you get one from a professional massage therapist.

Another reason why lead is toxic — it could set-off ADHD.

Here’s a relevant news flash from UPI: A U.S. researcher says attention-deficit hyperactivity disorder may be linked to the neurotoxin lead — still found in some toys, jewelry and water. Joel Nigg of Oregon Health & Science University in Portland points to lead as an ideal candidate to trigger the developmental disorder called ADHD, which stands for Attention Deficit Hyperactivity Disorder.

Children with ADHD usually show signs before age 7. Among the signs a child may have ADHD — he can’t sit still, has difficulty listening or focusing on tasks, and in school he may be labeled as a troublemaker or a lazy student.

In his article, published in Current Directions in Psychological Science, Nigg offers a causal model in which lead attaches to sites in the brain’s striatum and frontal cortex, and acts on the genes in these regions — causing them to turn on or remain inactive.

This disruption in brain activity alters cognitive control, and in turn results in hyperactivity and lack of vigilance. 

Two recent studies, Nigg says, provide strong evidence of the link between ADHD and lead.

One found children who had been diagnosed with ADHD had slightly higher levels of lead in their blood than healthy controls.
The second study shows a link between blood lead and both parent and teacher ratings of ADHD symptoms, including both hyperactivity and attention problems. In both studies, the connection was independent of IQ, family income, race or maternal smoking during pregnancy.

We adults are prone to the effects of this neurotoxin, but children are even more sensitive. Now, lead is even being identified as a trigger for ADHD!

Regulators have long clamped down on the use of lead because of its toxicity. Since the 1960s, the US and other parts of the world took major steps to reduce human exposure to lead. Lead is no longer used in paint; gasoline containing lead has been phased out; and many products have eliminated the use of lead in their manufacturing.

But, lead is still definitely around. Consider taking steps to protect your family — especially the little ones — from this toxin. You’ll be surprised where lead may be lurking right in your home.

Seven months into my pregnancy, after much reading and consulting with my doctor, I had a clear idea of how I wanted my delivery to go. It’s the same for most pregnant women. By this time, some have already decided they want a natural, drug-free birth; others sign up for an epidural vaginal birth; or there are women who just want a c-section.

The choice is yours, but it’s important you make it clear to your hospital and medical team or your midwife how you really hope your delivery will go. This is where a birth plan will come in. Trust me, in the throes of labor and delivery you don’t want to be answering too many questions. Your birth plan should be there for everyone’s reference.

A birth plan is a written document that outlines how you want your delivery carried out. From pain-relief methods to delivery positions to the number of support people, your options and preferences should be stated in your birth plan. Your doctor or midwife should be able to help you think of all possible options that you may want included.

You may, for instance, put down that you want your husband with you throughout the delivery. I had this in my own birth plans, along with having my babies on my chest right after delivery so I could make them latch onto my breast as soon as possible. I had also specified no water or any formula feeding for them during our entire hospital stay.

Dr. Patricia Rodriguez, obstetrician gynecologist at Northwest Hospital in Seattle says that about 80 percent of her patients write birth plans. “The process gives them a chance to clarify which aspects of childbirth are important to them, and it helps me better understand my patients,” says Dr. Rodriguez.

A good format for the document would be no longer than one or two pages. You can type it up or hand-write it legibly. Organize your thoughts into a concise bullet-point format.  Start with what’s most important to you.

Now, a birth plan is not going to guarantee a perfect delivery. You should be open to the possibility that on the big day itself, some parts of your plan may be impossible to execute. Labor can be unpredictable. It’s a plan, not a contract. For instance, you can’t get hostile if you are not allowed to hold your baby right away in case there was a complication. You may even have planned for an all-natural, no medication birth, but if your baby was struggling with a chord coil or the heartbeat isn’t normal, doctors may just have to give you a c-section.

A good birth plan shouldn’t just be a list of demands. It should be written with warmth and should have some details to convey who you are. The medical staff who reads such a birth plan will tend to be more sympathetic and undertanding. For instance, you can add such details as “it took us 5 years to get pregnant so use every bit of technology you need to to make sure our baby is born healthy.”

Finally, go over your birth plan with your husband. You are a team. It’s possible your husband way want a very medicated birth but you opt for going all-natural, no meds at all. Negotiate your terms, come up with a compromise and write up a plan that you have mutually agreed on.

Yes, labor can offer surprises and it may not always go exactly as planned. Still, you can always hope for the best. Besides, we make to-do lists to plan a regular day, why not make one for one of the biggest day you have ahead?

Doctors are easing up and letting women in labor have a sip or two.

The standard protocol for years in maternity wards has been no food or water for women in labor. The best thing you can get after hours of panting and sweating trying to get your baby out would be a few ice chips or sucking on wet wash cloths. Well, doctors say the practice may be outdated. Read on and make sure you know what this is all about before you write down your birth plan.

Drinks and food have long been banned during labor to prevent Mendelson’s syndrome. The conditions occur when stomach contents are drawn into the lungs while someone is under general anesthesia. This is a rare occurrence, but when it does happen it can be fatal.

These days, however, general anesthesia is rarely used during birth. Even c-sections are typically done using regional anesthesia. So the practice of fasting during labor has been called into question. A new medical review published last week by the Cochrane Collaboration says the practice is outdated and unnecessary.

Using 11 studies and covering 3,130 women — medical researchers found no benefit to restricting foods and fluids during labor. Their report says, “given these findings, women should be free to eat and drink in labor, or not, as they wish.

The New York Times reports that some hospitals have already eased up on the no eating or drinking rule during labor. They have lifted the ban on drinking fluids while giving birth late last year, since The American Congress of Obstetricians and Gynecologists issued new guidelines.

Still, some doctors are concerned despite the study’s assertion. The Times quotes obstetrician Dr. William Henry Barth, Jr. who says, “the problem is going to be for emergency c-sections, which are rare but not unheard of… there’s just not time in that setting to stop and do regional anesthesia and it can be unpredictable.”

More reason to get healthy even before the baby comes.

We know that obesity is associated with many illnesses, from diabetes to heart conditions. Now we can add an increased risk for birth defects in babies carried by overweight mothers. This comes from an analysis conducted by US researchers and published in the Journal of the American Medical Association. Obesity is defined as those who have a BMI or body mass index of 29 or higher.

Researchers report that women who were obese before pregnancy were more than twice as likely to have a baby born with spina bifida or other neural tube defects. Obese women are also more likely to have babies with heart problems, cleft palate, cleft lip, abnormal rectum or anus development and hydrocephaly or excess build-up of fluid in the brain.

The Journal of the American Medical Association cited researchers’ theories to explain obsesity’s link to those abnormalities. First, many obese women tend to have undiagnosed diabetes — a disease that leads to abnormal fetal development. Second, overweight mothers-to-be are most likely not eating properly and so are not receiving adequate nutrition. Third, it is highly possible obese women do not have enough nutrients like folic acid found in green leafy vegetables. Folic acid is vital to preventing birth defects — particularly spinal or neural tube defects.

If you are planning to start a family, it’s best to get into shape before getting pregnant. This doesn’t mean just shedding pounds through fad diets. This means eating a balanced diet and exercising, as well as making sure you are cleared for diabetes.

Even before the pregnancy test turns positive, add a folic acid supplement to your daily vitamin regimen. Studies have shown that women who get 400 micrograms (0.4 milligrams) daily prior to conception and during early pregnancy reduce the risk that their baby will be born with a serious neural tube defect (a birth defect involving incomplete development of the brain and spinal cord) by up to 70 percent.

Some expectant mothers are more prone to depression than others. A University of Michigan study reports that factors such as stress, mental health history, social support and whether a pregnancy was planned contribute to putting a woman at risk for depression during pregnancy.

This is important because women who are depressed have higher risk for dangerous complications during pregnancy. In fact, attending doctors are being encouraged to identify depression and its risk factors to minimize pregnancy complications.

Dr. Christie Lancaster, the study’s lead author and lecturer at the University of Michigan Department of Obstetrics and Gynecology says, “Depression has been associated with adverse outcomes for both mom and baby, including pre-term delivery, pre-eclampsia, sleep disturbances for both mom and baby, and maternal-infant attachment effects, in addition to its impact on the mother’s daily quality of life.”

Depression is experienced by almost 13 percent of pregnant women. Good news is, this complication can be treated during pregnancy. What is vital is that depression is identified early, so treatment can be administered.

Dr. Lancaster and her team of researchers had set out to study risk factors that could help doctors evaluate a patient’s risk factor for depression while pregnant. Most studies have focused on post-partum depression, but theirs is among the few that closely examine depression during pregnancy.

Their results show that maternal anxiety, stress, previous depressive episodes, lack of social support, domestic violence, unplanned pregnancy and relationship factors have a high correlation with depressive symptoms among women who are expecting.

Doctors caring for pregnant women are being urged to learn how to identify depression in pregnant women, so steps can be taken to cure their depression. This has a significant impact on the mother’s health as well as the health and outcome of the baby she is carrying.

Results of the study were published last week by the University of Michigan Health System.  At their health facility, all pregnant patients are screened for depression during pregnancy even though not all women with a positive screening test will have or develop clinical depression.

Dr. Lancaster says, “We are hoping that providers (doctors) can use the presence or absence of risk factors such as those identified in our study to enhance their assessments for depression in addition to the information that they obtain from the screening test.”