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Pregnancy Q&As

  1. Expert: Dr. William Camann
    July 14th, 2008
    Is it true that epidurals can lengthen labor or cause paralysis?

    The current research shows that labor, particularly in first-time moms, is about one hour longer when an epidural is used. This is just an average, however, so some women will experience a longer extension of their labor, while for others it may be shorter. In some cases, the epidural can even decrease overall labor time.


    Regarding paralysis, it would be incorrect to say it is impossible or never happens. However, it is so exceedingly rare that most anesthesiologists will go through their entire careers without seeing a single case of paralysis caused by an epidural. Several million women receive a safe epidural each year in the U.S. There are a few specific risk factors, most notably certain blood clotting diseases or infections, which may increase the chance of neurologic side effects but epidurals are not typically used in women who have these conditions.

    William Camann is the director of obstetric anesthesia at the Brigham and Women's Hospital in Boston. He is also an associate professor of anesthesia at Harvard Medical School, and past-president of the Society for Obstetric Anesthesia and Perinatology. An internationally recognized authority on obstetric anesthesia and pain control during childbirth Dr. Camann is the co-author of Easy Labor, Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth (Random House/Ballantine Books, 2006). You can find out more about his book at easylabor.net

  2. Expert: Joanne Saab, RD
    May 18th, 2008
    I am normally lactose intolerant, but when I got pregnant I could drink milk products with no side effects. Why did this happen?

    This is actually a very common phenomenon during pregnancy. Many women find they experience an improvement in lactose tolerance when they get pregnant and, for some, this ability to digest lactose remains after they deliver, but for others their lactose intolerance returns or even becomes worse.

    Healthcare professionals often talk about a "rule of thirds" during pregnancy. The "rule of thirds" means that approximately one third of pregnant women will see an improvement in their symptoms, one third will remain the same, and one third will see their symptoms worsen. This rule of thirds can occur with many conditions, including: migraine headaches, eczema, asthma and lactose intolerance. Researchers still don't completely understand why this happens, although some attribute it to hormonal changes during pregnancy.  

    Joanne Saab, RD is a registered dietitian who practices in pediatrics at McMaster Children's Hospital in Hamilton, Ontario. Joanne is co-author of three books in conjunction with the Hospital for Sick Children: Better Food for Kids, Better Food for Pregnancy and the best-selling Better Baby Food. Joanne also enjoys being the mother to twin daughters who have taught her a lot of practical know-how on kids' nutrition.

  3. Expert: Jack Newman, M.D.
    April 22nd, 2008
    Is it okay to continue breastfeeding throughout my pregnancy? I’ve heard rumors that breastfeeding can increase the risk of a miscarriage.

    There two main reasons people tell mothers they should wean their babies when they become pregnant: one, that breastfeeding puts you at an increased risk of miscarriage; and two, that a baby will suffer from lack of nutrients. Both claims are unsubstantiated. 

    In reality, it's hard to document why a miscarriage occurs. Unfortunately, 15 to 25 percent of all pregnancies end in miscarriage during the first three months. However, there are no studies that show breastfeeding increases this rate. 

    And there is no evidence that a baby whose mother is nursing will suffer from lack of nutrients if the mother's diet is healthy and balanced. (Millions of women nurse during pregnancy and give birth to healthy babies).
    There are, however, a few things women should know about breastfeeding during pregnancy:

    1. Nipple soreness is often associated with a new pregnancy so you may find you suddenly experience pain or discomfort while nursing.
    2. Fatigue is normal when you are in the early months of pregnancy, so if you feel tired while breastfeeding it's nothing unusual. Breastfeeding shouldn't make you feel more tired.
    3. Milk supply does decrease when you are pregnant. You can continue to breastfeed, but encourage your toddler to eat more solids and drink other liquids from a cup in order to make sure his nutritional needs are met.


    The choice to continue breastfeeding during pregnancy is totally up to you. Talk to your doctor about any concerns you have so you can make an informed decision you are comfortable with.

    Dr. Jack Newman established Canada's first breastfeeding clinic in 1984 at The Hospital for Sick Children in Toronto. As the need for his expertise grew, Dr. Newman opened clinics in several Toronto hospitals. In 2006 he co-founded the Newman Breastfeeding Clinic and Institute (NBCI) with Edith Kernerman. One of North America's most respected breastfeeding experts, Dr. Newman is the author of Newman's Guide to Breastfeeding (Canada) and The Ultimate Breastfeeding Book of Answers (United States) and The Latch and other keys to Successful Breastfeeding (www.ibreastfeeding.com). Dr. Newman's breastfeeding information is also at www.drjacknewman.com

     

  4. Expert: Tracey Mallett
    April 7th, 2008
    Is it safe to do downward dog in yoga during pregnancy?
    Any exercise where your head is lower than your heart should be practiced in moderation after the first trimester because additional blood volume can lead to nausea and/or loss of breath. Downward dog can be done in moderation, but don't hold the position for extended periods of time.

    If you decide to do the pose throughout your pregnancy, listen to your body and stop if you feel uncomfortable in any way. Also, modify the pose by keeping your knees bent and your heels lifted off the floor to reduce stress on your lower spine. Your arms should also be positioned a little further apart than in your regular practice. The modification means your body weight will be supported predominantly by your upper body to reduce compression of your abdomen.
     
    Safe alternates:
    Exercises that give similar benefits to downward dog are the cat-cow yoga pose and standing hamstring stretches with your foot resting on a chair.

    Tracey Mallett is a certified personal trainer and sports nutritionist. She is the author of Sexy in 6:  Sculpt Your Body with the 6-Minute Quick Blast Workout, as well as the creator and star of the 3-In-1 Pregnancy System for pre- and post-natal mothers. Her newest videos are Renew You and Super Body Boot Camp. A proud mother of two, Tracey lives in Los Angeles, California. (www.TraceyMallett.com)
     
  5. Expert: Andrea Grace
    March 24th, 2008
    How can I stay fit safely during pregnancy?

    If you followed a regular exercise program prior to pregnancy, you should be able to maintain that program to some degree throughout. The key is to listen to your body, which undergoes many anatomical and physiological changes that can affect your level of physical activity.

    As your body shape changes, your centre of gravity moves forward and the curvature in your spine increases. These changes may add a little discomfort to your workouts (particularly in the last trimester). Your joints also loosen up to get ready for birth, creating an increased risk for injuries. Here are some things to keep in mind when exercising during pregnancy:

    • Your body will naturally give you signals that it's time to reduce your level of exercise. Never exercise to the point of exhaustion or breathlessness–this is a sign that your body (and your baby) can't get the oxygen supply they need.
    • Wear comfortable footwear with strong ankle and arch support.
    • Take frequent breaks and drink plenty of fluids.
    • Avoid exercise in extremely hot weather.
    • Avoid rocky terrain or unstable ground when jogging. Contact sports and those with a potential for hard falls (such as horseback riding and skiing) should be avoided, while stationary cycling is recommend to reduce the risk of falls associated with regular cycling.
    • Weight training should emphasize improving tone–so increase the repetitions and decrease the weight. Avoid lifting weights above your head and using weights that strain the lower back muscles.
    • Due to the increase in your resting heart rate and decrease in maximal heart rate during pregnancy, don't use target heart rate to determine intensity of exercise.
    • Great exercises for moms-to-be include: any form of swimming or water exercise, walking and yoga, which can help your body prepare for the birthing process.

    Precautions: See your health care provider if you experience any of these symptoms during or after intense exercise: nausea, dizziness, shortness of breath, vaginal bleeding, sudden swelling of hands, ankles or face, headache, high heart rate, amniotic fluid leaking, back or pelvic pain.

    Some information provided by the American College of Obstetricians and Gynecologists

    Meet our expert:

    Andrea Grace is the president and creator of Mommy and Baby Fitness, pre- and post-natal fitness programs with locations across North America. She is a CanFitPro and ACE certified fitness professional with 20 years of teaching experience and specialty certifications in pre-and post-natal and children's fitness. mommyandbabyfitness.com


  6. Expert: Joanne Saab, RD
    February 25th, 2008
    Is it safe to drink herbal teas during pregnancy?

    The list of herbal teas that are safe to drink during pregnancy is short, simply because not enough studies have been done. Chamomile tea, however, is definitely not safe during pregnancy. Despite its soothing properties, chamomile may act as a uterine stimulant and was traditionally used to induce abortion and should be avoided. Safe herbal teas you can enjoy while pregnant include: citrus peel, ginger, lemon balm and rose hip–and you can have up to two to three cups a day of any of them.

    Other foods to avoid during pregnancy include: raw meat, pâté, raw fish (including oysters and sushi) and soft, unpasteurized cheeses, which contain the bacteria Listeria monocytogenes. Cheeses to avoid include: Brie, Camembert and blue-veined cheeses, such as Roquefort. Some pre-packaged soft cheeses, such as feta or chèvre, may be pasteurized, but just check the labels to make sure and avoid buying them fresh from a deli counter.

    If you're ever unsure about what is safe during pregnancy, a great resource is Motherisk (motherisk.org) at Toronto's Hospital for Sick Children.

    Joanne Saab is a registered dietitian who practices in pediatrics at McMaster Children's Hospital in Hamilton and has co-authored three books in conjunction with the Hospital for Sick Children: Better Food for Kids, Better Food for Pregnancy and the best-selling Better Baby Food.



  7. Expert: Daina Kalnins, MSc, RD
    January 14th, 2008
    I'm pregnant, but I haven't lost all the weight I gained from my previous pregnancy. How much should I be gaining now?
    The amount of weight you gain during pregnancy depends on how much you weighed before you got pregnant. The same weight gain recommendations for a woman who is at her ideal weight before pregnancy don't apply to a woman who is over- or underweight. So, if you're overweight going into a second pregnancy, you don't need to gain as much this time around. Here are some things to consider:

    1. How to tell if you're at your ideal weight.
    To determine whether you're at a healthy weight, it helps to know your BMI-a measurement of weight in relation to height. (To calculate your BMI, divide your weight in kilograms by the square of your height in meters-or check out Health Canada's online BMI calculator. Just go to www.hc-sc.gc.ca and enter "BMI" in the search box.)

    2. How much weight you should gain.
    If you have a normal BMI (20 to 25), then you should gain more weight during pregnancy than if you are overweight, or have a higher BMI. So, if you have a BMI of 20 to 25, then a weight gain of 25 to 35 pounds (11 to 16 kg) is recommended. If your BMI is greater than 27, then you should only be gaining 15 to 25 pounds (7 to 11 kg).

    3. With close pregnancies, you may need extra nutrients.
    In terms of micronutrients, you should make sure you get an adequate supply of folic acid, iron (which can be low during pregnancy and post-partum), calcium (and therefore vitamin D). It's best to check with your doctor to see how many extra nutrients you may need.

    4. Keeping your weight down.

     As always, some form of exercise routine is key–whether it's walking daily, cycling or doing prenatal yoga. And the "routine" part is probably the most important. Get in the habit of being active every day.
    And pay attention to your diet: decrease high fat and high salt foods, and focus on getting lots of fiber. Choose snacks like fruits and veggies and try to eat homemade foods as much as possible - that way you can control what you're getting. Remember to drink lots of water too.

    Daina Kalnins is a registered dietitian at the Hospital for Sick Children in Toronto. She has co-authored several books on healthy eating and nutrition in association with the Hospital, including Better Baby Food, Better Food for Pregnancy and Better Breastfeeding.