You: Having a Baby: The Owner’s Manual to a Happy and Healthy Pregnancy. Michael Roizen F.
for some pregnancy-related conditions throughout the book.
Get BP Under Control. If you have high blood pressure and take medication for it, be sure to continue doing so. Why? As you just learned, a mother’s blood pressure greatly influences how blood, nutrients, oxygen, and immune cells reach the fetus and also can affect the surface area available for efficient exchanges to occur. Any excessive fluctuations, both high and low, can negatively influence that process and even contribute to conditions that your child will have as an adult (remember the thrifty phenotype in chapter 1). Follow our general prescription principles from above, but always play close attention to what your ob/gyn or midwife tells you about your BP (for reasons we’ll also cover in chapter 9). Your optimal numbers are lower than 115/75 mm Hg (millimeters of mercury), but BP varies greatly during pregnancy, which is why you’ll want to work closely with your provider to establish ideal ranges for you.
Chill. You hear it all the time: Stress is detrimental to health, regardless of gender. One reason why it’s a problem in pregnancy is that anxiety depletes the immune system. And in a situation that’s already fragile because of the immune changes your body’s going through, the added stress of, well, stress compromises your immunity even further. Moreover, stress puts you at risk of preeclampsia (high blood pressure during pregnancy) and increases your risk of going into preterm labor. Some recommendations:
• It’s a perfect time to try meditation and deep breathing. For detailed instructions, see www.realage.com.
• Find a surrogate worrier, someone who can sweat the small stuff. This is a great task for a husband, friend, or mom who insists on helping with something.
• Find a buddy who’s been through it all before. (Your fertilizing buddy doesn’t count.) Her experience and assurances will help take the edge off during some of your more worrisome moments.
More stress-busting tips in chapter 6 and in our Flight Plan, p. 282.
Lie on Your Side. We know you’re not going to lie on your stomach as your belly grows and you enter the second trimester, but we do want you to avoid lying flat on your back. That’s because when you do so, the weight of your uterus compresses the blood vessels that are feeding the placenta, creating a drought in that blood lake we talked about. Lying on your left side is better than lying on your right side because it allows more blood to flow to the uterus. Either is better than lying on your back, because when you do, you also compress a large vein called the vena cava. The pressure from that compression reduces the flow of blood back to your heart as if you were bending a water hose, and that decreases the blood flow to your uterus and to your baby.
Decide on Vaccines. When you’re in an immunosuppressed state such as pregnancy, vaccinations may compromise your immune system further. The best course of action is to get updated on your immunizations three or more months before you get pregnant. We recommend that you avoid all vaccines during pregnancy, if you can. The one exception is the flu vaccine, which current data suggest has no adverse effect. The flu is more serious in pregnant women than in nonpregnant women and is the leading cause of hospitalization during pregnancy. Plus, serious flu symptoms can compromise the amount of oxygen mom and her baby are getting. Ask for the vaccine that does not use thimerosal (mercury) as a preservative. It’s slightly more expensive (between $4 and $8 more) but worth the price.
3 Eating for Who? Manage the Moments When You Feel Like Feeding on Everything—or Nothing at All
Having a baby brings out the math whiz in all of us. There’s a fair share of multiplication (8 diapers a day times 2.5 years equals about 7,000 changes per kid). There’s also plenty of division (you bathe her tonight, I’ll do it tomorrow). And unfortunately, we all do way too much subtraction (7 hours to sleep minus 3 feedings a night equals at least 1 whupped parent). But when it comes to the mother of all math equations, a lot of us get it all wrong.
See, when you become pregnant and think about your eating habits, the instinct—or at least the rationalization for many—is to follow this formula: My nutritional needs plus the baby’s nutritional needs equals “I’ll have a mashed potato sandwich with cheese, and make it a double.”
Right here, right now, let’s make a deal to take the “eating for two” mantra and pack it into our conversational Diaper Genie, never to see it, speak it, smell it, or think it ever again. The truth is that when you follow the science and look at adequate calorie consumption for growing a healthy baby, the more accurate principle that pregnant women should follow is “eating for 1.1.” (Has a nice ring to it, don’t ya think?)
Essentially, that means when you’re pregnant, you need to eat only 10 percent more than the number of calories you ordinarily eat to maintain your weight. We’ll explain how that formula works in more detail shortly. Then we’re going to discuss how you can cope with two eating extremes: those times when you crave the contents of the entire fridge and those times when you’re so sick that food is the very last thing you want to think about. The issue really becomes one of balance. You need to make sure that you get enough calories to feed your baby with the proper nutrients, but you also need to make sure you don’t overwhelm her with a fat-flooded placental buffet that will negatively influence her future health. What complicates the matter is that how you feel may not be in sync with what your body needs at any given time. When you’re sick and don’t feel like eating, you may very well need to. And when you’re famished and craving Ding Dong pizzas, it’s probably time to pull the reins and slow down.
As you know from our discussion about the placenta, virtually everything you do as a mother trickles down to your baby. And from our brief intro to epigenetics, you know that your actions influence not only his childhood health but also his health as an adult. More and more evidence suggests that adult diseases and conditions such as high blood pressure, obesity, and diabetes (and even his love of salami) are linked to mom’s early nutritional influence on the fetus. We also believe that it’s not a coincidence that we’re seeing more cesarean sections, more delivery complications, and more birth defects at the same time that we’re seeing our country’s nutritional habits score about a negative 37 on a scale of 1 to 10. That’s why we place so much emphasis, in this chapter and throughout the book, on the fuel you use to get yourself through your day—and get your baby through to the outside.
Food for Thought: Weight Control and Cravings
Right about now, you’re likely asking yourself how in the world we came up with 1.1—and furthermore, how in the world you’re supposed to keep track of that 0.1 throughout the day. Luckily, it’s all pretty simple. Research shows that the ideal caloric intake for pregnancy breaks down like this: Overall, aim to increase your consumption by about 10 percent. During the first trimester, you want to shoot for an increase of about 100 calories per day more than a typically healthy intake of calories, or the equivalent of an extra glass of skim milk. During the second trimester, you’ll want to increase to an extra 250 calories per day, or the equivalent of a healthy midafternoon snack of ten walnuts plus an apple. During the third trimester, you’ll want to increase to an extra 300 calories per day, or the equivalent of three pieces of fruit.
The Skinny on Losing Baby Fat
While some women blessed with good genes are able to fit into their prepregnancy clothes within just a few weeks, most women take longer to lose all of their pregnancy weight. Basically, it took nine months to put it on, and you should give yourself nine months to take it off. Bear in mind that if you plan to breast-feed, it is a great way to lose some of your additional fat stores, although you should also not diet while breast-feeding