Tuesday, April 08, 2008

Healthy tips can pave the way for those months of pregnancy

By Sally Watts

Women who are thinking about starting a family within the next few months, or even years, can do a lot now to prepare their bodies for pregnancy. Taking some extra steps and precautions beforehand can prevent problems during pregnancy and ensure that mother and baby have the best chance for a happy, healthy nine months.

As with most lifestyle choices today, there is an increasing "greening" trend in pre-pregnancy and prenatal care, so a woman has more choices than ever about how to care for herself during this time in her life.

Following are some general things for women to consider before attempting to conceive. Be sure to check with your personal physician for advice that's tailored to you and your needs.
Nutrition

Dr. Craig Koniver, owner of Primary Plus Family Medicine and founder of The Center for Organic Medicine in Charleston, says one of the issues he sees most with women of childbearing age is that they do not consume enough healthy fat.

"Fat has gotten a bad rap by the media, but healthy fats are extremely important to moms-to-be, nursing moms and everyone else, for that matter," says Koniver, who, as a father as well as a physician, takes a special interest in pre-pregnancy and prenatal wellness.

Healthy omega-3 fats can be found in fatty fish, such as salmon or sardines. (Koniver recommends the Web site www.gotmercury.org to determine which types of fish are safest to eat.) Omega-3 fats also are present in foods that contain flax. Koniver says that it's easier to keep up with omega-3 intake if women supplement their pre-pregnancy and pregnancy diets with fish oil and/or flaxseed oil. Koniver recommends even higher doses of omega-3 fats than are generally prescribed to help cancel out the effects of other fats in the diet.

Koniver also says it's critical that pre-pregnant women take a balanced multivitamin that contains folic acid, as well as other healthy minerals. Folic acid is vital to fetal development and guards against several congenital malformations. He also suggests selenium, a trace mineral crucial for proper immune system and thyroid function.

It is important for women considering pregnancy, and even all women of childbearing age, to take a prenatal multivitamin daily, Koniver says. "It is nearly impossible for anyone to eat such a well-rounded diet every single day to capture the necessary vitamins and minerals that are needed for proper biochemical functioning."

Koniver also recommends women consume as many organic fruits and vegetables as possible. Avoiding pesticides and fungicides will help maintain the delicate hormone balance during pregnancy, he says.

Another nutritional key before attempting to get pregnant is good hydration, which keeps all body systems running smoothly. During pregnancy, a woman's total blood volume increases by 20 percent or more, and hydration is critical in maintaining health. By getting used to drinking a lot of water now, women can continue the habit after conception. According to the March of Dimes, lack of proper hydration can trigger preterm contractions.
The March of Dimes also suggests women cut back on caffeine before they become pregnant, as caffeine has been linked to miscarriage in studies. Again, it's better to get the habits in place before the pregnancy begins so they're easier to follow once you conceive.


A good exercise regimen should be established before getting pregnant, which would make it easier and more natural to continue during pregnancy. Consult your doctor before beginning any exercise routine, and again after becoming pregnant.

It's important for women to feel strong and fit beforehand so they can handle the physical challenges of pregnancy and manage labor effectively. Koniver says he doesn't have any specific exercise recommendations or requirements for pre-pregnant and pregnant women, except that they choose an exercise regimen they truly enjoy so it will be easier to stick with it.
Exercise also can help control weight if needed. Ideally, pre-pregnant women should be within their healthy weight range. If that's not realistic, losing even 5 percent to 10 percent of total body weight can be beneficial.

Risks associated with pregnancy in obese women include pre-term labor, pre-eclampsia (elevated blood pressure during pregnancy), diabetes and gestational diabetes. According to the American Diabetes Association, gestational diabetes is more prevalent among women who are overweight, and there also is a link between gestational diabetes and increased likelihood or developing Type 2 diabetes in the future.

Women who are overweight should speak with their doctor about realistic ways to get their weight under control and minimize risks before attempting to conceive.
Medications

What about medications? What's OK to take during pregnancy? Women should work closely with their doctor and other medical caregivers to evaluate carefully all their medications to determine which ones are safe during pregnancy.

Ideally, the pre-pregnant body should be as "pristine" as possible in terms of medications and nutritional intake. However, some medications might be necessary for the mother's health.
Heidi Murkoff, author of "What to Expect When You're Expecting," says making the determination about medications and pregnancy is not always clear-cut, as in the case with antidepressant drugs. Women who are taking antidepressants should sit down with their doctor and have a frank discussion about their medications, including specific risks and mental history. For some women, going off antidepressants before becoming pregnant can pose an even greater risk of harm to themselves or to their baby if the depression worsens or turns into postpartum depression after delivery.
Checkups and care

Before planning a baby, women should schedule a thorough checkup with their primary care physician and/or OB/GYN. Doctors can make recommendations based on medical history, age, weight and other relevant factors.

Many women don't know that a thorough dental cleaning and checkup are in order before trying to conceive. Aleka Thorvalson, a Charleston nutritional consultant, says oral health has a direct effect on body health. There is a strong scientific study link between even minor gum disease and the risk of pre-term labor. Additionally, Thorvalson says, X-rays should be avoided during pregnancy, so it's best to get to the dentist before attempting to conceive.

Women can also consider massage and relaxation treatments before pregnancy. Paige Bickar, a licensed massage therapist who offers fertility massage and pregnancy massage, helps women get ready for pregnancy with reflexology, acupressure and cranial sacral techniques. She says the field is fairly new, but is evolving quickly as an alternative to fertility clinics that sometimes rely heavily on hormone intake.

Pregnancy massage is available at several Lowcountry day spas.
Sally Watts is a Charleston freelance writer. E-mail her at sidlesup@yahoo.com.

Sunday, April 06, 2008

Pamperers

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Published: April 6, 2008

Before a baby shower for the birth of my son last year, friends insisted I had to register for gifts, and enlisted my mother to escort me to Buy Buy Baby — two floors of everything you need for baby and a whole lot more you probably didn’t know needed to exist. My mother, a child of the Depression, held her tongue while I pored over the store’s list of must-buy products that she had somehow managed to do without while raising three children. We had spent 20 minutes trying to discern the difference between models of Diaper Genies when I came upon the Boppy Tummy Time pillow — which you apparently need in addition to the Boppy breast-feeding pillow, even though both are half-moon-shaped pieces of foam virtually indistinguishable from each other — and my mother began to giggle. We left without registering.

As Pamela Paul chronicles in her occasionally frightening account, “Parenting, Inc.,” my generation of parents has fallen into the grips of Big Baby. Pushed by a host of factors — the guilt and exhaustion of working parents, the dispersion of family networks that once passed knowledge from generation to generation, the pressure of admissions from preschool to college, and a culture that worships all things celebrity (including its offspring) — we are intimidated or bamboozled into buying all sorts of goods and services that we not only don’t need, but that may harm our children. Slaves to legions of professional advisers and predatory entrepreneurs, we are rendered unable to recall the advice Dr. Spock issued our parents: Trust yourself. You know more than you think you do.

Paul has tapped a real concern. An entire industry preys on parental anxiety, and succumbing to it, we risk raising children who don’t know what to do with “free” time and who will measure their value by what they can buy. Most parents will recognize a bit of themselves in Paul’s introductory complaint: “No matter what I do, someone else seems to be doing enviably more or improbably less, and either way, their child and family seem all the better for it.”

It’s not just the $800 strollers and fetal-education gizmos of her subtitle. It’s inventions like the Splash Shield to keep bath water in the tub or the TP Saver to foil curious hands before they undo the entire roll of toilet paper. There are baby “faires” to rival auto shows in convention centers around America and children’s country clubs in Manhattan, styled by the people who design the upscale Equinox Fitness Clubs, where children’s blouses sell for $380 and tots learn that it’s best to be exclusive when choosing playmates. (Just when I thought Paul might be reaching a bit, the PoshTots catalog arrived, offering a two-story Tumble Outpost for $122,730 — that is not a misprint — featuring a wraparound ramp, a tube slide and, presumably, at that price, a six-burner Viking range and water views.) Clearly, there’s a baby born to a rich sucker every minute.

Paul, the author of books on the pornography industry and “starter marriages,” includes horrifying quotations from marketers. “Everything we do is academic, even for toddlers and babies,” boasts one producer of computer software for children under 2. “There’s nothing in there that’s just purely for fun.” My competitive anxiety surged when I read Paul’s descriptions of the educational videos and software many parents buy, and it shot positively through the roof after reading the testimonials from those who insist that the “Your Baby Can Read!” videos allowed their child to read by age 1. But Paul nicely dismantles the claims of the “edutainment” industry, exposing the videos as little more than digital baby sitters. (Cancel my order!) Babies, one expert notes, simply filter out a lot of the stimulus from educational toys.

Paul tries to lead us out of the catastrophization of childhood but too often plays right into it. “It may sound like a leap to go from baby toys to the death of democracy, but it’s a valid concern,” she approvingly quotes a child advocate saying. “A democratic populace relies on people who know how to think critically, who are willing and able to take action.” She overreaches with statements like “Any woman worth the cover price of InStyle fantasizes about an array of diaper bags to suit various outfits and occasions.” Well, no. And, as she notes, the No. 1 registered-for item at Amazon’s baby store is diapers.

Paul is right that for some parents, children have become status symbols. “Three is the new two when it comes to having kids,” a Manhattan preschool admissions adviser tells her. (Or, as my sister-in-law, an Upper East Side obstetrician, says, “Three is the new Hummer.”)

Paul also correctly notes that the frenzy she chronicles is most acute in New York City, where she lives. But she strains when she argues it exists beyond the coasts and in small-town America, and then identifies these places as Newton, Mass.; Bethesda, Md.; Falls Church, Va.; and New Canaan, Conn. — hardly Peoria, where the median price of a house is less than that PoshTots Tumble Outpost. And she backs her case with poll and survey results that convey a breezy certainty, but on reflection can seem a little thin. One online survey of mothers, she tells us, found that “18 percent wanted to spend less time doing housework and more time with their children.” Only 18 percent?

Paul says she talked to parents, but I would have liked to hear more of their voices and less from the news stories and experts she quotes extensively. My guess is that most parents would share my panic in the face of Buy Buy Baby and then discover, as I did, that even the product that friends insist you must have is actually an encumbrance (and that all your lovingly selected toys pale when the kid discovers he can pull the saucepans out of the cupboard).

Most of us feel the pangs and then figure out some happy medium. We hyperventilate, we overbuy, and then we get a talking-to by a friend, a mother or a pediatrician (like the one who told me after we’d spent hundreds of dollars on a changing table that the only place to change the baby was on the floor), and we self-correct. Paul herself seems to come to this conclusion as she describes working out her son’s feeding woes. She even finds some good in the parenting industry: Web sites have put experts and blogging parents at our fingertips, and make it “a snap” to buy toys from abroad or the latest baby gear from Amsterdam, Sweden and New Zealand.

I, sanctimommy, raise an eyebrow at that carbon footprint. But then, Paul frowns on my Stokke highchair. So see? Not all models look the same, but in the end, we each figure out a way to, yes, trust ourselves.

Kate Zernike is a national correspondent at The Times.