Fish In Your Pregnancy Diet

Fish in your pregnancy diet: A source of omega-3 fatty acids and a killer for mercury,a double-edged sword? One thing you need to be careful about including in your diet during pregnancy is fish.  Read on to find out why.

Fish is a great source of protein and vitamins, and is also low in fat. In fact, the high levels of protein, omega-3 fatty acids, vitamin D, and other nutrients make fish an excellent food for pregnant mothers and their developing babies. Fish and shellfish are thus an important part of a healthy diet.

Fish as source of omega-3 fatty acids

Adding fish to your diet is a great way to boost your omega-3 fatty acids. Several studies have also shown that taking fish oil supplements, which are high in omega-3 fatty acids, is associated with a longer pregnancy and higher birth weight. Because omega-3 fatty acids are a component of brain tissue, it has been hypothesized that the developing brain of a fetus could benefit from high levels of omega-3 fatty acids.

The Problem With Fish: Fishes contain high levels of mercury that can harm your unborn baby

Fish and seafood are an important part of a balanced diet for pregnant women and those of childbearing age who may become pregnant. But there’s a serious downside to eating fish.

All fishes contain trace amounts of mercury. Some fish, however, contain high amounts of mercury. This is especially dangerous for pregnant and breastfeeding women because fetuses and newborns are very sensitive to mercury. Mercury in these fishes may harm an unborn baby in many ways. High levels of mercury can interfere with a fetus’s developing nervous system and brain. Mercury consumed during pregnancy has been linked to developmental delays and brain damage. Hence, the FDA currently recommends you to avoid fish with high levels of mercury when you’re pregnant. The benefits of eating fish can be counteracted by mercury which the fish accumulate.

It is still not clear if mercury leads to certain childhood developmental delays or problems with fine motor skills. Hence, when your including fish in your diet during pregnancy you need to be very careful about the kind of fish and the amount of fish in your diet.

Fishes to avoid: Fish that are high in mercury

Some fish contain high amounts of mercury. Eating the wrong kinds of fish can raise the level of mercury in your body. Fish that pose risk are large and long lived fish. Fishes absorb the mercury from contaminated water and accumulate more and more mercury over time in their bodies from the environment. The mercury binds tightly to the proteins in fish muscle and remains there even after the fish is cooked.

Which Fish Have the Most Mercury?

While your pregnant do not eat certain fish like Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury. The Food and Drug Administration (FDA) advises that pregnant women, women who may become pregnant, nursing mothers, and young children should avoid eating shark, swordfish, king mackerel and tilefish due to high levels of mercury in these fish.

Fishes that are safe: Fishes low in mercury

Fortunately, the most popular fishes, such as tuna and salmon, have lower levels of mercury and are safe to eat during pregnancy. Fishes that are low in mercury are salmon, haddock, tilapia, cod, sole, and shrimp, pollock, sardine, trout, whitefish, herring, trout and catfish. Choose these low in mercury fishes during pregnancy.

The FDA characterizes shrimp, catfish, pollock, salmon, sardines, and canned light tuna as low-mercury seafood. Crab, oyster, scallop, squid are low in mercury. Many of the fish chosen for sushi contain high levels of mercury.

How much of any fish is safe?

Even fish that is low in mercury isn’t mercury-free, so if fish are eaten in large quantities, mercury intake could add up to a significant amount. The risks from mercury in fish and shellfish depend on the amount of fish and shellfish eaten and the levels of mercury in the fish and shellfish. Hence, even safer fishes should be eaten only in moderation.

How much of fish you need to consume during pregnancy?

Even fish that is low in mercury isn’t mercury-free. Methylmercury and elemental mercury can be toxic to a fetus or young children. That is why pregnant and nursing mothers must be very careful about the amounts and types of fish they eat. FDA recommends that women who are pregnant or plan to become pregnant within the next one or two years, as well as young children should not eat more than 2 servings – 12 ounces (340 grams) of fish each week. They should include only those fish with low mercury content.

According to the FDA guidelines pregnant women can enjoy up to 12 ounces that is 2 servings of COOKED fish and shellfish lower in mercury each week.

Pregnant women should not consume more than two servings of fish per week. If your fish consumption exceeds the recommended level in a week, there’s no need for concern, simply cut back the following week. The most important thing is how your intake averages out over the weeks and months of your pregnancy.

When you eat fish twice a week, include one portion of oily fish such as sardines as thay contain omega-3 fatty acids. Oily fishes offer the benefits of omega-3 oils while avoiding any potential harmful effects. Fatty fish with low mercury content such as salmon are good for reducing cardiovascular risk.

Do not cut out fish from your diet

Do not give up fish during pregnancy altogether because of your concern for mercury. Pregnant women cutting fish out of their diets would leave out a prime source of nutrients that are important for a baby’s development.

Two recent studies looking at fish consumption in pregnant women showed that women who eat fish may actually have lower rates of preterm delivery, and their children may have higher IQs than those who do not eat fish.

In a perfect world, consuming fish every day would be ideal for boosting your omega-3 fats. As a compromise, you can eat a couple of servings of low-mercury fish per week and supplementing your diet with DHA or fish oil supplements or DHA-enriched eggs.

How fish accumalate mercury?

Fish and shellfish concentrate mercury in their bodies, often in the form of methylmercury, a highly toxic organic compound of mercury. Methyl mercury that may harm an unborn baby’s developing nervous system. Mercury and methylmercury is present in only very small concentrations in seawater. Much of the mercury, an estimated 40% that eventually finds its way into fish originates with coal-burning power plants and chlorine production plants. Small fish absorb methylmercury from water as they feed on aquatic organisms. The longer the fish lives the more methylmercury the fish accumulates in its body. Large, long-lived fish that feed on other fish (high in the food chain) accumulate the highest levels of methylmercury as they are high on the food chain. Species of fish that are long-lived such as tuna, shark, swordfish, king mackerel, tilefish contain higher concentrations of mercury than others. The older such fish become, the more mercury they may have absorbed. When these fish are consumed by humans they also consume the higher level of mercury the fish have accumulated. This process explains why predatory fish such as swordfish and sharks have higher concentrations of mercury in their tissue than could be accounted for by direct exposure alone. This is called biomagnification.

Precautions to take while eating fish caught locally

Check local advisories about the safety of fish caught locally in local lakes, rivers, and coastal areas. If you can’t find any information about a particular type of fish, eat only up to six ounces of it, one average meal of fish per week and don’t consume any other fish during that week.

Fish Exposed to Industrial Pollutants

Avoid fish from contaminated lakes and rivers that may be exposed to high levels of polychlorinated biphenyls. This is primarily for those who fish in local lakes and streams. Contact the local health department or Environmental Protection Agency to determine which fish are safe to eat in your area. This is applicable only for fish caught in local waters and not for fish from your local grocery store.

Drinking Alcohol During Pregnancy

Questions about drinking alcohol during pregnancy are very common, so here we provide the answers to some of the most frequently asked questions.

Q: I drank alcohol before I knew I was pregnant? Will my baby be OK? Will my baby have birth defects?

A: No evidence exists that a single episode of drinking has any increased risk of adverse effects on pregnancy. We don’t know for sure what a few drinks over a short period early in pregnancy can do to a developing baby. That’s why the Department of Health recommends that you give up drinking before getting pregnant. If you were not aware that you were pregnant and drank alcohol, now that you know you’re pregnant, the best thing you can do now is STOP drinking.

Q:   Is hard liquor worse for the baby than wine or beer?

A: They’re all considered the same risk. A can of beer, a glass of wine, and a mixed drink with one ounce of hard liquor contain roughly the same amounts of alcohol. All drinks that contain alcohol can be harmful to your baby.

Q:   My sister’s getting married. Can’t I have even ONE glass of champagne at her wedding?

A: Some people may tell you that it’s bad luck not to partake during the toast to the bride at a wedding. But there is no known safe amount of alcohol to consume while you are pregnant. Your number-one job as a mom-to-be is to provide as safe and as nurturing an environment as possible to your kid. What your kid needs is imperative. A little carelessness from your side can impair your child for life.

If you really feel you must, wet your lips out of someone else’s glass. That way, you won’t be tempted to overindulge.

Q:   My doctor suggested I have a glass of wine on the evening after my amniocentesis. Is this okay?

A: Alcohol is a tocolytic, which basically means that it relaxes the uterus. After amniocentesis, many women feel a little uterine cramping. The alcohol in a glass of wine minimizes that discomfort without hurting the baby.

If you are drinking with friends find a non-alcoholic drink that you enjoy and don’t let people pressurise
you into drinking. And remember all drinks that contain alcohol can be harmful to your baby.

Why is drinking alcohol during pregnancy a problem?

Drinking alcohol any time during your pregnancy can affect your baby. Every time a pregnant woman drinks, her fetus is exposed to alcohol. When you drink, alcohol passes from your blood through the placenta to your baby. Since, alcohol crosses the placental barrier it can directly interfere with your baby’s development. Drinking alcohol during pregnancy can effect development of your baby and too much of exposure to alcohol can seriously affect your baby’s development. It results in irreversible damage during your baby’s development.

A baby’s liver is one of the last organs to develop fully and does not mature until the last half of pregnancy. Hence, your baby cannot process alcohol as well as you can and alcohol breaks down much more slowly. This causes the alcohol to stay in the baby’s blood much longer than in the mother’s blood.

Because of this risk, avoid drinking alcohol if you’re pregnant or trying to get pregnant.

Effects of alcohol on your baby

Effect of alcohol during early pregnancy: Causes miscarriage

Drinking alcohol can lead to spontaneous abortion and other pregnancy complications. The National Institute for Health and Clinical Excellence (NICE) advises pregnant women to avoid alcohol in the first three months of pregnancy particularly, because it increases risk of miscarriage.

Damage can occur very early during an embryo’s development, so you should avoid alcohol if you may become pregnant and from the very start of pregnancy.

Effect of moderate drinking

Even moderate doses of alcohol during pregnancy effects your baby. But the effects may be more subtle, which may include small changes in brain function.

Effect of heavy drinking during pregnancy: Fetal Alcohol Syndrome (FAS)

If you drink heavily during pregnancy, your baby could develop a group of problems known as fetal alcohol syndrome(FAS). FAS leads to mental retardation, birth defects and developmental impairment.

Research has shown that the most severe form of alcohol’s negative effects on fetal development is FAS. Binge drinking such as drinking more than 5 drinks at one time or drinking seven or more drinks in one week, puts your baby at risk for FASD’s.

Prenatal alcohol exposure causes fetal alcohol syndrome. FAS has following effects:

Effects development of your baby

Alcohol can permanently damage your developing baby’s cells which in turn results in :

•  Developmental deficiencies: abnormal facial features, abnormalities of the limbs, Facial abnormalities

•  Effect proper development of organs: Can lead to defects such as heart defects

•  Growth deficiency: Prenatal alcohol exposure can lead to poor fetal growth and below average weight

Damages your baby’s nervous system

Heavy drinking during pregnancy results in damage of your baby’s nervous system. Alcohol has direct effects on nerve cells of your baby.

•  The main effect of FAS is permanent central nervous system damage, especially damage to the brain. Alcohol exposure at any point during pregnancy can cause fetal brain damage, since brain development is ongoing throughout pregnancy.

•  Damage to neurons and brain structures, can result in psychological or/and behavioral problems, and cause other physical damage.

•  Developing brain cells and structures can be malformed or have development interrupted by prenatal alcohol exposure; this can create an array of primary cognitive and functional disabilities such as :

ü  poor memory
ü  It can result in your baby having learning difficulties
ü  problems with movement and coordination throughout his life
ü  problems with day-to-day living
ü  attention deficits
ü  hyperactive behavior, impulsive behavior
ü  poor reasoning skills

•  It can also lead to secondary disabilities, for example, predispositions to mental health problems and drug addiction.

Is there any safe amount of alcohol to drink? Can I drink little or moderate amount of alcohol while I’m pregnant?

All pregnant women should avoid drinking alcohol. There is no known amount of alcohol that is safe to consume during pregnancy.

Medical science hasn’t defined an absolute safe level of alcohol intake during pregnancy. There is significant variation in every individual’s alcohol pharmacokinetics, that is the way each one’s body deals with alcohol is different. Hence, it is difficult to determine safe level of alcohol consumption. So, there has been much controversy over what the proper limits on drinking alcohol during pregnancy should be.

Scientific data shows that daily drinking and heavy binge drinking can lead to serious complications, although little info is available about occasional drinking. In fact, research has shown that not only binge drinking puts the baby most at risk for FASD’s, drinking less than 5 drinks at one time or drinking seven or more drinks in one week has been also known to lead to FASD.

Scientific evidence has not identified a threshold below which alcohol consumption during pregnancy is definitely safe, but neither has it shown any convincing evidence of harm at low levels of intake. This is why we don’t know what amount of alcohol can be considered safe.

The more you drink, the more you raise your baby’s chances of having problems.

Your First Act of Mommyhood

For many moderate drinkers those who enjoy a cocktail or two most weeknights and a few more on friday or saturday evening, giving up alcohol for your unborn child will constitute a major life event. But as the first step in the process of becoming a good parent, it is an absolute must. Your number-one job as a mom-to-be is to provide as safe and as nurturing an environment as possible. From this point on, what you want is irrelevant; what your kid needs is imperative.

There’s more room to wiggle on this once the baby’s actually born. A little carelessness from your side can impair your child for life and you’ll have to deal with it. So, instead of cursing yourself all your life for giving into temptations, give up alcohol with a stern mind atleast until your baby is safe and healthy in your hands.

I’m struggling to give up. What can I do?

Women who have difficulty to stop drinking alcohol because of addiction or other emotional problems should make every effort to seek treatment. Don’t feel uncomfortable talking to your practitioner about it. Special questionnaires are available to help your doctor identify whether your drinking is excessive enough to pose a risk to you and the fetus. This is crucial to your baby’s health and to your health. Your doctor or midwife won’t judge you. It’s their job to help you have as healthy a pregnancy as possible. And asking for help just shows how much you care about your baby.

No single food can satisfy all your nutritional needs during pregnancy. To have a healthy diet you have to include in your diet grains, vegetables, fruits, oils and fats, meat and milk products. They are the six food groups that are included in the USDA Food Guide Pyramid. These food groups in your diet ensure healthy eating during pregnancy. The USDA Food Guide Pyramid is a general guideline that also illustrates the relative proportions of servings you should eat in each group.

Grains

Grain products are the foods that come from wheat, rice, oats, cornmeal or barley. Grain products can be roughly classified into whole grain and refined grain products.

Whole grain products contain the entire grain kernel, including the bran (outer protective skin of the grain) and the germ (the small area at the base of each grain). Whole grains include wheat, whole cornmeal, oatmeal and brown rice.

In refined grains the bran and germ layers have been removed during processing. This results in removal of much of the fiber and some vitamins like Vitamin B and Vitamin E. Refined grain products include white flour, white bread, white rice and many pastas.

According to USDA an average sized woman needs 6 to 8 ounces of grains per day during pregnancy and atleast 50% of which should be in the form of whole-grains. This means eating about 3 to 4 ounces of whole-grain bread,  whole-grain cereal, whole-grain pasta, or other whole-grain products every day.

Vegetables

Vegetables are divided into five groups, based on their nutrient content. The following list orders them from highest nutrient content to lowest and includes examples within each category:

• Dark green vegetables: They are highest in their nutrient content. This group includes spinach, dark green leafy lettuce, romaine lettuce, broccoli, kale, turnip greens, watercress.

• Orange vegetables: Carrots; pumpkin; sweet potatoes; acorn, butternut and hubbard squash

• Dry beans/peas: Pinto, black garbanzo, kidney, navy, soy and white beans; split peas; lentils; tofu

• Starchy vegetables: Potatoes, corn, green peas, green lima beans

• Other vegetables: This group is lowest in their nutrient content. However, they are essential. Cabbage, cauliflower, iceberg lettuce, green beans, celery, green and red peppers, mushrooms, onions, tomatoes, asparagus, cucumbers, eggplant come under this group.

Pregnant women should try to eat 21/2 to 3 cups of vegetables each day. Any of the above vegetables or pure vegetable juice counts towards this goal, but dark green or orange vegetables and dried beans are best because their nutrient content is higher. Eating a variety of different vegetables is also important.

Fruits

During pregnancy it is very important to make fruits a compulsory part of your diet. Fruits contain good amounts of vitamins, minerals and fibre which is very important to help reduce constipation during pregnancy. They are a good source of Vitamin A, Vitamin C and Pottasium.

During pregnancy you should be eating atleast 2 to 21/2 cups of fruits every day. Fresh, frozen, canned or dried, you can choose the one you like. Its good to eat fruits than the fruit juices, as fruit juices contain lots of extra sugar.

Oils and Fats

The healthiest type of fats to eat are oils that remain liquid at room temperature, like vegetable oil, olive oil, and corn oil. These are mostly unsaturated fats. Foods like nuts, avocados, fish and olives are naturally high in unsaturated fats.

Solid fats are fats that are solid at room temperature, like butter, shortening, lard, and margarine. These foods are high in saturated fats.

Trans fats are a type of saturated fats that are common in processed foods and have been associated with obesity and heart disease.

Ideally, less than 20 to 35 percent of your total calories should come from fats, with less than 10 percent coming from saturated fats and trans fats have to be avoided altogether.

Milk Products

Milk, yogurt, and cheese are foods that fall in this group and all are great sources of calcium. It’s best to consume low-fat or fat-free milk products whenever possible. An average-sized woman needs to consume about three cups of milk or milk products per day.

Meat and Beans

Meat, poultry, fish, dry beans and nuts fall into this category. Low-fat and lean foods in this category are best for you. Baking, broiling and grilling are the healthiest ways to cook these foods. During pregnancy, you should eat five to seven ounces of food from this category daily.

Pregnancy And Folic Acid

All nutrients are essential during pregnancy, but folic acid is most essential. Folic acid, sometimes called folate, is a B vitamin (B9). To help prevent serious birth defects in your baby one of the most important things you can do is to get enough folic acid every day, especially before conception and during early pregnancy.

Folic acid was something your mother never thought about when she was expecting you. But within the past decade, folic acid has become a nutritional requirement for all pregnant women. The change came in 1991, when a British medical study demonstrated that folic acid reduced the recurrence of birth defects of the brain and spinal cord called neural tube defects. This reduction occurred in where a mother’s previous child was affected. Subsequent studies showed that even among women who have never had children with brain or spinal cord defects, those who consume enough folic acid can lower their baby’s risk of spina bifida (a spinal defect) and anencephaly (a brain and skull defect) by 50 to 70 percent.

What are the risks of not taking folic acid?

A number of complications can be avoided if you intake sufficient amount of folic acid and these include a number of congenital malformations.

•  Neural tube defects:

Neural tube defect is a birth defect involving incomplete development of the brain and spinal cord. Neural tube defects produce malformations of the spine, skull, and brain including spina bifida (an incomplete closure of the spinal cord and spinal column), and anencephaly, that is severe underdevelopment of the brain). They are the most notable birth defects that occur from folate deficiency.

•  Other congenital malformations:

Supplementation with folic acid has also shown to reduce the risk of congenital malformations such as congenital heart defects, cleft lips, limb defects, urinary tract anomalies.

•  Pregnancy complications :

Folate deficiency during pregnancy may also increase the risk of preterm delivery, infant low birth weight and fetal growth retardation, which may lead to spontaneous abortion and pregnancy complications, such as placental abruption and pre-eclampsia.

•  Development of DNA:

The development of every human cell is dependent on an adequate supply of folic acid. This vitamin is crucial in the synthesis of the precursors of DNA. As a result, folic acid plays a large role in cell growth and development, as well as tissue formation. Folic acid deficiency results in defective cellular growth and the effects are most obvious on those tissues which grow most rapidly.

•  Protection for the fetus

Folic acid supplements may also protect the fetus against disease when the mother is battling a disease or taking medications or smoking during pregnancy.

•  Studies suggest that folate and vitamin B12 status may also play a role in depression.

What foods contain folic acid?

Folic acid is found in the following foods. Foods that are very high in folate are:

•  Leafy vegetables such as spinach, asparagus, turnip greens
•  Legumes such as dried or fresh beans, peas and lentils
•  Egg yolks
•  Baker’s yeast
•  Sunflower seeds
•  Liver and liver products contain high amounts of folate
•  Kidney

Foods that contain folic acid in moderate amounts:

•  Citrus fruits and juices such as orange juice, canned pineapple juice, cantaloupe, honeydew melon, grapefruit juice, banana, raspberry and strawberry.
•  Vegetables like beets, corn, tomato juice, broccoli, brussels sprouts, romaine lettuce and bok choy, beer.

Fortified food products

Approximately half of all pregnancies are unplanned, so since 1996 the U.S. Food and Drug Administration has taken steps to fortify certain foods with folic acid. All enriched grains, flour, cornmeal, pasta, and rice are fortified so that all women of childbearing age get a daily dose of folic acid.

So, in addition to a healthy diet rich in folic acid, you can boost your folic acid intake by looking for breakfast cereals, breads, pastas, and rice containing 25% to 100% of the recommended dietary allowance (RDA) for folic acid.

But for most women, eating fortified foods or eating diet rich in folic acid isn’t enough. To reach the recommended daily level, you’ll probably need a vitamin supplement.

How much folic acid do I need?

The normal RDA for folic acid is 400 micrograms for women who are not pregnant. The RDA of folate equivalents for pregnant women is 600–800 micrograms, twice the normal RDA for women who are not pregnant.

All women of childbearing age and especially those who are planning a pregnancy should consume 400 micrograms of folic acid every day.

If spina bifida, anencephaly, or similar conditions run in your family, especially if you’ve ever carried a child with these problems, you should get ten times the usual amount (400 micrograms) every day.

Consult your doctor or a registered dietitian about appropriate levels of supplements of folic acid for you.

Should I take a folic acid supplement?

When studies confirmed link between insufficient folic acid and neural tube defects, governments and health organizations worldwide recommended folic acid supplementation for women intending to become pregnant. Hence, doctors advice women who are considering to become pregnant to eat foods fortified with folic acid or take supplements in addition to eating folate-rich foods to reduce the risk of serious birth defects.

Most people do not manage to get the recommended level of folic acid during their pregnancy through diet and fortified foods and so you should take a supplement that has folic acid in it. Any good prenatal vitamin will give you at least 400 micrograms.

When should I start taking folic acid?

Soon after conception, folate helps develop the neural tube, which becomes the baby’s spinal cord and brain. Hence, neural tube defects develop in the first 28 days of pregnancy, usually before a woman even knows she’s pregnant. So any woman who is considering pregnancy should make sure she’s getting enough folic acid. And only 50% of pregnancies are planned. That’s why it’s important for all women of childbearing age to consume 400 micrograms of folic acid every day, not just those who are planning to become pregnant.

All women who are planning to conceive are advised to consume 400 micrograms of folate every day, starting at least 30 days before conception. You start early so that plenty of the nutrient is in your system at the time the neural tube is forming. Repeated studies have shown that the best way to prevent neural defects is to take the 400 micrograms of folic acid daily for one month before conception and during the first three months of pregnancy.

If you find you are pregnant and have not been taking folic acid, you should start immediately to help prevent any neural defects in the first three months of pregnancy.

What are signs of a folic acid deficiency?

Folate deficiency is a lack of folic acid in the diet and the signs are often subtle. Folate deficiency anemia is the medical name given for the condition.

Common symptoms that may indicate you are suffering from a deficiency of folic acid include:

•  Diarrhea
•  Loss of appetite
•  A sore tongue
•  Weight loss and weakness
•  Headaches
•  Heart palpitations
•  Behavioral disorders

It is important to have a physician evaluate these symptoms so that appropriate medical care can be given. If you’re only mildly deficient, you may not notice any symptoms at all, but you won’t be getting the optimal amount for your baby’s early embryonic development.

How happens if I intake more folic acid?

Folic acid itself is a water soluble vitamin, so any additional folic acid that you may have taken in, that your body does not need will be flushed out of your system and will not harm you or your baby.

Taking too much folic acid may hide a possible B12 deficiency. It is uncommon to be low in B12 if you’re a healthy young woman with a varied diet, but it if you are a vegetarian or if your intake of dairy products is low then it can be a problem.

How do I know if I am at risk for having a baby with neural defects?

Women who have had a previous pregnancy that involved a neural defect are at greatest risk. Women who are not eating a balanced diet that includes folic acid are also at risk.

How are neural tube defects diagnosed?

Neural tube defects are detected through an alpha-fetoprotein test (AFP); AFP is a blood test administered at 16-18 weeks of pregnancy. The test measures alpha-fetoprotein, a substance produced by the fetus and secreted into the amniotic fluid, which is also in the mother’s blood. The level of AFP in mother’s blood peaks at about 30-32 weeks. Abnormally high amounts of AFP may indicate that a baby has a neural tube defect.

What are other reasons for an elevated AFP?

An elevated AFP could mean the mother is carrying twins or that there is a problem with the placenta. Women with diabetes or liver disease may also have an elevated AFP level. However, an elevated AFP could mean that there are birth defects present such as severe kidney disease, liver disease, esophageal or intestinal blockage, Down Syndrome, urinary obstruction, or osteogenesis imperfecta (fragility of the baby’s bones).

If I have an elevated AFP, what additional tests are available?

•  A second AFP test
•  An ultrasound
•  Amniocentesis