Air travel during pregnancy: Is it safe?

Air travel during pregnancy poses no special risks to a healthy pregnant woman and her fetus. Hence, commercial air travel during pregnancy is considered safe for women who have healthy pregnancies. Flying is not harmful to you or your baby. Still, if you’re pregnant, it’s best to check with your health care provider before you fly. Women with any health issue or pregnancy complication need to discuss with their doctor before they fly.

Avoid excessive flying. There are no hard and fast numbers. The rate of miscarriage was high in flight attendants who flew on average 74 hours per month.

The best time to fly during pregnancy

Pregnant women who are healthy and pregnant with single baby can fly safely up to 36 weeks of pregnancy. However, the safest time for a pregnant woman to travel by air is during her second trimester, provided she isn’t experiencing any complications. Try to do the majority of your traveling in the second trimester. Not only will you be more comfortable, the risk of first trimester – miscarriage and risk of third trimester – preterm labor can be avoided. Air travel in the last six weeks of pregnancy could trigger premature labour. The likelihood of going into labour is naturally high after 37 weeks (around 34 weeks if you’re carrying twins).

Hence, the best time to fly is from about weeks 14 to 28, in the middle of your pregnancy. This is when you’re likely to feel your best, and the risks of miscarriage and premature labor are the lowest.

Who should avoid air travel: Women with high-risk pregnancies

Pregnant women experiencing complications with their pregnancy are advised not to travel. Air travel during pregnancy might increase the risk of complications for such women. Some of these complications include:

•  Cervical problems, such as ‘incompetent cervix’

•  Vaginal bleeding

•  Multiple foetuses

•  If you are aged 35 years or over and pregnant for the first time

•  Gestational diabetes, past or present

•  High blood pressure, past or present

•  Pre-eclampsia, past or present

•  Abnormalities of the placenta, past or present

•  Prior miscarriage

•  Prior ectopic pregnancy

•  Prior premature labour.

•  Sickle cell disease

•  Clotting disorders

•  Placental insufficiency

•  Severe anemia

•  History of thrombophlebitis

All these are contraindications to flying. If you are experiencing any of the above complications and considering air travel, you must consult with your doctor, as you are having a high-risk pregnancy.

Pregnant women with placental abnormalities or risks for premature labor should avoid air travel. Pregnant women should avoid travel of any type after 36 weeks of pregnancy and if they are at risk of preterm delivery.

You should also take into consideration the standard of medical care at your chosen destination, just in case you need help.

Airlines and their policies

Each airline has policies regarding pregnancy and flying. Check with the airlines for their policy on flying during pregnancy when booking reservations, because some will require medical forms to be completed.

Most airlines allow domestic travel until the pregnant traveler is in week 36 of pregnancy, and international travel may be permitted until weeks 32–35, depending on the airline. Expectant mothers may be permitted to fly flights, till the end of 35 weeks of pregnancy provided there are no prior complications. However, after week 28 of pregnancy, the airline may ask for a letter from your doctor or midwife confirming your due date, and that you aren’t at risk of complications. A confirmation that you are fit to travel by air. A pregnant woman should be advised to carry documentation stating the expected day of delivery, contact information for her obstetric provider, and her blood type.

Some airlines won’t allow a pregnant woman over 35 weeks of pregnancy to fly. Expectant mothers between the 36th week till 38th week of pregnancy may be permitted to fly provided the expectant mother has a ‘Fitness to Fly’ certificate from her treating obstetrician or is accompanied by a doctor. For pregnant flight attendants and pilots, work-related air travel is restricted by most airlines by 20 weeks of pregnancy.

Things to do before you fly:

•  Talk to your practitioner before flying.

If you are pregnant and considering travel, you must consult with your doctor, especially if your pregnancy is high-risk. Before planning your trip, consult with your doctor to discuss any potential risks particular to your pregnancy. For example, a woman with gestational diabetes or multiple fetuses is generally advised not to fly.

•  Check the airline’s policy about air travel during pregnancy.

If you are into 36 weeks of pregnancy, many airlines will not let you fly for fear that you’ll deliver on board. Guidelines for pregnant women may vary according to airlines and destination.

•  Choose your seat carefully.

Make comfort arrangements. Try to get seats with more leg room. An aisle seat at the bulkhead or a seat near an exit will provide the most space and comfort, but a seat over the wing in the midplane region will give the smoothest ride. It is better to arrange with the airline a bulkhead seat for extra leg room.

•  Arrange for supplemental oxygen if required

If supplemental oxygen is required during flight because of preexisting medical conditions, arrangements for oxygen need to be made in advance.

•  Avoid travel to countries that would require immunization.

Precautions to take while you fly:

Flying is perfectly safe, especially if you take a couple of precautions. There are some precautions that a pregnant traveler should consider while flying:

•  Promote circulation.

Prolonged periods of sitting can cause blood to pool in your legs. During a smooth flight if possible take occasional walks up and down the aisle. During longer flights it is important that you get up from your seat occasionally and walk around the plane. Walking around keeps your circulation going. If you must remain seated, flex and extend your ankles often to prevent phlebitis.

•  How to buckle up.

Wear your seat belt under your belly and across your lap.

•  Drink plenty of fluids.

Airplane air is always very dry. Planes can’t carry enough water to keep the humidity up, because the extra water would add too much cargo weight. The relative humidity in airplanes is typically lower than in the Sahara desert. Because airplane air is so dry, you can easily become dehydrated during long flights. Drink plenty of water to reduce the risk of dehydration. Carry a water bottle with you and drink water frequently.

Dehydration can lead to decreased placental blood flow and hemoconcentration, increasing risk of thrombosis. Thus, pregnant women should drink plenty of fluids during flights.

•  Prevent DVT while flying

Keeping up your fluid intake will also reduce the risk of deep vein thrombosis (DVT). Long-distance travel carries a small risk of blood clots (DVT) in pregnant women especially if you travel longer than five hours.

To prevent DVT while flying:

• Drink plenty of water
• Move about regularly every 30 minutes or so.
• Buy a pair of support stockings which will reduce leg swelling.

Drinking extra water also ensures that you get up frequently to go to the restroom, which keeps the blood from pooling in your legs.

There are no complications that can arise in a healthy pregnant lady due to air travel

Decreased air pressure during flight

Decreased air pressure during flight may slightly reduce the amount of oxygen in your blood, but this isn’t likely to cause problems if you’re otherwise healthy. The lowered cabin pressure (kept at the equivalent of 5,000–8,000 ft [about 1,500–2,400 m]) has minimal effect on fetal oxygenation because of the favorable fetal hemoglobin-oxygen dynamics.

Airport security radiation exposure

Airport security radiation exposure is minimal for pregnant women and has not been linked to an increase in adverse outcomes for unborn children. However, because of early reports of a possible association of radiation exposure during pregnancy with subsequent increased risk of childhood leukemia and cancer, a pregnant passenger may request a hand or wand search rather than being exposed to the radiation of the airport
security machines.

In-flight radiation have shown to have a slight increase in potential problems. The radiation exposure associated with air travel at high altitudes is thought to be problematic for frequent fliers. Pilots, flight attendants and others who fly often might be exposed to more radiation than is considered safe during pregnancy. If you must fly frequently during your pregnancy, discuss it with your health care provider. He or she might limit your total flight time during pregnancy.

However, studies have shown that problems were more related to the length of time in the air, the route flown, and other flight phenomena.

Airport Metal Detectors

You don’t need to worry about airport metal detectors or any other metal detectors because they don’t use ionizing radiation. (The conveyor belt that carries your luggage after you check in does use ionizing radiation, however, you won’t be climbing onto the counter and sending yourself through that machine.)

Prolonged air travel like in flight attendants have proven a slight increase in first trimester miscarriage, but this was for the flight attendants who worked a greater number of hours. From the medical literature, it has been concluded that flying is fairly safe while pregnant, even for the flight attendants, with some minor adjustments. Considering that the average passengers don’t fly for extended periods.

Vaccinations

If you plan to visit tropical countries, where some diseases are particularly prevalent, you may want to be vaccinated before you go. You are generally advised to avoid travelling to countries where immunization is required.

If you have to travel then check with your doctor to see whether any vaccines you’re considering are safe to have during pregnancy. Vaccines are not recommended because of concerns that the virus or bacteria in the vaccine could harm the baby in the womb. Most vaccines are either dangerous to unborn babies or haven’t been adequately tested for safety on pregnant women. Generally, all live virus vaccines (such as mumps and measles) should be avoided during pregnancy. Some vaccines, such as yellow fever, may cautiously be given after the first trimester. Be advised by your doctor.

The risk of malaria

It is recommended that pregnant women avoid travelling to areas where malaria is present. Malaria is an infection carried by particular species of mosquito. A pregnant woman who catches malaria risks miscarriage, premature labour and stillbirth. Some antimalarial drugs (such as chloroquine) are considered safe to take during pregnancy, but others (such as doxycycline) are potentially harmful to the unborn baby.

Your medical kit for air travel

Discuss with your doctor the things you may need to carry to access during the flight. Your medical kit should contain:

•  Preparations to help you treat common pregnancy complaints, such as heartburn, constipation and haemorrhoids.

•  Tablets to deal with air sickness

If you’re prone to air sickness and have found dramamine helpful in the past, using it in normal doses while you’re pregnant is okay.

•  Oral rehydration preparations in case of travellers’ diarrhoea. Pregnant women should be careful about taking drugs commonly used to treat travellers’ diarrhoea.

•  Multivitamin tablets formulated for pregnancy.

•  Urine dipsticks to check glucose levels if you are having gestational diabetes.

Congenital toxoplasmosis is a group of symptoms that occur when an unborn baby (fetus) is infected with the parasite Toxoplasma gondii.

Cause and incidence

During pregnancy if the mother becomes infected with toxoplasmosis the developing baby can become infected. The infection may spread to the developing baby during the pregnancy itself, or during labor or delivery through the placenta.

The toxoplasmosis infection in the mother is generally mild, and she may not be aware of it. Infection of the developing baby can cause severe problems. Infection in early pregnancy results in more severe problems than infection in later pregnancy.

Complications in the babies due to the infection

Half of the developing babies who get infected with toxoplasmosis during the pregnancy are born prematurely. Congenital toxoplasmosis can damage the baby’s eyes, nervous system, skin, and ears.

Complications include:

•   Enlarged liver and spleen

•   Vision problems: Eye damage from inflammation of the retina or other parts of the eye which can lead to blindness or severe visual disability.

•   Feeding problems

•   Hearing loss

•   Jaundice (yellow skin)

•   Low birth weight (intrauterine growth restriction)

•   Skin rash (tiny red spots or bruising) at birth

•   Hydrocephalus

Brain and nervous system damage ranges from very mild to severe, and may include:

•   Seizures

•   Severe mental retardation or other neurological problems

Signs of infection in the new born

The health care provider will examine the baby after birth. Often, there are signs of infection in the baby at birth. However, newborns with milder infections may not have symptoms or problems for months or even years. If the babies are not treated, they develop problems especially in the eyes when they become adolescents.

The baby may have:

•   Yellow skin (jaundice)

•   Inflammation of the eyes

•   Large head size (macrocephaly) or smaller-than-normal head size (microcephaly)

•   Diarrhea or vomiting

•   Fluid on the brain (hydrocephalus)

•   Swollen lymph nodes (lymphadenopathy)

•   Swollen spleen and liver

Tests done to detect infection in the fetus

An invasive prenatal testing, postnatal or neonatal screening is done to check the fetus.

Tests done during pregnancy to detect infection include:

•   Detection of infection by checking for the presence of antibody for Toxoplasma gondii in the mother by testing mother’s blood.

•   Amniotic fluid testing and fetal blood testing

•   Ultrasound of the abdomen

After birth, the following tests may be done on the baby:

•   Antibody studies on cord blood and cerebrospinal fluid

•   CT scan of the brain

•   MRI scan of the brain

•   Neurological exams

•   Standard eye exam

•   Toxoplasmosis test

Treatment

An infection in the baby can be very serious since a baby’s immune system does not develop fully for the first year of life, and the resilient cysts that form throughout the body are very difficult to eradicate with anti-protozoans.

Spiramycin can treat infection in the pregnant mother. Pyrimethamine and sulfadiazine can treat fetal infection diagnosed during the pregnancy.

Treatment of infants with congenital toxoplasmosis typically includes pyrimethamine, sulfadiazine, and leucovorin for one year. Infants are also sometimes given steroids if their vision is threatened or if the protein level in the spinal fluid is high.

Calling your health care provider

Call for an appointment with your health care provider if you are pregnant and think you are at risk for toxoplasmosis. You are at high risk if you have a cat and your the person who cleans the litter box. Do not change the litter while your pregnant, ask some one else to do it.

Call for an appointment with your health care provider if you are pregnant and have not received any prenatal care.

Prevention

By following safe food preparation and hygiene practices pregnant women can prevent infection by toxoplasma. Your health-care provider should test for Toxoplasma infection before pregnancy or at your first prenatal visit. A simple blood test is performed and your doctor can determine if you are at risk for infection by toxoplasma.

Pregnant women who have pet cats are at increased risk of developing toxoplasmosis. They should avoid contact with any material that are potentially infected with cat feces. Cook meat until it is well done, and wash your hands after handling raw meat.

Treatment of pregnant women infected with toxoplasma is very important to prevent infection of the fetus.

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.

An early sign of pregnancy is fatigue, feeling exhausted. Pregnancy fatigue can start around the same time that you would take a pregnancy test, very early in pregnancy. Fatigue is a side effect of all the physical changes your body is experiencing, and due to the dramatic rise in hormone levels. Many women feel constantly tired in early pregnancy. Some women feel tired throughout pregnancy. Pregnancy fatigue makes some women feel like they could fall asleep all the time. It can seriously impair your life. Remember fatigue is nature’s way of telling you to get more rest.

What causes fatigue?

•  Fatigue during pregnancy is due to all the physical changes your body is experiencing. For all these preps your body will consume more energy and your metabolism will increase. This makes you feel fatigued.

•  In addition to the physical changes that your body is going through there is a dramatic rise in hormone levels to assist in fetal growth. Rising progesterone levels are responsible for much of the fatigue and other symptoms associated with pregnancy.

•  If you are experiencing nausea and vomiting in early pregnancy, that can drain you of all your energy.

•  If you experience frequent urination in early pregnancy then it’s hard to get a good night’s sleep, if you’re getting up frequently to use the bathroom. This can cause fatigue.

•  Fatigue and weakness are symptoms of iron-deficiency anemia, which is common in pregnancy. You may not have any symptoms, if you’re mildly anemic. The disease often goes unrecognized for some time as it tends to develop slowly and adaptation occurs. Hence, your practitioner will test your blood for this condition at your first prenatal visit and again in your late second trimester or early third trimester.

•  If you are feeling anxious about your pregnancy, anxiousness alone is enough to make you feel fatigued. So resting your mind is as important as resting your body. The emotional stresses associated with pregnancy can be huge. The to-be-mother has to deal with the anxiety that pregnancy brings in about motherhood and her ability to cope with labour etc, in addition to the hormonal and physical changes happening in the body.

•  Poor diet can cause fatigue, if you aren’t getting enough nutrients or are not eating enough.

How long will this feeling last?

Early pregnancy:

Fatigue during pregnancy is something that many women do not really expect until the end of the last trimester. But pregnancy fatigue can be an early pregnancy symptom. During the first trimester, you’re likely to feel overwhelming fatigue. The extreme tiredness will last for most of the first trimester. These are the months when the female body is making the most changes. All the physical and hormone changes your body is experiencing causes fatigue.

Second trimester:

Fatigue may start clearing up by the beginning of the second trimester around 12th to 14th week. You may feel more active and more energetic and start to feel like your old self during your second trimester. This is because the growth and changes swifts from mom’s body to baby’s body during the second trimester.

The last trimester:

The vast majority of pregnant women will feel very tired in the last trimester. For some women it may not be as severe as in early pregnancy. Especially, towards the end of pregnancy most to-be-mums tend to feel the strain. At this point you’ll be carrying more weight and may be having trouble sleeping well for a variety of reasons, including backache, heartburn, leg cramps or restless legs syndrome, the baby moving around, and especially the need to pee frequently. All these lead to fatigue.

How to cope with fatigue during pregnancy?

There are a couple of things that you can to do to combat the extreme fatigue and tiredness:

•  Take in nutritious food

Increase your energy levels by sticking to a healthy diet. Make sure you’re eating right. You need about 300 extra calories every day as you require more energy during pregnancy. Snack on healthy foods and fill this additional requirement with nutritious foods instead of junk food that is full of fat and sugar. A healthy diet made up of vegetables, fruits, whole grains, skim milk, and lean meats can be energizing. Try to eat five to six small, healthy meals a day to keep your body fueled.

•  Listen to your body.

All the physical changes that your body is going through during your first trimester: your body creating the placenta and storing vital hormones to assist in fetal growth and your baby’s growth will consume more energy. This can make you feel very tired, so if you are feeling tired just go to sleep. Heed your body’s signals.

•  Take a short nap during the day.

Take naps and rest, lack of sleep can make you tired. Even a 15-minute catnap can make all the difference. A siesta in the afternoon will help to recharge your batteries.

•  Go to bed earlier than usual at night and sleep well.

Sleep for at least 8 hours a night. The baby’s growth takes quite a toll on your body and the revitalization of sleep is about more than feeling refreshed. It is about rebuilding the body’s defenses and core structures.

•  Get checked for anemia.

Fatigue and weakness are symptoms of iron-deficiency anemia, get yourself checked for this condition. Taking medication for anemia will ease your condition.

•  Try to adjust your schedule.

Cut out unnecessary social commitments and let the housework slide. If you work outside the home, see if you can cut back on your hours or arrange to take work home over the weekend so you can cut out early once in a while. If you’re a stay-at-home mom, give yourself a break now and then so you can catch up on your sleep. If your kids are not letting you get enough rest, leave your children with someone else.

•  Stay hydrated

Keep yourself well hydrated and make sure you’re drinking plenty of water. If frequent urination is keeping you up at night, try cutting back your fluid intake a few hours before bedtime and make up for it during the day.

•  Avoid caffeine

They are digested quickly and leave you feeling empty.

•  Get some moderate exercise every day.

You may feel like you barely have the energy to walk, let alone exercise. But moderate activity, such as a short walk, can actually make you feel better. Excercising may sound counterproductive, but exercise feeds the body energy. Tiredness during pregnancy can be easily flipped to energy during pregnancy with the addition of a walk every morning or every evening after dinner.So unless your caregiver has advised you otherwise, make exercise part of your daily routine.

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 Symptom: Frequent Urination

Frequent urination is an early sign of pregnancy. Many women notice the increased need to pee, even before the other classic pregnancy signs. A pregnant women typically start noticing the need to urinate more frequently anywhere from six to eight weeks into pregnancy. While some women experience less urgency during their second trimester, others continue to feel the urge to urinate more frequently throughout their pregnancy.

What Causes Frequent Urination?

As you go through your pregnancy, the reason that’s behind frequent urination is different at different stages. Read on to find out what causes frequent urination.

•  Early in pregnancy

Frequent urination starts in early pregnancy. Right after conception a woman’s body begins to produce pregnancy hormones that promote and sustain the pregnancy. Pregnancy also causes the volume of blood in a woman’s body to increase. The extra blood and fluid used in pregnancy is excreted through your kidneys. That means the rate at which your kidneys produce urine increases, this increases your need to pee.

•  First trimester frequent urination

At the beginning of your pregnancy, your uterus is inside your pelvis. But towards the end of your first trimester, at around 12 weeks, your uterus expands enough to rise up into your abdominal cavity. Your enlarging uterus may compress your bladder, which both decreases its capacity and thus, increases your need to urinate frequently.

•  Second trimester frequent urination

Few women will have a break from the frequent urge to pee during second trimester.

•  Third trimester frequent urination

The reason behind frequent trips to the bathroom in the third trimester is pressure from the uterus on the bladder. As your pregnancy progresses the baby will grow large and heavy, put pressure on your bladder, causing you to feel the urge to go to the loo more often even if your bladder is not full.

Towards the end of pregnancy as your baby drops into the pelvis in preparation for delivery, this again exerts more pressure on your bladder. The added pressure prevents the bladder from filling completely and resulting in frequent trips to the bathroom.

•  Post partum urination

For the first few days after your baby is born you will still be using the bathroom more frequently. Your body is removing all the extra fluid that was needed for pregnancy. After the volume of fluid has returned to normal, you will need to use the bathroom less.

Waking up at night

Pregnant women need to use the bathroom often at night, even if they are careful to not drink large amounts of fluids before they go to sleep. The reason for this is the fluid that collects in the legs during the day has a chance to redistribute and be eliminated from your system via your bladder.

Hence, frequent urination is usually a whole pregnancy symptom. Frequent urination persists throughout pregnancy. From early on in your pregnancy, you may feel you’re spending most of your time in the restroom.

How to deal with frequent urination

You can’t do much about your need to urinate frequently. However, you can reduce the inconvenience it creates by following these:

•  Drink plenty of fluids but not at night

You will need to drink plenty of fluids to keep yourself hydrated during pregnancy. Never cut down on the amount of fluids that you take in to reduce the trips to the bathroom, as you could get dehydrated. Try to drink more during the day and less just before you go to bed so that you aren’t up all night going to the restroom. Cut back on the amount of fluid intake at night and compensate for it by drinking enough during the day.

•  Avoid coffee

You should also consider avoiding drinks that increase your need to urinate, like coffee, tea and other caffeinated drinks. Coffee and tea contain caffeine which is a diuretic. Diuretics increase the flow of urine and may aggravate the situation. So try decreasing the amount of caffeine you consume.

•  When trying to urinate, you can lean forward to make sure that your entire bladder is emptied. Many women find they have to pee again shortly after a visit to the bathroom simply because they were not able to empty their bladder fully. This is more common in the later stages of pregnancy.

•  Before going out for long (or even short) trips, empty your bladder so that you don’t find yourself needing facilities when none are available.

•  Practice kegel exercises

You may leak a bit of urine when you sneeze, cough or laugh if your bladder is full. This is called stress incontinence and will persist throughout your pregnancy. This will most likely go away with the birth of your baby. Kegel exercises can also help with urinary incontinence. While Kegel exercises may not resolve the problem completely it may help reduce the stress incontinence you experience during pregnancy.

Stress incontinence

Women in the third trimester and post partum commonly have stress incontinence. Stress incontinence is when a few drops of urine are released involuntarily when doing activities like laughing, sneezing, coughing; or when lifting heavy objects or exercising.

To reduce stress incontinence:

•  Regularly perform Kegel exercises to strengthen the pelvic muscles
•  Don’t stretch out the bladder by holding urine in when you have the urge to pee
•  Empty your bladder frequently

Kegel exercise

Kegel exercise is a pelvic floor exercise, which consists of contracting and relaxing the muscles that form part of the pelvic floor. It helps strengthen the pelvic floor muscles, referred to as the “Kegel muscles”. Many actions that are controlled by Kegel muscles include “holding in” urine or avoiding defecation.

Several tools exist to help with these exercises. Kegel is a popular prescribed exercise for pregnant women to prepare the pelvic floor for physiological stresses of the later stages of pregnancy and vaginal childbirth. Reproducing these types of muscle actions can yield stronger Kegel muscles and thus help in better “holding in” of urine.

Symptoms to look out for

Frequent urination during pregnancy is common. The increased rate of urination may also be caused by a urinary tract infection, diabetes, increased fluid intake, or tension or stress exerted on the body. But if you feel any discomfort or burning or notice blood during urination, talk to your practitioner. When you’re pregnant, bacteria in your urine are more likely than usual to cause a urinary tract infection.

You may experience the following symptoms if you have developed a urinary tract infection (UTI) or bladder infection – a common bacterial infection that can develop during pregnancy:

•  Burning during urination
•  You frequently need to urinate but aren’t able to pass more than a small amount of fluid.
•  Urgent need to urinate, yet scant amounts of urine
•  Painful urination
•  Only produce a few drops of urine when you try to go
•  Even more frequent urination
•  Fever
•  Abdominal pain, cramping
•  Backache
•  Foul smelling urine

If you experience any of these symptoms in addition to frequent urination talk to your doctor. UTI’s are quite common during pregnancy. It is important to treat urinary tract infections as soon as possible, because untreated infections can develop into serious pregnancy complications such as kidney infections and preterm labor. Fortunately with proper treatment most are cleared up in a few days.

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

Pregnancy Symptom: Breast Changes

For many women the first pregnancy symptom they experience is changes in their breast tissue. When you get pregnant, one of the earliest and most significant changes that happen in your body are to  your breasts. Your breasts will respond to you being pregnant by changing in preparation for breastfeeding.

Once fertilisation occurs the pregnancy hormones increase in a pregnant woman’s body. Increase in these pregnancy hormones – hCG, progesterone and estrogen are responsible for all the changes that are brought about to your breasts.  Especially large amounts of estrogen and progesterone are responsible for breast changes during pregnancy.

Here are some of the changes that you may experience in your breasts during early pregnancy which are symptoms of pregnancy:

·   Sore and tender breasts

Tender breasts can be the first symptom of pregnancy. During the first month of pregnancy, most women notice that their breasts feel sore and very tender. You may have a slight tenderness when you touch your breasts or you can have the severe pain whenever you wear a bra. For some women this is also a sign of an impending period, so it may go unnoticed.

·   Changes in nipple: Darkening of areola

The nipples and areolae – the circular areas around the nipples grow bigger and may also begin to darken.

·   Swelling of breasts, heavy breasts

Once fertilisation occurs the increase in pregnancy hormones – hCG, progesterone and estrogen within a pregnant woman’s body, increases blood volume in breasts which makes breast swell and heavy. Blood supply to the breasts also increases markedly. You may notice large, bluish blood vessels coursing along your breasts.

·   Enlargement of breasts

The pregnancy hormones cause the glands inside your breasts to grow and branch out, in preparation for milk production and breastfeeding after the baby is born. This makes the breasts large. Even during the first month of pregnancy, most women notice that their breasts grow considerably larger.

 ·   Montgomery’s Tubercules

You may notice small, goose bump or pimple like white raised  areas on the areola of your breast. They are called Montgomery’s tubercules. They usually begin within first six weeks of conception.

·   Leaking of breasts: leaking colostrum

Your breast may give out colostrum even before you may know you are pregnant. It can start at around any time during pregnancy. For some it starts around 3rd week and for some during second or third trimester. You may notice one breast leaks or both breasts leak.