0-6 Months: Breast milk and/or iron-fortified formula. (Note that all efforts should be made to breastfeed, with formula being second best.)

Developmental skills: Your baby’s mouth is designed to suck, not chew yet. She has a “tongue-thrust reflex” that pushes out solid foods.

6 Months: Strained, pureed starter foods. Try bananas, pears, rice cereal, or unsweetened applesauce. Some suggest starting with more bland-tasting veges so that your baby doesn’t develop an early sweet tooth.

Developmental skills: Baby can now sit up in a chair. Tongue-thrust and gag reflexes lessen, so she is now able to accepts solids. She may also begins teething!

7-9 Months: You can now begin finger foods such as teething biscuits, cheerios and small pieces of soft, cooked foods.  Add additional types of pureed and mashed foods.  Baby may also start drink from a cup.

Developmental skills: You may notice your baby begins to reach for foods and utensils. She is now able to hold a bottle or sippy cup, and begins trying to pick up small food morsels with her thumb-and-forefinger.
Beware of choking hazards, as she will taste just about everything she can get her hands on! She’s really “acting like a baby” now, and enjoys banging, dropping, and flinging things.

9-12 Months: Baby is ready to try foods with a lumpier consistency. Make sure food is cut into small enough piece so she can’t choke on them. New foods to introduce can be lamb, veal, tofu, poultry, noodles, bagel, beans, rice cakes, peas, egg yolk, yams, cheese, oatmeal, and yogurt.

Developmental skills: Your baby’s self-feeding skills are improving, although she still loves to make a mess with her food. Try to let her feed herself even if she spills much of her food (or tries to smear it into her hair!); it’s good for her development!

12-18 Months: Let your baby participates in family meals. She can eat almost any foods the rest of you eat. See how she likes papaya, cottage cheese, apricots, grapefruit, whole eggs, grape halves, beef, strawberries, tomatoes, fish (salmon, tuna), pasta, crackers, broccoli, cereal, spinach, honey, cauliflower, pancakes, melon, muffins, mango, kiwi.

Developmental skills: Baby’s  “Do it myself” desire intensifies, but luckily she can hold her spoon better and spill less when eating and drinking. It’s still normal if some of the food ends up on her lap, floor, or hair.  If baby has begun walking, you may have a hard time getting her to sit still and eat. She may prefer to stop by and pick off of your plate now and then.

18-24 Months: You toddler starts the grazing stage, often earning her the title of “picky eater.”  Try tempting her with various foods to see what she likes. Some options include sandwiches, stews, smoothies, shakes, pate, dips, toppings, spreads, soups. You can also try to make food fun by creating
fun-shaped snacks, such as avocado boats, cooked carrot wheels, cheese blocks, broccoli trees, o-shaped cereals, toast sticks, and cookie-cutter cheese melts.

Developmental skills: Molars appear, so toddler begins rotary chewing. She can mostly spoon-feeds herself without too much spilling.  She may be able to say things like “more” or “all done” or signal those meanings. However, you’ll probably need to be more persistent or creative in order to keep her at mealtime. Her eating habits may be erratic, so focus on small meals or snacks throughout the day as opposed to three set mealtimes.

Source: Dr. Sears

Note: May parents are concerned that their children get “enough” milk and dairy products, mainly because of the calcium. However, due to the increase in sensitivity to cow’s milk, you may NOT want to include too much dairy in your kids’ diets.  In fact, milk may not even be the best source of calcium after all. Other foods to try are calcium-fortified orange juice, calcium-enriched cereals or calcium-enriched soy milk, sesame seeds and sesame butter (tahini), broccoli, collards, spinach, baked beans, and supplements.

Feature image from Bella Baby Food organic, frozen baby food.

If something like this has happened to you, you’re not alone, and it’s actually quite normal.  These skin changes did not happen overnight, although you may notice them all of the sudden on morning.  The American Academy of Dermatology says that about 70 percent of pregnant women develop these blotchy areas of darkened skin. It’s called chloasma or melasma, but is also known as “the mask of pregnancy” (sounds more romantic than it is!).

The blotchy areas usually appear around your nose, cheekbones, and forehead (hence the name Mask of Pregnancy). They may also show up on your upper lip, cheeks, and jawline.  Some women also develop dark patches on other body parts that are exposed to the sun. You may also notice areas of skin that are naturally darker (nipples, freckles, genitals) — becomes even darker during pregnancy. Some women notice a darkened line, called the linea nigra, running from their belly button downward.

Why does it happen?

You guessed it– it’s those lovely hormones at work again!  During pregnancy, hormonal changes cause a temporary increase in your body’s production of melanin, the chemical that gives color to hair, skin, and eyes.

Women with darker skin are more likely that lighter-skinned women to get melasma.  This “mask” may become more pronounced with each pregnancy.

Will it go away?

The good news is that these darkened areas will probably fade within a few months after delivery. In some cases it never completely disapears, but for many women their skin will return to its normal shade.

Can I prevent it?

Although this skin pigmentation  usually disappear on its own after delivery, there are some things you can do to minimize the splotchy factor:

• Stay out of the sun and avoid tanning salons. Cover up or use sunblock if you’ll be out in the sun. More pigment is created when skin is exposed to sunlight.
• Use gentle cleansers and lotions. Irritating products can worsen the condition.
• Use concealer! When all else fails, there’s always the make-up bag.
• After birth: Continue to protect sensitive areas from the sun. Certain contraceptives containing estrogen may also cause melasma.

feature image from The Daily Green

Epidural anesthesia has become the most common form of pain medication for labor and birth, but it’s not for everyone.  Here are some common reasons an epidural might not be right for you:

1. Your Body Type: Sometimes, the doctor has no easy access to the epidural space. Factors that might make it difficult to find the right spot include obesity, scoliosis, scar tissue, unusual spinal archtecture or previous surgeries.
2. Drug interactions: Some medications, such as blood thinners, can make an epidural risky or ineffective.
3. Existing health issues: If you have a low platelet count, or other blood disorders, there is an increased risk of internal bleeding in the spine.
4. Timing: In some hospitals, anesthesiologists are available only at certain hours of the day, or certain days of the week. They may simply be busy and unavailable. Also, if you come into the hospital in advanced labor, or with a very quick labor, there might not be time to get an epidural in place.
5. Infection: If you have an infection on your back, you definitely don’t want your anesthesiologist putting a needle through that area.  It might cause the infection to spread to the spine and other areas of your body, which could lead to major problems.
6. Heavy bleeding or shock: Often, having an epidural lowers blood pressure. Therefor, if you are bleeding heavily or are suffering from shock, your already lowered blood pressure can make the situation even more dangerous.
7. Hospital restrictions: Some hospitals have policies about when you can have an epidural. Some stipulate that you must be at a certain point in labor (for example, four centimeters dilated) before an epidural can be given. Others may decide that epidural should not be given after a certain point of labor (for example when you’ve reached full dilation).

Source: About.com

image credit

• Ovaries
• Fallopian tubes
• Tissues that hold the uterus in place
• Outer surface of the uterus
• Lining of the pelvic cavity

According to the Endometriosis Research Center: “It is more prevalent than breast cancer, yet continues to be treated as an insignificant, obscure ailment… The average delay in diagnosis is a startling 9 years, and a woman will go through as many as 5 physicians before she is properly diagnosed and treated.”

Symptoms:

The most common symptom is pain in the lower abdomen (pelvis) or the lower back, mainly during menstrual periods. The amount of pain is different for each woman, and does not depend on how much endometriosis she has.

Other symptoms of endometriosis can include:

• Very painful menstrual cramps, which may get worse over time
• Chronic pain in the lower back and pelvis
• Pain during or after sex
• Intestinal pain
• Painful bowel movements or urination during menstrual periods
• Spotting or bleeding between menstrual periods
• Infertility or not being able to get pregnant
• Fatigue
• Diarrhea, constipation, bloating, or nausea, especially during menstrual periods
• Click here for other related health problems

The symptoms of endometriosis diminish during pregnancy. Symptoms also tend to decrease with menopause, when menstrual periods end for good.

Associated health problems

Endometriosis growths are benign (not cancerous), but they still can cause many problems. To understand why, it helps to be familiar with a woman’s menstrual cycle. Every month, hormones cause the lining of a woman’s uterus to build up with tissue and blood vessels. If a woman does not get pregnant, the uterus sheds this tissue and blood through the vagina, IE: as her menstrual period.

Patches of endometriosis also respond to the hormones produced during the menstrual cycle. But misplaced endometriosis tissue and the cells it sheds have no way of leaving the body. Trapped between layers of tissue, they cause inflammation, scar tissue, adhesions and bowel problems. These growths expand over time, adding extra tissue and blood. This is why the symptoms of endometriosis often get worse.

As endometrial tissue grows, it can cover or grow into the ovaries and block the fallopian tubes. Trapped blood in the ovaries can form cysts, or closed sacs. It also can cause inflammation and cause the body to form scar tissue and adhesions (tissue that sometimes binds organs together). This scar tissue may cause pelvic pain and make it hard for women to get pregnant. The growths can also cause problems in the intestines and bladder.

Can I reduce my chances of getting endometriosis?

Because the hormone estrogen is involved in thickening the lining of the uterus during the menstrual cycle, you can try to lower the estrogen levels in your body.

• Exercise regularly
• Keep a low amount of body fat
• Avoid large amounts of alcohol and caffeine
• Try to keep stress levels as low as possible
• Balance estrogen levels naturally. Read more here.

Testing

Pelvic exam. Your doctor will perform a pelvic exam to feel for large cysts or scars behind your uterus. Smaller areas of endometriosis are hard to feel.

Ultrasound. Your doctor could perform an ultrasound, an imaging test to see if there are ovarian cysts from endometriosis. During a vaginal ultrasound, the doctor will insert a wand-shaped scanner into your vagina. During an ultrasound of your pelvis, a scanner is moved across your abdomen. Both tests use sound waves to make pictures of your reproductive organs. Magnetic resonance imaging (MRI) is another common imaging test that can produce a picture of the inside of your body.

Laparoscopy. The only way for your doctor to know for sure that you have endometriosis is to look inside your abdomen to see endometriosis tissue. He or she can do this through a minor surgery called laparoscopy. You will receive general anesthesia before the surgery. Then, your abdomen is expanded with a gas to make it easy to see your organs. A tiny cut is made in your abdomen and a thin tube with a light is placed inside to see growths from endometriosis. Sometimes doctors can diagnose endometriosis just by seeing the growths. Other times, they need to take a small sample of tissue and study it under a microscope.

HSG. Women with endometriosis who are struggling to get pregnant can undergo a structural study known as an HSG (hysterosalpingogram). This diagnostic test can be performed in as little as five minutes. The procedure is associated with cramping, but ibuprofen can be used to ease the pain. During the test, radiocontrast media is injected through the cervix into the uterus. An x-ray is taken to examine the internal contour of the uterus and check whether the fallopian tubes are open.

Treatment

Conventional medicine states that there is no cure for endometriosis, but there are many treatments offered to deal with the pain and infertility.  A naturopathic/integrative medicine doctor will suggest a different course of action to clear up endometriosis based on diet, exercise, detox, addressing emotional stress, and/or natural progesterone.

Pain Medication. For women with mild symptoms, doctors may suggest taking over-the-counter medicines for pain. These include ibuprofen (Advil and Motrin) or naproxen (Aleve).

Hormone Treatment. When pain medicine is not enough, doctors often recommend hormone medicines to treat endometriosis. Only women who do not wish to become pregnant can use these drugs. Hormone treatment is best for women with small growths who do not have bad pain. Hormones come in many forms including pills, shots, and nasal sprays. Common hormones used for endometriosis include:

• Birth control pills to decrease the amount of menstrual flow and prevent overgrowth of tissue that lines the uterus. Most birth control pills contain two hormones, estrogen and progestin. Once a woman stops taking them, she can get pregnant again. Stopping these pills will cause the symptoms of endometriosis to return.
• GnRH agonists and antagonists greatly reduce the amount of estrogen in a woman’s body, which stops the menstrual cycle. These drugs should not be used alone because they can cause side effects similar to those during menopause, such as hot flashes, bone loss, and vaginal dryness. Taking a low dose of progestin or estrogen along with these drugs can protect against these side effects. When a woman stops taking this medicine, monthly periods and the ability to get pregnant return. She also might stay free of the problems of endometriosis for months or years afterward.
• Progestins. The hormone progestin can shrink spots of endometriosis by working against the effects of estrogen on the tissue. It will stop a woman’s menstrual periods, but can cause irregular vaginal bleeding. Medroxyprogesterone (muh-DROKS-ee-proh-JESS-tur-ohn) (Depo-Provera) is a common progestin taken as a shot. Side effects of progestin can include weight gain, depressed mood, and decreased bone growth.
• Danazol (DAY-nuh-zawl) is a weak male hormone that lowers the levels of estrogen and progesterone in a woman’s body. This stops a woman’s period or makes it come less often. It is not often the first choice for treatment due to its side effects, such as oily skin, weight gain, tiredness, smaller breasts, and facial hair growth. It does not prevent pregnancy and can harm a baby growing in the uterus. It also cannot be used with other hormones, such as birth control pills.

Surgery. Women with severe endometriosis — many growths, a great deal of pain, or fertility problems — may consider surgery. Your doctor might suggest one of the following:

• Laparoscopy can be used to diagnose and treat endometriosis. During this surgery, doctors remove growths and scar tissue or burn them away. The goal is to treat the endometriosis without harming the healthy tissue around it. Women recover from laparoscopy much faster than from major abdominal surgery.
• Laparotomy  or major abdominal surgery that involves a much larger cut in the abdomen than with laparoscopy. This allows the doctor to reach and remove growths of endometriosis in the pelvis or abdomen.
• Hysterectomy is a surgery in which the doctor removes the uterus. Removing the ovaries as well can help ensure that endometriosis will not return. This is done when the endometriosis has severely damaged these organs. A woman cannot get pregnant after this surgery, so it should only be considered as a last resort.

The Natural Path. Carolyn Dean, M.D., N.D. states: “While modern medicine insists the cause of endometriosis is unknown and there is no cure, it can be relatively simple to treat and control the symptoms. The standard medical treatment involves taking synthetic hormones, such as the birth control pill, that stops menstruation and therefore stops the buildup of blood and endometrial tissue outside the uterus. But there are new ways of approaching endometriosis that are much kinder to the body and address an underlying problem that certainly relates to the condition.” To learn about turning the tables on endometriosis using alternative methods, click here or here, or speak to a naturalistic doctor for more information.

Emotional Support

You may want to consider joining a support group (online or in your community) to talk with other women who have endometriosis.

You can find out more about endometriosis by contacting womenshealth.gov at 1-800-994-9662. You also can contact the following organizations:

Endometriosis Association
Phone Number(s): (414) 355-2200
Internet Address: http://www.endometriosisassn.org

The American College of Obstetricians and Gynecologists
Phone Number(s): (202) 638-5577; (202) 863-2518 (for publication requests only)
Internet Address: http://www.acog.org

Endometriosis Research Center
Phone Number(s): (561) 274-7442
Internet Address: http://www.endocenter.org

Eunice Kennedy Shriver National Institute of Child Health and Human Development
Phone Number(s): 1-800-370-2943
TTY: 1-888-320-6942
Internet Address: http://www.nichd.nih.gov

feature image credit.

CBS News reports that more than 75 percent of kids before the age of 5 have an ear infection, according to the Journal of the American Academy of Pediatrics. Ear infections have routinely been treated with antibiotics, but now, new research suggests the best medicine may be no medicine at all.  There is substantial evidence to show that about 80 percent of ear infections clear up without antibiotics, and with no ill effects.

What you may not have known is that most ear infections are caused by viruses, which are not treatable with antibiotics anyway.”  Everyone involved may have to work on their patience, but letting the ear infection run its course may be your best option.

The American Academy of Pediatrics is about to update its guidelines. The new “rules” will say that unless the child is very young or very sick, a doctor should employ “watchful waiting” — monitoring the child’s health. Your doctor might prescribe a safety net antibiotic prescription (SNAP) to be filled only if the child has not improved within 48 to 72 hours.

However, current guidelines suggest that some children should still get antibiotics:

• Are under age 2
• Appear seriously ill with fever of 102F or higher
• Have fluid dripping from the ears
• Have a double ear infection (both ears infected)

If you still don’t believe your child’s ear infection will heal best on its own, you should be aware of some side effects caused by antibiotic. The most serious side effect, she said, is antibiotic resistance.  In about 10 to 20 percent of children, Ashton said, antibiotics can cause upset stomach, vomiting, diarrhea. Less frequently, they can cause rashes.

You want to avoid over-use of antibiotics to avoid antibiotic resistance, which makes the next bug tougher to treat. The next time your doctor prescribes amoxicillin, the most common one for kids, it might not work. Doctors would be wise to head this new research, but in 84 percent of cases, they still prescribe antibiotics.  It may be up to  parents to decide that antibiotics may not be the best medicine, and forgo.

“Pediatricians are now focusing on pain relief,” CBS News Medical Correspondent Dr. Jennifer Ashton said. “Children screaming in pain will not get relief from an antibiotic in the first 24 hours. They should be given ibuprofen (Advil) or acetaminophen (Tylenol), and sometimes prescription ear drops can ease the pain.”

**Side Note: I only had one experiences with ear infections when my daughter was a baby, a few years ago. The doctor gave me a choice of antibiotics or a homeopathic remedy. I decided to try the homeopathic remedy, and it worked wonderfully. The ear infection may have gone away on it’s own, but the pain subsided very quickly and gave us no more problems!

This follows another Australian report from 2  years ago saying that researchers have confirmed women do become more forgetful during and after pregnancy.

This time, the researchers analyzed the mental function of a group of women before, during, and after pregnancy, and reported no differences at all.

“I think that people have the tendency to blame the fact that they’re pregnant on normal lapses of memory which happen all the time to us anyway,”  said lead researcher Helen Christensen.  “Our results challenge the view that mothers are anything other than the intellectual peers of their contemporaries.”

Well, no one is saying that pregnant women and mommies are dumber than we used to be. We are just slightly more absent-minded and forgetful. I’m not sure that is something that can be accurately measured.

“Women often report problems with memory and reasoning after they become pregnant,” Christensen said. “But the latest findings from our decade-long study, the most in-depth to look at this issue, has proven they do not.”

Blame it on sleep deprivation, hormonal changes, or just normal memory lapses… I still think there’s something to it.  I tend to agree with blogger Kimmama who refuses to believe that “baby brain” was all in her head.  She’s thinking, and I’m thinking too, that clearly none of these researchers have been pregnant before!

The Daily Mail reports mentions research carried out last year by Dr Craig Kinsley, of Richmond University in Virginia, suggesting that giving birth actually leads to dramatic improvements in mental capacity. He says that giving birth actually produces a “surge of memory and learning ability that makes women more vigilant and alert.”

Like I said, we’re not getting dumber… we’re just… what was it I said?

Benefits of Vigorous Exercise

The book “Exercising Through Your Pregnancy” by James F. Clapp M.D. cites over 20 years of research into the pregnancies of competitive athletes. Dr. Clapp found that exercising at a fairly high level throughout your pregnancy, including full weight bearing exercises, is safe and actually has many positive effects. Some of theses outcomes are obvious, such as reduced maternal weight gain and fat accumulation,  and improving your mood, energy levels, and muscle tone. But some are more surprising, including:

• reduced pregnancy-related symptoms
• Helps reduce backaches, constipation, bloating, and swelling
• May help prevent or treat gestational diabetes
• good placental growth
• fewer big babies
• increased chance of delivering close to due date
• shorter and less complicated labors
• more rapid recover after delivery.

Changes in Your Body

Your body is changing in many ways during pregnancy. You should be aware of these, as they will affect the way you move and exercise.

• Joints: Pregnancy hormones cause the ligaments supporting your joints to relax. This puts them at increased risk of injury, so you should avoid jerky, bouncy, or high-impact motions.
• Balance: The extra weight you’re carrying causes your center of gravity to shift. It also puts stress on your joints and muscles, specifically those in the pelvis and lower back. This puts you at risk of back pain, loss of balance, and falls.
• Heart Rate:  Growing a baby is hard work, and your body is working extra hard to deal with the weight gain and other changes.  Exercise directs oxygen and blood flow to the muscles being worked, and thus away from other parts of your body. It’s important not to overdo it if you begin to feel short of breath, faint, or exhausted.

What’s Safe and What to Avoid

This may come as news to your Grandma, who has probably told you to stop carrying the groceries into your house, and to lie down and put your feet up. But there are, of course limits to how much your pregnant body can handle.  The American Congress of Obstetricians and Gynecologists (ACOG) recommends walking, swimming, cycling, and aerobics.  Other activities, such as running, racket sports, and strength training are good if you’re body is already accustomed to these exercises.

Activites that should be avoided during pregnancy include:

• Downhill snow skiing: Your changing center of gravity can throw off your balance and cause falls and sever injuries. High altitudes with less oxygen may not be the best idea, either.
• Contact sports can result in injuries to you and your baby as well.
• Scuba diving: The water pressure can put your baby at risk for decompression sickness.
• Excessive weight lifting.
• Yoga poses that have you lying on your back or hanging upside down.
• Activities that increase your chance of falling and injuring yourself, such as horseback riding, water skiing, and gymnastics.
• Standing still for long periods of time should be avoided.

If you haven’t been exercising much before you became pregnant, start slowly and carefully. It’s a good idea to consult your doctor about what types of exercise are best.  You should also expect that physical exertion will become more difficult during the last trimester, and respond accordingly. Always incorporate a warm-up and cool-down stage for 5-10 minutes each.

Things to Watch Out For

Women with the following conditions will be advised against exercising during pregnancy:

• Risk factors for preterm labor
• Vaginal bleeding
• Premature rupture of membranes

The ACOG recommends the following guidelines for a safe and healthy exercise program:

• After the first trimester of pregnancy, avoid doing any exercises on your back.
• Avoid brisk exercise in hot, humid weather or when you have a fever.
• Wear comfortable clothing that will help you to remain cool.
• Wear a bra that fits well and gives lots of support to help protect your breasts.
• Drink plenty of water to help keep you from overheating and dehydrating.
• Make sure you consume the daily extra calories you need during pregnancy.

Stop exercising and call your doctor if you get any of these symptoms:

• Vaginal bleeding
• Dizziness or feeling faint
• Increased shortness of breath
• Chest pain
• Headache
• Muscle weakness
• Calf pain or swelling
• Uterine contractions
• Decreased fetal movement
• Fluid leaking from the vagina

Bottom Line: It’s good news for pregnant sports lovers and exercise enthusiasts! Exercise during pregnancy can help prepare you for labor and childbirth, in addition to staying fit and feeling good. And exercising afterward can help you get back into shape.  So put on those running shoes, get out your tennis balls and rackets, or head to the gym or nearest hiking trail. If there’s something you loved doing before pregnancy, chances are you may be able to continue in almost the same way that you always have!

feature image from Hello Beautiful

It’s important to realize that prenatal vitamins are not meant to be your sole source of nutrients. They are meant to supplement!  Pregnant women need more of almost every vitamin and mineral than non-pregnant women. Some say that most of these increased nutrient requirements can be met through a carefully planned, nutritious diet.  You should try your best to eat lots of fresh, non-processed foods. However, a supplement is important if you are NOT getting the required amounts from what you eat (and most of us probably are not!).

Not all prenatal vitamins are created equal. If you are unsure about the best one for you, do some research and talk to your doctors. Avoid artificial preservatives, flavors, colors, and sweeteners. You may want to follow this advice and purchase your vitamins at a health food store, instead of a drug company that “loads them with plenty of of low-quality, synthetic vitamins.”  Here are some other aspects to consider:

Iron
If you’re suffering from extreme exhaustion, you’re not alone. March of Dimes claims that anemia caused by lack of iron affects half of all pregnant women!

Your multivitamin won’t contain the 27 milligrams of iron that pregnant women need, so you can add to your levels by eating iron-rich foods like red meat or fortified cereals.

You may also be prescribed a supplement if you have low iron levels, or have pernicious anemia, sickle cell disease, or uterine fibroids. If iron makes you nauseous, try taking it in the evening, and improve your body’s ability to absorb it by avoiding coffee, tea, egg yolks, milk, fiber, and soy with your tablet.

Calcium
Calcium is so important for your baby’s bones that your body will steal your stores and give them to baby, if necessary – putting you at risk for osteoporosis. Prenatals don’t contain anywhere near the recommended 1,000 milligrams (and women carrying multiples need even more). So add calcium-rich foods to your diet, or ask your doctor about a supplement.

The World Health Organization recommends that in order to reduce the risks of preterm birth and eclampsia, pregnant women should consume 1,500 milligrams of calcium.  (Note that anything beyond 250 mg of calcium, or 25 mg of magnesium, should not be taken at the same time as supplemental iron since both calcium and magnesium interfere with the absorption of the iron.)

Vitamin D
Sunshine is the body’s leading source of vitamin D. There are many reasons why vitamin D is vital during pregnancy. Women with darker skin and those who get little sun should be tested for vitamin D, says the American Academy of Pediatrics. If you’re deficient, you should consider a supplement.

Omega-3s
Studies have shown that DHA, found in omega-3 fatty acids, improves baby’s visual-learning ability and attention span, and may help stave off postpartum depression. You can get enough DHA with two or three servings of salmon, herring, or sardines a week, but to be on the safe side, you might take a DHA supplement. The American College of recommends that pregnant women get 300 milligrams a day.

Iodine
Iodine is critical for your baby’s brain development, says Donnica Moore, M.D. You should use table salt that specifically says, ‘iodized.’  If you are on a low-salt diet or have trouble with water retention, it may be better to find a prenatal supplement with iodine.

Choline
Choline helps develop the hippocampus, the brain’s memory center, but is not included in many prenatal supplements. Eating two eggs a day can help you meet the 450-milligram daily choline requirement.

Folic Acid
Most moms have heard about the importance of folic acid in preventing pina bifida and other defects. The recommended dosage is 400 to 600 micrograms a day, but you need more if you’re carrying multiples, have anemia, sickle cell disease, or who’ve had a child with a similar brain defect.  (I did find one source saying that eating green, folate-rich foods is safer than taking folic acid, but I don’t know enough to comment on that.)

I can tell you, that drink is pretty nasty. It makes some pregnant women feel downright nauseous. Some women add ice or lemon juice, so it’s more of a lemonade-type beverage. I just gulp it down as fast as I can, and try not to think about it!

What is the Test For?

This is a routine test that is done to check for Gestational Diabetes Mellitus (GDM).  This is different than regular diabetes. In GDM, the hormones secreted by the placenta alter how insulin is used in the pregnant body. If untreated, a pregnant woman with GDM may experience problems with ecclampsia, blood pressure, urinary tract infections and an increased risk of Type II Diabetes later in life. The newborn may experience problems of the heart and kidney, and respiratory distress syndrome.

When is the Test Done?

The test is usually offered to most women around 28 weeks gestation. However, if you have a family history of diabetes or had gestational diabetes in a previous pregnancy they may test you earlier.  There are no risks involved, although some women are concerned about the effects that this blast of glucose has on a baby who is not used to receiving it is such quantities.

If you “fail” the one hour test, there’s another 3-hours glucose test. (It is important to note that only about a third of women who test positive on the first test are found to have diabetes upon further diagnosis.) You will be asked to drink or eat something with sugar and will be tested at 30 minutes, one hour, two hours, and three hours. You must pass in three of these tests to “pass” the entire test.

Treating Gestational Diabetes

If you are found to have Gestational Diabetes Mellitus (GDM), you will more than likely be sent to a nutritionist to learn ways that you can control your glucose levels through diet. You will also have a plan for monitoring blood sugar levels to assess your progress. Glucose intolerance during pregnancy affects about 100,000 women every year. The condition usually ends with the pregnancy. However, a small number of women will continue to be diabetic after delivery, so you’ll have to take another glucose test six weeks postpartum.

Do You Need to be Tested for GDM?

A friend of mine was just complaining that her doctor wants her to “redo the whole stinkin’ test.” Somehow they lost her lab results, and she’s tempted to just skip the whole thing, rather than drink the nasty glucose and take another blood test. “Is that crazy??” she wants to know (this is actually her 3rd pregnancy, and she’s never had a glucose problem in the past).

Well, no. It seems she wouldn’t be all that crazy, considering her current situation.

Although GTT  is routine in many places, the American College of Obstetrics and Gynecologists (ACOG) has actually stated that many women are tested unnecessarily. You may not need laboratory testing to screen for GDM if you meet all of the following criteria:

• Less than 25 years old
• Not a member of a racial or ethnic group with a high prevalence of diabetes (eg, Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)
• A body mass index (BMI) 25
• No history of abnormal glucose tolerance
• No previous history of adverse pregnancy outcomes usually associated with GDM
• No known diabetes in first-degree relative

Women who are at a higher risk for GDM usually have one of the following risk factors:

• age
• ethnicity
• obesity
• family history of diabetes
• past obstetric history

It can’t hurt to take the test, but if you can talk to your doctor about whether or not it is really  necessary for you.

The Jelly Bean Alternative

I thought it was interesting to note that several years ago some studies were done showing that eating 18 Brach’s® jelly beans worked just as well as the glucola. This definitely sounds a lot more pleasant, and supposedly has few stomach side effects than the glucola. Some women are just told to eat certain sugary foods before the test, which also seems to make sense.

feature image from the mommy diary

What is Vitamin D?

Vitamin D, sometimes referred to as the “sunshine vitamin,” is technically not a vitamin! It is a “steroid hormone precursor” that is NOT naturally present in food. Your skin produces vitamin D when exposed to sunlight (sans sunscreen). Its major role is to increase the flow of calcium into the bloodstream, and is also necessary for bone growth.

What do we need vitamin D for?

According to Medical News Today, there are many reasons your body  needs adequate levels of Vitamin D:

It is crucial for the absorption and metabolism of calcium and phosphorous, which have various functions, especially the maintenance of healthy bones.

It is an immune system regulator.

It may be an important way to arm the immune system against disorders like the common cold, say scientists from the University of Colorado Denver School of Medicine, Massachusetts General Hospital and Children’s Hospital Boston.

It may reduce the risk of developing multiple sclerosis. Multiple sclerosis is much less common the nearer you get to the tropics, where there is much more sunlight, according to Dennis Bourdette, chairman of the Department of Neurology and director of the Multiple Sclerosis and Neuroimmunology Center at Oregon Health and Science University, USA.

Vitamin D may have a key role in helping the brain to keep working well in later life, according to a study of 3000 European men between the ages of 40 and 79.

Vitamin D is probably linked to maintaining a healthy body weight, according to research carried out at the Medical College of Georgia, USA.

It can reduce the severity and frequency of asthma symptoms, and also the likelihood of hospitalizations due to asthma, researchers from Harvard Medical School found after monitoring 616 children in Costa Rica.

It has been shown to reduce the risk of developing rheumatoid arthritis in women.

A form of vitamin D could be one of our body’s main protections against damage from low levels of radiation, say radiological experts from the New York City Department of Health and Mental Hygiene.

Various studies have shown that people with adequate levels of vitamin D have a significantly lower risk of developing cancer, compared to people with lower levels. Vitamin D deficiency was found to be prevalent in cancer patients regardless of nutritional status, in a study carried out by Cancer Treatment Centers of America.

The Vitamin D Council adds that current research has implicated vitamin D deficiency as a major factor in the pathology of at least 17 varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, and more.

Vitamin D and Pregnancy

Vitamin D deficiency during pregnancy has effects on both the mother and fetus. The Vitamin D Council implicates it in cases of c-section, preeclampsia, gestational diabetes, and bacterial vaginitis.

During pregnancy, the active form of vitamin D increases significantly, according to Mayo Clinic, particularly in the second and third trimesters. During this time, the baby’s bones are developing, as are the brain, the nervous system, and the other organs.Your levels of vitamin D also play a role in determining your baby’s health later in life. Vitamin D deficiency been linked with low birth weight. It also appears that sufficient vitamin D in early life may decrease the risk of serious health problems such as newborn lower respiratory tract infection, diabetes, asthma, weak bones, schizophrenia, autism, brain tumor, heart failure, and a host of other maladies. (Read more here.)

The American Academy of Pediatrics (AAP) recently recommended that all pregnant women have a 25(OH)D blood test, because Vitamin D is vital  for normal fetal development .  If your obstetrician has not referred you for this test, you may want to consider asking that he/she does.

The Sun Exposure Quandary

For decades dermatologists have been warning about the hazards of sun exposure and skin cancers. We know that excessive sun exposure is dangerous, and have been cautioned to stay out of the sun,  wear sunscreen, and protective garments if we will be outdoors. At the same time, Vitamin D deficiency is at epidemic levels in the US (80-90% according to one expert). Getting just enough daily sun exposure to produce necessary levels of Vitamin D may actually be important for your health.

Further studies are required to address this dilemma. However, some health authorities are starting to change their recommendations. Medical News Today quotes the Cancer Council, Australia (2009):
“Sun exposure is the cause of around 99% of non-melanoma skin cancers and 95% of melanomas in Australia. However, exposure to small amounts of sunlight is also essential to good health. A balance is required between avoiding an increase in the risk of skin cancer by excessive sun exposure and achieving enough exposure to maintain adequate vitamin D levels.”

Getting Enough Vitamin D

The current U.S recommended daily allowance is 200 international units of vitamin D, however the current “tolerable upper limit” is 2000 IU. The Canadian Pediatric Society and other Vitamin D advocates suggests that this level may be appropriate for winter pregnancies. (Mayo Clinic) Some experts suggest that pregnant women need even higher levels than this, up to 5000 IU.  Speak to your doctor, as too much Vitamin D can be toxic.

The Vitamin D Council recommends 3 ways for adults to ensure adequate levels of vitamin D:

• Regularly receive midday sun exposure in the late spring, summer, and early fall, exposing as much of the skin as possible (being careful to never burn).
• Regularly use a sun bed (avoiding sunburn) during the colder months. (For more info on this topic: Are Tanning Beds Safe?)
• Take 5,000 IU per day for 2–3 months, then obtain a 25-hydroxyvitamin D test. Adjust your dosage so that blood levels are between 50–80 ng/mL (or 125–200 nM/L) year-round.