DIET

1. DIET

• Always eat breakfast
• Base your meals on starchy foods such as potatoes, bread, rice and pasta, choosing wholegrain if possible. These foods are satisfying without containing too many calories.
• Eat at least five portions of different fruit and vegetables every day rather than foods that are higher in fat and calories.
• Eat a low-fat diet and don’t increase the number of calories you eat. Eat as little fried food as possible and avoid drinks that are high in added sugars, and other foods such as sweets, cakes and biscuits that have a high fat or sugar content.
  Eat fibre-rich foods such as oats, beans, lentils, grains and seeds, as well as wholegrain bread, brown rice and wholemeal pasta.
• Eat some protein every day; choose lean meat, and try to eat two portions of fish a week. Lentils, beans and tofu are also a good source of protein.
  Eat dairy food for calcium but choose low-fat such as skimmed milk or low-fat yogurt.
• It is advised to eat no more than two portions of oily fish, such as mackerel or salmon, a week. This is because too much of a substance found in oily fish (mercury) can be harmful to an unborn baby’s development. Also, do not eat more than two fresh tuna steaks or four medium-sized cans of tuna a week, and avoid eating shark, swordfish or marlin.
• You can eat peanuts or foods containing peanuts (such as peanut butter). Eating peanuts does not appear to affect your baby’s chances of developing a peanut allergy. Don’t eat them if you’re allergic to them. Watch the portion size of your meals and snacks and don’t ‘eat for two’. Most women do not need any extra calories during the first six months of pregnancy. It is only in the last 12 weeks that they need to eat a little more, and then only an extra 200 calories a day, which is roughly the same as two slices of bread.
• Limit your caffeine intake to 200 milligrams (mg) per day, for example two mugs of instant coffee. Be aware that other drinks such as tea, green tea and energy drinks may also contain caffeine. There is limited data on the safety of herbal and green teas in pregnancy and it is best to drink them in moderation. Herbal teas may contain potent medicinal properties, apart from rooibos. No alcohol is advised as data is conflicting.                          

Foods to avoid

• Liver can contain high levels of vitamin A, which in high doses can harm the development of an unborn baby’s nervous system so you should avoid eating foods such as liver and liver products like pâté.
• To reduce the risk of getting listeriosis: Drink only pasteurised or UHT milk. Avoid eating ripened soft cheese such as Camembert, Brie or blue-veined cheese, however, hard cheese varieties such as cheddar, cottage and processed cheese are safe. Soft cheeses are safe to eat provided they are made from pasteurised milk e.g. cream cheese, mozzarella, feta, paneer, ricotta, goat’s cheese. Avoid eating pâté including vegetable pate. Avoid eating undercooked food.
• To reduce your risk of getting salmonella: Avoid eating raw or partially cooked eggs or food that may contain them, such as some types of mayonnaise or mousses. Avoid eating raw or partially cooked meat, especially poultry and shellfish.
• To reduce your risk of getting toxoplasmosis: Always wash your hands before and after handling food. Wash all fruit and vegetables, including ready-prepared salads cook raw meats and ready-prepared chilled meats thoroughly. Be cautious with col cured meats in pregnancy such as salami, ham, chorizo and pepperoni as they may contain toxoplasmosis. For ready to eat meats, you can reduce the risk by freezing for four days prior to eating. Wear gloves and wash your hands thoroughly after gardening or handling soil. Avoid contact with cat faeces (in cat litter or in soil) – or, if you must handle it, wear rubber gloves.

Game

• It is advisable to avoid game that has been shot with lead pellets. Enquire about this from the retailer before purchase of such meat.

FASTING IN PREGNANCY

• It is recommend that you do not fast during your pregnancy as this may have short and long term effects on the fetus. Most religions allow women not to fast during this time and in the post-partum phase. Should you feel strongly about fasting please consider a “modified fast” that includes only fasting for a few hours per day, or taking in fluids with limited nutritional foods like brown bread and peanut butter. Kindly discuss this with me in advance.

3. WEIGHT GAIN

• The average weight gain during pregnancy is between 5-15 kg’s. Every patient has a different pattern to their weight gain. A healthy BMI is above 18.5 but below 25. The more overweight you are, the greater the risks. Being underweight increases the risk of your baby not growing.

EXERCISE IN PREGNANCY

• Safe, however needs to be modified. Aerobic exercise and exercise that activates large muscle groups e.g. walking, swimming, cycling, rowing, jogging. Duration recommended is 30minutes for 5-7 times per week with the ability to have a conversation during the exercise (talk test). Ensure good hydration.
  
  

Exercise best avoided:

• Activities with high risk of falling, jumping movements and quick changes of direction, hot yoga
  and uncomfortable yoga positions, supine position exercises after the first trimester.

When to stop exercising?

• Vaginal bleeding, regular painful contractions, leakage of amniotic fluid, new dyspnoea before exertion, dizziness and syncope, headache, chest pain, muscle weakness affecting balance, calf pain and swelling.

SMOKING

• It is advisable to avoid smoking during pregnancy and to stop if you are a known smoker. Passive smoking may also bear risks, hence it is best to be in a smoke free environment and home.
  Smoking is bad for you and also reduces the amount of oxygen and nutrients that pass through the placenta which increases your risk of miscarriage, ectopic pregnancy, your baby dying in the womb (stillbirth) or shortly after, your baby being born with abnormalities such as face defects including cleft lip and palate, bleeding during the last months of pregnancy, which could be life threatening for you and your baby and premature birth. Your baby’s growth and health may be affected –a baby that is small due to smoking is more likely to have health problems when young and also later in life.
• Babies and children whose mothers smoke during pregnancy and thereafter are also at greater risk of sudden and unexplained death (SIDS), asthma, chest and ear infections and pneumonia, behaviour problems such as ADHD and performing poorly at school.
• Stopping smoking reduces all the risks described above.
• Nicotine replacement therapies (NRT), such as patches, chewing gum, lozenges or mouth sprays, deliver clean forms of nicotine and are safe and effective aids in pregnancy. Using NRT is safer than smoking because it doesn’t contain poisons such as tar or carbon monoxide but does provide you with some nicotine to help you manage any withdrawal cravings. These aids can however result in a higher risk of rebound smoking.

6. DENTIST

• It is advised to consult with a dentist during the second trimester for a routine check-up. Dental work including local anaesthetic and X-Rays to the dental region is acceptable.

7. BLOOD DONATIONS

• Not advised during pregnancy.