goodtoknow says: Congratulations! If you've just become pregnant you've got an exciting few months ahead of you. But make sure you get the basics right to keep you and your unborn baby in tip top condition. First start taking folic acid tablets, 0.4mg per day. Don't eat soft cheese, pate or raw fish and limit tea and coffee. If you're feeling sick and exhausted we really sympathise, but it's entirely normal and it will end. Limit alcohol to one or two glasses per week and give up smoking NOW if you haven't already.
If you are not yet pregnant, but are planning a pregnancy, an option is to try a course of NRT before becoming pregnant to help quit cigarettes. Most pregnant women can use NRT. It's important to talk it through with your doctor or midwife first. They can help you to weigh up the risks of continuing to smoke against the benefits of stopping using NRT. Using NRT is safer than smoking because it doesn't contain poisons like tar or carbon monoxide.
For a full medical explanation and advice on planning to become pregnant and pregnancy issues from patient.co.uk, read on.
This leaflet offers some advice to women who are planning to become pregnant, or have just become pregnant. The aim is to reduce the risk of harm to the unborn baby, and to reduce the risk of pregnancy complications. There is a summary checklist at the end of the leaflet.
Read on for info about folic acid and alcohol
To get a summary and checklist of all of our advice on the do's and don't's of pregnancy, click here
You should take folic acid tablets for at least the first 12 weeks of pregnancy - even if you are healthy and have a good diet. Folic acid is a vitamin which occurs naturally in certain foods. However, you need a good supply of folic acid when you are pregnant. If you take folic acid tablets in early pregnancy you reduce the risk of having a baby born with a spinal cord problem such as spina bifida. You can buy folic acid tablets from pharmacies.
you have had a previously affected pregnancy.
your partner, or a first-degree relative, have a spinal cord defect.
you have coeliac disease (as your intake of folate may be affected by this condition).
you are taking medication for epilepsy.
you have diabetes, sickle cell anaemia, or thalassaemia.
If you have one or two drinks of alcohol (one or two units), once or twice a week, it is unlikely to harm your unborn baby. However, the amount of alcohol that is safe in pregnancy is not definitely known. So, many women have little or no alcohol when they are pregnant.
It is known that if you drink heavily you have an increased risk of miscarriage, and it may cause serious harm to the baby's growth and brain development. If you find it difficult to cut down or stop drinking alcohol, then seek advice and help from your practice nurse or GP.
Read on for info about smoking and drugs during pregnancy
Where next?
- More about drinking in pregnancy
- If you don't want to take folic acid supplements find out what foods it's in
- Read other ways in which folic acid is good for you
- How much do you know about alcohol? Take our quiz to find out
- What to eat when you're pregnant
- And foods to avoid
If you smoke, you are strongly advised to stop smoking before getting pregnant. Tobacco smoke contains poisonous chemicals which pass into the baby's blood and can slow the baby's growth. The risk of having a miscarriage, premature birth, or stillbirth are higher if you smoke. Even after the birth, children of smoking parents have an increased risk of developing chest infections, asthma, 'glue ear', and sudden infant death syndrome (cot death).
For many women who smoke, planning to become pregnant is a good incentive to stop smoking. Also, it is often a good time to persuade partners to give up too. If you find it difficult to stop smoking then seek advice and help from your practice nurse, GP, or pharmacist.
If you take or inject street drugs, you are strongly advised to stop taking them before getting pregnant. The effects of street drugs on pregnancy are not fully known, but they are likely to pose a risk. If you cannot come off drugs easily, see your doctor for help. For example, substitute therapy in place of injecting heroin is an option which is safer during pregnancy.
Read on for info about food and diet
Aim to eat a 'healthy diet' (which everyone should be eating!) Briefly, the bulk of most meals should be starch-based foods (such as bread, cereals, potatoes, rice, and pasta), together with fruit and vegetables. Eat protein foods such as meat, fish, pulses, chicken, etc, in moderation.
Don't 'eat for two' and overeat when you become pregnant. Too much weight gain will increase your risk of developing problems later in the pregnancy. Also, the extra weight is difficult to lose after the birth. If you are already obese or overweight, ideally you should try to lose some weight before becoming pregnant to reduce the risk of pregnancy complications.
A growing baby needs these nutrients right from the start of the pregnancy.
You should not eat the following if you are pregnant or trying to become pregnant.
liver and liver products such as liver pâté and cod liver oil supplements.
vitamin tablets or supplements which contain vitamin A.
undercooked meats and eggs. For example, this may occur in some pre-cooked meats and pre-prepared meals. Make sure all meat foods are cooked until piping hot. Eggs should be cooked until both the white and yolk are solid.
soft cheeses such as brie. (Hard cheeses and processed cottage cheese are safe.)
pâtés.
shellfish and raw fish.
unpasteurised milk. Note: goat's milk is often unpasteurised, and goat's milk products such as cheeses are often made from unpasteurised milk.
Do not eat shark, marlin, or swordfish.
Limit the amount of tuna that you eat. You should eat no more than two medium sized cans (drained weight = 140 gm per can), or one fresh tuna steak per week. (This would be about six tuna sandwiches, or three tuna salads per week.)
One cup of instant coffee has about 75 mg caffeine
One cup of brewed coffee has about 100 mg caffeine.
One cup of tea has about 50mg caffeine.
One 50g chocolate bar has about 50 mg caffeine.
One can of cola, and half a can of an 'energy' drink has up to 40 mg caffeine.
Avoid contact with sheep and lambs at lambing time. This is because some lambs are born carrying the germs that cause listeriosis, toxoplasmosis, and chlamydia. These may be passed on to you and your unborn baby. See below about cats and kittens.
The effects of some prescribed drugs have been well studied and it is known that certain drugs are safe in pregnancy. For example, paracetamol at normal dose is safe and useful for headaches, backache, and other aches and pains that may occur during pregnancy. However, some drugs are not safe, and may be harmful to a developing baby, particularly if you take them in the early weeks of pregnancy.
Therefore, always tell a doctor or dentist who prescribes you medication that you are pregnant, or intend to become pregnant. Also, don't take drugs that you can buy (including herbal remedies) unless they are known to be safe in pregnancy. The pharmacist will advise.
If you already take regular medication, (for example, for epilepsy), it is important to discuss this with a doctor before becoming pregnant. If you have an unplanned pregnancy, discuss any medication that you take with your doctor as soon as possible.
Read on for info about infections during pregnancy
If you plan to become pregnant for the first time, you should check to see if you are immune to rubella before becoming pregnant. See your practice nurse for a 'pre-pregnancy' blood test. Most women are immune to rubella as they have been immunised as a child. However, childhood immunisation does not work in every child and you may not be immune. If you are not immune, you can be immunised. (But, you should not become pregnant for one month after the injection, and ideally until your immunity has been confirmed by a further blood test.)
The rubella virus causes a mild illness, but can seriously damage an unborn baby, especially in the early stages of growth. So, until you know that you are immune (from the result of the blood test), you should avoid anyone who has rubella, especially in the first 16 weeks of pregnancy.
This germ is commonly found in raw meat, sheep, lambs, and cat faeces. It can sometimes cause serious harm to an unborn baby. To avoid it:
A mother who is infected with hepatitis B has a high risk of passing it on to her new-born baby. If you are at high risk of catching hepatitis B you should be immunised against this virus before becoming pregnant. You are at increased risk and should be immunised if:
Having chickenpox when pregnant can be a nasty illness, and there is some risk to the developing baby. A vaccine is offered to healthcare workers (doctors, nurses, etc) who have not previously had chickenpox and so are not immune and may catch chickenpox. (About 1 in 10 adults have not had chickenpox as a child.) Therefore, non-immune healthcare workers should consider having this vaccination before getting pregnant. If you are not sure if you have had chickenpox, a blood test can check if you have previously had it.
Read on for info about work and pregnancy
If you think that your occupation may pose a risk to a pregnancy, then ideally you should discuss this with your employer before becoming pregnant. For example, if you work with chemicals, fumes, solvents, etc, which may pose a risk, or if you work with animals such as cats or sheep which may be carrying germs (see above).
You and your employer may wish to download information guides from the Health and Safety Executive website at www.hse.gov.uk.
Women with certain medical conditions may benefit from other advice before becoming pregnant. See your doctor if you have concerns about a medical condition which may affect pregnancy. For example:
Most pregnancies go well and without any major problems. But it is wise to reduce any risks as much as possible. So, a reminder of things to consider before becoming pregnant, or as soon as you realise that you are pregnant.....
Take folic acid tablets before you get pregnant until 12 weeks of pregnancy.
Check if you are immune against rubella.
Eat a healthy diet. Include foods rich in iron, calcium and folic acid.
Wash your hands after handling raw meat, or handling cats and kittens.
Wear gloves when you are gardening.
Too much vitamin A - don't eat liver or liver products, or take vitamin A tablets.
Listeriosis - don't eat undercooked meat or eggs, soft cheese, pâté, shellfish, raw fish, or unpasteurised milk.
Fish which may contain a lot of mercury - shark, marlin, swordfish, or excess tuna.
Sheep, lambs, cat faeces, cat litters, and raw meat which may carry certain infections.
Peanuts - if you have a personal or family history of eczema, hay fever, or asthma.
Caffeine in tea, coffee, cola, etc, - have no more than 300 mg per day. This is in about three cups of brewed coffee, or four cups of instant coffee, or six cups of tea.
Alcohol - have no more than 1-2 drinks, once or twice a week.
Smoking - you are strongly advised to stop completely.
Street drugs - you are strongly advised to stop completely.
Immunisation against hepatitis B if you are at increased risk of getting this infection.
Immunisation against chickenpox if you are a healthcare worker and have not previously had chickenpox and so are not immune.
Your medication - including herbal and 'over the counter' medicines.
Your work environment - is it safe?
Medical conditions in yourself, or conditions which run in your family.
© EMIS and PIP 2006 Updated: October 2006 PRODIGY Validated
A recent study claims that drinking caffeine when you're pregnant can double the risk of miscarriage. But with lots of 'do's' and 'don't's' during pregnancy what advice should you follow?
When you are pregnant, or trying to become pregnant, you should limit the amount of caffeine to no more than 300 mg per day. That is about the amount of caffeine in six cups of tea, or four cups of instant coffee.
Most of us will take in some caffeine on most days. Caffeine is a substance that:
A small amount of caffeine is fine. However, if you have a lot of caffeine it increases your risk of having a baby with low birth weight, and increases your risk of having a miscarriage. The increased risk is small. But, it is best to play safe. The Food Standards Agency recommends that you do not have more than 300 mg caffeine in any one day if you are pregnant, or if you are trying to become pregnant.
As a rough guide:
So, you do not have to stop your favourite drinks, but you may need to limit their amount. For example, you will reach the 300 mg limit for one day if you:
Read on for info about smoking and pregnancy
Where next?
- Pregnancy myths busted
- What to eat during your pregnancy?
- Food and drinks to avoid when you're pregnant
If you smoke and you are pregnant or planning to become pregnant, you are strongly advised to stop smoking. This is to benefit your health, and the health of your baby. Seek help from your practice nurse or GP if you find it difficult to stop smoking.
Tobacco smoke contains poisonous chemicals which pass into the baby's blood. Smoking when you are pregnant increases the risk of:
Even after the birth, children of smoking parents have an increased risk of developing chest infections, asthma, 'glue ear', and sudden infant death syndrome (cot death).
Of course, there are many other risks with smoking such as the increased risk of developing chest and heart disorders.
You and your baby will get most benefit, and the risks will be most reduced, if you stop before you become pregnant. Planning to become pregnant is a good incentive to stop smoking for many women who smoke, and is often a good time to persuade partners to stop too. However, your baby will still gain some benefit if you stop at any point during pregnancy.
Read on for top tips on how to stop smoking
For many people it is not easy to stop. Below are some tips, which may help.
This can help if withdrawal symptoms are troublesome. Nicotine gum, sprays, patches, tablets, lozenges, and inhalaters are available to buy, and on prescription. Using one of these roughly doubles your chance of stopping smoking if you really want to stop. A pharmacist, GP, or practice nurse can advise about NRT.
Stop smoking medicines such as Zyban and Champix may also help you to cope with cravings. They are only available on prescription and should be taken 1-2 weeks before you start to quit. They are not available if you are pregnant.
If you are committed to stopping smoking, but are finding it difficult, you may be helped by a counsellor who is trained to help people to stop smoking. There are over 150 local NHS Stop Smoking Services around England which offer one-to-one or group support sessions and advice from trained experts. Ask your GP, practice nurse or midwife for more details and find your nearest local NHS Stop Smoking Service online.
NHS Pregnancy Smoking Helpline - Tel: 0800 169 9 169 This is a confidential support service. A specially trained person will answer your call who will listen to your needs, suggest different ways of giving up smoking and can send you a free information pack. Ask them to tell you about your nearest local NHS Stop Smoking Service.
Go Smokefree website - http://www.nhs.uk/gosmokefree. An online resource run by the NHS for all the advice, information and support you need to stop smoking and stay stopped. Includes a section about smoking in pregnancy.
Quit - A charity that helps people to stop smoking. Quitline: 0800 00 22 00 Web: www.quit.org.uk.
Read on for info about pregnancy and rubella
© EMIS and PIP 2006 Updated: June 2006 PRODIGY Validated
Rubella (German measles) is usually a mild illness. However, if you are pregnant and catch rubella, it can cause serious damage to your unborn child. Before your first pregnancy you should have a blood test to check if you are immune to rubella. If you are not immune, you can be immunised before becoming pregnant.
Rubella is an infection caused by the rubella virus. It occurs most commonly in young children, but can affect anyone. The illness is usually mild, though during pregnancy it can cause serious damage to your unborn child. This is called 'Congenital Rubella Syndrome'. Children born with this condition usually have severe brain damage and other problems.
If you are infected with rubella in the first 10 weeks of pregnancy you have about a 9 in 10 chance that your baby will develop congenital rubella syndrome. If rubella is caught later in pregnancy, the risk to the baby declines. Damage to the baby is rare if you are infected with rubella later than 16 weeks of pregnancy.
You should have a blood test before you become pregnant. The blood test checks for antibodies in your blood to show that you are immune to rubella.
Most children in the UK are immunised against rubella as part of the routine childhood immunisation programme. However, in a small number of children who are immunised (about 1 in 50), the immunisation does not work well. In these children, when they become adults, their body does not have enough antibodies to protect against rubella.
The only way to check whether you are immune is to have the blood test.
This blood test may be offered in routine 'well women checks' given to younger women who have not yet become pregnant. If you have not had a test, your practice nurse can arrange for this to be done.
In particular, women who have come to the UK from overseas may not have been immunised and are then at risk of having a baby with congenital rubella syndrome.
If the blood test shows that you are not immune, you should be immunised.
One of the routine blood tests which is taken in early pregnancy checks for rubella antibodies.
In most women the test is positive for antibodies, which means that you are immune.
If your test is negative (no antibodies), you are at risk if you come in contact with rubella. You should keep away from people who might have rubella. Once your baby is born, you should be immunised to protect against rubella in future pregnancies.
www.sense.org.uk/rememberrubella/index.cfm Information about rubella, congenital rubella syndrome, and immunisation against rubella.
© EMIS and PIP 2004 Updated: July 2004 Review Date: August 2005 CHIQ Accredited PRODIGY Validated