Healthy Pregnancy

Having a healthy lifestyle is especially important if you are pregnant, or planning to be pregnant, as your baby will rely on you to provide them with the best start in life.

ANTENATAL APPOINTMENTS

Regular antenatal appointments are important to:

• Keep an eye on how your baby is growing
• Pick up some conditions such as pre-eclampsia and urinary tract infections – these might not have any early symptoms that you would notice but routine blood-pressure checks and urine tests can pick up on them, even if you feel fine
• Check the health of your baby through blood tests and ultrasound scans

If you can't go to an antenatal appointment, let your midwife or the hospital know so you can make another one.

HEALTHY EATING

Eating a healthy, nutritious diet is especially important if you're pregnant, or planning a pregnancy. Your baby relies on you to provide the right balance of nutrients to help them grow and develop properly (even after they're born). You don't need to spend lots of money or go on a special diet – you just need a balance of the right types of food. These include:

• Fruit and vegetables - aiming to eat at least 5 portions of fruit and veg a day.
• Starchy foods (carbohydrates) - these types of food are an important source of energy, certain vitamins and fibre.
• Protein - provides the building blocks for your baby to grow. Eggs produced under the British Lion Code of Practice (stamped with the red lion) are considered very low risk for salmonella and safe for pregnant women to eat.
• Dairy products - these contain calcium and other essential nutrients.

Eating for two is a myth. Being pregnant, you'll obviously be more hungry than usual but even if you are expecting twins or more, you don't need to eat extra portions. In the final 3 months of your pregnancy, you'll need an extra 200 calories a day – that's the same as 2 slices of wholemeal toast and margarine.

Foods to avoid during pregnancy include:

• Soft cheeses with white rinds such as brie and camembert. This includes mould-ripened soft goats' cheese, such as chèvre. These cheeses are only safe to eat in pregnancy if they've been cooked.
• Soft blue cheeses such as danish blue, gorgonzola and Roquefort. Soft blue cheeses are only safe to eat in pregnancy if they've been cooked.
• Eggs that are not Lion Code (have a logo stamped on their shell showing a red lion) unless they are thoroughly cooked until the whites and yolks are solid to prevent the risk of salmonella food poisoning.
• Pâté, including vegetable pâtés, as they can contain listeria.
• Raw or undercooked meat including meat joints and steaks cooked rare, because of the potential risk of toxoplasmosis. If you're pregnant, the infection can damage your baby, but it's important to remember toxoplasmosis in pregnancy is very rare.
• Cold cured meats such as salami, prosciutto, chorizo and pepperoni, are not cooked, they're just cured and fermented. This means there's a risk they contain toxoplasmosis-causing parasites.
• Liver or products containing liver, such as liver pâté, liver sausage or haggis, as they may contain a lot of vitamin A. Too much vitamin A can harm your baby.
• Game that has been shot with lead pellets as it may contain higher levels of lead.
• High-dose multivitamin supplements, fish liver oil supplements, or any supplements containing vitamin A.
• Fish to avoid includes shark, swordfish or marlin when you're pregnant or planning to get pregnant. You should also limit the amount of tuna you eat to no more than 2 tuna steaks or 4 medium-sized cans of tuna a week because tuna contains more mercury than other types of fish which could affect your baby's developing nervous system. Avoid having more than 2 portions of oily fish a week, such as salmon, trout, mackerel and herring, as it can contain pollutants like dioxins and polychlorinated biphenyls (PCBs).  Tuna doesn't count as oily fish, so you can eat tuna on top of the maximum amount of 2 portions of oily fish.
• Shellfish needs to be eaten cooked, rather than raw, including mussels, lobster, crab, prawns, scallops and clams, as they can contain harmful bacteria and viruses that can cause food poisoning. Cold pre-cooked prawns are fine.
• Sushi can be eaten raw or lightly cooked as long as any raw wild fish used to make it has been frozen first.
• Milk should be pasteurised, or ultra-heat treated (UHT), which is sometimes called long-life milk. Don't drink unpasteurised goats' or sheep's milk, or eat foods made from them, such as soft goats' cheese.
• High levels of caffeine can result in babies having a low birthweight, which can increase the risk of health problems in later life. Too much caffeine can also cause miscarriage. Caffeine is naturally found in lots of foods, such as coffee, tea and chocolate, and is added to some soft drinks and energy drinks. Green tea can contain the same amount of caffeine as regular tea. Some cold and flu remedies also contain caffeine. Talk to your midwife, doctor or pharmacist before taking these remedies. You don't need to cut out caffeine completely, but don't have more than 200mg a day. One mug of instant coffee contains 100mg, one mug of filter coffee contains 140mg, one mug of tea contains 75mg and one can of cola contains 40mg.
• Herbal remedy liquorice root should be avoided.

EXERCISE DURING PREGNANCY

Gentle exercise during pregnancy is good (and safe) for you and your baby. Not only does it help you maintain a healthy weight, it also helps prepare your body for labour. If you are used to doing regular exercise, keep it up, but do what feels comfortable for your body and don’t push yourself too much - exercise doesn’t have to be strenuous to be beneficial.

If you’re not used to exercising, or haven’t done any for a while, now is a good time to start. Try starting off with 10 minutes of daily activity - perhaps take a brisk walk or go for a swim. You can then build up to 150 minutes of weekly exercise.

Remember, whatever your fitness level, it’s important that you listen to your body and do what feels right for you. Always warm up and cool down. As a general guideline, you should be able to hold a conversation while exercising. If you can’t, you need to slow down.

Types of exercise that are good for pregnant women include – walking, running (if you are experienced at running), swimming, prenatal yoga, aerobic classes created for pregnant women and pelvic floor and abdominal exercises.

Types of exercise you should avoid include anything that risks your bump being hit, such as martial arts, rugby and football, scuba diving, exercising at high altitudes and exercises that involve you lying on your back for longer than a few minutes (particularly after 16 weeks).

VITAMINS AND SUPPLEMENTS IN PREGNANCY

You'll get most of the vitamins and minerals you need by eating a healthy, varied diet. But when you're pregnant you also need to take a folic acid supplement. It's recommended you take a daily vitamin D supplement too – especially in the winter months (October - March) when you don't get enough from the sunlight.

It's best to start taking folic acid as soon as you start trying for a baby, or as soon as you find out you're pregnant. You'll need 400 micrograms (mcg) every day until the end of your first trimester (12 weeks).

Whether you are pregnant, or breastfeeding, you should consider taking a daily vitamin D supplement containing 10mcg.

ALCOHOL DURING PREGNANCY

It’s safer not to drink any alcohol if you’re pregnant, or planning to become pregnant, because it can damage your growing baby. By not drinking, you are protecting your baby and minimising the risks to their development and future health.

Alcohol passes from your blood into the baby’s placenta. Your baby can’t process alcohol like you can, and too much can be extremely harmful to their development. If you carry on drinking, especially in the first 3 months of pregnancy, the risk of miscarriage, premature birth and low birth weight are increased.

Sometimes drinking in pregnancy can cause a serious condition called foetal alcohol syndrome. When the baby can’t process the amount of alcohol being consumed, it can affect their development in the womb, including their brain, spinal cord and other parts of the body. This can result in miscarriage, and if the baby survives, they may be left with lifelong problems such as poor growth, facial abnormalities, learning and behavioural problems.

Remember - the more you drink, the greater the risk.

SMOKING

Stopping smoking can be hard, but if you’re pregnant, this is the time to quit. When you smoke, carbon monoxide and thousands of other harmful toxins travel from your lungs, into your bloodstream, through your placenta and into your baby's body. When this happens, your baby struggles for oxygen. This lack of oxygen can affect your baby's development.  If your partner or anyone else around you smokes, this can be harmful to your baby too.

When you give up, the harmful gases (like carbon monoxide) and other chemicals will soon clear from your body. Reasons to stop smoking include:

• You're doing the best for your baby
• Your chances of having a miscarriage or still birth are reduced
• Your baby is less likely to be born early (premature) or underweight
• You'll minimise the risk of cot death (SIDS)
• You will be helping your baby in later life – there is an increase in asthma and other serious illnesses in children of mothers who smoked during pregnancy

Talk to your GP, midwife or pharmacist for help and advice.

SLEEPING IN PREGNANCY

Depending on how you normally like to snooze, you might have to rethink your favourite position while you're pregnant.

If you sleep on your back, it's safe to continue during the first trimester, but as your bump gets bigger and heavier you'll need to sleep on your side, so it's best to get into the habit as soon as you can.

By the third trimester (after 28 weeks of pregnancy), sleeping on your side is the safest position for your baby as it helps prevent the risk of stillbirth. Don't worry, if your pregnancy is uncomplicated your risk of stillbirth is low (1 in 200 babies are stillborn) and going to sleep on your side will make it even lower.

It's OK if you end up in all sorts of positions when you are asleep. The important thing to remember is to fall asleep on your side, as this means you are sleeping safely for your baby. If you wake up on your back, don't be alarmed, just turn onto your side and go back to sleep.

Try sleeping on one side with your knees bent, it'll help reduce the amount of pressure on your uterus and help you breathe better. Plus, this position can help relieve backache. You can use pillows under your belly, between your legs, and behind your back if you like.

You should go to sleep on your side whenever you have a snooze, including:

• going to sleep at night
• getting back to sleep, after waking up at night
• daytime naps

It’s normal to feel tired or have strange dreams during pregnancy. Have a chat to your midwife if you’re struggling to sleep.