Eating Right When Pregnant

Eating Right When Pregnant

Good nutrition during pregnancy, and enough of it, is very important for your baby to grow and develop. You should consume about 300 more calories per day than you did before you became pregnant.
Although nausea and vomiting during the first few months of pregnancy can make this difficult, try to eat a well-balanced diet and take prenatal vitamins. Here are some recommendations to keep you and your baby healthy.

Goals for Healthy Eating When Pregnant

• Eat a variety of foods to get all the nutrients you need. Recommended daily servings include 6-11 servings of breads and grains, two to four servings of fruit, four or more servings of vegetables, four servings of dairy products, and three servings of protein sources (meat, poultry, fish, eggs or nuts). Use fats and sweets sparingly.
• Choose foods high in fiber that are enriched such as whole-grain breads, cereals, pasta, rice, fruits, and vegetables.
• Make sure you are getting enough vitamins and minerals in your daily diet while pregnant. You should take a prenatal vitamin supplement to make sure you are consistently getting enough vitamins and minerals every day. Your doctor can recommend an over-the-counter brand or prescribe a prenatal vitamin for you.
• Eat and drink at least four servings of dairy products and calcium-rich foods a day to help ensure that you are getting 1000-1300 mg of calcium in your daily diet during pregnancy.
• Eat at least three servings of iron-rich foods per day to ensure you are getting 27 mg of iron daily.
• Choose at least one good source of vitamin C every day, such as oranges, grapefruits, strawberries, honeydew, papaya, broccoli, cauliflower, Brussel sprouts, green peppers, tomatoes, and mustard greens. Pregnant women need 70 mg of vitamin C a day.
• Choose at least one good source of folic acid every day, like dark green leafy vegetables, veal, and legumes (lima beans, black beans, black-eyed peas and chickpeas). Every pregnant woman needs at least 0.4 mg of folic acid per day to help prevent neural tube defects such as spina bifida.
• Choose at least one source of vitamin A every other day. Sources of vitamin A include carrots, pumpkins, sweet potatoes, spinach, water squash, turnip greens, beet greens, apricots, and cantaloupe.

• Foods to Avoid When Pregnant

• Avoid alcohol during pregnancy. Alcohol has been linked to premature delivery, mental retardation, birth defects, and low birth weight babies.
• Limit caffeine to no more than 300 mg per day. The caffeine content in various drinks depends on the beans or leaves used and how it was prepared. An 8-ounce cup of coffee has about 150 mg of caffeine on average while black tea has typically about 80 mg. A 12-ounce glass of caffeinated soda contains anywhere from 30-60 mg of caffeine. Remember, chocolate contains caffeine -- the amount of caffeine in a chocolate bar is equal to 1/4 cup of coffee.
• The use of saccharin is strongly discouraged during pregnancy because it can cross the placenta and may remain in fetal tissues. But, the use of other non-nutritive or artificial sweeteners approved by the FDA is acceptable during pregnancy. These FDA-approved sweeteners include aspartame (Equal or NutraSweet), acesulfame-K (Sunett), and sucralose (Splenda). These sweeteners are considered safe in moderation so talk with your health care provider about how much non-nutritive sweetener is acceptable during pregnancy.
• Decrease the total amount of fat you eat to 30% or less of your total daily calories. For a person eating 2000 calories a day, this would be 65 grams of fat or less per day.
• Limit cholesterol intake to 300 mg or less per day.
• Do not eat shark, swordfish, king mackerel, or tilefish (also called white snapper), because they contain high levels of mercury.
• Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese. These cheeses are often unpasteurized and may cause Listeria infection. There’s no need to avoid hard cheese, processed cheese, cream cheese, cottage cheese, or yogurt. 
• Avoid raw fish, especially shellfish like oysters and clams.

What to Eat When Pregnant and Don't Feel Well

During pregnancy you may have morning sickness, diarrhea, or constipation. You may find it hard to keep foods down, or you may feel too sick to even eat at all. Here are some suggestions:

• Morning Sickness: Eat crackers, cereal, or pretzels before getting out of bed; eat small, frequent meals throughout the day; avoid fatty, fried, and greasy foods.
• Constipation: Eat more fresh fruit and vegetables. Also drink 6 to 8 glasses of water a day.
• Diarrhea: Eat more foods that contain pectin and gums (two types of dietary fiber) to help absorb excess water. Examples of these foods are applesauce, bananas, white rice, oatmeal, and refined wheat bread.
• Heartburn: Eat small, frequent meals throughout the day; try drinking milk before eating; and limit caffeinated foods and beverages, citric beverages, and spicy foods.

Can I Diet While Pregnant?

No. Do not diet or try to lose weight during pregnancy -- both you and your baby need the proper nutrients in order to be healthy. Keep in mind that you will lose some weight the first week your baby is born.

Can I Eat a "Low Carb" Diet When Pregnant?

Low carbohydrate diets, such as Atkins and the South Beach Diet, are very popular. There have been no studies of the effects of a low carbohydrate diet on pregnancy, so its effect on the fetus, if any, are unknown. While you are pregnant, you should eat a balanced diet from all of the food groups.

Can I Maintain My Vegetarian Diet When Pregnant?

Just because you are pregnant doesn't mean you have to diverge from your vegetarian diet. Your baby can receive all the nutrition he or she needs to grow and develop while you follow a vegetarian diet if you make sure you eat a wide variety of healthy foods that provide enough protein and calories for you and your baby.
Depending on the type of vegetarian meal plan you follow, you may need to adjust your eating habits to ensure that you and your baby are receiving adequate nutrition (you should consume about 300 more calories than you did before you became pregnant).

Why Do I Need More Calcium When Pregnant?

Calcium is a nutrient needed in the body to build strong teeth and bones. Calcium also allows blood to clot normally, muscles and nerves to function properly, and the heart to beat normally. Most of the calcium in your body is found inside your bones.
Your growing baby needs a considerable amount of calcium to develop. If you do not consume enough calcium to sustain the needs of your developing baby, your body will take calcium from your bones, decreasing your bone mass and putting you at risk for osteoporosis. Osteoporosis causes dramatic thinning of the bone, resulting in weak, brittle bones that can easily be broken.
Pregnancy is a critical time for a woman to consume more calcium. Even if no problems develop during pregnancy, an inadequate supply of calcium at this time can diminish bone strength and increase your risk for osteoporosis later in life.
The following guidelines will help ensure that you are consuming enough calcium throughout your pregnancy:

• The U.S. Recommended Daily Allowance (USRDA) for calcium is 1000 mg per day for pregnant and breastfeeding women over age 18. The USRDA for teenage girls up to age 18 is 1300 mg of calcium per day.
• Eating and drinking at least four servings of dairy products and calcium-rich foods a day will help ensure that you are getting the appropriate amount of calcium in your daily diet.
• The best sources of calcium are dairy products including milk, cheese, yogurt, cream soups, and pudding. Calcium is also found in foods including green vegetables (broccoli, spinach, and greens), seafood, dried peas, and beans.
• Vitamin D will help your body use calcium. Adequate amounts of vitamin D can be obtained through exposure to the sun and in fortified milk, eggs, and fish.

How Can I Get Enough Calcium If I'm Lactose Intolerant?

Lactose intolerance is the inability to digest lactose, the sugar found in milk. If you are lactose intolerant, you may have cramping, gas, or diarrhea when dairy products are consumed.
If you are lactose intolerant, you can still receive the calcium you need. Here are some suggestions:

• Try consuming small amounts of milk with meals. Milk may be better tolerated with food.
• You may be able to tolerate certain milk products that contain less sugar including cheese, yogurt, and cottage cheese.
• Eat non-dairy calcium sources including greens, broccoli, sardines, and tofu.
• Use Lactaid Milk fortified with calcium. Talk to your dietitian about other lactose-reduced products.

Should I Take a Calcium Supplement During Pregnancy?

If you have trouble consuming enough calcium-rich foods in your daily meal plan, talk to your doctor or dietitian about taking a calcium supplement. The amount of calcium you will need from a supplement depends on how much calcium you are consuming through food sources.
Calcium supplements and some antacids containing calcium, such as Tums, may complement an already healthy diet. Many multiple vitamin supplements contain little or no calcium; therefore, you will need an additional calcium supplement.

Why Do I Need More Iron During Pregnancy?

Iron is a mineral that makes up an important part of hemoglobin, the substance in blood that carries oxygen throughout the body. Iron also carries oxygen in muscles, helping them function properly. Iron helps increase your resistance to stress and disease.
The body absorbs iron more efficiently during pregnancy; therefore it is important to consume more iron while you are pregnant to ensure that you and your baby are getting enough oxygen. Iron will also help you avoid symptoms of tiredness, weakness, irritability, and depression.
Following a balanced diet and including foods high in iron can help ensure that you are consuming enough iron throughout your pregnancy. In addition, the following guidelines will help:

• The U.S. RDA for iron is 27 mg per day for pregnant women and 15 mg for breastfeeding women.
• Eating at least three servings of iron-rich foods a day will help ensure that you are getting 30 mg of iron in your daily diet. One of the best ways to get iron from your diet is to consume a highly fortified breakfast cereal such as Total, which has 18 mg of iron. Note that iron intake is not equal to iron absorption. Absorption of iron into the body is greatest with meat sources of iron such as liver.
• The best sources of iron include enriched grain products, lean meat, poultry, fish, and leafy green vegetables.

What Are Good Sources of Iron?

• Meat and Seafood: Lean beef, chicken, clams, crab, egg yolk, fish, lamb, liver, oysters, pork, sardines, shrimp, turkey, and veal.
• Vegetables: Black-eyed peas, broccoli, Brussel sprouts, collard and turnip greens, lima beans, sweet potatoes, and spinach.
• Legumes: Dry beans and peas, lentils, and soybeans.
• Fruits: All berries, apricots, dried fruits, including prunes, raisins and apricots, grapes, grapefruit, oranges, plums, prune juice, and watermelon.
• Breads and Cereals: Enriched rice and pasta, soft pretzel, and whole grain and enriched or fortified breads and cereals.
• Other Foods: Molasses, peanuts, pine nuts, pumpkin, or squash seeds.

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Getting Pregnant: Easy Ways to Encourage Fertility

For some couples, getting pregnant is quick and easy. For others, things are not as easy.
Sometimes, problems are linked to such specific physiological issues as blocked fallopian tubes in the woman or low to no sperm count in the man -- problems that can be addressed by a fertility specialist and subsequent treatments like in vitro fertilization (IVF) or insemination.
For many others, however, reasons behind their infertility are much harder to define.
"Often, problems are subclinical -- meaning we know something is wrong, it's just not showing up on the radar," says Staci Pollack, MD, a reproductive endocrinologist at the Montefiore Medical Center's Institute of Reproductive Medicine and Health.
Pollack says standard fertility treatments can usually help, but in some cases, so can a host of other, less costly techniques -- some of which couples can try on their own.
The key to success: Knowing when to try -- and when it's time for more serious medical treatment. The good news: Doctors say both options can be clearly mapped out with the help of a medical fertility workup. Designed to rule out specific causes that require medical care, test results can also help you decide if any of these low-tech treatments are worth a try.
And what if you aren't anticipating a problem but just want to give your fertility a boost? Some of these low-tech methods can work for you as well. Just keep in mind that the American Society for Reproductive Medicine says if you don't get pregnant after 12 months of regular unprotected intercourse -- or six months if you are a woman over 35 -- it's time to seek help from a fertility specialist.

Fertility Booster No. 1: Eat Healthfully

Among the most common causes of unexplained infertility in women is "ovulatory dysfunction" -- an

Fertility Booster No. 2: Weight Control

Whether or not you eat the so-called "fertility foods," maintaining a healthy weight is another way to enhance your fertility.
Studies show that having either a very low or very high BMI (body mass index) disrupts ovulation and may also affect production of important reproductive hormones.
"One of the first things I counsel women about is the role of their weight in influencing their fertility," says Janet Choi, MD, a reproductive endocrinologist at the Columbia Presbyterian Medical Center in New York City.
For many women -- particularly those who are overweight -- problems are traced to ovulatory dysfunction, often caused by PCOS. That said, a recent Dutch study of some 3,000 women found excess weight could also interfere with fertility even if a woman is ovulating normally.
Reporting in the journal Human Reproduction, researchers documented a 4% decrease in conception odds for every point in BMI above 30. For women whose BMI was higher than 35, there was up to a 43% overall decrease in the ability to conceive.
The good news: Losing those extra pounds may preclude the need for pricey fertility treatments.
In fact, the British Fertility Society in 2007 issued new guidelines urging members to defer fertility treatments in very obese women (BMI over 35) until they gave weight loss a try.
At the same time, being too thin can also keep you from conceiving. "Women who are extremely lean often have a problem getting pregnant because they are not able to sustain a regular menstrual cycle -- for these women, it is more beneficial to gain weight," Chavarro says.

Fertility Booster No. 3: Reduce Stress

Although links between stress and infertility have been long debated, evidence continues to mount that the two are intertwined.
In studies conducted by Alice Domar, PhD, at Harvard's Mind-Body Institute, women who underwent stress reduction therapy saw dramatic increases in their ability to get pregnant. In fact, even women who were already undergoing fertility treatments had more successful outcomes when stress was kept under control.
More recently, research conducted at Magee Women's Hospital in Pittsburgh by Sarah Burga, MD, linked stress to a condition known as functional hypothalamic amenorrhea (FHA). Affecting some 5% of women in their reproductive years, it causes irregular or absent menstrual cycles.
Choi says, "I don't advocate quitting your job just to get rid of stress, but if you can try to get better day-to-day management of your anxieties, I believe it can work in conjunction with other methods to encourage fertility."
What can you do to reduce fertility-related stresses? Experts say anything that makes you feel relaxed can help -- be it listening to music, doing yoga, getting regular massages, writing in a journal, reading, gardening -- even chatting on the phone with friends.
You can also think outside the box for some unique ways to reduce stress. One recent study published in the journal Psychological Science found the simple act of holding hands with your spouse can drop stress levels dramatically. Or you might try renting a stack of romantic comedy videos.
If you're tempted to handle your stress by smoking or drinking alcohol, experts say don't. Numerous studies have shown that smoking contributes to both male and female infertility and can even impair the outcome of fertility treatments. Excessive alcohol consumption can impair ovulation in women and sperm production in men.

umbrella term encompassing problems with ovulation.
Though a number of factors can be responsible, many doctors now believe diet is one of the keys. In a study of some 17,000 women conducted by the Harvard School of Public Health, researchers were able to define a group of "fertility foods" able to improve conception odds.
Which dietary tenets were significant for increasing fertility?

• Eating more monounsaturated fats (like olive oil) and less trans fats (like the kind found in many baked goods or fast foods).
• Increasing intake of vegetable protein (like soy), while reducing animal protein (like red meat).
• Eating more high fiber, low-glycemic foods -- like whole grains, vegetables, and some fruits, while reducing the intake of refined carbohydrates and sugars.
• Consuming moderate amounts of high-fat dairy products -- like ice cream, whole milk, and cheese.

Jorge Chavarro, MD, a study researcher, believes diet made a difference because the majority of women experiencing ovulatory dysfunction were also suffering from undiagnosed or subclinical PCOS (polycystic ovary syndrome), a condition related to insulin resistance that also affects ovulation.
"It responds well to diet, so that could be one of the reasons these foods were so helpful," says Chavarro, who translated his medical study findings into a book called The Fertility Diet.
Pollack believes it's worth giving the diet a try but says, "You should not depend on it alone -- make it just one part of your overall efforts to conceive."

Fertility Booster No. 4: Acupuncture

Studies linking acupuncture to conception have by and large been conducted on women undergoing fertility treatments. Still, many experts are quick to point out that this ancient Chinese medical art may also work to help encourage fertility overall -- even for those couples trying to conceive naturally.
"I sometimes recommend acupuncture, in conjunction with stress reduction activities such as yoga, to help encourage pregnancy," Pollack says.
"I wouldn't advise a couple to rely only on acupuncture, or to try it without first getting a fertility workup, but if everything checks out OK, acupuncture can be helpful," she says.

Fertility Booster No. 5: Ovulation

While being intimate during the "right time of the month" won't do anything to increase your fertility, it can increase your chances of getting pregnant -- simply by ensuring you and your partner connect during the time conception is possible.
Timing is crucial, says Pollack, because "an egg only lives for 24 to 36 hours." But sperm can live in the lower portion of a woman's reproductive tract a lot longer -- often up to five days. So to increase your chances of conceiving you should be intimate with your partner beginning three to four days prior to ovulation, and continuing up to 24 hours after ovulation.
But how do you know when you're about to ovulate? Experts say there are several methods you can use to approximate.

1. Chart your basal body temperature (BBT): Your BBT, which is the lowest temperature your body reaches during the day, is affected by the hormones that influence ovulation. Just prior to egg release, your BBT drops about a half degree and then rises again after you ovulate. So by carefully monitoring and keeping track of your daily temperature for one or two months, Pollack says you will notice a pattern take shape. If you have intercourse during the days when your temperature drops, then there is a good chance you will be within your fertility window.
2. Chart your cervical mucus: Corresponding to changes in body temperature are changes in cervical mucus. Just prior to ovulation, the mucus will seem more copious, thinner, and clearer than on other days. You might even be able to pull it apart so that it looks somewhat like rubber cement -- a phenomenon known as "spinbarket." By checking your cervical mucus daily and coordinating its consistency with your BBT, you can further nail down your most fertile time.
3. Use an ovulation predictor kit (OPK): These over-the-counter kits, costing from $20 to $75 a month, check for the hormonal changes found in urine prior to ovulation. Some use a color-sensitive dipstick while newer OPKs have digital readouts that may be easier to interpret. OPKs can alert you to ovulation up to two days in advance. Once the OPK is positive, Pollack says, you would "have intercourse that day and every day for three days to help increase your chances of conception." Another device that may predict fertility is the "ferning" microscope, which can be used to detect changes in saliva that precede ovulation. However, experts say this approach may not be as reliable as an OPK.
4. Buy a fertility monitor: At $200 to $400, they are not cheap. But a fertility monitor can indicate as many as six or seven fertile days each cycle. That can give you a clearer sense of your fertility window and potentially increase your odds of conceiving. Try a wristwatch fertility predictor, which detects chemical changes on the skin that indicate ovulation. These fertility watches help women identify the four days prior to ovulation.

Fertility Booster No. 6: Conception Kits and Other Tests

A kit that helps predict ovulation may tell you when it's the best time to have intercourse, but most did little else to foster fertility -- until now.
A new kit developed by Conceivex not only offers ovulation prediction, but it also contains a small latex-free cervical cap to actually help you conceive. The idea here is to concentrate an ejaculate into the cap and insert it into a woman's body directly at the opening of the cervix. In a kind of do-it-yourself mini-insemination, it does away with the need for sperm to swim through a sometimes chemically "hostile" vaginal canal, placing them instead right at the palace gates.
Shari Brasner, MD, who has recommended the kit to patients, says it's most useful for women with previous cervical issues or for men with low sperm volume or performance anxiety.
"Short of diagnosing a cervical infection, we don't really have a test for cervical factor infertility -- and it is my belief that this could be the problem for many women with a past history of treatment for an abnormal Pap smear," Brasner says.
Though she says Conceivex won't repair any defects, it is a way around them. "It's also an important aid for men with sperm concentration problems," she says.
Although Conceivex requires a prescription, it can be purchased online after completing a questionnaire reviewed by their medical doctors. The cost is $300.
A second new kit is called Fertell. While the female version is simply an ovulation predictor kit, the male version is an at-home test able to measure sperm motility -- the ability of sperm to reach a woman's fallopian tubes. It sells for $99 and does not require a prescription. Other do-it-yourself sperm motility tests are available.
"There is no harm in trying these kits, or any of the other methods to encourage fertility. But if you don't get pregnant within the suggested time frame, then don't wait -- see a fertility specialist," Pollack says.

Your Pre-Pregnancy Checkup

Caring for your health before you become pregnant is good for you and your baby.
It's called preconception care. The goal is to check for any potential risks to you and your baby during pregnancy -- and to address any medical issues you may have before you get pregnant.
It's about becoming your healthiest self -- physically and emotionally -- before you take that next step into pregnancy.
You can get started by making a preconception counseling appointment with your health care provider. Here's what to expect.

What Happens at a Preconception Doctor's Appointment?

A preconception appointment is the perfect time to ask your doctor all the things that are on your mind -- whether it's your diet, prenatal vitamins, or any health concerns that run in your family.  
During a preconception office visit, you and your doctor will discuss your:

• Reproductive history:  This includes any previous pregnancies, your menstrual history, contraceptive use,  previous Pap test results, and any  sexually transmitted diseases  or vaginal infections you've had in the past.
• Medical history:  This includes any health problems you have now, so you can get those under control before you get pregnant.
• Surgical history:  Have you had any surgeries, transfusions, and hospitalizations? If so, tell your doctor.  
• Current medications:  Tell your doctor about any prescription or over-the-counter medications you are taking or have taken. In some cases, it may be time to make a change to help prevent birth defects. Also tell your doctor about any herbal medicines or supplements you take.
• Family health history:   Tell your doctor about any medical conditions that run in your family. They may also want to know if you or your partner have twins in the family.
• Home and workplace environment:  You'll talk about possible hazards -- such as exposure to cat feces, X-rays, and lead or solvents -- that could affect your ability to become pregnant or maintain a healthy pregnancy.
• Your weight:  It's a good idea to  reach your ideal body weight before you get pregnant. This means losing weight if you are overweight to reduce your risk of high blood pressure complications during pregnancy; or gaining weight if you are underweight to reduce the risk of delivering a low birth-weight baby.
• Lifestyle factors:  Your doctor will ask you questions about you and your partner's habits that could influence your pregnancy, such as smoking, drinking alcohol, and using recreational drugs. The goal is to help you stop any habits that could stand in the way of a healthy pregnancy. Your doctor will keep it confidential, so feel free to be open.
• Exercise:  Tell your doctor what type of exercise you do -- and if you don't work out, tell them that, too. Generally, you may continue your normal exercise routine while pregnant unless you are instructed to decrease or modify your activities.
• Diet :  Your doctor will ask you about what you eat and drink. It's ideal to go into pregnancy with good dietary habits already in place. That includes eating a variety of foods rich in fiber, and getting enough calcium, folic acid, and other nutrients.
• Caffeine:  Before you get pregnant, your doctor may recommend limiting caffeine to no more than 300 milligrams (mg) per day. That's about the amount in two 8-ounce cups of coffee. Remember, caffeine isn't just in coffee and tea -- it's also in chocolate, some soft drinks, and certain medications.
• Prenatal vitamins :  Before you're pregnant, you should be taking  a folic acid supplement. Folic acid makes it less likely that your baby will have a neural tube defect, and it's best to start taking it before you conceive. Your doctor will likely recommend taking 400 micrograms (mcg) of folic acid daily before conception and in early pregnancy.

Your doctor may also:

• Do a physical exam  to evaluate your heart, lungs, breasts, thyroid, and abdomen. A pelvic exam and Pap smear may also be performed.
• Order lab tests :  Some of the conditions screened for include rubella, hepatitis, HIV, syphilis, and others as indicated.
• Discuss how to chart menstrual cycles  to help detect ovulation and determine the time when you are most likely to get pregnant.
• Check on your vaccinations. If you are not protected against rubella or chickenpox, your doctor may recommend the appropriate vaccines and delaying attempts to conceive for at least one month.
• Discuss genetic counseling:  Genetic counseling can help you understand your chance of having a child with a birth defect. It may be advised for older mothers and people with a family history of genetic problems, birth defects, or mental retardation.

Pregnancy Symptoms

Do All Women Get Early Symptoms of Pregnancy?

Every woman is different. So are her experiences of pregnancy. Not every woman has the same symptoms or even the same symptoms from one pregnancy to the next.
Also, because the early symptoms of pregnancy are often like what happens right before and during menstruation , those symptoms aren't always recognized.
What follows is a description of some of the most common early symptoms of pregnancy. You should know that these symptoms may be caused by other things besides being pregnant. So the fact that you notice some of these symptoms does not necessarily mean you are pregnant. The only way to tell for sure is with a pregnancy test.

Spotting and Cramping

A few days after conception, the fertilized egg attaches itself to wall of the uterus. This can cause one of the earliest signs of pregnancy -- spotting and, sometimes, cramping.
That's called implantation bleeding. It occurs anywhere from six to 12 days after the egg is fertilized.
The cramps resemble menstrual cramps, so some women mistake them and the bleeding for the start of their period. The bleeding and cramps, however, are slight.
Besides bleeding, a woman  may notice a white, milky discharge from her vagina. That's related to the thickening of the vagina's walls, which starts almost immediately after conception. The increased growth of cells lining the vagina causes the discharge.
This discharge, which can continue throughout pregnancy, is typically harmless and doesn't require treatment. But if there is a bad smell related to the discharge or a burning and itching sensation, tell your doctor so they can check on whether you have a yeast or bacterial infection.

Breast Changes

Breast changes are another very early sign of pregnancy. A woman's hormone levels rapidly change after conception. Because of the changes, her breasts may become swollen, sore, or tingly a week or two later. Or they may feel heavier or fuller or feel tender to the touch. The area around the nipples, called the areola, may also darken.
Other things could cause breast changes. But if the changes are an early symptom of pregnancy, keep in mind that it is going to take several weeks to get used to the new levels of hormones. But when it does, breast pain should ease up.

Fatigue

Feeling very tired is normal in pregnancy, starting early on.
A woman can start feeling unusually  fatigued as soon as one week after conceiving.
Why? It's often related to a high level of a hormone called progesterone, although other things -- such as lower levels of blood sugar, lower blood pressure, and a boost in blood production -- can all contribute.
If fatigue is related to pregnancy, it's important to get plenty of rest. Eating foods that are rich in protein and iron can help offset it.

Nausea (Morning Sickness)

Morning sickness is a famous symptom of pregnancy. But not every pregnant woman gets it.
Here's why it happens. A pregnant woman's hormone levels can slow the emptying of her stomach. That contributes to nausea, often called morning sickness, though it can happen at any time during the day.
Also, some women crave, or can't stand, certain foods when they become pregnant. That's also related to hormonal changes. The effect can be so strong that even the thought of what used to be a favorite food can turn a pregnant woman's stomach.
It's possible that the nausea, cravings, and food aversions can last for the entire pregnancy. Fortunately, the symptoms lessen for many women at about the 13th or 14th week of their pregnancy.
In the meantime, be sure to eat a healthy diet so that you and your developing baby get essential nutrients. You can talk to your doctor for advice on that.

Missed Period

The most obvious early symptom of pregnancy -- and the one that prompts most women to get a pregnancy test -- is a missed period. But not all missed or delayed periods are caused by pregnancy.
Also, women can experience some bleeding during pregnancy. If you are pregnant, ask your doctor what you should be aware of with bleeding. For example, when is bleeding normal and when is it a sign of an emergency?
There are reasons, besides pregnancy, for missing a period. it might be that you gained or lost too much weight. Hormonal problems, fatigue, or stress are other possibilities. Some women miss their period when they stop taking birth control pills. But if a period is late and pregnancy is a possibility, you may want to get a pregnancy test.

Other Early Symptoms of Pregnancy

Pregnancy brings changes in your hormonal balance. And that can cause other symptoms..

• Frequent urination. For many women, this starts around the sixth or eighth week after conception. Although this could be caused by a urinary tract infection, diabetes, or overusing diuretics, if you're pregnant, it's most likely due to hormonal levels.
• Constipation. During pregnancy, higher levels of the hormone progesterone can make you constipated. Progesterone causes food to pass more slowly through your intestines.  To ease the problem, drink plenty of water, exercise, and eat plenty of high-fiber foods.
• Mood swings. These are common, especially during the first trimester. These are also related to changes in hormones.
• Headaches and back pain. Many pregnant women report frequent mild headaches, and others experience chronic back pain.
• Dizziness  and fainting. These may be related to dilating blood vessels, lower blood pressure, and lower blood sugar.

A pregnant woman could have all of these symptoms, or maybe have only one or two. If any of these symptoms become bothersome, talk with your doctor about them so you can make a plan to offset them.

Pregnancy Brain: Myth or Reality?

You may have heard about little bouts of forgetfulness during pregnancy. It's sometimes called momnesia or sometimes "pregnancy brain." At least one Australian study has cast doubt on whether there is such a thing as pregnancy brain.
But what if it's real? What can you do about it while you're pregnant?

Pregnancy Brain Is Real, but...

Pregnancy does not change a woman's brain even though some women don't feel as sharp as usual when they're pregnant.
Helen Christensen, PhD, of The Australian National University, says, "If you read pregnancy manuals and listen to pregnant mothers -- yes, there is such a thing as pregnancy brain or momnesia. And there is also evidence from research showing deficits in memory."
But, she adds, "the evidence from our study shows that the capacity of the brain is unaltered in pregnancy."

What Causes “Momnesia?”

It’s 100% normal to have memory lapses or be forgetful when you’re busy, stressed, or short on sleep, Christenson says.
Jane Martin, MD, director of the Neuropsychological Testing and Evaluation Center at New York's Mount Sinai Medical Center, agrees. "When you are not getting enough sleep and are multitasking, nobody's memory is good," she says. "You are not cognitively sharp when you haven't slept well."
Surging hormone levels and new priorities may help explain why pregnancy brain happens.
"There is 15 to 40 times more progesterone and estrogen marinating the brain during pregnancy," Louann Brizendine, MD, director of the Women's Mood and Hormone Clinic at the University of California, San Francisco, says. "And these hormones affect all kinds of neurons in the brain. By the time the woman delivers, there are huge surges of oxytocin that cause the uterus to contract and the body to produce milk -- and they also affect the brain circuits."
Pregnancy also shuffles what gets your attention. Your IQ doesn't change, but your priorities do.
"You only have so many shelves in your brain, so the top three are filled with baby stuff," Brizendine says.
Hormones may also affect spatial memory -- which includes remembering where things are -- in pregnant women and new moms, a British study shows.

What Pregnancy Brain Feels Like

Pregnancy brain is "the feeling of walking into a room, going after something, and not remembering what you went for about five to 10 times a day," Brizendine says.
There may also be an evolutionary aspect to it. Women’s health expert Donnica Moore, MD, says, "It has been postulated that, from an evolutionary standpoint, this memory impairment may be helpful so that women will forget about other stuff and focus on caring for the child."
Many pregnant women and new moms spend a lot of time thinking about the changes that having a baby will bring or taking care of their newborn. As a result, their short-term memory may suffer.

How to Help Your Memory

Moore says if you feel you're not as sharp as usual, that should be "your first tip-off that, when you are preparing to have a baby, you need to simplify other areas of your life because life is about to get a lot more complicated."
After the baby arrives, sleep deprivation is clearly a contributing factor. Brizendine says, "Women accumulate up to 700 hours of sleep debt in the first year after having a baby, and that causes the brain not to be at its best for things other than caring for the baby."
So what can you do?
Write things down. Ob-gyn Geeta Sharma, MD, of New York-Presbyterian Hospital/Weill Cornell Medical Center, says, "Most patients comment, 'I have to write my questions down or I will forget,' and then mention that they are more forgetful in general."
Jotting things down, whether on a grocery list or a list of questions to ask your obstetrician, helps. "Make lists, use a day planner, and keep your sense of humor," Moore says.
Get more sleep. This may be tricky for new parents. But it can make a real difference. "Most moms need more deep sleep, and within a week of getting better sleep, some of this momnesia stuff goes away," Brizendine says.
"If your memory problems are getting in the way of taking safety precautions or if you find yourself doing things like forgetting to put your child in the car seat, worry," Brizendine says. "Otherwise, it's normal."

Gain Weight Safely During Your Pregnancy

Eating a healthy, balanced diet will help your baby get the nutrients he or she needs and grow at a healthy rate. But how many extra calories do you really need?
Though you do need some extra calories, it's not necessary to ''eat for two.'' The average pregnant woman needs only about 300 healthy calories more a day than she did before she was pregnant. This will help her gain the right amount of weight during pregnancy.
Ask your health care provider how much weight you should gain. A woman who was average weight before getting pregnant should gain 25 to 35 pounds after becoming pregnant. Underweight women should gain 28 to 40 pounds. And overweight women may need to gain only 15 to 25 pounds during pregnancy.
In general, you should gain about 2 to 4 pounds during the first three months you're pregnant and 1 pound a week during the rest of your pregnancy. If you are expecting twins you should gain 35 to 45 pounds during your pregnancy. This would be an average of 1 ½ pounds per week after the usual weight gain in the first three months.
It's especially important to gain the right amount of weight when you're expecting twins because your weight affects the babies' weight. And because twins are often born before the due date, a higher birth weight is important for their health. When carrying twins, you may need between 3,000 and 3,500 calories a day.

Where Does the Extra Weight Go During Pregnancy?

• Baby: 8 pounds
• Placenta: 2-3 pounds
• Amniotic fluid: 2-3 pounds
• Breast tissue: 2-3 pounds
• Blood supply: 4 pounds
• Stored fat for delivery and breastfeeding: 5-9 pounds
• Larger uterus: 2-5 pounds
• Total: 25-35 pounds

Is It Safe to Lose Weight When Pregnant?

If a woman is very overweight when she gets pregnant, her doctor may want her to lose weight. She should only lose weight under her doctor's care. But in most cases, women should not try to lose weight or diet during pregnancy.

How to Gain the Right Amount of Weight During Pregnancy

If your health care provider wants you to gain weight while you're pregnant, try these tips:

• Eat five to six small meals every day.
• Keep quick, easy snacks on hand, such as nuts, raisins, cheese and crackers, dried fruit, and ice cream or yogurt.
• Spread peanut butter on toast, crackers, apples, bananas, or celery. One tablespoon of creamy peanut butter gives you about 100 calories and 7 grams of protein.
• Add nonfat powdered milk to mashed potatoes, scrambled eggs, and hot cereal.
• Add extras to your meal, such as butter or margarine, cream cheese, gravy, sour cream, and cheese.

What if You Gain Too Much Weight During Pregnancy?

 If you have gained more weight than your doctor recommended, talk to your doctor about it. In most cases, you'll want to wait until after delivery to lose weight.
Here are some tips to slow your weight gain:

• When eating fast food, choose lower-fat items such as broiled chicken breast sandwich with tomato and lettuce (no sauce or mayonnaise), side salad with low-fat dressing, plain bagels, or a plain baked potato. Avoid foods such as French fries, mozzarella sticks, or breaded chicken patties.
• Avoid whole milk products. You need at least four servings of milk products every day. However, using skim, 1%, or 2% milk will greatly reduce the amount of calories and fat you eat. Also, choose low-fat or fat-free cheese or yogurt.
• Limit sweet or sugary drinks. Sweetened drinks such as soft drinks, fruit punch, fruit drinks, iced tea, lemonade, or powdered drink mixes have lots of empty calories. Choose water, club soda, or mineral water to skip extra calories.
• Don't add salt to foods when cooking. Salt causes you to retain water.
• Limit sweets and high-calorie snacks. Cookies, candies, donuts, cakes, syrup, honey, and potato chips have a lot of calories and little nutrition. Try not to eat these foods every day. Instead, try fresh fruit, low-fat yogurt, angel food cake with strawberries, or pretzels as lower-calorie snack and dessert choices.
• Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream, and cream cheese. Try lower-fat alternatives.
• Cook food the healthy way. Frying foods in oil or butter will add calories and fat. Baking, broiling, grilling, and boiling are healthier preparation methods.
• Exercise. Moderate exercise can help burn excess calories. Walking or swimming is usually safe for pregnant women. Ask your health care provider what exercise would be right for you before getting started.

Your Healthy Pregnancy Diet: Top Nutrients

Eating a healthy, balanced diet while you're pregnant protects you and your growing baby. Although you should take a prenatal vitamin as insurance, choosing the right foods will help give you the complex mix of nutrients that pregnant women need. Aim for meals high in these important nutrients:

Calcium

Baby Benefits: Builds bones and teeth. (Your growing baby takes the calcium she needs from your body, so to keep your bones and teeth healthy, you need to get enough to replace that amount.)
Your Benefits: Protects your bone density. It may also help prevent high blood pressure while you're pregnant.
Pregnancy RDA: 1,000 milligrams (mg); don't exceed 2,500 mg
Best Food Sources:

• Yogurt, plain, low-fat, 1 cup -- 415 mg
• Yogurt, low-fat fruit flavored, 1 cup -- 345 mg
• Milk, plain or flavored, 1 cup -- about 300 mg
• Orange juice, calcium-added, 1 cup -- 300 mg
• Cheddar cheese, 1 oz -- 204 mg
• Tofu, firm, prepared with calcium sulfate and magnesium chloride, 1/4 block -- 163 mg
• Cottage cheese, 2% milk fat, 1 cup  -- 156 mg

Choline

Baby Benefits: Helps prevent problems in the spinal cord and brain, called neural tube defects, and enhances brain development.
Your Benefits: Builds strong bones and may help prevent high blood pressure.
Pregnancy RDA: 450 mg; don't exceed 3,500 mg
Best Food Sources: 

• Egg, 1 cooked -- 272 mg
• Pork tenderloin, 3 oz cooked -- 103 mg
• Atlantic cod, 3 oz cooked --  84 mg
• Ground beef, 3 oz cooked -- 83 mg
• Salmon, 3 oz cooked -- 65 mg
• Chicken, 3 oz cooked -- 65 mg
• Broccoli or cauliflower, 1 1/4 cup cooked -- 40 mg

Docosahexaenoic Acid (DHA)

DHA is one of the omega-3 fatty acids.
Baby Benefits: Helps boost brain development and vision.
Your Benefits: May reduce your risk of heart disease in the future.
Pregnancy RDA: 300 mg
Best Food Sources:

• Coho salmon, farmed, 3 oz cooked -- 740 mg
• Blue crab, 3 oz cooked -- 196 mg
• Canned light tuna, drained, 3 oz -- 190 mg
• Catfish, 3 oz cooked -- 116 mg
• Fortified eggs -- 85 mg to 200 mg

Folic Acid

Baby Benefits: Helps protect against spinal cord birth defects during the first 30 days of pregnancy, helps prevent early miscarriage and premature delivery.
Your Benefits: Prevents anemia.
Pregnancy RDA: 600 micrograms (mcg)
Best Food Sources

• Lentils, 1 cup cooked -- 358 mcg
• Spinach, 1 cup cooked -- 263 mcg
• White enriched rice, 1 cup cooked -- 195 mcg
• Enriched spaghetti, 1 cup cooked -- 172 mcg
• Broccoli, 1 cup cooked -- 168 mcg
• Orange juice, 1 cup -- 110 mcg
• Enriched bread, 2 slices -- 34 mcg

Iron

Baby Benefits: Helps prevent premature delivery.
Your Benefits: Wards off anemia in pregnant women.
Pregnancy RDA: 27 mg; don't exceed 45 mg
Best Food Sources

• Whole Grain Total Cereal, 3/4 cup -- 22 mg
• Cheerios, 1 cup -- 10 mg
• Enriched rice, 1 cup cooked -- 8 mg
• Canned white beans, 1 cup -- 8 mg
• Beef, 3 oz cooked -- 3 mg
• Lamb, 3 oz cooked -- 2 mg
• White meat chicken, 3 oz. cooked -- 1 mg

Your Benefits: Helps keep blood pressure in check and maintain proper fluid balance; necessary for normal heart beat and energy.
Pregnancy RDA: 4,700 mg
Best Food Sources: 

• White beans, 1 cup canned -- 1,189 mg
• Winter squash, 1 cup -- 896 mg
• Spinach, 1 cup cooked -- 839 mg
• Lentils, 1 cup cooked -- 731 mg
• Sweet potato, 1 medium cooked -- 694 mg
• Yogurt, fat-free, 1 cup -- 579 mg
• Orange juice, 1 cup -- 496 mg
• Broccoli, 1 cup cooked -- 457 mg
• Cantaloupe, 1 cup -- 431 mg
• Raisins, 1 cup -- 250 mg

Riboflavin

Your Benefits: Needed to produce energy; helps your body use the protein from food.
Pregnancy RDA: 1.4 mg
Best Food Sources: 

• Raisin bran cereal, 1 cup -- 1.7 mg
• Yogurt, plain, 1 cup -- 0.5 mg
• Mushrooms, 1 cup cooked -- 0.5 mg
• 1% milk, 1 cup -- 0.5 mg
• Frosted Mini Wheats cereal, 1 cup -- 0.5 mg
• Cottage cheese, low-fat, 1 cup -- 0.4 mg

Vitamin B6

Your Benefits: Helps produce protein for new cells, boosts the immune system, and helps form red blood cells.
Pregnancy RDA: 1.9 mg
Best Food Sources: 

• Product 19 cereal, 1 cup -- 2 mg
• Garbanzo beans, canned, 1 cup -- 1.1 mg
• Baked potato with flesh and skin, 1 medium -- 0.6 mg
• Beef, top sirloin, 3 oz cooked -- 0.5 mg
• Chicken breast, 3 oz cooked -- 0.5 mg
• Pork tenderloin, 3 oz cooked -- 0.4 mg
• Halibut, 3 oz cooked -- 0.3 mg

Vitamin B12

Your Benefits: Helps produce red blood cells and helps your body use fat and carbohydrates for energy.
Pregnancy RDA: 2.6 mcg
Best Food Sources: 

• Salmon, 3 oz cooked -- 5 mcg
• Rainbow trout, 3 oz cooked -- 4 mcg
• Light tuna, canned and drained, 3 oz -- 3 mcg
• Beef, 3 oz cooked -- 2 mcg
• Wheat Chex cereal, 1 cup -- 1 mcg

Vitamin C

Your Benefits: Makes it easier for your body to absorb iron from plant foods; builds strong bones and teeth; boosts immunity; keeps blood vessels strong and red blood cells healthy.
Pregnancy RDA: 85 mg; do not not exceed 2,000 mg
Best Food Sources: 

• Sweet red pepper, 1 cup raw -- 283 mg
• Orange juice, 1 cup -- 124 mg
• Strawberries, 1 cup -- 106 mg
• Grapefruit juice, 1 cup -- 94 mg
• Broccoli, 1 cup cooked -- 74 mg
• Orange, 1 medium -- 70 mg
• Tomato, 1 medium -- 32 mg

Vitamin D

Baby Benefits: Helps your baby's body use calcium to build bones and teeth.
Your Benefits: Helps your body absorb calcium from food and use it to build your bones and teeth.
Pregnancy RDA: 200 international units (IU); don't exceed 2,000 IU
Best Food Sources: 

• Milk, plain or flavored, 1 cup -- 100 IU
• Fortified orange juice, 1 cup -- 137 IU
• Fortified breakfast cereals, 1 cup -- 40 to 50 IU
• Egg,1 large (vitamin D is in the yolk) -- 18 IU

Baby Benefits: Brain development.
Your Benefits: Necessary to grow and repair cells and produce energy.
Pregnancy RDA: 11 mg; don't exceed 40 mg
Best Food Sources: 

• Cooked oysters, 3 oz -- 76 mg
• Whole Grain Total Cereal, 3/4 cup -- 17 mg
• Beef, 3 oz cooked -- 9 mg
• Crab, 3 oz cooked -- 5 mg
• Pork, 3 oz cooked -- 4 mg
• White beans, 1 cup canned -- 3 mg
• Yogurt, plain, fat-free,1 cup -- 2 mg