How can I stay focused while pregnant?
Self-care for expectant mothers is a matter of great importance to secure their overall wellbeing. The said self-care is much more than pampering pregnant moms with food or spa sessions. If you are pregnant, do take note of the following things you could do to ensure a smooth pregnancy journey.
1. Maintain a balanced diet
A balanced diet is crucial in order to accommodate for a growing foetus and encourage healthy gestational weight gain (GWG). Ensure that your nutritional needs are met by eating good food for your daily dose of energy, protein, vitamins and minerals. Taking enough roughage helps to alleviate constipation. Include some healthy fats such as cheese, nuts or olive oil to complete your diet.
Your energy intake requirements are not increased significantly within the first trimester. However, you should receive an additional 280-470 kcal per day from your second trimester onwards.1 Contrary to popular belief, pregnant mothers should not “eat for two” in order to receive enough energy and nutrients; a developing baby is smaller than a full-grown adult, so they do not require as much food.2
In addition, pregnant mothers should cut down on intake of sweet or fatty foods to avoid excessive weight gain or gestational diabetes. This also ensures that you do not fill up on non-nutritive foods, so you get the best diet for you and your developing baby.
2. Determine how much weight to gain
The amount of fat on a pregnant woman’s body determines the child’s size and health. Besides, your body will need this fat reserve as energy source during labour and lactating.3 Thus, you will need to gain sufficient weight according to your body mass index (BMI) at the time of conception.4 You should aim to gain between 11.5-16 kg if you fall within the normal BMI range (18.5-24.9 kg/m2). The amount of weight to gain is higher for underweight women (12.5-18 kg) and lower for overweight or obese women (7-11.5 kg or 5-9 kg, respectively).4 If you are carrying twins, your recommended GWG varies from singleton pregnancies. Women with normal BMI should gain between 17-25 kg, whereas overweight and obese women gain between 14-23 kg and 11-19 kg at term, respectively.4
Excessive weight gain during pregnancy is associated with many problems for both mother and child.5 Proper GWG reduces risk of caesarean delivery, preeclampsia, large for gestational age (LGA) births5,6 LGA births may lead to complications such as prolonged labour and perineal tearing during delivery.7
3. Drink plenty of water
You should drink at least 8 glasses of fluids each day to prevent constipation, haemorrhoids and urinary tract infections.8 Proper hydration is also important to maintain a healthy amniotic fluid volume as well as to ease swelling during pregnancy.9,10 A good way to keep track is to sip regularly throughout the day so that the urine is clear or pale yellow in colour.3
It is best to avoid caffeine and sugar in your drinks during pregnancy. Excess caffeine aggravates dehydration; sugar causes weight gain and may lead to diabetes. The best option for you to stay hydrated is water.3
If you find it challenging or boring to drink plain water all day, here are some tips to introduce variety to your daily drink:
- Try infusing water with fruits (e.g. citruses or berries) or herbs (e.g. mint) for subtle flavour. You could also mix up your favourite combinations for more variety.
- Switch to sparkling water.
4. Smart snacking
Keep a stock of healthy snacks such as cut fruits, unsweetened yogurt or dark chocolate in the fridge to satisfy your appetite. Whole grain crackers and unsalted nuts can fill you up between mealtimes. Make sure to choose healthy foods and snack in moderate portions.
You should also find ways to switch unhealthy foods for better alternatives for guilt-free snacking. If you crave for pizza, for example, you could substitute it by toasting whole-grain bread topped with some cheese, tomato sauce, mushrooms and bell pepper.3
5. Take small meals
As your pregnancy progresses, your developing baby will grow in size and push against your stomach and intestines, which may make it uncomfortable during mealtimes. To manage this issue, you could break your meals into smaller portions to eat throughout the day. This would help to make mealtimes more comfortable, prevent feelings of hunger and maintain a constant blood sugar level.3
6. Don’t skip prenatal supplement
Prenatal supplements are all the more important for mothers who have dietary restrictions (e.g. vegetarians/vegans), eating disorders or are having twins.11 Given the multitude of options available today, you should consult your doctor before taking any prenatal supplements to ensure it is best suited for your needs.
7. Exercise regularly
Regular physical activity of around 30 minutes per day helps to keep your body b and fit, your body weight in check and prepares you for labour and delivery.3,15 Low-risk exercises safe for mothers-to-be include brisk walking, swimming, yoga or squatting. Take care to avoid risky activities such as tennis (to avoid getting hit), cycling (due to risk of falling) or high-impact exercises (to protect the joints). Do not push yourself too strenuously; you should be able to hold a conversation without becoming breathless while exercising.16
8. Don’t ignore your dental health
It is important to keep your teeth and gums clean during pregnancy. Poor oral hygiene among pregnant mothers lead to increased risk of premature births.17-19 You must brush your teeth well for 2-3 minutes at least twice daily. You should also floss at least once daily.18
In addition, pregnant mothers who experience frequent vomiting or acid reflux have a higher tendency of tooth erosion due to exposure to stomach acid. Rinse your mouth with water immediately after vomiting and wait for at least 30 minutes to an hour before brushing your teeth to avoid damaging the softened outer enamel.18,19
Article contributed by Dato’ Dr Siti Zaliha, Consultant Obstetrician & Gynaecologist.
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References:
- Ministry of Health Malaysia (MOH). Recommended nutrient intakes for Malaysia, 2017. Available at http://nutrition.moh.gov.my/wpcontent/uploads/2017/05/FA-Buku-RNI.pdf. Accessed on 2 October 2018.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Health tips for pregnant women. Available at https://www.niddk.nih.gov/health-information/weight-management/healthy-…. Accessed on 2 October 2018.
- Baby Center. 8 things nutritionists wish you'd do during pregnancy. Available at https://www.babycenter.com/pregnancy-food-diary. Accessed on 2 October 2018.
- Rasmussen KM, Yaktine AL, editors. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2010.
- Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database Syst Rev. 2015;(6):CD007145
- Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet. 2006;93(3):269-74.
- Said AS, Manji KP. Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: a case-control study. BMC Pregnancy Childbirth. 2016;16(1):243.
- Healthline. Healthy Diet During Pregnancy. Available at https://www.healthline.com/health/pregnancy/diet-nutrition#vitamins. Accessed on 2 October 2018.
- Kilpatrick SJ, Safford KL. Maternal hydration increases amniotic fluid index in women with normal amniotic fluid. Obstet Gynecol. 1993;81(1):49-52.
- Baby Center. Swelling (natural remedies). Available at https://www.babycentre.co.uk/a549316/swelling-natural-remedies. Accessed on 22 October 2018.
- Baby Center. Prenatal vitamins - why they're so important. Available at https://www.babycenter.com/0_prenatal-vitamins-why-theyre-so-important_…. Accessed on 2 October 2018.
- Milunsky A, Jick H, Jick SS, et al. Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA. 1989;262(20):2847-52.
- Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-43.
- Rajarethnem HT, Bhat KMR, Jc M, Gopalkrishnan SK, Gopalram RBM, Rai KS. Combined supplementation of choline and docosahexaenoic acid during pregnancy enhances neurodevelopment of fetal hippocampus. Neurol Res Int. 2017; 8748706.
- The American College of Obstetricians and Gynecologists. Exercise During Pregnancy. Available at https://www.acog.org/Patients/FAQs/Exercise-During-Pregnancy. Accessed on 2 October 2018.
- Pregnancy, Birth & Baby. Exercising during pregnancy. Available at https://www.pregnancybirthbaby.org.au/exercising-during-pregnancy. Accessed on 2 October 2018.
- Offenbacher S, Boggess KA, Murtha AP, et al. Progressive periodontal disease and risk of very preterm delivery. Obstet Gynecol. 2006;107(1):29-36.
- Dental Health Services Victoria. Advice for pregnant women. Available at https://www.dhsv.org.au/dental-health/general-dental-advice/pregnant-wo…. Accessed on 2 October 2018.
- Better Health Channel. Pregnancy and teeth. Available at https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-…. Accessed on 2 October 2018.
