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Nine Months of Eating Well:

Not surprisingly, a lot goes into making a baby. Happily for babies and the parents who love them, nature’s incredibly good at what it does. Which means that the chances that your baby will be born not only perfectly cute, but perfectly healthy, are already excellent. What’s more, there’s something you can do to help make those excellent chances even better—while helping yourself to a healthier and more comfortable pregnancy. It’s something that’s relatively easy to do (except maybe when you’re feeling queasy)—and something that you probably already do at least three times a day. Yes, you guessed it: eating. But the challenge during pregnancy isn’t just to eat (though that may be challenge enough during those early months)—it’s to eat as well as you can. Think of it this way. Eating well when you’re expecting is one of the first and best gifts you can give to your soon-to-arrive bundle of joy—and it’s a gift that can keep on giving, handing out not just a healthier start in life but a healthier lifetime.

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The Pregnancy Diet is an eating plan dedicated to baby’s good health—and yours. What’s in it for your baby? Among many other impressive benefits, a better chance for a bouncing birth weight, improved brain development, reduced risk for certain birth defects—and as a bonus, believe it or not, better eating habits as baby grows to be a potentially picky preschooler (a perk you’ll really appreciate when broccoli’s on the dinner menu). It may even make it more likely that your child will grow to be a healthier adult.

And your baby’s not the only one who’s likely to benefit. The Pregnancy Diet can also increase the chances that you’ll have a safe pregnancy (some complications, such as anemia, gestational diabetes, and preeclampsia, are less common among women who eat well); a comfortable pregnancy (a sensibly selected diet can minimize morning sickness, fatigue, constipation, and a host of other pregnancy symptoms); a balanced emotional state (good nutrition can help moderate those crazy mood swings). a timely labor and delivery (in general, women who eat regularly and well are less likely to deliver too early); and a speedier postpartum recovery (a well-nourished body can bounce back faster and more easily, and weight that’s been gained at a sensible rate can be shed more quickly). For more on the many benefits of a healthy diet during pregnancy, see What to Expect: Eating Well When You’re Expecting.

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Luckily, scoring those benefits is a piece of (carrot) cake, especially if you’re already eating pretty well, and even if you’re not (you’ll just have to be a little more selective before bringing fork to mouth). That’s because the Pregnancy Diet isn’t all that different from the average healthy diet. While a few modifications have been made for the pregnant set (not surprisingly, baby making requires more calories and more of certain nutrients), the foundation is the same: a good, balanced mix of lean protein and calcium, whole grains, a rainbow of fruits and vegetables, and healthy fats. Sound familiar? It should—after all, it’s what sensible folks in the nutrition field have been touting for years.

And here’s some more good news. Even if you’re coming to your pregnancy (and bellying up to the table) with less than ideal eating habits, changing them to follow the Pregnancy Diet won’t be that tough, especially if you’re committed to making the changes. There are healthy alternatives for almost every less healthy food and beverage you’ve ever brought to your lips, which means there are nourishing ways to have your cake (and cookies and chips and even fast food) and eat it, too. Plus, there are countless ways to sneak crucial vitamins and minerals into recipes and favorite dishes—which means that you can eat well when you’re expecting without your taste buds being the wiser.

                                               Have It Your Way

Have your doubts about diets? Not a fan of eating plans? Just don’t like being told what to eat—or how much? No problem. The Pregnancy Diet is one way to feed yourself and your baby well, but it definitely isn’t the only way. A balanced, healthy diet—one that includes plenty of protein, whole grains, and fruits and vegetables, plus about 300 extra calories a day—will get the job done, too. So if you’d rather not keep track—don’t. Eat well, your way!

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There is a very important point to keep in mind as you embark on making a diet change for the better: What’s presented in this chapter is the ideal, the best possible plan for eating well when you’re expecting. Something you should strive for, certainly, but nothing you should stress over (especially early in pregnancy, when your appetite for healthy foods may face a smorgasbord of suppressive symptoms—from nausea to food aversions). Maybe you’ll choose to follow the diet closely, at least most of the time. Or you’ll follow it loosely, all of the time. But even if your allegiance remains to burgers and fries, you’ll still pick up in the pages that follow at least a few pointers that will help nourish you and your baby better during the next nine months (salad with that burger?).

Your Pregnancy Lifestyle:

OF COURSE, YOU’RE EXPECTING TO make some adjustments in your everyday life now that you’re expecting (good-bye baby-tees, hello. baby-on-board tees). But you might also be wondering just how drastically your lifestyle will have to change now that you’re living for two. How about that predinner cocktail—will it have to wait until postdelivery? Those regular dips in the hot tub at the gym—are those washed up, too? Can you wipe your bathroom sink with that smelly (but effective) disinfectant? And what’s that you heard about cat litter? Does being pregnant really mean you have to think twice about all those things you’ve never given a second thought to—from letting your best friend smoke in your living room to zapping your dinner in the microwave. In a few cases, you’ll find, the answer is an emphatic yes (as in “no wine for me, thanks”). But in many others, your expectant self will be able to continue doing business—and pleasure—as usual, with maybe just a side of caution (“Honey, it’s your turn to change the cat litter—for the next nine months!”).

What You May Be Wondering About:

Sports and Exercise

“Can I keep up with my regular exercise program now that I’m pregnant?”

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In most cases, pregnancy doesn’t mean giving up the sporting life; just remember that while you’re carrying a new life, moderation makes sense. Most practitioners not only permit but encourageexpectant moms whose pregnancies are progressing normally to continue their accustomed workout routines and athletic pursuits for as long as is practical—but with several caveats. Among the most important: Always check with your practitioner before continuing or beginning an exercise program, and never exercise to the point of fatigue.


“I use coffee to keep me going all day. Do I have to give up caffeine while I’m pregnant?”

No need to surrender your Starbucks card entirely—though you may have to start pulling it out a little less often. Most evidence suggests that drinking up to approximately 200 mg of caffeine a day is safe during pregnancy. Depending on how you take your coffee (black or with lots of milk), that could mean limiting yourself to about two cups (give or take) a day. Which means you’re good to go (and fuel your get-up-and-go) if you’re a light to moderate coffee drinker—but that you’ll have to reassess your intake if you’ve got a more serious java jones (five-shot lattes, twice a day, come to mind?)

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Why go so low? Well, for one thing, you share those lattes—like everything you eat and drink when you’re expecting—with your baby. Caffeine (found most famously in coffee but also available in other foods and beverages) does cross the placenta—though to what extent (and at what dose) it affects a fetus is not completely clear.And there’s more to the caffeine story. Sure, it has impressive pick-me-up powers, but it also has equally notable diuretic powers, causing calcium and other key pregnancy nutrients to be washed out of your system before they can be thoroughly absorbed. Need more motivation for cutting down? Caffeine’s stimulating effects may exacerbate your mood swings, making them even more volatile and intense than they already are (or than they will be once your hormones rev into action). It can also prevent you from getting the rest your body’s craving more than ever, especially if you drink it after noon. Plus excessive caffeine may interfere with the absorption of the iron both you and your baby need.

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Different practitioners have different recommendations on caffeine consumption, so check in with yours for a bottom line on your favorite brew. When calculating your daily caffeine intake, keep in mind that it’s not necessarily as easy as counting cups. Caffeine isn’t just found in coffee—it’s also in caffeinated soft drinks (too many Mountain Dews will have to be a Mountain Don’t), coffee ice cream, tea, energy bars and drinks, and chocolate (though the amount varies from product to product). You’ll need to know, too, that dark brews sold in coffeehouses contain far more caffeine than homemade; likewise, instant coffee contains less than drip does .

Your Pregnancy Profile:

THE TEST RESULTS ARE BACK; the news has (sort of) sunk in: You’re having a baby! Excitement is growing (along with that uterus of yours), and so is your list of questions. Many, no doubt, have to do with those wild and crazy symptoms you might already be experiencing (more on those later). But many others may have to do with your personal pregnancy profile. What’s a pregnancy profile? It’s a compilation of your gynecological, general medical, and obstetrical (if you’re not a first timer) histories—in other words, your pregnancy backstory. You’ll be discussing this backstory (which can actually have a lot of impact on the pregnancy story that’s about to unfold) with your practitioner at your first prenatal visit. In the meantime, this chapter can help you take stock of your pregnancy profile and figure out how it may affect—or may not affect—your nine months of baby making.

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As you read What to Expect When You’re Expecting, you’ll notice many references to traditional family relationships—to “wives,” “husbands,” “spouses.” These references are not meant to exclude expectant mothers (and their families) who may be somewhat “untraditional”—for example, those who are single, who have same-sex partners, or who have chosen not to marry their live-in partners. Rather, these terms are a way of avoiding phrases (for instance, “your husband or significant other”) that are more inclusive but also a mouthful to read. Please mentally edit out any phrase that doesn’t fit and replace it with one that’s right for you and your situation.

Keep in mind that much of this chapter may not apply to you—that’s because of your pregnancy profile (like the baby you’re expecting. is unique. Read what fits your profile and skip what doesn’t.

Your Gynecological History:

Birth Control During Pregnancy

“I got pregnant while using birth control pills. I kept taking them for over a month because I had no idea I was pregnant. Will this affect my baby?”

Ideally, once you stop using oral contraceptives, you’d have at least one normally occurring menstrual cycle before you tried to become pregnant. But conception doesn’t always wait for ideal conditions, and occasionally a woman becomes pregnant while taking the Pill. In spite of warnings you’ve probably read on the package insert, there’s no reason for concern. There’s just no good evidence of an increased risk to a baby when mom has conceived while on oral contraceptives. Need more reassurance. Talk the situation over with your practitioner—you’re sure to find it.

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“I conceived while using a condom with spermicides and kept using spermicides before I knew I was pregnant. Should I be worried about birth defects?”

No need to worry if you got pregnant while using a condom or diaphragm with spermicides, a spermicide-coated condom, or just plain spermicides. The reassuring news is that no known link exists between spermicides and birth defects. In fact, the most recent and most convincing studies have found no increase in the incidence of problems even with the repeated use of spermicides in early pregnancy. So relax and enjoy your pregnancy, even if it did come a little unexpectedly.

“I’ve been using an IUD as birth control and just discovered that I’m pregnant. Will I be able to have a healthy pregnancy?”

Getting pregnant while using birth control is always a little unsettling (wasn’t that why you were using birth control in the first place?), but it definitely happens. The odds of its happening with an IUD are pretty low—about 1 in 1,000, depending on the type of device used, how long it’s been in place, and whether or not it has been properly inserted.



Are You Pregnant?

MAYBE YOUR PERIOD’S JUST A day overdue. Or maybe it’s going on three weeks late. Or maybe your period isn’t even slated to arrive yet, but you’ve got a gut feeling (literally, in your gut) that something’s cooking—like a brand-new bun in your oven. Maybe the only heads-up your body’s given you so far is that missed period. Or maybe you’ve already developed every conceivable symptom of conception. Maybe you’ve been giving baby making everything you’ve got for six months or longer. Or maybe that hot night two weeks ago was your very first contraceptive-free encounter. Or maybe you haven’t been actively trying at all. No matter what the circumstances are that have brought you to this book, you’re bound to be wondering: Am I pregnant? Well, read on to find out.

What You May Be Wondering About:

Early Pregnancy Signs

“A friend of mine said she knew she was pregnant even before she took a pregnancy test. Is there any way to figure out whether or not I’m pregnant that early on?”

Tender breasts and nipples. You know that tender, achy feeling you get in your breasts before your period arrives? That’s nothing compared to the breast tenderness you might be feeling postconception. Tender, full, swollen, tingly, sensitive, and even painful-to-the-touch breasts are some of the first signs many (but not all) women notice after sperm meets egg. Such tenderness can begin as early as a few days after conception (though it often doesn’t kick in until weeks later), and as your pregnancy progresses, it could get even more pronounced. Make that a lot more pronounced.

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Darkening areolas. Not only might your breasts be tender, but your areolas (the circles around your nipples) may be changing colors. It’s perfectly normal for the areola to darken in hue during pregnancy and even to increase in diameter somewhat in the weeks after conception. You can thank the pregnancy hormones already surging through your body for these and other skin color changes (much more about those hormones in the coming months).

Goose bumps? Well, not really, but early in pregnancy you may notice an increase and enlargement in the tiny bumps on the areola (called Montgomery’s tubercles)—bumps you may have never noticed before. They’ll resemble goose bumps but are actually glands that produce oils to lubricate your nipples and areolas—lubrication that’ll certainly be welcome when your baby starts sucking on your nipples if you’re nursing. Another sign your body is planning ahead.

Fatigue. Extreme fatigue. Make that exhaustion. Complete lack of energy. Super sluggishness. Whatever you call it, it’s a drag—literally. And as your body starts cranking up that baby-making machine, it’ll only get more draining.

Before You Conceive:

SO YOU’VE MADE THE DECISION TO start a family (or to grow that family you’ve already started). That’s a great—and exciting—first step. But before sperm meets egg to create the baby of your dreams, take this preconception opportunity to prepare for the healthiest pregnancy—and baby—possible. The next steps outlined in this chapter will help you (and dad-to-be) get into tip-top baby-making shape, give you a leg up on conception, and get you to the pregnancy starting gate with all systems go.

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If you don’t get pregnant right away, relax and keep trying (and don’t forget to keep having fun while you’re trying!). If you’re already pregnant—and didn’t have a chance to follow these steps before you conceived—not to worry. Conception often sneaks up on a couple, cutting out that preconception period altogether and making those preconception pointers pointless. If your pregnancy test has already given you the good news, simply start this book at Chapter 2, and make the very best of every day of pregnancy you have ahead of you.Ready to board that cute little passenger on the mother ship? Here are some preconception steps you can take to make sure that ship is in shape.
Get a preconception checkup. You don’t have to choose a prenatal practitioner yet (though this is a great time to do so; see facing page), but it would be a good idea to see your regular gynecologist or internist for a thorough physical. An exam will pick up any medical problems that need to be corrected beforehand or that will need to be monitored during pregnancy. Plus, your doctor will be able to steer you away from medications that are pregnancy (or preconception) no-no’s, make sure your immunizations are up to date, and talk to you about your weight, your diet, your drinking and other lifestyle habits, and similar preconception issues.

Start looking for a prenatal practitioner. It’s easier to start looking for an obstetrician or midwife now, when the pregnancy meter’s not already running, than when that first prenatal checkup is hanging over your head. If you’re going to stick with your regular ob-gyn, then you’ve got a head start. Otherwise, ask around, scout around, and take your time in picking the practitioner who’s right for you. Then schedule an interview and a prepregnancy exam.
your mouth—and your mouth can possibly affect your future pregnancy. Pregnancy hormones can actually aggravate gum and tooth problems, making a mess of a mouth that’s not well taken care of to begin with. What’s more, research shows that gum disease may be associated with some pregnancy complications. So before you get busy making a baby, get busy getting your mouth into shape. Be sure, too, to have any necessary work, including X-rays, fillings, and dental surgery, completed now so that it won’t have to be done during pregnancy.

Check your family.It’s especially important to find out if there’s a history of any medical issues and genetic or chromosomal disorders such as Down syndrome, Tay-Sachs disease, sickle cell anemia, thalassemia, hemophilia, cystic fibrosis, muscular dystrophy, or fragile X syndrome.
Take a look at your pregnancy history. If you’ve had a previous pregnancy with any complications or one that ended with a premature delivery or late pregnancy loss, or if you’ve had multiple miscarriages, talk to your practitioner about any measures that can be taken to head off a repeat.

Putting It All Together:
Does looking at this list of to-do’s make you realize there’s a lot to do even before sperm meets egg? Having a hard time knowing where to start? For a list of questions to ask when choosing a prenatal practitioner, a complete personal medical and obstetrical health history, a family health history chart, and plenty of other helpful information to help you get organized for your baby-making journey, see The What to Expect Pregnancy Journal and Organizer.

About Dr.Alex Johnson

Making just a few changes in your lifestyle can help you live longer. A recent study found that four bad behaviors—smoking, drinking too much alcohol, not exercising, and not eating enough fruits and veggies

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