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Nutritionist’s Advice for a Healthy Pregnancy

Daniela GS
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Nutritionist’s Advice for a Healthy Pregnancy

Pregnant and googling every food under the sun? Making wise food choices may seem trickier in pregnancy. In between aversions and cravings, balancing nutritional needs may sometimes be easier said than done.

Deborah Malkoff-Cohen, Registered Dietitian and Nutritionist shares with Dreaming of Baby insight on pregnancy nutrition, calorie-intake, and the ideal diet for managing gestational diabetes.

Daniela: Good morning and welcome to Dreaming of Baby! We have with us today Deborah Malkoff-Cohen, a Registered Dietitian and Nutritionist with whom we shall be discussing pregnancy nutrition. It’s a pleasure to have you with us today, Deborah, we’re very much looking forward to what you have to share with our readers on this subject! Before we start our discussion, it would be great if you could introduce yourself to our readers.

Deborah Malkoff-Cohen, MS RD CDN CDE: Hi everyone! My name is Deborah and I am a new mom and Registered Dietitian. I started my mommy “journey” a little later in life and chose the IVF route for many different reasons and have a delicious little healthy chunky 9-month-old! I love everything nutrition-related and specialize in maternal and pediatric nutrition. I am also a Certified Diabetes Educator and counsel women with gestational diabetes, Type 1 and Type 2 diabetes to ensure a happy mommy and healthy baby. I also work with families pre-pregnancy to get them ready for what’s about to come. Can’t wait to work together!

How many extra calories do I need in pregnancy? Should I be eating for two?

Daniela: Great, thank you for this introduction Deborah, and congratulations! Before we delve in into the specifics, what does the ideal pregnancy diet look like?

Deborah Malkoff-Cohen, MS RD CDN CDE: The first step is to assess maternal weight to see where we are starting off at and to get an estimate of how much Mom should gain overall. Then discuss Mom’s current diet to see how well-balanced or not it is. There are certain nutrients of concern during pregnancy we want to make sure are being eaten or if not, supplemented to help the baby grow! These include folic acid, iron, calcium, Vitamin D, Omega 3, Choline, Iodine, Fluids, etc… We will also be asking: Is mom Vegan / Vegetarian? Coffee/soda intake? Artificial sugar intake? The least processed the better… Also, in the first trimester, no additional calories are needed. During the 2nd trimester, add 340 calories and in the 3rd, you need 452 extra calories daily. The old saying you are “eating for 2” is not true!

 

Extra calories you need during pregnancy:
1st trimester – 0 calories
2nd trimester – 340 calories
3rd trimester – 452 calories
Deborah Malkoff-Cohen, MS RD CDN CDE

 

Daniela: Great, thank you for this overview! I was actually going to ask about that – many times moms hear about the need to eat for two. The calorie additions you spoke of, do these increase if the mom is expecting multiples?

Deborah Malkoff-Cohen, MS RD CDN CDE: Yes….not in terms of daily calorie needs but in overall weight gain and it’s based on pre-pregnancy weight. The more you weigh before the less you’re expected to gain.

What should I be eating during each trimester?

Daniela: Thank you for clarifying. Looking at the pregnancy as a whole, would you say that there are different nutritional requirements for every trimester?

Deborah Malkoff-Cohen, MS RD CDN CDE: Yes, for example, folic acid is essential pre-pregnancy and for the first trimester to prevent neural tube defects. The organs and bones are developing so calcium/vitamin D are important. During the 2nd trimester, the baby’s brain is growing so omegas are important. Vitamin C helps those supporting structures of the bones like muscles and cartilage. In the third trimester, iron is important in anticipation for birth and to feed the baby’s brain and tissues with oxygen and fiber/water to prevent constipation in mommy!

Daniela: This is a very helpful overview for moms-to-be. It also shows the extent to which nutrition affects pregnancy! Let’s talk a little about cravings – should a mom-to-be succumb to these? Do cravings point to a specific deficiency?

Deborah Malkoff-Cohen, MS RD CDN CDE: I think it depends….and what it is. If it is a pickle every few days ok…as long as you are not retaining too much water. I think cravings are just part of pregnancy, as long as it does not endanger Mom and baby it is ok. No raw fish etc. If Mom is eating or chewing ice or non-food items that could be a sign of Pica which could mean she could be iron deficient.

What is Pica?

Daniela: Can you please elaborate a little on Pica?

Deborah Malkoff-Cohen, MS RD CDN CDE: PICA is craving and eating items that have no nutritional value like ice, clay, paper detergent, hair, paint chips, etc. This can be harmful!

Daniela: So if a mom-to-be gets this strange urge, she should immediately alert her OBGYN?

Deborah Malkoff-Cohen, MS RD CDN CDE: Absolutely, and they should run her iron panel. Remember, your blood volume DOUBLES when you’re pregnant.

Can I eat this when pregnant?

Daniela: Thanks for elaborating on this – Moving on to foods that a mom-to-be should be keeping away from, what does this list include?

Deborah Malkoff-Cohen, MS RD CDN CDE: All meats/eggs should be cooked through… No soft-boiled eggs or medium-rare burgers, no unpasteurized cheese, no sushi, nitrates, cold cuts (unless heated). Stay away from hot bars and salad bars you are not 100% confident in, anything where the temperatures cannot safely stay in the colder than 40- hotter than 140 range. Also, foodborne illnesses, hand washing is essential wherever you eat out, as well as for kitchen staff.

Can I drink coffee when pregnant?

Daniela: You also mentioned coffee earlier on – is this also unsafe during pregnancy?

Deborah Malkoff-Cohen, MS RD CDN CDE: It is. 200mg daily/one cup of coffee is ok. That being said, it’s not the actual coffee, it’s the caffeine. Watch the other sources like dark chocolate, tea, hot chocolate, soda, etc… These are added into the 200mg daily.

How can I manage Gestational Diabetes?

Daniela: Ah – that’s very good to know. So, it’s not just the coffee, it’s anything that has caffeine in it. Moving on to a more specific question: If a mom-to-be has been diagnosed with gestational diabetes, what should her diet look like?

Deborah Malkoff-Cohen, MS RD CDN CDE: Everything can be worked into the diet…it is the portion size. Higher in protein and healthy fats, less carbs. For instance:

Gestational Diabetes – safe meal plan:
Breakfast – 2 eggs/avocado/berries
Lunch – salad/grilled chicken or any protein veggies, or protein in low carb wrap;
Dinner – protein: 1/2 baked potato or 1/2 cup rice, unlimited veggies.
Snacks: apple/nut butter or cheese, nuts. All fruits need to be eaten with a protein to delay sugar spike.

Deborah Malkoff-Cohen, MS RD CDN CDE

Daniela: Less carbs – this relates to the sugars in the carbs?

Deborah Malkoff-Cohen, MS RD CDN CDE: Only portioning out the carbs. I work full-fat ice cream into the lifestyle, but it is 1/2 a cup and no carbs with dinner just protein and veggies. Carbs break down into sugar. Blood glucose needs to be 90 before a meal and less than 120 an hour after.

Daniela: Thanks for clarifying, the insight you have provided us with today will be helpful to many of our readers! On a final note, what would be your one piece of advice that you’d always share with an expectant mom nutrition-wise, also based on your own experience of pregnancy?

Deborah Malkoff-Cohen, MS RD CDN CDE: Especially for the first trimester, I was so nauseous. Eat healthy when you can. Do NOT feel guilty. All I could stomach for 12 weeks were crackers and pasta with cheese. Your body is feeding the baby from your stores, this is why prenatal vitamins and eating well BEFORE you conceive is so important. Enjoy every second, it goes so fast. You are growing a HUMAN. It is the BEST thing ever. I craved the weirdest things, things I never would think to eat before. As long as it is healthy give into it. Listen to your body. And CONGRATULATIONS!

Daniela: Wow, thank you for this Deborah! It’s been a pleasure speaking with you on such an important subject! All the best in your work with other expectant moms!

Deborah Malkoff-Cohen, MS RD CDN CDE: Thank you!

Need help with pregnancy nutrition? Read more from Deborah by clicking here.

Safeguarding Your Relationship Through Infertility

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Safeguarding Your Relationship Through Infertility

The thought of growing your family and trying for baby is exciting and draws couples closer. But, when month after month that dream is continuously shattered, frustration and sadness can have a profound effect on relationships.

Dreaming of Baby discusses the effect of infertility-related stress on relationships with Dr. Brian Levine from CCRM New York.

Charles: Hello, and welcome to Dreaming of Baby. We have with us today Dr. Brian Levine to discuss fertility and relationships. Dr. Levine, would you be so kind as to tell our readers a little about yourself?

Dr. Brian Levine: Hi Charles! It’s a pleasure to speak with you again! I am a practicing reproductive endocrinologist and infertility specialist in NYC.

Infertility and Your Relationship

Charles: I would like to discuss today a very important factor when it comes to fertility: relationships. Starting with the first visit, and from your experience working with couples, what can you tell us about the strain that an infertility or sub-fertility diagnosis may have on the couple and, conversely, on their chances of conceiving?

Dr. Brian Levine: As we all know, stress is part of being in a relationship. We all know that relationships have their ups and downs. When it comes to dealing with infertility, couples sometimes experience a new type of stress. Sometimes, one partner wants to know who is at fault and why it is not working. Other times, the partner prays that it is them so as to protect their partner. Given that infertility is 40% male origin, 40% female origin, and 20% unknown, it is often the first office visit that causes the most strain and stress in the relationship because the etiology of the infertility diagnosis is not clear.

Dr. Brian Levine: “Given that infertility is 40% male origin, 40% female origin, and 20% unknown, it is often the first office visit that causes the most strain and stress in the relationship because the etiology of the infertility diagnosis is not clear.”

Charles: How in your experience can a couple reduce this stress? What steps can they take, and what should they be asking their fertility specialist? Or, in some cases, not asking?

Dr. Brian Levine: As couples go down their journey, we start to see quite often that the stress tends to go away as patients become focused on addressing the cause of the infertility. Some of the best strategies for helping to address the stress of infertility include attending workshops together, joining support groups, or simply both going to appointments together. I cannot tell you how many times only one partner shows up to an appointment which then leads to a very unfortunate situation of the “telephone game “. And of course, my best advice is to disconnect their Internet. Because the Internet is full of misinformation.

Charles: What are some of the factors you would say reduce this stress? Is it the fact that the problem becomes clearer and therefore the couple goes from discovering the problem to working towards a solution?

Dr. Brian Levine: Exactly! Problems start to have solutions!

Charles: I know many couples worry about how likely it is that they can solve their fertility problem. What would you say is the best way to get over this anxiety?
Dr. Brian Levine: My best advice might seem very obvious but very few patients actually follow it. Have an open conversation with your doctor. Ask about the chances of success. Ask about their experience in treating such a condition. Ask about what are the potential good and bad outcomes in that scenario.

Charles: You mentioned a lot of information on the internet being misleading; how can patients decipher what to trust and what not to trust?

Dr. Brian Levine: I think it is hard to decipher when “in the moment.” With that said, use a trusted site that is vetted, such as this one. Avoid forums where patients are telling their anecdotal experiences. Avoid groups where it feels like vitamins are being sold more than discussed.

Charles: That makes a lot of sense and I think also consulting with your fertility specialist in terms of what your actual diagnosis is before researching everything under the sun would probably help alleviate stress. On a final note Dr. Levine, how important is it for couples not to fall into the blame game? From a medical perspective, is it generally a one-sided consideration or combined issues that are the cause?

Dr. Brian Levine: I think you are 100% correct. The most important thing that a couple can do, is to protect their relationship. Blaming helps in the moment but does not solve the problem. Trust, empathy, support and perseverance are the attributes to a successful therapeutic relationship between two patients and patient/partner/Dr.

Charles: Thank you for being with us today Dr. Brian Levine and for the beautiful bundles of joy you help bring into this world! If there is anything you would like to share with our readers that you think they need to know please feel free to do so!

Dr. Brian Levine: Thank you! I really appreciate you inviting me to participate. Tell everyone, scream it from the rooftops… Stay positive!

Dr. Brian Levine is Founding Partner and Practice Director of CCRM New York.  For more information on the services offered by CCRM New York, visit here.

Would you benefit from a free fertility program and fertility coach?

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Would you benefit from a free fertility program and fertility coach?

A fertility coach can help navigate a patient through their fertility journey. Often when a patient is struggling with infertility they feel lost and overwhelmed.

Hello and welcome to Dreaming of Baby; we are happy to have with us here today Dr Kimberley Thornton who will be discussing fertility treatment options, including fertility coaching, infertility treatment and fertility preservation. Dr, would you be so kind as to tell our readers a little about yourself and what you are currently working on?

Dr. Kimberley Thornton REI: I am both a board-certified OB/GYN and Reproductive Endocrinologist and Fertility specialist at Reproductive Medicine Associates in NY (RMA NY). I help couples who are struggling to build their families as well as patients who are interested in preserving their fertility for the future. Recently I have also paired up with the Glow Fertility Program, which is a program that helps alleviate some of the emotional and financial burdens of fertility treatment for patients.

CJ: Very interesting, from what I understand Glow Fertility program also offers fertility coaching, this is something I think our readers would be interested in learning more about. I would like to start by asking you what a fertility coach provides and for whom is a fertility coach useful, is it only for people with infertility issues or is a fertility coach useful in other situations?

Dr. Kimberley Thornton REI: A fertility coach can help navigate a patient through their fertility journey. Often when a patient is struggling with infertility they feel lost and overwhelmed. Many patients don’t know where to begin or who to turn to. A fertility coach can help give guidance on finding a fertility clinic. Fertility treatments can seem very confusing and having someone to talk to about this can be invaluable. Traditionally most fertility coaches work with infertility patients. However, as more women are preserving their fertility for either elective or medical reasons these coaches can also be valuable for these situations.

CJ: Fertility treatments for infertility as well as fertility preservation can be quite costly, how does consulting a fertility coach or going through a fertility program help with this? Is there an increase in financial burden when using a fertility coach?

Dr. Kimberley Thornton REI: Fertility treatments can be quite costly. While a few states have mandated fertility coverage, the majority do not and many insurance companies do not cover fertility treatment. Additionally, the costs for various services vary from clinic to clinic, and frequently patients may be surprised by additional costs that they may encounter as they begin treatment. In addition to providing useful information and support, the Glow Fertility Program can also help identify potential costs so that patients are fully informed as they embark on their fertility treatment path.

CJ: That is excellent, so would being part of the fertility program include having a fertility coach or is this something separate?

Dr.Kimberley Thornton REI: For Glow this is part of being in their fertility program, which is one of the great things about it. Patients can get both support and financial savings. I cannot speak for all fertility coaching programs as I would imagine it varies.

CJ: Excellent, that is good to know and is there a cost to being in the Glow fertility program?

Dr. Kimberley Thornton REI: There is no cost to join the Glow Fertility Program.

CJ: Sounds great. I’d like to understand a little more about how a fertility coach helps a fertility patient. Can you walk us through the journey for a couple that is trying to conceive, I am looking to understand how one would benefit from joining the program early on such as at the initial diagnosis stage. Many of our readers are only just starting their journey to parenthood and I think highlighting some of the big decisions and steps involved will make the benefits of a fertility coach clearer.

Dr. Kimberley Thornton REI: It’s a great idea for patients to speak with a fertility coach prior to a consultation with a physician. Since many patients are confused or overwhelmed by the process, a fertility coach can help provide an overview of what to expect during an initial consultation and assist in the preparation for their first visit. Generally speaking, a fertility evaluation is warranted if a couple has been trying to conceive for a year with no pregnancy for a woman under the age of 35 and after 6 months for women 35 and older. Typically an initial evaluation consists of going through a couple’s medical history, a physical exam, and some basic fertility testing. These fertility tests commonly consist of a gyn ultrasound, some blood tests to evaluate hormones, a hysterosalpingogram (HSG) or “dye test” to see if the fallopian tubes are open, and a semen analysis. Depending on what an evaluation shows will determine which type of treatment a physician will recommend.

CJ: Would I be correct in assuming that it is after the physician’s recommendation that a patient would most likely require the aid of a fertility program?

Infertility is something many people do not talk about and it is common for couples not to even know when they should be evaluated. A fertility program can help couples understand when it is time to see a physician and ease the anxiety of going for an evaluation.

Dr. Kimberley Thornton REI: Not necessarily. For many patients, the hardest step is walking through the door of a fertility clinic. Infertility is something many people do not talk about and it is common for couples not to even know when they should be evaluated. A fertility program can help couples understand when it is time to see a physician and ease the anxiety of going for an evaluation. Finding a physician can also be confusing for patients. Having someone to guide you on reputable places is also important. The Glow Fertility program only partners with top clinics in the U.S. that have high success rates and can help connect patients to clinics close to them that are appropriate for their specific situation.

CJ: Wow ok, so the program is something that should and could be looked into as early as pre-diagnosis; which as you stated above is a year for a woman under the age of 35 and after 6 months for a woman 35 and older. I believe the program also helps with fertility preservation. There is a lot of debate with regards to the reasons patients are opting for fertility preservation treatments. The main reasons identified so far are career planning, known medical conditions and not having found the right partner. Can you walk us through the process of fertility preservation and some of the guidance a fertility coach may be able to provide?

Egg freezing is a great option for single women while some couples decide they want to freeze embryos rather than eggs.

Dr. Kimberley Thornton REI: Egg and embryo (a fertilized egg) freezing are great options for women wanting to preserve their fertility for the future. If a woman is interested in learning more about these options she should schedule an appointment with a fertility specialist. Typically testing to look at a woman’s egg reserve is done. This usually consists of a gyn ultrasound and a blood test called an AMH. The process of egg or embryo freezing requires a woman to take injectable medications called gonadotropins in her belly for approximately 1-2 weeks to grow the eggs. Don’t worry the injection needles are small and not as scary as they sound! Once the potential eggs appear ready, they are retrieved through a needle in the vagina while a patient is under some light anesthesia. After that, the eggs are either frozen for the future or fertilized with sperm to form an embryo. Egg freezing is a great option for single women while some couples decide they want to freeze embryos rather than eggs.

Dr. Kimberley Thornton REI: A fertility coach can help guide a patient in finding a physician as well as provide support for the treatment process. Programs such as Glow even offer egg freezing packages to help patients save money ($3,000 on average).

CJ: That is excellent so what a fertility coach and fertility program provide is someone like you with experience that can help guide a potential patient through the entire process and save them money along the way whilst ensuring they are choosing the right clinics for their needs?

Dr. Kimberley Thornton REI: Fertility coaches are not MDs, but they have professional and personal experience with infertility and/or fertility preservation. The fertility coaches are not meant to replace a medical professional but are meant to advocate for the patient and provide a support system as they are navigating the fertility treatment process. Fertility coaches also work with pharmacies to ensure that patients are receiving the best care and prices on medication.

CJ: Having this experienced individual not only saves the patient money but also ensures they get the treatment they need and are well informed; this I am assuming also helps with the emotional component. In your experience as an REI, how much of the stress is caused by patients traveling into the unknown? I know to me the idea of having so many decisions to make with little to no knowledge would be stressful and somewhat terrifying.

Dr. Kimberley Thornton REI: Struggling with infertility or undergoing fertility treatments is one of the most stressful experiences, many patients go through. Infertility patient’s stress level has been shown to be equivalent to patients going through cancer treatment. I think the unknown is one of the worst parts. Having someone to talk through the process and make it a little less scary and unknown always eases stress.

CJ: On behalf of our readers I would like to thank you for having this important discussion with us, the path to parenthood varies for each and every couple. We understand that infertility can complicate the process and it is a privilege to have you here with us and to help our readers find ways to untangle a very complicated process by having the right support in place. Thank you for the work you are doing and for being such an excellent guest. In closing is there anything you would like to tell our readers that are dreaming of baby?

Dr. Kimberley Thornton REI: For anyone who is struggling with infertility, just know that you are not alone and that there are many support programs and fertility specialists who are here for you!

The Men’s Guide to the Delivery Room – The People

Daniela GS
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The Men’s Guide to the Delivery Room – The People

Part Two: The People in the Delivery Room

Can’t make head or tail of who’s who? If you have opted for a hospital birth, chances are that you’ll be meeting a colorful bunch of people who will be assisting in the birth of your child. Here’s the 101 on who you can expect, plus others that you will hopefully do without.

OB/GYN or Family Doctor

Whereas it would be ideal if you’re already familiar with the doctor who will be attending the birth, in larger practices, and in cases where your doctor is unavailable at that point in time, this is not always possible. The doctor attending the birth will oversee your partner’s care during labor and delivery but might not necessarily be present from the start.

Midwife

The Midwife will be your go to person during this experience. Midwives are well-trained to care for your partner and baby, as well as to deliver your baby. What’s special about the midwife is that they give a more personalized approach to care, and are generally more approachable. Most midwives will be working with a doctor who will be ready to assist in case of any complications.

Labor and Delivery Nurse

Your Labor and Delivery Nurse will be constantly reachable and will be taking care of your partner and your newborn before, during, and after the delivery. The Labor and Delivery nurse will also assist the doctor and midwife and in case of a cesarean she might also take the role of scrub nurse. In some cases, and depending on the hospital, a personal care attendant will be there to assist your labor and delivery nurse.

Doula

If you opted for a Doula to help you out with pregnancy and birth, then she will be there to assist you when you make your way to the hospital. Regardless of the number of people already involved in the birth, having a doula on board has various benefits. Apart from being a source of calm to both you and your partner, a doula can provide you with information when not everything is communicated clearly and provides the needed physical and emotional support to you both.

Anesthesiologist

This professional may very well become your partner’s hero. There to administer pain relief if requested, you will meet the anesthesiologist if you opt for an epidural. The anesthesiologist will also be there if a C-section is needed.

Maternal-Fetal Doctor

Specializing in high risk-pregnancies, maternal-fetal medicine physicians take care of your partner in case there are any chronic health problems or if issues such as pre-term labor, bleeding, high blood pressure, or gestational diabetes, occur during the pregnancy. In some cases, a maternal-fetal doctor will also be present if you’re expecting twins or other multiples. Basically, such a professional would have completed additional years of study and clinical experience to be able to care for both women and their babies in pregnancies with added risk.

Neonatologist

Here’s to hoping you won’t be meeting this professional during your hospital stay. A neonatologist is an expert in handling complex and high-risk situations involving your newborn such as premature birth, serious illness, injury from birth, or a birth defect. If a condition was detected whilst your baby was still in the womb, the neonatologist may be there for the delivery.

Medical Students and Residents

Medical Students are there to observe; residents have already graduated and are there to train. Your partner will be asked if it’s ok to have these added people in the room. Whilst she has every right to refuse, allowing them to participate will help them receive the necessary training needed in the run up to starting their own career.

Your partner

She’s the star of the show, the empowered one and the one who will be doing all the work. Your role is to assist her, be there for her, communicate her wishes with the rest of the team and encourage her on from start to finish. Do not expect too much in terms of please and thank you… your partner will be focused on getting the job done.

Oblivious as to the tools you’ll see in the delivery room? Then head here for some more delivery room knowledge.

All content on Dreaming of Baby is solely for informational purposes and should not be considered as a specific diagnosis, treatment plan or an alternative to professional advice.

The Men’s Guide to the Delivery Room – The Tools

Daniela GS
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The Men’s Guide to the Delivery Room – The Tools

Part One: Tools in the Delivery Room

It’s absolutely normal if you’re both apprehending and looking forward to the day where you get to drive to hospital and support your partner in the delivery room. As Birth Doula Liza Maltz notes, ‘Dads are usually super nervous’ when it comes to childbirth. Just like your partner, it helps to be prepared in the run-up to your baby’s birth. Time to wow the midwives with your thorough knowledge!

The gadgets

Rather than feeling overwhelmed with all the innocent-looking (yet possibly eerily scary) tools, it’s good to know what each is for as well as when in the birth process they might be used.

The speculum

Your partner will most probably be already well-accustomed to this tool; it is the same that is used in routine OB/GYN appointments to have a more thorough look of the cervix. This time it will be used to check cervix dilation in early labor.

Amniotic Hook

No, it has nothing to do with Captain Hook. Resembling a long crochet needle, this tool isn’t one to fear. If an Artificial Rupture of Membranes, that is breaking waters, is needed, then the amniotic hook is used to rupture the amniotic sac. The procedure is painless. Whilst your partner may feel a gush afterwards, this does not always happen as the water may simply trickle.

Scissors

If an episiotomy is needed in the pushing stage, then scissors will be used. If not, you can utilize them yourself when cutting your newborn baby’s umbilical cord.

Fetal Monitoring

Your baby’s heart rate and your partner’s contractions will be monitored via a fetal monitor strapped around your partner’s abdomen. Whilst its very common to find women laboring with fetal monitors strapped to them, recommendations by the American Congress of Obstetricians and Gynecologists (ACOG) state that intermittent monitoring should be considered in cases where this allows.  Not being constantly hooked means that your partner can move around more easily, helping labor to progress more quickly.

Internal Fetal Monitor

In high-risk pregnancies, the baby’s heart rate is monitored via a tiny device placed directly onto the baby’s head whilst still in the womb. It can also be used in low-risk birth if an accurate reading is not being achieved via the fetal monitor.

Forceps

Whilst their shape may remind you of salad tongs and the next BBQ, finding this tool in the delivery room refers to something else entirely. Forceps are used during the pushing stage to help guide the baby out of the birth canal if labor isn’t progressing or in case immediate delivery becomes a must. When an attempt at a forceps delivery is unsuccessful, a C-section might be needed.

Vacuum extractor

If assistance is needed during a vaginal delivery, suction may be used to help your baby out. This tool is basically a soft or rigid cup with a handle attached to a vacuum pump. It is used when the pushing stage is proving ineffective or when a need to have the baby born quickly arises. In the case that vacuum extraction fails, a C-section might be needed.

Hemostat

A Hemostat is a clamp used to contain bleeding and hold sutures. Once your baby is born, this is used to clamp the umbilical cord for cutting.

Now that you’re a pro on the tools, time to step here and get to know the people who will assist your partner with delivering your little bundle.

All content on Dreaming Of Baby is solely for informational purposes and should not be considered as a specific diagnosis or treatment plan.

The Effects of a Healthy Diet on PCOS

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The Effects of a Healthy Diet on PCOS

According to the National Institutes of Health, around 5 million women in the United States suffer from Polycystic Ovary Syndrome (PCOS). Unfortunately, many women remain unaware of the effects a healthy diet has on the sustainable management of PCOS.

As part of our segment on PCOS, Dreaming of Baby acquired professional insight from Angela Grassi, MS, RDN, LDN, author of The PCOS Workbook: Your Guide to Complete Physical and Emotional Health, and founder of the PCOS Nutrition Center. Angela Grassi shares how basic lifestyle changes can do wonders in helping you deal with this syndrome.

Daniela: Good morning Angela, it’s a pleasure to welcome you on Dreaming of Baby! Today we will be discussing Polycystic Ovary Syndrome (PCOS) from a diet and nutrition perspective, with a specific focus on treatment and its effects on fertility. To start with, it would be great if you could tell us a little about your experience in dealing with PCOS, both personally and professionally.

Angela Grassi, MS, RDN, LDN: I was diagnosed with PCOS one year after getting married. I always had a hunch I had PCOS even though I didn’t have the classic symptom of irregular periods. I did gain a rapid amount of weight (40 Lbs in under 3 months) and had no reason why. I gained the weight despite exercising daily and eating an average diet. I saw three doctors before seeing Dr. Katherine Sherif in Philadelphia who specializes in PCOS. She ran the appropriate tests and it turned out that I had high insulin, was on the verge of pre-diabetes, and did have PCOS.

I wanted to know if I had it or not because my husband and I wanted to try to start a family. I knew PCOS was the leading cause of infertility. Driving home the day of my diagnosis, I knew I wanted and needed to educate others about PCOS. So I wrote PCOS: The Dietitian’s Guide to start with, and then came the PCOS Workbook and PCOS Nutrition Center Cookbook. Today I counsel hundreds of women each year to improve their fertility and take control over PCOS through their lifestyle.

I was able to conceive both of my sons, now 10 and 7, with no difficulty as a result of making lifestyle changes.

Daniela: Wow, it’s impressive how you changed such a diagnosis into something very positive, also helping others in the process. In your view, how important is nutrition in dealing with PCOS?

Angela Grassi, MS, RDN, LDN: Yes, it was a way for me to cope and deal with it.

Nutrition is the first line of treatment for PCOS. A woman can change her exercise and take medicine, but she really needs to improve her diet for best results.

Daniela: Can changes in diet replace the need for other medical treatments, or they go together? Basically, can a woman opt solely for changes in nutrition rather than go on a more medicalized route?

Angela Grassi, MS, RDN, LDN: Sometimes. It can depend on the woman. If she is really insulin resistant, she may need medications but often times, diet changes and supplements can really make a difference, especially when it comes to fertility.

Daniela: That’s encouraging to hear. For the woman who has just been diagnosed with PCOS, what would be the first step in terms of dietary choices?

Angela Grassi, MS, RDN, LDN: I recommend cutting out sugary drinks and foods as much as possible. Maybe switch that morning macchiato to a regular latte for example. But sometimes women with PCOS focus too much on foods they shouldn’t be eating instead of foods that can improve their egg quality and lower insulin, like antioxidants. Antioxidants come from fruits, vegetables, whole grains, and unsaturated fats like fish and olive oil.

‘Nutrition is the first line of treatment for PCOS. A woman can change her exercise and take medicine, but she really needs to improve her diet for best results.’

Daniela: How do antioxidants, specifically, help improve fertility in women suffering from PCOS?

Angela Grassi, MS, RDN, LDN: It is believed that women with PCOS, because of their hormone imbalance, don’t have good quality eggs. A lot of times, their eggs are immature and don’t fully develop. Antioxidants have been shown to improve egg quality and ovulation.

Daniela: And how long does it take for symptoms related to PCOS to improve, following dietary changes and better nutritional choices?

Angela Grassi, MS, RDN, LDN: It really depends on the woman and the severity of her symptoms but in as little as a few weeks’ time, she may experience reduced cravings for sugar and her weight may go down. In a month to three months, most see improvement in menstrual regularity.

Daniela: Does this mean that for the woman who is trying for baby, such dietary changes lead to better chances for conception in a few months’ time?

Angela Grassi, MS, RDN, LDN: Yes! And I wish all reproductive endocrinologists/fertility experts would recommend women with PCOS to consult with registered dietitians who specialize in PCOS for this reason. Not only will a healthy diet improve her fertility, but it will also prepare her body for the demands of pregnancy.

Daniela: In this regard then, what would be the ideal first step in efforts to treat PCOS?

Angela Grassi, MS, RDN, LDN: It depends on factors like her age, how long she has been trying already but ideally, taking a few months to work on your diet if you have the time, may help with fertility significantly.

Best food to manage PCOS

Daniela: Turning to food choices again, how would the ideal day look like – food choice wise – for someone on the journey towards treating PCOS and also trying for baby?

Angela Grassi, MS, RDN, LDN: Start the day with an omelet with veggies, and a slice of sprouted grain toast; for lunch, a salad with chickpeas, shrimp, veggies, olive-oil based dressing and fruit; an afternoon snack of apple and nut butter; followed by a dinner of grilled salmon, veggies, and quinoa.

Daniela: Sounds very good! I’m sure this will help many women on their journeys. You mentioned earlier that following a healthy diet would also prepare a woman’s body for the demands of pregnancy. In which ways is this so?

Angela Grassi, MS, RDN, LDN: A healthy diet would get her iron stores up as well as vitamin D and omega-3s, all of which tend to be depleted by the end of pregnancy. Lowering insulin before pregnancy is also recommended in order to reduce the risk of gestational diabetes.

Daniela: In relation to insulin levels, does this mean nothing sugary then?

Angela Grassi, MS, RDN, LDN: Sugar as well as processed foods tend to raise insulin more than other foods.

Daniela: In that case, opting for whole foods is a safer bet for treating PCOS, improving fertility, and preparing your body for pregnancy?

Angela Grassi, MS, RDN, LDN: Yes, absolutely! I also recommend organic when possible.

Daniela: Thank you for all the insight you shared with us today! If there is one final message that you could impart to a woman wishing to conceive but who is also suffering from PCOS, what would it be?

Angela Grassi, MS, RDN, LDN: There is so much that feels out of control when you are going through infertility. How you feed and care for your body is something you can control that can increase your chances of pregnancy.

Let the Professionals inform you about PCOS. Read more here:

What you need to know about Polycystic Ovary Syndrome (PCOS)

How Lifestyle Choices Affect Fertility in PCOS patients

PCOS: The Truth About Your Eggs

Diagnosing PCOS in Adolescence

PCOS: A Personal Journey to Motherhood

The Emotional and Mental Effects of PCOS

PCOS: Preparing for your OB-GYN Appointment

Fresh or Frozen Embryos for IVF?

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Fresh or Frozen Embryos for IVF?

There is no clear cut answer.

In a study of close to 83,000 IVF patients published in the journal Fertility and Sterility, it was concluded that there is no one-size-fits-all solution.

IVF experts continue to disagree on the success rates between fresh or frozen embryos. The best technique depends on the patient, specifically how much eggs the patient produces.

Whilst some clinics push towards embryo freezing, the study undertaken by Duke Universal Medical Center found that embryo freezing may only be advantageous for women who produce 15 or more eggs after hormone stimulation.

In women who produced 14 eggs or fewer, fresh transfers led to better outcomes.

Read more about this insightful study in this Science Daily article:

Marijuana and Morning Sickness

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Marijuana and Morning Sickness

Research published in the journal JAMA Internal Medicine suggests that some pregnant women are using marijuana to self-medicate morning sickness.

Out of a study of 220,000 pregnant women, 2.3% were experiencing severe morning sickness. Out of these, 11.3% used marijuana.

Whilst the study found a link between marijuana use and morning sickness, it cannot be immediately concluded that pot is being used to self-medicate. Other factors, such as the possible contribution of marijuana to symptoms of nausea should not be disregarded.

Nonetheless, the study shows the importance of education on safe and effective treatments for morning sickness. The health effects of marijuana are unclear, but some studies report a link between marijuana use and low birth weight and impaired neurological development in newborns.

Read more about this study in this Live Science article:

Will stress during pregnancy affect my baby?

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Will stress during pregnancy affect my baby?

A new study has found that stress during pregnancy increases the risk of mood disorders in baby girls.

The research, published in Biological Psychiatry, reported increased anxious and depressive-like behaviour in girls at the age of 2.

Interestingly, baby boys were not found to experience the same symptoms. This sex-specific risk came as a surprise: ‘High maternal levels of cortisol during pregnancy appear to contribute to risk in females, but not males’.

These findings continue to emphasize the importance of prenatal health and well-being.

Read more about this study in this Science Daily article:

A look into Hilary Duff’s Pregnancy Style

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A look into Hilary Duff’s Pregnancy Style

Dealing with body changes in pregnancy is no easy feat and Hilary Duff certainly agrees.

In a heartfelt Instagram post, the mom of one wrote, ‘The boobs are big the belly is big the body is big. Man… pregnancy is hard.’

Regardless, she’s still rocking her pregnancy style. Maxi dresses, two-piece swimsuits, boho dresses, and show stopping evening dresses, Hilary is looking great in anything.

Still, we’re happy to see she also has a soft spot for good old black leggings and flowy tops!

Get pregnancy-wear inspiration in this E-news feature:

 

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