Tuesday, December 12, 2006
Alcohol
What are the risks to my baby? One of the most common known causes of mental and physical birth defects, alcohol produces more severe abnormalities in a developing fetus than heroin, cocaine, or marijuana.
Alcohol is easily passed along to the baby, who is less able to eliminate alcohol than the mother. That means an unborn baby tends to develop a high concentration of alcohol, which stays in the baby's system for longer periods than it would in the mother's. And moderate alcohol intake, as well as periodic binge drinking, can possibly damage a baby's developing nervous.
systemWhat can I do about it? If you had a drink or two before you even knew you were pregnant (as many women do), don't worry too much about it. But your best bet is to not drink any more alcohol for the rest of your pregnancy.
If you're an alcoholic or think you may have a drinking problem, be sure to talk to your doctor about it. He or she needs to know how much alcohol you've consumed and when during your pregnancy to get a better idea of how your unborn baby may have been affected. Your doctor may also be able to start you on a path to getting the help you need to stop drinking — for your sake and your baby's.
Caffeine
What are the risks to my baby? High caffeine consumption has been linked to an increased risk of miscarriage.
What can I do about it? If you're having a hard time cutting out coffee cold turkey, here's how you can start:
Cut your consumption down to one or two cups a day.
Gradually reduce the amount by combining decaffeinated coffee with regular coffee.
Eventually cut out the regular coffee altogether.
And remember that caffeine is not limited to coffee. Green and black tea, cola, and other soft drinks contain caffeine. Try switching to decaffeinated products (which may still have some caffeine, but in much smaller amounts) or caffeine-free alternatives.
If you're wondering whether chocolate, which also contains caffeine, is a concern, the good news is that you can have some of the scrumptious treat in moderation. Whereas a cup of brewed coffee has 95-135 milligrams of caffeine, the average chocolate bar has between 5-30 milligrams. So, small amounts of chocolate are fine.
Certain Foods
soft, unpasteurized cheeses (often advertised as "fresh") such as feta, goat, Brie, Camembert, blue-veined cheeses, and Mexican queso fresco
unpasteurized milk, juices, and apple cider
raw eggs or foods containing raw eggs, including mousse, tiramisu, raw cookie dough, eggnog, homemade ice cream, and Caesar dressing
raw or undercooked fish (sushi), shellfish, or meats
paté and meat spreads
processed meats such as hot dogs and deli meats (these should be very well cooked before eating)
Also, although fish and shellfish can be an extremely healthy part of your pregnancy diet (they contain beneficial omega-3 fatty acids and are high in protein and low in saturated fat), you should avoid eating:
shark
swordfish
king mackerel
tilefish
tuna steak (limited amounts of canned, preferably light, tuna is OK)
What are the risks to my baby? Although it's important to eat plenty of healthy foods during pregnancy, you also need to avoid food-borne illnesses, such as listeriosis, toxoplasmosis, and salmonella, which can be found in the foods listed in the first set of bullets. These infections can be life-threatening to an unborn baby and may cause birth defects or miscarriage.
And the types of fish mentioned above may contain high levels of mercury, which can cause damage to the developing brain of a fetus.
What can I do about it? Be sure to thoroughly wash all fruits and vegetables, which can carry food-borne illnesses or be coated with pesticide residue. And be mindful of what you're buying at the grocery store or when dining out.
When you choose seafood, eat a variety of fish and shellfish and limit the amount to about 12 ounces per week — that's about two meals. Common fish and shellfish that are low in mercury include: canned light tuna, catfish, pollock, salmon, and shrimp. But because albacore (or white) tuna has more mercury than canned light tuna, it's best to eat no more than 6 ounces (or one meal) of albacore tuna a week.
You may have to forego a few things during pregnancy that you normally enjoy. But just think how delicious they'll taste after waiting 9 months!
Over-the-Counter and Prescription Medications
What are the risks to my baby? Even common OTC medications that are generally safe may be considered off-limits during pregnancy because of their potential effects on the baby. Certain prescription medications may also cause damage to the developing fetus. (The type of harm and extent of possible damage depends on the kind of medication.)
Also, although they may seem harmless, herbal remedies and supplements are not regulated by the U.S. Food and Drug Administration (FDA). That means that they don't have to follow any safety standards and, therefore, could be harmful to your baby.
What can I do about it? To make sure you don't take anything that could put your baby at risk talk to your doctor about:
any medications you're taking — prescription and OTC — and ask which are safe to take during pregnancy
any concerns you have about natural remedies, supplements, and vitamins
Also, be sure to let all of your health care providers know that you're pregnant so that they'll keep that in mind when recommending or prescribing any medications. If you were prescribed a medication before you became pregnant for an illness, disease, or condition you still have, your doctor can help you weigh the potential benefits and risks of continuing your prescription.
If you become sick (i.e., with a cold) or have symptoms that are causing you discomfort or pain (i.e., a headache or backache), talk to your doctor about medications you can take and alternative ways to help you feel better without medication.
Recreational Drugs
What are the risks to my baby? Pregnant women who use drugs may be placing their unborn babies at risk for:
premature birth
poor growth
birth defects
behavior and learning problems
And their babies could also be born addicted to those drugs.
What can I do about it? If you've used any drugs at any time during your pregnancy, it's important to inform your doctor. Even if you've quit, your unborn child could still be at risk for health problems. If you're still using drugs, talk to your doctor for help on how to quit. Health clinics such as Planned Parenthood also can recommend health care providers, at little or no cost, who can help you quit your habit and have a healthier pregnancy.
Smoking
Likewise, you should steer clear of people who are smoking, whether they're coworkers, friends, family members, or other diners at a restaurant (if your state still allows smoking in public places).
What are the risks to my baby? If a pregnant woman smokes, it could cause:
stillbirth
prematurity
low birth weight
sudden infant death syndrome (SIDS)
asthma and other respiratory problems
And the risks to a fetus from regular exposure to secondhand smoke include low birth weight and slowed growth.
What can I do about it? If you smoke, having a baby may be the motivation you need to quit. Talk to your doctor about options for kicking the habit.
If you spend time with people who smoke, ask them nicely to do it outside — and away from you if you're outside as well. And, of course, request the nonsmoking area whenever you dine out.
Back to List
But What About...?
Whether you read it on an online pregnancy chat board, heard it from your best friend's coworker's cousin, or aren't sure where that nagging doubt came from, worries about what's OK during pregnancy abound. Here's the lowdown on some common ones that many expectant women wonder about.
Artificial Sweeteners (Sugar Substitutes)
Aspartame, sucralose, and acesulfame-K have been found to be safe to use in moderation during pregnancy. However, you should avoid aspartame if you or your partner has a rare hereditary disease called phenylketonuria (PKU), in which the body can't break down the compound phenylalanine, which is found in aspartame. In that case, you should avoid aspartame altogether since your baby may also be born with the disease.
But the jury still seems to be out on whether saccharin, which is found in some foods and in the little pink packets, is safe to use during pregnancy or not — it can cross the placenta and could stay in the fetus' tissue. (Also, a sweetener called cyclamate was banned in the United States because of concern about cancer.)
What are the risks, if any, to my baby? Although some people have alleged that the artificial sweetener aspartame is linked with birth defects and illnesses ranging from multiple sclerosis to Parkinson's disease, government authorities and medical groups throughout the world have evaluated aspartame and approved it as safe for human consumption, including during pregnancy.
Research done during the 1970s suggested that saccharin caused bladder cancer in lab rats when given in large quantities. Since then, though, those studies have often been called into question. Also, a warning saying that it could cause cancer was removed from all saccharin-containing products' labels in 2000.
What can I do about it? With aspartame, sucralose, and acesulfame-K, moderation is the key. It's OK to have an occasional diet soda or sugar-free food with these sweeteners here and there. But if you're really craving something sweet, it's probably better to have the real thing, as long as it's in moderation.
If you've already consumed something with saccharin in it during your pregnancy, don't obsess about it. It's highly unlikely that small amounts could do any harm to your baby.
Still, it's wise to check product labels and try to avoid — or at least limit — anything with artificial sweeteners (especially saccharin), just to be safe. After all, this is one time in your life when you have a good reason to avoid diet foods! And the more naturally flavored whole foods you eat during pregnancy, the better.
Computer Monitors (VDTs)
Should I avoid them? No. There is no evidence that computer monitors (also called video display terminals, or VDTs) cause any problems in unborn babies.
What are the risks, if any, to my baby? There's been speculation since the 1980s that VDTs are unsafe for pregnant women because of low levels of radiation (electromagnetic fields). But according to the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC), computer monitors have not been found to cause low birth weight or preterm births.
What can I do about it? You don't need to do anything. Before you quit your office job or sit 10 feet away from the screen using a pool stick to type, rest assured that computer monitors are OK.
Flying
However, pregnant women who shouldn't fly include those with:
high blood pressure (or hypertension) during pregnancy
sickle cell disease
gestational diabetes that hasn't been well-controlled
abnormalities of the placenta
the risk of going into premature labor
What are the risks, if any, to my baby? For women with healthy pregnancies, there are no significant risks. However, women who have difficult pregnancies, especially involving their cardiovascular system, could be compromised by air flight and should discuss any flying plans with their doctor.
What can I do about it? Discuss any plans for lengthy or distant travel with your doctor during your last trimester, just in case. If he or she says it's OK, check with the airlines to find out what their policies are regarding flying during pregnancy. (Most airlines will allow pregnant women to fly up until week 36 for domestic flights and week 35 for international travel.)
To make sure your flight is as comfortable as possible, you may want to:
Move your lower legs regularly and/or get out of your seat (especially during long flights) to promote blood circulation and help prevent blood cots.
Wear support stockings to further prevent clotting in your legs.
Keep your seatbelt on when you're seated to keep the jostling of turbulence to a minimum.
Hair Dyes
Having said that, though, very few studies have closely examined the many different kinds of hair treatments and their potential effects on a fetus. What we do know indicates that hair treatments are most likely safe.
What are the risks, if any, to my baby? None that are currently known.
What can I do about it? If you're still concerned, ask your doctor about natural, non-chemical dyes that could give you the little makeover you may need without the added worry. Also, having your hair highlighted (rather than dyed) uses far less chemicals.
High-Impact Exercise
weight training and heavy lifting (after the first trimester)
sit-ups (also after the first trimester)
contact sports
scuba diving
bouncing
jarring (anything that would cause a lot of up and down movement, such as horseback riding)
leaping
a sudden change of direction (such as downhill skiing)
What are the risks, if any, to my baby? High-impact exercise can cause increased pressure on the structures within the uterus that could lead to problems such as premature labor or bleeding.
What can I do about it? Some of the healthy ways pregnant women can stay fit include walking, swimming, water aerobics, yoga, and Pilates. But be sure to talk to your doctor before starting — or continuing — any exercise routine during pregnancy.
Household Chemicals (Cleaners, Paint, etc.)
What are the risks, if any, to my baby? It depends on the product. Some household chemicals may have no effect, while others in high doses could potentially be harmful.
What can I do about it? Here a few tips to help keep household chemicals in perspective during your pregnancy:
Talk to your doctor about any concerns you have with chemicals you use at home or at work.
Look at product labels before using any product. If it's unsafe to use during pregnancy, the label should say that it's toxic. Find out not only if it's safe for you to use, but if it's safe for you to be around when being used by someone else. If the label doesn't specify, contact the manufacturer.
Open windows and doors, and use rubber gloves and a mask when cleaning with or using any chemical.
Wash your hands and arms, even if you wore gloves, after using any chemical.
Opt for natural products like baking soda, borax, and vinegar for cleaning.
Have someone else paint the baby's nursery, as much you'd probably like to do it yourself. And definitely don't help with the removal of paint if your home was built before 1978 as it may contain lead-based paint. Although many paints today are considered safer than those of the past, it's still a good idea to let someone else handle painting. You can always take over the decorating duties after the paint dries!
Bug Sprays (Insecticides/Pesticides/Repellants)
What are the risks, if any, to my baby? Although there's no evidence that the typical occasional household use of insecticides does any damage to a baby, it's best to err on the side of caution. High levels of exposure may cause:
miscarriage
premature delivery
birth defects
As for insect repellants (which may contain DEET, or diethyltoluamide), the risks aren't fully known. So, it's best to either not use them at all during pregnancy or to wear gloves to place a small amount on socks, shoes, and outer clothing instead of putting repellants directly on your skin.
What can I do about it? If you have a real problem with pesky bugs around your home, the March of Dimes suggests the following:
Use safer methods of removal such as boric acid, which you should be able to find at your local hardware store.
Make sure someone else applies the pesticides.
When pesticides are sprayed outside, close all windows and turn off air-conditioning units and window fans to prevent the fumes from entering your home.
Remove utensils, food, and dishes from areas where the chemicals will be used.
Stay away from the treated area during the application and afterward for the amount of time specified on the product label.
Have someone else wash any treated area where food is prepared or served.
Wear rubber gloves when gardening outside where pesticides have been used.
Have your water supply tested regularly if you have well water and use pesticides, fertilizers, and weed killers.
Lead
Should I avoid it? Yes. However, exposure to high lead levels is rare for women in the United States.
What are the risks, if any, to my baby? Exposure to high levels of lead can cause:
- miscarriage
- premature delivery
- low birth weight
- developmental delays
But even low levels of lead can cause subtle problems with behavior and learning in children.
What can I do about it? If your home was built before 1978, it could have lead-based paint. But it only becomes a problem if the paint is chipping, peeling, or being removed. Some homes also may have lead pipes or copper piping with lead solder that can allow lead to enter the tap water.
If you have an older home or think that you may have lead piping or soldering and are concerned about lead exposure, you can have a professional come out to test your water, the dust in your home, the soil outside, and/or the paint around your home for lead.
Make sure that anyone who removes any potentially lead-based paint from your home:
- is a professional trained in removing lead paint (getting rid of lead-based paint isn't a project for a do-it-yourselfer!)
- removes it when you're not there
- doesn't scrape, sand, or use a heat gun to remove the paint (these methods may send lead dust into the air)
- thoroughly cleans the area immediately afterward
To help reduce potential lead levels in your tap water, you can run the water for 30 seconds before using it and/or buy a water filter that specifically says on the packaging that it removes lead.
Microwaves
What are the risks, if any, to my baby? There are no medically proven risks. Microwaves don't leak radiation, and any that did would emit extremely small amounts that are virtually undetectable.
What can I do about it? If you're still concerned, you might want to make sure your microwave is working properly and isn't leaking or damaged. Researchers have determined that if a microwave does leak any radiation, it diminishes exponentially with distance from the microwave. In other words, if you have any concerns, stand a few feet away instead of immediately in front of the oven.
Overheating (Hot Tubs, Saunas, Electric Blankets, etc.)
using saunas or hot tubs
taking very hot, long baths and showers
using electric blankets or heating pads
getting a high fever
becoming overheated when outside in hot weather or when exercising
What are the risks, if any, to my baby? If your body temperature goes above 102 degrees Fahrenheit (38.9 degrees Celsius) for more than 10 minutes, the elevated heat can cause problems with the fetus. Overheating in the first trimester can lead to neural tube defects. Later in the pregnancy, it can lead to dehydration.
What can I do about it? Instead of hot tubs or saunas, take a dip in a cool pool. And it's probably a good idea to stick to warm or slightly hot baths and showers. If you have a fever during your pregnancy, talk to your doctor about ways to lower it. And follow your body's cues that you're getting overheated when exercising or enjoying the great outdoors in the warmer months.
But if you've already become overheated during your pregnancy, don't worry too much about it. Chances are, you removed yourself from the uncomfortable situation before any damage was done.
Self-Tanners/Sunless Tanners
What are the risks, if any, to my baby? No risks specific to tanning have been documented.
What can I do about it? For a summer glow, skip the self-tanner and apply some bronzer to your face, neck, shoulders, and chest. And if you do decide to try a self-tanner, that's far safer than lying out in the sun and becoming potentially overheated. Overheating in the first trimester, as discussed above, can lead to significant problems for the baby; later in the pregnancy, it could lead to dehydration in the mother. Still, ask your doctor before applying any "tan in a bottle."
Sex
However, your doctor may advise against sexual intercourse if he or she anticipates or detects certain significant complications with your pregnancy, including:
a history or threat of miscarriage
a history of pre-term labor (you've previously delivered a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions)
unexplained vaginal bleeding, discharge, or cramping
leakage of amniotic fluid (the fluid that surrounds the baby)
placenta previa, a condition in which the placenta (the blood-rich structure that nourishes the baby) is situated down so low that it covers the cervix (the opening of the uterus)
incompetent cervix, a condition in which the cervix is weakened and dilates (opens) prematurely, raising the risk for miscarriage or premature delivery
multiple fetuses (you're having twins, triplets, etc.)
What are the risks, if any, to my baby? You should not have sex with a partner whose sexual history is unknown to you or who may have a sexually transmitted disease, such as herpes, genital warts, chlamydia, or HIV. If you become infected, the disease may be transmitted to your baby, with potentially dangerous consequences.
What can I do about it? Talk to your doctor about any discomfort you experience during or after sex or any other concerns.
Tap/Drinking Water
It's also important to note that just because water is bottled doesn't necessarily mean it's safer. Although bottled water (which is regulated by the FDA) may often taste better or just different, tap water meets the same Environmental Protection Agency (EPA) standards.
What are the risks, if any, to my baby? Different studies show different things, according to the March of Dimes. Some have found that the chlorine used to treat public water can turn into chloroform when it mixes with other materials in the water, which can increase the risk of miscarriage and poor fetal growth. But other studies have found no such links. Also of concern to some is the potential for the water to be contaminated by things like lead and pesticides. If you have well water you should probably have it checked regularly, such as once a year, whether you're pregnant or not.
What can I do about it? If you're concerned, contact your local water supplier to get a copy of the annual water quality report. If you're still concerned and/or have private well water, have your water tested by a state-certified laboratory. This can cost anywhere from $15 to hundreds, depending on the number of contaminants you want to have your water tested for.
To help ease your mind, you could also buy a water filtration system to help reduce the levels of lead, some bacteria and viruses, and chemicals such as chlorine. But be sure to read the product's label thoroughly, as some do more than others.
Countertop pitcher and faucet-mounted units are fairly inexpensive (some for under $50), whereas systems used to treat your entire home's water supply are much pricier (up to thousands of dollars). You can also have refillable water coolers delivered to your home, often through wholesale — or bulk items — stores.
Teeth Whiteners/Teeth Bleaching
Should I avoid them? Maybe. As with self-tanners, no good studies have been done on teeth whiteners that definitively say whether they're safe to use if you're expecting. And some makers of whitening products do caution against using them during pregnancy. Some dentists encourage waiting until after pregnancy to get your teeth whitened and others say that the procedures are safe. The concern is primarily about the chemicals used in teeth whitening products that could be swallowed and the potential effect on a fetus.
What are the risks, if any, to my baby? There's currently no evidence that teeth whitening can harm a fetus.
What can I do about it? Talk to your doctor before plunking down the cash on whitening products. If you'd rather wait until after your pregnancy to try to make your teeth pearly white, simply brush regularly with whitening toothpaste, which may give a little extra kick to your smile.
Vaccinations
Should I avoid them? Many — yes; others — no. It's best to wait until after your pregnancy for most vaccines, but a few are considered safe. Your doctor may say it's OK to get a vaccine if:
- there's a good chance that you could be exposed to a particular disease or infection and the benefits of vaccinating you outweigh the potential risks
- an infection would pose a risk to you or your baby
- the vaccine is unlikely to cause harm
However, the CDC recommends only these vaccines as safe during pregnancy if they're truly necessary:
- influenza (the flu) — but only the shot made with the inactivated virus
- hepatitis B
- meningitis
- rabies
- tetanus/diphtheria
What are the risks, if any, to my baby? Live-virus vaccines — those containing a live organism — aren't recommended for pregnant women because of the risk that the actual infection or disease the vaccine is meant to prevent may be passed along to the unborn baby. However, this depends on the circumstances and whether the vaccine would ultimately be safer to receive than being exposed to the actual disease. For example, the chickenpox vaccine may be safer to your unborn baby than getting the infection. So, it's important to speak to your doctor if you believe that you may have been exposed to a disease.
For the most part, though, researchers don't know what the risks of some vaccines may be to a fetus. So, it's wise to just wait to be vaccinated unless your doctor tells you otherwise.
What can I do about it? Be sure to talk to your doctor before getting any vaccination during pregnancy. It's also a good idea to inform your doctor if you became pregnant within 4 weeks of having a vaccine. And if your workplace requires certain vaccines, be sure to let them know you're pregnant before agreeing to be immunized.
X-Rays
Should I avoid them? Yes and no. If your doctor thinks it's truly necessary — for your own well-being or your baby's — to get one during your pregnancy, then it's highly unlikely that low levels of X-ray radiation will be harmful. However, if you can safely wait to get an X-ray until after your baby is born, then that's probably the best way to go.
What are the risks, if any, to my baby? According to the American Academy of Family Physicians (AAFP), X-rays are most likely safe during pregnancy. Most diagnostic X-rays emit much less than 5 rads, which is the limit of what the FDA suggests a pregnant woman should be exposed to.
Different imaging studies emit different amounts of radiation and the direction of the X-ray beam also affects the possible exposure to the fetus. Dental X-rays, for example, aren't cause for much concern because the X-ray area is far from your uterus. However, researchers believe that a fetus is more susceptible to damage by radiation because of the rapid rate with which their cells are dividing.
What can I do about it? First, make sure that all of your health care providers (including your dentist and the X-ray technician) know about your pregnancy before you get an X-ray. Also make sure that your stomach is covered with a lead apron.
If you're concerned and would rather not get an X-ray at all during pregnancy, your doctor may be able to use an MRI (magnetic resonance imaging) test during the first trimester or an ultrasound anytime.
Putting It All in Perspective
Above all, make sure to follow the most important healthy pregnancy habits — eat right; get plenty of rest; steer clear of drugs, alcohol, and tobacco — and you'll be well on your way to keeping both you and your baby healthy.