Pregnancy is a very special time in a woman's life when there is an added focus to take care of yourself and your unborn child. The adage'you are what you eat' takes on a whole new meaning during this period as it becomes the soon to be mother's responsibility to pack in extra nutrition to nourish her growing bump. Doctors often add in a dose of vitamins to ensure that the both mother and child are well nourished. But beyond that, the food choices you make will maintain a healthy weight gain for you and your baby and eventually even help when you want to shed the extra weight after your child is born.

Here are some tips to have a perfect diet during your pregnancy

Load up on the good stuff: even if you've always been eating healthy, it is time to crank things up a notch and include more proteins, vitamins, minerals especially folic acid and iron and some extra calories for energy and increase it as you progress in your pregnancy. But eating to get more nutrients doesn't have to mean eating more in general. If you are already at a healthy weight, then you don't need extra calories in the first trimester. In the second trimester, you need about 340 extra calories a day and about 450 extra calories a day in the third trimester. The numbers will change if you are underweight or overweight.

Say no to some: during pregnancy, give a skip to food items like raw seafood and undercooked meat and poultry. This could lead to potentially dangerous infections. Other foods to steer clear from include unpasteurized milk and soft cheese. All of these are possible sources of bacteria that can be harmful to an unborn child. It is always good to give your fruits and veggies a good extra wash, as always. Try to avoid the known culprits like popular local fruits that may be laden with artificial ripeners. Also avoid food with excess oil or preservatives. 

You will also have to say a complete no to alcohol or smoking during this period. While most sites suggest that you also ditch your caffeine fix, you can best keep it less than 200 mg or 12 ounces in a day. Stick to decaffeinated tea and sodas when possible. Some other foods that have to be avoided during pregnancy are packaged food, cold drinks, preserved food items as they contain preservatives, which are harmful. Also, chinese food should be avoided as it contains monosodium glutamate, which is again harmful due to teratogenic chemical.

Diet a big no: another big no during pregnancy is dieting or controlling the intake of food to lose weight. Pregnancy is the time you actually, for once, get to legally gain weight and be happy about. Don't mess up your natural system with forced diets.

Keep the food coming: pregnancy is the time for food craving at all odd hours and the time to give into them without an ounce of guilt! if you are dealing with nausea and food aversion, try to stick to small meals throughout the day. Replace the chips with carrot sticks and the pizza slice with soup. If that sweet tooth starts acting up, give it a frozen fruit dessert or shake.

Diet in Pregnancy

Why every 1 in 5 Women in India suffers from PCOS? (And what they need to know)

Polycystic ovarian syndrome (PCOS) is a medical condition related to a woman’s endocrine system. Generally, this disorder is characterised by an imbalance of the sex hormones (oestrogen and progesterone), which leads to the development of multiple small cysts in the ovaries. Symptoms of PCOS include acne, irregular menstrual cycle and depression to name a few.
The causes of PCOS have not been accurately identified so far, but researchers suggest that the following factors might contribute to the onset of the condition.

1. Increased amount of insulin secretion- Women suffering from insulin resistance may get PCOS as their body is not able to effectively use this insulin, which results in increased insulin secretion by the pancreas. This, in turn, triggers more androgen (male sex hormone) production in the ovaries, making it difficult for the ovaries to ovulate.

2. Lower inflammation levels- The white blood cells present in your body form resistance against infections through a response termed as inflammation. Women with lower inflammation levels are likelier to get PCOS as the decreased levels stimulate polycystic ovaries, thereby producing more androgens.

3. Genetic factor-  If you have a family history of PCOS, it’s highly probable that you may also get it as the disease is linked with your genes.

How To  Live with PCOS

PCOS comes with numerous side effects like acne, obesity, infertility, excessive facial or body hair among others. There are certain lifestyle changes, which you may consider to manage PCOS and minimise its side effects.

1. Change your diet - Opt for a low carbohydrate, low sugar diet to keep your insulin levels in control, as insulin is responsible for increasing the severity of PCOS symptoms. 

2. Try to maintain an ideal body weight - Obesity is known for worsening insulin resistance, and you can prevent this by regularly keeping your weight in check. You can practice some easy at-home exercise to reduce weight besides having a balanced diet.

3. Get yourself checked regularly - Visit a doctor and get yourself checked regularly for potential health risks as PCOS is often associated with increased chances of diabetes, heart diseases, certain forms of cancer, hypertension, and high LDL (bad) cholesterol levels.

4. Join a support group - Joining a PCOS support group will help you cope with your emotional difficulties, while helping you to live a better life by cultivating an optimistic outlook.

If you would like to consult with me privately, please click on 'Consult'.

Every 1 in 5 Women in India suffers from PCOS! Why? (And what they need to know)

If you lose a baby before 24 weeks of pregnancy, it is called a miscarriage. If this happens in the first 3 months of pregnancy, it is known as an early miscarriage. Unfortunately, early miscarriages are common, with 10 20 in 100 (10 20%) pregnancies ending this way. Late miscarriages, after 3 months of pregnancy but before 24 weeks, are less common: 1 2 in 100 (1 2%) pregnancies end in a late miscarriage. When a miscarriage happens three or more times in a row, it is called recurrent miscarriage. Recurrent miscarriage affects 1 in 100 (1%) couples trying to have a baby.

Why does recurrent miscarriage and late miscarriage happen?

Sometimes there is a reason found for recurrent and late miscarriage. In other cases, no underlying problem can be found. Most couples are likely to have a successful pregnancy in the future, particularly if test results are normal.

There are a number of factors that may play a part in causing recurrent and late miscarriage:

Age, the older you are, the greater your risk of having a miscarriage. If the woman is aged over 40, more than 1 in 2 pregnancies end in a miscarriage. Miscarriages may also be more common if the father is older.
Antiphospholipid syndrome (APS- a syndrome that makes your blood more likely to clot) is uncommon but is a cause of recurrent miscarriage and late miscarriage.
Thrombophilia (an inherited condition that means that your blood may be more likely to clot) may cause recurrent miscarriage and in particular late miscarriages.
Genetic factors, about 2 5 in 100 couples (2 5%) with recurrent miscarriage, one partner will have an abnormality on one of their chromosomes (the genetic structures within our cells that contain our DNA and the features we inherit from our parents). Although this may not affect the parent, it can sometimes cause a miscarriage
Weak cervix is known to be a cause of miscarriage from 14 to 23 weeks of pregnancy. This can be difficult to diagnose when you are not pregnant. It may be suspected if in a previous pregnancy your waters broke early, or if the neck of the womb opened without any pain.
Developmental problems of the baby may lead to a miscarriage but are unlikely to be the cause of recurrent miscarriage.
Infection that makes you very unwell can cause a miscarriage. Milder infections that affect the baby can also cause a miscarriage. The role of infections in recurrent miscarriage is unclear.
An abnormally shaped uterus may contributes to recurrent miscarriage or late miscarriages. However, minor variations do not appear to cause miscarriage.
Diabetes and thyroid problems can be factors in miscarriages. They do not cause recurrent miscarriage, as long as they are treated and kept under control.
It has been suggested that some women miscarry because their immune system does not respond to the baby in the usual way. This is known as an alloimmune reaction. There is no clear evidence to support this theory at present. Further research is needed.
Are there any other risk factors?

Being overweight increases the risk of miscarriage. Smoking and too much caffeine may also increase the risk. Excessive alcohol is known to be harmful to a developing baby and drinking five or more units a week may increase the risk of miscarriage.

The chance of a further miscarriage increases slightly with each miscarriage. Women with three miscarriages in a row have a 4 in 10 chance of having another one. This means that 6 out of 10 women (60%) in this situation will go on to have a baby next time. 

Why are investigations helpful?

Finding out whether there is a cause for your recurrent miscarriage or late miscarriage is important as your doctor will be able to give you an idea about your likelihood of having a successful pregnancy. In a small number of cases there may be treatment available to help you.

What investigations might be offered?

Blood tests:

For APS- APS is diagnosed if you test positive on two occasions 12 weeks apart, before you become pregnant again.
For thrombophilia- If you have had a late miscarriage you should be offered blood tests for certain inherited thrombophilias.
To check you and your partner s chromosomes for abnormalities. You may be offered this test if your baby has been shown to have abnormal chromosome
Tests for abnormalities in the baby You should be offered tests to check for abnormalities in your baby s chromosomes. This is not always possible but may help to determine your chance of miscarrying again. If you have had a late miscarriage you may also be offered a postmortem examination of your baby. This will not happen without your consent and you will have the opportunity to discuss this with your health team beforehand.

Tests for abnormalities in the shape of your uterus. You should be offered a pelvic ultrasound scan to check for any abnormalities in the shape of your uterus. If an abnormality is suspected, further investigations may include a hysteroscopy (a procedure to examine the uterus through a small telescope which is passed through the vagina and cervix) or a laparoscopy (a procedure in which a surgeon uses a fine telescope to look inside the abdomen and pelvis).

Tests for infection. If you have had a late miscarriage, tests such as blood samples and vaginal swabs may be taken at the time to look for any source of infection.




What are my treatment options?

Treatment for APS

If you have APS and have had recurrent miscarriage or a late miscarriage, treatment with low-dose aspirin tablets and heparin injections in pregnancy increases your chance of having a baby. Aspirin and heparin make your blood less likely to clot and are safe to take in pregnancy.

Having APS means you are at increased risk of complications during pregnancy such as pre-eclampsia, problems with your baby s growth and premature birth. You should be carefully monitored so that you can be offered treatment for any problems that arise.

Treatment for thrombophilia

If you have an inherited tendency to blood clotting (thrombophilia) and have had a miscarriage between 12 and 24 weeks of pregnancy, you should be offered treatment with heparin. At present there is not enough evidence to say whether heparin will reduce your chance of miscarriage if you have had early miscarriages (up to 12 weeks of pregnancy). However, you may be still offered the treatment to reduce the risk of a blood clot during pregnancy.

Your doctor will discuss what would be recommended in your particular case.

Referral for genetic counselling

If either you or your partner has a chromosome abnormality, you should be offered the chance to see a specialist called a clinical geneticist. They will discuss with you what your chances are for future pregnancies and will explain what your choices are. This is known as genetic counselling.

Monitoring and treatment for a weak cervix

If you have had a miscarriage between 14 and 24 weeks and have a diagnosis of a weak cervix, you may be offered an operation to put a stitch in your cervix. This is usually done through the vagina at 13 or 14 weeks of pregnancy under a general or spinal anaesthetic. Your doctor should discuss the surgery with you.

If it is unclear whether your late miscarriage was caused by a weak cervix, you may be offered vaginal ultrasound scans during your pregnancy to measure the length of your cervix. This may give information on how likely you are to miscarry. If your cervix is shorter than it should be before 24 weeks of pregnancy, you may be offered an operation to put a stitch in your cervix.

Surgery to the uterus

If an abnormality is found in your uterus, you may be offered an operation to correct this.

Hormone treatment

Taking progesterone or human chorionic gonadotrophin hormones early in pregnancy has been tried to prevent recurrent miscarriage. More evidence is needed to show whether this works.

Immunotherapy

Treatment to prevent or change the response of the immune system (known as immunotherapy) is not recommended for women with recurrent miscarriage. It has not been proven to work, does not improve the chances of a live birth and may carry serious risks (including transfusion reaction, allergic shock and hepatitis).

What if no cause is found?

Where there does not appear to be a cause for recurrent miscarriage or late miscarriage, there is currently no evidence that heparin and aspirin treatment reduces the chance of a further miscarriage. For that reason this treatment is not recommended in these circumstances.

What does this mean for us in the future?

You and your partner should be seen together by a specialist health professional. Your doctor will talk to you both about your particular situation and your likelihood of having a further miscarriage and a successful pregnancy. If a cause has been found, possible treatment options will be offered to you to improve your chance of a successful pregnancy.

For couples where no cause for recurrent miscarriage has been found, 75 in 100 (75%) will have a successful pregnancy with this care. It is worth remembering that the majority of couples will have a successful pregnancy the next time even after three miscarriages in a row.

Recurrent And Late Miscarriage - Tests & Treatment For Couples!

Menopause is the time in a woman's life when the menstruation ceases, bringing an end to a woman's childbearing years. There are a number of symptoms that mark this stage, including hot flashes, which are very commonly experienced in such cases. Hot flashes are like a feeling of a red hot flush that may wash over the body and lead to excessive sweating. It occurs in the blood vessels that are closest to the surface of the skin. Yet, menopause is not the only reason why one may experience these hot flashes.

Here are some of the reasons that may trigger these hot flashes:

1. Carcinoid syndrome: This is a disease that may cause hot flashes as a symptom. In this condition, a tumour will usually release varied chemicals into the body, which can create varied symptoms that seem like hot flashes.

2. Hyperthyroidism: Overheating of the body and the system from within is something that many patients suffering from hyperthyroidism may experience. This usually happens when the thyroid glands end up producing too much of the thyroid hormone that brings about many symptoms ranging from depression to weight loss and even hot flashes. In hyperthyroidism, the body goes into a hyper mode, which usually leads to overheating of the same. This gives rise to frequent and often severe hot flashes.

3. Hormonal changes: There are many hormonal changes that may affect various men and women from time to time. A drop in the level of the estrogen hormone is something that many women go through on a regular basis. This may happen due to pregnancy as well. Also, this condition usually brings about symptoms like hot flashes.

4. Eating disorders: The way we eat and nurture our body is the way the body reacts. When there is a case of an eating disorder like dyslexia or bulimia, it may lead to varied symptoms, including hot flashes. This is due to the fact that the body's hormonal levels as well as the nutritional level plunge to an all-time low. In many such cases, hot flashes are the body's way of demanding better nutrition. These disorders can also give rise to related conditions like the hypothalamus disorder.

5. Hypothalamus disorder: Hypothalamus disorder may also cause hot flashes. This is a condition that is caused due to poor eating habits. This disorder is characterised by a major drop in one's nutrition levels and also leads to many hormonal changes. These changes often lead to symptoms like hot flashes and other related complications.

Hot Flashes: Is it Due to Menopause or Something Else

Mastitis is primarily an infection that occurs inside or on women's breasts within the first three months after pregnancy. Sometimes the infection can also affect non pregnant women where it is referred to as periductal mastitis.

What are the causes and symptoms of mastitis?
The most common reason behind such an occurrence is malfunctioning mammary ducts in pregnant women. Milk stasis or blocked milk ducts happen due to irregular feeding sessions, the baby's difficulty in sucking or not being able to attach optimally to the breast for feeding. The other plausible reason is bacterial infection that has somehow entered the ducts through a crack in the nipple area. Blocked milk ducts carry a lot of stagnant milk that provides the most suitable breeding ground for bacterial cultures. Steps must be taken so as not to pass on this bacterium to the baby who depends on breast milk almost entirely for nutrition.

1. It often manifests itself in the form of redness, swelling, pain, fever and exhaustion, resulting from inflammation of the breast tissues and mammary glands.
2. There is also a palpable warmth and tenderness of the breasts, accompanied by a general feeling of malaise.
3. Other common symptoms include lumpy formations, wedges, burning sensation especially during breast feeding.
4. Nipple discharge, body aches and relatively higher body temperatures might also occur in association.

You must consult with your doctor immediately after the appearance of similar symptoms; promptness is advisable when you are pregnant.

What problems does mastitis cause?
1. Most commonly affecting nursing and recent mothers, mastitis poses a pertinent problem in breastfeeding as it causes dysfunctional lactation.
2. Mastitis is therefore also as precarious for the new born baby who is left without its primary diet.
3. Doctors often recommend such mothers to continue breast feeding in spite of the disease, after prescribing some antibiotics which usually work in suppressing the infection after a maximum of 2 to 3 weeks.
4. The affected mothers usually feel too tired to take care of their child while suffering from this kind of infection.

Preventive measures
1. Avoid wearing tight clothes or undergarments.
2. Regularize breastfeeding schedules; do not stop before 6 months.
3. Encourage your baby to feed especially when you experience of build-up of milk.

All About Mastitis

Many people across the world spend a considerable amount of time contemplating on which type of delivery is the most preferable. In earlier times, normal delivery was the only option but these days, there is an increase in the number of caesarean or C-sections. Today, 30% of children of children around the world have been born through the C-section. Since it is up to the woman to select which type of delivery she would prefer, it is imperative to comprehend the advantages as well as risks of both the options.

Advantages of vaginal delivery to the mother
From a psychological point of view, women who opt for normal delivery are believed to have a relatively positive birthing experience. Women who go through normal delivery often feel that it is empowering to be actively involved in the procedure of giving birth to their babies. Such mothers have a much shorter span of recovery time compared with those opting for C-sections. This procedure also lets the mother as well as the baby to come in contact with each other, which in turn speeds up the process of bonding.

Pros of normal delivery for the baby
It has been found that babies who are born via vaginal delivery are less prone to developing any kind of complications related to health. They can be fed, sooner and develop fewer allergies and respiratory issues. However, very few babies born through vaginal delivery can experience any injury while being born, though this is an extremely rare condition.

Benefits of Caesarean section for the mother
There are numerous women who opt for the C-section so that there is no need to go through extended hours of labour. Today, with the advancement in medical science, mothers are able to plan the birth of their child, and it allows more control over the birthing process along with more predictability. Women who go for a C-section do not suffer from any damage to the pelvic floor, which often leads to incontinence in the course of time.

Advantages of a C-section delivery for the child
In most cases, when there are twin babies, or a single baby is too large, opting for a C- section can prove to be the most viable option. Plus, if the mother is a carrier of certain diseases like HIV, then a C-section reduces the chances of passing it to the baby.

Thus, both the options have their own set of pros and cons, and it is best to speak with a qualified gynaecologist before deciding on anything.

C-Section Vs Normal Delivery - Which Is Better For You?

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