Cystic fibrosis (CF) is a progressive disease that can affect all organ systems but mainly the pulmonary, gastrointestinal, and reproductive organs are affected. Current median survival is 30 years old. If both parents are carriers of the CF gene, they have a 1 in 4 chance of having a child with CF. Our goal is trying to identify couples at risk of having a child with CF. All pregnant patients are offered this test but carrier risk differs depending on ethnicity. People of greatest risk of carrying the gene are of white northern European ancestry, Ashkenazi Jewish descent, those whose partners have CF, and those with a family history of CF. If you are tested and are determined to be a carrier, then your partner should be tested. If you are both carriers, we will discuss further the possibility of prenatal diagnosis by invasive DNA testing. The test to see if you are a carrier for CF can be done along with any other routine blood draw.
While we are unable to test for all types of congenital (inherited), developmental and medical problems that can affect children, you can have testing done to see if you are at increased risk of some abnormalities.
The Sequential ScreenSM test is used to screen for Down syndrome (Trisomy 21), Edward Syndrome (Trisomy 18) and spinal abnormalities (such as spina bifida). To perform this test, you will have an ultrasound between 11-13 weeks in the pregnancy to measure how thick the skin is on the back of the baby’s neck (the nuchal translucency). You will have blood drawn the same day as the ultrasound (to complete step 1 of the screen) and additional blood work drawn 2-3 weeks later (to complete step 2). This test is 80-90% accurate for detecting these 3 abnormalities. This is a noninvasive test with no risk to the pregnancy and is offered to all pregnant patients.
Amniocentesis and chorionic villus sampling are invasive tests usually offered to women over age 35 or women found to be at high risk of problems based on the sequential screening test, but any woman can ask for these tests. They are up to 99 percent accurate for diagnosing chromosomal abnormalities. Since they are invasive, there is a risk of miscarriage associated with them. With amniocentesis there is about a 1/200 to 1/400 risk of miscarriage and with CVS it is slightly higher at 1%.
Eat small meals throughout the day so that you’re never too full or too hungry.
Try eating high carbohydrate foods (plain baked potatoes, white rice or dry toast) or bland foods (such as saltine crackers, popsicles, chicken broths, ginger ale and pretzels).
Avoid rich, spicy, greasy or fatty foods. However, some women find that these foods actually help their morning sickness! There is no one “right” food-just eat whatever food helps YOU.
Avoid foods with smells that bother you or make you nauseous.
The iron in prenatal vitamins can bother some women. If you think your morning sickness is related to your vitamins, stop taking them for a day or two. If necessary, try the gummy prenatal vitamins available at some pharmacies. These do NOT Have iron in them so once you start feeling better you should resume the prescribed vitamins.
Before getting out of bed in the morning, eat a few saltine crackers to calm your stomach.
Wearing “acupressure” wrist bands, which are sometimes used by passengers on boats to prevent sea sickness, may help some women who have morning sickness. You can buy the bands at drugstores and from many internet sites.
Take Vitamin B6, 25 mg up to 4 times/day
Try Preggie Pops or B-natal Lollipops, available online, at pharmacies and at maternity stores. These candies include B6 and ginger to help ease your morning sickness.
For any of the following reasons, we ask you to come in for evaluation. If during office hours, you may come here. If after hours, proceed directly to The Birth Place at North Collier Hospital.
You are in labor: Labor is expected to occur between 37-41 weeks gestation. Signs of labor are persistent painful contractions that come regularly (every 2-20 minutes). If you are earlier than 37 weeks and think you are in labor, come in immediately. If you are 37 weeks or more and contractions have started, it is okay for you to stay home when in early labor. You can do any activities that keep you comfortable such as walking around, taking a warm shower or resting in bed. When the contractions are increasing in intensity (for example, if you cannot talk during the contraction), please come to the hospital.
Your membranes have ruptured: Rupture of membranes (when the bag of water “breaks”) is usually noted as a continuous trickle or a large gush of warm fluid. If you believe your membranes have ruptured, please come to the hospital to be evaluated even if you are not having contractions.
The baby is not moving well: On average, you should feel at least 6-10 movements per hour. If you are concerned about fetal movement, lay down in a quiet place and pay attention to his/her movements. If you continue to be concerned or if there is a decrease in fetal movement from what you are accustomed to, please come in for evaluation.
You are bleeding: A small amount of bleeding (spotting) may occur just after intercourse or after the physician examines you. If you are bleeding at any other time, especially if it is heavy, come in immediately for evaluation.
The following medications are considered safe to take in pregnancy in limited amounts. If you have any questions or concerns, or if your symptoms are not improving, please call us.
Allergies (Runny nose, sinus congestion, itching eyes): Benadryl, Claritin, Zyrtec
Back Pain: Tylenol (acetaminophen); Ice packs, Massage therapy, Biofreeze, Icy Hot
Constipation Prevention: Start a fiber supplement at a small dose and slowly increase. This may include Fibercon, Benefiber, Metamucil or Konsyl EZ-Mix. Colace (Docusate, stool softener) 1-2 x/day. Miralax (1 scoop in 8 oz liquid).
Constipation Treatment: Temporarily stop prenatal vitamins. They contain iron in them which can be very constipating. Senekot, Milk of Magnesia, Konsyl EZ-Mix, Colace (1 pill 2x/day), Miralax (1 scoop in 8 oz liquid)
Cough: Robitussin (make sure only ingredient is Guiafenesin)
Diarrhea: Imodium or Kaopectate; Start a BRAT diet (Bananas, Rice, Applesauce, Toast). Come in to see Doctor if: Fever, Not improved in 2-3 days, Weak or dizzy
Headache: Tylenol (Acetaminophen) *DO NOT TAKE ASPIRIN OR ADVIL/IBUPROFEN*. Come in to see Doctor if: Dizziness, blurred vision, Not getting better
Heartburn/Acid Reflux: Tums, Rolaids, Maalox, Mylanta, Zantac, Tagamet, Pepcid
Hemorrhoids: Preparation H or HC, Anusol, Tucks
Insomnia: Benadryl, Tylenol PM
Leg Cramps: Calcium 1000mg/day. Come in to see Doctor if only one leg hurting or swollen.
Nausea and Vomiting: Vitamin B6 50mg every 6 hours, Ginger, Ginger Tea, Emetrol. Come in to see Doctor if you are unable to keep liquids down for more than one day, feeling weak and dizzy, or/and are dehydrated
Nose Bleeds or Gum Bleeding: Common in pregnancy
Pain: Tylenol (Acetaminophen) *DO NOT TAKE ASPIRIN OR ADVIL/IBUPROFEN*.
Skin Irritation: Hydrocortisone cream, Benadryl cream, Calamine Lotion, Zyrtec, Oatmeal bath
Sore Throat: Cepacol lozenges, chloraseptic spray
You can continue doing any exercise you were previously doing. However, you should not elevate your core body temperature. General guidelines to help avoid this are to limit your target heart rate to 120-140 bpm or to make sure you can have a full conversation when at your max speed. Drink plenty of fluids before, during, and after exercise. Eat enough calories to meet the needs of your pregnancy and exercise program.
Stop exercising immediately if you have pain, bleeding, dizziness, or shortness of breath.
If you do not already exercise, you may want to start walking, stretching or doing yoga. The NCH Wellness Center offers Mommy 2 Be Water Aerobics and Yoga classed that are great for pregnant moms.
Yes, you can occasionally color your hair. We prefer that you not do it during the first trimester.
Eat a healthy well-balanced diet rich in fruits, vegetables and complex carbohydrates.
If you start the pregnancy at a normal body weight, you need only ~300 extra calories/day.
Eat regular meals each day. Try 5-6 smaller meals throughout the day as your growing baby needs a continuous infusion of calories.
Eat a variety of feeds to help get all appropriate vitamins and minerals.
Eat plenty of calcium-rich foods such as dairy products, leafy green vegetables, oranges, nuts and legumes.
Drink plenty of fluids. Your body needs at least 8-10 glasses of water each day. Low fat milk and low-sodium vegetable juice are good sources of fluids as well.
Take a prenatal vitamin every day. Make sure you are getting at least 800-1,000 micrograms of folic acid in your vitamins.
Do not eat raw (including sushi), undercooked or unpasteurized foods. There have been concerns about deli lunch meats and canned tuna fish so avoid or limit these.
Avoid swordfish, shark, king mackerel and tilefish as these can have very high
levels of mercury. Smoked or cured fish is not cooked and should not be eaten.
Limit recreationally caught fish to 6 ounes per week. Check with the environmental protection agency (EPA) at http://epa.gov/ost/fish and click on “National Listing of Advisories” to determine if the body of water the fish was caught in is safe.
A safe level of caffeine intake is not known. We recommend limiting your caffeine intake to no more than 12 oz per day (one cup of coffee or tea, one can of soda). Different drinks have different levels of caffeine in them so be cautious. Do NOT consume any of the energy drinks that are readily available.
In an uncomplicated pregnancy, you can travel until 35 weeks (at the latest). Try to walk around every 1-2 hours to promote circulation and decrease your risk of blood clots.
Routine dental visits are very important. In fact, poor dental hygiene is associated with preterm labor. Schedule your routine cleanings, but let them know that you are pregnant.
Quit Smoking as soon as possible. When you smoke, you risk not only your health but that of your baby. Smoking increases the risk of miscarriage, low birth weight and pre-term delivery. The sooner you quit smoking, the better it will be for both you and your baby. Children in a home where someone smokes (even if that person only smokes outside) are more likely to die of S.I.D.S.-Sudden Infant Death Syndrome. If you need help quitting, please talk with us.
Avoid Alcohol and Recreational Drugs. Alcohol is found in many drinks including beer, wine, wine coolers and liquor. Alcohol and drugs that are ingested while pregnant will also be ingested by the growing fetus. They can cause severe birth defects, mental retardation, stillbirth, preterm delivery, low birth weight and newborn addiction to the substance at delivery. It isn’t known if there is a safe level of alcohol, therefore, the safest choice is not to drink alcohol during pregnancy. If you need help with an addiction to alcohol or any types of non-prescription or prescription drugs, please talk with us.
Cord blood is the blood that remains in the umbilical cord and placenta following birth, which is usually discarded. Cord blood banking uses external facilities as a place to store and preserve your baby’s cord blood. The cord blood of your baby serves as an abundant source of stem cells, which are genetically distinctive to your baby and your family. Stem cells can transform into other types of cells in the body and create new growth and development; they are the building blocks of the immune system. This transformation of cells provides physicians with a way to treat leukemia and some inherited disorders. Cord blood stem cells have the same ability to treat disease as does bone marrow, however, there is significantly less rejection. Banking your baby’s blood and stem cells in a cord blood bank provides you with a type of insurance. Hopefully, you will not need to access your baby’s stem cells to address a medical problem, but using a cord blood bank can give you peace of mind that this valuable resource is there if you need it.
We support our moms that would like to breastfeed. Breastfeeding offers many advantages to you and your newborn.
Breast milk provides the ideal nutrition for infants. It has the perfect mix of vitamins, protein, and fat — everything your infant needs to grow. And it’s all provided in a form more easily digested than infant formula. Breast milk contains antibodies that help your baby fight off viruses and bacteria. Breastfeeding reduces your baby’s risk of having asthma or allergies. Babies who are breastfed exclusively for the first six months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea. They also have fewer hospitalizations and trips to the doctor.
Breastfeeding has been linked to higher IQ scores in later childhood in some studies The physical closeness, skin-to-skin touching, and eye contact all help your baby bond with you and feel secure. Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight children. Some studies have also shown a link between breastfeeding and a lower risk of sudden infant death syndrome (SIDS), diabetes, obesity, and certain cancers.
Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster. It releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth. Breastfeeding lowers your risk of breast and ovarian cancer. It may also lower your risk of osteoporosis.
Since you don’t have to buy and measure formula, sterilize nipples, or warm bottles, breastfeeding saves you time and money. Deciding to breastfeed provides you with regular time for relaxing quietly with your newborn as you grow close and emotionally bond.
The first few days after birth, your breasts produce an ideal “first milk.” It’s called colostrum. Colostrum is thick, yellowish, and scant — but there’s plenty to meet your baby’s nutritional needs. Colostrum helps a newborn’s digestive tract develop and prepare itself to digest breast milk.
Most babies lose a small amount of weight in the first three to five days after birth. This is unrelated to breastfeeding. A natural feedback loop exists between your baby’s feeding needs and your milk production. As your baby needs more milk and nurses more, your breasts respond by producing more milk. Experts recommend breastfeeding exclusively (no formula, juice, or water) for six months. If you supplement with formula, your milk production may go down.
Even if you breastfeed less than the recommended six months, it’s better to breastfeed for a short time than no time at all. You can add solid food at six months but also continue to breastfeed if you want to keep producing milk.