Pregnancy in a nutshell

The circulatory system:

• changes result, among other things, from an increase in the oxygen demand of tissues,
  increase in heart stroke volume,
  hemodilution – physiological anemia – there is more blood, but it is very diluted,
  rapid heartbeat.

Urinary tract:

• the presence of glucose and protein in the urine – trace amounts associated with the failure of reabsorption,
  pressure of the uterus on the bladder,
  increase in blood flow through the kidneys,
  increase in glomerular filtration.

Digestive system:

• drooling, nausea, vomiting
  gestational cholestasis,
  constipation
  topography changes.

Respiratory system

• increase in alveolar ventilation,
  skin darkening,
  the appearance of moles, freckles, scars – hormonal changes.

Joints:

• tendons softer and more flexible,
  proper posture and comfortable shoes – a must,

Swollen Gums:

• teeth and gums become much weaker (make sure you avoid the dentist during pregnancy).

Stretch marks:

• mechanical stretching of collagen fibers,
  prevention is: oil massages, silicone patches.

Breast:

• colostrum, breast enlargement from the second trimester

MOTHER’S DIET

Nutrition of pregnant women is one of the most important environmental factors responsible for the proper course of pregnancy, the development of the child in the womb and the health of the child, both in childhood and in adulthood. It also affects the health of the mother and her functioning after childbirth, therefore a balanced diet should provide the right amount of energy and contain the necessary nutrients in the right amounts and proportions. Certain foods should be avoided or completely eliminated from the diet, incl. raw meat, liver, highly processed products, cakes, sweets, as well as drinks such as coffee or alcohol. Remember the basic rules of nutrition. Eat whole grain cereal products. Remember to consume milk and dairy products every day. Use different sources of protein (pulses, fish, meat, eggs). Use vegetable fats (rapeseed oil, olive oil, various oils). Eat 500g of vegetables and 300g of fruit daily. Drink about 2-2.5 liters of fluids a day, the main source of fluids should be water (at least 1-1.5 liters a day), other fluids may be recommended during pregnancy, e.g. red teas, selected natural fruit or herbal teas (allowed for pregnant women). ), as well as vegetable and fruit juices without added sugar, squeezed from fresh products. Limit your consumption of sweets. Eliminate fast food from your diet. Limit the addition of salt to dishes and the consumption of foods that contain significant amounts. Limit coffee drinking to one cup a day or eliminate it entirely. Give up drinking alcohol. Remember to supplement with folic acid and vitamin D. If you are overweight or obese, try to reduce your body weight at least partially with the help of your doctor and dietitian, learning how to choose healthy food products.

salt – note the amount of Na ions; excess can lead to kidney failure, swelling and hypertension,
sugar – excess sugar can lead to gestational diabetes, obesity, increased incidence of vaginal infections, dental problems,
thirst – satisfy mainly with water and fruit and vegetable juices; avoid a lot of coffee and carbonated drinks; NOT FOR ALCOHOL.

Supplementation in pregnancy

During pregnancy and lactation, the need for micronutrients increases. A balanced diet largely covers the necessary components that should satisfy the basic deficiencies resulting from the woman’s condition. However, very often an optimal diet is insufficient to cover the needs of the pregnant woman and the fetus. That is why the Polish Gynecological Society has presented unified supplementation recommendations in the field of vitamins and micronutrients for women planning pregnancy, pregnant and lactating women. According to these records, supplementation with folic acid, iodine and vitamin D3 is necessary.

FOLIC ACID (drugs: Actifolik, Folik, Folacid)

• affects the development of the nervous system of the fetus,
  it is advisable to take when planning pregnancy at least 6 weeks before pregnancy and until the end of the second trimester; the recommended daily dose is 0.4 mg (not to exceed 1 mg),
  in the case of women using early hormonal contraception, antiepileptic drugs, smoking, obese women, the dose of folic acid should be increased with prescription preparations,
  dietary supplements and dietary medical products should be avoided.

IODINE

• small and moderate iodine deficiency leads to disorders of psychomotor development, severe deficiency leads to the development of cretinism; Hypothyroidism due to iodine deficiency increases the risk of miscarriage and premature birth,
  Poland is a country with an average risk of iodine deficiency in the diet due to iodization of table salt; during pregnancy, the demand for iodine increases, mainly in the first trimester,
  WHO recommends the intake of iodine 200-500 μg per day in pregnant and lactating women,
  an excess of iodine in a pregnant or lactating diet (over 500 µg / day) may cause hypothyroidism and goiter in the fetus or newborn,
  To cover the demand, use iodized table salt or iodized water.

VITAMIN D3 (OTC drug: Vigantoletten, Vigalex, Vigantol)

• affects the proper functioning of the calcium and phosphate economy,
  80-100% of the daily requirement comes from biosynthesis in the skin, to a small extent with food. In Poland, it is possible in the period from March to September with a minimum 30-minute exposure to sunlight without the use of UV filters; deficiency is often found due to insufficient exposure of the skin to sunlight,
  deficiency leads to a disturbance of the mineral balance, leading to osteopenia,
  pregnant and lactating women are particularly exposed to the loss of calcium from the bones,
  has an immunomodulating effect – it has been confirmed that D3 supplementation reduces the risk of bacterial vaginosis, correlating with some complications of pregnancy,
  the daily dose is recommended for women planning pregnancy, pregnant and lactating women to be 2000 IU (50 µg); the highest safe daily dose is 10,000 IU.

IRON (OTC drug: Ascofer; Prescription: Tardyferon, Hemofer; Tardyferon fol = Fe + folic acid)

• supplementation is recommended for women who plan to become pregnant and in whom iron deficiency can be expected, and for people who are on a vegetarian diet and with heavy menstruation,
  the recommended oral dose is 18 mg for women before pregnancy, 26-27 mg for pregnant women,
  taking iron preparations should be consulted with a doctor!

MAGNESIUM

• deficiency causes disorders of neuromuscular conduction, increases the contractility of muscle fibers and the risk of hypertension; the correct concentration of magnesium also affects the absorption of calcium,
  recommended supplementation from 200 to 1000 mg of magnesium daily, depending on indications, in deficiency states or its clinical symptoms, it is recommended to supplement about 6 mg / kg bw

CALCIUM

• daily demand for calcium increases in the second and third trimesters of pregnancy and during lactation,
  the risk of calcium deficiency in the body is greater in people who do not stay in the sun, in multiparous women, breastfeeding women,
  according to WHO, pregnant women are recommended to administer 1,500-2,000 mg of calcium per day,
  for pregnant and lactating women, the demand is approx. 1200 mg / day, which is often not balanced by diet and requires supplementation with oral preparations,
  calcium is also essential in the prevention of pre-eclampsia by helping to normalize blood pressure.

OMEGA-3 ACIDS

• DHA – docosahexaenoic acid, belongs to the group of omega-3 acids, is one of the most important components of the diet of a pregnant woman and during lactation,
  the role of DHA during pregnancy and lactation is very important because it influences: improving the development of the CNS in the fetus, ensures the proper development of the retina of the eye, reduces the risk of premature birth, postpartum depression, reduces the risk of gestational diabetes and hypertension in adulthood, allergies, is responsible for the proper development psychomotor,
  high demand for DHA is in the third trimester of pregnancy, which is associated with a rapid increase in the mass of nervous tissue in the CNS,
  recommended supplementation min. from the 20th week of pregnancy due to the intensive development of the nervous system,
  the daily requirement during pregnancy and lactation is 600 mg of DHA; in case of a significant deficiency or a high risk of preterm labor, it is recommended to take 1000 mg of DHA daily throughout the entire pregnancy.

VITAMIN E

• is an antioxidant that prevents the oxidation of vitamin A, lipids, and polyunsaturated fatty acids, thus protecting cell membranes against damage,
  vitamin E deficiencies occur in premature babies,
  daily requirement for vitamin E during pregnancy is approx. 15-19 mg / day.

VITAMIN A

• with caution in pregnancy; deficiencies are very rare! – you can easily overdose
  it is better to use beta-carotene as it is safer for pregnant women.

Pregnancy and medications

Drug-induced complications of pregnant women:

premature labor,
delayed labor,
effect on the fetus.

All medications should be consulted with the attending physician !!!

Use of drugs during pregnancy:

paracetamol belongs to category A, i.e. without a proven increase in the incidence of malformations in the fetus,
NSAIDs are not used in the third trimester of pregnancy, as it may lead to the closure of the Botal’s ductus arteriosus, leading to pulmonary hypertension.

When the baby arrives

Why is the baby crying?

Colic

• the rule of “threes” – babies suffering from colic cry more than 3 hours a day, for more than 3 days a week, for at least 3 weeks,
  possible causes of colic include lactose intolerance, food allergies, intestinal microflora disorders, improper feeding technique, immature nervous system, psychosocial factors (nervous childcare, anxiety, over-control).

Symptoms:

• paroxysmal crying that cannot be calmed down,
  a restless child,
  tense stomach,
  curling the legs.

Pharmacological methods of treating colic:

• probiotic – e.g. BioGaja drops,
  lactose – if the cause is lactose intolerance, e.g. Delicol drops,
  Simetikon – if there is an excessive accumulation of gases, e.g. Simetikon,
  fennel infusions – e.g. Herbapol.

Diarrhea

• in children, most often due to a viral infection,
  diagnosis when the child excretes 3 or more diarrheal stools / day,
  chronic diarrhea – lasts more than 14 days – may be a symptom of another disease,
  acute diarrhea – watch the baby! can become dehydrated in a matter of hours.

Medicines:

• Diosmectin (diosmectic),
  hydration, electrolytes per child’s weight – Orsalit, Acidolit,
  probiotics – Dicoflor, Biogaia.

Fever, cold

• temperature from 35 to 38 ° C – normal temperature in newborns, it often changes,
  thermometers – frontal, ear, non-contact,
  a bath a few degrees below the child’s body temperature, if the child has a fever above 38 ° C (approx. 35-37 ° C water).

  If the temperature exceeds 38 ° C, after consulting a doctor, we can give:

  paracetamol (suppositories, suspensions),
  ibuprofen – from 6 months life (sometimes from the 3rd month), antipyretic 5-10 mg / kg body weight; the maximum daily dose is: 40 mg / kg body weight; ibuprofen has a faster and stronger effect than paracetamol,
  the combination of ibuprofen and paracetamol is very effective; the strongest therapeutic effect is obtained by alternating both substances every 4 hours.

Chafing

• preparations such as allantoin, lanolin, panthenol are helpful in the treatment: Sudocrem, Linomag ointment, Bephanten, Alantan Plus, Alantan dermoline,
  skin should be gently cleansed and dried.

  Pregnancy is a beautiful period in a woman’s life, which involves taking responsibility not only for herself but also for the other person, therefore proper knowledge about the lifestyle in this state is necessary for the pregnancy to develop properly. Consult your doctor if you have any doubts or would like to learn more about other issues.

  Literature:

  https://imid.med.pl/images/poradnik-zywien-dla-kobiet-w-ciazy.pdf
  A. Wendołowicz, E. Stefańska, L. Ostrowska, Nutrition of women during pregnancy.