Tag Archive | "milk"

Hands on Pumping

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Hands on Pumping

Posted on 15 September 2014 by Kristrun

Although pumping or expressing is not recommended for the first 6 weeks after birth, it is sometimes necessary especially if your baby is ill, premature or unable to breastfeedingonbedbreastfeed for any reason. To get the milk production started after birth it is important to stimulate your breasts as soon as possible – preferably within two hours after the birth. To maximise the amount of colostrum produced, you may have more success hand expressing the first time since this is often more effective than using a pump.

After that initial expressing it is recommended to use a hospital-grade pump with a double pump kit about 8 times or more per 24 hours. This works out as approximately every 3 hours or whenever convenient – it doesn’t have to be always at the same time. For maximum milk production by pumping, it is important you use breast massage before and during the pumping session. This will stimulate the ‘let-down’ and the milk will flow more easily. When you’re pumping you should watch the sprays of milk and when this subsides, turn off the pump. This might take 5 minutes for some women and 25 minutes for others; you don’t pump for 20 minutes just to pump for 20 minutes. After you turn off the pump, it is recommended you try to hand express for 5-10 minutes into the pump flange since that can sometimes double your output and you can get more hindmilk which is the richest milk for your baby.

Maternal factors influence milk volume and things like stress, anxiety, fatigue and illness can decrease milk production significantly. Having an ill or premature baby can call on all these factors, so it is really important to be kind to yourself and give yourself time. It is crucial important to try to sleep and rest regularly, eat well and drink lots of fluids since your own nutritional status during lactation can affect milk volume and composition.

It is also important to know that there are experts out there who can help you so you don’t have to suffer in silence. If you’re having problems or concerns don’t hesitate to call Annerley and schedule an appointment with our breastfeeding consultant or one of our midwives. Or as a home visit.

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Water in Hong Kong and its use in making up infant feeds

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Water in Hong Kong and its use in making up infant feeds

Posted on 12 September 2014 by Kristrun

Here at Annerley, we are frequently asked by parents for information on which water to use for making up bottles of infant formula and for using on its own for baby to bagsofBreastmilkdrink. This is a very difficult area to look into with no definitive evidence for blanket recommendations. A quick search on the Internet will show you that there is a lot of confusing and contradictory information which does not help in any way to quell the concerns of many parents with young babies.  The following information is based on our research into this area and we hope that it will help to answer some of your questions. Nicole Edwards, Peadiatric Dietitian, has worked with us to provide the following information.

Choosing which water source to use for making up infant feeds can be a difficult and confusing task for parents in Hong Kong. In most countries using boiled, cooled tap water to mix with feeds is the ideal choice but many people in Hong Kong express their concern over the quality of our tap water, in particular how it is delivered to the domestic tap. Some parents have opted to use bottled or mineral water. However, this option does not come without its own potential problems and costs. There are no international evidence-based guidelines regarding the use of mineral or spring waters in infant formula feeding therefore it is difficult to make  recommendations regarding which brand to use.

The responsibility of which water to choose still falls on the shoulders of the parent especially as there is essentially no ideal solution to be recommended.

It is important to note that in all cases, any water which is to be used for making up infant feeds (tap/filtered/bottled/spring/mineral) MUST be boiled and then cooled prior to using.

If parents are happy to use tap water, they may want to invest in commercially available water filters which are fitted to the domestic tap and consist of an activated carbon filter through which the water flows. It is important to note however that they are not recommended by the Water Supplies Department (WSD) as it is felt that they may become an ideal breeding ground for bacteria and may represent a health hazard if not maintained properly. If these filters are used, it is recommended that parents follow the manufacturer’s instructions and ensure that the filter cartridges are replaced regularly (at least once a month). It is essential that water from the tap (even if it first passes through a self-fitted filter) is boiled before it is used to make up infant formula feeds.

Reverse osmosis (RO) filters claim to be a more effective type of filter, removing pathogens and chemicals from the tap water. The system is permanently fixed to the domestic tap. Specialist companies in HK provide this service and will return to check and replace the filters. The installation and service of these filters is considerably more expensive than attaching a commercial filter to the domestic tap. The filter process removes chemicals, 95% of the water’s mineral content and metals and pesticides. Some bacteria and viruses are also removed however, this is not guaranteed and thus RO water should still be boiled if it is to be used for making up infant formulas.

Regarding distilled water, there is conflicting advice (none of which appears to be scientifically based) on whether distilled water has the ‘leaching out’ effect of minerals in the body. Distilled water has been said to act like a ‘magnet’ which collects rejected, discarded, and unusable minerals in the body and, assisted by the blood and the lymph, carries them to the lungs and kidneys for elimination from the body (from the book “Fit for Life II: Living Health” by Harvey & Marilyn Diamond) The same authors feel that it is impossible for distilled water to remove minerals which are already part of the cell structure, thus the ‘leaching out’ of essential minerals does not occur as these are already part of the cell.  It is uncertain whether adding minerals back into the water (for example in a brand such as Watsons Water with Minerals) after the distillation process would counteract this suggested property of distilled water.

Guidelines on maximum mineral concentrations acceptable for drinking water (UK Dept of Health figures)

Bottled water is not recommended to make up a feed as it is not sterile and may contain too much salt (sodium) or sulphate. If you have to use bottled water to make up a feed, check the label to make sure the sodium (also written as Na) level is less than 200 milligrams (mg) per litre, and the sulphate (also written as SO or SO4) content is not higher than 250mg per litre. It is not usually sterile, so it will still need to be boiled, like tap water, before you prepare the feed.  However you may need to use bottled water to make up a feed if:

• your drinking water has been contaminated because of flooding
• you’re travelling abroad and drinking the local water is not recommended.

(Ref: NHS 2012)The mineral composition of many mineral/spring waters does however fall well below the guidelines above thus parents may question why these cannot be used. As there are no other guidelines apart from the DOH ones above, parents must know that  they use mineral waters at their own risk, but assuming they choose waters which conform to the above standards, the risk of solute overload may be small. Due to this lack of clarity on the suitability of various waters whose mineral content actually does fall under the above recommendations, plus the large variety of waters on the market, it is impossible to endorse or recommend specific brands.

In summary:

  1. All water used for infant formula MUST be boiled and cooled before using to make up infant feeds.
  2. The quality of HK Water is considered safe for use in making up infant formula feeds provided the pipes and holding tanks within the building structure are up to standard which is the responsibility of the building management and parents to check.
  3. If parents opt to use tap water for feeds it is probably a good idea to fit a commercial water filter or Reverse Osmosis water filter to the domestic tap. If this is the chosen option parents must be aware of the potential hazards of the filter becoming a breeding ground for bacteria. Commercial filters therefore must be changed as regularly as recommended by the manufacturing company. The RO filter will also need to be cleaned and checked regularly by the providing company.
  4. Distilled bottled water with added minerals may be a safe alternative to tap water provided parents are aware of the conflicting advice given regarding its suitability and safety when bottled in plastic bottles. There is insufficient scientific information, as noted by the WHO, on the benefits or hazards of regularly consuming distilled water.
  5. Choosing other bottled waters for the regular use of mixing with infant formula may be confusing and costly. It is likely that choosing water which is simply labeled ‘bottled water’ (as opposed to spring or mineral water) may be the safest option as these waters are expected to conform to essentially the same standards as the public water supply and they are therefore suitable for giving to infants or for preparing feeds.
  6. If it is absolutely necessary to use ‘spring or mineral water’ for example if one is abroad and the tap water is not safe, then the composition of the water should be checked and avoided if the levels of minerals exceed the guidelines given above. As generally bottled water is not sterile, this MUST be boiled before use with infants.

Thanks to Nicole Edwards BSc RD, Clinical & Freelance Paediatric Dietitian based in Hong Kong, for her contribution to this article, first published in 2008 in the Annerley Newsletter.  

Comments regarding NHS guidelines added by Conchita Amende, 2014.

Consultation with the midwives, available on Skype (face time or other platforms), over the phone or in the office. Click here to book. More information about our services on our website.

 

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Breastfeeding in government hospitals in Hong Kong

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Breastfeeding in government hospitals in Hong Kong

Posted on 21 August 2013 by hulda

BREASTFEEDING IN GOVERNMENT HOSPITALS IN HONG KONGBy Hulda Thorey –  Published in SassyMama – 10 April 2013

Breastfeeding is promoted, encouraged and supported in Hong Kong government hospitals in principal. However, in practice, the level of support offered can vary. Although well meaning, some staff may want to follow routines that are not necessarily in the best interests of the breastfeeding mother, but an informed and prepared mother can confidently stand her ground to get what’s best for her and her baby. Here, Hulda Thorey, midwife and founder of Annerley, provides advice on how to prepare for breastfeeding in the government system. 

Breastfeeding immediately after birth

Nowadays, if everything around your baby’s birth is normal, most hospitals will not take them away for the traditional initial check; and a request to have the baby given straight to you means that you can usually initiate immediate breastfeeding. Of course, on the rare occasion a baby is not doing so well straight after birth and the hospital wants to transfer the baby to the special care unit for neonatal help, most parents are more than happy for the quick response.

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Hulda Midwife at Annerley

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What is “normal” in breastfeeding?

Posted on 11 February 2012 by hulda

Hulda Midwife at AnnerleyDear all,

I have spent this week with women battling their breastfeeding challenges.  Mostly good news, but many interesting topics came up and a lot of women asked; what is “normal” in breastfeeding?

This topic reminds me a little bit of when woman are pregnant and they keep coming into Annerley after their checkups, half with concerns that their baby is suddenly too small and the other half with babies that in the last scan seemed to be alarmingly big.  Now this is another story for another blog, but in terms of the breastfeeding mums, pretty much half of them feel that they don’t have enough milk, and the other half is producing so much that they don’t know what to do to slow it down.

I am not writing a lengthy blog about this today, but I just wanted to raise a few points.

  1. First of all, not all babies grow the same.  There is no particular advantage of being  “average” or above the 50th percentile.  Even if your baby is bigger or smaller, as long as it grows, this is fine.
  2. Second, the breast milk production changes over time, over days and between the hours of the day.  It is also greatly affected by your sleep, food and drink intake, stress levels, outings, guests, travels, illness etc.  So there will be swings.  And similarly, baby’s need for milk changes through the day, between days and as it grows.

The great thing is that the two usually sync beautifully, if you just stay calm and let things happen.  After a few weeks of breastfeeding, there is harmony in this for most women but in the meantime, it is sometimes hard to stay patient, or even to believe that the day will come when everything is in balance.  But it makes no sense that there would not be enough milk for some babies, if everything is done “correctly” (why I put this this way is because correct can be many different ways).

Also, hard core breastfeeding support is sometimes a bit too hardcore.  Those that work in this field are always very optimistic and telling women to be patient, everyone can breastfeed etc.  But sometimes we fail to acknowledge that there are women out there that for one reason or another who will always have a harder time breastfeeding than others.  They can still breastfeed, but it must be admitted and they must not be made to feel bad when it is obvious that they do in fact only have just about the amount that the baby needs, or if they are the ones that always have a massive overflow of milk.

I will continue with this later.  But if you are a mother that produces more milk than makes you feel comfortable, or less milk than it seems that the baby wants,  be comforted by the fact that you are first of all not alone, this happens to many women but also, with time things always settle and you will find a pattern to feed your baby that suits both of you best.

As for my involvement, I must just say that I admire all of you ladies out there, you really make me feel proud of the strength that I see within you all.

Feel free to share your experiences and breastfeeding stories here or on our Facebook page, we love to hear from you.

Hulda

Too book consultation with our consultants (midwives and/or lactation consultants), click here or email us to info@annerley.com.hk

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Mastitis – blocked milk ducts

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Mastitis – blocked milk ducts

Posted on 12 January 2012 by Annerley

… I just wanted to write these words as a reminder to all breastfeeding mothers because I am now sitting here at home trying to rest and recover after a blocked milk duct that I failed to diagnose myself with in time!  I have literally spent the last few weeks warning all the mothers that I am seeing to be careful during the cold months and over Christmas when people tend to get more busy than usual – that this is a typical time for women to get mastitis, as they forget to check and sometimes the feeding schedules are a bit different from usual.

And here I am, after rather busy days since December,  – one homebirth and another very lovely birth at Union Hospital, – and lots of home visits, I somehow have managed to ignore the fact that my own feeding schedules are all over the place.  And I am really supposed to know about these things. In any case, I am just about finished with unblocking it by feeding much more frequently and resting in bed for more or less two days.  It is painful and saps all my energy but worth doing and now I feel much better.

So I guess one should never fail to check, feel and listen to the body.  Any changes in the usual daily patterns, more or less feeding, pumping, activities etc. may all lead to troubles if you are not careful.  I just wanted to share this – and finally say that as long as you do catch it in time, it is well worth fixing it by taking it slowly with the baby for a few days – it has been lovely here at home with my little ones.

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…some common baby q&a

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…some common baby q&a

Posted on 20 December 2011 by Annerley

Is it true that newborn babies only see black and white, and no colors?

To a certain extend this is correct.  The eyes of newborn babies are not fully developed and for a while after they are born they can not fully see colors.  They also cannot focus far away so only things around 10 – 30 cm away from their eyes are clearly visible.

My baby has got a bit of hair and it is growing fast, but there are some bold areas on the back of his head.  Is this normal?

Yes, and try not to worry about this.  This happens mainly because babies lie on their backs most of the time and the friction between the head and the surface underneath usually causes some of the hair to fall off.  Because of increased risk of cot-death when babies sleep on their front, sleeping on the back is the preferred position so most parents see bold spots on their babies’ heads after a while.  The good thing is that after the hair grows a bit thicker, this bold spot disappears and you never see any signs it was there in the first place.

When is the right time to give solid foods to babies?

The need for solid food differs quite between babies.  They also tolerate new types of food in a different way, so therefore it is important not to start too early and start really slowly.  We recommend parents to take the baby to a baby clinic and get advice from midwives or doctors on what is suitable for each child.  General guidelines from the WHO in 2005 are to wait until the baby is 6 months old and ideally to feed only breast milk until then.

How often do we have to change nappies?

As a rule of thumb, it is good to change nappies every time you feed the baby, ideally in the end of the feed since most babies will urinate/pass stools during the fees or right after.   If your child develops nappy rash, you must change more frequently than this and try and ensure some time every day without the nappy to dry the area.  You do not have to change the nappy every time the baby does a little pee unless the baby seems really sensitive to this.

Is it good or bad to warm up milk in the microwave?

BAD!!  Microwave ovens are designed in the way that temperature of fluids that have been heated can be extremely uneven.  Then when you touch the milk on the outside of the bottle it might seem the right temperature, but inside it might be a lot warmer, causing serious damage to the baby’s mouth and stomach.  Another reason is also that some of the ingredients of the Breast milk can be damaged with microwaves.

If you wish to warm up milk, we suggest to put hot water (30 – 40 degrees) in a small bowl and then to put the bottle in there for a few minutes.  The milk will warm up quickly without any risk to the baby.  Make sure to test the milk before feeding it, by putting a drop on the inside of your arm/wrist.  It should not feel hot.

Colic – what to do?

Babies often get the occasional colicky period, without developing“every day” colic.  Best way to deal with it is to try different advice and see what seems to suit your child.  You might want to try and have the baby lie flat on the stomach on your forearm and walk around like this.  Also you can make chamomile tea and cool it down until around room temperature, and then give around 2 teaspoons.  This often soothes the stomach and lasts for a few hours.  If the baby does not seem to be calmed in any way, call a midwife or a doctor to get advice.  Another treatment that has proven both very popular and useful is to have osteopathic treatment.  At Annerley, Ines De Beer is our in-house osteopath.

When can I give my child normal cow’s milk?

In the first year, if the baby is not given the breast milk, formula powder is the second best option.  When the child has been given food from all food groups and has gotten used to those, he/she can have cows milk.  This is usually around 12 months of age.  We recommend delaying giving other types of dairy, such as cheese and yogurt until 9 – 11 months, or at least give them sparingly.

How can I prevent nappy rash?

  • Most babies get nappy rash sometime in their early months.  Here are some tips about how to prevent it:
  • Clean the bottom carefully with only cotton wool and water and dry well with a cloth.
  • Leave the baby with no diaper on for a while every day, or even every time when you change a nappy.
  • Change nappies as soon as they get dirty.

If none of this works, a nappy rash cream might be helpful, especially the ones with zinc oxide in.

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Healthy nutrition for you and your baby

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Healthy nutrition for you and your baby

Posted on 17 August 2011 by Annerley

Eating healthy food will be good for you and your baby. What you eat today can have long term effects on your baby’s health even into adulthood. Do you need to eat any differently from normal when you are pregnant or hoping to have a baby?

Folic acid

Folic acid is a B vitamin and it is thought that you need more of this than usual in early pregnancy. Folic acid protects your baby against birth defects at the time that the brain and nervous system are developing (e.g. Neural tube defects such as spina bifida). It is difficult to get enough folic acid from your daily intake of food, so the Department of Health has recommended that you take a tablet of folic acid every day (each tablet should contain 400 micrograms or 0.4 milligrams). If you can not afford healthy foods find out where to apply for wic near me.

  • Start taking folic acid when you know you want to be pregnant. If you get pregnant first, don’t worry.  Just start as soon as possible and continue until you are sure you have passed the 12th week.
  • Folic acid can be found in green leafy vegetables, potatoes, baked beans, yeast extract, fortified breakfast cereals and bread with the F symbol. Try to include these foods in your daily diet.
  • If you or anyone in your family has ever had a pregnancy affected by spina bifida or another neural tube defect, you need a much larger dose of 4-5 milligrams of folic acid and your GP will prescribe this for you.

Aim for 5-a-day fresh fruit and vegetables

Fruit and vegetables, whether fresh, chilled, frozen, canned or dried, are rich in vitamins, minerals and fibre. A piece of fruit, a portion of vegetables not including potatoes, a glass of fruit or vegetable juice, and even a ‘smoothie’, will all count towards one of your 5-a day goal. However, it is important that you keep the 5 items varied, so five of the same thing does not count!

Starchy foods including bread, rice, pasta and potatoes are carbohydrates and are satisfying, making you feel fuller for longer and providing you with energy. However, if you eat too many of these you may put on excess weight during your pregnancy. Wholegrain versions are especially nutritious and the fibre helps to prevent constipation.

Protein based foods are an important part of your daily diet. If you suffer from morning sickness try a simply thick protein shake until you’re able to eat regularly. Lean meat, fish (twice a week, including oily fish once), eggs, cheese, beans and pulses give you protein and important minerals like iron and zinc. There is more information later in this article about protein-based foods to avoid in pregnancy and while you are breastfeeding.

Dairy foods like milk, yoghurt and cheese contain calcium but can be high in fat, so it is worth considering lower-fat varieties if you are concerned about excess weight gain as they are just as nourishing. There is more information later in this article about cheeses to avoid in pregnancy and while you are breastfeeding.

Sugary and fatty foods are more likely to add excess weight because they are high in calories and have very little nutritional value, but they will add pleasure and choice to your diet as long as they are eaten in sensible amounts.

Your baby should have the best of starts if you are not over or under weight when you get pregnant. Cutting down the calories that you eat while you are pregnant in order to control your weight should only be done under the guidance of a general practitioner (GP) or dietician, as unsupervised dieting will not help your baby.

 

If you think you are overweight or underweight, mention it to your midwife or doctor. What is certain is that dieting, often going hungry or eating mostly junk food will not help your baby and might even be harmful. Pregnant women who diet excessively or who live through famines tend to have difficult pregnancies, problems in labour and small babies. Even women who are overweight or who put on a lot of weight early in pregnancy don’t benefit from dieting and nor do their babies.

You may find that your doctor or midwife no longer take regular recordings of your weight during pregnancy, as the evidence about this suggests that this may not be helpful.  You can check whether your weight is appropriate for your height; this is called the body mass index (BMI).You can use the formula below to work this out for yourself or you can ask your midwife to do it for you. This will tell you whether you are within a healthy BMI range, which is between 20 and 25.

Nausea and morning sickness

Although feeling or being sick occasionally is common in pregnancy and will not harm your baby, it can be a very trying time for you. By the 12th to 14th week of your pregnancy, any nausea and vomiting should have settled. To reduce the effects of the nausea and or sickness, studies show that the following may be helpful:

  • Wearing travel sickness bands on your wrists is effective;
  • Vitamin B6 (pyridoxine) appears to lessen the nausea;
  • Taking ginger may help, though the evidence is weak;
  • Your GP may be able to prescribe specific medication to relieve the sickness and these are very effective.

Also, acupuncture and homeopathy has often been helpful for women with morning sickness, although this has not been proved with studies.  If the sickness becomes so bad that you can’t keep anything down, particularly drinks, you should consult your midwife or doctor immediately.

Iron

Your body needs iron to make haemoglobin – this is found in your body’s red blood cells and transports oxygen around the body. It is normal for haemoglobin levels to fall during pregnancy, partly because the fluid that carries your blood cells increases. Mild iron deficiency (anaemia) will not harm your baby, but if the amount of haemoglobin falls significantly, you may start to feel tired and breathless on exercise. Studies show that in this case you would be advised to take iron tablets. You may be able to avoid becoming anaemic by a regular intake of iron-rich foods. These would include red meat, dark green vegetables, fortified breakfast cereals, dried fruits, wholemeal bread, plain chocolate and eggs.  Eating foods that are rich in vitamin C at the same meal as the iron rich foods helps your body to absorb the iron more effectively. Drinking large amounts of tea and coffee can reduce the ability of your body to absorb iron effectively.

Some women should not take iron pills; this includes women who need regular blood transfusions for a sickle cell condition or thalassaemia.

Doctors and midwives do not know yet:

  1. At what point in pregnancy a poor diet may most affect your baby.
  2. What really influences women’s eating patterns

Vitamin D deficiency

You need vitamin D from sunlight or your food to absorb calcium effectively. Some women may not have enough exposure to sunlight either because of their natural skin coloring or because their culture or religion requires them to keep their skin covered. If you are a vegetarian you may also have a low intake of the foods that contain a lot of vitamin D, such as eggs, margarine or enriched spreads and oily fish like salmon. In this case, you can choose to eat more of the foods that are vitamin D rich, ensure you have some exposure to sunlight or you can take vitamin D as a supplement.  If you feel you are at risk of vitamin D deficiency, discuss this with your midwife or doctor.

Is calcium good for you?

Trials show that calcium supplements can help to reduce your blood pressure; however, you should not start taking these yourself. If you need calcium supplements, your midwife or GP should discuss this with you. Extra calcium has been shown to help women most who are not getting enough of this from their regular diet. Calcium rich foods are dairy products such as milk, cheese and yoghurt or high-calcium non-dairy foods like spinach and tofu.

When you are pregnant, you will come across a lot of advice about what you should or shouldn’t eat. It goes without saying that if you are usually on the best nootropics stack in your regular life, now would be wise to stop since the baby surely does not need to deal with that. Although this advice is usually research based, you may not be able to follow it either   because of your personal tastes and preferences, or perhaps because of the cost.

Other information about diet may catch the attention of the media although the evidence to support this may not always be authoritative. Women frequently have to decide which advice they can follow and it may be that their personal circumstances will impact on these decisions. For example, a woman who eats a vegetarian diet will have to find alternative sources of iron, as she cannot obtain this from eating red meat. Where this is the case, a woman can be left feeling guilty and anxious that she has not done the best for her baby.

If you have concerns or questions about your diet, you can always talk to your midwife, GP or health visitor about these.

Food Safety

There is now reliable information about foods to avoid when you are pregnant and  breastfeeding.

Liver and vitamin A supplements

Very high intakes of one form of vitamin A (retinol, found in liver, liver pate and sausage, fish liver oils and some supplements) have been linked with the baby being born with birth defects.  The other form of vitamin A is called ‘beta carotene’ and this is safe to take in pregnancy, but always check with your doctor or midwife before taking any vitamin A supplements.

Nut allergy

It may be wise not to eat peanuts or peanut products while you are pregnant, especially if you or your baby’s father or any brothers or sisters have a history of allergies. Studies suggest that a baby can develop peanut allergy before birth or while breastfeeding, but the evidence is uncertain.

Fish

A survey by the Food Standards Agency in the UK has found high levels of mercury in some fish. As mercury can affect the developing nervous system of the unborn baby, it is advised to limit the amount of tuna you eat to two medium cans or a single fresh steak a week and to completely avoid swordfish, marlin and shark. This applies when you are planning a pregnancy, actually pregnant or breastfeeding.

Cheese, meat and eggs

Listeria is a bacteria that grows in some specific foods and can cause miscarriage, stillbirth or serious illness in the newborn baby. Other bacteria such as salmonella can also cause serious illness to you and your baby. While hard cheeses are mostly safe to eat in pregnancy, it is advised to avoid soft mould-ripened cheeses like Camembert, Brie and all blue-veined cheeses. You should also avoid eating all types of paté and oven-ready meals that are uncooked or undercooked as well as raw or part-cooked eggs.

Caffeine

Studies show that high levels of caffeine are linked with miscarriage and stillbirth. It is better to choose decaffeinated drinks or keep to no more than 300mg of caffeine a day. That is three cups of brewed coffee or four cups/three mugs of instant coffee.

More information at https://ehiprimarycare.com/trim-down-diet-club-review/.

 

2009 Hulda Thorey/ Article based on the MIDIRS database  

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