Dr Rahul Sen | Specialist care for birth and beyond | Sydney, Australia

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best obstetrician in sydney morning sickness

Obstetrician’s advice on morning sickness

Morning sickness is a common symptom of early pregnancy and in many cases, goes away by the end of the first trimester. It is caused in part by changes in hormones during pregnancy and may make eating difficult.  

Although it is called ‘morning sickness’, nausea can happen at any time of the day.

Morning sickness does not usually cause any problems for the unborn baby. However, if a pregnant woman experiences severe ongoing vomiting, she should see a doctor.

Please have a look at some food and eating suggestions that may help manage symptoms of morning sickness.

  • Eat smaller meals more often. Missing meals can make nausea worse.
  • Avoid large drinks. Have frequent small drinks between meals.
  • Cut down on fatty, fried or spicy food.
  • Try eating a dry biscuit before you get out of bed in the morning.
  • Eat a healthy snack before you go to sleep at night. This might include fruit or yoghurt.
  • Avoid foods if their taste, smell or appearance makes you feel sick.

 

If you vomit, it is important to not become dehydrated. It may be easier to have lots of small drinks rather than drinking a large amount in one go and Hydralyte drinks/ice blocks (or similar products) may be easier to manage.

Please be mindful that the stomach acids in vomiting can soften tooth enamel. It is best not to use a toothbrush to clean the teeth straight after vomiting as this may damage them. Have a drink of water to rinse your mouth.
If the nausea is affecting your life or your diet a lot there are several medications you can take to help- you should discuss this with your doctor.  There are also some suggestions regarding nausea management:

 http://mothersafe.org.au/

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activity in pregnancy best obstetricians sydney

Activity in pregnancy – Obstetricians Sydney

We all know that keeping active when you are pregnant can be healthy.  It keeps you fit for labour and delivery, helps with stress management and aids in managing your weight and can reduce some pregnancy complaints and complications …but just how much exercise is recommended and what type is best?

It is recommended that unless there is an obstetric reason otherwise (speak to your doctor for a complete list but commonly ongoing bleeding, low lying placenta, shortened cervix), you ideally are aiming for 30 minutes of moderate intensity activity, most days of the week. What’s moderate?  Moderate is a level at which you are feeling a bit ‘huffy and puffy’ but are still able to talk or whistle.  The 30 minutes is just a guide and can be broken up into smaller intervals i.e. 3 x 10min walks.  

If you weren’t exercising before pregnancy, then you should gradually increase your activity level to the amount mentioned above, perhaps starting with 10-15 minutes 3 times per week.  If you are usually active, there is no reason you can’t continue with a higher level of activity while you are pregnant, though certain types of activity are not always advisable.  

There is likely to be higher risk with contact sports but also with some other sports that require balancing skill or risk of falls i.e. cycling, horse-riding and skiing.  Your centre of gravity changes when you are pregnant, and care is needed.  Other activities which result in significant increases in your core body temperature also need to be avoided (this includes exercising in particularly hot or humid conditions).

Pregnancy hormones can affect your muscle system, and this can result in looser and less stable ligaments.  This can also mean a greater chance of injury, especially with higher impact or faster-paced sports.  Warming up, cooling down and stretching are therefore particularly important when you’re pregnant and strapping of some joints may be necessary, particularly if you’ve had the previous injury.  Breathlessness can also be an issue, and you should stop exercising if you become breathless.

Commonly women undertake walking, swimming, yoga and pilates but there is also a range of pregnancy specific exercise classes you may find in your local area as well as many other activities which you may enjoy.  Just remember, if you are taking a class always ensure that you tell the instructor you are pregnant so they can guide you on some of the positions or moves that you need to avoid.  Lying on your back is not recommended after 18 weeks’ gestation.

Be guided by how you are feeling and don’t push yourself…but on the flip-side, don’t let the usual tiredness and nausea of the first trimester make you skip keeping active throughout the remainder of your pregnancy either!

If you need any help regarding your pregnancy, contact Dr Rahul Sen, one of the best obstetricians in Sydney and book an appointment.

Our experienced and dedicated team would is here for you in this special time in your life.

Visit our website to find out more.

Obstetrician

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food allergies pregnancy diet plan

Food allergies-do you need to be careful in pregnancy and breastfeeding?

It appears food allergy is becoming a more common problem, with some countries reporting a 50% increase in the rate of peanut allergy.  Overall it is estimated that around 5% of children develop food allergies most commonly to dairy products.  It is not well understood why allergy rates are on the rise.   Food allergies are more common with family histories of asthma and eczema.

Food allergy is distinct from food intolerance.  It is an immune-mediated response, usually to a protein in food and can cause a variety of reactions-both immediate and delayed.  The most serious of these events is anaphylaxis.  Food allergies tend to first present in early childhood and often resolve by the time the child is 5 (i.e. egg, milk) but some will be life-long (nuts, shellfish).

Given the growing size of the problem and possible implications, research has focused on ways of preventing future food allergy.  Studies have been performed, and continue to look at whether maternal avoidance of allergenic foods (nuts, seafood, egg, etc.) results in any reduced rate of allergy in the children of these women.

So far the answer is no.  There is no evidence that avoiding the more commonly allergenic foods (dairy, eggs, soy, gluten, shellfish, nuts) during pregnancy results in a lower risk of allergy in the children born of that pregnancy.  Some studies, in fact, report an increase in allergy rates when there is avoidance of these allergens in the maternal diet, though these results haven’t been consistent in all trials.

The second controversial area surrounds breastfeeding.  Again, there is some evidence that suggests that breastfeeding itself is associated with a reduced risk of allergy in children.  There is no evidence that a breastfeeding mother should avoid certain allergenic foods unless an allergy has been clinically diagnosed in her breastfed infant.  If the food allergy is diagnosed, she should continue to breastfeed but seek consultation with an experienced dietitian who can ensure her diet remains nutritionally adequate and well balanced and to ensure she has sufficient education regarding avoidance of the particular allergen/s.

The final area of interest surrounds introduction of solids for a child.  It is recommended that babies are exclusively breastfed for 4-6 months (guidelines vary depending on the country/organisation).  While in the past it has been recommended that the introduction of certain foods is delayed, the current evidence does not support delaying the introduction of any foods past six months, on the basis of allergy, once solids are commenced.

Dealing with food allergies can be worrisome and frustrating.  It is a complex area.  If you wish to discuss the topic further, please contact Natasha Leader on 0414 520 277 to set up an appointment time.

If you need more information about pregnancy diet plan visit:

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Pregnancy nutrition – Iron in Pregnancy

pregnancy nutrition

What is iron and why do I need it?

Iron is a mineral that is involved in making red blood cells, carrying oxygen and producing energy.  It is therefore important to ensure you’re eating enough of it!

What is different in pregnancy nutrition?

In pregnancy, your iron requirements rise greatly so you can provide for your baby’s blood supply and build up their stores.   If you eat meat, you should aim to include red meat at least three times per week as well as choosing white meats, eggs, wholegrain bread and fortified cereals, legumes and vegetables regularly.  Vegetarian women will need to rely more heavily on plant sources of iron, which aren’t as well absorbed by the body.

Why does my iron level matter?

Iron deficiency can lead to complications for you and your baby.  Women who are low in iron have a higher risk of small for gestational age babies as well as premature delivery.  Women themselves usually feel quite fatigued and may become short of breath.

How do I know if I’m getting enough iron in my pregnancy diet?

Even if you do eat red meat, it is often difficult to consume the amount of iron that is needed in the last trimester of pregnancy.  However, not all women will become iron deficient (anaemic), even those that follow vegetarian diets.  It will depend in part on how well you absorb iron and on your body’s initial store.

Dr Sen will check your ferritin (body store) level, usually when you are around 26-28 weeks.  Your haemoglobin level (amount of iron in your blood) is also checked, but as your blood supply doubles during your pregnancy, this level drops due to a ‘dilution’ effect and therefore isn’t reliable as a measure of iron deficiency.

Supplements

If your ferritin level is low increasing your intake of red meat will not be enough to increase your stores.  You will need to begin taking a high dose iron supplement formula (usually FerroGrad + C or Maltofer or Ferrotabs) 1-2/day depending on your result.  Iron supplements may cause tummy upset including constipation or diarrhoea, especially in higher doses.  If you suffer any discomfort, try taking it every 2nd day rather than stopping it all together.  Low dose iron or the iron in your multivitamin (if you’re taking) is not sufficient. It is normal that your stool colour can change to very dark/black.  This is not dangerous.  Dr Sen may also discuss the possibility of an iron infusion with you.

Iron supplements should be continued until 6 weeks after delivery, though if you’ve been taking more than 1/day you can decrease to just 1/day from when you have your baby.  Iron supplements are best consumed away from dairy products or calcium supplements.

It is not advised that women take a high dose iron supplement unless they have been shown to have iron deficiency.

If you have any more questions regarding your pregnancy nutrition, visit our website.

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Supplements for Pregnancy – Pregnancy Nutrition

pregnancy nutrition

Many pregnant women take supplements during their pregnancy but are they actually necessary?

You may have been told by your healthcare provider that if you eat a well-balanced diet, then a multivitamin in pregnancy is not usually required.  However, we know that often a woman’s diet is not always ideal and in fact, one recent Australian survey showed not a single woman who participated consumed the recommended daily dietary intake of food group serves for pregnancy!

Certainly, pregnancy is a time where your nutritional needs increase in order to provide support for the baby’s optimal growth.  However, your body also has an amazing capacity to adapt to different situations, and in some cases, although the requirement for a nutrient is greater in pregnancy, your body adjusts its processing of this nutrient so that increased intake from the diet is not actually required.  Things are further complicated by the fact that it isn’t always easy to measure certain vitamin and minerals either and different genetic influences may contribute individual variability as well.  So just what do you need to take?

Pregnancy nutrition -Folate

Without a doubt, we know that folate is critical for its role in reducing neural tube defects (NTD).  All women of childbearing age should take a folate supplement of 400mcg daily for one month before and throughout the first trimester.  Those with a family history of an NTD or who have pre-existing diabetes are recommended to take a higher 5mg daily dose.

If you need an advice regarding your pregnancy nutrition, Contact Dr Rahul Sen dietary advisor.

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To Snack or Not to Snack – Pregnancy Diet Plan

pregnancy diet plan

Snacks often get a bad wrap for being unhealthy…which, of course, they can be, but not if you choose wisely!  Snacks can be an important part of your pregnancy diet for several reasons.  Usually, when you are pregnant, you will notice you become hungry every few hours at least.  This is a result of the baby ‘siphoning’ glucose (and other nutrients) from you.  Ensuring a regular intake with mid-meal snacks tends to make you feel better and also makes it less likely that you’ll get super hungry for your meals. Have you noticed that once you’re excessively hungry, it’s much harder to try to control the amount you consume as well as the speed at which you eat?

You’ll often also find you can no longer fit in as much volume at a meal, especially as your pregnancy progresses.  Snacks are therefore a good way to fit in your fruit and dairy requirements, as you may no longer be able to eat them together with your main meals. And often small and frequent intake also helps with other common problems in pregnancy such as nausea and heartburn/reflux.

If you’re working or at home with little kids or just aren’t used to including mid-meal snacks, it’s often hard to adjust to remembering to eat. So planning and preparation is the key! When you’re out and about you’ll probably find it challenging to find something that is both nutritious but not calorie excessive. So it pays to have a working list of options you know you can grab when you need!

Some simple examples are:

A piece of fruit

A tub of yoghurt

A glass of milk

A small fruit smoothie

Whole grain crackers or high fibre toast with cheese, peanut butter or hummus.  Vege sticks with salsa

A small handful of nuts

There are just a few of dozens and dozens of other options to meet all your sweet and savoury cravings and which still consider the overall balance in your diet!

If of course you are happy eating just three meals per day and are meeting your nutritional requirements and not feeling hungry then there is no need to start adding in extra snacks either!  Everyone is different, and our diets would be so boring if it were any other way!

If you would like to know more about the pregnancy diet plan, visit our website.

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