Frequently Asked Questions

Alcohol in pregnancy

No amount of alcohol is considered safe during pregnancy. We strongly discourage any consumption of alcohol or recreational drugs during pregnancy as it significantly increases the risk to the baby. Please inform your provider of any substances you are using, and if you need information about resources that can help.

Breastfeeding / Bottle feeding Your Baby

Options

Exclusively breastfeed (feed breast milk only, either directly from breast or by pumping/bottle)

This method is considered by the American Academy of Pediatrics, and multiple other organizations, to be the healthiest/cheapest for feeding.

Breastfeeding + supplementing formula

This method offers flexibility and convenience for the parents, and may be needed in specific medical situations that your pediatrician will recommend.

Formula only

This is recommended only for patients with specific medical conditions or patients who must take certain medications and should not breastfeed.

Breastfeeding / Pumping Supplies

Our office will supply you with a prescription for a breast pump at your 36 week visit.

You will need to contact your insurance company regarding where and when you may obtain your pump.

Breastfeeding Classes

Beaumont offers 2 types of breastfeeding classes: a classroom setting, as well as an online class. Classes can be scheduled at www.classes.beaumont.edu, or call Beaumont’s scheduling line at 800-633-7377.

Breastfeeding Support

If you are having difficulties breastfeeding, there are outpatient lactation consultants who can help, and who can see you quickly. Please call our office for a referral.

Beaumont also has breastfeeding support M – F, 8:30am – 5pm, #248-964-6455.

Helpful websites

• • www.lalecheleague.org
  • www.kellymom.com

Coffee/Caffeine in Pregnancy

It is recommended that you consume no more than 200mg of caffeine per day, which is the equivalent of 2 small cups of coffee per day.

Dental Care in Pregnancy

Dental care remains very important during pregnancy, especially as you are more likely to experience sore and sometimes bloody gums. DO get your routine checkups, including cleanings and fillings. If x-rays are necessary, make sure they cover your abdomen with a lead apron. DO NOT consume nitrous oxide as part of your treatment. Make sure to inform the dentist/hygienist that you are expecting.

Exercise in Pregnancy

It is recommended that during uncomplicated, low-risk pregnancies, you continue your pre-pregnancy routine with some modifications. Regular exercise will help keep you and the baby healthy, can help you meet your pregnancy weight gain goals, and can make labor and delivery easier! We recommend a moderate exertion, with your heart rate staying in the 130’s (Click here to learn how to check your pulse) for 30 minutes daily. Stop if you notice any vaginal bleeding, cramping, or if you are having difficulty catching your breath or are having any chest pain or dizziness. Drink lots of water!

You may be asked not to exercise if you are having any issues with blood pressure, preterm contractions, vaginal bleeding, growth concerns with the baby or multiple-birth pregnancy. This will be evaluated on a case-to-case basis. Check out the full selection of Prenatal Classes offered by Beaumontincluding exercise, yoga and swimming.

Foods to Eat in Pregnancy: Diet Recommendations

Diet During Pregnancy

In this discussion you will learn why you need a well-balanced diet while you are pregnant and what foods you should eat. You will find out foods you should avoid and foods that will help some of the unpleasant side effects of pregnancy. 

What foods do I need to eat?

Eating regular, well-balanced meals is more important when you are pregnant than at any other time of your life. What you eat provides food for your baby as well as yourself.

You need about 300 more food calories a day than when you were not pregnant. Most pregnant women need about 2200 to 2700 total calories each day. Your health care provider will suggest a range of weight that you should gain. The usual recommended gain is about 20 to 35 pounds.

Your need for protein increases to about 60 grams a day when you are pregnant. Many women already eat this amount of protein daily when they are not pregnant. However, if you are vegetarian or eat little meat or dairy, you may not be getting enough protein in your diet. You also need more vitamin and minerals, especially folic acid and iron. These nutrients are important for your baby’s growth and development. They give your baby strong bones and teeth, healthy skin, and a healthy body.

Foods that are excellent sources of protein and vitamins

• Beans and peas
• Nuts
• Peanut butter
• Eggs
• Meat
• Fish
• Poultry
• Cheese, milk, and yogurt

Good sources of folic acid (also called folate)

• Leafy greens, such as collard greens, spinach, kale and mustard greens
• Broccoli
• Asparagus
• Fortified breakfast cereals and grains
• Beans
• Oranges and strawberries
• Yellow squash
• Tomato juice

Foods rich in iron

• Lean red meats, pork, chicken, and fish
• Fortified cereals
• Dried fruit
• Leafy green vegetables
• Beans
• Eggs
• Liver
• Kidneys
• Whole-grain or enriched bread

If you need financial help buying nutritious foods, a government program called the Special Supplemental Food Program for Women, Infants, and Children (WIC) can help you buy foods like milk, eggs, and bread.

How do I know if I am eating a balanced diet?

Eat a variety of whole, fresh foods. Use the following as a guideline for what you should eat every day.

Meat, poultry, fish, beans, or eggs

• You need 2 to 3 servings every day
• One serving of meat us 2 to 3 ounces of lean meat, poultry, or fish
• One serving of other, nonmeat foods is 1 cup cooked beans, 2 eggs, 2/3 cup nuts, 1 cup tofu, or ¼ cup peanut butter

Grains, rice, pasta, bread

• It is good to have 6 to 9 servings every day
• One serving is ½ cup pasta, ½ cup cooked cereal, or 1 slice of bread
• Choose less- processed, higher fiber grains more often

Fruits

• You need 3 or more servings of fruits every day
• One serving of fruit is 1 medium apples, 1 medium banana, ½ cup chopped fruit, or ¾ cup fruit juice

Vegetables

• You need 4 or more servings of vegetables every day
• One serving is 1 cup of raw, leafy vegetables, ½ cup of other types of raw or cooked vegetables, or ¾ cup of vegetable juice

Milk, cheese, or yogurt

• You need 4 servings every day
• One serving is 1 cup of milk, 1 cup of yogurt 1 and ½ ounces of hard cheese, or 2 ounces of processed cheese

Do I need to take dietary supplements?

• Calcium. Calcium needs for pregnant women are the same as for women who are not pregnant: 1000 mg a day for adult women and 1300 mg a day for adolescents. Many women do not get enough calcium in their diet, so it’s important to make sure you’re meeting your calcium needs every day. Dairy products such as milk, yogurt, cheese, and smoothies are great sources of calcium.
• Folic Acid. Folic acid is important for spinal cord development of the baby. Pregnant women need 400 micrograms (mcg) a day. Synthetic folic acid added to fortified foods and vitamin supplements is almost twice as well absorbed as the folic acid in natural foods. It is recommended that pregnant women get 400 micrograms (mcg) of folic acid from fortified foods (cereals and whole grains) and supplements, in addition to eating foods hat ate good sources of folate, such as legumes and leafy green vegetables. Read labels. Many foods are supplemented, and you should not have more than 1,000 mcg each day. Ask your provider if you need a folic acid supplement.
• Iron. Women need 30 mg of iron a day during the last half of pregnancy. An iron supplement may be necessary to meet this need. Women carrying twins, women with low iron in their bloods, and large women may need more than 30 mg or iron a day. Taking an iron supplement in addition to the iron already contained in your prenatal vitamin is not recommended unless prescribed by your health care provider.

Can I continue to follow a vegetarian diet while I am pregnant?

• If you do not eat any animal foods, it may be hard to get enough important nutrients, including protein, iron, vitamin B12, and vitamin D. Your health care provider may ask you to meet with a registered dietitian who can help you to plan meals, and may also recommend that you take additional supplements.
• Ovo-lacto vegetarians (women who include dairy and eggs in their diet) usually can meet their nutrition needs with diet and prenatal vitamins.

What foods and substances should I avoid when I am pregnant?

• Avoid alcoholic drinks, tobacco, and drugs
• Check with your provider before taking any medications or herbal supplements. Some medicines and supplements can cause birth defects.
• Limit caffeine to less than 300 mg a day, or 2 cups of coffee. High amounts of caffeine from coffee, tea, soft drinks, and chocolate could increase the risk to your baby.
• Avoid herbal teas, unless your health care provider recommends them. Some herbal teas, if drunk in large amounts, may cause early contractions and increase your risk for early (preterm) labor.
• Avoid meat, fish, shellfish, and eggs that are raw or undercooked. Also avoid foods from deli counters, or thoroughly reheat cold cuts before you eat them.
• Do not eat soft chesses, such as brie, camembert, feta, blue-veined cheeses, queso fresco, or queso blanco, and panela, unless the label says they are pasteurized milk. The pasteurization process kills dangerous bacteria called listeria, which live in unpasteurized soft cheeses. Although most cheeses processed in the country are pasteurized, there is no guarantee. Always read the labels. If you are unsure if a cheese is safe, you may choose to avoid soft chesses altogether. Hard chesses (such as cheddar), processes cheese slices, cottage cheese, and cream cheese are safe.
• Do not eat or drink any other unpasteurized dairy products, such as unpasteurized milk.
• Avoid raw vegetable sprouts and fresh (unpasteurized) fruit and vegetable juices. They can carry disease- causing bacteria such as E. coli and Salmonella.
• Avoid anything that is not food. Sometimes pregnant women crave something that is not food, such as laundry starch, dirt, clay, or ice. This condition is called pica, and you need to tell your health care provider if you are having this kind of craving. Pica can cause poor nutrition for you and your baby. It can also make it hard for you to gain weight and is dangerous to your health.

Keep following these recommendations while you are breast-feeding your baby.

You do not have to eat less salt during pregnancy, as was thought in the past. A moderate amount of salt helps keep proper levels of sodium in your body as your baby develops. Use iodized salt.

Is it okay to eat fish?

Fish and shellfish are an important part of a healthy diet. They contain high-quality protein and other essential nutrients. They are low in saturated fat and contain omega-3 fatty acids that can contribute to heart health.

However, nearly all fish and shellfish contain traces of mercury. Some fish and shellfish contain higher levels of mercury that may harm an unborn baby’s developing brain and nerves. The Food and Drug Administration (FDA) advises women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish with high mercury levels. Instead, they should eat fish and shellfish that are lower in mercury. 

Here are some guidelines for eating fish and other types of seafood:

• Do not eat shark, swordfish, king mackerel, or tilefish (also called golden or white snapper) because these fish contain high levels of mercury.
• Do not eat more than 6 ounces of canned white (albacore) tuna, tuna steak, or halibut each week.
• Do not eat more than 2 servings or a total of 12 ounces of fish each week.
• Choose shrimp, scallops, salmon, Pollock, cod, catfish, or light canned tuna. These types of fish and seafood contain less mercury. Eating oysters and clams may increase your risk for infection. Avoid eating them or make sure to boil them for at least 4 to 6 minutes (as you should do with all shellfish).
• Do not eat refrigerated smoked seafood unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna, or mackerel is most often labeled as nova- style, lox, kippered, smoked or jerky.
• Check local advisories about the safety of fish caught in local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish caught from local waters, but don’t eat any other fish during that week.

What should I do if I don’t feel like eating or if I have other digestive problems?

Morning sickness

Many women have morning sickness during the early months of pregnancy. (In most cases, symptoms of nausea and vomiting are less common by the second trimester.) In early pregnancy, the changes in your body can cause you to feel nauseated when you eat or smell certain foods or when you get tired or anxious. It may help if you:

• Eat crackers, pretzels, or dry cereal before you get out of bed in the morning.
• Eat small meals often.
• Avoid greasy, fried, or spicy foods that may upset your stomach.
• Drink plenty of liquids, but between meals rather than with the meal.
• Try crushed ice, fruit juice, or fruit-ice pops if water makes you feel nauseous.
• Avoid unpleasant odors.
• Get enough rest.
• Ginger has been shown to help some women have less nausea, but you should talk to your health care provider about this before you add ginger to your diet.

Constipation

To help relieve constipation:

• Eat more fresh fruits, vegetables, high-fiber breads, and cereals.
• Get as much exercise as you can. Walking and swimming are good choices.
• Try fiber supplements such as psyllium powder, Metamucil, or Citrucel. (You must drink plenty of fluids when taking these supplements).
• Drink more liquids.
• Do not use laxatives unless your health care provider tells you to.

Diarrhea

• Try eating more yogurt, rice, dry toast, or bananas.
• Ask your health care provider about taking Pepto-Bismol or Maalox.

Heartburn

For heartburn you should:

• Eat 5 or 6 small meals a day
• Avoid foods that commonly cause symptoms such as spicy and fried foods, orange and grapefruit juices, peppermint, garlic, and onions.
• Cut down on soft drinks, chocolate, coffee, and other drinks with caffeine. Drink water, milk, and apple or cranberry juice instead.
• Don’t lie down for at least 1 to 2 hours after you eat. If heartburn gets worse when you lie down, raise the head of your bed 4 to 6 inches.
• Ask your health care provider which antacids you can take.

Women’s Health Advisor 2006.4; Copyrights © 2006 McKesson Corporation and/ or one of its subsidiaries. All Rights Reserved. Developed by McKesson Provider Technologies. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis, or treatment by a healthcare professional.

Hair Dye in Pregnancy

We advise you to wait until your second trimester (12 weeks pregnant) to begin using permanent hair treatments.

Massage in Pregnancy

Massage can help ease sore muscles and joints in pregnancy, and encourages relaxation. It is safe in pregnancy if you lie on your left side, or at a specific prenatal massage salon where they have back and belly support to securely hold you and the baby while lying down. They may ask for a note from your practitioner, which we are happy to provide if there are no concerns.

Medication in Pregnancy: Prescriptions

This is something that is very important to discuss with your practitioner, preferably BEFORE you start trying to conceive. Some medications are perfectly safe for the baby while others can be very dangerous, even deadly to the baby. Discuss all home medications and supplements at every visit.

Medications in Pregnancy, Non-Prescription (Over-the-Counter)

There are common conditions that you might face during pregnancy. To help with symptom control, the following meds are considered safe while pregnant. Please note that no drug is 100% without risk or side effect and, of course, you should avoid any drug that has ever caused you an allergic reaction. As always, discuss management options with your practitioner.

Many brands have a multitude of options. Please carefully read the labels, as any “multi system” or “sustained action” forms of drugs might contain unsafe items. Also, always follow the instructions on the box, never exceeding the recommended amounts.

If you do not see a medication on this list, avoid or discuss it specifically with your practitioner.

Allergies/sinuses/cold and flu

• Benadryl (Diphenhydramine)
• Claritin (Loratadine)
• Robitussin DM (Guiafenesin/Dextromethorphan)
• Halls cough drops
• Cepocal lozenges
• Chloroseptic
• Sudafed (Pseudoephredrine) if no elevated blood pressure or heart rate
• Tylenol (Acetaminophen) for aches
• Saline nasal drops

Constipation

• Diet changes- increase fruits, veggies, oatmeals, whole grains, fluids
• Citrucel
• Colace (Dioctyl Sodium Sulfosuccinate) 1-2 caps daily
• Fibercon
• Metamucil
• Glycerin rectal suppository

Diarrhea

• Increase fluid intake and call the office if severe (>12 episodes/ day) or persists beyond 2 days

Fever

• Call for any temperature above 101°F
• Tylenol (Acetaminophen) Follow instructions on bottle for dosage.
• DO NOT TAKE IBUPROFEN OR ASPIRIN DURING PREGNANCY

GI upset or reflux

• Diet change- small, frequent meals, avoid spicy, greasy foods and extreme hot or cold foods
• Stay upright for 1 hour after eating
• Tums
• Mylanta
• Pepcid
• Protonix

Pain/Headache

• Tylenol (Acetaminophen). Follow instructions on bottle for dosage.
• DO NOT TAKE IBUPROFEN OR ASPIRIN DURING PREGNANCY

Hemorrhoids

• Anusol
• Preparation H
• Tucks
• Witch hazel

Leg cramps

• Stretching, heat and regular exercise
• Tums (Calcium carbonate) 2-4 tabs (max 15 tabs/day)

Nausea

• Try small, frequent meals, flat Coke or ginger ale, ginger tablets, tea, peppermint, chewing gum, lemon drops
• Vitamin B6 (25 mg tablet) with ½ tab Unison 2 x daily
• Sea Bands
• Good article on morning sickness

Skin problems

• Neosporin
• Bacitracin
• Benadryl cream
• Caldryl lotion
• Hydrocortisone cream/ointment
• Oatmeal bath

Vaginal Yeast infection

• Monistat 7 (Miconazole vaginal cream)

OB Office Visit Pregnancy Schedule

How often will I be seen in the office for prenatal visits? Below schedule is for an uncomplicated, low risk pregnancy. High-risk pregnancies may involve more regular visits and additional testing at the office or in the hospital. This will be determined with your provider.

• 8 weeks, first visit
• Every 4 weeks from 8 weeks to 32 weeks, monitoring growth and changes
• Around 20 weeks, you will have a thorough anatomical ultrasound of the baby (ask about our 3D ultrasound!)
• 24-28 weeks you will have a glucola (blood sugar) test for gestational diabetes
• Every 2 weeks from 32-36 weeks
• Every 1 week from 36 weeks to delivery

Postpartum Adjustment Resources/Perinatal Loss Services

Postpartum Adjustment Services through Beaumont offers excellent support for anyone working through postpartum depression or baby blues. Please call 248-898-3234 to access these services. Please check out the Parenting Program for access to a full line of resources at 248-898-3230 (Monday – Friday 8am – 4:30pm).

Also, for those grieving miscarriage, stillbirth or infant loss, there is support through the Perinatal Loss Program, 248-898-7219.

This resource guide is incredibly helpful. Is what you’re experiencing normal? Do you need help? How can you find it?

Pregnancy/gestational age- How Far Along Are You?

Start with the first day of your last period (LMP) and plug it into an online pregnancy calculator.

Preparation for Labor/Delivery

We recommend you seek educational opportunities to not only help prepare you for birth, but also for infant care. Check out Beaumont’s prenatal and infant classes here.

Swimming/Baths in Pregnancy

Swimming in a fitness pool is a wonderful exercise during pregnancy, and can help ease tension in back muscles. AVOID scalding hot baths and any jacuzzi or sauna while pregnant. You do not want to raise your core body temperature above 100F.

Travel During Pregnancy

Traveling by car or plane is fine up to 34 weeks in an uncomplicated pregnancy. Stop to walk around every hour and drink plenty of fluid. If flying, check you’re your airline before you book the flights, as each airline has different guidelines about how far into your pregnancy that will let you travel. We are happy to provide you a note proving your gestational age. If you must travel >1 hr away after 34 weeks of pregnancy, we recommend carrying a copy of your prenatal records with you in case you should go into labor while away from our care.

Vaccines in Pregnancy

All pregnant patients, during any trimester, should receive the flu shot to prevent infection. Not only can the flu make you miserable, but it can be dangerous for you and your baby.

During flu season, Oakland Macomb OB/GYN is offering flu shots to all pregnant patients. They are also available at some pharmacies for a nominal fee. For more information on the flu shot.

Also, for pregnant patients: pertussis (whooping cough) is on the rise and can be very harmful to a newborn. Please get your Tdap vaccine update, after 28 weeks gestation, and have every member of your family and all caregivers for the baby get theirs, too. For more information on the pertussis vaccine.

Yoga in Pregnancy

Yoga is a wonderful way to stay relaxed, flexible, and strong during pregnancy. It can be done safely, with some modifications. Make sure your yoga instructor knows you are pregnant, or if you are doing a video, that you avoid lying flat on your stomach and any twisting motions.

We offer Yoga at our Troy office for $10 every Tuesday at 7pm and and Saturday at 11am, taught by a Labor and Delivery nurse and certified prenatal yoga instructor. See this flyer for more information: PrenatalYogaFlyer2017

Zika Virus

It is essential to avoid contact with a mosquitos infected with Zika during pregnancy and in the months leading up to pregnancy, as it known to cause birth defects.

Information on Zika regarding pregnancy 

The virus can be transmitted between sexual partners. There are travel advisories in Mexico, South And Central America, the Caribbean, the Pacific Islands, parts of Asia, and parts of Miami, Florida and Texas.  See here for travel precaution areas.

Follow this CDC link for the latest updates and information, alone with ‘Zika Travel Information’ for an up-to-date service the CDC offers which allows you to text your travel destination and find out if there are Zika warnings. Information is changing rapidly, so stay abreast to the new CDC recommendations.

If you have any questions/concerns about travel during or in anticipation of pregnancy, or if you think you may have been exposed, please don’t hesitate to talk to your Oakland Macomb provider.