PREGNANCY TABLE 1: COUNSELLING POINTS FOR THOSE TRYING TO CONCEIVE1, 2 General Advice Smoking Alcohol Consumption Stress Weight
Around 92% of couples will become pregnant after two years of trying for a baby2
. Lifestyle plays an important
role in promoting a successful, uncomplicated pregnancy. Table 1 outlines some of the advice that can be provided to patients who are trying to conceive.
LIFESTYLE DURING PREGNANCY Lifestyle has a big influence on pregnancy. Exercise is important, as physical fitness can lead to a healthier pregnancy. For those who don’t exercise regularly and want to start exercising whilst pregnant, good advice is to begin with walks or gentle swimming. Most forms of exercise are fine to be continued throughout pregnancy, however women should be advised to avoid contact sports, horse riding, cycling, scuba diving and exercising at high altitudes. Pelvic floor exercises are recommended and should be continued throughout life in order to prevent stress incontinence1. In the first trimester and in the last few weeks of the third trimester, women can feel very tired. Adjustments to normal routine can help women to cope with tiredness; they should be advised to rest when they can. Although evidence is unclear, there may be an increase in miscarriages and infertility with stress.
Smoking in pregnancy is associated with stillbirth, premature birth and low birth weight infants. Men who smoke tend to have a lower sperm count2
.
Women who smoke can take longer to conceive. NHS Scotland advises it is best to wait 3-4 months after quitting smoking before trying to conceive. There are also lower incidences of cot death in households of non- smokers. Pharmacists are well-placed in community to provide the smoking cessation service and to assist couples in quitting smoking.
Both partners should be involved in all aspects of infertility management. Regular intercourse should be advised (two to three times weekly). Temperature monitors and Luteinising Hormone monitors are no longer recommended.
Smoking reduces fertility and passive smoking reduces the chances of conception in women. Smoking in men is linked to reduced semen quality. Smoking cessation should be offered.
The Department of Heath recommends no alcohol whilst trying to conceive. If women choose to drink, they should be encouraged to limit their intake to one or two units once or twice weekly.
Stress can reduce libido and hence reduce chances of conception. Psychological stress can occur hand in hand with fertility problems and investigations; counselling may be appropriate
Couples should aim for a Body Mass Index of 19-25kg/m2. Group programmes involving exercise and dietary advice positively influence the chances of pregnancy.
DIET DURING PREGNANCY Diet is important in pregnancy as there are a range of foods that are considered unsafe in large quantities and others which should be avoided altogether. Table 2 below highlights some of the foods
MEDICINES AND SUPPLEMENTS Since the thalidomide tragedy of the 1960s, medicine usage in pregnancy has become an important topic. The general rule for prescribing in pregnancy is that no harm should come to the mother or baby as a result of a medical condition being inadequately treated, however of equal importance is the protection of the developing baby from the adverse effects of any medicines used to treat
TRYING FOR A BABY
Seven Seas Trying for a baby provides essential nutrients needed to support pre- conception and early pregnancy.
It contains the 400mcg of Folic Acid recommended by the UK Department of Health for pre-conception up to 12 weeks of pregnancy to help prevent neural tube defects as well as 10mcg of Vitamin D.
It also contains Zinc to support normal fertility and reproduction, Vitamin B6 which helps regulate hormonal activity and Iron.
TABLE 2: DIETARY ADVICE IN PREGNANCY.1, 2 Food Fish Details
Shellfish should be cooked thoroughly to avoid the risk of food poisoning. Shark, marlin and swordfish should be avoided due to potential mercury accumulation. Sushi is okay provided it was frozen prior to eating2. Oily fish such as mackerel, herring, tuna, salmon and trout should be limited to two portions a week due to the possibility of pollutants such as dioxins and PCBs3. Smoked fish, such as smoked salmon, is okay to eat.
Eggs Meat Eggs must be thoroughly cooked in order to avoid salmonella food poisoning.
Undercooked or raw meat should be avoided. Pre-packed meats such as corned beef and ham are safe to eat. Cold-cured meats should be cooked or frozen prior to eating. Liver contains high levels of vitamin A which can cause birth defects – any foods containing liver, including pate and haggis, should be avoided.
Caffeine
Intake of caffeine is associated with low birth weight and miscarriage, therefore intake should be limited to 200mg per day. One mug of tea contains approximately 75mg of caffeine and one mug of instant coffee contains approximately 100mg of caffeine.
Alcohol Peanuts Pate Alcohol should be avoided. Peanuts are okay to eat in pregnancy, provided the mother is not allergic. Avoid all pate, including vegetable pate, as they contain listeria. SCOTTISH PHARMACIST - 39
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56