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Q1: I am 3 months pregnant and my morning sickness is a constant battle. I feel nauseous most of the time. This is my 1st pregnancy and I'd like to know the lowdown on nutrition during pregnancy. Please enlighten me.
A1:
Pregnancy is a blessed event that marks the beginning of a new chapter in a woman’s life. However, the 9-month journey isn’t exactly smooth sailing for mothers-to-be. Every pregnant woman goes through a series of physical and psychological changes during the different stages of pregnancy. Divided into 3 trimesters (3 months each), each stage of pregnancy holds different and unique experiences which are a result of the growth and development of foetus as well as hormonal changes.
 
First trimester (Week 1 – Week 12) – The first stage of pregnancy is most often a mixture of excitement and frustration. First, there is a feeling of joy as you discover that you are pregnant but concurrently, you begin to experience mood swings including the dreaded morning sickness. One will most likely feel tired with some dizzy spells and as the pregnancy progresses, breast tenderness and frequent urination may occur. Besides, food cravings start to kick in and you will love pickles and ice-cream more than ever! This is a crucial time when the brain cells, tissues and the organ systems of the baby begin to form. The baby’s heart starts to beat, muscles begin to develop and movements are gradually becoming stronger.
 
Second trimester (Week 13 – Week 27) – This is perhaps the most physically enjoyable period for pregnant women. Morning sickness, fatigue and breast tenderness usually abates by this time and you will be able to feel your baby’s movement – which is one of the greatest milestones of the second trimester! Don't be surprised, though, if a few new discomforts appear.Along with weight gain, one is likely to suffer from muscle cramps, heartburn and constipation due to enlarging uterus. During this phase, sensory development of the little one starts to take off as the brain forms specialised areas for taste, smell, hearing, vision and touch.
 
Third trimester (Week 28 – Week 42) – In the last few months of pregnancy, weight gain, which appears to be a contributing factor to leg cramps, becomes more noticeable and backache, varicose veins as well as vaginal discharge are fairly common. Frequent urination and swollen ankles may become an issue as the growing uterus exerts pressure on the veins and bladder respectively. In this scenario, pregnant woman may find herself urinating more often or may even leak urine when she laughs, coughs and sneezes. Most rapid brain development occurs during this final stage of pregnancy and at week 38, the baby is considered full term. The baby’s bones are fully formed but remain soft and pliable as he/she builds up calcium.
 
The prospect of pending motherhood and the thought of nurturing a new life inside you for nine months is indeed an exciting experience but it also brings about physical and emotional challenges. Any unwarranted complications during the course of pregnancy may thwart the joy and jeopardise you and/or your baby’s health. Heartburn, indigestion and constipation relief during pregnancy is a question many pregnant women will ask. On top of a high fiber diet and increasing intake of fluids, probiotics is next in line when we talk about gastrointestinal problems. Termed as live bacteria, which upon ingestion in adequate amounts, confer health benefits on the host, probiotics play a role in restoring and maintaining the microflora balance in our gut necessary for proper digestive functions. A clinically proven probiotic strain, Lactobacillus acidophilus NCFM has been shown to be effective in relieving digestive complaints such as bloating, indigestion, constipation and heartburn. Apart from promoting regular bowel movement, Lactobacillus acidophilus NCFM also enhances nutrient absorption which is particularly important during pregnancy to ensure a healthy nutritional status of both mother and baby. With their action on gut microflora, probiotics can also help prevent the growth of harmful bacteria that cause illnesses. Probiotics are safe for pregnant mothers.
 
Put aside the common complications, maternal nutrition is another major concern during pregnancy. Good maternal nutrition has a significant influence on the health of the offspring throughout life and the main emphasis is on the importance of omega-3 fatty acids namely docosahexaenoic acid (DHA) for optimal brain and eye development. The human brain starts to form during the first trimester of pregnancy, as early as 3 weeks after conception and brain development peaks during the last trimester and thus, substantial amounts of DHA is required. During pregnancy, the foetus is wholly dependent on its mother for its nutritional needs and hence, pregnant women must consume adequate amounts of DHA-rich foods to allow their child’s brain and vision develop to its full potential.
 
Recent studies demonstrate that a high maternal DHA intake during pregnancy leads to a higher DHA status at birth and promotes cognitive development, attention, movement quality and visual acuity in infancy to early childhood. Experts from The International Society for the Study of Fatty Acids and Lipids (ISSFAL) recommend that pregnant women should take at least 300mg of DHA each day. Mothers-to-be can obtain the key nutrient either from consuming oily fish such as tuna, mackerel, salmon and sardine or taking tuna oil capsules.
 
Tuna oil is a richer source of DHA in comparison to other fish oils. A formulation that contains 135mg (27%) DHA and 35mg (7%) eicosapentaenoic acid, EPA per 500mg capsule is an ideal “brain food” supplement for pregnant women. This precise blend is similar to the DHA and EPA ratio of 4:1 in breast milk. In addition, DHA supplementation during pregnancy can also help lower the risk of postpartum depression.
 
It is never too early to start caring for yourself and your baby during the crucial nine months and below are some useful tips you can follow to help ensure a healthy pregnancy.
  • Eat small, frequent meals to relieve heartburn and nausea. Don't stop eating or start skipping meals as your body weight increases. 
  • Pay attention to what you eat. Select foods that are high in protein, fibre-rich carbohydrates, iron and calcium. Avoid eating raw fish, undercooked shellfish, meat or eggs.
  • Drink extra fluids, at least 6-8 glasses a day throughout pregnancy to help your body keep up with the increases in your blood volume. 
  • Moderate exercise during pregnancy can benefit both you and your baby by lessening discomfort and fatigue, providing a sense of well-being, reducing labour complications and increasing the likelihood of early recovery after delivery.
  • Avoid alcohol, tobacco, toxic substances and chemicals.
  • Get plenty of rest. Listen to your body to determine if you need short breaks during the day and get at least 8 hours of sleep every night.
 

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