PCM in Pregnancy! yes or no?

There has been a recent study which has reported that taking paracetamol (PCM) in pregnancy can possibly increase the risk of your baby having asthma. This was a large study conducted in Norway and published in 2016 (1).
The study showed that paracetamol intake by the mother during pregnancy, increases the risk of the baby going on to develop childhood asthma by 13 %. Also, giving a baby paracetamol in the first 6 months of life increases the risk of asthma by 29 %, as per this study.
However we need to understand that the study does not tell us at what dose this effect is seen. Also, Paracetamol remains the only safe medication to manage fever in pregnancy. And we do know that fever if left untreated can be more harmful for the fetus.
But, the lesson to be learnt from this study is that paracetamol (for that matter any drug) should be consumed in pregnancy only when needed, at the lowest dose possible and for the least amount of time.
So take your PCM with caution and ofcourse after discussing with your doctor!

Reference

1.  Magnus M.C et al. Prenatal and infant paracetamol exposure and development of asthma: the Norwegian Mother and Child Cohort Study Int J Epidemiology first published online February 9, 2016 doi:10.1093/ije/dyv366

 

Pregnant!!! What to eat?

If you are pregnant, especially if this is your first pregnancy, I am sure you have a million questions. Your main concern is that you want to give your baby the healthiest start possible. a very important aspect of that is what you eat!!

Well, worry not! Diet in pregnancy is no rocket science. If you are lucky ( even though you may not agree at the time ) you have mothers, mothers in law, sisters, aunts etc to guide you. But if not, don’t panic. Overall you should be able to continue to eat what you have been eating. You might crave for things you have never liked before or develop an aversion to certain food items you liked earlier. But that is normal. It is best to listen to your body and eat what you FEEL like eating.

How much to eat?

These days, it is not recommended to increase the total calories in your diet in the first 6 months of your pregnancy( NICE, UK). From the seventh month onwards you should be eating a bit more i.e. about 200 kcal more per day. So, even if you are carrying twins or triplets you do not need to “eat for two”. In fact the normal weight gain is only 11-16 kgs in pregnancy.

What to eat?

In the initial months you may lose your appetite, however that will usually improve by the end of your third month. Try and ensure the following:

a. Eat three proper meals and three snacks in between. It is best to divide the portions of your lunch and dinner into two and eat them a couple of hours apart. This allows better digestion and higher energy levels for longer. Try and eat something every 1 and a 1/2 to 2 hours even if it is just a fruit or biscuit.

b. Keep one third of your meal carbohydrate based. This includes brown bread, brown rice, whole grain or multi grain breads and pasta, potatoes etc.

c. Eat lots and lots of fruits and vegetables. Unless you have a problem in your blood sugars, there should be no restriction on the fruits you eat. They will provide you with the necessary vitamins and minerals and also fibre.This additional fibre will also help reduce constipation which is very common in pregnancy.

d. Foods rich in iron: include a portion of foods like pulses, red meat, green vegetables like spinach, jaggery, dry fruits like raisins and apricots.

e. Foods rich in calcium : Try and consume more of dairy products – low fat yoghurt, milk and cheese. Other foods rich in calcium are Spinach, kale, soybean, tofu, fortified cereals like cornflakes etc.

There are many myths associated with what to eat and what not to eat.

Ill be writing about some common myths – fact or fiction soon.

One last tip that worked for me and for many of my patients : eat something sweet, just chew it slowly, just after waking up and even before getting out of bed. Trust me, it will reduce your morning sickness!

If you have any specific queries please do write to me at drnehagami(at)gmail.com