Hello,

Thanks for writing to us. I am trying to give answer to your queries.

First of all, I like to congratulate you for being pregnant once again and wish you for successful motherhood.

1) Following measures are needed to be taken during pregnancy period:

1) Continue to take Folic acid & vitamin supplements and Doxinate tablet (in case of morning sickness) up to 12 weeks.
2) Take Healthy protein XXXXXXX diet (Milk/ Meat/ Fish/ Pulses/ Beans/ Nuts/ Dals etc.) with extra 350 Kcal/day than usual and eat more XXXXXXX vegetables & fresh fruits. You completely avoid fruits like papaya, grapes, pineapple (these are related with early onset of labor) or any raw unwashed fruits/ vegetables.
3) Take dry food preferably puffed rice or other to avoid the tendency of nausea.
4) Drink lots of fluid/water to stay hydrated & for better feto-placental circulation.
5) Take an adequate bed rest and preferably 8-10 hrs daily in divided schedule.
6) Maintain personal hygiene including breast & genital care with proper washing.
7) Try to avoid stress/tension/emotional upset by regular XXXXXXX breathing.
8) Do check up with ultrasound scan in 8-10 weeks of pregnancy if previously not done. Repeat scan is needed in later month also to assess growth & development of fetus.
9) Take calcium supplements from 16 weeks onwards, Two doses of TT in the 2nd trimester and complete all necessary investigations.
10) Periodic measurement of weight gain and blood pressure. 10-12 kg weight gain is normal in pregnancy period.

Try to avoid following things (preferably in the 1st trimester):

1) Any type of sexual activity/ intercourse.
2) Long journey/ stepping uneven surface/ heavy work.
3) High heel shoe (risk of fall on ground with miscarriage).
4) Bitter taste/ bad smell/ spicy food to avoid nausea.
5) Unprescribed/ unsafe medication as first 12 weeks are more vulnerable to defective organogenesis with external factor.

In case of low blood hemoglobin or iron level with moderate anemia, she can take prescribed iron tablet (Slowfe) as per her doctor's recommendation in early weeks but mostly safe to start taking from 16 weeks onwards. Also, she has to continue thyroid medication till the delivery of the baby and thereafter to avoid certain pregnancy related complication like pre eclampsia, congenital hypothyroidism, miscarriage etc. Baby may born with low IQ.

But concurrent intake of both iron tablet & thyroid medication within 2-3 hrs should be avoided for better absorption.

Iron XXXXXXX food stuff- red meat, egg yolk, XXXXXXX vegetables, dry fruit (like prunes, raisins), iron enriched cereals, XXXXXXX or chicken giblets, beans, lentils, chick peas and soybeans, liver etc.

Foods to be avoided in thyroid deficiency patient- cabbage, cauliflower, mustard, mustard greens, soy milk, soy, soybean oil, radishes, bok choy, broccoli, brussels’ sprouts, XXXXXXX kohlrabi etc.

2) Taking iron tablet does not effect on baby's fairness or skin color. It is genetically determined and comes from parents. It also depends on melanin production of the baby's body. Iron tablet is much needed to treat iron deficiency anemia and during pregnancy to stable hemodynamically.

3) Eating promogrenates & apples also does not help to get fair skin color of the baby.

Hope I have answered your query. If you have any further questions, I will be happy to help.

You can directly consult with me by visiting my profile on WWW.WWWW.WW and press the button "ask me a question".

Take care yourself & enjoy your pregnancy.

Regards,
Dr Soumen

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Hello,

Thanks for your follow up query. I am happy to help you.

1) Yes, broccoli contains lots of folic acid but it is better to avoid in thyroid deficiency. In such case, prescribed folic acid tablets are much needed supplements for better growth & development of fetal nervous system.

2) Both iron and thyroid deficiency can cause certain complication during pregnancy and baby may born with low IQ. Here, you should continue both iron and thyroid medication till the delivery of the baby and there after. Iron XXXXXXX healthy diet with above said medication and taking protein supplements are very much sufficient for growing of a healthy baby with better IQ. Don't be worried about this and just continue suggestive measures.

3) Baby skin color completely depends on parental genetic determination. Drinking saffron with milk is a one type of myth & such evidence is not proved scientifically. Taking healthy nutritious diet, consuming more water/ fluids (help in better feto placental circulation) along with suggestive medication can only give you a healthy baby with good skin texture.

4) Melanin is a body pigment and it is mostly responsible for black or fair skin color. But it is not under your control and you can't do anything while your baby is within the womb. So, you don't be stressed and avoid mental upset regarding this. Just enjoy your pregnancy and wish for a healthy baby only.

5) Some studies have showed that doing creative work or learning new thing or even listening music & doing meditation can make baby more active and intelligent after birth. You can do these all things for your upcoming sweet charming baby.

Hope, I have clarified everything that you have asked. If you do not have any query, you can close the discussion and rate the answer.

Keep good faith in yourself and hope for positive things. Wish your successful motherhood.

Good luck for that.

Regards,
Dr Soumen

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Hello,

Thanks for follow up queries.

1) In pregnancy or lactation period, daily requirement of DHA-omega-3 fatty acid is 300 mg and folic acid is 500 micro gram.

All three supplements are very much sufficient & XXXXXXX source of above nutrients. But she needs to take those on regular basis. One egg should be taken daily and not on alternate day as she does not like fish.

She does not need to take other extra supplements for these nutrients as per daily requirement. Taking regular dietary food stuffs is sufficient. She can take one additional good health drink (optional).

2) Yes, she can take red meat (rich source of iron & other nutrients) if she likes but it is taken to be weekly basis.

Above fruits & vegetables are quite good enough and no need to take extra food stuff. Cauliflower is not to be taken in thyroid deficiency.

She completely avoids fruits like papaya, grapes, pineapple (these are related with early onset of labor) or any raw unwashed fruits/ vegetables. Take only cooked food XXXXXXX in protein, carbohydrate, fat, vitamin & minerals- in one word balanced diet.

Salmon fish is good source of omega-3 fatty acid and it is advisable to take particularly in first trimester (first 12 weeks). But it can be taken throughout the pregnancy period for better growth & development of the baby.

3) You can take nuts like almonds, cashews, peanuts, walnuts or pistachios which are XXXXXXX source of essential fatty acid and other minerals/ nutrients.

She only can take sprouted nuts and not raw/ roasted nuts. Walnuts are good source of omega-3 fatty acid and can be taken as much she likes but regular 8-10 walnuts is sufficient.

Sprouted nuts are easy digestible, have greater nutritional value with good flavor.

As she is taking all other food stuffs for omega-3 fatty acid, then she may not need to take flax seeds additionally with juice.

For more information on seeds & nuts, you can visit this site WWW.WWWW.WW

If you do not have any clarifications, you can close the discussion and rate the answer.

You can directly consult with me by visiting my profile on WWW.WWWW.WW and press the button "ask me a question".

Wish your good health and enjoy your pregnancy.

Regards,
Dr Soumen.

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Hello,

Thanks for follow up queries.

1) Normal fetal heart rate (FHR) is 120-160 bpm (beats per minute) after 6 weeks gestation. By 9-10 weeks FHR can be XXXXXXX 170 bpm.

After that, FHR gradually decreases like as 150 bpm by 14 weeks >> 140 bpm by 20 weeks and 120-130 bpm near term.

2) Chorionic Villus Sampling (CVS) can be done around 10-12 weeks to detect chromosomal abnormality or genetic disorder. It is generally done to rule out DOWN'S SYNDROME in early weeks.

In 2nd trimester, AMNIOCENTESIS, TRIPLE SCREEN TEST & TIFFA scan can be carried out to check major & minor congenital anomaly of the developing fetus. Routine prenatal investigations are always to be completed.

3) In this case, blood Sugar (PPBS & FBS) & HbA1c level are needed to estimate in the 1st & 2nd trimester in primary level to check out mother's diabetic tendency. Strong family history is always a risk factor for developing diabetes in pregnant mother. Gestational Diabetes can cause several ill effect on developing fetus if it is not treated or diagnosed properly.

To diagnose Gestational Diabetes Mellitus (GDM), OGTT (Oral Glucose Tolerance Test) can be performed around 24-28 weeks as per WHO guideline. Other supportive investigations in suspicion of Type 1 DM are C-peptide level & some auto-antibodies.

Ultrasound scan is also needed to be done in 2nd & 3rd trimester to check fetal macrosomia, IUGR (Intrauterine Growth Retardation) or polyhydramnios etc. Here, consultation with diabetologist is needed in case of diagnosed GDM for suggestive measures.

4) Generally nuts are not allergen. It does not causes any ill health effect in both mother & baby. So, don't be much worried.

5) Omega-3 fatty acid has several sub types like DHA, EPA, ALA etc which are considered as essential fatty acid. Several study shows that DHA & EPA have better health effect than ALA type. Taking one Citra Natal 90 DHA tablet is sufficient as per daily requirement during pregnancy. No other supportive food stuff is needed.

6) In pregnancy period, daily requirement of dietary iron is 35-48 mg/ day. Therefore, in my opinion, taking 90 mg prenatal iron tablet along with iron XXXXXXX food stuff is sufficient and more than enough.

I don't think that it is good to take additional iron supplements other than above said.

I am always ready to help you further. For any future query, you can directly consult with me by visiting my profile on WWW.WWWW.WW and press the button "ask me a question".

Wish your good health and successful motherhood.

Regards,
Dr Soumen.

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