Pregnancy

Does the pain medications used during childbirth pose any risks to my baby?

DEAR DOCTOR K: I'm about to have my first baby. Can you tell me about medications that may be used during childbirth? Will they pose any risks to my baby?

DEAR READER: Many medications can be given for pain relief during childbirth. Other drugs may be given to assist your labor. The pain medicines may not stop pain completely, but they will greatly lessen it. Narcotics such as meperidine (Demerol) are frequently used to relieve labor pain. If a baby is born soon after a mother receives any narcotic, the baby's rate of breathing may be slower than normal at birth. This effect generally is short-term. If it occurs, it can be reversed with an anti-narcotic drug.

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It is safe to have the pertussis vaccine while pregnant?

DEAR DOCTOR K: I am pregnant. My doctor wants me to have a pertussis vaccine. Why? And is this safe?

DEAR READER: Pertussis, also known as whooping cough, is a highly contagious bacterial infection that causes violent coughing. The coughing makes it hard to breathe and produces a deep "whooping" sound. Pertussis bacteria spread through droplets that move through the air when an infected person sneezes, coughs or talks. Pertussis can occur at any age, but serious illness is most common in infants and young children.

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I have Type 2 diabetes, how can I achieve a healthy pregnancy?

DEAR DOCTOR K: I have Type 2 diabetes, and I would like to get pregnant. What can I do to increase my chances of having a healthy baby?

DEAR READER: Like you, some women already have either Type 1 or Type 2 diabetes before they become pregnant. There also is a kind of temporary diabetes that develops during pregnancy called gestational diabetes. It goes away after the baby is born. You're right to be concerned. Type 1, Type 2 and gestational diabetes all cause high blood sugar and can cause pregnancy complications. But for this column, I'll focus on pregnancy and Type 2 diabetes.

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How does my diet and stress level affect my baby’s health?

DEAR DOCTOR K: My husband and I are planning on having our first baby. I've been told that what I eat, and how much stress I have while I'm carrying the baby, could affect the baby's health decades later. That seems hard to believe. Is there any truth to it?

DEAR READER: It makes sense that a child's nutrition and exercise during childhood might affect the child's health as an adult. But it's harder to imagine that your behavior and your health while you are pregnant could affect your child's health for decades to come. But over the past 35 years, many studies have found that a mother's diet and stress levels can shape her child's health in middle age.

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How does cytomegalovirus affect a pregnancy?

DEAR DOCTOR K: At a recent pregnancy checkup, my doctor said something about cytomegalovirus. What is that, and what does it have to do with pregnancy?

DEAR READER: Cytomegalovirus (CMV) is one of eight members of the family of human herpesviruses. The first two members are the viruses that cause "herpes" sores of the mouth, genitals and other areas. All of the herpesviruses cause a lifelong infection. Once you are infected with CMV, it always remains in your body, generally causing no trouble. Up to 85 percent of adults in the United States have been infected.

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What are the benefits of breast-feeding?

Mother breastfeeding baby

DEAR DOCTOR K: I'm pregnant and am getting a lot of pressure from family and friends to breast-feed. I'm not ruling that out, but I'd like to know what the research shows about the benefits of breast-feeding.

DEAR READER: Breast-feeding can be a contentious issue. On the one hand, there's no question that breast-feeding is healthy for babies. But some mothers prefer not to breast-feed, and others simply can't for a variety of reasons. So how much difference does breast-feeding make to a baby's health? A series of articles recently published in the journal Pediatrics gives us an idea.

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Will multiple sclerosis affect my pregnancy?

DEAR DOCTOR K: I have multiple sclerosis. My husband and I would like to have a baby. What do I need to know before I get pregnant?

DEAR READER: Multiple sclerosis (MS) is a disease that affects communication between nerve cells in the brain and spinal cord and the rest of the body. This results in symptoms that may include fatigue, weakness, pain and trouble with movement. In the most common form of the disease, sudden worsening of symptoms (flare-ups or relapses) alternate with symptom-free periods (remissions)

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What should I know about traveling during pregnancy?

DEAR DOCTOR K: My job requires a lot of travel, and I recently became pregnant with my first child. What do I need to know about traveling safely during pregnancy?

DEAR READER: Being pregnant doesn't mean you have to stay at home for nine months. There are exceptions; particularly in the last three months, some women develop complications of pregnancy that require them to be resting. But for most women, travel poses no threat to the mother or child. But travel by car, train or airplane can be less comfortable when you're pregnant, so you should take a few precautions to travel comfortably and safely.

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How much weight should a woman gain during pregnancy?

DEAR DOCTOR K: I am pregnant, and my doctor says that I'm gaining too much weight. I trust the doctor, but I've heard that it's normal to gain weight during pregnancy. How much weight should a woman gain?

DEAR READER: It's natural for a woman's appetite to increase during pregnancy. This is nature's way of making sure that she eats enough for herself and her growing baby. All women should gain weight during pregnancy, while eating healthfully and sensibly. But too much weight gain isn't good for a woman or her baby.

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What fish should I avoid while pregnant?

DEAR DOCTOR K: I recently found out that I'm pregnant. I'd like to continue eating fish, but I understand some fish contain mercury, which could be harmful to my baby. What fish should I avoid?

DEAR READER: Fish are a great source of lean protein, and many types are rich in heart-healthy omega-3 fatty acids, which help brain and nerve development and protect the heart. In fact, current dietary guidelines recommend that women who are pregnant eat 12 ounces of seafood a week. But as you noted, some species of fish do contain worrisome amounts of methylmercury. This toxin is especially dangerous to developing brains. High-mercury fish you should avoid during pregnancy include swordfish, shark, king mackerel and tilefish.

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