Our family GP tackles your pregnancy queries
A. She’s partially right. You should limit how much you have as, early on in pregnancy, large amounts of caffeine increase your risk of miscarriage and, later on, can also affect your baby’s growth. The risks are small so don’t worry if you’ve been overdoing it so far, but limit your total daily caffeine intake to 200mg or less. Coffee contains a significant amount of caffeine, though amounts vary depending on the type and strength – instant coffee usually contains less than filter, and some large coffee shop cups contain more than the recommended daily allowance in pregnancy. Cola, chocolate, tea, energy drinks, and some medicines also contain caffeine.
Here’s how it breaks down: A medium mug of instant coffee is around 100mg caffeine; filter coffee is 140mg; tea is 75mg; a 50g bar of milk chocolate is 25mg of caffeine (double for dark chocolate); a can of cola is 40mg. So, the best way to enjoy your morning coffee without worry? Decaf.
A. It’s good that you’re keeping an eye on changes in your skin, which everyone in the family should do, pregnant or not. You don’t say where the moles are, but it’s true that pregnancy can cause existing ones to become larger or darker, and new ones can appear, most commonly on the face, thighs or breasts. I frequently see mums-to-be who are worried that changes are due to skin cancer. It’s thought that hormones are the culprit, but the exact reason behind the changes is uncertain. It’s important to know that moles are no more likely to become cancerous during pregnancy than at any other time. However, if any have an irregular outline or colour, or become red, raised, painful or bleed, get them looked at, and if you have a family history of malignant melanoma, make sure your GP knows. Remember, sun safety is still important when pregnant so don’t expose yourself to strong sunlight and use a high SPF face cream, even in winter.
A. If you’re sure that you had chicken pox as a child there is nothing to worry about, as your immunity will protect you and your baby. However, if you (or more likely your parents) aren’t sure if you’ve had it or not then visit or speak to your GP as soon as possible.
You’ll probably be given a blood test to see if you’ve had chicken pox in the past as most women – 90 per cent in the UK – have. If the test shows you’re immune, you’re fine. If, however, it turns out you’ve never had chicken pox, then you’ll be treated with an injection to strengthen your immune system, and make the chicken pox milder if you do develop it.
If you catch chicken pox in pregnancy there’s a small chance it can affect the baby and you’ll need to be monitored closely, so definitely go and see your GP as soon as you can to get a test.
A. Urine infections are more common in pregnancy because the tubes from your kidney to your bladder dilate, causing the urine to stay in the tubes for longer. If they’re left untreated, urine infections can spread to the kidneys and make you unwell, and even more seriously, trigger premature labour and affect the growth of your baby.
Symptoms can include pain when you wee as well as needing to go to the loo more often. If you’ve ever had cystitis you’ll know what I’m talking about.
Assuming your doctor knows you’re expecting a baby, he or she will have prescribed an antibiotic that’s safe to take in pregnancy. If you’re in any doubt that your GP knows you’re pregnant, go back and check with him or her before starting the course of antibiotics.
A. Itchy skin over your bump is fairly common as the skin is stretched. However, occasionally I see a woman with persistent severe itching often on the palms of the hands and soles of her feet. It can sometimes just be a rash, but there is also a condition called obstetric cholestasis. This is a liver disorder that leads to a build-up of bile acids in the bloodstream, causing the itching. The blood test suggested by your doctor will show any abnormalities with your liver. Make sure you get it done as the condition can create problems with your pregnancy and needs to be closely monitored.
A. Linea nigra describes a brown line that some pregnant women get between their belly button and pubic bone. Not all pregnant women get it – it tends to be more common in darker-skinned women.
Linea nigra is caused by deposits of the pigment melanin in your skin. It usually appears in the second trimester and fades a few months after birth, although it may not go away completely.
Getting a suntan will make it darker, so use a high factor sun cream. Also, make sure you’re taking either a pregnancy multivitamin or folic acid and eating a good diet, as low levels of folic acid and linea nigra may be related.
A. If you are rhesus negative but your baby is rhesus positive and the two blood types mix, which can happen during pregnancy and birth, you can develop antibodies to your baby’s blood, which could make him anaemic or jaundiced. However, this is now very rare. As part of the routine blood tests done during pregnancy your midwife or doctor will check whether you’re developing any antibodies, and keep a close eye on you. The solution is an injection called Anti-D, which you’ll be offered at 28 and 34 weeks, after birth and following any bleeding or injury to your bump.
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