The most comprehensive guide to first trimester dos and don’ts you’ll ever need!

The most comprehensive guide to first trimester dos and don'ts you'll ever need!

by Dr Anitha Anchan

Pregnancy is a normal phase of life. Yet, the moment your pregnancy is confirmed a million questions haunt your mind – what to eat and what to avoid, should I exercise or not, will my medicines affect my growing baby. You are anxious to know what's right and what's not.  Here's a list of dos and don'ts which will help you get through your first trimester.

Dos

1.   Get your required number of calories from all food groups, not just fat!

Nutritional needs increase during pregnancy and to meet them you need to have a well-balanced diet. According to Naini Setalvad, a renowned nutritionist and diet and obesity consultant, you need to include variety of foods in the diet like whole grains, pulses, legumes and nuts. Meat, poultry, eggs and fish also provide protein. Incorporate whole fruits and vegetables and whole pulses and grain cereals that contain plenty of fibres. Drink plenty of water. (Read: 10 diet dos and don'ts during pregnancy)

2.  Make sure you get your calcium from milk or other food

Calcium is necessary for healthy nerves and muscles and for the growth of your baby's bones and teeth. It also helps prevent high blood pressure brought about by pregnancy. Take 600 ml of milk or milk products every day for the calcium content. Lactose intolerant mothers can substitute it with jaggery, nachani, etc. says our expert Sonali Shivlani, an Internationally Certified Pregnancy, Lactation and Child Nutrition Counsellor.

3.  Get your dose of vitamin D

Do this either through food like egg yolks, herring, sardines, tuna, salmon, fortified milk, fish liver oil, or through exposure to sunlight. It helps maintain calcium and phosphorus levels. And a lack of it during pregnancy can not only increase your risk of developing preeclampsia but can also cause your baby to lack the vitamin at birth increasing the risk for abnormal bone growth and delayed physical development.

4.  Increase your intake of  omega-3 fatty acids

They are necessary for the development of your baby's brain, nerve and eye. Good sources of omega-3 fatty acids are flaxseeds and fish. 

5.  Take iron and folic acid supplements as prescribed by your doctor

Our expert Sonali Shivlani stresses on the importance of taking supplements (only those prescribed by a doctor). During pregnancy, the baby develops rapidly and hence needs nutrients in the right proportion. If folic acid is deficient in the mother, it can lead to complications in the mother and defects in the baby as well. Folic acid is important during the pre-conception and early pregnancy phase because this is when the foetus develops spine and nerve cells. Deficiency can lead to neural tube defects or malformation of the spine in the developing baby – known as spina bifida – it has a life-long impact on the child.

For the mother, folic acid is especially important as it is responsible for the development of blood cells which reduces incidents of certain types of anaemia. And with the right haemoglobin levels, a pregnant mother can nourish the developing foetus well. All this helps in reducing the chances of IUGR (Intrauterine Growth Retardation) in the baby. Folic acid supplements also help the mother manage pregnancy symptoms such as tiredness and fatigue better. There are foods like green leafy vegetables, dried herbs, sunflower seeds, peanuts, bean sprouts, beans, soybean and liver that are great sources of natural folic acid. 

The recommended dietary allowance for iron in normal adult women is 21 mg/day and during pregnancy it is 35 mg/day. Iron is required for making baby's blood as well as for maintaining mothers own iron levels. According to a study, taking iron supplements during pregnancy can reduce the risk of anaemia and low birth weight. Other sources of iron are green leafy vegetables, sesame seeds, legumes, jaggery, meat, fish and egg. (Read: Load up on iron ladies)

6.  Eat frequent, smaller meals

You must remember that there are various hormonal changes and food gets digested more slowly, says Sonali Shivlani. The baby needs to be fed constantly so eat every two to three hours. Small mini-meals can also help prevent common pregnancy complaints like acidity, nausea and that bloated feeling, she adds.

7.  Gain weight gradually

How much weight you should gain during your pregnancy depends on your body mass index or BMI (your body weight divided by the square of your height) before you conceived. For the optimal growth of your baby you should gain around 0.5- 2 kg in the first trimester. Weight gain during pregnancy helps nourish the baby and accumulate calories to produce milk for breast-feeding. You should gain weight at a steady pace.

Inconsistent weight gain, too little or too much, can affect your baby adversely. Gaining very little weight during pregnancy can lead to premature delivery and low birth weight. It may also cause developmental delays and chronic health problems in your baby.

On the contrary, putting on too much weight increases your risk of high blood pressure (pre-eclampsia) and gestational diabetes. It may also lead to an overweight or obese baby which may necessitate a caesarean birth. You may also have a tendency to retain too much weight after pregnancy which may cause higher weight and its accompanying problems in subsequent pregnancies.

Giving out some handy dos and don'ts for mothers-to-be about eating habits, Naini Setalvad says that every pregnant woman needs to understand that she is NOT eating for two people. She only requires 300 more calories than her normal diet. Nutritionist Sonali Shivlani says that just two slices of bread, a glass of milk and an extra fruit per day are enough to complete that requirement.

8.  Get some exercise

It is important to keep yourself active during pregnancy. Stretching can help improve your muscle flexibility. Regular gentle exercise can help ease or prevent back pain, boost your energy, build stamina and help you prepare for the physical changes of labour and delivery. Scientists have found that women who exercise during pregnancy are less likely to require a caesarean birth. And the ones undertaking brisk walking in particular, thrice a week, could reduce their risk of having a heavy infant by half. Exercise also lowers the chances of developing a type of diabetes that only affects pregnant women. But avoid strenuous exercises. However, discuss with your doctor before starting any new activity. (Read: Why pregnant women need exercise)

9.  Don't miss your visits to the doctor

Your prenatal check-ups are your window into the womb and they help detect any issues early and can be corrected in most cases. Blood tests and ultrasonography are routinely done during pregnancy. Blood tests can determine your blood type and also help rule out anaemia, infections etc. If you are in a high-risk category you may get blood tests done for genetic disorders screening. Ultrasonography may be used to visualize the foetus in your womb at around four and a half weeks after your last menstrual period (LMP). It can tell you how many weeks you are into pregnancy and how healthy your baby is. You may be able to see your baby's heartbeat by seven weeks after LMP. Ultrasonography can also help detect certain birth defects.

10. Increase your fluid intake

Blood volume needs to increase during pregnancy to facilitate oxygen and nutrient delivery to both you and your baby. So drink plenty of fluids. It can also prevent dehydration and constipation. Sipping iced water could offer some relief from nausea and vomiting.

11. Get lots of sleep

Most pregnant women experience nausea, vomiting, dizziness, heartburn and a constant need to pee mostly during this time of pregnancy. This can make you feel tired. Hormonal changes also make you feel worn out. So make it a point to get few naps whenever possible. Try to turn in early to bed. (Read: Top five foods to help you sleep)

12. Get your teeth professionally cleaned

Pregnancy gingivitis is caused by hormonal changes that can make your gums more sensitive to the bacteria in plaque. If left untreated, it can lead to periodontitis, a more severe form of gum disease.

According to some studies, severe gum disease has been linked to preterm birth and low birth weight.

Practising good oral hygiene habits can help you enter and complete your pregnancy in good health. Brush at least twice a day, floss once a day and use an antimicrobial mouth rinse. Getting a professional dental cleaning before getting pregnant or during pregnancy would be more important than ever. (Read: Dental hygiene basics)

13. Cut down on caffeine

It is best to cut down or skip caffeinated drinks altogether. Large amounts of caffeine consumption and an increased risk of miscarriage have been linked in some studies. High levels of caffeine have also been linked to lower birth weight and stillbirth. But caffeine intake in moderation is unlikely to harm your baby. Or you can switch to decaffeinated drinks instead. (Read: Coffee can make women infertile)

Don'ts

1. Don't take any medication unless necessary

Medicines taken by you can cross the placenta and enter the bloodstream of your baby. Hence it's best to know the safety of any medications you're taking during pregnancy – especially in the first trimester. It is during this trimester that your baby's organs are rapidly developing making them potentially vulnerable to ill effects of the medicines. Some drugs have been linked to increased risk of miscarriage. There are certain medications like anti-epileptic drugs which can cause genetic defects in the baby. If you are already on medication for a previous health condition talk to your doctor regarding its safety or alternatives. Your doctor will replace more toxic drugs with milder ones so that the baby is affected as little as possible.

2. Don't be too adventurous with food

Foods to be avoided during pregnancy include raw/undercooked meat, soft cheese, seafood and raw eggs. They could be possible sources of harmful bacteria and parasite. Bacterial infection may cause severe food poisoning. If you get infected for the first time with toxoplasmosis parasite during your first trimester of pregnancy it can cross the placenta and harm your baby. Keep away from seafood that is high in mercury which can damage the developing nervous system of your baby and cause developmental delays and brain damage.

3. Reduce your exposure to environmental pollutants

We are exposed to lots of potentially toxic pollutants every day.  Try and avoid the obvious ones as far as you can. Limit your exposure to household cleaning products and paints which contain harmful toxins that may be inhaled or absorbed through the skin and put your baby's health at risk.

Clean your vegetables thoroughly to rid them of the pesticides which have been linked to neural tube defects, limb deformities, etc.

According to a study, women exposed to elevated levels of ozone air pollution (smog) in the first three months of pregnancy may be at increased risk for complications such as preeclampsia and premature birth.

Another study claims that pregnant women who drink water with traces of arsenic may give birth to babies who have increased odds of respiratory infections.

4. Quit smoking

When you smoke during pregnancy, your unborn baby gets affected by the chemicals from the cigarette. There is an increased risk for premature rupture of the amniotic sac, placenta previa (a condition where the placenta is placed in an unusual position in the uterus), miscarriage, and neonatal death.

It has also been found that new-borns whose mothers smoked during pregnancy have the same nicotine levels in their bloodstream as adults who smoke. The child goes through withdrawal symptoms from the first day of its life, just like an adult would.

Passive and active smoking during pregnancy increases the risk of health and behavioural problems in the baby and is linked to infant mortality.

According to a British research, pregnant women who puff can triple their baby's chance of developing meningitis. Chewing tobacco during pregnancy decreases the gestational age at birth and decreases birth weight. (Read: Natural remedies to quit smoking)

5. Don't drink alcohol

Well, you may have to give up on alcohol too. It increases the risk of miscarriage. Alcohol can cross the placenta and reach your baby's bloodstream. Excessive drinking impairs the mental and physical development of your baby, in what is known as foetal alcohol syndrome. It is known to cause a range of health problems from behavioural disorders and impaired IQ to facial disfigurement in unborn babies. It may also be a contributing factor for attention deficit hyperactivity disorder (ADHD) in children. 

6.  Don't get stressed, depressed

Abnormal stress which makes you sad and unhappy should be avoided. High levels of stress can affect the unborn baby's health and increase your chances of miscarriage.

Stress and depression stimulate the production of certain chemicals and hormones in your body that can constrict blood vessels and decrease oxygen supply to the uterus and affect your baby's growth. (Read: Feeling stressed? Try these natural remedies)

7. Don't go on diet while you're pregnant

You may end up with deficiency of iron, folic acid, vitamins and minerals which can potentially harm you and your baby. If you are morbidly obese when you get pregnant your doctor may advise you to lose weight. But it should be done only under his/her supervision.

8. Don't use hot tubs/ sauna

Stay out of saunas and hot tubs. They have been linked to an increased risk of miscarriage. They can raise your core body temperature which can cause dehydration and threaten the developing baby.

For more articles on pregnancy, visit our Pregnancy Section and for videos check out our YouTube Channel. 

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