Health promotion in pregnancy

Southern Health and Social Care Trust – Self Help Guides (ntw.nhs.uk)

You do not have to follow a special diet during your pregnancy, however there are some foods we encourage you to avoid and ones to increase in your diet. Try to have a balanced diet, rich in fruit and vegetables, sources of protein and carbohydrates.

Foods to avoid

• Some types of cheese- like Brie, Camembert and others with a similar rind. You should also avoid soft blue-veined cheese, like Danish blue.
• Raw or undercooked meat– Cook all meat and poultry thoroughly so that there is no trace of pink or blood, take particular care with sausages and minced meat.
• Liver products and Pâté
• Supplements containing vitamin A- Don’t take high-dose multivitamin supplements, fish liver oil supplements or any supplements containing vitamin A.
• Some types of fish– Don’t eat shark, marlin and swordfish, and limit the amount of tuna you eat to no more than two tuna steaks a week.
• Raw shellfish- Eat cooked rather than raw shellfish as they can contain harmful bacteria and viruses that can cause food poisoning.
• Unpasteurised milk

Vitamins and minerals

Vitamin D

• All pregnant women should take 10 microgram supplement of Vitamin D during autumn and winter months as sunlight is not strong enough to make vitamin D. You need this vitamin to keep your bones healthy. People who cover their skin for cultural reasons, those confined indoors or with dark skin should take a daily supplement of vitamin D throughout the year.
• Folic acid
• Folic acid is important as it can reduce the risk of neural tube defects such as spina bifida in your unborn child. If you are thinking about getting pregnant, you should take a 400 microgram folic acid tablet every day. If you already have a baby with spina bifida, or if you have coeliac disease, diabetes, are obese or take anti-epileptic medicines, ask your GP or midwife for more advice as you may require higher dose.

Vitamin C

• Vitamin C helps your body absorb iron. Citrus fruits, tomatoes, broccoli, peppers, blackcurrants, potatoes and some pure fruit juices are good sources of vitamin C.

If your iron levels are low, it may help to drink orange juice with an iron-rich meal.

Calcium

• Calcium is vital for making your baby’s bones and teeth. Dairy products and fish with edible bones like sardines, breakfast cereals, dried fruit such as figs and apricots, almonds and tofu are all good source of calcium.

Caffeine

High levels of caffeine can result in babies having a low birth weight, which can increase the risk of health problems in later life.

You don’t need to cut caffeine out completely, but you should limit how much you have to no more than 200mg a day.

Anaemia (a low blood count) in pregnancy is common with as many as 1 in 4 women being anaemic before pregnancy. You will be offered a blood test to check for anaemia at your booking appointment.

You might not be aware that you are anaemic but if you experience tiredness, paleness, shortness of breath or dizziness these could all be warning signs.

Women with anaemia in pregnancy have been shown to have a higher risk of low birth weight babies and of needing a blood transfusion.

There will be huge demands on you after birth and being anaemic will make the caring for you and your baby much more difficult.

Good sources of easily absorbed iron include red meat, chicken and fish. If you are vegetarian/vegan ensure you are getting enough iron from other foods such as tofu, beans, lentils, peas and dried fruits.

Your doctor may also give you a prescription for iron tablets.

Research has found that protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. Smoke from other people’s cigarettes can damage your health and that of your unborn baby, so ask your partner, friends and family not to smoke near you.

Smoking during pregnancy has been linked to a variety of health problems, including:

• miscarriage
• sudden infant death syndrome (SIDS) also known as cot death
• premature birth
• low birth weight
• breathing problems or wheezing in the first 6 months of life

It can be difficult to stop smoking, but it is never too late to quit and there is support for you and your family. Within Southern Trust, you can avail of Stop Smoking Service at your local pharmacy or via your G.P. When you are pregnant, your midwife can also refer you to this service, so please ask at your first appointment.

Additionally, NHS Smokefree offers free help, support and advice on stopping smoking, including when you are pregnant. Their helpline (0300 123 1044) is open 9am to 8pm Monday to Friday, and 11am to 4pm at weekends.

Smoking in pregnancy | Stop Smoking (stopsmokingni.info)

Supporting clients who want to stop vaping (ncsct.co.uk)

Quit smoking – NHS (www.nhs.uk)

The Chief Medical Officers recommend that the safest approach is not to drink alcohol at all.

Do not drink alcohol if you are pregnant or trying to get pregnant, as alcohol can be passed to your unborn baby.

The risk of damage to your baby’s physical and mental development increases the more you drink which is why binge drinking is especially harmful. This risk relates to a range of conditions including Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorder (FASD).

Find out about alcohol and pregnancy, alcohol units and tips for cutting down.

During pregnancy, we recommend that you consider the following vaccines:

• Pertussis (whooping cough) vaccine, between 16-32 weeks gestation
• Flu vaccine at any gestation
• Covid-19 vaccines at any gestation

Vaccines are manufactured in different ways using part of the germ or virus that causes the disease. They work by helping the body produce an immune response against the disease but do not cause the disease itself. When taking any vaccines during your pregnancy, the antibodies produced will cross the placenta to the baby, offering them protection after birth.

Sorcha MacLaimhin from Public Health Agency on Vimeo.

The Chief Medical Officers recommend that pregnant women should aim for 150 minutes of moderate exercise throughout the week. This could be activities such as walking, swimming, cycling or yoga. If you are not currently active, start gradually and listen to your body.

Here are some helpful tips:

• Exercise doesn’t have to be strenuous to be beneficial.
• Make sure that you warm up and cool down.
• Avoid any strenuous exercise in hot weather.
• Drink plenty of water and other fluids.
• If you go to exercise classes, make sure that your teacher is properly qualified and knows that you are pregnant and how far your pregnancy has progressed.
• You might like to try swimming, because the water will support your weight. Some local swimming pools provide aqua-natal classes with qualified instructors.

As your baby grows, the hollow in your lower back may become more pronounced and this can cause backache.  During pregnancy, your ligaments become softer and stretch to prepare you for labour. This can put a strain on the joints of your lower back and pelvis, which can cause backache.

If you are experiencing back pain or pelvic discomfort, also knowns as pelvic girdle pain, you may find it beneficial to follow certain exercises every day to manage your symptoms. Our Physiotherapy Department has put together a very useful video with some advice on this topic, please follow the link below to view it

https://youtu.be/mBE3A1gXkHA

Below link is for the postnatal exercise video which you may find useful following the birth of your baby.

https://youtu.be/C9QqaYVM6DI

Remember everyone gets stressed.

Life and work can be stressful and people handle stress in different ways. Some are quietly stressed, others more openly, but everyone needs an outlet.

Whatever works for you – exercise, friends, religion, hypnotherapy, and meditation – make sure you take time out from your busy life to keep yourself healthy. You are too precious to ignore.

Everyone’s mental health journey is different, but whatever happens, you will have a team of people supporting you. This may include midwives, GPs and mental health specialists. If you are feeling overwhelmed or if your mood is low, please talk to us.

Below we have listed some useful resources to support your mental health on your pregnancy journey:

• Take 5 steps to wellbeing campaign talks about the five simple steps to help maintain and improve your wellbeing. Try to build these into your daily routines – think of them as your ‘five a day’ for wellbeing. Please see link HERE for more information.

• AWARE Mood Matters Parent and baby is a mental health awareness programme for expectant mothers and parents of babies under 3 years of age. It is currently delivered online and if you would like to register, please click link HERE.

Aware NI have teamed up with the Public Health Agency to produce a free resource on looking after the mental health of you and your baby, as you may need extra support during these difficult times. Please download HERE.

• Mellow Bumps One of the best things you can do before the baby is born is to look after yourself as well as preparing for the new arrival. Mellow Bumps is a 7- week online group, which will help you relax and get ready for the birth of your baby. There will be time to think about how you feel about becoming a parent and getting ready to welcome your baby to the world. If you would like to avail of this course, please speak to your midwife or email Mellow.Parenting@southerntrust.hscni.net

Breathing & Relaxation

Controlling your breathing is one of the quickest ways to relax. Relaxation helps to calm you and baby down. When you are calm, your heart rate is regular and there is good blood flow through the placenta to the baby. The baby may start moving and kicking because he/she is enjoying the calm time. You will produce oxytocin, the “feel good” hormone and the baby will get this through the placenta. This will counteract the more negative stress hormones such as adrenaline or cortisone. For good brain development, babies require high levels of oxytocin.

Mastering the skill of relaxation and deep breathing is a life skill.

There are many different types of relaxation, and what suits one person will not always suit another.

You may choose to practice relaxation by:

• using a relaxation app
• joining a mindfulness or hypnobirthing course

Tommy’s has launched the Sleep On Side campaign today in response to the publication of a fourth research study that confirms that the risk of stillbirth is doubled if women go to sleep on their backs in the third trimester.

More information can be found HERE