Omega-3 Fatty Acids and Heart Health

  Omega-3 Fatty acids include EPA, DHA, and ALA.  DHA is felt to be important for fetal brain development, but EPA and DHA are receiving attention for the heart health they provide.  Both are found primarily in fish.  One study showed that they decrease the risk of death from heart attack, and recurrent heart attacks by 20%.  For heart protection, adults should eat  “oily” fish (salmon, tuna, sardines, trout, mackerel) twice per week.  This amount of fish is equivalent to 400-500 mg of EPA plus DHA per day.  Numerous omega-3 fatty acid dietary supplements are available for those who avoid or limit the amount of fish in their diets.

Vitamin D In Pregnancy

Vitamin D deficiency in pregnancy has been associated with abnormal bone development in the fetus, newborn rickets, and fractures in the newborn.  Routine screening of Vitamin D deficiency in pregnancy is not recommended, testing in those at risk can be performed by a blood test. When Vitamin D deficiency is identified, supplementation with 1000-2000 IU/day is safe. Safety of higher doses has not been studied. In those not at risk, Vitamin D supplementation beyond that amount in a prenatal vitamin should await further studies on safety.

IUDs (Intrauterine devices) For Contraception

IUD’s are the most effective, reversible (non-permanent) form of contraception available. The device is placed inside the uterus during an office visit and does not require an anesthetic.  Although the devices available do not need to be replaced for 5-10 years, they can be removed at anytime with rapid return of fertility. Prior to 2005, IUD package inserts suggested that IUD’s not be inserted in women who have not had children. Recommendations have continued to evolve since that time. IUDs are now considered suitable in nearly all women. This includes women who have never had a child and adolescents. 

Pacifiers and Breast Feeding

New mothers are encouraged to breast feed their newborns for the nutritional benefits.  Encouragement comes from the American Academy of Pediatrics (AAP), the American College of Obstetrics and Gynecology (ACOG), and The World Health Organization (WHO); not to mention family and friends.
For a new mother experiencing difficulty with breast feeding, "advice" is abundant and often conflicting. A 2011 review has shown that the use of a pacifier does not affect breast feeding success up to 4 months of age. The review can be found at:

Drink Plenty of Fluids During Pregnancy

No one needs to be reminded about the hot Texas summers.  Please get plenty of fluids during the pregnancy.  Inadequate fluid intake can cause low blood pressure, dizziness, uterine contractions, and constipation.  Dehydration also increases the risk of urinary tract infections and kidney stones.  "Thirst" is a good indication that you are not getting enough fluid.  Also, if the urine is a darker yellow, you may not be getting enough fluid.  In general, you should drink 2 to 3 liters (8-12 cups) of water per day.  If you exercise or if you are outdoors; your intake should increase.