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Winters (CA) Express, Thursday, August 18, 2011 — A-10How to eat right during pregnancyBy JAMES N. MARTIN JR.,MD, president of theAmerican Congress ofObstetriciansand GynecologistsAs your baby’s solesource of nutrition duringpregnancy, eating a wellbalanceddiet is essential.Many women have questionsabout how manymore calories they need,what is safe to eat, andwhat foods to avoid.Pregnant women needmore calories and nutrientsto support a developingfetus, but it’s importantnot to overeat. Mostwomen only need a moderateincrease of 100–300 caloriesper day — the equivalentof a bowl of cerealwith skim milk. Early inpregnancy, nausea maymake it difficult to increaseyour food intake.Eating smaller nutritiousmeals and snacksthroughout the day canhelp you add extra calories.Your weight gain shouldalso be moderate andbased on your pre-pregnancyweight. The range ofweight gain should be25–35 pounds for women ofnormal weight, 28–40pounds for underweightwomen, 15–25 pounds foroverweight women, and11–20 pounds for obesewomen.Increase nutrient intakeby consuming a diversediet that contains wholegrains, lots of fruits andvegetables, healthy fats,dairy, lean meats and fish,and beans. Your doctormay also prescribe prenatalvitamins for extra folicacid and other nutrientsnecessary for healthygrowth and development.Fish is a good source ofhigh-quality protein. Pregnantwomen can consumeup to 12 ounces per week ofa variety of fish and shellfishthat are low in mercurysuch as shrimp,canned light tuna (ratherthan albacore), salmon,pollock and catfish. Shark,swordfish, king mackereland tilefish should beavoided because they arehigh in mercury.Calcium is a vital nutrientfor a growing fetus.Most women get enough,but lactose-intolerantwomen should increasetheir consumption of calciumfrom non-dairy sourcessuch as sardines, cannedsalmon, dark leafy greenvegetables and fortifiedorange juice. Your doctorcan also prescribe calciumsupplements if necessary.Vegetarian and veganwomen must be sure to getenough protein from nonmeatsources such asbeans, nuts and soy products.Your ob-gyn may recommendan eating planand supplements to provideadequate amounts ofvitamins and minerals,especially iron and vitaminsB12 and D.If you are pregnant,avoid alcohol entirely. Donot eat unpasteurized milkor soft cheese; raw orundercooked meat, poultryor fish; or preparedmeats such as hot dogs ordeli meat (unless cookeduntil steaming hot). Thesefoods can harbor listeriosisbacteria, which cansicken both mother andbaby. You should also tellyour doctor about any vitamins,herbs or other supplementsthat you takebecause they could beharmful to your fetus.For more information, thePatient Education Pamphlet“Nutrition DuringPregnancy” is available atwww.acog.org/publications/patient_education.Understanding and preventing urinary tract infectionsBy James N. Martin Jr,MD, president of theAmerican Congress ofObstetricians andGynecologistsUrinary tract infections(UTIs) are acommon problem thataffect up to 60 percentof women. They canbe painful and maycause serious illness,especially if the infectionspreads to thekidneys.UTIs usually occurwhen bacteria thatlive on the skin nearthe rectum or in thevagina enter the urinarytract. The urinarytract consists offour parts: the kidneys,which produceurine; the ureters,which take urine fromthe kidneys to thebladder; the bladder,where urine is stored;and the urethra,which takes urine outof the body. Sexualcontact or wipingback to front cantransport bacteria tothe urethra. Thebacteria can thenspread to the bladder,ureters and kidneys.UTIs may also becaused by a blockage(stone) in the kidneys,bladder, or ureters; anarrowed tube orkink in the urinarytract; or problemswith the bladder wall,urethra or pelvic musclesor nerves.A UTI can cause astrong urge to urinatethat cannot be delayed,an urge to urinatevery frequently,or a sharp pain orburning in the urethraas you urinate.Your urine may lookcloudy, have a strongWoodland Healthcareoffers ‘Living withCancer’ support groupodor, or be tingedwith blood. Additionally,if you have backpain, chills, fever,nausea or vomiting,the infection mayhave spread to yourkidneys. Kidney infectionsmust betreated right away.Contact your doctor ifyou experience any ofthese symptoms.UTIs can be quicklydiagnosed with aurine test. Your doctorwill prescribe anantibiotic to clear upthe infection. Mostsymptoms go away ina day or two, but it isimportant to finish allof the prescribedmedication to lowerthe risk of the infectioncoming back.Recurrent infectionsmay signal otherproblems with theurinary tract, andyour doctor may needto perform more teststo make sure there isnot a more seriousproblem.You may be at higherrisk for UTIs if youare obese, diabetic,have had UTIs before,have sickle cell trait,are postmenopausal,have diabetes, use adiaphragm or spermicidefor contraception,have intercoursefrequently, or have anew partner.These tips may helpprevent UTIs:~ Always wipe frontto back after bowelmovements and urination~ Avoid usingdouches, powder anddeodorant sprays~ Drink plenty offluids, includingwater and cranberryjuice~ Empty your bladderas soon as you getthe urge, about every2 to 3 hours~ Try to empty yourbladder before andafter sex~ Wear cottonunderwearFor more information,the Patient EducationPamphlet“Urinary Tract Infections”is available inEnglish and Spanishat www.acog.org/publications/patient_education.Woodland Healthcareoffers a Livingwith Cancer supportgroup, free of charge,for people who have orhave had cancer andare receiving treatmentor not.The group meets onthe first, third andfifth Tuesday of everymonth from 7-8:30 p.m.in the cafeteria atWoodland MemorialHospital, 1325 CottonwoodSt. in Woodland.Spouses, caregivers,family members andfriends are welcome.Studies on supportgroups have foundthat regular attendancecan boost qualityof life, calm anxiety,and make patientsmore active and incontrol of their care.The goals of WoodlandHealthcare’s Livingwith Cancer supportgroup are toreach people as soonas possible after diagnosis;to provide support,understandingand referrals to communityresources; toshare feelings in a safeand confidential atmosphere;to provideeducation about cancerand its myths; andto provide speakers.The support groupis funded by theWoodland HealthcareFoundation.For more, call supportgroup facilitatorand registered nurseSheila Murray at 669-5305.