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prescribed drugs Can you take Tums (calcium carbonate) while pregnant? Tums (generic calcium carbonate), an over-the-counter chewable antacid, is usually considered safe in pregnancy to treat the symptoms of indigestion, acid reflux, gas, bloating, heartburn as well as an upset stomach resulting from them [1, 2] . Although it is recommended to avoid any medication during this period, and try to manage the symptoms of acid indigestion through lifestyle changes and safe alternative home remedies, taking Tums occasionally does not generally cause any harm to the baby [3] . But, like all other drugs, it is recommended to consult your doctor before using oral calcium carbonate while pregnant . Tums FDA Pregnancy Category Category C [4] Despite being considered relatively safe for pregnant women, it is assigned in Category C as it crosses the placenta and there is a lack of adequate research on human pregnancy. Animal studies have shown no harmful effects on the fetus [5] . Is Tums safe during early pregnancy? Calcium carbonate, the active ingredient in the antacid, is considered safe during the first trimester with little proven association with an increased risk of birth defects [6, 7] . However, extreme overdoses may be harmful . What is the recommended dosage of Tums during pregnancy? It is usually not recommended to take any more than seven regular strength tablets within 24 hours in pregnancy [8] . However, the dosage may vary according to your doctor s instructions [9] . Studies regarding the potential risks and benefits of taking Tums while pregnant One 1960s study failed to find any association between the use of calcium carbonate by the mother and having increased chances of birth defects in the baby. However, the same study reported significantly higher risks of serious physical deformities with exposure to certain other antacids in the womb in late pregnancy. Calcium based antacids (as well as the magnesium based ones) were recommended for pregnant women at a European consensus conference , where the medicines were found to offer the additional benefit of higher calcium supplementation, reducing the risks of high blood pressure and preeclampsia. The calcium content of Tums is also useful for proper fetal bone development, especially when taken in the third trimester [12] . Tums while breastfeeding Tums is considered safe for breastfeeding mothers with the maximum daily dosage usually not recommended to exceed 1,200 mg [10] . It does enter the breast milk, but there is no evidence of any harm to the nursing infant [4, 11] . Make sure to consult with your doctor before taking the calcium carbonate pills to understand its potential effects. [ref] http://www.webmd.com/heartburn-gerd/guide/heartburn-during-pregnancy http://pregnant.thebump.com/pregnancy/is-it-safe/qa/what-medications-are-safe-during-pregnancy.aspx http://americanpregnancy.org/is-it-safe/tums-during-pregnancy/ http://reference.medscape.com/drug/tums-calcium-carbonate-341983 http://www.medscape.com/viewarticle/515100 http://www.babycenter.com/404_which-heartburn-medicines-are-safe-during-pregnancy_1440876.bc http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231543/ http://www.nhs.uk/medicine-guides/pages/MedicineOverview.aspx?medicine=Tums%20Antacid%20tablets http://www.everydayhealth.com/drugs/calcium-carbonate http://www.virginiawomenscenter.com/services-obstetrics-post-safe-medications-while-breastfeeding.html http://www.babycenter.com/404_is-it-safe-for-a-breastfeeding-mom-to-take-antacids_10370371.bc http://www.drugs.com/pregnancy/calcium-carbonate.html [/ref] it will

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superb Is Zantac (Ranitidine) safe during pregnancy Zantac (generic name ranitidine), an oral medication in the group of histamine-2 blockers, is usually considered safe during pregnancy [1] for treating problems like acid reflux, nausea, indigestion and heartburn [2] . It has also been safely used for preventing Mendelson s syndrome [3] . However, it is always recommended to consult your doctor to discuss any potential risks, whether you are considering the prescription or over-the-counter dosages [4] . Zantac FDA pregnancy category Category B Studies have shown ranitidine to cross the placenta, but there is no evidence of any serious harm to the baby [1] . How much Zantac can you take while pregnant The dosage varies from one individual to another, depending on the purpose of use, severity of the symptoms and the medical history of the mother. The regular recommended adult dosage of 300mg per day [5] is usually considered safe for pregnant women. Smaller dosages of 75mg and 150mg are also available [6] . Make sure to talk to your physician before starting on any specific dose . Are there any risks of taking Zantac while pregnant A 1996 study compared 178 women who were exposed to histamine-2 receptor antagonists with another group of 178 women with no such exposure. Both groups had similar gestational age, alcohol and smoking history. In the exposure group, 71% of the women took ranitidine with the rest having other forms of H2RAs. There was no exceptional difference between the two groups in terms of elective or spontaneous abortions, preterm birth, congenital malformations and birth weight [7] . One study showed its maternal serum-umbilical cord concentration ratio to be 0.9 in average after an intravenous administration of ranitidine for preventing Mendelson s syndrome in 20 women in the 38th week of their pregnancy. The ratio averaged around 0.38 when a 150mg dosage was given to 80 women, 1 to 8 hours prior to a scheduled c-section at the 37th week [1] . Another study was done where 909 women in labor were given a 150mg oral dosage of ranitidine every 6 hours for preventing Mendelson s syndrome. The results were compared with those of a control group consisting of 378 women who received conventional alkali therapy. There was no evidence of a higher incidence of any surgical intervention or placental/post-partum hemorrhage in the ranitidine group. The study showed similar outcomes for neonatal health between the two groups as well [1] . Animal studies have shown no evidence of fetal harm even after administration of dosages 160 times higher than that recommended for humans [8] . Most studies have been performed to determine the safety of ranitidine (Zantac) during the later stages of pregnancy, specifically the third trimester; however, no adverse outcomes have been reported due to its use in the first and second trimesters. A study carried out between 1985 and 1992, showed no association between any birth defects and the use of ranitidine in the first trimester [7] . Zantac and breastfeeding It is secreted into breast milk in small amounts and should be used with caution by nursing mothers. However, studies have failed to show any serious adverse effects [9] . It is strongly advised to talk to your doctor before using it [8] . [ref] http://www.drugs.com/pregnancy/ranitidine.html http://www.ncbi.nlm.nih.gov/pubmed/9207819 http://patient.info/doctor/mendelsons-syndrome http://www.webmd.com/drugs/2/drug-4090-7033/zantac-oral/ranitidinetablet-oral/details#precautions http://www.drugs.com/dosage/zantac.html http://www.womenshealthcare.org/Patient-Info/Info-for-Pregnancy.aspx http://www.medscape.com/viewarticle/515100_5 https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Zantac_Oral/pdf/ZANTAC-ORAL.PDF http://www.medscape.com/viewarticle/515100_6 [/ref] a terribly

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was firm Heartburn is a burning sensation felt in the esophagus and chest due to indigestion and reflux of stomach acids. Women often experience mild to moderate heartburn [1] during the early stages of pregnancy. It is quite common during the second and third trimesters as well. Is Heartburn an Early Sign of Pregnancy? It is counted among the earliest signs of pregnancy along with nausea, vomiting, food craving and aversions, dizziness and mood swings [2] . What Does Heartburn Feel Like? Burning sensation in the chest, behind the breastbone especially after eating [22] Burning sensation in the throat with a feeling of sour, hot, acidic fluid at the throat s back Feeling of foods stuck in the middle of one s throat or chest [21] Mild to moderate chest pain especially when lying down or bending over Chronic cough or sore throat What Causes Heartburn in Pregnancy? Causes during early pregnancy: The high levels of the hormone progesterone relax the valve between the esophagus and stomach. As a result, it is unable to close properly to prevent stomach acids from entering the esophagus and irritating the lining, causing heartburn [1] Causes during later stages: The growing uterus is the main reason for the symptom, especially after the 20th week. It pushes the stomach against the diaphragm, causing the stomach contents to move into the esophagus. This leads to acid reflux and heartburn [3] . Foods that Cause Heartburn when Pregnant Alcohol (especially red wine) Fried and fatty foods [4] Black pepper Garlic Raw onions Avocado [5] Cheese Citrus fruits like oranges (or orange juice), tomatoes and grapefruits Chocolate [6] Peppermint Coffee and caffeinated beverages like tea and soda Carbonated beverages Tips for Preventing Heartburn While Pregnant Eating several small meals rather than three large ones [7] Eating slowly, chewing the food properly Drinking at least 8-10 glasses of water every day [8] Avoiding the common food triggers [9] Maintaining a certain activity level as prolonged inactivity (e.g. extended bed rest) can relax the muscles, worsening the symptom [10] Drinking less water during meals [11] Sitting upright in a high-backed comfortable chair instead of slouching Avoiding lying down or bending over directly after a meal Keeping the head and chest in a higher position than the rest of the body when lying down Wearing loose fitting clothes to reduce the pressure on the stomach Trying not to gain too much weight Avoiding smoking Heartburn Relief during Pregnancy Medicines for Severe Heartburn Symptoms during Pregnancy Non-prescription antacids like TUMS can be safely used for getting rid of heartburn in pregnancy while they also provide certain nutrients (e.g. calcium) essential during pregnancy [12] . Physicians strongly recommend avoiding antacids containing aluminum while sodium bicarbonate (or baking soda) and sodium citrate sold as antacid tablets should be avoided as well [13] . Apart from calcium containing antacids, a few other safe medications are: Ranitidine [14] (Zantac: pregnancy category B in US) Omeprazole (Prilosec: pregnancy category C in US) One should consult her doctor before using any of the above medicines; otherwise, they may lead to various pregnancy-related problems. The following side effects [14] may occur in some rare cases: Headaches Diarrhea/constipation Nausea Vomiting Home Remedies to Cure Heartburn during Pregnancy Here are some other ways to stop heartburn: Eating some yoghurt after each meal [15] (the probiotics found in yoghurt are believed to neutralize the stomach acids) Papaya (in any form) [16] as its digestive enzymes soothe the stomach Chewing gums [17] reduces the acid levels by encouraging saliva flow while the bicarbonate in gums helps to neutralize the refluxed acids. Drinking some milk (preferably cold) or having some ice cream before meals and whenever the symptom occurs [14] Taking a glass of warm milk mixed with a tablespoonful of honey [18] Having two teaspoonfuls of apple cider vinegar along with 8 oz water (add honey if desired) [19] Ginger (in any form) Taking 1-2 teaspoonfuls of mustard [23] Raw almonds Snacking on a fresh celery stick [23] Basil leaves When to Call the Doctor? It is advisable to call the doctor in case of the following symptoms along with heartburn: Constant heartburn [9] Difficulty swallowing Severe heartburn causing sleep disturbances Spitting up blood Excessive weight loss [9] Black stools Myths Associated with Heartburn during Pregnancy One myth says that if a woman suffers from heartburn during pregnancy, she is going to have a baby with a full head of hair [20] . There is another myth saying one can find out if she is going to have a boy or girl depending on whether or not she has heartburn while pregnant. But in truth, these are just old wives tales as each pregnancy is different with different signs and symptoms. Heartburn ICD-9 and ICD-10 Codes Its ICD-9 code is 787.1 while the ICD-10 code used for heartburn is R12. [ref] http://americanpregnancy.org/pregnancyhealth/heartburn.html http://voices.yahoo.com/13-early-signs-symptoms-pregnancy-8482897.html?cat=25 http://pregnant.thebump.com/pregnancy/pregnancy-problems/articles/heartburn-during-pregnancy.aspx http://www.parents.com/pregnancy/stages/3rd-trimester-health/heartburn-causing-foods/ http://www.webmd.com/heartburn-gerd/features/top-10-heartburn-foods?page=2 http://www.webmd.com/heartburn-gerd/guide/common-heartburn-triggers-exercise-medications-and-large-meals http://www.webmd.com/baby/heartburn-pregnancy http://www.babble.com/pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy-7/ http://www.marchofdimes.com/pregnancy/heartburn-and-indigestion.aspx http://www.whattoexpect.com/pregnancy/pregnancy-health/bed-rest/staying-horizontal-and-healthy.aspx http://www.webmd.com/heartburn-gerd/guide/heartburn-during-pregnancy http://www.sheknows.com/parenting/articles/807341/pregnancy-heartburn-tips-to-stop-the-burn http://www.babycenter.com/404_which-heartburn-medicines-are-safe-during-pregnancy_1440876.bc http://www.nhs.uk/conditions/pregnancy-and-baby/pages/indigestion-heartburn-pregnant.aspx#close http://www.babble.com/pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy-9/ http://www.babble.com/pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy-10/ http://www.babble.com/pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy/heartburn-remedies-acid-reflux-relief-pregnancy-8/ http://yourhealthybody.jillianmichaels.com/foods-can-prevent-heartburn-pregnancy-3577.html http://www.pregnantchicken.com/pregnant-chicken-blog/pregnancy-heartburn http://healthyliving.msn.com/pregnancy-parenting/advice/12-myths-about-pregnancy-1 http://www.webmd.com/heartburn-gerd/guide/heartburn-symptoms http://www.mayoclinic.com/health/heartburn-gerd/DS00095/DSECTION=symptoms http://tipnut.com/heartburn/ [/ref] one of the best

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discount Many women experience diarrhea or frequent watery bowel movements, often within a few hours of taking a meal, during various stages of pregnancy. There is a common misconception that diarrhea or constipation during pregnancy can cause miscarriage [1] , but in truth, it is perfectly normal to have this symptom, especially during the earlier trimesters [2] . Some women also report having diarrhea before labor [3] . Is Diarrhea an Early Sign of Pregnancy? It is one of the earliest symptoms of pregnancy, occurring along with nausea and vomiting (morning sickness) [4] and food cravings or aversions. Diarrhea during Late Pregnancy Diarrhea during the third trimester is quite common and is often caused by the same reasons as in the earlier trimesters [3] . Passing watery stool during the later pregnancy weeks may also indicate upcoming labor or a preterm labor [4] . However, having the symptom does not always mean that the baby is coming immediately. Sometimes, it occurs as the body undergoes certain changes in its preparation for labor and delivery. What Causes Diarrhea during Pregnancy? One or more of the following factors may contribute to cause the problem: Like constipation during pregnancy, diarrhea can occur due to certain hormonal changes that take place within the body during this time Changes in the diet to provide the fetus with all the necessary nutrients [5] The extra water intake for keeping the body hydrated Pregnancy workouts that improve the intestinal functions and sleep patterns [4] The iron content in prenatal vitamins [6] (changing the brand of the vitamin may also be responsible) Food poisoning [7] Stomach flu (caused by certain bacteria or viruses) Maternal gastrointestinal conditions like inflammatory bowel disease and irritable bowel syndrome (chronic diarrhea) [3] Apart from the above common and relatively harmless causes, upset stomach and diarrhea may also be caused by certain bacterial and viral infections (e.g. listeria, group B streptococcus) of the uterus and placenta.Ectopic pregnancy is another possible cause of painful diarrhea, especially during the first 3 months [8] . Is diarrhea during Pregnancy Harmful for the Baby? In most cases, it does not cause any harm to the baby. However, severe diarrhea can dehydrate the mother, hampering the blood flow to the fetus. Diarrhea occurring due to some serious pregnancy complications such as abdominal or uterine infections, especially during the second and third trimesters, may also be dangerous for the baby. How to Treat Diarrhea during Pregnancy Although, it is a common symptom of pregnancy, one should not neglect constant diarrhea as it is one of the most common causes of preterm labor [10] . Home Remedies Diarrhea occurring due to changes in the diet or a new pregnancy workout schedule generally subsides automatically after a couple of days. In such instances, the following natural remedies help to retain water and electrolytes, preventing dehydration and providing relief from the symptoms. However, they are insufficient for curing any serious underlying conditions causing the diarrhea [11] . Drinking plenty of water (1 liter per 1-2 hours until symptoms subside) and snacking on salty crackers [12] Ginger tea prepared by boiling some ginger in water, letting it seep for around 10-15 minutes before straining it [11] Drinking a mixture of one glass water and 3-4 tablespoons of honey once every day Consuming a blend of lemon juice, ginger powder (half a teaspoon each) and crushed black pepper (quarter teaspoon) twice every day Drinking a mixture of water (half cup) and some peppermint extract 2-3 times a day Psyllium husk [13] Anti-Diarrhea Medication for Severe Diarrhea in Pregnancy Imodium (FDA pregnancy category B; to be used only for 24 hours after 12 weeks of gestation) [14] Polycarbophil (FDA pregnancy category C) [13] Kaopectate (kaolin-and-pectin) [15] Parepectolin (not classified by FDA; not recommended unless benefits outweigh potential risks) [14] Dietary Measures Doctors often suggest certain dietary alterations to manage frequent diarrhea with the BRAT diet (Banana, Rice, Applesauce, Toast) [16] being commonly recommended. One should opt for whole wheat toast (without butter) and brown rice for better results [11] . Additionally, it is advisable to eat starchy foods to provide the body with vitamins and minerals essential during this time. Foods to eat Vegetable soups (non-milk base) Chicken soup Lean meats (turkey breast or skinless chicken) [10] Carrots Potatoes Unsweetened cereals Yogurt [16] Foods to avoid Carbonated and caffeinated drinks [11] Dried fruits (e.g. prunes) Fried fatty foods Dairy products [2] Spices Red meat Sugary foods like chocolates and candies Is it Normal to Have Green or Black Diarrhea during Pregnancy? The leafy vegetables, diet supplements and prenatal vitamins taken during pregnancy are often responsible for the green coloration of the stools [9] while black diarrhea is usually caused by iron supplements. So in most cases, there is nothing to worry about in having green or black bowel movements. When to Call the Doctor? Diarrhea continuing for more than 1-2 days should be reported to the doctor, even if the symptoms are mild. Watch out for the following symptoms along with diarrhea: Blood or mucus in the stool Severe stomach pain or cramping [17] Fever (over 100 F) [18] Severe vomiting Severe headache Rapid heart rate Decreased urine production [ref] http://miscarriage.about.com/ od/miscarriagecauses/f/Can- Constipation-Or-Diarrhea- Cause-Miscarriage.htm http://www.whattoexpect.com/ blogs/pregnancycareformoms/ diarrhea-during-early- pregnancy http://www.babycenter.com/404_ is-it-normal-to-have-diarrhea- in-late-pregnancy_2649.bc http://www.ipregnancysigns. com/diarrhea-during-pregnancy. html#.UjLIPNLPWgQ http://americanpregnancy.org/ pregnancy-concerns/diarrhea- during-pregnancy/ http://pregnant.thebump.com/ pregnancy/pregnancy-symptoms/ articles/diarrhea-during- pregnancy.aspx http://www.whattoexpect.com/ pregnancy/symptoms-and- solutions/pregnancy-diarrhea. aspx http://www.marchofdimes.com/ pregnancy/abdominal-pain-or- cramping.aspx http://www.pregnancy-baby- care.com/articles/515/during- pregnancy/green-diarrhea- during-pregnancy.html http://pregnancysymptoms.pregn ancybymonths.com/diarrhea/ diarrhea-during-pregnancy/ http://www.yogawiz.com/blog/ home-remedies/home-remedies- for-loose-motions-during- pregnancy.html http://www.webmd.com/ digestive-disorders/tc/ diarrhea-age-12-and-older- home-treatment http://www.babycenter.com/0_ chart-over-the-counter- medications-during-pregnancy_ 1486462.bc http://women.webmd.com/ pharmacist-11/pregnancy- medicine http://www.babycenter.com/406_ is-it-safe-to-use-anti- diarrhea-drugs-during- pregnancy_1246906.bc http://www.babymed.com/ pregnancy-symptoms/diarrhea- during-pregnancy http://blessedmom.hubpages. com/hub/Diarrhea-during- Pregnancy-How-to-detect-and- treat http://www.babymed.com/ pregnancy-complications/ diarrhea-causes-and-treatment [/ref] additionally it is

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for ever and ever Is Colace safe during pregnancy Colace (generic name docusate or docusate sodium) is a stool softener usually considered safe for managing constipation in pregnancy [1, 2] , as its active ingredients are minimally absorbed in the mother s bloodstream, thus posing no serious threats to the developing baby [3] . Colace (docusate sodium) FDA Pregnancy Category It has not been formally evaluated and classified by the FDA. So, it should only be taken in pregnancy when clearly needed and when the potential benefits outweigh any possible risks for complications [4] . How much Colace can you take while pregnant The duration and dosage depends on the purpose of use, any chronic or underlying complications as well as the stage of pregnancy you are in. However in most cases, it is only recommended for a short term use, when prescribed by your gynecologist [4, 5] . Are there any risks of taking Colace during pregnancy The Collaborative Perinatal Project studied 30 women who used docusate (Colace) in the first trimester and 116 women who used it anytime during their pregnancy. The results reported birth defects in 3 babies [4] . A Michigan Medicaid study reviewed 229,101 deliveries between 1985 and 1992, where 232 women were exposed to docusate in their first trimester and 3003 were exposed anytime in their pregnancy. In the first trimester exposure group, 9 malformations were reported, including a case of cardiovascular defect and polydactyly each. Another reviewed data with 6589 first trimester exposures between 1980 and 1983 showed no association between docusate usage and any congenital anomalies [4] . In one case, symptomatic hypomagnesemia was reported in the baby within one day after birth where the mother had taken a 100mg dosage of docusate sodium daily throughout her pregnancy [6] . Colace while breastfeeding Not much data is available regarding the excretion of Colace into breast milk [7] and its possible effects on a nursing baby. So, it is always recommended to talk to your doctor before considering using it. However, it is commonly considered safe for short term use [8] . One study, done with 35 nursing mothers receiving a docusate-dihydroxyanthraquinone combination, reported diarrhea in 1 breastfeeding infant [9] . [ref] http://www.webmd.com/baby/guide/taking-medicine-during-pregnancy http://www.colacecapsules.com/constipation/pregnant/ http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/pregnancy-constipation/faq-20058550 http://www.drugs.com/pregnancy/docusate.html http://www.iodine.com/drug/colace/pregnancy http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418980/ http://www.everydayhealth.com/drugs/colace http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breastfeeding-and-medications/art-20043975?pg=2 http://www.drugs.com/pregnancy/docusate-senna.html [/ref] reduction

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companies Women often experience mild to severe constipation at any stage of pregnancy, but more commonly in early pregnancy ( 1 ) . Is Constipation an Early Sign of Pregnancy? Constipation is considered one of the earliest signs of pregnancy, especially when it occurs along with nausea, dizziness, mood swings and food cravings ( 4 ) . Symptoms of Constipation in Pregnancy Symptoms of constipation ( 3 ) : Less than three bowel movements in one week Hard feces making it difficult to pass, feeling like some feces has remained in the rectum Occasional rectal bleeding due to hard feces Decreased appetite Lower abdominal bloating, pain or cramps. When you are experiencing repeated rectal bleeding or abdominal pain, visit your doctor, because these may be symptoms of a serious health condition, such as intestinal inflammation or parasites. Constipation Causes Constipation Causes in Early Pregnancy? Increased production of the hormone progesterone, which relaxes the muscles of the intestinal wall, which makes it less capable of moving waste materials ( 1 ) . Oral iron supplements ( 5 ) Dehydration ( 1 ) Lack of exercise ( 1 ) Constipation Causes in the Late Pregnancy The same causes as in early pregnancy The enlarged uterus pressing upon the intestine and rectum during later stages of pregnancy ( 2 ) . Tailbone pain or pelvic pain during pregnancy Stress Women prone to constipation in general are more likely to be constipated during pregnancy. Natural Remedies to Relieve Constipation During Pregnancy Squeeze half a lemon into a glass of lukewarm water and drink the mixture every morning to have a smoother bowel movement ( 4 ) . Eating plenty of dry fruits, such as prunes (or prune juice), dates and raisins ( 4 ) . Drinking other fruit juices can also help with the symptoms. How to Maintain Regular Bowel Try to have bowel movements regularly, a good time is every morning after breakfast. Try to maintain regular sleeping and eating schedule. Exercise regularly. Swimming ( 7 ) or walking for around 20-30 minutes at least 2 to 3 times every week stimulates bowel motility. Yoga may help to reduce stress. Drink enough water (or coconut water) to keep you well hydrated ( 6 ) . However, there is no need to exaggerate with water. More than 300 mL of translucent or yellow urine in the morning and tense skin on the back of your hand which becomes flat immediately when you pinch and release it are few signs of good hydration. Include some foods high in fiber in your diet: whole-grain breads or cereals, brown rice, beans and peas, fresh vegetables and fruits. Fruits and vegetables most useful for this purpose include prunes, kiwi, peas and beans. NOTE: Large amounts of foods, high in soluble fiber, such as barley or oat bran, can cause unpleasant bloating. Avoid or limit these foods: Foods low in fiber, such as fried potatoes, white bread, toasted or popped cereals, large amounts of meat, cheese, chocolate or sweets Foods very high in calcium, such as cheese, certain mineral waters, calcium-fortified cereals and juices. Foods, which have particles or fiber that may stick in your bowel: sunflower, pumpkin, watermelon seeds or other seeds with shells, oranges with large amount of white fibrous threads. Supplements that may be associated with constipation: Oral iron supplements (which are also part of prenatal vitamins) may cause constipation in some women ( 1,4 ) . Try to increase the intervals between your iron supplement dosages or spread out the dosage throughout the day. You can cut the tablet in halves, taking one half in the morning and the other in the evening. You can also ask your doctor to prescribe a vitamin supplement with lower iron levels or ask for iron injections. Unless your doctor specifically recommends you, avoid excessive amounts of calcium supplements and calcium or aluminum antacids ( 1,11,12 ) . Laxatives Safe for Treatment of Constipation During Pregnancy Bulk Forming Laxatives Psyllium Bran Stool Softeners Docusate sodium or calcium ( 14 ) Lubricants Mineral oil ( 8,18 ) Osmotic Laxatives Magnesium hydroxide (milk of magnesia) ( 10 ) Magnesium sulfate ( 16 ) Lactulose (pregnancy B category no adverse effects in animals, but not tested in humans) ( 13 ). Lactulose may cause excessive gas (flatulence) ( 8 ) . Sorbitol ( 15 ) Stimulants Bisacodyl Senna Stimulant laxatives may cause abdominal cramps and should be used only when other laxatives are not effective ( 8 ) . NOTE: None of the above treatment options and home remedies should be used unless they are approved by your doctor. Seek immediate medical attention if you are experiencing serious complications such as rectal bleeding and hemorrhoids. Laxatives to Avoid During Pregnancy Polyethylene glycol (category C may harm the baby) ( 9 ) Magnesium citrate is category C pregnancy drug ( 17 ) [ref] Constipation causes (nhs.uk) Constipation causes in late pregnancy (birth.com.au) Constipation symptoms (nhs.uk) Early signs of pregnancy (birth.com.au) What can help to relieve constipation in pregnancy (birth.com.au) Coconut water during pregnancy Swimming tips for pregnant women (swimming.org) Laxatives during pregnancy (cfp.ca) Polyethylene glycol (drugs.com) Milk of magnesia pregnancy safety (drugs.com) Calcium supplements and constipation (ods.od.nih.gov) Aluminum hydroxide and constipation (drugs.com) Lactulose and pregnancy (drugs.com) Docusate sodium and pregnancy (drugs.com) Sorbitol and constipation in pregnancy (drugs.com) Magnesium sulfate and pregnancy (drugs.com) Magnesium citrate and pregnancy (drugs.com) Mineral oil and pregnancy (drugs.com) [/ref] typical

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back-links Almost all women experience varying degrees of headache at some point during their pregnancy. According to old wives tales, having recurring headache means you are having a boy; however, there are no scientific evidence to prove it. Are headaches a common sign of pregnancy Headache is one of the common early pregnancy symptoms [1] occurring during the first trimester, along with other symptoms such as nausea, joint and jaw pain and constipation/diarrhea. What causes headaches during pregnancy Apart from the usual causes like allergies, fasting and gas, factors like fatigue, lack of sleep, certain vitamin and mineral (folic acid, magnesium) deficiencies [8] , caffeine withdrawal [3] and being in a congested or noisy place [2] may trigger headache in a pregnant woman. Headache during early pregnancy The hormonal changes occurring in the body [1] , as well as the increasing blood volume [28] , are believed to play a vital role in bringing on the pain, especially early in the first trimester. The changing estrogen levels are specifically believed to trigger migraine headaches [29] . Vomiting due to morning sickness may sometimes lead to dehydration, which may cause a headache [5] , often along with other symptoms like nausea, dry mouth, constipation and dark urine [30, 31] . Headache occurring during the first trimester generally subsides on its own once you enter the second trimester [1] as the hormone levels begin to gradually settle down. Headache later in pregnancy Bad posture, from the pressure of carrying the growing baby, may worsen the pain toward the end of pregnancy [1] . Headaches in the third trimester may also be caused by preeclampsia which needs immediate medical intervention [25] . Chronic (Constant or Frequent) headaches Tension headache Women often experience a constant dull ache or a squeezing pain [3] on the lower back of the head and neck, on the top of the head or one/both sides resulting from the stress, anxiety, tension and even depression associated with pregnancy. What to do: Relax, apply cold compress to ease the pain [9] Sinus headache Persistent throbbing pain in the forehead, extending to the cheekbones and the bony nasal bridge, worsening with sudden movement of the head [32] . Symptoms include swelling or tenderness of the face, congested/runny nose and fever [7, 33] . Common causes: Viral or bacterial infections, allergies What to do: Warm compresses over the forehead, nasal irrigation with saline (neti pot). Consult your doctor about safe OTC painkillers or nasal sprays. Migraine Moderate to extreme pulsing pain, usually only on one side of your head that gets worse with physical activity and may last from few hours to few days [34] . Symptoms include sensitivity to light and vomiting. The pain may be preceded by aura that may include tingling, blurred vision, sense of flashing lights and nausea [34] Common triggers: Chocolates, preserved meat, peanuts and old cheese What to do: Rest in a dark room, apply ice packs, massage to relax the muscles [24]. Consult your doctor about safe OTC painkillers Sudden, Acute, Severe headaches Preeclampsia Persistent, throbbing pain that begins suddenly [35] and worsens over time, occurring along with other symptoms like dizziness, upper right abdominal pain, sudden weight gain, swelling of hands [36] Flu Sudden, considerable headache, often extending around the eyes, along with a fever, fatigue, dry cough, red watery eyes, flushed skin and even diarrhea [38] . Prevention: Flu shot (after consulting your doctor) What to do: Proper sleep and rest Cluster headache [4] Sudden, sharp or burning pain on one side of your head, typically felt around the temple or eye (sometimes extending to the face) [37] . Cluster headaches usually cause recurrent attacks in the same area, often at night with an intense pain waking you up in the middle of the night [6] . How to get rid of a headache while pregnant Home remedies for managing the pain Try to relax : Lie down in a quiet room and keep your eyes closed. You may also try putting on some soothing music if that relaxes you. Warm/cold Compress : Apply a warm compress (e.g. warm towel) on the face, temples and eyes [14] as it relaxes tightened muscles. You can also try a cold compress (an ice pack) on the back of the head and neck as it reduces the blood pressure by constricting the blood vessels Massage: Get a prenatal massage for relaxing the shoulders, neck and temple s [12] Aromatherapy: Aromatherapy with essential oils may help to deal with the pain but, use it only after consulting your physician, especially in the first trimester. Rubbing some lavender or peppermint oil [16] on the temples and forehead, or putting a few drops on a handkerchief and breathing it in may provide some relief from persistent headaches. However, it should only be used occasionally with no more than 3 drops of oil being recommended [11] . Most herbal headache remedies, like butterbur and feverfew are usually not recommended for pregnant women [14] as they may lead to complications including preterm contractions and labor [11] . Acupuncture and Homeopathy Although acupuncture is a safe procedure [18] to have for reducing migraine and other headaches [17] , make sure to consult a certified practitioner to avoid any risk or complications in pregnancy. Homeopathic treatment options usually vary with the type of headache. Consult your gynecologist to know about its safety during the pregnancy [22] . What medicines can you take for a headache while pregnant An overdose of any painkiller may lead to various health problems and complications like kidney and liver damage [19] . So, make sure to consult your physician regarding the safety and dosage of all medications. Safe painkillers Tylenol (acetaminophen) is considered relatively safe to take during pregnancy, providing a quick pain relief [21] . Medicines to avoid There is a lack of studies on human pregnancy regarding the effects of NSAIDs (Nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil and Motrin) and naproxen (Aleve). Although included in Category C for the first and second trimesters, they may increase the chances of blood pressure abnormalities in the baby and even miscarriage [20] if taken in the third trimester. Using aspirin late in pregnancy may also cause severe hemorrhage in the mother during childbirth. Tips to prevent headache when pregnant Avoid triggers : Keep track of what triggers your headache episodes and try to avoid them. [10] Regular light work-out routine: Moderate aerobic exercises, walking or prenatal yoga Managing your stress levels: Spend time with family and friends, practice calming techniques such as deep breathing or sign up for biofeedback classes [14] . Proper eating habits : Avoid staying hungry for extended periods. Eat smaller meals at short intervals instead of three large meals [11] . Plenty of rest : Follow a proper sleep schedule [13] . Drinking lots of fluids to stay hydrated [12] and maintaining a good posture [13] can also help. When to call the doctor Call a doctor if you experience: Sudden, severe headache of an unknown cause Chronic headache of an unknown cause (it could be brain tumor or other underlying disease Fever Lower abdominal contractions, as they may indicate a urinary tract infection [23] . Drowsiness or other impairment of consciousness Persistent headache after an injury ICD-9 and ICD-10 Codes ICD-9 codes: 339, 784.0 [26] ICD-10 codes: G43-G44, R51 [27] [ref] http://www.marchofdimes.com/pregnancy/headaches.aspx# http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/headaches-during-pregnancy.aspx http://www.babycenter.com/0_headaches-during-pregnancy_2035.bc http://health.utah.gov/mihp/pregnancy/preged/duringpreg/headaches_during_pregnancy.htm https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=134&ContentID=3 http://www.mayoclinic.org/diseases-conditions/cluster-headache/basics/definition/con-20031706 http://www.babycentre.co.uk/a549318/sinusitis-natural-remedies http://www.patient.co.uk/health/folic-acid-deficiency-anaemia http://www.mayoclinic.org/diseases-conditions/tension-headache/basics/lifestyle-home-remedies/con-20014295 http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/migraines.aspx http://www.babycentre.co.uk/a549297/headaches-natural-remedies#section2 http://www.inhabitots.com/8-natural-solutions-for-pregnancy-headaches/hotwaterbottle/?extend=1 http://www.parents.com/pregnancy/my-body/aches-pains/headaches-during-pregnancy/ http://www.mayoclinic.com/health/headaches-during-pregnancy/AN01870 http://www.babycenter.com/0_stuffy-nose-during-pregnancy_1076.bc , http://patient.info/health/acute-sinusitis http://naturalparentsnetwork.com/essential-oils-pregnancy/ http://www.whattoexpect.com/pregnancy-acupuncture.aspx http://www.acupuncture.org.uk/public-content/public-pr-press-releases/acupuncture-and-pregnancy.html http://www.today.com/id/9811838/#.Ul_GotIbAbI http://www.amershamclinic.com/new-medical-research-articles/medical-articles-on-common-medications/general-medical-article-sample http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/headaches-during-pregnancy/faq-20058265 http://www.naturalmothering.ca/index.php/pregnancy-a-labour/88-homeopathy-and-pregnancy http://www.birth.com.au/frequent-urination-in-pregnancy/infection-of-the-bladder http://www.mayoclinic.org/diseases-conditions/migraine-headache/basics/lifestyle-home-remedies/con-20026358 http://americanpregnancy.org/pregnancyhealth/headaches.html http://www.icd9data.com/2013/Volume1/320-389/339-339/339/default.htm http://apps.who.int/classifications/icd10/browse/2010/en#/G43 http://www.healthline.com/health/pregnancy/headaches-dizziness#360 http://www.healthline.com/health/hormonal-headaches#Overview1 http://americanpregnancy.org/pregnancy-complications/dehydration-pregnancy/ http://www.babycentre.co.uk/x7233/how-will-i-know-if-im-dehydrated-and-what-can-i-do-about-it http://www.parents.com/pregnancy/my-body/aches-pains/pregnancy-headaches/ http://www.webmd.com/migraines-headaches/guide/sinus-headaches http://patient.info/doctor/migraine-pro http://www.parents.com/pregnancy/my-body/aches-pains/pregnancy-symptoms-that-warrant-a-call-to-your-ob-gyn/ http://www.nhs.uk/Conditions/Pre-eclampsia/Pages/Introduction.aspx http://www.nhs.uk/conditions/cluster-headaches/Pages/Introduction.aspx http://www.webmd.boots.com/cold-and-flu/flu-guide/flu-symptoms [/ref] you don’t have any

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big Are fever and chills early signs of pregnancy? Having body temperature above the normal limit of 98.6 F (37 C) is considered a fever [1] . Fever and chills are not counted among the normal signs of pregnancy as they might indicate several underlying conditions [2] . However, there are plenty of ways to treat a fever while carrying before it can harm you or your baby. Symptoms of fever in pregnancy The common symptoms are the same as you are likely to get with fever even when you are not pregnant: High temperatures Chills Headache [3] Sweating Fatigue sore throat Muscle pain [1] Dehydration Causes of fever and chills in pregnancy The rising pregnancy hormones change your immune responses to help the fetus grow properly [4] . This makes you more susceptible to common viral conditions like fever, cold and cough [5] , often leading to low grade fever along with flu-like symptoms. On the other hand, although the hormones are more likely to make one feel warm and sweaty, some women may get the opposite effects of feeling cold and chilled, commonly early in the first trimester [6] . However, there are many infections and other health conditions that might lead to raised body temperature along with the other symptoms. These include influenza, common cold and a stomach bug [2] . Thyroid problems diagnosed in pregnancy may also cause the unexplained chills while other more serious causes include various infections [6] . Differential diagnosis for fever during pregnancy Blood and urine tests may be performed [7] to determine the exact causes of your fever as well as to establish the differential diagnosis [8] : Cholecystitis Appendicitis Urinary tract infections Q-fever Amebiasis Hepatitis A/B Typhoid Rubella Abscesses (hepatic, pelvic, cerebral) Rheumatic fever Scarlet fever How to treat a fever while pregnant? It is always advisable to consult your doctor before trying any natural remedies or medical treatments to properly understand the causes behind the raised temperatures and chills. The treatment varies depending on the condition and its severity. Low grade fevers are usually not a serious cause of concern as they often go away on their own [9] . Tips and home remedies to manage a low grade fever Drinking lots of fluid to keep your body well-hydrated [5] Taking lots of rest, staying in bed as long as you want to; but try to stay cool (unless you have the chills) as getting overheated might harm the fetus [10] Pressing a cold compress on your forehead to lower the temperature [3] Safe medication Tylenol (acetaminophen) has been considered a safe fever medicine for pregnant women for a long time [11] . However, a recent study suggests an association between the use of Tylenol and an increased risk of ADHD in the child [12] . NSAIDs such as Advil (ibuprofen) are not recommended during this time as they might be harmful for the fetal cardiovascular system [3] . It is best to talk to your health care provider before using any medications for fever. Dietary tips for getting rid of a fever Eating plenty of fruits and vegetables (especially those rich in vitamin C like citrus fruits, cantaloupe, honeydew etc.) as they are useful for treating as well as preventing cold and fever [5] Including low fat dairy products and other calcium rich foods to your diet Having hot chicken soup with lots of well-cooked vegetables Drinking decaffeinated tea [5] Does a fever in pregnancy harm your baby? Running a fever over an extended period of time in the first and early second trimesters can hamper the growth of your baby, leading to various birth defects including central nervous system or neural tube defects [13] , cataracts, heart anomalies, micrencephaly (abnormally small braincase) and abdominal wall defects. Extremely high temperature within the first month of pregnancy is sometimes associated with higher chances of miscarriage [9] . According to some studies, a long-running fever any time in pregnancy can increase the risks of autism and developmental delay [14] . However, having a mild fever in the third trimester does not usually affect the baby unless it is caused by some serious condition [13] . When to call the doctor? Having a fever that lasts longer than 24-36 hours Fever over 100 F at any stage of pregnancy [15] Fever accompanied by bleeding and period-like cramps (might indicate serious complications relating the fetus and placenta) [16] Fever and chills along with rashes, severe nausea [3] , vomiting, dizziness, abdominal cramps, joint pain, back pain and contractions (might indicate infectious conditions like a kidney infection) [6] Elevated temperatures with severe vomiting, nausea and diarrhea (puts you in danger of dehydration) Having a fever while your waters break [7] Fever with severe lower abdominal pain, bleeding, weakness and vomiting (might indicate an ectopic pregnancy) [17] Having a fever along with migraine [18] The usual fever symptoms along with jaundice (indicates a yellow fever) Severe chills with or without fever (might indicate conditions like anemia and low blood pressure) Fever ICD-9 and ICD-10 codes The ICD-9 code used for indicating fever is 780.6 [19] , while its ICD-10 code is R50 [20] . [ref] http://www.mayoclinic.org/diseases-conditions/fever/basics/symptoms/con-20019229 http://www.parents.com/pregnancy/complications/health-and-safety-issues/fever-pain-chills-during-pregnancy/ http://pregnant.thebump.com/pregnancy/pregnancy-symptoms/articles/fever-during-pregnancy.aspx http://www.medscape.com/viewarticle/734891_2 http://www.whattoexpect.com/pregnancy/eating-well/week-32/fever-and-cold.aspx http://www.parents.com/advice/pregnancy-birth/my-pregnant-body/are-the-chills-normal-during-pregnancy/ http://www.babycentre.co.uk/x554816/how-can-i-treat-fever-safely-in-pregnancy http://www.antimicrobe.org/new/printout/e42printout/e42intro.htm http://www.healthline.com/health-blogs/fruit-womb/fever-pregnancy http://www.mayoclinic.org/diseases-conditions/fever/basics/lifestyle-home-remedies/con-20019229 ] http://www.webmd.com/women/pregnancy-medicine http://www.webmd.com/add-adhd/childhood-adhd/news/20140224/use-of-acetaminophen-in-pregnancy-tied-to-higher-adhd-risk-in-child http://www.babycenter.com/406_can-running-a-fever-while-im-pregnant-harm-my-baby_1246886.bc http://www.ncbi.nlm.nih.gov/pubmed/22562209 http://www.babycenter.com/signs-of-a-pregnancy-problem http://www.parents.com/pregnancy/complications/bleeding-and-spotting-during-pregnancy/ http://emedicine.medscape.com/article/2041923-clinical http://americanpregnancy.org/pregnancyhealth/migraines.html http://www.icd9data.com/2014/Volume1/780-799/780-789/780/780.6.htm http://apps.who.int/classifications/icd10/browse/2010/en#/R50 [/ref] locate

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barely enough Definition of Morning Sickness Morning sickness is a popular nickname for a medical term nausea and vomiting of pregnancy or NVP ( 1 ) . When Does Morning Sickness Start and How Long Does It Last? The onset of morning sickness is usually at sixth week, or, rarely, as early as at fourth week of pregnancy (which is, actually, two weeks after conception) ( 1 ) . Rarely, women have reported having nausea immediately after conception ( 34 ) . Nausea usually peaks at the second month ( 1 ) . In most pregnant women, nausea ends at about 12-18th week (fourth month), but in some it can extend throughout the whole pregnancy ( 1,11,39 ) . Do all women experience nausea during pregnancy? Some women never experience nausea during pregnancy. Some women do not experience nausea every day. In some women nausea goes away at certain time but can return later and come and go throughout pregnancy ( 1 ) . Is nausea an early sign of pregnancy? Yes, besides missed menstruation, nausea is an early sign of pregnancy and may be accompanied by tender/swollen breasts, fatigue, shortness of breath, constipation, food craving, diarrhea, dizziness, headache, cramping and mood swings ( 40 ) . Is it possible to have morning nausea and negative pregnancy test? Theoretically, it is possible that a pregnant woman feels nausea before the pregnancy test is positive ( 34 ) . What Does Morning Sickness Feel Like? Nausea is usually worse in the morning and often lasts all day. Women may describe morning sickness as indigestion, hunger pains, dry heaves, or having feelings resembling car sickness or food poisoning. Some women vomit several times a day. Typically, women develop increased sensitivity to certain smells and tastes, such as fish or meat, or common foods in a refrigerator, and aversion to certain foods ( 6,7 ) . In some way, nausea is a good sign, since it suggest you that you may be pregnant. Can morning sickness last all day? For most pregnant women, nausea is worse in the morning, but usually lasts all day ( 1 ) . What Are Other Symptoms Related to Nausea During Pregnancy? Heartburn due to gastroesophageal reflux disease (GERD). What can help: avoiding eating before bed, sleeping with elevated head, antacids ( 16 ) . Excessive salivation (ptyalism or sialorrhea) ( 35 ) Constipation, which may be worse when you are not eating or drinking regularly Headache or migraine, especially in women who had menstrual migraines ( 39 ) Dizziness, fainting, fatigue, bad (metallic) taste in mouth, which may be symptoms of dehydration due to lack of drinking or after repeated vomiting ( 33 ) . Nausea in the Second and Third Trimester In some women, nausea can extend into the second or third trimester of pregnancy with its severity varying from woman to woman. Possible mechanisms include increased levels of the hormones thyroxine and oestrogen . NOTE: Nausea that goes away in the fourth month and then appears later unexpectedly, may or may not be related to pregnancy. Food poisoning, gastrointestinal, liver and kidney diseases, low blood pressure, low blood glucose levels (hypoglycemia) and other disorders may cause nausea or vomiting in pregnant women just like in nonpregnant ones. Acute, Severe, Extreme Sickness Hyperemesis Gravidarum Symptoms Nausea, which is so severe that prevents a woman to eat and drink Vomiting several times a day Usual remedies, vitamins and antihistamines recommended for nausea do not help More than 5% weight loss (of pre-pregnancy weight), especially rapidly losing weight (more than a pound per day) Dry mouth, wrinkled skin and other symptoms of dehydration Fatigue Headache (Reference 39) Complications Detached retina, torn eardrum, broken ribs, torn esophagus ( 4 ) . Treatment In one study, doxylamine (an antihistamine) was effective only in 20% women ( 4 ) . According to a study performed by UCLA university, women with severe nausea who take antihistamines to help them sleep have significantly increased risk to have a premature birth or have low-birth-weight babies ( 4 ) . Starting therapy before or immediately at the nausea onset may significantly reduce the severity of symptoms ( 25 ) . The IV drugs that might be used by your practitioner include antihistamines, dopamine antagonists, serotonin antagonists, chlorpromazine and glucocorticoids ( 3 ) . What Causes Nausea in Pregnancy? Nausea in the Early Pregnancy Nausea during pregnancy indicates that the hormone levels in your body are high enough for the growth and development of your baby. During the early stages of pregnancy, your body produces large amounts of the hormone human chorionic gonadotropin (hCG) . The hCG levels drop again when the placenta takes over nourishing and maintaining the fetus. As a result, nausea usually vanish during the later parts of pregnancy, usually between the 12th and 14th week ( 1 ) . It is not certain why nausea occurs in pregnancy, but here are some possible reasons: Increased levels of pregnancy hormones ( 1 ) : Human chorionic gonadotropin (hCG) Estrogen or other hormones Increased stomach sensitivity ( 1 ) What else can trigger nausea or vomiting? Hunger Stress, anxiousness Pain Tiredness Smell of certain foods or perfumes; certain odors can trigger gag reflex Flickering light (more likely in women who have migraine) Hot or crowded rooms Changing positions quickly Travel with a car or ship (Reference 1) Is nausea worse when carrying, twins, a boy or a girl? Women who carry twins or higher multiples usually have more nausea, but some may have no nausea ( 1 ) . This may be due to high levels of hCG, estrogen or other hormones ( 1 ). Women who carry a girl more often have severe nausea ( 1 ) . What increases the risk of nausea in pregnancy? Nausea in previous pregnancies Nausea after contraceptive pills History of migraine headaches Genetic predisposition: your mother or sisters had nausea during pregnancy Gastric reflux (References 1,9) Can nausea during pregnancy affect the baby? Mild to moderate nausea and occasional vomiting should not affect the baby ( 15 ) . Even if the mother does not gain any weight during the first trimester, but get enough water and nutrients, she and the baby should be fine. Statistically, mothers who have nausea during pregnancy have healthier babies than mothers who do not ( 15 ) . Severe, prolonged vomiting and weight gain less than 15 pounds were associated with low birth weight and preterm births ( 1 ) . Does absence of nausea increases the risk of miscarriage? Statistically, women who have no nausea during pregnancy have more miscarriages. However, absence of nausea by itself is not a bad sign; many women with no or little nausea have had healthy children ( 2 ) . What To Eat and Drink to Overcome Nausea? What to eat? Eat whatever you feel you are in peace with and do not be overly scrupulous about having balanced diet. Observe what calms your stomach. Listen your body. Even if you eat somewhat less than usually in your first trimester, this should not affect your baby. In general, pregnant women need between 2,200 and 2,900 Calories per day and they do not need any extra calories in the first trimester ( 26 ) . Small, frequent meals can help you overcome nausea caused by empty stomach. Eat slowly to prevent bloating and stomach upset. Recommendations from pregnant women, midwives and obstetricians ( 2,7,8,9,38 ) : How to get over nausea in the morning? Have some saltine (soda) crackers or dry toast (maybe with ginger jam) and then wait about 20 minutes before you get up. The principal object is to consume something mild, plain and starchy before rising up. Get out of the bed slowly, maybe sit on the bed for a while. Avoid having an empty stomach. Protein foods, such as beans, peas, lentils and lean meats, and whole grain cereals stay in the stomach for a longer time than plain sugars or rapidly digestible starches (white bread, potatoes, white rice). You can have some of these foods in the evening to keep the stomach full throughout the night and thus prevent morning sickness. Examples of carbohydrate foods that many women tolerated well: whole-grain bread, cereals, potato chips, tortilla chips, egg bagels Examples of high-protein foods that may ease nausea: scrambled eggs, peanuts or peanut butter, tuna melt, scrambled eggs Fruits in moderation: a banana, kiwi, watermelon, apple slices, or dried fruits to increase fiber intake in constipated women. Eat fruits and vegetables having a high water content to prevent dehydration and constipation, two main triggers of nausea. Snack on lots of carrots, celery, melons, apples, grapes and pears throughout the day. Vegetables: lemon cauliflower Soups, broths Suckers: hard candies, fruit popsicles, lollipops Snacks: celery sticks, pretzels, nuts (trail mix) Other: fudge ice pop, gelatin What to drink? Drink the amount of fluid that will keep you well hydrated. A general recommendation is to drink at least 8 cups (8 x 8 oz or 2 liters) fluid per day, but this depends on how much water and salt you get with food and how much you sweat. Drink more if you notice symptoms of dehydration: thirst, dry mouth and lips, less than 200 mL of dark-colored urine in the morning, skin fold on the back of the hand that does not get flat immediately after you pinch and release the skin. Take few sips at the time, not full cups. Do not drink during and up to 30 minutes after meals to avoid bloating and gastric reflux ( 11 ) . Chose what works for you: water, mineral water, lemonade, herbal teas, ginger ale, ginger soda, ginger beer. You may tolerate colder and clear drinks easier. You can try ice chips or popsicles. If you vomit a lot, drink sport drinks or rehydration fluids that contain sodium and potassium you have lost during vomiting. Foods To Avoid in Morning Sickness Limit or avoid ( 1,27,36,39 ) : Foods that trigger nausea or smell bad to you; colder foods tend to have less smell. Fatty and fried foods, which may take longer to digest Sugary foods Spicy foods and acidic foods, which may upset your stomach Large amounts of foods and beverages, which may cause bloating: beans, peas, lentils, cabbage, fruits, carbonated beverages Drink only small amounts of fluid during meals, so you will not feel full and you will be able to eat enough food. Fruit juices and other sweetened beverages stay in the stomach longer than non-sweetened ones. Carbonated beverages may cause bloating in some women. Caffeinated drinks Alcoholic drinks Other foods to avoid during pregnancy from reasons other than nausea, such as risk of infection or poisoning. Nausea After Eating To prevent nausea after eating ( 11 ) : Do not lie down after meals, because this may slow digestion. Brush your teeth and rinse mouth several times a day. Spit out excessive saliva. General Tips to Prevent Nausea During Pregnancy Get fresh air. Avoid places with food, smoke, perfumes, chemicals and other heavy smells in the air; avoid cooking. Avoid excessive exercise and get enough rest. You may need at least 7-8 hours of sleep per night. If you constantly feel tired, you may consider having few short naps during the day. However, relaxation does not help to everyone; some women find relief in being active, visit someone, just to distract themselves from nausea ( 21,38 ) . Avoid hot and humid places and noise. Wearing headphones and listening music while travelling may help to prevent motion sickness. When your fight with nausea does not seem to be successful, call a doctor. How to cope with nausea at night? During nighttime, you can curb nausea by taking small amount of food any time you wake up; this will prevent you from having an empty stomach. How to deal with nausea at work? Try to arrange that you will work at calm, cool place without strong odors. Have frequent snacks. Have frequent short breaks if possible, walk around and get some fresh air. Avoid bending over in the waist; kneel when you pick things from the floor. Avoid standing and heavy physical work. Sit properly to avoid tailbone pain or pelvic pain . Natural Home Remedies for Morning Sickness Relief There are several possible ways to stop nausea in pregnancy, but not every remedy or drug works for every woman. Herbs Ginger Supplements Ginger supplements containing up to 1,000 mg (1 gram) of ginger extract per day helped to alleviate nausea in some women and there was no evidence of harm for the babies ( 10,14,15,22 ) . Speak with your doctor before using powdered ginger root capsules. Side effects of ginger powder in capsules include nausea, heartburn, bloating and excessive gas ( 14,37 ) . Can ginger ale help? Ginger ale with real ginger may help ease nausea. Ginger ale in supermarkets usually does not contain real ginger, though. Other Ginger Products Ginger tea Ginger candies Crystallized ginger Ginger pops Ginger gum Fresh or dried ginger with salt Various dishes with ginger root Ginger cookies may contain a lot of sugar and not enough ginger to be effective ( 37 ) . The effect of ginger in soothing nausea is thought to be due its aroma ( 10 ) . Herbal teas Herbal teas are some of the best home remedies. Both hot and iced tea can help to relieve the symptoms. Ginger tea is considered safe; there is lack of studies about safety of peppermint and spearmint tea in pregnancy ( 28 ) . Chamomile tea or chamomile extract supplements. Speak with your physician before taking the herb in any form. Peppermint tea or peppermint candies, but these can upset your stomach. Other home remedies Smelling a slice of fresh lemon or drinking warm lemon juice can provide instant relief from nausea ( 38 ) . Baking soda (hydrogen carbonate) can help to soothe your stomach by neutralizing the stomach acid. Take one cup of water, add two tablespoons of baking soda and drink the solution slowly. Fennel seeds, like mint, contain certain anesthetic substances that help to reduce queasiness. Put one tablespoon of crushed fennel seeds in a cup before filling it with boiling water. Let it seep for about 10 minutes and then drink the mixture slowly like tea. Thyme and lavender What Else Can Help You Survive Through Nausea During Pregnancy Vitamins Vitamin B6. Doses up to 200 mg day are considered safe ( 15 ) . Prenatal vitamins may cause nausea, mainly because of iron they contain. Discuss with your doctor if you can use folate alone or regular multivitamins that do not contain iron, or time-release formula. Try to take vitamins in the evening rather than the in morning. Over-the-counter (OTC) anti-nausea medications safe in pregnancy: Antihistamines Antihistamines of the first generation (brompheniramine, chlorpheniramine, dimenhydrinate, diphenhydramine, doxylamine, hydroxyzine, meclizine and pheniramine) are considered safe to use in pregnancy ( 15,18,29 ) . Antihistamines of the second generation (cetirizine, desloratadine, fexofenadine, and loratadine), which do not cause drowsiness, are also considered safe ( 18 ) . Doxylamine plus Vitamin B6 Doxylamine (an antihistamine) in combination with pyridoxine (vitamin B6), in the form of delayed-release capsule is now again approved by FDA and is a first choice treatment for pregnancy nausea in the U.S. and Canada ( 11 ) . Side effects include drowsiness, vertigo, headache, irritability, nervousness, insomnia, stomach pain, diarrhea. There are no known reports about increased sleepiness in babies after delivery ( 32 ) . Taking doxylamine and vitamin B6 even before the onset of pregnancy symptoms may prevent nausea to develop or decrease its severity ( 17 ) . Consult your physician before using any of these medicines as they may cause side effects, such as drowsiness. Prescription Medications The following prescription medications are not approved by the U.S. Food and Drug Administration (FDA), but are used in Canada ( 11 ) and some other parts of the world. Antiemetics: Phenothiazines are considered safe in pregnancy ( 11,19 ) Chlorpromazine Prochlorperazine Promethazine (Phenergan) is available as tablets, injectable solution, oral solution or a rectal suppository. Side effects may include dry mouth, drowsiness, muscle contractions leading to jerking movements. NOTE: Prochlorperazine and promethazine should not be taken together. Dimenhydrinate ( 11 ) Trimethobenzamide ( 41 ) Acid-lowering drugs ( 11 ) : Calcium, aluminum and magnesium antacids in usual prescription doses are considered safe in pregnancy ( 16 ) . Magnesium trisilicate (prolonged use of high doses) increases the risk of kidney stones and respiratory distress in the baby ( 16 ) . Bicarbonate antacids can cause metabolic acidosis ( 16 ) . Calcium carbonate in doses higher than 1.4 grams calcium can cause milk-alkali syndrome ( 16 ) . H2 blockers, such as cimetidine, ranitidine (Zantac), famotidine (Pepcid) and nizatidine, do not increase the risk of spontaneous abortion or preterm delivery ( 16,44 ) . Proton pump inhibitors (PPIs), such as omeprazole, pantoprazole, lansoprazole, esomeprazole, and rabeprazole are considered safe in pregnancy ( 16,23 ) . Emetrol Emetrol solution contains dextrose (glucose), fructose and phosphoric acid ( 31 ) . You can take it alone or with food, but do not mix it with other drinks ( 31 ) . Side effects: None with small/regular doses; bloating and diarrhea with large doses; allergic reactions are possible ( 30,31 ) . There are no known harmful effects of emetrol on the developing baby ( 30,44 ) . Treatment of H. pylori infection It is not clear, if Helicobacter pylori infection of the stomach causes nausea during pregnancy; some studies have found no relationship between H. pylori, nausea in pregnancy or birth defects ( 42,43 ) . It is therefore not clear if the infection should be treated or not. When treated, the combination of antibiotics (amoxicillin, clarithromycin) and a proton pump inhibitor (omeprazole or lansoprazole) can be used ( 43 ) . Breath test 14C-UBT for diagnosis of H. pylori is considered safe in pregnancy ( 24 ) . Possibly Unsafe Drugs for Pregnancy Nausea Many doctors believe that below drugs are safe to use in pregnancy, but here are some possible dangers: Corticosteroids, such as methylprednisolone, should not be used in the first 10 weeks of pregnancy, since it may cause birth defects ( 11,19 ) . Droperidol ( 19 ) Metoclopramide (Reglan) ( 11,19 ) Ondansetron (Zofran) was associated with increased risk of cleft palate in the babies and severe heart arrhythmia in mothers ( 11,12,19 ) . Other Treatment for Pregnancy Nausea Acupressure Wrist Bands Wrist bands, such as sea-sick band, travel band and acustimulation bracelets probably have only a placebo effect. Some women find them helpful, though ( 20 ) . Hypnosis There is lack of studies that would prove effectiveness of hypnotherapy in pregnancy nausea ( 21 ) . Aromatherapy Essential oils used for aromatherapy include scents, such as mint, peppermint, spearmint, lemon, lime, orange, ginger (occasionally) ( 37,39 ) . Reflexology Reflexology is a type of massage that helps to relieve your symptoms by relaxing your muscles. Make sure to see a certified practitioner since a wrong massage session can aggravate your symptoms. Your body may need some time to come to terms with the treatment, so, it is normal for the symptoms to worsen to some extent before they subside after the first treatment session. Summary: Cures That Work Currently, there is no definitive cure for morning sickness, but the following was often reported as effective: Avoiding certain foods and smells Either additional rest or activity Ginger A combination of doxylamine and vitamin B6 Prescribed antiemetics [ref] Morning sickness facts (babycenter.com) Pregnancy nausea and miscarriage (babycenter.com) Drugs that work in nausea of pregnancy (babycenter.com) Antihistamines and increased risk of premature birth in hyperemesis gravidarum (newsroom.ucla.edu) FDA-approved drug for morning sickness (fda.gov) Early signs of pregnancy (webmd.com) Morning sickness tips (webmd.com) Foods to eat in morning sickness (voices.yahoo.com) Morning sickness (medicinenet.com) Ginger capsules safety and effectiveness (motherisk.org) Treatment of nausea and vomiting in pregnancy (motherisk.org) Ondansetron safety (motherisk.org) Doxylamine plus pyridoxine information leaflet (duchesnay.com) Ginger powder side effects (nccam.nih.gov) Nausea of pregnancy facts (mothertobaby.org) Heartburn and safe antacids during pregnancy (motherisk.org) Preventative use of antiemetics (motherisk.org) Antihistamines safety during pregnancy (motherisk.org) Safety of drugs for nausea in pregnancy (ncbi.nlm.nih.gov/pubmed) About seabands (motherisk.org) Nausea related to rest and activity (motherisk.org) Ginger vs vitamin B6 (motherisk.org) Proton pump inhibitors safety (motherisk.org) Safety of breath test 14C-UBT (motherisk.org) Hyperemesis gravidarum starting treatment before symptoms onset (nih.gov/pubmed) Calorie needs in pregnancy (eatright.org) Caffeine and pregnancy (marchofdimes.com) Ginger, peppermint and spearmint tea safety (motherisk.org) Meclizine is a category B drug (drugs.com) Emetrol safety in pregnancy (drugs.com) Emetrol facts (drugs.com) Doxylamine and sleepy baby (motherisk.org) Bad taste (motherisk.org) Nausea at first week (motherisk.org) Ptyalism in pregnancy (nih.gov/pmc) Alcohol and pregnancy (motherisk.org) Treatment options for morning sickness (babycentre.co.uk) How to cope with morning sickness (sogc.org) Nausea and vomiting in pregnancy facts (uptodate.com) Early signs of pregnancy (mayoclinic.com) Trimethobenzamide information (drugs.com) Helicobacter pylori and dyspepsia during pregnancy (lww.com) Treatment of H. pylori infection during pregnancy (wiley.com) Over-the-counter (OTC) medicines safe in pregnancy (parentsconnect.com) [/ref] these days

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lack of know-how Can you take Benadryl (Diphenhydramine) while pregnant? Benadryl (generic name diphenhydramine) is usually considered safe to take while pregnant and is commonly used as a sedative and antihistamine for treating minor cold and flu symptoms such as runny/stuffy nose, congestion, sneezing, watery eyes, nausea as well as allergy symptoms like rashes, itching and hives [1] . It may also be used for management of minor anxiety and as a sleep aid by pregnant women [2] . It is never advisable to use Benadryl in pregnancy without consulting your doctor to assess the potential risks [3] . Benadryl FDA Pregnancy Category Category B Diphenhydramine does cross the placenta but animal studies show little evidence of harmful effects on the fetus. However, there is a lack of data regarding its effects on a human pregnancy [4] . How much Benadryl can you take in pregnancy? Doctors usually recommend taking a 25mg to 50mg oral dose once every six hours [11] in the first trimester, while the dosage should not generally exceed 25mg in six hours during the last two trimesters [6, 7] . Is Benadryl cream safe during pregnancy? Use of topical Benadryl is considered safe in pregnancy as there is little evidence of harm to the fetus. However, there is inadequate data regarding whether the diphenhydramine in the ointment form crosses the placenta [5] . Expert medical guidance is recommended to assess chances of complications. What are the risks of taking Benadryl while pregnant? Drowsiness is the most common yet harmless side effect on this drug. In case of overdose: One case study shows oxytocin-like effects of the drug in case of high dosages and overdose. Moreover, it may have certain additional adverse effects when used by pregnant women, which are less likely to occur in non-pregnant patients [8] . Fetal morbidity: One study showed the use of Benadryl along with Restoril (temazepam) to significantly increase the chances of fetal morbidity. Risk of birth defects: Certain case reports have shown a possible association between the use of diphenhydramine in the first trimester and an increased risk of cleft lip or palate in the baby [9] . Withdrawal symptoms: In another case study , daily use of 150 mg Benadryl by the mother led to withdrawal symptoms in the baby. Benadryl while Breastfeeding Occasional use has not been associated with any serious adverse effects in the nursing infant [10] . However, prolonged use is contraindicated as the drug is excreted in the breast milk when taken by breastfeeding women [4] . Long term use or larger doses have been shown to decrease the breast milk supply of have some negative effects on the infant (e.g. irritability and lethargy). [ref] http://www.parents.com/advice/pregnancy-birth/my-pregnant-body/what-allergy-medications-are-safe-to-take-while-im-pregnant/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633026/ http://www.everydayhealth.com/drugs/benadryl http://reference.medscape.com/drug/benadryl-nytol-diphenhydramine-343392 http://reference.medscape.com/drug/benadryl-itch-stopping-diphenhydramine-d-diphenhydramine-999685 http://www.obgynspecialistsofmacon.com/uploads/OB%20MEDICATION%20LIST.pdf http://www.upmc.com/patients-visitors/education/pregnancy/pages/medicines-and-pregnancy.aspx http://www.aafp.org/afp/2003/0615/p2517.html http://www.drugs.com/pregnancy/diphenhydramine.html http://www.drugs.com/breastfeeding/diphenhydramine.html http://www.upmc.com/patients-visitors/education/pregnancy/Pages/medicines-and-pregnancy.aspx [/ref] current

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