Oxford Handbook of Midwifery by Janet Medforth, Sue Battersby, Maggie Evans, Beverley Marsh, Angela Walker Page B
Ads: Link
A before the seventh week of pregnancy has produced an increased frequency of birth defects, including cleft lip; ventricular septal defect; multiple heart defects; transposition of the great vessels; hydrocephaly; and neural tube defects.
Retinol is given to animals as a growth promoter, and any excess is stored in the liver. Since 1990, women who are pregnant or planning a pregnancy have been advised to avoid eating liver and liver products such as pâté or liver sausage, as they contain large amounts of retinol.
Vitamin A deficiency is largely a problem of developing countries, and is relatively uncommon in the developed world in the absence of disease. In the UK, the reference nutrient intake (RNI) is 600micrograms/day, with a 100micrograms/day increase during pregnancy. 5 Most women in the UK have a vitamin A intake in excess of the RNI.
Cod liver oil supplements may contain large amounts of vitamin A and should not be taken during pregnancy, except on medical advice.
Caffeine
Caffeine is a methyl xanthine, a naturally occurring compound found in plants. It is present in tea, coffee, and chocolate, and acts as a stimulant. It is also added to some soft drinks and so-called ‘energy’ drinks, as well
CHAPTER 5 Health advice in pregnancy
90
as over-the-counter anti-emetics and analgesics. 6 In pregnant women it is metabolized more slowly, and studies have suggested an association between the ingestion of caffeine and an increased risk of spontaneous abortion. 7 During breastfeeding an excessive intake can cause irritability and sleeplessness in both the mother and the baby.
The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment looked at the effects of caffeine on reproduction, and concluded that caffeine intakes above 200mg/day may be associated with low birthweight and, in some cases, miscarriage. Therefore, the Food Standards Agency 8 has issued advice to pregnant women to limit their intake of caffeine to less than the equivalent of two mugs of coffee a day.
It is not necessary for women to cut out caffeine in the diet completely, but it is important that they are aware of the risks, so they can ensure that they do not have more than the recommended amount. 200mg of caffeine is roughly equivalent to:
2 mugs of instant coffee (100mg each)
2½ cups of instant coffee (75mg each)
2 cups of brewed coffee (100mg each)
4 cups of tea (50mg each)
3 cans of cola (up to 80mg each)
• 4 (50g) bars of chocolate (up to 50mg each).
Food Standards Agency (2007). Your questions answered: listeriosis. Available at: M www.food. gov.uk/multimedia/faq/anchorcatering (accessed 3 November 2009).
Tommy’s The Baby Charity (2001). Toxoplasmosis: A Hand Book for Health Professionals . London: Tommy's. Available at: M www.tommys-campaign.org/problems/ToxoAcquired.pdf (accessed 2.3.10).
Elsheikha HM (2008). Congenital toxoplasmosis: priorities for further health promotion action.
Public Health 122 (4), 335–53.
Azais-Braesco V, Pascal G (2000). Vitamin A in pregnancy: requirements and safety limits.
American Journal of Nutrition 71 (55), 13255–335.
Department of Health (1991). Report on Health and Social Subjects 41. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Dietary Reference Values for the United Kingdom . London: HMSO.
Jordan S (2002). Pharmacology for Midwives The Evidence Base for Safe Practice . Hampshire: Palgrave, p. 18.
Cnattingius S, Signorello LB, Anneren G, et al. (2000). Caffeine intake and the risk of first- trimester spontaneous abortion. New England Journal of Medicine 343 (25), 1839–45.
Food Standards Agency (2008). Advice for Pregnant Women on Caffeine Consumption . London: FSA. Available at: M www.food.gov.uk/news/pressreleases/2008/nov/caffeineadvice (accessed 3 November 2009).
FOLIC ACID
91
Folic acid
Folic acid is a water-soluble B vitamin that is necessary for DNA synthesis and has a key role in cell division and development. Folates are
Retinol is given to animals as a growth promoter, and any excess is stored in the liver. Since 1990, women who are pregnant or planning a pregnancy have been advised to avoid eating liver and liver products such as pâté or liver sausage, as they contain large amounts of retinol.
Vitamin A deficiency is largely a problem of developing countries, and is relatively uncommon in the developed world in the absence of disease. In the UK, the reference nutrient intake (RNI) is 600micrograms/day, with a 100micrograms/day increase during pregnancy. 5 Most women in the UK have a vitamin A intake in excess of the RNI.
Cod liver oil supplements may contain large amounts of vitamin A and should not be taken during pregnancy, except on medical advice.
Caffeine
Caffeine is a methyl xanthine, a naturally occurring compound found in plants. It is present in tea, coffee, and chocolate, and acts as a stimulant. It is also added to some soft drinks and so-called ‘energy’ drinks, as well
CHAPTER 5 Health advice in pregnancy
90
as over-the-counter anti-emetics and analgesics. 6 In pregnant women it is metabolized more slowly, and studies have suggested an association between the ingestion of caffeine and an increased risk of spontaneous abortion. 7 During breastfeeding an excessive intake can cause irritability and sleeplessness in both the mother and the baby.
The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment looked at the effects of caffeine on reproduction, and concluded that caffeine intakes above 200mg/day may be associated with low birthweight and, in some cases, miscarriage. Therefore, the Food Standards Agency 8 has issued advice to pregnant women to limit their intake of caffeine to less than the equivalent of two mugs of coffee a day.
It is not necessary for women to cut out caffeine in the diet completely, but it is important that they are aware of the risks, so they can ensure that they do not have more than the recommended amount. 200mg of caffeine is roughly equivalent to:
2 mugs of instant coffee (100mg each)
2½ cups of instant coffee (75mg each)
2 cups of brewed coffee (100mg each)
4 cups of tea (50mg each)
3 cans of cola (up to 80mg each)
• 4 (50g) bars of chocolate (up to 50mg each).
Food Standards Agency (2007). Your questions answered: listeriosis. Available at: M www.food. gov.uk/multimedia/faq/anchorcatering (accessed 3 November 2009).
Tommy’s The Baby Charity (2001). Toxoplasmosis: A Hand Book for Health Professionals . London: Tommy's. Available at: M www.tommys-campaign.org/problems/ToxoAcquired.pdf (accessed 2.3.10).
Elsheikha HM (2008). Congenital toxoplasmosis: priorities for further health promotion action.
Public Health 122 (4), 335–53.
Azais-Braesco V, Pascal G (2000). Vitamin A in pregnancy: requirements and safety limits.
American Journal of Nutrition 71 (55), 13255–335.
Department of Health (1991). Report on Health and Social Subjects 41. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Dietary Reference Values for the United Kingdom . London: HMSO.
Jordan S (2002). Pharmacology for Midwives The Evidence Base for Safe Practice . Hampshire: Palgrave, p. 18.
Cnattingius S, Signorello LB, Anneren G, et al. (2000). Caffeine intake and the risk of first- trimester spontaneous abortion. New England Journal of Medicine 343 (25), 1839–45.
Food Standards Agency (2008). Advice for Pregnant Women on Caffeine Consumption . London: FSA. Available at: M www.food.gov.uk/news/pressreleases/2008/nov/caffeineadvice (accessed 3 November 2009).
FOLIC ACID
91
Folic acid
Folic acid is a water-soluble B vitamin that is necessary for DNA synthesis and has a key role in cell division and development. Folates are
Similar Books
