You and Your Pregnancy

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					FA M I LY                    H E A LT H               P R O G R A M                     TM



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                                           Looking After
                                You and
                             Your Pregnancy
 In proud partnership with




                               See inside for special SPOTLIGHT ON sections from the
                                                                  Family Health Program 1
                                    Centers for Disease Control and Prevention!
                                     W elcome . . .
                                       . . . to the Family Health Program™ brought to you in proud partnership
                                       with the Centers for Disease Control and Prevention’s “Learn the Signs.
                                       Act Early.” Campaign, Visiting Nurse Associations of America (VNAA) and
                                       the makers of LYSOL® brand products.
                                       Looking After You and Your Pregnancy places special focus on you during
                                       this exciting — and sometimes confusing — time. This informative
                                       guide explores need-to-know areas of prenatal care, well-being and germ
                                       protection to help keep you and your home “healthy” as you prepare for
                                       the arrival of baby.

     A Health Program Especially for You
     A pregnant woman has special needs, and during this period in your life, you can be more susceptible to
     infectious diseases than other healthy adults. Daily lifestyle decisions can also affect not only your own
     health, but that of your developing baby, too.
     As public health experts, we know that there are several things you can do to keep yourself — and the
     baby inside you — healthy, including:
     • Prenatal care
     • Specific immunizations that are safe before and/or during your pregnancy
     • A healthy diet and lifestyle that keeps your growing baby safe — including no alcohol or smoking
     • Thorough personal and home hygiene to help prevent the spread of disease-causing germs


     Your Healthy Home
     The CDC, VNAA and LYSOL® partnership team is committed to education for the health and well-being
     of you and your soon-to-arrive baby. In fact, this book is the first in a series that targets moms-to-be
     and moms of young children at different ages. We are also committed to keeping you and your family
     healthy by providing safe and convenient disinfecting and cleaning solutions for your home. For more
     on what we are doing to ensure a healthy home for you and your family, visit: www.cdc.gov,
     www.vnaa.org, and www.lysol.com.
                       We wish you all the best in Looking After You and Your Pregnancy!



                                Andy Carter                                   Tom Bach
                             President and CEO                      Professional Relations Manager
                        Visiting Nurse Associations         Reckitt Benckiser Inc., the makers of LYSOL®
                                 of America




2   Family Health Program
                                                               Looking After
                           You and Your Pregnancy
           Maintaining a healthy pregnancy is impacted by many things. Throughout Looking After You and Your
           Pregnancy, you’ll find practical information and tips for staying healthy as you get ready for your new
           arrival. You’ll discover need-to-know advice in such areas as prenatal care, nutrition and food safety,
           keeping your home clean and healthy, and more. In addition, you’ll find references to help you locate
           further information on those subjects of particular interest to you.
                                                                      So, please read on!
                               Watch for these special sections that feature important information from the Centers for Disease
        SPOTLIGHT ON Control and Prevention’s National Center on Birth Defects and Developmental Disabilities.


                                                            Table of Contents
 A Healthy Pregnancy                                                                       Nutrition During Pregnancy ...................................... 36
                                                                                           Food Safety During Pregnancy .................................. 39
 Planning for Pregnancy                                                                    SPOTLIGHT ON Smoking ............................................................. 41
 Prenatal Care . . . Before Getting Pregnant ............ 4                                SPOTLIGHT ON Alcohol ............................................................... 42
 Gynecological Health ................................................... 4                Caffeine ........................................................................... 43
 SPOTLIGHT ON Folic Acid: Before and During Pregnancy .. 5
                                                                                           About Recreational Drugs ........................................... 43
 Vaccinations ................................................................... 6        Wearing A Seatbelt During Pregnancy .................... 44
 Existing Health Conditions ........................................ 7                     Emotions and Stress .................................................... 44
 SPOTLIGHT ON About Diabetes and Pregnancy                      ................. 8        Pregnancy and Sleep .................................................... 46
 Genetic Testing .............................................................. 10         Choose Your Pediatrician ............................................ 47
 Healthcare During Pregnancy
 Prenatal Care ................................................................. 11        Health and Well-Being at Home
 SPOTLIGHT ON Medications During Pregnancy ................... 15                          Safety
 SPOTLIGHT ON Preventing Infections During Pregnancy .. 16
                                                                                           First Aid Kits .................................................................. 48
 Pregnancy: Changes, Challenges and
   Suggestions ................................................................. 17        Germs
 Pregnancy Weight Gain ............................................... 25                  Germ Growth at Home ................................................ 49
 Bed Rest .......................................................................... 26    In the Kitchen ................................................................ 51
 Preparing for Multiple Births .................................... 28                     In the Bathroom ............................................................ 52
                                                                                           Flooring and Furniture ................................................ 53
 A Healthy Lifestyle During Pregnancy
 Handwashing ................................................................. 31          Animals, Insects, and Rodents
 Exercise ........................................................................... 32   Household Pets .............................................................. 54
 Oral Care ......................................................................... 34    Insects, Rodents, and Wild Animals ......................... 55
 Grooming During Pregnancy ..................................... 35

The contents of Looking After You and Your Pregnancy are for informational purposes only and should                  The web links provided in each chapter were
never replace the advice and care of a licensed healthcare professional. Neither Reckitt Benckiser                   current at time of publication. In the event that
nor VNAA guarantees the accuracy, completeness or timeliness of any information contained in this
                                                                                                                     they change and/or are no longer available, we
booklet, and neither shall be liable for any loss, damage or injury directly or indirectly caused by or
resulting from such information or its use. VNAA’s cooperation in the publication of Looking After You               suggest that you visit the “home page” of the
and Your Pregnancy does not and shall not in any manner be interpreted to constitute an endorsement                  named organization or company. From there,
by VNAA of any products or services that may be advertised or referenced in the publication.                         search for topical information.
                                                                                                                                  Family Health Program 3
                      GERMS: What They Mean for You and Your Family
                       Germ Growth at Home
                       The main sources of germs in your home are usually people, pets, food, and water.
                       Some germs, particularly bacteria, like to live in warm, moist places.



Germs can grow and multiply quickly in places where       How Germs Are Spread
water and waste matter accumulate, such as in sinks,      Germs are typically spread in one of three ways:
toilets, wet cleaning cloths, mops, and towels.
                                                          • Direct Contact. This is skin-to-skin contact, contact
What’s more — bacteria can grow and divide every
                                                            with infected people or animals, or contact with
20 minutes. One single bacteria cell can become more
                                                            blood or other body fluids. The tendency of germs
than 8 million cells in less than 24 hours.
                                                            to spread via direct contact underscores the
                                                            importance of handwashing for everyone.
Bad Germs = Pathogenic Ones
                                                          • Indirect Contact. This happens when germs that are
Some germs, if they get into the wrong place, can
                                                            present in raw food or water, in soil, and on animals
cause an infection and may have potentially
                                                            are picked up on your hands and transferred to the
serious consequences. Typically, these germs are
                                                            mouth, eyes, or nose to cause infections. Common
called pathogens because they can cause illness.
                                                            contact points include:
Pathogenic microorganisms fall into five categories:        — Contaminated surfaces like dirty diapers,
• Bacteria — such as Salmonella or E. coli, which               surfaces that held raw food, etc.
  cause foodborne illness.                                       • Items used to clean these surfaces, such as
• Fungi — such as Candida albicans, which causes                   cloths and sponges, can also act as a means of
  thrush; or some mold, such as Cladosporium, which                spreading germs in the home.
  can cause nasal stuffiness, eye irritation, wheezing,          • Toothbrushes can carry germs too, and should
  or skin irritation.                                              be replaced every 3 months and after any
• Viruses — such as rotavirus, which can cause                     upper respiratory, oral, or skin infection (such
  severe diarrhea in babies, or rhinovirus, which                  as thrush, herpes, impetigo, colds, sinus
  causes the common cold.                                          infections, or strep throat).
• Parasites — such as Toxoplasma gondii, which can          — Pets and other animals
  cause birth defects in the fetus; and Giardia, which      — Insects like mosquitoes, fleas, ticks, and spiders
  can cause severe diarrhea and dehydration.
                                                          • Through the air. Some germs spread through the
• Prions — unlike the organisms listed above, these         air, either carried on skin scales (dust) shed from
  pathogenic agents composed entirely of protein            the body, or in tiny droplets expelled through
  cause a variety of neurodegenerative diseases             coughing, sneezing, or talking. People can pick up
  such as Creutzfeldt-Jakob disease. Conventional           these germs (i.e., some viruses and tuberculosis) by
  sterilization and disinfection practices are not          breathing them in.
  effective against prions. However, strong solutions
                                                            — Germs that can be transferred this way include
  of either bleach or sodium hydroxide for periods
                                                                childhood diseases like measles, mumps, and
  beyond 1 hour contact time are believed to provide
                                                                rubella, or other contagious diseases like
  some efficacy.
                                                                tuberculosis.




                                                                                     Family Health Program       49
 Controlling Germs: Cleaning vs. Disinfection                  Cleaning
 Cleaning and disinfecting are not the same thing.             When you clean, you are physically reducing the
 Cleaning removes germs from surfaces, whereas                 soils and the number of germs on the surface you
 disinfecting actually destroys them.                          are cleaning.
 Cleaning with soap and water to remove dirt and most          • Cleaning entails using soap/detergent and water
 of the germs is usually enough. However, through its            or a good cleaning solution, in combination with
 “Ounce of Prevention” campaign, the U.S. Centers for            thorough scrubbing.
 Disease Control and Prevention stresses that it’s             • When you feel that you need to do more than just
 important to routinely clean and disinfect surfaces.            “clean,” it’s time to disinfect.
 • While surfaces may look clean, many infectious
   germs may still be lurking. In some instances, germs        Disinfecting
   can live on surfaces for hours — and even days.             When you disinfect, you are killing germs. According
 • Disinfectants are registered with the U.S.                  to the CDC, the rule of thumb is to disinfect those
   Environmental Protection Agency (EPA) and contain           areas where there can be large numbers of dangerous
   ingredients that destroy bacteria and other germs.          germs — and where there is a possibility that these
   Check the product label to make sure it says                germs could be spread to others.
   “Disinfectant” and has an EPA registration number.          • When you disinfect with an EPA-registered
 Since cleaning and disinfecting are not the same                disinfecting wipe or disinfectant spray, you are
 thing, you’ll need to decide which is appropriate in            actually killing most of the germs present on the
 each situation.                                                 surface you are wiping or spraying, giving even
                                                                 better protection.


                                             G erms At-A-Glance
                 According to CDC’s Ounce of Prevention campaign, there are many types of germs
                 (viruses, bacteria, parasites, fungi) that cause many types of illnesses — including the
                 common cold or flu, foodborne illness, Lyme disease, hantavirus, or plague.
                 These germs can spread easily from one person to another — and have wide-reaching
                 effects. Germs can spread via direct contact or indirect contact, or through the air.
                 Sources of Germs are:
                 a. People             e. Fish
                 b. Food and water     f. Soil
                 c. Animals            g. Contaminated surfaces
                 d. Insects


     For More Information . . .
 Germs: www.cdc.gov/ounceofprevention and you can also watch how bacteria can grow at www.lysol.com/
 topic_germs.shtml
 Germ “Hot Spots” in the Home: www.lysol.com/coldFlu/cfProtect.shtml
 Cleaning and Disinfecting for a Healthy Home: www.lysol.com and www.cdc.gov/ncidod/op
 General Microbiology and Specific Pathogens: www.vnaa.org/vnaa/g/?h=html/germ_protection_center_home
 or www.vnaa.org/vnaa/g/?h=html/germ_protection_center_viruses
 Foodborne Bacteria: www.cfsan.fda.gov
 Toxoplasmosis: www.cdc.gov/toxoplasmosis/pregnant.html

50    Family Health Program
                      In the Kitchen
                      In the United States, government and industry have worked closely together in
                      developing basic guidelines for handing and preparing food safely.


The 4 Simple Steps for preventing foodborne illness are:          Preventing Foodborne Illness — Kitchen Tips
                                                                  • Cutting Board Cleanliness: In addition to
             CLEAN: Wash hands and surfaces often                   washing cutting boards, dishes, utensils, and
             • Wash your hands with warm, soapy water for           countertops with hot, soapy water after
               20 seconds before and after handling food.           preparing each food item and before going on to
               According to the CDC, “Washing hands is one          the next food, try using separate cutting boards.
               of the most important actions parents can take
                                                                    Designate one for fresh fruit/vegetables, and
               to prevent foodborne illness in their children.”
                                                                    one for raw meats, poultry, and seafood.
             • In addition, wash your cutting boards, dishes,
               and other surfaces with hot, soapy water after     • Throwing Germs Away: Use disinfecting wipes
               preparing each food item and before going on         to clean up kitchen surfaces, or use paper towels
               to the next food.                                    along with with antibacterial kitchen cleaner.
             • Wash fruits and vegetables with cold water           Then, throw the germs away! If cloth towels are
               before using.                                        used, launder them often, using hot water.
                                                                  • Disinfect: Periodically disinfect kitchen
             SEPARATE: Don’t cross-contaminate
                                                                    countertops using a kitchen disinfecting product,
             • Separate raw, cooked, and ready-to-eat foods
                                                                    such as an antibacterial kitchen cleaner and/or
               while shopping, preparing, and storing.
                                                                    disinfecting wipes. Follow label directions for
             • Never place cooked food on a plate that              effective use.
               previously held raw meat, poultry, or seafood.
                                                                  • Prevent Germs in the Refrigerator: Clean your
             COOK: Cook food to proper temperatures                 refrigerator regularly. Wipe up spills immediately;
             • Use a food thermometer to be sure!                   and clean inside walls and shelves with hot water
             • For more on food thermometers and safe               and a mild liquid dishwashing detergent, then
               minimum internal food temperatures,                  rinse. Use disinfecting wipes to clean up spills.
               visit www.isitdoneyet.gov.                         • Discard Old Food: Once a week, check
             HEALTH ALERT: Make Sure It’s Cooked! Don’t             “expiration” and “use-by” dates, and throw
             eat uncooked or undercooked eggs, meats or             out foods if the date has passed.
             fish while you are pregnant. These can make
             you sick and may harm your baby.
                                                                           S pecial Foodborne Issues
             CHILL: Refrigerate Promptly                                      For Pregnant Women
             • Refrigerate or freeze perishables, prepared           This section covers food safety for all.
               foods, and leftovers within 2 hours or sooner.        There are also three key food safety issues
                                                                     that relate specifically to pregnant women.
                                                                     Read about them on page 39!

  For More Information . . .
Food Safety During Pregnancy: www.cfsan.fda.gov/~pregnant/pregnant.html
Kitchen Tips: www.lysol.com/topic_eating.shtml
Food Safety in general: www.fightbac.org
                                                                                       Family Health Program       51
                        In the Bathroom
                        Although toilet bowls are likely to contain germs, the risk of picking up germs
                        directly from the toilet bowl is usually low, unless you touch it or it splashes during
                        use or flushing.

 In fact, the greatest risk of infection comes from           • Clean shower curtains with a suitable disinfectant
 surfaces that are frequently touched — like the toilet         or launder them according to the curtain
 flush handle, toilet seat, faucets, and door handles.          manufacturer’s instructions.
 You should regularly clean and disinfect these               • Store personal items (like toothbrushes) where
 surfaces using these guidelines:                               germs are unlikely to splash onto them. Rinse them
 • Clean and disinfect the toilet bowl as often as              after each use and store them dry. Never share
   necessary to prevent the buildup of dirt and scum            personal items.
   that can harbor germs and cause nasty odors. Use           • Launder and replace towels frequently.
   a disinfectant toilet bowl cleaner. If you use a toilet    • Keep the bathroom clean and well ventilated to
   brush, make sure it is stored clean and dry after            prevent the growth of molds.
   each use.                                                  • Wash your hands thoroughly after using the toilet
 • Clean up spills immediately, and disinfect these             and after cleaning the bathroom.
   surfaces. Disposable cleaning cloths or disinfecting       • For added protection, spray surfaces with an
   wipes are quick and easy to use.                             EPA-registered disinfectant spray.
 • Rinse baths, sinks, and showers after each use
   and clean them regularly with a suitable product to
   remove all the lime scale and soap scum that can
   harbor germs.


     For More Information . . .
 Bathroom Cleaning: www.lysol.com/home-and-family/protecting-your-home/bathroom-hygiene
 Cleaning the Shower: www.bathenclosures.org




52   Family Health Program
                       Flooring and Furniture
                       Usually, floors and furniture contain low risk for the spreading of germs. However, there
                       are some general cleaning guidelines you should follow in order to keep a clean and
                       healthy home.

• Vacuum carpets and soft furnishings to pick up                       • Damp-dust hard surface furniture to minimize
  dust, dust mites, and other debris. See the chart below                dust and dirt.
  for information on how often to clean carpets.                       • To prevent the growth of molds and fungi, clean
• If possible, replace bathroom and kitchen carpets                      and disinfect tiled walls and other hard surfaces,
  with hard surface floorings, such as tiles, linoleum,                  where moisture is likely to collect.
  or laminates.                                                        • Do not use bleach products on carpets, wooden
  — These are more hygienic because they are easier                      surfaces, or in confined unventilated areas.
      to clean and do not collect debris in the same way               • Remember to wash your hands after cleaning.
      that carpets can.
• Clean hard surface floorings with an appropriate                     Frequency of Floor Cleaning
  cleaner and water to remove dust, dirt, and visible                  The general rule of thumb is to not wait until floors or
  mold growth.                                                         carpets are visibly dirty to clean them. Plus, the more
  — You should only have to disinfect these surfaces                   often you clean them, the easier the chore will be.
      if they have become contaminated by body fluids.                 • Frequency of cleaning hard surface floors will
  — Use disposable paper towels to remove spills of                      depend on the level of “traffic” as well as any
      body fluids, then clean and disinfect the surface.                 accidents or spills. Follow the guidelines shown at
  — In bathrooms and kitchens (where spills often                        left for cleaning hard surface flooring.
      occur), hard surface floorings are easier to keep                • For carpeting, the chart below outlines the
      clean and don’t accumulate dirt the way carpets do.                U.S. Environmental Protection Agency’s (EPA)
  — Use an all-purpose disinfectant cleaner to help                      recommendations for frequency of cleaning.
      clean and disinfect flooring and other surfaces.
  — If you use a mop and bucket, disinfect them after
      each use and store them dry; position the mop
      head upwards.
                                  Carpet Cleaning Frequency Guidelines for Residences
                                         2 persons,           2 persons,              young            young children
                   Environment
                                        non-smoking          with smoking            children             w/pets

                 Normal                  6-12 months            4 months             6 months            3-6 months

                 Contaminated;
                                           2 months             2 months             1 months             1 months
                 Outside Dusty

                 Extreme Cold
                                         4-6 months             3 months             3 months             2 months
                 Weather Climates

                 High Humidity
                                         4-6 months             4 months             3 months             2 months
                 Biogenic

                Courtesy of Here’s to your (Carpet) Health, Cleaning and Maintenance Management, June 1997.


  For More Information . . .
Clean and Healthy Homes: www.lysol.com
Preventive Home Cleanliness Tips: www.cleaning101.com
                                                                                                          Family Health Program   53
                                             Special thanks to:

                                                  VNAA Reviewer
                                               Shelley Ludwick, RN
                                            Clinical Programs Consultant
                                      Visiting Nurse Associations of America




                                                                                       JMH Education, New York, NY www.jmheducation.com
                                                        VNAA Staff
                                                 Donna Grande
                                      VP of Communications and Development
                                      Visiting Nurse Associations of America

                                                    Project Editor
                                                        Tom Bach
                                                         LYSOL®

                                                  LYSOL® Reviewer
                                             Donna J. Gaber, BA, MT
                                            Infection Control Practitioner
                                               Consultant for LYSOL®

                                                   CDC Reviewers
                                         Spotlight
                                        SPOTLIGHT ON content reviewers and
                                         various content reviewers from
                                    Centers for Disease Control and Prevention




                            Germ Protection Center                     www.lysol.com
                         www.vnaa.org/vnaa/g/?h=html/
                         germ_protection_center_home




56   Family Health Program

				
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