Your Pregnancy Nutrition This Week ( week 19) Stress ? is it worth it? Pregnancy can be an emotionally exciting time for women, but for some, it brings on great stress. It is OK to feel some anxiety about all the changes going on in your life, but know that very high levels of stress can contribute to pre-term birth or low birth weight in full term babies. Here are a few tips on how to handle the stress: Eat and drink well on a regular basis. Be consistent. Rest when you can and when your body needs it. Stay away from stressful situations and people that cause you stress. Resist any urges to cope with your stress by drinking, smoking or anything else that will make you feel even worse after the fact. For tips on how to deal with the external stresses o f pregnancy read Too Much Baby Talk. Your Pregnancy Fitness This Week How do I stay motivated to exercise? As with anything else in life, all good intentions and resolutions only last so long. Ins tead of ditching all of yours before you even hit mid-second trimester, check out the following tips to keep yourself motivated for the long haul. Make up a reward system and use it as positive reinforcement for coming back for more exercise. Make the reward something that is not food related, rather, something like a massage, a new shade of lipstick or a new hairdo. Set realistic goals. Now is not the time to set those hour-long workout goals every day of the week for the entire pregnancy. Make a realistic game plan that sets yourself up for success. How about putting a picture of the ultrasound on the treadmill? Isn't that the main reason to keep working out and staying healthy? For more information about staying motivated throughout all areas of your pregnancy check out our 8 Hidden Reasons to Stay Motivated During Your Pregnancy. Your Baby's Development This Week Age of Fetus?17 weeks The baby is developing at a steady pace and has undergone some incredible changes. This week, the baby begins taking on more fat, which is very important for its ability to create and maintain heat and for metabolism. If your baby is a girl, primitive egg cells are developing in her ovaries. Girls are born with all the eggs they will ever have. The egg you released to conceive this baby is as old as you are now! Other changes that are happening: The baby's ears now stand out from the head. The placenta will continue to grow from this point on but only in diameter, not thickness. This week a temporary hair called lanugo will appear on the baby's body and head but disappear by birth. No one is sure of the purpose of this hair. Baby's Size (head to rump) this week: About 5.25 to 6 inches Weight: Approximately 7 ounces Right now your baby is about the size of a small banana. Too Much Baby Talk How to Handle Unwanted Advice -- By Rachel Von Nida, BabyFit Expert ―Wow, you‘re huge!‖…― You are not nearly big enough, is your baby growing?‖…―Oh I hate that name‖…―You know, you shouldn‘t do that…‖ Have you had unsolicited comments or advice from family, friends or complete strangers? Somewhere along the way, most expectant moms receive comments about their size, habits, and exactly how they should raise their children. The question is: How should we respond? Obviously there is not an easy answer and it will vary with every situation. Many people do not realize how hurtful, stressful, or just plain annoying all of the intrusive queries and quotes of ―scientific data‖ can be. Here are a couple of options to consider: 1. Just ignore it. People often do not realize that they are being hurtful or feel that they truly have a unique bit of wisdom they must share with you. When you are confident that you are communicating well with your doctor and feel comfortable with your weight gain, prenatal activities, and post-natal plans, etc., you are able to politely smile and move on. 2. Humor. It may put you at ease to laugh off the comments that are not critical to you or the baby. For example, if someone notices a nice shiny new pimple on my cheek, I like to say, ―Oh, thanks for noticing!‖ 3. Privacy. I‘ve known many couples that simply keep certain information between the two of them. Parents- to-be can keep baby names, the baby‘s gender, and other choices quiet in order to avoid remarks about whether family members approve or are disappointed before the baby arrives. 4. Selective listening. There is some really good advice out there. Experienced parents can often share lots of great stories and tips. Sometimes it is all about perspective and reliable sources. There are at least 5 theories on baby‘s temperament, sleep, eating, etc. Be selective about whose advice you thoughtfully consider. I have one friend whose son is 6 months older than my daughter. She and I are both working moms and we share many of the same values and goals. She always has great advice for me! It is a gift to have her experience to learn from. Overall, parents should feel confident about the choices they make for their family. Pregnant moms have a unique responsibility to their growing babies and to themselves – this does not require the approval of friends, family members, and strangers 8 Hidden Reasons to Stay Motivated Ways to Rediscover Your Drive for Health -- By Zach Van Hart, Staff Writer Pregnancy is an intimidating thing. Yet, our friends, our family, sometimes people on the streets tell us that everything will be fine and that pregnancy will be a great experience. Here's a few reasons why they are right, and why you should keep working towards having a healthy baby, even when you are tired of adding up vitamins, tired of trying to exercise, and tired of following everything the doctor suggests. Here are 10 of our ‗hidden‘ motivating reasons to stay healthy during your pregnancy. Use one or all of them to keep the fire burning inside you. 1. Confidence How did it feel after that first walk around the block? Or when you first went to the doctor and heard the words "healthy baby?" The more and more you accomplish towards pregnancy health, the more you‘ll believe in yourself and your abilities as a mother. 2. Make the week easier Ever felt like a week was taking forever? It feels like Friday, but it‘s only Tuesday? Your feet are swollen, everything is aching, and you just want to shout "Will this ever end?". Concentrate on smaller chunks of time instead of the all-too- intimidating 40 weeks. Think of little steps that you can take to get your baby the stuff it needs. The week will not only go faster, but be more enjoyable. 3. Gives you purpose Every once in a while, we need a good reason to get out of bed. Here is your biggest reason, right in front of you. Eat the healthy breakfast that‘s going to jump start your day, or walk to the driveway and grab the newspa per. Keep caught up on your doctor's appointments. When you‘re motivated, you have a reason to do what you do. 4. For your kids And your grandkids. And their kids too. The healthier you are, the healthier your baby will be, and the better able you'll be to watch your kids grow and spoil your grandchildren. The fun doesn't end once you've given birth. You'll need even more energy for the years to come, so why not start the momentum of being concerned for your health now? 5. The ‘wow’ effect Picture this: Walking into a store, running into a friend, their eyes light up. ―Wow, you look great!‖ If you are working hard during your pregnancy to stay healthy, it will show. The healthier you are, the more confident you'll become. That pregnancy glow will be obvious. You're going to be a great mom, and everybody knows it. Watch the ―Wows‖ add up. 6. Energy boost Pregnant or not, exercising gives you energy. At first, this might seem a little counterintuitive, but it's true! Even just a 30 minute walk will rev up the body. So, the more you exercise, the more energy you'll have to do everyday tasks that you might otherwise have flopped out on. Exercise is good for your baby too! 7. Keep gaining expe rience The more you do, the more you learn. You‘ll discover what pregnancy tactics work best for you and which ones don‘t. What worked for your sister or your best friend might not work for you. But you'll figure it out and become an expert for your own baby. So keep on trying even if the "magic cure" for heartburn does n't quite do the trick for you. You'll figure out your own mystical solutions. 8. Rewards will feel like rewards What‘s your favorite food? Cookies, ice cream, a big double cheeseburger? For most of us, it‘s the food that no one should eat on a regular basis. But every once and a while, when that craving hits, that food will just taste great. And when you are treating yourself, enjoy it! You can worry about the folate and calcium later. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Your Pregnancy Nutrition This Week (Week 20) Frozen Pudding Pops Get ready for a fun, cold snack that feels indulgent, but isn't. This treat is better for you than wolfing down fatty ice cream snacks, yet it offers you the cold creamy flavor that does the trick for your craving. 2 cups low- fat or skim milk 1 small box of instant pudding (any flavor) Prepare pudding according to package directions. Freeze in pop molds or spoon into small paper cups and insert popsicle sticks or plastic spoons. Place in freezer until solid. Makes 6 servings. Pudding is a great source of calcium, find out why Calcium is Important during Pregnancy. Your Pregnancy Fitness This Week Standing Bicep Curls Stand with your feet shoulder width apart and knees slightly bent. Hold a small weight in each hand at your sides, palms facing inward, and exhale as you curl your arms towards your shoulders. Inhale as you lower your hands back down to your sides. Focus on keeping the movement fluid and controlled. Repeat. Click here to see this exercise Also find some ways to Exercise Without the Gym. Your Baby's Development This Week Age of Fetus?18 weeks You and the baby have really been growing! By now, you have probably put on 12 pounds plus or minus a few. While much development remains, the rapid growth rate of the baby is going to slow down just a little near this time. To aid in muscle development, the amniotic fluid is supporting the baby's movements. Your baby is quite the little gymnast and is getting busy with twists, turns and forward summersaults! Other changes that are happening: The baby's eyebrows are now forming. Your baby is sleeping and waking much like a newborn at this time. Permanent hair is now growing on the scalp, but even this hair will fall out the second week after birth and will be replaced by thicker hair. Baby's Size this week: About 5.3 to 6 1/2 inches (head to rump). Weight: Approximately 9 ounces The Time Is Now To Take Your Childbirth Class Some days it may seem as though pregnancy will last forever, but now is the time to register for a childbirth class. Have the class completed within 3-4 weeks of your due date. Click here and learn how you and your labor partner can make this event less stressful and more enjoyable! Calcium Foods and Supplements How Much Do You Really Need? -- By Becky Hand, Licensed and Registered Dietician Most pregnant women know to pay special attention to their need for calcium. The calcium is necessary to build and maintain strong bones and teeth for both mom and baby. Despite your good intentions, sometimes it's difficult to ensure you are getting all the calcium you need everyday. During pregnancy, the daily recommendation for calcium is 1,000 mg. The best way to meet your calcium needs is by eating a variety of calcium-rich foods. Foods high in calcium include dairy products like milk, cheese, and yogurt. Other sources are broccoli, collard greens, kale, salmon and sardines canned with bones, and calcium-set tofu. By eating 3 - 4 servings of dairy products daily, with one or two other high calcium foods, you can easily meet your calcium needs. If you don't like dairy products or they don't like you, then try some of these tips to increase the amount of calcium in your diet. Use milk in preparing hot chocolate, mashed potatoes, oatmeal, and soups. Make a fruit smoothie using yogurt and frozen fruit for a light refreshing meal or snack. Use nonfat plain yogurt to replace part or all of the sour cream, mayonnaise or cream cheese in recipes. Use canned salmon with bones, instead of tuna, for sandwiches and casseroles. Serve a stir- fry packed with calcium- rich foods like broccoli, bok choy and tofu. Make a sandwich spread from calcium- fortified cottage cheese and chopped veggies. Mix part-skim ricotta cheese with cinnamon and raisins to spread on bagels or English muffins. Serve pudding made with milk for a dessert or snack. While calcium-rich food is the preferred source of calcium, it may be necessary to use calcium supplements if you are not getting enough from your diet. If you need to take a calcium supplement, discuss this with your healthcare provider first, and follow these guidelines: Do not take more than the recommended amount of calcium. Avoid taking calcium with iron pills or your prenatal supplements. Calcium can interfere with the absorption of the iron. Do not take your calcium supplement with a high fiber meal. Fiber reduces the absorption of the calcium. It is best to take calcium with meals or at bedtime. It is better absorbed. Drink a glass of milk, juice, or water with each supplement to promote absorption. Do not take more than 600 mg of calcium at one time. If more is needed, take smaller doses several times during the day. Avoid using dolomite, bone meal and oyster shell as your calcium source. They may contain lead and are poorly absorbed. Not all of the calcium in a supplement is absorbed. When choosing a supplement, the amount of elemental calcium per tablet will indicate the approximate amount absorbed. Most supplements should provide 200 - 500 mg of elemental calcium per tablet. Chewable supplements dissolve well and are easily absorbed. To test other supplements, place it in a cup of vinegar at room temperature and stir every 5 minutes. The pill s hould disintegrate completely in thirty minutes. Many healthcare providers recommend calcium carbonate because it is an inexpensive and efficient source of calcium. Some antacids contain calcium carbonate and can be used as a calcium supplement. Most contain 200 - 300 mg of elemental calcium. If you choose to use antacids as a calcium source, check with your healthcare provider on the number that can be taken daily. Antacids lower the acidity in your stomach, therefore decreasing the absorption of iron and zinc. There is no reason to pay more money for supplements with claims, such as: "no starch", "no preservatives", "natural", and "proven release". Save your money; there will be plenty of extra expenses when the baby arrives. Exercising Without The Gym Home Workouts: Convenient and Effective -- By Sara Hambidge, Physical Therapist Since you‘ve become pregnant, your have read everything you can get your hands on about making this the best pregnancy ever. It‘s a good bet that you‘ve learned how beneficial it is to exercise, but would rather save your money than spend it on a gym membership. The good news is that you can get a great workout in the comfort of your own home—by spending little to no money. First get your doctor‘s OK to exercise at least 30 minutes, on most or all days of the week, throughout your pregnancy. This half- hour session can include cardiovascular work, stretching, and strengthening. Without access to a treadmill, bike, elliptical trainer, or other cardio equipment, the best way to get your exercise is to go for a walk. Be sure to put on a pair of supportive shoes before you hit the road. Walk for 10-15 minutes and gradually increase your time as much as you feel comfortable. Swimming is another easy and fun way to get aerobic exercise. . For the stretching and strengthening, pick and choose exercises from the following lists. Try to do what you feel comfortable with, and vary your routine on a weekly basis to avoid boredom—when you enjoy working out, you‘re more likely to stick with it. You can do the stretching and strengthening on the same day or on opposite days, but both are important. Stretches Hold each stretch gently for 15-20 seconds, and repeat 2-3 times. Don’t bounce or overstretch! Seated Hamstring Stretch: Sit on the floor with right leg extended, and left knee bent, tucking your left foot in toward your groin. Lean forward, keeping back straight, until a stretch is felt in the back of the thigh. Switch sides. Standing Hamstring Stretch: Place one foot on a step or chair, toe pointing up. Keeping back straight, lean forward until a stretch is felt in the back of the thigh. Switch sides. Groin/Hamstring Stretch: Sit with legs open like a V, shoulders back, abs in. Bending from the waist and keeping the spine straight, slide hands forward on the ground until stretch is felt. Try to relax with each outward breath. In later pregnancy, you can sit on a book to keep your stomach from hitting the floor. You can also stretch with a partner by sitting across from one another and grasping hands; one person leans back as the other leans forward. Stretch for Adductors: With feet wide, toes pointing out, squat down without letting heels come off the ground. (Hold onto a table for balance if necessary.) Place elbows inside knees and hands on the ground. Gently push knees outward until a stretch is felt. Try to do 5 kegel/pelvic floor contractions while in this position. Plantar Fascia Stretch: Standing on the edge of a step or stair, lower one or both heels down until a stretch is felt in the calf and/or foot. Calf Stretch: Stand facing a wall, arms extended, palms touching the wall. Step back with the right leg and bend the left knee, leaning into the wall. Keep arms on the wall with elbows straight,and back in a straight line. Inner Thigh Stretch: Sit on the floor with your back against the wall. Bend knees so that soles of feet are touching. Push knees towards floor until a stretch is felt in the inner thigh. Quadriceps Stretch: Stand up straight, holding on to a table or wall with your left hand. With your right hand, grasp your right ankle or foot behind you. Keep back flat and abs pulled in. Hip Flexor Stretch: Kneeling on the floor, place your right leg on the floor in front of you (similar to a lunge position). From here, pull in your abs, and lean your torso forward until you feel a stretch in the front of your left thigh. Switch sides. Chest Stretch: Stand in a corner or doorway, place hands at shoulder height on wall/door frame, and lean forward until a stretch is felt across the chest. Strength Exercises Do 1-3 sets of 10-15 repetitions. If an exercise requires you to lie on your back, only do so in the 1st trimester. During the 2nd and 3rd trimesters, you can perform supine exercises while lying on either an incline or a stability ball. Pelvic Tilt: You can perform this exercise lying down, seated, standing, or on hands and knees. While exhaling, use your abs (not your butt) to tilt your pelvis backward, by pulling your stomach towards your spine, decreasing the curve in your low back. Inhale back to neutral. Kegels: Pelvic floor contractions!! Side-Lying Leg Lift: Lie on your side on the floor, legs stacked, abs pulled in toward your spine. Lift top leg toward ceiling with toe pointed slightly upward to work the outer thigh and quad. You can also lift the bottom leg to work the inner thigh. Add ankle weights to increase intensity. Trunk Stability: On hands and knees, tighten stomach and keep back flat. Lift right arm and left leg off the floor, until parallel to floor. Switch sides to complete one rep. Chair Squat: Hold onto a chair for balance, keeping feet flat on floor, shoulder-width apart. Squat as low as you can comfortably, keeping knees behind toes. Add hand weights to increase resistance, or let go of chair and raise hands above your head for a bigger challenge. Lunges: Lunge forward, to the side, or backward, keeping foot in line with knee. Do not let knee travel past your toes in front. Return to standing and repeat on other leg. You can add a forward or overhead punch holding 3-5 pound dumbbells to increase the challenge. Wall Squat: Stand with back against wall (or with back on ball against wall), feet out in front of you, shoulder- width apart. Slide down wall so that knees are at a 90-degree angle (less if you have knee pain). Hold for 5-10 seconds the return to standing. Do not let your knees come forward in front of your toes. Step-Ups: Place foot on a stair or foot stool 4-8 inches tall. Shift weight and use the strength of the leg on the step (without pushing off the back leg) to raise yourself up. You can increase difficulty by placing 3-5 pounds weights in hands, or try a lateral raise or punch with arms while stepping up. Front Arm Support (Plank): On hands and knees, extend one leg behind you, then the other leg so you are in a push up position, keep back flat and abdominals pulled in. Hold 5 seconds and return one leg at a time. Wall Push Up: Stand in front of a wall. Extend arms slightly wider than shoulder width to touch the wall. Lean into wall bending elbows, performing a push-up. Try to keep heels flat on ground so you also get a stretch in your calf. You can progress to kneeling push ups on the floor, then full push up (on toes) if able. Seated Row with Band: Sit on the floor, legs extended in front of you. Wrap the center of a resistance band around your feet and grasp handles in each hand, arms extended in front of you. With abs in and back straight, squeeze shoulder blades together as you pull your arms back, bending at elbows. Return to starting position. Forward and Lateral Raises: Stand holding weights 3-5 pound weights. Keep abs pulled in tight and palms facing down. Raise arms out to the sides (laterally) or to the front, up to shoulder height. You can progress to standing on one foot to challenge your core. These are a few great ways to get in shape at home. Only perform the exercises that you feel comfortable with, and mix them up often. Pick 3-4 exercises from each group (stretching and strengthening) for each workout. Dumbbells and exercise tubing are relatively inexpensive—but make a great investment. You can use anything for resistance—a can of soup, a water bottle—so no more excuses! Exercise is too important for the health of you and your baby A quality class will help you discover what options are available and how to achieve the kind of birth experience you and your partner hope to have. Childbirth Education Association 513-661-5655 The Childbirth Education Association of Cincinnati was established in 1950 as a non-profit organization dedicated to preparing couples for the birth of their baby. Our group of Registered Nurses and Registered Dieticians provide comprehensive childbirth preparation. Our classes are designed to meet your individual educational needs. Topics include nutrition, breastfeeding, comfort techniques for labor, the role of the labor partner, exercises during pregnancy, hospital procedures, and special situations, including Cesarean birth. While there are a number of childbirth classes available, CEA classes are comprehensive, in-depth and focused on preparation.