[A]

Pregnancy Do's and Don'ts: The Smart Woman's A-Z Pocket Companion for a Safe and Sound Pregnancy
by Elisabeth Aron, M.D.

For when you need the facts — not fear — about what food, drinks, activities, and procedures you should avoid during each month of your pregnancy.

Over the years, Dr. Elisabeth Aron has soothed the worries of many soon-to-be moms who have come to her with questions such as:

• Can I exercise during my first trimester?
• Is canned tuna safe to eat throughout my pregnancy?
• Do self-tanners contain chemicals I should be worried about?
• I have to fly for work during my second trimester. Is this safe?
• Is cookie-dough ice cream safe to eat?
• Can I wear an underwire bra during my pregnancy?
• I'm six months pregnant. Is it alright for me to have a glycolic peel facial?
• Are peanuts safe to eat or will my baby develop a peanut allergy if I eat too many?
• There is a lot of chlorine in my health club's pool. Is that a good or bad thing?

Pregnancy Do's and Don'ts includes hundreds of entries on possible concerns — from apple cider to zinc and everything in between. In each entry, Dr. Aron identifies the item, the possible cause for concern, and explains the bottom line — whether it is something a woman should avoid completely, something to take a better-safe-than-sorry approach toward, or something that is perfectly fine.

Chapter 1

Accutane® See Isotretinoin.

Acetaminophen

Acetaminophen, also known as Anacin-3(r), Datril(r), Panadol(r), Tylenol(r), and Valorin(r), is an over-the-counter pain medication (see Pain relievers) and fever reducer. It is an ingredient in numerous cold and flu remedies (see Cough and cold suppressants).

Concerns: A scientific study noted a link between high (almost everyday) acetaminophen use in the third trimester of pregnancy and wheezing and asthma in children. There was no link with average or high use prior to 20 weeks of pregnancy.

Acetaminophen has been assigned a pregnancy risk factor category of B (see Appendix 1). Although controlled studies have not been performed on humans, there is no evidence that taking an occasional acetaminophen or two during pregnancy causes any problems. Further, a prolonged high fever in pregnancy could cause problems for the baby, so you should always try to bring a fever down with acetaminophen.

The bottom line: Acetaminophen is considered to be the safest pain reliever and fever reducer in pregnancy. It is viewed as the pain reliever of choice in pregnancy.

Acidophilus

Acidophilus is a nutritional supplement that contains the bacteria Lactobacillus acidophilus. Many people think that the bacteria aid in digestion and play a role in keeping our immune systems healthy. Acidophilus can be taken orally as a capsule or powder, or is present in some brands of yogurt (see Yogurt). It is also available as a vaginal suppository to treat yeast infections.

Concerns: Because acidophilus is categorized as a food supplement, it is not regulated by the U.S. Food and Drug Administration. Thus, there is no guarantee of the strength, purity, or safety of this product. If you are experiencing a pregnancy complication, you may want to avoid vaginal suppositories. It is a good idea to inform your health care provider if you are taking any nutritional supplements.

The bottom line: Some studies have observed beneficial digestive effects from taking acidophilus by mouth or using it in a vaginal suppository to treat vaginal yeast infections. Acidophilus may also aid in the treatment of chronic diarrhea; however, its usefulness in other conditions is unclear. Acidophilus appears to be safe in pregnancy.

Acrylic nails

Acrylic nails are artificial nails created by a liquid monomer and a powdered polymer that are combined to form an epoxy. The mixture is then shaped and applied over the natural nail or to a plastic tip that has been glued to the nail. The result is a strong, natural-looking nail that can last for several weeks.

Concerns: Because most manicurists find it necessary to wear face masks to avoid breathing in fumes, many pregnant women have concerns about having this treatment and about visiting salons where this treatment is performed. It is also known that some chemicals can be absorbed into the natural nail itself.

No studies have been performed that deal specifically with acrylic nails and pregnancy, but the U.S. Food and Drug Administration has deemed one ingredient used in acrylic nails, methyl-methacrylate (MMA), a health hazard due to the potential of allergic reactions and asthma exacerbations. Be sure to ask your salon if this chemical is used on the premises. Stay clear of any salon that still uses MMA, regardless of pregnancy status. The ingredient ethyl-methacrylate (EMA) is a safer alternative.

The bottom line: If you are worried, avoid the treatment outright while pregnant. Make every effort to limit potential effects by waiting until after the first trimester, when there is less risk to the development of the baby's organs; go to a well-ventilated salon; visit earlier in the day when there are less fumes; consider wearing a mask; and avoid getting chemicals on your skin.

Acupressure

Acupressure is a less invasive form of acupuncture (see Acupuncture) that uses thumb or finger pressure, in place of needles, to balance or correct the internal flow of energy. Acupressure has been used to decrease the symptoms of morning sickness, turn breech babies, and reduce labor pains. A typical session can last from 30 minutes to 1 hour.

Concerns: Several studies have looked at the effectiveness of acupressure to relieve or reduce symptoms related to morning sickness. Wristband acupressure has been shown to safely relieve or reduce the symptoms of morning sickness. This technique can be applied by a provider, by oneself, or through the use of elastic bands. Some acupoints are thought to help speed or induce labor, and reasonable care must be taken prior to being full term.

The bottom line: Based on recent scientific studies, acupressure does seem to have some usefulness during pregnancy, especially to control nausea. There is no scientific literature indicating that acupressure has been harmful to a pregnancy.

Acupuncture

Acupuncture is based on the traditional Chinese belief that health depends on a balanced flow of life energy, or qi (also spelled chi). To correct any imbalances, acupuncture needles are placed into acupoints, which act to correct the flow of qi and to redirect the flow of energy to affected areas. Traditional Chinese medicine has used acupuncture for thousands of years to reduce pain during childbirth. More recently, scientific studies have examined the usefulness of acupuncture for infertility, nausea, back pain, carpal tunnel syndrome, turning breech babies, postpartum depression, and the induction of labor.

Concerns: Most traditional western OB/GYNs have a limited knowledge of acupuncture and are not likely to recommend its use during pregnancy. Concerns over how it works and the safety of sticking needles into the body have contributed to recommendations to avoid acupuncture during pregnancy. Practitioners of acupuncture caution against overuse throughout pregnancy due to concerns about overstimulation of the fetus. They also suggest avoiding certain acupoints that may stimulate premature labor in the first and second trimesters.

The bottom line: Based on recent scientific studies, acupuncture does seem to have some usefulness during pregnancy, especially to control labor pain, back pain, and nausea, and to increase the success of in vitro fertilization. However, because some acupoints are thought to induce or help speed labor, reasonable care must be taken to avoid these acupoints prior to 37 weeks. There is no scientific literature indicating that acupuncture is harmful during pregnancy. Be sure you visit a licensed or certified acupuncturist. Requirements vary from state to state, but you can learn more through your state's medical board or health department.

Adderall®

Adderall® is a brand name of amphetamine (see Amphetamines).

Adrenaline Rush®

Adrenaline Rush® is a brand name of an energy drink (see Energy drinks).

Advantage®

Advantage® is a brand name of animal flea medication (see Flea and tick medications).

Advil®

Advil® is a brand name of ibuprofen (see Ibuprofen; Pain relievers).

Air conditioners

Air conditioners lower the air temperature in an enclosed area.

Concerns: Some people notice increased allergy symptoms when using air conditioners during the summer months, which is often due to nonfunctioning air filters. A simple way to avoid this is to maintain the unit properly. Replace filters according to the manufacturer's suggestions; some manufacturers recommend as often as once per month. Air conditioning can also exacerbate the dry skin you may experience during your pregnancy. To help with this condition, consider using a good moisturizer and humidifier.

There has also been some publicity about the association of Legionnaire's disease outbreaks with air conditioners. Legionnaire's disease is caused by a bacterium called Legionella pneumophila, which lives in warm-water environments, such as those found in air conditioners, plumbing systems, and humidifiers. It is estimated that 8,000 to 10,000 people contract Legionnaire's disease every year. However, it is often difficult to diagnose the disease accurately because symptoms can vary from person to person. Unless a doctor specifically suspects Legionnaire's, the appropriate tests are often not performed. The disease is most dangerous to those who have a weakened immune system due to cancer therapy, smoking, or organ transplants. Pregnancy does not appear to be an increased risk factor for getting this disease. While the U.S. Department of Labor's Occupational Safety and Health Administration has standards in place for work-related systems, it is unclear how many cases of Legionnaire's disease are acquired in private homes and what the optimal methods of prevention are. Proper maintenance of all plumbing systems, air-conditioning systems, and humidifiers should minimize your risk of contracting this disease.

The bottom line: A well-maintained air conditioner is safe in pregnancy.

Copyright © 2006 by Dr. Elisabeth Aron. Excerpted by permission of Broadway, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

About the Author

Dr. Elisabeth Aron is an award-winning, board-certified specialist in obstetrics and a senior clinical instructor at the University of Colorado's Department of Obstetrics and Gynecology. She lives in Fort Collins, Colorado.