Advise to allergy-prone and anaemic women who are also pregnant

Allergies and Anaemia during pregnancy

While some allergy-prone women enjoy welcome relief during pregnancy, others may find that they’re worse-off than before. Don’t confuse nasal congestion or a ‘stuffy nose’ with allergies. This common pregnancy phenomena is caused by higher oestrogen levels that affect the lining of the nasal passages, causing them to swell and make more mucus. Pregnant women are also known to struggle with certain food, dust, pollen, animal-fur and tobacco smoke allergies. It’s best to avoid the cause – but this is not always practical.

While most allergies are inconveniently uncomfortable, they don’t affect the baby. However, severe allergies that are associated with breathing problems, asthmatic attacks or anaphylactic shock (e.g. bee, wasp or penicillin allergies) are problematic. Women with these types of allergies should tell her doctor at her first visit. She should also wear an allergy-alert bracelet and keep anti-histamines with her at all times.

It’s not a good idea to take over-the-counter (OTC) antihistamines, or any other non-prescribed medicines during pregnancy. Ask your doctor for a script or to speak to your pharmacist. OTC homeopathic remedies are also helpful, but do see a homeopath first. In this way, you will get the correct dosage and mix of tinctures for your needs. 

Can you pass these allergies on to your unborn baby?

While babies can inherit allergies from their parents, they won’t become allergic during pregnancy because allergy immunoglobulins don’t cross the placental barrier. While some literature suggests that pregnant women should avoid eating highly allergenic foods like peanuts and dairy products, this has not been scientifically proven. I asked Roxanne Smith, a dietitian at Wits Academic Training Hospital, Johannesburg, if there is any evidence to support this theory. Here’s what she told me.

“Maternal dietary allergen exclusion during pregnancy has been proposed as a potential strategy for reducing allergy risk in offspring, but the available data does not support any beneficial effects. Similarly, exclusion of allergenic foods by lactating mothers has not been shown to have any beneficial effects on the development of allergenic diseases. Because maternal exclusion diets can lead to inadequate supply of certain nutrients, and they have shown no beneficial effects, they are not recommended.”

I asked Roxanne what is recommended.  

“There is new evidence that eating fish oil during pregnancy and breastfeeding can reduce the risk of allergies in children. While there is no strong evidence for fish oil supplementation, pregnant and lactating mothers are advised to eat at least two portions of oily fish per week. Examples of oily fish include sardines, pilchards, herring, mackerel, salmon, and trout.”

Breastfeeding (for at least six months, a year or even longer) is undeniably the best way to protect your baby from allergies.

I asked Roxanne about allergies and intruding solids.

“Very early introduction of solid foods (before six months) can increase the risk of eczema and food allergies in infants, while no protective effects have been shown when foods are introduced after six months. Introducing allergenic foods (eggs/cow’s milk/fish/wheat/ peanuts/soy) after six months also doesn’t show protective effects. For all babies, regardless of familial allergy risk, complementary foods should not be introduced before the 17^th week of life, or later than the 26^th week of life, with continued breastfeeding.”

Anaemia

Anaemia means not having enough oxygen-carrying red blood cells. Red blood cells are made in the bone marrow of large bones and live for about 120 days. The body needs iron (mainly from the diet, but also from broken-down red blood cells) to make new red blood cells.

Anaemia can be a problem for pregnant women from about 20 weeks onwards, especially if she is not getting enough iron from her diet, or has insufficient stores to make new red blood cells. Women with chronic mild anaemia caused by heavy periods, will enjoy welcome relief from this problem in early pregnancy. But, from 20 weeks onwards, there’s a surge in blood production to satisfy the needs of the baby and to prepare the woman’s body for the birth, and this when anaemia can occur.

What are the symptoms?

Women look pale, feel weak and tired, experience heart palpitations and feel breathless when walking, exercising or climbing stairs. Women with serious morning sickness, those who are pregnant with twins (or more) or women who are frequently pregnant, are at risk of becoming anaemic.

 

How can you avoid becoming anaemic?

To make new red blood cells, the body needs iron. It’s for this reason that all women are prescribed iron supplements during pregnancy. These however, can make constipation worse, so take them with lots of water.  Molasses contains natural iron and a number of other minerals and doesn’t cause constipation. Drink a teaspoonful in a cup of hot water every morning. Eat more food that’s rich in iron e.g. meat and liver, sardines, dried fruit and green leafy vegetables. Vitamins that help with the absorption of iron are B12, and vitamin C.

Ascorbic acid helps the body to absorb iron from the diet. I asked Roxanne how combining foods can boost iron reserves.

“Take your iron supplements with a glass of orange juice. The vitamin C will help with the absorption of iron. It’s best to take iron on an empty stomach, but if this makes you feel sick, take with a small amount of food.

Iron absorption is inhibited by calcium, caffeine, and tannins. It’s important that you do not take iron and calcium supplements at the same time, and do not take iron supplements with a glass of milk. It’s also not a good idea to drink iron supplements with coffee or black tea, but rooibos tea is fine.”

The art of making sandwiches

The humble sandwich.

Sandwiches are the food of life. I learned this when I went to boarding school. Mid-morning, we were given a mug of fresh farm milk and a brown-bread jam (jelly) sandwich. It was the only food of the day that I enjoyed. When my parents bought a caravan-park on the beachfront, my sister and I went back to day school. Here our restaurant chef made the best cheese and tomato sandwiches, and I was the envy of my friends at school. To this day, cheese and tomato sandwiches are my favourite.  

In high school, Mom delegated me the task of making the school-lunches. This sealed my friendship with sandwiches for life.

The history of the sandwich:

Apparently, our ancestors made their plates from bread. They put meat and vegetables onto their bread-plates and ate it with their fingers (sounds delicious – a bit like our ‘banya’ or ‘bunny-chows’). Then along came rabbi Hillel the Elder who mixed some nuts, apples and spices with wine, put it between two pieces of matzoh’s (unleavened bread) and wrote down the recipe. But it was the eighteenth-century English aristocrat, John Montagu, the fourth Earl of Sandwich who gave the ‘sandwich’ its name. A notorious gambler, he became annoyed when his gambling was interrupted because he had to leave the table to eat his supper. He told his valet to bring his meat tucked between two slices of bread so that he could eat with one hand, and carry on gambling with the other. Soon his friends were also calling for a ‘Sandwich’. The rest is history.

  

Tips on how to make delicious sandwiches:

The secret of a successful sandwich is to combine a variety of flavours and textures for your taste-buds to enjoy.

Use only fresh bread. Open sandwiches can be made with a variety of herb and rye breads. Old bread can be toasted, used for a quiche base, or cubed and fried in butter for crunchy croutons.  

 

Use butter if you’re not on a tight budget. Butter or easy-to-spread bread margarine seals the bread so that the filling doesn’t make the bread soggy. For extra flavour (or when you’re feeding a crowd), mustard, onion or garlic salt, or marmite can be added to the butter before spreading. Spread the butter/margarine thinly and evenly over the whole slice, including the corners.

Mayonnaise, creamy salad dressings, cream cheese, mashed avocado or banana can be used as a binder and moisturiser to make spreading easier. These also enhance the flavour.

Savoury sandwiches:

Meat:  Cold meats e.g. ham, beef, lamb and any sandwich loaf can be combined with sauces e.g. Worchester, tomato, sweet ‘n sour, ‘HP’, mint sauce with lamb, mustard with cold beef or chopped pickles e.g. gherkins, onions or ‘chakalaka’. Finely sliced or grated biltong (dried meat or jerky in the US) makes a tasty sandwich filling.

Chicken: Can be combined with a vegetable or mayonnaise

Liver Paste: On its own or with tomato sauce or freshly sliced tomato with finely chopped spring onions or chives.

                 

Hard boiled eggs: Mash and moisten with mayonnaise. Enhance flavour with onion or garlic salt, plain salt and pepper, coriander, Italian or mixed herbs. Add crunch with finely sliced lettuce leaves, radishes, chopped onion or grilled bacon.

    

Fish: Tinned pilchards, sardines or salmon mixed with mayonnaise and or tomato sauce with a hint of fresh onion makes a tasty filling. Smoked trout or salmon is pricy but worth it for the accolades, especially on an open sandwich made with sliced French loaf.

Vegetables: Mashed potato with mayonnaise and chopped spring onion or chives makes an interesting ‘potato salad’ sandwich. Add a slice of cold beef for a satisfying lunch sandwich.

Mashed avocado pear with a squeeze of lemon juice to prevent browning mixes well with just about any filling.

Lettuce, radishes, chopped spring onion, celery or chopped chives enhances the flavour of any filling as do chopped salted nuts e.g. cashew, almond or peanuts.

Cheese:  All varieties, flavours and cheese consistencies are suitable for open, closed and toasted sandwiches.

Sweet sandwiches:  

      

Children prefer sweet sandwiches. You can add nutritious ingredients to enhance school lunches. Some examples are dates and raisons, chopped stewed fruit or Christmas mincemeat with cream cheese. Peanut-butter and jam (or syrup). Peanut butter can be combined with chopped grilled bacon bits for a different combination. Try marmite and chutney with a few slices of fresh tomato and some grated cheese.

Stale bread makes the best toast. Very thinly sliced and toasted under the griller makes delicious melba toast – a handy standby starter. Here’s the recipe for a quiche you can make from an old bread roll or the left-overs from a French loaf.

You need:

Medium slices of bread

2 eggs

1 cup milk

Filling e.g. spinach, cheese, bacon, sliced German Vienna’s, cooked asparagus or sliced ham.

You do:

Butter a shallow pie dish. Put the oven onto 180⁰C/ 350⁰F. Arrange the slices of bread, mix 1 egg with about ⅟₂ cup milk and leave to soak. Prepare your filling using the ingredients of your choice and add another egg with the remaining milk. Add this to your bread base, and pop into the oven.  Bake for about 30 minutes or until the tester comes out clean and it looks brown and delicious. Serve with a fresh tossed salad.

Enjoy!  

How to prepare for labour

Let’s talk about labour.

Magazines and baby-books tend to sweet-talk labour and encourage women to write a ‘birth plan’ as though they’re going on holiday. What you’re not told is that childbirth is unpredictable, hard work (that’s why they call it labour) and that you need to prepare your mind, body and soul for this marathon event in your life. (P.S. ‘birth plans’ fly out the window the minute you step into a maternity unit).

What can you do to prepare for labour and birth?

Get your body ready. There’s a reason why mother nature restricts childbearing years to between menarche and menopause. A younger woman is naturally fit and healthy – not only to carry a pregnancy through to 40 weeks, but also so that she has the physical strength to push her baby through the birth canal, breastfeed and survive to rear her child.

Get your mind ready. Tokophobia is the fear of giving birth. Most women are afraid of labour. They will tell you that they don’t like hospitals, needles and drips and the smell of disinfectant. Their senses ring alarm bells. Hospitals are a place of pain and suffering. Fear blocks happiness hormones, and this anxiety can interfere with labour by slowing down contractions. Side-step these anxieties by bringing a birth-partner (a doula, girl-friend or your baby’s father) establishing a trusting relationship with your doctor or midwife, and going on the ‘hospital tour’ when booking your bed so that you’re familiar with the hospital setting, and you’ve met some of the staff.

Get your soul ready. Keep telling yourself “I can do this”. You, your spouse and your baby are unique. You can’t anticipate what your birthing experience is going to be like – even if you have been through it before. Expect the unexpected. Live, breathe, move the moment. Connect with your baby. Pray. Sing. Humm. Moan. Move. This will help your body release endorphins – nature’s natural morphine – that sends you into another realm and separates you from fear. These hormones make you strong and help you to work with, and not against, your contractions. Connect with your baby who sleeps while you’re in labour, trusting you, waiting like an astronaut to catapult into this world.

This is how women have been giving birth for eons. This is how women who don’t have sophisticated medical services give birth. This is how midwives used to deliver babies in their communities. I remember doing voluntary work during my holidays as a student midwife in a little clinic in the heart of a township. The roads were mud when it rained, the tin shacks freezing in winter and burning hot in summer. Some of the better houses were made from red brick with plain cement floors. They were meticulously clean and smelt of paraffin, lifebuoy soap and candlewax. Tables were covered with newspaper and shelves decorated with newspaper cut into patterns. Invariably there was a gaggle of women chatting and drinking tea in the tiny kitchen with a menagerie of children running around the yard when Sister Brenda and I arrived with our little suitcase of ‘goodies’ to deliver the baby.

Many years later when I ran a series of workshops for teachers for the Department of Education on how to talk to teenagers about sex, one of the ice-breakers was to get the teachers to share what they were told where babies came from as children. While some said believed that babies came from aeroplanes, many had the impression that babies were brought by the midwife in a little suitcase!

Trust your instincts. They’re stronger than you realise. You are a creature of the universe, descended from millions of years of genetic and epigenetic inheritance, cut and spliced to fit into 23 pairs of chromosomes. You’re passing these onto the next generation. Be proud. Walk tall. You CAN do this!  

       

Nurturing good genes in your children

School report cards

We’re in the throes of packing up to move and there’s a lot of giving away and throwing out to be done. I came across a tattered brown envelope where my dear mother had kept all my school records. Report cards, music exams, scholar patrol, eisteddfods, first Holy Communion and even an agricultural certificate – my introduction to environmental consciousness 54 years ago when I was 10.

It was interesting reading about me through older eyes. I realised that it was a good education that helped me to be successful in later life. My marks in maths and science were consistently low, but when it came to English, music, art, handwork and religious instruction, I scored pretty well. In high school my English teacher once remarked that I was good at writing, and that it would take me far one day. But she also lamented that my spelling was atrocious and begged me to read more.

Recent epigenetic research (a branch of genetic studies) emphasises the importance of our genetic inheritance and the influences of our internal and external environment. Our external environment includes nutrition, chemicals, toxins etc while the internal environment means neuropeptides (emotional molecules) and stress hormones. According to Dr Lauren Wilson (read more about this on www.motherjourney.com) ghosts of our ancestors live in our DNA and this influence affects not only our generation, but future generations too. Who and what we are today will be carbon-copied in some small way onto our grandchildren, great-grandchildren and many, many more generations to come.

Genetics and epigenetics pave the way for future generations. Parents give their children a good start in life by instinctive selection of a mate with good genes. They keep their children healthy with good nutrition. They teach them skills, about life and how to survive. It’s instinct. Nobody has to tell parents to do this.

Right now, your children won’t thank you for disciplining them at school and at home to pay attention, do their homework, respect their teachers and always do the best they can. But they will thank you one day when they appreciate what you did for them when they were young. What you do for your children today, they’ll do (even better) for your grandchildren one day.

Six months pregnant: advice for labour and breastfeeding

Pregnancy files: The last trimester

Pregnancy is divided into three groups of three months each. The first three months (or first trimester) is the ‘taking-in’ or getting used to the idea of pregnancy and motherhood stage. Hormones are adjusting, emotions swing from excitement to terror and your body adapts to the needs of your growing baby. Your second trimester is the ‘holding-on’ or ‘honeymoon’ phase when hormones and emotions have settled down and you feel special carrying new life. The third trimester is ‘letting-go’ which means preparing your body for your baby’s exit and independence.

Motherhood is not just about giving birth. It’s a life-long commitment. From now on, preparing for it is serious business. Breastfeeding takes determination and commitment. Labour is hard work. Getting ready for this mammoth task takes the dedication of a marathon runner.  Ante-natal (or Lamaze) classes can help you do this. Google to find a qualified midwife or physiotherapist in your area.

Classes must include an exercise routine that you can follow every day. Unlike regular exercises, ante-natal exercises are geared to strengthen muscles of your spine and pelvis when your heavy womb puts extra strain on them, and teaches you to use the muscles you will need to give birth. The exercise routine will not get harder either – it will slow down as your body becomes more cumbersome closer to your delivery date. At my ante-natal classes at our local community centre, I encouraged couples to bring a few pillows and a little toy, and to wear comfortable leggings. The idea of the toy was distraction and happy association. Moms put the little toy on their tummies during breathing exercises and focused on it while practising contraction-coping breathing techniques. The classes were fun and the couples became friends. On labour day, moms took the little toy with them and used it as a happy distraction. Try it. It really works.

Ante-natal exercises strengthen internal muscles you never knew you had. Do them to your favourite music. Finish up with relaxation, deep breathing and focusing on your baby.

You may also notice a bright yellow liquid glistening on your nipples. This is colostrum – your baby’s first milk – so don’t panic. Get used to handling your breasts by massaging them in the bath. Soap your hands and cup your breast with one hand while stroking it from the base towards the nipple with your other hand. If you feel any lumps, simply massage them away. Keep your nipple dry and support your breasts at night with a sleeping bra. Wear a well-supporting bra during the day. If you need to buy a bigger size, look for the breastfeeding type. It will save the expense of having to buy these later on.

Eat healthy too. This in not the time to diet or to indulge in chocolate cake. Your baby’s brain is growing at a phenomenal rate and will be equipped with most of the neurons it will ever need by the time your baby is born. That’s why your baby needs the best nutrition you can give. After the birth your baby’s brain will keep growing, so that by the time he is six, his brain will be nearly adult size. 

Good reason why you should strive to give your baby the best start in life.