What’s the world coming to?

A woman gives birth to a 17 pound and one ounce baby….

Women contemplate artificial insemination….like Carolyn on the HBO hit Tell Me You Love Me…

The phrase “eating for two” seems ingrained in the minds of pregnant women around the world….

And doctors struggle to find the optimal amount of weight gain during pregnancy that will promote health for the baby and a successful and complication-free pregnancy for mom.

Almost two decades ago, the Institute of Medicine, a major medical authority in the US, developed guidelines concerning the recommended amount of weight women of varying body types should gain during pregnancy.  These guidelines seemed simple enough and have been used for years to guide expectant mothers and their doctors.  Even during my pregnancy, I found myself pouring over all the information I could about healthy eating, exercising during pregnancy and nutrition. 

I had what seemed like thousands of questions about my pregnancy.  What types of food should I avoid during pregnancy?  How much exercise is recommended during each trimester of pregnancy?  Can I still exercise during my third trimester of pregnancy?  How much weight should I gain each trimester?  How can I prevent from getting those all-too-common stretch marks on my ever-expanding belly? 

And to go along with those thousands of questions, came even more words of advice, recommendations and suggestions from family, friends, colleagues and let’s not forget the random strangers who thought nothing about coming up to me, extending their hand and commence talking to me like we’ve known each other for years as they rubbed or patted my belly.  How many times have you heard or even advised someone else that “they’re eating for two now”….that “they can now eat anything they want”….that “you have free reign when it comes to eating”? 

Don’t be embarrassed…we’ve all done it before.  But it’s NOT the truth.  Expectant mothers are NOT eating for two.  And if you or someone you know believes that they are eating for two…the only “two” you’ll see is the “two of you” years later after you’re still struggling to lose that “baby weight”.  

The news article about the Siberian woman who recently gave birth to a 17 pound and one ounce girl failed to mention the weight of the mother, who at the age of 43 had given birth to 11 other children…all born in excess of 11 pounds!  How much total weight did she actually gain during her pregnancy to have given birth to a 17 pound baby!

I can only surmise that her eating habits…which consisted largely of carbohydrates…was more out of a sense of survival and not gluttony but she did report that she “ate everything.”   Everything in the Western world would consist of all the McDonald’s, pizza, ice cream and bon-bons that you can find or that you can get someone to run out in the middle of the night to buy. 

The Institute of Medicine’s recommendation that underweight women gain 28 to 40 pounds during pregnancy, normal weight women aim for 25 to 35 pounds and overweight women try to keep their weight gain between 15 and 25 pounds while obese women aim at gaining no more than 15 pounds has been the measuring rod for almost 30 years.  The Institute’s main goal for initiating these guidelines was to lower the risk of women having low birth weight babies.  And they’ve succeeded….or so why think? 

Instead of reporting the world’s smallest baby….we’re hearing about the world’s largest baby.  Many women are now exceeding these recommended weight guidelines and are gaining substantially more weight during their pregnancy, resulting in poorer health outcomes for both the baby and mother.  Overweight babies are at risk for birthing complications such as shoulder dislocation or deformities during attempted vaginal delivery and mothers of overweight babies are at risk for developing gestational diabetes and high blood pressure. 

Doctors, women’s magazines, medical journals and even the internet are taking a stand to get the message out to women that “eating everything” and “eating for two” can be costly to their overall health and the health of their unborn child.  The Institute of Medicine is even contemplating revising their pregnancy weight gain recommendations in response to this growing obesity trend. 

But until then, we have the current pregnancy weight guidelines and hope that the next news bulletin won’t report that the Guinness World Record for the largest baby at 22 pounds and 4 ounces has been broken. 

To your (and your baby’s) wellness,
Dr. Traci Ferguson, The Health and Wellness Queen 

P.S.  If you want to stay healthy before, during and after pregnancy, check out The Backyard Workout Manual that you can do in the comfort of your home or backyard. 

When my close friend called me at work to say that my 17 month old son was congested, with a runny nose and slight fever, I knew she was calling to find out what she should do.  She loves Rufus like her own and realized that although I was at work, I’d want to know what was going.  Rufus had recently spent time at daycare several days earlier and he most likely picked up a virus. 

A viral illness may cause fever— even a high fever, cough, a sore throat, runny nose and congestion but it’s self-limited and doesn’t require much, if any medication. 

So I wouldn’t go for the overkill.  He needed something….he was getting fussy and irritable and wasn’t feeling well at all.  He had taken liquid Tylenol on occasion  since the age of 6 months at his pediatrician’s suggestion after getting his routine immunizations so I knew Rufus could tolerate a dose of acetaminophen if needed.  Tylenol would be a good and safe option.  So I recommended that she buy infant’s Tylenol and give him one dropper full—a single dose. 

With the virus spreading throughout the house from Rufus to me and on to my husband, I headed to the pharmacy several days later to pick up some over-the-counter cold medication for myself.  As I walked down the cold remedies aisle, I was struck by the overwhelming number of choices for children and adults from acetaminophen and ibuprofen-based products for fever and pain relief, dextromethophan or guaifenesin-based medications for cough relief to pseudoephedrine for decongestion. 

I spent over fifteen minutes searching the aisle looking for the exact combination of components that would control my symptoms without adding extra medications that I didn’t need like chlorpheniramine or diphenhydramine/Benadryl which causes drowsiness.  I finally settled on a cough syrup containing a decongestant.  After getting my medication, I wandered over to the children’s section just to see what was available. 

Even as a physician, I found it difficult to sort through all the medication combinations and became brutally aware of how easy it would be to get confused or unintentionally give more than the recommended dose of medication to your child…especially if your child has multiple caregivers.  Say for example, your babysitter gives your child a dose of cold medication right before you pick him up.  You forget to ask her when your child last received his medication and then within two hours you give him another dose…virtually giving him a double dose of medication within a short period of time. 

Most of the time a single extra dose of medication won’t kill him but in some instances it might.  If your child has continued to receive multiple extra doses over a course of several days, one additional dose may be toxic and lead to serious complications and even death. 

The Food and Drug Administration has received numerous reports of serious events and death related to cold medicine preparations in children and in response to these reports issued a public advisory regarding over-the-counter cough and cold medications for young children. 

These guidelines are useful for parents and caregivers and especially for physicians who often advise their patients on how to treat the common cold in children: 
 

1. Cough and cold medications should not be used in children under the age of 2 unless directed by your doctor.  Rufus had been advised to use Tylenol as needed after receiving his vaccinations to his prevent a post-immunization fever and help relieve any discomfort at the vaccine site.
2. Cold and cough medications intended for use by adults should not be used by children.  In other words, if you don’t have Children’s Tylenol in your medicine cabinet but you have adult cough syrup, DO NOT try to substitute this for medication designed especially for children.  Even in smaller quantities, the adult formulation may still be too potent and too strong for your child.
3. Use the packaged measuring device to administer the liquid medication.  DO NOT use a household teaspoon or tablespoon to estimate the dose.  You may inadvertently given significantly more than the intended dose.  And if you don’t have a measuring device, BUY ONE before you leave the store.
4. If your child’s condition doesn’t improve or worsens, stop using the medication and contact a doctor immediately.  
5. And the fifth guideline is from me, Dr. Traci, the Health and Wellness Queen:  Keep a running log of when your child has received his last and is due for his next dose of medication.  Make sure you alert all of your caregivers concerning your child’s medications, either prescription or over-the-counter.  This log will avoid over dosing or missing doses.  Good communication between caregivers is the key to keeping your child safe when fighting a cold.

To safely treat the common cold, be smart and use over-the-counter medication only as directed.

To your wellness,
Dr. Traci Ferguson, The Health and Wellness Queen.

Life in the Big Apple…

This past weekend my husband and I lived life in the fast lane on a weekend getaway trip to New York City.  For those of you who haven’t traveled to the NYC lately, there’s a new “Zero trans fat” law that went into effect this summer which mandates that all restaurants prepare foods using “0 trans fat” ingredients.  This new law is a victory for everyone especially for those who follow a heart healthy diet. 

Trans fat can significantly increase your bad cholesterol, or LDL—and it has no nutritional value.  Unlike olive oil or canola oil, synthetic fats often used in fast food cooking that made McDonald’s fries famous, may make some foods “tasty” but with the fat come a worse cholesterol profile, excess calories and NO nutritional value. 

So without having to deal with trans fat, my goal during our NYC trip was to maintain my eating program….filling up on lean protein, fruits and vegetables with selective carbohydrates with the ultimate goal of keeping on top of my eating so that when I’d step back on the scale after the trip I wouldn’t be blown away with any additional pounds.

We spent our first evening in the Big Apple at a popular steakhouse where Coach Ferguson stuck to his guns and ordered steak tomatoes with mozzarella, drizzled with vinegar (but no olive oil) followed by a lean cut of steak and steamed broccoli.  I, too, passed on the warm bread, and chose the leanest cut of steak on the menu with asparagus and ended the meal with dessert….a small cup of fruit sorbet!  I said “NO” to crème brulee, cheesecake, ice cream, mousse and a chocolate soufflé…and instead, I selected a lighter dessert option to satisfy my sweet tooth and avoided all the unnecessary calories.   

I continued on my quest to experience all that New York has to offer without compromising my food plan or my waistline.  Breakfast at a corner café featured an egg white omelet with fresh vegetables and whole grain toast.  I passed over the stack of pancakes and French toast drenched in syrup for a high protein and fiber rich breakfast which held me throughout the morning.  After stopping by a local convenient mart and picking up some protein bars, we headed down Broadway to make the 2pm Theatre matinee.

Even after experiencing an amazing Broadway performance with The Color Purple featuring Fantasia, we’d continue our whirlwind tour of New York at the US Open in Tennis.  There was no Venus, no Serena, no Roddick, no Federer but there was amazing tennis to watch.  Seeded or unseeded, the men and women’s third round of play held our attention way past midnight before we caught the 1:08am train back downtown.  Having missed “dinner” in order to make the 7pm US Open start, it was close to 2 o’clock in the morning by the time we sat down to eat.  We ended the night at a 24 hour diner with….you guessed it…. an egg white omelet!

Mushroom and tomatoes, peppers and onions, or spinach and asparagus…..whatever your combination is, load up on veggies, stick with a low-fat cheese option (if available) and avoid extra fat and calories by eliminating sausage, bacon or ham from your egg white (or egg substitute) omelet and you’ll have a filling and heart healthy meal.

Whether you’re in New York City, Miami, Los Angeles or Suburbia, USA, you can enjoy life in all of its abundance by choosing healthy food options even when out on the town!

If we can do it….you can do it!

To your wellness,
Dr. Traci Ferguson, The Health and Wellness Queen