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Full Listing with story descriptions
A Healthy Balance
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From Surviving to Thriving
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Ask the Doctor
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My Doctor Says I Need a Test
Childbirth
Full Listing with story descriptions
Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
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Bleeding in Pregnancy
Breastfeeding Benefits
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Blue after Baby or Postpartum Depression
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Getting a latch on breastfeeding
Group B Streptococcus
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Planning a Pregnancy
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Postpartum Repetitive Strain Injuries
RH Disease
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Sex During Pregnancy
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Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
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When Baby Comes Home
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When to go to the Doctor
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Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
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Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
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Baby Bottle Tooth Decay
Baby Teeth
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A Healthy Mouth
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The Smile You Want
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Smiling through the Senior Years
Teeth for Life
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Tobacco Risks to Oral Health
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Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
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Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
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Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
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Blood Sugar Lows
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C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
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Diabetes and Thyroid Disease
Diabetes and Your Mouth
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Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
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Why Fad Diets Fail
Fats
Fill up on Fibre
Fill Your Day with Energy
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
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Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Keep Cholesterol in Check
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
Natural Health Products
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines and Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
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Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
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Carpal Tunnel Syndrome
Check-Up
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Do I Need a Bone Density Test?
Doctor Visit
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Family Doctor
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Food Poisoning
5 Ways to Stay Healthy
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Get Active!
Glare
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Human Papilloma Virus
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Medical Digital Technology
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Restore Your Core
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Win by Losing
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Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
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Emergency Care Guidelines
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Fainting and Convulsions
First Aid Travel Kit
Hypothermia and Frostbite
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Can I see Well Enough to Drive?
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Eating Well
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Get Active!
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Grief
Have Health, Will Travel
Health Tips for Seniors
Hearing
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Living Longer With Diabetes
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Male Menopause (Andropause)
Maintaining Quality of Life as You Age
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New Corneal Treatments
Nutrition for Seniors
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Seniors and Medications
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Skin Over 50
Solving Sleep Issues
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Travel Tips for Snowbirds
Wills and Personal Directives
Modern Living
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Abuse
Acupuncture
Adult ADHD
Aging and Memory
Alcohol and Your Health
Anger Management
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Barbecue Basics
Bathtub Safety
Binge Drinking
Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
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Depression
Diabetes Epidemic
Discipline
Diseases from Pets
Downsizing
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Erectile Dysfunction New Treatments
Exotic Travel
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Fetal Alcohol Spectrum Disorder
Foodborne Illness
Flu Pandemic
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Healing Through Music
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Mature Student
Melamine in Food
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Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
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Safe Drinking Water
Schizophrenia
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Sexually Transmitted Diseases
Soy
Stigma of Mental Illness
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Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
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Travel Comfort Tips
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Whiplash
Wind Chill Index
Workplace Drug Testing
Workplace Health
Nutrition
Full Listing with story descriptions
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
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Weight Wise Tips
Pharmacy Care
Full Listing with story descriptions
After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biologics
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heartburn
Heart Health
Insomnia
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
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Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
Quit Smoking
Skin and Cosmeceuticals
Sports & Nutrition Supplements
Sunscreen
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Take as Directed
Using Antibiotics Wisely
Viagra
Vitamin D
Yeast Infections
Your Best Shot
Your Medicine Cupboard
Prevention
Full Listing with story descriptions
Accident Prevention
Alcohol
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Bedbugs
Disaster Planning
Diseases from Pets
Caffeine
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
Chronic Disease Prevention
Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
E-cigarettes
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
Injury Prevention
Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
Meningitis
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Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
Seniors and STIs
Should You Immunize?
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Surviving Disaster
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Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
Travel Tips
Type 2 Diabetes Prevention
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Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Anemia
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
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Contraception for Mature Women
Cosmetic Procedures
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Estrogen's Effect on the Brain
Fear of Fracture
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Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
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Menopause
Menstruation Myths
Menstrual Pain
Third Generation Birth Control Pills
Osteoporosis
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Oral Contraction (The Pill)
Pap Test
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Viagra for Women
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Your Pelvic Floor
Family Health Online / Pharmacy at Safeway
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Family Health Magazine - CHILDBIRTH

Advice from the Maternity Clinic
Common questions answered

Maternity care providers understand that women and their families have many questions about pregnancy and the time shortly after birth. Some may be reluctant to ask their questions, afraid that they might bother the doctor or nurse with something routine or possibly trivial. Although a question may be common, it is still important that you have an answer. Clinic staff want all of your concerns answered. Ask your questions, regardless of how normal they might seem. Following are examples of questions often asked and the answers to them.

Q1: Is it safe to use sweetener or drink diet pop when I’m pregnant?

Sweeteners have never been studied to see if they are safe in pregnancy, but most have been around for a long time. No problems have been reported, so we believe that most of them are safe in small amounts. As with any kind of junk food, too much is not healthy for anyone!
Sweeteners believed to be safe in small amounts during pregnancy include maltitol, mannitol, sorbitol, lactitol, isomalt, xylitol, acesulfame potassium, aspartame, and sucralose.

Two sweeteners should not be used during pregnancy or breastfeeding, as we do not know if they are safe. These are cyclamates (Sugar Twin® in the yellow box or Sweet’N Low®, and Sucaryl™) and saccharin (Hermesetas™).

Q2: How much vitamin D do I need during pregnancy?

As we learned more about the benefits of vitamin D, the daily recommended intake rose. The current recommended amount of vitamin D for pregnant and breastfeeding women is 2000 international units (IU) per day.

Vitamin D is available in our food. Fish are a source of this vitamin. Three ounces (85 grams) of salmon provides 800 IU, three ounces of mackerel provides 400 IU. In Canada, our milk supply has added vitamin D (100 IU per cup).

More importantly, vitamin D is produced naturally when our skin is exposed to sunlight. Since Canada is a northern country, the sun’s rays are less intense. As well, we spend far fewer hours outside than our ancestors did and so produce less vitamin D. This is a greater concern for Canadians with darker skin tones. Still, all Canadians should take extra vitamin D.

Most prenatal vitamins provide 250 to 400 IU of vitamin D. Vitamin D supplements, in the form of drops or tablets, can be purchased over-the-counter in 400 IU or 1000 IU doses.

Q3: What positions are safe for sleeping during pregnancy?

Lying on the back makes some pregnant women feel faint or dizzy, particularly in the last three months of pregnancy.

Many women have heard the advice to sleep on their left side during pregnancy. However, recent evidence shows that a baby is not affected when the mother lies on her back, even if she has symptoms. The bottom line is you can sleep on either side or your back. If you feel faint or dizzy, change positions to help yourself feel better but do not worry that you have harmed your baby.

Q4: My ankles are swollen. When is this a concern? What can I do about it?

Ankle and calf swelling are very common in pregnancy. This is caused by a combination of many normal changes in the body during pregnancy. Rarely, it can be due to a blood clot deep in the muscles (called deep vein thrombosis or DVT). If one leg is swelling much more than the other or is noticeably painful, call your doctor or midwife right away. This may signal a blood clot.

With the normal swelling of pregnancy, it may help to:

Q5: What is round ligament pain?

The round ligaments, which support the growing uterus during pregnancy, extend from the uterus to the labia. Round ligament pain is sudden, sharp, brief pain in the lower abdomen that spreads to the groin. Sudden movements, such as rolling over in bed, often bring it on. Symptoms often begin in the second trimester and can last until delivery.

Treatment includes rest and changing your position or how you move. Avoid sudden movements. Try supporting your growing uterus with your hands when moving and bend forward at the waist to avoid pain. You might also use Tylenol® and hot compresses.
Alert your physician or midwife if you experience severe pain or cramping of the uterus, pelvic pressure that does not improve with rest, bleeding or spotting, fever or chills, or pain when passing urine.

Q6:What are picket fence pains?

Picket fence pains are brief, sharp, stabbing pains felt in the vagina, often in the third trimester. They are thought to be caused by normal changes of the cervix in preparation for labour. Although they can be annoying, this is a good sign that your body is doing the right things to prepare for a normal birth.
Alert your physician or midwife if you experience severe pain or cramping of the uterus, pelvic pressure that does not improve with rest, bleeding or spotting, fever or chills, or pain when passing urine.

Q7: Is it safe to lift and do physical activity while pregnant?

Every woman and every pregnancy is different. It is not possible to provide specific guidelines on lifting or physical activity in pregnancy.

Some studies have shown a link between physical exertion in pregnancy and preterm delivery. However, the evidence is not conclusive. Repetitive or heavy lifting can cause or worsen muscle and joint symptoms such as low back pain that are common in pregnancy.

Early in your pregnancy, assess the physical demands of your lifestyle and occupation. Change them if necessary. Let your physician or midwife know if you have any difficulties doing so.

Q8: Is it safe to have caffeine during pregnancy?

Beverage

Caffeine Content

Brewed coffee
8 oz/230 mL

135 mg

Starbucks coffee
8 oz/230 mL
250 mg
Starbucks latte
8 oz/230 mL
35 mg
Tea
8 oz/230 mL
35 mg
Dark chocolate
1.5 oz/45 grams
31 mg
Coca-Cola
12 oz/355 mL
46 mg

It is hard for researchers to conduct accurate studies on this topic. Less than 200 milligrams of caffeine per day is a good guideline. More than 200 milligrams of caffeine per day has been shown to reduce babies’ growth by a small amount. To give an idea of what kind of beverages to choose during pregnancy, here are some examples of caffeine content.

Q9: Is it safe to do sit-ups during pregnancy?

Sit-ups or abdominal crunches can be done in the first trimester. After the first trimester they are not recommended for the following reasons.

As you progress through the second and third trimesters, switch to different core-strengthening exercises. For instance, you might try planks, seated crunches and pelvic tilts.

Q10: What are the recommendations on eating fish during pregnancy?

Health Canada recommends that pregnant women eat at least 150 grams of fish each week. This is equivalent to a small can of tuna. Fish provides significant amounts of omega-3 fats and other essential nutrients like vitamin D, zinc and iron.

Omega-3 fatty acids transfer across the placenta and play an important role in the growth and development of the baby.

Limit tuna (fresh and frozen), shark, swordfish, marlin, orange roughy and escolar to no more than 150 grams per month due to concerns about methyl mercury ingestion. Also, limit intake of canned (white) albacore tuna to no more than 300 grams per week. However, canned light tuna is low in mercury.

Q11: Are fish oil supplements recommended in pregnancy?

If you do not eat the recommended amount of fish in your diet, fish oil supplements are a source of omega-3 fatty acids. If you choose to take a supplement, look for a Natural Product Number (NPN) on the product label. This shows that the supplement is government-approved for safety, quality and how well it works.

Avoid taking cod liver oil – in combination with a prenatal vitamin you may get a toxic amount of vitamin A.

Q12: Are there restrictions on travel or flying during pregnancy?

Canadian airlines will allow you to fly within Canada up to and during your 36th week. Complications in your pregnancy may prevent you from travelling or flying, so it is best to discuss travel plans with your care provider.

If you are travelling out of your community or city, carry a copy of your prenatal record with you. If you are heading outside of Canada, be sure to have adequate travel medical insurance for both you and the baby. Travelling outside of North America requires that you be assessed for risks of infectious diseases at your destination.

Q13: How do I avoid overdoing it when exercising while pregnant?

At one time, exercise recommendations were made based on your heart rate during exercise. This is no longer the best. Instead, use your sense of how hard you are exerting yourself. One way to assess this is with the ‘talk test’. During exercise you should be able to talk easily (low intensity) or in somewhat shorter sentences (moderate intensity). You should not be breathless (high intensity).

As you progress through your pregnancy, you will likely need to modify your workouts to attain the same level of exertion.

Q14: I am having leg cramps. What can I do?

Leg cramps are common in pregnancy. They often happen in the lower legs, in the latter half of pregnancy, and are most common at night.

To prevent cramps, stay well hydrated. Take enough calcium and magnesium, using an over-the-counter supplement if needed. At bedtime, stretch your calf muscles. Stand about a meter from your bed and lean forward until your ankle flexes as far as it will go. You should feel the stretch in the back of your leg.

Avoid stretching with your toes pointed downwards, as this can trigger a cramp. If you do, try stretching your toes and feet upwards. Massage and warmth, such as a shower, bath or hot pack, may also help.

Q15: What happens if I go past my due date?

Remember, the due date is a guess. Really, it marks the middle of the due month rather than the last day of pregnancy. However, if your pregnancy continues well past the due date, it is important to reassure yourself that your baby is doing well. Counting the baby’s movements at least once a day is one way to check on the baby’s well-being. Most care providers will do an ultrasound if you go a week past your due date, and offer to induce (start) labour eight to ten days past the due date.

Q16: In the newborn period, what is ‘demand feeding’?

Demand feeding means to start feedings based on your baby’s hunger cues, rather than the time since the last feeding.

Babies’ feeding patterns vary greatly, and can be as often as every hour. In the first few weeks of life the average frequency of breastfeeding is eight to 12 times per day.

You will find it is easier to start nursing your baby once you can recognize his early hunger cues. Your baby will move his hands toward his mouth, suck on his fists and finger, repeatedly open and close his mouth, and smack his lips.

By the time your baby is fussy, agitated, flailing his arms and legs or crying loud and persistently, it is harder to begin feeding him.

Q17: In the newborn period, what should I expect in the baby’s diapers?

The amount that your baby pees will show whether she is well-hydrated. Be reassured if your baby is peeing at least as many times as she is days old. That is, she should pee once in her first day of life, three times on her third day, and so on until she is six days old. After that point, the average is six to eight pees a day.

Babies that are successfully feeding will finish passing meconium stools (the first black and tarry poop) and transition to newborn stools within three days of birth. Typically, poop is then pale yellow and looks seedy.

Most infants pass at least three stools per day, often associated with feedings. However, this varies greatly. Formula-fed babies tend to have far fewer stools that are often pasty and more difficult to pass.

These are just a few of the many questions about pregnancy. You may have others. Feel free to discuss any concerns with your care provider. If you do not, you may miss out on some helpful advice.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6    [CB_FHa11]
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