AR Pharmacist: Pregnancy Health

Becoming a new mom can be thrilling, terrifying, and exhausting, especially when it’s your first bundle of joy. There’s so much to know and learn about welcoming your baby into the world that new parents will take all the help they can get. Your local pharmacist is a great resource for help, and we had Elisabeth Mathews from the Arkansas Pharmacists Association to give us some tips and reminders about having a baby.

Prenatal Vitamins:
The first thing to remember about supplements during pregnancy is right there in the word. It’s a supplement, meaning these are in addition to your normal diet, not instead of. Also, you really want to ask your pharmacist for help in choosing vitamins because they are the medication experts.

You should not take any single vitamin or mineral supplements in higher-than-normal doses unless recommended by a health-care provider for a special condition. For instance, you’ll sometimes see that vitamins in the store will contain hundreds or sometimes thousands of percentages of your daily recommended intake. There can be too much of a good thing, so watch those labels. It is safest to take only prenatal vitamins that you’ve talked about with your physician and pharmacist and no other over-the-counter vitamin supplements. That way, you do not have to remember which ones can be toxic or risk an accidental overdose on a vitamin.

Also, not all supplements are created equal. The FDA does not certify the purity or quality of supplements. So, anytime you’re looking for a new supplement ask your pharmacist to help you choose a high-quality product you can depend on.

In addition to supplements, caffeine intake is also something to consider. Caffeine can affect the fetus during pregnancy and also can be passed on to an infant through breast milk so we encourage pregnant women to avoid, or at the very least minimize, their consumption of caffeine. You’ll even find caffeine in some of those over the counter medications, especially in migraine formulations, so read those labels and ask your pharmacist for help.

I would also add, that there are several prescription medications that are not safe to take while pregnant. These include cholesterol medications, some blood pressure medications, and several blood thinners, just to name a few. As soon as you find out you’re pregnant, I cannot stress how important it is to plan a consult with your pharmacist to find out what changes or additions need to be made to your medication regimen.

Vaccinations to Protect Your Baby:
Before becoming pregnant, you should be up-to-date on all routine adult vaccines, especially the MMR (measles, mumps, and rubella) vaccine. The MMR vaccine is key because it will protect you against rubella, a disease that could cause miscarriage, stillbirth, or

serious birth defects. MMR is a live vaccine, so once you become pregnant it’s too late to get the protection you need.

Once pregnant, there are two important vaccines every expectant mother should get – the flu vaccine and the whooping cough vaccine. Changes in the immune system, heart, and lungs during pregnancy make pregnant women more likely to suffer from severe illness caused by the flu. Complications from the flu during pregnancy could include premature labor, delayed growth, hospitalization, or even death. Flu season is typically October through May, so if you are pregnant during this time, you will need to get a flu shot. The CDC reports that the flu shot has been given to millions of pregnant women over the years and is safe to get during ANY trimester of pregnancy.

Now, the whooping cough vaccine is commonly referred to as Tdap. Ideally, women should get the Tdap vaccine between weeks 27 and 36 of EACH pregnancy. After receiving this vaccine, your body will create protective antibodies trained to fight off whooping cough and then pass them to your baby before birth. This will help protect your baby during the first few months of life, when they are most vulnerable to whooping cough and its complications. The CDC has reported an increase in the cases of whooping cough over the past several years, so it is certainly important to protect each baby you have by getting this vaccine during each pregnancy.

Additionally, you can provide indirect protection for your baby by encouraging everyone around them to get vaccinated as well. This includes dads, grandparents, aunts, uncles, siblings, caregivers, anyone really. Encourage others to get their flu shot and a whooping cough vaccine at least 2 weeks before meeting your baby, if they haven’t gotten them already.

 

Contraceptions after Pregnancy
Contraceptives that contain only progestin are compatible with breastfeeding and are a safe option, assuming there's no medical reason you can't use this hormone.

On the other hand, combined contraceptives – ones that contain both estrogen and progestin – aren't a good choice for nursing mothers, particularly in the first six months, because they may cause you to produce less milk. This applies to all methods that contain estrogen and progestin, such as the combined birth control pill, the patch (Ortho Evra), and the vaginal ring (NuvaRing).

You have a few choices when it comes to progestin-only contraceptives, or POCs. First, a birth control pill that’s also known as the “minipill” because it contains only a very low dose of one progestin instead of the more common combination of progestin and estrogen. This form of birth control must be taken every day at nearly the same time so consistency is key.

Another choice is the progestin-only shot. You can get this shot at your six-week postpartum visit, but you have to go back every 12 weeks for another dose. Unlike other progestin only contraceptives, this method doesn't wear off right away when you stop using it; you may not be fertile for a year or longer after discontinuing the shots. Take this into account when you make your choice.

Another choice is an implant, which is a flexible rod placed under the skin of your upper arm which continually delivers a small amount of progestin. Implants are more than 99 percent effective and last for several years (depending on which implant is used). Your fertility returns soon after the implant is removed. Once implanted, the rod can remain in place for up to three years and is nearly 100 percent effective.


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