Healthy Surrogate Pregnancy... the DO's and DONT'S
10 Steps to a Healthy Pregnancy
There is a lot you can do for your surrogate baby… in womb!
by Brooke Kimbrough on February 22, 2017
Tips for a Healthy Pregnancy
Source: The Mayo Clinic Guide to a Healthy Pregnancy, 2011. Mayo Foundation for Medical Education and Research.
As your surrogate journey begins, often times surrogates wonder what they can do for their parents and surrogate baby to ensure the best outcome possible. The number one thing parents are worried about is the health of their unborn child (and yours) so here is a reminder of all of those do’s and dont’s associated with healthy pregnancies.
Foods--The Good and the Bad
The Good Stuff
Basic diet principles: Eat plenty of fruits, vegetables and whole grains. Choose lean protein and low-fat dairy products. And select a variety of foods. If you can remember these key principles, you and surrogate baby will be well on your way to a balanced diet. Make sure that you incorporate various colors into your diet and rely heavily on the greens!
Seafood high in mercury. Seafood is a good source of protein and iron, and the omega-3 fatty acids in many fish may possibly help promote fetal brain development. However, some fish and shellfish contain potentially dangerous levels of mercury, which can damage a baby’s developing nervous system. These fish include albacore tuna, tuna, swordfish, shark, king mackerel, and tile-fish.
Avoid raw, undercooked or contaminated seafood. It’s best to avoid raw fish and shellfish, such as oysters and clams, and refrigerated smoked seafood, such as lox. Most seafood should be cooked to an internal temperature of 145. Sorry, ladies. Sushi is on a temporary hiatus.
Avoid undercooked meat, poultry and eggs. To prevent foodborne illness, fully cook all meat and poultry before eating them. Use a meat thermometer to make sure the meat is done. If you’re having a steak, it’s OK to eat the steak “medium rare” or “medium.” Just make sure the internal temperature reaches at least 145 F.
Cook eggs until the egg yolks and whites are firm, and avoid foods made with raw or partially cooked eggs. Raw eggs can be contaminated with salmonella bacteria.
Avoid processed meats. Meats can become contaminated during their production, especially if a lot of processing is involved. Meats such as bologna, salami or hot dogs are of most concern. They can be the source of a potentially serious food-borne illness called listeriosis. This can also include pre packaged deli meats.
Avoid unpasteurized foods. Low-fat dairy products can be a healthy part of your diet, but anything containing unpasteurized milk is a no-no because the products may lead to foodborne illness. Stay away from soft cheeses — Brie, feta, Camembert, and blue cheese — unless they’re clearly labeled as being made with pasteurized milk. Also, don’t drink unpasteurized juice.
Avoid unwashed produce. Raw fruits and vegetables are great to eat during pregnancy, just make sure to wash them, especially if they come from a garden, farmers’ market or orchard, where they may not have been thoroughly cleaned. The risk here is harmful chemicals sprayed on food including fertilizer, herbicides and pesticides. Even organic foods need to be washed to avoid overspray and potential contamination.
Avoid large quantities of liver. Liver is OK to eat during pregnancy, but don’t overdo it. Liver is high in vitamin A. Eating very large amounts of liver can lead to Vitamin A toxicity, which can in turn lead to birth defects. Does anyone really eat liver anyway???
Essential vitamins and minerals
Definitely take folate and folic acid Folate is a B vitamin that helps prevent neural tube defects, serious abnormalities of the brain and spinal cord. The synthetic form of folate found in supplements and fortified foods is known as folic acid. You want 400 to 800 micrograms (mcg) of folate or folic acid three months before conception and the first two to three months of pregnancy. For the rest of your pregnancy, the goal is 600 mcg daily. Good sources include fortified cereals, leafy green vegetables, citrus fruits, and dried beans and peas.
Definitely take calcium. You and your surrogate baby need calcium for strong bones and teeth. Calcium also helps your circulatory, muscular and nervous systems run normally. If there’s not enough calcium in your pregnancy diet, the calcium your surro baby needs will be taken from your bones. Aim for 1,000 milligrams (mg) a day. Dairy products provide the richest sources of calcium. Simply drinking 3 cups of milk every day — a cup at each meal — will go a long way toward meeting your calcium needs. You can also get your calcium from other dairy products. Many fruit juices and breakfast cereals are fortified with calcium, too.
Eat a good amount of protein. Protein is crucial for your belly buddy’s growth, especially during the second and third trimesters. The recommended amount is 71 grams daily. Lean meat, poultry, fish and eggs are great sources of protein. Other options include dried beans and peas, tofu, dairy products and peanut butter.
Make sure to get lots of iron. During pregnancy, your blood volume expands to accommodate changes in your body. Your body is also making extra blood to help your surro babe form his or her entire blood supply. As a result, your need for iron nearly doubles. Your body uses iron to produce hemoglobin, a substance in red blood cells that enables them to carry oxygen. If you don’t get enough iron, you’ll likely notice it. A common symptom of too little iron is fatigue. ( Like you aren’t already tired enough??) The recommended amount is 27 milligrams of iron a day. Lean red meat, poultry and fish are good sources of iron. Other options include iron-fortified breakfast cereals, nuts and dried fruit.
Vitamin D Vitamin D is important because it helps your body absorb calcium, which in turn keeps your bones strong and protects you from diseases such as osteoporosis. Sunlight is a great source of vitamin D, as are dairy products and fish. Studies suggest that vitamin D may decrease the risk of preeclampsia and improve birth weight and infant bone mineralization. It also appears that sufficient vitamin D in early life may decrease the risk of health problems later in life.
Nutrition experts recently increased the U.S. Recommended Dietary Allowance for vitamin D. Experts now recommended that pregnant women get 600 international units (IUs) of vitamin D daily. The upper limit for pregnant women is 4,000 IUs.
Omega-3 fatty acids. Standard prenatal vitamins don’t include omega-3 fatty acids. The benefits of omega-3 fatty acids on fetal development are uncertain, but there’s some evidence they may promote fetal brain development. If you’re unable to or choose not to eat fish, or other foods high in omega-3 fatty acids,you can also use prenatal vitamins that contain ‘fish oil’ or Omega-3 fatty acids. AVOID any fish that is high in mercury (e.g., tuna, albacore tuna, swordfish, etc.). Cooked salmon is ideal as it is high in Omega-3s, but low in mercury.
Caffeine. It’s best to avoid caffeine whenever possible during pregnancy. Tea, carbonated beverages, cocoa and chocolate also contain caffeine.
Herbal supplements/products. It may be tempting to turn to herbal products to help alleviate some of your aches, pains or other symptoms during this time when traditional medications are pretty much a no-no. Perhaps some melatonin could help you sleep? Or what about echinacea to prevent a cold? Or weight-loss herbal supplements? But don’t be misled by the belief that just because herbal products are “natural,” they must be safe. The fact is, herbal products need to be treated in the same manner as most medications — avoid them. Only if your care provider says it’s OK to use a certain herb, should you do so. Why? Because herbal products can be just as dangerous during pregnancy as traditional medications. They could even be more harmful because so little is known about many herbal supplements. Unlike prescription and nonprescription drugs, herbal supplements sold in health food stores and pharmacies aren’t tested and approved by the Food and Drug Administration. And they’re not required to undergo clinical trials, in which the safety and effectiveness of the product is determined.
Hair dyes/bleach/coloring. Few studies have examined women’s use of hair dye before and during pregnancy. A 2005 study suggested a possible association between hair dyes used during pregnancy and certain childhood cancers. This should be discussed specifically with you agency and intended parent prior to legal contracts.
Alcohol. If you drink alcohol, so does your baby. It doesn’t matter if you drink beer, wine or other forms of liquor. Once in your bloodstream, alcohol passes through the placenta to your baby. Sustained drinking during pregnancy increases your risk of miscarriage and fetal death. It can also cause permanent damage to your baby. Fetal alcohol syndrome is the most serious problem caused by excessive alcohol consumption. It can cause such birth defects as facial deformities, heart problems, low birth weight and mental retardation. Babies born with fetal alcohol syndrome may also have permanent growth problems, experience short attention spans and learning disabilities and have behavioral problems. As soon as you know you’re pregnant, don’t drink alcohol. If you’re planning to get pregnant, it’s a good idea to stop drinking beforehand. Alcohol exposure can cause birth defects in the early weeks of your pregnancy, before you may know you’re carrying a child. Once your child is born, small amounts of alcohol can wind up in breast milk and be passed on to your baby through your milk. Therefore, it’s best to abstain from alcohol use until you’re finished breast-feeding.
Tobacco. Smoking also is dangerous for you and baby. Smoking during pregnancy increases your risk of stillbirth, premature birth, low birth weight and sudden infant death syndrome (SIDS) after birth. Cigarette smoke contains literally thousands of harmful chemicals. Don’t smoke ever. Period. Duh.
Illicit drugs. Obviously this is a given but had to put it in here for good measure. Any and all illicit drug use can harm your baby. This includes everything from marijuana to cocaine, heroin, methadone, LSD, phencyclidine (PCP), methamphetamine and any other kind of recreational or street drug. While you’re pregnant, the drugs you take can pass from you to your baby. This can affect the development of the fetus and the future of your child as he or she grows up. It can also cause the death of your fetus or withdrawal symptoms in newborns that if untreated can lead to death.
Medications. As a general rule, it’s best to use caution and avoid use of medications during pregnancy when possible. All medications that you are currently taking or that you plan on taking should be discussed with both your agency and your doctor, prior to consumption. Some drugs can cause an early miscarriage or impair your baby’s development. Very few drugs have been proved to be completely safe in pregnancy. It’s best to check with your care provider before taking any medicine, be it prescription or over-the-counter. Some medications have been shown to be extremely harmful to a developing fetus, even in the early weeks of pregnancy. Some of the most dangerous medications during pregnancy include: the acne medication isotretinoin (Accutane); multi-use medication thalidomide (Thalomid); psoriasis medication acitretin (Soriatane)
Other medications to avoid:
Medications containing pseudoephedrine (Sudafed, Claritin-D, Claritin-D, others), especially during the first trimester
Medications containing dextromethorphan (Robitussin, Vicks NyQuil, Vicks DayQuil, others)
Medications containing phenylephrine (Tylenol Allergy Multi-Symptom)
Bismuth subsalicylate (Pepto-Bismol)
Ranitidine (Zantac), Cimetidine (Tagamet)
Ibuprofen (Advil, Motrin, others), Naproxen (Aleve), Aspirin.
Avoid hot tubs and saunas. But saunas should be avoided, and pregnancy and hot tubs can be a dangerous combination. Spending 10 or more minutes in a hot tub can raise your body temperature to 102 F, causing a condition known as hyperthermia. Some studies have shown an increased risk of miscarriage and neural tube defects in the babies of pregnant women exposed to high temperatures in the first four to six weeks of pregnancy.
Avoid X-rays. When you have an abdominal X-ray during pregnancy, your developing baby is exposed to radiation. If the radiation causes changes in your baby’s rapidly growing cells, it’s possible that your baby could be at a slightly higher risk of birth defects or illnesses, such as leukemia, later in life.
Basic Household Cleaners. Regular use of normal household cleaners hasn’t been shown to harm a developing baby. Still, it’s a good idea to stay away from oven cleaners that emit strong fumes in a contained space. And — pregnant or not — don’t mix chemicals such as ammonia and bleach because the combination can produce toxic fumes. When cleaning or when coming home after someone has done a cleaning, avoid inhaling any strong, caustic fumes. Wear protective gloves to avoid absorbing any chemicals through your skin. You might also consider switching to cleaners such as vinegar and baking soda or other products that don’t contain any harsh, toxic chemicals.
Kitty Litter Boxes. Toxoplasmosis is an infection that can threaten the health of an unborn child. It’s caused by a parasite called Toxoplasma gondii. The parasite multiplies in the intestine of cats and is shed in cat feces, mainly into litter boxes and garden soil. You can get the parasite by handling cat litter or soil where there are cat feces. You can also get the parasite from eating undercooked meat (such as rare beef) from animals infected with the parasite. To avoid toxoplasmosis during pregnancy, have another member of the family change the litter box. If you must handle the chore, wear rubber gloves and wash your hands thoroughly afterward. Also wear gloves when you garden.
Sports and pregnancy If you’re a regular jogger, runner or swimmer, it’s likely you’ll be able to continue these activities throughout most of your pregnancy, with your care provider’s consent. Worries such as overheating have proved largely unfounded in studies of women who exercise at a low to moderate intensity. For example, running three miles or more, four times a week, at a 10-minute-mile pace is generally safe. Concerns of preterm labor due to strenuous exercise and reduced blood flow to the baby haven’t been proved either. Dehydration, on the other hand, can be harmful to you and your baby, and can provoke contractions. So it’s very important to replace any fluid you lose during an exercise session. Most active women, even competitive athletes, tend to decrease the intensity of exercise especially toward the end of their pregnancies. As your weight increases, your center of gravity shifts and your ligaments become looser. Activities to approach with care.
After the first trimester, it’s best to avoid floor exercises that require you to be on your back for a long period of time. The weight of the baby can cause problems with blood circulation. Also be especially careful with activities that carry a high risk of falling or abdominal injury. Gymnastics, horseback riding, downhill or water skiing, and vigorous racket sports have greater risk of injury. It also may be wise to avoid high contact sports such as basketball or soccer. These sports involve the risk of falling or colliding with another person. Plus, they often require you to jump or change directions quickly. You may run a greater risk of straining the cartilage and ligaments that support your joints, which soften during pregnancy.
Traveling. Please do not travel to areas with Zika virus including areas within the United States known to have reported cases.
Healthy Pregnancy Equals Happy Parents
While every parent feels eternally grateful for your willingness as a surrogate to carry a child(ren) for them, health is paramount. If you have any questions about any potential pitfalls or additions, please feel free to reach out to us for clarification.