Keeping Baby Safe: Potential Toxins to be Avoided During Pregnancy
During pregnancy, certain substances in your environment are harmful to your developing baby. Some are more harmful than others. Here is a list of harmful substances; some are still under study to find out if they are harmful. As always, it is up to you, the pregnant mother, to decide how you will use this information. I have more information for each substance; my doula clients are welcome to ask for more information.
Tobacco
Most people know that smoking can cause lung cancer. But it is also harmful to a developing fetus. As a mother smokes a cigarette, the oxygen transported to her baby is replaced by carbon monoxide. We all need oxygen; it is an essential nutrient that the baby needs to grow. If baby does not get enough oxygen, he/she is essentially starving in the womb. Therefore, the baby will not be able to grow as needed and will be small at birth because of malnutrition. In addition, smoking can cause breathing problems that are far-reaching; adults whose mothers smoked during pregnancy may still have asthma and allergies that are related to smoking, and those adults are also more likely to smoke themselves, as they have already been exposed to the addictive substances in cigarettes.
Quitting cigarette smoking can be tricky. Cigarettes are more addictive than many illicit drugs because of the additives in them that are designed to be addictive. If you need help finding a support group or therapy to help you quit, talk to your care provider.
Second-hand cigarette smoke can be almost as harmful to your baby as if you smoked yourself. Consider making a no-smoking rule in your home; anyone who wants to smoke can still smoke outside, but not inside in order to protect the health of your baby. (And you!)
Alcohol
Drinking alcoholic beverages while pregnant can cause damage to the developing fetus. There is a higher risk of miscarriage, more low-birthweight babies (as with smoking, alcohol can block nutrients from reaching the baby), learning disabilities, infant mortality, and Fetal Alcohol Syndrome. The risk of damage to the baby is higher in early pregnancy, which is why it is advisable to stop drinking before conception. But quitting anytime in pregnancy will result in less damage to the baby than not quitting at all.
There is no safe amount of alcohol consumption, but decreasing the amount during pregnancy is always better.
Caffeine
Here is some good news: there is a generally-accepted amount of caffeine that is considered safe during pregnancy, so giving up coffee altogether is not necessary. Some women do decide to abstain from any caffeine during pregnancy just to be on the safe side; each woman must make that decision for herself. Often women develop aversions to coffee during pregnancy, so you may not even have to worry about it.
An excessive amount of caffeine can cause stress to the baby's central nervous system, compromising immune system and weakening heart muscles. Caffeine crosses the placenta into the baby's bloodstream, and becomes more concentrated. The baby's liver is taxed more than the mother's by excessive amounts. Caffeine stays in the baby's bloodstream for longer than it would in an adult, and also stays in a pregnant mother's bloodstream longer than if she were not pregnant.
The generally-accepted amount of caffeine considered safe during pregnancy is 150 mg. That is a little over one cup of coffee or 3 ½ cups brewed black tea. Keep in mind that caffeine also occurs in chocolate (1 oz. of dark contains 20 mg, 1 oz. of milk chocolate contains 6 mg), soft drinks (cola contains about 35 mg per 12 oz.), over-the-counter pain relievers (each tablet of Exedrin contains 130 mg) and green tea (about 30 mg per cup).
Recreational Drugs
Drugs like marijuana, cocaine, methamphetamines, and opiates all have their risks in pregnancy. Some are worse than others. Smoking anything will keep oxygen from getting to the baby, and so is to be avoided for that reason. Methamphetamines and cocaine can cause brain damage and keeps oxygen from getting to the baby, causes Intra-Uterine Growth Retardation, rapid breathing, drowsiness, developmental delays and aggressive behavior in the newborn and child. Opiates are associated with menstrual irregularities, so a woman may not even know she is fertile or pregnant until after damage has already occurred from drug use. The usual needle risks can occur when the drug is injected: hepatitis, syphilis, and HIV. The baby quickly becomes addicted and fetal death can occur at withdrawal. Low birth weight can result from opiates, and growth and behavior problems in the newborn are common. Risk of Sudden Infant Death Syndrome increases 5-10 times with opiate use.
Over-the-Counter Medications
One potential toxin that just about any pregnant woman encounters is OTC drugs. What should you take for a headache? The safest of pharmacalogical OTC pain relievers is Acetaminophen (Tylenol). It should be used only sparingly, though, as it can also build up in the maternal and fetal livers and cause damage. Ibuprofen and Aspirin should not be used at all during pregnancy as they both disrupt blood-clotting abilities among other problems. It is wise to try alternate remedies for relieving pain, though be careful with some herbal remedies as they are also contra-indicated during pregnancy. For headache, drink plenty of water and get sufficient rest and eat well.
Antacids are safe for use in pregnancy, though they do interfere with digestion so should be used sparingly.
Antihistamines have not been shown harmful in humans, but have in mice. Use with caution and sparingly.
Decongestants: some can cause birth defects and should not be used: any with Brompheniramine (in Dimetane, Dimetapp, and Drixoral). Relatively safe are decongestants that are made up of pseudoephedrine plus triprolidine (Actifed), pseudoephedrine plus chlorpheniramine or Meclizine. Use sparingly.
Anti-Nausea drugs: Bendectin has been shown to cause birth defects, and so should be avoided. There are natural remedies available for nausea; just ask your care provider for suggestions. If necessary, a combination of Unisom and vitamin B6 (25 mg of each) can be used instead of Bendectin.
Any time you are adding a medication or a remedy it is wise to talk with your midwife about the safety of the substance. We will go over all supplements in your diet at your first visit. Please feel free at any time to discuss any substance you have any questions about.
Prescription Drugs
Almost any medication you take during pregnancy will reach the baby. You and your care providers must carefully weigh the effects of the medication on the baby with the severity of your illness. Ideally, no medications would be used during pregnancy but in the real world, women do get sick and get infections during pregnancy, some of which would be harmful to herself and her baby if left untreated.
Antibiotics: some are more dangerous than others. Always ask your doctor before taking any antibiotic if it is relatively safe for use in pregnancy. Relatively safe antibiotics include: Ampicillin, Cleosin, cephalosporins (Keflex), Macrodatin, Bactrim, Erythromycin and Penicillin. Contra-indicated antibiotics in pregnancy are: streptomycin (causes deafness in babies), tetracycline (tooth discoloring), all sulfonamides, all aminoglycosides, and all quinolones. Metronidazole (Flagyl) is especially harmful in the first trimester.
Talk with your care provider if any medication is needed for mental health issues.
Food Additives
Food is, of course, a necessity for every pregnant woman. Not all substances that ride along with your food are safe for baby, however. Some to keep in mind: food preservatives, artificial colors and flavors, pesticides, MSG, aspartame, and other unnatural additives can be harmful, but for most of these substances the jury is still out on how harmful they are. The best possible diet includes fresh foods made at home without artificial additives, including plenty of organic fruits and vegetables, whole grains, and proteins without added substances.
