How to increase the likelihood of having a healthy baby?


MAINTAINING REMISSION

Keep in mind that if your disease is under control while you are pregnant then the baby is more likely to be healthy. So it is important to follow your treatment plan and to ensure that you are as fit as possible before and during your pregnancy.

Talk to your doctor or our IBD team if you have any worries about how to manage your IBD while pregnant. In particular, tell your doctor if you have a flare-up of your IBD or are failing to gain weight as expected.

DIET

For any pregnant woman, a balanced and varied diet with sufficient calories, vitamins and minerals is important for the growth of their baby. 

Having IBD, the increased nutritional needs of pregnancy may mean you need to supplement your diet, especially if you are underweight or have active disease. You may find it helpful to talk to a dietitian or your IBD team about this.

Extra folic acid may be suggested. Folic acid (also known as vitamin B9) can help reduce the risk of birth defects such as spina bifida. All pregnant women are now recommended to take a folic acid supplement for the first 12 weeks of pregnancy. The usual recommendation is 400 micrograms a day. Inflammation in the small intestine and some IBD drugs can affect how well you absorb folic acid. So, if you are on sulphasalazine, have Crohn’s in the small intestine, or have had surgery to remove part of your small intestine, you may need a higher dose of folic acid, for example up to 5mg a day. Check with your doctor what dose of folic acid would suit you. You may also need extra vitamin B12, especially if you take extra folic acid.

You should not take extra vitamin A while pregnant, unless your doctor specifically advises it. Research suggests that too much vitamin A can be harmful to the baby and that most pregnant women can get all the vitamin A they need from their normal diet.

If you take steroids, calcium and vitamin D supplements can be useful to help prevent bone loss. Iron deficiency is quite common in IBD and extra iron may be needed to meet the increased demands of pregnancy. Your doctor will be able to recommend a suitable supplement.

ALCOHOL

Drinking alcohol while you are pregnant can seriously harm your baby’s development. The Department of Health recommends that you avoid all alcohol if you are trying to conceive or are pregnant. NICE (the National Institute for Health and Care Excellence) also advises giving up alcohol for at least the first three months of a pregnancy as it may increase the risk of miscarriage.

SMOKING

Smoking when pregnant is known to harm the baby. It has been shown to be linked to a wide range of birth defects and can also increase the risk of a miscarriage.

Smoking can also affect the mother’s health, and for women with Crohn’s Disease, smoking can be especially risky. Research has shown that smoking may make Crohn’s symptoms worse and increase the chance of a flare-up.

If you have UC, the likely effect on your disease is less clear cut. There is some evidence that people with UC who smoke tend to have milder symptoms. However, this does not mean that smoking will necessarily improve your UC and it could cause the same direct damage to the baby as in any non-IBD pregnancy. The consensus among health professionals is that whatever type of IBD you have, it is better not to smoke. For more information, see our page: Smoking and IBD.

EXERCISE AND FATIGUE

Regular moderate exercise can help to keep you healthy and is important in pregnancy. Gentle exercises, such as walking, yoga and swimming, can be especially valuable. That said, it is also important not to overdo it, especially if you already suffer from IBD-related tiredness and fatigue. If you are uncertain whether a particular type of exercise would be advisable, or if you start feeling increasingly tired and exhausted, talk to your doctor or IBD team.


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