Welcome to Ask a Doctor! Every week we’ll be asking our CarePoint Health doctors some questions that we’d all like to know the answers to.
This week we have a return guest, Doctor Osbert Fernandez MD, FACOG, FAAFP. He’s one of our OBGYN specialists in Hoboken with an interest in high risk obstetrics and minimally invasive gynecological surgery. This week he’s answering our questions about Pap smears.
Q: What are some general nutritional recommendations in pregnancy?
A: Nutritional recommendations in pregnancy consist of appropriate weight gain, physical activity, consumption of a variety of foods, appropriate vitamin supplementation and avoidance of alcohol and tobacco.
Q: What is the appropriate weight gain during pregnancy?
A: If you are at your ideal body weight, (BMI, or Body Mass Index, between 18 and 25) appropriate weight gain would be 25 to 30 lbs. For patients who are underweight, (BMI less than 18) 30 to 40 lbs. may be appropriate. If the patient is overweight, (BMI over 30) 15 to 25 lbs. is recommended.
Q: When should you start supplementing folic acid?
A: Folic acid supplement should be started one month before conception and for three months after conception. The dose should be 0.4 mg daily. If there is a family history of neural tube defects, the dose should be increased to 4mg.
Q: What foods are best to avoid?
A: It is best to avoid undercooked or cured meat products, soil contaminated fruits or vegetables, unfiltered water, soft cheeses and raw or unpasteurized milk.
Q: What if I am a vegetarian? Do I need to supplement differently?
A; Balanced vegetarian diets do not appear to have any significant health effects on the pregnancy or the fetus. That being said, the nutritional adequacy of the diet must be evaluated on a case-by-case basis. Diets that exclude animal products may be deficient in Iron, Amino acids, Vitamin B12, and Vitamin D. All of theses vitamin levels can be checked in the office with a simple blood test.
Q: Which fish should I avoid or limit in pregnancy?
A: Pregnant women should avoid eating predator fish such as shark, swordfish, and king mackerel because they may contain higher levels of mercury. Canned tuna should be limited to 12 oz. per week. Sushi or sashimi should be avoided during pregnancy.
Osbert Fernandez, MD, FACOG, FAAFP is a graduate of St. George’s University School of Medicine. He completed his Obstetrics and Gynecology residency at St. Vincent’s Hospital and Medical Center in New York City where he served as Chief Resident in 2003. He is dual board certified in Family Practice and Obstetrics and Gynecology. Dr. Fernandez is an Attending Physician with CarePoint Medical Group, serves as Associate Director of the Department of Obstetrics and Gynecology at Hoboken University Medical Center and is an Assistant Clinical Professor at New York Medical College in the Department of Family Medicine. Dr. Fernandez has special interest in high risk obstetrics and minimally invasive gynecological surgery. He is fluent in Spanish.