Staying Hydrated During Pregnancy

Everyone needs to stay hydrated for healthy living. For the body and vital organs to function properly, you need to have lots of water. And if you are pregnant, the amount of water to be taken increases to a great extent.

During pregnancy, your body needs more water to meet the demanding needs of your changing body. So, it becomes very essential for the mom-to-be to remain adequately hydrated. Moreover, water is one of the key components for breast milk and essential for proper lactation.


How much water do you need during pregnancy?

A pregnant woman is required to have approximately three litres of fluid every day. Fluids include water, milk, fruit and vegetable juices, and other non-alcoholic refreshments. Apart from having water directly, your body receives water indirectly from fruits, vegetables, yogurt etc. So, you can have water according to the intake of other fluids, fruits and vegetables.



Benefits of water during pregnancy:

  • As water is one of the main sources for carrying nutrients and oxygen to your organs, cells and tissues, staying hydrated during pregnancy ensures that your baby is receiving the required nutrients for proper growth.
  • It helps in preserving the required amount of amniotic fluid and helps in the kidney function of the foetus by facilitating the waste your baby’s kidney filters.
  • Drinking enough water lets you keep hydrated as dehydration during pregnancy leads to headaches, dizziness, cramps and nausea.
  • Water can help prevent constipation and haemorrhoids.
  • Drinking adequate water helps in preventing morning sickness, indigestion, acidity and heartburn.
  • Keeping hydrated means it keeps your urine diluted which not only helps in keeping all things in order but also keeps Urinary Tract Infections (UTIs) at bay.
  • During the third trimester, hydration becomes especially important as dehydration can cause contractions leading to preterm labour.


How to know that you are hydrated?

During pregnancy, the best way to know that you are hydrated is to check the colour of your urine. If the colour is pale or straw-coloured, then you are adequately hydrated. But if it is dark, it means you need to have more water. So, keep a water bottle handy which will remind you to keep hydrated.

Images Courtesy:


Summer Tips During Pregnancy


If you are pregnant and the arrival of summer is making you anxious, there is nothing to be worried about. With the advent of summer and your belly becoming bigger and bigger, at times you may wonder — will you be able to pass this phase comfortably.



Normally, pregnant women feel hot due to the extra flow of blood raising the body temperature higher than normal. In addition, the extra weight you gain adds to the discomfort. Though pregnancy during summer is not easy and pleasant, there are several ways to cope with the heat and stay comfortable. 

Healthy Tips to Beat the Summer Heat During Pregnancy:


Here are some awesome ways to beat the summer heat.


  • Consume a large quantity of fluids — be it water, vegetable and fruit juices — throughout the day. Drinks containing electrolytes can help in replacing the lost salt. Staying hydrated during summer will let you feel good and fresh.
  • During summer, do your outdoor work during the morning hours or in the evening time when the heat of the sun is low.
  • Stay indoors or in the shade or under the fan when the temperature goes up.
  • Wear loose fitting and light-coloured clothes during summer. The fabric should be breathable, so that it will help you to keep cool and prevent rashes due to heat under the breasts and abdomen. Heat rash in such areas is a common problem for pregnant women.
  • Wear flip-flops to keep your feet cool.
  • To keep yourself cool, take quick baths frequently during the day.
  • Use a damp cloth on the head, forehead and back of the neck to lower your body temperature.
  • Exercise at a time when the heat is low and avoid doing exercises to the point of overheating.
  • Always carry a water-filled spray bottle with you; when you feel hot, you can mist yourself with the spray.
  • Indulge in swimming which will not only help you keep cool but also lose some excess weight.
  • During summer, to reduce swelling of your feet which is common during pregnancy, place them on a chair or table.
  • Take frequent naps to keep yourself fresh and active.
  • To prevent stretched skin and itchiness which increases during summer, use moisturising lotion immediately after taking a shower.


If you follow these health tips and consult your doctor regarding any issues, remaining cool during pregnancy in the summer months will become very easy. In fact, if you deliver during the summer months, you and your baby will have good health as you will get fresh air.

Images Courtesy:

Allergies and Intolerances during Pregnancy – How to avoid them?

Pregnancy is one of the most beautiful stages of a woman’s life. But being pregnant doesn’t only mean taking care of the baby, but taking care of self, as well. Taking care of self is one of the vital things during pregnancy. And, if you have allergies, you should consult your doctor regarding the same. Because when you stay fit and healthy, only then will the baby receive all the vital nutrients required for proper development.


Image Courtesy:


What is an allergy?

An allergy is a response by the body’s immune system to allergen, which may not be very harmful. Some people are sensitive to the allergens and get affected when exposed to them. Though most of the allergies are mild and don’t do much harm, some are severe and life-threatening. The life-threatening ones are known as Anaphylaxis. Food allergies are the most common form of allergy which occur during pregnancy.

Food Allergies and Food Intolerances

Image Source:

Food allergies are not to be mistaken with food intolerances. Though seemingly similar, each has different signs and symptoms. But it is very difficult to differentiate between the two. The following will help you know the difference:

  • Food allergies occur when the immune system of the body reacts abnormally to certain foods. Food intolerances, however, don’t have an allergic reaction.
  • Allergic reactions happen quickly while the symptoms of food intolerance usually manifest a few hours after having food.
  • In case of food allergy, even a small amount of the food can cause allergic reaction. But the case is not same for food intolerance.

Image Courtesy:

Symptoms of Food Allergy:

  • Vomiting
  • Itching and tingling
  • Swelling of mouth, lips and throat
  • Constipation
  • Atopic eczema
  • Loose motion
  • Blood or mucus in stool
  • Tiredness
  • Poor growth

Symptoms of Food Intolerance:

  • Diarrhoea or loose stool
  • Bloating and tummy pain
  • Skin rashes and itching

How to Avoid Allergies and Intolerances?

Change in the hormonal level during pregnancy leads to change in allergy symptoms. Pregnant women should note the following to help avoid allergies and intolerances.

  • Avoid food that causes allergy and intolerance
  • Consult your doctor if you are allergic to certain foods
  • Take medications for allergy and intolerance as per your doctor’s advice
  • Check the medication information if it is suitable for use or not during pregnancy
  • Make a list of your allergic and intolerance factors
  • Inform emergency staff about your allergies
  • Ensure all your medicines are easily accessible
  • Avoid alcohol and smoking

Remember, it is very essential for pregnant women to take care of their own health along with the baby in the womb.



Infant Skin Care


The skin is the largest organ in the human body. Besides serving as a protective barrier, it has the function of thermoregulation, UV protection, protection from invasion of microbes and external antigens, repair and regeneration of wounds and synthesis of nutrients. It also has immunological  and sensory autonomic functions. We must remember that the skin of the neonate is not the miniature of the adult skin.

Differences between adult and term or preterm neonate skin

  1. The skin of the newborn is 20 to 30% thinner than the adult skin.
  2. Newborn skin is less hydrated and has reduced natural moisturization factor compared to adult.
  3. Ratio of body surface area to weight of a term neonate is up to 5 times that of an adult and that of preterm is 7 times than of an adult.
  4. Stratum corneum or the outermost layer of skin of a preterm baby is thinner than that of a term baby.
  5. At birth, the pH of newborn skin is slightly acidic whereas the adult skin has acidic pH from 5 to 5.5. Alkaline pH predisposes to diaper dermatitis and favours colonisation of Staphylococcus aureus and Candida albicans.


The skin of the newborn undergoes structural and functional modifications from the first few days of life up to almost the first year to adapt to the transition from the utero wet world to the extrauterine environment. The structural and functional immaturity of the skin of a preterm baby results in increased transepidermal water loss, susceptibility to mechanical trauma, microbial invasion and percutaneous absorption of toxins. In order to reduce the morbidity associated with immature skin barrier, optimum care for the skin of a newborn is essential.

 Cleansing and cleansers

Cleansing is a process of removing dirt, sebum, micro-organisms, exfoliated corneum cells from the skin surface by a complex interaction between the skin barrier, dirt, body secretions and a surfactant. Water is a good cleanser which removes the water soluble dirt but not the fat soluble particles.


Cleansers are surface active substances that emulsify the fat soluble particles and convert them into water soluble matter which can be washed off with water. Today a wide variety of soaps, special soaps and liquid cleansers are available in the market.

Cleansers are classified into three categories, namely true soaps, syndet bars and combars. Soaps are fatty acids derived from animal fat or vegetable fat processed with sodium or potassium hydroxide by saponification.

True soaps are composed of long chain fatty acid-alkali salts with a pH between 9 and 10. The high alkaline nature causes dissolution of lipids from the skin surface, disruption of acid mantle and stratum corneum barrier and raises the pH of the skin, Soap precipitates in hard water producing insoluble calcium or magnesium salts that prevent foam formation. Use of soap particularly in diseases of the skin may cause dryness and irritation of the skin resulting in redness and itching.

Special additives added to the soaps have resulted in the various subsets of soaps such as superfatted soaps, transparent soaps, medicated antibacterial soaps. Superfatted soaps contain increased oil and fat which help in minimizing the dryness of skin. Transparent soaps contain glycerine and sucrose. Antibacterial soaps contain antibacterial agents such as triclosan, triclocarban. These soaps reduce the skin biofilm bacterial count by blocking the lipid synthesis in the bacterial cell wall.

Syndets or synthetic detergents are synthetically derived organic quarternary ammonium compounds or polymerized or sulfonated fatty acids. They have a pH of 5.5 to 7. They are less likely to produce dryness and irritation of the skin.

Combars are composed of alkaline soaps to which surface active agents with a pH of 9 and 10 are added. They are milder cleansers than true soaps.

Other variants of cleansers

Soapless cleansers are lotions that are primarily composed of either glycerine or propylene glycol and cetyl/steryl alcohols and they can be wiped off without using water.

Liquid cleansers with appropriate blend of anionic, non-ionic and amphoteric surfactants are available. They are milder in nature and do not disrupt the skin barrier or acid mantle.

An ideal skin cleanser is one that is mild and has minimal interaction with skin and removes all unwanted materials from the skin. It should not affect the acid mantle of skin surface. It should be colourless and fragrance free and should not irritate the skin or eyes.



Shampoos that are available in the market are soapless and consists of a principal surfactant for detergent and foaming power, secondary surfactants to improve and condition the hair and additives to complete the formulation and special effects. Formaldehyde is the most common preservative used in shampoos and does not cause any side effects due to the short contact.

Baby shampoos should be ideally fragrance free and should not cause eye irritation. Medicated shampoos with ketoconazole, tar, zinc pyrithione, salicyclic acid are available for special hair conditions.


Vernix Caseosa


It is a naturally occurring complex, lipid rich substance coating the skin surface of the fetus. It is a chalky white material with shed epithelial cells, sebum and sometimes lanugo hair.

Preterm babies have very little vernix compared to the term babies and post term babies may not have vernix.

Vernix is highly beneficial. It is a natural cleanser and moisturizer with anti-infective, antioxidant and wound healing properties. It helps in the development of acid mantle and supports the normal bacterial colonization. WHO guidelines mention that vernix should not be removed at the time of birth.

Bathing the newborn


WHO guidelines mention that the initial bath for term newborn should be given 6 hours after birth. Any baby who is term and weighs more than 2.5 kgs could be given bath 6 hours after birth. In term IUGR babies only sponge bath is to be given until the baby’s weight crosses 2.5 kgs. There are some studies which have advocated bath after fall of the umbilical cord. Bathing makes the baby calmer and quieter than washing with cloth or sponge. The tactile stimulation that occurs during bathing provides a pleasurable experience for the baby and promotes the bonding between the baby and the parent or the caregiver.

How to give a bath:

  • Should be given in a warm room
  • Temperature of the bathwater should not exceed 37°C
  • Check the temperature of the water before placing the baby in the bath
  • If tub bath is given, the depth of the water should be 5cm up to the hip of the baby
  • Bathtubs may be a potential source of infection hence they must always be disinfected
  • Bath duration should not exceed 5 minutes in order to prevent overhydration of the skin which may lead to easy fragility of the skin and decrease threshold for injury

Routine bathing

Routine bathing of newborns and infants does not cause any harm. Daily baths are more preferable but during winter and in the hilly regions babies may be given bath twice or thrice in a week. 


Use of alkaline soaps during the neonatal period is to be avoided. If possible, liquid cleansers with acidic or neutral pH may be used which will not affect the skin barrier function or acid mantle. Syndets and mild soaps may be used in infants.

Care of the diaper area


Diaper area is exposed to excessive hydration, occlusion, friction and maceration. Faecal ureases catalyze the breakdown of urea to ammonia, which increases the pH of the skin surface. The pH increase will contribute to the activity of faecal enzymes, proteases, ureases and lipases which are highly irritant to the skin. Water and wet cloth are the gold standards for cleansing the nappy area. Mother should be advised to use only cloth napkins which should be changed frequently. It is important to keep the area dry. After defecation, moistened cloths or cotton balls soaked in lukewarm water can be used for cleaning the area. In case diapers are used, barrier creams containing zinc oxide and petrolatum based preparation could be used. Cloth napkins are to be washed with a mild detergent in warm water and dried in sunlight. Use of antiseptics to be avoided as a routine.

Care of the umbilical cord

Umbilicus should be kept dry and clean. Lukewarm water should be used for cleaning and cord should be kept exposed to air.

Care of the scalp

Cradle cap of the scalp is common in newborns. Mineral oil can be applied to the crusts and removed after two to three hours. Baby shampoos which are free from fragrance could be useful in removal of crusts and scales. The pH of the shampoos should be close to that of tears and should not cause irritation to the eyes.


Baby’s hair wash is to be given after the cord falls with a frequency of twice a week after that.

Use of baby powders


Mothers should be advised to smear the powder on the hands and then gently apply on the baby’s skin. Accidental inhalation of powders could happen if applied with puffs.

Care of the skin of preterm baby

Preterm babies have immature barrier function which results in increased transepidermal water loss, increased skin permeability, impaired thermoregulation, increased percutaneous absorption and susceptibility to trauma.

There is acceleration of permeability barrier maturation following birth hence within 2 to 3 weeks post-natally, babies develop competent barriers. But in preterm born at 22 to 25 weeks it takes 8 weeks to mature. In these preterm babies acid mantle develops over 2 to 8 weeks after birth. Gentle and minimal handling of the preterm babies is to be practiced. Hand hygiene measures are to be strictly followed by the mother or health care workers.

Sponge bath with water is to be given until the baby weighs 2.5 kgs after which regular bath is advised with mild cleanser. Micropore adhesives may be used to secure IV cannulas and while removing the adhesives use guaze piece soaked with warm water. Gentle application of emollients will help reduce the dryness and maintain the barrier function. Emollients also decrease the risk for invasive infections in preterms by preventing access to deeper tissues and the bloodstream through skin portals of entry.



Emollients are lipid containing substances that soften the skin and prevent transepidermal water loss. They help in restoration of skin barrier and thus retard further damage. Emollients contain hydrocarbon oils like petrolatum, mineral oils, paraffin and squalene. Fatty acids like lanolin acid, stearic acid and fatty alcohol like lanolin alcohol and cetyl alcohol are also used as emollients. Regular use of emollients is indicated in preterm babies. Emollients could be used in term babies with cleansers induced dryness.

Massage – Touch therapy

Touch is considered absolutely essential for growth and development of a neonate.

Lack of appropriate touch results in poor growth of the infant, delayed attachment to parent and psychological disturbances. Systematic application of touch is termed as massage. Massage promotes circulation, suppleness and relaxation of the different areas of the body and tones up the muscles. Massage results in promotion of mother-infant bonding.

Benefits of massage


  • Increases food absorption hormones such as insulin
  • Increased weight gain by increasing insulin and insulin like growth factor
  • Greater bone mineralisation and more optimal behavioural and motor responses
  • Babies become more active and alert

Oil massage

Oil massage is traditionally practiced in India. Oil enhances skin barrier function, acts as a source of warmth and nutrition and increases weight gain. Infants also showed less stress behaviour and lower cortisol levels following massage. Very low birth weight preterm neonates given oil massage showed better weight gain. Coconut oil, sunflower oil, mineral oil and synthetic oil are being used for massage. Mustard oil is recently been discouraged due to irritant and allergic contact dermatitis potential. Sunflower oil enhances the skin barrier function. Some studies have shown that olive oil can cause erythema and disruption of skin barrier function. During summer one has to avoid oil massage when baby has miliaria rubra. Oil massage should be given before bath during summer and after bath during winter.


Massage is ideally given by mother, father, grandparents or caregivers. It could be started after the 10th day of life in a well baby. Massage is to be given to babies when they are alert and active, preferably 1 to 2 hours after feed. Massage is to be done in a warm room. Mother or the caregiver has to cut their nails, and remove rings and watch. Strokes should be gentle and firm and not jerky. These gentle strokes should be given from head to foot. As the baby may not lie still, one should work with and not against the movements. Full body massage will take 15 minutes.


Comfortable signs of baby enjoying massage are happy vocal sounds like cooing, easy breathing pattern, bright-eyed look, ability to focus and take in surroundings comfortably and enjoying stretching, sucking, clasping own hands or feet.


ZIKA Virus


The Zika virus, a mosquito-transmitted disease, was first identified in the Zika Forest of Uganda in 1947 in the rhesus monkey. Eventually, it got transmitted to humans in 1952. This illness is transmitted by two species of mosquito — Aedes Albopictus and Aedes Aegypti. The Zika virus is similar to yellow fever, dengue, West Nile and Japanese Encephalitis viruses.


Image Courtesy:

Signs & Symptoms:

The time from incubation to exposure is not so clear but it lasts for 2-7 days.

  • The symptoms are a bit similar to dengue, usually causing mild illness which appears after some days of being bitten by an infected mosquito.
  • Mild fever, skin rashes, headache, muscle and joint pain, and pain behind the eyes may occur in an infected person.
  • Conjunctivitis, vomiting and malaise are some other symptoms of Zika virus.

 Modes of Transmission:


Image Courtesy:

  • Primarily, the Zika virus gets transmitted to humans through the bite of an infected Aedes mosquito, mainly Aedes Aegypti.
  • Unlike the Anopheles mosquito causing malaria which is active during night hours, the Aedes mosquito is extremely active during daytime; it can survive in both outdoor and indoor environment.
  • When a mosquito feeds on the blood of an infected person, it gets infected itself, transmitting the virus to other humans through bites.
  • Transmission through asymptomatic blood donors in whom RNA of Zika virus has been identified.
  • Possible transmission through sexual contact has also been reported.


A Zika virus infected person can be diagnosed through the following ways:

  • The presence of the Zika virus can be based on general symptoms such as mild fever, rash, conjunctivitis, pain, vomiting, uneasiness etc., Zika virus can be suspected through the patient’s place of living and history of travelling.
  • However, proper diagnosis is done by laboratory testing of blood, urine, saliva or other body fluids through the following tests:
  • PCR (Polymerase Chain Reaction) or by RT-PCR (Reverse-Transcription Polymerase Chain Reaction) for viral RNA
  • Serology Test


As the disease caused by Zika virus is usually mild, it does not require much medical attention. Those infected require proper rest, should drink plenty of fluids and take common medicines for fever and pain.

If the symptoms worsen, it is advisable to seek proper medical treatment. Currently, there is no vaccine or specific drugs available to fight the Zika virus.


To protect yourself from Zika virus, the following measures should help:

  • Avoiding mosquito bites is the best prevention.
  • Using insect repellent to kill mosquitoes.
  • Wearing light-coloured clothes that cover most parts of your body.
  • Sleeping under mosquito nets.
  • Covering water containers and emptying them from time to time

Microcephaly and Zika Virus:

Microcephaly is a neurodevelopmental disorder due to which babies are born with unusually small heads. The brains of these babies don’t develop properly during pregnancy or may stop growing in the first year of birth. Children infected with microcephaly experience problems like intellectual defects, developmental delays, hearing loss etc. It may also occur if a pregnant woman is malnourished, has diabetes or consumes alcohol.


Image Courtesy:

It is found that the rate of babies born with microcephaly in the virus-affected places is rising due to the possibility of pregnant women being infected by Zika virus.

Those travelling to infected areas should take all the preventive measures. Women planning to get pregnant or already pregnant and living in the affected areas should follow the measures strictly. Others should refrain from visiting these places so they don’t get infected.

Virus Affected Zone:

As per the update till 15 February, 2016, the Centers of Disease Control and Prevention (CDC) have warned about travel in the following areas with Zika virus transmission.

  • South and Central America: Brazil, Bolivia, Colombia, Mexico, Costa Rica, Paraguay, Panama, Venezuela Ecuador, El Salvador, French Guiana, Guyana, Guatemala, Honduras, Suriname and Nicaragua
  • Caribbean: Dominican Republic, Puerto Rico, Guadeloupe, Haiti, Jamaica, Barbados, Curacao, Saint Martin, Martinique and US Virgin Islands
  • Oceania: Samoa, American Samoa and Tonga
  • Africa: Cape Verde