Colds & Flu
Okay to Take:
• Tylenol – for body aches and low-grade fever.
• Sudafed – for congestion.
• Robitussin – for cough.
• Chloraseptic spray/lozenges/salt gargles: for sore throat.
• Tylenol Cold.

Call Your Doctor if:
• Fever over 101 degrees > 24 hours.
• Shortness of breath or heaviness in chest.
• Coughing up phlegm.
• No improvement in 2-3 days.

Allergies:
Okay to Take:
• Benadryl, Zyrtec, Flonase, and Allergy shots.

Constipation:
Okay to Take:
• Metamucil, Citrucel, Fibercon, Milk of Magnesia.
• Increase fluids; include fruit juices and prune juice.
• Increase fiber; bran cereals, vegetables or raw fruits, especially apples and pears. Increase exercise and water.
• If no bowel movement for 2 days may start Colace daily.

Call Us if:
No bowel movement within 48 hours of starting Colace.

Diarrhea:
Okay to Take:
• Imodium AD, Kaopectate, “BRAT” Diet-Bananas, Rice, Applesauce, Toast & Tea.
• Increase fluids, especially water to avoid dehydration.
• Avoid fruit juices and dairy products – these can increase diarrhea.

Call Us if:
• No Improvement in 2-3 days.
• Fever > 101.

Headaches:
Okay to Take:
• Tylenol as directed.
• NO ASPIRIN – this includes Excedrin.
• NO IBUPROFEN (Advil or Motrin).
• NO NAPROSYN (ALEVE).

Call Us if:
• Not relieved by Tylenol within 24 hours.
• Blurred vision and/or dizziness.
• Excessive swelling in hands & face.

Headaches in the early weeks of your second trimester are normal.

Hemorrhoids:
Okay to Take:
• Anusol and Preparation H.
• Increase fiber – ensure soft stool.
• Warm sitz baths.
• Avoid heavy lifting.

Nose or Gum Bleeds:
• Common in Pregnancy – due to extra blood supply.
• Good oral hygiene (frequent brushing and flossing).
• Going to the dentist is okay; just alert them of your pregnancy.
• To stop nosebleeds, apply firm pressure to the side of nose that is bleeding with your fingers.

Call us if:
• Trouble getting bleeding to stop.
• Increase in frequency.

Leg Cramps:
• Common in pregnancy, especially in last trimester.
• Increase fluids, calcium, and potassium.
• Stretch your legs throughout the day and prior to going to bed.
• Avoid pointing toes with stretching or exercise.
• Avoidance of High or “chunky” heels will help.

Call us if:
• Only one leg is hurting all the time.
• Reddened area that is hot to touch.
• Hurts to flex toes (pulling them toward your head).

Dental Problems:
Okay to:
• Have x-rays with Lead Abdominal Shield.
• Have Novocain (numbing medication).
• Have some Pain meds and/or antibiotics.
• Check your medication list first, then call.
• CANNOT have LAUGHING GAS.

Vaccines:
Okay to Have:
• TB skin test, Flu Shots (after 13 weeks).
• Hepatitis A&B, Tetanus Booster.

Heart Burn/Reflux:
Okay to Take:
• Maalox, Mylanta and Tums.
• Try eating small bland meals.
• Do not lie down for at least 1 hour after eating.
• Elevate head with pillows vs. lying flat.
• Wait 2 hours after eating before exercising.
• May use Zantac 75 or Pepcid AC if no relief of symptoms.
• Coffee, dairy products (i.e. – ice cream before bed), mint will make some symptoms worse.

Fatigue/Rest:
• Common in Pregnancy, especially in first trimester.
• Make sure to get 8 hours of rest at night.
• May need to take naps during the day, however, long naps will affect your ability to sleep at night.
• Rest on your left side for an hour in the middle of the day.
• Side resting promotes blood flow to the baby and your kidneys.

Frequent Urination:
• This is a common in pregnancy and occurs when the uterus expands and puts pressure on your bladder.
• Most common during the first and third trimester.
• Please do not limit your fluid (water) intake.

Call Us if:
• Burning sensation during urination.
• Change in the odor or color of your urine.
• Fever of 100.5 with the above symptoms.

Viral Exposure

• Fifths disease:
Call for appointment to have Parvo titers drawn.

• Roseola:
Do not be concerned.

• Chicken Pox:
NO concern if you’ve had vaccine or prior exposure. Call us immediately if you are not immune or are unsure of your immunity.

• Scarletina or Strep Throat:
Use good hand washing. Call us if symptomatic (sore throat & fever).

• Nausea and Vomiting:
Common during the first 14 weeks of pregnancy. This is often called “morning sickness”, but it can occur anytime throughout the day. We recommend the following to help make you more comfortable; however, if symptoms are unrelieved and nausea is severe (unable to keep fluids down or food despite all followed suggestions), please call the office.

Things to try first:
• Eat dry toast or crackers before getting out of bed.
• Get up slowly and sit on the side for a few minutes.
• Eat five to six meals daily.
• Do not let your stomach get completely empty.
• Avoid unpleasant smells.
• Eat what sounds good to you.
• Avoid spicy and greasy foods.
• Drink room temperature carbonated drinks.
• Dry starch foods will help with nausea any time of day.

If your symptoms do not resolve with the above recommendations, then try:
• Sea-Bands – may be purchased at any pharmacy.
• Vitamin B6 – 25 mg two times per day.
• Unisom – 25 mg two times per day.
• Zantac 75 or Pepcid AC – two times a day.

Call Us if:
• Unable to keep fluids down > 24 hours.
• Dark urine with decreased output.
• Feeling weak and dizzy.

Prescription medication is usually reserved for significant vomiting that results in dehydration.

Low Backache:
Common in pregnancy. Try wearing comfortable shoes and using good posture. Exercise; especially stretching, as this will relieve your backache more than anything else.

Sexual Relations:
Sexual intercourse is permitted at any time during your pregnancy unless you have vaginal bleeding, ruptured membranes, or premature labor. Many couples experience a decrease in sexual desire late in pregnancy, which is normal.

Inability to Sleep:
During your second and third trimester, you may find it hard to sleep. Your abdomen is large, and it is hard to get comfortable.

Suggestions to help you get the rest you need:
• Take a warm shower at bedtime.
• Rest for short breaks during the day.
• Lie on your side with a pillow under your abdomen and another between your legs.
• Avoid caffeinated beverages in the evening.

Vaginal Discharge:
An increase in vaginal discharge is a normal response to hormones during pregnancy. You may also notice a change in odor. There is not much that can be done to change this; however, a discharge that has a bad odor, causes itching or is blood tinged should be evaluated.

Abdominal pain:
Common in pregnancy. During the first trimester, you may experience menstrual like cramps. This is due to the uterus growing and moving up into the pelvis.

Round ligament pain, is the stretching or spasms of the ligaments that support the uterus. These cordlike structures originate beneath the groin regions and extend to the top of the uterus on both sides. Sudden movements like rolling over in bed or prolonged walking can aggravate round ligament pain. Decreasing physical activity and applying warm heat can help.

If you should ever experience severe abdominal pain that prevents you from standing, walking, or is associated with bleeding, Call Our Office Immediately.

Braxton-Hicks Contractions are uterine contractions that occur spontaneously from early pregnancy until the onset of labor. Usually, the contractions are irregular and painless. If they become progressively closer together (more than 6 per hour), last longer that 15-30 seconds, and become more painful, you need to call the office. This could be a sign of pre-term labor. Braxton Hicks contractions are more common with second or third pregnancies.

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Medication, Travel and Referral List

• Medication and Referral List will be provided
• NO aspirin, aspirin containing products, or ibuprofen, unless your physician prescribes them.

Travel:
• You may travel up to your 35th week of pregnancy; however, if you have a history of premature labor or rupture of membranes, you need to check with us first.
• When traveling by car, stop every 2 hours to walk and stretch.
• When traveling by air, increase water consumption before, during and after the flight to prevent dehydration. You should get up every 2 hours to stretch.

Smoking and Alcohol

Smoking:
Cigarette smoking is associated with an increased risk of miscarriages, stillbirth, fetal growth retardation, and SIDS. Therefore, we strongly recommend that you quit smoking during your pregnancy. If you are unable to quit, then please limit smoking as much as possible.

Alcohol:
It is well documented that alcohol causes fetal malformations and mental retardation. Since a safe limit of alcohol consumption is not known, we recommend avoiding alcoholic beverages during pregnancy.

Additional special testing after the birth of your baby

Baylor Supplemental Newborn Screening:
The Institute of Metabolic Disease, located in Dallas at Baylor University Medical Center, offers supplemental newborn screening for 30 additional disorders not included in the state required screening. A metabolic disease is caused by an accumulation of chemicals produced naturally in the body. The diseases are usually serious, some even life-threatening. However, with early diagnosis and treatment, metabolic disease can often be managed effectively.

Cord Blood Banking:
Preserving cord blood stem cells allows immediate access in the even your child would ever need a stem cell transplant. Stem cell therapy is used to treat a wide range of diseases, including cancer, leukemia, lymphoma, some forms of anemia, and sickle cell disease. The collection is done immediately after the birth and the stem cells are cryogenically frozen.