Saturday, August 8, 2020

Your Diet During Pregnancy

Once you find out that you are pregnant, you may have questions.  One of them might be what to eat and what not to eat during this time.  Pregnant or not, eating a variety of foods is a good way to ensure getting what you need for health.  Pregnancy is a great time to focus on getting the best nutrition possible. 
What should you eat during pregnancy?
Your Diet During PregnancyFruits and vegetables provide nutrients not found in other foods.  So that's a good place to start.  Eat them!  Your doctor will likely prescribe prenatal vitamins.  But, while you should take them, they do not replace a nutritious diet.  If you aren't eating at least 2-4 servings per day of fruit and 4 or more servings per day of veggies, you should work on increasing your dietary intake.  This would provide vitamins, minerals, and fiber, as well as other phytonutrients.  These are natural chemicals that help protect plants from germs, fungi, bugs and other threats.  It is thought that they may help prevent disease and keep your body functioning properly, though they are not considered essential.  There are more than 25,000 phytonutrients found in plant foods, including antioxidants.  
Other sources of phytonutrients are whole grains, nuts, and beans.  While you may hear of diets that recommend avoiding or limiting carbohydrates, these foods (including beans and whole grains) are the body's main source of energy.  They also provide iron, B vitamins, fiber and some protein.  Aim for 6 - 11 servings per day of foods from this important food group.  How many servings you should have is based on your weight and individual needs.  Consult a Registered Dietitian (RD) for an individualized plan.  If your doctor's office does not have an RD on staff, they may be able to refer you to one.  Your health plan may cover this.
Your developing baby needs plenty of protein, things like meat, poultry, fish, eggs, and beans.   These foods also provide B vitamins and iron.  Iron helps carry oxygen to your baby but also to your muscles, which helps prevent fatigue, weakness, depression and irritability.  Three servings a day - 3 ounces equals a serving - provides about 27 grams of protein, the U. S. RDA or Recommended Dietary Allowance.  
Another nutrient to pay attention to is calcium.  You will need at least 1,000 milligrams of calcium daily to help build strong bones and teeth.  If your diet doesn't provide this, your body draws it from your bones.  Four servings a day of milk, cheese, or yogurt will supply this.  Calcium is also contained in green leafy vegetables, seafood, beans, and dried peas.  If you prefer a nondairy "milk," check to see how much calcium it contains.  Your body can't utilize a lot of calcium intake at one time, so try to eat the four servings separately throughout the day.  Calcium from food is also better for your body than taking a calcium supplement.
If you are not used to eating some of these healthy foods, try searching for different ways to prepare them.  There are many resources available for recipes.  This is another service an RD can offer.   
What foods or drinks should you avoid during pregnancy?
Here are some foods to limit or avoid...
  • A 12-ounce cup of coffee has about 200 milligrams of caffeine.  That is generally considered safe during pregnancy.  Try to limit yourself to that one 12 ounce cup.
  • Alcohol, however, is best avoided at this time as it passes directly to your baby and is associated with fetal alcohol spectrum disorders.  
  • Also avoid fish containing high levels of mercury.  Swordfish, shark, king mackerel, marlin, orange roughy, and tilefish fall into this category.  Some tuna also contains mercury.  The safer choice is the canned light tuna, though canned white tuna, also called albacore, is considered safe to have (6 ounce portion) three times a month.  
  • Stay away from unpasteurized food, including juice, milk and cheese, when you are pregnant.
  • Also avoid raw or rare/undercooked meat and poultry, raw or undercooked fish or shellfish.  
  • Don't eat raw or undercooked eggs or foods that contain them.
  • Avoid raw or undercooked sprouts.  
If you have any questions about diet during pregnancy, please log into your account and send us your question. We are here to help.

Sydney Rephan, RD, LD

Monday, August 3, 2020

Contact Dermatitis: Part 2

Last week we talked about the symptoms and causes of contact dermatitis.  Today I want to talk about how contact dermatitis is diagnosed, how it can be prevented, and how to treat it.
How do we diagnose contact dermatitis?
Much of the diagnosis is made based on the appearance of the rash along with a good history to uncover clues about the possible causes. 
Contact DermatitisIf your doctor suspects an allergic cause, they might recommend allergy testing, such as a patch test, to confirm the diagnosis.  
How is a patch test done?
Small amounts of the possible trigger allergens are put on patches that adhere to your skin like tape.  You will then go home with these patches in place, where they will stay on for 2-3 days.  You will need to keep your back dry during that time period.  After 2-3 days, you return to the doctor to have the areas evaluated for skin reactions.  
What can be done to prevent contact dermatitis?
There are several things that you can do for prevention.  Here are a few:
  • Avoid triggers - For instance, make sure you know how to identify poison ivy and avoid it.  Avoid overuse of hand sanitizer or other irritants.  
  • Wear protective clothing - Depending on the possible exposure, you can wear gloves, long sleeves, face mask, or goggles to protect you against irritating substances.
  • Wash your skin after exposure - If you do come in contact with an allergen or irritant, wash your skin right away after coming in contact with it.  Use warm water and a mild soap.  Rinse completely.  Also put any clothes that you were wearing into the washing machine before washing your skin, so that you don't get exposed again from touching those clothes.
  • Use a barrier cream - This protective layer may prevent the irritant or allergen from penetrating your skin.  For example, an OTC cream such as IvyBlock may prevent or lessen a skin reaction to poison ivy IF you apply it before you come into contact with the plant.
  • Keep your skin healthy - Use moisturizers regularly, and treat cuts and scrapes appropriately, which can help keep your skin healthy enough to keep some reactions to a minimum.
  • Be careful of pets - Pets can carry some allergens or irritants on their fur after they are exposed (including poison ivy).  They can then spread these substances to people.  
  • If you are sensitive to nickel, look for nickel-free jewelry.  You can also apply an iron-on patch to the inside of clothing that contains metal buttons to keep them from contacting your skin. 
How is contact dermatitis treated?
  • Eliminate any exposure to triggers - If you develop an irritant reaction to hand sanitizer, you should stop using it.  If you develop an irritant or allergic reaction to cleaning chemicals, you should stop using them or always wear gloves when you need to use them.  This is an important step in treatment.
  • Steroid creams or ointments - You might initially try some OTC steroid treatments, such as hydrocortisone 1% cream or ointment (I think the ointment works a little better.)  If this does not help, your doctor might prescribe a stronger steroid cream or ointment.
  • Antihistamines - You might initially try OTC antihistamines, such as Benadryl.  If OTC antihistamines don't help, your doctor might prescribe a different oral antihistamine.
  • Oral steroids - In severe cases, your doctor might prescribe an oral steroid such as prednisone, which can reduce inflammation in the skin, and decrease your allergic reaction.
  • Antibiotics - Antibiotics are not indicated as treatment for contact dermatitis.  However, if you have severe contact dermatitis, and scratch excessively, you can develop a secondary skin infection.  In that case, your doctor may prescribe either topical or oral antibiotics.  
  • Wet compresses - Use cool, wet compresses (a towel or wash cloth wet with cool water) on the affected area for 15-20 minutes at a time, several times a day.
  • Avoid scratching - If you can't keep yourself from scratching, apply a dressing over the area to avoid direct contact.
  • Soak in an oatmeal bath, or take a cool shower.
If you have any questions about contact dermatitis treatment or prevention, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Contact Dermatitis

Contact dermatitis is a rash caused by direct contact with a substance that either irritates the skin or causes an allergic reaction within the skin.  Although the rash is not life-threatening, it can be very uncomfortable.  
Many different substances can cause contact dermatitis as we will talk about below.  Recently, many people have developed contact dermatitis as a result of frequent use of hand sanitizer.  I thought this would be a timely topic for our discussion this week.
What are the signs and symptoms of contact dermatitis?
Contact DermatitisSymptoms usually occur in areas that have been directly exposed to the irritant or allergen.  For instance, with poison ivy, it would be the area that came into contact with the plant or oil from the plant.  Hand sanitizer would most commonly cause symptoms on the hands.  
Here are the things to look for: 
  • A red rash, which may include bumps and blisters
  • Blisters may develop oozing and crusting
  • Itching, which can be quite severe
  • Cracked and scaly dry skin
  • Swelling   
  • Burning sensation
  • Tenderness
What causes contact dermatitis?
Contact dermatitis can be caused by two different types of substances.
The first type is irritants.  Irritants are substances which damage your skin's outer protective layer.  Sometimes people react to a strong substance after one exposure.  Other times, the reaction develops after repeated exposure to milder irritants.  
Here are some common irritants:
  • Products containing rubbing alcohol, including hand sanitizer
  • Solvents
  • Bleach and detergents
  • Hair products, including shampoos, hair dyes, or perm solutions
  • Fertilizers or pesticides
  • Sawdust
  • Wool, or wool dust
The second type of substance is something that causes an allergic reaction within the skin.  Something that causes an allergic reaction is called an allergen.  This allergic skin reaction usually only affects the skin that was directly exposed to the allergen.  But it can be triggered by something that you eat or drink, such as foods, food dyes or flavorings, or medication.  It is also possible for something that contacts the skin in one area to cause an allergic reaction in the skin all over the body.  Sometimes you may react to an allergen the first time you are exposed, but you can also develop an allergy after multiple exposures over several years.  
Here are some common allergens:
  • Nickel, found in jewelry, belt buckles, and many other items
  • Plants, such as poison ivy
  • Medications
  • Formaldehyde, found in disinfectant, preservatives, and some clothing
  • Balsam of Peru, used in many products from perfumes to mouth rinses
  • Personal care products, such as deodorants, cosmetics, nail polish, etc.
  • Products that cause a reaction when your skin is exposed to sunlight, such as some medications and some sunscreens.
Are some people at higher risk for contact dermatitis?
People who have certain hobbies or jobs are at higher risk simply because they are exposed to more of the possible causes.  These include:
  • Health care workers
  • Metal workers
  • Construction workers
  • Hairdressers and cosmetologists
  • Auto mechanics
  • Cleaners
  • Gardeners, farmers, and agricultural workers
  • Cooks and others who work with food
 Are there complications that might occur from contact dermatitis?
The primary complication is infection in the skin, which is not uncommon if you repeatedly scratch the affected area.  Scratching damages the skin and allows bacteria or fungi to grow.
Next week, we will talk more about prevention and treatment of contact dermatitis.  
If you have any questions about contact dermatitis, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor