Pregnancy Weight Gain

The Institute of Medicine (IOM) today issued new guidelines on how much weight to gain during pregnancy. But actually, those guidelines begin before pregnancy.

The IOM wants women of childbearing age at a healthy weight before getting pregnant, for the sake of the health of mother and baby alike. And the IOM wants women to be offered preconception counseling about weight, diet, physical activity -- and contraception, if they're overweight or obese, so that they can lose extra weight before pregnancy.

Then, once a woman gets pregnant, she's supposed to keep her weight gain within certain limits, based on her BMI (body mass index) before pregnancy.

Here are the IOM's weight gain allowances for a woman carrying one child: If she's underweight, she should gain 28-40 pounds. If she's at a normal weight, she should gain 25-35 pounds. If she's overweight, she should gain 15-25 pounds. And if she's obese, she should gain 11-20 pounds.

Does that sound doable to you? Or did you figure that since you're "eating for two," you can double your calories -- especially if you're having cravings or feeling hormonal?

Don't go there, says Melissa Goist, MD, a clinical assistant professor of obstetrics and gynecology at the Ohio State University Medical Center.

A normal-weight woman would need only 300 extra calories per day to maintain a healthy pregnancy with one baby -- that's one-sixth of her prepregnancy calorie budget and roughly the amount of calories in a Snickers bar, Goist says.

Of course, Goist isn't recommending that pregnant women get their extra pregnancy calories from candy bars -- a healthy, balanced diet is the way to go.

Goist says it can be tough to talk to pregnant patients about weight, like her patient who was 8 pounds heavier each month that Goist saw her. Keeping that pace for nine months would put her way over the IOM's recommended weight gain. Plus, Goist says that patient wasn't following her dietary advice -- she was feasting on carbohydrates.

Goist, and the experts who wrote the IOM's new guidelines, say the public hasn't gotten the message that pregnancy isn't a time to ignore weight or eat with abandon.

What do you say? If you've been pregnant, how much weight did you gain, and did your doctor talk to you about it? How hard was it to lose the weight after the baby was born, and would you gain more or less weight if you had to do it all over again?

Summer Begins -- Swine Flu Ends?

Memorial Day is the unofficial start of summer, so does that mean the official end of swine flu?

Attention to swine flu has waned, but swine flu hasn't. It looks like swine flu is here to stay -- for how long we don't know. While flu is unusual in the warm, summer months, swine flu is still swirling around. CDC officials say the entire U.S. is likely affected, and they continue to see more people with swine flu. Officials aren't sure what will happen when the fall flu season arrives.

So as school comes to a close, is the threat of swine flu going to affect your summer plans? Should you be concerned about exposing your child to a crowded group of kids at summer camp?

The CDC says there is no reason to keep your kid out of school unless he/she is sick. The same holds true for summer camp or any other summer activity.

Yes, the risk of swine flu is out there. But thankfully, very few people are developing serious illness. It appears we have no more reason to be concerned than during the normal flu season.

While you don't need to let swine flu get in the way of a fun summer for you and your family, hopefully the attention that swine flu has received will help all of us remember how to stop the flu. And no time like the present to teach your kids a few simple tricks.

Lead by example. It's tough to get kids to wash their hands -- much less for the recommended 20 seconds (a good rule of thumb is to sing Happy Birthday twice). Most of us aren't so good at that either.

Your kids have likely heard about swine flu, so take the time to explain to your kids why frequent hand washing is so important. It'll go a long way to not only preventing the very contagious swine flu but also other respiratory viruses, such as colds, and even stomach bugs.

And come fall, most of us have no reason not to get the flu vaccine. The CDC has found that people born before 1957 may have a bit more immunity to the swine flu virus than younger people. This is likely due to their exposure to previous flu viruses and possibly having received flu vaccines in past years.

Are you going on about your normal business or has swine flu caused you to change your summer plans?

Pneumonia Vaccine for Swine Flu?

Kudos to the reader that asked this question. It's very insightful and shows you're thinking about this swine flu outbreak logically.

"Dr. Smith, Since a complication of swine flu (and other flu) is pneumonia, shouldn't we all be getting the pneumonia vaccine? Wouldn't having protection from pneumococcal pneumonia help you if you did contract the swine flu? Is this type of pneumonia what is killing some swine flu victims?"

You're right in that bacterial pneumonia is often one of the main things that kills people who have the flu (about 36,000 people die from the flu every year). Sometimes that bacteria is pneumococcus. Sometimes it's other bacteria, like staphylococcus. The pneumococcal pneumonia vaccine (more commonly known as just the pneumonia vaccine) would help if it's pneumococcus.

However, many of those that have died from swine flu have died from viral pneumonia. This means that the swine flu virus itself is causing the lung infection and inflammation. Unfortunately, a pneumococcal vaccine wouldn't have helped in these instances.

Those of you who have kept up with my blog know that I'm a very big proponent of the flu vaccine. Same is true for the pneumonia vaccine. Both save lives.

So who should get the pneumonia vaccine?

Currently, it is recommended for:

• All adults 65 or older
• Everyone 2 and older with chronic medical conditions such as diabetes, chronic lung, heart, kidney or liver disease, or alcoholism
• People over 2 whose immune systems have been weakened by such conditions as cancer or HIV infection
• People without a functioning spleen
• People with sickle cell disease

In October, a CDC panel also recommended that people with asthma or those who smoke should receive the pneumonia vaccine. It's not an official recommendation at this point but if you have asthma or you smoke, ask your doctor if the pneumonia vaccine is right for you.

Something Good Out of Swine Flu

It's tough to think of something good that could possibly come out of the swine flu outbreak that has killed 3 people as of today, but I'm keeping my fingers crossed.

During the normal flu season, I have to practically beg and plead some people to get a flu shot -- including my parents! But that's because most people go through the flu season with a "not me" attitude. I thought we grew out of that when we were teenagers.

Even though this swine flu outbreak has been mild so far -- and that could change -- I hope it's at least made an impact on people. I'm hoping that, come November, more people will be rushing to get their flu vaccine. After all, the normal flu kills 36,000 people every year!

It's unclear at this point if a swine flu vaccine will be included in the recommendations this year (or if one will even be developed in time) ... but we know that the annual flu vaccine stands to save thousands of lives.

The flu vaccine is the #1 best way to prevent the flu and prevent flu complications, such as pneumonia and even death.

Let's learn something from this swine flu outbreak.

If you can significantly lessen the likelihood of getting the flu and flu complications, why not? A few minutes, and a tiny needle stick, just might save your life -- or the life of a loved one.

Do you always get a flu shot or do you think the swine flu outbreak will finally convince you to get a flu vaccine?

Swine Flu: One Extreme to the Other

It almost seems like we've gone from one extreme to the other with the swine flu outbreak.

When swine flu first hit the scene about 3 weeks ago, you might have thought the world was coming to an end. Actually, a few comments to some of my early blog posts did feel a bit chicken littleish.

I think we've learned at this point that the world will continue to exist -- for at least a little while longer. But now it seems that people already have flu fatigue and are going to go back to their old ways until some other flu virus -- or some other germ -- rears its ugly head.

Now is not the time to slack off. The truth is that what we do today -- and for the next few months -- could have a significant impact on the fall & winter flu season.

Since the swine flu scare, I've noticed definite improvement in the steps people are taking to prevent spread of infection. Better hand washing ... more use of alcohol-based gels to kill germs ... and limiting touching of public areas (or at least wiping your hands down afterward if you do).

If we can just keep up the good work through the summer and into the fall and winter, we can help prevent spread of swine flu -- or any other type of flu that may come up in the future.

So far, this swine flu has been milder than we originally feared. But we continue to see more cases and there's a good chance that this swine flu strain could come back in the fall -- when the normal flu virus also gets ramped up.

Have you stepped up your germ-killing efforts or already feel yourself reverting back to your old ways?

You Have Swine Flu -- Now What?

I've probably hit you over the head enough about not worrying too much about getting swine flu. But what happens if you actually do get it?

Earlier this week, someone asked "If your child gets sick with symptoms of the flu, do you go to the pediatricians office, hospital, where? Is there a test for this flu strain? How are people being treated that suspect they may have it?"

But what about for older adults -- "Hi Doc, I am 67 years old and I could tell you when the last time I had any type of flu. Should I be worried? Also I have not heard anybody say what to do if you get it, like take aspirin, drink lots of fluids, bed rest or what?"

I bet many people wonder what it would feel like to get the swine flu. You probably wouldn't be able to tell the difference between swine flu and the normal flu that you've likely had a time or two.

Swine flu symptoms, and regular flu symptoms, are fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. The difference is that more people with swine flu seem to have diarrhea and vomiting, which we don't usually see with the regular flu.

For most people, the only treatment that would be needed for swine flu is also the same as regular flu treatment. Make sure you get plenty of fluids so you don't become dehydrated, take over-the-counter medications to help relieve symptoms, such as congestion and coughing, and get plenty of rest.

For children, particularly young children, you need to watch them closely to make sure they're not getting dehydrated, not overly lethargic, and not having any breathing difficulty. If you're concerned about these or any other symptom, it's always best to call or see your pediatrician.

Some people might benefit from taking antiviral drugs. The good news is that the flu drugs Relenza and Tamiflu are effective against the swine flu virus. However, the trick is to take them very early -- within 48 hours of developing symptoms. They can help lessen the severity of the flu, help you recover more quickly, and may help prevent serious complications from the flu.

While anyone can take an antiviral drug if your doctor feels it's right for you, those at high risk from swine flu complications, such as the very young, the very old, pregnant women, or those with a heart or lung problem, would benefit the most.

If your doctor does suspect you may have swine flu, there is a simple swab test that can confirm the infection. It takes a few days to get the results back so you would be treated while waiting on the results.

And lastly, keep in mind that even if you get the swine flu, chances are very great that you will recover just fine in just a few days.

Keep the great questions coming!

Are You Hankering for a Swine Flu Vaccine?

Within days of hearing about the swine flu outbreak, people started asking, "What about a swine flu vaccine?" And I'd bet that many Americans were ready to take the shot right then and there.

I wish people were so eager during the regular flu season. If they were, maybe fewer people would get infected -- and we'd see fewer deaths from the seasonal flu. As it is, about 36,000 people die every year from the flu.

And before you get ready to stand in line next week for the swine flu vaccine, the CDC says a swine flu vaccine won't be ready for about 6 months -- and that's if they decide to ask manufacturers to develop a vaccine against this strain. It's really going to depend on how this outbreak plays out.

The 1976 swine flu outbreak is good evidence why we shouldn't try to speed up the process. Our lives may just be at risk.

In that swine flu outbreak, one person died from the actual swine flu. However, 32 people died from the quickly-developed vaccine and another 500 people developed paralysis from Guillain-Barre syndrome, a usually very rare complication of the flu vaccine.

Regardless of what happens with the current swine flu outbreak, a vaccine isn't going to have any impact for at least several months. So, don't ease up on your flu prevention efforts.

The good news is that the outbreak seems to be calming down a bit -- or maybe it's just the hysteria that is easing off. No, we're not out of the woods completely, but time appears to be telling us that this swine flu outbreak is not likely to be one to kill scores of people. As of yesterday, there were 2 swine flu deaths in the U.S.

If a swine flu vaccine were available today, would you be first in line?

Swine Flu Supplements: Magic Pill?

Since people are always looking for that magic cure pill, it's inevitable that I've been getting questions about supplements for swine flu.

It's of no surprise that some companies have jumped at the opportunity to sell supplements that supposedly combat swine flu. And it's no surprise that there is so much interest.

People are very concerned -- honestly, far more concerned than they probably should be -- about getting sick from swine flu.

There are absolutely no supplements that are known to help fight swine flu. Last week, the FDA and the FTC alerted the public to be wary of any product that claims to diagnose, prevent, treat, or cure the H1N1 swine flu.

A group of supplement industry associations have joined together to come out against swine flu supplements, pointing out that they are "unaware of any scientific data supporting the use of dietary supplements to treat swine flu. Furthermore, federal law does not allow dietary supplements to claim to treat any diseases, including swine flu."

What concerns me even more is why people feel they need swine flu supplements.

At the risk of repeating myself, let me bring up a couple of quick stats about the regular flu season that we see every year. On average, 200,000 people are hospitalized with the seasonal flu just in the U.S. and 36,000 people die in this country. But I'd guess that not many of us think much about the risk of this garden-variety flu -- much less taking supplements to treat this flu.

Compare that to what we've seen thus far with the swine flu. As of yesterday, there has been one swine flu death. I'm certainly not making light of that death as it's very tragic. I'm making the point that relative to what we normally see with the flu, the swine flu thankfully has been very mild so far.

To date, very few swine flu infections have been serious and almost everyone has fully recovered.

Your risk of getting serious flu infection, and even dying, is far greater with the regular flu than it is, thus far, with the swine flu. And while officials are being cautious, there is nothing to suggest that this swine flu outbreak will all of a sudden cause more serious infections.

Don't take this as an excuse to lighten up on your flu prevention -- you should still wash your hands regularly and frequently, avoid close contact with sick people, avoid touching your mouth, nose, and eyes, and stay home if you feel ill.

You can stay on top of the latest swine flu news with WebMD's Swine Flu Guide.

And let us know what's on your mind. Are you feeling better about the swine flu outbreak? Still worried sick?

Swine Flu or Allergies: How Do You Tell the Difference?

Given that allergy season is upon us, people are wondering how to tell the difference between allergy and swine flu symptoms?"

Ev345 asks, "My question is how do you differentiate between swine flu and seasonal as well as indoor(to cats/dogs/dust mite etc.) allergies?

It's actually pretty easy.

Symptoms of swine flu are like regular flu symptoms and include fever, cough, sore throat, body aches, headache, chills, and fatigue.

There are 2 symptoms that are always present with the swine flu that you don't get with allergies.

While allergies can make you feel awful, allergies do not cause fever. Without fever, you don't have the swine flu. Another symptom that almost everyone with the flu will have is body aches. This is also very unusual with seasonal allergies or allergies to dogs or cats.

A runny nose and congested sinuses, even if combined with coughing, are not signs of swine flu. If these are your symptoms, you likely have either allergies or possibly a sinus infection. Not so pleasant either, but certainly not swine flu.

Still worried about the swine flu? The WebMD news team did a great piece on 7 reasons why you don't need to worry.

And in case you didn't keep up with the latest swine flu news over the weekend (we're all allowed a break), today's story "H1N1 Swine Flu: No State Is Immune" will bring you up to speed.

Let us know what's on your mind. Have a question? We'll put our team of writers, editors, and doctors to work and try to find out for you.

Swine Flu: What's in a Name?

You thought swine flu sounded strange. Well, try H1N1 influenza A virus on for size!

It appears that the use of the term "swine flu" has had quite an impact.

The pork people say it's hurting their industry because it's misleading people into thinking that pork is bad. They have a point. You absolutely cannot get this virus (goodness, I don't even know what to call it anymore) from eating pork. Someone should tell the Russian and Chinese governments that. They're banning pork imports from Mexico and parts of the U.S. If government officials are taking such misleading action, what's the public to think?

But the damage has been done. Pork sales have apparently fallen by 80%. It bears repeating -- you CANNOT get this virus from eating any type of pork.

This is not the only flu myth floating around. Check out WebMD's "Top 14 Flu Myths" to get up to speed.

The Israeli government has also said they would abandon the use of "swine flu," so Jews would not have to use the term.

Then, the World Health Organization has said it will use "North American influenza" to note, as they have done in the past, the location of origin of a potential pandemic. And then you have the Mexican government saying that the virus actually got into their country from someone visiting from Asia, where most flu viruses typically originate.

By the way, the U.S. government has also jumped on the "be kind to pigs" bandwagon and also abandoning "swine." As of today, both WHO and the CDC sites are still using "swine flu" on their websites -- guess they have a few things going on right now.

Got all that?

There is potentially a scientific reason to change the name. The name was originally used because this virus is one that generally stems from pigs. However, the virus has yet to be isolated from a pig, leaving some to wonder if it's actually a pig virus. Then, there have also been reports that the virus contains part of bird flu viruses as well.

But a report I read today says that 80% of the virus is derived from swine, with the remaining 20% being a mixture of bird and human flu viruses. Many scientists say that this is a swine flu virus.

So where does that leave us? I certainly don't want to offend anyone or mislead people into thinking things that aren't true. But at least come up with a name that people can remember -- and try to come up with something that makes sense. I'm just glad I'm not a government official that needs to worry about all the concerns of the world and come up with a name for a microscopic virus!

What do you think we should call this virus?