Guidelines for the Management of Pregnancy in Women w/ CF

[Keepercjr]

I got an email about this report this morning and thought I would pass it on. Its a really long read but interesting. It includes everything from preconception through postpartum, and breastfeeding info. Even pregnancy post transplant

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X2D-4R5G3DG-1&_user=10&_coverDate=01%2F31%2F2008&_rdoc=2&_fmt=full&_orig=browse&_srch=doc-info(%23toc%237268%232008%23999929999.8998%23677240%23FLA%23display%23Volume)&_cdi=7268&_sort=d&_docanchor=&_ct=2&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9f441a1725148d39a4abc4ccf089ba23
">http://www.sciencedirect.com/s...48d39a4abc4ccf089ba23
</a>
If the link doesn't work let me know and I'll try to fix it.

Here is the abstract:

Women with cystic fibrosis (CF) now regularly survive into their reproductive years in good health and wish to have a baby. Many pregnancies have been reported in the literature and it is clear that whilst the outcome for the baby is generally good and some mothers do very well, others find either their CF complicates the pregnancy or is adversely affected by the pregnancy. For some, pregnancy may only become possible after transplantation. Optimal treatment of all aspects of CF needs to be maintained from the preconceptual period until after the baby is born. Clinicians must be prepared to modify their treatment to accommodate the changing physiology during pregnancy and to be aware of changing prescribing before conception, during pregnancy, after birth and during breast feeding. This supplement offers consensus guidelines based on review of the literature and experience of paediatricians, adult and transplant physicians, and nurses, physiotherapists, dietitians, pharmacists and psychologists experienced in CF and anaesthetist and obstetricians with experience of CF pregnancy. It is hoped they will provide practical guidelines helpful to the multidisciplinary CF teams caring for pregnant women with CF.

 

[Keepercjr]

I got an email about this report this morning and thought I would pass it on. Its a really long read but interesting. It includes everything from preconception through postpartum, and breastfeeding info. Even pregnancy post transplant

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X2D-4R5G3DG-1&_user=10&_coverDate=01%2F31%2F2008&_rdoc=2&_fmt=full&_orig=browse&_srch=doc-info(%23toc%237268%232008%23999929999.8998%23677240%23FLA%23display%23Volume)&_cdi=7268&_sort=d&_docanchor=&_ct=2&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9f441a1725148d39a4abc4ccf089ba23
">http://www.sciencedirect.com/s...48d39a4abc4ccf089ba23
</a>
If the link doesn't work let me know and I'll try to fix it.

Here is the abstract:

Women with cystic fibrosis (CF) now regularly survive into their reproductive years in good health and wish to have a baby. Many pregnancies have been reported in the literature and it is clear that whilst the outcome for the baby is generally good and some mothers do very well, others find either their CF complicates the pregnancy or is adversely affected by the pregnancy. For some, pregnancy may only become possible after transplantation. Optimal treatment of all aspects of CF needs to be maintained from the preconceptual period until after the baby is born. Clinicians must be prepared to modify their treatment to accommodate the changing physiology during pregnancy and to be aware of changing prescribing before conception, during pregnancy, after birth and during breast feeding. This supplement offers consensus guidelines based on review of the literature and experience of paediatricians, adult and transplant physicians, and nurses, physiotherapists, dietitians, pharmacists and psychologists experienced in CF and anaesthetist and obstetricians with experience of CF pregnancy. It is hoped they will provide practical guidelines helpful to the multidisciplinary CF teams caring for pregnant women with CF.

 

[Keepercjr]

I got an email about this report this morning and thought I would pass it on. Its a really long read but interesting. It includes everything from preconception through postpartum, and breastfeeding info. Even pregnancy post transplant

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X2D-4R5G3DG-1&_user=10&_coverDate=01%2F31%2F2008&_rdoc=2&_fmt=full&_orig=browse&_srch=doc-info(%23toc%237268%232008%23999929999.8998%23677240%23FLA%23display%23Volume)&_cdi=7268&_sort=d&_docanchor=&_ct=2&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9f441a1725148d39a4abc4ccf089ba23
">http://www.sciencedirect.com/s...48d39a4abc4ccf089ba23
</a>
If the link doesn't work let me know and I'll try to fix it.

Here is the abstract:

Women with cystic fibrosis (CF) now regularly survive into their reproductive years in good health and wish to have a baby. Many pregnancies have been reported in the literature and it is clear that whilst the outcome for the baby is generally good and some mothers do very well, others find either their CF complicates the pregnancy or is adversely affected by the pregnancy. For some, pregnancy may only become possible after transplantation. Optimal treatment of all aspects of CF needs to be maintained from the preconceptual period until after the baby is born. Clinicians must be prepared to modify their treatment to accommodate the changing physiology during pregnancy and to be aware of changing prescribing before conception, during pregnancy, after birth and during breast feeding. This supplement offers consensus guidelines based on review of the literature and experience of paediatricians, adult and transplant physicians, and nurses, physiotherapists, dietitians, pharmacists and psychologists experienced in CF and anaesthetist and obstetricians with experience of CF pregnancy. It is hoped they will provide practical guidelines helpful to the multidisciplinary CF teams caring for pregnant women with CF.

 

[Keepercjr]

I got an email about this report this morning and thought I would pass it on. Its a really long read but interesting. It includes everything from preconception through postpartum, and breastfeeding info. Even pregnancy post transplant

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X2D-4R5G3DG-1&_user=10&_coverDate=01%2F31%2F2008&_rdoc=2&_fmt=full&_orig=browse&_srch=doc-info(%23toc%237268%232008%23999929999.8998%23677240%23FLA%23display%23Volume)&_cdi=7268&_sort=d&_docanchor=&_ct=2&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9f441a1725148d39a4abc4ccf089ba23
">http://www.sciencedirect.com/s...48d39a4abc4ccf089ba23
</a>
If the link doesn't work let me know and I'll try to fix it.

Here is the abstract:

Women with cystic fibrosis (CF) now regularly survive into their reproductive years in good health and wish to have a baby. Many pregnancies have been reported in the literature and it is clear that whilst the outcome for the baby is generally good and some mothers do very well, others find either their CF complicates the pregnancy or is adversely affected by the pregnancy. For some, pregnancy may only become possible after transplantation. Optimal treatment of all aspects of CF needs to be maintained from the preconceptual period until after the baby is born. Clinicians must be prepared to modify their treatment to accommodate the changing physiology during pregnancy and to be aware of changing prescribing before conception, during pregnancy, after birth and during breast feeding. This supplement offers consensus guidelines based on review of the literature and experience of paediatricians, adult and transplant physicians, and nurses, physiotherapists, dietitians, pharmacists and psychologists experienced in CF and anaesthetist and obstetricians with experience of CF pregnancy. It is hoped they will provide practical guidelines helpful to the multidisciplinary CF teams caring for pregnant women with CF.

 

[Keepercjr]

I got an email about this report this morning and thought I would pass it on. Its a really long read but interesting. It includes everything from preconception through postpartum, and breastfeeding info. Even pregnancy post transplant

<a target=_blank class=ftalternatingbarlinklarge href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X2D-4R5G3DG-1&_user=10&_coverDate=01%2F31%2F2008&_rdoc=2&_fmt=full&_orig=browse&_srch=doc-info(%23toc%237268%232008%23999929999.8998%23677240%23FLA%23display%23Volume)&_cdi=7268&_sort=d&_docanchor=&_ct=2&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9f441a1725148d39a4abc4ccf089ba23
">http://www.sciencedirect.com/s...48d39a4abc4ccf089ba23
</a>
If the link doesn't work let me know and I'll try to fix it.

Here is the abstract:

Women with cystic fibrosis (CF) now regularly survive into their reproductive years in good health and wish to have a baby. Many pregnancies have been reported in the literature and it is clear that whilst the outcome for the baby is generally good and some mothers do very well, others find either their CF complicates the pregnancy or is adversely affected by the pregnancy. For some, pregnancy may only become possible after transplantation. Optimal treatment of all aspects of CF needs to be maintained from the preconceptual period until after the baby is born. Clinicians must be prepared to modify their treatment to accommodate the changing physiology during pregnancy and to be aware of changing prescribing before conception, during pregnancy, after birth and during breast feeding. This supplement offers consensus guidelines based on review of the literature and experience of paediatricians, adult and transplant physicians, and nurses, physiotherapists, dietitians, pharmacists and psychologists experienced in CF and anaesthetist and obstetricians with experience of CF pregnancy. It is hoped they will provide practical guidelines helpful to the multidisciplinary CF teams caring for pregnant women with CF.

 

[wanderlost]

Thanks for sharing. I found these tidbits the most interesting (I didn't read the entire thing)

<i>These data confirm lung function to be the most significant predictor of pregnancy outcome and suggest that pregnancy may directly affect women with poor lung function leading to further decline impacting on long-term prognosis. <b>Conversely, those with good lung function were unaffected by pregnancy.</b></i>


<i>All reviews of pregnancies in women with CF have shown that the majority end in spontaneous vaginal delivery of the baby. Where there is evidence of maternal or foetal compromise caesarean section is the delivery of choice, preferably with spinal anaesthesia. Indications for operative vaginal delivery are traditionally split into foetal or maternal.

The foetal indications are no different to those in non-CF women but it may be judicious to shorten the second stage of labour in women with severe CF to prevent prolonged Valsalva manoeuvres. Forceps and vacuum extraction are associated with different benefits and risks12 but may be used if appropriate to the clinical circumstances.</i>

<i>11.3.3. Nutrition and breast feeding
Breast feeding and breast milk have considerable benefits for both the infant and the mother and successful breast feeding in mothers with CF has been reported [127] and [128]. In a Scandinavian study, 26 of 33 babies (79%) were breastfed, however, the breast feeding was stopped before three months [129]. Experience suggests many women with CF are unable to maintain breast feeding for the recommended six months but the consensus remains that women should be encouraged to continue for as long as possible, possibly supplementing breast with bottle feeding to allow her to rest unless it is clear that she is unwilling or physically unable to sustain feeding any longer.

<b>The mother's choice of infant feeding method should be respected and it is sensible to discuss infant feeding options during pregnancy.</b> Breast feeding is time consuming and potentially exhausting and the mother will need to consider how she will cope with this alongside her own medical treatments. Breast feeding increases maternal nutritional requirements for energy, calcium and many other minerals and vitamins [38] and whilst not contraindicated in CF, each mother should be individually assessed and advised taking into consideration their individual preferences, health, clinical condition and circumstances.

11.3.3.1. Composition of breast milk in CF
<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i>

 

[wanderlost]

Thanks for sharing. I found these tidbits the most interesting (I didn't read the entire thing)

<i>These data confirm lung function to be the most significant predictor of pregnancy outcome and suggest that pregnancy may directly affect women with poor lung function leading to further decline impacting on long-term prognosis. <b>Conversely, those with good lung function were unaffected by pregnancy.</b></i>


<i>All reviews of pregnancies in women with CF have shown that the majority end in spontaneous vaginal delivery of the baby. Where there is evidence of maternal or foetal compromise caesarean section is the delivery of choice, preferably with spinal anaesthesia. Indications for operative vaginal delivery are traditionally split into foetal or maternal.

The foetal indications are no different to those in non-CF women but it may be judicious to shorten the second stage of labour in women with severe CF to prevent prolonged Valsalva manoeuvres. Forceps and vacuum extraction are associated with different benefits and risks12 but may be used if appropriate to the clinical circumstances.</i>

<i>11.3.3. Nutrition and breast feeding
Breast feeding and breast milk have considerable benefits for both the infant and the mother and successful breast feeding in mothers with CF has been reported [127] and [128]. In a Scandinavian study, 26 of 33 babies (79%) were breastfed, however, the breast feeding was stopped before three months [129]. Experience suggests many women with CF are unable to maintain breast feeding for the recommended six months but the consensus remains that women should be encouraged to continue for as long as possible, possibly supplementing breast with bottle feeding to allow her to rest unless it is clear that she is unwilling or physically unable to sustain feeding any longer.

<b>The mother's choice of infant feeding method should be respected and it is sensible to discuss infant feeding options during pregnancy.</b> Breast feeding is time consuming and potentially exhausting and the mother will need to consider how she will cope with this alongside her own medical treatments. Breast feeding increases maternal nutritional requirements for energy, calcium and many other minerals and vitamins [38] and whilst not contraindicated in CF, each mother should be individually assessed and advised taking into consideration their individual preferences, health, clinical condition and circumstances.

11.3.3.1. Composition of breast milk in CF
<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i>

 

[wanderlost]

Thanks for sharing. I found these tidbits the most interesting (I didn't read the entire thing)

<i>These data confirm lung function to be the most significant predictor of pregnancy outcome and suggest that pregnancy may directly affect women with poor lung function leading to further decline impacting on long-term prognosis. <b>Conversely, those with good lung function were unaffected by pregnancy.</b></i>


<i>All reviews of pregnancies in women with CF have shown that the majority end in spontaneous vaginal delivery of the baby. Where there is evidence of maternal or foetal compromise caesarean section is the delivery of choice, preferably with spinal anaesthesia. Indications for operative vaginal delivery are traditionally split into foetal or maternal.

The foetal indications are no different to those in non-CF women but it may be judicious to shorten the second stage of labour in women with severe CF to prevent prolonged Valsalva manoeuvres. Forceps and vacuum extraction are associated with different benefits and risks12 but may be used if appropriate to the clinical circumstances.</i>

<i>11.3.3. Nutrition and breast feeding
Breast feeding and breast milk have considerable benefits for both the infant and the mother and successful breast feeding in mothers with CF has been reported [127] and [128]. In a Scandinavian study, 26 of 33 babies (79%) were breastfed, however, the breast feeding was stopped before three months [129]. Experience suggests many women with CF are unable to maintain breast feeding for the recommended six months but the consensus remains that women should be encouraged to continue for as long as possible, possibly supplementing breast with bottle feeding to allow her to rest unless it is clear that she is unwilling or physically unable to sustain feeding any longer.

<b>The mother's choice of infant feeding method should be respected and it is sensible to discuss infant feeding options during pregnancy.</b> Breast feeding is time consuming and potentially exhausting and the mother will need to consider how she will cope with this alongside her own medical treatments. Breast feeding increases maternal nutritional requirements for energy, calcium and many other minerals and vitamins [38] and whilst not contraindicated in CF, each mother should be individually assessed and advised taking into consideration their individual preferences, health, clinical condition and circumstances.

11.3.3.1. Composition of breast milk in CF
<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i>

 

[wanderlost]

Thanks for sharing. I found these tidbits the most interesting (I didn't read the entire thing)

<i>These data confirm lung function to be the most significant predictor of pregnancy outcome and suggest that pregnancy may directly affect women with poor lung function leading to further decline impacting on long-term prognosis. <b>Conversely, those with good lung function were unaffected by pregnancy.</b></i>


<i>All reviews of pregnancies in women with CF have shown that the majority end in spontaneous vaginal delivery of the baby. Where there is evidence of maternal or foetal compromise caesarean section is the delivery of choice, preferably with spinal anaesthesia. Indications for operative vaginal delivery are traditionally split into foetal or maternal.

The foetal indications are no different to those in non-CF women but it may be judicious to shorten the second stage of labour in women with severe CF to prevent prolonged Valsalva manoeuvres. Forceps and vacuum extraction are associated with different benefits and risks12 but may be used if appropriate to the clinical circumstances.</i>

<i>11.3.3. Nutrition and breast feeding
Breast feeding and breast milk have considerable benefits for both the infant and the mother and successful breast feeding in mothers with CF has been reported [127] and [128]. In a Scandinavian study, 26 of 33 babies (79%) were breastfed, however, the breast feeding was stopped before three months [129]. Experience suggests many women with CF are unable to maintain breast feeding for the recommended six months but the consensus remains that women should be encouraged to continue for as long as possible, possibly supplementing breast with bottle feeding to allow her to rest unless it is clear that she is unwilling or physically unable to sustain feeding any longer.

<b>The mother's choice of infant feeding method should be respected and it is sensible to discuss infant feeding options during pregnancy.</b> Breast feeding is time consuming and potentially exhausting and the mother will need to consider how she will cope with this alongside her own medical treatments. Breast feeding increases maternal nutritional requirements for energy, calcium and many other minerals and vitamins [38] and whilst not contraindicated in CF, each mother should be individually assessed and advised taking into consideration their individual preferences, health, clinical condition and circumstances.

11.3.3.1. Composition of breast milk in CF
<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i>

 

[wanderlost]

Thanks for sharing. I found these tidbits the most interesting (I didn't read the entire thing)

<i>These data confirm lung function to be the most significant predictor of pregnancy outcome and suggest that pregnancy may directly affect women with poor lung function leading to further decline impacting on long-term prognosis. <b>Conversely, those with good lung function were unaffected by pregnancy.</b></i>


<i>All reviews of pregnancies in women with CF have shown that the majority end in spontaneous vaginal delivery of the baby. Where there is evidence of maternal or foetal compromise caesarean section is the delivery of choice, preferably with spinal anaesthesia. Indications for operative vaginal delivery are traditionally split into foetal or maternal.

The foetal indications are no different to those in non-CF women but it may be judicious to shorten the second stage of labour in women with severe CF to prevent prolonged Valsalva manoeuvres. Forceps and vacuum extraction are associated with different benefits and risks12 but may be used if appropriate to the clinical circumstances.</i>

<i>11.3.3. Nutrition and breast feeding
Breast feeding and breast milk have considerable benefits for both the infant and the mother and successful breast feeding in mothers with CF has been reported [127] and [128]. In a Scandinavian study, 26 of 33 babies (79%) were breastfed, however, the breast feeding was stopped before three months [129]. Experience suggests many women with CF are unable to maintain breast feeding for the recommended six months but the consensus remains that women should be encouraged to continue for as long as possible, possibly supplementing breast with bottle feeding to allow her to rest unless it is clear that she is unwilling or physically unable to sustain feeding any longer.

<b>The mother's choice of infant feeding method should be respected and it is sensible to discuss infant feeding options during pregnancy.</b> Breast feeding is time consuming and potentially exhausting and the mother will need to consider how she will cope with this alongside her own medical treatments. Breast feeding increases maternal nutritional requirements for energy, calcium and many other minerals and vitamins [38] and whilst not contraindicated in CF, each mother should be individually assessed and advised taking into consideration their individual preferences, health, clinical condition and circumstances.

11.3.3.1. Composition of breast milk in CF
<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i>

 

[Scarlett81]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>wanderlost</b></i>

T


[
11.3.3.1. Composition of breast milk in CF

<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i></end quote></div>

Thanks so much for letting us know about this report and for posting this, Shannon too! So interesting about the low efa levels...I've been taking extra efa's myself since day one to up the ante in my milk. its a compound for preg and nursing mamas.

 

[Scarlett81]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>wanderlost</b></i>

T


[
11.3.3.1. Composition of breast milk in CF

<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i></end quote></div>

Thanks so much for letting us know about this report and for posting this, Shannon too! So interesting about the low efa levels...I've been taking extra efa's myself since day one to up the ante in my milk. its a compound for preg and nursing mamas.

 

[Scarlett81]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>wanderlost</b></i>

T


[
11.3.3.1. Composition of breast milk in CF

<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i></end quote></div>

Thanks so much for letting us know about this report and for posting this, Shannon too! So interesting about the low efa levels...I've been taking extra efa's myself since day one to up the ante in my milk. its a compound for preg and nursing mamas.

 

[Scarlett81]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>wanderlost</b></i>

T


[
11.3.3.1. Composition of breast milk in CF

<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i></end quote>

Thanks so much for letting us know about this report and for posting this, Shannon too! So interesting about the low efa levels...I've been taking extra efa's myself since day one to up the ante in my milk. its a compound for preg and nursing mamas.

 

[Scarlett81]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>wanderlost</b></i>

T


[
11.3.3.1. Composition of breast milk in CF

<b>Contrary to an early report [130] breast milk from women with CF has normal electrolyte and protein levels [131] and [132] however low levels of the essential fatty acids linoleic and arachidonic acid [133] and low cholesterol levels [134] have been reported</b>.</i></end quote>

Thanks so much for letting us know about this report and for posting this, Shannon too! So interesting about the low efa levels...I've been taking extra efa's myself since day one to up the ante in my milk. its a compound for preg and nursing mamas.

 

[rubyroselee]

That was a good piece on CF and pregnancy.

I thought this would be helpful too for some. I got this from my CF center's dietician. I guess it was given to her by the CFF.

<u><b>CF PREGNANCY ASESSMENT TOOL</b></u>

<b>Preconception/Initial Visit</b>
- Confirm OB involvement (high risk OB preferable)
- Goal BMI: 22
- Review annual labs (including OGTT), weight history, and GI complications (reflux, constipation, DIOS, etc)
- Baseline OGTT (preconception or when pregnancy confirmed
- Assess intake (especially calcium)
- Vitamin recommendation: 1 prenatal vitamin and one CF vitamin, ensure adequate (0.4 mg) folic acid
- Review program eligibility for supplements/vitamins
- Set target weight and recommended gains

<b>First Trimester</b>
- Assess weight gain, intake, GI symptoms, and labs (albumin, vitamins A, D, E, Hgb, and Hct)
- OGTT at 11-12 weeks
- Recommendations: add 300 calories/day, small and frequent meals, and adequate calcium rich foods

<b>Second and Third Trimesters</b>
- Assess weight gain, intake, and GI symptoms
- OGTT at 20-24 weeks and 30-34 weeks (or sooner if weight gain is inadequate)
- Discuss planned feeding method after birth (breast vs. bottle)

I plan on giving this to my high-risk OB at my first appointment.

Leah 26 w/CF, 2 months pregnant, mom to 11-month-old non-biological son

 

[rubyroselee]

That was a good piece on CF and pregnancy.

I thought this would be helpful too for some. I got this from my CF center's dietician. I guess it was given to her by the CFF.

<u><b>CF PREGNANCY ASESSMENT TOOL</b></u>

<b>Preconception/Initial Visit</b>
- Confirm OB involvement (high risk OB preferable)
- Goal BMI: 22
- Review annual labs (including OGTT), weight history, and GI complications (reflux, constipation, DIOS, etc)
- Baseline OGTT (preconception or when pregnancy confirmed
- Assess intake (especially calcium)
- Vitamin recommendation: 1 prenatal vitamin and one CF vitamin, ensure adequate (0.4 mg) folic acid
- Review program eligibility for supplements/vitamins
- Set target weight and recommended gains

<b>First Trimester</b>
- Assess weight gain, intake, GI symptoms, and labs (albumin, vitamins A, D, E, Hgb, and Hct)
- OGTT at 11-12 weeks
- Recommendations: add 300 calories/day, small and frequent meals, and adequate calcium rich foods

<b>Second and Third Trimesters</b>
- Assess weight gain, intake, and GI symptoms
- OGTT at 20-24 weeks and 30-34 weeks (or sooner if weight gain is inadequate)
- Discuss planned feeding method after birth (breast vs. bottle)

I plan on giving this to my high-risk OB at my first appointment.

Leah 26 w/CF, 2 months pregnant, mom to 11-month-old non-biological son

 

[rubyroselee]

That was a good piece on CF and pregnancy.

I thought this would be helpful too for some. I got this from my CF center's dietician. I guess it was given to her by the CFF.

<u><b>CF PREGNANCY ASESSMENT TOOL</b></u>

<b>Preconception/Initial Visit</b>
- Confirm OB involvement (high risk OB preferable)
- Goal BMI: 22
- Review annual labs (including OGTT), weight history, and GI complications (reflux, constipation, DIOS, etc)
- Baseline OGTT (preconception or when pregnancy confirmed
- Assess intake (especially calcium)
- Vitamin recommendation: 1 prenatal vitamin and one CF vitamin, ensure adequate (0.4 mg) folic acid
- Review program eligibility for supplements/vitamins
- Set target weight and recommended gains

<b>First Trimester</b>
- Assess weight gain, intake, GI symptoms, and labs (albumin, vitamins A, D, E, Hgb, and Hct)
- OGTT at 11-12 weeks
- Recommendations: add 300 calories/day, small and frequent meals, and adequate calcium rich foods

<b>Second and Third Trimesters</b>
- Assess weight gain, intake, and GI symptoms
- OGTT at 20-24 weeks and 30-34 weeks (or sooner if weight gain is inadequate)
- Discuss planned feeding method after birth (breast vs. bottle)

I plan on giving this to my high-risk OB at my first appointment.

Leah 26 w/CF, 2 months pregnant, mom to 11-month-old non-biological son

 

[rubyroselee]

That was a good piece on CF and pregnancy.

I thought this would be helpful too for some. I got this from my CF center's dietician. I guess it was given to her by the CFF.

<u><b>CF PREGNANCY ASESSMENT TOOL</b></u>

<b>Preconception/Initial Visit</b>
- Confirm OB involvement (high risk OB preferable)
- Goal BMI: 22
- Review annual labs (including OGTT), weight history, and GI complications (reflux, constipation, DIOS, etc)
- Baseline OGTT (preconception or when pregnancy confirmed
- Assess intake (especially calcium)
- Vitamin recommendation: 1 prenatal vitamin and one CF vitamin, ensure adequate (0.4 mg) folic acid
- Review program eligibility for supplements/vitamins
- Set target weight and recommended gains

<b>First Trimester</b>
- Assess weight gain, intake, GI symptoms, and labs (albumin, vitamins A, D, E, Hgb, and Hct)
- OGTT at 11-12 weeks
- Recommendations: add 300 calories/day, small and frequent meals, and adequate calcium rich foods

<b>Second and Third Trimesters</b>
- Assess weight gain, intake, and GI symptoms
- OGTT at 20-24 weeks and 30-34 weeks (or sooner if weight gain is inadequate)
- Discuss planned feeding method after birth (breast vs. bottle)

I plan on giving this to my high-risk OB at my first appointment.

Leah 26 w/CF, 2 months pregnant, mom to 11-month-old non-biological son

 

[rubyroselee]

That was a good piece on CF and pregnancy.

I thought this would be helpful too for some. I got this from my CF center's dietician. I guess it was given to her by the CFF.

<u><b>CF PREGNANCY ASESSMENT TOOL</b></u>

<b>Preconception/Initial Visit</b>
- Confirm OB involvement (high risk OB preferable)
- Goal BMI: 22
- Review annual labs (including OGTT), weight history, and GI complications (reflux, constipation, DIOS, etc)
- Baseline OGTT (preconception or when pregnancy confirmed
- Assess intake (especially calcium)
- Vitamin recommendation: 1 prenatal vitamin and one CF vitamin, ensure adequate (0.4 mg) folic acid
- Review program eligibility for supplements/vitamins
- Set target weight and recommended gains

<b>First Trimester</b>
- Assess weight gain, intake, GI symptoms, and labs (albumin, vitamins A, D, E, Hgb, and Hct)
- OGTT at 11-12 weeks
- Recommendations: add 300 calories/day, small and frequent meals, and adequate calcium rich foods

<b>Second and Third Trimesters</b>
- Assess weight gain, intake, and GI symptoms
- OGTT at 20-24 weeks and 30-34 weeks (or sooner if weight gain is inadequate)
- Discuss planned feeding method after birth (breast vs. bottle)

I plan on giving this to my high-risk OB at my first appointment.

Leah 26 w/CF, 2 months pregnant, mom to 11-month-old non-biological son