Obstetric & Gynaecology Malaysia


Can herbs affect pregnancy and post partum period?

It is best to avoid herbs that are roots (ginseng, dang gui, pat zhen, bak kut teh, tong sum, yong sum soo, pau sum, dang sen, du zhong, cordyceps) or barks (black fungus, cinnamon) that can either impair placental flow, stimulate contractions or increase bleeding. Advisable to seek a licensed Chinese practitioner if a pregnant woman still prefer to consume herbal soup, as some herbs from leaves or flower can also induce contraction.  Excessive consumption of lemon grass, pineapple or estrogenic rich content found in raspberry tea leaf, cactus (Millenium or RosyTime), collagen or evening primose oil (  Udo’s 3•6•9 Oil  Blend) can induce contraction

Can caffeine in my diet affect my pregnancy?

Consuming fewer than 200 mg of caffeine (one 350mls cup of coffee) a day during pregnancy is safe.

Red/black dates, goji berries, ginger, chicken essence, bird nest, lavender or chamomile tea is safe.

1 cup of green tea=30-50 mg of caffeine. Maximum caffeine per day is 200 mg=4 cups of green tea.

How can food poisoning affect my pregnancy?

Food poisoning in a pregnant woman can cause serious problems for both her and her fetus. Vomiting and diarrhea can cause your body to lose too much water and can disrupt your body’s chemical balance. To prevent food poisoning, follow these general guidelines:

  • Food hygience-wash all raw produce thoroughly under running tap water.
  • Avoid all raw and undercooked seafood, eggs, and meat. Do not eat sushi made with raw fish (cooked sushi is safe). Food such as beef, pork, or poultry should be cooked to a safe internal temperature.

What is listeriosis and how can it affect my pregnancy?

Listeriosis is a food-borne illness caused by bacteria. Pregnant women are 13 times more likely to get it especially nearing birth due to altered immune system. Listeriosis can cause mild, flu-like symptoms such as fever, muscle aches, and diarrhea. Listeriosis can lead to miscarriage, stillbirth, and premature deliveryAntibiotics can be given to treat the infection and to protect your fetus. When you see your doctor, do check if the antibiotic given is categories as pregnancy safety index of A, B.

To help prevent listeriosis, avoid eating the following foods during pregnancy:

  • Unpasteurized milk and foods made with unpasteurized milk
  • Hot dogs, luncheon meats, and cold cuts unless heated until steaming hot just before serving
  • Refrigerated pate, meat spreads, smoked seafood, raw and undercooked seafood, eggs, and meat

How much weight should I gain during pregnancy?

The amount of weight gain that is recommended depends on your health and your body mass index (BMI) before you were pregnant. If you were a normal weight (BMI of 18-22.9 kg/m2) before pregnancy, you should gain between 8 to 10 kg during pregnancy ie 300-400gram per week (counting weight gain from 12 to 39 weeks). If you were overweight (BMI of 23-27.4 kg/m2) before pregnancy, you should gain less weight ie 100-300gram per week (3-8kg during pregnancy). However, if you are or obese (BMI of >27.5 kg/m2), it will be fine not to gain much weight. Irrespective of weight gain, a women who are less than 160cm tall will only lose 4-6 kg after her childbirth. Elsewhere if a women who are more than 160cm tall will likely lose 6-8 kg after her delivery.

Can being overweight or obese affect my pregnancy?

Overweight, obese women and women with excessive weight gain during pregnancy are at an increased risk of several pregnancy problems eg gestational diabetes, high blood pressure, preeclampsia, preterm birth, and emergency cesarean delivery. Babies are also at risk of macrosomia=big baby with possible birth injury, stillbirth, breathing problems at birth and childhood obesity.

How can I plan healthy meals during pregnancy?

You could use the mobile apps like MyFitnessPal to track your calories of ~1200kcal to 1500kcal a day. Pregnant women are advised to monitor their weight daily at around the same time every day.

Why are vitamins and minerals important in my diet?

Vitamins and minerals play important roles in all of your body functions during pregnancy.

How can I get the extra amounts of vitamins and minerals I need during pregnancy?

Taking a prenatal vitamin with fish oil eg Blackmore Pregnancy & Breasfeeding, Ganilia, (Obimin Pluz-BPA) or maternal milk, can ensure that you are getting these extra supply all of the other vitamins and minerals you.

If you eat fish regularly, then prenatal vitamin without fish oil Obimin, Pramilet/Similac, Elepro, Nutrilite, Appleton Natal care, Usana Prenatal CellSentials or Zincofer given by KKIA.

What is folic acid and how much do I need daily?

During pregnancy, you need 600mcg(micrograms) of folic acid daily, a vitamin B9 to help prevent major birth defects of the fetal brain and spine called neural tube defects. Common folic acid content in Malaysia is 5mg=5000mcg. 

Why is iron important during pregnancy and how much do I need daily?

Iron is used by your body to make a substance in red blood cells that carries oxygen to your organs. During pregnancy, you need extra iron to help your body make more blood to supply oxygen to your fetus. The daily recommended dose of 27 mg iron, which is found in most prenatal vitamin supplements. You also can eat iron-rich foods, including dark green vegetables eg spinach, lean red meat, poultry, fish, dried beans and peas, and prune juice. Avoid taking iron supplements with milk, oats, tea or coffee 2 hours prior as iron absorption will be impaired, except that Maltofer is advised to be taken with meal. Option of iron are Maltofer 100mg tablets, Sangobion, Iberet folic, Ferrous Fumarate or Salux Floradix liquid.

Why is calcium important during pregnancy and how much do I need daily?

Calcium is used to build your fetus's bones and teeth. All pregnant women should get 1,000 mg of calcium daily. If you have milk intolerance, you can get calcium from broccoli; dark, leafy greens; sardines; or a calcium supplement eg Obical, Elecal, Isotonic Calcium or Salux Salydynum. However your body can absorb 600mg calcium each time.

Why is vitamin D important during pregnancy and how much do I need daily?

Vitamin D is essential for healthy skin and eyesight & works with calcium to help the fetus’s bones and teeth develop. All women, need 600unit to 1000unit=25mcg vitamin D daily. The optimal serum 25(OH)D level in pregnancy is ~ 20 ng/mL (50 nmol/L). In pregnant women with vitamin D deficiency, the safety of 50,000 international units of vitamin D weekly for 6-8 weeks has not been adequately studied, so vitamin D3 2000 international units daily is a safer option.

Common body aches and leg cramps during pregnancy could resolved with supplementation of oral vitamin D3 800 unit od, Methycobal B12 500mg od, Magnesium 400mg daily, zinc with additional calcium supplements.

What are the benefits of including eggs and fish and shellfish in my diet during pregnancy?

Omega-3 fatty acids are a type of fat found in many kinds of fish. Choline in eggs, mushroom & nuts. They may be important factors in your fetus’s brain development. To get the most benefits from omega-3 fatty acids, women should eat at least 2 servings of fish (~300gms) per week while pregnant, and while breastfeeding. If taking fish oil supplements, the content of DHA<250 mg daily eg, Neurogain, Blackmore Fish Oil 1000mg, Usana, Nutrilite

What are the options of vegan DHA in pregnancy?

Algae-derived DHA eg Nordic Natural from iHerb or eating diet rich in walnuts, brussel sprouts, chia seed, flaxseed or perilla leaves oil. Broccoli, cantaloupe, kidney beans, spinach, and cauliflower.

What should I know about eating fish during pregnancy?

Some types of fish have higher levels of a metal called mercury than others. Mercury has been linked to birth defects. Do not eat shark, swordfish, king mackerel, or tilefish (seafish >25cm long).

Are oils and fats part of healthy eating?

During pregnancy, the fats that you eat provide energy and help build many fetal organs and the placenta. Most of the fats and oils in your diet should come from plant sources. Limit solid fats, such as those from animal sources or in processed foods eg fried food.