Day 171 baby development and maternal changes

A: Left-side sleeping reduces pressure of the uterus on the inferior vena cava and improves placental blood flow, so it’s the recommended position. But you don’t have to force staying that way all night — turning onto your right after falling asleep is fine; comfort and good sleep matter. The main thing to avoid is prolonged lying on your back (the growing uterus presses the great vessels, which can cause supine hypotensive syndrome with dizziness).

A: Systematic counting usually starts at week 28. At week 25 you can first become familiar with your baby’s active routine, feeling at set times each day (such as after meals and before bed) whether the baby is active, without strict counting. If you feel a clear reduction in movement, seek care any time.

A: The core is "control total amounts, split meals, mix coarse and fine, cut refined sugar": 3 main meals plus 2-3 snacks a day at seven-or-eight-percent fullness; replace part of refined rice and noodles in staples with whole grains and beans; cut sugary drinks, choose low-GI fruit eaten in portions; pair protein and vegetables in each meal and walk after meals. Your specific menu is set by the nutrition department based on your blood sugar and weight.

A: Not necessarily. Most GDM is well controlled through diet management + exercise + blood-sugar monitoring; only when blood sugar stays above range after diet and exercise will the doctor add insulin (which is safe in pregnancy and not addictive). Whether medication is used depends on blood sugar — follow your doctor.

A: A growing belly, frequent urination and trouble turning over all affect sleep. Use a pregnancy pillow to support your lower back, belly and legs, sleep on your left side, soak your feet before bed to relax, reduce evening fluids to cut night urination, and exercise moderately during the day. Avoid screens before bed and caffeinated drinks.

A: Uterine pressure, constipation and increased pelvic blood flow easily cause haemorrhoids. Eat more fiber-rich vegetables and fruit, drink 1.5-2L of water daily, walk after meals, toilet regularly without squatting long; soak in warm water if they flare up. For severe bleeding or pain, see a colorectal doctor and use a pregnancy-safe topical medication — don’t self-medicate.

A: The three measurements at 25 weeks: BPD (biparietal diameter) about 61.7mm, AC (abdominal circumference) about 204.9mm, and FL (femur length) about 44.2mm, reflecting head, abdomen and leg development. If the three are in step, growth is good; a single slight deviation isn’t necessarily abnormal — go by your obstetrician’s overall assessment.

A: For a standard BMI, about 0.4-0.5kg a week in the second trimester, with a cumulative gain of roughly 7-10kg by week 25 being common. Watch the overall trend — use a weight-gain calculator to manage by BMI — and discuss with the doctor if it’s too fast or too slow.

A: Dilutional anaemia is common in the second and third trimesters. Food first: red meat, animal liver (≤50g a week), spinach with vitamin C; when the prenatal visit confirms iron-deficiency anaemia, the doctor prescribes iron, taken separate from calcium, milk, strong tea and coffee for better absorption.

A: ACOG advises women without complications about 150 minutes of moderate-intensity exercise accumulated weekly (walking, prenatal yoga, swimming), split over 5 days at about 30 minutes a day. Walking after meals especially helps sugar control with GDM. Avoid intense exercise and pressure on the abdomen; stop and seek care for pain or bleeding.

A: It’s recommended. The CDC and ACOG recommend that pregnant women receive the inactivated flu vaccine: pregnant women are at higher risk of severe flu, the vaccine protects mother and baby, and it is safe at every stage. During flu season (September to April) you can get vaccinated; tell them you’re pregnant.

A: If there’s no placenta praevia, bleeding, cervical insufficiency or threatened preterm labour, gentle sex is fine using positions that don’t press on the belly and with gentle movements. Pause if you feel unwell or the doctor advises against it; see a doctor for post-sex bleeding or pain.

A: Forward-shifting centre of gravity and ligament relaxation cause common lower-back pain. Avoid long standing or sitting, wear supportive low-heeled shoes, side-sleep with a pregnancy pillow between the legs, do prenatal yoga and pelvic-floor exercise, and apply local warmth. Sharp pain on one side or with bleeding and fever needs care.

A: When a cramp hits, flex the foot and massage the calf. Prevention: supplement calcium and magnesium, drink water, stretch before bed, wear support stockings, and avoid long standing or sitting. If cramps are frequent with weakness and numbness, check blood calcium, magnesium and electrolytes at a prenatal visit.

A: Avoid raw or undercooked meat, fish and eggs, high-mercury large fish, unpasteurised dairy, alcohol, caffeine over 200mg a day, and excess animal liver. If you have GDM, strictly control refined sugar and sugary drinks as well.

A: Choose low-GI fruit: strawberries, blueberries, cherries, kiwi, grapefruit, apples, etc., about 200-350g a day eaten in 2-3 portions between meals, avoiding juice and overeating at once. Eat less high-sugar lychee, longan, durian and watermelon (especially if you have GDM).

A: Higher oestrogen increases white discharge; milky-white or clear and odourless is normal. Watch for turning yellow-green, foul-smelling, with itching (infection), or a sudden large amount of watery leakage (rupture of membranes) — seek care the moment these appear. Wear cotton underwear and don’t douche.

A: Eat more coarse grains and vegetables for dietary fiber, drink 1.5-2L of water daily, walk after meals, and toilet on a regular schedule without squatting long. Iron supplements can worsen constipation — discuss an adjustment with your doctor; in serious cases choose a pregnancy-safe laxative rather than buying a stimulant laxative yourself.