Your pre-conception checklist

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F Sessions Cole, MD

So you think you know what you need to do to have a baby? Well, there's more to a healthy pregnancy than just "doing the deed." From F Sessions Cole, MD, director of newborn medicine at St. Louis Children's Hospital, comes this pre-conception checklist of ways you can give your baby the best chance of avoiding birth defects and getting a great start in life.

The best start
1. Control your weight. Get as close to your ideal weight as possible. Being seriously overweight or underweight can predispose your baby to birth defects such as cleft palate and diabetes.

2. Stop smoking, and avoid secondhand smoke. While the body cleanses itself of many harmful substances from smoke in days, some are stored in fat and take longer to eliminate. Smoking is associated with prematurity and low birthweights, increased risk of Sudden Infant Death Syndrome (SIDS) and asthma.

3. Stop drinking alcohol. As with smoking, the body stores some harmful substances in fat and can take a month or more to eliminate them. Fetal alcohol syndrome can cause serious defects and learning disabilities -- some of which might not show up for several years.

4. Stop recreational drugs. All have an adverse effect on your baby.

5. Discuss with your caregiver any prescription medications you are taking. You may need to stop taking some drugs for heart disorders, blood thinners and some medications for depression, anxiety and other emotional disorders -- but only in consultation with a physician. Conditions such as cleft lip and palate, heart defects and limb abnormalities are associated with some prescription medicines.

6. Start taking prenatal vitamins, including folic acid, calcium and other nutrients. These are important to a healthy pregnancy and baby, at least two months before conception.

7. Check out your immunity to rubella and chicken pox. Your immunity to both childhood diseases can be checked easily with a blood test; this will save you from concern if you are exposed to them during pregnancy. Even if you were vaccinated as a child or think you had these illnesses, being sure is important.

8. Find out your HIV status. HIV-positive women can spare their babies from contracting the disease if they are aware of their HIV status before delivery.

9. Know your blood type and that of the father. If they are not compatible, your blood type also may be incompatible with the baby's, leading to anemia or more serious problems for the infant at birth. RH disease, which results from incompatibility, can be treated easily during the pregnancy.

10. Create a prenatal family history to identify possible genetic birth defects. This is a record of your family's health history that focuses on medical problems present since birth, or those that may help uncover a pattern of undiagnosed birth -- or pregnancy-related problems. The goal is to help make you aware if any hereditary birth defects run in the family. Materials to chart your prenatal history are available on the St. Louis Children's Hospital web site.

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