Q: Good evening Dr, please why does my breast remain the same even while pregnant and any solution to flattened breast? Thanks

A: Thanks for writing in. Pregnancy affects different people differently, you know. Some people will feel that their bust doubled in size immediately and for others, it’s the opposite J

Please see below, normal symptoms of pregnancy and I’ve also thrown in a bonus…the red flags (symptoms that should make you show up in the hospital immediately).

Breast tenderness: this is inevitable as your breast ducts prepare for the job of lactation. Bra sizes could go up from 1 to several sizes up. Perhaps yours went up just one or perhaps even just remained the same. It is not abnormal. If it does start to increase, be sure to get a good support bra and keep going up sizes as your breast size increases. This will help reduce sagging.

Discharge: A thin milky discharge is normal during pregnancy. But if this becomes yellow, greenish or foul smelling, please see your doctor.

Heartburn and Constipation: These happen due to one of the hormones produced during pregnancy. The antenatal vitamins also play a part in worsening constipation J

Frequency of urination: As the baby grows in the uterus, it presses on the bladder making you feel like urinating more often.

Tiredness: As your body works overtime to support a growing life inside you, you would feel exhausted.

Food cravings and aversions: Well, I certainly had loads of aversions with my first pregnancy. I can’t remember any cravings as I couldn’t get any food to stay down. However, some people develop a craving for the oddest, craziest foods when pregnant. Go easy on eating for two though…the healthy living dictum of eating loads of fruits/vegetables and low calories does not change during pregnancy. The more you gorge or give in to the food cravings, the more work you have to do to get it off after the baby. However, if you find yourself craving things like clay, sand etc, please see your doctor as it could be a sign of iron deficiency anaemia.

Morning sickness/nausea: This is due to the hormones of pregnancy (again!). This may be mild or so severe that the person actually gets hospitalised. If your nausea is severe, please see your doctor. But generally, you can help push this back by eating some bland food especially in the mornings when it is worse like crackers or cheese. 

So, as you can see, most of the symptoms you have complained about can be explained away by pregnancy! 

Now for the red flags…these have to be checked out by your obstetrician immediately:

Significant bleeding. If you’re not sure what is significant and what’s not, please see your doctor all the same. Better safe than sorry.

Severe abdominal pain: This could be a sign of a threatened miscarriage

Severe nausea/vomiting: This could lead to dehydration which could affect the baby adversely

Severe dizziness

Too little weight gain or too much weight gain: Try to keep weight gain between 11 to 15kg during the pregnancy. Your doctor could have recommended more or less depending on your pre-pregnancy state.

Pain or burning sensation when urinating: This could be a urinary tract infection. It needs to be dealt with.

Vaginal discharge: Foul smelling, yellow or greenish colour could indicate an infection and could affect your baby.

High fever: This could signify an infection.

As for what you can do about the morning sickness, here’s a post I had done on this recently.

The standard teaching is to try eating some bland foods like Crackers biscuits or dry toast. That personally didn’t work for me. I preferred tart things…which some may want to avoid. I loved lemons during my pregnancies. They were the one thing guaranteed to ‘wake up’ my mouth and chase nausea far away. I also had a particular brand of very tart bubble gum, I indulged in  These were key for me because, though I didn’t have the real bad case of morning sickness that sent you to the hospital, brushing my teeth in the morning always sent me into a bout of retching/vomiting. Therefore, I always had a ready supply of the gum or lemon/lime to pop into my mouth once I was done brushing/retching! Not a very pleasant memory ;D

So, if lemons work for you to prevent nausea, go for it. Remember that moderation is key. A few drops (one or two) in a glass of water are enough to provide that tart kick that sends nausea far away. There is a catch here though…remember the heart burn associated with pregnancy. The acid content of lemon might make the heart burn and any pre-existing gastro-esophageal (stomach and esophagus/gullet) problems worse. So, this is all the more reason to be very moderate or stop if it exacerbates an already bad case of heartburn. Wherever and whenever in doubt, please be sure to see your doctor.

Other tips:
• Eat little amounts of food frequently as an empty tummy increases the likelihood of throwing up. Remember this is not an excuse to binge and over eat 
• Avoid fatty and greasy foods.
• Avoid smells that trigger nausea
• Cold foods may be preferable to hot as the former does not give off smells that may cause you to feel queasy.
• Get loads of fresh air and rest
• And drink sufficient fluids daily

Have a great day, everyone