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Page 337

337

formerly disliked. In extreme cases this so-called pica (abnormal craving) is manifested by the “clay eating” habit of southerners, or the strange love for “pickles and ice cream” that ordinarily seems like a repulsive combination. Mothers need to be careful that their appetites are controlled by reason when such cravings become abnormal. Where vomiting in pregnancy becomes persistent, hospitalization may prove necessary. One or two days of intravenous feedings is normally sufficient to bring back a normal digestion once again. Emotional contributions to this gastric problem are frequent. These can be related to ambivalence about being pregnant, or an underlying temperament of nervousness manifested in an unusually sensitive stomach. Nevertheless, the physiologic and hormonal changes that occur are profound. Such endocrine considerations may well explain these early digestive symptoms. A tolerance for food usually emerges by the fourth month, enabling a normal digestive tone to continue for the remainder of pregnancy. Adequate fluid intake is vitally important from the start. It is suspected that the common, insufficient intake of water is one principal cause of persistent nausea and vomiting. Drink at least six to eight glasses of water per day, at whatever temperature is best tolerated by the sensitive stomach. If the mother avoids soups and creamed mixtures, and chews thoroughly a rather dry meal of whole grain crackers, breakfast cereals, or raw vegetables, her food will stay down better and permit the best nutrition at this critical stage. Vaginal discharge is often troublesome during the latter months of pregnancy. This may be due to the parasite Trichomonas, but is more commonly caused by a buildup of yeast or Monilia (Candida albicans). Hormone changes combined with increased perineal moisture and warmth, create an environment favorable to the growth of these organisms. Diabetes mellitus, particularly aggravates the tendency to develop yeast infections. Administration of hormones such as the birth control pill may produce a diabetes-like state in non-pregnant women. However, pregnancy increases this trend. Nylon underwear, panty hose, and tight slacks tend to increase the propensity for vaginitis. This is because greater warmth and moisture are produced in the perineum when one wears those synthetic fabric materials. Air circulation around the body and “breathing” of the skin is impeded. Then it leads to the rapid multiplication of yeast germs with such unpleasant symptoms as discharge, burning, itching, and skin rash. Gentle vaginal douches, with a dilute vinegar solution (one tablespoon of white vinegar to one quart of warm water) can help decrease the discharge and restore normal acidity to the birth canal. Specific agents are available to help in acute stages (such as Massingill products). However, the intestinal tract always harbors these germs, so it is impossible to completely escape from them. Therefore,


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