Pregnancy Q&A
DR KELLY LOI is an Obstetrician & Gynaecologist at Mount Elizabeth Hospital.

dizzy spells… strange cravings…
loss of appetite

I am four months pregnant and have dizzy spells on and off. What should I do?

It is quite common to feel light-headed with dizzy spells on and off during pregnancy. One major contributing factor is that during pregnancy, dramatic changes occur to your circulatory system: the amount of blood in your body expands and your heart rate increases. Usually, the heart and nervous system are able to adjust to these changes, but sometimes they don't, causing you to feel light-headed and dizzy. One common cause in pregnancy is anaemia or low blood count which can be diagnosed with a simple blood test. If you are found to be anaemic by your doctor, an iron supplement may be prescribed in addition to your usual prenatal vitamin intake.

As soon as dizzy spells occur, you should lie down to avoid fainting and hurting yourself. If you can't lie down, try to sit and put your head between your knees. Avoid standing up too quickly as blood tends to pool in your feet and lower legs, and your body may not be able to adjust when you stand up quickly, resulting in a drop in blood pressure. Avoid getting overheated by doing things like taking a hot shower, as your blood vessels may dilate, causing a drop in blood pressure and dizziness. Ensure that you always have enough to eat and drink; low blood sugar levels and dehydration may also cause dizzy spells.

Dizzy spells may sometimes be a sign of a more serious problem if you actually faint or if there are associated symptoms such as headaches, blurred vision and palpitations. No matter what the suspected cause, do let your doctor know about these dizzy spells so that the appropriate care can be given.

Why do some women get strange cravings during pregnancy and is this harmful?

As with all things that are difficult to explain, we usually attribute the cause to 'hormones'. Some nutritionists believe that certain cravings are indications of what your body needs. For example, cravings for ice and strange substances such as laundry starch and cigarette butts (a condition

called pica) have been linked to an iron deficiency – even though none of those items contain significant amounts of iron. In some cases, there may be a biological cause for cravings. A shortage of magnesium is thought to be a trigger for a craving for chocolate. However, this link is not always, in fact rarely, evident. If we truly crave what our body needs, we probably should want more broccoli and spinach instead of char kway teow!

Cravings are usually not harmful unless you crave alcohol. You can't always fight the symptoms, so just try to respond with reason, except for alcohol which you should always avoid during pregnancy. Keep in mind that most cravings disappear or lessen by the fourth month.

I am two months pregnant and I have no urge to eat. I'm worried I may harm the baby if I go on like this.

Loss of appetite during early pregnancy is usually caused by nausea which reduces the desire to eat. Other contributing factors include an increase in the levels of the progesterone hormone, which causes the digestion process to slow down with an increased tendency for constipation, all leading to a loss of appetite during early pregnancy. When you experience a loss of appetite during early pregnancy, try to eat smaller meals during the day. Continue to drink plenty of fluids and try to maintain a healthy diet with leafy green vegetables and fibre-rich foods. Try to avoid fatty or oily foods that are hard to digest. Supplementing your diet with a prenatal vitamin may be helpful, particularly if your appetite is poor.

Loss of appetite is usually transient and improves after the first three months of pregnancy and the severity of nausea will also lessen. If your lack of appetite is a continual problem or is severe enough that you fear you aren't getting adequate nutrition, talk to your Singapore obstetrician who can assess your diet or recommend some tests to assess for health-related problems such as diabetes or a thyroid disease.