Posted in Pre-Parenting

Morning Sickness Mastery: Science & Other Tips to Feel Better

Morning sickness (also known by its medical term “NVP: nausea and vomiting during pregnancy”) affects around 50-75% of pregnancies, particularly during the first trimester.  Typically it begins around six weeks since the last menstrual period, and “…peaks at approximately 9 weeks of gestation. 60% of cases resolved by the end of the first trimester, and 91% resolved by 20 weeks of gestation” (NEJM 2010).

Morning sickness severity varies significantly, but regardless it is usually a very uncomfortable experience (and definitely not confined to the morning).  If you do suffer from it, perhaps you’ll feel slightly better that  research suggests it’s linked to a decrease risk of miscarriage-possibly because of higher pregnancy sustaining HCG hormones (JAMA 2016).   (If you do not have morning sickness though consider yourself lucky and don’t worry!) Realize there are a range of medications that can help, so definitely talk to your health care provider as needed–especially if you fall on the spectrum closer to the 1% of patients with hyperemesis gravidarum with continuous vomiting and significant dehydration!

For those trying to do home remedies- read on!  

First, we’ll discuss the few research driven morning sickness remedies.  Then, as many morning sickness home treatments aren’t studied (NPR)-we’ll also discuss many options for food/behaviors that are low risk but might benefit you to feel better sooner.  

(Please note, none of our articles constitute medical advice:  always confer with your personal health care provider regarding any specific remedies or treatments for your pregnancy.)  

Research Driven Treatments:  

2002 Cochrane Review suggests Vitamin B6 to be effective and acupressure equivocal.  Ginger has been studied more recently, and is shown to lower nausea and have no negative side effects.  (More study details below for the curious.)

  • Vitamin B6 (aka Pyridoxine): Generally considered effective.
    • A 1995 Ob/Gyn RCT (randomized, controlled trial) showed statistically significant reduction of nausea, and a decrease in vomiting (although not statistically significant) with 30mg daily of Vitamin B6.  Future studies have commonly used Vitamin B6 as a positive control to compare other treatments.
    • Talk with your Ob/Gyn for the latest dosing and recommendations- some prenatal vitamins incorporate higher Vitamin B6 dosing, or it can be found in over the counter supplements like Preggie Pop Drops.
  • Ginger:  Likely helps nausea, no evidence of harm.
    • 2005 ObGyn Systematic Review suggests 4 of 6 RCT studies showed ginger superiority over placebo for nausea and vomiting; in 2 of 6 ginger was as effective as reference drug (vitamin B6).  No adverse effects reported.
    • A 2014 systematic review of 12 RCT showed statistically significant improvement of nausea compared with placebo; no statistically significant reduction of vomiting although there was a trend towards improvement.  No increased risk of miscarriage or side effects.  Lower dose of ginger (under 1500mg/day) was possibly more effective.  The study reports:  “Ginger could be considered a harmless and possibly effective alternative option for women suffering from NVP”.
  • Acupressure/Acupuncture: Possibly effective- mixed results, but no obvious harm.
    • Studies focus on the P6 acupuncture region of the wrist, shown in this image.  
    • Acupressure effect on P6 was equivocal in the 2002 Cochrane review.
      • Various nausea bands target the P6 point with acupressure (~$8 or $16 on Amazon) – likely with few risks for most.  (However, I avoided them due to concern for worsening carpal tunnel- a condition pregnancy can already make worse.)
    • Acupuncture might be more effective.  A 2002 RCT shows reductions of nausea or retching with general treatment by an acupuncturist (placebo effect might contribute-but regardless people felt better).  Further details here.  

Morning Sickness Hacks:

 Morning sickness can be hard to deal with–it’s good to have a long list of options.  Considering risks vs benefits, many options for food/behaviors are low risk but might benefit you to feel better sooner.  

Here are some compiled hacks for managing morning sickness on your own (feel free to try and adapt anytime!)  

  1. Eat early and often with small bland meals
  2. Stay hydrated
  3. Time your eating to minimize symptoms
  4. Try ginger, lemon, and other things that help your symptoms
  5. Plus, some extra things I found helped me (feel free to Contact Us to add more!)

More details–

1) Eat early and often with small bland meals.

  • Have a snack pack by your bed of foods that help to eat when you first wake up (crackers, dry cereal like Cheerios, ginger candies, watermelon Jolly Ranchers, etc.).  Ditto for making a similar one for your car, your purse, etc. 
  • If you’re starting to feel early signs of nausea, usually eating a little something helps!  (Really counterintuitive, but it works!)
  • Try combining protein with simple carbs when you eat- like peanut butter and crackers, or cheese and apples, or whatever you can tolerate…
  • Your baby will still get enough nutrients even if your diet is restricted, just try to make sure to get your prenatal vitamins.  (If regular prenatal vitamins are hard on your stomach, talk to your ObGyn for different brand or try gummy ones like this.)

2) Stay hydrated

  • Have ways you can drink while staying in bed- some swear by the Camelbak or just a long straw.
  • Cold things are easier to keep down. I invested in a 40 oz. steel water bottle (with straw lid) that keeps things cold for 24 hours and kept that with me at all times (example here).  Also doing popsicles, particularly lime popsicles worked for me.
  • Generally 1 oz per kilogram per day of water is recommended for pregnant women- about 80 oz for many of us (aiming for two 40oz bottles a day helps keep track).  You have to balance this with how often you have to pee, especially early on. To save bathroom trips, you can also drink earlier in the day and cut back the last two hours before bed.
  • If even water makes you nauseous:  Trying cold water helps, perhaps trying a filter or bottled water. Putting lemon or lime in the water can really help too.  I tended to do fresh lemon or lime only in a bottle or glass I could fully wash to avoid sensitive tastes.  Plus there’s trying flavored drinks or water-rich foods like soup, popsicles, or fruit etc if you can handle it.
  • Avoiding drinking while eating food–sometimes the stomach distension makes you more nauseous, so you can try spacing eating from drinking if needbe.  
  • Try even just one or two sips at a time. This can help even if you’re getting nauseous with water alone.
  • Lemonade or juice can be easier to tolerate if water makes you feel sick. Combining with a salty snacks such as potato chips or crackers also seems to help.
  • Trying Ginger in water or other things, and leaving a pitcher of that mixed in the fridge might be helpful.
  • Certain people like teas or other drinks, however do be careful with some herbal teas that might have a mix of things that aren’t recommended in pregnancy (check with your Ob/Gyn).  Also, make sure to not get over the 200mg/day recommended maximum of caffeine during pregnancy.  

3) Time your eating to minimize symptoms.

  • Symptoms can be worse at certain times for various people, mine were worse in the afternoon or evening. You can try eating certain foods when you’re less sensitive to nausea. (Salads for breakfast became my only way of getting vegetables for awhile.)
  • Getting hungry can make you feel more nauseous, so eating at regular intervals really helps–even if you don’t feel hungry.  (If you’re concerned about eating too much with this snacking, you could measure out chips or snacks in advance so you know how much you’re getting. The Academy of Nutrition and Dietetics suggests you don’t need extra calories in the first trimester, and typically only 340 more calories/day in the second trimester–most people don’t have to watch this too closely though.  Feel free to talk to your doctor for any concerns–many people with bad morning sickness don’t gain weight or even lose weight during that time so it’s not a big concern.  Again, your baby will still get enough nutrients even if your diet is restricted by nausea (especially in the first trimester), just try to make sure to get your prenatal vitamins. 

4)  Try ginger, lemon, or other things that help your symptoms.

  • It can be hard to know what you can eat sometimes–try things in small portion with just one taste at a time. You can try smelling it first and see if it makes you feel bad, and then a slight taste. If your symptoms are mild that’s usually enough to warn you whether it will make you sick to try eating a whole thing.
  • Some common things people say help (compiled from various online resources):
    • Ginger: Ginger, lemon, apple cider is a combo people sometimes swear by.  Or trying ginger candies or ginger-infused drinks.  
    • Lemons or citrus:  mixing lemon with water, or some people swear by lemonade with potato chips.  
    • Vitamin B6 supplements/candies (see research section above).  
    • Ginger or peppermint teas: however do be careful with some herbal teas that might have a mix of things that aren’t recommended in pregnancy (check with your Ob/Gyn), or a few are caffeinated– 200mg/day recommended maximum of caffeine during pregnancy.  
    • Motion sickness bands:  possibly effective, see science section above.  
    • Crackers/saltines
    • Bananas
    • Baby food or applesauce
    • Protein anyway you can get it- scrambled eggs, cheese sticks, etc.
  • Also, first trimester bloating and constipation is real! Mixing in fiber-rich foods can help with some symptoms since constipation can sometimes make nausea worse.  (Oatmeal, chia or flax are especially good bland sources of fiber.)  Talk with your doctor if you need something to help with constipation.

5) Plus, some extra things I found helped me: (Everyone is different, feel free to Contact Us to add more!)

  • Keep things bland and repetitive- it’s ok if you stick with foods you know you can eat for awhile (just keep taking your prenatal vitamin).
  • Avoid strong smells if they make you nauseous– keep windows open for fresh air or consider even taking a walk.  Consider buying fragrance free soaps and lotion if you need to.
  • Taking your prenatal vitamin at night if that helps you feel better (sometimes the iron in it can increase nausea). I also did gummy prenatal vitamins for awhile to lower nausea.
  • You can use an App to track nutrition if you’re really concerned about it (I have some I’ve reviewed in a separate article).  However, for the most part it isn’t necessary and your baby is getting what it needs with the prenatal vitamin.
  • Even if you can’t eat vegetables, trying fruit that sounds good can get you similar nutrients (some easier to eat fruits seemed to be: cantaloupe, kiwis, bananas or apples),
  • Incorporate fiber via chia seeds in juice, or plain oatmeal with some flax added and fruit for breakfast.
  • If brushing your teeth makes you gag, try using mouthwash more often.  (There’s also a recommended mix of baking soda and water to avoid tooth erosion if you vomit a lot too.)  Dental hygiene gets even more important with the changes of pregnancy.
  • If you swim for exercise, but the chlorine smell of the pool makes you sick like me–chlorine reducing shampoo really helps.  Ultraswim brand was inexpensive and worked for me, plus had the benefit of being on Amazon since it was hard to find in local stores.
  • Additional (kind of random) foods that worked for me:
    • Popsicles or Smoothies with frozen fruit.
    • Salty things like potato chips, or Gatorade (but I still didn’t find a good non-dye Gatorade substitute)
    • Ginger ale:  Trader Joe’s version didn’t have many artificial colors or flavors
    • York Peppermint Patties
    • Bagels with cream cheese
    • Cheese sticks
    • Bush’s Baked Beans (also has lots of fiber)
    • Eggs scrambled with cheese and tomatoes only
    • Beans and rice with lime and cilantro (was great, until it absolutely wasn’t)!
  • Foods you like/can eat become highly individual, so feel free to try and keep adapting what works for you!

BEST OF LUCK!!  The aim was for an All-in-One source to help with your morning sickness symptoms.  Feel free to Contact Us with any updates or tips that worked for you.

Additional sources for some of the tips above, plus additional helpful links:

Recipes for nausea: http://www.whattoexpect.com/pregnancy/eating-well-menu/nauseated.aspx

Good all around morning sickness and other hacks: https://www.babylist.com/hello-baby/life-hacks-for-pregnancy

Morning sickness specific remedies: https://www.babble.com/pregnancy/morning-sickness-remedies-nausea-during-pregnancy/

General pregnancy hacks, including clothing, morning sickness, etc: https://www.buzzfeed.com/morganshanahan/pregnancy-hacks-that-will-change-your-life?utm_term=.ou9jnD55Y#.luRGm0NNd

 

 

Posted in Parenting, Pre-Parenting

Lead Risks and Testing

Flint, Michigan brought awareness to the risk of lead exposure–raising the question whether we should be testing for lead?  Lead is an odorless, tasteless material that can be found in paint (before 1978), water or other sources, which can cause serious neurological, behavioral, or health issues in children or adults.  (Breathing or swallowing lead paint dust can provide exposure without you even knowing it.) The American Academy of Pediatrics (AAP) says there is no safe level of lead and calls for stricter regulations and testing.

You’re at high risk for lead exposure effects if: you’re planning to become pregnant, already pregnant or nursing, or have young children at home (under the age of 6).  Young, rapidly growing fetuses or children incorporate lead more readily, but lead can affect everyone depending on its levels.  Lead testing is useful anytime if you are at risk–find out more about risks and testing below.  

Lead in Paint:

Lead paint was banned In 1978, so newer homes are generally safe.  Lead exposure is highest in older homes that have chipping or degrading paint, dust released by opening or closing doors/windows with lead paint, or soil that accumulated lead over time.  (More details of other risks from the EPA here).  For home testing, the EPA approves several lead paint tests kits, including 3M Lead Paint Sticks (8 for ~$24 on Amazon).  If the 3M Lead tests are positive/inconclusive, or your house is high risk: you can check the EPA for certified lead testers or google “lead testing” in your area to find companies that provide testing and hopefully piece of mind (~$250+ depending on your home/location).  

If you find you have lead paint: there are several ways to mitigate risks detailed by the EPA, including regular dusting, wiping areas with wet cloths and avoiding disturbing lead paint etc.  If you have lead paint, doing any renovations requires a certified lead specialist (as it can stir up more lead dust and increase your exposure risks)- find out more on the about renovations from the EPA here.

Lead in Water:

Lead in water is especially high risk when using water to mix infant formula, or for pregnant women or young children (under the age of 6).  The EPA regulates lead levels in tap water to a maximum of 15 parts per billion (ppb) (which is believed not to raise lead levels in adults); however, despite these EPA rules there are several recent cases of high lead levels in Flint Michigan, or even school drinking fountains across San Diego. Even if city systems are tested and regulated, the CDC warns that lead can still get to your tap by water mains connecting to your house or older piping within your house (especially in houses built before 1986).   If you are concerned, you can bring a sample to an EPA certified lab for lead testing (using a certified bottle to collect the first sample in the morning from home sources).  I chose an EPA certified lab that was $25/sample rather than paying ~$15/sample for less accurate home test strips (home test kit reviews aren’t great).  For more testing info check out these links: from the EPA, info about collecting sample tips, San Diego specific testing info here (or find EPA approved laboratories by searching here or googling your own city). 

If you find you have lead in your water: the CDC has detailed tips for lead mitigation here (including running the tap on COLD for certain amounts of time before drinking, etc.)  Some people opt for water filtration systems attached to your faucet (however, I had difficulty finding exactly how much lead was removed by various systems).  Some people opt for bottled water.  The FDA regulates bottled water, setting maximum lead levels to 5ppb in bottled water vs 15ppb EPA regulation for tap water (however, many internet articles suggest FDA bottled water regulation might be more lax than desired–bottled water can be just tap water and might have less regular testing).  The FDA discusses bottled water regulation here, and the CDC has some limited tips here.  Some people bring up concerns about plastic levels (or BPA) in bottled water, which may be addressed in a future blog post.  

Blood Tests for Lead:

Lead is tricky to detect once it gets in the body because it creates an equilibrium of lead storage in bone versus other tissues like blood (and adults may not display obvious symptoms).  Lead blood test levels alone don’t fully rule out lead risk in adults (and environmental testing of lead paint, water etc if indicated is highly encouraged).  

Pregnant or Lactating Women: Beyond present environmental lead exposures, pregnancy or breastfeeding can also release old lead from bones due to increased bone turnover (especially with low calcium or anemia).  Lead is transmitted across the placenta and found in fetal brains as early as the first trimester.  While the American College of Obstetrics and Gynecology (ACOG) doesn’t recommend routine blood lead screening for ALL pregnant/lactating women–  with EVEN ONE lead exposure, ACOG recommends Lead Screening for Pregnant or Breastfeeding women.  (Full EPA lead exposure list here; full ACOG recommendations here for testing and treatment; additional CDC 2010 information here.)

Infants and Children:  Basically if you have known environmental exposure to lead, earlier or more frequent blood testing may be indicated tell your Pediatrician about specific lead exposures/risks to get lead blood testing.   (Age 6-12 months can be marked by rapid lead absorption- and all children under 6 years old are at increased risk for lead effects because of their small body size, higher percentage body water, rapid growth, and increased risk for lead dust/paint ingestions.)   Officially, the American Academy of Pediatrics (AAP) recommends a lead “risk assessment at the following well-child visits: 6 months, 9 months, 12 months, 18 months, 24 months, and at 3, 4, 5 and 6 years of age. The recommendation is to do a risk assessment, and do a blood lead level test only if the risk assessment comes back positive.  According to the AAP and CDC, universal screens or blood lead level tests are not recommended anymore except for high prevalence areas with increased risk factors as described in a 2012 CDC report, such as older housing.”   However, as many Medicaid-eligible patients are higher risk, the AAP may recommend standard screening Blood Lead Level at age 1 and 2 years for all Medicaid patients, depending on your state.  Further AAP lead information hereSummary: bring up any concerns (like older housing) to your Pediatrician to warrant blood lead testing.

If there is lead in the blood lead test:  Blood lead level under 5 micrograms per deciliter is generally considered low-risk; however, because lead is stored in bones and other areas it cannot be fully ruled out.  Known environmental exposures or higher blood levels may require repetitive monitoring, or even treatment (more info from ACOG or AAP).  Adequate intake of calcium, iron, zinc, vitamin C, vitamin D helps decrease lead absorption (ACOG)

Lead Testing Summary:

This article isn’t meant to alarm, but to inform.  If you find you are at risk for any environmental lead exposures, further lead testing AT ANY POINT is beneficial to your pregnancy or children.  Many good resources are linked in the article above.  A few more quality resources can be found below, including an image below from the EPA further detailing the effects of lead.  Many of the negative effects of lead can be treated, mitigated or prevented if you find out early and get tested.

More details of other lead risks from the EPA here: https://www.epa.gov/lead/protect-your-family-exposures-lead)

Consumer Report Review of Lead Test Kits: https://www.consumerreports.org/cro/lead-test-kits/buying-guide

Lead impacts on health: https://www.epa.gov/sites/production/files/2017-06/documents/pyf_color_landscape_format_2017_508.pdf ) (Source of the image below:)

EPA Lead Health Effects

 

Posted in Pre-Parenting

Pre-Parenting: Bras and Pregnancy

The pregnancy hormone progesterone prepares your breasts for milk production very early.  Sore breasts and enlargement can be some of the earliest signs of pregnancy, and support and comfort become high priorities!  On average, you gain 2 to 3 lbs. of breast tissue by the time you give birth.  A well-fitting, supportive bra not only keeps you comfortable, but also prevents sagging and helps avoid future problems with breastfeeding.  While many of us wouldn’t usually think much about our breasts or bras- the Pregnancy-related tips below are very useful!

  1. Help sore breasts (especially in the first trimester) by wearing a comfortable sports bra or built-in bra camisole even when sleeping.  Cotton is best for breathability.  Save money by starting with existing bras you have, or otherwise get a few cotton ones for sleeping at Target or Walmart ($4-12/each).
  2. Extend the use of your current bras by using stretchable sports bras, or buying a bra extender from a craft store or Amazon ($1-3/each) 
  3. Be prepared for rapid changes. (Within 2 months I changed bra size by 4 inches and 2 cup sizes, and needed several different shopping trips since new bras quickly stopped fitting.)  Try buying just just one or two well fitting bras early on, and as things stabilize it might be worth just buying a maternity (nursing) bra too.  (Having bras fit well on the tightest hook in store also means you can loosen it as your body grows.)  
  4. Invest in a bra that fits.  Check the bra fit yourself with these good bra fitting tips at a cheaper store like Target ($12-35 for maternity bras).  Or go to a store where professional staff to help you with a free bra fitting at Nordstrom ($40-75 bras), JC Penney ($20-30) or Dillards ($45-75 but smaller selection than Nordstrom).  Trying on bras in-store beats online shopping since numeric size doesn’t predict fit/comfort well in pregnancy.  
  5. Support is key:  Underwires are a trade off of support versus comfort. You might like a mix of bra types depending on where you are in the pregnancy- underwires can get uncomfortable cutting into your growing baby bump.  Wider shoulder straps, and an adjustable closure on the back are also recommended.  
  6. Nursing (Maternity) Bras are your friend: The shoulder clip that allows you to lower each cup to easily breastfeed is totally worth it (nursing in most regular bras is nearly impossible/very uncomfortable). If you plan to breastfeed, have two or three nursing bras by the time you give birth (including a comfortable cotton one for sleeping). Again you may want slightly different sizes or soft/flexible cups as breast tissue will change over time.
  7. Cool your bra in the freezer if it’s summertime. People on Buzzfeed swear by this hack if you have sore breasts, especially in the heat.
  8. Breast Pumping Bra Hack:  If you are pumping once you give birth, you may want to convert an old sports bra into a hands free breast pump holder (see the image at tip #2 here), or otherwise buy a custom bra for that.  This can free you up and save your wrists too.  For more working mom pumping hacks, click here.

 

Want even more info?

Check out the Consumer Reports Nursing Bra Buying Guide:   https://www.consumerreports.org/cro/nursing-bras/buying-guide

Or get some facts or empathy for Pregnancy Related Breast Changes here:

https://www.webmd.com/baby/tc/breast-changes-during-pregnancy-topic-overview#1

https://www.babycenter.com/0_breast-changes-during-pregnancy_262.bc

https://www.fitpregnancy.com/pregnancy/all-about-boobs-your-crazy-breast-changes-pregnancy

 

Posted in Pre-Parenting

Pre-Parenting: Pregnancy Nutrition Apps

Healthy nutrition in pregnancy is important, and ACOG (American College of Obstetrics and Gynecology) has a list of nutrition recommendations.  Plus daily prenatal vitamins are essential pre-conception or as soon as you know you are pregnant.

Liking data and tech, I was curious to track my own nutrition.  After doing that for a month, here’s what I learned:

  1. Nutrition Apps Reviewed.
  2. Nutritional take-aways (based on my data) that can save you time & effort.

Nutritional Apps Reviewed:

Many pregnancy Apps allow you to record servings of food groups for example (Ovia Pregnancy is one good example of this).  However, I found that not that useful for me as:

  1. Serving sizes vary and aren’t mentioned in the App, so my data recorded is probably not that accurate.
  2. Micronutrients (vitamin A, vitamin C etc.) are ball-parked via this method but not checked accurately.
  3. Caveat: For the most part in a modern, varied diet with fresh foods plus a prenatal vitamin, most pregnant women do get adequate nutrition (so most people don’t have to stress about this).

However, I like data and wanted all the facts behind it.  To get more data I had to look behind traditional Pregnancy Apps (reviewed here) with their limited nutrition settings, and used Nutrition Specific Apps:  MyFitness Pal and Fooducate.  (More information comparing the two upcoming.)

Nutritional Take-Aways:

Tracking my daily food data, I found trends of two important things I was consistently short on.  If you’re like me, focusing on these two elements might be most worth your efforts.

  • Fiber
  • Calcium

More on using this to enhance your nutrition without counting all of your calories coming up!

 

Posted in Pre-Parenting

Pre-Parenting: Pregnancy Apps Reviewed

While Fertility Apps had a clear winner I wrote about here, looking through Google Play for Top-Rated Pregnancy Apps was much tougher.  I easily filled up the memory on my phone, but didn’t find a clear winner that balanced data gathering, usability and education.

My conclusion:  figure out what you want out of a Pregnancy App and go from there.  I gave top reviews based on features below.  (This is my unpaid, unbiased review.)

Top Things I Found Useful (maybe you will too):

  1. Monthly calendar that easily shows weeks gestation.  Bonus if you can put notes ahead of time on certain dates (i.e. I just read recommended testing schedules so I note that at 12 weeks on my calendar I should schedule a prenatal test, etc.) or mark future doctor appointments.
  2. Useful articles.  Many Apps time these articles by gestational age, which is nice so you get educational materials that are time relevant.  I also liked a library of articles within the App so I could read up on things archived in a logical manner.
  3. Tracker.  Keeping track of sleep, activity, mood or other notes can be nice.  Recording symptoms, or especially weight, nutrition, or blood pressure can be medically relevant based on your situation (but if it is, your clinic is likely following it even more closely too).  I have yet to find a good user interface for this though. (And I’ll talk about reviews for getting a good Nutrition Specific App in another article.)  I’m also too early to need the fetal movement tracker (kick-counter) although I could see how that could be useful.
  4. Medication or Food Safety Look Up.  I found this rarely on Apps.  While I didn’t use it that often, I did find it helpful if I wasn’t sure about a food.  (For Medications– my opinion is I’d still want to clear most medications with my OB/Gyn beyond what any App said.)

Items I would have liked:

  1. A Monthly Calendar that also maps typical timing for appointments and testing based on guidelines from ACOG.
  2. Academic leanings on the Articles.  More facts about elective prenatal testing (percentage of risk etc.) would be useful, most information included is pretty general and requires further research outside the APp.
  3. Better Tracker User Interface (UI).  Most Apps were a step down in UI even from the fertility tracker apps (sometimes of the same brand)
  4. Share the App with your Partner.  It could be nice to both have access to the same info.

Things I didn’t find useful (you might disagree, but this helps you understand my rankings):

  1. The online community.  The random posts or surveys of “is this normal?” just made me uncomfortable or needlessly nervous, especially if the App pro-actively listed this information without seeking it out.  It can be nice to check with people, but your own real-life friends or health care providers are probably a safer bet in my mind.
  2. Reminders alerting my phone when I hadn’t logged into the App in a few days.  😛  This gets pretty annoying and awkward when a Baby Bump Icon appears on your phone asking you to check their App when people might see that over your shoulder, especially if it’s too early in the pregnancy to make it public.
  3. Videos.  Most of these Weekly Update Videos were pretty patronizing and done by bad actors.  I prefer to read the info…but if you’re a video person maybe you’d like different Apps than I did.

Top Apps:

Ovia Pregnancy.  Best Features: Calendar showing gestational weeks and allowing you to put notes/appointments on it. Tracks symptoms.  Good Articles and Medical/Food Safety Lookups.  Review:  Begrudgingly it still won, although it changed the smooth data entry UI I liked in its Ovia Fertility Tracker to a much clunkier way to enter the same data.  (Since my initial review, Ovia updated its clunky symptom tracker UI–now it’s easily the #1 App in my mind!) Ovia Pregnancy won for it’s simple good UI Calendar view that overlaid weeks gestation on dates, plus it allowed you to record future notes and doctor visits–this is my most used feature by far.  Its articles were fair– with timely in the newsfeed feature and good curation for reading other articles whenever you wish.  The tracker collected good data, but not as smoothly as before.  It does track trends in weight visually, but not the other metrics like blood pressure, etc.  Ovia has a Medication and Food Safety lookup that was also nice to have when needed as well.  The Videos and Community Features are there for those who like that. I liked the added Notes/Milestones feature in Ovia Pregnancy, although was bummed it is only visible by clicking on the date you recorded the info rather than keeping a running list visible somewhere (like a running list of baby name ideas for example).  With 2 weeks of trying all the Apps, I came back to Ovia the most.

Mayo Clinic Pregnancy.  Best Features:  Limited but more-indepth articles from knowledgeable Mayo source.  Review: Rather streamlined, this App takes your estimated due date and offers weekly updates of 1 to 2 articles.  The articles are more academic than others and can be useful.  Clicking on the Menu shows a Blog with more articles, but those are not curated by topic or weeks gestation.  There are no extra tracking, calendar or note features like in other Apps.  I felt it a little pushy, but 2 of the 3 real tabs under the Menu are a direct link to buying Mayo’s Healthy Pregnancy Book, and Mayo Healthy Baby Book.  I happen to have bought their book separately, but even to me that seemed a little too much.  All-in-all for a free App, it’s worth having on the phone to check every week or so to get a little more detailed information in the articles than other Apps provide.

Meh Apps:

I’m Expecting.  Best Feature: Symptom tracker easily inputs data, has a visual calendar option and compares symptoms with other moms.  Review:  It offers cute baby pics on the landing screen, week by week baby size (today your baby’s 1/16 of an inch!), articles by the week, videos, symptoms manual, a weight or steps graph.  The symptom calendar feature had promise–mapping your symptoms by colored icons daily on the actual calendar.  However, it wasn’t very intuitive to use the calendar with its odd symptom symbols…nor is it that medically relevant since things like morning sickness are there regardless and you don’t have the option to track things that might prevent it.  Symptoms input is relatively simple at least; furthermore, if you wonder if you’re normal or what to expect, it gives a % of women reporting similar symptoms that week.  That can feel reassuring.  I’m Expecting emphasizes the Community Feature with moms in your age bracket, or even a group of moms you’re automatically enrolled in with the same estimated due date– reading any of those things just up my anxiety rather than info though.  Without a weekly calendar or the ability to track other things or notes, I found it rather limited. Its week by week articles were timely but were not possible to read from an archive otherwise.  Its videos had an Ob/Gyn reading you the few sentences of info….but the poor thing looked so uncomfortable the videos are awkward to watch.

What to Expect.  Best Feature: Articles.  Review:  This App is based on the famous book, and has lots of common features of articles, videos and community chat features.  I found their book to be not as academic as Mayo for example, and wasn’t too keen on this App probably because of that.  It offers many standard App features you may like (my husband kept this on his phone…and he’d occasionally update me on things he learned). I must say the thing that most sticks in my mind from it though is that the lady who does their videos is an awkward older lady who is clearly reading from a teleprompter…I’m not sure why they hired her, it’s pretty painful to watch.

Nurture.  (This App also has Fertility and Parenting related Apps called Glow) Best Feature:  Log daily symptoms that are pretty medically relevant (prenatal vitamins, doing kegels, symptoms etc.)    Review:  The opening screen is an embryo pic and this week’s calendar only, plus 3 or 4 daily article that can be useful, plus a Library with all articles but only if you pay for Premium. (It has a “view week” feature that lets you zoom out to see a few weeks and the gestational age, and click on those dates; however, still no calendar view and no way to record things beyond today.)  There is a pretty useful daily Yes/No log for relevant things- spotting, cramps, kegels, taking prenatal vitamins etc (although data entry can still be pretty slow).  It displays streaks of how long you keep doing certain things when you log, but otherwise there’s not any easy way to display trends in the data. Plus I felt it’s % completion of entering all data points was a bit pushy to do it everyday.  For those who like that, it has a Community Feature as well.  Overall though I was turned off by its cluttered interface, and repetitive pushes to pay to join Premium and happy to delete the App.

Pregnancy +.  Best Feature: Timeline feature showing landmarks and testing per week gestation.  Slightly less cluttered UI than Nurture, otherwise very similar and also emphases adding premium feature. Review:   Login shows a fetus pic, current  number of weeks, a time sensitive article or two for the day, plus a sample ultrasound image and baby size guide.  You can enter appointments in advance that sync to a regular calendar.  You can map your weight over time.  There is also a baby kick counter, but it requires payment to use.  This one has videos that are lifelike embryo pictures that scroll by with no talking or education…it’s kind of eery too, and only goes a few weeks unless you pay them $3.99 for 2nd and 3rd trimester.  It does have a the best timeline display I’ve seen, although it’s hard to find:  Click> Baby>Timeline.  Most time time I got lost in a still relatively chaotic UI.  Plus there was no article archives to read up on other information.  Another downside, the widget for this App on your phone is a kind of creepy fetus head.  I was happy to delete it.

BabyBump Pro.  Best Feature: Free Kick Counter or Contraction Timer might be useful later in pregnancy; a few useful checklists.  Fun-Finder display for similar sounding Baby Names has a nice UI.  Review:  Overall this App’s info seems pretty limited, but it does have a few later pregnancy features you might like.  For today it gives you one article or you can scroll through weekly info.  It emphasizes taking weekly baby-bump photos (personally I’m not a fan).  It has Group Community Message boards you can peruse or have friends on.  People might enjoy the Journal feature (but it’s weight and waist, text entry of symptoms that’s not searchable….looks paper based transferred to a phone screen).  It does have Baby Names searchable by origin, popularity and you can mark favorites but not best UI.  There is a free kick counter that runs a stopwatch and you press a button each time you feel a kick.  There’s also a contraction timer that you hit start/stop and it counts duration and interval between contractions.  There’s also a 3D video of a simulated baby being born that is supposed to inspire you to do the Birth Plan Checklist on the same page.  There’s also a one stop Newborn Essentials checklist that might be useful. It might be worth revisiting this App later in pregnancy to see if the kick counter/contraction timers are useful compared to other Apps.

The Bump.  Best Feature:  Snazzy UI, although comparatively few features.  Review:  The UI looks hip at the start with a trendy “How big is baby” prompt (answer, a pea!), and tells you how many weeks along you are.  There are a range of articles, and questions are answered by an expert plus community members (something that seemed better than the standard Community settings on other apps).  It proactively links you to registry options and says what % discount you get by registering at common stores.  You can also enter weekly bump photos or videos.   There aren’t any trackers of symptoms or other things of substance, however- it is nice to look at at least.

Don’t waste your time:  

ACOG Apps.  I was hoping to read the American College of OB/Gyn’s recommendations and information directly from their free App. Unfortunately you have to have a membership (be a practicing OB/Gyn) to access that information from either your App or online.  It did have a feature that can adjust your due dates based on last period and ultrasound findings to a more accurate date which I found interesting, but your doctor will do that anyway.  Many of the reviews said the App was buggy, and I had some issues getting it to open too.  It got quickly deleted.

I’d love to have you add your comments, experience and wisdom in other Apps you may have tried!

Posted in Pre-Parenting

Pre-Parenting: Fertility Tracker Reviews

You like data– and you’re looking to conceive.  There’s an App for that!  But which one?

As a Doc and data-addict, I wanted a usable but data relevant App and compared with other doctor friends doing the same.  (This is an unbiased, unpaid review.)

The clear winner from all of us….

Ovia Fertility available for Free here on Google Play (4.7 star rating).  This user-friendly app easily maps symptoms, basal body temperature, and everything you’d need in a great User Interface (UI).  Plus it has helpful articles and an informative positive daily feedback of the data you enter which makes it a positive experience.  It requires a free login, but then you can set up a quick PIN for privacy so only you will see the data on your phone.  (Note: it does collect a fair amount of data, you might want to read its service agreement closely if that’s a concern for you.)  Ovia Fertility won hands down for being both useful and usable.  (Note, Ovia Pregnancy or Ovia Parenting Apps warrant a separate review as they are very different.)

Other Fertility Apps I checked didn’t even compete (I’d downloaded them but deleted them after I started Ovia):

Glow Ovulation and Fertility (4.6 stars on Google Play): collected similar data as Ovia, but UI was not great and took a lot longer to enter data.  Plus it had an annoying % completion of data feedback that kinda made me bummed each day with its high expectations.  It did have some neat zoomable comprehensive graphs, but required Premium to fully unlock at minimum $3.99/month or more, and frankly the additional data you got wasn’t really clinically relevant or worth the price.  You get much more from Ovia for free with its calendar and summative graphs and you’ll enjoy using it much more.  (The data side of me did like the daily % pregnancy chance it gave…but Ovia’s 1-10 fertility rating is essentially the same and worth it for the overall usability so my vote is that Ovia will still serve you better.)

Flo Period and Ovulation Tracker (4.8 stars on Google Play):  Seemed more geared towards general period tracking.  The UI looks nice at first…but quickly became too Pink and girly and a little too simple for me (big dot covering whole screen).  It’s one week at a time display I didn’t find very helpful vs the monthly calendar used by Ovia or others.   It says neural networks and AI interpret the data which might be great (although I must say the data itself isn’t that complicated so that level of computation).  The summative graphs aren’t as great of UI, but it does analyze other things like sleep and activity separately if you desire.   It didn’t have the useful articles of the Ovia or Glow Apps either or positive reinforcement for data entry.  Overall I didn’t really find it usable.

Fertility Friend Tracker (4.5 stars on Google Play):  OK but its data summary displays were really old school 1990s design and didn’t seem as useful.  Unfortunately didn’t compete with Ovia for UI and usability.

Note: Many of these Apps are also on iPhone (but since I don’t have one I didn’t check that).  Also, signing up for many of these Free Apps might send an awkward “Welcome to Fertility App” email to whatever account you list (make sure that email’s not prominent at work etc. by using a junk email account).  Also, downloading might pop these Apps on your main screen on your phone that anyone can see when you unlock so beware.

Bonus Free App Recommendation: EZPregnancy  (Free on Google Play)  A simple but very usable “Pregnancy Wheel” App that Ob/Gyn doctors use to calculate due date.  If you’re trying to conceive and want a reference when the baby would be due based on first date of last period, this is an easy app to have.

Also, another useful recommendation.   If you’ve used an App for a month or two and want to increase chances of getting pregnant, Ovulation Tests are pretty affordable (especially when you use the App to narrow what dates to test). Ovulation tests give a 12-36hour notice before your most fertile days and can help increase odds of conception. One with the best reviews and reasonable price point I had success with was:  Clearblue Digital Ovulation Test (buying the 20 ovulation test strips supply will prob be all you need for $35.99 at Target, Walmart or cheaper here at Amazon).

Thanks for reading and good luck!