This topic is about managing pregnancy while living with an ileostomy, focusing on dealing with blockages, gas, and nutritional concerns. An expectant mother, who has had an ileostomy since 2009, is experiencing increased gas pressure, sluggish output, and partial blockages during her pregnancy. These issues are making it difficult for her to eat properly, and she is worried about providing enough nutrition for her baby. She is seeking advice on how to prevent blockages, relieve gas, and maintain proper nutrition.

Here are some helpful suggestions:

1. Nutrition and Calories
- Consider high-protein or meal-replacement shakes to ensure you get enough calories and nutrients.
- Switch to liquid, chewable, or gummy prenatal vitamins, ensuring they include folic acid and B-vitamins. Consult with your healthcare provider before making changes.
- Try blending, puréeing, or juicing foods that are difficult to digest, and stick to a soft-food diet if necessary.
- Keep a food diary to track and identify foods that trigger blockages, then adjust your diet accordingly.
- Some foods that might be easier to tolerate include boiled eggs, calves’ liver, raw spinach in salads, mac & cheese, milkshakes, cake, or ice cream, as long as you meet your nutritional needs.
- Visit a health-food or nutrition store for pregnancy-specific liquid vitamins or supplements.

2. Medical Follow-up
- Keep your OB/GYN and GI/ostomy teams informed about any increase in blockages. They can help with dietary adjustments and monitor both your and your baby's health.

3. Blockage Prevention
- Replace problematic solid foods with puréed or liquid versions, chew your food thoroughly, and increase your fluid intake as recommended by your healthcare provider.
- Regularly reassess your diet as your pregnancy progresses, as intestinal compression may increase near the end of your term.

4. Gas Management
- Periodically "burp" your pouch by opening the tail or outlet to release gas before it becomes too much.
- Consider using pouches with built-in gas-release valves, as several manufacturers offer filtered or vented systems.
- If a vented pouch isn't available, use a cotton diaper, light jacket, sweater, or other fabric to muffle any sudden sounds.

5. Emotional and Practical Tips
- Carry a light sweater or jacket in public to help dampen unexpected loud gas noises.
- Share your experiences and progress with supportive peers or online forums, as others have successfully managed similar concerns during pregnancy.