Possible Pregnancy-Related Issues

The following information is for women who are already pregnant as well as those likely to become pregnant soon. It must be emphasized that you should think about preparing your body nutritionally for a healthy pregnancy before conception.

Pregnancy is all about change. It can be a challenging time both emotionally and physically. But with the right approach, some enthusiasm, positive thinking, professional guidance and support from friends and family, it can be a time of learning, a renewed feeling of health and the beginning of a rewarding relationship with your new family.

Taking good care of both yourself and your partner before conception will help ensure that both of you and your baby stay healthy throughout the pregnancy and beyond. One of the reasons for this is that the development of the sperm and the egg can be affected by various personal and environmental factors. Before deciding to have a baby, you should try and ensure that you are healthy physically and emotionally including:

  • Being within the recommended healthy weight range for your height and build. Losing or gaining that extra weight once you are pregnant is not a good idea.
  • Avoiding as much as possible any artificial additives in foods, and environmental chemicals/pollutants.
  • Quitting (or at least very much reducing) your smoking and alcohol consumption.
  • Managing lifestyle stress, for example by avoiding stressful situations, by exercising, relaxing and enjoying the outdoors.
  • Ensuring your diet is adequate in providing all the nutrients you require.

Healthy eating is essential for you and your baby to have the best chance of staying healthy and happy. Remember that while you are pregnant you are the only source of the essential nutrients your baby needs to grow adequately and be healthy. If your intake of these nutrients is insufficient, your baby’s requirements will not be met or the nutrients will be removed from your own body structure to satisfy the baby’s needs, both of these being unhealthy. The important principles are to avoid the foods which can harm the baby, to select a variety of foods from each of the food groups (and vary this choice according to what you most want at the time because this is probably what your body needs), and to eat in moderation (eating for two does not mean eating twice as much!)

Medical journals are packed with studies advocating a nutrient-rich diet and sensible supplementation for expectant mothers. German research bears this out with evidence that women who use multiple prenatal supplements can expect up to a 17% reduction in birth defects for their newborns. Which nutrients do you need and why? Some supplements are more vital to a comfortable pregnancy and a healthy baby than others.

  • Folic Acid Is Critical. Folic acid plays a critical role for the developing fetus by preventing neural tube defects such as spina bifida, a condition in which parts of the spinal cord are unprotected by vertebrae, and anencephaly, a fatal defect in which both the skull and most of the brain are missing.
  • Prevent Anemia with Iron. Adequate iron intake is important during pregnancy, a time when some women become anemic. Studies show that women who have iron-deficiency anemia run the risk of delivering shorter, smaller babies.
  • Calcium & Vitamin D for Bones. Calcium is the final critical component of gestational nutrition. It is primarily used for building a fetus’ bones and teeth, although cells and blood also rely on calcium to function. Vitamin D is essential for calcium absorption and bone formation in babies.
  • MagnesiumNausea, Cramps, Edema And More. Magnesium is essential for maintaining a healthy pregnancy.
  • Other Nutrients for Good Measure. Vitamin B6, a nutrient needed for amino acid metabolism, is also required for your growing baby. Much of the way your baby develops essential proteins, such as DNA and insulin, depends on zinc.
  • Protein. Sufficient protein can be important in preventing preeclampsia.

Remember, a vitamin pill can’t replace a healthy diet. If you’re pregnant, eat wholesome foods such as whole grains, fresh vegetables and fruits, beans, legumes, nuts, seeds, and lean meats. Most importantly, work with your primary care practitioner to determine which dietary and supplement programs are best for you and your growing baby.

Once the baby is born…

Keeping a child’s environment too clean can increase the risk of developing allergies. Reduced microbial stimulation during infancy and early childhood may result in slower postnatal maturation of the immune system and increase allergy risk.

Breast feeding for at least 4 months or, to a lesser degree, consumption of oily fish or Omega 3 fatty acids during pregnancy, improved maturation of babies’ visual cortexes with resulting better vision at 3 1/2 years of age.

References

Hort A, Bran H. Gesundheitswesen 1997;59(4): pp.248-251.

Preziosi P, et al. Am J Clin Nutr 1997; 66: pp.1178­82.

A Hint for Delivery time.

Don’t push! The pushing stage of birth is coached in most hospitals and involves the attendants telling the birthing woman when her cervix is fully open (dilated) and encouraging her to give long, strong pushes with each contraction.

Previous research shows that coached pushing does not improve the short-term outcome for mothers and babies, except when the baby needs to be born as soon as possible. This study randomized 325 women giving birth to coached or uncoached pushing. Three months later, they measured the pelvic floor and bladder function of 128 of these new mothers.1

Women in the coached group had decreased bladder capacity and less urge to empty their bladder. They were more likely to have an overactive bladder muscle, and to have stress incontinence, on testing.

Researchers commented, “With uncoached pushing, bearing down does not occur until uterine contractions are well established and the urge to push is present. There are normally several short bearing down efforts per contraction with breath holding for 5 to 6 seconds.”

In contrast, “In coached pushing, the mother is alerted to begin pushing as soon as a contraction is noted, and she is encouraged to push for 10 seconds, take a deep breath, and push again. Coached pushing could potentially increase the amount of pressure on the pelvic floor with subsequent deleterious effects.” .

 


Signs, symptoms & indicators of Possible Pregnancy-Related Issues

Lab Values - Cells  

High ESR or elevated ESR



Symptoms - Female  

Having galactorrhea



Symptoms - Skin - General  

Red palms/fingertips




Conditions that suggest Possible Pregnancy-Related Issues

Infections  

Periodontal Disease - Gingivitis

During pregnancy the body experiences hormonal changes. These changes can affect many tissues, including the gums. Gums can become sensitive and at times react strongly to the hormonal fluctuations, which may in turn increase the susceptibility to gum disease. Additionally, the more the mouth is affected by periodontal disease, the more likely a woman is to deliver a premature baby, according to an ongoing study of more than 2,000 pregnant women.



Lab Values  


Skin-Hair-Nails  

Female Hair Loss

The hormone changes occurring at childbirth can cause hair loss.




Risk factors for Possible Pregnancy-Related Issues

Lifestyle  

Being a smoker

Women who smoke during pregnancy are at risk for premature birth, pregnancy complications, low-birthweight infants, stillbirth and a higher rate of infant mortality. For pregnant women and new mothers, smoking puts their baby at risk for sudden infant death syndrome (SIDS), poor lung development, asthma and respiratory infections. Women who smoke during pregnancy also have an increased risk of having a baby with clubfoot.



Nutrients  

Manganese Requirement

There is a risk of fetal malformations, including increases in neural tube defects, without an adequate amount of manganese.



Symptoms - Food - General  

Partial aspartame avoidance or not avoiding aspartame



Symptoms - Nails  

Some/possible clubbing of digits or clubbing of toes and fingers



Counter Indicators
Symptoms - Nails  

Absence of clubbing



Symptoms - Reproductive - General  

Chance of becoming pregnant soon



Counter Indicators
Symptoms - Reproductive - General  

No chance of becoming pregnant




Possible Pregnancy-Related Issues can lead to

Musculo-Skeletal  

Restless Leg Syndrome (RLS) / Periodic Limb Movement Disorder (PLMD)

Secondary causes of RLS are associated with dopamine receptor blockers, end-stage renal disease, fibromyalgia, iron deficiency, discontinuation of opiates, pregnancy, use of spinal anesthesia, and uremia.




Recommendations for Possible Pregnancy-Related Issues

Amino Acid / Protein  

Glutamine

Glutamine passes through the placenta and may actually be concentrated in the baby’s blood, producing very high levels. Glutamate plays a major role in the development of the baby’s brain. Excess glutamate has been shown to cause significant impairment of brain development in babies and can lead to mental retardation.



Animal-based  

Probiotics / Fermented Foods

Gastrointestinal alterations in bacterial flora are common in infants suffering from allergic disease or who will develop allergic disease later. Probiotic supplementation helps normalize and strengthen the lining of the GI tract in infants. Eczema symptoms have been reduced in infants when they were supplemented with probiotics. In addition, probiotic supplementation in mothers for 6 months before and after birth reduced the incidence of eczema in their children by 50%. [Brit J Nutr 2002 Sep; 88 Supp 1: pp. S19-27] Antibiotic use in early infancy has been associated with an increased risk of allergic disease in later childhood, which is in keeping with the understanding that a disturbed GI flora will contribute to an allergic tendency. A family history of atopic disorders like dermatitis further suggests that probiotic supplementation would be wise both pre- and postnatally.



 

Fish Oil / Krill

The incidence of preterm delivery was reduced more than 3 fold by the consumption of 15gm (1/2 ounce) of fish (or 500mg of fish oil) per day compared to women who ate none. Since it has been demonstrated that consumption of Omega 3 oil does increase EPA but not DHA in the breast milk of women eating it, using flax seed oil alone to achieve the effect of fish oil, which contains EPA and DHA, may not work to prevent preterm deliveries. [Brit Med J 2002;324: pp. 447-450]



Botanical  

Ginger Root (Zingiber officinalis)

Ginger syrup was used to reduce nausea and vomiting in a controlled study of 26 women during the first trimester of pregnancy. 250mg ginger was used four times daily [Altern Ther Health Med 2002;8(5): pp.89-91]. Although this was the amount used in the study, the recommended dose is 1 gram as needed several times per day, says Varro Tyler, PhD., dean and distinguished professor emeritus at Purdue University in West Lafayette, Indiana.

Using capsules of ginger root purchased at a health food store will give you the greatest convenience and control over the amount of ginger you are using. There may be a variety of products available from your health food store designed to help control nausea which include ginger. One such product is called Preggie Pops, a lollipop created for this problem. It does, however, contain sugar.

Do not use more than 3-5gm of dried ginger per day during early pregnancy.



 

Herbal Combinations

Triphala (generally used for constipation) should not be used during pregnancy, as it’s ‘downward flowing’ energy is believed to favor miscarriage.

ViaViente, a combination product, is safe for pregnant and/or lactating women.



 

Licorice Root (Glycyrrhiza glabra)

A high consumption of licorice (glycyrrhizin 500mg per week) was associated with an increased risk of preterm delivery in a study Finnish women. [Am J Epidemiol 2002;156(9): pp.803-5]



 

Neem

Due to its contraceptive and possible abortion promoting properties, neem should be avoided in woman of childbearing years who are or may want to become pregnant.



 

Evening Primrose Oil / GLA

EPO does nothing to shorten gestation or improve labor. Instead it increases the risk of premature rupture of membranes (and increased infection risk), arrest of decent, and vacuum extraction. EPO is not recommended for use during pregnancy. [Journal of Nurse-Midwifery in May/June 1999]



 

Kava

Kava use is discouraged due to possible complications.



 

Parsley (Petroselinum crispum)

Parsley contains essential oils; the most important one, apiole, is a kidney stimulant. Because these essential oils can stimulate uterine contractions, pregnant women should avoid eating large quantities of it.



 


 

Vitex

Vitex should not be used by pregnant women.



 

Saw Palmetto (Serenoa repens)

Saw palmetto should not be taken by women who are pregnant, nursing or trying to conceive, because it affects sex hormone levels.



Chemical  

BHT (Butylated Hydroxytoluene)

BHT should not be used supplementally in pregnancy although there is no evidence that consuming foods where it has been added as a food preservative is harmful.



Diet  

Caffeine/Coffee Avoidance

Human studies have found an increase in the rate of miscarriages, stillbirths, breech births and low birth weight when given in doses greater than 300mg (an amount equal to three cups of coffee) per day. Pregnant women are also three times slower to metabolize caffeine than nonpregnant women. Therefore, it is recommended that pregnant women consume less than this amount – in fact some doctors say that coffee should be completely avoided during pregnancy and breast feeding.

Fetuses and newborns cannot metabolize caffeine in their livers, so it remains in their bodies for up to four days, stimulating their nervous system the entire time, causing irritability and sleeping difficulty. In addition, the use of large amounts of caffeine by a mother during pregnancy may cause problems with the heart rhythm of the fetus.

Studies in animals have linked high blood levels of caffeine to premature birth, delivery complications, low birth weight and birth defects when given in very large doses (amounts equal to 12 to 24 cups of coffee a day), and with bone growth problems when given in smaller doses.



 

Alcohol Avoidance

Alcohol is definitely harmful for the baby, no matter how much is consumed, especially during the first three months when the baby is forming. There is also a definite correlation between the amount of alcohol drunk during pregnancy and the severity of the symptoms, and also a link with the risk of miscarriage and stillbirth. Evidence shows that even pregnant mothers who only drink in moderation have a greater chance of miscarriage and low birth weight babies than those who do not. Numerous studies have also shown that heavy drinking is extremely damaging for the baby and has the potential to lead to fetal alcohol syndrome. Such babies have low birth weight, with a smaller head circumference and mental retardation is often present. Some affected babies have malformed faces and congenital heart defects.

The current recommendation from doctors and health experts is that pregnant women should not drink at all. If the urge is too strong, one standard drink is the absolute maximum. However, in the first few weeks of pregnancy, it is difficult to know that you are pregnant and this is a particularly crucial stage for the formation of the baby. So, if you suspect that you are pregnant, or are planning to conceive, you should stay away from alcohol. The risk of miscarriage doubles with more than two drinks per day.



 

High/Increased Protein Diet

Adequate protein intake can prevent preeclampsia, and a higher protein diet can often successfully reverse preeclampsia.



 

Artificial Sweetener Avoidance

Dr Diana Dow Edwards, a researcher, was funded by Monsanto to study possible birth defects caused by the ingestion of aspartame. After preliminary data showed damaging information about aspartame, funding for the study was cut off. A separate genetic pediatrician at Emory University has testified that aspartame is causing birth defects.

In the book, While Waiting: A Prenatal Guidebook by George R. Verrilli, M.D. and Anne Marie Mueser, it is stated that aspartame is suspected of causing brain damage in sensitive individuals: a fetus may be at risk for these effects. Some researchers have suggested that high doses of aspartame may be associated with problems ranging from dizziness and subtle brain changes to mental retardation.



 

Increased Fruit/Vegetable Consumption

Women who eat vegetables such as potatoes and turnips while pregnant may increase their child’s risk of developing diabetes, according to a study on mice. Now, researchers have found that bafilomycin, a toxin found in some bacteria called streptomyces that infect vegetables such as potatoes, sugar beets, turnips and radishes, may be a trigger for type 1 diabetes in children who are genetically susceptible. The toxin, which cannot be destroyed through cooking, appeared to affect the development of the pancreas, which could cause type 1 diabetes in susceptible persons, according to researchers.

Finland, where potatoes are commonly eaten, and Sardinia, where people eat a lot of sugar beets, have the highest rates of diabetes in the world, researchers said. [The Australian June 9, 2003]

Eating apples while pregnant may give new meaning to an apple a day keeping the doctor away. Compelling new research has concluded that mothers who eat apples during pregnancy may protect their children from developing asthma later in life. The study was published in Thorax online April 2007.

This unique longitudinal study tracked dietary intake by nearly 2000 pregnant women, then examined the effects of the maternal diet on airway development in more than 1200 of their children five years later. Among a wide variety of foods consumed and recorded by the pregnant women, the researchers concluded that the children of mothers who ate apples had a significantly reduced risk for the development of asthma and childhood wheezing.

This study focuses on medical evaluations for asthma and related symptoms (i.e., wheezing) when the children were five years old. As a result of the evaluations cited in this research, other than apples, there were no consistent associations found between prenatal consumption of a range of healthful foods and asthma in the 1253 children who were evaluated.

Children of mothers who ate apples during pregnancy were much less likely to exhibit symptoms of asthma (including wheezing), say the researchers who hail from institutions in The Netherlands and Scotland. These same researchers previously reported positive associations between maternal consumption of vitamins A, E, D and zinc with reduced risk of asthma, wheeze and eczema in children.

The only other positive association found between prenatal food intake and risk reduction in the children was with fish, for which the researchers found that children of mothers who ate fish had a lowered incidence of doctor-confirmed eczema.



 

Increased Fish Consumption

Based on the recommendations of the Environmental Working Group and the U.S. Public Interest Research Group, it is recommended that shark, swordfish, king mackerel and tilefish, tuna, sea bass, halibut, marlin, pike, Gulf coast oysters and white croaker not be eaten by pregnant women and women of childbearing age who might become pregnant due to mercury contamination. It also recommended that nursing mothers and young children steer clear of these fish. In addition, the report says canned tuna, mahi-mahi, cod and pollack should not be eaten more than once a month.

“The widespread contamination of fish with mercury has given its reputation as ‘brain food’ a new and disturbing connotation. Mercury is toxic to the developing fetal brain, and exposure in the womb can cause learning deficiencies and delay mental development in children.”

A Center for Disease Control report finds that an estimated 375,000 babies being born each year at risk of neurological problems due to exposure to mercury in the womb. The Mercury Policy Project report indicates that at least 10 percent of women of childbearing age have levels of mercury in their bodies that exceed what the U.S. Environmental Protection Agency considers acceptable and this translates to nearly six million women.

It is a tragedy that the modern way of living has damaged a very healthy food with mercury toxicity as a result of burning coal for electricity, which releases mercury into the atmosphere. Generally the larger the fish, the more mercury it contains. It would be best to avoid fish consumption during pregnancy and strictly limit it thereafter in young children. On the other hand, fish oil, containing essential fatty acids, is usually free of mercury as a result of processing and its use has been shown to reduce the frequency of preterm deliveries.



 

Therapeutic Fasting

Fasting should be avoided during pregnancy.



Drug  

GHB (Gamma-Hydroxybutyrate)

GHB induces “remarkable hypotonia” (muscle relaxation) (Vickers, 1969). It is now gaining popularity in France and Italy as an aid to childbirth. GHB causes “spectacular action on the dilation of the cervix,” decreased anxiety, greater intensity and frequency of uterine contractions, increased sensitivity to oxytocic drugs (used to induce contractions), preservation of reflexes, a lack of respiratory depression in the fetus, and protection against fetal cardiac anoxia (especially in cases where the umbilical cord wraps around the fetus’ neck) (Vickers, 1969; Laborit, 1964).



 

Conventional Drugs / Information

In December 2005, the Food and Drug Administration warned pregnant women and their doctors away from the antidepressant Paxil because of an increased risk of heart defects in newborns. With this warning, the agency for the first time placed a popular antidepressant – one in the same drug class as Prozac and Zoloft – into its second-highest category for risk of birth defects.

July 2011. Children whose mothers take Zoloft, Prozac, or similar antidepressants during pregnancy are twice as likely as other children to have a diagnosis of autism or a related disorder, according to a small new study, the first to examine the relationship between antidepressants and autism risk.

Using Kaiser Permanente’s patient database, which includes more than 3.2 million people, Croen and her team identified 298 children with an ASD who were born between 1995 and mid-1999, and matched them with 1,507 children without autism who were roughly the same age and were born in the same hospitals.

The authors then cross-checked whether their mothers, in the year before delivery, filled prescriptions for an SSRI, including Prozac, Zoloft, Luvox, Celexa, and Paxil (or their generic versions). The researchers could not confirm whether the mothers actually took the medication, however.

A larger study needs to be done to confirm this relationship, but based upon this discovery, it would seem wise to avoid antidepressants, if possible, during pregnancy.



Electrical  

Electrical Devices

The ReliefBand® Device is a drug-free remedy which has received FDA clearance for treatment of nausea and vomiting due to pregnancy, chemotherapy, motion sickness, and as an adjunct to antiemetics for post-operative nausea. ReliefBand® Device is a class II medical device. Further information can be viewed on their home page.



Environmental  

Chemical Avoidance

If a baby is exposed to several endocrine-disrupting compounds in utero, changes may occur that lengthen the period of sensitivity to carcinogens. Therefore, even if the compounds don’t cause cancer directly, they may contribute to cancer risk by increasing susceptibility. An embryo and fetus develop at much faster rate than adults. While this development occurs, cell division and growth is rapid. These rapid changes provide many opportunities for mistakes to occur. Since cell division and growth do not occur at this rapid rate in adulthood, the chances of mistakes being made are much more common in an embryo or fetus than in an adult. Additionally, barriers such as the blood-brain barrier are not yet complete in the womb, and mechanisms that help detoxify contaminants do not fully develop until after birth, both of which leave the embryo and fetus more vulnerable still.

Several human studies suggest a causal relationship between developmental exposure to contaminants and cancer in children and young adults. Examples include occupational exposures of parents and brain cancers in children; pesticides, paints, paint thinners and solvents and leukemia; and cigarette smoke and childhood cancer. Since childhood cancers are so uncommon, prospective studies rarely have a large enough sample to yield conclusive results, and animal studies for developmental exposures and early age or adult cancer are more convincing and extensive than the available epidemiological data.

Animal studies have shown that prenatal and early postnatal exposure to radiation and chemicals causes cancers in the exposed animals later in life. Developmental exposure to carcinogens can increase sensitivity to carcinogens later in life. For example, one study showed that adults who had been exposed to ethylene thiourea (ETU), an industrial chemical, perinatally developed more cancers when exposed to the chemical in adulthood than those exposed only in adulthood. [OurStolenFuture.org November, 2002]

Pregnant women who are exposed to phthalates, a chemical commonly used in plastics, may be at risk of a shortened pregnancy. Women who were exposed to the chemicals gave birth more than one week earlier than women who were not exposed to them.

The chemicals are added to plastic products such as food containers to add flexibility along with moisturizers, nail polishes, hairsprays and insect repellants and are known to leach out of the products and into the environment. It was previously thought that exposure to phthalates occurred primarily through ingesting contaminated foods. However, researchers found that inhalation and even dermal absorption may also significantly influence a woman’s exposure. [National Institute of Environmental Health Sciences November 4, 2003]

The less you are exposed to synthetic pesticides and chemicals during your pregnancy, the better it will be for your baby now and in years to come.



Habits  

Tobacco Avoidance

Smoking in pregnancy is very clearly linked to a higher risk of miscarriages, low birth weight babies and premature babies. There is also a link to risks of stillbirths and babies dying in the first few weeks of life. This is due to nicotine which decreases the amount of blood delivered to the fetus, therefore less nutrients and oxygen is received by the baby.

The current recommendation of doctors is for the mother to not smoke at all, however if the mother is having difficulty quitting, 3-6 cigarettes a day is the absolute maximum. If you are a smoker, the best time to stop is before you get pregnant because the first few weeks of pregnancy are crucial to the development of the baby. Also, you should encourage other members of the family to quit smoking or not to smoke in your presence because passive smoking may be damaging to the mother and fetus. In addition, smoking around your new-born increases his/her risk of developing asthma and other respiratory disease.



Hormone  

Melatonin

On the basis of theoretical ideas about how melatonin works, some authorities specifically recommend against using it for depression, schizophrenia, autoimmune diseases and other serious illnesses, and in pregnant or nursing women.



Mineral  

Calcium

Children of mothers who took calcium during pregnancy were still reaping the benefits seven years later in one Argentinian study. Blood pressure was lower in these youngsters – especially among overweight children – than those in the non-supplement-taking group. [Belizan JM, et al. Brit Med J 1997;315(7103): pp.281­5] Taking calcium may also decrease a woman’s chance of developing pre-eclampsia, pregnancy-related hypertension. [Moutquin HM, et al. Can Med Assoc J 1997;157(7): pp.907­19]

A growing baby acquires most of its calcium during the last trimester of pregnancy; an additional amount is needed during breastfeeding. This translates into a greater need for calcium during and after pregnancy. A pregnant woman who fails to consume adequate calcium -1,200mg per day is recommended – increases her risk of developing osteoporosis later in life, especially if she becomes pregnant again. [Vandecanderlaere M, et al. Rev Med Interne 1997;18(7): pp.571­4]



 

Magnesium

Low magnesium levels are common among women suffering from severe nausea and vomiting, says Miriam Erick, M.S., R.D., dietetic manager of Clinical Obstetrics at Brigham and Women’s Hospital in Boston. Therefore, magnesium for these expectant moms is critical. Magnesium can also help treat pregnancy-related leg cramps [Dahle LO, et al. Am J of Obst & Gyn 1995;173: pp.175­180] and alleviate severe pre-eclampsia, a serious condition in which high blood pressure, edema and protein in the urine are present in pregnant women. [Brit J Obst & Gyn 1997;104(10): pp.1173­9] Taking prenatal magnesium may also reduce risk for cerebral palsy and mental retardation among very low birth-weight infants. [Schendel DE, et al. J of the AMA 1996;276(22): pp.1805­10]

In a study of 535 women who were expected to deliver within the one day, subjects received a loading dose of 4g of magnesium sulfate at a 0.5 g/ml concentration in a 60-ml bag compared with 527 women who received an isotonic sodium solution, both over 20 minutes, followed by a maintenance infusion at 2 ml/hour for up to 24 hours. At 2 years, the children of women who received magnesium sulfate had a reduction in total mortality (13.8% vs 17.1%), less cerebral palsy (6.8% vs 8.2%), and less combined death or cerebral palsy (19.8% vs 24.0%) compared with those who received the placebo. There was significantly less gross motor dysfunction and combined death or substantial gross motor dysfunction in the magnesium group versus the isotonic sodium chloride group. There were no serious harmful effects seen with the magnesium sulfate infusion. [JAMA. November 26, 2003;290(20): pp.2669-2676]



 

Iron

Iron is routinely prescribed for pregnant women during the second and third trimesters, when blood volume increases by 50%. The growing baby is also making blood. Hemoglobin, the blood component that carries oxygen to the cells, is composed in part of iron. During pregnancy, your baby receives plenty of this critical mineral because your body absorbs iron more efficiently. [Eskeland B, et al. Acta Obstetricia et Gynecologica Scandinavia 1997;76: pp.822­8]

There is some controversy about whether iron supplementation is really needed or effective, except for women such as diabetics or those with anaemia, whose iron deficiency is a real threat. [Lao TT, Tami KF. Diabetes Care 1997;20(9): 1368­9] Iron supplementation for anemia often fails because women don’t take iron long enough, say researchers at the University of California, Berkeley. They suggest beginning iron supplementation before conception and continuing until breastfeeding is finished. [Viteri FE. Nutr Rev 1997;55(6): pp.195­9]

It is preferable to get your iron in natural foods. Iron supplements may cause nausea and constipation, making the common discomforts of pregnancy worse. Too much iron is also bad for the circulation. If you do need to take iron supplements on doctor’s advice, iron chelate is better tolerated by the body and is available from chemists. The U.S. RDA is 30mg.



 

Zinc

Inadequate amounts of zinc can lead to central nervous system and other malformations, small-for-age babies and miscarriage. Adding a moderate dose of zinc to your prenatal supplement regimen may also benefit your baby’s immunity. [Lastra Md, et al. Arch of Medl Res 1997;28(1): 67­2]

The U.S. RDA is 15mg.



 

Selenium

A small study of infertile women and women with a history of miscarriage suggests that low levels of magnesium may impair reproductive function, and may contribute to miscarriage. Oxidation, a process that is damaging to cell membranes, can lead to loss of magnesium. The same study suggests that the antioxidant selenium protects the cell membrane, thereby maintaining appropriate levels of magnesium. The authors of the study suggest taking both magnesium and selenium supplements.

Women who have miscarried have lower levels of selenium than women who carry a pregnancy to full term. Although the authors of the above-mentioned study do not specify the exact amount to take, the recommended doses are generally 300 to 400mg per day of magnesium and 200mcg per day of selenium.



 

Flouride

Fluoride avoidance reduced anemia in pregnant women, decreased pre-term births and enhanced babies’ birth-weight, concludes leading fluoride expert, AK Susheela and colleagues, in a study published in Current Science (May 2010).

Susheela’s team explains that anemia in pregnancy, which can lead to maternal and infant mortality, continues to plague many countries despite nutritional counseling and maternal iron and folic acid supplementation. This is the first examination of fluoride as an additional risk factor for anemia and low-birth-weight babies.

Anemic pregnant women living in India, whose urine contained 1 mg/L fluoride or more, were separated into two groups. The experimental group avoided fluoride in water, food and other sources and ate a nutritious diet per instruction. The control group received no instructions. Both groups supplemented with iron and folic acid.

Results reveal that anemia was reduced and pre-term and low-birth-weight babies were considerably fewer in the fluoride-avoidance group as compared to the control. Two stillbirths occurred in the control group, none in the experimental group.



Nutrient  

DHA (docosahexaenoic acid)

According to an article in the American Journal of Clinical Nutrition, healthy full-term infants who are breast-fed for at least four months show greater visual perception skills at early childhood than their bottle-fed counterparts. Testing revealed differences in the maturity of the brain’s visual cortex, an important stage in a child’s neurological development. [Am J Clin Nutr 2001;73(2): pp.316-22]

Of the 15 factors analyzed that could potentially influence that rate of visual development in infants, breastfeeding for 4 months or more independently had the greatest positive impact. The only other factor in this study that independently affected the children’s stereoacuity at 3.5 years was the mother’s consumption of oily fish during pregnancy.

This supports the idea that children may develop improved visual acuity and achieve a higher verbal IQ when breast-fed because they receive a fatty acid, docosahexaenoic acid (DHA) found in breast milk [Arch Dis Child Fetal Neonatal Ed 2001;84: pp.23-7]. The amount of DHA found in breast milk increases with the consumption of oily fish or when otherwise supplemented and decreases when less DHA is consumed. Indeed, testing has revealed that a child’s visual acuity directly correlated with the mother’s level of DHA in her red blood cells.

During the last trimester of a pregnancy the mother transfers to her fetus much of the DHA needed for the development of its brain and nervous system. As a consequence, she may lose as much as 3% of her brain mass during this time and therefore supplemental DHA may help prevent postpartum depression and ensure an adequate supply for the nursing baby.

The DHA content in the mother’s diet reflects the amount of DHA passed on to the baby. If the baby is not breastfed at all, it receives much less DHA, thus hindering and impairing mental and visual acuity. DHA levels of premature infants are especially low since they miss much of that last trimester. Premature babies are also more likely to be bottle-fed.

Vegan diets are devoid of preformed EPA and DHA, while vegetarian diets provide small amounts in dairy products. Vegetarian and vegan women should therefore ensure their diets include sources of alpha-linolenic acid (ALA), the precursor of EPA and DHA, during pregnancy and breastfeeding. Supplemental DHA may be appropriate in some cases. It is suggested that vegans use plant oils with a low ratio of linoleic acid (Omega-6) to ALA (Omega-3), such as flax or canola, as a higher ratio may inhibit the conversion of ALA to DHA..



 

Essential Fatty Acids

Adequate and balanced essential fatty acid intake is important for the optimal neurologic development of the baby. Fish oil, containing essential fatty acids, is usually free of mercury as a result of proper processing.



 

Lecithin / Choline / GPC

According to a study, the important nutrient choline “super-charged the brain activity of animals in utero, which resulted in the creation of larger cells that were quicker at firing electrical “signals” that release memory-forming chemicals.

These significant changes in the brain could be used to explain how choline improved learning and memory in animals in earlier behavioral studies. Researchers said this data could mean boosting cognitive function, diminishing age-related memory decline and decreasing the brain’s vulnerability to toxic insults in children. This research has led to the decision to raise choline to the status of an essential nutrient, particularly for pregnant and nursing women.

Choline can be found as a naturally occurring nutrient in egg yolks, milk, nuts, fish, liver and human breast milk. [Journal of Neurophysiology April 2004;91(4): pp.1545-55]



 


Oriental Medicine  

Acupressure

Sea-Bands have proven effective in clinical trials for the relief of morning sickness. Sea-bands are worn around the wrists to maintain pressure on certain acupuncture points, which can alleviate or reduce morning sickness.



Vitamins  

Vitamin Folic Acid

In 1992, the U.S. Public Health Service recommended that all women of childbearing age consume additional folic acid. This means that increased consumption of folic acid is crucial not only during pregnancy, but also before conception. Women should take at least 400mcg of folic acid daily. It has been estimated that if all women of childbearing age met this allowance, the number of neural tube defect cases in the United States could decrease by at least 50%. [CDC. Morbidity and Mortality Weekly Report, 1992; 41(RR-14)]

Although foods such as dark-green leafy vegetables provide a reasonable source of folic acid, most women don’t reach the recommended 400mcg through diet alone. [Johnston RB, Staples DA. 1997. J Am Med Assoc 1997;278 (11): pp.892­93]

Neural tube defects: (spina bifida): In one study, women who consumed 400mcg of folic acid per day cut in half their chances of having babies with birth defects of the brain and spinal cord, such as spina bifida. Whether a baby develops these defects is determined in the first days after conception (the critical time may be day 27-28) – perhaps before a woman knows she is pregnant. Even with food fortification it can be hard to get enough, so health experts recommend that every woman of childbearing age take a daily dietary supplement, such as a multivitamin, containing 400mcg of folic acid.

In another study, one-half of women who had delivered children with spina bifida or anencephaly were found to have had a poor diet during the pregnancy which ended with a child with a neural tube defect. 103 of these women received dietary counseling prior to their next pregnancy while 71 controls received no counseling. Of those who improved their diet, all delivered normal children, while all 8 out of 186 newborns with NTD were born to women who ate a poor diet during their first 6 months of pregnancy [Laurence KM. Nutr Health 2( 3/ 4), 1983].

Scientists currently theorize that women who give birth to babies with neural tube defects are less able to convert homocysteine to methionine, and that high levels of homocysteine may cause birth defects. Folic acid, along with vitamin B12, is required for this biochemical conversion, as well as new tissue production and growth in both baby and mother.

Downs: Mothers with a genetic abnormality that hinders how the body processes folic acid were 2.6 times more likely to have a child with Down syndrome than mothers without that genetic defect. Millions of women appear to have this genetic abnormality, yet the risk of having a child with Down syndrome actually is small – one in 600 births. If you have this mutation and you happen to have a very poor diet, it magnifies the problem; the researchers call this a gene-nutrient interaction. The March of Dimes estimates there are 250,000 Americans with Down syndrome. (American Journal of Clinical Nutrition October 1999)

Cleft palate: Only high pharmacological doses (6mg per day) of folic acid in the critical period of the primary and the secondary palate development seem to be effective for the reduction of clefts. Doses less than 1mg of folic acid cannot reduce these birth defects.

Case Report: After giving birth, a woman developed severe depression, confusion, disorientation and hallucinations. Over the next 19 months, trials with numerous medications and electroshock therapy were unsuccessful. Folic acid deficiency was diagnosed and folate supplementation was started. In 10 days, she was completely cured.

Leukemia

Folic acid supplementation during pregnancy was associated with a reduced risk of acute lymphoblastic leukemia in children in Western Australia. Lancet 2001;358(9297): pp.1935-40 [Lancet 2001;358(9297): pp.1935-40]



 

Vitamin B Complex

Many naturopathic and other doctors suggest using vitamin B complex (50mg per day) with additional vitamin B6 and folic acid (800 to 1000mcg per day) for women planning to become pregnant and for those who are pregnant. These preventive measures are supported by studies that suggest a connection between recurring miscarriages and problems metabolizing methionine and homocysteine in the body. Folic acid, vitamins B6 and B12, and betaine all play a role in the proper use of these compounds.



 

Vitamin E

Several studies imply that harmful free radicals called lipid peroxides contribute to pre-eclampsia [Khan KS, Chien Pl. Brit J of Obst & Gyn 1997;104(10): pp.1173­9], and that women with this condition are low in the antioxidants that combat them. [Ziari SA, et al. Am Jl of Perinat 1996;13(5): pp.287­91]

The U.S. RDA is 10mg.



 

Vitamin C (Ascorbic Acid)

Several studies imply that harmful free radicals called lipid peroxides contribute to preeclampsia [Khan KS, Chien Pl. Brit J of Obst & Gyn 1997;104(10): pp.1173­9], and that women with this condition are low in the antioxidants that combat them. [Ziari SA, et al. Am Jl of Perinat 1996;13(5): pp.287­91]

In one study of over 300 consecutive births, the mothers were given 5gm of vitamin C in the first trimester, 10gm in the second and 15gm in the third. Their babies were all born very healthy and the nurses often commented that the vitamin C babies and mothers were generally healthier than the non-vitamin C participants.

The U.S. RDA is 70mg. NOTE: Be very careful to avoid high doses.



 

Vitamin K1/K2

The U.S. RDA is 65mg.



 

Vitamin D

The Children’s Memorial Hospital in Chicago studied five vitamin D-deficient infants; at least two cases were caused by low vitamin D levels during pregnancy. Health problems ranged from seizures and growth failure to rickets. [Daaboul J, et al. J of Perinat 1997;17(1): 10­4] Congenital cataracts have also been linked to low levels of vitamin D. [Blau EB. The Lancet 1996;347: p.626] Other research points to vitamin D as a possible adjunct therapy for premature babies with respiratory distress syndrome [Nguyen TM, et al. Am J of Physiol 1996; 271(3): L392­9] and for women with gestational diabetes. [Rudnicki PM, Molsted-Pedersen L. Diabetologia 1997; 40(1): 40­4] The U.S. RDA is 400 IU or 10mg.

It would be wise to make sure you are getting some vitamin D in supplement form or adequate sun exposure during your pregnancy. In analyzing over a million records it was found that babies born in the autumn weighed more than those born at springtime. In later life, low birth weight was associated with increased blood pressure, cholesterol levels, some forms of obesity and a decrease in lung function. Babies born in autumn also lived 4-7 months longer. This is just one more reason to take care of yourself and your child during this time. It is also something you can tell your child you did with them in mind when they are older.



 

Vitamin B6 (Pyridoxine)

Vitamin B6 is necessary for optimal brain development and is an essential coenzyme for neurotransmitter synthesis. [Gerster II. Z. Ernahrungswiss 1996;35(4): pp.309­17] One animal study found that vitamin B6 helped prevent the formation of cleft palates. [Jacobsson C, Granstrom G. Cleft Palate Craniofacial J 1997;34(2):95­100] Like magnesium, vitamin B6, together with vitamin B1, may also ease pregnancy-related leg cramps. [Avsar AF, et al. Am J of Obst & Gyn 1996;175(1):233­4]

The U.S. RDA is 2.2mg.



 

Vitamin A

The U.S. RDA is 4,000 IU or 800mg. NOTE: Be very careful to avoid high doses of over 10,000 IU per day during pregnancy or if there is a likelihood of becoming pregnant soon.



 

Bioflavonoids

Quercetin inhibits conversion of vitamin A to retinoic acid. Retinoic acid is needed to help control gene expression in unborn babies. “It’s possible that a diet rich in quercetin during pregnancy may upset retinoic acid production, and lead to incorrect development and birth defects,” Dr. Kitson says. “It has recently been found that some baby boys born to exclusively-vegetarian mothers (some vegetarian diets are high in naturally occurring quercetin) have urogenital abnormalities.”

However, there is currently no direct evidence indicating that quercetin causes chromosomal changes in the fetus. As a maximum safe dose for pregnant women or nursing mothers has not been established, a cautious recommendation would be that high doses of quercetin be avoided during the early part of pregnancy until further research is done.



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Weakly counter-indicative
Very strongly or absolutely counter-indicative
May do some good
Likely to help
Highly recommended
May have adverse consequences
Reasonably likely to cause problems
Avoid absolutely

Glossary

Folic Acid

A B-complex vitamin that functions along with vitamin B-12 and vitamin C in the utilization of proteins. It has an essential role in the formation of heme (the iron containing protein in hemoglobin necessary for the formation of red blood cells) and DNA. Folic acid is essential during pregnancy to prevent neural tubular defects in the developing fetus.

Neural Tube

The tube of tissue that lies along the central axis of the early embryo. It gives rise to the brain, spinal cord, and other parts of the central nervous system.

Spina Bifida

A nerve tube defect present at birth that results in a gap in the bone that surrounds the spinal cord. Spina bifida is relatively common, occurring about 10 to 20 times per 1,000 births.

Anemia

A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Iron

An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.

Calcium

The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.

Vitamin D

A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.

Magnesium

An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.

Nausea

Symptoms resulting from an inclination to vomit.

Edema

Abnormal accumulation of fluids within tissues resulting in swelling.

Vitamin B6

Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.

Amino Acid

An organic acid containing nitrogen chemical building blocks that aid in the production of protein in the body. Eight of the twenty-two known amino acids are considered "essential," and must be obtained from dietary sources because the body can not synthesize them.

Metabolism

The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Protein

Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

DNA

Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.

Insulin

A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

Zinc

An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.

Preeclampsia

A toxic condition developing in the last 4 or 5 months of pregnancy that is characterized by a sudden rise in blood pressure, excessive weight gain, generalized edema (especially hands, ankles, feet and face), albuminuria, severe headache, and visual disturbances. It used to be called toxemia of pregnancy. Some rise in blood pressure is normal during pregnancy, but in preeclampsia the rise is dramatic and is accompanied by other changes. The most notable of these are high concentrations of protein in the urine and a tendency to swell up, especially in the face and hands. This can cause women with preeclampsia to put on several pounds in a few days.

Allergy

Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Immune System

A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.

Fatty Acids

Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.

Cervix

The lower part of the uterus that opens into the vagina.

Hormones

Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Asthma

A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress.

Manganese

An essential mineral found in trace amounts in tissues of the body. Adults normally contain an average of 10 to 20mg of manganese in their bodies, most of which is contained in bone, the liver and the kidneys. Manganese is essential to several critical enzymes necessary for energy production, bone and blood formation, nerve function and protein metabolism. It is involved in the metabolism of fats and glucose, the production of cholesterol and it allows the body to use thiamine and Vitamin E. It is also involved in the building and degrading of proteins and nucleic acid, biogenic amine metabolism, which involves the transmitting of nerve impulses.

Dopamine

A neurohormone; precursor to norepinephrine which acts as a stimulant to the nervous system.

Fibromyalgia

(FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.

Anesthesia

Loss of sensation caused by neurological dysfunction or a pharmacological depression of nerve function.

Uremia

Condition characterized by excessive urea and other nitrogen compounds in the blood due to renal insufficiency.

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