Planning Nutritionally for a Healthy Baby and Pregnancy

So, your trying to conceive, recently found out you are pregnant, or have recently given birth. Whatever stage you are, nutrition is fundamental to the health of both you and your baby. 

One of the first steps many women take when they have made the decision to try to conceive, is to take a prenatal vitamin. FANTASTIC! This is a wonderful beginning step to preparing yourself, and setting the foundation for pregnancy. That being said, most over the counter prenatal vitamin supplements are made up of fillers and synthetic, chemical based, laboratory created vitamins. They are often hard to digest and absorb, leading women to wonder why they are deficient in crucial nutrients when they are taking their vitamins regularly. The best sources of vitamins are from their natural sources. Even when a woman is taking a high quality, natural, food sources vitamin supplement, there is often a portion of the supplement that is not absorbed properly. This is why diet and eating highly nutrient dense foods are so important in preparation and during pregnancy.

**A Little Note on Birth Control:

The majority of women out there have been on some form of birth control, whether it was the pill, IUD, Depro, etc... We often forget, or where not informed that these common forms of birth control can cause vitamin deficiencies in our bodies that can lead to difficulties conceiving, or complications during pregnancy. 

The contraception pill not only lowers levels of zinc (will talk about its importance later) by raising copper levels (as does the IUD), but it also induces deficiencies of vitamin B, B6, B12, folic acid, and vitamin C. The pill prevents conception by altering the body's hormone system. Even after it has been stopped, the body can take upwards of 3-6 months to begin producing certain hormones again. This is important to keep in mind if you are planning to begin trying to conceive in the near future.

Healthy Diet By Trimester

If we look at the changes that occur during each trimester in both the fetus and the mother, it is easier to see exactly what the nutritional requirements of both are.

Preconception - First Trimester

The nutritional requirements are the same for those who are trying to conceive and those who have recently conceived, as the goal is the same, to nourish a healthy mother and support a healthy fetus.

• Vitamin A: Vitamin A is vital to proper fetal growth and in particular the eyes. It works in balance with other nutrients (zinc, B Complex, vitamins C, D and E). Sources: liver, sweet potatoes, carrots, dark leafy greens, butternut squash, apricots

• B Vitamins: B vitamins should always be taken as a B complex (in conjunction with other B vitamins), as their functions are linked and dosing with one may lead to a deficiency of others. The body's need for all of the increases during pregnancy and deficiencies are linked to defects such as cleft palate. Deficiencies in B6 may lead to morning sickness. Sources: rice bran, egg yolks, liver, nuts, dark leafy greens, cold water fish

• Folic Acid: Mothers who supplement with folic acid and vitamin B12 before conception and during the first trimester have a lower incident of neural tube defects. Folic acid in food is destroyed by sunlight, heat and acidic environments, and the use of antibiotics can also cause deficiencies. Sources: liver, nuts and seeds, dark leafy greens, beans, asparagus, root vegetables

• Vitamin C: Vitamin C helps boost the immune system, and increase the resistance to toxins. It is needed to produce healthy collagen (connective tissue), and it aids in the absorption of iron and prevents anemia. Deficiencies have been linked to miscarriages. Sources: peppers, dark leafy greens, kiwi, citrus, strawberries, broccoli, rose hips

• Vitamin E: Vitamin E is important in the development of the heart, oxygenation of cells, and the protections of RNA and DNA from damage. Sources: nuts and seeds, apricots, olives, dark leafy greens, eggs.

• Iron: During pregnancy blood volume and circulation increases to help oxygenate the placenta. Iron is needed to make hemoglobin, the substance that transports oxygen. Deficiencies can lead to weakness, fatigue, depression, headache, confusion and memory loss. Too much iron can deplete since and therefore iron supplements should be avoided until conception is confirmed. Sources: chocolate, pumpkin, organ meat, red meat, eggs, dark leafy greens.
• Zinc: considered the MOST IMPORTANT supplement to take in preparation for pregnancy. Zinc absorption is aided by vitamin B6, and citric acid. Too much iron and copper depletes zinc. Deficiencies are linked with genetic abnormalities, low birth weight, still births, difficult births, and miscarriage. Sources: oysters, red meat, seeds, dark chocolate, peanuts, dark leafy greens.

**Note on Morning Sickness

Morning Sickness is often  caused by the rising levels of hormones, such as HCG. It can also be a sign of vitamin deficiencies. Most commonly; B6, Magnesium, Potassium, and/or Zinc. All vitamins that are depleted when you are on birth control.

Second Trimester

Approaching the middle of pregnancy, physical changes are more noticeable, nausea and fatigue are passing and appetite is increasing. The old adage of eating for two isn't quite as good as it sounds. The second person starts out the size of a pea, and really doesn't consume all that many calories, and even at their biggest, the mother only needs to consume an additional 300 calories per day. While it is important to maintain a healthy diet full of quality, nutritious foods, too much weight gain will make for future difficulties, such as difficult labor and delivery, diabetes, high blood pressure, and general strain on both the mother and baby. 

• Vitamin A: the organs of the baby are forming and vitamin A is essential to development of the eyes, hair, skin, teeth, mucous membranes, and bone structure. Deficiencies at this stage are linked with still births.
• B Vitamins: B vitamins are needed for energy, metabolism, and for the baby's developing nervous system. (in particular vitamin B3 helps form serotonin, an important neurotransmitter for sleep and mood) 
• Vitamin C: Vitamin C aids in the absorption of both iron and zinc. It helps make collagen and connective tissue, and forming a strong amniotic sac. Deficiencies have been linked to premature labor, and premature rupture of membranes.
• Vitamin D: Vitamin D is vital for bones and teeth. It aids in the absorption of calcium and phosphorus. It is made in the skin when UV rays meet with certain forms of cholesterol. It is rarely deficient, except in Asian women who naturally produce less and those who over use sunscreen. Sources: fish oils, dairy, eggs, mushrooms

• Vitamin E: Vitamin E helps to oxygenate the blood and keep skin supple
• Vitamin F: (Essential Fatty Acids) These form a large part of the cell membranes and give rise to prostaglandins. They help absorb nutrients and activate enzymes. Deficiencies may contribute to pre-eclampsia. Sources: nuts, cold pressed oils, cold water oily fish

• Calcium: A woman's calcium needs goes up 3 times in pregnancy. It forms strong bones, teeth and helps with muscle development and nerve functions. Deficiencies are associated with low birth weights and premature births. Sources: whole fat dairy, whole grains, nuts and seeds, dark leafy greens

• Chromium: Chromium is needed to GTF (Glucose Tolerance Factor), which lowers blood sugar levels by carrying blood glucose to cells to be stored or used. It is not easily absorbed, but is easily lost, especially when there is overconsumption of sugar. Deficiencies can lead to diabetes. Sources: brewer's yeast, molasses, whole grains, butter

• Iron: By the second trimester the mother's iron needs are 30% higher than pre-conception. The expanding blood volume dilutes the concentration of oxygen in the blood stream. Deficiencies lead to poor memory and fatigue in the mother, and eye, bone and brain defects in the fetus, as well as being a factor in neonatal mortality.
• Magnesium: Magnesium works with Calcium to create strong bones and teeth and is essential to a baby's development of muscles and nervous system. Pregnancy will aggravate any deficiencies causing muscle cramps, twitching, insomnia, and depression. Deficiencies are also linked to premature and low birth weight babies.
• Selenium: Selenium is a race mineral that is a powerful antioxidant, and vital for enzymes that help the body fight infections. More effective if taken with vitamin E. Sources: nuts, liver, fish, whole grains, pork, shellfish

• Zinc: Zinc and copper are antagonistic, and copper levels naturally rise during pregnancy. Daily requirements during pregnancy are around 20 mg, although most women get less that half of this from their diets. The common use of phosphate fertilizers prevents plants from absorbing zinc from the soil. Deficiencies can cause low birth weight and premature births.

Third Trimester

During the final 3 months of pregnancy, a baby grows faster, doubling in size. Nerve cells increase, the lungs and immune system mature, the digestive tract developed, bones strengthen, and the body begins to store fat, calcium, and iron in preparation for birth. The mother needs an additional 200-300 calories per day, with an emphasis on protein.

• Vitamin A: Vitamin A helps make the hormones connected with lactation
• B Vitamins: B Vitamins help prepare the body for lactation
• Folic Acid: WHO (World Health Organization) reports that up to half of pregnant women suffer from folic acid deficiencies during the last 3 months of pregnancy. Folic Acid is needed to manufacture DNA and with vitamin B12, to make red blood cells. Deficiencies can lead to pernicious anemia.
• Vitamin C: As well as helping the body absorb iron (preventing anemia), and zince, and preparing the body for lactation, vitamin C is an antiviral and so helps fight infections, and promotes healing after delivery.
• Vitamin E: Vitamin E speeds wound healing and keeps skin elastic, leading ot an easier labor and recovery. It is also needed for lactation.
• Vitamin F: (Essential Fatty Acids) Research has identified two EFA's needed for the development and functioning of the brain-AA (arachidonic acid) and DHA. during the third trimester, the brain of the fetus increases 4-5x in weight, using 2/3 of the energy supplies of the mother. AA and DHA are used as components of the brain cell membranes, and are found in high concentration in the eye. A lack of AA and DHA in the mother's diet can lead to long term problems and conditions such as hyperactivity, dyslexia, depression, alcoholism, drug addition, ADD/ADHD, and schizophrenia.
• Vitamin K: Vitamin K is vital in the making of prothrombin, which is needed for blood clotting and prevents hemorrhage in the mother and hemorrhagic diseases in the newborn. It is often given as an injection to the child at birth to prevent hemorrhage. Sources: dark leafy greens, onions, brussels sprouts, broccoli, cabbage, eggs.

• Calcium: Stores of calcium are laid down by the baby as its bones and teeth harden. Calcium given with vitamin D at labor may help ease labor pains.
• Iron: Stores of iron are laid down by the baby to make its own red blood cells and fight infections. Taking iron by itself can lead to malabsorption of other minerals, so it is best absorbed if taken with foods containing vitamin C
• Zinc: Zinc is essential for milk production and for balancing the hormones. Zinc deficient mothers have a greater incidence of complications at birth and birth defects, and an increased risk of needing a caesarean birth. It is also linked with undescended testicles in boys.

During Labor

All good nutrition and correct diet during pregnancy needs to be followed up with the correct diet for the preparation of labor. It is important for the mother to eat plenty of complex carbohydrates for energy stores during the last 2 weeks. This means plenty of whole grains, vegetables, and legumes to ensure that glycogen reserves stored in the muscle and liver are filled to capacity. Labor can be compared in energy requirements to running a marathon. Deficiencies in energy stores can lead to long, difficult labors requiring medical interventions such as medication, and caesarean deliveries.

Postpartum

A healthy and well-balanced diet is just as important after delivery. The effects of blood loss, risks of infections, fatigue, and start of lactation take its nutritional toll on new mothers.

• Iron: Iron helps healing and fights infections by making hemoglobin to carry oxygen. It is particularly important if there has been heavy blood loss.
• Zinc: Zinc is needed for the production of hormones and to help combat postpartum depression
• Vitamin C: Vitamin C is good for the immune system, and speeds healing and recovery. It also aids in the absorption of iron
• Vitamin F: (Essential Fatty Acids) EFA's are transported through the breast milk and are essential for brain development in the baby

Foods to Avoid

Generally this means avoiding processed and refined foods and many pre-made foods such as cakes, sodas, processed and cured meats. Pregnant women should avoid foods that also contain a risk of salmonella or listeria contamination such as; undercooked meat, uncooked eggs, pate, soft cheeses, cheeses with blue veins, and unpasteurized dairy.