Pregnancy
Every parent’s biggest wish is for a healthy baby but not everyone realises how much we can do to make it happen. This is what this leaflet is about.
DIET
A baby grows very fast and needs a vast amount of nutrients (vitamins, minerals etc). Have a diet which supplies these. The best foods are those that are alive. This means food from the following four groups:- fruit, vegetables, seeds and nuts (not roasted or salted). The very best sources of these are organic foods which contain higher levels of nutrients. Keep sugar and white flour products and processed foods low.
Baby’s brain grows very rapidly in pregnancy and brains are mainly made up of fat. This means having good quality fats (essential fats) in the diet and reducing bad fats. The main sources of essential fats are oily fish, such as mackerel, sardines, herrings, wild salmon and pilchard, seeds such as sunflower seeds, pumpkin seeds, linseeds) and nuts (unroasted). Eating nuts in pregnancy also lowers the risk of a baby having nut allergy (which is increasing).
Keep low on hydrogenated fats, (also called trans fats, vegetable fat, shortenings) as these unnatural fats are harmful to the body and compete with essential fats. These are mainly found in margarines, supermarket cooking oils (except olive oil) but they are also commonly found in many processed foods such as biscuits, cakes and mayonnaise.
There are stories of mothers who breast feed and baby can’t seem to get enough milk. This is usually because the mother is short of essential fats.
Drinking more than 4 cups of coffee makes pre-eclampsia 60% more likely.
Milk has a high hormone content and this may explain why milk drinkers were found to have a five-fold higher rate of twins compared to non-milk drinkers in one study.
Some foods such as luncheon meats, hot dogs and soft cheeses (brie, feta, camembert and blue veined cheeses) carry a higher risk of listeria which can cause miscarriage and abnormalities in the baby. This is a rare disease (affecting 20 pregnancies a year in the UK and three-quarters have normal babies). However these foods are best avoided.
A good diet reduces the risk of malformations. One study found that those who had a varied diet, low in processed food, in pregnancy had a 51% lower chance of having a baby with anencephaly and a 34% lower chance of having a baby with a hair lip. Lack of vegetable in mother’s diet is a risk factor for childhood cancer.
Ideally start these changes before pregnancy as sperm and eggs mature 4 months before conception.
ULTRA-PROCESSED FOODS (UPFs)
Ultra-processed foods are industrially-produced substances with complex mixtures of largely synthetic ingredients. Almost any natural ingredient is likely to be replaced with a cheaper artificial one. Most of the ingredients have never been eaten before this time. They would be inedible without the added sugar, salt and flavourings. They disrupt our sense of taste (which is an essential clue to what foods we need to eat) and distort our appetite and are designed to be addictive.
Ultraprocessed foods are defined as foods containing chemicals not found in our kitchens. They are usually wrapped in plastic and contain multiple ingredients. They include ready meals, all fizzy drinks, most juices, most breads and baked goods and multiple other foods. Typically, they are high in sugar, adulterated fats and salt. Emulsifiers or flavourings on the label are a useful warning sign that it is UPF.
Today 57% of the food we eat in the UK is ultra-processed. We are only beginning to recognise the danger from these foods: they are thought to be linked with 22% of deaths in the UK and they are also linked with increasing obesity, cancers, diabetes, heart disease, dementia, inflammatory bowel disease, fatty liver and a range of other conditions. UPFs are likely to be harmful to the foetus.
Of course, it is impossible to completely avoid UPFs but it would make sense to keep the amounts of these low.
SUPPLEMENTS
You need more nutrients in pregnancy than any other time.
Using supplements in pregnancy can make a big difference.
We now know that folic acid protects against spina bifida. It makes sense to have a supplement of this. This can be prescribed.
Other nutrients are important in pregnancy. Deficiencies of vitamins B1, B2, B6, zinc, iron, calcium and magnesium have all been linked with birth defects as have excesses of lead, cadmium and copper (good levels of nutrients protect against these.)
In one study it was shown that by taking a multi-vitamin, multi-mineral supplement you can reduce the risk of pre-term delivery by a quarter (starting at beginning of pregnancy). The chance of a low birth weight baby was reduced by a half.
There are some multi-vitamin/multi-mineral supplements specifically formulated for pregnancy. These are available in health food shops. Vitamins C and E reduce the risk of pre-eclampsia. Avoid Vitamin A in doses of more than 10,000 units per day. Avoid cod-liver oil and fish oils which often contain PCBs and other chemicals.
A multi-vitamin taken in the first month of pregnancy was found to reduce autistic spectrum disorder by 50%.
Magnesium is a key supplement in pregnancy. It is well known that it reduces the chance of pre-eclampsia and eclampsia but less well-known that it reduces the chance of premature birth, birth defects and cerebral palsy. Few people get enough magnesium. Although it is present in green vegetables, seeds and nuts the amount we eat today is about half what we ate 100 years ago as it has declined markedly in the soil and hence in the vegetables we eat. Consider supplementing this valuable mineral.
The commonest nutritional problem in the UK is lack of Omega 3 fats (found in foods such as oily fish, walnuts, flaxseeds). These are essential for brain development and this deficiency of these fats can lead to lower intelligence and children that are more anxious. This can be corrected by supplementation in pregnancy but not at a later stage. Levels of Omega 3 fats are also typically low in breast milk so this is also a time when supplementation helps.
THE CRITICAL FAT-SOLUBLE VITAMINS
The dentist Weston Price visited a variety of indigenous populations in the 1930s. He noted that they had exceptionally good health, easy births, and excellent teeth (despite the fact that they never brushed their teeth). Once these populations started eating western food they developed smaller jaws with crowded, unhealthy teeth.
He identified the fat soluble vitamins as critical for the health of their teeth but also for the shape of their jaw and lower face. These vitamins were vitamins A and D but also a unknown vitamin he called Activator X which he felt was the most important. Later research identified this as Vitamin K2. He found these populations obtained 4 times as many water-soluble vitamins (eg Vitamins C &B) compared to western populations but 10 times more fat soluble vitamins. Despite this rich diet, these societies made sure that women had “special foods” rich in Activator X before and during pregnancies and also made sure their husbands ate more. They also made sure the women had a gap of at least 2 years between children to let levels of critical nutrients build up again.
Sadly Vitamin K2 has decreased alarmingly in the modern diet, mainly due to changes in farming. It is almost impossible to get enough Vitamin K2 from diet today although some foods such as egg yolk, liver and meat from wild animals contain some (see osteoporosis leaflet for more information). Supplements are available and I would suggest at least 90 mcg of menaquinone-7 daily. I would regard this as an insurance against later dental problems.
Good teeth depend on a hormone osteocalcin. You need Vitamins A and D to make osteocalcin but Vitamin K2 to activate it so all these vitamins play a key role.
Vitamin D is also a key supplement and the current recommendation of 400ciu daily is set far too low (it is 2000 iu daily in Canada). A fascinating 30 year study from Finland showed that taking 2000 iu Vitamin D in pregnancy reduced the rate of type 1 diabetes in their children by 80%. A study of 500 women who took between 2000 and 4000 units of Vitamin D found no adverse effects and the women who took 4000 units had the lowest rates of premature labour, premature birth and infection. Another randomised controlled trial from the University of South Carolina by Hollis and Wagner found that even taking 2000 IU was inadequate and they recommended taking 6000 IU daily. This dose had no adverse effects.
Pregnant women are sometimes warned against Vitamin A as it can be toxic at high levels. The original warnings relate to isotretinoin, a synthetic Vitamin A-like substance with a long list of adverse effects. But there is some questionable evidence that doses of Vitamin A above 25,000 IU can be harmful.
A much greater danger is taking too little Vitamin A as it is critical to baby’s good health. In particular foetal alcohol syndrome is caused by an inability to produce the active form of Vitamin A (retinoic acid) due to alcohol overload. Avoid doses of more than 10,000 units per day as a precaution but doses of 5000 IU daily are fine. Avoid cod-liver oil and which often contain PCBs and other chemicals.
FOOD, SUPPLEMENTS AND BRAIN DEVELOPMENT
Sugary drinks (including fruit juice) taken in pregnancy are inversely related to baby’s subsequent IQ (at age 3 and 7). Each daily serving of sugary drinks reduced IQ by 1.2 to 1.7 points. Junk food almost certainly has the same effect. In addition, sugar intake in pregnancy drives foetal fat production. In other words, the more sugar mum takes in pregnancy, the more likely baby is to become fat.
A study from Avon found the more fish eaten by mother (at 32 weeks) the higher baby’s IQ.
The most important substance for the developing brain is DHA (docosahexanoic acid). The main source of this is oily fish. The need will be higher in those eating more processed food which contains harmful fats. Research has found the more fish mother eats in pregnancy the higher the child’s IQ. However keep in mind farmed fish has much lower levels of DHA.
Iodine is a key nutrient in pregnancy as it is critical for brain development. Iodine used to be added to salt and bread but this is not done any longer in the UK so it is very difficult to get enough in the diet although there is some iodine in fish like herring & mackerel and some in yoghurt and milk. It is thought that about 67% of mothers are deficient in iodine. The optimum dose is 2-3mg daily but levels of up to 15mg daily are okay (see leaflet on iodine for more information). Mothers taking extra iodine typically have children with higher IQs, sometimes 20 points above their parents! Globally, the loss of IQ from iodine deficiency amounts to 10-15 points on average.
The other key substance is choline. This is an essentialbuilding block for nerve transmitters. In one study children who received higher doses developed better attention span. It is not found in many supplements. Liver is the richest source followed by eggs, nuts, meat and some cheeses.
AND HELP PREVENT CHILDHOOD CANCER
A study in 2005, A Prenatal Multivitamin Supplementation and Rates of Childhood Cancer: a Met-Analysis, found using supplements in pregnancy was associated with a reduced risk of brain tumours, neuroblastomas and leukaemias in the children.
RUBELLA
Have your rubella antibodies checked before pregnancy. Unfortunately it is normally checked at 12 weeks but the danger period for a rubella infection is during the first 12 weeks.
TOXINS
Babies, unlike us, have virtually no way of eliminating toxins from their systems. Mothers living near toxic waste dumps were found to be one third more likely to have babies with congenital abnormalities. Avoiding cigarettes and keeping alcohol to a minimum is an obvious precaution. Pesticides used in the home have been associated with childhood cancer. Don’t paint baby’s bedroom at this time. A study from University of California found mums who were exposed to paint before conception or during pregnancy were 3 times more likely to have children who developed acute lymphoblastic leukaemia. Flea treatments for pets used during pregnancy can increase the chance of autism. So keep your exposure to chemicals, additives in foods, cigarettes, alcohol, hair dyes, dental fillings and anything unnatural to the minimum. Avoid using pesticides, use organic foods where possible, avoid air fresheners and doing DIY jobs with chemicals and keep plastics off your food, especially if microwaving. Regular use of standard hair sprays doubled the risk of birth defects in the urinary tract in one study (anything you inhale or put on your skin goes straight into your body).
Don’t diet in pregnancy as during dieting chemicals are released from the fat stores into the blood stream and hence into the foetus.
Avoid smoking which involves inhaling at least 50 toxic chemicals and keep alcohol intake as low as possible.
Nearly all chemicals are stored in the fat and will therefore pass into breast milk (350 chemicals at the last count) and are also present in cow’s milk formula feeds. It is best to avoid dieting in pregnancy or whilst breast feeding as this adds to baby’s toxic exposure by releasing chemicals from fat stores.
MOBILE PHONES
Mobile phones and pads give off electromagnetic radiation with known harmful effects. These dangers have increased as phones have got smarter. For instance there are 38 cases of breast cancer reported in young women who kept their phone in their bra. This gives an indication of how dangerous they can be when held close to the body.
But the foetus is at much greater risk because rapidly growing tissue, particularly the brain, is extremely vulnerable to electromagnetic radiation. Mobile radiation disrupts hormones and two studies have found it increases the risk of miscarriage. Rats exposed to mobile radiation in utero found it three times more difficult to get out of a maze suggesting long-term brain damage. Mice exposed in mobile radiation in the womb became more hyperactive, more anxious with reduced memory and reduced fear.
Today mobiles, because they are used so much, are a major hazard in pregnancy and the smarter the phone the more danger. Even small bursts can be harmful. Keep them far from baby and switch off the wifi setting wherever possible as having this setting on increases the harmful effects. Other electrical fields can be harmful: never use electric blankets for instance.
CHILDHOOD OBESITY
This is an increasing problem, and carries with it the risk of later heart disease and diabetes. Animal studies have shown that the most effective way of producing obesity is to give poor quality food in pregnancy followed by overfeeding immediately after. Overfeeding a baby has a much bigger impact on obesity than overfeeding later in life. It is better to breast feed as overfeeding is more difficult (but not impossible). Bottle fed babies are at much greater risk from overfeeding as the standard charts are based on formula fed babies who are probably overweight. If you breast-feed then avoiding topping up with a bottle. Unfortunately this practice is sometimes encouraged by health professionals. To sum up: eat the best quality food in pregnancy and avoid overfeeding after the pregnancy. Remember: overfeeding is almost always more harmful than underfeeding.
ALLERGIES
There is now an epidemic of asthma and eczema in our children. How do we avoid this? If there is any history of allergy in the family consider these measures. There is good evidence that breast feeding for 4 to 6 months will help. Eating a variety of foods in pregnancy also helps. For instance peanut allergy is less common in populations that eat peanuts routinely in pregnancy. Introducing a variety of foods between 3 and 6 months also reduces allergies to food. There is some evidence that using paracetomol in pregnancy makes asthma more likely.
DIABETES
Children that have cow’s milk as formula feeds have a 50-60% greater risk of insulin dependent (Type 1) diabetes. Although this risk is not large, the risk is much greater for those with a family history of diabetes (about 12 times greater). Because of this the American Academy of Paediatricians have advised that children in these families should not have cow’s milk formula feeds or cow’s milk in the first 2 years of life.
BREAST-FEEDING
Breast-fed babies have lower rates of chest, gut and ear infections, probably due to oligosaccharides in the milk which boost immunity. Breast-feeding adds 3 to 5 points to intelligence (IQ) and this persists for at least 15 years. As adults they have lower rates of allergies, inflammatory bowel disease, lymphomas, asthma, heart disease and juvenile onset diabetes. They are also less prone to obesity. Bottle fed babies are more sickly and visit a GP 20 times more frequently than breast-fed babies in the first year of life in some studies. Mothers who breast-feed have lower rates of ovarian and breast cancer and children who have been breast-fed for 6 months have a lower risk of leukaemia and lymphoma.
People who live longer usually have longer telomeres. These are part of our chromosomes. Breast-feeding increases telomere length (when measured at 4 to 5 years of age). This strongly suggests that breast-fed children will live longer.
However breast-feeding is not easy. It’s better for baby but worse for mum. The biggest problem for mums who want to breast feed is that it can take weeks for breast feeding to become fully established. Sometimes lack of professional support adds to this problem. However the charity La Leche League may be able to help as might local branches of the National childbirth Trust (NCT). It’s best to avoid using bottle feeds during this time as it interferes with the breast feeding and baby may even not want the breast. The key here is patience.
BABY FOODS
These are a relatively new invention. In the past children were given adult foods which were mashed up a bit. Most baby foods include pureed fruit. They are often unnaturally high in sugar and are best avoided.
