Effects of nutrition during pregnancy & birth

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If you breed what isn’t healthy, you are bound to get offspring that aren’t healthy either”1By eating healthily and getting a good level of all the nutrients before conception, during pregnancy and into motherhood, a woman can build her stores to a safe level for her and her baby to thrive. Even if she finds she has morning sickness in the first three months and is unable to eat much her stores will be high enough to support herself and her baby.

The elements of a healthy pregnancy diet & the importance of quality foods during pregnancy
Each component of a healthy diet cannot function effectively by itself. Proteins, carbohydrates, vitamins and minerals are all needed to come together to create a healthy body and a healthy baby. A yummy cake is not the ingredients separately but the outcome of the ingredients mixed and processed together. Leaving out an ingredient will totally change the cake and make it something else entirely. The same is true for humans; if we leave out a nutrient, or do not have enough of it, then the person will not reach their full capacity.

Protein is used to develop every cell in the body, every hormone, enzyme and bodily process. Protein is used for muscle development, for brain functioning and for general energy levels. It is important to increase good quality proteins in the diet during pregnancy. Proteins are made of amino acids of which there are 20. 8 amino acids are essential in our diets because our bodies cannot create these particular ones. It is essential that the pregnant diet contains high enough quantities of these essential amino acids to help mother and baby thrive.

Fats are essential to a healthy diet but only in moderation and of the right type. Each cell has a membrane made up of a fatty layer which is important for allowing nutrients, waste and messages to pass through, allowing for healthy function and cell communication.

Carbohydrates (sugars) are used by the body for energy. Refined carbohydrates have been processed and are absorbed and used by the body very quickly. These include brown and white sugar, glucose and maple syrup. These types of carb’s are ‘empty’ as they contain little nutritional value and are not needed if the diet is balanced properly with unrefined carbohydrates. Wholemeal flower, brown rice, fruits and potatoes are good sources of unrefined carbohydrates and contain other nutrients and fibre to give an even better diet.

Vitamins are essential for any healthy diet. Each vitamin has an essential role to play in bodily processes, immunity and emotional well-being. Some vitamins are stored by the body, such as vitamin A, whereas others are used and released as needed, such as vitamin C.

Minerals are needed in small quantities for a healthy, balanced diet. Iron, for example, is needed in blood to help carry oxygen to each cell as well as producing proteins and enzymes. Magnesium is essential for a healthy nervous system. Calcium and phosphorus are required for healthy bones. Iodine is essential for healthy thyroid function.

Zinc is essential for healthy growth and brain and nerve formation. It is often needed to work together with other minerals and helps produce enzymes, speeds healing and is essential for breastfeeding.

So it is important to contain all of these aspects of food, in their natural state (not in tablet form) so as to obtain the right balance and encourage the best absorption for the body to function optimally. The recommended daily intake of each of these food groups only states what is recommended to prevent illness. What we really need to eat are optimum levels of nutrition so as to maximise our full potential and have the healthiest mother and baby we can hope for.

Poor nutrition and the link to pregnancy/birth complications
Deficiencies in Zinc can cause depression, skin problems, diarrhoea, eye problems and limited growth.
Animal studies indicate that maternal zinc deficiency can upset both the sequencing and efficiency of the birth process. An increased incidence of difficult and prolonged labour, haemorrhage, uterine dystocia and placental abruption has been documented in zinc deficient animals. These effects may be mediated by the defective functioning of oestrogen via the oestrogen receptor, which contains a zinc finger protein. A review of pregnancy outcomes in women with acrodermatitis enteropathica, reported that out of every seven pregnancies, there was one abortion and two malfunctions, suggesting the human foetus is also susceptible to the teratogenic effects of severe zinc deficiency. However, a review on zinc supplementation trials during pregnancy did not report a significant effect of zinc supplementation on neonatal survival… In rats, the “first visible sign” of zinc deficiency is a decreased appetite.”2

A deficiency in iron will cause tiredness and breathlessness, and has been linked to maternal and foetal death during childbirth. 3 Pregnant iron levels indicating deficiency are much lower than non-pregnant women (because of the increase in blood volume), but they are often prescribed supplements when they may not need them. Supplements can cause problems such as constipation and knock out other nutrients such as zinc.

Folic acid is a B vitamin that has had much research and news coverage over the last few years. It has been found to be very beneficial in preventing neural tube defects (defects with the spinal cord, brain and skull development) in babies. 4 Mothers who are deficient are at a higher risk of having a miscarriage, still birth or a very sick child.

Protein, antioxidant and fatty acid deficiencies have been linked with pre-eclampsia and eclampsia (toxaemia). Low protein causes water to leak out into the tissues from the blood circulation 5 , causing water retention (oedema) and high blood pressure. In her book Ina May Gaskin cites her statistics for The Farm’s toxaemia levels. Out of 775 women, only one had toxaemia 6 . She puts this down to the healthy vegetarian diet, specifically high in protein. Her 0.1% rate of toxaemia is in significant contrast to the standard USA rate of 14-20% of first time mothers and 6-7% of women who already have babies.

By measuring the serum osmotic pressure of 65 pregnant women, all at seven months gestation, Strauss [Am J Med Sci 190, 1935] demonstrated that the pressure was directly related to protein intake. Serum osmotic pressure, serum albumin, and dietary protein were highest among the 35 non-toxemic women in the study, second highest among the 20 women who had non-convulsive toxemia, and lowest among the 10 women who had eclampsia.” 7

Weight gain
There is new research that suggests that;
Individuals who experience a poor diet in the womb are less able to store fats correctly in later life. Storing fats in the right areas of the body is important because otherwise they can accumulate in places like the liver and muscle where they are more likely to lead to disease.

“Professor Anne Willis of the MRC Toxicology Unit at the University of Leicester explains “One of the ways that our bodies cope with a rich modern western diet is by storing excess calories in fat cells. When these cells aren’t able to absorb the excess then fats get deposited in other places, like the liver, where they are much more dangerous and can lead to type 2 diabetes.

“The team found that this process is controlled by a molecule called miR-483-3p. They found that miR-483-3p was produced at higher levels in individuals who had experienced a poor diet in their mother’s wombs than those who were better nourished.

“When pregnant rats were fed low protein diets their offspring had higher levels of miR-483-3p. This led to them developing smaller fat cells and left them less able to store fats in adulthood. These rats were less likely to get fat when fed a high calorie diet but were at a higher risk of developing diabetes. Rats are known to be a good model for studying human dietary diseases and the team also found that miR-483-3p was present in elevated levels in a group of people who were born with a low birth weight.” 8

Weight gain during pregnancy is a very shady topic. In the ‘80’s women were told they were eating for two. This lead to a lot of unhealthy weight gain as women were eating two pieces of cake and filling up far too much. This has led many health professionals to restrict the diets of pregnant women and stop them from gaining too much. This in turn can have damaging effects.

A small baby does not need the diet of a grown adult. However, they do need extra nutrition so a pregnant woman should be encouraged to eat more (healthy food) than she would before pregnancy.

Oxytocin, the hormone of relaxation, love and bonding, increases during pregnancy. There are oxytocin receptors in the digestive tract which helps with the absorption of nutrition. This increase will help the pregnant woman absorb more to feed her baby. She may not be used to these higher hormone levels and may store fats that she wouldn’t normally on the same diet (being stressed will inhibit oxytocin… a common condition of today’s busy person).

Several studies have demonstrated the negative effects of obesity on various physiological pathways. Such outcomes resulting from excessive weight gain during pregnancy include increased risk of developing breast cancer, increased birth weights in offspring, augmented probability of developing obesity or metabolic syndrome in their lifetime, development of gestational diabetes, and the possibility of delayed lactogenesis (failure to lactate for more than 72 hours postpartum).” 9

When reading reports such as this, it’s important to keep in mind the types of people they were researching and the limitations of the research. These are rarely discussed in media articles. It could be that the women who had problems had a very unhealthy diet and lifestyle. Other women may keep putting weight on but they are eating healthy foods and taking exercise. It is also very difficult to attribute maternal weight with breastfeeding issues since there are so many factors that can prevent a woman from confidently feeding her baby that have nothing to do with her weight. Given the low rate of breastfeeding across the ‘developed’ world I do not think we can put the blame on something like weight gain.

The current thinking about salt intake and pregnancy
The recommended daily intake of salt is around 1 teaspoon. Salt (sodium) is found in many foods such as Okra, celery, strawberries, apples, milk, cheese and other foods that have salt added such as bread, processed meats and canned vegetables. Sodium helps to keep the stomach wall alkaline to secrete enough hydrochloric acid for digestion.

The typical American diet will have 1-3 teaspoons of salt daily. High salt levels have been linked with high blood pressure, heart failure, water retention, kidney stones, breathing difficulties, gastric ulcers and hormone imbalances.

So, naturally, when thinking of pregnancy, medical professionals have had a tendency to restrict salt intake with the belief that it could cause all of the above.
However, pregnant women have a different physiology from the rest of the population. Salt restriction during pregnancy restricts the normal expansion of blood volume causing problems to the placenta’s development such as dead tissue that reduces nutrients to the baby. Sometimes the placenta may separate from the uterine wall. When salt levels are low the kidneys release a hormone called Rennin into the bloodstream, influencing other hormones that cause the small arteries to constrict. This in turn raises the blood pressure even higher. 10

Reducing salt may affect the pregnant woman’s appetite as food tastes different. This may lead to lower food consumption and deficiencies in other food groups. The kidneys will excrete less water to conserve salt levels which can lead to water retention/oedema. Sodium helps fluid balance for the mother and for the amniotic fluid for the baby.

Salt should be eaten to taste in healthy diets. Diets with lots of processed and canned foods should not need more salt.

Sugar and caffeine
Sugar is very addictive and the more you have the more you want. This may also be true for babies; the more sugar a pregnant woman eats, the more the baby will ask for. The fear is that the more sugar a woman eats, the more likely she will get gestational diabetes and cause her baby to be overweight. Henci Goer is very dubious as to the reality of gestational diabetes and its risks, and even more dubious about the treatment for it (restricted diet and/or insulin injections).

The standard GD diet is a good one; adequate calories, limit simple sugars, moderate fat intake, eat whole grains and plenty of fruits and vegetables and eat smaller meals more frequently. Also beneficial is the advice to engage in moderate, regular exercise. If that was all that happened, identification as a gestational diabetic would be a good thing. Some tracking of blood sugars to make sure they aren’t drifting into the true diabetic range is probably also a good thing, as is identifying the one in a thousand women who has or will develop glucose values in that range. However, most women will find themselves caught up in frequent doctor visits, multiple daily blood tests, restrictive diets, possibly insulin injections, repeated foetal surveillance tests and a considerable chance of a labour induction or caesarean section.” 11

I’ve had women come for massages who have been diagnosed with gestational diabetes, they’ve been put on a restricted diet (more restricted than Henci’s suggestions above) and now have a baby who is under weight for gestational age and she is also losing weight. She wasn’t even particularly big in the first place.

During pregnancy the woman’s insulin levels need to be able to fluctuate according to what her baby is asking for. She needs sugar in her blood to be able to feed her baby. However, sometimes this may look like diabetic blood because of the high volumes of sugar, but at a different time of day, or different point in pregnancy, things are back to normal. A pregnant woman’s insulin levels are rarely broken, they’re just different from the non-pregnant body.

I found this article about research done with rats and the effects of caffeine on the unborn baby with the conclusion;
“...Thus, it seems that early caffeine exposure, even at quite low doses, is able to induce a wide variety of neurochemical changes. These deficits concern both constitutive material such as proteins, DNA and RNA, and functional material such as neurotransmitters and ions.
“Offspring of female rats exposed to 60 or 100 mg/kg caffeine in their drinking water throughout gestation have reduced learning capacities as adults in a novel environment. In an open field, these animals also spend less time grooming, playing, and touching new objects. The authors concluded that the behavioural effects induced by prenatal caffeine exposure could be related to the “hyperactive” children syndrome
(Sinton, C. M. et. al., 1981).” 12

I read a blog post a while ago about a woman whose unborn baby was thought to be in distress on a routine medical check. The baby’s heart rate was unusually fast so they took her to hospital where she was then sent to another hospital with more equipment for testing. With each change in location the baby’s heart rate became more normal. It wasn’t until a clever doctor asked the mother what she had been eating/drinking shortly before the visit that they discovered that she had eaten a large amount of chocolate. They found that the baby was sensitive to the caffeine and was responding to its stimulation with a fast heart rate. I can’t find the blog anymore, but I remember the woman being very grateful that the baby was going to be ok and they weren’t going to induce her so she could go home and wait for labour and have her planned homebirth.

Vitamin supplementation
Folic acid supplementation for one month pre-conception until 12 weeks of gestation is recommended for preventing neural tube defects.
If a diet is healthy and balanced with fresh foods as close to their natural state and there is plenty eaten regularly, then there should be no need for the average person to take supplements.

In the past 100 years we’ve seen different fashions for dieting, restrictions on certain foods and general confusion with what constitutes a healthy diet. Fast food, foods that contain unmarked ingredients and processed foods that have not been tested properly will all contribute to deficiencies and health/emotional issues. Many people find it very difficult to change their diet and so for those with poor eating habits who are not prepared to change, vitamin supplementation would be advised.

Depending on the supplement, how it was produced and what it contains will determine how useful it is, how the body absorbs it and whether or not it is causing more damage than good. It’s always advisable to get supplements from a nutritionist or naturopath who can recommend the correct supplements for the individual.

Tran’s fats and foetal brain development
Hydrogenated fats are the unhealthy, tran’s fats that increase health problems such as obesity, heart disease, depression and ME. Here’s how…
Each and every cell in the body has a fatty membrane that protects the cell as well as allowing nutrients, waste and messages to pass through, keeping the cell and the person healthy. This membrane is a double fat layer. Each fat molecule looks a bit like this O~ and so in the cell’s membrane they look like this O~~O The wiggly part of the fat molecule is where the messages and nutrients are passed through. When a fat is heated it picks up hydrogen atoms. This creates a tran’s fat, or hydrogenated fat. These new fats molecules are hard and make the membrane look a bit like this O=O and make it a lot more difficult for nutrients and waste to pass through. When a cell has a membrane like this, healthy fats (O~) are not able to join and so they are deposited around the body as fat stores, increasing body weight and straining the body.

Every nerve cell contains a fatty membrane. The brain contains millions of cells, each requiring a fatty membrane.
Myelin, the protective sheath that covers communicating neurons, is composed of 30% protein and 70% fat. One of the most common fatty acids in myelin is oleic acid, which is also the most abundant fatty acid in human milk and in our diet.
“Monosaturated oleic acid is the main component of olive oil as well as the oils from almonds, pecans, macadamias, peanuts, and avocados.
” 13

When a diet is high in hydrogenated fats (margarines, ingredients in many pastries and readymade foods), the cells get a hard fatty membrane and are unable to communicate with each other effectively. If a pregnant woman is eating lots of hydrogenated fats then her baby will be growing cells with in-efficient membranes, their brain formation as well as cognitive and emotional capacity will be impaired and they may gain excessive weight.

Healthy, natural fats produce healthy, happy people.

Importance of water
Given that we are made of 70% water, it’s not surprising a pregnant woman will need to increase her water intake. With the increase in blood volume (by 40% or more depending on how many babies she’s carrying), the need for amniotic fluid and the water required to grow a baby, a pregnant woman will need to drink at least 2 litres of water a day.

Drinking plenty of water helps to keep the blood pressure balanced, keep the amniotic fluid at a healthy level and helps with concentration. Water is used in all of the body’s processes so it’s essential to have enough clean water for optimum health.

Amniotic fluid is essential for proper foetal development and provides your baby with protection and buoyancy. The effect of oligohydramnios [not enough amniotic fluid] on the baby depends on the cause, the stage of pregnancy during which it occurs, and how little fluid there is.
If it occurs in the first half of the pregnancy, oligohydramnios can cause foetal abnormalities of the lungs and limbs, poor foetal growth, and increases the risk of miscarriage, preterm birth and stillbirth. Your baby “breathes” the fluid into its lungs and swallows it, promoting healthy growth of his or her lungs and gastrointestinal tract. Too little fluid for a prolonged period may cause abnormal or incomplete lung development, called pulmonary hypoplasia. The amniotic fluid also promotes normal development of muscle and bone by allowing your baby to move around within the uterus.
” 14

So it’s really important to drink plenty of water, and reduce dehydrating drinks such as those with caffeine and/or sugar.

How emotions and food are related
Getting a healthy intake of food during pregnancy is important for the mother and baby’s wellbeing. The way we live our lives teaches children how to live theirs. If a mother does not eat healthily during pregnancy she is teaching her unborn baby to eat unhealthily. The effects of poor nutrition go beyond low energy as the resulting emotional and psychological imbalances created also teach the baby how to respond to life.

Good nutrition affects how we eat, sleep, act and think. It affects everything about us- our work, our moods, our ability to relax, our sex lives, our patience with our children- everything. It affects how well we grow our babies and how well our uteri contract. It affects the elasticity of our cervix, and our stamina during labour.” 15

Oxytocin, the hormone of relaxation, love and bonding, increases during pregnancy. There are oxytocin receptors in the digestive tract which helps with the absorption of nutrition. If we are stressed or upset our oxytocin levels go down and our stress hormones go up. This means we cannot absorb as much nutrition and we suffer deficiencies as a result.

The body doesn’t know the difference between reality and imagination, so even watching something stressful on television will reduce oxytocin and cause stress on the digestive system.

The most important facts about good nutrition to include in a class
I often say to my massage clients, would you feed that to your baby and expect them to be healthy on it? I think this is the key to good pregnancy nutrition. You wouldn’t feed your baby a cup of coffee, a glass of wine or a can of coke. You would want your baby eating lots of fruit and vegetables and quality protein.
This doesn’t mean you’re not allowed a piece of cake now and then or a coffee occasionally. It’s about creating balance with optimum nutrition to create a person that is the healthiest they can be. Everything you eat goes towards making this new person, you are literally building them through the food you put into your stomach.

Eat plenty of protein, unrefined carbohydrates, natural fats, vitamins and minerals all as close to their natural food state as possible.

Advice for vegetarians
Women who are vegetarian may have different nutritional balances than meat eaters. So long as she has been a vegetarian for a very long time her iron, B vitamin and zinc levels will be normal for her even if they are considered low for most other people. She will still be able to function well and produce a healthy baby. If she has been vegetarian since adulthood, it is believed that her baby is in more risk of these deficiency problems because she is not used to the lower levels of iron, B vitamin and zinc than when she was a meat eater.

So long as a pregnant woman gets all of the important food groups, vitamins and minerals, proteins and carbohydrates, fats and oils, she will produce a healthy baby.

Concept of holistic nutrition
Holistic nutrition is about all the elements that are taken into the body, not just about food, but about the emotional, social and psychological information that the body receives each day. Focusing on negative situations such as watching the news, complaining about people, working in an environment that is depressing, listening to other people criticising, watching scary films etc., will inhibit the optimum functioning of the mind, the body and the spirit.

References

1. Wainer Cohen, N & Estner, L.J (1983) Silent Knife; Cesarean Prevention & Vaginal Birth After Cesarean. Bergin & Garvey p.125

5. Nobel, E. (2003) Having Twins & More. P.130

6. Gaskin, I M, (2003) Ina May’s Guide to Childbirth. P.187

10. Nobel, E. (2003) Having Twins & More. P.179

15. Wainer Cohen, N & Estner, L.J (1983) Silent Knife; Cesarean Prevention & Vaginal Birth After Cesarean. Bergin & Garvey. P.125

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