pregnancy is a time in a womans life when she thinks about her health more than any other time. But she is also becoming intimately concerned about someone elses health too that little person growing inside her.
pregnancy might also be the first time that some women start taking supplements. The Government recommends that women take 400mcg of folic acid for the first 12 weeks of pregnancy and in the period leading up to conception.
pregnant women are much more aware of what theyre eating than at any other time because they know it is going into another human being, says natural health expert, Marilyn Glenville.
However, many doctors and midwives are still reluctant to recognise the benefits of taking VMS during pregnancy. Doctors and midwives who say that no supplementation is necessary are basing it on outdated opinion rather than current research, says Susannah Lawson, co-author with patrick Holford of Optimum Nutrition Before, During and After pregnancy.
It is widely recognised that women need extra nutritional support during preconception, pregnancy and breast feeding due to the extra demands on her body. Most womens food intake increases by 15-20% but the amount of nutrients needed increases by 30-100% for some nutrients so women need to focus on the quality rather than the quantity of food, says nutritionist Yinka Thomas.
Many nutrition experts believe that our current diets provide less nutrients than they once did due to the mineral depletion of the soil and polluted water ways. Faye Higgenbotham from Solgar says: Supplementation for pregnant women is important because there are less nutrients in food nowadays.
As well as making sure that she gets enough nutrients there are a myriad other symptoms and health problems which pregnant women may have to deal with, ranging from morning sickness to headaches and stretch marks.
A number of manufacturers in the natural products industry have responded to this by developing products specfically for pregnant women. Viridian is one such manufacturer which recently launched a multivitamin product developed specifically for pregnant women called pregnancy Complex.
Cheryl Thallon, director of Viridian, says because women are generally more cautious during pregnancy they like the security of taking a supplement formulated especially for them. A good multivitamin is excellent for pregnancy but consumers need the confidence they get from a specially formulated complex, says Thallon.
Vitabiotics and Sage Organic also do pregnancy formulas which are designed to reduce confusion and appeal to women looking for an all-in-one product to use during pregnancy.
Nutrition is not only important during pregnancy but also in the months leading up to conception. Nutritionist Yinka Thomas says the preconception period is particularly crucial: A good diet is vitally important not only during pregnancy but also in the pre-conception period because so much development takes place during this time. The critical period for neural tube development happens before most women know theyre pregnant, she says.
Also, many fertility problems can be tackled with good nutrition and adequate supplementation. Diet is obviously a priority and I believe that organic food is a must pre-conceptually and beyond to give the baby maximum nutritional input and to limit toxin exposure, says Alex Kirchin, technical advisor at Viridian.
Marilyn Glenville, an expert in preconceptual health, agrees: Nutrition in preconception is really crucial and folic acid should be taken for three months before pregnancy. The nutrient levels need to be higher during preconception and then they should be maintained during pregnancy.
Many women are waiting until they are older to start a family and age is one factor that affects fertility. Diet and lifestyle also plays a major role in fertility levels and women should avoid what patrick Holford describes as anti nutrients which deplete the body of vital resources and contribute nothing nutritionally. The main ones to avoid are alcohol, tobacco and coffee because all three have been found to reduce fertility in research studies.
Other factors, including chemicals and pollutants in the environment, have been found to affect fertility as do weight and stress. Recent research has revealed that the quality of sperm has decreased by 50% over the last 50 years. patrick Holford puts this down to a combination of factors including pollution, poor nutrition, stress and unhealthy lifestyles. The main problem, however, according to Holford, is an increased exposure to environmental chemicals that have an oestrogenic effect on sperm. They are found in paint, plastics, food packaging, pesticides and cosmetics.
During pregnancy larger amounts of nutrients are required for growth and metabolism of maternal and foetal tissues and for storage in the foetus. All nutrients are crucial because each has a role to play during pregnancy, says Susannah Lawson.
pregnancy also places extra demands on women and they need to change their diets accordingly.
folic acid is the nutrient that most women are aware they should take during pregnancy because the Government recommends it. This is because it is known to prevent neural tube defects such as spina bifida a congenital defect in which the spinal column is imperfectly closed at birth.
A recent study linked high doses of folic acid taken later on in pregnancy with an increased risk of breast cancer. Many natural health experts have criticized this research which used extremely high doses well above the 400mcg recommendation. And even the scientists that carried out the research said it could be a chance finding and more studies are needed.
Women who continue to take folic acid throughout pregnancy have been found to have babies with good birth weights and apgar scores (a numbered score doctors use to assess a baby's physical state at the time of birth), confirms Glenville, who adds that the main nutrients for a healthy pregnancy are B vitamins, zinc, magnesium and calcium.
Apart from folic acid, I would consider all the usual nutrients to be of benefit, but there is probably an extra need for iron, calcium, magnesium, zinc and DHA, says Faye Higgenbotham from Solgar.
Alex Kirchin says that although folic acid supplementation is crucial, it should really be taken in combination with other nutrients. Nutrients work in synergy, so I would always recommend a supplemental strategy to incorporate other B group vitamins. Many nutritionally-orientated doctors are recognizing the need for more than just folic acid. Nutrients such as iron for reducing the incidence of iron deficiency anaemia in pregnancy, and low levels of antioxidants have been implicated in cases of pre-eclampsia.
Vitamin C has many roles during pregnancy. It is essential for the formation of collagen, which helps to keep the protective membrane surrounding the baby strong. It also keeps bones, skin and joints firm and helps to keep skin supple, which may help to reduce stretch marks. It is an antioxidant which is key for a healthy immune system. Vitamin C is also necessary for the body to absorb certain forms of iron.
This is a powerful antioxidant which helps to get oxygen to the cells. It also speeds up wound healing and helps to keep skin supple. Marilyn Glenville recommends it during pregnancy when the skin is being stretched: Vitamin E oil is good for stretch marks women can open a capsule and rub it straight into the skin. It is also excellent for scar tissue.
There is a great deal of debate about whether or not vitamin A should be taken during pregnancy. Most natural health experts recommend taking vitamin A as long as it is not in large doses.
Vitamin A is a vitamin found in both animal foods (retinol) and in some vegetables (betacarotene). The controversy surrounding it refers to the retinol variety, which, at high doses, has been linked to damage to the embryo.
Vitamin A is not a problem, provided it is not taken in large amounts, says Higgenbotham of Solgar. In this country doctors are nervous about vitamin A and it is limited to 1 or 2,000iu's in pregnancy formulas, but in the US they are happy for you to take 7,000iu's, she adds.
These are just as important during pregnancy as vitamins. In particular, calcium, magnesium, zinc and iron are beneficial for a healthy pregnancy and baby. Calcium is important for building the babys bones and teeth and promotes a healthy heart and nervous system.
Iron deficiency is very common during pregnancy and women suffering from it may have symptoms of lethargy, pale skin and palpatations. Nutrients such as iron are important for reducing the incidence of iron deficiency anaemia in pregnancy, says Kirchin from Viridian.
The most absorbable form of iron is found in red meat, eggs and oily fish. Vegetable sources include cereals, dried fruit and dark green vegetables. It is important for vegetarian mums-to-be to make sure they have enough vitamin C in their diets as this helps absorption of iron. It is also a good idea to avoid wine, tea and coffee because the tannins they contain block iron absorption.
Raspberry leaf tea has been drunk by pregnant women for centuries, but are herbs safe to recommend during pregnancy Glenville says they should be taken with caution. If a woman wants to take herbs during pregnancy she should see a herbalist. The only exception is for raspberry leaf tea which still should not be taken until week 34 of the pregnancy.
Faye Higgenbotham from Solgar agrees: It is probably best to avoid most herbs, unless on the advice of a herbalist, as the majority might not have had sufficient research or historical use to be able to say 100% that they are okay during pregnancy. Generally the most proven ones are ginger for morning sickness and raspberry leaf (in the last weeks of pregnancy) for an easier delivery, she adds.
Raspberry leaf is thought to help prepare the uterus for labour and, therefore, make labour easier and quicker. One study on 192 first-time-mums found that those that had taken a raspberry leaf supplement had a shorter second stage of labour and a lower rate of forceps delivery than those that were given a placebo.
The importance of EFAs
In the last year a number of companies have launched essential fatty acid (EFA) products specifically for pregnant women. There has been a great deal of positive media coverage on the importance of EFAs in our diet recently particularly during pregnancy and early childhood.
There is much more interest in essential fatty acids which is probably due to the recent research into autistic children and how they can have a positive effect on behaviour, memory and intelligence, says Susannah Lawson. EFAs are key for the formation of the brain and the nervous system and crucial for structural building, she adds.
The Food Standards Agency (FSA) recommends that we increase our intake of EFAs because of its benefits for cardiovascular health and the benefits during pregnancy and breastfeeding for the development of the babys brain. However, it also warns pregnant women about eating too much oily fish during pregnancy because of the high levels of mercury pollution it contains. Therefore, EFA supplements offer women an alternative source of essential oils they might otherwise lack due to their diet.
According to Kevin Sweeney of Mums Essentials which manufactures a range of EFA supplements: The technology for removing contaminants is now available to make supplements safe its difficult to get enough EFAs from diet alone.
The two families of essential fatty acids are known as Omega 3s and omega 6s. These EFAs cannot be manufactured by the body and so it is essential that they are acquired from the diet. From omega 3 and 6 the body is then able to manufacture other varieties including docosahexaenoic acid (DHA) and arachidonic acid (AA).
Essential fats are always important, says Higgenbotham, but DHA is particularly useful during pregnancy and breastfeeding for the development of the baby's brain.
Researchers in Scotland found that infants fed formula milk supplemented with DHA and AA from birth to four months had better problem-solving ability at 10 months compared to children given standard infant milk formula.
Further research from Denmark has found that women who consume diets rich in omega-3 fatty acids have significantly longer gestations and higher birth weights than women with diets low in these fatty acids.
Research is also ongoing into links between EFA deficiency and post natal depression and other pregnancy symptoms. During pregnancy the baby will take what it needs from the mother, so with EFAs it will take it from her brain. Research is currently looking at the link between so-called pregnancy fog and EFA depletion, says Yinka Thomas.
Equazen has a product called Mumomega which is designed for women to take during and post pregnancy. It contains DH-rich marine fish oil and virgin-pressed primrose oil and one capsule a day is recommended for pregnant and lactating mothers. The company has also launched Mumomega Infancy a capsule containing DHA and AA which is designed
to be added to an infants food once breast feeding has stopped.
Mums Essentials has also launched two EFA products for pregnant women and following childbirth. They contain omega 3 and omega 6, as well as folic acid and other vitamins and minerals.As the nutritional requirements of pregnant and breastfeeding women differ dramatically we are delighted to be able to offer formulations tailored to meet changing needs, says Kevin Sweeney, md.