Most women are in agreement that when it comes to pregnancy, the most important thing is to have a healthy pregnancy and baby. Engaging in preconception and prenatal health care is the best way to ensure a smooth and optimal journey.
A healthy pregnancy starts before conception. With the basics of a well-balanced, whole-food based diet and exercise regime in place (always start with the basics!), our next step is to ensure you have adequate levels of the top nutrients researchers have found to be important for both mom and growing baby, through pregnancy and beyond.
Folate
Folate (folic acid, Vitamin B9) is a vitamin necessary for DNA synthesis and the growth and protection of cells in our body. We have an increased need for folate when our cells are growing and dividing rapidly, as happens vigorously in pregnancy! It is therefore important to ensure adequate folate levels before conception. Many physicians and naturopathic doctors will advocate for all women of child-bearing age to take a vitamin B complex in cases of unplanned pregnancy. Adequate folate levels are important for supporting the neural development of the baby. It is known to prevent spina bifida, neural tube defects and other birth abnormalities such as cleft lip and palate, and limb defects.
Supplementation of folate is recommended during the pre-conception and pregnancy period. A good pre-natal vitamin should contain the minimum daily requirement of 400 mcg. Be mindful of the form found in your prenatal. Though most pre-natal supplements will list folic acid, it has to undergo a few chemical and enzymatic reactions before it becomes absorbable and usable by the body. For this reason, it is advisable to look for folate in the form of methyltetrahydrofolate (MTHF, or methyl-folate), the active form of folate easily absorbed by the body, to avoid any deficiencies.
Folate tip
The best food sources of folate include dark leafy green vegetables, whole grains, and citrus fruits. An easy way to remember that folate is present in dark leafy greens is to think of foliage, from which the term folate is derived!
Omega-3 fatty acids
Omega-3 fatty acids (FAs) play an important role in both the development of a healthy baby and in the health of the mother. Omega-3s are long-chain polyunsaturated fatty acids found mainly in cold water fish. They are commonly called Essential Fatty Acids (EFAs) because they are essential to our health and development but cannot be made by the body, and therefore must be obtained through our diet or supplementation. The most important omega-3 FAs are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). EPA is known to be important for our heart, immune system, and management of inflammation. DHA is important for our brain, eyes and central nervous system.
Adequate levels of EPA and DHA during conception and pregnancy are vital to the neurological and visual development of the fetus. Studies also show a reduced risk of allergies, asthma, and eczema later on. And the health benefits do not stop with baby! It also seems that women with higher intake of omega-3s have a decreased risk of pre-term labour, preeclampsia, and low birth weight. There is also a correlation between low omega-3 levels and postpartum depression.
Health Canada has an excellent page about the health benefits of omega-3s, as well as a chart of fish safe for consumption, outlining nutrient profiles and the breakdown of EPA and DHA per fish. In pregnancy, aim to get a minimum of 1 gram of EPA and 400 mg of DHA per day. This can be done through diet or a high quality fish oil supplement.
Omega-3 tip
Take fish oil supplements with food (in the middle of your meal) to avoid any fishy burps or aftertaste!
Vitamin D
Vitamin D, affectionately known as the sunshine vitamin, is another important nutrient for conception and pregnancy. It is estimated that approximately 50% of the Canadian population is deficient in vitamin D. The reasons for this are many. For one, there are few foods that contain vitamin D. There are also a variety of factors that influence our ability to make or absorb vitamin D. In the northern latitudes of North America, we are exposed to very little sun in the winter months. Vitamin D requires a certain amount and level of sunlight on our skin for the body to produce it. Considering we cover up much of our bodies for the majority of the year and our use of sunscreen, we are generally at risk for not producing sufficient vitamin D. The best way to find out if you are deficient is to get a blood test.
Deficiency or not, it is recommended that women who are conceiving and/or pregnant supplement with vitamin D. Studies have found that women who supplement with vitamin D have a decreased risk of developing gestational diabetes, pregnancy related high-blood pressure, and preeclampsia. It has also been shown to decrease the risk of premature labour and delivery. For the baby, we have also seen a reduction of risk in the development of type-1 diabetes, allergies, and asthma when vitamin D is at adequate levels in the mother.
The amount of vitamin D in most prenatal vitamins is often insufficient. The minimum requirement is heavily debated. Currently it is suggested at 400 IU per day, however most studies showing its benefits are done with a dose of 4000 IU per day. Consult with a naturopathic doctor or functional medicine doctor to discuss what levels would be most appropriate for you.
Vitamin D tip
Vitamin D is a fat-soluble vitamin, and therefore best absorbed when taken in liquid oil form with food.
Iron
Iron is required for the production of haemoglobin, the oxygen-carrying molecule in red blood cells. Pregnancy increases our need for iron, due to the baby developing its own blood supply and mooching a large amount of the mother’s oxygen! A deficiency in iron can lead to anemia, causing a host of different symptoms, the most familiar of which is extreme fatigue. The good news is that checking your ferritin levels (the protein that stores iron in our bodies) is a routine procedure in all pre-natal visits.
Beyond prevention of anemia, we also know that adequate iron is associated with decreased risk of premature birth and low birth weight. Iron deficiency is linked to poor placental development and increased risk of miscarriage.
If you are found to be low in ferritin or anemic, your health care provider will advise you on the best supplemental forms. Many women find that iron causes cramping and constipation. To avoid this, ensure you choose it in the form of iron glycinate or bisglycinate. A good pre-natal supplement typically contains a sufficient amount of iron, so additional supplementation is not typically necessary, but you should still focus on including iron-rich foods in your diet. Dark leafy greens, liver, red meat, and black strap molasses are some examples of foods that are high in iron.
Iron Tip
Consume iron rich foods together with foods high in vitamin C to increase its absorption.
Probiotics
Probiotics and our gut flora are all the health rage these days, and for good reason. Research is exploding with how vital these live microorganisms are to our health on multiple levels. The right balance and strains of beneficial bacteria promote a healthy digestive tract, strengthen the immune system, prevent and help manage atopic conditions, and help combat illness. Benefits in conception and pregnancy are no exception.
Probiotics are often used to treat a variety of digestive complaints that can plague pregnant women, including constipation, diarrhea, heartburn, and indigestion. Mothers who have a healthy gut flora also have decreased risk of being positive for Group-B-Strep. Fetal exposure to good probiotics in mom and baby help to stimulate the growth of the immune system and prevent the development of allergies. When babies are born, their gastrointestinal tracts are considered sterile and their first healthy dose of probiotics is from their mother during a vaginal birth. Babies born via c-section have been tested and found to have a completely different colonization of bacteria compared to those who pass through the vagina. Some hospitals are adopting vaginal smears for babies born via c-section to introduce the mother’s flora to the baby and impart the many benefits known from that inoculation process. When babies are exposed early to a diverse colonization of their mother’s bacteria, we see a decrease in atopic conditions such as eczema, allergies, and asthma, as well as a more robust immune system with fewer incidences of colds and sickness.
Including a high-quality supplement and a diverse selection of fermented foods throughout your pregnancy will help create and maintain a vibrant gut-flora profile. Options for fermented foods include sauerkraut, kimchi, kefir (either milk or water-type for those who are intolerant to dairy), yogurt, and kombucha.
Probiotic tip
If supplementing with probiotics, take it with food to ensure best absorption and colonization.
The benefits of taking the time to master a healthy regime throughout your pregnancy are numerous! Not only will you prevent many pregnancy-related complications, you will feel more energetic, clearer of mind, and ready to start this exciting new journey. Aiming to get the right amounts of these nutrients through diet also starts wonderfully healthy habits you can maintain for the rest of your life. If and when supplementation becomes necessary, please consult with a qualified health care provider to ensure you are taking the correct amounts and forms.
