Pregnancy & babies series: Nutrition for the developing baby


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It may be surprising to learn that you only need an additional 200 calories during the last trimester of pregnancy; it’s important to ensure the majority of your calories are nutrient dense and provide the foetus with the energy and nutrients it needs.

You receive the fantastic news, and suddenly your priorities are all focused in one direction; now your efforts go towards optimising the development of your growing baby, to create the next Einstein, or a perfectly formed little being at the least!

For healthy development of your baby, it is not about eating for two (unfortunately), it is about providing your baby with the all-important nutrients to grow and develop in a healthy manner. During pregnancy, your diet should be extremely nutrient-dense. Only approximately 200 additional calories are needed during the last trimester, which works out at only 10% extra for most women, although nutrient requirements are around 50% more! We may already find it hard to meet the recommended nutrient requirements, partly due to our love of refined or fast foods, so nutrient-dense foods should be your absolute priority.

Protect your baby in the early stages

The first 3 months of pregnancy are considered to be the most insecure. To protect your baby against any possible stressors and to reduce risk of miscarriage, it is important to take things steadily; relax and provide your baby with everything that it needs, to send out the messages that you have the perfect environment ready for them to enter the world.

You can still carry on with most normal daily life activities, unless you are a stunt woman! Continue exercising moderately, but avoid contact sports for obvious reasons. Relaxing forms of exercise such as yoga and swimming are particularly suitable at this time.

Even in the early stages of pregnancy, you should seriously consider your alcohol intake. Official recommendations are to avoid alcohol during pregnancy, due to the high risk of alcohol inducing foetal abnormalities and miscarriage. Some individuals will choose to have the occasional drink, however make sure that you are aware of the possible consequences before making this decision. Research has shown that just 4 alcoholic drinks per week is associated with a significant increased risk of miscarriage. (1)

The risk of food poisoning and the consequences are much greater during pregnancy (due to reduced immune function), so be extra cautious when handling certain foods. Reduce your risk of catching an infection by washing hands and surfaces thoroughly after preparing raw meat. Even vegetables can carry parasites such as toxopasma in soil residues, so scrub your vegetables clean, especially if eating them raw. This particular parasite can be very harmful to an unborn baby, and can also be found in cat stools, so consider wearing gloves if you are cleaning out a litter tray which has not had parasite preventative medication.

Nourish your growing baby

There is no wonder diet specifically designed for pregnancy, and you do not need to make any drastic changes. Ensuring that you are eating a wide range of nutrient-dense foods sourced from each of the food groups will get you a long way to providing all your baby’s needs.

Folate / folic acid

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Spinach and dark leafy greens are an excellent source of folic acid, particularly important during pregnancy.

Folate, otherwise known as folic acid or vitamin B9 is possibly the most well known vitamin required during pregnancy. With overwhelming evidence of folate deficiencies significantly increasing risk to neural tube defects (2) (a serious condition involving deformed growth of the spine or brain), consuming folate-rich foods is essential. Beans, lentils and most green foods such as spinach, asparagus, lettuce and avocado are rich in folate. You may wish to supplement in addition to eating these folate-rich foods.

Bone support

Providing adequate nutrition for bone development is vital for normal healthy development of your baby. Simply drinking cow’s milk full of calcium doesn’t quite cut it when it comes to optimising bone health. In children, calcium, on its own, has not been shown to improve bone density; (3) bones also require magnesium to transport the calcium into the bone structure and vitamin D for calcium absorption. Vitamin D levels during pregnancy also appear to affect bone density in offspring. (4) Rich food sources of calcium include dark green leafy vegetables, dairy, almonds and fish. Magnesium-rich foods include dark green leafy vegetables, nuts, seeds, beans and lentils. To ensure that you are getting adequate vitamin D, try to get 20 minutes of sun exposure per day from the months April – October (in the UK). You may need longer exposure if you have dark skin. Vitamin D can be stored in the body for several months, so really try to get an extra boost at the end of summer. Towards the end of the winter, in particular, you may wish to supplement with vitamin D, unless you have the pleasure of a mid-winter holiday in the sun to top up your levels!

Iron and blood flow

You may hear about the importance of iron during pregnancy, and women suffering from anaemia as a common occurrence from a lack of this mineral. There is a valid reason for this. Iron is vital for the blood to support the transport of oxygen around the body, so imagine how crucial this is at a time when your baby needs oxygen and the amount of blood in your body is higher than ever. Avoid iron deficiency anaemia and associated low birth weight (5) by eating plenty of iron-rich foods. Iron is most highly concentrated in red meat, seafood, seeds, nuts, beans and pulses. Iron is even high in cacao, giving us a great explanation for our chocolate cravings (but be sure to crave less sweet, dark, high-cocoa chocolate)!

Brain development

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Omega-3 EPA and DHA found in oily fish are crucial for healthy brain development; a high quality supplement during pregnancy ensures both mother and baby receive adequate omega fats.

Ensuring your baby has a healthy functioning brain is very closely related to the types of fats eaten during pregnancy. Your baby will take what it needs; if you already have a fatty acid deficiency, which is very common, your baby’s brain may be missing out on essential nutrients. Why is fat so important? The brain structure is mostly made up of omega-3 and omega-6 fats. Generally, we do seem to get plenty of omega-6 in our diets (if we are eating meat, eggs, nuts and grains), but we are commonly deficient in omega-3. Omega-3 EPA and DHA found in oily fish are crucial for healthy brain development, especially as DHA is required to build the developing brain structure and to support visual and cognitive function. (6) Eating plenty of fish and vegetables is also associated with a lowered risk of allergic disease in infancy. (7)

It can often be confusing with recommendations to eat more oily fish, but then at the same time not to eat too much during pregnancy. This apparently contradictory advice is simply due to the fact that toxins found in fish may cause harm to your baby if eaten in excess. As larger fish eat smaller fish, larger fish contain higher levels of toxins. Smaller oily fish such as anchovies, mackerel and herring are ideal to eat during pregnancy. Please don’t be put off by small levels of contaminants, as the health benefits of including fish in your diet during pregnancy far outweigh any risks of very low levels of contaminants which your liver should be able to filter.

Foods and drinks to avoid during pregnancy

Generally, it is better to concentrate on healthy foods to include in the diet during pregnancy rather than worrying about all the foods which are recommended to avoid. This list of foods to avoid can often become quite a minefield, so here is a simple list to consider.

  • Caffeine (in moderation) is ok – i.e. 1 tea / coffee per day
  • Unpasteurised soft cheeses such as feta, brie and blue cheeses are best avoided due to high risk of listeria bacteria infection (soft cheese made from pasteurised milk is fine to include)
  • Cold meats, raw meat, pate (high risk of toxoplasmosis parasite)
  • Uncooked eggs which have not been pasteurised (although rare, salmonella can increase risk of miscarriage)
  • Large fish such as swordfish (due to methyl-mercury content and other toxic contaminants)
  • Liver (due to vitamin A toxicity). Can be eaten very occasionally i.e. once per month

Supplements

 

Pharmepa MAINTAIN is a perfect supplement for pregnancy, containing a combination of omega-3 EPA and DHA with organic evening primrose oil, ideal for healthy brain development and for keeping skin supple during pregnancy, possibly reducing development of stretch marks.

There is no official advice that you must take supplements during pregnancy, however it is extremely difficult to obtain optimum levels of nutrients from the diet, therefore supplementing for the most important nutrients is considered ideal. Do consider advice from your healthcare practitioner.

Purified fish oils are most commonly taken to enable a high dose of omega-3 EPA and DHA to be ingested without the worry of toxin levels. Ideally, you should take a supplement providing a combination of omega-3 EPA and DHA, with around 250mg of DHA. Pharmepa MAINTAIN is a perfect option for pregnancy as it contains concentrated sustainable wild anchovy oil (certified free from contaminants) combined with organic evening primrose oil. Evening primrose oil is an added bonus for you; it’s an excellent oil for keeping skin supple during pregnancy, particularly beneficial for dry skin (8), therefore possibly reducing development of stretch marks.

Taking a good all-round pregnancy-specific multivitamin is also a good idea for all mums to ensure that you are taking in basic requirements of all vitamins and minerals. 400µg of folate or folic acid should be provided in all pregnancy supplements. Supplementing with folic acid has been shown to prevent 90% of neural tube defects. (9) The best form of folate to supplement is considered to be the easily absorbed natural source, with the long name 5-methyltetrahydrofolate. (10) Note that although iron is required at higher levels during pregnancy, iron in high doses is actually toxic, so more is not always better. Vitamin A can also be toxic in high doses so don’t take high-dose antioxidant supplements containing vitamin A.

References

(1)   Avalos LA, Roberts SC, Kaskutas LA, Block G, Li DK. Volume and type of alcohol during early pregnancy and the risk of miscarriage. Subst Use Misuse 2014 Sep;49(11):1437-45.

(2)   Fekete K, Berti C, Cetin I, Hermoso M, Koletzko BV, Decsi T. Perinatal folate supply: relevance in health outcome parameters. Matern Child Nutr 2010 Oct;6 Suppl 2:23-38.

(3)   Winzenberg T, Shaw K, Fryer J, Jones G. Effects of calcium supplementation on bone density in healthy children: meta-analysis of randomised controlled trials. BMJ 2006 Oct 14;333(7572):775.

(4)   Goodfellow LR, Cooper C, Harvey NC. Regulation of placental calcium transport and offspring bone health. Front Endocrinol (Lausanne) 2011;2:3.

(5)   Domellof M. Iron and other micronutrient deficiencies in low-birthweight infants. Nestle Nutr Inst Workshop Ser 2013;74:197-206.

(6)   Brenna JT, Carlson SE. Docosahexaenoic acid and human brain development: evidence that a dietary supply is needed for optimal development. J Hum Evol 2014 Dec;77:99-106.

(7)   Netting MJ, Middleton PF, Makrides M. Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches. Nutrition 2014 Nov;30(11-12):1225-41.

(8)   Kawamura A, Ooyama K, Kojima K, Kachi H, Abe T, Amano K, et al. Dietary supplementation of gamma-linolenic acid improves skin parameters in subjects with dry skin and mild atopic dermatitis. J Oleo Sci 2011;60(12):597-607.

(9)   Czeizel AE, Dudas I, Vereczkey A, Banhidy F. Folate deficiency and folic acid supplementation: the prevention of neural-tube defects and congenital heart defects. Nutrients 2013 Nov;5(11):4760-75.

(10)   Obeid R, Holzgreve W, Pietrzik K. Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? J Perinat Med 2013 Sep 1;41(5):469-83.


Kyla Williams

About Kyla Williams DipION, BSc, MSc

Kyla is a highly qualified clinical nutritionist with a master’s degree in Nutritional Medicine. Kyla runs her own private practice, offering personalised dietary and supplement advice. Kyla has extensive experience in weight management, skin disorders and digestive issues. Her website is at www.kylawilliamsnutrition.com. Kyla regularly contributes to articles for leading consumer magazines, and blogs about healthy cake ingredients and recipes at www.healthybake.co.uk.

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