Keys to a Healthy Pregnancy

A healthy lifestyle – encompassing the right nutrients, exercise and training, and what to avoid – during pregnancy is key to a healthy newborn.

A well-balanced diet and lifestyle are vital to ensure the birth of a healthy baby. Specific nutrients and toxins influence the production and maintenance of the ovum and sperm, and therefore affect the conception and subsequent health of the foetus, and later, the child. While genetics plays a major role, a very important requirement for the good health of a baby is the parents’ avoidance of harmful substances, such as caffeine, alcohol, nicotine, and recreational and some prescription drugs, before conception as well as during pregnancy. This is particularly the mother’s duty, but the father has a big role to play.

 

THE FATHER-TO-BE

It takes approximately 90 days to generate a completely new ‘batch’ of sperm, and each stage in its production requires nutritional input. As an example, looking at a single nutrient – folate – findings show associations between folate deficiency and sperm aneuploidy1 (a type of chromosome abnormality), sperm DNA damage2 and a low sperm count3. Alcohol interferes with the secretion of testosterone, speeds up the conversion of testosterone to oestrogen, and lowers sperm count and sex drive. Smoking can seriously jeopardize a man’s fertility. Men who smoke have a greater chance of decreased sperm count,4 reduced testosterone secretion5, decreased sperm density and a lower proportion of motile sperm6. A father-to-be who smokes, consumes alcoholic and caffeinated drinks, and eats junk food is therefore not going to produce the healthiest sperm, and ultimately the healthiest baby. If he also exposes his partner to second-hand smoke or encourages her to drink alcoholic or caffeinated drinks, it will have a detrimental effect on the health of mother and fetus.

NUTRITION

The best possible nutrition, with optimal levels of lean protein, low glycaemic index (GI) carbohydrates, healthy fats and oils, an abundance of vegetables and some fruit, is the single biggest controllable health factor7 when preparing for and during pregnancy. Wash foods well, and peel fruit and vegetables if they aren’t organic. Vary your diet to help reduce intolerances. Eat smaller meals more often, with five to six small nutrient-dense meals a day, especially during the third trimester, when the size of the foetus will have increased enough to affect your stomach capacity and digestion.

Eat plenty of:

  • Fresh fruit and vegetables (be cautious with the fruit if you are prone to yeast infections or blood sugar problems).
  • Folate-rich foods such as leafy green vegetables (e.g. spinach), fruits (e.g. citrus) and legumes (consume these even before conception).
  • Whole grains for fibre and B-vitamins (avoid wheat or gluten if you suspect allergies or intolerances).
  • Legumes – peas, beans, lentils, chickpeas, etc. – are filling and reasonably priced, are good sources of B-vitamins, fibre and plant protein, can help reduce cholesterol levels, and help to stabilise blood sugar levels because they have a low GI. Chew these well and take a digestive enzyme when you eat these if they cause gas or bloating.
  • Nuts and seeds (raw and unsalted) are sources of absorbable plant calcium, some B-vitamins, fibre, polyunsaturated fatty acids and vitamin E.
  • Seafood and fish (well cooked) are excellent and easily digestible sources of protein and also contain iodine, zinc and calcium (if you eat the soft bones). The omega-3-rich oily fishes are ideal, but if you’re nauseous, rather stick to light fish like hake. Avoid the larger deep-sea fresh fish like tuna or swordfish, as they may contain high levels of toxins (including mercury).
  • Lean meats (low saturated fat) such as ostrich, skinless chicken and turkey, beef and lamb (choose organic when possible, and remove excess fat) will provide you with protein, zinc, iron and some of the B-vitamins.
  • Plant sources of iron (non-haem), such as kelp, seeds and nuts, legumes, raisins, green leafy veg and deep orange or yellow fruits and veg, are less well absorbed vs animal sources (haem), but contain many other important nutrients and can be eaten in abundance – again just be cautious with the fresh and dried fruit if you have any blood sugar issues. Iron is absorbed best when taken in conjunction with vitamin C or vitamin C-containing foods.
  • Ensure good hydration by drinking plenty of good, clean, filtered water (about 2 litres a day). Be cautious with herbal teas, other than rooibos, unless approved during pregnancy.

Eat in moderation:

  • Dairy products. Natural unsweetened live yoghurt is good (if you’re not dairy intolerant). Eat mainly fat-free yoghurt, to limit the intake of saturated fats, but still get the benefits of the yoghurt’s probiotics, prebiotics, calcium and protein.
  • Organ meats. Liver is an especially good source of iron, but make sure it is from an animal that has been fed organically, as the liver is a filtering system for toxins. Haem or animal sources of iron should be consumed with vitamin C or vitamin C-containing foods.
  • Salt (table/NaCl/sodium chloride/Nat Mur). Make sure you maintain a balance with all the tissue salts (of which there are 12), as excess NaCl can decrease available calcium to mother and foetus, increase blood pressure, and alter healthy circulation of body fluids.

Avoid

  • Refined carbohydrates and sugars (you’ll ‘crave’ these at times, but keep them to a minimum).
  • Artificial additives, colourants, preservatives and sweeteners. Phosphates from soft drinks and food additives may cause allergies, as well as affect bone health. Most processed and pre-packed foods contain high levels of sodium chloride, flavourants and preservatives.
  • Unhealthy fats – saturated, heated, trans- and hydrogenated – are notorious for their adverse health effects.
  • Caffeine, found in coffee, tea, some sodas, chocolate and some drugs, contains xanthine alkaloids – psychoactive stimulants that readily cross the placenta to the foetus. These may increase the foetal heart rate, decrease blood flow and hence nutrients across the placenta, decrease absorption of iron and possibly increase the risk of anaemia. In a 2008 study, caffeine consumption was associated with an increased risk of fetal growth restriction throughout pregnancy.8 Caffeine can stay in a pregnant woman’s system for 9 to 11 hours.
  • Flavonoids in black tea can bind non-haem iron, inhibiting its intestinal absorption. Having one cup of tea with a meal has been found to decrease the absorption of non-haem iron in that meal by about 70%,9 so to maximise iron absorption from a meal or iron supplements, don’t drink tea at the same time. I suggest no more than two cups a day, and preferably rooibos. Stay away from raspberry tea, cohosh, slippery elm, ginseng and green teas, which may stimulate uterine contractions. Avoid chamomile tea (especially during early pregnancy) because it can promote menstruation. Fruit, ginger or mint teas are generally all fine during pregnancy.
  • Drinking alcohol during pregnancy is the leading known cause of birth defects. Because the amount of alcohol required to cause foetal alcohol syndrome is unknown, pregnant women are advised not to drink any alcohol at all.
  • Undercooked or raw fish or meats (including raw cured meat such as salami or Parma ham), unpasteurised milk, soft or blue-veined cheeses, and uncooked eggs (including mayonnaise) to avoid parasite infestation (fungal and bacterial).
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SUPPLEMENTATION

The nutrients required during pregnancy should be obtained mainly through a healthy diet, but taking some basic supplements can be of benefit to you and your developing baby. If you are not eating well, are very nauseous, or have specific medical or health-related conditions, it’s essential to take suitable nutritional supplements. Dosages depend on the products and the individual’s needs.

Seek professional advice from a qualified nutritional therapist and don’t self-dose, as it can be harmful to you and your developing baby. Some supplements that may be beneficial during pregnancy include:

  • A good pregnancy-specific multivitamin and mineral supplement acts as an ‘insurance policy’ for all the nutrients you may not be getting in your diet. It should contain sufficient levels of folic acid, as discussed below. Avoid products with high levels of herbal combinations (see ‘Herbs to avoid during pregnancy’).
  • B-vitamins work best in combination (B complex). Especially important is folic acid, which significantly reduces the risk of neural tube defects resulting in malformations of the spine (spina bifida), skull and brain (anencephaly) when consumed in addition to a healthy diet before and during the first month after conception.
  • The B-vitamins could make you feel a little nauseous, especially at the beginning of your pregnancy, so take them in lower doses, with food, and spread them out over the day.
  • B-vitamins are water-soluble and therefore can flush out of the body within about six hours, once your body takes what it needs. This may be seen as a change in the colour of your urine to a brighter yellow (which should normally be a pale straw colour throughout the day if drinking sufficient water).
  • Choline serves as the raw material for several important metabolites that play key roles in foetal development, particularly the brain. Lecithin (phosphatidylcholine), usually extracted from soybeans, is the most common form of supplemental choline. A varied diet should provide enough choline, but vegetarians who consume no milk or eggs may be at risk of inadequate choline intake.
  • Vitamin C is important for formation of collagen, connective tissues, cartilage and bone, as well as being a powerful antioxidant essential for immune function.
  • Calcium and magnesium are integral for bone and teeth formation, and magnesium also plays a structural role in cell membranes and chromosomes. These minerals also help to relax tense muscles. I recommend taking them at night.
  • Vitamin D helps with calcium absorption and protects against urinary tract infections as well. You will benefit from daily exposure to the sun (see ‘Exercise’).
  • Omega-3 supplements containing GLA, DHA and EPA for brain function and performance, blood ‘thinning’ and hormone production, to mention just a few. DHA is particularly important in the third trimester and while breastfeeding, for the growth of your developing baby’s brain (and maintaining yours).
  • Zinc helps prevent stretch marks and boosts the immune system, as well as helping to prevent certain cravings. It is essential for normal foetal growth and development, and for milk production. Low maternal serum zinc levels have been associated with pregnancy-induced hypertension, abnormal delivery and congenital abnormalities.
  • Iron is needed for oxygen transfer and increased blood volume, as well as helping reduce anaemia and unusual cravings (pica) that could be harmful to you and your foetus. Food sources are best. Have your levels checked regularly, and don’t take extra iron if you don’t need to!

Supplements to avoid

Large quantities of lipid-soluble vitamins: A, D, E and K should be avoided, as these can accumulate in the liver and affect you and your foetus’s health. Please have your levels checked before supplementing, as these vitamins are fat-soluble and can build up in the body to toxic levels.

HERBS TO AVOID DURING PREGNANCY

Culinary herbs (basil, oregano, etc.) are usually safe in the small amounts used in cooking, but not in larger doses such as those used for teas, juices and treatments. Anthraquinone laxatives stimulate muscle, including the uterus, and may cause miscarriage. Uterine stimulants should be avoided for the same reason. Alkaloids, bitter principles or essential oils should be avoided because they affect functions in the mother’s body as well as in the foetus. Abortifacients might cause miscarriage, and emmenagogues promote and regulate menstruation, so should be avoided during pregnancy. More comprehensive lists are available from a certified phytotherapist or online.

Harmful to both mother and foetus

Some harmful substances are teratogenic (able to disturb the growth and development of an embryo or foetus), and others are mutagenic (capable of causing a gene change or damage). Here are a few:

  • Don’t forget that exposure of the mother to second-hand cigarette smoke may be as harmful to a foetus as smoke inhaled directly from a cigarette.11
  • Pregnant women who use recreational drugs are placing their unborn babies at risk of premature birth, poor growth, birth defects as well as behaviour and learning problems, and the baby could be born addicted to those drugs.
  • Some medications – and even ‘natural’ remedies – are not all safe in pregnancy. If you decide to use herbals, aromatherapy or homeopathic remedies, make sure that your practitioner is qualified and inform him/her that you are pregnant.
  • Pesticides, insecticides and certain cleaning products should be avoided during pregnancy. Although some household chemicals may have no effect, others can cross the placental barrier. Opt for organic products, but also check these for potential toxicity during pregnancy.
  • Bisphenol A (BPA), used in dental fillings, food containers, plastic baby bottles, containers for mineral water storage, and food and beverage can linings, acts as a chemical oestrogen or endocrine disruptor. BPA can migrate from polymer to food, especially at high temperatures – for example, when food in a can is heated or plastic dishes are used in the microwave.12
  • Common sources of heavy metals, such as lead and mercury are: lead paint, lead-based fuels from old cars, lead from old plumbing in water supply, lead-contaminated soil, and tobacco smoke.
  • Being overweight or obese can lead to gestational hyper- tension (high blood pressure), diabetes and/or pre-eclampsia and eclampsia, and increases the likelihood of a caesarean delivery and health risks to your foetus. Babies born to overweight and obese mothers are at increased risk of being born prematurely, having certain birth defects, needing neonatal intensive care, and being obese in childhood.13
  • Avoid over-exposure to electronic equipment (electro-magnetic fields), as there is evidence that exposure during pregnancy may result in an increased rate of spontaneous abortions and low-birth-weight babies.14

CONCLUSION

Deciding to have a child is not a decision that should be made lightly. Bringing a new life into this world should take careful thought, commitment, planning and preparation – starting a few months before conception takes place. Optimal health (both physical and emotional, and for both father- and mother-to-be) and a good understanding of nutrition, hydration and the importance of exercise and rest are all very important. But even more important is that a child should be conceived and raised in a loving and secure environment, with both mother and father fully committed to supporting, loving and nurturing the whole family – for as long as it takes!

References are available on request from the Natural Medicine office: Tel 021 880 1444

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Keys to a Healthy Pregnancy

Dr Adele Pelteret
About The Author
- BComp.Med “ Naturopathy and BSc.CHSc (summa cum laude), FLT-LE, Dip.CN, H.D.E. She is a qualified Naturopath, Nutritional Therapist, Teacher, and Functional Medicine Lifestyle Consultant with BSc degrees in both Complementary Medicine and Naturopathy. She practises as a natural ‘GP’ in Pinelands, Cape Town, where she uses an individualised approach to diagnose and treat patients. She is the National Secretary for the SA Naturopathy Association, and has a special interest in physical therapies, ergonomics, epigenetics, public speaking, and corporate wellness.