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Bump & Beyond

Growing a baby demands a lot from your body so you want to make sure you’re as healthy as possible well before you conceive. Naturopath and medical herbalist Rebekah Paddy takes a look at the nutritional demands of pregnancy and offers advice on supplements for expectant mums.

A healthy baby begins with healthy parents, particularly a healthy mum. The need for ‘pre-conception care’, for three months prior to getting pregnant, is now well recognised and many women (and men) change their lifestyles to a ‘cleaner’, more holistic one when planning a baby. Avoiding alcohol and coffee, eating whole foods, drinking plenty of water, avoiding environmental toxins, and introducing exercise are easy changes you can make before conception.Once pregnant, the demand for high levels of nutrients increases dramatically. The first trimester is a time of massive embryo growth; it is the time when the rate of cell replication is highest and all the baby’s organs are formed. It is important the extra nutrients required are in place before this time to support this process. It is now widely accepted that supplementation of certain nutrients is required before and during the early weeks of pregnancy (see the Ministry of Health recommendations on page 8). It is also becoming widely accepted that other nutrients are crucial in pregnancy and throughout breastfeeding. To promote better overall health outcomes for mother and baby, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommends women take a multi mineral and vitamin supplement to support the increased demands on the body during this time.

MAKE IT A MULTI

Because nutrients work with each other to support all bodily functions, taking vitamins and minerals together in a ‘multi’ supplement is most effective. (The absorption of calcium relies on sufficient vitamin D levels, for example, and B vitamins work together as a ‘complex’.) Here is a list of the most important nutrients needed before, during and after pregnancy.

Folate – Vitamin B9, also known as folic acid. Folic acid is the synthetic form of vitamin B9 found in fortified foods such as cereals and supplements. There are other forms of B9 such as folinic acid and methyl folate which are the activated forms of this vitamin which are closer to the form found in foods and can be more readily absorbed by our cells. Food sources of folate (the natural and preferred form of B9) are plentiful in a healthy diet that includes dark green leafy veges, broccoli, nuts, lentils and avocados. This vitamin is needed for a plethora of functions during pre-conception, pregnancy and breastfeeding. Known to reduce the risk of neural tube defects, other functions which require folate include egg maturation and implantation and the ability to synthesise DNA, for cell division and cell growth. Folate is also important for a child’s growth and development once born.

Iodine – The thyroid is under immense pressure during pregnancy and iodine is needed for a healthy thyroid, as well as foetal growth and development. New Zealand soils are critically low in iodine so eating foods rich in this nutrient such as sea salt (with added iodine), fish, egg yolk and seaweed is essential. After birth iodine is a key nutrient for breast health.

Essential fatty acids – These are needed in larger amounts during pregnancy to support the cognitive and eye development of the foetus. Omega 3 also helps to calm the nervous system of pregnant women and reduce aching joints associated with the extra stress placed on them. During breastfeeding a baby will benefit from a mother taking Omega 3. Studies have shown benefits to baby’s immune health including reduced allergies, and it is known that Omega 3s, when used in high doses, and with other natural approaches, can help to combat mild to moderate post-natal depression. Omega 3-rich foods include oily fish, flaxseed oil, avocado, nuts and seeds.

Vitamin D – Vitamin D can be acquired from the sun but because our sun is very harsh and we need to be careful, many New Zealanders are deficient in this vitamin. Vitamin D is needed for calcium absorption and healthy immunity among other things. Supplementing mothers with vitamin D through pregnancy and breastfeeding has been shown in studies to help reduce allergies in children. A vitamin D deficiency in pregnant women is associated with an increased risk of premature birth. Food sources include cod liver, sardines, egg yolk, milk and cheese.

Iron – Iron levels will usually drop in pregnancy so healthy levels of this important mineral are needed prior to conception to reduce the risk of deficiency. Ferritin, which measures iron storage, is checked throughout pregnancy by your LMC and often supplementation is required. To help maintain good iron levels eat iron rich foods such as red meat, eggs, lentils and brown rice. Iron deficiency symptoms include fatigue, breathlessness, anxiety and headaches. In the post-natal phase iron deficiency is associated with failure to thrive in children and recurrent infections.

Calcium – Well known to be found in dairy, calcium can also be found in products such as broccoli, nuts, salmon and sardines with bones. Calcium is essential in pregnancy for skeletal development of the baby and to ensure no loss of bone or teeth health in the mother. During breastfeeding calcium is also important for the healthy bone strength and teeth growth of the infant.

Magnesium – This mineral is often low in pregnant and lactating women and deficiency can cause headaches, constipation, insomnia, leg cramps and anxiety, to name a few symptoms. Found in dark leafy greens and nuts such as almonds, magnesium and calcium are commonly supplemented together in pregnancy.

Zinc – New Zealand women are very often low in zinc as we do not have zinc-rich soils. Low zinc status has been associated with premature deliveries and low birth weight which can lead to increased risk of health issues such as allergies and respiratory conditions in infants. Zinc is also needed for wound healing so good levels ensure a quicker recovery from C-section or episiotomies. White spots on the nails can be a sign that you’re low in zinc.

Selenium – Another nutrient critically low in NZ soils, selenium is essential for healthy thyroid and immune function. However, it is easy to have too much selenium so check with your healthcare provider or a naturopath if you are unsure. Selenium-rich foods include brazil nuts (3 nuts will give you a good amount of selenium), egg yolk and mushrooms.

Probiotics – Not only beneficial for pregnant women’s gut microbiomes and therefore immunity and digestion, the use of certain strains in the third trimester, during breastfeeding and also given to the newborn have been shown in studies to reduce allergic atopic conditions such as eczema in babies.

If you are concerned that you are not getting the nutrients you need or you feel you are deficient in certain nutrients, speak to your naturopath or other healthcare provider. Being pregnant can be an amazingly exciting time, and knowing you are doing the best for yourself and your baby can bring great peace of mind.

Rebekah Paddy is a naturopath, medical herbalist and director at Mother-Well Holistic Health, www.mother-well.co.nz

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