1. Before You Become Pregnant
There
are several dietary guidelines that everyone should follow, but there
are also specific guidelines for women who are planning to become
pregnant. In the months before a woman becomes pregnant, her nutritional
intake can be a key factor in the outcome of the pregnancy. The foods
she eats and the vitamins and minerals she takes will help ensure that
both she and the fetus have the nutrients required right from the very
start of the pregnancy.
General Pre-Pregnancy Tips
The key to a
healthy pregnancy diet is to plan ahead. First, work to improve your
diet. You, as well as your partner, need to follow a well-balanced
healthy diet with at least three meals per day. Meals should be spaced
evenly throughout the day and should provide foods from all of the food
groups. If you are not sure how to go about eating healthier, now is the
perfect time to make an appointment with a registered dietitian who can
point you in the right direction.
Most of a
baby’s major organs form very early in pregnancy. Birth defects and
other problems can occur before a woman has missed her first period or
knows she is pregnant. You can lower the risk of birth defects and
problems with pregnancy by making healthy nutritional choices before you
even get pregnant.
Make a prenatal
doctor’s visit, and get a checkup before you become pregnant. This will
ensure you are in good health. If you have medical problems, an early
visit to your doctor can help get your problem under control and can
give you a heads-up for what you might need to do or expect during
pregnancy. Talk to your doctor about your family history, including
genetics and birth defects. While at your doctor, ask about beginning a
prenatal supplement to ensure you are getting all of the nutrients you
need. These supplements can help build up the nutritional stores that
can be depleted quickly during pregnancy. They can also ensure you are
getting essential nutrients, such as folic acid, that help prevent birth
defects.
Reaching
a healthy weight may mean losing or gaining weight before trying to
conceive. Make sure that you are at a healthy weight or working toward
it. The body mass index (BMI) is one tool that can be used to determine a
healthy weight. You should use the BMI only as a general guide. Many
factors need to be considered when estimating how much a person should
weigh.
Get yourself
on a regular exercise plan. Being in good physical shape at least three
months or more before you conceive can make it easier to maintain an
active lifestyle while you are pregnant. It can also be a benefit during
labor. Physical fitness can help maintain good moods and energy levels
as well as get you back in shape quicker after you deliver. Part of
fitness is the ability to cope well with daily challenges. Do what you
can to reduce your stress levels, and learn to cope with your stress
through meditation, exercise or other coping methods.
Take a look at
your lifestyle habits, and begin to make changes to bad habits. Research
shows that smoking, drinking, and taking drugs are most definitely
connected to low birth-weight babies, miscarriages, sudden infant-death
syndrome (SIDS), and possible behavioral problems later in life. It is
best to stop these habits before trying to have a baby.
Avoid
using hazardous substances and chemicals, including many household
cleaning products. Be careful about what products you use and how.
Do what you
can to take care of yourself and avoid infections. Some infections can
be harmful to the fetus, so keep up your resistance. You can do this by
washing your hands, keeping your distance from people around you who are
sick, and staying away from unsafe foods.
Nutritional Needs for All Women
Your first
plan of action should be to ensure that you are receiving all of the
nutrients needed for optimal health in your age range. Some nutrient
needs, as well as calorie needs, will increase with pregnancy and
breastfeeding. But your increased need for vitamins and minerals is
immediate and does not depend on whether you are pregnant. Vitamins and
minerals are key nutrients to every process that takes place in your
body. They work together to make all your body processes happen
normally. Your needs for certain nutrients are more imperative before
and during pregnancy. Specific nutrients that are important include
folate, calcium, and iron.
The Dangers of Mega-Dosing
Just because
a vitamin or mineral is beneficial, more does not always mean better.
Some vitamins and minerals have toxic effects at very high levels; for
instance, be particularly aware of your intake of iodine and vitamins A,
D, E, and K. Let’s take the example of vitamin A to see how high levels
can be ingested and a sample potential danger of ingesting too much of a
nutrient. Other vitamins and minerals in too-high doses carry different
risks; pay attention to what you eat, and be sure to go to your doctor
with any questions or concerns.
Vitamin
A is important for promoting the growth and health of cells and tissues
in both the mother and fetus. Vitamin A needs are not increased during
pregnancy because the reserves in a woman’s body easily meet the needs
of the fetus. In fact, research suggests that excess vitamin A ingested
from supplements—over 10,000 international units (IU) daily—can be toxic
and increase the risk of birth defects. Vitamin A in larger amounts
poses the most risk two weeks prior to conception and during the first
two months of pregnancy. These findings do not pertain to beta-carotene,
a precursor of vitamin A, which does not pose a risk and is not toxic.
Check any supplements you take to learn the source of the vitamin A, and
take in this vitamin only in amounts recommended or prescribed by your
doctor. Stay away from mega doses of any vitamin or mineral before,
during, and after pregnancy.
2 .Focus on Folic Acid
Folate, found
naturally in foods, is one of the B vitamins; it is also known as folic
acid, which is the name for the form found in supplements and fortified
foods. Folic acid merits special consideration. During pregnancy, this
vitamin helps to properly develop the neural tube, which becomes the
baby’s spine. When taken in daily optimal amounts at least one month
before becoming pregnant and during the first trimester, folic acid can
help prevent birth defects of the brain and spinal cord, called neural
tube defects (NTDs).
Though the
Instutite of Medicine of the National Acadamies still states that the
recommended intake is 400 mcg for women of childbearing age, recent
studies show that to decrease the risk of birth defects, folic acid
should be increased to 800 to 1000 mcg daily (the amount in most
prenatal vitamins) in those attempting pregnancy. So your doctor will
likely prescribe a prenatal vitamin with this higher amount.
Spina
bifida, sometimes called “open spine,” affects the backbone and
sometimes the spinal cord. Spina bifida is the most common severe birth
defect in the United States, affecting 1,500 to 2,000 babies (1 in every
2,000 live births) each year. Anencephaly is a fatal condition in which
the baby is born with a severely underdeveloped brain and skull.
Because most
women do not know that they are pregnant right away and because the
neural tube and the brain begin to form so quickly after conception,
taking optimal amounts of folic acid on a daily basis is important for
all women in their childbearing years.
Intake Requirements
Even though a
woman follows a healthy, well-balanced diet, she may still not be
consuming the recommended amount of folic acid each day. For this
reason, in 1998 the Institute of Medicine recommended “that to reduce
their risk for an NTD-affected pregnancy, women capable of becoming
pregnant should take at least 400 mcg of synthetic folic acid daily,
from fortified foods or supplements or a combination of the two, in
addition to consuming food folate from a varied diet.” You can use an
over-the-counter multivitamin/mineral supplement or prenatal supplement
to make sure you get your folic acid. Check the label on
over-the-counter supplements because not all contain folic acid in the
recommended amounts. The intake for folate increases with pregnancy and
breastfeeding. Women who have previously had a baby with an NTD may have
higher folate requirements and should speak with their doctors.
Until more
information becomes available, both pregnant and non-pregnant women ages
nineteen years and older should not exceed the tolerable upper limit of
1,000 mcg of folate per day from foods, fortified foods, and
supplements unless otherwise prescribed by their doctor.
To help
women consume more folate, in 1998 the U.S. Food and Drug Administration
(FDA) required that all grain products such as breads, flour, crackers,
and rice be fortified with folic acid. Other very good sources of
folate include orange juice, fortified breakfast cereals, lentils, dried
beans, dark-green leafy vegetables, spinach, broccoli, peanuts, wheat
germ, and avocados. Folate can be destroyed during cooking, so eat
fruits and vegetables raw or cook them for as short a time as possible
by steaming, microwaving, or stir-frying.
Do folic acid supplements really make that much of a difference in preventing certain birth defects?
According
to the U.S. Centers for Disease Control (CDC), when taken one month
before conception and throughout the first trimester, folic acid
supplements have been proven to reduce the risk for an NTD-affected
pregnancy by 50 to 70 percent.