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.

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