Prenatal article - April 2023 (2023)

With a whirlwind of hormones stirring up your emotions, and feelings of nausea challenging your every move, your next meal may not be at the forefront of your mind. But in the early stages of pregnancy, your baby is at its most vulnerable, and key development depends on your nutrition.

While your growing baby is, quite literally, taking everything it needs from you, it is time to get clued up on nutrient-dense foods. Knowing which nutrients to focus on can really help; although only around 10% extra calories are needed during the last trimester, nutrient requirements are significantly higher, at around 50% more.

Although it is probably quite high on your priority list to concentrate on the health of your developing baby, as a mum-to-be you must also not neglect your own well-being at this precious time. If you want to feel good about yourself by the time the baby arrives, here are a few tips to help you enjoy the experience throughout the whole pregnancy.

BRAIN DEVELOPMENT AND OMEGA FATS

The types of fats eaten during pregnancy have an effect on the development of your baby’s brain, as the brain structure is mostly made up of omega-3 and omega-6 fats. Although your baby will take what it needs, if you already have a fatty acid deficiency, your baby’s brain may miss out on these essential nutrients. Generally, we get plenty of omega-6 in our diets (if we are eating meat, eggs, nuts and grains), but omega-3 is commonly deficient. Omega-3s 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. (1)

As recommendations are to eat more omega-3 fats but also to limit oily fish when pregnant, it can be confusing to know just what the ideal amount is. The seemingly contradictory advice is due to toxins (such as methylmercury) found in fish, which may cause harm to your baby if eaten in excess. As larger fish eat smaller fish, these larger fish (such as swordfish and tuna) 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 very small amounts 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. Taking pure omega-3 EPA & DHA rich fish oils or algae oils is an alternative to eating fish, or they can be taken in addition to eating fish to ensure your intake is sufficient.

NEURAL TUBE DEFECTS AND FOLATE

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

As it is difficult to get enough from diet alone, it is widely advised to take a folate supplement during pregnancy. Supplementing with folic acid has shown to prevent 90% of neural tube defects. (3) You could otherwise take a prenatal multivitamin supplement including a wider range of nutrients, including 400 µg of folate. During pregnancy, folic acid or folate is crucial, but it is important to note that the quality of supplements varies hugely. Ensure you choose a supplement in the bioactive folate form L-methylfolate, ready for the body to metabolise. (4) Also, choosing a ‘clean label’ supplement (free from fillers such as silicon dioxide) is ideal during pregnancy.

BONE DEVELOPMENT FOR YOUR GROWING BABY

Long gone are the days when we thought drinking cow’s milk alone would be enough for bone development. In children, calcium on its own has not shown to improve bone density. (5) Bone development is much more complex than simply providing calcium, as to optimise bone health, magnesium is required to transport the calcium into the bone structure and vitamin D is also needed for calcium absorption. Vitamin D levels during pregnancy also appear to affect bone density in offspring. (6)

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 enough vitamin D, try to get 20 minutes of sun exposure each day to your skin, from the months April – October (in the UK). You may need longer exposure if you have dark skin.

If your intake of dairy is low or if you have a diet low in magnesium-rich foods, consider taking a calcium and magnesium supplement.

Although it is healthy to focus on nutritious foods to include in your diet during pregnancy, you also need to consider which foods are best avoided completely, or at least limited in your diet while pregnant.

During the early stages of pregnancy, especially the first 3 months, you should 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, research has shown that just 4 alcoholic drinks per week is associated with a significant increased risk of miscarriage. (7) If you’ve had a few drinks before you found out you were pregnant, don’t worry, this is very common! As the biggest risk is miscarriage, if you are still pregnant, your baby is most likely doing absolutely fine.

A ‘wine and cheese night’ may be out of the question, but you can certainly still indulge in other delicious foods and drinks. If you are craving soft cheeses, you can opt for pasteurised soft cheeses; some have added herbs and garlic, making them a rich alternative, so you won’t feel like you are missing out. While caffeine is difficult to replace, try decaf alternatives to your usual drinks, or something different such as rooibos, a naturally caffeine-free option.

You can also now have poached eggs when pregnant! The majority of eggs have the British lion stamp, indicating that the eggs have been laid by hens vaccinated against salmonella. These types of eggs are considered safe to eat during pregnancy, even if the yolk is runny.

The risk of food poisoning and its consequences are much greater during pregnancy due to reduced immune function, so be 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 toxoplasma in soil residues, so scrub your vegetables clean, especially if eating them raw. This parasite can be very harmful to an unborn baby, and can also be found in cat stools; consider wearing gloves if you are cleaning out a litter tray, especially if your cat has not had parasite preventative medication.

What your body does during pregnancy is incredible, but it certainly takes a toll on your body if your nutrition is not optimal. The array of unusual pregnancy early symptoms rarely come up in conversation (amongst non-pregnant women), from pregnancy leg cramps to acid reflux, so they can often come as a surprise if you are expecting your first baby. It’s difficult to predict what the symptoms of pregnancy will be for you as an individual, but the most common include morning sickness, fatigue and pregnancy lower back pain.

One of the first pregnancy symptoms is often nausea or vomiting in the first few months of pregnancy (often starting around pregnancy 6 weeks). While commonly known as ‘morning sickness’, it can actually occur at any time of day. This reaction could be considered as your body’s natural defence system to warn you off foods which may be harmful to your unborn baby, but the cause is not well understood.

Not only is morning sickness an absolute nuisance, it can also cause problems with how much food is properly consumed, and therefore could lead to nutritional deficiencies. Deficiency of protein and healthy fats are the main issues, which could lead to muscle loss, and your skin, hair and nails may suffer too.

If you are trying to suppress those nauseous feelings, within the first hour or so in the morning, try sipping on a glass of warm water with fresh lemon juice and/or fresh sliced ginger. Ginger has been shown to significantly reduce symptoms for pregnancy nausea when compared to a placebo. (8)

At least 30 minutes after finishing your drink, eat something simple and plain, such as a rice cake, rye cracker or oat cake. Plain carbohydrate foods are usually easier to stomach at this time, as they are less overpowering for pregnancy nausea. If you feel well enough, try having nut butter, avocado or cottage cheese on your cracker, to help slow the release of carbohydrates from the cracker, to stabilise your blood sugar levels.

During pregnancy, early symptoms also include fatigue and weakness, and it can be quite debilitating for some, especially if combined with low iron levels. With hormonal changes and an increased nutritional demand during these early stages of development, it is no surprise that you will often feel you need to rest.

Listen to your body and take it easy if you are feeling fatigued. You can still carry on with most normal daily life activities, but don’t overdo it, and don’t start any new forms of exercise that your body is not used to. To protect your baby against any stressors and to reduce risk of miscarriage, it is important to take things slowly. Relaxing forms of exercise such as yoga and swimming are particularly suitable at this time and maybe it’s even time for a pregnancy massage!

Another possible cause of low energy levels during pregnancy is low iron, resulting in anaemia. There is a valid reason for why this may be: 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 (9) 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! If your diet is low in these foods, you may wish to take an iron supplement. Although iron is required at higher levels during pregnancy, iron in high doses is actually toxic, so more is not always better.

While we optimistically welcome a pregnancy glow for our skin, not everyone is so lucky. It’s actually quite common for the complete opposite to occur, and you may end up with skin issues.

If you usually have oily skin, you may experience breakouts while your hormones are running wild during the first trimester of pregnancy, but this often calms down later on in pregnancy. On the other hand, if you have dry skin, brittle nails and dry hair, this may be a sign that you are low on healthy fats. If your diet is low in fat, your baby will take the healthy fats from your skin, which could lead to dry skin and eczema during pregnancy, especially during the last 2 trimesters.

Whether your skin is oily or dry, you will almost always benefit from a good dose of healthy omega-3 to calm inflammation and provide moisture to your skin. Omega-3 fats are required for your skin, hair and nails, so if you aren’t having oily fish 2-3 times per week, then consider a high-dose omega-3 fish oil to provide EPA and DHA.

Although completely normal and usually harmless, if the possibility of developing stretch marks during pregnancy bothers you, there are a few new habits you could try to develop. Stretch marks are small tears of the skin which appear when an area of your skin grows quicker than your skin cells can replicate. Stretch marks are very common during pregnancy, but if you want to give your skin a boost of nutrition and blood flow, you may be able to help your skin cells keep up with your growing belly.

Key nutrients to support skin cell growth include zinc, iron, vitamin A, C and E and protein, specifically collagen. Omega-3 fats may also help to keep skin supple, keeping skin well moisturised from the inside.

Limit products which may dry out your skin (such as shower gels containing sodium lauryl sulphate), use a vitamin C serum, good moisturiser, and a natural oil such as rose hip or jojoba oil.

Any activities that increase blood flow are also great for improving the skin’s ability to replicate cells, so gentle exercise, skin brushing and pregnancy massage are all great to fit into your normal routine.

As obtaining optimum levels of nutrients from the diet may be difficult during pregnancy, taking supplements may help you to reach your nutrient goals. Here are the key supplements to consider:

PRENATAL MULTIVITAMIN

Taking a good all-round pregnancy-specific multivitamin will ensure that you are reaching your daily requirements of a wide range of vitamins and minerals, including folate and vitamin D.

OMEGA-3 FISH OR ALGAE OIL

To support brain development for your baby and to support your skin during pregnancy, take a high dose omega-3 EPA and DHA supplement.

COLLAGEN PROTEIN POWDER

If your protein intake is low (collagen is created from amino acids derived from protein in the diet), you may benefit from taking a collagen powder to support your skin health.

Suitable if your diet is low in dairy or other calcium- and magnesium-rich foods. Calcium and magnesium are often present in multivitamins, but only at low levels. For an adequate dose, this is best taken as an additional supplement.

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