Nothing can replace the benefits of a well-balanced diet, but once healthful eating habits are established, women may benefit from taking dietary supplements to decrease the risk of birth defects in their babies and to prevent and treat ailments that can accompany pregnancy.
Here, Kathie Golden and Sarah Ackerly, naturopathic physicians and midwives, give their recommendations for supplementation to ease two common complications of pregnancy.
Nausea—During the first trimester especially, many pregnant women become nauseated as progesterone and estrogen levels rise. Vitamins B6—found in all foods but especially in brewer’s yeast, carrots, chicken, and wheat germ—and K, found in alfalfa, broccoli, green leafy vegetables, molasses, and egg yolks, can help alleviate nausea because those two vitamins help regulate the nausea center in the brain.
One caution: the Balchs warn against taking large doses of synthetic vitamin K during the last weeks of pregnancy because it can be toxic for newborns. Babies, however, are sometimes given vitamin K shots if the mother’s diet is low in the nutrient and did not pass sufficient amounts through the placenta to the baby. Vitamin K is necessary for blood clotting.
Depression—Hormonal changes and swings in blood sugar are a normal part of pregnancy, but vitamin B6, which is essential to mental and emotional function, can be useful in balancing the emotions. According to The Nutrition Desk Reference by Robert Garrison, Jr. and Elizabeth Somer (Keats Publishing, 1985), deficiencies in this vitamin can cause weakness, mental confusion, irritability and abnormal electroencephalograms. Boron and chromium, Golden says, can help treat postpartum depression by regulating blood sugar.
Difficulty in conceiving a child may have many causes. If your health-care provider has ruled out anatomical or hormonal abnormalities or psychological problems, consider your nutrition. Processed foods, foods grown in nutrient-depleted soils, environmental toxins, and certain drugs have caused nutritional deficiencies. Even the use of birth control pills can cause deficiencies in vitamin B6, iron, and folic acid.
For her patients who are having trouble conceiving, Sarah Ackerly, a naturopathic physician and midwife at the Open Gate Traditional Health Care Clinic in Brunswick, Maine, recommends that they change their diet to include more of vitamins A, E, and C as well as the B vitamins and zinc. If her patients prefer supplements, she makes dosage recommendations based on their individual health profiles. (If you are interested in taking therapeutic doses of vitamins, it is wise to seek your health-care professional’s advice; taking high doses of vitamins, even a multivitamin, may block absorption of other key nutrients.) Vitamins B6 and B12 are necessary for a healthy menstrual cycle and conception. Vitamin B6 supports many bodily functions, including protein metabolism and the formation of red blood cells. Vitamin B12 promotes the synthesis of DNA and the formation and maturation of red blood cells. Intrinsic factor, a substance normally secreted by the gastric glands, is necessary for its utilization, and a deficiency of this factor causes anemia.
In part to safeguard the child’s health, Ackerly advises women to begin taking multivitamins before conception, but she adds that taking too much vitamin A has been linked to some birth defects, including congenital deformities. Because it is fat-soluble, excess vitamin A is accumulated in the liver, not excreted as it would be if it were water-soluble. Thus, toxic levels can build up. A recent study reported in the British Medical Journal suggests that pregnant women or women who wish to become pregnant not exceed 5,000 IU per day of vitamin A.
Infants whose mothers take multivitamins before conception and throughout the first trimester of pregnancy have a reduced risk for some types of heart defects. A study published in Pediatrics (November 1996) shows that mothers who reported using multivitamins at least three months before conception and during the first trimester of their pregnancy showed a 43 percent lower risk of having babies with conotruncal defects—malformations of major blood vessels associated with the heart—than did mothers who didn’t take multivitamins. A major cause of infant deaths, these birth defects kill 3,000 babies each year in the United States alone.
Beginning multivitamin supplements after the second month of pregnancy had little effect on preventing these defects, and starting after the third month had none. Although folic acid is known to be essential for normal neural tube development, whether it is also responsible for reducing the risk of conotruncal defects is not clear (all supplements used in the study contained folic acid).(1)
Ackerly and Kathie Golden, a naturopathic physician and midwife in San Mateo, California, each recommend that women continue taking a prenatal multivitamin during lactation. They recommend naturopathic multivitamins (available by prescription) containing an appropriate balance of vitamins and minerals for pregnancy and lactation but no fillers and synthetics, saying that the body doesn’t break down synthetic ingredients as well as it does natural ingredients, so they are not utilized by the body as well.
Both women say they advise their patients to avoid once-a-day prenatal vitamins because they believe that the nutrients are not absorbed into the tissues and bloodstream as well as those from a prenatal multivitamin taken several times a day. Ackerly says to look for prenatal multivitamins that don’t have large amounts of vitamin C and the B vitamins because large amounts of those can mean the manufacturer has skimped on other important, more expensive nutrients such as zinc and vitamin E.
During the first trimester of pregnancy, the tiny fertilized egg undergoes profound changes and growth as its cells differentiate and major organ systems develop. Good nutrition for the mother is essential during this period to ensure the health of the fetus. This includes plenty of protein in the diet.
For vegetarians, Ackerly and Golden say, complete proteins (ones containing all of the essential amino acids) can be easily obtained by combining complementary protein sources such as beans and rice. Sometimes, they may need additional vitamin B6, iron, and copper. Vegans—those who eat no animal by-products—also may need additional vitamin D, zinc, and B vitamins throughout their pregnancies. To meet the additional protein requirements of pregnancy, Golden suggests drinking protein shakes or other beverages because the higher amounts of protein are easier to consume that way than eating the quantities of food necessary to supply the same protein level. It is important, however, not to exceed the recommended daily dosages of vitamins.
Zinc is vital for the growth of tissues of the fetus, promoting the growth of collagen and the synthesis of protein. A zinc deficiency in the mother during the first trimester—which can be caused by some illnesses, poor nutrition, or the poor absorption of zinc attributable to drinking hard water or eating too many grains and legumes—can cause miscarriage, birth defects, and complications during delivery, according to James and Phyllis Balch, authors of Prescription for Nutritional Healing (Avery Publishing, 1990).
The fetus takes on human form and increases greatly in size during the second and third trimesters; its bones ossify, and its organ systems mature in preparation for life outside the uterus. As long as it remains in the uterus, though, it must rely on its mother’s good nutrition for its own nourishment.
Vitamin B6 can help both mother and child by helping metabolize proteins so essential for fetal growth. If a woman is deficient in B6, hydrochloric acid production decreases because the vitamin is needed for the production of hydrochloric acid and the absorption of fats and proteins, according to the Balchs. Golden encourages her patients to seek calcium sources other than dairy products, because the phosphorus and protein in dairy products can block calcium absorption. Nuts, canned fish, and beans are good calcium sources, she says. If taking a calcium supplement, calcium citrate is better absorbed than the carbonate form, she adds.
For newborns, nothing beats mom. While multivitamin formulas for newborns are available, Ackerly recommends that women stick to breast milk to feed their babies because some vitamin supplements might be dangerous. For example, studies have linked iron supplementation to Sudden Infant Death Syndrome.
Balancing a wholesome diet with a dietary supplement program during pregnancy can go a long way toward protecting your health and that of your child. By taking care of your body’s needs, you are, in turn, offering your child a foundation for a lifetime of good health.
(1) Pediatrics, Vol. 98, November 1996.
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