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  • Pregnancy: when is nutrition most important?

    Just pondering something while up at night and thought all you smart people might have an answer!

    Of course good nutrition is very important throughout (even before) pregnancy, but is there a time when it is more important or most important? I wonder, because when I was in the worst of my morning sickness, my doctor said "don't worry, even if you can't eat at all, the baby is getting everything it needs." I said "really, I could be starving and the baby would be fine?" and he said "yes, in the first trimester the baby's needs are so small, it can pull everything from your reserves. That's evolutionary, because many women can't keep food down. Just stay hydrated." Wow! BUT the first trimester is universally considered the most dangerous time to take most medications, be exposed to chemicals, etc, because the organs are forming. And folate is only helpful in preventing spina bifida, etc. if taken early in pregnancy. Is there some contradictory advice here, or am I missing something?

    Still, it does kind of make sense that the 2nd and 3rd trimester - when the organs are done forming and the baby starts growing very rapidly - might be the most important time for good nutrition. It seems like most doctors recommend DHA supplements from the 2nd trimester on (I was taking fish oil pre-pregnancy so I just kept taking it, but the medical advice seems to be once you're in the 2nd tri.) And I was told that as long as I ate right once the morning sickness passed at around 11-14 weeks, everything would be fine with both me and the baby.

    Here's a good summary of what happens week-by-week, anyone want to take a stab at when you want to be most vigilant with your diet? Pregnancy (Stages - Trimesters of Pregnancy) Symptoms, Causes, Treatment - What is the third trimester (week 29-week 40) on MedicineNet

    Thanks

  • #2
    Good question...

    I think getting as good of nutrition as possible throughout as much of the pregnancy as possible is probably the best. Granted, I have spent several first trimesters just getting by (though thankful for the limited Zofran I took that helped with that a little). However, I think I agree that 2nd-3rd trimesters are the most important, especially 2nd trimester. That is, also, of course, if you do your best in the first trimester and went into it with good reserves. The baby WILL take what it needs from mother, but that can set mom up for depletion in later pregnancy with teeth and bones are really forming well, which I don't think would be good.

    Just as examples from my own pregnancies - first one has a more pinched face, teeth spacing issues from toddlerhood, and some behavioral issues - SAD the whole pregnancy.

    2nd was Brewer pregnancy diet - he has a nice wide face, great teeth, huge wide feet, still some behavioral issues, but mainly it's personality

    3rd modified Brewer diet (so he wouldn't be 10.5# like his older brother) - also nice wide face with good teeth, good feet, etc.

    5th more "healthy" SAD than Brewer, but still fairly decent - so far, he looks like he has good facial/jaw/teeth structures and nice feet.

    As I had/have more pregnancies, the first trimester gets harder and harder. But I try to make sure I'm eating well the rest of the pregnancy, and so far, those little faces look good. I'm a little concerned about this little guy, only because I really slipped into SAD out of desperation for not feeling well, until about 31ish weeks when we switched over to PB/paleo.

    Anyway, long way to say that I think that doing your best, and focusing on 2nd-3rd trimester (and beyond) is probably the best way to go, if you can.
    Amy
    ~wife and mother

    Started primal a month before the end of my pregnancy with P who is now 1. Went from a size 14 down to a size 4 in less than a year. Now sitting at 20-21% body fat, a solid 130 pounds, and 5'9". Feeling better than ever before, and able to run around and chase my 5 little boys who range in age from 14 months up to 11.5 years old.

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    • #3
      I am definitely no expert and cannot offer "confirmed medical advice" here, but I understand that no matter what trimester you are in, the baby will take the nutrients, etc. that it needs from Mother first - meaning that whatever nutrition you get it will go first to baby and then to you. I believe that I was told this was an evolutionary thing - protecting the baby and trying to guarantee its survival, regardless of the Mother's health. This was all told to me because I was worried about my calcium intake (I had suffered from "IBS" since I was 5 years old and dairy foods were the trigger foods, so I have never had an excellent intake of calcium). Someone told me not to worry (can't remember if it was a doctor or not), because the baby would be getting the calcium she needed, even if it meant that it left me depleted. Basically, I think you should eat as healthy as you can for your entire pregnancy, both for baby's sake and yours.

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      • #4
        As far as I understand, preconception nutrition is just as important as prenatal nutrition (for example, you're supposed to get folate BEFORE conception to get the most protective benefits from it). The fat soluble nutrients (esp. A,D&K) are so important for proper mineral use and bone formation.

        The Health Skeptic has an excellent series on prenatal nutrition: http://healthybabycode.com/signup
        http://www.prettyinprimal.blogspot.com

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        • #5
          I'm no expert, but I don't see the contradiction that you do. Since the fetus takes its nutrition from you throughout pregnancy (i.e., you will have a deficiency before the fetus), the fetus would also absorb any negative substances you ingest, which is the reason for the caution about meds.

          Most doctors advise any woman who thinks she may become pregnant (i.e., is not preventing pregnancy) to use caution because if you're taking any negative substances, you could be pregnant well before you're aware of it. In other words, consider yourself pregnant in terms of what you ingest--because you may be.

          Just as a footnote. My sister had difficulty getting pregnant and had decided that she would never conceive. She was 4 months pregnant before it was confirmed (she visited the doctor earlier, and he told her that she wasn't pregnant). In any case, she had been taking a slew of very powerful fertility drugs, pain meds for her arthritis, using Valium for anxiety, and OTC anti-histamines for her allergies--and smoking! The doctor told her that the only thing he was concerned about were the anti-histamines, which she thought were the least harmful. Baby was fine and just turned 19.

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          • #6
            Question, I'm about 4 weeks pregnant and am reading a book about traditional foods for mother and baby. It recommends taking brewer's yeast for b vitamins. Is this ok even though it is derived from wheat?

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            • #7
              Originally posted by Jenn View Post
              Question, I'm about 4 weeks pregnant and am reading a book about traditional foods for mother and baby. It recommends taking brewer's yeast for b vitamins. Is this ok even though it is derived from wheat?
              Jenn~
              Liver once a week is a better source of B vitamins, iron and Vitamin A. Chicken liver paté is a nice way to eat it.
              Ancestral Nutrition Coaching
              Pregnancy Nutrition Coaching
              Primal Pregnancy Nutrition Article

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              • #8
                Of course good nutrition is very important throughout (even before) pregnancy, but is there a time when it is more important or most important?
                Good question! My experience is that pre-conception nutrition/health is the most important, since it is the pre-pregnancy period that builds the matrix in which the baby will grow.

                With the ttc moms I work with, I recommend giving their bodies at least 6-9 months of Primal eating and whatever extra time they need to drop any excessive body fat (which is essentially a detox), and decrease stress so that they are in the best possible health going into pregnancy.

                I consider this essential "remodeling", if you will, to get the baby's new "home" ready.

                This also gives them time to fine tune their diet to eliminate any sources of inflammation that are unique to them (nightshades, dairy, FODMAPS, etc.) If the mom is stable & comfortable with her diet, she is much more likely to be able to deal with the hormonal changes of pregnancy and not "give in" to eating gluten grains, etc.

                Obviously, this is an ideal situation and won't work for everyone.
                Ancestral Nutrition Coaching
                Pregnancy Nutrition Coaching
                Primal Pregnancy Nutrition Article

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                • #9
                  I could see the argument for pre-pregnancy since the baby WILL take what it needs from mom, pre-pregnancy nutrition builds up all those reserves and gets your body in as healthy and baby-friendly environment as possible (level blood sugar, reduced inflammation). I'd probably say the 2d trimester is most important since during the first, your baby's needs aren't great and it will pull from your body. The 2d trimester may have some of your reserves depleted, so eating well will help make sure you and the baby stay flush with nutrients. Plus, the baby is still developing and growing rapidly.

                  When my SIL was preggers, she couldn't eat veggies....They'd make her puke and she was really worried about the baby. He was born (unfortunately C-section b/c he was breech) happy and healthy, which he still is at 8 months old now.

                  The Chris Kresser/Healthy skeptic baby series is great, but he makes you feel like if you don't eat liver/offal, your baby and pregnancy are doomed. I can't eat liver. It's just. not. going. to. happen. And it won't do me any good if it (and everything else I eat with it) doesn't stay down.

                  I've had a week or two here and there where I just craved bread (strange for me since I never cared for bread pre-pregnancy). And so I ate bread. For a few weeks, the only thing I could eat for breakfast was cereal...so I did (because I'd feel REALLY sick if I didn't eat breakfast). Then I transitioned to oats and now I'm back to savory paleo brekkies. (yay!) Just do the best you can and your baby will be fine.

                  eta: One thing I've noticed is that my body is a LOT LOT LOT LOT more tolerant of non-paleo foods than it was pre-pregnancy. Kind of surprising to me. My midwife was thrilled that I eat primal/paleo and has supported this diet for optimal nutrition during pregnancy...wish I could have been 100% with it, but sometimes life (and morning sickness!) get in the way!
                  Last edited by kennelmom; 09-08-2011, 10:29 AM.
                  Heather and the hounds - Make a Fast Friend, Adopt a Greyhound!

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                  • #10
                    Originally posted by Jenn View Post
                    Question, I'm about 4 weeks pregnant and am reading a book about traditional foods for mother and baby. It recommends taking brewer's yeast for b vitamins. Is this ok even though it is derived from wheat?
                    Nutritional yeast flakes are better than brewers yeast. It is also gluten free. Or at least Red Star says it is. I have the NOW foods brand right now. I try to add it to sauces when I think it will work well with the flavor. Red Star is another good brand.

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                    • #11
                      kennelmom, your post is so comforting to me! I've had both issues... vegetable aversions and cereal cravings. It's really surprising, since I've been paleo forever. I can still eat some vegetables (carrots and spinach mostly) but others which I usually love, like broccoli and kale, suddenly make me want to gag. I've been trying to convince myself this is okay (and downing my greens supplement and prenatals religiously... hopefully that will cover at least some of the lost nutrients? Pretty please?) And my craving for rice krispies and even bread has been intense... and I haven't had either in years!

                      I guess I'm struggling with my own CW. I believe I am really in tune with my body. Pre-pregnancy, paying attention to my body and listening to what it wanted always steered me in the right direction. Do I suddenly throw that out the window because my crazy pregnant body obviously doesn't know what's good for it? Or do I eat the darn rice krispies?

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                      • #12
                        Oh yes...I used to eat leafy greens 3-4 times a week...I'd eat them every day but the hubs gets tired of them. Got pregnant and no way, not happening. Collards, kale, spinach...pretty much any green makes me gag. Fortunately, all other veggies are still acceptable. Eggs were out for a while, now they're back in. My body is like some weird alien body lately! LOL

                        The first few "cheats" from primal that I had were REALLY stressful...I was like: OMG, I'm a terrible mother! My baby is going to be made of GLUTEN! LOL But, sometimes you just have to eat what you can eat. I'm still probably 70/30 primal...that's pretty darn good I think. And, I agree, if you were in tune with your body before, I'd still listen to what it's telling you. Nature's got the pregnancy thing down pretty well.

                        eat the darn rice krispies As long as that's not ALL you eat, you'll be fine. I swear my baby loves enchiladas.... LOL
                        Heather and the hounds - Make a Fast Friend, Adopt a Greyhound!

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                        • #13
                          As a mom who suffers from the most extreme form of morning sickness, hyperemesis gravidarum, and now as a volunteer who helps pg women survive this illness, I have a few throughts on this. (Oh, and shout out to the Zofran user -- 2 of my 4 babies are Zofran babies, maximum dose every day for 9 months saved our lives.)

                          First, your doctor is right, and so are the posters here who say preconception nutrition is very important. During the first trimester the fetus can properly form on an extremely limited diet -- or even no diet at all -- if the mother is hydrated enough and if the mother's own systems are not shutting down.

                          I get kind of ticked when docs blow off treating extreme morning sickness because "baby will get all he or she needs." Sure -- unless mom's heart, kidneys or liver stop working properly due to malnutrition. It happens.

                          The dangerous part for baby is second trimester. I know many, many women whose babies basically starved to death in second trimester, because mom's reserves were depleted (losing 40 lbs in 3 months while pg will do that) and there was simply nothing left for baby to suck off mom -- and she still wasn't able to eat or drink.

                          This is why it is imperative any women with severe morning sickness symptoms get treatment immediately, rather than "waiting and seeing." She may pull through T1 with baby intact, but a severely depleted mom in T2 means possible death for baby, possible death for both, or long-term health impacts for mom or baby or both.

                          If you, or someone you know or love, is pregnant and throwing up excessively, can barely eat or drink, etc -- you need help and right away. Ginger will not solve that.

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                          • #14
                            Thanks cin. That is such good advice. I also developed hyperemesis and ended up on Zofran... it is such a nightmare and unfortunately most people have no idea how bad it is. We finally announced the pregnancy to our family and friends, and my mother was horrified that I am taking a drug for nausea... she's thinking thalidomide. I got the whole "everyone gets morning sickness, this is not the time to be selfish, you need to think about the baby now" speech, and I wanted to cry.

                            Thankfully she called a nurse friend with her worries about my "taking drugs," and she set her straight in no uncertain terms about hyperemesis! It is not feeling a bit icky and puking once or twice in the mornings. It is hell on earth. With Zofran I can eat, drink and function. I have no doubt anymore that it was the right choice to take it. Your post is absolutely spot on, and I'm sorry you had to go through this too!

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                            • #15
                              Originally posted by kennelmom View Post
                              Oh yes...I used to eat leafy greens 3-4 times a week...I'd eat them every day but the hubs gets tired of them. Got pregnant and no way, not happening. Collards, kale, spinach...pretty much any green makes me gag. Fortunately, all other veggies are still acceptable. Eggs were out for a while, now they're back in. My body is like some weird alien body lately! LOL

                              The first few "cheats" from primal that I had were REALLY stressful...I was like: OMG, I'm a terrible mother! My baby is going to be made of GLUTEN! LOL But, sometimes you just have to eat what you can eat. I'm still probably 70/30 primal...that's pretty darn good I think. And, I agree, if you were in tune with your body before, I'd still listen to what it's telling you. Nature's got the pregnancy thing down pretty well.

                              eat the darn rice krispies As long as that's not ALL you eat, you'll be fine. I swear my baby loves enchiladas.... LOL
                              OMG, thank you for your positive attitude! I am pregnant right now and have nausea in the morning. I have to eat something and lately I have been eating rice krispies because that's the only thing I can tolerate! I feel better after eating it and then focus on protein and good fats the rest of the day. And while I still do focus on primal, I am being more lenient with myself. I did have a slice of artisan 3-day fermented sourdough with Kerrygold butter and felt like a horrible mom for poisoning my child with gluten. But then I realized the worry was probably worse than the damn bread.

                              I am also a physician assistant student (currently on my surgery rotation) and am not really able to eat between 5:00 a.m. (when I get to the hospital) and about 2:00 p.m. (after the morning surgeries are over). I admit that granola bars from Trader Joe's will likely save my sanity for the month. I'm trying to eat clean and organic as much as possible. I will do what I can do.

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