Pregnancy: when is nutrition most important? page

[paleo_hailey]

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

[mamagault]

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.

[Mrs. Griffin]

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.

[hazyjane]

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

[emmie]

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.

[Jenn]

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?

[Dragonfly]

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.

[Dragonfly]

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.

[kennelmom]

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!

[wendyland]

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.