Pregnancy Complications II
Quitting Your Bad Habits
Health And Nutrition
Working While Pregnant
Being A Stay-At-Home Mom
The Baby Shower
All About Feeding
Cord Blood Banking
Trouble Getting Pregnant?
Is It Safe?
Looking & Feeling Good
Naming Your Baby
Caring For Your Newborn
Baby Boot Camp
Sex & Pregnancy
Getting Good Sleep
Twins and Multiples
Health And Nutrition: How To Optimize Your Body For Your Baby
Our Experts In This Episode
Dr. Michael Broder wrote the book The Panic Free Pregnancy. He is also an Assistant Clinical Professor of Obstetrics and Gynecology at the David Geffen School of Medicine at UCLA.
Dr. Laurie Moyer-Mileur is a nutritionist and an Associate Professor of Pediatrics at the University of Utah. She is also the Director of the Center for Pediatric Nutrition Research.
Cynthea Denise is a Prenatal Yoga Instructor and a Registered Nurse in Oakland, California.
Welcome to your Pea in the Podcast. I'm Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life as you begin your journey as someone's mom.
This week, it's all about what you eat...
"Good nutrition or a well-balanced diet is essential for normal fetal growth and development."
And getting up off the couch...
"Increasing your level of activity during pregnancy reduces your risk of gestational diabetes and it also makes you fit for delivery."
A nutritionist, an obstetrician, and a nurse-turned-prenatal-yoga-instructor help you get healthy in this Pea in the Podcast.
Now that you're pregnant, you know you're eating for two, so one of the main things on your mind is probably nutrition.
"It's probably one of the most important things a mother can do for her developing fetus. Good nutrition or a well-balanced diet is essential for normal fetal growth and development."
For many of you used to eating on the run, good nutrition may be a somewhat foreign concept to you. Dr. Laurie Moyer-Mileur is Director of the Center for Pediatric Nutrition Research at the University of Utah School of Medicine and she runs down the basics of good prenatal nutrition.
"It's getting your foods from a variety of sources, so not limiting it to one particular food source, trying to avoid high-fat foods, incorporating more whole grains into your diet, fruits and vegetables, using good quality protein sources, consuming dairy and limiting your consumption of fats and sweets."
All foods aren't created equally...
"If they can concentrate on good quality proteins and consuming fresh fruits and vegetables that that will give you a source of not only your protein but also a lot of good vitamins and other nutrients that when you are eating something that is fresher if you're avoiding processed foods then you're not actually having to worry about things that have been overcooked and having the nutrients cooked out of them."
Okay, so what does that mean? According to the March of Dimes, when you're not pregnant you should be eating two to four servings a day of fruit and three to five servings a day of vegetables. If they’re fresh, even better. Whole foods are chock full of nutrients. If your veggies are overcooked, as Moyer-Mileur mentioned, a lot of the good stuff is cooked out of them. You should have 6 to 11 servings a day of grains, preferably whole grains. The March of Dimes also suggests three to four servings of milk products and three to four servings of proteins. Moyer-Mileur says there are a variety of good sources for protein.
"Chicken, fish, meats, peanut butter, cheeses and eggs and yogurt are good as well."
Most women will also supplement their diet with prenatal vitamins, and it's not a bad idea.
"You probably just need a good multi-vitamin that has an additional amount of iron in it. Iron needs are increased during pregnancy so that a mother can increase, her blood volume is going to increase to support the pregnancy, so you want to make sure she doesn't become anemic and sometimes it's hard to take in enough iron from food. So you want to make sure that you're getting additional iron and that also the vitamin has sufficient folate."
Folate. Folic acid. You've probably seen some public service announcements urging all women of childbearing age to make sure they're getting enough of it. So what's the big deal?
"The concern there is that it has been well-documented that women who are deficient in folate during their pregnancy have a higher incidence of infants who are born with neural tube defects and so by just adding folate to the diet you can prevent this birth defect."
A neural tube defect you may have heard of is spina bifida, which occurs when a fetus's spine does not close properly during the first month of pregnancy. While this opening can be closed after birth surgically, there's usually permanent nerve damage, which can result in paralysis, so folic acid before and during pregnancy is essential.
Now you know what you should eat. What shouldn't you eat? Dr. Michael Broder is an obstetrician at UCLA and the author of the book The Panic Free Pregnancy.
"The CDC has recommended that women avoid certain foods while they’re pregnant mostly because of the risk of listeria, which is a relatively uncommon infection, but one of the few that can cross the placenta and infect the fetus. So there's some, like cold lunch meats and, for example, lox -- cured salmon -- that can carry listeria, so that's probably on the "avoid" list, and some soft cheeses, as well, so the blue vein cheeses, in particular, are not a good idea, but even things like brie can occasionally have listeria, so generally that's not recommended. So soft cheeses, but other than that there's not really much."
There are warnings related to fish, and it's all about mercury. Mercury can cause serious health problems for your baby and it can be found in many types of fish including swordfish, shark, king mackerel, and tile fish and even tuna. You need to eat these in moderation. But what about the Omega-3 fatty acids found in these fish? Researchers have found evidence that babies born to moms with higher blood levels of the Omega-3 fatty acid, DHA, at delivery, well, they had better attention spans, and that advantage remained well into their second year of life. There's also evidence that Omega-3’s are beneficial to your baby's brain and eye development, so if you're limiting fish what do you do? I took a prenatal fish oil supplement and Moyer-Mileur says, well, that's a good alternative.
"Any concern that a consumer might have about mercury levels really doesn't seem to be a problem when looking at the mercury content of supplements. It's fairly negligible or non-detectable and so really taking the supplement should be fairly safe."
Dr. Broder says you should be careful about how you handle food while pregnant. For instance, unsafe handling of eggs can increase the risk of salmonella contamination.
"But if you prepare eggs, you know, wash your hands, and actually salmonella infection rate of eggs has dropped dramatically over the last few years in the United States, so that's probably even less risk. Then there's E. coli, which you can get in some meats, particularly hamburger, and you know the solution there is just cook it to medium. And the risk of E. coli infection is really in the mother only, so it's something that's not pleasant but it's not any particular, it's not particularly more dangerous while you’re pregnant."
But, generally, the placenta is a pretty good protector for your baby, you don't have to be too concerned about anything you eat causing allergies, but Dr. Broder says there may be an exception worth noting.
"There is definitely reason to think that women who eat peanuts during pregnancy are more likely to have a child with a peanut allergy. In fact, it's one of the theories about why there's been such an increase in the number of kids with peanut allergies over the last few years and so I think it might be worth avoiding, you know, during pregnancy if unless you're a vegetarian and that's a primary source of protein and then again you just have to weigh the risks and benefits."
As you progress through your healthy pregnancy, you're going to gain weight.
"Well currently it's recommended that you gain somewhere between 25-35 pounds during pregnancy. Now if a woman is underweight prior to conception she may need to gain a little bit more. She may need to be gaining at the upper end, 35, maybe even 40 pounds. If a woman is overweight at the time of pregnancy she may want to limit her weight gain to the lower end of the range, so keep it around 25 pounds."
For some women watching the numbers on the scale go up is extremely difficult. Some moms-to-be are even tempted to diet during pregnancy. Don't.
"Well, certainly we know that mothers who don't consume enough energy have infants that are born very small for weight and that would, babies born with smaller weights may have had less brain growth and so you may not have reached their full genetic potential as far as intellect or cognition. Women who have limited protein intake have infants who are smaller. Women who have not consumed adequate levels of folate may have infants who have developed a neural tube defect and women who don't consume enough iron during pregnancy can become anemic and there is some concern that women who are anemic during pregnancy that their anemia itself will affect the fetus’s brain growth."
Moyer-Mileur tries to refocus women in her practice who are struggling with this.
"It's really important to stress the importance of good nutrition and the importance of actually having adequate weight so that the fetus is healthy. And I think if you can really turn it from what her body looks like, because every body it is very kind of, it is very hard to watch your body go through those changes but to really focus on having a healthy fetus and a healthy outcome, is probably the most important thing."
So don't diet, okay? But do exercise.
"They talk about smoking as the single worst thing that you could do for yourself during pregnancy, exercise is the single best probably."
Dr. Broder says the benefits of exercising while pregnant are worth talking about.
"Pregnant women have an extra incentive to stay active. Increasing your level of activity during pregnancy reduces your risk of gestational diabetes and it also makes you fit for delivery. And, you know, it's sort of an old joke but why do you think they call it labor? You know it is a lot of work to have a baby and the more you've prepared for that work, the easier it is and being physically fit is about the best thing that you can do to prepare."
Moyer-Mileur agrees with Dr. Broder.
"Labor is like running a marathon and so, you know, you need to train for marathons, you should be preparing for labor in somewhat the same way and I'm not talking about excessive exercise. If somebody can take a walk for 30 minutes a day that is going to be very beneficial for them."
Exercising is good for you...
"Well, it's going to not only prepare them for delivery but also minimize the risk of them developing gestational diabetes, help with maintaining a normal blood pressure and also help with alleviate or minimize problems with constipation, especially if they’re drinking adequate fluids and they have, you know, taking in adequate fiber but exercise as well will help, help minimize that as the risk of constipation or the constipation symptoms as well."
...and exercise is good for your baby.
"There is some recent research that suggests that exercise helps to promote brain development in the fetus. Now the latest work is from an animal study in mice and so how that translates to a human fetus isn't probably as well known, however there are studies that show that women who do exercise during pregnancy have decreased levels of stress and there are studies that show pregnant women who have increased stress affects brain development in the fetus, so the fetus does respond to maternal stress so if you can decrease maternal stress, say through low impact exercise than that's a benefit again to the fetus."
So what type of exercise is best for a pregnant woman?
"The best type is the kind you're going to do. It really doesn't matter too much what you do as long as you do something. For example, if you are a bike rider, you will hear a lot of advice that late in pregnancy you shouldn't ride a bike because your balance might off. But if you're a bike rider and the exercise that you're going to get is riding a bike then all you have to do is get yourself a stationary bicycle when you feel uncomfortable on a regular bike, so that's perfectly safe and a good thing to do. Runners can run, swimmers can swim, golfers can golf. It really, really just about anything, I mean sky diving is not one I recommend, scuba diving, either, but other than that you know you're, it's pretty safe."
And Dr. Broder says if you've been sedentary your whole life until now, well that's no excuse to remain on the couch.
"Anybody can exercise, get up and walk around the block and the next day walk around twice."
Moyer-Mileur says it doesn't take much to make a difference in your health and in your baby's development.
"We're not asking them to become an athlete, but surely if they can take, you know, the time for 30 minutes a day just to take a walk, even if you know if they’re working, if they can just take a walk around the building where they work or within the hallways so they're up and moving and getting more circulation going."
And you might want to consider prenatal yoga.
"Well, yoga is a very good exercise during pregnancy and actually helps with relaxation as well as muscle tone and so it can be a stress reliever as well."
Cynthea Denise is a Registered Nurse and prenatal yoga instructor. She suggests signing up for a class.
"If it's a class that practices often, then she can begin to strengthen the floor of her pelvis through some of the work that we do in class, and perhaps even more importantly, a woman gets in touch with her breath in a way that she might not normally do in her day-to-day life, and so becoming aware of how you breathe, how you’re emotional, your emotions can effect your breath, how your thoughts and thinking process can effect your breath. So it puts a woman in touch with her breathing and she can begin to develop some tools of learning how to breathe more deeply and be calm."
You may think that strength training may offer the greatest benefit for a woman training for the marathon of labor, but Denise says that actually comes in second.
"The women who come to my class regularly -- like, there are many women that start in the first trimester and come throughout the pregnancy -- those women I would say almost, at least 90% of them will e-mail me after they have the baby and say the greatest benefit that they got was their ability to stay with their breath and use their breath to help them to focus and to shift their attention away from the intensity of the contraction and just stay with the breath, realizing that the contraction was going to stop at some point."
But the benefits of the strength training of yoga are very real. For example, as you strengthen the pelvic floor, you'll be strengthening your kegel muscles. Your kegel muscles?
"They’ll know what they are because, you know, if you have to use the bathroom, you'll start to contract there to avoid from peeing in your pants, basically, so they have an idea. So what I often tell women to do, they'll say, ‘well, I know my kegel muscles aren't very strong’ and I’ll say, ‘well, every time you have to urinate, then you practice stopping your stream several times throughout,’ and that can really start to give her some idea of where those muscles are."
And the cool thing about exercising your kegel muscles is you can do it anywhere and nobody can tell you're doing it. Stronger kegel muscles may help keep two embarrassing problems of pregnancy at bay, bladder leaks and hemorrhoids; they may also help you avoid an episiotomy or a tear. Yoga also helps you have faith in yourself as you endure the discomfort of pregnancy and then labor.
"If you prepare yourself and you begin to grow strong in your body you think, ‘oh, okay I did this in yoga class I was able to sustain this pose for, you know, a minute and a half, so if I can do that in class then I can allow my body to endure this strong contraction for a minute or a minute and a half’ and really encouraging women to stay present instead of thinking, ‘okay I’ve got another, who knows how long it's going to take?’ but just keep with the breath and keep with one contraction at a time allowing their body to do what it needs to do."
A pregnant woman should probably not try to go to regular yoga class, there are certain things you should not try to do.
"Avoid deep twisting and then inversions as well when she's well into her second and third trimesters because both of the inverted poses and deep twisting can compromise the blood flow to the baby so if you start to twist deeply you can see or you can have a sense that you could compress major vessels that are supplying the placenta so you want to avoid those things and the rest of the time I just encourage women to listen to their bodies."
And learning to listen to your body may be the most important lesson of all.
"Women often really come home to their body, if you will, during their pregnancy because in pregnancy their body’s cueing them in ways that they're not accustomed to being cued in and so they really start to listen more deeply to their bodies and trust what their bodies are saying as opposed to override. I think it’s easy for all of us to override, the body will say it's tired, it needs to rest and we'll go, ‘too bad, I’m going to drink a cup of coffee and keep going’ and I think that pregnancy is a time when women perhaps stop overriding the cues that their body’s giving them and listen to it more deeply and honor its needs."
Your body will rarely lead you astray as you seek to have a healthy pregnancy and a healthy baby. And Moyer-Mileur says if you get discouraged or overwhelmed...
"You have a need to keep in mind that it's such a great big time in their lives and that they really, you know, it's a good time if they haven't been practicing a healthy lifestyle to start practicing a healthy lifestyle."
And maybe keep those new healthy habits long after the baby is born.
We hope you've enjoyed this Pea in the Podcast: Having a Healthy Pregnancy. Please visit our website, peainthepodcast.com, for more information about our experts, to find links and transcripts, and to register to receive tailored week-by-week shows for each week and stage of your pregnancy. It’s everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I'm Bonnie Petrie, thanks for listening.