I have seen several types of doctor’s regarding my fertility, and then later, my pregnancy, and I truly loved all of them. However, none of them spoke to what to eat when you are pregnant. I know most medical programs require only a few hours in nutrition training, but pregnancy is a crucial time to be choosing the right foods. The only guidance I personally received were a few handouts about what to avoid (the typical deli meat, raw eggs, certain fish) etc. Many of these guidelines are actually extremely outdated and not necessary to be avoided AND can cause women to miss out on important nutrients for their growing babies (more on that to come in a separate blog post). However, I really did not receive anything that even had basic nutrition advice like to eat lots of fruits and vegetables!
I think there is also the general inclination that if you are taking a prenatal, everything is ok. This is flawed thinking for several reasons - 1) not all prenatal vitamins are created equal, some are synthetically created in labs and will act differently in the body than those from whole food sources and different ones just have different nutrient profiles, synthetic or not and 2) you can’t out-supplement a bad diet. A 2019 study of 1,000 pregnant women in the US found that a majority of pregnant women are not receiving enough of certain nutrients despite being on a prenatal vitamin, the most deficient were Vitamin D, Vitamin E, magnesium and iron. By contrast, most pregnant women were getting too much sodium (6). Given that over 75% of sodium intake is from processed food not table salt, it means many pregnant women in the US are eating too much processed food, and relying too heavily on prenatal vitamins that aren’t holding up .
Many people take the 10 months of pregnancy as a free pass to forget nutrition since they aren’t trying to fit into their skinny jeans… so why eat healthy right? This is really unfortunate, and I am not trying to blame anyone. I think most people are genuinely trying to do their best with the information they are given. However, the information they are given is, unfortunately, not very complete. So, I’m trying to correct this by highlighting a FEW of the most important things to consider when eating while pregnant. Please note this blog post is not all inclusive, it is just a few topics that I think are not mentioned enough in the mainstream, so if you are pregnant or looking to become and want to optimize your nutrition, I recommend working with me or someone else on a one on one basis or reading a book about prenatal nutrition or a combination of the above. My two favorite books on the topic are Real Food For Pregnancy by Lily Nichols and Expecting Better by Emily Oster (this second one only has a few chapters on food but it does go into the data behind food borne illnesses and pregnancy so you know what’s actually important to avoid and what isn’t). Hint: a lot of the stuff we are told to avoid is not supported by the clinical evidence!
Vitamin A
It’s important to look closely at your prenatal and your diet to ensure you are actually getting enough of this important nutrient since it can be confusing. Many people think vitamin A is found in beta carotene rich foods (brightly colored vegetables like sweet potatoes, carrots, bell peppers). However, this is actually provitamin A, or carotenoids (5). There is nothing wrong with carotenoids but most people have a very low conversion rate of provitamin A to preformed vitamin A. Preformed vitamin A is crucial for fetal growth and gene development and specifically impacts the heart, eyes, ears, limbs and immune system (7). Lack of vitamin A (this is PREFORMED vitamin A) can lead to serious malformations of the head, face, limbs, and internal organs (8).
So back to where you can get your vitamin A. Since our conversion of provitamin A or beta carotene is low and even lower in individuals who eat a lot of beta carotene (unfortunately, since I am one of those people) (9). I actually had my conversion rate tested and assumed since I ate so healthy it would be high, but actually my healthy eating worked to my detriment since I do not convert much betacarotene into preformed vitamin A so I must eat my preformed vitamin A. Even if you don’t eat a lot of sweet potatoes and carrots, the maximum conversion rate in any human is pretty low so it’s important to get your vitamin A in it's usable form.
I always think the best source for anything is food, preformed vitamin A can come from things like pasture-raised egg yolks, grass-fed beef, full-fat grass-fed dairy and liver (be careful with liver since too much vitamin A in pregnancy can have detrimental effects and this one is the most concentrated sources). But you can also check your prenatal vitamin to see if it says the form of vitamin A. Mine says “vitamin A …. beta carotene, carrot”. This is not preformed vitamin A, I know I must eat some sources of preformed vitamin A, which, is why I’ve made sure to eat properly raised meat and eggs through out pregnancy. You can read more about what to look for in meat in blog post here.
Calories
My personal opinion is that calories oversimplify things. I don’t believe in counting calories as a means of healthier eating ever, let alone in pregnancy. Our bodies are not calculators or machines and there are SO many factors that will impact your overall nutrient need each day. And by the way calories totally ignores nutrients, it just tells you how much energy is required to raise the temperature of 1 kilogram 1 degree celsius… so really calories are not important, but the types of foods we eat are. And then in terms of quantity, I am a big believer of listening to your body. Hunger is a message from your body telling you to eat more. When you are full stop eating. This same principle applies to pregnancy.
Yes, you will need more calories when pregnant. Even when your baby is just a few cells, your body is doing A LOT behind the scenes, so you may experience increased hunger. In these cases, the calorie guidelines can seem too low. Personally, I was hungriest first trimester and was eating more than the “zero” extra calories (1) recommended by the American Academy of Dietetics, but it didn’t seem like the right time to ignore the signals from my body and stay hungry so I did not surpass recommended calorie guidelines.. However, some women experience nausea and food aversions that counteract this hunger in the first trimester. So for these people, the zero extra calories in the first trimester may work. Also each pregnancy is different. So I don’t necessarily think a very specific calorie number (340 calories in second trimester and 450 in third) is helpful (1). Like I said, each day is different and counting calories can be tedious and distracting from making healthful food choices.
Long story short, I don’t think anyone should get too hung up on the calorie guidelines during pregnancy (or ever). I will repeat it again, we are not machines or calculators and there are too many factors to count that will impact our daily nutrient needs. A much better policy, is to focus on getting a diversity of real whole foods that will nourish ourselves and our growing babies and to listen to the signals our amazing bodies will give us!
Carbohydrates
This is the only non-essential macronutrient. There are three macronutrients - carbohydrates, proteins and fats. Of these three, there are essential amino acids (which are the building blocks of proteins), essential fatty acids (fats) but no such thing as essential carbs (2). Essential nutrients are ones that your body cannot produce itself, but needs to survive. I am not saying everyone should go 100% carb-free, or even low carb. However, there are lots of non-nutritive carbs in the modern diet. So I am definitely saying be wary of these. And also noting that if you don’t include as many carb-dense foods, it won’t necessarily be detrimental.
One of my favorite colorful, unprocessed ways to get carbohydrates and load it up with fat, fiber, protein and other nutrients is sweet potato toast. Recipe is on my website!
In fact there is lots of data to support that too many carbohydrates can have detrimental outcomes for pregnancy. Most people know about gestational diabetes as one of these risks but there are risks even before women reach the gestational diabetes threshold. I think processed carbohydrates are overemphasized during pregnancy, which, inevitably crowds out more nutrient dense items from people’s plates and causes chronically spiked insulin levels (which, is problematic even if one does not have gestational diabetes). As my clients and those who follow me closely know, I always recommend colorful carbs first (carbs that come from whole foods like fruits and vegetables) since these are rich in phytonutrients (vitamins, minerals, antioxidants etc.) and are naturally paired with fiber. I also recommend avoiding “naked carbs” to help manage blood sugar, by pairing carbohydrates with a quality protein and/or a fat. You can read more about this in my balanced plate blog post here.
Now, back to what can happen when you don’t manage your blood sugar in pregnancy. Reminder: the food that will impact blood sugar/insulin the most is carbohydrates, so you can manage it by choosing whole foods carbs and pairing them with protein, fat and fiber. A 2015 Stanford University study that shows that elevated blood sugar far below the threshold for gestational diabetes is linked to significantly higher risk of congenital heart malformations in the babies of those mothers (3). Another study shows that high insulin levels in early pregnancy were linked to significantly higher risk of neural tube defects in babies (4). A higher carbohydrate diet during pregnancy is also linked to a higher risk of developing gestational diabetes, preeclampsia (high blood pressure), gall bladder diseases in pregnancy and for your baby to grow unhealthily large (macrosomia) and increases baby’s chances of having heart disease, diabetes and impaired lung development (5). A little processed carbs won’t kill you or your baby or give you a completely unhealthy baby. I don’t think it’s a good use of time to stress about every morsel that goes into your mouth. However, I do think we need to all take our carbohydrate consumption during pregnancy a little more seriously given that they are non-essential, so there is in’t a minimum required for life AND there can be detrimental outcomes of eating too many, especially of the non-nutritive ones.
My favorite sources of carbohydrates for anyone, pregnancy included, are COLORFUL whole foods sources. Whole foods means unrefined carbohydrates as close as possible to their original source. So if you look at the label on whole wheat bread, there are usually 20 plus ingredients and each of those ingredients may be processed. That’s not necessarily very close to the source. However, if you look at a sweet potato or some lentils those ARE the original source so they are great whole foods carb sources. And nature is so smart it filled these foods with nutrients that are important for the developing baby. The things that gives fruits and vegetables their colors also have so many health benefits. The phytonutrients are what gives these fruits and veggie carbs their colors (and yes white is a color so I’m pro potatoes, cauliflower, coconut, garlic etc.) Plus, the less processed the carb, the more it will allow your blood sugar to remain balanced (which means it is less likely to cause the complications mentioned above with gestational diabetes or really just high insulin variability even before GD kicks in. So moral of the story here is to choose your carbs wisely (whole foods carbs) and if you don’t choose to eat that many every day, you may just be fine, as long as you are eating enough overall since carbohydrates are not essential.
Choline
One of my favorite choline-rich meal prep recipes is my easy frittata! This is a version of the one on my website in the recipes section.
This nutrient is very often forgotten or not mentioned when it comes to prenatal nutrition but it is extremely important. Choline is required for fetal brain development, prevents neural tube defects and helps with placental function (23). In fact, some of its functions are actually similar to folate, which is commonly discussed, however, choline is rarely discussed.. One of the best sources of choline, and my personal favorite is egg yolks. Beef liver is also rich in choline. However, it is very hard to get choline from a plant-based diet. The recommended minimum of choline in pregnancy is 450 mg a day. One egg with the yolk provides 115 mg, by comparison 1/2 cup of cooked pinto beans, brussels sprouts, or broccoli provides 30 mg (30 mg). So you could have 4 eggs with yolks and get to your daily choline requirement, or have 8 cups of broccoli, pinto beans or brussels sprouts. I LOVE broccoli and that even seems like a lot to me. Feel free to get your choline how you want, but in my opinion it is easiest to get enough choline when eating animal foods. I also specifically picked a prenatal for myself that contained some choline as insurance for if I’m not eating 4 eggs a day, which let’s be honest, I definitely do some days (I LOVE eggs), but there are days I don’t eat any eggs.
Although 450 mg is the minimum required amount of choline (I made sure to find a prenatal that includes choline, this is honestly pretty rare!) and also ate a lot of eggs during pregnancy (those who follow my social media probably noticed this), studies have shown that the optimal amount of choline is more than 900 mg per day. This level is specifically beneficial to fetal brain development and placental function (24, 25). A 2018 randomized, double-blind, controlled study (AKA the gold standard when it comes to clinical studies) tested the effect of a prenatal diet containing 480 mg of choline per day compared to a diet of 930 mg per day on infant brain development. The infants of mothers who were given both the 480 mg and 930 mg choline per day during the third trimester were tested at 4, 7, 10, and 13 months of time for visuospatial memory and information processing speed. The infants born to the mothers who got 930 mg of choline per day had significantly faster reaction times at all four age testing intervals (26), thus showing that perhaps our current choline guidelines are not enough or mothers do fine with the current choline recommendations but would do better with more choline.
Vitamin D
Here I am shading myself from the sun (so therefore reducing my vitamin D exposure) and hence why supplementation is often necessary. I’m also snacking on nuts and fruit! Great, portable, unprocessed combo that hits PFFP.
Most prenatal vitamins only contain about 400 IU of vitamin D but at this level most pregnant women are still deficient in vitamin D. 40-60% of the pregnant population in the US is deficient in vitamin D (6, 10). That’s a lot! So additional supplementation clearly seems necessary or making sure to eat lots of vitamin D rich foods (or both). Studies have shown that 4,000 IU of vitamin D daily is ideal for both mother and baby during pregnancy (11). Unfortunately so many of our modern diet resources tell us to avoid naturally vitamin D rich foods (ex: eat only low-fat dairy when vitamin D is a fat soluble vitamin and will be more bioavailable and present in full fat dairy, or eat only egg whites even though the yolks contain the fat necessary to absorb vitamin D and vitamin D itself). But by sticking to a more whole foods based way of eating we can make sure we are getting more usable vitamin D, whether we are pregnant or not. I consider full fat dairy to be more of a whole food than reduced fat, since they replace the fat with sugars, chemicals etc. and it decreases the nutrient value of things like vitamin D, and same with eating whole eggs vs. egg whites.
Since vitamin D is so important for the mother’s health, and there are increased needs during pregnancy, it is related to immune function, healthy cell division, bone health, metabolic function, insulin sensitivity, good sleep and brain health and has even been shown to be preventative for many types of disease such as cancer (11). That being said vitamin D is super important for mama and she has increased needs because baby is taking some, so I don’t think 400 IU cuts it!
Another factor to consider when thinking about vitamin D, is vitamin K2 since vitamin K2 will impact the absorption of vitamin D and also vitamin A (all fat soluble vitamins). Vitamin K2 is different from the plant form of the vitamin (vitamin K1) which does not help with vitamin D and calcium absorption and therefore bone health in the same way. Vitamin K2 is important for mineral metabolism in the body (making sure all the minerals get to the right place, i.e. making sure baby’s skeleton, teeth etc. are all formed correctly and are strong!) It is also important for mother’s bone health and if she does not have enough to provide for baby, her body will leech vitamin K2 from her bones and tissues to give to baby, which, is a good thing for baby but can leave mom with all sorts of complications postpartum, like maternal osteoporosis (5). So the solution here is to get a vitamin D supplement that also includes K2 (I like this one) and/or eat vitamin K2 rich foods such as full fat dairy, egg yolks (yep the same ones that include vitamin D, how smart is nature!?), liver, grass-fed butter and ghee, grass-fed beef, dark chicken meat (12). Finally, vitamin D can be absorbed from the sun. However, if you live somewhere with short days part of the year and do not spend the majority of your day outside and/or avoid sun exposure, you can’t rely on the sun for your vitamin D. Again, I’d look at your total intake and assess how much supplementing you think you will need, but most people need at least SOME.
Omega-3 Fatty Acids - DHA
One of my favorite meals during pregnancy was salmon with zoodles and my avocado pesto (SO creamy and decadent!) Recipe for the pesto is on my website. This salmon is Sizzlefish of course! See link and discount below.
There are several types of omega-3 fats: ALA (the plant-based form), EPA and DHA. DHA is by far the most important for brain health and baby’s and toddlers brain development, in fact the plant-based form has almost no impact on baby’s brain development because the conversion into the usable form of DHA is so low (5). These important DHA fatty acids are found almost exclusively and most prevalently in wild caught seafood. Unfortunately, many pregnant women have been told to avoid seafood or to limit it to very small amounts. The reasoning behind this is mercury toxicity which could be a very harmful neurotoxin, however, if you are smart about your fish consumption this should not be an issue (more on this below). Avoiding fish can have a detrimental effect on their baby’s developing brain. A study of over 1,200 mother-infant pairs looked for a correlation between fish consumption and IQ and eating over 12 oz of fish per week correlated strongly with the baby’s with the highest IQs and actually the babies with the lowest IQs came from mothers who consumed no fish at all (13).
Well if mercury is a neurotoxin and some fish contain mercury, how can eating fish be good for you? First of all, fish are also naturally high in selenium (even more so in their raw form so the sushi off limits thing does not make total sense either but again that’s another blog post). Selenium helps the body detox mercury (14). Mother nature at it again with how amazingly smart she is! So the net effect of any mercury should be minimal especially if you are choosing the right type of fish. Fish to avoid:
Farm-raised fish, these are usually given antibiotics and hormones that you and baby don’t need in your body, and also can be hosts to antibiotic resistant bacteria that can be harmful (15, 16, 17). Additionally, farm raised fish are also proven to have higher levels of mercury than wild-caught fish.
High mercury fish like tilefish, king mackerel, swordfish and shark. The amount of mercury is pretty directly correlated to the size of the fish and if it was wild caught or not (5).
What about tuna? Skipjack is one of the smallest kinds and therefore contains way less mercury, this is mostly what I ate during pregnancy. Larger breeds like bluefin and albacore have much higher mercury ratings (22), the recommendation is to keep this to less than 6oz a week. Also wild caught is still important here! That will greatly reduce mercury amount.
More Sizzlefish wild caught salmon, cooked with avocado oil and Trader Joe’s bagel seasoning (another one of my fave combos)
Now, back to why DHA is so darn important! If the study above didn’t convince you that DHA helps the baby’s brain develop and have a higher IQ here are some more facts. DHA is incorporated into the rapidly developing brain and eyes of the fetus in utero where it forms neurons (brain cells) and protects the brain from inflammation and damage (18). It is crucial during pregnancy, and remains crucial during the first two years of life. If you are planning to breastfeed, it is important to get enough DHA since the amount of DHA found in breast milk is directly correlated to mother’s consumption (19).
So where to get your DHA? Personally, I have been eating a lot of wild caught salmon. Not only is it delicious but it’s loaded with DHA. It’s the top pregnancy-safe fish source of DHA (20). I like to order mine from Sizzlefish (code PRESS10 to save 10% on any non-subscription order). Other good sources of DHA are trout, oysters (these should be completely safe during pregnancy if from a reputable source (21) but if you don’t feel comfortable I totally understand, cod and other smaller whitefish, sardines, shrimp. Some of these are also available on Sizzlefish if online ordering is your thing (it’s mine). I also have been eating low mercury tuna as I mentioned, like skipjack and also have been keeping this to wild caught.
Folate vs. Folic Acid
You have most likely heard of folate and/or folic acid and the importance of this nutrient in preventing neural tube defects in the baby. Folate deficiencies can also lead to problems in mother's during pregnancy too (like anemia and peripheral neuropathy) (30, 31). Most sources suggest supplementing at least 3 months before you plan to get pregnant. This is one nutrient that supplementation is definitely necessary for since folate in foods diminishes the longer they are on the shelf, and the needs during pregnancy are high. However, many practitioners do not distinguish between folate and folic acid. And the truth is, these two are not exactly the same thing, as you may have been told.
Folic acid is the synthetic form of folate. The fact that is synthetic is not the problem, it's the fact that most people's bodies just can't use this synthetic version quite as well. In fact, 40-60% of the population can't convert folic acid properly to folate. And with this being such an important nutrient during pregnancy, I'd say use the most bioavailable (usable) form for your body and baby. Additionally, unconverted folic acid in the bloodstream may also cause problems (29). So if you are among the half of the population that does not convert it well, not only might your baby not be getting enough folate, but you might run into other problems for your own health.
Some of the best food sources of folate are dark leafy greens like spinach, lentils, beef liver and some nuts and seeds. However, like I mentioned, we actually need about 800 mcg per day during pregnancy, which would mean several cups of one of the above foods (29). This is also assuming those foods kept all their folate content, which, is rare unless you are picking the spinach right from your garden with perfect soil. So what should you look for in your prenatal vitamin? Look for folate, not folic acid, but also make sure that folate is not misrepresented. Sometimes it says “folate” with an * that says something like “as folic acid”. So it’s really just the synthetic form. Other terms for folate that you may see on a prenatal or another supplement are: L5MTHF, Methylfolate, 5-MTHF, Quatrefolic (a brand name of methylfolate). For instance, the prenatal I take says “Folate… L-5-MTHF as broccoli”.
Glycine
Glycine is conditionally essential during pregnancy. This means that when you’re not pregnant your body may be able to make enough glycine to support your bones, skin, nails, dental health & gut lining on its own. During pregnancy, this changes. Your body’s demand for this amino acid increases so much that you must consume glycine from food sources to support a healthy pregnancy. While there is no RDA for glycine, researches estimate that the minimum amount of glycine needed in the diet (this is in addition to what your body is able to make itself) for non-pregnant adults is 10 grams or 10,000 mg (27, 5). So even when you are not pregnant, it's advisable to eat glycine-rich foods in addition to just relying on your body's natural production.
I have been sneaking in collagen peptides (one of the best sources of glycine) EVERYWHERE. Especially places like home-baked goods. I made so many loaves of my no-sugar added paleo banana bread and would usually put about 1/4-1/2 cup of collagen in each batch. Recipe is on my site!
During pregnancy, glycine supports the growth of the baby’s teeth, internal organs, skeletal system, hair, skin, nails and is important for mama’s growing uterus and placenta and stretching skin. Glycine is the simplest amino acid structure so it serves as the building block of SO many parts of our bodies and our fetuses. It is also an important metabolic precursor (28). Since glycine is a structural amino acid, found mostly in connective tissue, skin and bones, it’s not actually contained in high amounts in most usual animal protein sources such as muscle meat, and is contained in very low concentrations in any form of plant-based protein. The best sources for glycine are connective-tissue based which may not be a part of everyone's diet.
My favorite source during pregnancy was a grass-fed collagen protein supplement (I actually take this when not pregnant too since it is one of the best ways to support a healthy gut and your own connective tissue - skin elasticity, nails etc.). I use Further Food (code START10 to save). Another great source is bone broth, since this is made by soaking connective tissue (bones and ligaments) it will contain some of those amino acids. Also eating any animal connective tissue is also a great source, for instance pork rinds or eating chicken or fish with the skin on will give you some glycine.
Magnesium
About half the American population is deficient in Magnesium (31). So I think we ALL need to consider this mineral a little more, not just pregnant people. As I mentioned previously, magnesium was one of the top nutrients that pregnant women who ARE on a prenatal vitamin supplement are still deficient in(6). Additionally, women with gestational diabetes are more likely to be deficient in magnesium. Magnesium deficiency can also be made worse in the presence of excess calcium and this combination can make pregnant women more susceptible to conditions like preeclampsia (32). I think the importance of calcium is often over-emphasized at the detriment of magnesium. Magnesium is also essential for many metabolic functions, nerve and muscle communication, protein synthesis and and regulations body temperature (36). These functions are all important in pregnancy or not but pregnancy is a good time to get your ducks in a row, since postpartum can be a little hectic and adding a magnesium supplement to your regimen may not be top of mind.
This picture doesn’t have much to do with magnesium but pregnancy overalls are the best and so is Claudette the frenchie!
Magnesium has particular importance during pregnancy. It helps reduce muscle cramps during pregnancy, reduce the risk of high blood pressure/hypertension and preeclampsia in pregnant women. Magnesium supplementation has been shown to reduce or prevent these medical complications in over 50% of those who supplemented with additional magnesium (33, 34). Magnesium can also prevent fetal growth restriction and prevent small for gestational age babies (35). A 2017 study showed that pregnant women who supplemented with 200 mg of magnesium daily had significantly lower risk of numerous complications including: intrauterine growth retardation, preterm labor, maternal body mass index (BMI) that was too high, neonatal weight, pregnancy-induced hypertension, preeclampsia, gestational diabetes mellitus, cramps (36).
Anecdotally, I have been supplementing with magnesium glycinate (there are many kinds of magnesium so I would check with a practitioner to see which one is right for you before supplementing) orally since the beginning of my pregnancy, and have not experienced any of these symptoms. The nausea was to my particular surprise. I’m not sure if the magnesium is the cause of my minimal nausea during the first trimester, but I’m sure it didn’t hurt. Now that I am in my third trimester and it’s the middle of summer and my feet and ankles are swelling, I have been using magnesium topically in the form of a lotion in the evenings on my feet.
Probiotics
Probiotics are the “friendly bacteria” that live in and on our bodies (no they are not a traditional “nutrient” like many of the other things we discussed but they are still very important for prenatal, or any health). They actually outnumber our own human cells (and genes) in a 10:1 ratio. So we are 90% probiotics. Whoa, that’s a lot. Many of these good bacteria, funghi and single-celled organisms live in our digestive system, but they are also on our skin (our largest organ), our mouthes and in our vaginas. So they will have an impact on far more than just gut health. They impact our skin (acne, exema, rashes can all be because of probiotic dysbiosis or imbalance), our oral health (these play a huge role in propensity to get cavities and other oral diseases or not) our vaginal health (yeast infections are also when the bad bacteria outgrows the good bacteria), and of course our digestive health (everything from our metabolism, how many nutrients we are able to extract from food, how many calories we extract from food, whether we have bloating, gas, constipation, diarrhea etc.) These, among other reasons I will discuss below, are all great reasons to make sure our bacterial population are in balance.
This bowl I ate on our baby moon in Ojai, CA was loaded with probiotics (there were several types of fermented veggies in there and not to mention all the different colors) and other pregnancy-friendly foods (hello grass-fed bison burger).
Shockingly, this is another supplement that I have heard many prenatal practitioners say is “not safe” during pregnancy. There is no clinical evidence to show that probiotics are not safe, and in fact they are extremely important during pregnancy. I would say, don’t go taking a “homemade probiotic” from an unreputable source, but other than that, make sure you are getting a good source of probiotics. This is another one I recommend supplementing with to ensure survivability through the gastric juices in the stomach. Early in my pregnancy, I actually switched to Just Thrive probiotic (and prebiotic) supplement because they have the strongest clinical evidence to support 100% survivability through the gastric juices. You can use code PRESS15 to save on your own, whether you are pregnant or not.
Now back to probiotics and pregnancy. First of all, we populate our baby’s microbiome (friendly bacteria population) when they pass through our birth canal and even those who give birth via cesarean pass on bacterial populations through the placenta and also breast-milk if breastfeeding (29). So if we want to give our baby the best start at life, I recommend taking care as to what bacteria is living in and on you. In addition to the important roles I mentioned above, our gut is home to our enteric nervous system (ENS) which plays a huge role in how our brain functions and our mood. In fact, 90% of our serotonin is produced in our gut (37, 39). Happier gut = happier moms and babies! Additionally, our guts are home to something called GALT, or gut activated lymphatic tissue. Lymphatic tissue refers to immune tissue. So this is a fancy way for saying our gut health plays a huge role in our immune system. About 75-80% of our immune system is actually controlled by our gut (40). Additionally, our gut helps our bodies detox harmful substances like small particle LDL cholesterol and can help prevent things like the onset of cardiovascular disease (38) and, when in the right “balance” can help reduce inflammation in the body, which is the root cause of almost every disease (41). However, when not in “balance”, or when the gut is in a state of “dysbiosis” it can cause widespread inflammation in the body, which can cause many diseases. So by taking care of your gut, you can stay healthy during pregnancy and give your baby the best chance at starting life out happy (serotonin) and not sick (immune system) and so much more.
Our microbiome, or bacterial balance in our bodies also has some other direct impacts on pregnancy outcomes. Studies have shown that dysbiosis (imbalance of unhealthy and healthy bacteria in the gut) can increase the mother’s risk of excessive weight gain during pregnancy, preeclampsia, gestational diabetes and preterm birth (42). Probiotics can actually help prevent mother’s who do have gestational diabetes for having a too large baby (which is common in this population) and can help balance blood sugar in both mothers with gestational diabetes and without (see carbs paragraph for why balanced blood sugar is important) (44). Additionally, a good probiotic supplement can reduce inflammation in the placenta, which, can prevent many other conditions. In fact, the placenta has recently been discovered to have its own microbiome (or bacterial population), which, of course is entirely populated by the mother in utero (43). In addition to a quality probiotic supplement that will survive (see above, most do NOT survive gastric juices which is why I have carefully chosen mine), it is important to care for our microbiome and thus our baby’s micro biome by eating a diversity of colorful, whole foods, and avoiding things that harm gut bacteria such as traditional cleaning chemicals, phthalates, BPA and BPS, many compounds in traditional beauty products, antibiotics (such as those in conventionally raised meat and seafood), gluten (to the extent possible) and much more. If you want more guidance on this, please contact me.
summary
Another plate loaded up with the pregnancy goods! Eggs (hi choline, protein, DHA, vitamin D, vitamin K) and sweet potatoes for those unrefined carbohydrates and green veggies for folate. So you don’t need to eat out of the ordinary foods, just be mindful of what you’re taking in!
Whoa, that was a lot of information. If you made it this far, thank you for reading! Like I said, this should not replace working with a practitioner to optimize your prenatal nutrition, but hopefully, can teach you some new things to at least look into for your own prenatal diet and care. I always advocate for a diverse diet of whole foods (minimally processed). But I also think pregnancy is as good a time as any to listen to your body. So I am not trying to impose guilt or shame on anyone who ate some bread or pasta or candy during pregnancy, but rather trying to clue you in on what other things you might want to consider including, whether that’s a supplement or a food group or both. And finally, I will put a link to the main prenatal vitamin that I took during pregnancy again here since I know I will get questions about it. However, please note that this is NOT the only supplement I took, and I still recommend working with someone to see what you might need in addition. And finally, if you are mama to be reading this, CONGRATS and try to enjoy the process!
References:
https://www.eatright.org/health/pregnancy/prenatal-wellness/healthy-weight-during-pregnancy
https://academic.oup.com/ajcn/article/75/5/951/4689417
https://www.ncbi.nlm.nih.gov/pubmed/26457543
https://www.ncbi.nlm.nih.gov/pubmed/11679789
Nichols, L. (2018). Real food for pregnancy: The science and wisdom of optimal prenatal nutrition. {United States?: Lily Nichols.
https://www.reuters.com/article/us-health-pregnancy-diet/average-pregnant-woman-in-u-s-may-have-poor-nutrition-idUSKCN1TM2KL
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