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maternal health

  • Are you Tired or Iron Deficent?

    As summer steams up, many of us start feeling a little lethargic. If you are living in a hot and humid area, it is easy to get the pregnancy doldrums that make our maternity weight feel like it is double, even if you aren’t expecting twins. For many women the hot weather is not the only cause of pregnancy fatigue, it may also stem from a lack of sufficient iron in your diet.

    Research shows that only one in five women begin their pregnancy with sufficient iron levels. No matter the geography, iron is the most common and widespread deficiency in women around the world and the leading cause of fatigue in women. Other symptoms from low iron are poor concentration and quick mental fatigue as well as a low tolerance for exercise and physical exertion.

    During pregnancy women’s iron requirements double and without the proper diet and supplementation iron reserves can continue to deplete with each subsequent pregnancy. Studies show that as many as 50% of pregnant women are iron deficient and 20% of non-pregnant women. Clearly we all need to be getting more iron in our diet or at least supplementing more.

    If your diet has 15mg of iron and 30mg of iron supplementation you are probably meeting your iron requirement during pregnancy. If you are not meeting your iron requirement, an easy way to add more iron to your diet is to eat more iron-enriched cereals and grains (read the labels) as well as snacking on dried fruits such as raisins and prunes. Also, foods in the bean family such as lentils, chick peas and soybeans are all high in iron as well. We all know that dark leafy greens like Popeye recommends such as spinach and collards are rich in iron and very good for you.

    Other foods high in iron are red meat and egg yolks. But even if you are a vegetarian or a vegan there are still plenty of iron rich food options for you. Talk to your doctor about a supplement (or have a blood test) if you suspect you may be low on iron in your diet, particularly if you are pregnant.

  • Is your Baby getting enough Vitamin D?

    Breastfeeding your baby is a great way to not only bond with your baby but to give them the very best customized nutrition and antibodies that they need to be healthy.  However the one vitamin that you may be lacking in providing through your breast milk is vitamin D. Vitamin D is an important part of both your pregnancy diet while your baby’s bones are developing and your breastfeeding diet as your baby continues to grow and develop.

    If you do not get enough Vitamin D in your diet when you are pregnant your baby may develop a condition called rickets from soft bones. Also by getting enough Vitamin D while you are pregnant you increase your chances of having a healthy, uncomplicated pregnancy.

    While breastfeeding it is important that you eat a healthy diet as your nutrient intake is what feeds your baby the vitamins and minerals they need to be healthy as well. Depending on how much vitamin D you are getting with your diet and sun exposure, you may or may not be providing enough vitamin D for your baby. If you do not have enough vitamin D in your diet, you will need to give your baby a vitamin D supplement (and you should probably a supplement for yourself too).

    Vitamin D deficiency is linked to a number of factors including:

    Not enough sun exposure outside.

    Having dark skin

    Being overweight or obese

    General recommendations for Vitamin D for pregnant women by the Vitamin D Council are 4,000-6,000 IU/day. Researchers found that moms that took at least 4,000 IU a day where more likely to have uncomplicated births and their newborns were likely to have enough vitamin D when he or she was born. Women without enough Vitamin D in their diets were more likely to have premature births, develop gestational diabetes, have preeclampsia and more likely to have a C-Section.

    The Vitamin D Council’s recommended intake of vitamin D for babies is 1,000 IU/day.  If you are getting enough vitamin D as a breastfeeding mother, then your baby is also getting enough vitamin D and does not need a supplement. If you baby does need a supplement you can give them prescription vitamin D drops directly or add them to food or drink for your baby.

    If you as a breastfeeding mother are taking a supplement of 6,000 IU of vitamin D each day, then your baby does not need a vitamin D supplement as your breast milk will have enough. If you are not taking a supplement (or you are taking less than 5,000 IU/day of vitamin D) and not getting a good amount if sun exposure, then you need to give your baby a vitamin D supplement.

    If you are getting a good amount of skin exposure to the sun each day, then you are probably getting enough vitamin D to make your breast milk rich with vitamin D. However most mothers are not able to get enough skin exposure every day to meet this requirement and do need a supplement 5-6 days a week. When you are not getting enough sun exposure for a number of days your breast milk will quickly clear itself of vitamin D unless you are taking a supplement.

    The upper limits for Vitamin D intake is 2,000 IU/day for babies and 10,000 IU/day for pregnant women. So, unless you are over supplementing, it is hard to exceed these limits. Formula milk varies with how much vitamin D in the formula. Most formula milk has between 40-100 IUs of vitamin D per 100 calories. You will need to figure out how much formula your child has a day to add up the vitamin D IUs they are getting. Based on this result you can figure out if you need to supplement your baby with vitamin D or not and how much to supplement. Remember to adjust your supplements as your baby’s intake of formula may increase over time.

    Although exposing your skin to the sun is a great way for pregnant and breastfeeding women to increase their vitamin D supply for both themselves and their babies, you also want to be careful not to burn. Although skin exposure for your baby will increase their vitamin D directly, your baby’s skin is extra sensitive and should not be exposed directly to the sun for at least the first six months, according to the American Academy of Pediatrics. Even after 6 months you will need to be careful of your baby’s sun exposure, especially in the hot summer months as burns can happen quickly to your baby’s sensitive skin.

    Vitamin D supplements are a good subject to bring up with your pediatrician. However it is also good to educate yourself on this subject as well so you can have a very informed conversation with your doctor on how to best supplement your baby if needed.

  • Diet matters for a Healthy Pregnancy

    A recent study led by Englund-Ögge with the Department of Obstetrics and Gynecology at the Institute of Clinical Sciences at the Sahlgrenska Hospital in Gottenburg, Sweden showed the diet was very important for a healthy pregnancy and for lowering the risk of a preterm birth. Dr. Linda Englund-Ögge told Reuters Health in an email.

    "Diet really matters when it comes to preterm delivery and it is very important for pregnant women to choose or to increase the intake of an overall healthy diet consisting of fresh and raw vegetables, fruit, whole-grain products, certain fish and to drink water."

    In recent years there has been more interest and more research done concerning maternal diet how it affects the risk of preterm delivery. In this study 66,000 Norwegian women participated between 2002-2008 to study the effects of diet and maternal health. Those who had a “Prudent Diet” consisting of cooked vegetables, salad, onion/leek/garlic, fruit and berries, nuts, vegetables oils, water as a beverage, whole grain cereals, poultry and fiber-rich bread had the lowest instance of preterm birth. Those with a “Western Diet” which included more salty snacks, sweets and chocolates, French fries, white bread, ketchup, sugar-sweetened drinks, pasta and processed meat products had a much higher instance of preterm birth.

    There were a total of 3,505 preterm deliveries. The researchers found that women who adhered most closely to the Prudent Diet were 11 percent less likely to have preterm deliveries compared to women who didn't follow the diet as closely.

    "We would like for doctors, midwives and all others who work with pregnant women to reinforce the important message that pregnant women should be encouraged to eat a balanced and healthy diet," Englund-Ögge said.

    "There are modifiable risk factors that people can address to enhance their pregnancy outcomes," Dr. Louis Muglia told Reuters Health.

    Based on this study, he said, a balanced diet with more foods rich in vitamins and other micronutrients probably facilitates a full-term pregnancy. Additionally women that followed the prudent diet were also more likely to have other beneficial lifestyle habits which would contribute to good pregnancy outcomes. These women were more likely to maintain a healthier weight, smoked less and avoided alcohol.

    "So I think there are a lot of things that go along with that prudent lifestyle that increases the likelihood of having a healthy pregnancy and reduces the likelihood of a preterm birth as well," Muglia said.

    This research is helpful in relying the message that we assumed for years, that as expecting moms we can positively affect our developing baby’s health by eating healthy foods during pregnancy and following a healthy lifestyle. The research noted that even the women in the “Prudent Diet” category did indulge in Western eatting from time to time and did indulge in sweets sometimes as well, but it’s the overall diet pattern that mattered the most. This is good news for all of us as it’s impossible to be perfect in pregnancy or anytime!

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