Have questions for a midwife? Dr. Cathy Carlson-Rink is a Naturopathic Physician and Registered Midwife practicing at the Family Health Clinic in Langley, BC with a focus on pregnancy, infertility, and women’s and children’s health, and a mom of three girls born at home. She’s teamed up with longtime Mothering sponsor Floradix Iron and Herbs to answer some of our questions about diet, supplements and iron in pregnancy. Check back next week for the second part of our interview!
What are certain foods every pregnant mom should include in her diet to get the nutrients she needs?
Dark Green & Leafy Vegetables
These are truly nature’s fast foods, as they cook quickly—and many can even be eaten raw. They are the perfect pregnancy food, full of vital nutrients such as calcium, magnesium, B vitamins, iron, trace minerals, folic acid, and vitamin K. They are also great sources of antioxidants and carotenes. Add more of the following to your diet: kale, watercress, beet greens, bok choy, Chinese (Napa) cabbage, collard greens, dandelion greens, endive, mustard greens, Swiss chard, and turnip greens.
Yellow and Orange Vegetables
Rich in carotenes, yellow and orange veggies contain potent antioxidants, boost immune function, aid the growth and repair of tissue, reduce ultraviolet damage to skin, and support eye and skin health. Good choices include carrots, yams, pumpkin, squash, and sweet potatoes.
Broccoli and Cabbage Family
High intake of cruciferous vegetables like broccoli and cabbage is important for immune function. These veggies are high in indols and carotenoids, which have been proven to possess anticancer properties. Broccoli is also a great source of calcium, vitamin C, potassium, and iron. Some mothers need to avoid this vegetable group in the first three months of nursing. Other members of the cruciferous family: brussel sprouts, kale, bok choy, collards, turnips, mustard greens, kohlrabi, and watercress.
Dark Pigmented Berries
High in antioxidants and rich in fiber, potassium, vitamin C, and flavonoids known as anthocyanins, berries boost the immune system and reduce free-radical damage and inflammation. They help with collagen formation, eyesight, and circulation. Oxidative damage (from free radicals) has been linked to gestational diabetes and preeclampsia, so eating a diet high in antioxidants makes sense. Also, berries in combination with fermented milk products like yogurt have been shown to reduce the incidence of urinary tract infections that can cause kidney infections and premature rupture of membranes during pregnancy. Food sources include rosehips, blackberries, blueberries, raspberries, cranberries, and strawberries.
Nuts and Seeds
Nuts and seeds are high in essential fatty acids, vitamin E, and concentrated protein. Essential fatty acids found in nuts and seeds help influence cellular strength, balance hormones, protect nerves, and reduce inflammation. They are also concentrated sources of vitamins and minerals like calcium, magnesium, and zinc. Consume raw or as cold pressed, unrefined vegetable oils. Cashews, almonds, walnuts, sunflower seeds, flax seeds, and sesame seeds are good choices.
Plain, Organic Yogurt with Live Cultures
This fermented food enhances digestion and is a great source of complete protein, calcium, B12, potassium, and zinc. Both prebiotics (food for probiotics that aids in absorption of calcium), and probiotics (beneficial organisms for the digestive tract) are important. Probiotics have demonstrated the ability to enhance the immune system and aid in detoxification. Probiotics compete with yeast and “bad” bacteria to prevent urinary tract infections and yeast infections that can be more prevalent during pregnancy.
Whole grains are superior to refined grains because they have more protein, fiber, B vitamins, calcium, iron, and vitamin E. B vitamins are key, as they are necessary for the release of energy from carbohydrates, protein, and fat.
Sources of whole grains include whole wheat, brown rice, barley, steel cut oats, corn, buckwheat, rye, millet, quinoa, spelt, amaranth, and teff.
Legumes like beans are staples around the world but are eaten comparatively rarely in North America. They are high in protein, complex carbohydrates, fiber, iron, B vitamins, folic acid, potassium, and magnesium, and low in fat. Regular consumption has shown to stabilize blood sugar, reduce obesity and high blood pressure, and relieve constipation. They are also a rich source of antioxidants. The darker the pigment, the higher the antioxidant activity. Add these legumes to your diet: black beans, pinto beans, chickpeas, lima beans, fava beans, mung beans, aduki beans, soybeans, white beans, cranberry beans, lentils, peas, and green beans.
Cold-water fish is high in omega-3 fatty acids and vitamin D. Due to high mercury content, avoid shark and swordfish. Salmon has been shown to have the lowest levels of toxins and heavy metals.
Free Range, Organic Eggs
Eggs are rich in protein, zinc, and vitamins A, D, E, and B12. Eggs are also a great source of choline and betaine, both involved in the process of methylation that reduces homocysteine levels. Elevated homocysteine levels have been linked to infertility and complications in pregnancy. Choline is also necessary for the structure and function of cell membranes and for the production of brain chemicals to boost memory and concentration. Animal studies have demonstrated that choline taken from mid-pregnancy to birth improved learning and memory recall in the newborn and that the effects were lifelong.
What do you recommend for supplements during pregnancy?
Multivitamin and Mineral Supplement with Folic Acid
Simply taking a high-quality multivitamin/multimineral while you are pregnant has significant benefits to both you and your baby. It reduces the incidence of high blood pressure in the mother, childhood cancers, and birth defects. I prefer to use methylated folate form of folic acid as 60% of women are missing the enzymes to convert folic acid routinely found in supplements.
Iron deficiency is the No. 1 deficiency in pregnancy. Research shows only one in five fertile women starts her pregnancy with adequate iron levels. Iron deficiency in pregnancy is linked with miscarriage, low birth weight, preterm labor, postpartum depression, and iron deficiency in infants. A 2003 study from the American Journal of Clinical Nutrition showed that using a low-dose iron supplement of 20 mg per day from the 20th week of pregnancy through delivery reduced anemia and iron deficiency at delivery and postpartum without the side effects.
Probiotics used in pregnancy and breastfeeding have been shown to improve the immunoprotection of breast milk and significantly reduce eczema in the first two years of life in both allergic and non-allergic mothers.
Essential Fatty Acids
DHA, an omega-3 fatty acid, taken during pregnancy and breastfeeding has been shown to increase infant IQ, improve social behavior, vision and hearing, and reduce risk of eczema. Supplementing with fish oil by itself can reduce the amount of omega-6 essential fatty acids crucial for infantbrain development, and sufficient birth weight. In a double blind, randomized, placebo-controlled trial, a combination of fish oil and Evening Primrose Oil (omega 6), was found to provide DHA without reducing key omega 6 fatty acids.
Many pregnant women and new moms face low energy levels. Could this be due to diet or low iron?
For women, iron is the most common deficiency in the world. It is the leading cause of fatigue. Three main symptoms are present with mild iron deficiency or low iron stores: poor concentration, poor tolerance for exercise, and mental and physical fatigue.
From the first period (menarche) to the last period (menopause), the iron status of women is determined by the loss of iron during menstruation and pregnancy. Research shows only one in five fertile women start their pregnancy with adequate iron levels. Women’s iron requirements double during pregnancy and without proper diet and effective supplementation, iron stores can drop and continue to decline with each subsequent pregnancy. They key is to prevent the problem in the first place with adequate dietary intake and safe iron supplementation. Most women who have 15 mg of iron in their diet and 30 mg in a supplement are able to meet their requirement for iron in pregnancy. A 2003 study from the American Journal of Clinical Nutrition, showed a low dose iron supplement of 20 mg/day from 20 weeks pregnant to delivery reduced iron deficiency anemia and iron deficiency at delivery and postpartum without the side effects usually found with high dose iron supplements. Pregnant mothers who took iron supplements returned to normal iron levels by six months postpartum but it took two years for those women who did not.
Thanks so much to Dr. Carlson-Rink for this information, and check back in two weeks for Part 2 of this interview!