The importance of good nutrition (and nutritionist!) in pregnancy
A letter from Heike Cushway, co-founder and Operations Director of The Iron Suites Medical Centre and mum of two little monkeys.
Congratulations on your pregnancy!
I’m personally very passionate about nutritional health in pregnancy. As you are probably aware, obtaining adequate nutrition is one of the most important responsibilities mothers have throughout pregnancy - not only for yourself but also for your growing baby. Unfortunately, research suggests that most mums are not getting enough essential nutrients, despite the many dietary supplements that are often recommended. Postnatal depression and other postnatal issues related to nutrient deficiencies are far too common. The good news: good nutritional intake is totally achievable!
Deficiencies in iron, zinc, DHA (an important Omega-3), magnesium, folate and the vitamins B12, D, C, A, K are common. It is incredibly difficult to check all the boxes for vitamins, minerals and nutrients, every single day, given you are also dealing with increased demand, nausea, as well as taste and energy fluctuations. Many standard dietary recommendations are out of date or not tailored to the individual, so you might often need to do some research yourself to be able to recognise the common signs and symptoms of nutritional deficiencies. Combining whole foods (unprocessed and unrefined) with good quality supplements is the best way to ensure adequate levels.
Iron deficiency is the world’s most common nutritional deficiency. About 3 in 4 women suffer from iron deficiency (with or without anaemia) in their third trimester. This is not very surprising when we consider that more than 30% of women of child-bearing age already suffer from iron deficiency and that each pregnancy requires an additional 1,000mg of iron (and the average women only has 3,000mg of iron). Iron reduces the risk of depression, plays a crucial role in our immune system, and is essential for the physical, cognitive and emotional development of your baby. Despite these staggering rates and significant impacts on both mother and baby, iron levels are rarely proactively checked by most doctors. Look through your previous results, have you ever seen serum ferritin on your lab report? Ideally, you would like to commence your pregnancy with a concentration of 100-300ng/mL but anything below 30ng/mL indicates absolute iron deficiency.
Zinc, a mineral present in many foods, plays an essential role in the construction of your baby’s cells and DNA during pregnancy. Yet the World Health Organisation (WHO) estimates that worldwide over 80% of pregnant women have insufficient zinc intake. It is needed for cell division, adequate tissue growth and supports development as your baby grows. A healthy intake of zinc as part of a well-balanced diet is crucial. Zinc is also important in helping to minimise postnatal depression.
DHA, the most important fatty acid in the Omega-3 group, is essential for the brain development of the baby and an adequate DHA level (between 4-5%) is ideal to help avoid the risk of preterm birth. Due to the increased demand during pregnancy, the body automatically converts many fatty acids into DHA.
Vitamin D plays an important role in pregnancy. Vitamin D supplementation (when deficient) during pregnancy may reduce the risk of pre-eclampsia, low birthweight and/or preterm birth. Some studies have also shown that Vitamin D deficiency may increase the risk of children being born with autism.
Folate, magnesium, vitamin B12, C, A and K are other important nutrients for both your wellbeing and the optimal development of your baby. Most of these vitamin levels are not routinely tested except for vitamin B12 and folate levels.
Top tip: Having enough zinc (red meat, legumes, wheatgerm), vitamin A (sweet potatoes, carrots, dark greens), vitamin E (sunflower seeds, avocados) and DHA (salmon and sardines) can do wonders for improving skin elasticity and, therefore, preventing stretchmarks and tears. If you suspect a deficiency, get it checked out.
The good news is that several health professionals in Singapore are specifically trained in nutritional medicine and can help you to review your individual test results and guide you on what exactly your body needs at this important stage (pre and postnatally).
I highly recommend a full nutritional health check-up when you’re planning to fall pregnant as well as regularly during your pregnancy (especially re-checking in the third trimester when baby requires so much) as your levels may change significantly with the growth of the baby. The experts in our clinic, Dr Dheeraj Khiatani, and our Australian Dietitian, Dr Naras Lapsys, would love to support you throughout your beautiful journey.
All the best for your pregnancy and all the exciting times ahead,
The Iron Suites Medical Centre
The Iron Suites Medical Centre focuses on the diagnosis and optimal management of iron deficiency as well as overall nutritional health that can lead to increased fatigue or impaired general wellbeing. Every third woman suffers from iron deficiency at some point in her life – largely due to heavy menses and/or pregnancy. Pregnancy is one of the most critical times where iron stores are essential as each pregnancy requires 1,000mg of iron (and women only have up to 3,000mg of iron in their bodies).
Iron is critical for the wellbeing of the mother and also for the cognitive and physical development of the growing baby. Early detection of iron deficiency enables the provision of dietary advice and, when appropriate, prescribed medical treatment with oral or intravenous iron. The Iron Suites has treated more than 2,000 women and is recognised Internationally as experts in the administration of intravenous iron.
Karin Graubard-Reiter | Nutritious N Delicious
Karin G. Reiter is an internationally acclaimed functional medicine practitioner, speaker, and consultant. Over two decades, she has helped thousands of individuals and employees at organisations all over the world (McKinsey, Google, Rolls Royce and more) make small but profound changes in their nutrition and wellness.
After being diagnosed with two autoimmune diseases and being told by doctors that she would never lead a ‘normal’ life, Karin set out on a journey of healing through food, and while healing herself, created the D.N.A. Program (Delicious, Nutritious, Available), the ultimate formula for balancing nutrition and flavour. For Karin, food is life, food is love, food is what connects us as people and as a culture.
Health 2 Mama
Health 2 Mama have nutritionists who work alongside their physio trainers to specifically target the nutritional needs of mothers during pregnancy, breastfeeding and after birth. They offer online and in-person consultations and have specific programs where they can support with meal plans via WhatsApp or through the Health 2 Mama app.