Written by Mrs Josie Elles for Doctify
It’s 6am on Saturday the 25th of July 2015. My eyes are barely open and I head to the bathroom to find out if I can drink prosecco at my good friend’s wedding tonight. I’d much rather not (i.e., I am hoping the pregnancy test is kind to me this morning and shows me his smiley face). The flight to Dublin leaves in a few hours and I haven’t packed yet. 3 minutes of nervous shivering and the stick reveals – Oh My God! – A SMILEY FACE!!! We check again – but the icon is still there, beaming at us. There is not much time to think now. My first baby journey has just begun.
The Joys of Morning Sickness
The next 8 weeks are not so much fun. How can this be called “morning” sickness? The nausea hits me the second I get up and stays with me until I fall asleep. Most nights I am woken up by it at least once. If I eat something it may go away for a few minutes but often enough the food makes me nauseous too. As a nutritionist, I am expected to be able to deal with this and I try all tricks in the book: ginger, crackers, eating little and often. The only thing that seems to work for me is lemon and ginger juicy water. But with one bottle wrapping up 36g of sugar I try to save it for emergencies only.
Sugar – My Best Friend and Worst Enemy
In those first 2 months sugar seems to be my biggest friend and my worst enemy. Most people think of sugar as the small white grains that you add to your tea or coffee. This type of sugar in nutritional terms is called sucrose and is made up of one molecule of glucose and one molecule of fructose. The reality is that any type of carbohydrate is relatively easily metabolised into glucose. So in other words, if you are trying to watch your sugar intake you also have to consider other types of carbohydrates such as bread, cereals, pasta, rice or potatoes as they all share the same fate. During the digestive process, they are broken down into glucose molecules which enter the blood stream and trigger the release of insulin. Why go into such detail in the context of pregnancy? Because of new research that has been emerging in a field called “Epigenetics”.
Epigenetics is the study of how genes behave under the influence of certain environmental factors – one of them being our diet. Epigenetics seeks to examine what influence the mother’s diet has during pregnancy on the future expression of the child’s genes. In layman’s terms, if the baby carries the gene for diabetes and the mother eats an excess of carbohydrates during pregnancy, is the child more likely to develop diabetes during its lifetime? And if that was true, what is the ideal amount of carbs one should eat during pregnancy?
As I am, in vain, trying to find scientifically validated answers to these questions in pregnancy guidebooks, journals, on the web and from my GP and midwife, my body clearly decides that the only thing it wants right now are indeed carbohydrates. Just thinking about meat, fish or tofu instantly increases my nausea. I am actually unable to set foot into a supermarket let alone cook a balanced meal. Whilst my pre-pregnancy diet contained roughly 80-90g of protein, I now barely manage to get 40g.
Protein, however, is the essential building block for the baby’s growth. Again, there is no clear answer on how much is needed. Whilst the NHS refrains from giving any concrete guidelines and just talks about eating “some protein” every day, recommendations from other sources vary between 55g and 70g. Consequently, I decide to trick myself into increasing my protein intake by smuggling whey protein into my cereals and organic sausages into soups and stews. But, I generally go with my intuition and am not too harsh on myself if occasionally all I can manage to stomach is “Pasta al Pesto”.
I start buying organic vegetable soups and various types of organic sausage meat in large quantities. I stick them in the freezer to ensure that I always have a healthy meal at home that requires no effort. My husband does the shopping on the weekend and if I feel well I also pre-cook soups and stews in batches. In the morning, I choose high fibre cereals and porridge with skimmed milk and added whey protein. During the day I snack on fruit, nuts and wholegrain biscuits. I discover Nature Valley protein bars, which have 8g of protein and 10g of carbs. They are my saviour when I get hungry during the night. The little protein helps to stabilise my blood sugar during the night, so the nausea is less severe when I get up in the morning.
What Supplements Should I Be Taking?
Then there is the other question of supplementation. Every pregnant woman in the western world is indoctrinated to take folic acid pre-conception and during pregnancy. Chances are your GP will recommend Pregnacare. Folic acid, however, is a synthetic product that is supposed to mimic the natural vitamin Folate. Folate naturally occurs in foods, such as green leafy vegetables, broccoli and pulses and is a critical nutrient for the synthesis, repair and methylation of DNA. The problem is that folate cannot be synthesized by the body and therefore needs to be administered in sufficient amounts through the diet.
The crucial question now is if Folic Acid does really help or may actually harm as an artificial supplement, and opinions vary widely. The safest solution seems to be to stuff yourself with greens but if your nausea is anything like mine that appears to be impossible – even more so since folate is especially important during the first trimester when morning sickness is at its peak. We also don’t know how high the vitamin content in the food really is once it has travelled through the modern food chain and been prepared for a meal.
Hope to solve this dilemma comes from a new breed of supplements that are emerging on the market – the so called “food-state” supplements. Two brands are currently available in the UK: “Wild Nutrition” and “Together Health.” Apparently, the vitamins are produced in a very innovative way which involves the use of real foods and therefore produces a supplement that is as close to nature as possible. The brands claim that “food-state” folic acid therefore behaves like folate without any of the pitfalls of synthetic folic acid. My personal decision was to take a food-state supplement daily as long as the nausea was severe (i.e., until the early 2nd trimester). Since it has eased off and I am capable of managing a balanced diet again, I have upped my levels of greens. Now I take the supplement less persistently but especially when I feel I need extra nutrients. But that is a very individual choice you should make in consultation with a practitioner, depending on your circumstances.
The one nutrient however that seems to be universally recognised as being beneficial during pregnancy is DHA, an Omega 3 fatty acid. DHA, like folate, has to come from the diet and there are studies that suggest it is helpful in promoting the development of your child’s brain. Again you may consider trying to get enough from your diet, by regularly eating oily fish, but you have to take the pollution of the sea into account. Recommendations in terms of how much DHA to take vary. Whilst the European Food Safety Authority (EFSA) recommends up to 200mg/day for pregnant and lactating women, many of the supplements available on the market contain more than that. My personal decision is to take a pre-natal supplement as recommended by the manufacturer whilst ensuring that the product is certified by The International Fish Oil Standards™ (IFOS™) Program – the only third party testing and certification program for the purity and efficacy of fish oils.
Emotional Wellbeing and Stress
This is just a brief introduction into the most important considerations for a pregnancy diet. If you would like to have more information, feel free to book a consultation to discuss your personal situation. Let’s now look at another crucial aspect that may have an effect on your baby’s health – it’s that of emotional wellbeing and stress. Research suggests that higher levels of cortisol, a stress hormone, released by the mother during pregnancy, are associated with a lower IQ and an increased risk of mental illness in the offspring. Closer investigation however seems to reveal that the level of stress is decisive – whilst severe stress undoubtedly has a negative impact, mild to moderate stress may actually be beneficial, promoting immune health and preparing the baby for the stress of birth. Stress is obviously very subjective and more research is needed to give generalised advice. However, from my experience as a practitioner, I strongly believe that a happy and relaxed Mum-To-Be provides a healthier environment for the foetus to develop.
Staying Calm and Relaxed
Whether you’re having your first baby or third, with so many changes taking place in your body and life all at once it can be hard to maintain a positive and level-headed attitude. There can be a number of reasons for this: the burden of nausea and tiredness, the influx of hormones (which may make you more sensitive), the constant changes in your body (including the weight gain), or the anxieties surrounding the health and wellbeing of your baby and your own future.
You suddenly have an immense responsibility to care for the unborn child, whilst the demands of your career, social life and partnership don’t diminish. It can become a massive juggling act and you may feel as if you have lost total control over your body, your energy levels and your emotions. At the same time, many of the usual coping strategies, such a glass of wine to unwind, a hot bath or a pampering beauty treatment are not at your disposal, as they bear risks to the developing foetus, especially in the first trimester. But there are other ways to treat yourself and wind down. It took me a while to find my mojo but here are a few ideas that worked well for me:
- Having a few low sugar, alcohol free drinks in the fridge, to enjoy as a treat instead of a glass of wine, after a long day. You can stock home-made ice tea, alcohol free beer (great for its vitamin B content), ZEO (a fizzy water with natural flavours and stevia), coconut water etc.
- Getting the “Friends” sitcom box set – believe it or not this has had a major impact on my wellbeing. Being a child of the early 80s, Friends is still my favourite show that makes me giggle every time especially during the first trimester when the surge of hormones may lead to energy lows, mood swings, sleep interruptions, etc.
- Writing a bucket list – particularly if you are pregnant for the first time a bucket list can really help manage the 9 month wait. I mainly put things on there that I won’t be able to do as easily anymore once the baby is there. Some items are personal to me and some I share with my husband, such as visiting girlfriends out of town, going to a concert, eating out at a favourite restaurant etc. It’s a good way to appreciate the relationship and consciously enjoy the remaining time where it’s just the two of us
- Mindfulness Meditation – I know it’s everywhere at the moment and chances are you are already hooked or have heard enough of it, but I must say that Mindfulness really helped me manage my anxiety during the first trimester. For me, having a baby will be the biggest wish come true which is why the first 12 weeks when pregnancies are still very unstable, at times appeared as an eternity. There are a few apps for guided meditations. My favourite one is called “mind the bump”
- Expressing your needs and emotions – this may sound a little platitudinous, however I still feel the need to stress the importance of this. It is extremely likely that your needs during pregnancy will change. The chances are that your partner won’t be able to read your mind and if your expectations of him or her change it’s only fair to let them know calmly and clearly. Most likely they will want to do everything to make you happy and comfortable but in order for them to be able to do that, they need to know what these things are. Don’t be afraid to recognise when you are a little out of character due to the hormones – it doesn’t mean you are using it as an excuse to be selfish – it just means both of you are more aware and can support each other to foster good communication skills
- Gentle exercise – last but not least, I feel that gentle exercise is a fantastic way to release stress and boost mood. My favourite ways are swimming and walking. Walking also helped me a great deal to cope with the nausea, even if all I was able to do was crawl round the block. Swimming instead I found to be helpful in easing minor back pain
My first baby
But enough from me for today. I hope you enjoyed my little first baby report and found it useful. Whether you are partner to a pregnant lady, planning to become pregnant or in the same situation as me, don’t hesitate to get in touch. I would love to hear your views or try to answer your questions. I hope all goes well for you and I will endeavour to update you how things are progressing in a few weeks.
Until then have a happy holiday and stay safe.