nutrition

Building a Global Team of Teachers for Healthy Pregnancy, Birth & Baby

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Danc­ing Thru Preg­nancy®, Inc.

Women’s Health & Fit­ness Pro­grams
found­ed 1979
MISSION STATEMENT
Many impor­tant health issues for girls and women involve mat­ters of repro­duc­tive
health, child­bear­ing, fer­til­ity and aging. Research informs us that an active, healthy
lifestyle pro­vides a num­ber of ben­e­fits through­out a woman’s life span:

  • reduced dis­com­forts from preg­nancy, labor, birth, recov­ery & menopause
  • reduced risk of hyper­ten­sive dis­or­ders of preg­nancy and pre­ma­ture birth
  • poten­tially short­er active labor and reduced risk of cesare­an deliv­ery
  • more rapid return to joy­ful activ­i­ties, less excess weight fol­low­ing birth
  • moth­er-infant inter­ac­tion, lead­ing to infant psy­chomo­tor enhance­ment
  • reduced rates of obe­sity, car­dio­vas­cu­lar dis­ease, and type 2 dia­betes
  • reduc­tion of some can­cers, osteo­poro­sis, falls and loss of mus­cle mass
  • improved social sup­port, net­work­ing and stress man­age­ment skills
  • greater belief in one’s abil­ity to be strong and capa­ble (self-effi­ca­cy)

Holiday Contributions That Make a Difference.

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This is the time of year many of us con­sid­er where to make our char­i­ta­ble con­tri­bu­tions. We have assem­bled a list of  groups to which you might want to con­sid­er giv­ing this year. By donat­ing to these orga­ni­za­tions you can help improve the lives of moth­ers, newborns,children and fam­i­lies around the world. Most will also send a card or email mes­sage to a mom in whose hon­or you give the gift.

UNICEF Inspired Gifts.  You can choose gifts that improve edu­ca­tion, water, health, nutri­tion, emer­gency care and oth­er fac­tors that affect the well-being of women and chil­dren.

White Rib­bon Alliance for Safe Moth­er­hood. You can advo­cate for every moth­er and every child in 152 nations when you give to this orga­ni­za­tion.

Inter­na­tion­al Con­fed­er­a­tion of Mid­wives. This group exists to raise aware­ness of the glob­al role of mid­wives in reduc­ing mater­nal and new­born child mor­tal­i­ty.

The Fis­tu­la Foun­da­tion. This group exists to raise aware­ness of and fund­ing for fis­tu­la treat­ment, pre­ven­tion and edu­ca­tion­al pro­grams world­wide. Fis­tu­la is the dev­as­tat­ing injury cause by untreat­ed obstruct­ed labor.

The Preeclamp­sia Foun­da­tion. This orga­ni­za­tion sup­ports research to pre­vent and treat one of the most dan­ger­ous dis­or­ders of preg­nan­cy, one that accounts for a large per­cent­age of pre­ma­ture births and low birth weight infants. Hav­ing preeclamp­sia is also a risk fac­tor for lat­er heart dis­ease for the moth­er.

Clean Birth. Clean Birth Kits are designed to pro­vide birth atten­dants and/or expect­ing moms with the tools they need to ensure a clean birthing envi­ron­ment. The Kits ensure the WHO’s “6 Cleans”: clean hands, clean per­ineum, clean deliv­ery sur­face, clean cord cut­ting imple­ment, clean cord tying, and clean cord care.

March of Dimes. The “moth­er” of all char­i­ties for help­ing pre­vent and treat dis­or­ders and dis­eases that affect chil­dren.

Peace, Love and Joy to all.

High Birth Weight: The New Adverse Outcome

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While pub­lic aware­ness of low birth weight and pre­ma­ture infants is becom­ing — at long last — inter­est­ing to the main­stream cul­ture and media, anoth­er phe­nom­e­non is begin­ning to shake the pro­fes­sion­al birthing world:  high birth weight. Because it is occur­ring in a more afflu­ent ele­ment of soci­ety, it is alarm­ing. This tells us that you can­not buy your way out of preg­nan­cy risks that are cre­at­ed by a seden­tary, tox­ic food life-style.

Here is the dilem­ma:

Nor­mal weight and some over­weight women who eat too much in preg­nan­cy tend to have babies who are, basi­cal­ly, already obese at birth. There­fore, these infants already have meta­bol­ic and car­dio­vas­cu­lar dys­func­tion. Babies born over 8 lbs. 14 oz. are at increased risk for Type 2 Dia­betes and heart dis­ease.

Inter­est­ing­ly, the Insti­tute of Med­i­cine  recent­ly issued new guide­lines on preg­nan­cy weight gain. After near­ly 20 years of adher­ing to the “nor­mal” weight gain being 25 to 35 pounds, the Insti­tute rec­og­nized that pre­na­tal BMI plays a role in how much weight gain is nec­es­sary for a healthy preg­nan­cy.

The evi­dence that under­lies this change demon­strates that gains greater than 22 pounds — for all clas­si­fi­ca­tions of pre­na­tal BMI — is the demarka­tion point for increased health prob­lems.  More infor­ma­tion on this is avail­able at:  New IOM Guide­lines.

We have known for a while now that obe­si­ty in preg­nan­cy puts moth­er and infant at risk for a num­ber of prob­lems from car­dio­vas­cu­lar, meta­bol­ic and immune dis­or­ders to pre­ma­tu­ri­ty, low birth weight, increased need for cesare­an birth and slow recov­ery. Add anoth­er one:  Obese new­borns with increased risk for heart and metab­o­lism prob­lems.

Ref­er­ence on weight gain and high birth weight:

Lud­wig DS, Cur­rie J. The asso­ci­a­tion between preg­nan­cy weight gain and birth­weight: a with­in-fam­i­ly com­par­i­son. Lancet. 2010 Sep 18;376(9745):984–90. Epub 2010 Aug 4.

A good ref­er­ence for issues sur­round­ing obese preg­nan­cy:

Led­dy MA et al. The Impact of Mater­nal Obe­si­ty on Mater­nal and Fetal Health. Rev Obstet Gynecol 2008;1(4):170–178.

New Breastfeeding Research: More Baby Protections

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We have long known that vagi­nal birth and breast­feed­ing are key fac­tors in the devel­op­ment of a healthy immune sys­tem in infants. Pass­ing through the vagi­na expos­es the baby to an array of bac­te­ria that help stim­u­late its unchal­lenged immune sys­tem. Breast-fed babies receive anti-bod­ies, pro­teins and oth­er mol­e­cules that pro­tect it from infec­tion and teach the immune sys­tem to defend the infant.

Breast­feed­ing is key for long-term health.

Recent research at UC Davis has shown that a strain of the bifi­do bac­te­ria — acquired from the moth­er — thrives on com­plex sug­ars (large­ly lac­tose) that were pre­vi­ous­ly thought to be indi­gestible. The bac­teri­um coats the lin­ing of the imma­ture diges­tive tract and pro­tects it from nox­ious bac­te­ria.

This com­bi­na­tion of inter­ac­tions affects the com­po­si­tion of bac­te­ria in the infant gut as it matures. Anoth­er exam­ple of how evo­lu­tion has “invent­ed” the per­fect nutri­tion for infants, this research con­tributes to the notion that evo­lu­tion has select­ed for many genes that serve nor­mal birth and breast­feed­ing by pro­tect­ing the new­born. Inter­ven­ing with the nor­mal pro­gres­sion of birth and breast­feed­ing — while occa­sion­al­ly nec­es­sary — inter­rupts these ben­e­fi­cial adap­ta­tions and con­tributes to aller­gies and autoim­mune dis­or­ders.

Fetal Programming

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What is fetal pro­gram­ming? Every per­son liv­ing on earth was first exposed to a uter­ine envi­ron­ment that helped deter­mine their life­time health and devel­op­ment. The term for this phe­nom­e­non is fetal pro­gram­ming. It is a hot top­ic and deserves atten­tion.

Accept­ing the impor­tance of fetal pro­gram­ming places respon­si­bil­i­ty on the moth­er-to-be to do all she can to insure her body pro­vides nutri­ents and oxy­gen to her grow­ing infant while avoid­ing pos­si­ble risks and tox­ins. At the same time, genet­ic and envi­ron­men­tal fac­tors con­tribute great­ly to the poten­tial for some dis­or­ders and prob­lems that arise. Thus, we must be care­ful in assign­ing guide­lines for accept­able behav­ior or blame for poor out­comes to preg­nant women.

On the one hand, we can all see the neg­a­tive con­se­quences of some­thing like fetal alco­hol syndrome…clearly the result of mater­nal behav­ior. Is a preg­nant woman whose baby has been dam­aged in this way guilty of abuse?

But, what if a moth­er is obese, eats poor­ly and ends up with an infant with a dis­turbed metab­o­lism. Is this abuse? What if the moth­er has an infec­tion that results in cere­bral pal­sy? Or what if she lives near a high­way and invol­un­tar­i­ly inhales fumes that neg­a­tive­ly affect the pla­cen­ta?

How do you get a healthy baby? Of course, there are no guar­an­tees. There remain many unknown fac­tors that can affect the course and out­come of a preg­nan­cy. Some fac­tors we are aware of, such as avoid­ing cer­tain fumes or chem­i­cals.  There are some behav­iors we know can max­i­mize the poten­tial for a good out­come, such as eat­ing ade­quate pro­tein, aer­o­bic con­di­tion­ing and strength train­ing. [Note for new readers…lots of these fac­tors have been cov­ered in our pre­vi­ous posts.]

But, what about all the things we don’t know about?

If these goats eat the wrong grass, will they go into labor?

Here is a cau­tion­ary tale:  There is a species of goat that, if they eat a cer­tain type of skunk grass on day 14 (and only day 14) of preg­nan­cy, will not go into labor. Why? Plant tox­ins in this grass inter­fere with the devel­op­ment of a small por­tion of fetal brain, the par­aven­tric­u­lar nucle­us. This nucle­us is involved in the sig­nal­ing cycle of labor. With­out it, the moth­er will not go into labor!

What are the take-home mes­sages here?

  • Prob­a­bly no one is ever a per­fect fetus…too many pos­si­ble threats.
  • There are some threats we can avoid…being lazy, over-eat­ing, smok­ing.
  • There are some threats we can­not avoid, so we do the best we can.

Do the best you can by your baby…aerobic fit­ness, good nour­ish­ment, sleep, good hygiene and de-stress­ing your life.

More on Preventing Childhood Obesity!

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Rachael Blum of San­ta Mon­i­ca, CA, has alert­ed us to an excel­lent arti­cle in the New Eng­land Jour­nal of Med­i­cine con­cern­ing the evi­dence for the role of exer­cise in preg­nan­cy in help­ing pre­vent child­hood obe­si­ty:  http://healthcarereform.nejm.org/?p=3321&query=home. Rachael, our newest DTP fam­i­ly mem­ber, has also alert­ed us to an LA Times arti­cle on this sub­ject:  LA Times arti­cle.

With the recent empha­sis on the impor­tance of move­ment in the fight against child­hood obe­si­ty, there is recog­ni­tion that ben­e­fi­cial fetal pro­gram­ming through mater­nal exer­cise can make a big con­tri­bu­tion to this effort. A com­bi­na­tion of prop­er mater­nal nutri­tion and mater­nal fit­ness may well prove to be most effi­cient and poten­tial­ly effec­tive way to help chil­dren devel­op an appetite for motion!

One fac­tor in this is the find­ing that reg­u­lar, mod­er­ate-inten­si­ty exer­cise helps pre­vent obe­si­ty in the new­born: http://www.nlm.nih.gov/medlineplus/news/fullstory_97212.htmlt. This, may in turn, help pre­vent child­hood obe­si­ty.

Recess for every­one!!!

Twins & Triplets — Exercise & Nutrition Tips

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A detour: We received a ques­tion about nutri­tion and exer­cise for mul­ti­ples. So, here is some infor­ma­tion for those with twins and triplets. Add a com­ment if you have a ques­tion or expe­ri­ence to share on this top­ic! Next comes birth, we promise!!

If one is a girl and one is a boy, they're fraternal!

If one is a girl and one is a boy, they’re fra­ter­nal!

Nutri­tion for Mul­ti­ples:

The pri­ma­ry thing we tell peo­ple with twins or more is that the pro­tein needs rise about 30 grams/baby/day above the 70 — 90 grams/day need­ed for a sin­gle­ton. Water intake also needs to rise. Avoid thirst and as much as pos­si­ble, drink until urine runs clear rather than yel­low (as best as you can).

Mul­ti­ples is con­sid­ered a risk fac­tor, and for each risk fac­tor (mul­ti­ples, under­weight, teenage mom, inter-preg­nan­cy peri­od less than a year) an addi­tion­al 200 calo­ries is often rec­om­mend­ed, with 400 extra calo­ries the upper lim­it.

Exer­cise with Mul­ti­ples:

A crit­i­cal fac­tor in suc­cess­ful implan­ta­tion and growth of the pla­cen­ta appears to be aer­o­bic fit­ness in the six months pri­or to and the first half of preg­nan­cy. Once bio­me­chan­ics become dif­fi­cult in mid-preg­nan­cy, women with mul­ti­ples can con­tin­ue activ­i­ty safe­ly as long as mon­i­tor­ing show the babies are grow­ing appro­pri­ate­ly. A bel­ly sup­port can be extreme­ly help­ful when exer­cis­ing.

Con­traindi­ca­tions for exer­cise include the dis­cov­ery that one fetus is grow­ing at a sig­nif­i­cant­ly slow­er rate than the other(s), that both/all are too small, that the placenta(s) is/are mal­func­tion­ing, or some oth­er con­di­tion occurs, such as an incom­pe­tent cervix or pla­cen­ta pre­via, that would be a fac­tor in any case.

Absolute size dif­fer­ence does not nec­es­sar­i­ly mean that one baby is grow­ing more slow­ly, as some fetus­es may be a cou­ple weeks younger than their uterus-mate(s) if the moth­er ovu­lat­ed twice in the fer­til­i­ty cycle. Or, s/he might be small­er if genet­i­cal­ly des­tined to be a small­er infant at birth. Thus, growth rate is the mea­sur­able fac­tor that helps deter­mine if a fetus is at risk of not receiv­ing ade­quate ener­gy. This can hap­pen when there are two pla­cen­tas and one pla­cen­ta is work­ing more poor­ly than the oth­er, or for some rea­son there is a flaw in the umbil­i­cal cord of an iden­ti­cal. The com­pe­ti­tion for ener­gy places a slow­er grow­ing baby at risk.

Pro­tect­ing Mom and Baby:

The pla­cen­ta is designed to nour­ish the baby and will do so at a cost to the moth­er first if there is inad­e­quate nutri­tion. Thus, activ­i­ty to the lev­el the moth­er can tol­er­ate and fol­low­ing nutri­tion­al guide­lines above — in the absence of med­ical com­pli­ca­tions — pro­duces healthy off­spring. Mul­ti­ples will gar­ner all the same ben­e­fits a sin­gle­ton does.

Note about images:  we strive to use images we own or that are adver­tised as free on the inter­net. We want to thank google, bing and yahoo for mak­ing free images avail­able.

Pregnancy Pathway, Pregnancy — Nutrition

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Fresh fruit = vitamins & minerals!!

Fresh fruit = vit­a­mins & min­er­als!!

Ques­tion:

How many extra calo­ries do you need in each trimester to off­set the meta­bol­ic cost of preg­nan­cy?

Answer:

First trimester — 0; Sec­ond trimester — 300; Third trimester — 500 (source: Insti­tute of Med­i­cine).

Keep in mind that you may also need calo­ries for any fit­ness pro­gram you are doing. If you are con­tin­u­ing a pro­gram, the only change is due to the preg­nan­cy.

If you begin or increase your activ­i­ty, you need to take that into account. One yoga class = 100 — 150 calo­ries. One aer­o­bics class = 200–400 calo­ries. Walk one mile = 100 calo­ries.

1 slice whole grain bread = 50-100 calories

1 slice whole grain bread = 50–100 calo­ries

Be sure you read food labels so that you can bal­ance your food intake and your calo­rie out­put. A small woman (under 5′3″ & 130 lbs.) prob­a­bly needs about 1200 calo­ries per day as a base. A medi­um sized woman needs about 1400, and a large woman (over 5′9″ & 160 lbs.) prob­a­bly needs 1600 to 1800 calo­ries. Add your activ­i­ty and preg­nan­cy needs to your base amount.

Ques­tion:

What foods are nec­es­sary for a healthy preg­nan­cy?

Answer, part A:

PROTEIN. Lean pro­teins like turkey and those with omega 3 fats like ocean fish and eggs.…yes! EGGS!

Turkey is a good protein

Turkey is a good pro­tein

Ocean fish 1 or 2 times/wk = good protein & omega 3 fat

Ocean fish 1 or 2 times/wk = good pro­tein & omega 3 fat

Eggs are a perfect pregnancy food!

Eggs are a per­fect preg­nan­cy food!

70–90 grams of pro­tein are nec­es­sary each day, along with  ade­quate water.  These are need­ed to make an extra 40% blood vol­ume required to sup­port the pla­cen­ta.

Answer, part B:

WATER. Two (2) quarts of water…more if you are very active…are need­ed to make extra blood and to pre­vent dehy­dra­tion.

Ques­tion: What else?

Fresh vegetables also provide fiber

Fresh veg­eta­bles also pro­vide fiber

Answer: CARBS. Fresh, col­or­ful fruits & veg­gies pro­vide nec­es­sary vit­a­mins and min­er­als, as well as fiber. Eat 5 serv­ings a day from all the col­ors:  yel­low, orange, red, pur­ple and green, and you will get live vit­a­mins all day long that help your baby devel­op prop­er­ly! Fruits, veg­eta­bles and whole grains are low glycemic index car­bo­hy­drates — the good ones!

Dairy provides calcium

Dairy pro­vides cal­ci­um

Ques­tion:

Do I need dairy prod­ucts and red meat? Can I get the need­ed min­er­als in oth­er ways?

Answer:

Cal­ci­um is need­ed in ade­quate amounts for bones and teeth. It is most eas­i­ly obtained by drink­ing milk or eat­ing cheese, yogurt or cot­tage cheese. Soy, dark green leafy veg­eta­bles and cal­ci­um for­ti­fied juice are alter­na­tives.

Iron is nec­es­sary for red blood cells to take up oxy­gen. It is found in high amounts in beef,  and less­er amounts in raisins, spinach, and prune juice. Pre­na­tal vit­a­mins are your insur­ance against defi­cien­cies of these essen­tial min­er­als.

Ques­tion:

Any­thing else that’s essen­tial?

Answer:

Yes! Healthy FAT!!

Avocado is an excellent source of omega 6 fat

Avo­ca­do is an excel­lent source of omega 6 fat

In addi­tion to omega 3 fats found in fish, wal­nuts and flax seeds, you need also need omega 6 fats, which are found in avo­ca­dos, olive oil and oth­er veg­etable oils. Healthy fats help bal­ance car­dio­vas­cu­lar con­stric­tion and dila­tion, reduc­ing the risk for hyper­ten­sion.

Last Ques­tion:

What is a healthy weight gain?

Answer:

In 2009, the Nation­al Acad­e­my of Sci­ences revised its rec­om­men­da­tions. It now bases desir­able weight gain on pre-preg­nan­cy BMI (Body Mass Index…google this!).

BMI less than 18.5 (low) — 28 to 40 lbs.; BMI between 18.5–24.9 (nor­mal) — 25 to 35 lbs.; BMI 25.0 to 29.9 (high) — 15 to 25 lbs.; obese women (BMI over 30.0) — 11 to 20 lbs.

Com­ing Next: Avoid­ing Risks.