Fertility & Conception

Fertility & Conception

This article provides both mums and dads ‘to be’ with a good breadth of information on a range of health aspects that impact on fertility and conception. This includes preconception planning notes for both men and women, and healthy planning suggestions ahead of both pregnancy & breastfeeding. With guidance on the most relevant nutrients and supplements including information for vegetarians, vegans and those on special diets. And sensible diet and nutrition suggestions for women whilst pregnant and breastfeeding.

Diet, nutrition and lifestyle are all key factors toward a successful pregnancy; the expectant mother and growing foetus both have substantial nutritional demands. And this healthy regime is also essential in the period of breast-feeding, and beyond, to support growth in the baby and to meet the demands and recovery placed on the mother.

preconception-planning
Diet, nutrition and lifestyle are all key factors toward a successful pregnancy

If you are planning for a baby good nutrition is essential too, and for two reasons. Firstly, it can take days or weeks before the pregnancy is confirmed yet the right nutrition is essential for the foetal development from the moment of conception.

Secondly, nutrition and lifestyle factors can help support both the mums and dads-to-be toward successful conception. For example good levels of certain nutrients will help support testosterone levels and sperm motility.

Preconception Planning

It is estimated that one in six UK couples experience difficulty in conceiving, with poor diet, stress, maintaining a healthy weight and lifestyle issues such as smoking and drinking considered major contributory factors.

Preconception is an important time, during which both prospective parents can prepare their bodies by ensuring a healthy diet and good nutrition to assist fertility and conception. A nutritionally replete diet and healthy lifestyle can assist in sustaining a healthy pregnancy and providing your baby with as healthy a start as possible.

Forward planning is the optimal approach for conception and pregnancy as baby’s development is well underway once pregnancy has been confirmed. So planning for a healthy baby needs to begin as soon as possible, ideally 6 months before conception, or at least 3 months, as it is during this time that the sperm and ova commence their maturation process. Both are extremely vulnerable to nutritional deficiencies and toxins at this stage.

Dads to Be

Nutrition has a direct impact on the potency of your sperm. Poor eating habits and regular consumption of alcohol, for instance, can lower the quality of your sperm, making conception more difficult and influence the birth weight of your baby.

Some of the most important nutrients at this time for men to ensure a healthy and plentiful supply of sperm are folic acid, zinc, selenium, vitamin C and additional antioxidants (full details below). We would suggest that you consider a multivitamin and mineral supplement specifically formulated for men to ensure that you include all the important nutrients.

Men should ensure that supplements selected contain either no iron or very small amounts of iron only. Typically, a product for menstruating women will include approximately 7mg of iron up to a maximum of 20mg. For men, supplemental iron should be no higher than 2mg/day.

Mums to Be

A number of nutrients are known to be essential for both conception and a healthy pregnancy. In women contemplating pregnancy there is an increased requirement for a variety of nutrients – Folate, Iron and Vitamin D being some of the most important. Current UK Government health recommendations emphasise the importance of certain nutrients and such guidelines and full details on respective vitamins and minerals are provided later on.

Supplementing with a multivitamin and mineral can ensure that levels are elevated to optimal or near optimal levels, dependent on diet. Ensure that any supplements are suitable for conception and pregnancy: supplementing with high dose individual nutrients is not recommended.

Pregnancy & Breastfeeding

During pregnancy your body requires extra protein, vitamins and minerals in order to support your growing baby and to allow for changes in your own body. Nutritional recommendations during the early stages of breastfeeding are very much the same as during pregnancy (vitamin and mineral intake remains important).

It is important to be aware that what you eat during this time has a significant impact on the health of you and your developing child. It is now believed that nutrition in early life, including before birth, can shape the health of the individual for many years.

Dietary recommendations during pregnancy are to follow a healthy, balanced diet. “Eating for two” is not a part of this, with energy/calorie guidelines now only increasing slightly during the third trimester. As a rule, pregnancy increases nutrient needs by a further 50% but only increases calorific needs by 30%. This may not be appropriate for all during pregnancy, based on an assumption of reduced energy expenditure: those remaining physically active may require additional calories.

What is important is to ensure that the food consumed provides good nutrition, avoiding the use of empty calories from nutrient-poor processed foods (including high sugar or saturated fat foods). Within the healthy eating regime, women are encouraged to ensure they consume iron and folate-rich foods.

It is vital to maintain good levels of a wide range of nutrients and in particular Vitamin D and Folic Acid (a B-Complex vitamin). We cover the most important nutrients for pregnant and breastfeeding women later; plus a detailed section on nutrition, diet and lifestyle advice during Pregnancy and breastfeeding.

Nutritional Supplements for Preconception, Pregnancy & Breastfeeding

Folate-Supplements
“Women who are planning a pregnancy or might become pregnant, or who are already pregnant, should take a folic acid supplement (and vitamin D supplement)”

Why supplement? Many of us are nutritionally depleted, despite consuming adequate or excessive amounts of food, often as a result of poor dietary choices or poor quality food. Ensuring a balanced diet that provides all the vitamins, minerals and essential fats we require can be challenging and difficult to achieve. Research has demonstrated that girls and women are particularly low in a number of nutrients essential for health and of relevance for pregnancy and conception.

Forward planning is also appropriate for introducing vitamin and mineral supplements to your diet. Remember: if you start from a depleted state it will take time for supplements to correct this deficiency. Nutritional supplements are widely available. Select those specifically formulated for conception and pregnancy; products are also available for the health and fertility of prospective fathers.

Please Remember: vitamin and mineral supplements should not replace a healthy diet. Instigate your dietary and lifestyle changes first, and support with supplements.

Folate / Folic Acid
Supports: Preconception for Men & Women; Pregnancy & Breastfeeding

The UK Department of Health current recommendation is that “Women who are planning a pregnancy or might become pregnant, or who are already pregnant, should take a folic acid supplement (and vitamin D supplement)”

The Government advice also states that “If you didn’t take folic acid supplements before getting pregnant, you should start taking them as soon as you find out you’re pregnant.”

Folate (also termed folate) is part of the water-soluble ‘B-Complex’ vitamins and Folate is necessary for proper brain function as it is concentrated in the spinal and extra cellular fluids. Folate plays an important role toward the production of RNA and DNA as it helps in the formation of red blood cells and nucleic acids. Folic Acid supplements should provide the recommended dose of 400µg daily. Recent research indicates the benefit for folic acid supplementation beyond the previously advised twelve weeks of pregnancy.

If you are planning to take a supplement with folic acid we would recommend Methylfolate (5MTHF) – this is the most stable, safe and bioeffective supplement form of Folate and it is ideal as a supplement for pregnant women and women planning pregnancy.

Folate is derived from the term “foliage”, which indicates where this vitamin is found: in green, leafy vegetables (broccoli, spinach, sprouts) as well as oranges, beans, rice, brewer’s yeast and liver.

A number of studies provide evidence of a link between folate intake and sperm abnormalities and hence a suitable and regular intake of folate rich foods for dads to be is a good idea.

Folic acid is vital for the baby during early pregnancy and in particular it is needed by the baby for the development of the neural tubes. Folic Acid has a number of approved health claims and this includes ‘Folic Acid/Folate contributes to normal maternal tissue growth during pregnancy’.

In 2013 Folate has been issued with a ‘favourable opinion’ by EFSA (The European Food Safety Authority). Specifically EFSA has issued a favourable opinion on the use of supplemental folate to reduce the risk of neural tube defects (NTD) such as spina bifida and anencephaly in newborn children (In order to obtain the claimed effect, 400 μg of supplemental folate should be consumed daily for at least one month before and up to three months after conception).

Since the neural tubes are the first thing to develop, almost before many women know they are pregnant, it is imperative that folic acid is taken either as an individual supplement or within a multi-formula before pregnancy starts.

The water solubility of the B-Complex vitamins means that any excess is excreted and not stored (e.g. excreted by going to the toilet or sweating); therefore they must be continually replaced.

Vitamin D
Supports: Preconception for Men & Women; Pregnancy & Breastfeeding

Vitamin D is most commonly associated with contributing to the maintenance of strong bones and teeth, helping support the functions of the immune system and contributing toward normal muscle functions. In respect of pregnancy the UK Department of Health have stated:

“Women who are planning a pregnancy or might become pregnant, or who are already pregnant, should take a vitamin D supplement”

Vitamin D is important in pregnancy to support the mother and in particular to provide the foetus and subsequent baby with suitable levels of the vitamin. Vitamin D is needed for normal growth and development of bone in children. For children one consequence of not having enough vitamin D is it can cause their bones to soften and can lead to rickets (a bone development disease in children).

In December 2012 the Royal College of Paediatrics and Child Health expressed ongoing concerns about vitamin D deficiency in UK children leading to an increased range of ailments including a worrying rise in rickets cases. Breast feeding women who are themselves deficient in Vitamin D will pass little of the vitamin in their breast milk.

Vitamin D is termed ‘the sunshine vitamin’ as the vitamin is mostly made in our skin by exposure to sunlight; and a lack of sunshine is likely to lead to not enough Vitamin D; for example this is one of the causes reported on widespread Vitamin D deficiency in Scotland.

Most of the foods we eat contain very little vitamin D, though more recently some makes of processed foods are fortified with added vitamin D. The following are examples of foods that contain Vitamin D: salmon, mackerel, tuna, sardines, milk, eggs, beef, liver and Swiss cheese.

Vitamin D3 is the most bioavailable form of this nutrient and far preferable to Vitamin D2 to supplement with. The NHS recommendation (for preconception and pregnancy) is supplementing with 0.01mg of vitamin D, however there is ongoing debate on what levels of Vitamin D to supplement with – recent studies suggest much higher levels than the current UK RDA (Recommended Daily Allowance) are optimally beneficial. If, post childbirth, you are using a formula then it is likely to contain vitamin D.

In general those on certain medications (e.g. for some heart ailments), those with rare medical conditions (e.g. kidney disease), vegetarians and vegans (due to diet), and those with darker skins e.g. African, South Asian (they are unable to ‘make’ as much vitamin D) can all be more susceptible to Vitamin D deficiency.

vitamin-d-sunshine-vitamin
Vitamin D is known as the ‘sunshine vitamin’ and current UK Government recommendations are that “Women who are planning a pregnancy or might become pregnant, or who are already pregnant, should take a vitamin D supplement”

It should be mentioned that post childbirth and breastfeeding the chief medical officer for England recommends that all pregnant and breastfeeding women and children aged six months to five-years-old should take vitamin D supplements.

Essential Fatty Acids
Supports: Preconception for Men & Women; Pregnancy & Breastfeeding

The ‘essential fatty acid’ Omega 3 is particularly important for pregnancy, breastfeeding and subsequent development of the baby. Suitable Omega 3 levels can help a baby’s nervous system and vision to develop. That is why they are now added to baby foods, and why the Government recommends we eat oily fish at least twice a week (recommendations vary during pregnancy and preconception).Good Omega 3 levels are beneficial as part of preconception planning for both men and women.

The primary food source of Omega 3 is fish and especially oily fish such as mackerel and sardines. Shellfish, algae and seed oils such as flaxseed are other excellent sources (the latter ideal for vegetarians and vegans). Fish and crustacean sources have positive benefits requiring much smaller daily amounts than seed oils, for example, and provide omega 3 in a form that is well utilised by the body.

The health benefits of oily fish can be mainly attributed to its fatty acid content. There are 2 types of fatty acid: Omega 3 and Omega 6. When we ingest Omega 3 our body breaks the fatty acids down to 2 other fatty acids – Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA), and these are the components our body uses for many essential activities such as the maintenance of eye health, cell membrane integrity, skin health, joint mobility, and normal liver function.

The NHS advice for women planning pregnancy and those pregnant is to avoid some types of fish (normally fish at high risk of mercury pollution such as tuna and swordfish) and limit the amount they eat to two portions a week. This is because pollutants found in oily fish may affect the development of a baby in the womb in the future.

Many people prefer to take Omega 3 supplements rather than eat fish. The most popular supplements are fish oil and krill oils in capsules or liquid. However the advice for pregnant women and those planning a baby is to avoid fish oil supplements that comprise fish livers; these are high in vitamin A (retinol), which can be harmful to your unborn baby. Heavy metals can also accumulate in the liver of oily fish. Pregnant women are advised to avoid taking supplements that contain vitamin A as retinol.

Fish oils made from whole body fish excluding the livers and krill oils are naturally rich sources of Omega 3 – make sure you select a reputable supplier who guarantee pollution free and ethically sourced oils.

For vegetarians and vegans who do not eat fish a good supplement option for rich Omega 3 is flaxseed oil. For flaxseed oil supplements you will again look for a pure oil rich in ALA (alpha-linolenic acid), organic so it is free from herbicides, and cold-pressed, which means that it is unprocessed and that the fatty acid content will remain unharmed in the extraction.

N.B. It is advisable to stop taking fish, krill or flax oil about 10 days before the birth due date and to resume about 10 days after. This is simply because omega-3 thins the blood and in the event of surgical intervention during the birth it might serve to increase the risk of excessive bleeding.

Iodine
Supports: Preconception for Women; Pregnancy & Breastfeeding

The mineral iodine helps make the thyroid hormones. These hormones help keep cells and the metabolic rate healthy. Good food sources include sea fish and shellfish, plant foods such as cereals and grains, and dairy produce. Suitable iodine levels are important in preconception, pregnancy and breastfeeding as the nutrient supports the baby’s future neural development.

In the UK the NHS also advises on the recommended daily needs for Iodine and currently state “Most people should be able to get all the iodine they need by eating a varied and balanced diet. However, if you are pregnant, you may need to take iodine supplements. This is because an iodine deficiency during pregnancy can harm the development of your baby.”

In addition the World Health Organization currently recommends that pregnant and breastfeeding women consume 250 micrograms of iodine a day.

Iodine cannot be stored by the body for a long period and it must be obtained regularly via the diet. Amongst various recognised functions Iodine contributes to normal cognitive and neurological function, normal thyroid function, normal production of thyroid hormones, normal energy-yielding metabolism and the maintenance of normal skin.

In the UK, a good source of iodine is found in cows’ milk, although levels can vary depending on what the cows are fed and whether the milk is organic (where iodine levels may be lower).

One other food source that is rich in iodine is Kelp. Kelp is the name given to a whole variety of seaweeds and Kelp contains large amounts of organic iodine. Of course seaweed is extremely unlikely to feature in our diets however kelp supplements (generally in tablets or capsules) are popular for their iodine rich content.

Kelp contains large amounts of organic iodine and traces of every known mineral and element, which act as catalysts in the body and stimulate vital enzyme reactions. Kelp and seafoods are the most reliable natural sources of iodine because certain vegetables which contain iodine also contain substances which interfere with its absorption by the body.

Iron
Supports: Preconception for Women; Pregnancy & Breastfeeding

Maintaining good levels of the mineral iron are important at all stages for menstruating women and particularly so during pregnancy and breastfeeding. It is important to therefore plan for pregnancy with iron at optimum levels. Iron is essential for the foetus and baby too with iron particularly needed for development of normal cognitive function.

Anaemia can be a problem during pregnancy regardless of diet because the developing foetus will draw on the mother’s iron stores to create stores of its own which are required for the healthy formation of red blood cells. A typical symptom of anaemia is tiredness.

Also, maternal blood volume increases by 50%, therefore iron is needed in larger amounts, particularly in the later stages. Eat foods rich in iron, such as dark green leafy vegetables, dried beans, nuts, legumes and dried fruits. If you are a meat-eater you will find it easier to keep your iron levels topped up, as “haem iron” (Iron from blood in red meat) is much better absorbed than vegetable iron.

If the iron levels in pregnancy become low a GP or midwife is likely to advise the use of iron supplements. A multi vitamin and mineral supplement formulated for pregnancy and breastfeeding is likely to contain reasonable levels of iron.

Calcium & Magnesium
Supports: Preconception for Women; Pregnancy & Breastfeeding

The important minerals calcium and magnesium (plus phosphorus) are in great demand during pregnancy. Intestinal absorption of calcium doubles early in pregnancy, and the mineral is stored in the mother’s bones. Later, as the foetus begins to develop, the mother’s stores are drawn upon.

Calcium is essential for making the baby’s bones and teeth. Dark green leafy vegetables and low fat cheeses are good sources of calcium, magnesium and also vitamin D. Phosphorus is abundant in most foods. Increased amounts (above the recommended daily allowance) of Calcium may be needed for women during pregnancy and lactation.

Not only is vitamin D important in its own right but Calcium works with vitamin D in bone and teeth development. Vitamin D contributes to build strong bones and teeth and also supports the normal usage of calcium and phosphorus in the body.

When looking at supplementing with calcium we would not recommend the common calcium carbonate supplements which are not soluble in the hcl acid of the stomach. Conversely calcium supplements from organic calcified seaweed have a porous and hydrolised surface area because of years in the ocean and this helps it to be very soluble in the hcl acid of the stomach; this permits uptake into food calcium metabolic pathways for optimum end organ fate.

Magnesium is an essential mineral with nearly 70% of the body’s supply located in the bones. Magnesium aids in bone growth and is necessary for the proper functioning of muscles. Magnesium is involved in many essential metabolic processes including the release of energy from glucose and normal nerve function.

B-Complex Vitamins
Supports: Preconception for Men & Women; Pregnancy & Breastfeeding

The B-Vitamins bestow a wide range of health benefits for preconception, pregnancy and breastfeeding; for example the B6 Vitamin Pyridoxine (or Pyridoxal) contributes to the regulation of hormonal activity. Whilst vitamin B12 contributes to normal red blood cell formation and provides a role in the process of cell division. Both vitamins B12 and B6 are needed for the production of red blood cells during pregnancy.

We have previously covered the all important B-Complex vitamin for preconception, pregnancy and breastfeeding – Folic Acid. Most or all of the eight B-Complex vitamins typically feature in multivitamin and mineral supplements specifically formulated for preconception and pregnancy. These are all important vitamins for the health of both mother and child and support preconception for both partners too.

All the B vitamins are water-soluble substances that are naturally present in brewer’s yeast, liver and whole-grain cereals. Production of B vitamins by our own intestinal bacteria is another important source. Because they are water-soluble they are not stored in the body in any appreciable amounts, and must be regularly replaced.

B-Complex vitamins are necessary for the normal functioning of the nervous system and may be the single most important factor in the maintenance of the nerves. However stress can rapidly deplete our B-Complex vitamin levels. Each of the B-Complex vitamins can be found in different food sources, for example Folic Acid is found in leafy green vegetables such as sprouts and spinach.

Selenium & Zinc
Supports: Preconception for Men & Women; Pregnancy & Breastfeeding

Selenium: Selenium is a mineral that plays an important role in our immune system’s function (at all stages of life) and in reproduction. Good food sources of selenium include brazil nuts, fish, meat and eggs.

Selenium is a natural antioxidant that protects against free radicals and the mineral is necessary for the production of ‘prostaglandins’ and as such plays an important role in maintaining thyroid functions and male fertility and reproductive functions.

Selenium has a number of approved health claims and this includes “Selenium contributes to normal spermatogenesis” so we can see its importance for dads to be and male preconception planning.

Zinc is the second most abundant trace mineral in the body, being present in all tissues. Zinc has a wide variety of functions including growth and human development, the healthy functioning of the immune system, and the maintenance of healthy skin, hair, nails and bone.

Soil exhaustion and the processing of food adversely affect the zinc value of the food we eat. Diets high in protein, whole-grain products, brewer’s yeast, wheat bran, wheat germ, herring and pumpkin and squash seeds are usually high in zinc. Approved health claims for zinc include: “Zinc Contributes to the maintenance of normal serum testosterone concentrations” and “Zinc Contributes to normal fertility and reproduction”.

Vitamins C & E
Supports: Preconception for Men & Women; Pregnancy & Breastfeeding

Vitamin C is always important in its protective capacity, the vitamin protects cells and helps keep them healthy. Vitamin C contributes to a wide range of bodily functions including the normal function of blood vessels, energy-yielding metabolism, the immune system, iron absorption and collagen formation for bones, cartilage, gums, skin, teeth.

Vitamin C however is a ‘water soluble’ vitamin and rapidly excreted from our body by sweating and going to the toilet for example. So we need to continually top up our vitamin C levels with foods rich in the nutrient.

Vitamin C during pregnancy
The best known natural sources of vitamin C are the citrus fruits: oranges, lemons, tangerines, limes and grapefruits. The fruits with the highest natural concentrations are citrus fruits, rose hips, strawberries and acerola cherries.

The best known natural sources of vitamin C are the citrus fruits: oranges, lemons, tangerines, limes and grapefruits. The fruits with the highest natural concentrations are citrus fruits, rose hips, strawberries and acerola cherries. Vegetable sources include: red and green peppers, broccoli, Brussels sprouts, tomatoes, asparagus, parsley, dark leafy greens, cabbage and sauerkraut.

When looking at vitamin C supplements choose ones in a food form base such as oranges or cherries – as opposed to ones in an ‘isolated’ supplement form such as calcium ascorbate. Multivitamin and mineral supplements specifically formulated for preconception and pregnancy normally contain good levels of vitamin c (but again check to see if it is in a food based form).

Vitamin E contributes to the protection of cells from oxidative stress. Vitamin E occurs naturally in cereals, vegetable oils, raw seeds, nuts and soybeans.

However in the modern diet for many the nutritive content of vitamin e may be limited. For example most of the vitamin E in green vegetables is contained in the dark green outer leaves – the part of the plant which is often discarded in food preparation. In addition the actual seed germ content in relevant foods is limited. A multi formula supplement comprising suitable levels of vitamin E may therefore be useful in order to ensure appropriate levels of vitamin E in the diet during pregnancy and breastfeeding.

When assessing a suitable supplement be aware that vitamin E occurs in nature as ‘tocopherols’ and ‘tocotrienols’, of which there are four of each. However most supplements on the market sold as vitamin E contain only d-alpha tocopherol or are isolated vitamin E. We would not recommend either of these and you should seek a supplement with all four of the four tocopherols and four tocotrienols.

Vitamin A (Beta Carotene)
Supports: Preconception for Men & Women; Pregnancy & Breastfeeding

More than minimal levels of vitamin A as Retinol should be avoided in pregnancy; vitamin and mineral formulations are available providing the more suitable Beta Carotene, a precursor of vitamin A, which is converted to vitamin A in the body as required.

Vitamin A occurs in two natural forms: vitamin A1 (Retinol) and vitamin A2. Beta Carotene is among this second type of vitamin A (termed ‘Carotenoids’) and comes from plants such as green vegetables and carrots.

As Beta carotene is a precursor of vitamin A found in plants it is enzymatically converted to vitamin A in the body as it is required. Beta Carotene is considered safer than taking Vitamin A because the body only converts the amount it needs at any point in time.

Amino acids
Supports: Preconception for Men

L-Arginine, an amino acid found in many foods, is essential for sperm production. We would recommend including foods rich in L-Arginine to your diet before choosing to supplement. Food sources include meat, fish, dairy, nuts and grains – particularly oats and wheat germ.

For those who wish to include an L-Arginine supplement, we would recommend that you consult your doctor or a qualified practitioner as this may not be suitable for all, particularly those who are susceptible to herpes (cold sores or genital herpes) and those taking certain prescribed medication.

L-Carnitine, an amino acid, is essential for the normal functioning of sperm cells. Food sources include meat, poultry, fish and dairy.

Guidance Notes on Supplements

  • We would recommend that herbal products are only taken under the guidance of your doctor or a fully qualified herbalist; this particularly applies during preconception, pregnancy and breastfeeding.
  • It is important that nutritional supplements are taken to support your diet and should not replace healthy eating and lifestyle.
  • It is possible for nutrients to interact with medications, so you should check with your doctor and/or the supplement company before taking any new products.
  • It is important not to exceed recommended safe levels of nutrients.

Vegetarians, Vegans & special diets

A healthy lifestyle and an appropriate diet rich in fruit and vegetables is essential for expectant and breastfeeding mums. However for Vegetarians and Vegans who do not eat meats and fish you need to be particularly aware of your iron, vitamin B12 and Omega 3 levels. Talk to your doctor, midwife or qualified health practitioner (e.g. nutritional therapist) to discuss this further.

Also seek professional dietary advice if you follow a strict dietary regime (e.g. for religious reasons) or you suffer from food intolerances and bowel ailments such as coeliac disease. Certain ailments can seriously impair nutrient intake and vitamin B12 and pernicious anaemia is a good example.

Vegetarian and Vegan friendly supplements are available for iron, B12 and Omega 3. A good Vegan supplement option for rich Omega 3 is flaxseed oil. The Vegan Society (www.vegansociety.com) provides some helpful information on this subject including the following:

“The only reliable vegan sources of B12 are foods fortified with B12 (including some plant milks, some soy products and some breakfast cereals) and B12 supplements.

Good plant sources of iron include dried fruits, whole grains (including wholemeal bread), nuts, green leafy vegetables, seeds and pulses. Other foods rich in iron but which are usually eaten in smaller amounts includes soya flour, parsley, watercress, black molasses and edible seaweeds. The use of ironware when cooking foods also contributes to dietary intake.”

Planning Ahead – Advice for Preconception Planning

When planning ahead for a healthy pregnancy both fathers and mothers to be should include a review of the following:

Pregnancy-and-fertility-vitamins
A healthy lifestyle and an appropriate diet rich in fruit and vegetables is essential for expectant and breastfeeding mums.

Weight

Those who are significantly under or over weight may find increased difficulty in conceiving. It has been found that women of a healthy weight for their height frequently find it easier to conceive. Women who are underweight or overweight ovulate (release an egg) less regularly, or sometimes not at all, compared to women of a healthy weight.

You should not be attempting to conceive and be dieting at the same time, particularly any form of crash dieting, severe exclusion diets or detoxification diets.

Diet

Now is the time to review your diet, if you do not already follow a healthy eating regime. Your diet should include lots of fresh fruit and vegetables, organic if possible, and provide a balanced diet including a good variety of foods providing protein, whole grains and essential fats. Avoid where possible processed and packaged foods. You can eat wild salmon, herring, sardines and trout beneficially 2-3 times a week, but avoid marlin, swordfish and shark as the mercury toxicity is the highest levels in these fish. Limit fresh tuna to no more than 2 steaks per week or 4 medium-sized cans a week.

If you are not a great fish or shellfish eater to ensure adequate intakes of omega-3 fatty acids we would recommend that you consider a suitable fish oils supplement; they come in a liquid or capsule form (make sure it is derived from a sustainable source and free from heavy metals and other contaminants). Vegetarians and vegans Omega 3 supplements are also available such as Flaxseed Oil (in liquid or capsules).

It is important that anyone taking blood thinning medication such as Warfarin or Heparin should discuss the taking of ‘essential fatty acid’ oils (e.g. Omega 3 and 6 supplements) with their medical consultant prior to starting any such supplements.

Cigarettes

If either of you or both of you smoke, now is a good time for you and your partner to give up.

Caffeine

An excessive consumption of caffeine is not desirable. Review your intake of tea, coffee and caffeine-based drinks: remember cola (for example) contains large amounts of caffeine, sugar and/ or sweeteners.

Alcohol

Reduce your alcohol intake now: it will be easier to follow an alcohol-free pregnancy if you reduce your levels now. Although there is no conclusive evidence that smoking and alcohol affects sperm production and motility in men most professionals would advise dads-to-be to keep their intake to a minimum.

Contraceptives

Try to give up hormonal contraceptives in advance of planned conception. The contraceptive pill and coil tend to result in nutritional imbalances. Consider barrier methods of contraception until your body is clear of the artificial hormones.

Medication

Review any herbal supplements and non-prescription medication you are taking. These may not be safe to take during early pregnancy, and some may affect your ability to conceive: check the manufacturer’s instructions on all medications. Even a regular ‘pain killer’ may have a manufacturer’s warning to avoid in pregnancy. For all prescription drugs, ensure that you discuss their suitability during conception and pregnancy with your GP.

Exercise

Keeping fit and healthy is important: however, excessive exercising can reduce your ability to conceive. Future fathers should be aware that for those who cycle regularly over long distances or periods of time this can potentially reduce their fertility.

Visit your dentist

Although dental treatment is free during pregnancy*, this is not the time to need amalgam fillings to be removed or added due to the presence of mercury. Better to ensure that your teeth and gums are healthy and any fillings are replaced before pregnancy.

Gingivitis which causes gum inflammation and bleeding is common during pregnancy due to hormone balance changes. Make sure you maintain good dental hygiene and get your teeth regularly cleaned.

*You’re entitled to free NHS dental treatment if you’re pregnant and for 12 months after the baby’s birth when you’re accepted for the course of treatment. Link below for full details.

Water

We would advocate a good intake of fresh, clean water for everybody and certainly when planning pregnancy and during pregnancy when fluid needs are high.
Some people question the intake of large amounts of tap water when pregnant due to the inclusion of chemicals and fluoride. You can of course check with your local water authority as to what chemicals are added to the water supply in your area.

Nutrition during Pregnancy

Energy

Be careful! You do not need as many calories as you might feel you want. In general, you will need about an extra 200-300 calories per day, beginning in the second trimester. If you are still physically active you may need more, but it is all too easy to put on too much weight during pregnancy, because many women find that they are constantly hungry. If you experience this, listen to your body; it might be telling you that you are short of vital nutrients, such as minerals. Mineral satiety will often reduce ravenous hunger.

Protein

Protein is made up from amino acids, which are the building blocks of all the cells in both your own body and that of the growing baby. When you are pregnant, you must ensure you get enough protein – particularly in the second and third trimesters, when the baby is growing fastest. Protein recommendations during pregnancy are for an additional 10-15 grams per day. This should average a total of about 60 grams per day. If you are vegetarian or vegan and omitting meat, eggs and dairy from your diet, you need to ensure you replace these with protein-rich foods such as soy, tofu, beans, pulses, seeds and nuts.

Fats

Do not reduce your intake of the healthy fats during pregnancy. Both you and your baby need essential fats during this time, and your baby in particular needs poly-unsaturated fats to form healthy skin and vision. The most beneficial fats at this time are polyunsaturated fats, which include omega-3 fatty acids found in fish and seeds.

Monounsaturated fats are also important, and the best source of these is olive oil. Studies have shown that the omega-3 chain fatty acids (DHA in particular) may lower a woman’s risk of depression, aid foetal visual development and even help to regulate the sleep patterns of the new-born.

Diet & Lifestyle Advice in Pregnancy

Continue to follow the general dietary advice contained in our ‘preconception’ section provided earlier; remembering in particular:

Fish

Pregnant and breast-feeding women are advised to avoid marlin, swordfish and shark: it is considered the mercury toxicity is the highest levels in these fish. Fresh tuna should also be limited to no more than 2 tuna steaks per week or 4 medium-sized cans a week. (We would recommend that to ensure adequate intakes you consider a suitable Omega 3 supplement) Wild salmon, sardines, trout and herring are safe 2-3 times per week.

Caffeine

Pregnant women are advised to limit their consumption of caffeine to no more than 200mg a day (approximately 2 cups of coffee). Remember, caffeine is found in some canned and bottled drinks as well as coffee, tea and chocolate.

Alcohol

Recommendations are to avoid alcohol during pregnancy for the safety of your baby.

Morning Sickness

If you are troubled by morning sickness, try ginger tea or a ginger biscuit. Some find keeping a plain, sweet biscuit by the bedside to nibble on before rising can help. Choline Bitartrate can be helpful during the early stages of morning sickness.

Digestive Disorders & Candida

To maintain a healthy digestive tract which will benefit both you and baby, a good probiotic supplement can be taken. It is particularly important for those who experience intestinal disturbances candida and thrush symptoms.

Also, the following guidelines are considered important to your pregnancy:

Listeria

Pregnant women are advised to avoid foods where high levels of the bacteria Listeria have been found, e.g. paté and blue-veined and soft cheeses such as Brie and Camembert. There is no risk associated with hard cheeses such as Cheddar or Cheshire, cottage cheese, processed cheese or cheese spread. It is recommended that you ensure ready-cooked meals are reheated until piping hot, and to ensure meals containing poultry are well cooked.

Salmonella

The effects are unpleasant and undesirable during pregnancy, although it is not believed to have a direct adverse effect on the unborn baby. Pregnant women are advised to avoid eating raw eggs or food that contains raw or partially cooked eggs. Eggs should be cooked until both the white and yolk are solid. Raw meat and chicken can also be a source of salmonella. Meat, especially poultry, should be thoroughly cooked.

Toxoplasmosis

An illness caused by a parasite found in cat faeces. Contact with cat litter trays or cat excrement should be avoided. The parasite can also be present in raw meat and, occasionally, goat’s milk. The illness can, in rare cases, be passed to the unborn baby via its mother, resulting in a range of problems – some of them serious. As a safeguard, pregnant women should not eat raw or under-cooked meat, unpasteurised goat’s milk or goat’s cheese.

Diet & Lifestyle Advice in Breastfeeding

The recommendations during the early stages of breastfeeding are very much the same as during pregnancy. Essentially, you need a nutrient-rich diet with plenty of dark green vegetables, fresh fruits, nuts, seeds and pulses. The key is to make every mouthful a nutritious one – limit your intake of nutrient-empty foods, such as those found in many highly processed foods. If you suffer from post-natal depression, it is vital that you have a good level of intake of dietary and supplemental zinc and omega 3 chain essential fatty acids.

Zinc stores can rapidly be depleted during the tissue healing stage after the birth, and low zinc levels can trigger post natal depression. Similarly, omega 3 chain fatty acids are mood elevating and membrane stabilising, and good tissue and intake levels are vital for mental well-being at all times, particularly post-partum. Aim for 20mg zinc per day intake from food and supplemental sources during the first 2 months after the birth, and then reduce to 11mg-15mg total intake for maintenance.

If you choose to breast-feed for over 6 months you need to be aware of the mineral-drain this could begin to have on your resources. Up until this time, eating well and supplementing in the same way as you did for the later stages of pregnancy should suffice, but as time goes on (depending on how you are feeling and faring) you might need to increase your intake of minerals and essential fatty acids. As a rule of thumb you need to elevate your vitamin and mineral intake by an extra 50% during pregnancy and breastfeeding, but your calories only 10%-15%.


Latest News – What mother eats & baby’s genes and health

News just published today (8th May) from the Prestigious publication ‘Nature’ is of great relevance and interest. They report details of a study which absolutely identifies that what a mother eats at the time of conception will impact on the expression of the genes of the baby conceived. This particular aspect will be fully explained in a future article, but it is a finding worthy of mention.

What this means is that mums-to-be really need to start eating a careful healthy diet weeks before planning a baby, as poor diet, unhealthy food choices, smoking and alcohol have the potential to make the baby more susceptible through life to a whole range of illnesses. Conversely a good nourishing wholefood diet with optimum levels of key nutrients will impact beneficially on the gene expression and long term health of the baby.

Link to relevant article: Nature.com


If you have any questions regarding this article, any of the health topics raised, or any other health matters please do contact me (Amanda) by phone or email at any time.

Amanda Williams, Cytoplan
[email protected], 01684 310099


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