Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition

date Jan 31, 2019
authors Lily Nichols and Melissa Powell
reading time 35 mins

Why prenatal food is important?

The way you nourish yourself during pregnancy quite literally shapes your baby’s health, and not just in early infancy, but for the rest of his or her life. The foods you eat, the supplements you take, the way you move your body, the toxins you are exposed to (or not), and the way you handle stress, can leave a direct—and lasting—mark on your baby’s DNA, and thus his or her risk for health problems later in life.

Supplements are just insurance

some prenatals contain poorly utilized forms of nutrients (like folic acid instead of L-methylfolate). A high-quality prenatal vitamin can serve as an insurance policy of sorts, but there really is no replacement for a nutrient-dense diet of real food.

Healthy mommy, healthy baby

We also had excellent outcomes: healthier moms who didn’t struggle with hunger or excessive weight gain; who had far lower rates of preeclampsia; and who had healthy babies who were born at a normal weight and with normal blood sugar levels.

Pre-pregnancy food is equally important

This book is geared towards women who are already pregnant; however, because your health pre-pregnancy impacts your health during pregnancy, this advice is equally appropriate if you are trying to conceive.

Genes can be turned on and off

Though most of us view our genetics as a solid blueprint, researchers have found that genes can be turned on or off by certain exposures in utero, such as levels of nutrients, a mom’s blood sugar and insulin levels, exercise habits, stress hormones, toxins, and much more.

Preparing for pregnancy is well worth it!

When it comes to your experience of pregnancy, you have the power to lower your chances of developing gestational diabetes, preeclampsia, delivering prematurely, becoming anemic, and gaining too much or too little weight during your pregnancy, all by the way you live your life. How empowering is that?

Why real foood?

  • Real food is as close to its source as possible and grown or raised in conditions that maximize nutrient density.
  • Real food is minimally processed, so it appears just like you would find it in nature.

Real food diet

At minimum, a well-balanced real food diet for pregnancy includes vegetables, fruit, meat, poultry, fish and seafood, nuts, seeds, legumes and plenty of healthy fats.

How much more to each?

That said, if we assume 300 calories is a ballpark figure, that’s the equivalent of adding an extra snack to your day, not double portions at every meal. As one scientist puts it, “the old saying that a “pregnant woman needs to eat for two,” is an overstatement, and should be modified to “a pregnant woman needs to eat for 1.1.” What does increase significantly is your need for certain nutrients, such as vitamin A, folate, vitamin B12, choline, iron, iodine, and many others.

Easy to over-consume carbs!

I’ve observed that it’s quite common (and easy) for women to over-consume carbohydrates, but rarely do I observe women over-consuming protein or fat.

Better types of carbs

Well, although legumes, milk, and yogurt all contain protein, they also contain a significant amount of carbohydrates and therefore raise your blood sugar. They are, however, a wise carbohydrate choice compared to breads, crackers, pasta, and cereals because of their protein content. Legumes are also rich in fiber, which slows how quickly the carbohydrates found within them are digested.

Which types of carbs to prioritize

I simply encourage you to prioritize the most nutrient-dense, low-glycemic sources of carbohydrates, like non-starchy vegetables, Greek yogurt, nuts, seeds, legumes, and berries. There’s still room for more carbohydrate-dense foods, like sweet potatoes, fruit, and whole grains, but treat them as a small side dish or snack

Complete vs Incomplete proteins

Foods of animal origin or “animal foods” — such as meat, fish, eggs, and dairy — are complete proteins. Plant foods — such as beans/legumes, nuts, and seeds — are incomplete proteins.

Protein targets

In the first half of pregnancy, aim for a minimum of 80 g of protein per day. In the second half of pregnancy, aim for a minimum of 100 g of protein per day. If you’re a larger person or are very physically active, you may want to aim a little higher.

Main Sources of Protein:

  • Beef, lamb, pork, bison, venison
  • Chicken, turkey, duck, and other poultry
  • Fish & seafood
  • Sausage & bacon
  • Organ meats
  • Homemade bone broth or stock
  • Eggs
  • Cheese
  • Yogurt (Greek yogurt is especially high in protein and low in carbohydrates)
  • Nuts: Almonds, pecans, peanuts, walnuts, hazelnuts, pumpkin seeds, sunflower seeds, cashews
  • Nut butter, such as peanut butter or almond butter
  • Beans, peas, lentils and other legumes (also a source of carbohydrates)

Choline and Vitamin A

For example, requirements for choline and vitamin A, both found in high concentrations in liver and egg yolks, rise significantly in pregnancy.

DHA

One type of omega-3 fat, called DHA, is especially important at this time, as it plays a fundamental role in brain and vision development. As we’ll explore in later sections, DHA is found primarily in fatty fish and seafood, grass-fed meat, and pasture-raised eggs.

healthy fat

It probably goes counter to everything you’ve been told about what constitutes a “healthy fat,” but lard and butter are far better choices than vegetable oil… That means eating chicken with the skin, full-fat dairy, eggs with the yolks, and not trimming the fat off of that juicy grass-fed steak.

Main Sources of Fat:

  • Animal fat: lard (pork fat), tallow (beef fat), duck fat, chicken skin
  • Dairy fat: butter, ghee (clarified butter), heavy cream, sour cream, cream cheese
  • Plant fat: olives, coconuts, avocados, nuts, seeds, and any unprocessed oils derived from these foods

Non-picky eater

Also, aim for as much variety as you can, not only to maximize your nutrient intake, but because your growing baby’s preferences for healthy foods are partly formed in utero. Yes, your baby can “taste” what you’re eating via your amniotic fluid. This early exposure to healthy foods helps set the stage for a non-picky eater once your child transitions to solid food.

Non-Starchy Vegetables:

  • Artichoke
  • Asparagus
  • Bell pepper
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cactus (nopal)
  • Cauliflower
  • Celery
  • Chayote squash
  • Cucumber
  • Eggplant
  • Garlic
  • Greens: beet, collard, dandelion, mustard, spinach, kale, chard, turnip greens, spinach, watercress, bok choy, arugula
  • Tomatillo
  • Tomato
  • Green beans
  • Kohlrabi
  • Leek
  • Lettuce: endive, escarole, iceberg, romaine, “baby” greens
  • Mushroom
  • Okra
  • Onion (all types)
  • Radish
  • Rutabaga
  • Summer squash
  • Zucchini
  • Turnip

Salt

It’s no coincidence that cravings for salty pickles and olives are so common in pregnancy, but you’ve probably been told to avoid salt during pregnancy to keep your blood pressure from going up. However, this is not evidence-based advice. For most people, salt does not have an impact on blood pressure.

Mindful eating

Mindful eating means listening to the signals your body sends you about food and honoring what it has to say. It means eating when you’re hungry and stopping when your body has had enough… When you ignore your hunger cues, you tend to ignore your fullness cues as well. So mindlessly overeating or consciously under-eating are equally unhealthy and unsustainable.

Why smaller meals are better

However, for most women, eating small meals and snacks has three benefits: You never get too hungry (this stabilizes your blood sugar and energy levels) You don’t have to eat huge portions at meals Your baby gets a consistent supply of nutrients throughout the day Smaller meals are also helpful if you’re managing common pregnancy complaints like nausea or vomiting, heartburn, reflux, or feeling full quickly.

Why eggs

To start, egg yolks are rich in choline. Choline is a relative of the B-vitamins that didn’t gain much attention until the last two decades. In fact, the first recommended intakes for choline were issued in 1998… Eggs are one of the few non-seafood sources of DHA, a key omega-3 fat that is linked to higher IQs in infants. Choline works synergistically with the omega-3 fat, DHA, enhancing how much DHA is incorporated into cells.

Eggs as breakfast

Researchers investigating people’s responses to different types of breakfast have found that, compared to a bagel, those who eat eggs naturally eat less throughout the day, have fewer cravings, and experience fewer spikes in blood sugar and insulin. Eggs are full of nutrients, they keep you satisfied, and they stabilize your energy levels. They are a win-win-win.

Dietary carbs vs dietary cholesterol

It turns out that excessive dietary carbohydrates are more closely linked to high blood lipids than dietary cholesterol (or saturated fat). Besides, our brains need cholesterol. In fact, 25% of the cholesterol in our bodies is found in the brain where it plays a crucial role in normal neural function. If you want to provide the raw materials to help your baby develop a healthy brain, you should absolutely be consuming cholesterol.

Liver rich in Vitamin A

Many of you reading this may have been specifically warned to not consume liver during pregnancy, precisely because it is rich in vitamin A. This has sparked controversy over the years, mostly because old studies linked high-dose synthetic supplemental vitamin A to birth defects. However, we now know that naturally occurring vitamin A does not exert this toxicity, particularly when consumed with adequate vitamin D and vitamin K2, nutrients that are also found in abundance in liver.

Nutrients from real food

This illustrates perfectly why obtaining nutrients from food is far safer than getting them from supplements.

Eat more than just the boneless meat

Traditional cultures didn’t eat boneless, skinless chicken breasts and throw out the rest of the animal. They ate the organs, the fat, and they used any tough cuts of meat, bones and skin to make soup.

Glycine

The most reliable food sources of glycine include bone broth, slow-cooked tough cuts of meat (think pot roast or pulled pork), skin-on and bone-in poultry (like chicken wings, thighs, or whole roasted chicken), pork rinds, bacon, and sausage or ground meat (as these are often made from tougher cuts).

Folate and greens

Greens are one of the most abundant sources of folate, which makes sense considering that folate derives from the word “foliage,” meaning leaves (the other two major sources are liver and legumes).

Eating with fats

Keep in mind that the nutrients in all vegetables, especially the antioxidants and fat-soluble vitamins, are best absorbed when you eat them with some fat, so don’t be shy about eating grass-fed butter, coconut oil, olive oil, avocado, nuts, or other healthy fats alongside your vegetables.

Fish

Unfortunately, this information is a little misguided. While there are certain fish that are very high in mercury and should be avoided (namely swordfish, king mackerel, tilefish, and shark; tuna should be limited to <6 oz per week), many other types of fish are perfectly safe to eat while pregnant, even if they contain small amounts of mercury.

Seafood

In fact, the worst cognitive outcomes were among children whose mothers consumed no seafood during pregnancy. These children were more likely to have problems with fine motor skills, social development, and communication skills.

Fatty fish

Fatty fish such as salmon, herring, and sardines (plus fish eggs or “roe”) provide the most concentrated sources of dietary DHA and are also low in mercury.

Iodine from seafood

Consuming seafood—in particular, seaweed, scallops, cod, shrimp, sardines, and salmon—is a great way to meet iodine needs.

Fermented dairy

I also recommend including some fermented dairy, such as yogurt, kefir, and aged cheese.

Oysters and Viatmin B12

Some vegetarian and even vegan women, whose dietary choices are for ethical reasons, make an exception to eat oysters to obtain vitamin B12, as they do not have a central nervous system and purportedly do not feel pain. Oysters are incredibly rich in vitamin B12, with 1 oz providing more than the RDA.

Animal Vitamin A

Most of us have been taught that plant foods are a good source of vitamin A, but it’s important to recognize that plants don’t contain true preformed vitamin A (retinol); rather, they contain provitamin A (carotenoids). This means your body must convert carotenoids into retinol, however, this conversion rate is quite low in many individuals.

hard cheese

Hard cheeses that have undergone a long fermentation time, like parmesan, cheddar, and gouda, tend to have higher levels of vitamin K2 than soft, mild cheeses.

Stay safe from food poisoning

some ways, this is prudent advice. During pregnancy, your immune system makes some incredible adaptations to allow your baby to grow, and as a result, your body becomes slightly more susceptible to infections. Food poisoning—or foodborne illness, as researchers call it—can cause serious pregnancy complications.

Reputable and safe sources of soft cheese

“If food is properly handled and stored, the risk of being infected with Listeria appears to be low. Therefore, pregnant women need not avoid soft-ripened cheeses or deli meats, so long as they are consumed in moderation and obtained from reputable stores.”

Eat fish!

Sadly, the risks of mercury tend to make headlines more than the nutritional benefits of fish and seafood—and as a result, we have a lot more pregnant women missing out on the DHA, iodine, zinc, iron, vitamin B6, vitamin B12, glycine, and other nutrients that are abundant in many safe-to-eat types of fish.

Raw fish

Aside from mercury, women are often warned to avoid eating raw fish or sushi due to risks of food poisoning, however that recommendation remains controversial. In Japan, consumption of raw fish is not only common during pregnancy, but encouraged for optimal fetal development.

Eat raw fish from reputable and safe sources

Cooking is the most effective method for inactivation of parasites, although flash-freezing is also effective and is often used for sushi-grade fish. Pregnant women need not avoid raw fish if it is obtained from a reputable establishment, stored properly, and consumed soon after purchase.”

Shellfish

Unless you’re absolutely certain of the freshness and source, I’d ensure any shellfish you eat has been thoroughly cooked. Shellfish is incredibly nutrient-dense and I encourage you to eat cooked shellfish if you enjoy it.

Always check!

Most of the conventional “foods to avoid” are of animal origin, however vegetables and fruits can be just as risky; they are not a guaranteed safe choice. If you’re at an outdoor potluck in the summer heat with food sitting out for hours, you should be just as careful eating egg salad as you should with fruit salad or green salad.

Sane carefulness

In fact, a 2013 analysis of outbreaks found that leafy green vegetables account for more food borne illnesses than any other food type and they are the second most frequent cause of hospitalizations due to food poisoning. Yet, you never hear health officials warning pregnant moms to avoid eating salad.

Tips on checking food:

  • Trust your nose. If smells funny, don’t eat it
  • Be smart about where you purchase perishable food.
  • Avoid purchasing pre-cut vegetables or fruit
  • Cook at home more often
  • Defrost frozen meat in your refrigerator overnight (not on the counter)
  • Separate raw and cooked foods to avoid cross-contamination
  • Include bone broth and slow-cooked meat in your diet regularly

Avoid

Difficult to test for alcohol

One challenge in studying prenatal alcohol exposure is that researchers can’t randomize studies and force some women to drink and others to abstain. That means studies rely on observing women who choose to drink and those who don’t.

No consensus on alcohol

Nonetheless, these researchers caution that, “Healthcare providers should continue to advise abstinence from alcohol during pregnancy until further evidence on the effect of low-moderate gestational alcohol use becomes available… International guidelines have not reached consensus on safe alcohol recommendations for pregnant women.”

Alcohol in fermented drinks

Note: The one exception I take is fermented beverages that have naturally very low amounts of alcohol and offer the benefits of probiotics, such as kombucha, a type of fermented tea.

Coffee?

What we know is that caffeine crosses the placenta and that a baby’s caffeine levels are similar to mom’s. Also, the rate at which your body eliminates caffeine from your bloodstream decreases over the course of pregnancy.

Less nutritious foods High in Refined Carbohydrates:

  • Refined grain products, including anything made from white flour or “enriched” flour (bread, bagels, pizza, pasta, noodles, crackers, pretzels, chips, etc.
  • Breakfast cereal (yes, even those made from whole grains with no added sugar)
  • “Puffed” grains (popcorn, rice cakes, etc.)
  • “Instant” products, namely instant rice (or quick-cooking rice), instant noodles (like ramen), instant potatoes, and instant oatmeal (or quick oats)
  • White rice

In general, the more refined carbohydrates you eat, the less nutritious your diet is overall. A study into the micronutrient content of prenatal diets found that intake of refined carbohydrates was the number one predictor of a nutrient-deficient diet.

Dried fruits

Dried fruit, for example, is extremely concentrated in sugar. A mere ¼ cup of raisins has 25 g of sugar—that’s more than 6 teaspoons!

Eat less processed sugar

Also, be aware that less-processed sources of sugar, such as dried fruit, honey, and maple syrup, are still very concentrated in sugar. I prefer those to refined sweeteners like white sugar or corn syrup, thanks to their complex flavors and trace amounts of other nutrients, but they are still sugar and should be a minimal part of your overall diet.

Vegetable oils

Vegetable oils are those that are extracted from seed crops, like canola (rapeseed), soy, corn, safflower, and cottonseed. A better name for them would be “processed seed oils,” but the way they are marketed in the grocery store is “vegetable oils.”

Snacks!

Snacks can help you eat slightly less at meals (preventing a spike in blood sugar, heartburn, and indigestion), and also prevent you from getting too hungry between meals, which can often help keep junk food cravings at bay.

Vitamin A in supplements

Some formulas also completely leave out preformed vitamin A (retinol), opting for the less potent beta carotene. Retinol supplementation in high doses (over 10,000 IU per day) is contraindicated in pregnancy, but I have yet to see a prenatal vitamin with excessive amounts.

Taking supplements

Take it alongside a meal or snack rather than on an empty stomach, as this improves absorption and minimizes side effects, like nausea.

DHA from diet

It is absolutely possible to meet your DHA needs from diet alone if you consume 2-3 servings of cold water, fatty fish each week, such as salmon, herring, sardines, trout, fish eggs (roe), or mussels. Eggs from pasture-raised chickens (or those fed flaxseeds, marketed as “omega-3 eggs”) and meat, organs, and dairy obtained from grass-fed, pasture-raised animals are other (although less concentrated) sources of DHA.

Fermented food

One way to ensure your body has a healthy balance of bacteria is to regularly consume fermented foods, nature’s original probiotic “supplement.” Kefir, yogurt, aged cheese, raw sauerkraut, kimchi, lacto-fermented vegetables (like pickles), raw apple cider vinegar, fermented beverages (water kefir or kombucha), miso, and natto.

Iron

The best source of iron, by far, is liver and organ meats. Red meat, game meat, oysters, sardines, dark meat poultry (like chicken legs and thighs) are also reliable sources.

Ginger

Ginger is the most well-studied herb used during pregnancy, and has been proven effective in the treatment of nausea and vomiting. Ginger has been used for centuries to reduce nausea and is the only herb that is almost universally considered safe in pregnancy by conventional standards.

Chamomile

Often used as tea, chamomile may aid in relaxation and encourage restful sleep. Chamomile is one of the most commonly consumed herbs in pregnancy, yet safety data is lacking. Some research suggests that it may stimulate uterine contractions.

Tamarind and lemon

In India and Mexico, sweet/sour foods (such as tamarind) are traditionally recommended to ease nausea. Other options to try include lemon water, tangy popsicles (homemade versions with citrus juice work well), avocado with salt and lemon juice, and unsweetened dried cherries (a good balance of sweet and tart, like nature’s sour candy).

Lavender

Aromatherapy with pure lavender and peppermint essential oils is both safe during pregnancy and effective at alleviating nausea.

Potassium

Potassium-rich foods are helpful at this time, such as avocados, bananas, potatoes, sweet potatoes, winter squash, and oranges.

Tricky food for heartburn… keep track!

The most common culprits I’ve observed in practice are sugary foods, spicy foods, caffeine (coffee or tea), chocolate, acidic foods (like citrus or tomatoes), dairy, and gluten. That said, reactions to foods are highly individual, so if you suspect certain foods trigger your heartburn, keep a detailed food diary to help narrow down the list.

Non food tips

Posture

Lastly, consider your posture. As your pregnancy progresses and there’s less and less room in your torso, slouchy posture becomes especially problematic. If you sit with your shoulders hunched and your belly compressed, guess what? There’s even less room for your internal organs to find space around your baby, and your poor stomach doesn’t have anywhere to go. Make an effort to sit up straight with your weight directly over your sitz bones

Fats are good to bowel movements

Eating enough fat is key to having regular, easy-to-pass bowel movements for several reasons. First, dietary fats and oils help to lubricate, for lack of a better word, your intestines and keep bowel movements from becoming too dry and hard. Second, fat stimulates the release of bile from the gall bladder, which naturally stimulates peristalsis (movement of your intestines) and facilitates “propulsive contractions” of your colon.

Squatting

By the way, this is excellent preparation for labor, as it helps you learn to relax your pelvic floor muscles and encourages blood flow to the area, both of which lower your chances of having perineal tears.

Why pregnancy weight is important

One researcher puts it this way: “pregnancy may serve as an inciting factor that leads to increased body weight 15 to 20 years postpartum.” This means that your weight gain during pregnancy can impact your weight and risk of metabolic problems later in life.

Lower blood pressure

Other foods that help to lower blood pressure include fresh vegetables and fruits that are rich in both potassium and antioxidants, such as green leafy vegetables, tomatoes, Brussels sprouts, mushrooms, winter squash, avocados, oranges, and broccoli. Berries are especially high in antioxidants and studies suggest they may help lower your blood pressure.

Keeping a healthy bloog sugar

To put it simply, your body is obsessed with keeping your blood sugar fairly low during pregnancy. High blood sugar is a known cause of birth defects and can impact your baby’s growth, development, and metabolic health for life. Your baby’s blood sugar levels are a direct reflection of your own.

Keeping carbohydrates low

The good news is that blood sugar is highly responsive to lifestyle changes. First and foremost, the most important step to lower your blood sugar is to understand that the only nutrient that significantly and directly raises your blood sugar is carbohydrates.

Why exercise?

The American Congress of Obstetricians and Gynecologists (ACOG), which provides professional guidelines for prenatal medical providers across the United States, suggests that pregnant women “engage in 30 minutes or more of moderate exercise on most, if not all, days of the week” unless they have medical contraindications.

Exercise is good for the feutus as well

Also, research has found that regular exercise in pregnancy increases fetal heart rate variability, which may benefit brain and nervous system development.

Exercise for blood circulation

the only way your baby is getting nourishment and excreting waste is through your circulation, so keep that blood moving!

Don’t continue if you cannot talk

You’re exercising at a good level if you have a noticeable increase in heart rate and are still able to carry on a light conversation.

Heart rate check is not really ideal

Many women want to check their heart rate to monitor their body during exercise. However, you may be surprised to learn that heart rate does not correlate with exertion during pregnancy nor is there a set guideline on what heart rate is ideal (or too high) during pregnancy.

Careful of stretching too much

For some, deep lunges can put too much strain on the hips/sacrum and cause pain. Use caution with stretching and yoga, especially in the third trimester when you’re carrying around the extra weight of your baby (and of course, your placenta, amniotic fluid, etc.). Know your limits and don’t push it. It’s easy to accidentally stretch too far and pull a muscle during pregnancy.

Exercise with good form!

Exercise is only beneficial and safe if you do it with good form. This is even more important during pregnancy, when your body has to cope with a shift in your center of gravity, and often, a lot more weight.

Strong core muscles

Back pain is compounded when abdominal muscles are weak, since the abdominal muscles help you maintain alignment and “lift” in your spine. Exercises that involve core stabilization and/or an exercise ball have been shown effective to alleviate lower back pain and pelvic girdle pain that is so common in pregnancy.

Squats, pelvic tilts and kegels

Aside from static pelvic floor exercises, like kegels, where you “lift inward,” functional movements like squats are helpful at promoting normal pelvic floor function.

Flexible muscles

You don’t necessarily want a tight pelvic floor; you want a functional one. A functional pelvic floor engages when needed and relaxes when it’s not needed; in other words, it’s not tight all the time.

Avoid deep crunches and planks

That said, not all abdominal exercises are right for pregnancy, especially in the second half. Exercises like crunches, “roll ups” in Pilates, and unmodified planks can put too much pressure on the abdominal muscles and pelvic floor.

Relax the core muscles

Should you engage your core all the time? In short, no. You want to engage your muscles when you need them, not all the time. They need a chance to relax.

Other workouts:

  • Cat & Cow Stretch
  • Child’s Pose
  • Side Lying Chest Opener
  • Side Leg Series: Circles, Lifts, Point Flex
  • Wall Push-ups

Walking, light weights and resistance bands

Stay open to the possibility that a short 5-15 minute walk might help you feel better. Resistance exercises, like light weights or using resistance bands, have been shown to help combat fatigue and boost energy in pregnancy.

Don’t lie on your back from 2nd trimester

Exercises done lying on your back may become uncomfortable at this stage in pregnancy, depending on how much weight you have gained or where the baby is positioned. This is because your baby’s weight is pressing on the vena cava, a large vein that carries blood from your lower extremities back to the heart. This can make it difficult for you to receive enough blood and oxygen, leaving you light headed.

Poses to avoid

For this same reason, exercises where the hips go above your heart—such as bridge pose in yoga, pelvic tilts in Pilates, or any inversions—are generally avoided beyond 16 weeks.

Good posture

Make good posture a priority. Regularly reassess your posture and sit up straight, with shoulders gently pulled back and your chest open.

Braxton Hicks contractions

you notice slight contractions during exercise (and especially if you’re far from your due date), they might be Braxton Hicks. Just stop and allow the contractions to pass before resuming your activity.

Exercise

There will always be excuses to not exercise if you look for them. Remember that prenatal exercise isn’t about proving yourself to anybody, it’s about keeping your blood flowing, getting outside, feeling strong, and connecting with your body that’s doing the amazing feat of growing another human being.

Vitamin D

As you prepare for the postpartum period, know that breastfeeding mothers need a minimum of 6,400 IU of vitamin D per day to provide adequate vitamin D for baby (if your baby is exclusively breastfed).

Thyroid

Your thyroid is a tiny gland located at the front of your neck that produces several hormones. Thyroid hormone levels are most widely recognized for their role in metabolism, however they influence many other systems in the body.

Iodine

In Japan, iodine intake is consistently higher than in other areas of the world, thanks to regular consumption of seaweed.

Iron, zinc and selenium

Iron and zinc are both abundant in meat and seafood; selenium is highest in Brazil nuts, fish and seafood, liver and organ meats, beef, lamb, poultry, mushrooms, and eggs. There are other nutrients involved in thyroid health beyond those listed above, which is why a nutrient-dense, real food diet, as described in this book, is so crucial for thyroid health.

Presence of ketones in urine is normal

However, if you are not an insulin-dependent diabetic, have normal blood sugar levels, and are not starving yourself, the presence of ketones in your urine is usually nothing to worry about. During pregnancy, your body naturally has a tendency to go into a state called nutritional ketosis in which your body preferentially burns fat for fuel.

Others

Tips to minimize exposure to BPA & phthalates

  • Avoid storing or heating food in plastic. Use glass, ceramic, or stainless steel containers for leftovers
  • Do not microwave food in plastic containers or covered in plastic wrap
  • Do not let plastic wrap come in direct contact with your food
  • Use a glass or stainless steel water bottle
  • Bring a reusable glass or stainless steel mug when going out for coffee/tea

Other healthy tips:

  • Eat less canned food
  • Handle receipts as little as possible (grocery receipts, airline boarding passes, ATM receipts, etc.)
  • Consume fewer drinks packaged in cans or plastic bottles (aluminum cans are lined with BPA—yet another reason to ditch soda!).
  • Read ingredient labels on cosmetics and personal care products. Avoid products that contain phthalates. Phthalates often include the word “phthalate” in the name, like “diethyl phthalate.”
  • Stop using perfumes and scented products
  • Skip the nail polish and spend less time in nail salons.

Tips to minimize exposure to parabens

  • Read labels on cosmetics and personal care products. Avoid methylparaben, ethylparaben, propylparaben, butylparaben, isobutylparaben, and other parabens
  • Ditch deodorant or opt for a natural version
  • Use natural oils as lotion, such as coconut oil, shea butter, tallow balm
  • Use less makeup or opt for products that don’t require preservatives, such as mineral-based powder foundation
  • Opt for preservative-free products

Caution about fish with mercury

  • certain types of fish are high in mercury and need to be entirely avoided (namely: swordfish, shark, king mackerel, tilefish) and
  • just because fish may contain mercury doesn’t mean you’ll necessarily absorb it. This is because most fish contains high levels of selenium, which can help counteract the toxicity of mercury

Benefits of eating seafood

These researchers concluded that the “risks from the loss of nutrients were greater than the risks of harm from exposure to trace contaminants in 12 oz seafood eaten weekly.” Simply put: although there’s nothing you can do at this moment about mercury contamination in oceans, the benefits outweigh the risks for eating most types of fish.

Houseplants

Get a houseplant. The NASA Clean Air Study helped identify numerous houseplants that remove common chemicals from the air. Among them are: Boston ferns, peace lily, spider plant, and aloe vera.

Relaxing for stress

  • Spend time outdoors. Walk in the park, go on a hike, sit by a river, work in your garden
  • Practice deep breathing
  • Incorporate mindfulness

Sleeping schedule

A few things may be beneficial: aim for a similar bedtime each night, stay off electronics in the last 1-2 hours before bed, use blackout curtains in your room (even small amounts of light interfere with your melatonin levels, a hormone that helps you sleep), and try a pregnancy body pillow to make sleep more comfortable.

Get help and don’t try to do everything right after giving birth

What is clear, though, is that women in traditional cultures are not expected to “do it all” alone and are actively discouraged from doing so in the early weeks after giving birth. This is the polar opposite to modern expectations.

Postpartum

Nutrition for breastfeeding mothers is still very high

You might be surprised to learn that nutrient needs in breastfeeding moms are higher than while you were pregnant. Technically, you’re still growing a baby. Your baby is just outside of the womb. That means nourishing yourself should remain a huge priority.

Warming food

From rich bone broths to organ meats, from seafood to eggs, our ancestors understood that the nutrients found in these foods were extremely important for healing and milk production in new moms. The second commonality is that “warming” foods are encouraged. Yes, this includes steamy broths, herbal teas, and porridges, but it also includes recipes with warming spices, like cinnamon and ginger.

Animal food

In addition to the heavy emphasis on broths and soups, foods that encourage milk production and healing include pork, chicken, organ meats, rice, eggs, sesame seed oil, ginger, ginseng, herbal teas, and rice wine. Animal foods are central: “Meat is served every day, usually rotating between chicken, pork, pig liver and kidney.”

Keep the carbs level same

The dairy industry, which has a clear incentive to keep milk production up, has found that milk production drops when cows don’t consume enough energy and therefore go into the fat burning state known as ketosis. For this reason, dairy farmers actively try to keep their milking cows out of ketosis, to keep milk output high.

Recommendation: at least 6 months

If your goal is to follow the World Health Organization’s recommendation to exclusively breastfeed for the first 6 months and “continue breastfeeding along with appropriate complementary foods up to two years of age or beyond,” you’ll want to be prepared for the journey ahead.

Breastfeeding mothers club

Most women attend a breastfeeding class to help prepare, and don’t get me wrong, I absolutely encourage you to take a breastfeeding class while pregnant, but I found the best preparation for me was actually spending time with new moms.

Nutrient dense food

The key message here is inclusion not exclusion; Include more nutrient-dense foods in your diet as often as you can. It’s your overall diet quality that’s most important, not day-to-day variations.

Prenatal vitamins

This explains why most health professionals encourage you to continue taking your prenatal vitamin for the duration of breastfeeding. Even in moms who choose not to breastfeed, it’s wise to continue your prenatal for at least 6 months postpartum to replenish nutrient stores.

Start normal exercise after 6 weeks

At minimum, most exercise physiologists recommend a 6-week rest period after birth before resuming exercise beyond walking and strategic rehabilitative exercises (such as gentle pelvic floor or abdominal activation). In other words, less is more in the early postpartum phase.

Keep to low impact exercise

Some research has found that it takes a full year for your pelvic floor to return to normal function following birth. Engaging in high impact activity that puts excessive pressure on your pelvic floor too soon in your recovery is a recipe for incontinence or prolapse.

Avoid full abdominal exercises

In general, it’s wise to avoid abdominal exercises that involve crunch-like movements, such as sit ups, or those that put too much pressure on the abdominal wall, such as full planks, for a period of time.

Give a full year to return to pre-pregnancy health

I could do most of the same exercises that I was doing pre-pregnancy, but still … that took 10 months. I believe I was able to avoid incontinence, prolapse, and a worsening abdominal gap because I listened to my body and slowed down.

Take turns in carrying baby in arms vs baby wearing

I also noticed that carrying my baby in my arms, as opposed to always babywearing, took a lot of pressure off my pelvic floor and back—and as a bonus, I got super strong arms.

9 months on and on

There’s a huge variation in the rate of weight loss postpartum. The mantra “9 months on, 9 months off” is a good one to repeat if you’re feeling frustrated.

Post-pregnancy body will not be the same!

I think one area that’s particularly ignored is the fact that we, as women, need time to mourn the loss of our old selves—of our old bodies. We may have spent two or three or more decades without kids and suddenly after having a baby, everything is different.

4th trimester

We’d see the 4th trimester firsthand and understand that young infants are constantly attached to mama (or want to be). We’d see that most infants don’t sleep through the night consistently for a long, long time. We’d see that breastfeeding is a full-time job. We’d see that full recovery from birth can take quite a while.

At least 18 months for another kid

The latest research supports pregnancy spacing of at least 18 months, meaning waiting until your infant is 18 months old to conceive your next child. Not everyone wants to wait that long to get pregnant again, especially older mothers or those who want a large family. If 18 months is out of the question for you for any reason, researchers note that even waiting 12 months postpartum to get pregnant again is associated with fewer adverse outcomes, especially lower chances of developmental delays and autism in the child.