Give your baby the best start by beginning to eat for two with the healthiest, most nourishing pregnancy diet around. This is called “The Brewer Diet,” but I always refer to it as the “Midwives' Diet” because it is how my midwives instructed me to eat while pregnant. Don't despair if you can't eat all this food. Just know that this is an excellent way to help reduce the chances of eclampsia late in pregnancy and increase the chances your baby will be born hearty at the end.
The Brewer Diet Basics. Each day have the following:
1. Milk and milk products-- 4 servings
2. Calcium replacements--as needed 3. Eggs-2 any style 4. Protein Combinations--6 to 8 servings
5. Fresh, dark green vegetables--2 servings 6. Whole grains--5 servings
7. Vitamin C foods--2 servings
8. Fats and oils--3 servings
9. Vitamin A foods--1 servings
10. Liver--at least once a week (optional)
11. Salt and other sodium sources--unlimited
for serving amounts and suggestions for foods that fulfill each of these requirements, see list below.
...that's how much protein you are supposed to consume daily for a singleton pregnancy. The amount goes up to 110-130 grams for twins, and another 30 grams a day for each additional baby.
At this point, you may be wondering, "How in the world am I going to eat 100+ grams of protein a day?" Here are some ideas doula Kim Johnson has come up with for how to sneak protein into your diet.
(with thanks to PAC for original list, http://childbirthanddoulas.
Excerpted from "Preventing Complications with Nutrition," Midwifery Today, Issue 67
Nutrition in pregnancy—a no-brainer, right? Who would think it was so controversial? Disagreement over a healthy diet during pregnancy continues to rage, with one side saying that what a woman eats will have no effect on her pregnancy and the other saying it has an enormous impact. So what's a woman to eat?
The fact is that research has been done on this subject, but with the exception of folic acid, it stopped somewhere around the 1980s when the focus shifted to drugs as the answer to curing all ills. The research that was done was not widely accepted due to the fact that it could not include clinically controlled studies. It would not show common sense or ethics to starve a group of pregnant women in order to supply a control group. The researchers did the logical thing and used the women's previous diet and circumstances as the control. The results were amazing. Dr. Tom Brewer totally eradicated preeclampsia in specific populations where the former rates were upwards of 40 percent. He had the women eat a healthy, varied, well-balanced diet that included high quality foods, adequate protein and complex carbohydrates. He also had them drink water to thirst, salt to taste and avoid drugs. Unfortunately, the National Institute of Health refused to publish the results because he couldn't do a clinically controlled study.
So what's the problem with pregnancy nutrition? The standard medical community does not believe that women need to eat this way. Doctors keep saying that they don't know the cause of preeclampsia, but they are madly searching for a "magic pill" or single cause to shed some light on the mystery.
"Since such a common and lethal disease must have rational, scientific etiology or cause, theories other than maternal malnutrition in late pregnancy have proliferated, as private drug firms have stampeded in a frenzy to find the 'magic bullet" to cure or treat blindly the signs and symptoms of this still 'mysterious,' enigmatic, cryptic 'disease of antiquity.' So far all of these non-nutritional, drug-focused efforts have failed."
—Dr. Tom Brewer, The New Genetics in Global Maternal-Fetal Medicine/Perinatology, 2003
This attitude means that the majority of women receive no education on nutrition in pregnancy. Desperate treatments of preeclampsia, such as diuretics, elimination of salt intake and calorie and weight gain restriction, only exacerbate the problem by further reducing and restricting much-needed blood volume (called hypovolemia) and reducing the blood supply to the placenta and fetus. Women call Dr. Brewer daily with horror stories of eclampsia, premature babies, placental abruption and fetal growth restriction.
He has spent a lifetime doing research and education on preeclampsia prevention, the cause of which is widely thought to be unknown. But not to Dr. Brewer. He found in his obstetrical practice over the years that asking women what they ate and having them eat a well-balanced, adequate protein and salt, high complex carbohydrate (whole grains, beans, vegetables, etc.) varied diet all but eliminated the incidence of preeclampsia in the populations with which he was working. Another plus was the lower incidence or elimination of premature labor and births, placental abruption, fetal growth restriction and hypovolemia.
Preeclampsia, toxemia and eclampsia are all symptomatic degrees of the same disease that Dr. Brewer calls "metabolic toxemia of late pregnancy." They are evidenced by symptoms of high blood pressure, edema (swelling), sudden weight gain, proteinuria (protein in the urine), spots before the eyes, headaches, elevated liver enzymes and, in the most severe cases, eclamptic seizures. It is a dangerous disease of pregnancy that can kill both mother and baby. Any one of the symptoms alone is not necessarily an indication of preeclampsia. For instance, some swelling is normal during pregnancy; and it is not uncommon for a healthy, well-nourished woman to have a month where she gains 5–10 pounds due to a normal, healthy, expanding blood volume (usually in the seventh to eighth month).
The anatomy of eclampsia is complicated, but the basis of Dr. Brewer's research is simple: Eat good food and avoid drugs. Working with a poor, malnourished population, he looked at what the women were eating and the high rate of eclampsia and other serious maternal/fetal health problems. Rather than throwing complicated, expensive technology and drugs at the problem, he did something logical—he fed them. He asked what they were eating and recommended they eat whatever health[ful], whole foods were available to them. Apparently their diets were especially deficient in protein, so he recommended they eat eggs and drink milk because these were not only nourishing, but also inexpensive and easy to come by. Meat was expensive and scarce, but if the women could afford to obtain some, he recommended they add it to their diets, too. Contrary to the popular beliefs at the time, he told women to salt their food to taste. This supports an expanding blood volume necessary to support pregnancy and grow a baby. He reduced the rates of eclampsia from 40 percent to almost nothing.
— Amy V. Haas
Some OTC Drugs to Avoid in Pregnancy
The Food and Drug Administration (FDA) [uses a] rating system to categorize the potential risk to the fetus for a given drug.
Category D [are those for which] adequate, well-controlled or observational studies in pregnant women have demonstrated a risk to the fetus. (However, the benefits of therapy may outweigh the potential risk. For example, the drug may be acceptable if needed in a life-threatening situation or serious disease for which safer drugs cannot be used or are ineffective.)
Ibuprofen - Some common brands are Advil and Motrin. This drug is considered category B (drugs that do not appear to cause birth defects or other problems) until the third trimester, then it is category D. It has a borderline association with gastroschisis (a congenital defect characterized by an incomplete closure of the abdominal wall with protrusion of the viscera). All NSAIDs (non-steroidal anti-inflammatory drugs) used near term may cause premature closure of the ductus arteriosus and inhibit labor. Oligohydramnios after prolonged use is a common complication with NSAIDs as a class. No adequate studies have been done on ibuprofen in pregnant women. Therefore, ibuprofen is not recommended during pregnancy.
Tums (calcium carbonate) is category D in pregnancy. Extended heavy use of calcium antacids (20 grams or more daily for a prolonged time) may cause excess calcium in the blood, which can lead to kidney stones and reduced kidney function. People who already have impaired kidneys may develop milk-alkali syndrome (causing symptoms such as nausea, vomiting, loss of appetite and mental confusion) with as little as four grams a day. (The amounts listed are incredibly high intake amounts and far exceed the normal dosage recommendations.)
Know what you are taking! Ask your midwife or look up the drug yourself. Some good online resources are:
~ Demetria Clark
Excerpted from "Common OTC Drugs and Use in Pregnancy," The Birthkit, Issue 55