Must-have nutrients for mothers-to-be - whole foods; docosahexanoic acid; folic acid; dietary iron supplementation

4 recommendations to keep you and baby healthy.

Pregnancy brings about an increased need for vitamins and minerals -- for both mother and baby. Deficiency -- or excess -- of any of a number of nutrients can lead to birth defects and/or complications during pregnancy. What is a mother-to-be to do?

Recommendation #1:

The key recommendation is to focus on natural, whole foods and to stay away from processed foods that have little or no real nutritional value.

Also, read food labels carefully and stay away from foods that contain trans-fatty acids and partially hydrogenated oils, including margarine and shortening. Studies have shown that the higher the mother's intake of trans-fatty acids, the greater the risk of delivering a premature baby. In addition, these fats interfere with fetal development, especially in the brain.

Another type of food to avoid during pregnancy (or anytime, really) are cured and smoked meats. These foods contain nitrites and nitrates, which appear to be very harmful to the fetus. Studies implicate diets high in nitrites and nitrates during pregnancy with higher rates of brain cancer, diabetes, and leukemia in the offspring.

Recommendation #2:

Eat two to three servings per week of cold-water fish or take one tablespoon of flaxseed oil (or a flaxseed- oil supplement) daily. These food sources are high in omega-3 fatty acids, which have been shown to increase the level of docosahexanoic acid (DHA) available to the growing fetus. Adequate levels of DHA are important for all ages, but are particularly important pregnant and nursing women.

DHA is one of the most important omega-3 fatty acids for fetal development. In fact, DHA is essential for brain and eye development and for mental and visual function. DHA is the most abundant omega-3 long-chain fatty acid in breast milk and studies show that breast-fed babies have intelligence quotient (IQ) advantages over babies fed formula not supplemented with DHA.

The bad news is that DHA levels in the breast milk of U.S. women are among the lowest in the world. Increasing DHA levels should be a primary goal for all pregnant or lactating women. Cold-water fish, fish oils, and DHA supplements provide preformed DHA. Flaxseed oil (one tablespoon daily) is also good because it provides alpha-linolenic acid, an omega-3 fatty acid that the body eventually can convert to DHA.

Recommendation #3:

The discovery that folic-acid supplementation (400 mcg per day) in early pregnancy can reduce the incidence of neural-tube defects in a growing fetus by as much as 80 percent has been called one of the greatest discoveries of the latter part of the 20th century.

In addition to folic acid, a deficiency of virtually any nutrient during pregnancy is going to have serious repercussions for the mother and the baby. Taking a multiple vitamin and mineral designed specifically for pregnant and lactating women makes perfectly good sense. The only caveat is to not take more than 5,000 IU of vitamin A per day if you are pregnant, unless it is provided in the form of beta-carotene rather than as retinol.

Recommendation #4:

Often, the dramatically increased need for iron during pregnancy cannot be met through diet alone. Supplementation is often warranted. Usually the amount of iron contained in a prenatal multiple is sufficient, but if a mother-to-be develops anemia or has evidence of low iron stores, then additional supplementation is required.

There are two forms of dietary iron: "heme" iron and "non-heme' iron. Heme iron is found in fish, meat, and liver, and is the most efficiently absorbed form of iron; the absorption rate of heme iron is about 35 percent. Non-heme iron, as found in plant foods and in most supplements, is absorbed at a rate of about 3 percent on an empty stomach and 0.9 percent with food. Note that iron supplementation causes nausea, flatulence, and diarrhea in some people.

For iron deficiency during pregnancy, take either 30 mg of heme iron such as ferrous succinate or fumarate twice daily between meals. If this recommendation results in abdominal discomfort, take 30 mg with meals three times daily.

Michael T. Murray, N.D., is widely regarded as one of the world's leading authorities on natural medicine. In addition to maintaining a private medical practice, Dr. Murray is a noted writer, educator, and lecturer. He is currently the editor of the Natural Medicine Journal. Visit Dr. Murray's website at: www.doctormurray.com.

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