Monday, April 6, 2009

Pregnancy diet & "big baby vs. small baby"

I've had a few emails with questions regarding diet during pregnancy.
The diet I followed is well known in the natural birth community, but it is great for all birthing situations keeping mother and baby thriving.
(click above to read more about it)
Milk products & substitutes--4 servings
1 serving = 8 grams protein
Total = 32 grams protein
Calcium replacements--2 per soy (above)
Eggs--2 servings
1 serving = 6 grams protein
Total = 12 grams protein
Other proteins--6 to 8 servings
1 serving = 1 oz = 7 grams protein
Total = 6 to 8 oz. (approx. 42-56 grams protein)
Total proteins = 86-100 grams
Green vegetables--3+ servings
Vitamin A foods--1 serving
Whole grains--5 servings
Vitamin C foods--2 servings
Fats and oils--3 to 5 servings
Total calories = 2600-3000
Recommended weight gain--unlimited (average 35-45 pounds)
Average size baby--7 lbs 2 oz to 8 lb 8 oz ?
*The Basic Brewer Pregnancy Diet Plan
However you plan to get the protein, it is important to remember that the Brewer Diet is not just about protein. For this diet to work as it's intended to work, it needs to include extra protein, PLUS extra calories, PLUS extra salt and lots of greens and whole grains. The goal is to increase the mother's blood volume by 60%, by increasing the osmotic pressure in her bloodstream, and those three components in the diet are what helps to do that. The reason that the blood volume needs to increase is to service the growing placenta. When that level of blood volume increase does not happen on the schedule that it wants to, that is when we see the cascade of effects that can include problems with the placenta, and premature contractions.
I would also like to issue a caution concerning the philosophy that a smaller baby is easier to push out than a larger baby is. That idea started in 1800, and I think that we now have good reasons for why that doesn't work as well as might seem obvious. One reason that that plan might not work so well is that the uterus needs to grow so much new muscle tissue during the pregnancy. Before pregnancy, the uterus weighs only 2 oz. At the end of pregnancy, the uterus alone should weigh about 2 lbs, which means that the uterus has to grow 1 lb 14 oz of new muscle cells. If the baby is on the smaller size because the mother has been restricting her nutrition for the purpose of having a smaller baby, the uterus has also been getting less nutrition, and may have less muscle tissue as a result. According to Brewer, this results in a less-strong uterus that may be more prone to dysfunction during labor, and more likely to need medical help such as pitocin. Another reason why this plan might not work so well is that the pelvic bone needs to stretch during the pushing stage of the labor. The pelvis appears to be one solid bone, but it is actually composed of three bones held together by ligaments. In the non-pregnant body, the pelvis functions as one solid bone because these ligaments are so tight. During pregnancy, the placenta secretes the equivalent of 100 birth control pills a day. One of these placental hormones has the function of loosening these ligaments that hold the pelvic bone together. If a baby is on the "larger" side due to the mother's eating a better diet, the placenta will also be better nourished and more capable of making a good amount of this hormone that loosens these ligaments, resulting in a stretchier pelvis. So if a baby is on the "larger" side because the mother has been eating better, it is possible that that baby could be easier to push out through a more-stretchy pelvis than a baby who is on the "smaller" side and is being pushed through a less-stretchy pelvis from the mother restricting her food intake for the purpose of having a smaller baby. I recognize that one thing that is problematic with a discussion like this is the lack of standard definition of what "larger" and "smaller" mean. In mainstream medical obstetric practice, 5 lbs is the standard dividing line between "normal" and "low birth weight", and from what I've heard in responses from mainstream professionals, they seem to regard any birth weight over 8 lbs to be "too big". On the other hand, Dr. Brewer used to quote a researcher who considered any birth weight less than 7 lbs 2 oz to be less than optimal. And in the natural-birth and homebirth circles that I've been involved with, it seems that the average birth weight is about 7.5 lbs. to 8.5 lbs, with many babies reaching 9 - 9.5 lbs without anyone being concerned. So the idea of what an ideal birth weight is can be rather relative, at least where the above-seven-pounds range goes. But I do think that the bottom line is that it can be risky for the mother to try to have a smaller baby by eating less food.
Here is more on that question from Dr. Brewer....

1 comment:

Susie Faye said...

em, this blog, your other blog. fiddler. moving. morris and rog. I have a question and want an honest many hours do you sleep a night? I mean really. Unless you have that thing like on Harry Potter where you can turn back time and you get more hours in the day than the rest of us...maybe that's it. =)