Caffeine use during pre-pregnancy and pregnancy remains controversial. The current guidelines offer a safe range of 0-300 mg/ day. But, there have been studies that have shown ill effects on women at lower doses. Some women are simply more sensitive to caffeine and so to be on the safe side let’s set a more conservative limit of 0-100mg/ day. This more conservative guideline will lessen the chance of more sensitive women reacting to the stimulant and lower the risk of dehydration through caffeine’s diuretic properties. The following chart shows the caffeine content of popular beverages.

Caffeine isn’t the only chemical compound in caffeinated beverages that you should be worried about. Another reason to remove sources of caffeine is that other compounds in the beverages interfere with key nutrient absorption. Soda pop contains phosphates that decrease iron absorption. Coffee and black tea contain tannins which interfere with the absorption of manganese, calcium, magnesium and iron (from non-heme sources of iron, plants, but not from heme sources of iron, red meat). Herbal teas do contain some tannins, though less than caffeinated teas. You can reduce the affect of tannins on iron absorption two ways. The first is by adding lemon to your tea; vitamin C enhances iron absorption. The second is to be careful not to oversteep your tea. You may have noticed that oversteeped tea tastes bitter; this bitter taste is due to tannins. Reduce your steeping time and you will reduce the amount of tannins in your tea.

The more caffeinated drinks you are consuming the longer it may take you to gradually remove yourself from this habit. You can lessen your chances of experiencing withdrawal symptoms, such as headaches, shakiness and tiredness (remember, stimulants are drugs) by gradually lowering your daily intake over a week or two and replacing your usual caffeinated beverage with a healthier option. If you are addressing your caffeine intake before you get pregnant then you have the luxury of slowly removing yourself from caffeine. If you are already pregnant then you should immediately switch over to non-caffeinated choices. You can weather the withdrawal symptoms by staying hydrated and resting with a cold compress across your forehead to help with the headaches. Filtered water, seltzers or herbal teas are your best choices. Herbal teas are truly ‘caffeine free’ and have not undergone a decaffeination process, which always leaves some caffeine behind.

Do not take any medication to counteract the withdrawal symptoms unless approved by your doctor.

Angela Pifer, MSN, CN Seattle Nutritionist

www.NutritionNorthwest.com Enjoy the day to day support, structure and accountability that will finally help you meet your health goals!

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Many health organizations suggest limiting artificially-sweetened foods in your diet to only 2 or 3 servings a day.

Examples of one serving include:

· 12 ounce can of pop

· 1/2 cup of pudding, ice cream, or gelatin product

· one bowl of sweetened cereal

· one portion of a bakery item

Though the following low-calorie sweeteners have been approved by the Food and Drug Administration, and are considered safe for pregnant women and children, again I highly disagree and recommend to all my pregnant patients to refrain from their use pre-pregnancy through breastfeeding:

· Aspartame (NutraSweet, Equal, Sugar Twin) is a combination of two amino acids, phenylalanine and aspartic acid. It is two hundred times sweeter than table sugar. It can be used in moderation by diabetics. One packet of Equal is the same in sweetness as two teaspoons of sugar. The average amount used supplies no calories. Individuals who have phenylketonuria (PKU) and cannot metabolize phenylalanine, or are sensitive to aspartame, should not use it.

· Saccharin (Sweet’N Low, Sweet Twin, Necta Sweet) is not metabolized and passes through the digestive system unchanged. It is a noncaloric sweetener produced from an organic compound. It is 375 times as sweet as table sugar and can be used in moderate amounts by diabetics.

· Acesulfame K (Sunett and Sweet One, Sweet and Safe) is not metabolized and is excreted unchanged by the kidneys. It can be used in moderation by diabetics. One packet of Sweet One is equal to the sweetness of two teaspoons of sugar. It can be used in cooking and baking.

· Sucralose (Splenda) is not well absorbed and is excreted unchanged. Splenda is the only artificial sugar substitute that is made from sugar. It is 600 times sweeter than sugar. Splenda or sucrolose is often used in baked goods, soft drinks, chewing gum, frozen dairy desserts, fruit juices and gelatins. One of the unique attributes of sucralose is that it can be used virtually like sugar without losing any of its sugar-like sweetness, even in applications that require exposure to high temperatures. Therefore, it can be used in baked products as well. More than 100 studies over 20 years have found no link between splenda and any health problems. It can be used by pregnant women and breastfeeding mothers.

· Neotame (made by The NutraSweet Co.) is quickly metabolized and completely eliminated from the body. This sweetener is designed more for food industries than the direct consumer or tabletop sweetener market. The main markets for this product are soft drinks, yogurt, frozen dairy desserts and chewing gum. It would take approximately 8,000 teaspoons of sugar to equal 1 teaspoon of neotame.

· Natural Sweeteners

Although most natural sweeteners can cause many of the same problems as refined sugars when consumed in excessive amounts, they are considered better alternatives since they retain many of their original vitamins and minerals.

Angela Pifer, MSN, CN Seattle Nutritionist

www.NutritionNorthwest.com Enjoy the day to day support, structure and accountability that will finally help you meet your health goals!

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q If you haven’t already done so, schedule your first prenatal visit with your practitioner.

q Avoid alcohol, drugs and cigarettes, both first-hand and second-hand smoke.

q If your immunizations are not up to date, let your practitioner know.

q Stay hydrated: drink 8-10 glasses of filtered spring water each day.

q Focus on whole foods. If you can picture a food growing and your grandmother would recognize it as food, then it is most likely a whole food.

q Stick to a diet naturally high in folic acid. Folate “foliage” is found in beans and vegetables and is especially high broccoli, black beans, spinach and asparagus.

q Eat iron-rich foods like beans, raisins, spinach, quinoa and dried prunes and apricots. Add a food rich in vitamin C to increase the absorption of iron, like a squeeze of lemon juice or mandarin oranges. Calcium enriched foods or supplements should be eaten away from iron rich foods, which inhibits the absorption of iron.

q Choose organic as often as possible and especially for the following twelve fruits and vegetables: strawberries, bell peppers, spinach, cherries, celery, apples, red raspberries, imported grapes (Chile), nectarines, peaches, pears, and potatoes (US).

q Keep your blood sugar level in check by eating 4-5 small meals through the day. The meals should be visually composed of 70% complex carbohydrate: 25% high quality protein: 5% healthy fat.

q As a general rule, avoid over the counter medication and consult with your doctor regarding current prescription medication.

q Get plenty of sleep, and try to nap if you feel tired during the day. 8 hours is ideal.

q Exercise, but moderately. Don’t start a new vigorous exercise regimen when you’re pregnant, and be careful not to become overheated for prolonged periods. Walking is safe for pretty much everyone and, if done consistently, will help increase your circulation, moderate your moods and keep your weight in check.

q If you’re a coffee drinker, switch to decaf or try herbal or decaffeinated tea. Current recommendations are to reduce your caffeine intake to < 300 mg. To be on the safe side, make a goal of reducing your caffeine intake to < 100 mg.

q If your family has a history of genetic disorders, consider prenatal testing and consult a genetic counselor.

q Cats are perfectly safe to be around when you are pregnant. The concern is toxoplasmosis. The risk is specifically in hand to mouth transmission. Do not touch your face while changing your cat’s box. Next to cat boxes, gardening poses a greater threat to contracting toxoplasmosis. This can easily be avoided by using gloves while gardening and taking extra care to not touch your face. (Truth be told, you have a greater chance at contracting toxoplasmosis from your garden than you do a cat’s box. This is because numerous outside cats or other animals may use your garden to defecate in). Ask another family member to change the cat box. If you are the only person in your household then use gloves, a paper mask and use proper hygienic habits, lots of soap and warm water, after cleaning the cat box. If your cat is an indoor cat and does not have access to raw meat, there is a very minute chance that your feline has toxoplasmosis. Better safe than sorry, but there is NO need to get rid of your kitty.

q Home garden? Take special care to wash your fruits and vegetables before you eat them raw or prepare them.

q Start budgeting for your new life with baby.

q Choose a place to give birth (hospital, birthing center, home).

q Consider who will help you through the birth (doula, midwife, OBGYN). Ask your friends or coworkers for referrals, check with your insurance for a list of providers and/ or check with your preferred birthing center or hospital for a list of practitioners who hold privileges at that location. Be sure to interview candidates. This is your pregnancy and you will want to be sure that the practitioner you choose holds your same views on how the pregnancy and birth process is to proceed.

q Consider starting a pregnancy diary and having someone take a picture of you (and your expanding belly) each month.

q Refrain from getting perms, dyes, manicures or pedicures and other hair treatments involving heavy chemicals.

Angela Pifer, MSN, CN Certified Nutritionist

www.NutritionNorthwest.com Enjoy the day to day support, structure and accountability that will finally help you meet your health goals!

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Over the next few weeks I will be exploring topics related to pregnancy, fertility and prenatal to postpartum care; including nutrition, fitness, supplementation and other lifestyle changes that will benefit your pregnancy. I will also start a series on how to feed infants to reduce the risk of food sensitivities and how to plan their diet around the optimal windows of time that they have adequate digestive enzymes to process the newly introduced foods.  If you know someone who is pregnant, or trying to get pregnant, please forward this blog post to them so then can sign up to receive the information!

What you eat right before and during your pregnancy can affect the health of your growing baby. Even before you start trying to get pregnant, you should take special care of your health. Adopting and maintaining healthy eating patterns before your pregnancy will provide benefits that go well beyond your immediate well-being, by supporting your future pregnancy and ensuring a healthier you later in life.

The complex processes that occur during pregnancy require a rich supply of protein, vitamins and minerals for both mother and child. If you’ve built up good stores of nutrients before conception through a healthy diet, the added demands of pregnancy can be met with modest adjustments. If, however, your nutrient stores are low, you run a greater risk of diet-related problems during pregnancy, such as anemia. Because they will miss out on critical nutrients during their development, these same nutrient deficiencies could also place your baby at risk.

It goes without saying that the foods we consume on a daily basis can affect our health in a positive or negative way. Nutrient rich foods can bolster our immune systems, allow us to age gracefully, help us maintain a healthy figure and carry us through the day as it supplies the necessary energy for our bodies to do work. Foods that are high in calories and low in nutrients, also called ‘empty calories,’ can have the opposite affect; leading to suppressed immune systems, bodies that look old before their time and lead to extra pounds that seem to creep on year after year. Pregnancy is the one time in your life when your eating habits directly affect another person.

Because of these reasons it is crucial to assess where you are at with your health, weight and dietary patterns as early as possible before pregnancy. By improving your eating patterns, nutritional status, weight and your health you will enter into the pregnancy in a better place for you and your baby. But remember that it is never too late to start!

Angela Pifer, CN Seattle Nutritionist

www.NutritionNorthwest.com

Please visit my website for further information.  http://www.nutritionnorthwest.com/Seattle-Nutrition-A-Healthy-Pregnancy.htm including two new downloads: Healthy Pregnancy Guide and Healthy Eating Guide for Infants and Toddlers.