PRENATAL VITAMINS

Prenatal vitamins are are great sources of vitamins and minerals for pregnant women. The problem comes when we have misconceptions about prenatal vitamins. Here are some of the most common myths about prenatal vitamins:

• Prenatal vitamins are a cure all.
  There is no doubt about it - prenatal vitamins are great as supplements. The real issue at stake is that we believe that we can have poor nutrition fixed by popping a pill. Even when that pill is a great prenatal vitamin, it's not going to do anything but boost your nutrition. Remember, the better your nutrition, the more you will get out of your prenatal vitamin.
• You have to use a prescription prenatal vitamin.
  While drug companies would love you to believe that their prenatal vitamin is the only thing that will really work, most prenatal vitamins will work for most women, with a few exceptions. There are many over-the-counter prenatal vitamins that work really well. If you are in doubt, bring your bottle with you to your next visit with your doctor or midwife.
• You have to use a prenatal vitamin.
  There are also some good multivitamins available that are safe in pregnancy. You need to ensure that it has an adequate amount of folic acid and the appropriate amounts of other vitamins and minerals. Some vitamins, like Vitamin A, in high doses, can actually cause birth defects. Though if you have trouble taking regular prenatal vitamins, many practitioners will recommend other variations on the traditional prenatal vitamin.
• You need to take it before pregnancy or it does not good.
  This one is actually only partially a myth. You should begin taking a prenatal vitamin before you want to become pregnant, hopefully at least several months before you become pregnant. If you fall into that category of becoming pregnant prior to taking vitamins, it is still advisable that you begin taking prenatals immediately as there are still benefits to be had.

NEURAL TUBE DEFECTS--ALL YOU NEED TO KNOW

Neural tube defects (NTDs) are serious birth defects with symptoms that range from mild to severe impairment. They are caused by incomplete development of the brain, spinal cord and/or their protective coverings. This occurs when the fetus' spine fails to close properly during the early stages of pregnancy.

Types of neural tube defects:

• Anencephaly
• Encephalocele
• Spina Bifida

The Spina Bifida Association of America (SBAA) says spina bifida is the most common NTD. Some other types of NTDs include anencephaly and encephaloceles.

NUTRITION FOR PREGNANT WOMAN

A pregnant woman's nutrition directly influences the course of the pregnancy and normal fetal development, and also the long-term health of the mother and child. In the first half of pregnancy, nutrition requirements mainly concern quality, while in the second half, quantity is also an issue, to ensure fetal growth. Proper nutritional habits should already be established at the start of this second life - if possible even before conception.

Energy and nutritional requirements

The pregnant mother's body is subject to greater demands to ensure fetal development as well as the growth, health and functioning of the uterus, placenta and amniotic fluid. A daily increase of 150 calories in food consumption is recommended at the start of pregnancy, which will eventually reach an extra 250 calories a day by the end of pregnancy. This entails a "double-shot" in the form of a daily glass of milk during the first trimester and an additional piece of fruit or slice of bread during the final six months. While weight gain is normal, the mother-to-be should not let herself starting "eating for two" (or more). The average weight gained is between 9 and 12 kg (20 to 26 lbs), although there is a natural variation between individuals. With overweight women, it may be less, while thinner women may gain more.

An additional intake of 10 g (1/3 ounce) of protein a day during the entire pregnancy is recommended to build up, maintain, and regenerate body tissue in both the fetus and mother. This daily ration of 70 g (2½ oz) of protein is guaranteed with our current nutritional recommendations. Glucose, the basic stuff of carbohydrates, is the main source of energy drawn on by the fetus. A daily intake of carbohydrates in the form of bread, pasta, or fruit is needed for a problem-free pregnancy. Fats with essential fatty acids are critical for the development and functioning of the baby's nervous system.

Minerals and vitamins

The increased demand for minerals and vitamins during pregnancy can be satisfied by an adequate, varied, and balanced diet. Attention should be paid to folic acid, calcium, and iron in particular, since these are often deficient.

More Calcium

A substantial transfer of calcium occurs between the mother and the fetus throughout pregnancy, allowing the baby's bone and teeth formation. In the first six months, the mother stores up calcium in her own bones. When its skeletal growth reaches its peak in the last three months, the fetus draws on the mother's store. This is when the consumption of high calcium-containing foods such as milk and milk products must be increased, since a calcium deficiency will damage the mother's teeth and make her bones brittle.

More Iron

The demand for iron, essential for blood formation, is also increased during pregnancy because the mother's blood volume increases, and the fetal red blood cells have to be developed. Iron is available in meat, fish, egg yolk, whole-grain products, and vegetables. Iron of plant origin is not as well assimilated as iron of animal origin. However, if you ingest vitamin C from raw food during the same meal, iron is more easily absorbed.

More folic acid

This vitamin promotes the development of the fetal central nervous system and prevents developmental defects of the neural tube (spina bifida). Folic acid is contained in vegetables, wheat germ, tropical fruits, and in eggs. However, routine nutrition does not always supply enough folic acid (vitamin B9) to meet the requirements of a pregnant woman. Additional folic acid intake is necessary in the months before pregnancy and during the first trimester.

FINDING FOODS WITH FOLATE

Certain information on food and dietary supplement labels can help women spot foods containing substantial amounts of folate. Some labels may claim that the product is "high in folate or folic acid," which means a serving of the food provides 20 percent or more of the Daily Value for folic acid. Or the label may say the food is a "good source" of folate, which means a serving of the food provides 10 to 19 percent of the Daily Value for folic acid. The exact amount will be given in the label's Nutrition Facts panel.

Some food and dietary supplement labels may carry a longer claim that says adequate folate intake may reduce the risk of neural tube birth defects. Products carrying this claim must:

• Provide 10 percent or more of the Daily Value for folic acid per serving
• Not contain more than 100 percent of the Daily Value for vitamins A and D per serving because high intakes of these vitamins are associated with other birth defects
• Carry a caution on the label about excess folic acid intake, if a serving of food provides more than 100 percent of the Daily Value for folic acid. FDA has set 1 mg (or 1,000 micrograms) of folate daily as the maximum safe level. There are limited data on the safety of consuming more than 1 mg daily, and there may be a risk for people with low amounts of vitamin B₁₂ in their bodies--for example, older people with malabsorption problems, and people on certain anticancer drugs or drugs for epilepsy whose effectiveness can diminish when taken with high intakes of folate.
• List on the label's Nutrition or Supplement Facts panel the amount by weight in micrograms and the %Daily Value of folate per serving of the product. This information, which appears toward the bottom of the panel, along with the listing of other vitamins and minerals, can be used to compare folate levels in various foods and supplements.

Optional information may appear with the health claim to let consumers know about other risks associated with neural tube birth defects, when to consult a doctor, other foods that are good sources of folate, and other important messages about neural tube defects.

Other Considerations

The claim about folate cannot imply that adequate folate intake alone will ensure a healthy baby, since so many factors can affect a pregnancy.

Women should bear this in mind when contemplating pregnancy, advises Jeanne Latham, a registered dietitian and consumer safety officer in FDA's Office of Special Nutritionals. "Folate can make a significant contribution," she said, "many factors, including an overall good diet, are involved in having a healthy baby."

Genetics plays a role, as do other healthful prenatal practices, such as eating an all-around good diet. But unlike genetics, diet is a risk factor women can modify to their--and their baby's--advantage, said Jeanne Rader, Ph.D., director of the division of science and applied technology in FDA's Office of Food Labeling.

"Folic acid is one of many nutrients needed in a healthy diet for women of childbearing age," she said. "A well-balanced diet with a variety of foods can provide all those nutrients, including adequate amounts of folate."

Women have options for reaching the folate intake goal: They can get the necessary nutrients and calories both before and during pregnancy by eating a well-balanced diet, keeping in mind folate-rich foods, nutrition experts say. Folic acid-fortified grain products, including breakfast cereals, will help, too. Dietary supplements are another source of folate. Any one or a combination of these options for ensuring adequate folate can help assure women of childbearing age that, if they become pregnant, their babies will be off to a healthy start.

FOLATE FACTS

Folate is a B vitamin found in a variety of foods and added to many vitamin and mineral supplements as folic acid, a synthetic form of folate. Folate is needed both before and in the first weeks of pregnancy and can help reduce the risk of certain serious and common birth defects called neural tube defects, which affect the brain and spinal cord.

The tricky part is that neural tube defects can occur in an embryo before a woman realizes she's pregnant. That's why it's important for all women of childbearing age (15 to 45) to include folate in their diets: If they get pregnant, it reduces the chance of the baby having a birth defect of the brain or spinal cord.

Folate's potential to reduce the risk of neural tube defects is so important that the Food and Drug Administration requires food manufacturers to fortify enriched grain products with folic acid. This will give women one way to get sufficient folate: by eating fortified breads and other grain products, such as enriched pasta, rice, waffles and cereal bars.

Other ways to do this are:

• Eat fruits, dark-green leafy vegetables, dried beans and peas, and other foods that are natural sources of folate.
• Eat folic acid-fortified enriched cereal grain products and breakfast cereals.
• Take a vitamin supplement containing folic acid.

Nutrition information on food and dietary supplement labels can help women determine whether they are getting enough folate, which is 400 micrograms (0.4 milligrams) a day before pregnancy and 800 micrograms a day during pregnancy.

Folate Sources

Folate occurs naturally in a variety of foods, including liver; dark-green leafy vegetables such as collards, turnip greens, and Romaine lettuce; broccoli and asparagus; citrus fruits and juices; whole-grain products; wheat germ; and dried beans and peas, such as pinto, navy and lima beans, and chickpeas and black-eyed peas.

Under FDA's folic acid fortification program, which became effective January 1998, the agency requires manufacturers to add from 0.43 mg to 1.4 mg of folic acid per pound of product to enriched flour, bread, rolls and buns, farina, corn grits, cornmeal, rice, and noodle products. A serving of each product will provide about 10 percent of the Daily Value for folic acid. Whole-grain products do not have to be enriched because they contain natural folate. Some of the natural folate in non-whole-grain products is lost in the process of refining whole grains.

Folate also can be obtained from dietary supplements, such as folic acid tablets and multivitamins with folic acid, and from fortified breakfast cereals.

A report recently released by the Institute of Medicine indicates that the evidence suggests that folic acid, the synthetic form of folate, may be better absorbed than folate found naturally in foods. The report also points out that, if taken in adequate amounts, food folate may eventually be demonstrated to be as effective as folic acid.

Some Good Sources of Folate

Food	Serving Size	Amount (Micrograms)	%Daily Value*
Chicken liver	3.5 oz	770	193
Breakfast cereals	1/2 to 1 1/2 cup	100 to 400	25 to 100
Braised beef liver	3.5 oz	217	54
Lentils, cooked	1/2 cup	180	45
Chickpeas	1/2 cup	141	35
Asparagus	1/2 cup	132	33
Spinach, cooked	1/2 cup	131	33
Black beans	1/2 cup	128	32
Burrito with beans	2	118	30
Pasta	2 oz.	100-120	25-30
Kidney beans	1/2 cup	115	29
Cereal bars	1 bar	40-100	10-25
Baked beans with pork	1 cup	92	23
Lima beans	1/2 cup	78	20
White rice, cooked	3/4 cup	60	15
Tomato juice	1 cup	48	12
Brussels sprouts	1/2 cup	47	12
Orange	1 medium	47	12
Broccoli, cooked	1/2 cup	39	10
Fast-food French fries	large order	38	10
Wheat germ	2 tbsp	38	10
Fortified white bread	1 slice	38	10

*based on Daily Value for folate of 400 micrograms
(Source: Food Values of Portions Commonly Used, 16th edition)

PRE-PREGNANCY STAGE--ALL YOU NEED TO KNOW

Pre-pregnancy stage is a stage where you prepare yourself with knowledge and information all around before you get pregnant. At this stage, you may want to get some advice on pregnancy, the dos and don’ts and many important things that is relevant for you to prepare for your pregnancy. In the meantime, it will also help you with the correct information needed during pregnancy and to ensure that you experience the easiest pregnancy and have a healthiest baby possible. It is advisable for you to get yourself prepared six months before you’re getting pregnant to ensure that you will be well-prepared as well as reserving you the time you need to work on any health issues you may have.

So, going straight to the point, these are what you can do:

· Meet the doctor

o I recommend a doctor for pregnancy which is the specialist in this field.

· Meet the midwife

o Any midwife that is close to you—your mother of course! Your sister, neighbour or anyone who had already experienced the pregnancy themselves.

· Preparations

o Mental preparation

o Physical preparation

o Emotional preparation

o Health check

· Do homework

o Find out what you have to know! Here are the lists:

§ Folate facts. Find out more about folate here.

§ Find out what your body needs during pregnancy and the significance of what you take towards your baby. Find out more here.

§ Food intake. The nutrition needed by a pregnant mother. Read the rest here.

These are the things that you can do in your pre-pregnancy stage. Note that the doctors and midwife may help a lot in giving you advice and support in any information you need as they can provide you the right answers of pregnancy. This may include the ovulation process which you may not know.