Making Healthy Babies

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Making Healthy Babies

• Jacqueline A. Eberstein, R.N.
• Controlled Carbohydrate Nutrition, LLC

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Prevention Its Never too Early to Start
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We Need to do Better

• 2010 UN stats-US 50th in maternal mortality.
• Recent doubling maternal mortality.
• 50 of maternal deaths are preventable.
• COD hemorrhage, HBP, infection, embolism,
  cardiomyopathy, other CV conditions such as
  stroke.
• Economic and social costs.
• More than 50 pregnancies are unintended.

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Unprepared for a Healthy Pregnancy

• Potential parents are overweight earlier in life
  weigh more than ever before.
• More than 60 of women of child-bearing age are
  overweight or obese.
• 33 of women are obese at time they conceive.

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Unprepared for a Healthy Pregnancy

• 20 women ages 20 to 44 have prediabetes and high
  triglycerides assoc. with GD and pre-eclampsia.
• Have more chronic and undiagnosed conditions such
  as diabetes, high blood pressure.
• Many do not use birth control thinking they cant
  get pregnant.
• Bodies are not prepared for pregnancy.

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Increased Mortality Because

• Little follow-up care after delivery. Risk for
  embolism, hemorrhage, infection.
• Increase in postpartum strokes, HBP and heart
  disease. Stroke risk lasts 12 weeks postpartum.
• Insurance allows for 1 postpartum visit only
  following an uncomplicated delivery.

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Risks for Complications

• Obesity-even overweight with sl. increase in
  blood sugar is a risk.
• Diabetes-prior to pregnancy or gestational
  diabetes (GD).
• Poor prenatal, delivery or post partum care.
  Rural areas poorer access to care.
• Poor nutritional state before and during
  pregnancy.
• Substance abuse-includes smoking and alcohol.

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Risks for Complications

• Higher mortality in African-American women.
• Increased use of medical interventions. US does
  more C sections and induction of labor than other
  countries.
• Longer gestation time. Full term 40 weeks.
  Between 37 and 40 weeks brain and lungs are still
  reaching full maturity.
• 10 to 15 of deliveries in US occur before 39
  weeks for no medical reason.

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Overweight and Pregnancy

• Gestational diabetes-common complication of
  pregnancy.
• Increased risk C section with potential
  complications to Mom and child
• Pre-eclampsia high blood pressure, edema,
  protein in urine. May lead to seizures and death.
  Higher lifetime stroke risk. Treatment is
  delivery of the baby.
• Increased health care costs for Mom and baby.
• Increased morbidity and mortality.

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Overweight and Pregnancy

• Birth defects- spina bifida, neural tube defects,
  heart problems, cleft lip/palate, hydrocephaly.
• Due to nutrient deficit, undiag DM and poor
  diet.
• Miscarriage, stillbirth before term.
• Preterm birth. World rank is 131. As an adult
  have decreased insulin sensitivity. In US 1 in 9
  babies African-American 1 in 5.

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Overweight and Pregnancy

• Brain development in 2nd trimester may be
  effected with increasing rates autism and
  appetite dysregulation.
• Life long health risks to baby due to an
  unhealthy early fetal environment. Increased risk
  chronic kidney disease.

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Gestational Diabetes

• Associated with obesity, previous GD or family
  history of diabetes.
• 18 of pregnancies.
• Used to disappear after deliverynot now.
• Increased odds of Mom getting type 2 within 5 to
  10 yrs.
• All women should be screened for GD at 24 weeks.
• Birth defects.

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Gestational Diabetes contd

• Babies too large for safe delivery. Damage to
  shoulder during delivery or C section. Also risk
  for hypoxia and intrauterine death.
• Improper uterine contractions. May lead to C
  section delivery.
• Hypoglycemia in newborn.
• May increase risk of child developing obesity and
  diabetes early in life. Also higher risk of
  asthma and cancer.
• GD-34 increase in cost of care for Mom and baby.

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Obesity Related Mortality

• Babies are 3 times more likely to die within 4
  weeks of birth.
• US leads all industrialized countries with infant
  death rate in first 24 hrs.
• In NY state 2/3 of maternal deaths are associated
  with obesity.
• US infant mortality rank 30th.

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Not Eating for Two

• Normal wt women- 50 will gain too much.
• Over wt women- 64 gain too much.
• Need only 300 extra calories during pregnancy and
  not until the 3rd trimester.
• New Weight Guidelines
• Normal wtgain 25 to 35 lbs.
• Overweight gain 15 to 25 lbs.
• Obese- gain 11 to 20 lbs.

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Breast Feeding is Protective

• Milk production requires proper insulin
  functioning. Women with BS/insulin dysregulation
  may have diff. with milk production.
• Exclusively for 6 months then one year with food
  introduction. US only 15 breast feed
  exclusively.
• Follow a different growth pattern than formula
  feed babies. Slower wt. gain encourages a
  healthier eating pattern.
• Lowers level of insulin and growth factor in
  blood. May help prevent obesity and diabetes in
  child.

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Breast Feeding Benefits Mom

• Immediately after delivery helps uterus to
  contract decreasing blood loss.
• Reduces risk of breast and ovarian cancer.
• Help with weight loss.
• Bonding with her child.
• More economical.

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Breast Feeding Benefits Baby

• Healthier gut environment.
• Offer some protection from allergies, eczema,
  asthma, ear infections, stomach infections.
• Less ADHD, obesity, diabetes.
• Fatty acids and cholesterol promote better growth
  brains white matter in 1st yr. Higher IQ, higher
  verbal and nonverbal intelligence.

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A Word About Ketones

• Ketones cross the placenta and can be used by the
  fetus for energy.
• Later stages of development fetal liver makes
  ketones.
• Ketones are important source of fuel in newborn.
  Important for brain development.
• Not usually in ketosis until about 12 hrs after
  birth.

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Negative Lifelong Effects on Child

• Preconception wt may be more important than gain
  during pregnancy.
• Genetic tendency obesity and DM.
• Poor diet in womb may cause improper fat storage
  later in life, esp. in liver and muscle leading
  to disease.
• BMI at birth may predict adult weight.

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Ongoing Research

• Increasing wt in Mom linked to increasing leptin
  levels. Leptin receptors in fetal lungs. ? risk
  asthma in child.
• Vit. C defic. in Mom (dont smoke) stunts growth
  fetal hippocampus (memory center) cant be
  treated with C after birth.
• MRIs in utero found the heavier the Mom the
  larger fat deposits in the abdomens of babies
  (liver). This is not normal!
• Obese women with elev. GGT before pregnancy more
  likely to get GD. A tool for prevention?

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Dads Important too

• Dads folate levels at time of conception may be
  just as important as Moms. Study in mice.
• Adequate levels of folate prevent birth defects
  and miscarriages.
• Recent study of newborns of obese men found
  changes in DNA methylation of IGF2. ? Increased
  risk of cancer.
• Sperm of obese men pass on a molecular signal
  that favors obesity in offspring. Mouse study.
  Pass on diabetes tend. Affects females more than
  males.

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Healthy Pregnancy/ Healthy Baby

• A healthy Mom and Dad at least 6 months before
  conception. Lose excess body fat before making a
  baby.
• Wait at least 2 yrs between pregnancies. Lose the
  previous pregnancy weight.
• Stop smoking before conception-LBW, attention
  deficit. ? Bipolar.
• Begin exercise before pregnancy.
• Optimal nutrient status prior to conception.
• Check vitamin D level and thyroid function.

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Healthy Baby Pregnancy contd

• Follow a healthy diet during pregnancy to keep
  weight gain within new recommended ranges.
• Diet -- best to avoid empty calories with low
  nutrient value. Eat whole foods, minimally
  processed. Eat natural fat. Regular protein
  intake.
• Lower risk of gallstones with low carb.
• Continue an appropriate exercise program during
  pregnancy unless your doctor suggests otherwise.
• Take the prescribed supplements.

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Healthy Eating for Your Child

• Consume a wide range of healthy unprocessed foods
  during pregnancy and lactation to help a child
  develop a wide range of tastes that can continue
  throughout life.
• These preferences appear to be developed early in
  infancy.
• A poor diet may have a negative impact on the
  brains reward centers ? Leading to addiction.

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Thank You Jacqueline
Eberstein, R.N. www.controlcarb.com
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