Thinking about having a Baby

Let’s talk about planning and preconception care…


It is estimated that approximately half of all pregnancies in Australia are unplanned, however if you are in a position to do some preconception care before trying for a baby, you may be able to increase your chances of a healthy conception and pregnancy.


Whilst some sources promote a lengthy two year period of strict detoxification, no alcohol or caffeine and major dietary and lifestyle changes, for most of us this is unrealistic and let’s face it, boring! Rather takes the spontaneity out of the whole process don’t you think!?

There is however merit to having a few months (or thereabouts) up your sleeve to ensure that both prospective Mum and Dad are in a reasonable state of health for fertility and pregnancy. For individuals with health conditions of behaviours associated with an increased risk of threatened fertility or healthy pregnancy, the ideal preconception care period may be more lengthy.


You may be wondering “Is preconception care recommended in the greater health care sector”? 

YES!!!

The RACGP (Royal Australian College of General Practitioners) states “there is increasing evidence that optimising health in the preconception period is crucial to improving short-term and long-term outcomes for mothers and babies”.


WHO (The World Health Organisation) concurs stating;  “preconception care improves the health of women and men, while reducing the chances of premature birth, low birth weight, birth defects and other birth-related conditions that may hinder optimal child development.” 

Studies have found those undergoing preconception care more likely to have enhanced fertility and pregnancy knowledge and demonstrate positive health behaviours. Fewer neonatal deaths and higher rates of breastfeeding have also been observed.


So… What are some of the simple and realistic preconception care strategies or changes you can implement to improve your likelihood of fertility and a healthy pregnancy and bub???

• TAKE A QUALITY MULTIVITAMIN

Taking a prenatal multivitamin may support both Mum and Dad’s levels of vital nutrients for fertility and pregnancy.

Nutrients of particular importance for Mum include:

• Folate - (generally the more bioavailable methylated folate is preferable to the synthetic folic acid). Taking 400–500 µg daily for at least four weeks prior to pregnancy and for the first 12 weeks of gestation, reduces the risk of neural tube defects such as spina bifida.
• Iodine - Taking 150 µg daily  in the short term preconception phase as well as throughout pregnancy and breastfeeding, supports the production of thyroid hormone in Mum and fosters brain and central nervous system development in the foetus. 

Nutrients of particular importance for Dad include:

• Zinc, Selenium, Essential fatty acids, CoQ10 and B12, which contribute to healthy sperm production and quality, and support libido. 

Other foundational nutrients including Vitamin D are important for general health and wellbeing for both Mum and Dad.

*Generally my brand of choice for preconception multis for both Mum and Dad is NaturoBest, a quality Australian practitioner only range specialising in fertility and pregnancy care. Talk to your health care practitioner or the qualified staff at Healthy Heights to find out if these products are the right fit for you. 

• QUIT SMOKING

This one’s a biggie!!! Smoking in pregnancy is the most important preventable cause of a wide range of adverse pregnancy outcomes, however despite the risks more than 10% of women smoke when pregnant. 

The most common adverse effects for bub of smoking in pregnancy are growth restriction and preterm birth. Nicotine reduces placental blood flow and carbon monoxide lowers oxygen availability to the fetus. Many other toxic compounds, including cyanide, benzene and heavy metals, also cross the placenta.


So if you’re a smoker planning for a baby...QUIT! 

It’s advisable to avoid passive smoking as much as possible in the preconception phase and pregnancy (...and life in general), which has also been linked with detrimental pregnancy outcomes.

• LIMIT ALCOHOL INTAKE

There is no established ‘safe’ level of alcohol consumption for the developing fetus, so abstinence is advised in the preconception period and especially emphasised during pregnancy.

In saying that, we all know that many a healthy baby has been conceived after a few too many wines, so it’s reasonable to assume that consuming some alcohol in the preconception phase shouldn’t cause major concern.

If you are trying for a baby limit your alcohol intake, and if you become aware you’ve fallen pregnant then avoid alcohol completely!

• LIMIT CAFFEINE INTAKE

Excess caffeine consumption has been linked with increased risk of foetal growth restriction. With this in mind limit your consumption to 100-200mg per day (MAX 300 mg), which equates to 1 or 2 standard coffees.

*Remember, coffee isn’t the only source of caffeine. Black and green tea, chocolate, cacao and energy drinks also contribute to your daily caffeine intake.

• WORK TOWARDS A HEALTHY BODY WEIGHT

Falling within the healthy body weight range is ideal for reproductive health, as being either over or underweight can be problematic. Measuring body mass index (BMI) may reflect whether you need to lose or gain weight in the preconception phase.

For women:

• Obese women often experience fertility issues and face a higher risk of stillbirth, preeclampsia, gestational diabetes in pregnancy. 
• On the other hand, underweight women may also struggle to fall pregnant particularly if they have abnormal or absent menstrual cycles as a result of hormonal disturbance from low body fat percentage. 
  
  

For men:

• Being very overweight or obese can also threaten male fertility, causing hormone imbalances, erectile dysfunction and other health conditions linked with obesity. Sperm take about three months to develop, so being within a healthy weight range for at least three months prior to conception is ideal. 

 

• TIDY UP YOUR DIET 

There are some basic dietary changes that may be beneficial in the preconception phase:

• Reduce intake of processed foods and refined carbohydrates.
• Increase intake of vegetables and fruits (max 2 serves of fruit daily)
• Consume lean protein including meat, fish and eggs
• Enjoy nuts and seeds, rich in micronutrients
• Drink plenty of water
• Limit or avoid larger mercury containing fish (shark & billfish), linked with heavy metal exposure. Instead eat two to three serves of other, smaller fish weekly. 

Remember to enjoy a balanced diet, including some treats! Abstaining from naughties all together may lead to a feeling of deprivation followed by a junk food binge and then regret… So relax and enjoy your food choices.

• EXERCISE REGULARLY

It’s important for both Mum and Dad to exercise in the preconception phase. Aim for 150 minutes of exercise per week or 30 minutes most days of low-moderate intensity exercise, with some high intensity intervals. Avoid contact sports if trying to conceive or pregnant!

Exercise is also great for your mental and emotional wellbeing, so get outdoors in the fresh air and move!

• HAVE A GENERAL HEALTH CHECK UP

It’s a good idea to visit your GP or health care practitioner in the preconception phase to touch base regarding your general health and discuss factors specific to fertility and pregnancy including:

• Relevant screening or testing (pathology testing for nutrient deficiencies etc)
• Genetic testing if indicated from personal/family history or ethnic background
• Discussion about mental and emotional wellbeing (including domestic violence risk)
• Review current disease status and implications for fertility & pregnancy
• Review current medications or supplements and their safety in pregnancy
• Screening for sexually transmissible infections and other infectious diseases
• Cervical screening and breast examination
• Consider Zika Virus risk from prior or planned travel
• Discuss options for antenatal care (public vs private care etc)

Making an appointment to see a naturopath or nutritionist may also permit more focused and detailed exploration of nutritional status and overall health and wellbeing in the preconception phase.

• REDUCE YOUR CHEMICAL INTAKE/EXPOSURE

Assess your work, home and recreational environments to consider if you can reduce your exposure to chemicals and toxins. Consider switching to natural cleaning products, cosmetics and body products, after all the skin is the largest organ of the body.

Limiting exposure to industrial chemicals used in renovations, factories etc is also important.

Reduce your use of plastics, both for your own health and the environment!



TO SUMMARISE:


A preconception care phase gives us a chance to clean up our act prior to trying for a baby, for best overall health outcomes.

Take a good prenatal multi (both Mum and Dad)

If you’re a smoker, QUIT… you can do it!

Don’t overdo the alcohol or caffeine. However, don’t beat yourself up if you fall pregnant without undergoing preconception care, many healthy babies have been conceived after a glass (of bottle) of wine.

Work towards a healthy bodyweight, not over or under.

Eat a balanced diet with plenty of fresh and brightly coloured veggies.

Exercise regularly

Have a general health check up

Minimise your chemical exposure



Happy trying!

Sarah :)


This article is intended as a general informational source, not an individual prescription. See your health care provider for individualised advice for your preconception care or pregnancy journey.






Bibliography

https://www1.racgp.org.au/ajgp/2018/july/preconception-care/

Dean SV, Imam AM, Lassi ZS, Bhutta ZA. Systematic review of preconception risks and interventions. Pakistan: Aga Khan University, 2013.
Whitworth M, Dowswell T. Routine pre-pregnancy health promotion for improving pregnancy outcomes. Cochrane Database Syst Rev 2009
Schummers L, Hutcheon JA, Bodnar LM, Lieberman E, Himes KP. Risk of adverse pregnancy outcomes by prepregnancy body mass index: A population-based study to inform prepregnancy weight loss counseling. Obstet Gynecol 2015

World Health Organization (WHO). Report of the commission on ending childhood obesity. Geneva: WHO, 24 March 2016.

Gardiner PM, Nelson L, Shellhaas CS, et al. The clinical content of preconception care: Nutrition and dietary supplements. Am J Obstet Gynecol 2008;199(6 Suppl 2):S345–56. doi: 10.1016/j.ajog.2008.10.049.

Jones M, Lewis S, Parrott S, Wormall S, Coleman T. Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: A systematic review. Addiction 2016;111(6):981–90. doi: 10.1111/add.13309.

Floyd RL, Jack BW, Cefalo R, et al. The clinical content of preconception care: Alcohol, tobacco, and illicit drug exposures. Am J Obstet Gynecol 2008;199(6 Suppl 2):S333–39. doi: 10.1016/j.ajog.2008.09.018.

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/weight-fertility-and-pregnancy-health


Photo Cred:

https://images.squarespace-cdn.com/content/57a8bd6aebbd1a5a511c7a5f/1470680567880-X9K9SYWL6AURQ1UDLTG0/Screen-Shot-2015-11-17-at-20.51.48.png?content-type=image%2Fpng