Nutrition under pregnancy
As part of the initial prenatal visit to our clinic, all women are in detailed counseled to eat a well-balanced and varied diet that includes natural meats, dairy products, fruits, vegetables, and grains. It is very important that women and their physicians understand that baseline caloric intake requirements do not increase until the second and third trimesters of pregnancy – and then only by 340-450 calories a day. Whether or not pregnant, a person’s baseline caloric needs depend on body size and exercise activities. In general, sedentary and less active persons will remain at a stable weight if they consume 28 kcal per kg of body weight each day. Exercise (depending upon the intensity) raises that maintenance requirement to 35-40kcal per kg of body weight daily.
This means a moderately active 60 kg woman will need approximately 2,000 calories a day to maintain her weight and activeness if she is not pregnant. During pregnancy, she will need just a little increased caloric requirement to 2,100 kcal a day until her second trimester of pregnancy when she will require caloric intake between 2400-2600 kcal a day. Most guidelines recommend that women with a normal BMI gain between 12-16kg of gross weight during their pregnancy. Higher or lower weight gain has been associated with increased risks to mothers and babies. Understanding these basic guidelines of weight management the daily caloric requirements of both pregnant and non-pregnant women is the cornerstone to helping all patients maintain a healthy weight throughout the course and changing circumstances of their lifetimes.
Besides routine counseling about alcohol, cigarette smoking, drug use, and the health hazards it poses to the pregnant women, they should also be counseled regarding the use of nutritional supplements during their pregnancy. Many patients are already taking nutritional supplements, and certain ones may even be harmful during pregnancy if not taken with right guidance and physician advice. For instance, vitamin A intake should be constrained to less than 5,000 units a day, as higher levels have been implicated in fetal defects. This is in contrast to other supplements that are recommended both before and during pregnancy like folic acid supplementation (0.4-0.8 mg) which should be started at least 1 month pre-conception and taken at least until the 12th week of gestation in order to prevent neural tube defects. Other supplements may be required depending upon the patient’s usual dietary habits and their diet charts. Patients who have been screened and found to be anemic may require stronger iron supplementation. Patients whose diets are deficient in calcium may require supplementation to meet the calcium requirement during pregnancy of 1000 mg-1300 mg each day. Vitamin D supplementation should be limit to not more than of 200 IU per day as higher levels may be harmful to the fetus.
Advising Surrogate Mothers
As part of the initial consulting process, we collect the gross diet history of the surrogate mother. This helps us tailor our nutritional recommendations regarding her diet. There are many common dietary practices that might require education and/or modifications. For instance, women who consume artificially sweetened foods and drinks should be counseled regarding the unknown effects of these sweeteners, especially saccharin which is known to cross the placenta and may remain in fetal tissue. Caffeine is advised to be consumed in strict moderation, but should be limited to 150-300 mg/day (about 1½ cups of coffee).
Surrogate Mothers are advised to strictly avoid unpasteurized milk and milk products as pregnant women have increased susceptibility to Listeria and Toxoplasmosis, bacteria sometimes found in unpasteurized milk products. Soft cheeses, lunch meats and meat spreads may also carry Listeria, and they are counseled regarding this risk. They are also advised to avoid eating raw eggs: any pregnant woman should be counseled specifically about the risk of Salmonella leading to intrauterine sepsis. Finally, they are advice to clean and wash all fruits and vegetables before eating them and should use caution regarding foods cut on a cutting board that may have not been properly washed between uses, cleanliness of food is very vital and essential.
Regarding herbal preparations, Surrogate Mothers are advised not to use them without medical consent as many have never been tested for safety. Teas containing ginger, citrus peel, lemon balm, and rose hips are safe. However, they should avoid teas containing chamomile, licorice, peppermint or raspberry leaf as there is some controversy regarding their safety in pregnancy – particularly the first trimester.
To avoid Listeria, they are advised to thoroughly heat any leftover foods and processed meats like hot dogs should be heated to steaming hot. Raw or undercooked meats should be avoided to prevent Toxoplasmosis. Utensils and cutting boards used to cut these foods should be washed with soap and water before further use.
Similarly they should also avoid raw seafood of any type due to possible contamination with parasites and Norwalk-like viruses and limit the intake of seafood to 2 days per week. Due to high levels of mercury, seafood like shark, swordfish, king mackerel, tilefish, tuna steaks and other long-lived fish high on the food chain should be avoided completely.
As part of our efforts to increase the success of pregnancy and to bring on a baby with the best possible health, we elaborate a personalized dietary plan for every Surrogate Mother. The dietary plan is a well thought to minimize any possible side effect of a deficient nutritional status of the Surrogate Mother.
Supplying the Surrogate Mother with artificial dietary supplements, although it is better than nothing it is not enough and far from the ideal to avoid the complications of a deficient nutrition and/or to ensure a good health later in the life of the future baby. In addition to supplementing with vitamins, minerals, calcium and iron, we supply fresh products, super foods like Quinoa and high quality meat to our Surrogate Mothers. The delivery is made weekly and monthly depending of the type of food.
In such a way we can be sure that the nutrition of the Surrogate Mother and therefore also the nutrition of the future baby are excellent. For the parents it is a tranquility to know that their babies will grow strong and healthy and for the Surrogate Mother a guarantee that she will not suffer from nutritional deficiencies once the period of pregnancy is over. And for us is just a matter of common sense that nonetheless is totally ignored by other surrogacy clinics.