Preconception: Preparing for a healthy pregnancy & a healthy baby

A concept that I find difficult to communicate with patients and in my writing, is that of preconception. Most of us think of this in terms of fertility, and getting pregnant. I would like to extend the concept of preconception to that of improving the health of our future children.

The idea that we can take steps pre-conception to improve the health of our future children is truly incredible, and with the enormous rise in childhood illnesses such as allergies, autism, asthma and ADHD, it has become essential.

The good news is, that there are many steps parents can take, before pregnancy to reduce the risk of childhood illness. Some of the areas that we examine include:

1. Personal & Family history

What do we need to prevent? Is there a history of allergies, eczema, asthma, autoimmune disease, mood disorder, ADHD, diabetes, etc. Here we can use the research and target preventative strategies in your preconception plan. For example, your blood sugar control in pregnancy, can influence future diabetes risk in your children.

2. Gastrointestinal health and microbiome support

Your microbiome is one of the most important things you pass on to your children. The gut microbiome has been linked to risk of allergies, autoimmune disease, obesity, Crohn’s disease, depression, and more (1,2,3,4,5,6).

The steps are: removing foods that are inflammatory to you; clearing out microorganisms that are pathogenic (parasites, certain bacteria and yeast); replenishing with probiotics; repairing the intestinal tract lining; and supporting digestive function.

3. Optimal nutrition and supplementation to prevent deficiency

Did you know that your nutrition for the three to six months pre-pregnancy is even more important to your child’s health than your pregnancy nutrition (7)? This requires a close look at your nutrition based on your current diet and individual metabolic needs, and the addition of appropriate vitamins and supplement to fill in any gaps.

4. Detoxification to reduce your toxic load preconception

In this day and age, toxins surround us. Reducing your toxic load means to reduce your intake and exposure through processed foods, plastics, personal care products, cleaning chemicals, alcohol intake and more. The next step is to support detoxification pathways through the liver, kidneys, lymphatic system and skin.

5. Stress reduction and balance of adrenal hormones

When your body is under prolonged periods of high stress, it creates an environment that may impact your fertility, your postpartum recovery, and your risk of postpartum depression. Exposure to high stress hormones can also affect your baby’s development in-utero, and beyond (8,9,10).

The bottom line is that you can make an impact on the outcome of a pregnancy, and the health of your child by taking the appropriate steps preconception. Much of this work is in the foundations of health: good nutrition, stress management, sufficient sleep, regular movement, and taking good quality prenatal vitamins preconception. There are however additional steps that are helpful to ensure that you are doing the most you can to support a healthy conception.

The other important note, is that whenever possible we want to engage both parents in preconception work. The health of both partners is essential for a healthy pregnancy and baby – this is not just the mother’s role.

References:

1. Musso, G; Gambino, R; Cassader, M. Obesity, Diabetes, and Gut Microbiota. The hygiene hypothesis expanded? Diabetes Care October (2010) 33 (10): 2277-2284
2. Esteve, Eduardo; Ricart, Wifredo; Fernández-Real, Jose-Manuel. Gut microbiota interactions with obesity, insulin resistance and type 2 diabetes: did gut microbiote co-evolve with insulin resistance? (2011) ,14(4): 483-490.
3. Tilg H, Kaser A. Gut microbiome, obesity, and metabolic dysfunction. J Clin Invest. 2011; 121(6): 2126-2132.
4. Foster JA, McVey Neufelt KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends in Neurosicences. 2013; 36(15): 305-312.
5. Evans JM, Morris LS, Marchesi JR. The gut microbiome: the role of a virtual organ in the endocrinology of the host. J Endrocrinol. 2013; 218: R37-R47.
6. Galland L. The gut microbiome and the brain. Journal of Medicinal Food. 2014; 17(12): 1261-1272.
7. Ramakrishnan U, Grant F, Goldenberg T, et al. Effect of Women’s Nutrition before and during early pregnancy on maternal and infant outcomes. Pediatric and Perinatal Epidemiology. 2012; 26(1): 285-301.
8. Buss C, Davis EP, Shahbaba B, Preussner JC, et al. Maternal cortisol over the course of pregnancy and subsequent child amygdala and hippocampus volumes and affective problems. PNAS 2012 109 (20) E1312–E1319.
9. Huizink AC, Robles de Medina PG, mulder EJ, et al. Stress during pregnancy is associated with developmental outcomes in infancy. Journal of Child Psychology and Psychiatry. 2003; 44(6): 810-818.
10. Mulder EJ, Robles de Medina PG, Huizink AC, et al. Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Human Development. 2002; 70(1-2): 3-14.

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