Monthly Archives: June 2013

Top 5 supplements for a healthy pregnancy and baby

As a mother of two boys, maternal and child health are very dear to my heart. Pregnant women in my practice often ask me which supplements they should be taking during their pregnancy. These five supplements are what I recommend to every woman of child-bearing age who might one day get pregnant.  Why you ask? Because these are the supplements that keep on giving. Even after a mother has had her baby, these supplements continue to benefit both the mother and baby.

1. Iron:  is an important vitamin for both maternal and fetal health. It is involved in the transport and storage of oxygen. It is required for energy and it supports the growth and development of the fetus and placenta. It is also involved in brain development and cognition.  Anemia in pregnancy may result in a baby with a low birth weight.

Interestingly enough, iron in breast milk is small but much more absorbable and the amount of iron is more dependent on maternal stored iron. A recent research study found that mother’s that were supplemented with iron during pregnancy had higher iron levels in their breast milk.  Meaning that it is important for pregnant and soon to be pregnant women to have a healthy iron level before they give birth. An anemic mother will lead to an anemic baby once born. Most women at some point or another in their pregnancy become anemic. It is always a good idea to start out with a reservoir of iron instead of a deficiency.

It is important to get a good digestible source of iron that will not cause constipation. My preference is chelated iron bisglycinate. It is relatively inexpensive and it works well. According to the University of Maryland Medical Centre, pregnant women need 27mg of iron daily. Even if a woman is mildly anemic, I still treat them with supplemental iron due to an increase risk of post partum bleeding.  As always please consult a licensed care provider before taking any supplement.

2. Probiotics: these are microorganisms that live in our entire digestive tract.  Lactobacillus and bifidobacterium are the major microorganisms and they play an important role in digestive and immune health. There is research to suggest that maternal levels of bifidobacterium affect infant levels as early as 3 days. Bifidobacterium  readily passes from the breast milk to the nursing baby. Probiotics enhance our immune system, enhance the assimilation and absorption of vital nutrients, promote healthy skin, decrease atopic disease (asthma, allergies, eczema) and act as Group B Strep prophylaxis. While you can get probiotics in supplement form, I always encourage people to get additional probiotics through foods such as sauerkraut, kim chee, yogurt, miso or anything fermented.

3. Omega 3 fatty acids: the 3 main types of essential fatty acids are EPA, DHA and ALA. They are called essential fatty acids because they must be obtained from the diet. EPA and DHA are readily found in seafood such as fish, squid and algae. ALA is mainly found in flaxseeds, soybean oil, canola oil.  I will discuss the problems with soybean and canola oil in a later blog. ALA is not readily converted to DHA by the body so I usually just supplement patients with DHA and EPA. During pregnancy and breastfeeding, the mother is the primary source of essential fatty acids. DHA in the developing infant is needed for visual and neurological development, cognition and hand/eye coordination. For pregnant and nursing mothers, essential fatty acids can help with mood stabilization and to banish baby brain.

4.  Vitamin D: with the war against sun exposure in full bloom, Vitamin D deficiency is becoming rampant. I have my issues with the whole everyone must wear sunscreen year round campaign but this is not the place for that discussion. Being a physician in the Pacific Northwest, I see and treat a lot of Vitamin D deficiency. Vitamin D deficiency is now becoming a significant public health concern especially the further  away  you are from the equator. Vitamin D deficiency has been linked to gestational diabetes, pre eclampsia, infection, Cesarian section and fetal growth restriction. Vitamin D in addition to calcium is also required for proper bone development. A recent paper published in February of this year suggested that supplementation may be a simple way to reverse adverse risk factors associated with low Vitamin D status. A licensed health care practitioner can check your Vitamin D status for you and suggest an appropriate Vitamin D dosage based on your lab results.

5. Prenatal Vitamin: research is just now starting to focus on the role of micronutrients in pregnancy outcomes. According to recent research,  reduction in  essential micronutrients may contribute to recurrent spontaneous abortions.   A good quality prenatal will provide you with all the important micronutrients such as magnesium, selenium, zinc, copper, chromium, manganese among others. In addition, these vitamins and minerals will be in a form that is easily absorbed by the body. Not all supplements are created equally. For example, most supplement companies sell magnesium in oxide form. This form is not readily absorbed by the body whereas the malate or citrate form is much better absorbed. I always advise women to start taking their prenatal vitamins well before they are thinking of getting pregnant. The worse thing that can happen is your hair grows thicker and faster. I also tell women that they need to think of their  womb as a garden. The egg and sperm represent the seed. In order to get a good yield of produce, you have to prepare your garden and fertilize it preferable with organic manure. When you have good soil and good seed, you have a good harvest. Pregnancy is no different.

Are there any supplements you find helpful for pregnancy and post partum?


Tips for a Chemical free summer (part 2)

I would hope that after reading my first blog, some of you would have rushed out to replace your Hawaiian Tropic sunscreen with something that is a little bit better for your health.

Pesticides are a significant source of toxicity. People are exposed to pesticides via food and the environment in particular lawn care. While research is usually focused on massive pesticide exposure, low dose long-term pesticide exposure is difficult to capture. Not to mention the fact that pesticide residue has been linked to everything from hypospadias to decreased intelligence, learning and memory in children. Children are particularly vulnerable because of their immature organs, rapidly dividing and migrating cells, higher metabolic rate and smaller size.

Ways to decrease pesticide exposure.

1. Eat locally and organically. Summer is the perfect season to do this. Farmer’s markets are filled with everything from organic produce to baked goods and plants. Summer is also a good time to  plant an organic garden and decrease your grocery bill while nourishing your body.

2. Avoid the herbicide atrazine. According to Health Canada, atrazine is used extensively in Canada as weed control for corn and rapeseed. It is also used on lawns, sugarcane fields and golf courses. According to healthy child healthy world, atrazine is an endocrine disruptor that has been linked to cancer, miscarriages, developmental and birth defects, miscarriages, weakened immune system, reproductive abnormalities and sexual changes. Visit the Health Canada site for ways to maintain a beautiful lawn without nasty pesticides.

3. Remove your shoes when you come in from outdoors. People who know me are aware that this is a big issue with me. There is a lot of environmental residue that gets attached to the bottom of our shoes. It is important to have a no shoes in the house policy for guests and family members.

4. Invest in a water filtration system that will get rid of organic pollutants. Atrazine has  shown up in drinking water. Water can be a significant source of environmental contamination and toxicity.

5. Keep your floors clean by vacuuming and moping regularly. This is especially important if you have small children that are crawling.

6. Petition the government in your city to make sure parks and areas that children play at is free of harmful pesticides and chemicals.

7. Make your own bug repellent by using essential oils instead of DEET and permethrin. Oil of lemon eucalyptus has been shown to be just as effective as DEET. DEET has been shown to be a neurotoxin. Just remember that you have to reapply often with essential oils. Avoid scented products and cover up when outdoors. Wellnessmama is a wonderful website with information on how to make your own natural insect repellent that works.

What are you doing to decrease your exposure to environmental toxins?

Tips for a Chemical Free Summer (part 1)

With the days getting longer and the nights shorter, summer has finally arrived here in the Pacific Northwest. We have been enjoying wonderful weather consistently for the past 3 weeks here in Vancouver and with that I am now declaring summer here.

Summer activities such as barbecues, picnics, water parks, camping or just plain lazing in the sun is just around the corner. However with all this merriment and enjoyment, our exposure to environmental contaminants is likely to increase. From sunscreens to lawn care, summertime is prime time for increase exposure to chemicals that may have an adverse effect on our health and that of our children. This blog will focus exclusively on sunscreens since there is so much information to be covered.

According to the Environmental Working Group (EWG), melanoma (the most deadliest skin cancer) rates are on the increase and sunscreen alone cannot reverse this trend. The rate of melanoma has steadily increased in the past 35 years despite approximately 60% of adults claiming to apply sunscreen while out in the sun. While most sunscreens offer protection against sunburns, they are not effective at preventing DNA damage from exposure to UV rays. 

Sunscreens are made of either physical or chemical barriers. Chemical barriers contain ingredients such as Oxybenzone and octyl methoxycinnamate, are readily absorbed by the body and have been known to cause allergic skin reactions and disrupt hormones. Not something you want for your children or yourself for that matter if you are pregnant or trying to get pregnant. Physical barriers have mineral ingredients such as zinc oxide and titanium dioxide. They tend to contain nano particles which make the product non whitish when applied to the skin.

Tips for decreasing toxic exposure while in the sun.

1.  As mentioned above, choose physical barrier sunscreen instead of a chemical barrier. Avoid spray sunscreens because they contain nano particles that are not safe when inhaled and they get applied to the skin too unevenly.

2. Don’t be fooled by a higher SPF. Anything higher than SPF 50 does not offer additional protection and may actually make you stay in the sun longer and not re apply as often.

3. According to the healthy child healthy world website, it is best to avoid the sun between the hours of 10 am and 3 pm when it is the strongest. For children, wear breathable clothing that covers their hands and legs, put on a sun hat and stay in the shade. Of course adults can follow this recommendation. There are several companies such as Hanna Andersson who sell SPF clothing and sun hats. Sunscreen is not recommended for children younger than 6 months. I am aware that there are now new recommendations that say it’s ok but I say better safe than sorry. There isn’t any research looking at the link between toxicity in infants and sunscreen use.

4. Avoid any sunscreen with Vitamin A (i.e retinyl palmitate or retinol). While Vitamin A and it’s derivatives have been used for anti aging, research has shown it to accelerate the development of skin tumors and lesions on sun exposed skin

5.  Have your Vitamin D level checked by your health care provider. Higher levels of Vitamin D has been linked to a decrease rate of melanoma.

6.  Increase consumption of foods such as tomatoes, sweet potatoes, flax seeds, green tea, spinach, pomegranate, almonds, dark chocolate, broccoli, celery, apples, cherries. You get the point; a plant rich diet is chuck full of antioxidants that help reverse and at times prevent the DNA damage that occurs with UV exposure. Diet can offer significant protection in the fight against skin cancer.

7.  The University of  Maryland Medical Centre recommends herbs such as milk thistle, ginger, turmeric, billberry, ginkgo and hawthorn for their skin protecting abilities. Please consult a trained/licensed practitioner to prevent adverse reactions if you decide to take herbs.

8. Visit the EWG website to see if your sunscreen is safe. The database has over 1000 different products that can be looked up. While you are at it, don’t stop at your sunscreen, check out other personal care products that you use on a daily basis and see if they are affecting your health negatively.

What are your favourite healthy sunscreens?