HIMBA: Thinking of getting pregnant?

The first 1000 days of life (from conception to age two) is the most critical window for your child’s lifetime health and development. There are many things you can do before your baby is born to set good foundations for their health and development.

What can you do?

Three months before you plan to try and conceive, review your health- a good tool can be found here: https://www.tommys.org/pregnancy-information/planning-pregnancy/planning-for-pregnancy-tool

Consult with a medical professional for a pre-conception check. Medications that you may be on, a diet you may be following or diagnosed health conditions may require review prior to pregnancy. Vaccinations such as MMR may also be required.

Consider both female and male health. DNA comes from both the mother and father and healthy eggs and sperm are equally important for the health of the child.

Ensure both parents have a varied diet. This is the best way to ensure optimal nutrition can be obtained from food sources.

Some additional supplements are recommended due to the difficulties obtaining these in diet. These are FOLIC ACID (400mcg) and VITAMIN D (10IU).

Additional supplements may be required if you are deficient. Speak to a healthcare professional about this. Foods rich in vitamin B(s), C, D, iron, zinc, iodine, selenium, omega 3 and calcium are advised. These vitamins can be found in a diet rich in: leafy vegetables, fruits, nuts, oils, meat, fish, dairy and wholegrains (brown rice, oats, rye etc). Processed foods and refined sugars are not recommended .

Do not take vitamins with vitamin A included. Liver, pate and fish liver oils are high in vitamin A and are not recommended when pregnant. Vitamin A is high in retinol which is harmful for your baby’s development.

Reduce alcohol when trying to conceive and when pregnant, stop all alcohol intake. Reduce caffeine to 200mg per day- 2 cups of tea or coffee.

Ensure that all dairy is pasteurized. Do not eat soft cheeses like brie or mouldy cheeses.

Ensure meat and eggs are well-cooked and avoid sushi if it has not been frozen beforehand.

Eat 2 portions of oily fish such as salmon or sardines are recommended per week but avoid shark, swordfish and marlin. Tuna is safe twice a week but due to high mercury levels should be avoided in larger quantities.

Continue to exercise. The recommendation is around 150 minutes of moderate intensity exercise (walking, cycling) and two strengthening based exercise sessions per week which help with bone, muscle and joint strength. When pregnant, it is safe to continue doing the exercise you completed pre-pregnancy. Vigorous exercise that gets pregnant women out of breath or contact sports are not recommended. Women should be able to talk throughout exercising. Continuing to remain active is important to reduce the risk of hypertension, gestational diabetes and support overall general fitness and healthy weight gain during pregnancy.

Try to maintain a healthy, regular menstrual cycle by having regular sleep, minimal stress and adequate nutrition and calories. A healthy Body Mass Index (BMI) increases the chance of getting pregnant and having positive outcomes during pregnancy and birth. http://www.emro.who.int/nutrition/information-resources/bmi-calculator.html

Prepare your mental health for pregnancy. Many physiological and hormone changes can impact antenatal mental health and mental health after the baby arrives. 1 in 5 and 1 in 10 men are affected by mental health during pregnancy and the first year after birth.

See resources for mental health here:

https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/perinatal-mental-health-toolkit.aspx

https://ihv.org.uk/for-health-visitors/resources-for-members/resource/ihv-tips-for-parents/mental-health/emotional-health-and-wellbeing-mothers/

https://ihv.org.uk/for-health-visitors/resources-for-members/resource/ihv-tips-for-parents/mental-health/emotional-health-and-wellbeing-fathers/

Resources and references:

https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5a55fdb253450a0fe1bc703b/1515584964573/Eating_Well_for_a_healthy_Pregnancy_2017.pdf

https://www.nhs.uk/start4life/pregnancy/

https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-healthy-eating-and-vitamin-supplements-in-pregnancy.pdf

https://www.acog.org/patient-resources/faqs/pregnancy/nutrition-during-pregnancy

https://thousanddays.org/why-1000-days/

https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/1496/1496.pdf

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chief-medical-officers-physical-activity-guidelines.pdf

Author: Abigail Laurie, Registered Midwife and Specialist Public Health Nurse in the United Kingdom