Looking after bones and teeth - for both baby and mum
The body adapts in pregnancy to ensure that calcium from
food and drink is well absorbed, but it is important to make sure that women
have adequate amounts of the two nutrients that are very important for healthy
bones: vitamin D and calcium.
Vitamin D
Most people over the age of 5 years make enough vitamin D in
their skin when it is exposed to summer sunlight. (The UV rays in sunlight are
strong enough to do this in some parts of the world between April and
September.) Although women who regularly go outside with some of their skin
exposed* should be able to make enough vitamin D for the whole year, some women
may be at risk of vitamin D insufficiency:
- All pregnant women are considered to be at risk of lower vitamin D status, and low vitamin D status in the pregnant woman can impact on the bone health of the baby throughout its life.
- Women with darker skin (for example, those from South Asian, Caribbean or African descent) may be at greater risk, as darker skin requires more sun exposure to make sufficient vitamin D.
- Women who rarely go outside may not make enough vitamin D. They may not go outside because they are unable to do so because of a disability, because they are in a residential setting, or because they choose to stay inside.
- If women wear concealing clothing when they are outside - for example, if they never have their shoulders or arms exposed to the sun - they may not be able to make enough vitamin D.
- Women who do not eat meat or fish may get less vitamin D from their diet (dietary vitamin D). Although dietary vitamin D alone does not prevent vitamin D insufficiency, it can provide a useful additional source.
All pregnant women should take a supplement of 10 micrograms
of vitamin D a day throughout pregnancy. This is included in the Healthy Start
vitamins.
* Current Sun Smart guidance suggests that people should
spend some time in the shade between 11 am and 3 pm when the sun is at its
strongest, and everyone should take care not to burn their skin. People with
fairer skin are likely to need greater protection from the sun than people with
darker skin, but all skin types can burn.
Calcium
It is also important to get adequate amounts of calcium from
the diet. Milk, cheese, yogurt and fromage frais are the best sources of
calcium, but other foods also contain some calcium. Many of the recipes in this
blog are good sources of calcium.
Women who drink large amounts of fizzy drinks, particularly
cola drinks, may also be more prone to bone problems, as the phosphorus in
these drinks makes it harder for the body to absorb calcium.
Women who don’t eat or drink dairy products
Some women may avoid dairy products (milk, yogurt and
cheese) because they are lactose-intolerant. Lactose is the sugar naturally
occurring in milk and all milk-based products, and lactose intolerance is
frequently found in some women of Asian and African descent. It is caused by a
deficiency in the enzyme lactase. Intolerance of dairy foods can be variable.
Some people experience unpleasant symptoms such as diarrhea, bloating and
nausea when they have even small amounts of lactose, while others can consume
small amounts without severe effects.
If dairy foods are avoided, intake of calcium, riboflavin
and iodine might be low, so it is important that good sources are included in
the diet.
Calcium: Unsweetened
calcium-fortified soya milk can be used instead of milk as a drink and in
recipes. (Some brands of soya milk may also include vitamin B12 and vitamin D,
which can be useful additions to the diet for vegans, but soya milk on its own
may not provide enough of these nutrients. To find out whether a particular
soya milk brand uses vitamins that are from non-animal sources, check with the
Vegan Society.)
Non-dairy sources of calcium
include: spinach, sardines, pilchards and other tinned fish eaten with the
bones, tofu, soya drink fortified with calcium, bread, sesame seeds, peas,
beans and lentils, dried fruit, oranges and egg yolk.
Non-dairy sources of riboflavin
include: kidney, malted drinks, fortified breakfast cereals, almonds, lean meat
and poultry, and eggs.
Non-dairy sources of iodine are
fish, eggs and iodized salt.
Some seaweed has a very high
iodine content and should be avoided, unless the iodine content of the product
is known and is stable. Dried nori seaweed used in making sushi is safe to
include in the diet and can be sprinkled on soups and stews and included in
home-made burgers and other dishes. Very high intakes of iodine are also
dangerous and if women take an iodine supplement this should provide no more
than 150 micrograms a day.
Looking after teeth
Hormonal changes in pregnancy can
make gums more prone to infection, and keeping teeth and gums healthy is
important to prevent future tooth loss.
Top tips for looking after teeth
- Cut down on fizzy and soft drinks. One of the biggest risk factors for poor dental health is the frequent consumption of soft drinks, fizzy drinks, squashes, juices, smoothies and sports drinks. Drinking water, milk or unsweetened decaffeinated tea or coffee between meals will not damage teeth.
- Avoid eating sugary snacks throughout the day - for example, sucking or chewing on sweets or eating biscuits regularly between meals. Teeth constantly bathed in sugar are more likely to decay.
- Brush teeth twice a day with a fluoride toothpaste.
