- unrefined, complex carbohydrates (such as wholemeal bread, brown rice, wholegrain cereals, wholewheat pasta, baked potatoes) which are an important source of energy, vitamins, minerals and fibre. They are slowly digested and do not cause large fluctuations in blood sugar levels, as can occur from eat¬ing simple carbohydrates (such as sugars). Aim to obtain at least half your daily energy intake in the form of unrefined complex carbohydrates. Five to six slices of wholemeal bread per day will help to meet your energy requirements.

- fresh fruit and vegetables – which provide minerals, vitamins and fibre. Aim to eat at least 5 servings per day (a glass of unsweetened orange juice with breakfast, large salad with lunch, 2 pieces of fruit during the day plus 2 vegetables with your evening meal equals 6 servings). Buy produce as fresh as possible and use quickly. Wash and, where practical, peel all fruit, salads and vegetables (especially carrots and apples) before eating as the potentially harmful effects of pesticides and fertilizers are not yet fully understood. Eat them raw or lightly cooked – without additional salt. Where possible, steam for a very short time only. If boiling, bring water to the boil before adding the vegetables, as the boiling water helps to destroy enzymes that break down vitamins such as vitamin C. Re-use vegetable water for sauces, gravies and soups.

- protein-rich foods (such as lean meat, fish, pulses, eggs, milk, cheese, cereals, nuts and seeds). US recommendations (1989) suggest that protein requirements increase during pregnancy from the normal 50 g to 60 g per day. UK dietary reference values are slightly lower at 45 g per day for non-pregnant women, 51 g per day during pregnancy, 56 g per day during the first 4 months of breastfeeding and 53 g per day for breastfeeding from 4 months onwards. Most women in the Western world already obtain more than 60 g protein per day. Vegetarians can substitute pulses, grains, cereals, nuts and seeds for fish and meat. Avoid liver and liver products, how¬ever, due to the risk of vitamin A toxicity,

- calcium-rich foods (such as milk, pasteurized yoghurt, pasteur¬ized cheese, green vegetables, oranges, bread). Calcium is the only mineral whose requirement doubles during pregnancy. It is essential for the development of fetal bones. If calcium is in short supply, it will be leached from your bones and teeth,

- foods rich in essential fatty acids – such as oily fish, nuts and seeds. These are vital for your baby’s growing brain and ner¬vous system.

- cut back on your intake of table salt (sodium chloride) by avoiding obviously salty foods, checking labels of pre-bought foods (75 per cent of dietary table salt is hidden in processed foods) and avoiding adding it during cooking or at the table

- avoid highly processed foods jumping with additives

- eat red meat 3 times per week or less, rather than the more usual once or twice per day – eat more fish in its place use olive or rapeseed oil during cooking and do not re-use oils (which contain higher amounts of harmful trans-fatty acids)

- when hungry, snack on healthy foods such as fruit, toast, bread, plain biscuits, malt loaf, yoghurt or fromage frais rather than sweet cakes, sweet biscuits, crisps and pastries ‘keep your intake of sweets, chocolates and sugary, fizzy drinks to a minimum

- avoid alcohol as much as possible,

- avoid foods that are an infection hazard such as:
1. ripened soft cheeses such as Brie, Camembert, Cambozola
2. blue-veined cheeses such as Stilton, Roquefort, Blue Shropshire, Blue Brie, Dolcelatte
3. goat or sheep cheeses such as fetta, Chevre any unpasteurized soft and cream cheese
4. any under-cooked (raw, rare or pink) meat
5. raw eggs or any that are not fully hard-boiled
6. cook-chill meals and ready-to-eat poultry unless thoroughly re-heated
7. all types of pate
8. ready-prepared coleslaw and salads
9. unwrapped foods that are not re-heated thoroughly (such as sausage rolls)
10. unpasteurized milk or dairy products
11. shellfish
12. all foods past their ‘best by’ date
13. rolls or sandwiches containing any of the above
14. soft whipped ice cream from ice-cream machines.

Keep your kitchen clean and dry, with fridge temperatures below 5°C (41°F) and freezer below -18°C (0°F). Wash hands thoroughly before preparing foods. Store raw meat at the bot¬tom of the fridge, covered, and keep it separate from cooked foods. Defrost frozen produce thoroughly before cooking. Cook foods thoroughly, and throw away any that are past their use-by dates. Finally, keep pets out of the kitchen at all times.

Birth defects, also called congenital anomalies, can range from mild to very severe and not compatible with life, meaning the baby may not live. The main causes of birth defects are environmental exposures and genetics. Many times the causes are unknown. Birth defects are seen in all parts of the world. The “background rate” for birth defects has been reported as 3 to 4 percent in the general population. This means that anyone has a 3 to 4 percent chance of having a baby with a birth defect.

Here is a short list of possible environmental or external exposures that can contribute to congenital anomalies:

- Medications. Accutane, Coumadin, alcohol, valproic acid
- Infections. German measles, toxoplasmosis, cytomegalovirus, herpes simplex
- Maternal disease. Diabetes
- Heat. Fever, external prolonged heat exposure
- Heavy metals. Lead, mercury

Another major cause of birth defects is chromosomal or genetic in nature and thereby hereditary. When there is suspicion of potential birth defects caused from a chromosomal or genetic transmission, there are early prenatal tests that can be performed to aid in the diagnosis. The following is a list of early prenatal testing for some congenital anomalies:

- Alpha-fetoprotein. This protein is secreted by the fetal liver and will be at abnormal levels in certain spinal cord and abdominal wall defects. With a Tetra Screen, the alpha-fetoprotein is drawn in addition to a human chorionic gonadotropin (hCG), estriol, and inhibin. During pregnancy, the estriol and inhibin levels are altered by the placental tissue. This level, depending on the laboratory, can be drawn from maternal blood between the fifteenth and twenty-first week.

- Chorionic villus sampling (CVS). Chorionic villus sampling is a sampling of the placental tissue early in the gestation. This tissue is then tested for chromosomal anomalies. This test is usually done between the tenth and thirteenth week, which is earlier than amnio¬centesis, discussed below. The tissue sample is obtained by inserting a needle through the maternal abdomen and then through the uterus into the placenta. It can also be performed by inserting the needle through the cervix rather than the abdomen. Because of its invasive nature, this procedure carries an increased risk of miscarriage or fetal mortality of 0.2 to 0.3 percent. CVS will not detect all congen¬ital anomalies. On occasion some of the cells within one sample may be abnormal while others are normal. Many of these cases prove to have normal gestations. Because CVS testing is not as commonly done as amniocentesis, you should find an institution with significant experience in performing the required procedure. This testing should be reserved for those pregnancies where the earliest possible detection of an anomaly is imperative to the parents and the risks are outweighed by the benefits.

- Amniocentesis. This procedure involves inserting a hollow needle through the abdomen and uterus into the amniotic fluid. Approximately 5 to 10 cc of fluid is removed and sent to a lab for evaluation of fetal skin cells that are floating in the fluid. Chromosomes from these cells are evaluated for chromosomal integrity and number. Amniocentesis can be performed for chromosomal study, to evaluate for infection, to determine a spinal cord defect such as spina bifida, and to evaluate fetal lung maturity in the third trimester. The risk of miscarriage following this procedure is approximately 1 in 200, but some feel it may actually be more like 1 in 600. While this test is done later than CVS, it is generally deemed safer than CVS. Amniocentesis is performed between the twelfth and fourteenth weeks but can be performed at any time during the pregnancy with similar risks. In the latter half of the second trimester, the risks of puncturing the placenta, umbilical cord, and fetus are greater, but the procedure is still deemed safe under the proper protocols.

DHA levels in your baby’s brain steadily increase from around 20 weeks gestation in the womb. They are important for the fluidity of membranes at the synapses, and for fast transmission of electrical signals, so this observed fall in brain levels of babies fed unenriched formulas is likely to be non-optimal – if not detrimental – as it slows synaptic transmission of information. Researchers have stated that the structure and function of cell membranes in a baby’s cerebral cortex are likely to be extremely important during early development, and failure to maintain intakes of fatty acids similar to those provided by breastmilk may cause permanent adverse effects.

Manufacturers are now starting to enrich formula milks with LCPs for mothers who are unable or unwilling to breastfeed. Several random, double-blind prospective studies of develop¬mental quotient in healthy, full-term infants have been performed. When breastfed babies are compared with those randomly assigned to receive standard formula or LCP-enriched formula milk, psychomotor developmental assessments show that a baby’s DHA levels are directly related with his developmental advancement. No other fatty acid shows the same relationship. The results are the same when babies’ visual acuity is assessed. Researchers have concluded that, when breastmilk is not available, the use of a formula containing LCPs is the most effective way to achieve DHA levels beneficial for early brain development.

Research also shows that adding LCPs to formula milks dur¬ing the first 30 weeks significantly improves a baby’s sharpness of vision compared with babies not receiving LCP-enriched formulas. Trials are ongoing to see if enrichment also boosts intelligence. At present, it seems that breastfed babies, and those receiving formula enriched with LCPs, may have up to a 10-point IQ advantage on children not receiving LCPs during early development. Breastfeeding also confers additional advantages such as nerve growth factors, which influence brain growth and maturation.

Not surprisingly, there is considerable controversy at present concerning these findings. If a mother is unable or unwilling to breastfeed, however, she is well advised to stake her baby’s intellectual future on an enriched formula. At the worst, it can do no harm. Chances are it will provide a significant intellectual benefit.

If you decide to give your baby a formula milk, check the labels and choose one supplemented with LCPs. These are now becoming more widely available. At first, LCPs were only routinely given to premature infants (since around 1991). They were expensive and difficult to extract in a pure form, but new technology means they can be produced more cheaply. For example:

- DHA may now be extracted from vats of algae that naturally synthesize it, or from eggs
- AA is extracted from fungi that naturally produce it.

Ideally, an LCP-enriched formula should be given to term infants for at least the first 4-6 months of life after birth – until your baby can start making DHA himself in adequate quantities from other dietary essential fatty acids. After this age, continue either giving him formula enriched with LCPs or with linoleic or linolenic acids to ensure his intake of DHA building-blocks. Some milk formulas now have added nucleotides too, molecules needed for the production of new genetic material and for healthy immunity.

It’s crucial for an expectant mother to follow a nutritious, balanced diet of foods containing vitamins and minerals critical for the healthy development of the unborn child. Carbohydrates are an important component in that endeavor.

Carbohydrates are organic compounds that include sugars, starches, celluloses, and gums and serve as a major energy source in our diet. Carb-rich fare includes many foods pregnant mothers are encouraged to consume.

Many mothers-to-be are advised by their doctors to drink a lot of milk, eat dairy products, and take prenatal supplements. On the official Atkins website, the carb calculator indicates most dairy products (excluding cheese and some cream) should be avoided in favor of a protein-rich, high-fat diet. The site warns that the weight-loss diet isn’t appropriate for pregnant and nursing women.

Even if you are neither pregnant nor female, many nutritionists caution that the Atkins Diet or any diet that pitches deprivation isn’t an ideal or healthy way to lose weight. Some dieters risk higher cholesterol levels due to the substitution of fattier foods as well as secondary ailments or deficiencies, such as heart disease and osteoporosis.

Most importantly, pregnancy isn’t a time to be watching your figure. Expectant mothers should embrace a larger, varied diet and weight gain for the sake of their child’s and their own health. After giving birth, Mom has plenty of time to shed her pregnancy weight. In fact, breast feeding may be an excellent way for new moms to burn calories while taking care of their child’s hunger pangs.

A baby starts babbling sounds together to make nonsensical phrases by the age of 8 weeks. The more words your infant hears, both in the womb and during early life after birth, the faster he will learn his native language. The basic sounds that make up the words of a particular language are hard-wired into the brain by the age of 1 year. Neurons that respond to different sounds are spaced apart according to how similar the sounds are. In English for example, ‘Rrr’ and ‘Lll’ sound quite different and are pro¬grammed apart so they are more easily recognized. In Chinese, ‘Rrr’ and ‘Lll’ sound very similar and are programmed in to neu¬rons sitting close together. As a result, a child brought up in a home where Chinese is spoken will find it more difficult to dis¬tinguish between these two sounds should he later learn to speak English in secondary school. Similarly, English-speaking children will find difficulty in rolling their Rs as the French do, as this is not a sound they are accustomed to.

If you have the opportunity to expose your child to the sounds of a different language, as from a bilingual parent or an au pair, do so from as early an age as possible. Preferably from birth. It is much easier for your child to learn a second language along with the first, than to learn it afterwards when he is older.

Speak to your baby as much as possible. Explain what you are doing when you are making his breakfast, putting on his clothes or doing housework. Immerse him in the sounds of words as much as possible – although remember that quiet periods offer¬ing time for reflection are important, too. If you are concentrat¬ing on something and are unable to interact with your baby for a while, put on the radio so he can still hear some background conversation and music. Interestingly, it did not seem to matter what words the mother used – hearing simple words seemed to be just as good for laying down ‘sound’ circuits in the brain as hearing complex words. These circuits then act as the internal dictionary that starts to absorb more words.

Yet more research shows that babies and infants who were talked to a lot from an early age had significantly higher IQ scores than those who received less parental communication. They also had significantly more advanced creativity, reading, writing, problem-solving and decision-making abilities.

The size of your child’s vocabulary will continue to increase throughout life as long as you encourage him to retain his innate love of words and word games such as Scrabble or crosswords.

New research suggests that children whose parents read to them at a very young age will perform better when learning to read, write and do arithmetic. This was independent of social class or environmental background. Families of 300 9-month-old children were given a free book, a poetry poster and information on how to join their local library. By the age of 30 months and by the time of starting school, they were reassessed and were significantly ahead in reading, listening and speaking ability, using numbers and han¬dling shapes, spaces and measures than were similar children not exposed to books at an early age.

Women have a lower alcohol tolerance than men due to their higher percentage of body fat – around 30 per cent body weight compared to 15 per cent in the male. Pregnancy is also a time when your body fat stores increase by an average of 10 per cent. Fatty tissue absorbs alcohol like a sponge and slowly releases it into the circulation. Alcohol therefore stays in your body longer than in the average male, as it is only slowly transported to the liver for processing.

When you drink alcohol it is rapidly absorbed from your stomach and small intestines into your bloodstream. Before your body has time to break it down, it will pass from your circulation into the placenta and straight into your baby’s system. Your baby will also receive a constant alcohol infusion, as the alcohol absorbed by your fatty tissues is slowly released.

During early embryonic life, alcohol will enter the rapidly dividing embryonic cells and start to interfere with some of the enzymes responsible for early metabolic reactions. This results in increased levels of acidity within your baby’s circulation (meta¬bolic acidosis) and is highly toxic. In adults, alcohol is broken down in the liver to a poison, acetaldehyde. If this accumulates in adults, it is a potent trigger of nausea and vomiting – as any¬one who has ever suffered a hang-over will recognize. When it accumulates in your developing baby, it can trigger congenital defects or even a miscarriage.

Because of the way alcohol is distributed throughout your body fluids, if you drink alcohol during pregnancy your developing baby will develop a higher blood concentration of alcohol than you. Alcohol will also stay in your baby’s tissues longer -including his developing brain – as once it reaches his body, his liver is less efficient at breaking down alcohol than yours. And as the tiny liver bud only develops during the 4th week after con¬ception, your baby is most vulnerable to alcohol damage in the first month after conception – often before you even know you are pregnant. Unless you take positive steps to avoid alcohol during the months before trying to conceive, as well as during pregnancy itself, you may have affected your baby’s future brain potential.

So why is the US national cesarean section rate 25 to 27 percent? We think there are a few reasons why: as one notable saying goes, “once a C-section, always a C-section.” Some experts think that more and more women are asking for a first-time, purely elective cesarean section. Yet in a survey that asked 1,600 women who had undergone cesarean section why they had the surgery, only one person admitted that it was because of a personal desire. This means that while women do request a primary C-section, meaning they have never had a C-section, the number is relatively insignificant. Perhaps there are more indications for C-sections and physicians are merely adjusting accordingly. The indications for a cesarean section are numerous, but there are some that might be more controlled by our current medical system than others. Data suggest, for example, that women who undergo induction of labor with a cervix that is not ripened have a higher rate of C-section. Some people claim that the invasive nature of hospital care also contributes to the rising cesarean rate, although there are minimal data to support this.

Fifteen years ago, it was common for physicians to offer women an attempt at vaginal birth after cesarean section (VBAC). Today, women who desire a VBAC may not be given the choice. Physicians and hospitals are less eager to perform VBACs because of the small but substantial risk of uterine rupture.

Rates of uterine rupture during VBAC range from 0.02 percent to 9 percent, depending on the type of uterine incision.23 Women who have a low transverse incision (side-to-side) have a rupture rate of 0.02 percent to 1.5 percent, while those with a classical incision on the uterus (up-and-down) have rates from 2 percent to 9 percent. In many cases of uterine rupture, the fetus will either die or be severely damaged by acute blood loss. When women learn there is an approximately 1 in 200 chance that their baby will be seriously injured during VBAC, many opt for the repeat cesarean section. The truth of the matter is that both physicians and mothers may be more cautious about performing VBAC deliveries simply because of this increased risk.

Women who desire a vaginal birth after cesarean section should also consider the reason for their cesarean section in the previous pregnancy. If a cesarean section was performed because the baby would not fit through the pelvis (cephalopelvic disproportion), this may indeed be the case in subsequent pregnancies. While some hospital statements show increased reimbursements for cesarean sections, some studies have shown that VBAC is actually more expensive.

Obviously, the concern for cesarean section is real and with rates close to 30 percent there is a need to investigate and at least consider its possible etiologies. The decision to perform a cesarean section should not be taken lightly, as all surgery has inherent risks. The decision to proceed with cesarean delivery is a decision made between the patient and her health¬care provider. In our experience, this decision is never made lightly, and we carefully consider the care of both mother and baby.

Why You Need It during Pregnancy

Folate is needed for a wide number of body functions, including the:

• healthy production of new cells
• metabolism of sugars and proteins
• maintenance of healthy nerves.

When a cell divides in two, its genes are copied so that each daughter cell contains a full set of genetic material. Folic acid is essential for this process, so that if your levels of the vitamin are low, cells that are dividing become larger than normal and are more likely to contain abnormal chromosomes. As pregnancy is a time of rapid growth and division of cells, good supplies of folic acid are vital. In fact, folic acid is the only vitamin you need twice as much of during pregnancy than at any other time. Like vitamin B12, it is especially needed by cells that are dividing rapidly, such as those in your baby’s developing central nervous system.

Lack of folic acid during the first few weeks of pregnancy can trigger a type of congenital abnormality known as a neural tube defect. This is when your baby’s central nervous system (spinal cord and brain) starts developing – around 3 weeks after the egg has been fertilized:

• first, a long thickening forms where your baby’s spine will eventually develop
• the edges of this thickening grow upwards to form a U-shaped groove
• the walls of the groove start to fold over and fuse to form a tube which will develop into the baby’s brain and spinal cord groups of cells then grow in and around the tube which will eventually form the protective back bones (vertebrae).

If folic acid is in short supply, the cells forming the neural tube cannot grow and divide properly. The neural tube does not fuse fully along its length, so a gap is left at the top or bottom of the spine. This is known as a neural tube defect, examples of which include:

• spina bifida – literally meaning split spine - a distressing condition in which one or more of the bones in the back (vertebrae) fail to develop properly so the spinal cord and nerves are damaged due to lack of bony protection. Sometimes the membranes surrounding the spinal cord and even the spinal cord itself may be abnormal, too.
• some cases of hydrocephalus (a build-up of cerebrospinal fluid in the skull due to faulty development of drainage channels) – but probably only those cases associated with spina bifida.
• anencephaly – a rare condition in which most of the brain and the top of the skull fail to form.

Other birth defects which have been linked with lack of folic acid include cleft palate, hare lip and abnormalities of the limbs, heart, lungs and skeleton.

Sadly, at least two babies are conceived with a neural tube defect every day. If a man or woman has had one previous child suffering from a neural tube defect, or if either parent is affected him- or herself, the risk of having a baby with a neural tube defect is 10 times greater than normal. If a man or woman has had two affected children, the risk of a third baby with a neural tube defect is 20 times greater. It is reassuring to know that taking a folic acid supplement can reduce these risks by 75 per cent.

There is still some way to go before all women who are planning a baby or who are pregnant increase their intake of folic acid. A recent survey by the UK Health Education Authority showed that only 27 per cent of women were spontaneously aware of the importance of folic acid during pregnancy, although this was better than the 9 per cent who were aware the previous year.

Folic acid supplements may also help to protect against preeclampsia, which was recently found to be linked with high levels of the amino acid, homocysteine. Around one in 10 people inherits higher than normal blood levels of homocysteine. This can damage artery linings (including those in the placenta) and more than triples the risk of a heart attack in later life. One in 160,000 people has extremely high levels, with 30 times the risk of premature heart disease. Folic acid supplements (400 – 650 meg per day) can lower homocysteine levels to reduce the risk of pre-eclampsia in affected women (and, if continued after pregnancy, supplements also reduce their long-term risk of a heart attack). Folic acid supplements during pregnancy may decrease the risk of the offspring developing a brain tumour during childhood by over 60 per cent.

How Much You Need

If you are planning a baby, you should increase your intake of folic acid in three ways, by:

1. choosing foods which have been fortified with folic acid (including many breakfast cereals and some breads)
2. eating more folate-rich foods such as green leafy vegetables
3. taking a daily dietary supplement of 400 meg folic acid daily.

Ideally, you should start boosting your intake at least 3 months before trying for a baby, or certainly from the time you stop using contraception. Supplements should continue for at least the first 12 weeks of pregnancy and preferably throughout the whole 9 months. After the first 3 months, you can drop down to taking 200 meg folic acid if you wish.

If you have previously conceived a child with a neural tube defect, you should take a supplement containing at least 10 times more folic acid. Supplements containing 5 mg folic acid are available on prescription for this purpose.

Research suggests that after having a baby, it takes more than 6 months for a mother to return to her pre-pregnancy folic acid levels.

Good Dietary Sources

Folic acid is such an important vitamin for health that more and more foods are being fortified with it to boost everyone’s intake. These are now also easier to spot, thanks to the UK Health Education Authority’s new ‘flash’ scheme which leading manufacturers are adding to their packaging. Look out for flashes saying:

• contains folic acid – on foods that can provide at least one-sixth of your daily requirement
• with extra folic acid – on foods enriched to provide at least half your daily requirements.

When planning a pregnancy, you should aim to eat foods rich in folic acid as well as taking folic acid supplements.

Folic acid is mainly found in green leafy vegetables and fortified foods.

Good Sources of Folic Acid for Pregnant Women

• fortified foods such as cereals and breads
• green leafy vegetables such as spinach, broccoli, Brussels sprouts, kale, spring greens
• green beans, cooked black-eyed beans and baked beans
• cauliflower
• potatoes
• wholemeal or granary-style bread
• yeast extract -soya products
• kidney
• dairy products
• citrus fruit
• eggs
• yoghurt

Don’t boil your vegetables for too long. Eat them crisp – or even raw – as prolonged boiling destroys much of the folic acid present in the green leaves. Folic acid is also destroyed by prolonged contact with light and air, but can be protected by the antioxidant, vitamin C (as by squeezing lemon juice over your vegetables).

Potential Problems

There is no evidence that taking folic acid supplements in the amounts recommended for pregnancy are harmful.

If you have epilepsy, and are taking drugs to stop your fits, you should seek medical advice before trying for a baby. Some anticonvulsant drugs work by interfering with the way your body handles folic acid, so supplements can affect your treatment. It is best to seek specialist advice about which anti-epilepsy drugs are safe to take during pregnancy, and what level of folic acid supplementation you need.

Most environmental toxins cross the placenta and pose a risk to the developing fetus. A study by the UK Woman’s Environmental Network suggests that up to 8 per cent of British children suffer from poor responsiveness and memory loss because of toxic damage in the womb. They may also have reduced intelligence in later life. Even if only 1 per cent are affected, this still represents thousands of children per year.

Cadmium

Cadmium is a common pollutant linked with increased risk of congenital abnormalities (including cleft palate, hare lip, limb deformities), low birthweight, small head, reduced intelligence, miscarriage, preterm delivery and stillbirth, especially when coupled with high lead and low zinc levels. Your main sources of exposure to cadmium are:

• cigarette smoke
• processed foods
• water that has coursed through galvanized mains
• industrial waste
• shellfish from polluted waters
• burning fossilized fuels.

Zinc seems to be important in counteracting some of the adverse effects of cadmium exposure.

Lead

Lead is associated with an increased risk of miscarriage, congenital abnormalities, fits, delayed development, reduced intelligence, stillbirth and neonatal death. You are exposed to lead from a number of sources:

• exhaust fumes from lead in petrol
• water that has coursed through old, lead water pipes, old, lead-glazed earthenware mains or copper piping with alloy joins containing lead
• unlined tin cans
• food grown in polluted soil
• smoking tobacco treated with lead-containing insecticides.

Lead is rapidly carried across the placenta to your baby and can build up to cause lead poisoning from as early as 12 weeks of pregnancy. In one study, babies’ blood levels of lead were assessed both before and after birth, and regularly up to the age of 7 years. When these children took part in IQ tests between the ages of 11 and 13, it was found that IQ was related to lead levels, and seemed to fall by 3 points as concentration of lead doubled. Other studies have also confirmed that exposure to lead can reduce IQ by averages varying from 3 to 9 points. Some research suggests that lead interferes with the way some brain communication chemicals (the neurotransmitters glutamine and dopamine) function. Others believe that it leads to low levels of oxygen within brain cells.

Mercury

Mercury is a toxic metal that crosses the placenta and is concentrated in your growing baby, so his mercury levels may be as much as 20 times higher than your own. Mercury toxicity is linked with impaired neural development in babies exposed to mercury in the womb, leading to an increased risk of cerebral palsy, small brain, mental retardation, blindness, fits, preterm delivery and stillbirth. Your main sources of exposure to mercury are:

• pesticides and fungicides
• fish (especially tuna) from polluted waters (reputable fish oil supplements are screened for contaminants)
• industrial waste -dental amalgams.

It is important to avoid having mercury amalgam tooth fillings removed or inserted during pregnancy if at all possible.

Organophosphorus and Other Pesticides

Pesticides are powerful chemicals that affect specific biological systems (such as fungi, caterpillars, whitefly) in low concentrations but can build up to cause harm in humans – especially during pregnancy – as they can easily cross the placenta to enter the developing baby and trigger congenital malformations. Many of the most harmful chemicals are fat-soluble, and become concentrated in animal fat products.

PCBS

Polychlorinated biphenols (PCBs) are an environmental pollutant that has been linked with lowered intelligence in infants and young children. In 1968, contamination of rice oil in Japan led to babies being born with developmental abnormalities, lower body weight, hyperactivity, behaviour problems and lower intelligence scores.

In one study, women exposed to PCBs as a result of eating contaminated Lake Michigan fish had blood and breastmilk levels assessed, and their children were followed up at regular intervals. Children exposed to the highest levels of PCBs were three times more likely to have a low average IQ score, and twice as likely to be at least two years behind in reading ability than those not exposed. This suggests that the developing brain may be sensitive to PCBs. The researchers concluded that exposure to slightly higher concentrations of PCBs than occur in the general population can have long-term effects on intelligence. Tests showed prenatal exposure to high PCB levels reduced verbal IQ scores by 7 -16 points, performance IQ scores by 10 -18 points, and overall IQ by 9 – 18 points. The differences remained throughout the 6 years of follow-up.

The use of PCBs are now banned, although they are difficult to eliminate as they were so widely used in industry and are resistant to biodegradation.

To reduce your exposure to environmental poisons:

• Eat organic wholefoods where possible.
• Cut down on your consumption of animal fats.
• A void tinned foods, processed foods and excess salt.
• Eliminate all dietary additives.
• Wash all vegetables, fruit and salad stuff thoroughly, and peel as many as possible.
• Eat garlic, yoghurt, bananas and pectin-containing fruits to help reduce absorption of dietary toxins.
• Avoid heavy traffic and inhaling exhaust fumes – keep car windows closed in traffic jams.
• Avoid burning waste rubbish, especially newspapers, magazines and plastics.
• Switch to lead-free petrol and a car fitted with a catalytic converter.
• Avoid any sheep-dipping activity or contact with clipped sheep.

- a narrow, receding forehead
- a short, upturned nose
- a receding chin
- asymmetrical, poorly formed ears
- thin lips
- an unusually long distance between the nose and lips, with flattened or absent skin folds
- short-sightedness
- squint
- heavy epicanthic folds between the nose and eyes
- slanted eyes
- congenital heart disease
- small brain
- low intelligence.

If a woman regularly drinks 2 or 3 units per day throughout pregnancy, she has an 11 per cent chance of her baby developing fetal alcohol syndrome. This risk rises to 19 per cent with 4 units per day, and 30 per cent in women who drink more than 5 units daily. A pregnant woman who regularly drinks more than 9 units of alcohol per day is almost certain to have an affected child. Babies of women who are pregnant over the age of 30 seem to be especially vulnerable to the effects of alcohol and to developing fetal alcohol syndrome.

1 unit alcohol is equivalent to each of the following:

= 100 ml (one small glass) of wine (there are 7.5 units per bottle of wine)
= 50 ml (one measure) of sherry
= 25 ml (single tot) of spirits
= 300 ml of normal-strength beer

NB In the US, a unit of alcohol is called a drink.

How Much Alcohol Is Acceptable During Pregnancy?
Recent studies suggest that low intakes of alcohol (up to 8 units spread throughout the week) are not linked with birth defects. The effect on intelligence is less clear, however. It seems sensible to avoid such a potent toxin altogether during pregnancy if pos¬sible. Many women find they go right off the taste of alcohol during pregnancy, anyway, in one of nature’s spectacular ways of protecting the unborn child. If you find it difficult to go without alcohol altogether, then accepted opinion is that 1 or 2 units of alcohol once or twice a week during the last 3 months of preg¬nancy is unlikely to do serious harm. There does seem to be an increased risk of spontaneous miscarriage, however, even when amounts are this low.