Maternal Depletion: What moms need to know about closely-spaced pregnancies and lactation

Contrary to popular belief, it is NOT normal for women to have worsening health problems as a result of pregnancy. We should not be shrugging off worsening hormone imbalance (weight gain, irregular cycles), postpartum depression, and other common health issues that come after having children. And these everyday prenatal complications, birth defects, and deficiencies in children almost always stem back to prenatal nutrition, despite conventional medicine always trying to find the cause. (The conventional medical field more commonly studies prescriptions and surgery so nutrition information can be hard to come by in that field.)

We are even hearing reports of women whose teeth are falling out and who get diagnosed with cancer soon after having a child. (Yes, cancer is simply a manifestation of nutrient deficiencies. Read my article on the Truth of Cancer here.)

And there are increasing numbers of miscarriages, preterm labors, birth defects, and children with learning disabilities. This trend reflects the severe nutrient depletion caused by the combination of a nutrient-deficient diet and frequent pregnancies that do not allow mother to restore depleted nutrient levels. It's a simple truth but unfortunately so commonly ignored.

Back-to-back pregnancies/periods of lactation can deplete even a healthy mom of nutrients very quickly. Most women do not stop to consider the large amount of nutrients it takes to grow a new life and then to nourish it solely off of her breastmilk. But as most of us know, breastmilk contains large amounts of nutrients, so those nutrients must come from somewhere! 

As a result of these deficiencies, we are seeing an increase in things that previously only affected third-world countries during pregnancy and childbirth.

Sometimes, these health issues as a result of prenatal nutrient deficiencies take longer to reveal themselves and a mother may not see the connection.

Now before we continue, I would like my readers to note that I have six children, so I very much believe that children are a blessing from the Lord. (My children are spaced at least 2 1/2 years apart so they range in age from 11 months to 18 years as of the date of writing this.) Most of my friends have their own large families. My goal in this article is to help mothers be blessed with children but not at the cost of their own health or their children's health. As a holistic nutritional counselor for over 5 years, I have seen the impact this has on a mom's health--the things that other people don't always see or know about when they see these families.

While some may have issues related to their faith regarding spacing children apart, it's important to remember that the things that prevent this from happening naturally according to God's design are unnatural things that we have allowed in our lives that go against His design--things that cause hormone imbalances that prevent natural delay of menstruation such as eating Man-made foods rather than God-made foods, not adhering to natural exclusive breastfeeding the way He designed babies to be fed, etc. We must also keep in mind God's recommendations to His people in the Old Testament to let fields rest every seven years, as well as various recommendations regarding the harvest of fruit trees, especially new ones, in order to prevent them from being depleted.  

I would also like to address the unfortunate trend of children born with increased health problems and decreased mental health/intelligence to mothers who are depleted in nutrients. We are leaving children at a major disadvantage but not giving them what their bodies (and brains!) need to properly form and develop.

In previous societies, women would adhere to traditional practices of what we today call "extended breastfeeding" where children were breastfed beyond the first year and usually into at least the second year. This usually prevented a subsequent pregnancy from occurring too close to the previous one. Today, however, most women suffer from hormone imbalance as a result of poor diet and environmental estrogens, so even women who breastfeed are not able to delay the return of their menstrual cycle which can cause them to become pregnant again before they have been able to restore their nutrient levels.

(For more on the practice of Ecological Breastfeeding to naturally space apart children which is the method my husband and I use in order to allow my nutrient levels to restore between pregnancies, click here to read my article on Ecological Breastfeeding: What it is and why it doesn't work for some women.)

If a hormone imbalance is causing a woman's menstrual cycles to return soon after birth, the side effect of this is not just frequent, closely-spaced pregnancies. The problem is that the majority of cases of breast cancer are in women who have had years of hormone imbalance symptoms that they ignore. 

It was very common for many traditional societies to require women who were considering pregnancy to be placed on a much more nutrient-dense diet than the rest of the society. For example:

The Maasai only allowed men and women to marry after spending several months consuming milk from the wet season when the grass was especially lush and the milk much denser in nutrients. Maasai milk is higher in fat and cholesterol and lower in sugar than commercial American milk.

The highest quality Maasai milk used for preconception diets, however, is even richer: compared to commercial American milk, it has over twice the cholesterol, nearly three times the fat, and over five times the quantity of phospholipids (see Figure 2).7 The phospholipid content is particularly important. Since most of the choline in milk is contained in phospholipids,8 this means that high-quality Maasai milk is probably about five times richer in choline than the milk you would find in the grocery store.

Compared to grain-fed milk, grass-fed milk is much higher in fat-soluble vitamins, pigments, conjugated linoleic acid (CLA) and omega-3 fatty acids.9 Price showed that the content of vitamin A, activator X (which we now believe to be vitamin K2), and essential fatty acids markedly increased in butterfat during the rainy lush season.10 As the quality of grass increases, we can presume that the content of other grass-related nutrients—such as pigments, vitamin E and CLA—will also markedly increase in the milk. (Weston A. Price Foundation)

In other societies, women seeking pregnancy were given the most nutrient-dense foods that were in short supply. Some women and their families would walk many miles to gather the nutrient-dense foods that were needed for a healthy pregnancy. They could not rely on expensive NICU technology or formula to feed their babies in the event of nutrient-deficient complications, so they put a huge emphasis on prevention.

Some of the common problems associated with maternal depletion (for mom and baby) include:

• Morning Sickness
• Postpartum depression (Click here to read my article on PPD)
• Thyroid disease
• Hormone imbalance
• Infertility (Click here to read my article on infertility/conception)
• Miscarriage
• Preterm Birth
• Stillbirth
• Increased pregnancy complications (gestational diabetes, preeclampsia, swelling, PUPPPS rash, etc.)
• Anemia
• Increased labor complications
• Premature rupture of membranes
• Endometriosis
• Small for Gestation Age (SGA) Infants
• Birth defects
• Spina Bifida
• Lip tie/tongue tie
• Cleft lip/palate
• Insufficient breastmilk production
• Decreased IQ in child and increase in learning disabilities
• Increased susceptibility to chronic disease in child's future, such as Type 2 diabetes, heart disease, stroke, etc.)
• Eye problems (cataracts, poor vision, etc.)
• Down Syndrome

The mother's nutritional status at conception may be compromised and her ability to support fetal growth and development may be less than optimal. Most of the research in this area has focused on maternal protein and energy status (1, 2). It seems reasonable to assume, however, that micronutrients may also be depleted in women with early or closely spaced pregnancies.1

Some of the factors that require an even higher intake of nutrients for a healthy pregnancy and baby include:

• Pregnant with more than one baby (twins etc.)
  • Additional 500 calories and 30 grams of protein for each additional baby
  • Are currently breastfeeding
    • Additional 500 calories and 30 grams of protein as long as breastfeeding continues
    • Have one or more of the following stress factors which affect nutritional needs: (an additional 200 calories and 20 grams of protein for each stress factor, up to a maximum of 400 calories and 40 grams of protein)
      • extreme vomiting
      • pregnancy spacing of less than one year
      • poor obstetrical history (previous stillbirths, prematurity)
      • serious life stresses (divorce, death in the family, loss of family income, etc.)

http://www.midwiferyservices.org/pregnancy_nutrition.htm

Most people do not realize that these kinds of things, especially things like stress, can deplete a woman's stores of nutrients in addition to poor diet. 

Additionally, many women do not realize that environmental factors and medications in their years before pregnancy can cause severe nutrient deficiencies that may be hard to correct.

For instance, birth control pills cause serious nutritional deficiencies and sometimes disrupt the body's proper methylation of essential prenatal vitamins. Click here to read my article on how birth control pills can cause these deficiencies that last for many, many years.

Together or independent of those factors, closely-spaced pregnancies leaves both mom and baby at a disadvantage. For example:

Women with interpregnancy intervals of <6 mo had a higher risk for maternal death, third trimester bleeding, prelabor rupture of membranes, puerperal endometritis and anemia than did women with interpregnancy intervals of 18–23 mo. 

Risks To Babies

Women with short interpregnancy intervals or early pregnancies are at increased risk for delivering preterm, low-birth-weight or small-for-gestational age (SGA)3infants (3– 8).

In the United States, women with interpregnancy intervals of <8 mo were 14–47% more likely to have very premature and moderately premature infants than were women with intervals of 18–59 mo (10). In a study of >810,000 infants born to Michigan women between 1993 and 1998, both white and black women with interpregnancy intervals of <6 mo were 50% more likely to have a low-birth-weight infant, 20% more likely to have a preterm birth and 30% more likely to have an SGA infant than were women with intervals of 18–23 mo (11). 

Risks to Both

The concentration of folic acid in maternal serum and erythrocytes declines from midpregnancy until 3–6 mo postpartum (33). During pregnancy folic acid is needed for cell division; during lactation it is required for the synthesis and secretion of milk. If the dietary supply of folate is low, circulating levels begin to decline during the fifth month of pregnancy and continue to decline until several weeks after delivery. Among women in developed countries, 20% have low serum folate levels 6 mo after delivery (33). Epidemiological studies in the United States have found an association between preterm births or SGA deliveries and lower concentrations of folate in the serum or erythrocytes (34). A poor maternal folic acid status at conception may contribute to the poor reproductive outcomes in women with early or closely spaced pregnancies.

Iron is another nutrient that is mobilized from maternal stores during pregnancy, and the stores of iron tend to remain low for several months after delivery (35). Iron deficiency anemia is a prevalent problem among pregnant adolescents (6) and is associated with preterm delivery and associated low birth weight. The excess preterm birth rate among women with short pregnancy intervals or early pregnancies may be due in part to poor maternal iron stores resulting from insufficient repletion after a previous pregnancy or to recent growth demands (35).

The research's conclusion:

A short interval between pregnancies... increases the risk for preterm birth and growth retarded infants. Maternal nutrient depletion has been proposed as a possible cause of these poor pregnancy outcomes.1

These are just a few small examples of the impact nutrient deficiencies can have on both mom and baby. More research can be found on the impact these things have on baby's intelligence and risk of chronic diseases later in life.

So What Can We Do?

First of all, it's crucial that women assess and maintain proper hormone balance. The presence of a hormone imbalance (which can be evidenced by return of menstruation before 6 months and even before one year in exclusively breastfeeding moms, as well as other symptoms of hormone imbalance) indicates additional underlying health problems as well as those associated with the imbalance.

Check out my post on Ecological Breastfeeding for tips on things that cause hormone imbalance to eliminate those factors and how to successfully ward of menstruation.

You can also check out my article on Birth Control for additional tips on naturally spacing out pregnancies to allow mom time to replenish nutrients.

This is a nutrient-dense diet that includes foods very high in essential fertility nutrients, including beef liver from grass-fed animals, organic leafy greens as well as high quantities of organic vegetables in general, whole raw milk, eggs from pastured hens, probiotic-rich foods, and nutritional supplements like fermented cod liver oil. These are all things that contain the most essential nutrients for pregnancy and lactation including the essential folate, B12, biotin, vitamin A, and good fats, and they contain them in larger quantities than any other foods. Whether a mama has closely-spaced pregnancies or pregnancies that are spaced far apart, these foods are so important!

It is also very important to consider the things that can quickly deplete our body's essential nutrients and be careful to avoid them, including:

• Refined sugars (These quickly deplete our body of B vitamins and essential minerals like magnesium and calcium)
• Caffeine (Caffeine causes depletion of minerals/electrolytes and fluids more quickly than we can replenish them.)
• Processed foods (refined flour, vegetable oils, chemical preservatives, and foods with nutrients processed/cooked right out of them!)
• Medications (OTC and prescription-See Suzy Cohen's book Drug Muggers for a really good list of each of the nutrients specific drugs deplete in your body). Past use of any and all medications will have caused deep-rooted nutritional deficiencies that should be addressed before becoming pregnant.

Other factors to consider when determining if you are getting enough nutrients include health problems such as:

• Damaged gut health (aka leaky gut) which prevents your body from properly absorbing nutrients
• Methylation issues such as MTHFR which prevents your body from properly absorbing/utilizing essential B-vitamins and is associated with increased rates of infertility, miscarriages, and birth defects. (See my article link above on birth control pills for how a past history of oral contraceptive use can increase your likelihood of this problem.)

By addressing any of these factors present, avoiding things that deplete nutrients as much as possible, incorporating a nutrient-dense diet like that laid out in my Prenatal Regimen, and giving mom's body adequate time to restore nutrients, we can provide our children with a much better future that includes better health, physically and mentally, for them AND a healthy, active, energetic mom to raise them!

REFERENCES:

1.  
2. J. Nutr. May 1, 2003 vol. 133 no. 5 1732S-1736S (http://jn.nutrition.org/content/133/5/1732S.full)
3.  
4. http://lpi.oregonstate.edu/infocenter/lifestages/pregnancyandlactation/