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Real Food for Pregnancy
Lily Nichols, takes prenatal nutrition advice out of the dark ages and provides an easy-to-follow guide for making the best food and lifestyle choices during pregnancy.
Most prenatal nutrition advice is either outdated or not evidenced-based. In Real Food for Pregnancy, Lily Nichol’s debunks a LOT of prenatal nutrition myths. Misconceptions of conventional prenatal nutrition: macronutrients, salt, “foods to avoid,” fish, etc. In this episode we talk about testing for gestational diabetes—pros/cons of all the methods and traditional postpartum care and the impact of nutrients on breast milk quality.
Karen Tell me a little bit more about the book and how it came about?
Lily Thank you for the detailed introduction, I feel well set up to answer all the questions. How the book came about, I have worked in prenatal nutrition most of my career and much of my work like you shared in my bio is related to gestational diabetes and when I started looking for a different approach for managing gestational diabetes more effectively with nutrition I started coming across a lot of research showing you that you can have very mildly elevated blood sugar below the diagnostic threshold of gestational diabetes has some adverse outcomes, can have some adverse outcomes for infants including certain developmental problems such as congenital heart defects or neural defects, I thought given that 50% of the US population at the moment has some form of blood sugar issue whether diabetes of pre diabetes most of which are undiagnosed, I really should be getting this information out to a broader group of people beyond the people who are officially diagnosed with gestational diabetes. I have written my first book “Real food for gestational diabetes” I’m not sure how big of an impact it would have, but I was humbled it became popular quite quickly and I started getting asked by practitioners will I write a book on regular prenatal nutrition, at the time I recently became pregnant so I had to go through my own pregnancy and have my baby, I start writing this book in the first year post-partum with my son, I just felt compelled to really get the information out there
Karen One of the things you talk about is the misconceptions of testing for gestational diabetes, and I know that a lot of the woman I work with question me about, is it absolutely necessary I’m not sure if its done in the States but the typical glucose tolerant test that’s usually done at about 28 weeks in pregnancy, where they come in, they told to fast in the morning, we check their blood sugar and give them 75grams of glucose and then test an hour later, what are your thoughts on testing for gestational diabetes at 28 weeks and of all the different methods
Lily What I’ve come to realise is that there is probably not a one size fits all way best way to test for gestational diabetes, any test has the chance of giving you a false positive or a false negative. However for the glucose tolerant test or the glucola it’s the same thing by a different name is considered the gold standard right now, and the method that you describing with the 75gram glucose tolerance test, correct me if I’m wrong but your ladies just come in for one test right and then their done
Karen Yes unless it gives a high reading in which case they will go on for further testing
Lily Ok meaning a 100 gram glucose tolerance test
Karen They would probably repeat the test and then be treated for gestational diabetes
Lily Ok ok so there’s been controversy around the way glucola was done, and the international diabetes and pregnancy study group has looked at the different ways to do the glucola, and the most accurate and reliable way is with a 75gram 2 hour glucose tolerance testing done fasting, most countries outside the US do that test and it has the benefit of being a one-time thing, you either pass or fail and then you know to test your blood sugar if you’re levels come out high from that test. The way that most practitioners do it in the United States is an older version where its actually 2 glucose tolerance tests, they give you one of 50 grams if you fail that screening then they give you a second one of 100 grams, the blood sugar levels that set the cut off, and also just the methods in which the tests are done, mean that fewer woman get diagnosed with gestational diabetes than maybe should. Meaning a lot of women with mild elevated blood sugar past those tests. If we going to bother testing then we should move in the direction of doing the 75 gram test. There are some cover ups with the test, for women that have been following a low carbohydrate diet through their pregnancy they will be at a greater risk of having a false positive of the test and its been known since at least the 1960’s that this happens whether pregnant or not, your body is more primed to process a large quantity of sugar at once if you regularly consuming a higher carbohydrate diet. That’s one situation in which I think we want to look at different options like home blood sugar monitoring for a couple of weeks to see what’s happening with a woman’s blood sugar, I also think there is rational for testing woman in early pregnancy, via haemoglobin A1C which is a very simple blood test, you don’t have to drink any sugar drink leading into it just can be added to the prenatal labs but it helps to give you an idea of the woman’s blood sugar for the last 2 to 3 months, that can catch essentially prediabetes that was happening before pregnancy. But with the research they have looked at women with higher A1C’s and then give a glucose tolerance test. A higher A1C accurately predicts failing a glucose tolerance test by 98.4 % so we could if testing earlier catch women early in pregnancy helps them get a better lifestyle plan earlier on and minimise blood sugar for another whole trimester, so I think that would be great to add in addition to all the clarity what to do at 28 weeks
Karen it certainly would, it would be getting that nutritional advice in the trimester that it really counts as well in the developmental stages of the first trimester. What would be prenatal nutrition advice on nutritional management of gestational diabetes if that test was done in the first trimester and shown to be high what would you advise a women to change in her diet to manage that
Lily Well the biggest thing regardless of when a women is diagnosed or realises her blood sugar is high, the first thing is learning to figure out what foods raise your blood sugar the most and there is some basic nutritional teaching that can be done around that, there is also some blood sugar monitoring by pricking your finger and testing your blood sugar after eating that also comes into play, so from the nutritional side of things if we just look at which foods are highest in carbohydrates, that’s often really helpful for women because carbohydrates of your 3 macro nutrients are carbs, fat and protein. Carbohydrates are the ones that raise your blood sugar the most. So the first thing I would do in my teaching is explain to women which food are highest in carbohydrates so she can be aware of those foods and start to notice if having larger portions of those foods leads to her blood sugar to be high or not, the ideal amount of carbohydrate for each women is going to be different so that’s where the home blood sugar monitoring comes in, maybe someone can tolerate 30grams of carbohydrates at a meal and have great blood sugars, but you may only be able to get away with 15 or so, but you can only figure that out by testing your blood sugars and comparing it to targets, that definitely the first one, and then of course I also teach what foods don’t raise your blood sugar cause you still have to eat, and that’s a big mistake that happens as a women that gets diagnosed, here’s all these scary statistics that can happen to her and her baby and they end up starving themselves because they think they can’t eat anything, so I also tend to shift a lot of my teaching to foods that you don’t have to worry about portion size with necessarily and still have great blood sugar, so any of your eggs, meat, fish, nuts, seeds and non-starchy vegetables the ones other than things like potatoes or sweet potatoes they tend not to raise the blood sugar very much or healthy fats, fats don’t raise your blood sugar, avocado, olive oil, fats that are naturally in butter on your meat those don’t raise your blood sugar either, there’s a large percentage of the diet that can be eaten freely without worrying so much about portion control
Karen There’s a lot of misconceptions and myths about foods that you need to avoid during pregnancy which I know caused a lot of women a lot of stress. Can you help me debunk a few of those myths some of the common ones that you get faced with and that you talk about in your book?
Lily Sure thing, this is a really common question, I feel like women find out they pregnant and the first question is what can’t I eat
Karen As opposed to what can I eat and what should I eat
Lily Exactly so the foods to avoid list that you hear are there for a reason and they there because you’re immune system makes adaptations to allow your baby to grow and as a result your body becomes more susceptible to infections and this can include illnesses from bacteria, viruses or parasites that are in food. However when you look at the data on which foods are mostly likely to cause you to get sick or which ones are most commonly linked to outbreak of food illnesses, some of the ones that are on the list such as eggs with runny yolks are rarely responsible for outbreaks and also there’s a very low risk that your food is actually going to be contaminated with something. So eggs with runny yolks the chances that you come across an egg that is contaminated with salmonella is 1 in 30 000 and its been found to be 7 fold lower if chickens have been raised in pasture or in organic farming methods, so very slim. Now in the case of eggs if you are a person who only likes your eggs with runny yolks and you can’t stomach them any other way, and you going to avoid them because of this theoretical safety concern its actually a lot of nutrition that you would be missing out on from the eggs, probably the most important one is a nutrient called choline which is important for you babies brain development, it is found in other foods but not nearly in the concentration that its found in eggs, and women that who consume eggs actually consume about half of the choline in their diet, compared to women who eat eggs. In the case of eggs the nutritional trade-off is actually greater than the risk of getting sick from eggs with runny yolks in the first place, that’s one example I can go through more if you want but it might get quite lengthy
Karen it’s interesting that you brought up the eggs because I know several woman that stopped eating mayonnaise because of the egg content in mayonnaise so what would your advice be around that, because that’s raw egg
Lily That’s interesting, well in the States all the mayonnaise are pasteurised so its not even a raw egg risk here but if the only mayonnaise they have is from raw egg or maybe you making it at home on your own, I would say if you going to do it go for the best quality eggs you can get. Salmonella that’s the bacteria we concerned about with eggs, Salmonella only gets in the egg if the chicken have salmonella in their gastro intestinal tract, that’s where the egg is formed, all the same whole in chickens, if your eggs are coming from chickens raised in a healthy environment not in confinement, outside where they able peck and eat grass and bugs and other things, they’re not in a crowded area where they spreading disease and chickens that are raised in confined barns situations, hence the rates of salmonella of eggs raised in those conditions, so I would say get the best quality eggs when making mayonnaise or you could like cook the egg yolk if you really concerned or purchase store bought so the eggs are pasteurised
Karen And one of the other common questions is sushi
Lily Well sushi is an interesting one, what I found interesting in looking into the sushi thing, not all countries have warnings against sushi so in many parts of Asia its considered normal to consume raw fish during pregnancy. Even in the UK they condone eating sushi cause the sushi grade fish has all been frozen for a period of time to a level where it kills any active parasites or anything like that, they say sushi is fine to eat as long as you getting it from a reputable establishment and its eaten fresh . I think that’s another one where its not necessarily that sushi is always unsafe its bad quality sushi or sushi that’s been sitting out would be considered unsafe, if it smells fishy don’t eat it, if its not freshly prepared from reputable restaurant don’t eat it, if its pre-packaged at a grocery store and it’s a raw fish type of sushi, I probably wouldn’t eat it you must eat the possibly freshest one you can get. Our fears of the food safety thing have been oversold, at least in the US the most common way that you going to get sick from food about the half the food poisoning outbreaks are linked back to fresh produce mostly leafy greens and raw fruits, especially pre-packaged and pre-cut fruit and vegetables, nobody wants pregnant woman to avoid fruit or avoid salad, we have all these warnings about other foods when the actual chances of you getting sick from them are not high so you need to make sure your salad greens are super fresh and fruits are super fresh as you should, your animal products ,eggs and fish
Karen that’s a really valid point. Just to do one more I notice that there’s a rise in an amount of people that I’m seeing with allergies to peanuts, sometimes they ask if they have an allergy to peanuts will their child, the baby they carrying necessarily be allergic to peanuts
Lily It’s not always a direct relationship sometimes your kid will and sometimes it won’t, obviously if you have a food allergy yourself don’t eat it, stay away from it, and doesn’t necessarily mean that your child will have that allergy. From woman that doesn’t have a peanut allergy theirs actually been mixed research showing consumption of common allergenic foods like peanuts during pregnancy may up the risk of allergy or the latest thinking and latest finding from studies that consumption of peanuts during pregnancy decreases the risks of allergies in among children because they have been exposed to small amounts throughout their lives
Karen That makes sense
Lily I’m not sure of you saw the study that came out linking the use of baby wipes to higher incidents of allergies in infants, this is baby wipes on the actual babies themselves, they believe the wipes disrupt the skin barrier on the baby then food allergens, that particulates that are left on a care givers hands after eating and then touch the babies skin can absorb, there are so many possible things going on here, I think the best way to ensure our babies immune system to develop properly is that you keep really good care of your immune system which would be avoiding things that flare up any issues for you, including avoiding foods that are known allergens but also really taking care of your gut, microbiome the healthy bacteria that live in your gut because its estimated at 70% of your immune system is actually located in your gut, so keep your probiotics and flora healthy during pregnancy and has a carryover effect on your infant, and in fact they do show that in studies I’m not just pulling that out of thin air
Karen Obviously in saying that in order for you to keep your gut healthy and your immune system healthy, there are certain foods that you would say are essential in order to do that. What would you say the top 5 essential foods are, could you bring it down to 5 or would there be more than that?
Lily There would probably be more than that, there’s nutrients in many different foods that are valuable for our health, there are definitely some I can highlight for their specific benefits and coming back to the egg thing, eggs definitely make the list for anyone who can eat eggs meaning you don’t have an food allergy to them, they a very wise addition to your diet during pregnancy, especially eggs either the yolks they have that important b vitamin like compound called choline which is vital for your babies brain development, it shows that woman that get more choline show their infants have better memory and cognition and faster reaction time so that’s a really important food, its got many other benefits but I will stop at the choline. Liver also fantastic food during pregnancy which is a surprise for a lot of people because many people have been warned against it, but it is one of the nutrients dense foods in our diet, often till the last 50 so years organ meats were really valued part of our diets, if you harvested an animal you wouldn’t throw away any of the parts, you don’t waste any and the organs are the most nutrient dense parts, and especially high in nutrients that are hard to get in your diet and woman are often deficient in, liver is 200 times more concentrated in vitamin B12 than muscle meats, meaning steaks or ground beef or something like that, its really high in iron in an easy to absorb form, high in vitamin A its high in choline its high in zinc, all these nutrients have really beneficial effects on pregnancy and reduce certain pregnancy complications and that’s a fantast one, and if people are curious on the research on it being too high on vitamin A, that’s something I wold direct them to look at in the book. I would also say meat on the bone, slow meat or bone broth is a really valuable source of nutrition, we have to rewind the clock to our grandmothers or great grandmothers era where you didn’t waste any parts of the animal we now know there is a very important amino acid called glycine in these foods that concentrated in the bones, skin and connected tissue of meat, it becomes conditionally essential during pregnancy its required for your babies DNA, skeletal development, bone, skin, organ development, its also required for your stretching skin, your uterus, for integrity of your amniotic sac, integrity of your perineum if we start going into birth. Its tough to get in your diet if you don’t include some of those foods, I think its valuable to use all parts of the animal, purchase meat on the bone, cook your bones down to broth like your great grandmother used to do and reap the benefits. Definitely vegetables you can’t live without vegetables, those are highly valuable source of nutrition rich in so many different vitamins and minerals and fibre as well really helpful for managing your digestion and staying regular, that’s kind of an obvious one so I will go past it pretty quick. I’ve lost count of how many I’ve gone through but I will go with one more which is salmon fatty fish another seafood, the reason why this is so valuable, like all foods there’s many reasons, foods are not one or two nutrients it’s a whole combination of dozens of different nutrients working together but these foods are one of your primary sources of a special fatty acids for your babies brain development that’s called Dha and outside of fatty fish and seafood the only other place you will find it is in certain algae oil supplements for woman who don’t eat this its definitely something to look at. They find better brain development in children of mothers who consume 12 ounces or more of fish a week, it is generally recommend that woman need about 300 milligrams of Dha a day there seems to be benefits if you have larger quantities of this. But Dha is essential there is also iodine in these foods, its definitely the richest source of iodine that’s also crucial for your health and pregnancy, thyroid health and also your babies brain development, a lot of things end up circling back to what nutrients do they contain why are they valuable, how are they important for mothers health and how do they affect your babies development, and that’s how these things make up my list
Karen Now despite the vegetables and the fibre all the others would be foods that a vegan wouldn’t be able to eat, so how would a vegan mom be able to get all those nutrients if she was not eating the salmon and the fatty fish, bone broths, liver and eggs
Lily It’s a nutritional conundrum and I included pretty lengthy fully sighted section in the book on that, personally for ethical reasons for my profession I can’t professionally endorse a vegan diet during pregnancy I know some woman will choose that anyway but knowing what I know and knowing the nutrients that are left out of the discussion of the professional guidelines on pregnancy such glycine which is essential to consume during pregnancy, its likely impossible to meet that on a vegan diet, that is something that will be very challenging to supplement cause even the supplemental sources are animal sources like collagen or gelatine. For a woman who is consuming eggs and dairy products its much more doable to meet most of your nutrient needs through food, and then add in specific supplements on top of that, for example vitamin B12 is a really wise addition in larger amounts that are provided in a prenatal vitamin by the way, we now have research showing that vitamin B12 are triple what our current recommendations are. If a woman is not consuming eggs very very in decent quantities a choline supplement might be warranted and also considering a Dha supplement for sure so the algae based Dha would be a really good addition. Do you have a section on this on tips to optimise a vegetarian diet because I know this is a really common question and I do want to give woman the best chances regardless of what their food choices are? From meeting it from food or from the addition of more supplements
Karen If a woman was following a regular diet that included meat and fish and chicken, what supplements if any would you recommend or would you say are they necessary
Lily I think for most woman a prenatal vitamin makes a lot of sense I mean even if you eating mostly nutrient dense foods there’s probably going to be time periods when you not eating the healthiest such as when 1st trimester nausea hits or with food aversions, kind of an insurance policy of sorts I don’t think it replaces real food if I did I wouldn’t bother writing a whole book about real food for pregnancy, I do think it’s a good idea, insurance policy to have a prenatal vitamin based on the data we seeing on vitamin D deficiency in pregnancy and vitamin D deficiency as a population as a whole I think a vitamin D supplement is often warranted beyond what’s in prenatal if we look at the latest data for someone who gets a lot of sun exposure in equatorial latitudes without sunscreen their vitamin D levels might be great and they might not need it and that’s something you can get a blood test for to decide. Another one would be like fish oil for woman who aren’t consuming fish regularly about a minimum of 12 ounces a week can reach your Dha needs and if you not doing that, you have food aversions or seafood isn’t your favourite thing, it’s certainly acceptable to do a Dha supplement or a fish oil supplement to meet those needs. Then there’s others that can be added in based on what’s happening for a woman so maybe she’s anaemic then an iron supplement makes sense, maybe she’s tending towards pre-eclampsia and her blood pressure is getting high like a magnesium supplement might makes sense, but I don’t think beyond those 3 there’s many that are must haves, but I do go through those in the book if people want to pick and choose the ones that make sense for them
Karen Folic acid is one of the ones that they generally start before they even fall pregnant and I know that there’s controversy with folic acid and folate, can you talk about that a little bit more?
Lily Sure I’m glad you bring up folate that one is essentially always covered in a prenatal vitamin so that’s something you won’t need additional amounts if you getting in prenatal. Folate is very important, the controversy, the benefits of folate or folic acid is that’s its been shown at a population level to reduce the risk of neural defects and serious anomalies like spinabifada, its very important for babies developing neural tube and brain especially in the early parts of pregnancy, so those sorts of defects actually happen in the first 8 weeks of pregnancy and that’s often times before the woman doesn’t know she’s pregnant, hence the recommendation for supplementing early. The controversy stems from the fact that a large percentage of the population anywhere from 40 to 60 % has a genetic difference in their ability to convert folic acid which is a synthetic version of folate into its active form in your body, that means that supplemented folic acid might not be helpful for those woman or in some cases could be harmful. So what a lot of practitioners are shifting their focus to supplementing with an active form of folate called methyl folate, there’s a couple different forms as well and I try not to confuse people and just focus on one that you can look for, methyl folate. That will have all the same benefits as folic acid without any of the down sides whether or not you have this genetic mutation that is called the MTHFR your body can utilise it just fine. I personally recommend a prenatal vitamin that has that type of folate in it
Karen I recently read some research, before I go back to the research bit, is it possible to have too much folate or folic acid before and during pregnancy. The reason I ask that question I’m seeing a lot of babies who have been diagnosed with tongue tie and some research that’s coming up is that its related to the folate because its been given to prevent neural tube defects and in that beginning when everything is developing from the centre outwards, that there is over development of the frenulum causing the tongue tie, have you read up about that or do you have any comments on that?
Lily I have seen some discussions around midline defects as they call it and its relationship to folic acid, folic acid is involved in the reproduction of cells in rapidly developing cells especially which is something that is happening when you growing a baby, I can’t say I’ve seen a definitive research paper or a handful of research papers saying a strong yes or no but it is something I see circulating around the maternal care sphere that people are kind of concerned about. We had concerns about folic acid a decade or more ago because they started fortifying the food supply in the US with folic acid a while ago, sort of a means to hit especially underserved populations, people that are consuming a lot of refined grains, it does make sense, if that’s the main food source and you not getting it naturally in the whole grain or in other nutrient dense foods it will at least make sure you meet this nutrient need. It did at a population level reduce the levels of neural tube defects but they also found at the same time that it increased the level of colon cancer, particularly like small what should have been benign polyps that would go away actually progressing into full blown colon cancer. The idea was that the folic acid is so readily taken up directly from the gastro intestinal tract that those rapidly dividing cells which cancer cells are were feeding off the high amounts of folic acid. So I do think its like maconistic physiologic biochemical stand point it does make sense to me to play a role in midline defects but I don’t have solid proof yet to say a strong yes or a no, I just think we know from the other things that folate does in our body and all the ways and the disruption of our folate cycle can mess up other processes in our body, it makes sense to just supplement with the form that anybody bodies can use versus this one form that 40 to 60% of us aren’t that readily able to use. Why not supplement with the better version, we just have to wait for supplement companies to catch up and start using it instead of folic acid
Karen And also at the end of the day tongue tie is treatable whereas a neural tube defect is irreversible
Lily That’s absolutely right
Karen We would rather prevent the neural tube defect. Something else I wanted to chat about that is particularly close to me is helping moms with breastfeeding is the impact of nutrition on breast milk quality and certainly the impact of nutrition on breastfeeding and the breastfeeding mom. So often what I find is moms just consuming the foods that are known to be galactagogues but not having healthy diets, galactagogues on their own are not going to help stimulate breast milk production, it’s that in addition to a healthy diet, would you agree with that?
Lily I would definitely agree with that, you can’t just live off oatmeal, first and foremost your milk production other than all the mother and child nipple stimulation relationship to everything, other than that part of it, actual nutritional production of breast milk requires adequate amounts of calories and fluids, simply put. So if you only prioritising galactagogue foods but you not consuming enough calories its not going to help, its like taking a galactagogue supplements like fenugreek or some of those other herbs, they can boost production but they not going to sustain it if you not consuming enough food yourself. Breastfeeding is very energetically demanding and nutritionally demanding an exclusively breast feeding mom at least in the first 6 months of her baby’s life will burn 500 additional calories just making breast milk so I think people are really shocked in early post-partum how hungry they are, and then they also faced with this bizarre unrealistic pressure from society to bounce back but it doesn’t make any sense cause its not physiologically how we work. So some woman find themselves frustrated cause they hungry and then intentionally undereating as a means to get to loosing baby weight faster and all of this is counterproductive to their body goals and also counterproductive to breast feeding because then you put in this situation where your body is not getting enough food itself to make milk. The other thing about breastfeeding is it required a lot of nutrients as well and that was something I wanted to look at the literature behind it, because I feel like even for me when I had my son I went to breast feeding class taught by a really wonderful lactation consultant, and she pretty much said theres no special way of eating when you breast feeding, every mom makes the most nutritious milk for her baby, and that was it you can eat anything. But are some nutrients in breast milk effected by what a mom eats or is it not, or is your body going to sacrifice a moms nutrients storage to always make good breastmilk, and it turns out the answer is a little more nuance cause there are some nutrients aren’t necessarily effected by the mothers diet, meaning the milk will always contain adequate amounts which include things like folate, however there’s a whole host of other nutrients, a lengthier list than the ones are always adequate which are effected by the moms intake. I’m very careful with how I go through the data on this in my book because I don’t want to discourage mothers from breastfeeding that’s not my goal. I mean as I was writing this book I was still breastfeeding my son and so I know how nutritionally, energetically, emotionally draining it can be as a new mom, and I don’t want to discourage woman, they always going to be making, breast milk is always the best food for your baby. You can just make it a little more nutrient dense when your diet is also nutrient dense, and guess what, you can also recover faster from childbirth, meaning heal any incisions, tears or other things, help your skin regain elasticity, have better energy, support your thyroid health, all those things by eating a nutrient dense diet. When I go through that information its not a means of making woman feel bad, its to really encourage them to take care of themselves, as many traditional cultures really emphasize, they usually ha someone living with you, providing your food, cooking for you or taking care of you, in the earlier time when you a new mom and nursing around the clock and not sleeping, and all that stuff. So if you want to go through specifics we can I always like to layout the general sphere here?
Karen What I would like to do actually is run what I tell the moms by you and get your feedback on what I’m saying cause maybe I’ve been misleading them as well. What I generally recommend is that they eat 3 meals a day and 3 small snacks, most of them are feeding their baby an average of 8 to 10 times a day which is more or less 3 hourly, and every time they feeding the baby their body goes into action to produce more milk and they usually find when they sit down to feed they get both hungry and thirsty, so if it’s not a meal time for them they can have a healthy snack whether its half a banana or a little bit of humus, some vegetable sticks or a small smoothie with fruits and leafy greens and then I generally recommend they include salmon at least twice a week, avocado, coconut oil, and obviously leafy greens. I recommend they have a bit of protein at every meal
Lily I agree with all of the above, you will be very hungry when you nursing especially in the first month or so cause you also recovering from childbirth, whether it was a natural labour or was a surgical birth you still have a lot of physical recovery to do from that, you also need to replete yourself for the nutrients that were transferred to your baby during pregnancy. There’s a lot of nutrient repletion that needs to happen, you will be ravenously hungry, absolutely eat whenever you hungry whether that’s 3 meals and 3 snacks or 3 meals and 6 snacks I don’t care just make sure you eating and its really easy to forget about your own needs when suddenly all effort focuses on your baby. I often recommend that woman plan to have shelf stable snacks if they don’t have help in the house with them all the time, have shelf stable snacks near where they nursing so you have something there with you, stash bottles of water all over the house, so there’s some by the bed, some by the couch, some by the rocking chair, so you getting enough of all of those. I certainly agree on the protein thing, you do need quite a bit of protein to heal from the birth, it also tends to be stabilising for your blood sugar levels for any blood sugar highs and lows, which you are very prone to post-partum because you’re energetically using up so much of your nutrition and your blood sugar to produce breast milk, for woman who have diabetes pre pregnancy who have required insulin for many many years, there insulin needs plummet post-partum because their breasts are taking up so much glucose they don’t need as much insulin, so just use that as a proxy like you’ve got to be really refuelling really filling your tank and trying to eat things that are satiating and blood sugars stabilising as much as possible otherwise you will just tank. Certainly woman don’t necessarily need to be low carb or anything but they need to be consuming adequate amounts of high protein and high fat foods just to stabilise them and just to get enough energy, so its not a time to restrict anything. I love your list the only thing I will add to that would be eggs for sure, cause the choline and protein. Eggs would be a fantastic breakfast, if you like them hard boiled or whatever they’re great
Karen And bone broth that’s the other thing
Lily Yes Bone broth is fabulous for healing, and in a lot of traditional cultures they really push brothy foods, a) you getting fluids built in, you getting electrolytes but you also getting that really important healing amino acid glycine which is really important for your skin for healing your incision or your tear, or helping your pelvic floor heal and its also good for baby too. Bone broths fabulous
Karen so important that, and it makes such a difference and I always say that if they are ravenously hungry all the time and they are eating to hunger then we know that everything is working well, because all systems are working, as you eating you constantly digesting that, you making milk you feeding the baby its all good
Lily I was shocked at how much I ate, my husband brought me breakfast a few days post-partum and I laughed in his face, I’m going to need triple or quadruple that amount of food, you better be making another plate right now.
Karen Lily this has been such fantastic conversation and there’s so much more I can ask you but I see that we already heading towards an hour, I have a list of what I call quick fire questions, just short sharp one word answers wherever possible, then we going to end up and wrap up telling people how they can contact you, and more information where they can get hold of your book or even get hold of you if they want to work with you,
Heading into our quick fire questions who is your inspiration and why?
Lily It has to be my son, he is just so energetic and chipper
Karen Are you a leader or a follower
Lily A leader
Karen What is the best piece of advice that you’ve ever received
Lily Be yourself
Karen As a child what did you wish to become when you grew up
Lily A chef or a baker
Karen at least you still in the field of food then you always knew it was going that way
What accomplishments are you most proud of?
Lily Right now my son and my 2 books
Karen Absolutely I always say having just finished a book of my own I know exactly know how proud you can be of a couple of pages cause you know how much love, sweat and tears have gone into that
And your favourite movie
Lily Just because it’s goofy and always makes me laugh, the breakfast club
Karen Great memories from the 80’s. What are you reading at the moment?
Lily The 2nd edition of one of my colleague’s books called Digestive health Real Food
Karen Your biggest influence?
Lily I guess I will choose my father for this one, he never gives up he’s very steady
Karen And last but not least your favourite quote?
Lily There’s one from Walt Disney that I really like which is “The way to get started is to quit talking and begin doing”
Karen I love that, and you certainly have done that with your book or 2 books in fact, how can people get hold of your book?
Lily Both books are available on Amazon that’s the best way to get them, unless it’s a wholesale order in which case reach out directly. You can find my books on respective websites which is realfoodforpregnancy.com or realfoodforgd.com and you can find me on my website which is lilynicholsrdn.com
Karen Super and I will be putting links to your websites and to the books on the show note so people can contact you and I want to thank you so much for joining me this morning and sharing all that wonderful information about optimal nutrition during pregnancy and our everyday lives
Here are just some of the ways that I can help you
A 10 day guided online course to create a realistic and powerful birth plan that includes the 10 essential elements of birth preparation.
A self directed, work at your own pace, holistic course of video, audio and written content to guide you step by step through each stage of pregnancy.
A highly personalised package that includes access to all my courses and bi-monthly check in calls. I will guide you through doctors visits, discuss your choices, share the latest evidence and direct you to the best care and resources. Together we co-create a beautiful, positive pregnancy and birth experience.
I invite you to journey away from life as you know it and allow yourself a weekend away with me to co-create and prepare for your birth. I work closely with Alila luxury boutique hotel brand to offer these VIP 1 or 2 day retreats. The brand reflects my commitment to luxury and service excellence. Alila means “Surprise” in Sanskrit, which suitably describes the refreshing character of their properties and impressions of the guests.
The Virtual Midwife podcast is for the thinking woman, not afraid to question the current policy based maternity system. In this podcast she shares lessons from the labor room, women’s wisdom, interviews with thought leaders and discussions with change makers, along with transformational lessons and meditations for pregnancy and birth.
Buy my book Expats Expecting – The essential guide for giving birth abroad.
Along with all the traditional information typical of a book about pregnancy and birth, this book will guide you to know that a positive outcome is not just possible, but to expect it and know how to get it. Using inspirational anecdotes from expats who have travelled the road before you, coupled with practical wisdom of 20 years abroad, Karen provides the road map to embrace pregnancy as part of your expat adventure.
A simple tool to help you incorporate the 5 essential breathing techniques into your daily life during pregnancy so that you are fully prepared for labor and birth.
Video tutorials, prenatal yoga classes, tips and tricks for labor and birth.