Nutrition and lifestyle advice

We recommend everyone to eat healthy and varied. It is not necessary to eat for two. Make sure you consume dairy, fresh vegetables, fruit and brown bread every day. Eat some extra iron rich food like green greens (spinach and beans) and red greens (beet), legumes, dried apricots and even meat if you want because the chance of anaemia is slightly increased during the pregnancy. 

It is important to drink a sufficient amount of fluid, preferably water (recommend amount is 2 litres a day).

Extra

From a month before the conception through the first ten weeks of the pregnancy it is recommended to ingest 0.5 milligram folic acid every day. Doing this decreases the chance of spina bifida in the child. During the pregnancy and in the period that you are breastfeeding it is recommended to ingest 10 microgram of vitamin D. This plays an important part in the bone formation of the baby. Both folic acid and vitamin D can be bought at the pharmacy or drugstore in the specific amount for pregnant women. Brand does not matter. House brand contain the same vitamins as the other brands.

Toxoplasmosis

Toxoplasmosis is a parasite that can cause abnormalities to the nervous system and the eyes of the unborn child. You can get the parasite mostly from eating raw or mostly raw meat. Because the parasite also can live in the excrement of (mostly young) cats, it is recommended not to clean the litter box when you are pregnant. It is also recommended to wear gloves when working in ground that cats could have been in and to wash vegetables that can be eaten raw.  

Listeriosis

Listeriosis is a bacterium that can cause an early birth or even a stillbirth. It occurs in animal products like milk but is killed through heating. Because of the chance of a listeriosis infection it is not wise to eat soft cheese which is made of raw milk. These are mostly the soft white cheese. The cheese that is wrapped in factories is heated and sterilized/pasteurized and therefore not dangerous. Cheese to avoid is soft cheese coming from a farm or when you do not know the origin of. Especially in foreign countries like France cheese that is made of raw milk is eaten regularly.

Listeriosis can also occur in food that is kept a longer time after preparation. It multiplies very easily inside the refrigerator. Recommend is not to keep food longer than twenty four hours after preparing and if you do want to eat food kept longer than twenty four hours after preparing to heat it very well before eating. Residing in the packaging of vacuum packed fish could be a too high count of listeriosis bacteria. This is why it is recommended not to eat prepacked smoked salmon, eel and mackerel. Freshly smoked fish is not a problem. Contrary to popular opinion you can eat fresh sushi in the pregnancy. The only question is whether the sushi is really fresh; do not eat sushi that could have been kept for a longer period of time in the cooling of a supermarket.  

Vitamin A

During the pregnancy it is important not to ingest too much vitamin A because of the risk of harm to the unborn child. Vitamin A is mostly found in organ meat like liver. We recommend not eating organ meat at all and not eating organ products like liverwurst or pate more than once a week.

Smoking/drugs/alcohol

Of course, it is wise not to smoke, do drugs or drink alcohol. All these interfere with the development of the unborn child and can cause defects. Only use medicine on the express advice from us and/or the GP.

CMV (Cytomegalovirus)

Cytomegalovirus (CMV) is a common virus that can infect almost anyone. Most people don't know they have CMV because it rarely causes symptoms. Pregnant women who become infected are at low risk of transmitting the virus to their babies. If it's the first time you've had the infection (primary CMV), risk of transmitting the virus to the baby is higher than it is with reactivated infection. Transmission usually occurs during the first half of pregnancy, usually the first trimester. Most babies who are infected before they're born appear healthy at birth, but a few develop signs over time — sometimes not for months or years after birth. The most common of these late-occurring signs is hearing loss. A small number may develop mental retardation as well.

It is very difficult to avoid transmission of CMV. Pregnant women are advised to wash their hands when in contact with saliva of urine from young children and to avoid sharing food, utensils and cups with young children.

RIVM: CMV and pregnancy

Parvo B19 (fifth disease)

Parvo B19 (also called the fifth disease) is a childhood disease. If a women gets this disease in the first 20 weeks of the pregnancy there is a small risk of miscarriage or problems with the fetus. You can only get this disease once in your life. After that you will form antibodies that protect you from infection with the virus. We can test your blood (at you own expense) for antibodies if you want to. If it turns out that you have had this disease you don't have to worry about Parvo in the pregnancy, because you cannot get it a second time. 

RIVM: Parvo B19 (fifth disease) and pregnancy

News: hormone-disruptive substances in plasticisers

For many years scientists have been saying that hormone-disruptive substances in plasticisers, pesticides and some preservatives could have harmful effects on the human body. These substances could give a higher risk in defects and developmental delays, especially with unborn children and children up to three years old. With laboratory animals this is already proven. With human beings it is not yet proven. The effects on human beings are very difficult to determine because the effects can only be identified later in life, scientists say. That is why results from scientific research are not available at this moment.

This lack of evidence in humans is the reason that the Dutch government has decided to not actively counsel people about the possible harmful effects. In Denmark the government does counsel parents and pregnant women since 1992. In Denmark some of these substances are prohibited or forbidden in food products for children under the age of three. Pregnant women are advised to eat biological food en not to use cosmetics with parabens in them. There is many information available for people in Denmark. The European Commission has forbidden a few hormone-disrupting substances, but is waiting for further research before taking more action/measures.

Conclusive: There is no hard evidence and no unisonous advise. The TV-show Zembla made a documentary in 2013 about hormone-disruptive substances; what do scientists say? What does politics say in Europe and Holland? What is the Denmark government doing? (link

In 2015 Zembla made another documentary with an update; what do scientists know now and what happens in European and Dutch policics? (link)

Reaction from the RIVM for the 2013 broadcast: (link

Pregnancy/breastfeeding and use of medication

When you are pregnant or breastfeeding it is wise to be careful with the use of medication. You can find a lot of information about this subject on this website: Lareb 
Of course you can always contact us with questions too. 

 

For more information you can visit these websites:
pregnancy and infectious diseases
voedingscentrum.nl (general national guidelines with little room for nuance or discussion) 
stivoro.nl
alcoholenzwangerschap.nl