Topic of the Week

For information about Aspartame see Dr. William Sears' website and midwife Ronnie Falcao's website. I am so far unable to find information written by Dr. Tom Brewer or Gail Sforza (Brewer) Krebs on the subject, which I thought I had seen somewhere.

The following is reprinted from The Very Important Pregnancy Program, by Gail Sforza Brewer (Krebs), 1988. (p. 32)

Q: Although caffeine isn't an additive, it has been linked to birth defects. How much is safe?

Although the research on caffeine shows a strong association between the heavy use of caffeine-containing beverages (coffee, tea, colas) and birth defects, it's still not clear whether the problems linked to caffeine also involve the malnutrition of the mothers consuming it.

Let's face it, anyone who's drinking the equivalent of ten cups of coffee or ten soft drinks a day just hasn't much room left for nutritious foods. Plus, the stimulation from the caffeine depresses the appetite. All this adds up to a mother who is seriously deficient in nutrition--a classic type of affluence-related malnutrition. They don't give soda pop or coffee away. That money might better be spent on nutritious beverages, milk being the winner in terms of nutrients provided per dollar. This is particularly true if you're on a limited income. You must buy wisely, putting the best foods at the top of your shopping list.

I know of thousands of mothers who drank a cup of coffee or tea with breakfast or after dinner--and who were following the diet--and neither they nor their babies experienced ill effects. Some pregnant women prefer to use decaffeinated coffee or mild herbal teas, but even for them the warning still holds. Too much of these no-nutrient beverages robs a pregnant woman of critical space for more nutritious foods. Don't overdo. A couple of cups a day ought to be enough. The rest of the time, drink real fruit or vegetable juices, broth or bouillon, or milk.

The following is reprinted from the "Introduction" in Eating for Two, by Isaac Cronin and Gail Sforza Brewer, 1983.

Caffeine presents another consideration: it is a stimulant. As a result, beverages containing caffeine not only take up space in your diet that might better be given over to more nutritious foods, the caffeine itself revs up your nervous system so you feel bouncy and full of pep even though you haven't obtained all the nutrients you need. Small wonder that test results show a higher proportion of birth defects and prematurity in studies where mothers consumed more than eight cups of caffeine-containing beverages (coffee, tea, colas) a day. Remember, that's a half gallon a day--a large percentage of your stomach capacity--taken up by no-nutrient beverages. There may be some women who do this out of habit while working, but their numbers aren't that many. If you absolutely can't face the day without your morning coffee, so be it. But for the rest of the day, drink milk, real fruit juices, or an occasional mild herbal tea. You may experience caffeine withdrawal (headaches, lethargy, jitters) for a few days, but once you're weaned from it, you'll appreciate your calmer disposition and your improved ability to sleep--another important part of your complete pregnancy care program.

In my opinion, one of the biggest problems with the consumption of caffeine during pregnancy is that caffeine destroys B-vitamins, which are essential vitamins in pregnancy. According to Adelle Davis, nutritionist and author of Let's Have Healthy Children, "Since the B vitamins dissolve in water, they are readily lost in urine. The stimulating effect of coffee and caffeine-containing soft drinks causes them to be washed through the body." (p. 98) She also says that a deficiency of Vitamin B6, one of the B-vitamins, can cause or exacerbate nausea and vomiting, bad breath, headaches, dry, scaly skin, intestinal cramps, aches and cramping in the legs (especially at night), nervousness, insomnia, dizziness, irritability, dandruff, difficulty concentrating, hemorrhoids, anemia, and lowered resistance to infections. She found that all of these symptoms disappeared within 2 weeks of the volunteers being given the level of B6 that they needed (p. 46).

It's very easy to have a B-vitamin deficiency in pregnancy, according to Ms. Davis, because the body's need for B-vitamins "increases immediately after conception" (p. 45). And most prescription prenatal vitamins have very low levels of B-vitamins. Most of them have less than 5 mg of most of the B-vitamins, while most pregnant women need 50-100 mg or more of the B-vitamins, varying from B vitamin to B vitamin, and varying from woman to woman. For example, in order to help alleviate the nausea and vomiting of pregnancy a pregnant woman needs to take "10-25 mg of B6 every hour or two for a day or longer" (p. 47). Taking extra B-vitamins can also help with insomnia, anemia, and hemorrhoids in pregnancy.

However, it should also be noted that it is important to not take either the multi-vitamin or the extra B-vitamins after 3 PM, because the B-vitamins in them may interfere with sleep if taken at that time of day, while they can help alleviate nighttime insomnia, if they are taken before 3 PM. If you are working on alleviating nausea and vomiting with extra B6 supplements, you can try continuing to take them every hour or two after 3 pm, and see if your sleep is affected when you do that.

If you do decide to switch from your prescription prenatal vitamins to a health-food-store brand, the "Whole Foods" brand of prenatal vitamins is one brand that contains more adequate levels of B-vitamins than the prescription brands do, in my opinion. However, if you decide not to switch away from your prescription brand, you can still supplement your prescription prenatal vitamin by taking that prescription multi-vitamin with breakfast, and add your extra B-vitamins with lunch. If you do this, be sure to find a brand of B-complex vitamin which has all the B-vitamins in the proper balance. I suggest that you avoid the "B-25" or "B-50" or "B-100" vitamins, in which all the B-vitamins are at the same level, since that is not a safe way to take B-vitamins. The proper proportion of B-vitamins is as follows: "For every 3 mg of vitamin B1, there should also be 3 mg of vitamins B2 and B6; 18 mg of pantothenic acid, niacin amide and PABA; 600 mg of cholin and inositol, and 9-15 micrograms of vitamin B12 and biotin respectively." (p. 191) One of the "Whole Foods" B-Complex preparations is apparently balanced in a fashion similar to Ms. Davis' description.

The bottom line is that one of the main dangers of consuming caffeine--in coffee, tea, sodas, or chocolate--is in the fact that caffeine destroys B-vitamins, which are important nutrients in pregnancy. So even if you have only 1 cup of coffee a day, it can be destroying some of the B-vitamins that you're paying good money to put into your body, at the same time that your body's need for more Bs has increased because of the pregnancy.

I recommend that you get a copy of Adelle Davis's book, Let's Have Healthy Children, from your local library, or through inter-library loan, and find out more about B-vitamins in pregnancy. I also recommend that you consult with your midwife regarding your questions about caffeine and B-vitamins.

One of the big reasons that insomnia can be a problem in pregnancy is that one of the causes of insomnia can be a B-vitamin deficiency, and it's very easy to have a B-vitamin deficiency in pregnancy because the body's need for B-vitamins increases soon after conception. In addition, most prescription prenatal vitamins have very low levels of B-vitamins. Most of them have less than 5 mg of most of the Bs, while most pregnant women need 50-100 mg or more of the B-vitamins, varying from B vitamin to B vitamin, and from woman to woman.

Another contributor to insomnia is a lack of enough calcium (which can also cause leg cramps).

So here's my usual recipe for insomnia in pregnancy....

1) If your prenatal vitamin seems to be low in the Bs, you can consider switching to the "Whole Foods" brand of prenatal vitamins, which has good levels of the Bs and also keeps them in balance with each other. Or you can look for another health-food-store brand--one in which the B vitamins are at higher levels and are balanced with each other.*

2) If you'd rather stay on the prenatal multi-vitamin that you have, and it seems to be low in the Bs, you can take your prenatal multi-vitamin with breakfast, and then add a B-complex vitamin with your lunch. Here again, I suggest a "Whole Foods" B-complex preparation. Look for a B-complex preparation that gives the Bs in different levels, rather than a "B-50" or "B-75", etc, which give all the Bs at the same level, which means that they aren't in balance with each other.

3) Be sure not to take any B-vitamins after 3 pm (unless you're working on alleviating nausea and vomiting). Taking them before 3 pm helps with sleep, but taking them later than 3 pm can inhibit sleep.

4) Try to cut out all sources of caffeine from your diet, including coffee, tea, sodas, chocolate, and some brands of aspirin (which you need to avoid during pregnancy anyway), because caffeine destroys B vitamins, and a B-vitamin deficiency can cause or contribute to insomnia.

5) Take 1000 mg of calcium at bedtime. Calcium helps with sleep, and it takes about 1-2 hours to take effect. So if you have trouble getting to sleep, take the calcium about 1-2 hours before you want to sleep. Look for a calcium supplement that does not have Vitamin D in it, because it is easy to get too much Vitamin D in pregnancy, and you're already getting Vitamin D in your prenatal multivitamin, and in your milk products, breads, and cereals.

6) Avoid using TUMS as your calcium supplement. TUMS is an antacid, and in order to be absorbed into your body properly, your calcium supplement needs to be accompanied by acid or fat in your stomach. So you probably get little if any calcium from an antacid preparation. To help your calcium supplement absorb better, you can take it with an acid, like orange juice, or something with some fat in it, like milk or a nut butter (almond butter, cashew butter, etc).

7) Avoid having anything with sugar in it at bedtime. Sometimes what wakes people up in the middle of the night is low blood sugar. Having sugar at bedtime gives you a blood sugar peak, and then when your insulin kicks in and does its job, you end up with a blood sugar valley in the middle of the night.

8) Do have an unsweetened protein snack at bedtime. Protein helps stabilize your blood sugar and keep it steady all night long.

9) You can also keep a protein snack, such as a glass of milk, some cheese cubes, or crackers with a nut butter (almond, cashew, etc) at your bedside. That way, if you wake up during the night you can have some protein to help stabilize your blood sugar levels again, so that you can continue sleeping.

*Another problem with many prescription prenatal multivitamin preparations is that their levels of iron are too high, in my opinion. If your midwife feels that you need an iron supplement, many midwives believe that the best source for that is Floradix, and it is available at many health food stores.