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May 13, 1976

The following is reprinted from The Commercial Appeal, Memphis, Tenn., May 13, 1976, p. 26.

"Nutrition Tips Scales in Baby Doctor's Eyes", by Christine Arpe

Pregnant patients of Dr. Tom Brewer sometimes worry when it is time to stop on the scales. "A lot of them are afraid they haven't gained enough weight," Brewer said.

Brewer, obstetrician at the Contra Costa County clinic in Richmond, Calif., could be called a maverick among those in the business of birthing babies.

He doesn't believe in weight control for pregnant women, salt restriction or prescribing diuretics.

"We should throw out weight control and concentrate on nutrition," Brewer said yesterday [to] those attending Nutrition Symposium VII, sponsored by the Memphis Area Nutrition Council. The symposium continues today at the University of Tennessee Center for the Health Sciences.

"We need to get our minds off pounds and onto the problem of providing a woman with good food."

"We need to get our minds off pounds and onto the problem of providing a woman with good food."

To help get his message across to patients, Brewer has a brown paper sack filled with foods. He shows and tells his patients what not to eat, such as laundry starch (often craved by pregnant women), candy bars, soft drinks and potato chips. Then he shows them what they should eat, such as milk, eggs, fresh fruits, vegetables and a vitamin pill he prescribes.

This lecture comes on the woman's first visit to the clinic and lasts about 45 minutes. A lot of obstetricians give similar instructions or have their nurses do it.

"The difference is I follow up. When a woman comes back, I ask what she had for breakfast, if she's drinking enough milk and so on," Brewer said.

He said that 35 pounds is a normal weight gain, but he doesn't get upset with patients who gain 50 to 60 pounds during a pregnancy.

"The ones who gain 35 pounds get back to their normal weight in three or four weeks after delivery, especially if they breast-feed. Those who gain 50 to 60 pounds will be overweight. But it is better for the mother to be a little overweight and to have a baby with a healthy brain," he said.

Studies have shown, he said, that babies with the lowest infant mortality rate and fewest problems range in weight between 7 pounds, 14 ounces and 8 pounds, 12 ounces at birth.

Brewer is particularly concerned with toxemia in late pregnancy and is taking a sabbatical from the clinic to revise his book, "Metabolic Toxemia of Late Pregnancy: A Disease of Malnutrition."

He cited studies which showed the incidence of toxemia increased when mothers did not get adequate protein and when they restricted their salt intake.

Brewer's advice is simple, "Eat to appetite and salt to taste."

Brewer first became interested in nutrition during pregnancy and the effects on toxemia as a medical student at Tulane University in New Orleans in 1950. "We were doing studies on poor, pregnant women with toxemia. I started asking them what they had to eat and compared my findings with what was in the medical literature."

In a recent study he did in Contra Costa County, he found that of teh 546 pregnant women he treated, only 3 developed toxemia in late pregnancy. Two were mild cases and one was moderately severe, occurring in a woman who had twins.

The National Institute of Health is studying his results.

Tom's Response: About 300 people heard this lecture on heart of Deep South: dieticians, nutritionists, public health nurses, home economics people, etc.--but not one OB-Gyn MD!

How is N.I.P. moving? I feel we are still in Dark Ages--in Tennessee they don't even have a "flour enrichment" law--so they sell un-enriched white flour 25% cheaper.

Keep the faith,

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