Please be aware that traveling and moving can disrupt your eating routine just enough to trigger a low blood volume problem
which can start the rising BP/pre-eclampsia/HELLP/premature labor/IUGR/abruption process. Putting the brakes on that process
can be more difficult than preventing it. Sometimes just being aware of this risk is enough to help you to remind yourself
to continue providing for your nutritional needs, in spite of any changes and stresses which may be going on in your life.
And please be aware that as your baby and the placenta grow, and as the seasons change, and as other changes occur in your
life, you may find that your unique version of the Brewer Diet, which you used effectively last week, may no longer be adequate
this week, or next week, or next month. To get the most benefit out of the Brewer Diet, you will need to stay in tune with
what your unique needs are every single day.
Scroll to one third of the way down the page for the details on how to adjust your diet
to fit your lifestyle
~ "Corrective Allowances" ~
The following is the "Chapter 1" reprinted from Eating for Two, by Isaac Cronin and Gail Sforza Brewer, 1983.
"The Complete Pregnancy Diet: Meeting Your Special Needs", by Gail Sforza Brewer (p.1)
Making your diet satisfy your pregnancy nutrition needs may be as easy as adding a few servings of high quality foods to what
you usually eat, or it may be so complicated that you will want to consult a dietician or nutrition counselor for expert advice.
What makes the difference are the special circumstances you find yourself in during this pregnancy, the unique combination
of strengths and stresses in your life right now that create nutritional pluses or minuses. No two pregnancies are ever conducted
under exactly the same conditions, so even if you've had a pregnancy before, you need to plan your diet based on your current
lifestyle, appetite, philosophical beliefs, religious practices, family traditions, medical care, and all the many other factors
that affect your everyday eating habits.
The goal, of course, is to obtain every day throughout gestation all the essential nutrients you and your unborn baby need
for healthful growth and development. A complete pregnancy diet consists of all the foods necessary to provide those nutrients
in the proper proportions, and in forms that are easily assimilated and used by your body. This means that your diet must
contain adequate proteins, fats, carbohydrates, vitamins, minerals (including sodium), fiber, water, and calories to meet
the daily demands of your particular pregnancy.
A minimum adequate diet for pregnancy, a concept introduced by Winslow Tompkins, M.D. of Philadelphia Lying-In Hospital in
the 1930s, has been outlined in the medical and nutrition professional literature by numerous researchers. Whenever there
has been a conscientious effort made to insure that pregnant women actually followed this basic pregnancy diet, researchers
have reported dramatic reductions in pregnancy and pediatric problems. (An annotated bibliography of much of this work is
available from the Foundation for Perinatal Education, Box 221, Bedford Hills, NY 10507.) [as of 1983] This has been true
not only in the United States, but also in clinics located in countries with as diverse populations as Scotland, India, Australia,
Ethiopia, and the Philippines. Pregnant women everywhere have the same biological makeup: the support systems that are responsible
for a successful pregnancy do not vary from country to country, age group to age group, or social class to social class.
While there are obviously many different kinds of diets that can be adequate for pregnancy in terms of the food choices made,
all of the adequate diets somehow provide the essential nutrients that are universally needed by expectant mothers. In other
words, they are complete.
This cookbook focuses on getting the most, nutritionally, from the foods you eat. We include the minimum adequate diet list
as a guide to those foods which are of highest nutritional value--that is, they provide the most essential nutrients in their
respective food groups per given serving. The recipes demonstrate how to use the highest quality foods as the basis for daily
family cooking and how to arrange the recipes in interesting combinations to create menus that assure balanced and complete
nutrition every day of your pregnancy.
The Complete Pregnancy Diet list which follows was originally designed for use in the nutrition education program of the California's
Contra Costa County prenatal clinics. It has been used in other clinics throughout North America and has appeared, with minor
modifications, in numerous books dealing with childbirth preparation and in brochures distributed by public and private health
agencies and organizations working to improve maternal and child health.
The foods on this list are generally available to most people in ordinary supermarkets. Some seasonal and ethnic variations
are mentioned; vegetarian alternatives to animal products are also suggested. However, a single diet list cannot possibly
be all-inclusive. If you have particular food requirements that differ markedly from the foods on this list, you may well
need to consult a professional nutritionist to construct a diet plan that will be both adequate for pregnancy and within your
range of acceptability. The bibliography at the end of this book can direct you to some resources for reliable information
about diets that diverge from the norm.
See here for vegetarian versions of the Brewer Diet -- Lacto-Ovo and Vegan
The portion sizes on this diet list are geared to average needs and should be viewed as a nutritional floor,
not a ceiling. Of course, the "average" woman for whom this diet would be perfect does not really exist: she is a statistical
abstraction--neither overweight nor underweight, neither very short nor very tall, with a metabolism neither exceedingly fast
nor exceedingly slow, moderately active, and carrying a single baby. You are a unique individual, so keep in mind that this
diet is the minimum adequate diet for the "average" woman, and that most mothers will need to eat more of everything
on the diet to obtain the extra calories they need to feel their best. In most cases, your appetite will tell you (you will
feel hungry) when you need a snack between regular meals. Most pregnant women find themselves eating at least seven times
a day: breakfast, midmorning, lunch, midafternoon, dinner, before bed, and middle of the night (when they have to go to the
bathroom). Nutritious snack foods and other "portable" foods can be found in Chapter 10. An occasional indulgence in a piece
of cake or a candy bar doesn't mean you are harming your baby (these foods do contribute needed calories, if almost nothing
else, to your nutritional requirements). Pregnancy is not meant to be a time of dietary martyrdom--just the opposite--but
as a general rule your should be trying to get your extra calories from more nutritious sources.
See here for the Basic Plan of the Brewer Pregnancy Diet
DAILY NUTRITION SUMMARY:
What the Complete Pregnancy Diet Provides
When you follow the diet, eating to appetite, salting to taste and drinking to thirst each day, you will obtain these key
nutrients from your food. Each key nutrient is listed, along with the amount of each provided by the Complete Pregnancy Diet
and the sources of each among the twelve food groups named by the diet. Figures are approximate, reflecting variations in
daily intake depending on specific foods chosen. These figures meet all recommended allowances of the National Academy of
Science/National Research Council [as of 1983], and, in most cases, provide additional amounts of nutrients where clinical
work in obstetrics has shown that healthier mothers and babies result with additional intakes. When key nutrients are supplied
in abundance from a wide variety of foods, deficiencies of other essential nutrients required in much smaller quantities (such
as trace minerals) do not occur.
DAILY NUTRITION SUMMARY
KEY NUTRIENT -- AMOUNT/SOURCE -- IMPORTANCE IN PREGNANCY
CALORIES (ENERGY) -- 2,600-3,000 -- Groups 1,2,3,4,5,6,7,8,9,12 -- Supply food for all the work of the body. Extra
required in pregnancy to spare protein for tissue growth. Not getting enough calories results in protein being burned for
energy and mother and baby suffering from protein deficiency.
PROTEIN (complete in all eight essential amino acids) -- 80-100 grams -- Groups 1,2,3,5,9) -- Supports growth via its
component element, nitrogen. Extra needed in pregnancy, 1)to develop baby's tissues and brain, 2)to promote growth of mother's
uterus, breasts, and blood volume, 3)to form the placenta, 4)to meet increased demands on the liver for detoxification and
synthesis of plasma proteins, and 5)to form hormones, enzymes and antibodies to provide reserves for labor, delivery and lactation.
A (oil soluble, stored in liver in large amounts) -- 15,000-30,000 International Units (I.U.) -- Groups 1,2,4,6,8,9 --
Assists in preventing infection by maintaining integrity of mucous membranes. Helps regulate thyroid gland. Necessary for
cell formation, bone growth, normal vision, strong hair and nails, and the depositing of enamel on the unborn baby's teeth.
D (oil soluble, stored in liver and fatty tissues, synthesized by skin after exposure to ultraviolet light) -- 400
I.U. -- Groups 1,7 -- Influences absorption of the minerals calcium and phosphorus. Essential to bone formation and calcification
(hardness). Deficiency of vitamin D causes rickets.
E (fat soluble, mixed tocopherols) -- 15 I.U. -- Groups 1,2,3,4,5,8 -- In experiments, has been shown necessary for
proper placental implantation. Promotes longevity of living cells by slowing oxidation. Protects function and structure
of smooth muscles (like the uterus), skeletal muscles, cardiac muscle (your heart has to pump all that extra blood as pregnancy
advances), and vascular tissue (supplemental E has been shown effective clinically in the treatment of varicose veins of the
legs, vulva and anus). Helps maintain integrity of liver tissue (liver works overtime all during pregnancy).
B-COMPLEX (water soluble) -- B1 Thiamine (3 mg) -- B2 Riboflavin (4.5 mg) -- Niacin (40 mg) --
B6 Pyridoxine,synthesized in the gut (2 mg) -- B9 Cobalamine, synthesized in the gut (6 mg) -- Groups
1,2,3,4,5,9 -- Essential to proper metabolism of proteins, carbohydrates, and fats. Increased quantities of food require increased
amounts of the B vitamins. Helps in formation of red blood cells which carry oxygen to developing baby via the placenta.
Too low an intake of B vitamins results in loss of appetite, indigestion, deficient hydrochloric acid secretion, apathy and
fatigue, tingling and/or numbness in the hands and feet, failure to heal, skin eruptions. One tablespoon daily of brewer's
yeast and dessicated liver tablets (if you won't eat liver) are excellent sources.
C (water soluble) -- 400-700 mg. -- Groups 4,6,8 -- Essential for formation of collagen (the substance that bonds cells
together)--especially needed by rapidly growing uterus for efficient action and strength during labor. Promotes wound healing
and healthy capillary walls (if you are bruising easily or your gums are tender and bleed after brushing, you may be an individual
with needs above the average). Helps maintain resistance to infection when the body has optimum tissue stores. Stored in
adrenal tissue for response to stress. Promotes absorption of iron and maturation of red blood cells.
CALCIUM (stored in bone, plus additional .5 g in body fluids) -- 1.5-2 g. -- Groups 1,2,4,5 -- Builds and maintains skeletal
tissue and teeth in mother and baby. Promotes normal blood clotting after birth. Essential to normal contraction-relaxation
cycle in muscles, especially heart. Required for proper functioning of central nervous system of mother and baby.
SODIUM (stored in bone and in body fluids) -- 3-4 g. from foods on list and widely varying amounts from table salt
used to taste -- Groups 1,3,10 -- Assists in maintaining dramatically expanded blood volume needed for placental circulation.
Needed for normal functioning of muscles--lack of sodium often causes leg cramps during pregnancy, a clear sign to add more
at the table. Essential component of amniotic fluid surrounding baby. A major element in control of the body's fluid balance,
glucose transport through cell walls (getting energy into each cell so it can perform), and the acid-base balance essential
to life itself. Inadequate sodium intake can result from vomiting, diarrhea, failure to consume enough high-protein foods
of animal origin (meats, seafood, milk, eggs--all of which also happen to be high in naturally occurring sodium), excess losses
in perspiration during hot weather, in overheated workplaces or while engaging in strenuous sports. All these are indication
for adding more salt at the table; generally your food will taste flat and unappetizing when you need sodium, a response of
your taste buds to your body's need. Deliberate attempts to restrict sodium in the diet, were at one time a popular component
of standard prenatal advice--advice which has now been proven to be detrimental to normal pregnancy adjustments in the mother's
body. Salt to taste. Use iodized salt.
IRON (stored in red blood cells as part of hemoglobin, and in liver, spleen and bone marrow in combination with protein)
-- 30-40 mg. -- Groups 1,2,3,4,5,6,8,9 -- Required for formation of the hemoglobin molecule, the carrier of oxygen to all
body cells. Extra needs in pregnancy due to 1) expansion of red cells in circulation by approximately 25 per cent, 2)increased
stores required in anticipation of blood loss at delivery, and 3)demands of developing baby for iron stores (well-nourished
baby at birth has iron stores in liver that last for 4-6 months). Cessation of menstruation during pregnancy prevents the
monthly loss of approximately 20 mg. toward buildup of reserves. Virtually everything grown in the earth's crust contains
some iron. Most of the time, only about 20 per cent of iron ingested is actually absorbed. Absorption of iron is enhanced
by presence of adequate hydrochloric acid in the stomach, and by calcium and vitamin C in the diet. Occasional use of cast
iron cookware will boost iron intake higher than amount listed. When tissues are saturated and additional iron is not needed,
excess is excreted in feces (your stool will look very dark, nearly black, with extremely high doses of supplemental iron
from pills or tonics). Excessive iron intake can irritate the gut, causing nausea and/or constipation.
FATS (stored in body as adipose tissue, a metabolically active tissue once thought to be only a static deposit, located
in a layer just below the skin, in the abdominal lining, and in muscular connective tissue) -- 140-180 g. -- Groups 1,2,3,5,7,9
-- Concentrated source of fuel (9 calories per gram) for all the extra work of the body in pregnancy. Essential for the body's
absorption of fat soluble vitamins. Protects vital organs from external injury. Insulates body against rapid temperature
changes and excessive heat loss. Fat-related compounds affect the production of sex hormones and adrenal hormones--necessary
to support pregnancy--and the function of brain and nerve tissues. Help to maintain skin integrity by strengthening capillary
and cell wall structure, resulting in fewer skin eruptions.
CARBOHYDRATES (stored in very small amounts in liver and muscle) -- 350-400 g. -- Groups 1,3,4,5,6,8,12 -- Major source
of energy for the body (4 calories per gram). Carbohydrates must be consumed regularly and at frequent intervals to keep
energy availability optimal; the body stores only enough for about eight hours of moderate activity in pregnancy so if you
miss dinner, you are likely to have ketones in your urine at the doctor's office the next morning. Helps liver in detoxification.
Helps regulate protein and fat metabolism. Provides glycogen stores in the heart for contractile action. Brain and nervous
tissue contain no stored glucose, and therefore must rely on minute-to-minute supply from the bloodstream. Carbohydrates
provide a first-choice source of energy, thereby freeing proteins for their vital work in tissue-building: so to get the most
benefit from your protein intake during pregnancy you must eat heartily from foods high in carbohydrates. Because absorption
of glucose into cells is sodium-dependent, obtaining adequate amounts of sodium is essential also.
Agnes Higgins, past president of the Canadian Dietetic Society and director of the Montreal Diet Dispensary [as of 1983],
has developed a procedure for estimating calorie and protein requirements in excess of the pregnancy levels we've already
established as a baseline. She emphasizes that any of the following factors increases a mother's nutritional needs:
As a corrective allowance, Mrs. Higgins and her staff counsel mothers to add twenty grams of protein and two hundred
calories to their basic daily pregnancy diets for each condition listed above (an individual mother
may be experiencing more than one of these stress conditions).
Multiple pregnancy is the only exception: each extra baby requires a nutritional supplement of thirty grams of protein
and five hundred calories per day. Higgins comments that this requirement can be met most economically by adding
one quart of whole milk a day to the expectant mother's diet (to be drunk, used in cream soups, custards, milkshakes, cream
pies and tarts, or as exchanges in yogurt, ice milk, and natural cheeses). Of course, there are many other ways to increase
the protein and calories during pregnancy by eating an additional four-ounce serving of meat, fish, shellfish, poultry, or
meat substitute as detailed on the diet list. A sample daily menu plan for a mother expecting twins would look something
Twin Brewer Pregnancy Diet (click for details)
You must have, every day, at least:
(plus 30 g protein and 500 calories for each additional baby):
Group 1 (milk and milk products)--8 choices
Group 2 (calcium replacements)--as needed
Group 3 (eggs)--2 choices
Group 4 (protein sources)--12 choices
Group 5 (dark green vegetables)--2 choices
Group 6 (whole grains, starchy vegetables & fruits)--5 choices
Group 7 (potato)--1 choice
Group 8 (vitamin C sources)--3 choices
Group 9 (fats and oils)--5 choices
Group 10 (vitamin A sources)--1 choice
Group 11 (liver)--Optional
Group 12 (salt and sodium sources)--unlimited, to taste
Group 13 (water)--unlimited, to thirst
Group 14 (snacks)--4 or more
Group 15 (supplements)--as needed
See here for more details on serving suggestions and portion sizes
See here for twin diet checklist for printing and putting on your refrigerator
Generally speaking, these conditions result in an increased appetite; however, women who are working, moving
their households, or under emotional stress sometimes fail to pay attention to their bodies' signals for more
food. Calling special attention to their extra needs by assigning specific goals for extra protein and calorie consumption
makes it much less likely that their nutritional needs will go unfulfilled.
At the Montreal Diet Dispensary, underweight is defined as weighing five per cent or more less than the weight recommended
for your height in the Table of Desirable Weights of the Metropolitan Life Insurance Company, a standard used for thirty years.
You should use the column for a "large frame" as the company recently disclosed that they have been underestimating all the
optimal weights on the chart by ten per cent ever since they first published it! If you really do have a large frame, use
the standard for the next taller height.
Undernutrition means any protein deficit between what you're used to getting from your food and the minimum adequate pregnancy
requirement (eighty to a hundred grams per day). The Higgins nutrition intervention method uses a twenty-four hour diet recall,
a technique you can use on your own to see how close your regular diet has been coming to what you actually need. You will
need to write down everything you've eaten for the past twenty-four hours (pick a typical day for you), including all
snacks, all beverages, and all second helpings. Note what the food was, how much you ate, then consult the Protein-Calorie
Counter (see Appendix) to check the amount of protein contained in those portions of those foods. For each gram of protein
you lack, add that to your personal protein goal, plus an additional ten calories to free that protein for its most important
work in pregnancy: keeping you own tissues healthy and building those of your unborn baby. If you come up with a deficit
of ten grams of protein, then, you also need to add a hundred calories to your basic requirements.
If you take supplemental vitamins and minerals, brewer's yeast, wheat germ, or other dietary supplements (such as protein
drinks, powders, or pills), be sure to take them with meals, since their absorption is enhanced in the presence of complete
foods, which provide enzymes necessary for their metabolism. Many people turn to these nutritional aids when they find they
have significant nutritional problems in pregnancy; however, it's important to keep in mind that a pill two or three times
a day cannot substitute for the foods on the Complete Pregnancy Diet list. These preparations must be viewed strictly as
supplements to a good diet, not the diet itself. There are many factors in food substances, such as enzymes,
that are not contained in pills or powders, and there may be other substances in foods that are essential to human life that
have not yet been isolated by nutrition scientists. So relying on the protective foods on the diet list is the best guarantee
of satisfactory pregnancy nutrition.
This food record chart should help you keep track of your daily progress on the diet. Just check off each requirement as
you meet it, day by day, week by week, month by month.
See the Brewer Pregnancy Diet Basic Plan Weekly Record here
If you encounter any difficulties with any aspect of the diet, or any questions about the nutritional management of your pregnancy,
you may telephone a national pregnancy nutrition hotline, co-sponsored by the Foundation for Perinatal Education and the Toxemia
of Pregnancy Foundation. The line is staffed twenty-four hours a day and referrals to pregnancy nutrition consultants can
be had for many parts of the country. The number: (914)666-5199.
May all your meals bring you and your family pleasure, an energetic pregnancy, and a strong baby born in excellent health.
Note from Joy: Unfortunately, I was unable to find either of these two organizations on the internet, so it's probably
the case that neither one still exists. If anyone knows otherwise, please let me know and I will post their contact information.
Eating for Two, by Gail Sforza Brewer and Isaac Cronin, available here
At the first sign of a rising BP, pathological edema, pre-eclampsia, IUGR, premature labor, or HELLP, a Brewer Diet counselor
should sit down with the mother and help her to evaluate her lifestyle and her diet to see if any adjustments can be made
to optimize the fit between her pregnancy, her diet, and her lifestyle. For example, to compensate for her salt and calorie
losses, she can cut back on her exercise program and her work schedule, she can stay out of the heat (outdoors, at work, or
at home), she can postpone a move until after the birth (and 6 weeks postpartum), and she can increase her salt/calorie/protein
intake. As described by Gail Brewer earlier on this page, one way that she can increase her diet intake is to add 200 calories
and 20 grams of protein for each of the following situations:
The following is excerpted from the "Introduction" reprinted from Eating for Two, by Isaac Cronin and Gail Sforza
"A Cookbook for Pregnancy: The Medical Reasons", by Tom Brewer, M.D. (p.ix)
PNP (PREGNANCY NUTRITION PRINCIPLE) #3:
MANY LIFE SITUATIONS
CAN CREATE NUTRITIONAL PROBLEMS.
IDENTIFY THEM AND MAKE DIETARY CHANGES AS NEEDED
TO PROTECT THE NECESSARY SUPPLY OF NUTRIENTS
FOR YOUR PREGNANCY
When people are under stress, they often don't eat regularly or they may not feel like eating the foods they need. Pregnancy
itself can provoke stress within families and events unrelated to a woman's pregnancy can have great impact upon it, such
as the illness of a parent or child, loss of one's job, or abandonment of the pregnant woman by her mate. Also, an expectant
mother can become ill with any disease that affects the non-pregnant population, often with damaging results toher nutritional
status. Some of the most common situations that wave the red flag of possible undernutrition to me:
Using these fundamentals, counseling my patients at every prenatal appointment, making sure each woman understood her diet,
trying to catch early any problems each might be having in following the diet--these all paid off. In our clinics, according
to data from the National Institute of Health, which spent three years collecting information from our 1965-1970 prenatal
charts and another five years analyzing it, there was not one case of eclampsia in over five thousand pregnancies,
and mild MTLP fell to less than one per cent in mothers having their first babies (traditionally viewed as those at greatest
risk of developing the disease). Other public clinics report anywhere from fifteen to forty per cent of their first pregnancies
complicated by MTLP. Furthermore, women in our program were ten times less likely to develop hypertension (high blood pressure)
in pregnancy, a problem that can occur separately or as part of the symptoms of MTLP. Finally, the incidence of low birth
weight (five-and-a-half pounds or less at birth) dropped to 2.2 per cent overall and 2.8 per cent in first-time mothers, as
compared to another clinic serving the same population but not using these nutrition methods where the rate stayed at 13.8
per cent. I was gratified to have NIH confirmation of our approach, but not surprised by it, since this was the correct way
to conduct prenatal care if we were seriously interested in producing the healthiest possible babies and mothers.
The success of your pregnancy is largely in your own hands. I hope this cookbook will help you to have an enjoyable, problem-free,
and rewarding experience.
Eating for Two (by Gail Brewer and Isaac Cronin) available here...
In September of this year (2008) a study came out from Denmark which seems to emphatically support something which the Brewers
and their supporters have been saying for over 30 years. That is that pregnant women who lose extra salt, or burn extra calories,
through extra exercise NEED to compensate for those losses by adding extra salt and calories to their diets. When they do
not make special allowances for their unique needs in this way, their blood volume will drop, and they will develop rising
BPs, pathological edema, pre-eclampsia, HELLP, IUGR, premature labor, underweight babies, and other complications associated
with low blood volume. This particular study was looking at only pre-eclampsia, and only at recreational exercise, but those
of us who understand the Brewer principles understand that the same principles do apply to all of these other complications,
and to any source of salt/fluid/calorie loss, as well.
"Pregnant exercise 'unsafe'"
"Women who exercise during pregnancy face risk of pre-eclampsia, researchers warn"
"Exercise in pregnancy linked to fatal raised blood pressure condition"
Lifestyle Adjustments: As you evaluate your nutrition and lifestyle, it would also be helpful to evaluate your level
of activity and add extra nutritious calories if you use extra calories during the week, with jogging, biking, skating, skiing,
or other sports, or other extra calorie-depleting activities, like teaching, dancing, waitressing, nursing, doctoring, or
other activities that keep you on your feet all day. Caring for other children, working both outside and in the home, caring
for other family members, and housework would also use up a lot of calories, especially as the baby gets bigger and you burn
up calories just carrying around the extra weight of the baby, uterus and extra blood volume. You can also evaluate whether
other stresses in your life might be using up extra calories. If you have had extra stresses in your life, then adding extra
nutritious calories and other nutrients to compensate for those calorie-burning stresses would help to keep your blood volume
expanded and your pregnancy and baby healthy.
See here to help you evaluate your daily nutrition patterns
See here for a nutrition/lifestyle self-assessment which I highly recommend
Eating Patterns:The usual eating pattern that we suggest that pregnant women can use to keep up with their nutritional
needs is as follows: breakfast, mid-morning snack, lunch, mid-afternoon snack, supper, bedtime snack, middle-of-the-night
snack. If you are having trouble keeping up with the amount of food that you need, or if you are having trouble keeping your
blood pressure within a normal range, we suggest that you eat something with protein in it (glass of milk, cheese cubes, handful
of nuts, handful of trail mix, etc), every hour that you are awake.
Please be aware that traveling and moving can break up your eating routine just enough to trigger a low blood volume problem
which can start the rising BP/pre-eclampsia/HELLP/premature labor/IUGR/abruption process. Putting the brakes on that process
can be more difficult than preventing it. Sometimes just being aware of this danger is enough to help you to remind yourself
to continue providing for your nutritional needs, in spite of any changes and stresses which may be going on in your life.
Morning Sickness: If you are dealing with nausea, vomiting, or diarrhea, it is vitally important to try to alleviate
those problems as soon as possible, since they also can contribute to depleting your blood volume. You can try frequent, small
snacks, herbs, and homeopathy to help you in this effort. If you decide to try using ginger, which can be very effective
for "morning" sickness, use it only in small amounts, and only just before eating some kind of food, since too much ginger
can cause bleeding and possibly miscarriage.
See a resource for homeopathy for morning sickness here
See here for more information on ways to alleviate morning sickness
Adjusting for Salt Loss: It would also be helpful for you to evaluate whether you are ever in situations that result
in your losing extra sweat and salt--situations such as gardening in hot weather, exercising, living in hot homes during the
winter, or living without air-conditioning in the summer, or working in over-heated working conditions. If you do have one
of those situations, it would be helpful for you to add extra salt and nutritious fluids to your daily nutrition. This extra
effort will help to keep your blood volume expanded to where it needs to be to prevent elevated blood pressure, pre-eclampsia,
and other complications.
See here for more information about the importance of salt in pregnancy
Calories plus Salt plus Protein: Eating the recommended amount of protein every day isn't enough to keep your blood
volume expanded to where it needs to be for preventing complications in pregnancy. It is also vitally important to make sure
that your intake of nutritious calories and salt are also at the recommended levels, with special extra allowances added as
needed for your unique situation.
See here for more information on the importance of calories in pregnancy
Herbal Diuretics: Unfortunately, some areas of the "alternative medicine" community have followed mainstream medicine
in the belief that diuretics are important and useful for treating edema and elevated blood pressure in pregnancy. Many pregnancy
teas and some supplements and juices include nettle, dandelion, alfalfa, bilberry, or celery, all of which have diuretic properties.
Diuretics are no safer for pregnancy in herbal form than they are in prescription medications, so it is important for pregnant
women to watch which herbs they are taking.
See here for more information about the use of herbal diuretics in pregnancy
Empowering Women: I would also like to add here the assurance that Dr. Brewer was not blaming the mother for her situation,
as some would claim that he was, and neither am I. He is clearly blaming her doctor for not having the routine of examining
her nutritional status and doing a differential diagnosis for her. He is saying that if her doctor is not doing this with
her, then it is most important for her to do it for herself, for the sake of her own health and that of her baby.