The second I found out Suz was pregnant I became a little obsessed with how to grow the strongest and healthiest baby possible. Through my functional medicine training I knew that much of a person’s future health was determined by the quality of nutrition while in the womb and in the first two years of life. This forms the base of your life’s pyramid and if you want a pyramid that lasts, you can’t have cracks in the foundation. I wanted to pour as good of a foundation for my baby as possible so that when setbacks come he can lean on the excellent foundation we poured for him.
This started with Suz’s nutrition through pregnancy. The sources of information I leaned heavily on included an amazing book called Real Food for Pregnancy  by Lily Nichols, the Weston A. Price Foundation (WAPF), and the primary research cited by these two sources. The WAPF puts out amazing information that every parent should read to raise a healthy child.
The nutrients that we paid special attention to were the fat soluble vitamins (vitamins A, E, D, K), EPA/DHA, biotin, folate, B12, and choline.
The fat soluble vitamins play essential roles in skeletal formation, immune system development, and brain development. Vitamin E is needed for proper placenta formation and is a potent antioxidant. This is the least studied fat soluble vitamin with pregnancy, but nonetheless important to mention.
Vitamin A is a crucial vitamin for proper development of every organ in our bodies and was written about extensively by Weston A. Price in his book Nutrition and Physical Degeneration. Vitamin A deficiency in laboratory animals has shown to cause spontaneous abortion, prolonged labor with death of the mother, eye defects, defects of the snout and dental arch, displacement of internal organs (kidneys, ovaries, testes), and deafness. There is controversy about how much as there was one study that used synthetic vitamin A and found above 10,000 units caused birth defects. Every other study on vitamin A has essentially shown that higher doses, up to 40,000 units, cut the risk of birth defects. I believe it comes down to whole foods vs synthetic vitamins. The WAPF recommends 10,000-20,000 units per day from whole foods and I think this is a reasonable goal, but if people are getting it from whole foods I suspect they will be around 10,000 units per day. I believe this will get you all the benefits and none of the risks. Note: beta carotene isn’t a replacement or equivalent to retinol. You need to get vitamin A in its active form as this is the only form used by our bodies and most people don’t have the cellular machinery to convert beta-carotene at a high enough rate to make it useful. Retinol only comes from animal foods, so focus on these as your source of vitamin A.
Vitamin D is more well known to most people and plays big roles in skeletal development. It also plays roles in lung maturation and immune system development. This is especially true when derived from a food source. The WAPF recommends cod liver oil as the source of vitamin D and I tend to agree with them. There was a study out of Finland that looked prospectively at 12,058 children and found that children supplemented with vitamin D at 2000 units essentially had no risk of type 1 diabetes compared to those that didn’t supplement.2 To me, this shows the immense role that it plays in proper immune system development. Having a properly formed skeleton is no small matter so everyone should focus on getting enough of this vital nutrient from food sources (i.e. cod liver oil).
Vitamin K2 is the vitamin made famous by Weston A. Price (initially called activator X) and then more recently by Chris Masterjohn Phd. Vitamin K tells your body where to put calcium (i.e. your bones) and where to keep it out of (i.e. your organs). It is essential in forming every solid structure in your body. It also plays roles in hormone production and signaling as well as protects our genes. MK-4 is form of vitamin K2 that you get from food and is essential for healthy baby development. Weston A. Price believed this was the missing nutrient from our modern diet and with it we could eliminate much of western disease. He found that it was in high concentrations in the butterfat of milk of mammals, eggs, and organs/fats of animals. Traditional cultures have cherished these foods for pregnant women because they know the vital importance of this nutrient in developing healthy children, even if they don’t have the “science” to prove it.3
In order to get these fat soluble vitamins in Suz’s diet during pregnancy, we did an ounce of liver per day (in the form of 6 capsules), 4-5 egg yolks, 1.5 tsp of a fermented cod liver oil, and lots of whole milk, hard cheese, and other dairy products. As of now, if I could do it over again, I would have added a fermented butter oil to increase the vitamin K2 content of her diet.
EPA and DHA are major fats in the brain and are thus tied to cognitive development. A fetus uses massive amounts of DHA during development, at a rate ten times that which it can synthesized by the growing baby. This means we must get much of it from our diet in order to feed our growing baby’s brain. The best sources of this are cod liver oil, egg yolks, fatty fish, and to a lesser extent, grass fed meat. Eggs from chickens that are not fed corn and soy are a great source with as much as 350 mg per egg. This was a big source for us as well as the 1-2 Tbsp of cod liver oil that she consumed daily.
Biotin is another B vitamin that is essential for pregnancy. In animals, it has been shown that even a marginal deficiency can cause problems in the offspring, especially in limb and palate development. This hasn’t been studied in humans, but I still took this nutrient very seriously during Suz’s pregnancy. It is mostly found in liver and egg yolks and she was consuming these foods everyday. Please note that egg white, and especially raw egg white, has something called avidin that will bind biotin and make it unavailable to our bodies, so just consuming the yoke or cooking your whole eggs is needed to absorb a good portion of the biotin.
Folate is the nutrient that everyone relates to pregnancy. This is because it is very important for proper neurologic development. You need 600 mcg of folate during pregnancy in order to prevent birth defects. Most will take a prenatal vitamin, which should always be methylated folate as that is the active form your body needs. However, if you are ambitious and make intentional food choices you can do it without a prenatal vitamin. Using an app like cronometer can be great as you can log your food and they tell you the exact amount that you are getting. With Suz, we did a combination of prenatals and food. If she hit the targets for the day then we skipped it, but if she didn’t she took enough prenatal to cover her needs.
Choline is the last of our specific nutrients that I will address. This nutrient is essential for proper brain development. Rats fed large amounts during pregnancy give birth to offspring with increased visuospatial memory, better cognitive function with aging, better ability to concentrate, and are more resilient to  neurotoxic insults in our environment. Obviously this is something we want lots of. I may sound like a broken record, but this is mostly found in egg yolks, high quality dairy, and liver. Thus, these foods should be staples in every pregnant woman’s diet.
Pregnancy is a very exciting time and when you take the time to learn and implement the changes above it can be very empowering. However, obsessing over this is not beneficial and it takes time and effort in order to incorporate all this properly. Its often best to work with someone that knows this information and can help you implement it, but you can also learn it on your own if you read and are intentional about what you put in your body. Good luck!