Eating down in pregnancy does not prevent difficulty delivery —Experts

Many women have incorrect knowledge about nutrition in pregnancy owing to false beliefs derived from popular practices, particularly those food-related beliefs and practices specifically related to reducing food intake in pregnancy. Although not all the beliefs were harmful, there were some that were found to be detrimental to health, including eating down in pregnancy to prevent having a big baby or a difficulty delivery.

Unfortunately, mothers who eat down or badly during pregnancy may be putting their children at risk of developing long term, irreversible health issues including obesity, raised levels of cholesterol and blood sugar.

Throughout South Asia, various African countries, Iran and even Europe, pregnant women have been observed to purposively reduce food consumption during pregnancy, a behaviour commonly referred to as “eating down.” It is commonly reported that the causes of eating down in South Asian contexts, where the behaviour is supposedly widespread, were related to fears that having a large baby could lead to more difficult deliveries.

Very frequently, the local wisdom of women is sound and that in fact, having a large baby would result in an increased risk of obstructed labour, especially among women with short stature in the South Asian context.

Dr Ogunbode, consultant obstetrics and gynaecologist, University College Hospital (UCH), Ibadan, stated that women  ought to eat normally to ensure they can gain at least 12 to 15 Kilogrammes during pregnancy.

“If the woman is not having adequate nutrition, it can result in malnutrition. Also, the baby will also not be well-nourished and may end up smaller for gestational age, what is medically termed intrauterine growth retardation (IUGR).

Dr Ogunbode, however, declared that the baby’s weight is related to the mother’s weight. maternal height and uterine volume

“If the weight of the mother is within the acceptable normal range, then they will have an average-sized baby, provided there are no other complications of pregnancy. There are many other conditions that alter the weight such as nutritional intake, infections, diabetes, pregnancy-induced hypertension and the genotype of the baby,” he added.

Dr Femi Adesanya, a consultant obstetrics and gynaecologist, stated that by basic principles, the baby will take from the mother anything the baby needs even if she eats a little.

“That is why you will see a mother that is very skinny, yet the baby will come out big. It is only when the store and the reserve in the mother are used up, that is when it starts telling on the baby,” he added.

Dr Bukola Adesina a consultant obstetrician and gynaecologist, UCH, Ibadan, stated that there is no scientific evidence to support the notion many women have that reducing their food intake in pregnancy in order to have smaller babies will prevent difficulty delivers.

“No, it has nothing to do with it. Once you eat your normal portion, it does not translate to a difficult delivery. In fact, if you cut down, you run the risk of IUGR which has a significant implication. Children who have IUGR do poorer than children who have normal birth weight, in the immediate and long term. “So it is not a good idea, it is a mistake and a miss-normal but if you eat too much and your baby comes out big, then it can be a problem. But that means that you probably eat too much, more than you should have eaten during pregnancy.”

However, Mrs Taiwo Olawoye, a mother of three, said despite her inability to tolerate food when pregnant, her babies are always big at birth.

She added that many pregnant women eat less because of other factors such as personal preferences, aversion to food, food in-availability, lack of appetite, food  distribution in the family and ill health.

Now, a study carried out in rats and funded by the Wellcome Trust, suggests that rodents which ate a diet rich in fat, sugar and salt whilst pregnant were more likely to give birth to offspring that overate and had a preference for junk food when compared to the offspring of rats given regular feed.

Now, in a follow-up study published in The Journal of Physiology, the researchers have shown that a mother’s diet has an effect lasting beyond adolescence in the rats, even when the offspring were weaned off the junk food, affecting how their bodies metabolise the food and suggesting a long term health impact.

The offspring of the mothers fed junk food diets had raised levels of cholesterol as well as higher levels of triglycerides, a type of fat found in the bloodstream. Both are known to increase the risk of developing heart disease. Similarly, the offspring had higher levels of glucose and insulin, both of which increase the likelihood of developing type 2 diabetes.

The researchers studied the rats beyond adolescence through to adulthood and observed that the rats were still fatter than those whose mothers had eaten a healthier diet whilst pregnant and breastfeeding. Crucially, this partly manifested itself as increased fat mass surrounding the kidneys relative to body mass; this so-called perirenal fat is also involved in the development of insulin resistance and type 2 diabetes.

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