'Eating down' during pregnancy

"EATING DOWN" DURING PREGNANCY

"There is a widespread belief among women in developing countries that
decreased food intake during pregnancy is safer for the mother (and possibly
the child) because a smaller fetus will make for an easier delivery..[i]in
the absence of comprehensive obstetric care...[this widespread belief] needs
not only to be studied further but to be honored until better data become
available..."
--David Rush, MD [American Journal of Clinical Nutrition, Vol. 72, No. 1,
212S-240s, July 2000, via Donna Young]

OPEN LETTER (archived for global access; see below)

David Rush, MD
Professor Emeritus, School of Medicine
School of Nutrition Science and Policy
Tufts University
711 Washington Street
Boston, MA 02111
E-mail:
Also via:
Patricia Campbell, Acting Executive Associate Dean
E-Mail:

David,

You indicate that belief in "eating down" to make smaller babies should be
honored if comprehensive obstetric care is not available.

You express concern about babies developing large heads and women developing
small pelves in areas where comprehensive obstetric care is not available.


Comprehensive obstetric care routinely closes pelvic outlets up to 30%.

Comprehensive obstetric care is spreading to developing countries.

Comprehensive obstetric care should not be blindly honored - anywhere - esp.
not with OBs routinely closing pelvic outlets.

For simple PROOF that OBs are knowingly closing birth canals up to 30%...

For simple instructions on how women can allow their birth canals to OPEN
the "extra" up to 30%...

See Connecticut EMTs to help OBs (and babies)?
http://health.groups.yahoo.com/group...t/message/2731

Todd

Dr. Gastaldo


This Open Letter will be archived for global access within 24 hours in the
Google usenet archive. Search http://groups.google.com for "'Eating down'
during pregnancy."

"There is a widespread belief among women in developing countries that
decreased food intake during pregnancy is safer for the mother (and possibly
the child) because a smaller fetus will make for an easier delivery..

Oooh, I just read about this in "Child of Mine" (nutrition book). The
author cites a few studies showing that, statistically, when maternal
weight gain is inadequate, especially during the third trimester, the
BRAINS AND INTERNAL ORGANS of their babies are substantially smaller
than control babies -- it's not just a "baby fat" thing. Scary!

That being said, she also points out that this practice was developed
during a time in history when many women suffered from rickets and
contracted pelvic bones, so that decreasing the size of the baby by
restricting the mother's diet was actually a good risk/benefit
trade-off. Not much you can do during labor to get that extra 30% of
space if you've got rickets.


Mary S.

I noted that OBs are denying up to 30% of pelvic outlet area...and that it
easy for women to allow their pelvic outlets to OPEN the "extra" up to
30%....
http://health.groups.yahoo.com/group...t/message/2732

I also quoted David Rush, MD on "eating down" in pregnancy:

"There is a widespread belief among women in developing countries that
decreased
food intake during pregnancy is safer for the mother (and possibly the
child)
because a smaller fetus will make for an easier delivery..[i]in the absence
of
comprehensive obstetric care...[this widespread belief] needs not only to be
studied further but to be honored until better data become available..."
--David Rush, MD [American Journal of Clinical Nutrition, Vol. 72, No. 1,
212S-240s, July 2000, via Donna Young]


Mary S replied:

"...Not much you can do during labor to get that extra 30% of space if
you've [had] rickets."

Yep, if the baby can't get through the pelvic inlet, it doesn't matter how
much "extra" room there is to be had at the pelvic outlet - but I don't know
that all cases of rickets cause an inadequate pelvis.

I guess it wouldn't take many maternal and fetal deaths - due to rickets or
other causes - to result in a widespread cultural belief that it's worth it
to try to make a smaller baby by eating less during pregnancy.


Apparently, rickets is still an important disease of childhood in some parts
of the world, as in the following PubMed abstract...

J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):491-5. PubMed abstract

Vitamin D-deficiency in Asia.

Fraser DR.

Faculty of Veterinary Science, University of Sydney, Sydney, NSW 2006,
Australia.

Vitamin D-deficiency rickets is an important disease of childhood in China.
It occurs in all regions (20-53 degrees N) but is more prevalent in the
north. A survey in Beijing indicated that Vitamin D-deficiency (plasma
25(OH)D concentration 12.5 nmol/l) occurred in more than 40% of adolescent
girls in winter. Dietary calcium was often as low as 350 mg per day and a
positive correlation was found between this and both bone mineral density
(BMD) and Vitamin D status. In a subsequent intervention study with 757
Beijing schoolgirls, a daily supplement of milk, fortified with calcium, was
provided on school days for 24 months. From anthropometric and bone density
data, it is evident that the increased calcium intake from milk, had
significant effects on bone and that deficiencies of both calcium and of
Vitamin D had been affecting bone growth and development. In neighboring
Mongolia (42 degrees -50 degrees N), rickets is also common, but its
prevalence has increased since 1990. A 2-year survey (2000-2002) in Mongolia
indicated that, as in China, a low intake of calcium and limited exposure to
solar ultraviolet (UV) light in summer were associated with Vitamin
D-deficiency. However, over the last decade, malnutrition has become
widespread. It now appears that malnutrition impairs the efficiency of the
utilization of Vitamin D obtained in summer. Hence, a number of factors need
to be addressed to prevent Vitamin D-deficiency during growth.

Todd

Dr. Gastaldo



Copied to: Dr. Fraser


"Mary S." wrote in message
...

"There is a widespread belief among women in developing countries that
decreased food intake during pregnancy is safer for the mother (and
possibly
the child) because a smaller fetus will make for an easier delivery..

Oooh, I just read about this in "Child of Mine" (nutrition book). The
author cites a few studies showing that, statistically, when maternal
weight gain is inadequate, especially during the third trimester, the
BRAINS AND INTERNAL ORGANS of their babies are substantially smaller
than control babies -- it's not just a "baby fat" thing. Scary!

That being said, she also points out that this practice was developed
during a time in history when many women suffered from rickets and
contracted pelvic bones, so that decreasing the size of the baby by
restricting the mother's diet was actually a good risk/benefit
trade-off. Not much you can do during labor to get that extra 30% of
space if you've got rickets.


Mary S.

In sci.med Todd Gastaldo wrote:
: "EATING DOWN" DURING PREGNANCY

: "There is a widespread belief among women in developing countries that
: decreased food intake during pregnancy is safer for the mother (and possibly

Women (and teens) in developing countries have something to be concerned
about --namely obstetric fistula -- which is someithing we don't see so
much of in N. America.

When teens aren't done growing, the baby can get stuck, and they can
labour for days -- or the tissue between the vagina and rectum tears.

Read more about this at:

http://www.engenderhealth.org/news/i...ws/030622.html

Emma