Does Chocolate make for Happy Babies?
Some of the nutritional advice seems like common sense, and some is based on fairly decent research, if you can keep up with it all. For instance, if you want to offer women nutritional advice linked to premature labour, fish oil appears to reduce this risk (Olsen et al 2000), while liquorice appears to increase it (Strandberg et al 2002). Of course, there is always the opportunity to follow the advice of the studies you like, and ignore those you don't.
One of my current favourites in this area is a recent Swedish study (Raikkonen et al 2004), which is particularly positive about chocolate. These researchers asked mothers how frequently they ate chocolate during pregnancy, and, when their babies were 6 months old, asked them to rate their babies' happiness. The results showed a significant difference between the scores given by the mothers who ate chocolate every day of their pregnancy (who appear to have very happy babies) and the mothers who ate chocolate occasionally or never (whose babies as, by comparison, less happy). Mind you, it is hard to know whether this is because chocolate crosses the placenta or wanders into the breast milk and makes the babies happy that way; whether the effect of chocolate on the woman's happiness makes the baby happy without there being a physical effect, or whether woman who eat chocolate every day are simply more happy themselves and thus see their baby's happiness as being greater because of this.
Celebrating Gastronomic Variety
I think most people have come to realise that we are not all the same as far as diet is concerned. Some people thrive on being vegetarian or vegan, while others become pale and find most of their haemoglobin leaves their body at the mere thought of not eating meat. Some love the current fad for no- or low-carbohydrate diets, while others couldn't live without their potatoes. This seems to support the notion that we should individualise nutritional advice, and perhaps look for ways to help women find out what their own bodies need.
A good number of midwives have felt this for a long time, suggesting that pica ~ the condition where women eat all sorts of odd things ~ might be the body's way of getting the nutrients it needs. (To digress briefly, the things eaten by women who experience pica might also be changing with time. Coal, for instance, is not as widely available as it once was, so women are seeking more modern oddments to eat. One example of this is the woman who loved to eat post-it notes, but only the yellow and pink ones; the green ones apparently didn't taste good at all…). Although Horner et al (1991) described pica as a disorder, many pregnant woman and midwives see this as a natural and relatively common occurrence, and perhaps as a form of body wisdom that helps women get the nutrients they need (presumably even the trace ones that are hidden in post-it notes).
However, I have noticed a bit of a dichotomy even amongst those who offer a more holistic and people-centred approach. At home, if I crave carrots or lentils, then my naturopath partner deems that a wise and important message from my body that leads to us having carrots or lentils for dinner. If, on the other hand, my body announces it wants to eat a whole bar of green and black's chocolate in one go, my body is (apparently) no longer wise… Likewise, some of the nutritionists who write about pica (e.g. Horner et al 1991) feel that this can be a problem and lead to nutritional deficiency.
Perhaps the time has come for us to think about some of these debates and put nutrition, and the question of what we tell pregnant woman about this, higher up on the agenda than it currently is. Is there any value in continuing to offer lists of nutritional "dos" and don'ts" to woman? Do we want to give women the message that their bodies are generally good at telling them what to eat, or do we want to continue to convey the message that we know best? And are our ~ and women's ~ bodies only wise when they crave the favoured nutrients of the day?
REFERENCES
Horner RD, Lackey CJ, Kolasa K, et al (1991). Pica practices of pregnant women. Journal of the American Dietetic Association. 91(1): 34-8.
Olsen SF, Secher NJ, Tabor A, et al (2000). Randomised clinical trials of fish oil supplementation in high risk pregnancies. British Journal of Obstetrics and Gynaecology. 107(3): 382-95.
Raikkonen K, Pesonen AK, Jarvenpaa AL, et al (2004). Sweet babies: chocolate consumption during pregnancy and infant temperament at six months. Early Human Development. 76(2): 139-45.
Strandberg TE, Andersson S, Järvenpää
A-L et al (2002). Preterm Birth and Licorice Consumption during Pregnancy
American Journal of Epidemiology. 156:803-805.