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19 October 2022

For a healthy start in life

By Dr. Fong Kah Leng
Obstetrician and Gynaecologist
MBChB (Glasgow), MD (Singapore), FRCOG (UK

Nutrition and weight management before and during pregnancy has a profound effect on the development of infants. This is a rather critical time for healthy fetal development as infants rely heavily on maternal stores and nutrient for optimal growth and health outcome later in life. Prenatal nutrition has a strong influence on birth weight and further development of the infant.

The "Barker Hypothesis", or thrifty phenotype, states that conditions during pregnancy will have long term effects on adult health. Associated risk of lifelong diseases includes cardiovascular disease, type-2 diabetes, obesity, and hypertension. Babies born lighter in weight appear to have an increased rate of mortality than babies born at a heavier weight. This does not mean that heavy babies are less of a concern. Death rate would rise as birth weight increases beyond normal birth weight range. Ideally, the rate of weight gain should be monitored during pregnancy to support the most ideal infant development.  Eating a healthy diet is always a wise idea.  Eat smart to cover any nutritional gaps in your diet.

Prenatal star supplements & superfoods

You are likely to be already on folic acid - one of the prenatal star supplements. Folic acid prevents malformations of the brain and spinal cord in babies and anaemia in pregnant women. A minimum of 600 mcg of folic acid per day during pregnancy can reduce the risks by as much as 70 per cent.

As the brain and spinal cord begin to form in the first trimester of pregnancy – before most women even know they are pregnant – women of childbearing age are to take a supplement containing folic acid daily, either as part of a multivitamin pill or as an individual nutrient, whether they are actively trying to get pregnant or not.  Folic acid occurs naturally in green leafy vegetables, fruits, dried peas and beans. 

Iron supplementation has been associated with a 50% reduction in the hazard for anaemia and a 19% reduction in the risk of low birth weight. Therefore, women who took iron supplements during pregnancy had a significantly lower risk of anaemia and low-birth-weight babies, according to a large meta-analysis.

During Pregnancy, iron needs increase per day. Thus, women should start taking prenatal vitamins that contain 30 mg of iron per day beginning with their first prenatal visit. Because this dose of iron can make some women nauseated or constipated, the  prenatal vitamin should be taken with food (to minimize nausea) and to consume adequate fluids and high-fiber foods to cut down on constipation.

Docosahexaenoic acid (DHA), an omega-3 fatty acid, especially the kind found in fish, have been shown to be vital in normal brain and eye development and functioning in fetuses. It can also lower the risk of premature birth and increase the birth weight. There is also some evidence that supplementation might help prevent preeclampsia, postpartum depression, menopausal problems, postmenopausal osteoporosis and breast cancer. It also helps women avoid heart disease.

Almost all fish contain at least trace amounts of DHA, but salmon, herring, anchovies, and bluefin tuna are especially good sources of it. DHA is also found in some eggs, and fortified in some milks, cheeses, soymilks and snack foods such as cereal bars.

Choline is an important nutrient that helps brain cells develop properly. Animal studies suggest that adequate choline during pregnancy has long-lasting effects on a baby's ability to learn and remember – and may even provide some resistance to mental illness.

The recommendation for pregnant women is 450 mg of choline per day. You don't have to get the recommended amount of choline every day. Instead, aim for that amount as an average over the course of a few days or a week. Eggs, meat and fish are good sources of choline.

Prenatal exercises

The effect of exercise in pregnant women has been the subject of comprehensive research. Studies show that, in most cases, exercise is safe for both mother and fetus during pregnancy and they support recommendations to initiate or continue exercise in most pregnancies to derive the health benefits associated with such activities. It helps you cope and may even shorten your labour. More  importantly, it helps you get back into shape after delivery.

If you have been exercising regularly before pregnancy, you should be able to continue all the way till delivery. Adapt your routines to your growing belly and listen to your body. If you have been a couch potato all this while, the recommendation is to start slow and easy, with 15-minute prenatal exercises three times a week, increasing gradually to 30-minute sessions four times a week, and finally to daily sessions. While exercise is generally safe for both mother and foetus during pregnancy, always remember to get the nod from your doctor before starting on an exercise regime while pregnant.

Women who have gestational diabetes mellitus must take particular precautions with exercise including monitoring blood glucose, regulating meal times, scheduling rest periods and carefully tracking fetal activity and uterine contractions.

No adverse effects on the fetus have been reported to occur during water exercise in pregnancy. The physiology of water exercise offers some compensation for the physiological changes of exercise on land that may beneficially affect pregnancy. If a woman is exercising in water (as in aquanatal classes) the water temperature should not exceed 32 degrees Celsius. Thirty-five degrees Celsius is the recommended maximum while using a hydrotherapy pool.

Women should stop exercising and seek medical advice should they feel unwell or experience any chest pain, vaginal bleeding, abdominal discomfort, reduced fetal movements etc.


You have probably heard of the Mozart effect. It’s the idea that if babies listen to music composed by Mozart they will become more intelligent. A quick internet search reveals plenty of products to assist you in the task. There are CDs and books to help you to harness the power of Mozart’s music, but when it comes to scientific evidence that it can make you more clever, the picture is more mixed. 

The Mozart Effect was a very popular study conducted by the University of California in 1993. The results of this study showed that college students who listened to the Austrian composer’s creations displayed an increase in IQ points in spatial reasoning. However, while music is recognised as a wonderful stimulation or relaxation tool, there is no solid evidence that you can increase your foetus’s future intelligence by playing music to it. While a daily dose of Mozart during pregnancy won’t make your baby a musical prodigy, he may recognise and be soothed by it when he hears it again as a newborn. It might also help you to relax, reduce stress and deepen your own feelings for your baby.

In the same way, your baby might also demonstrate that he recalls and is comforted by other noises heard while in the uterus. These could be the theme tune of your favourite TV programme (Hepper PG. 1988), or a story frequently read out loud to him (DeCasper AJ. et al. 1980). He may also prefer your voice, paying attention when you speak (DeCasper AJ. et al. 1980).

Don’t worry if you’re not comfortable with singing and chatting to your bump. The natural stimulation your baby receives from everyday conversations, and activities, is more than enough to prepare him for the outside world.

The above are positive steps to take to make pregnancy a wonderful experience – eat balanced meal, quit smoking, avoid alcohol, and give you and your baby a healthy start.