The Brewer Pregnancy Diet - Treating Pre-eclampsia

Author // Joy Jones, RN

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The Brewer Pregnancy Diet
Treating Pre-eclampsia
When is the Diet Important?
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Treating Pre-eclampsia

One way to treat pre-eclampsia is to educate the mother about its relationship to nutrition and blood volume. Once she understands the physiology, we can strongly encourage her to eat according to the Brewer Diet plan. As part of that plan we can suggest that she eat something every hour that has protein in it, and that she work at increasing her salt and calorie intake. We can also sit with her and obtain a lifestyle history, and work with her to match her nutrition to her activity level and environment. This will help her balance her calorie/salt/protein intake and her calorie/salt/protein expenditures. The goal is to customfit the Brewer Diet to each individual mother. Start with the Brewer Diet’s Basic Plan as the minimum amount of food to build on, and add calories, salt and protein according to her unique needs and lifestyle.

When the problem demands a more immediate response, a doctor can give the mother albumin intravenously, and sometimes put her on antibiotics (to lessen the load on the liver by aromatic toxins from the intestines). Dr. Brewer would often tell of one woman who, unable to find a doctor who would give her IV albumin, brought her blood pressure down by eating 52 eggs and drinking 6 quarts of milk over a period of 3 days.

Anne Frye, a midwife and author in Washington, recommends having the mother eat a high-protein item every waking hour. “Initially recommend an increase to 150 to 200 grams of protein daily (250 to 350 grams or more with multiple gestations), with 3,000 to 4,000 calories and 500 mg of choline daily,” she suggests. “If the woman has a history of liver disorders, recommend less protein (120-150 grams for a single fetus); her liver may be overwhelmed otherwise, and monitor her lab work closely for changes…. Once liver enzymes and blood proteins have normalized, the hemoglobin has dropped appropriately, the fetus is an appropriate size for dates and secondary symptoms have subsided, the woman can cut back to 100 grams of protein daily (150 grams with multiples).”

Other Complications of Malnutrition

All of the complications mentioned thus far are related to blood volume, but also to a lack of adequate nutrition. If the malnutrition is not corrected, some liver tissue can die and hemorrhage, leading to small hemorrhages in the mother’s adrenals, lungs, brain and the lining of her heart. The cells lining the capillaries in the kidneys can be damaged as well, and the falling blood volume can cause kidney dysfunction. Abruption of the placenta can happen when the blood volume is so low that the maternal pool of blood that is normally behind the placenta begins to clot as the flow through that arteriovenous shunt slows down. Intrauterine growth retardation and low birth weight can result from lack of nutrients in the mother’s blood, and from low pressure of the blood behind the placenta. Babies can suffer neurological impairment due to this lack of nutrients and calories when their brains are at the most critical stage of development.

Ninety percent of premature labor is caused by inadequate nutrition and falling blood volume. The blood volume necessary to prevent premature labor increases with the number of babies the mother is carrying. The exact mechanism is unknown, but there is speculation that it is due to the fact that an undernourished placenta is less capable of producing the muscle relaxant which keeps the uterus quiet during pregnancy, or that an inadequate blood volume somehow triggers an increase in the production of oxytocin by the pituitary. In any case, premature labor due to an abnormally low blood volume can be prevented with a proper diet, and it can be stopped with the use of IV fluids (without medications added) or IV albumin.

In addition, inadequate nutrition in pregnancy can lead to several labor complications.

1) Inadequate nutrition can mean that a smaller baby can be more difficult to push out than a larger one is. When the baby is small because of food deficiency, the uterus will also be malnourished, and less capable of functioning at its full potential. A non-pregnant uterus weighs 2 ounces. At the end of pregnancy, the uterus alone weighs about 2 pounds. This means that during the pregnancy the uterus needs to grow 1 pound 14 ounces of new muscle tissue. If the mother is eating less food than she needs, her uterus won’t be as strong as it would have been had she eaten well. Her uterus will also be more prone to dysfunction during the labor process. Eating well will give the mother a larger baby, but will also give her a stronger uterus, more capable of pushing out that baby.

2) The pelvis is designed to stretch during labor
. A wellnourished placenta will produce good amounts of the hormones needed to loosen pelvic ligaments so that it can stretch to allow the baby through. Therefore, it can be easier to push a larger baby through a more-stretchy pelvis than it would be to push a smaller baby through a pelvis unable to yield.

3) With a lower-than-normal blood volume, a mother is also more prone to dehydration
. In the event of extra bleeding, she won’t have the fluid reserves to draw from—fluids she would have been building had she been on a better diet. A mother who enters her labor with a well-expanded blood volume from an excellent diet during her pregnancy, and who continues to eat real, solid food and drink nutritious fluids during her labor, does not need the added insurance of IV fluids during her hours of labor.

4) In fact, postpartum hemorrhage is more likely with a malnourished mother, since the liver damage malnutrition causes can make her clotting mechanisms malfunction
. The liver has at least 500 metabolic functions, and pregnancy puts a lot of stress on it. But the liver is designed to deal with the stress of pregnancy, as long as the mother eats well enough to provide all the nutrients it needs.

As previously mentioned, one of the liver’s metabolic functions during pregnancy is to make enough serum albumin to help the mother’s blood volume expand by 50 to 60 percent. Another of the liver’s most important tasks during pregnancy is manufacturing essential clotting factors to prevent abnormal bleeding during pregnancy, labor and postpartum. When the liver becomes damaged in pregnancy from an inadequately expanded blood volume or the use of anti-hypertensive drugs, the manufacture of essential clotting factors can become compromised. This could lead to the development of HELLP syndrome and abnormal bleeding. The judicious use of the Brewer Pregnancy Diet can prevent these complications.