Doing right by baby

Most mothers would say they want to do the best thing for their children. But when does that providing start?

An emerging field of research called 'epigenetics” leads some to believe that perhaps providing children the best health in life starts before they're even conceived.

The term epigenetics was coined in 1942, but its current use and meaning are much newer. In 2008, the accepted definition of epigenetics was decided by a group of geneticists at the Cold Spring Harbor Lab in New York: 'An epigenetic trait is a stably heritable phenotype resulting from changes in a chromosome without alterations in the DNA sequence.” What this means is that there are things in the genes' environment that change the way they are expressed.

Think what might happen if a gene was meant to make a baby with red hair, but something in the mother's environment caused the baby to have blonde hair instead. This type of change hasn't been known to happen, but similar changes have. Some of these changes are creating children with obesity and type 2 diabetes, for example.

What changes are causing genes to misbehave? The truth is, doctors don't know them all, but we do know some.

In the early 1990s, a couple of researchers noticed that babies exposed to high levels of sugar during pregnancy were more likely to become obese and have diabetes later in life than babies that weren't. One of the gene changes is called 'methylation.” When this change happens, the baby gets altered amounts of the hormones that control hunger and regulate fat.

Mothers with higher sugar levels in their blood, as is the case with mothers with diabetes (type 1, type 2, or pregnancy-associated diabetes), provide the environment that causes this methylation for the babies.

So what can be done? How do we lower the methylation of these genes? The best way is by lowering mom's sugar levels to normal. In order to do that, mothers need to reduce their risks of pregnancy-associated diabetes.

For women who have diabetes outside of pregnancy, getting the best sugar control possible before getting pregnant is the most important thing to do. Taking diabetes medicine or insulin regularly as prescribed by the doctor will help by lowering a hemoglobin that shows healthy or poor sugar control in the blood.

Women who are planning to get pregnant and who are not diabetic have lots of opportunity to reduce the risk of these genes misbehaving. Lifestyle, dietary and activity interventions can reduce the chances of having diabetes during pregnancy.

Losing weight before getting pregnant is great, but doing it in a healthy way is important. Carbohydrate restricting diets have been shown to do more harm than good right before pregnancy. Increasing activity, like taking a brisk 30-minute walk every day, can lower the risk of diabetes in pregnancy. Also, getting plenty of sleep and reducing stress can help.

In order to provide the best for their children, mothers need to take good care of themselves, and reduce their risks of diabetes in pregnancy. In this way, babies can start out with the best health possible.

' Dr. Angela Stoehr is a physician specializing in obstetrics and gynecology at the Eastern Iowa Health Center in Cedar Rapids. Contact: astoehr@eihc.com