Chris, I continue to be confused about Vitamin A and pregnancy. Paul Jaminet, for instance, suggests that even if a pregnant woman is consuming adequate Vitamin D, she should rely on diet and not take any supplemental A (even Green Pastures’ FCLO) because of the risk of toxicity over 10,000I IUs. He also says to avoid supplemental folic acid. Chris Masterjohn suggests that 5,000 IUs can be adequate for pregnancy. Of course the doctors and midwives are very concerned about anyone taking too much Vitamin A, but could this be mainly based on the study in which the women were taking synthetic A and were probably D-deficient?

For me in terms of nourishing a growing baby, the question remains: is it safer to rely on diet (in which you may inadvertently become deficient in an important nutrient) or supplements (which may result in toxicity or other imbalances)?

Vitamin A is vital for:

-heart development
-lung development
-bilateral symmetry on the outside of the body, meaning the right side of your body is a close mirror to the left side
-bilateral *A*symmetry on the inside of the body, meaning an uneven distribution of organs, but in such a way that they fit together in the body cavity properly
-proper eye development
-proper ureteral bud development. The ureteral bud develops in one direction to become the nephrons or filtering structures of the kidney, and develops in the other direction to become the ureter, or tube leading from the kidney to the bladder.

If you do some digging on Google and Science Daily you will find studies supporting everything I’ve said here. I mean to put together an article for Associated Content or similar, Real Soon Now, because this stuff is all tremendously important, and now they’re telling pregnant women not to eat liver.

I suffered from just enough vitamin A shortage in my second (and so far last) pregnancy that while my daughter’s eyes appear to have developed correctly, she was born with vesicoureteral reflux into both kidneys, meaning the valves where the ureters meet the bladder were not closing correctly and the urine sometimes ran backwards. Additionally, the right kidney was significantly smaller than the left–some asymmetry is expected, but not that much–and the ureter on that side was noticeably enlarged. The left side eventually corrected itself as her bladder grew. The right side needed surgical reinsertion.

I have done some digging around after hearing rumors, and it turns out that urinary tract defects are the most common class of defects in the developed world. I have also been advised by a friend who at that time worked in an organ transplant clinic that VUR is a major risk factor for end-stage renal disease later in life. There is not exactly a surplus of kidneys on the organ market, as it were, so that’s going to mean dialysis at some point if we’re not very careful (and, who knows, maybe even if we are).

The pediatric urologist said he didn’t know why kids get VUR but that it was probably hereditary since a child with the disorder has a 30 percent chance of having a sibling with the disorder as well. I think he’s only halfway right–a mother who is malnourished for one pregnancy is likely to be malnourished for another, especially subsequent pregnancies from the first one where something went wrong developmentally.

Again, they are telling pregnant women not to eat liver. They are actually telling them to depend on beta carotene even though it is known that infants and very small children can’t convert beta carotene, so it stands to reason an embryo or a fetus can’t either. And I’ve also heard of a couple of studies, one in the US and one in the UK, where they found that between 40 and 50 percent of the study respondents were not able to convert beta carotene adequately to get their vitamin A needs met. The studies were small and it’s unknown to me whether the researchers controlled for diabetes, hypothyroidism and other conditions that interfere with beta carotene conversion. But we know that not all expectant mothers are in perfect health, either, especially if it’s not their first pregnancy.

We wouldn’t need the March of Dimes half so much if we’d just give mothers better dietary advice, and make the foods they actually need more available to them.