Abstract: Water is an essential element of life. Water is required to maintain nutrient absorption, cellular function, maintain temperature, and remove waste. Particularly during pregnancy, adequate fluid intake supports the health of both mom and baby. 

Hydration: Why It’s So Important 

When you think of survival one of the first requirements you think of is water. Water makes up about 55-65% of a person’s body weight. It plays important roles in all of your bodily functions including:

• • • • The absorption of water soluble vitamins which are vitamin C, folate (folic acid) , niacin, riboflavin, B6, B12, biotin, and thiamine.
      • Cellular function and structure
      • Transport of nutrients throughout the body
      • Elimination of waste products
      • Maintaining body temperature
      • Supports digestion

In this article we will:

• Review waters role in pregnancy 
• Explore common water contaminants, pollutants, and how to avoid them
• Define recommended intake, toxicity, and deficiency 
• Highlights a variety of ways to stay hydrated

How Does Water Help In Pregnancy?

Water is necessary for circulation of blood from mom to fetus. Additionally, water supports proper amniotic fluids which support nutrient and oxygen transport. 

During pregnancy research finds water can:

• Softens skin
• Increases energy 
• Decreases risk of UTI
• Decreases risk of preterm labor and preterm birth
• Reduce constipation 

For birth outcomes, there is a positive correlation between hydration status and birth weight, length, head circumference, and chest circumference. This means the more hydrated the mom, the better birth outcomes of the baby. 

Unfortunately, although we know essential functions of fluids in the human body, there is not enough research conducted on pregnancy and fluid intake. 

Did you know? Water makes up about 78% of a newborn baby's body weight!

Water In Action: What Does It Do In The Body?

Water could be called the most essential nutrient. This is because of all the functions it has in the body, in addition to the fact that the high amounts of water loss means you constantly need to be replenishing. 

Although water is so important, there is many ways in which it can become contamiatined thus causing more harm than good for the body. The following two sections will review common water contaminants and ways to reduce risk.

Water Pollutants and Contaminants: The Down and Dirty

Tap water is unavoidably contaminated with pesticides, heavy metals, sewage, industrial waste, and toxins produced by bacteria. Although we have some laws and regulations around filtration, there are many times these laws get overlooked and under enforced. Particularly in low income areas, there is high risk due to lack of infrastructure that is able to maintain a safe water supply. 

Below is information obtained from Environmental Protection Agency’s (EPA) national drinking water regulations. These are all substance which have been found in drinking water and the EPA has set standards for:

Heavy metal contaminants include lead, arsenic, cadmium, and cyanide

Industrial waste contaminants include benzene, dichloromethane, polychlorinated biphenyls (PCBs)

Sewage and bacterial contaminants may include giardia lamblia, e coli, and cryptosporidium

Lead and Fetal Development

The first disaster I think of when I hear lead in water is the Flint Michigan water crisis.

Although Flint Michigan had historically obtained water from Detroit, In 2013 Michigan decided to push for a more cost effective alternative, supplying Flint’s water directly from the Flint river. In addition to industrial waste products contaminating the river, lead was leached into the water from old piping and the surrounding factory waste. 

In 2014 a research study was conducted on the water supply in Flint which concluded that more than 40% of samples measured in the ‘very serious’ levels of lead within the water. Lead contaminated water can severely damage fetal development, newborns, infants, and children. Health risks of lead in water include:

• impair brain development of babies and infants
• Lower IQ
• Anemia 
• Impaired growth

Additionally, lead in water at a young age can have negative health impacts long term such as risk of cardiovascular disease, high blood pressure, kidney disease, and infertility later in life.

Alternative to tap water include bottled water or at home filtration systems ranging from carbon filtration, to reverse osmosis which can all minimize risk of contamination. Different filtration systems have different effects on contamination so it is important to research best practices to make an informed decision. 

How Much Fluids Should I Have Per Day?

There may be compounding factors that increase your needs for fluid such as increased aerobic activity due to exercise or work, climate, and various disease states such as UTI, kidney stones, or hypertension.

Current guidelines for a healthy adult and pregnant women recommend 1ml of fluid/kcal. This means as calorie needs increase fluid should also increase.

Current recommendations are:

• No excess calories or water during 1st trimester
• About 300 kcal and 300ml fluid for the 2nd trimester
• An additional 450 kcal and 450 ml fluid for the 3rd trimester 

Did you know? One research study conducted on more than 500 pregnant women found that 98% did not intake enough water!

What are ways to hydrate?

Water is the most obvious answer to this question, but in fact there are many ways other than water to stay hydrated! 

• Ways to hydrate other than water include:
• Fruits and vegetables
• Soups 
• Milk
• Juices
• Smoothies 

What foods/drinks are dehydrating to the body?

While taking fluids in is important, it is equally important to be aware of what foods/drinks may dehydrate the body. Some of the top dehydrating foods/drinks are:

• Alcohol 
• Sugar sweetened beverages such as soda, energy drinks, or excessively sweetened teas, coffees, and juices 
• Salt snack such as pretzels, chips, and popcorn

How much is too much water?

Overhydration of water can lead to something called hypernatremia, or low sodium. This low sodium causes an electrolyte imbalance and also affects magnesium and potassium levels important to both mom and baby’s health. 

What happens if I don’t have enough water?

Inadequate fluid intake during pregnancy can result in poor health outcomes for the mom throughout her pregnancy, and for the fetal development. 

For mom, low fluid intake can lead to constipation, UTI, and risk of preterm labor. For baby, low fluid could increase risk of nutrient deficiency, low birth weight, length, and head circumference, and potential long term consequences of improper cellular functioning.

In addition to making sure you have enough fluids, it is important to be sure that water is safe. Low income communities are at high risk for unsafe drinking water exposure. Globally access to clean drinking water is an even greater public health concern. 

Summary

Water is necessary for life, particularly during pregnancy and early life. It plays a variety of roles in the human body, metabolism, regulation, and elimination. Access to safe drinking water continues to be a public health concern, particularly in low income areas. Inadequate intake of water can lead to poor health outcomes for the baby, and poor fetal development in utero. Although water is the most commonly thought of way to hydrate, there are many other ways to make sure you are maintaining a healthy amount of fluids. 

Reference:

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