Last month

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what my wife and I found to work for her to avoid the first trimester nausea by changing her diet. Some women got really upset about it, but a lot of other women, and surprisingly all men that reacted, asked for more information. So here it is. Everything we did, when, why, and what happened.

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Before I start, these are probably not the best possible protocols for you. Every couple is different, and anyone who tells you they have the universal answer is lying to sell something. This is what we did, why we did it, and what happened. That said, many interventions can be adopted by most, and that's why I am writing this.

Some say we were lucky, and I hate it. Unless "waking up every morning at 4 AM to prepare her breakfast and go to the gym" or "changing all your daily habits and diet" or "spending hours every evening researching" or "having spent the last ten years looking after your health" is considered being lucky. Then sure, we were lucky, the same way someone who drinks every day is unlucky when the baby has fetal alcohol syndrome, or how someone drunk driving is unlucky if he gets into an accident.

My wife had a straightforward and easy pregnancy, a fast labor, a baby who latched in the first hour, and a milk supply that came in on schedule. Not everyone gets that and I know it. But I also think we created most of our luck, and the creating part is what I can share.

I am a biomedical engineer by training, and I love reading research papers on things I care about – and I care a lot about health. I pride myself on being an old-school researcher, skeptical of most findings when people have a financial interest in finding specific results. Especially in medicine, where somewhere along the way we forgot that the goal was to treat people instead of managing symptoms while making hospitals as much money as possible. I obsess over trying to trace the mechanism to the right causal layer whenever possible, and build a system from there.

When my wife told me she was pregnant I started thinking about one question only: what does a human infant actually need to develop properly, and how far has the standard approach drifted from the answer?

Apparently very far. Disturbingly and disgustingly far.

## The Inputs

Fortunately, we already had good diets. Both of us have cared about what we eat for years, so the change when we found out we were having a child wasn't too big of a change. When buying or making food, the question quickly went from "is this good for us?" to "is this the best possible input for a woman building a human from scratch?" and that reframing changed only slightly what we ate daily.

The logic is very simple: the developmental environment for a baby is the mother's body. Every molecule the mother eats, breathes, or produces hormonally becomes the raw material for building a new human. The quality of the building materials is the quality of the baby.

Alcohol was easy. Neither of us drinks much (I enjoy my wine as every other Italian), so cutting it was a non-event. Coffee was supposed to be harder, both of us love it, so I was braced for a negotiation, but the pregnancy handled it itself. By week 3/4 coffee tasted awful to her, and she stopped on her own. The body knew something we didn't and acted on it before we had to. To our amazement, she became coffee-averse before we knew we were having a baby, and in hindsight it was the first signal.

The food part was not so much about removing as about optimizing. The baseline was already healthy: meat, fish, eggs, avocados, dark leafy greens, berries, nuts, bone broth, sardines, etc. so we only had to change the amounts and timings. This to many sounds like the normal diet, but unfortunately to some it's not. Some would even call it "extreme". The standard Western pregnancy diet actually is seed oils, refined sugar, processed everything, and fast food. All of it fed to a woman whose body is trying to build a brain from scratch.

The supplement stack changed the same week. A prenatal (with methylfolate instead of folic acid), Omega-3s, vitamin D, creatine, and choline. Choline is the nutrient very few talk about and which I think about constantly. The developing fetal brain needs it for cell membrane synthesis and neural tube development. The official adequate intake during pregnancy is 450mg per day (with some studies showing continued benefit up to 1000mg). The prenatal supplement our gynecologist recommended, supposedly the best a soon to be mom could buy, contained 25mg. Twenty-five. To get the right dose from that supplement alone she would have had to take eighteen times the labeled dose, which is both impossible and insane. Three eggs a day cover most of it. I cannot think of a cleaner example of how far the standard of care has moved away from the actual biology and towards simple mitigation: the official prenatal, prescribed by the specialist, delivering about five percent of the nutrient the baby's brain needs most.

My wife and I joke about this often, but our gynecologist never once covered what to eat. She spent considerable time over multiple appointments stressing what to avoid, among which there were runny eggs. The concern about salmonella is relatively legitimate, but the result is that mothers end up choline deficient because of an overblown fear of it. The system is better at scaring you away from the inputs than at telling you what the inputs should be.

That pattern repeated itself across almost everything we looked at, and it set the tone for the entire pregnancy. The gap between what the biology needs and what the standard of care provides is not small. And that was infuriating. The problem is that nobody in the system has an incentive to make things as good as they can be; they must avoid problems for themselves, avoid the worst outcomes, minimize risks, but never maximize benefits, or aim at the best possible outcomes –– so that's what we set ourselves up to find out.

## The Nausea

First trimester nausea started affecting Andrea around week three and did not leave until we found out it was due to the pregnancy and we figured out how to avoid it.

The standard advice from every pregnancy website and every forum we read as well as every well-meaning relative was to keep crackers by the bed or eat bland carbs. This advice is mechanistically wrong for most women, and I want to explain why, because it affects almost every pregnant woman who goes through it and almost none of them hear the actual explanation.