Amavithamini Okukhulelwa Ayiketshezi Esiza Ukukhulelwa Okunempilo

Ukudla okunomsoco ngaphambi kokubeletha kuyinto eza kuqala kunoma ubani olungiselela ukwamukela impilo entsha emhlabeni. Ibhalansi efanele yama-vitamin namaminerali ingasiza ukusekela impilo kamama ngenkathi inikeza nengane yakhe esakhula ukuqala okungcono kakhulu. Eminyakeni yamuva, abaningi kochwepheshe bezempilo kanye nabazali abalindele ingane baye bagxila kumafomula asekelwe emanzini, njenge-liquid prenatal vitamins, akhelwe ukuhlangabezana nalezi zidingo ezibalulekile. Ngezansi kunokuhlaziywa okuningiliziwe kokuthi kungani imikhiqizo enjalo isibe yingxenye ebalulekile yezempilo yokukhulelwa nokuthi ihlukile kanjani kwezinye izindlela zendabuko. 

Ukugxila Okushintshayo Ekudleni Okunomsoco Phambi Kokubeletha

Eminyakeni eminingi, ochwepheshe bagcizelele ukubaluleka kokudla okunomsoco ngesikhathi sokukhulelwa. I-Folate, insimbi, ikhalisiyamu, i-vitamin D, nezinye izakhi ezincane kumele zibe sezingeni elanele ukuze ingane ekhula esibelethweni ithuthuke kahle. Umlando ukhombisa ukuthi omama abakhulelwe babeyalelwa ukuba bathembele ekudleni kuphela noma bahlanganise uhlelo lokudla olunomsoco namaphilisi okuqala ngaphambi kokubeletha enziwe “ubukhulu obubodwa kubo bonke”. Nokho, ingxoxo yandile eminyakeni embalwa edlule ukuze ihlanganise nezinye izindlela zokuletha lezi zinto ezibalulekile, ngaleyo ndlela kubhekwane nezidingo nezintandokazi ezithile.

Ucwaningo olubalulekile lwango-2023 olwashicilelwa kumagazini wezempilo yomhlaba luveze ukuthi ukushoda kwemisoco ngaphambi kokubeletha kungahambisana nobungozi obufana nokuphazamiseka komgogodla wengane (neural tube defects) nokuzalwa kwengane inesisindo esiphansi. Ngokusho kokutholakele, ukwengeza ukudla ngezithasiselo zezinga elifanele esigabeni ngasinye sokukhulelwa kunganciphisa amathuba ezinkinga. Lolu lwazi lukhuthaze ukuhlolwa kwezinhlobo ezahlukene zamasuphilimenti angalungiswa ngezidingo zomuntu ngamunye futhi enze kube lula ukubhekana nezinselele ezivamile ezifana nobunzima bokugwinya amaphilisi [1].

Imisoco Ebalulekile Kubalulekile Ekukhulelweni Okunempilo

Ngaphambi kokungena ezindaweni ezahlukene zamasuphilimenti, kubalulekile ukuqonda imisoco eyinhloko ebandakanyekayo ekusekeleni umzali okhulelwe nengane yakhe esakhula:

• I-Folate (i-Folic Acid): I-Folate isiza ukuvikela izinkinga kumgogodla wengane (neural tube defects) futhi isekele ukuhlukana nokwanda kwamaseli. I-Centers for Disease Control and Prevention (CDC) nezinhlangano eziningi zodokotela bokubelethisa zincoma okungenani u-400 kuya ku-800 microgram ngosuku kwabesifazane abahlela ukukhulelwa nakuyo yonke iminyaka yokuqala yokukhulelwa [2].
• Insimbi: Ukukhiqizwa kwe-hemoglobin nokuthuthwa komoyampilo kuncike kakhulu ensimbini. Njengoba umthamo wegazi wengezeka kakhulu ngesikhathi sokukhulelwa, isidingo sensimbi sivame ukukhula kakhulu ukuze kugwemeke isifo segazi sokushoda ngensimbi (anemia)3].
• Ikhalisiyamu: Amathambo namazinyo omgogodla osakhulayo adonsa esitokisini se-calcium sikamama. Nakuba inani elinconyiwe lokudla liya ngokuthi umuntu uneminyaka emingaki, livamise ukuba phakathi kwamamiligremu angu-1,000 no-1,300 ngosuku.
• IVithamini D: Lo msoco usebenzisana ne-calcim ukugcina amathambo eqinile futhi uhlotshaniswa nokusebenza kohlelo lokuzivikela emzimbeni kanye nezinqubo ezehlukene zokuguqula ukudla kube amandla. [4].
• I-iodine: Abalulekile empilweni ye-thyroid, ethinta ukuthuthuka kobuchopho bengane nokukhula komzimba.
• Amafutha Anamafutha e-Omega-3 (DHA/EPA): Asiza ekuthuthukiseni impilo yobuchopho namehlo omgogodla osakhulayo. Nakuba engase angabi khona kuzo zonke izimveliso zokubeletha, izinzuzo zawo ziqoshiwe kabanzi [5].

Zonke lezi zingxenye ngokuvamile zivela ngendlela ethile kuma-supplement okubeletha, kodwa izinga lazo langempela liyahlukahluka. Lapho kubonakala khona elinye lezinzuzo ezisemqoka zezinketho ezisekelwe olweleni: zingakhiwa ngendlela elinganisa imisoco ukuze iphendule emihlahlandleni eguqukayo nasocwaningweni olusha.

Izinselelo Ngezindlela Zendabuko Zokunikeza Izesekeli

Amaphilisi ajwayelekile okubeletha namakhepsuli asatholakala kakhulu, kodwa angaholela ezinselelweni kwabanye abantu:

1. Ubunzima Bokugwinya Amaphilisi: Izifazane ezikhulelwe eziningi, ikakhulukazi lezo ezihlangabezana nesicanucanu sasekuseni, zithola ukuthi amakhepsuli amakhulu anzima ukuwagwinya. Umuzwa wokuhlanza ungaba buthaka kakhulu, kanti nosayizi wale miphilisi ungakhathaza.
2. Izinkinga Zokumuncwa: Abanye abantu bathola ukuthi uhlelo lwabo lokugaya alubekezeleli kahle amathebulethi ajwayelekile. Imiphumela emibi yamathumbu—efana nokukhanila, isicanucanu, noma isilungulela—ingandisa ngenxa kwezinye izinhlanganisela.
3. Ukulungisa Okulinganiselwe: Amaphilisi ngokuvamile eza ngemithamo emisiwe, okwenza kube nzima ukuhlela uhlelo lwezesekeli ngendlela ehambisana kahle nezidingo zomuntu. Ngokuphambene, izinhlobo ezisekelwe olweleni zinganikeza usayizi wesisu ongashintshwa ukuze kusetshenziswe indlela egxile kakhulu kumuntu ngamunye.
4. Ukunambitheka Okungalungile Okusele Emva: Nakuba imikhiqizo eminingi yamaphilisi okubeletha inamajazi angaphandle noma inambitheka ethile, ezinye izifazane zibika ukunambitheka okungemnandi noma iphunga elinamandla. Lokhu kunyanya kungavimba ukusetshenziswa okuqhubekayo.

Ukuphendula le mikhathazo, sekuvele izinhlanganisela ezintsha, ezithembisa indlela elula yokunikezwa kanye nokwenzeka kokwanda kwezinga lokumuncwa. Kulabo abakhetha izinketho zama-vitamin angahlafunwa, ukufunda indlela yokuthola ama-vitamin okubeletha angahlafunwa amahle kungaba enye indlela enhle esikhundleni sezesekeli zolwelo noma ezisekelwe emaphilisini, ikakhulukazi kubantu abanezinkinga zokugwinya noma zokugaya.

4. Kungani Abanye Omama Bekhetha Izingxube Eziketshezi

Inani elikhulayo labesifazane abakhulelwe selibheka izixazululo eziketshezi ezingafakwa kalula emikhubeni yansuku zonke. Kunezizathu eziningana zale ndlela esakhula:

• Ubulula Bokugwinya: Ingxube ewuketshezi ikhipha umgoqo wokugwinya amaphilisi amakhulu. Lokhu kungasiza kakhulu ngesikhathi sokuhlanza kwasekuseni (morning sickness) noma kulabo abangakuthandi ngokuphelele ukuthatha amaphilisi.
• Ukumuncwa Okungase Kuthuthukile (Bioavailability): Noma ngabe isivumelwano sesayensi asikaphelele, abanye abacwaningi bezokudla baphakamisa ukuthi izithasiselo eziketshezi zingangena kalula emzimbeni, ikakhulukazi uma zithathwa kanye nokudla okulinganiselayo.
• Umthamo Oguquguqukayo: Amafomula amaningi asekelwe koketshezi afika nezinkomishi zokulinganisa noma ama-dropper, okuvumela ukuthi umthamo ulungiswe ukuze uhlangabezane nezincomo ezikhethekile ezinikezwe uchwepheshe wezempilo. Lesi sici singaba sibalulekile uma imiphumela yokuhlolwa kwegazi ikhombisa isidingo esikhulisiwe sensimbi noma i-vitamin ethile.
• Ukunambitheka Nokwamukeleka: Ukuhleleka kobuchwepheshe sekube nomthelela ekuthuthukisweni kokunambitheka okuthuthukile. Nakuba ukunambitheka kuyinto yomuntu ngamunye, imikhiqizo eminingi yesimanje ye-prenatal ewuketshezi izama ukufaka ukunambitheka okubuthakathaka, okujabulisayo ukuze ikhuthaze ukuthi umkhiqizo uthatheke njalo.

Nokho, le mikhiqizo ayinawo nhlobo amabala amnyama. Eminye inokunambitheka okuqinile noma ingadinga ukufakwa esiqandisini ukuze igcine amandla ayo. Ngaphezu kwalokho, amanani ayahlukahluka kakhulu, kanti eminye imixube ekhethekile ingase ibize kakhulu kuneyamaphilisi.

Izinto Ezibalulekile Okufanele Zicatshangelwe Omama Abakhulelwe

Ngaphambi kokunquma isu lezithasiselo, kunokuningi okumele ukucabangele:

1. Ukuqondiswa Uchwepheshe Wezokwelapha: Xhumana nochwepheshe bezempilo ukuze uqonde noma yiziphi izingcuphe noma izidingo zakho siqu. Ukuhlolwa kwegazi kungaveza ukuswela okudinga ukunakwa okukhethekile, njengensimbi noma i-vitamin D.
2. Amaphrofayili Ezingxenye: Amafomula oketshezi ayahlukahluka kakhulu. Hlale ufunda amalebula ukuze uqinisekise ukuba akhona amavithamini abalulekile njenge-folate, insimbi, i-iodine, namanye amavithamini, ngesikhathi uhlolela futhi izithasiselo noma ama-sweetener.
3. Ukuhlolwa Kwefomula Nezindinganiso: Imikhiqizo ethembekile ngokuvamile ilandela izinqubo ezinhle zokukhiqiza (GMP) futhi ingase ibe nokuhlolwa okuqinisekiswa iqembu lesithathu mayelana nekhwalithi nokuhlanzeka. Lezi zinga zokuhlolwa zingasiza ukuqinisekisa ukuthi uthola okuqukethwe okukhonjiswe ilebula ngaphandle kokungcola okuyingozi.
4. Izidingo Zokugcinwa: Ezinye izithasiselo eziseketshezinini zidinga ukupholiswa efrijini ukuze zigcine amandla nokunambitheka. Lokhu kungaba yinselelo uma uhamba njalo noma ungenawo amathuba okugcina izinto zibandayo njalo.
5. Amathuba Okweqisa Umthamo: Nakuba kungase kube lula ukulungisa umthamo ngomkhiqizo osekelwe eketshezini, qaphela ukuthi ungawudluli umthamo onconyiwe, ikakhulukazi uma kukhulunywa ngamavithamini ancibilika kumafutha afana no-A no-D noma amaminerali afana nensimbi. Ukwengeza ngokweqile kungaba yingozi.

Abesifazane abakhulelwe noma abahlelela ukukhulelwa abacabanga lezi zici basendaweni engcono yokukhetha uhlelo lokwengeza ukudla kwangaphambi kokubeletha oluhambisana nezinhloso zabo zezempilo, okuthandwa kwabo, nemikhuba yabo yansuku zonke.

Imihlahlandlela Yesimanje evela Egunyeni Lezempilo

Imihlahlandlela yakamuva igcizelela ukwenza uhlelo lokudla kwangaphambi kokubeletha luhambisane nesidingo somuntu ngamunye. Ngokwesibonelo, i-American College of Obstetricians and Gynecologists (ACOG) ikhuthaza ukudla okucebile ngokusanhlamvu okuphelele, izithelo, imifino, amaprotheni anokuncane kwamafutha, nobisi noma okuthatha indawo kobisi—kanye nezithasiselo uma kudingeka. Sekuya kuvunywa kabanzi ukuthi ukukhulelwa kushintsha ngokushesha ukusuka kwikota eyodwa kuya kwelinye, nezidingo zezakhamzimba zishintshe kanye nalokho. Kuze kube ngu-2025, izithasiselo eziseketshezinini azikakashintshi ngokusemthethweni amaphilisi endabuko emihlahlandleleni esemthethweni, kodwa seziqashelwe njengomunye umuthi osebenzayo kulabo abangakwazi ukubekezelela amaphilisi.

Inhlangano Yezempilo Emhlabeni (WHO) iphinde igcizelele ukubaluleka kokuhlangabezana nezidingo zansuku zonke zezakhamzimba, ikakhulukazi ezindaweni lapho ingozi yokungondleki kwamalunga omama noma isifo sokushoda ngegazi iphezulu. Isikhundla sabo siyaguquguquka mayelana nohlobo oluqondile lokwengeza ukudla, begxile kakhulu ekuqinisekiseni umthamo ofanele. Ngokuhambisana nalo mkhuba, odokotela bezempilo beluleka abesifazane ukuthi bacabangele ukudla kwabo, indlela yabo yokuphila, nanoma yiziphi izingqinamba abazibhekene nazo lapho bekhetha uhlelo lokwengeza ukudla kwangaphambi kokubeletha.

Izakhamzimba Ezikhethekile: DHA ne-Choline

Nakuba abantu abaningi behlobanisa kakhulu ukwengeza ukudla kwangaphambi kokubeletha namavithamini namaminerali, kukhona nezinye izakhi ezingaba nzima ngokufanayo. I-DHA (docosahexaenoic acid) isithole indawo ekhethekile ezingxoxweni eziphathelene nokuthuthuka kobuchopho bombungu. I-Choline nayo isisendaweni ekhanyayo, kukholakala ukuthi isekela ukusebenza kwengqondo ezinganeni nezinga elinempilo lokusebenza kwesibindi kubantu abakhulelwe.

Lezi zinto zingase zihlanganiswe eminye imikhiqizo yesimanje yabesifazane abakhulelwe esekelwe koketshezi. Uma uthola ukuthi ukudla kwakho kwansuku zonke akunayo inhlanzi enonile noma ezinye izinhlobo zokudla ezinothe nge-DHA, futhi ungathathi uwoyela wenhlanzi ohlukile noma izithasiselo ezenziwe nge-algae, inhlanganisela yabesifazane abakhulelwe ewuketshezi equkethe lezi zinto ingaba wusizo.

Indima Yokudla Kwasekhaya Nendlela Yokuphila

Izithasiselo, kungakhathaliseki uhlobo lwazo, zihloselwe ukweseka kunokuthatha indawo yokudla okulinganiselayo. Abesifazane kufanele baqhubeke bekwenza kubaluleke kakhulu ukudla ukudla okunomsoco omningi, okuhlanganisa izinhlobo ezahlukene zezithelo nemifino, amaprotheni avela ezitshalweni njengobhanana ne-lentils, inyama engenamafutha, kanye nezinhlamvu eziphelele. Umsebenzi womzimba ojwayelekile ofanele isigaba ngasinye sokukhulelwa—ngokuholwa uchwepheshe wezokwelapha—uphinde ulethe umthelela empilweni yonke futhi ungathuthukisa indlela imisoco eguqulwa ngayo emzimbeni.

Ukugcina umzimba unamanzi naye ubaluleke ngendlela efanayo, ikakh especially ngesikhathi sokukhulelwa. Amanzi asiza ukuthutha imisoco amaselula futhi asize ekugcineni izinga elifanele loketshezi lwesibeletho (amniotic fluid). Uma isithasiselo esiwuketshezi siyingxenye yohlelo lwakho lwansuku zonke, ukuqinisekisa ukuthi uphuza amanzi njalo kungavimbela noma yikuphi ukungakhululeki kokugaya ukudla okungase kuvele ngenxa yensimbi noma amanye amaminerali akhona kuleyo nhlanganisela.

Ukudlula Ekuzondeni Kokudla Nasesicanucaneni Sasekuseni

Isicanucanu nokuhlanza ekuqaleni kokukhulelwa kuyizithiyo ezivamile ezingadala ukuthi umqondo wokugwinya noma yini ubonakale ungenabumnandi. Uketshezi olunokunambitheka okuthambile noma okususelwa ekunambithekeni kwemvelo kwesinye isikhathi luba lula ukulubekezelela kunamaphilisi. Abanye omama bayabona impumelelo ngokwehlukanisa umthamo ususwe usuku lonke ukuze banciphise imiphumela emibi. Isibonelo, isigamu somthamo ekuseni kanti esinye isigamu ngesikhathi sokudla kwasebusuku singasiza ukunciphisa ukungakhululeki esiswini.

Kuphinde kufanele ukushiwo nokuthi izinhlobo zensimbi ezithambile kakhudlwana, njenge-iron bisglycinate, ezitholakala kwesinye isikhathi emikhiqizweni ewuketshezi, zinganciphisa imiphumela emibi esiswini uma kuqhathaniswa ne-ferrous sulfate. Ukuhlola uhlobo lwensimbi oluqukethwe kunoma yiluphi uhlobo lwezithasiselo kuwukuhlakanipha, ikakh especially kulabo abanezisu ezizwelayo [6].

Kwabomama abalindele izingane abahlushwa isicanucanu, i-Conceive Plus Morning Sickness Relief inikeza isixazululo esingokwemvelo nesiphephile, esisebenzisa amandla ejinja ukunciphisa ukungakhululeki nokwenza ukukhulelwa kube lula ukuphatha.

Amaphuzu Okuxoxa Nomhlinzeki Wakho Wezokunakekelwa Kwempilo

Ngaphambi kokwethula uhlelo olusha olusekelwe koketshezi, xoxa ngokukhululekile nodokotela wakho, umbelethisi, noma udayithishini. Amaphuzu okungaxoxwa ngawo afaka:

• Imiphumela Yamanje Yezivivinyo Zaselabhorethri: Hlola izinga lensimbi, i-vitamin D, nanoma yiziphi ezinye izinto ezibalulekile ekudleni.
• : Uma uke waba nesifo se-anemia noma unenkinga yomfutho wegazi, ukuhlela uhlelo lwakho lwezinsiza zokudla okunomsoco ngendlela ekhethekile kubaluleke kakhulu.Izimo zangaphambilini
• Ukusebenzisana kwemithi: Ezinye izidakamizwa ezibhalwe udokotela zingaphazamisa ukumuncwa kokudla okunomsoco, okwenza ukuthi isikhathi ozithatha ngaso noma uhlobo lwazo olukhethiwe kube kubalulekile kakhulu.
• Isu Sesikhathi Eside: Njengoba ukukhulelwa kuqhubekela esigabeni sangemva kokubeletha, izidingo zokudla okunomsoco ziyashintsha futhi. Ukuhlela kusenesikhathi kungalulula lolu shintsho futhi kusekele ukubuyiselwa esimeni sangemva kokubeletha.

Ingxoxo eningiliziwe enjena iqinisekisa ukuthi ukhetha ifomula nemthamo ohambisana ngempela nendlela ophila ngayo nesimo sempilo yakho.

Okubalulekile

Ukuqala ukukhulelwa kudinga ukunaka ngokucophelela impilo yonke yomzimba. Kwezinye omama abakhulelwayo, amayivithamini okukhulelwa anguketshezi angaba inketho ehehayo ehlanganisa ukuvikeleka ekuguquguqukeni, ubulula bokuwaphuza, kanye nethuba lokuwahlela ngendlela okudingayo. Okubaluleke kunakho konke, ukuthola umkhiqizo wekhwalithi ephezulu, ukuqinisekisa iphrofayili yawo yokudla okunomsoco, nokufuna iseluleko kudokotela noma uchwepheshe omethembayo kungaholela emiphumeleni engcono kanye nolwazi lokukhulelwa olunethezeke kakhulu.

Izinkomba

1. Purandare CN. Maternal nutritional deficiencies and interventions. J Obstet Gynaecol India. 2012 Dec;62(6):621-3. doi: 10.1007/s13224-013-0347-9. PMID: 24293835; PMCID: PMC3575894.
2. Kadir M, Hood RB, Mínguez-Alarcón L, Maldonado-Cárceles AB, Ford JB, Souter I, Chavarro JE, Gaskins AJ; EARTH Study Team. Folate intake and ovarian reserve among women attending a fertility center. Fertil Steril. 2022 Jan;117(1):171-180. doi: 10.1016/j.fertnstert.2021.09.037. Epub 2021 Nov 19. PMID: 34809974; PMCID: PMC8714696.
3. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 14, Iron Nutrition During Pregnancy. Available from: https://nap.nationalacademies.org/read/1451/chapter/16
4. Dragomir RE, Toader OD, Gheoca Mutu DE, Stănculescu RV. The Key Role of Vitamin D in Female Reproductive Health: A Narrative Review. Cureus. 2024 Jul 28;16(7):e65560. doi:10.7759/cureus.65560. PMID: 39071069; PMCID: PMC11283644.
5. Stanhiser J, Jukic AMZ, McConnaughey DR, Steiner AZ. Omega-3 fatty acid supplementation and fecundability. Hum Reprod. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9308390/
6. Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011 Jun;40(2):309-34, vii. doi: 10.1016/j.gtc.2011.03.009. PMID: 21601782; PMCID: PMC3676933