Before Pregnancy

Planning for a healthy baby occurs well before a family is ready to conceive. Those who are considering pregnancy should investigate up to one year in advance the steps needed to ensure the healthiest possible pregnancy.

Pre-Pregancy Actions:

Understand Your Medical History

A parents medical history can be a signficiant indicator of Autism risk.  Many studies indicate that individuals with a history of autoimmune disorders, diabetes, infections or allergies are at a greater risk of having a child on the autism spectrum.

In one study, 46% of families with autistic children have two or more of their family members with autoimmune diseases. These diseases consisted of Type 1 diabetes, adult-onset rheumatoid arthritis, hypothyroidism and lupus.1 Most autoimmune diseases cause inflammation and controlling inflammation can help prevent possible damage to the fetus.

Medical history is a critical component to pre-pregnancy, pregnancy and the future child’s health. In addition, the parents medical history should be shared with the pediatrician to identify symptoms that may indicate problems with the newborn's immune system.

 

Find the Right Medical Provider

There are many types of medical providers for expecting parents ranging from OBGYN, Nurse Practitioner, Certified Nurse Midwife to a Licensed Midwife.

To find the right fit reseach should include a background check, speaking with former clients (if available) and interviews. It’s also possible to form a team of providers across all diciplines. A reccomended and vetted listing of medical professionals is available at our Find a Doctor page.

 

Lower your BMI:

Obesity in pregnancy can carry multiple risk factors that endanger the baby. Women should try to have a BMI of 21-29 prior to conception. It is not recommended to diet directly before conceiving but to work with a nutritionist or registered dietitian (RD) well in advance to lose the weight in a healthy, nutrition building fashion.2

 

Stop using the pill:

Discontinue use of the contraceptive pill at least 3 months before pregnancy because it can interfere with absorption of Vitamin B6 and Zinc. A deficiency in B6 can cause anemia, neuritis, depression, dermatitis, renal calculi and possibly convulsions. Zinc is helpful in cell development, bone growth, wound healing, protein metabolism and unlocks stored vitamin A. Zinc requirements increase over 30% during pregnancy. Inadequate Zinc intake can increase severity of morning sickness and their babies can have low birthweight, born premature and have impaired immunity. With adequate Zinc levels the risk of stillbirth due to deficient nutrition decreases.2

 

Prenatal Testing:

These tests can be performed by a healthcare provider or purchased via an online lab test provider, such as MyMedLab.com. Online providers liase with local dotors to verify the lab tests and provide prescriptions for testing.  Results are available in a secure online environment with the ability to fax to your chosen doctor or get medical advice from a doctor or nurse on call.

Genetic testing, TORCHS panels (detection of toxoplasmosis, rubella, cytomegalovirus, Herpes Simplex, HIV and syphilis) and obstetric exam is part of a regular prenatal visit with your physician or other medical professional.2.2 This testing should not replace good prenatal care.

These suggested Prenatal Testing Panels were designed to help find and target illness and nutritional deficiencies that could create complications during pregnancy. Testing is for the father and mother including blood type, nutritional deficiencies, thyroid status, and exposures to toxins/medications. These tests can be done anywhere between 3 months to 1 year before conception.3

  • Journal of Neurological Sciences, Roman 2007 talks about Thyroid Deficiency in Pregnancy: "transient intrauterine deficits of thyroid hormones result in permanent alterations of cerebral cortical architecture reminiscent of those observed in brains of patients with autism" which suggested that the "current stage of autism could be related to transient maternal hypothyroxinemia resulting from dietary and/or environmental exposure to antithyroid agents". These agents include mercury, fluoride, coal derivatives and PCB's. 4
  • The American Journal of Clinical Nutrition, Hollis and Wagner's  2006 editorial discusses Vitamin D deficiency in pregnancy as an "ongoing epidemic" that isn't linked just to bone formation. Studies have shown that "vitamin D is linked to fetal "imprinting" that may affect chronic disease susceptibility later in life as well as soon after birth". This vitamin D deficiency has also been linked to several autoimmune diseases like MS and rheumatoid arthritis. To correct a deficiency the nutritional intake of vitamin D must reach equal to or greater than 2000 IU/d.5

Additional Suggested Prenatal Panels:

For Both Mother and Father Pre-conception (3 months to 1 year prior):

  • CBC, Chem Panel
  • Serum Ferritin
  • Serum Iron
  • Vitamin D3 25 hydroxy
  • Blood type ABO/Rh
  • If diabetes risk: HbA1C, GGT
  • If cardiac risk: CRP

For Mother Pre-conception (3 monoths to 1 year prior):

  • Thyroid, Free T3, Free T4, TSH
  • Vaccine Titers: Rubella, Varicella
  • Genetic testing is done thru your physician according to state
  • Hep B, Syphilis, HIV
  • Blood Type ABO Rh
  • Diabetes screen HbA1c

Nutrition Testing Pre-pregnancy

  • Zinc
  • Organic Acid Test (OAT)
  • Comprehensive Stool
  • Food Allergy IgG, IgE
  • Celiac Blood Panel
  • Porphyrin Urine
  • Serum A, D, E, K
  • RBC mineral panel
  • Opiate Peptide Urine
  • Adrenal profile for cortisol and DHEA

 

Food Allergies and Intolerances:

Allergies are sensitivities to one or more substances that can be eaten, touched or inhaled and are often times referred to as allergens.  Allergies are inherited or a predisposition to an allergen is passed down from the parent to the child. The more allergic a parent, the sooner the onset of the symptoms of allergies. Studies have shown that if the parents are allergic to a substance, the child will have a 75 to 100 percent chance of having the same allergy. If neither parent has allergies the chanced of the child having allergies drops to 10 percent.6

In some cases the child still has severe allergies with both parents having no history or allergic reactions. This can be explained by several factors. The parents had an illness or disease, the mom was exposed to poor nutrition, drugs or alcohol, radiation, contracted a virus or bacterial infection or suffered from severe stress. These factors can cause the genes to mutate instead of developing normally, so what should have been a low allergy genetic code was changed into an imbalanced genetic code that creates high rates of allergies, sensitivies which can lead to a variety of other disease states.6

Allergies occur because the immune system has been weakend at some point in utero or after birth. There are mulitple studies showing that certain vaccines can alter the immune response causing an allergic reaction response to increase.7

Testing and treating allergies can be accomplished prior to connception. A healthcare provider can perform a  food allergy IgG, IgE panel for common food allergies. Once allergans are know, eliminating allergies from the diet can be accomplished. A nutritionist or other health care provider can also create a plan to eliminate allergies from the diet while treating with NAET.  Removing allergic foods from the diet will decrease the amount of inflammation leading to a healthier mother. NAET, Nambudripads Allergy Elimination Techniques, is a non–invasive allergy emination technique that uses all avenues of medicine, from all over the world to reduce inflammation, improve health and can reduce or emilinate food allergies or intolerances if done correctly by a qualified NAET certified practitioner.  As with any treatment, outcomes are dependant on the skills of the provider, the compliance of the patient and many other variables. Research and information along with providers can be found on www.naetautismtreatmentcenter.com.  Recently NAET was published in Integrative Medicine Vol. 10, No. 5 Oct/Nov 2011 issue about a research study showing the success of recovery in allergy induced autism.8

Another good resource for elimination diets is Julie Matthews, a Certified Nutritionist, books and prenatal seminars found at http://nourishinghope.com/.

 

Eat Healthy and Keep good Nutrition:

After determining the allergens and foods that need to be eliminated based on the results of the IgG and IgE allergy panels, as well as knowing vitamin and supplement deficiencies, a good nutrition plan should be implemented.  

Food choices vary by person, and nutrition plans will vary, but all will include eating a "clean" diet, free of chemicals and preservatives, organic fruits and veggetables and grass-fed meats. Most will also limit fish due to mercury content.

Consider consulting with a nutritionist and or Registered Dietician (RD) as they are very important in this phase of prevention. A great nutrition course, called Nutrition for Pregnancy by Julie Matthews focuses on prevention of autism is available online here: http://nutritionforpregnancy.com/

In addition to a good nutrition program, a supplement protocol should also be considered. Necessary amounts vary by patient and health history and a consultatition with a medical practitioner is highly recommened.

 

Vitamins:

Prentatal Vitaimins:

Prenatal Vitamins, a vegan/organic source is best. They are usually free from food dyes, wheat, gluten, milk, eggs, toxins and other allergens. A multi-dose option (1 capsule 2 times per day or 1 capsule 3 times per day read the label), helps to absorb the water soluable vitamins better and the levels stay more consistant in your system. 3

Calcium and Magnesium:

Calcium and Magnesium are very important in bone growth and hormone regulation. Magnesium in general can help with sulfation and detoxification while eliminating constipation and muscle fatigue or cramping.9

Fish Oils

Fish Oils, Omega 3's or essential fatty acids (EFA's) contribute to brain cell function, hormones and healthy neurotransmitters like serotonin. 9 

Vitamin D

Vitamin D is good for bone formation, hormone regulation, immune modulation and prevention of allergy and other inflammatory conditions. Additional vitamin D should be supplemented with prenatal vitamins because the RDA of 400IU is generally too low to maintain healthy levels.5

Probiotics

Powerful Probiotics of at least 50 to 100 billion CFU's help to build healthy bacteria to increase immune defense. 3

Zinc

Zinc can help with digestion, cognitive function and immune regulation. Zinc is often thought of as "No Zinc, No Think". 9In addition, Zinc is important in preventing viral replication.10

 

Supplements to Avoid or Limit

Some supplements should be avoided during pregnancy. Please consult with your medical practicioner on the following.

Vitamin A

Vitamin A is very important for the health of the mother and the baby but should be limited to no more than 8000IU – 10000IU per day.11

Any medications that contain sources of A like retinols (acne treatments) should be discontinued. Talk to your medical professional about all of your medications and supplements you are taking to make sure they are safe before, during and after pregnancy.

Visit the Teratology Society to learn more about possible side effects and research. http://teratology.org/

 

Uncover and Treat Yeast, Bacteria, Parasitic and Viral Infections:

Consult a medical practitioner to discover and treat any infections at least six months to a year before conceiving.

The body's inflammatory process should be evaluated before pregnancy with a simple stool test for yeast, bacteria and parasites. In addition with an immune panel blood test that looks for any present viruses and parasites. A heathcare practitioner will build a treatment regime based on the panel results.

The Yeast Beast:

Yeast is commonly seen as a vaginal yeast infection, but yeast can be in all parts of the body causing damage and inflammation.  Yeast overgrowth in the gastrointestinal tract can cause "leaky gut syndrome" which hinders the body's ability to digest foods correctly causing malabsorption, food intolerances and nutritional deficiencies.20

The Central Nervous System communicates with the GI tract via nerves sending important messages using neurotransmitters. Some research shows that 90% of serotonin (a very important neurotransmitter) is located in the GI tract.

Serotonin maintains a balanced mood and enhances the sleep cycle as a precursor to melatonin. Yeast, bacteria and other infections may damage nerves regulating serotonin causing mood destabilization that may result in depression, aggression and anxiety. With 80% of the of the immune system in the gastrointestinal tract yeast overgrowth can lead to autoimmune conditions.13

A yeast fighting plan usually consists of 1) A candida fighting diet such as the Specific Carbohydrate Diet (not to be used during pregnancy, just while fighting yeast) 2) Anti-fungal medications (either Rx or naturals) 3) Replinish the GI tract with a powerful probiotic at least 50-100 Billion cfu's.

When treated, yeast may release toxins during "die-off" and can be uncomfortable at times including loose stools, headaches and stomach pains. To help prevent this, slow down the yeast control program.

Clear up the Bacteria:

Maternal bacterial infections such as a UTI or infection of the placenta can cause an inflammatory response in the mother.14 Damage to the placenta can harm the fetal brain and can cause subsequent fetal mortality or neurodevelopmental defects. 15 1617

Treating any underlying bacterial infections present in a stool test before pregnancy is very important. During pregnancy the immune system is lowered so that the body does not reject the baby.  While pretecting the fetus, this may lead to complications for the mother if she has unresolved infections. Bacterial infections may be treated with antibiotics or natural remedies, such as Goldenseal. 3

Find and treat any Parasites:

Similar to other infections, parasites can be very dangerous to the fetus and one's general health.

There are a variety of parasites that can be found on a comprehensive stool test. Treatment is laid out according to type of parasite. Natural antiparasitic medications like Humaworm, Wormwood or eating a Garlic Clove.18

A parasite called toxoplasma gondii causes the disease toxoplasmosis. Most that become infected don't even know it because their immune system keeps them from showing side effects. This disease can be acquired anywhere in the world by eating undercooked meat, cat stool transmission, from child to parent. The CDC recommends testing before becoming pregnant. A positive test prior to pregnacy indicates previous infection and no further treatments or testing needs to be done for toxoplasmosis. If the test is negative, precautions such as hand washing, avoiding cat litter box cleaning, cooking foods to safe tempertures, washing fruits and vegetibles well, avoiding raw fish, wearing gloves during gardening and having younger children wash their hands well may prevent infection.

Toxoplasma testing is part of a routine prenatal blood test panel. Treatment is not usually needed before pregnancy, as it will clear on it's own. A doctor will treat toxoplasmosis during pregnancy only when a positive blood test is found with a prior negative result.19

The Viral Danger:

One proposed etiology for autism is prenatal or early infantile viral infections. The Central Nervous System (CNS) is not fully developed at birth and is more susceptible to viral damage.20

Viruses have been shown to hinder the development of the CNS in fetuses.

"Viral infections in pregnancy are major causes of maternal and fetal morbidity and mortality"21

These viruses can infect the fetus via the placenta during gestation, during the birthing process from blood or other secretions and from breast milk after the baby is born. The infection risk is related to the virus itself and the age when the baby was exposed, indicating the need for testing. 21

There are routine viral panels to test for these diseases. Preventing viral infections is complicated. Hand washing, diligent testing and good immune staus can help. Speaking with a medical professional about ways to find, treat and prevent viral infections is recommended.

Live a Non Toxic Lifestyle

Achieving a non-toxic life in today's world is almost imposible. Understanding what is toxic, how the particular toxins are harmful and how to avoid toxins will help reduce toxic intake.  

Reasonable home health improvements include: non-toxic paints, carpets, bedding, cleansers, aluminum free deodorants, soaps, non-aluminum cooking utensils and pans, stainless vs plastic water bottles, decrease electronic frequencies that contain radiation (EFMs) no cell phones next to bed or in your pocket, and decrease eletronics in the bedroom. 22

Use common sense, read labels and research the ingredients.

Studies have shown genes that each parent gives to the baby in the first early days of development, during "genomic imprinting" can be changed by environmental factors, altering the function of the gene for the fetus. This is called epigenetics. Epigentics is when a gene in our body is altered by an enviromental factor that changes the funtion of the gene but not the actual DNA sequence. 23

Genes can be changed due to a toxic enviornment, stressors, infections and other factors. Thus meaning it is not always the parent's genetic make-up that influenced the predisposition to autism or other developmental delays, it could be many other controllable factors.24

In the 1950's there were many papers on the role of early development, pregnancy, birth and it's effects on mental health, development and behavior of the child through their lifetime. These ideas weren't used again until the late 1990's where they showed a link between prenatal enviornment and metabolic and cardiovascular disorders.25

Additional information can be found on the following websites: 

The Environmental Working Group is the nation’s most effective environmental health research and advocacy organization. They offer information on the latest research in the fields of environmental health as well as listings for families to make safer choices in skincare, foods and household items.  - www.EWG.org.

Healthy Child Healthy World is a nonprofit organization that empowers parents to take action and protect children from harmful chemicals. They offer easy steps and resources towards healthier living.  http://healthychild.org/

Studies have shown that risks for potential off gassing and toxic chemicals may be linked to overall health issues, that concern led the makers of Intellibed to create a nontoxic mattress and pillows including the IntelliGEL technology.  To learn more and read the research visit http://www.intellibed.com/

Additional information can be found on the following websites;
The Environmental Working Group is the nation’s most effective environmental health research and advocacy organization. They offer information on the latest research in the fields of environmental health as well as listings for families to make safer choices in skincare, foods and household items.  - www.EWG.org
Healthy Child Healthy World is a nonprofit organization that empowers parents to take action and protect children from harmful chemicals. They offer easy steps and resources towards healthier living.  http://healthychild.org/

Studies have shown that risks for potential off gassing and toxic chemicals may be linked to overall health issues, that concern led the makers of Intellibed to create a nontoxic mattress and pillows including the IntelliGEL technology.  To learn more and read the research visit http://www.intellibed.com/

 

Avoid Mercury

There is a lot of focus on mercury and it's role in autism and other developmental disorders. Reasons for this are clear: Mercury has detrimental effects on the immune system, internal organ function and the brain. This has been proven is several instances including Pink's Disease caused by mercury based tooth powder. 18

Mercury is the world's second most neuro-toxic element.  Mercury is naturally occurring in the environment, but also occurs in man made sources such as the perservatives in vaccines, mercury in fish and dental amalgams.  During our history mercury was not properly disposed and it is now present in the soil and the ocean. Mercury that cannot succesfully be discarded by the body accumulates in fatty tissue and disrupts many of the body's natrural functions.  Symptoms of mercury toxicity range from sensory disorders, speech and hearing problems, cognitive issues, and unusual behaviors. 26

Avoidance of all known sources of mercury is vital prior to conception. It’s often suggested to avoid fish, any new dental amalgams with mercury or improper removal of them. Removal of amalgams should  be done at least one year before pregnancy. 3

Mercury chelation should  be done a few years in advance of becoming pregnant. Mercury chelation done safely and effectively in low-doses with proven medications that have documented half-lifes (the time the medication stays at the same level in the body) is not a quick and easy process. For more information and to talk with an expert in the field of chelation go to http://www.noamalgam.com/. Dr. Cutler will work with any medical doctor or other medical professional to help clarify treatments and help achieve safe and accurate removal.

For a listing of safe dentists go to http://www.holisticdental.org/find_holistic_dentist

Flu Shot:

The influenza vaccine has been shown to be ineffective in a large study of pregnant women. 27In an ongoing study published in 2009 and updated this year entitled "Vaccines for preventing influenza in healthy adults," scientists said they found no plausible substantiation that the flu vaccine prevented death or hospitalization from flu-related complications and only marginally reduced the number of days of lost work attributed to the illness. 28

Many integrative medical practicioners recommed avoiding the flu shot for at least a year prior to getting pregnant. 29

Research for yourself and make an informed decision. Safe Minds created a good resource for vaccine information awareness: www.smartvax.com

Stop using fluoride.

In the 1940's and 50's fluoride was added to drinking water believing it would help prevent tooth decay.  Modern research has since proven that fluoride has minimal benefit when taken internally and its ability to fight cavities when applied to teeth is being questioned. In fact, it has been shown to cause multiple problems including reducing intelligence in children, causing tooth defects called dental fluorosis and transporting other toxins such as lead from the water pipes across the blood brain barrier.30

Fluoride is an endocrine disruptor and can cause reduction in thyroid function in many individuals. 31 A study demonstrated that "transient" thyroid deficiency in pregnancy can result in permanent changes in the brain similar to those seen in autistic brains. The study goes on to suggest that the rise in autism cases could be linked to hypothyroidism of the mother due to environmental exposure of thyroid toxic agents. 4

Not only does fluoride damage teeth it can harm the nervous system, thyroid and multiple body systems. Use filtered water and find a fluoride free toothpaste.

Read more about fluoride on these links:

http://slweb.org/ftrc.html

http://www.fluoridealert.org/

http://nofluoride.com/

http://www.earthclinic.com/fluoride_questions_and_answers.php

 

1 Comi A, Zimmerman A, Frye V, et al. Familial clustering of autoimmune disorders and evaluation of medical risk factors in autism. J Child Neurol 14:388-394, 1999.

2 Burden & Jones (2011). Preconception Care. In S. Macdonald & J.Magill-Cuerden (Eds.), Mayes' Midwifery 14th Edition(Chapter 20). London, UK: Bailliere Tindall Elsevier.

2.2 Laake, D. (2009). Comprehensive Prenatal Nutrition. Defeat Autism Now Conference (pp. 131-142). Dallas: ARI, Autism Research Institute.

3 McCarthy & Kartzinel. (2009). Healing and Preventing Autism, A Complete Guide. New York, NY: Dutton.

4 Roman, G. (2007). Autism: Transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents . Journal of Neurological Sciences, 262(1-2), 60-70.

5 Hollis & Wagner (2006).Vitamin D deficiency during pregnancy: an ongoing epidemic. Am J Clin Nutrition, 84(2), 273.

8 Nambudripad, D. (2002). Say Goodbey to Illness, A Revolutionary Treatment for Allergies & Allergy Related Conditions (3rd ed.). Buena Park, CA: Delta Publishing Company.

7 Imani, F. & Kehoe, K. (2001). Infection of human B lymphocytes with MMR vaccine induces IgE class switching. Clinical Immunology, 100(3), 355-361.

8 Jacob Teitelbaum, MD; Devi S. Nambudripad, MD, PhD, DC, LAc; Yvonne Tyson, MD; Ming Chen, MD; Robert

Prince, MD; Mala M. Moosad, RN, LAc, PhD; Laurie Teitelbaum, MS. (2011) Improving Communication Skils in Children with Allergy Related Autism Using Nambudripads Allergy Elimination Techniques A Pilot Study. Integrative Medicine, 10(5), 36-43.

9 Bock, K., & Stauth, C. (2008). Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergies, The Ground Breaking Program for the 4-A Disorders. New York: Ballantine Books.

10 Korant, B., Kaurer, J., & Butterworth, B. (1974). Zinc ions inhibit replication of rhinoviruses Nature, 248 (5449), 588-590 DOI: 10.1038/248588a0

11 (1987) Teratology Society Position Paper: Recommendations For Vitamin A Use During Pregnancy TERATOLOGY 35:269–275

12 Matthews, J. (2008). Nourishing Hope for Autism, Nutrition Intervention for Healing Our Children (3rd Ed.). San Francisco, CA: NourisingHope.com.

13 DeFelice, K. (2006). Enzymes: Go with Your Gut, Nore Practical Guidelines for Digestive Enzymes. Bound, Minnesota:ThunderSnow Interactive.

14 Nelson, K.B., T. Change. (2008). Is cerebral palsy preventable? Curr.Opin Neurol. 21: 129-135.

15 Shalak, L.F. et al. (2002). Clinical chorioamnionitis, elevated cytokines and brain injury in term infants. Pediatrics, 110, 673-680.

16 Back, S.A. (2006). Perinatal white matter injury:the changing spectrum of pathology and emerging insights into pathogenetic mechanisms. Mentally Retarded Developmentally Disabled Res. Rev.,12, 129-140.

17 Volpe, J.J. (2009). Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurology, 8, 110-124.

18 Claire, R., Martin, J. & Taylor, T. (2012). Fight Autism and Win, Biomedical Therapies That Actually Work!. Rochester, NY: JRT Publishing.

19 Center of Disease Control. (2013). Parasites Toxoplasmosis General Information. Retrieved from http://www.cdc.giv/parasites/toxoplasmosis/gen_info/faqs.html

20 Prescott. (2010) Proceedings of the Nutrition Society, 69, 366-372

21 Marino et.al., Medscape Reference. (2012). Viral Infections and Pregnancy. Retrieved from http://emedicine.medscape.com/article/235213-overview

22 Evironmental Working Group. (2009). Pollution in Minority Newborns: 11 Healthy Pregnancy Tips. Retrieved from http://www.cdc.giv/parasites/toxoplasmosis/gen_info/faqs.html

23 Bressan FF, et al., (2009). Unearthing the Roles of Imprinted Genes in the Placenta, Placenta Journal doi:10.1016/j.placenta.2009.07.007

24 Groom A, Elliott HR, Embleton ND, et al. (2010). Epigenetics and Child Health Basic Principles. Archives of Diseases in Childhood doi:10.1136/adc.2009.165712

25 Barker, D.J., (1995). The fetal origins of adult disease. Proc. R. Soc. Lond. B Biol. Sci. 262, 37–43.

26 Cutler, A. (1999). Amalgam Illness diagnosis and treatment, What you can do to get better, How your doctor can help. (1st ed.). Sammamish, WA: www.noamalgam.com.

27 Black SB, Shinefield HR, France EK, et al. (2004). Effectiveness of the influenza vaccine during pregnancy in preventing hospitalizations and outpatient visits for respiratory illness in pregnant women and their infants. 21:333-339.

28 SmartVax.com. (2013). Vaccine Decisions to Make During Pregnancy. Retrieved from http://www.smartvax.com/index.php?option=com_content&view=article&id=143

29 Autism Research Institute. (2013). Minimizing Risks. Retrieved from http://www.autism.com/index.php/prevention

30 Xiang Q, et al. (2003a). Effect of fluoride in drinking water on children’s intelligence. Fluoride 36: 84-94; 198-199.

31 National Research Council. (2006). Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. National Academies Press, Washington D.C. p. 189-224.

32 Tiran, D. (2011). Nutrition. In S. Macdonald & J.Magill-Cuerden (Eds.), Mayes' Midwifery 14th Edition(Chapter 17). London, UK: Bailliere Tindall Elsevier.

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