September 23rd 2009 - Diet & Nutrition
To eat well during pregnancy you must do more than simply increase how much you eat. You must also consider what you eat. Although you need about 300 extra calories a day - especially later in your pregnancy, when your baby grows quickly - those calories should come from nutritious foods so they can contribute to your baby's growth and development.
Why It's Important to Eat Well When You're Pregnant
Do you wonder how it's reasonable to gain 25 to 35 pounds (on average) during your pregnancy when a newborn baby weighs only a fraction of that? Although it varies from woman to woman, this is how those pounds may add up:
• 7.5 pounds - average baby's weight
• 7 pounds - your body's extra stored protein, fat, and other nutrients
• 4 pounds - your extra blood
• 4 pounds - your other extra body fluids
• 2 pounds - breast enlargement
• 2 pounds - enlargement of your uterus
• 2 pounds - amniotic fluid surrounding your baby
• 1.5 pounds - the placenta
Of course, patterns of weight gain during pregnancy vary. It's normal to gain less if you start out heavier and more if you're having twins or triplets - or if you were underweight before becoming pregnant. More important than how much weight you gain is what makes up those extra pounds.
When you're pregnant, what you eat and drink is the main source of nourishment for your baby. In fact, the link between what you consume and the health of your baby is much stronger than once thought. That's why doctors now say, for example, that no amount of alcohol consumption should be considered safe during pregnancy.
The extra food you eat shouldn't just be empty calories - it should provide the nutrients your growing baby needs. For example, calcium helps make and keep bones and teeth strong. While you're pregnant, you still need calcium for your body, plus extra calcium for your developing baby. Similarly, you require more of all the essential nutrients than you did before you became pregnant.
A Nutrition Primer for Expectant Mothers
Whether or not you're pregnant, a healthy diet includes proteins, carbohydrates, fats, vitamins, minerals, and plenty of water. The U.S. government publishes dietary guidelines that can help you determine how many servings of each kind of food to eat every day. Eating a variety of foods in the proportions indicated is a good step toward staying healthy.
Food labels can tell you what kinds of nutrients are in the foods you eat. The letters RDA, which you find on food labeling, stand for recommended daily allowance, or the amount of a nutrient recommended for your daily diet. When you're pregnant, the RDAs for most nutrients are higher.
Here are some of the most common nutrients you need and the foods that contain them:
Nutrient Needed for Best sources
Protein cell growth and blood production lean meat, fish, poultry, egg whites, beans, peanut butter, tofu
Carbohydrates daily energy production breads, cereals, rice, potatoes, pasta, fruits, vegetables
Calcium strong bones and teeth, muscle contraction, nerve function milk, cheese, yogurt, sardines or salmon with bones, spinach
Iron red blood cell production (needed to prevent anemia) lean red meat, spinach, iron-fortified whole-grain breads and cereals
Vitamin A healthy skin, good eyesight, growing bones carrots, dark leafy greens, sweet potatoes
Vitamin C healthy gums, teeth, and bones; assistance with iron absorption citrus fruit, broccoli, tomatoes, fortified fruit juices
Vitamin B6 red blood cell formation; effective use of protein, fat, and carbohydrates whole-grain cereals, bananas
Vitamin B12 formation of red blood cells, maintaining nervous system health meat, fish, poultry, milk
(Note: vegetarians who don't eat dairy products need supplemental B12)
Vitamin D healthy bones and teeth; aids absorption of calcium fortified milk, dairy products, cereals, and breads
Folic acid blood and protein production, effective enzyme function green leafy vegetables, dark yellow fruits and vegetables, beans, peas, nuts
Fat body energy stores meat, whole-milk dairy products, nuts, peanut butter, margarine, vegetable oils
(Note: limit fat intake to 30% or less of your total daily calorie intake)
Scientists know that your diet can affect your baby's health - even before you become pregnant. For example, recent research shows that folic acid helps prevent neural tube defects (including spina bifida) from occurring during the earliest stages of fetal development - so it's important for you to consume plenty of it before you become pregnant and during the early weeks of your pregnancy.
Even though lots of foods, particularly breakfast cereals, are fortified with folic acid, doctors now encourage women to take folic acid supplements before and throughout pregnancy (especially for the first 28 days). Be sure to ask your doctor about folic acid if you're considering becoming pregnant.
Calcium is another important nutrient for pregnant women. Because your growing baby's calcium demands are high, you should increase your calcium consumption to prevent a loss of calcium from your own bones. Your doctor will also likely prescribe prenatal vitamins for you, which contain some extra calcium.
Your best food sources of calcium are milk and other dairy products. However, if you have lactose intolerance or dislike milk and milk products, ask your doctor about a calcium supplement. (Signs of lactose intolerance include diarrhea, bloating, or gas after eating milk or milk products. Taking a lactase capsule or pill, or using lactose-free milk products may help.) Other calcium-rich foods include sardines or salmon with bones, tofu, broccoli, spinach, and calcium-fortified juices and foods.
Doctors don't usually recommend starting a strict vegan diet when you become pregnant. However, if you already follow a vegetarian diet, you can continue to do so during your pregnancy - but do it carefully. Be sure your doctor knows about your diet. It's challenging to get the nutrition you need if you don't eat fish and chicken, or milk, cheese, or eggs. You'll likely need supplemental protein and may also need to take vitamin B12 and D supplements. To ensure that you and your baby receive adequate nutrition, consult a registered dietitian for help with planning meals.
What Do Food Cravings During Pregnancy Mean?
You've probably known women who craved specific foods during pregnancy, or perhaps you've had such cravings yourself. Researchers have tried to determine whether a hunger for a particular type of food indicates that a woman's body lacks the nutrients that food contains. Although this isn't the case, it's still unclear why these urges occur.
Some pregnant women crave chocolate, spicy foods, fruits, and comfort foods, such as mashed potatoes, cereals, and toasted white bread. Other women crave non-food items, such as clay and cornstarch. The craving and eating of non-food items is known as pica. Consuming things that aren't food can be dangerous to both you and your baby. If you have urges to eat non-food items, notify your doctor.
But following your cravings is fine, as long as you crave foods and these foods contribute to a healthy diet. Frequently, these cravings diminish about 3 months into the pregnancy.
What Should You Avoid Eating and Drinking During Pregnancy?
As mentioned earlier, avoid alcohol. No level of alcohol consumption is considered safe during pregnancy. Also, check with your doctor before you take any vitamins or herbal products. Some of these can be harmful to the developing fetus.
And although many doctors feel that one or two 6- to 8-ounce cups per day of coffee, tea, or soda with caffeine won't harm your baby, it's probably wise to avoid caffeine altogether if you can. High caffeine consumption has been linked to an increased risk of miscarriage, so limit your intake or switch to decaffeinated products.
When you're pregnant, it's also important to avoid food-borne illnesses, such as listeriosis and toxoplasmosis, which can be life-threatening to an unborn baby and may cause birth defects or miscarriage. Foods you'll want to steer clear of include:
• soft, unpasteurized cheeses (often advertised as "fresh") such as feta, goat, Brie, Camembert, and blue cheese
• unpasteurized milk, juices, and apple cider
• raw eggs or foods containing raw eggs, including mousse and tiramisu
• raw or undercooked meats, fish, or shellfish
• processed meats such as hot dogs and deli meats (these should be well-cooked)
If you've eaten these foods at some point during your pregnancy, try not to worry too much about it now; just avoid them for the remainder of the pregnancy. If you're really concerned, talk to your doctor.
You'll also want to avoid eating shark, swordfish, king mackerel, or tilefish, as well as limit the amount of other kinds of fish that you eat. Although fish and shellfish can be an extremely healthy part of your pregnancy diet (they contain beneficial omega-3 fatty acids, and are high in protein and low in saturated fat), these types of fish may contain high levels of mercury. Because mercury can cause damage to the developing brain of a fetus or growing child, the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) say that these fish should not be eaten at all by pregnant women, women who may become pregnant, nursing mothers, and young children.
Mercury, which occurs naturally in the environment, can also be released into the air through industrial pollution and can accumulate in streams and oceans where it turns into methylmercury in the water. The methylmercury builds up in fish, especially larger fish that eat other smaller fish.
If you're pregnant and eat shark, swordfish, king mackerel, or tilefish, even occasionally, it's a good idea to stop. Although almost all fish and shellfish contain small amounts of mercury, you can enjoy some with lower mercury levels (shrimp, canned light tuna, salmon, pollock, and catfish) in moderation (no more than 12 ounces a week, say the FDA and EPA). Because albacore (or white) tuna or tuna steaks are higher in mercury than canned light tuna, it's recommended that you eat no more than 6 ounces a week.
Avoiding Some Common Problems
Because the iron in prenatal vitamins and other factors may cause constipation during pregnancy, it's a good idea to consume more fiber than you did before you became pregnant. Try to eat about 20 to 30 grams of fiber a day. Your best sources are fresh fruits and vegetables and whole-grain breads, cereals, or muffins.
Some people also use fiber tablets or drinks or other high-fiber products available at your pharmacy, but check with your doctor before trying them. (Don't use laxatives while you're pregnant unless your doctor advises you to do so. And avoid the old wives' remedy - castor oil - because it can actually interfere with your body's ability to absorb nutrients.)
If constipation is a problem for you, your doctor may prescribe a stool softener. Be sure to drink plenty of fluids, especially water, when increasing fiber intake, or you can make your constipation worse. One of the best ways to avoid constipation is to get more exercise. You should also drink plenty of water between meals each day to help soften your stools and move food through your digestive system. Sometimes hot tea, soups, or broth can help. Also, keep dried fruits handy for snacking.
Some pregnant women find that broccoli, spinach, cauliflower, and fried foods give them heartburn or gas. You can plan a balanced diet to avoid these foods. Carbonated drinks also cause gas or heartburn for some women, although others find they calm the digestive system.
If you're frequently nauseated, eat small amounts of bland foods, like toast or crackers, throughout the day. If nothing else sounds good, try cereal with milk or a sweet piece of fruit. To help combat nausea, you can also:
• Take your prenatal vitamin before going to bed after you've eaten a snack - not on an empty stomach.
• Eat a small snack when you get up to go to the bathroom early in the morning.
• Suck on hard candy.
How Can You Know If You're Eating Well During Pregnancy?
The key is to eat foods from the different food groups in approximately the recommended proportions. If nausea or lack of appetite cause you to eat less at times, don't worry - it's unlikely to cause fetal harm because your baby gets first crack at the nutrients you consume. And although it's generally recommended that a woman of normal weight gain approximately 25 to 35 pounds during pregnancy (most gain 4 to 6 pounds during the first trimester and 1 pound a week during the 2nd and 3rd trimesters), don't fixate on the scale. Instead, focus on eating a good variety and balance of nutritious foods to keep both you and your baby healthy.
Birth in the Tradition/ Mother's Keeper
Atlanta, GA 30349