Nutrition Before and During Pregnancy

It is ideal to assess a woman’s nutritional status before pregnancy so she can adopt a healthy diet to optimize maternal and child wellness before conception. Ongoing assessment and dietary modifications are appropriate across pregnancy and during lactation.

The key components of a healthy lifestyle during pregnancy include appropriate weight gain, appropriate physical activity, consumption of a variety of foods in appropriate amounts of vitamin and mineral supplementation, avoidance of alcohol, tobacco, and other harmful substances, as well as food handling safety.

Will I need to change the way I eat when I am pregnant?

You will probably need to change the way you eat before you get pregnant. You will also need to start taking a multivitamin that has folic acid in it. Women of reproductive potential should take a multivitamin containing 0.4 to 0.8 mg of folic acid.

If you want to get pregnant, see your doctor before you start trying. He or she will explain how your diet needs to change and outline the steps you can take to have the healthiest pregnancy possible.

Eating the wrong foods could harm your baby. For example, if you eat cheese made from unpasteurized milk or raw or undercooked meat, you could get an infection that could lead to a miscarriage. Likewise, if you take too much vitamin A (more than 10,000 international units a day) in a vitamin supplement, your baby could be born with birth defects. Making healthy food choices is also important for your health as a mother. As your baby grows and changes inside you, it will take nutrients from your body. You will have to replace these nutrients to stay healthy and have all the energy you need. Women with metabolic diseases (eg, diabetes mellitus, phenylketonuria) should try to normalize abnormal metabolite levels to minimize adverse effects on the fetus. These women should have formal nutritional counseling during the preconception period.

Which foods should I eat?

• Ensure that you eat a variety of different foods to get the right balance of nutrients for your growing baby and for your body to deal with the changes taking place.
• Fresh fruits, vegetables and whole grains
• Low-fat dairy products. If you do not get enough dairy intake, you will need to obtain calcium from other sources. The recommended daily allowance for elemental calcium is 1000 mg per day, with at least 250 mg being taken.
• Sources of protein, such as meat, fish, eggs, or dried peas or beans.
• If you are a vegetarian, speak to a nutritionist (food expert) about your food choices. Vegetarian diets can sometimes be missing nutrients that are important for a growing baby.

Prepare some health snacks between meals in case you are hungry.

Which foods should I avoid?

You should avoid certain types of fish and all forms of alcohol. You should also limit the amount of caffeine in your diet, and check with your doctor before taking herbal products.

●Fish – You should not eat types of fish that could have a lot of mercury in them. These include shark, swordfish, king mackerel, and tilefish. Mercury is a metal that can keep the baby’s brain from developing normally.

You can eat types of fish that do not have a lot of mercury, but not more than 2 times a week. The types of fish and other seafood that are safe to eat 1 or 2 times a week include shrimp, canned light tuna, salmon, pollock, and catfish.

Check with your doctor about the safety of fish caught in local rivers and lakes.

●Alcohol –Alcohol increases the risk of miscarriage or may lead to fetal alcohol syndrome, resulting in severe abnormalities in your baby. Pregnant women should avoid drinking alcohol.

●Caffeine – Limit the amount of caffeine in your diet by not drinking more than 1 or 2 cups of coffee each day. Tea and cola also have caffeine, but not as much as coffee. Caffeine is a stimulant that is found in tea, coffee and soft drinks. Too much caffeine should be avoided as it can pass through the placenta and may affect your baby.

Drugs and medication

Taking drugs during pregnancy is not recommended as it may seriously harm you and your baby. Over-the-counter medicines and herb products should also be avoided.

Follow your doctor’s advice regarding any and all medication you take.

Smoking

When you smoke, carbon monoxide, nicotine and other toxic chemicals cross the placenta directly into the baby’s blood stream, meaning that the baby smokes with you. Stop smoking to give your baby a healthy start in life.

Should I prepare food differently?It is important to prepare and cook your food carefully to prevent food poisoning. Avoid uncooked fish, meat, eggs and soft cheese.Here’s what you should do to avoid germs in your food:

●Wash your hands well with soap and water before you handle food.

●Make sure to fully cook fish, chicken, beef, eggs, and other meats.

●Rinse fresh fruits and vegetables under lots of running water before you eat them.

●When you are done preparing food, wash your hands and anything that touched raw meat or deli meats with hot soapy water. This includes counter tops, cutting boards, and knives and spoons.

What are prenatal vitamins?

Prenatal vitamins are vitamin supplements that you take the month before and all through your pregnancy. These vitamins, which also contain minerals (iron, calcium), help make sure that your baby has all the building blocks he or she needs to form healthy organs. Prenatal vitamins help lower the risk of birth defects and other problems.

You can buy prenatal vitamins from a store or pharmacy. Choose a multivitamin that’s labeled “prenatal” and that has at least 400 micrograms of folic acid. Folic acid is especially important in preventing certain birth defects. Show your doctor the vitamins you plan to take to make sure the doses are right for you and your baby. Too much of some vitamins can be harmful, such as vitamin A. Your doctor can also prescribe a prenatal vitamin for you. Prescription vitamins often have more of some vitamins and minerals than the ones found in stores. For example, your doctor might give you a prescription if he or she thinks you need extra iron. It’s important to get enough iron while you’re pregnant. Iron is one of the important elements to develop baby’s brain and hematopoietic system. Any other supplements should only be taken after checking with your physician. If you require more advice about your diet, your physician can refer you to a dietitian.

How much weight should I gain?

That will depend on how much you weigh at the beginning of pregnancy. Your doctor will tell you how much weight gain is right for you. In general, a woman who is a healthy weight should gain 25 to 35 pounds during her pregnancy. A woman who is overweight or obese should gain less weight.If you start to lose weight, for example, because you have severe morning sickness, call your doctor.

The following are the recommendations from Institute of Medicine(IOM) for single pregnancy:

•Body mass index (BMI) <18.5 kg/m2 (underweight) – weight gain 28 to 40 lbs (12.5 to 18.0 kg)

1 to 4 Ibs(0.5 to 2kg) over the first trimester and about 1Ib(0.5kg)/week thereafter

•BMI 18.5 to 24.9 kg/m2 (normal weight) – weight gain 25 to 35 lbs (11.5 to 16.0 kg)

1 to 4 Ibs(0.5 to 2kg) over the first trimester and about 1Ib(0.5kg)/week thereafter

•BMI 25.0 to 29.9 kg/m2 (overweight) – weight gain 15 to 25 lbs (7.0 to 11.5 kg)

1 to 4 Ibs(0.5 to 2kg) over the first trimester and about 0.5Ib(0.25kg)/week thereafter

•BMI ≥30.0 kg/m2 (obese) – weight gain 11 to 20 lbs (5 to 9.0 kg)

1 to 4 Ibs(0.5 to 2kg) over the first trimester and about 0.5Ib(0.25kg)/week thereafter

If you have any concern or worry about the food you are taking, discuss with your doctor for further information.