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Nutritional advice for you and your baby while pregnant

Nutritional advice for you and your baby while pregnant

Information in this article is not intended to substitute speaking with your physician and receiving proper prenatal care.

We have all heard the overused phrase “you are what you eat,” but what does this mean when you are carrying a developing life? By consuming a balanced diet and receiving proper supplementation before and during pregnancy, you are optimizing a successful outcome for yourself and your baby. You have the tremendous opportunity to affect both the course and result of this pregnancy, so here are some of the basics for the next 280 days that can be discussed further with your physician.


Do

Do establish care with a physician you trust

Selecting a physician who specializes in obstetrics is the first step in preparing for and continuing to ensure optimal prenatal status. If you haven’t yet selected one, talk to friends, family members and coworkers to get recommendations, or speak with your primary care physician for suggestions. Find a physician you trust and are comfortable with and establish care with this physician. Address questions and concerns with this physician regularly and maintain appointments as scheduled by your physician. 

Do seek supplemental program assistance if needed

The Special Supplemental Nutrition Program for Women, Infants and Children (abbreviated as WIC) serves  participants (pregnant women, postpartum women (non-breastfeeding postpartum up to 6 months, breastfeeding postpartum up to 1 year), and children up to age 5) with the following criteria: low income, at nutritional risk and live in an area served by WIC. Please visit the USDA WIC site for additional information.

Do gain appropriate weight during your pregnancy

The Institute of Medicine has made recommendations for pregnancy weight gain based on your prepregnancy body mass index or BMI. It's calculated by weight divided by height and is as follows:

BMI

Recommended weight gain (pounds)

Underweight (<18.5)

28 to 40

Normal (18.5-24.9)

25 to 35

Overweight (25-29.9)

15 to 25

Obesity (>30)

Not defined (speak with physician)

Do focus on maintaining a balanced diet

A well-balanced diet is one which includes fruits, vegetables, whole and enriched grains, dairy, healthy fats, proteins and adequate fluids. Since the requirements for many nutrients (including fiber, protein, vitamins and minerals) increase during pregnancy, eating whole, unprocessed foods will contribute the most powerful nutritional punch. Only a select few are highlighted below.

Energy: Metabolism increases by 15 percent during pregnancy, meaning that your body will require additional calories. According to the 2002 DRIs,during the first trimester this may only be 10 calories, however during the second your body will required an additional 340 calories, and during the third trimester, an additional 112 calories (452 beyond your normal requirements).

Protein: Protein needs remain the same during the first half of pregnancy (RDA is 0.66g/kg/d). However, during the second half of pregnancy, protein needs increase to 71g/d. If it is a multiple pregnancy, this number increases 25g per fetus.

Fiber: The DRI for fiber in pregnancy is 25g/d. This can be obtained by consuming foods such as dried fruits, nuts, seeds, fresh fruits with skins, leafy vegetables, and whole grains.

Do ensure you are receiving adequate vitamin supplementation

Several vitamins have heightened recommendations during pregnancy, including folate and iron.

Folic Acid: For the prevention of neural tube defects, the RDA set for folic acid in pregnancy is 600mcg (DRI for non-pregnant women age 14-70+ is 400mcg). The Institute of Medicine recommends that 200mcg come from foods, but it is recommended that the remaining 400mcg be obtained via supplementation or folate-fortified foods. Speak with your physician about selecting the appropriate supplement.

Iron: The RDA for iron in pregnancy is 27mg/d (DRI for non-pregnant women age 19-50+ is 18mg).  Supplementation of 30mg daily iron supplementation is recommended during the seconnd and thirrd trimesters even for women consuming a balanced diet. Caution should be taken to avoid excess iron consumption. Speak with your physician about selecting the appropriate supplement.

Do engage in physical activity as recommended by your physician

Women who regularly engage in physical activity may continue these activities with the approval of their physician. The benefits of maintaining activity include improved fitness, reduction in stress and avoidance of gestational diabetes. Do not initiate a new or more rigorous exercise program while pregnant. Excessive exercise in combination with inadequate intake can lead to inadequate maternal weight gain during pregnancy. High altitudes should also be avoided secondary to compromised oxygen delivery to the fetus. The American College of Obstetricians and Gynecologists released guidelines several years ago stating that pregnant women should not have their heart beat exceed 140 beats per minute. (Desirable range is between 120-130 beats per minute.) Cycling, walking, and swimming are all options to be discussed with your physician.

Do effectively manage common complications in pregnancy

Common complications of pregnancy may begin to interfere with achieving optimal nutritional status.

Nausea and vomiting: Most women commonly experience nausea and vomiting during the first trimester. Morning sickness can occur anytime throughout the day. Try to consume small, frequent meals which include crackers or toast (easily digestible carbohydrates). If your nausea and vomiting get extremely bad, seek the attention of your physician.

Heartburn: Common later in pregnancy and the result of an enlarged uterus, try small, frequent meals and smaller meals prior to bed to help cope with this common complication.

Constipation: Ensure that you are drinking adequate fluids and consuming foods high in fiber such as whole grains, vegetables, legumes, fruits, nuts, seeds and high-fiber cereals.


Don't

Do not use drugs or alcohol

Honestly reveal to your physician if you have used drugs or alcohol recently or foresee avoidance during the pregnancy as potentially difficult. A referral for the appropriate treatment program or professional can be made to support you through your pregnancy. Alcohol (even in small amounts such as in cold medications or fermented beverages) is not recommended in pregnancy.  Fetal alcohol syndrome is associated with maternal alcohol consumption and is characterized by facial and skeletal abnormalities, developmental delay, microcephaly and growth failure.

Do not use herbs or medications without your physician's consent

Your physician must be made aware of all herbs and medications you are currently taking or considering taking during your pregnancy. The potential for adverse drug-nutrient interactions should be evaluated closely by a health practitioner.

Do not consume non-nutritive substances in foods such as caffeine and artificial sugars

Caffeine consumption may increase first trimester spontaneous abortions, and therefore it is recommended to limit consumption. Select decaf options and read labels carefully. Artificial sweeteners you may encounter in your foods or beverages in the US include saccharin (Sweet N low), sucralose (Splenda), or aspartame (NutraSweet, Equal). The research on artificial sweeteners and potential for complications is extremely limited and caution is advised consumption of products in excess that contain these sweeteners.

Do not consume seafood high in mercury

Consumptions of tuna, swordfish, mackerel, shark and tilefish should be limited to no more than two 4 oz portions weekly. A general rule of thumb is: the larger the fish and the closer to industrial areas, the higher the potential for mercury.

Do not consume unpasteurized or potentially contaminated foods

PCBs-Avoid fish that are high in PCBs (polychlorinated biphenyls) such as lake trout, carp and salmon.
Listeria- Listeria monocytogenes can cause spontaneous abortion or meningitis of the fetus, and therefore should be avoided. Raw vegetables should be carefully washed, while smoked seafood, frankfurters, soft cheeses, cold cuts of deli meat, undercooked meats and raw milk should all be avoided.


Summary
Jumping cartoon

By achieving optimum nutritional well-being prior to and during pregnancy, you are optimizing the environment for your baby draws their nutrients, as well as maximizing your own body's ability to adapt to the considerable physiological changes that occur during pregnancy.  Start by establishing care with medical professionals you trust, or seeking supplemental assistance from WIC. Understand what is an ideal weight gain for your pregnancy so that you can focus on consuming a well-balanced diet with adequate fluids, fiber, energy and protein from fruits, vegetables, legumes, nuts, seeds and lean proteins to meet your individualized needs. Take vitamin supplements as directed by your doctor. Continue to do moderate aerobic activity as advised by your physician, and learn how to manage complications that may arise during pregnancy. 

The opportunities to optimize the outcome for both you and your baby are plentiful in the next forty weeks, and it's highly important that you take them all early on in the journey!


More expert advice about Pregnancy

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Tarynne Mingione, RD CDClinical Pediatric Dietitian

Tarynne presently works at Seattle Children's Hospital as a clinical pediatric dietitian. She earned her Bachelor’s degree in Nutrition from Bastyr University, where she also completed her dietetic internship. She has a diverse resume includin...

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