Nutrition in Pregnancy

The goal of having a positive pregnancy experience is to make sure both the mother and baby are healthy. There is no magic formula for a healthy pregnancy diet. In fact, during pregnancy the basic principles of healthy eating remain the same: get plenty of fruits, vegetables, whole grains, lean protein, and healthy fats. During pregnancy you will need 300-500 extra calories a day so the baby will grow and develop normally. This means healthy foods, not sweets or fast foods. In addition, there are at least six types of minerals/vitamins that are important during pregnancy.

The first vitamin/mineral is folate and folic acid. Folate is a B vitamin that helps prevent neural tube defects, which are serious abnormalities of the brain and spinal cord. The synthetic form of folate found in supplements and fortified foods is known as folic acid. Folic acid supplementation has been shown to decrease the risk of preterm delivery. A pregnant woman needs at least 800 mcg daily from conception to delivery. Fortified cereals are great sources of folic acid as well as leafy green vegetables, citrus fruits, and dried beans and peas. Prenatal vitamins contain folic acid and should be taken three months prior to conception to ensure adequate amounts.

The second vitamin/mineral is calcium. Both the mother and baby need calcium for strong bones and teeth. Calcium also helps a pregnant woman’s circulatory, muscular, and nervous systems run normally.  Pregnant women need at least 1,000 milligrams a day; pregnant teenagers need 1,300 milligrams a day. Dairy products are the best-absorbed sources of calcium. Non-dairy sources include broccoli and kale. Many fruit juices and breakfast cereals are fortified with calcium, too.

The third vitamin/mineral is Vitamin D. This also helps build the baby’s bones and teeth. Pregnant women should get 600 international units (IU) a day. Our bodies make Vitamin D naturally through sunlight, but protecting our skin from skin cancer combined with the fact that many of us don’t work outside all day long can keep us from making enough Vitamin D. Some good sources of Vitamin D are fatty fish, such as salmon, and fortified milk and orange juice.

The fourth vitamin/mineral is protein. Protein is crucial for a baby’s growth, especially during the second and third trimesters. Pregnant women need approximately 71 grams a day. This can be found in lean meat, poultry, fish, and eggs. Other options include dried beans and peas, tofu, dairy products, and peanut butter.

The fifth vitamin/mineral is iron. Your body uses iron to make hemoglobin, a protein in the red blood cells that carries oxygen to your tissues. During pregnancy the blood volume expands to accommodate changes in the body and help the baby make his or her entire blood supply, doubling the pregnant woman’s need for iron. Many women can become fatigued and more susceptible to infections if they don’t get enough iron. The risk of preterm delivery and low birth weight also might be higher. Pregnant women need 27 milligrams a day.     

Several good sources of iron are lean red meat, poultry, fish, iron-fortified breakfast cereals, beans, and vegetables. Prenatal vitamins typically contain iron. In some cases, your health care provider might recommend a separate iron supplement. The iron from animal products, such as meat, is most easily absorbed. To enhance the absorption of iron from plant sources and supplements, pair them with a food or drink high in vitamin C, such as orange juice, tomato juice, or strawberries. If you take iron supplements with orange juice, avoid the calcium-fortified variety. Although calcium is an essential nutrient during pregnancy, calcium can decrease iron absorption.

The last vitamin/mineral that is important during pregnancy is supplements. Even if you eat a healthy diet, you can miss out on key nutrients. Taking a daily prenatal vitamin can help fill any gaps. Your health care provider might recommend special supplements if you follow a strict vegetarian diet or have a chronic health condition. If you’re considering taking an herbal supplement during pregnancy, consult your health care provider first.

A sample diet is listed below:

• Dairy Foods  (4 servings) Examples: Milk, yogurt, cheese, salmon, dark leafy greens, cottage cheese

• Protein Foods (6 servings) Examples: Beef, pork, lamb, chicken, fish, eggs, cheese, cottage cheese, Tofu, peanut butter, dried beans or peas, nuts, seeds

• Vitamin A Rich Fruits and Vegetables (1 serving) Examples: Carrots, spinach, dark leafy greens, sweet potatoes, winter squash, chili peppers, red peppers, tomatoes, cantaloupe, mango, papaya, apricots, vegetable juice cocktail

• Vitamin C Rich Fruits and Vegetables (1 serving) Examples: Oranges, grapefruit, tangerines, lemons, cantaloupe, kiwi fruit, strawberries, mango, papaya, broccoli, brussel sprouts, cabbage, cauliflower, chili peppers, red and green peppers, tomatoes

• Other Fruits and Vegetables (3-7 servings) Examples: Apples, bananas, grapes, peaches, pears, pineapple, plums, watermelons, green beans, beets, corn, cucumbers, lettuce, peas, potatoes, radishes, zucchini

• Bread and cereals (6-11 servings) Examples: Breads, tortillas, crackers, hot and cold cereals, rice, noodles, macaroni

• Fats - Examples: Butter, margarine, oils, bacon, salad dressings, olives, avocados. Use in moderation.

• Fluids (8 glasses of liquids)

There are also some foods that need to be avoided or eaten in moderation during pregnancy.  Many pregnant women ask if they can eat fish. The answer is yes. All fish contain some levels of methylmercury. However, larger fish that have lived longer contain higher amounts of methylmercury because they have a longer time to accumulate it. These fish are shark, tilefish, king mackerel, and swordfish. These fish should be avoided during pregnancy and nursing. The high levels of methlymercury can affect the way a newborn baby and young child’s nervous system develops.

Smaller fish can be eaten 1-2 servings a week. A serving size is 6 to 12 ounces. These fish are bass, rockfish, cod, catfish, flounder, sole, haddock, halibut, herring, Atlantic-, Pacific-, and Spanish mackerel, monkfish, perch, pollock, salmon, sardines, shad, skate, snapper, tilapia, trout, tuna (canned chunked light), and weakfish. Medium-sized fish can only be eaten 1-2 times a month. If you eat one of these fish, you cannot have any other fish that month. Examples of medium fish are: bluefish, grouper, marlin, orange roughy, tuna (canned white albacore), and tuna steaks (fresh or frozen).

The other group of food that should be eaten with caution is lunchmeat and processed meats. Listeria is a bacterium that can be found on refrigerated foods, ready-to-eat foods, unpasteurized milk, and soil. In the first trimester, the infection can cause a miscarriage. In the third trimester, the infection can cause preterm labor, low birth-weight baby, mental retardation, paralysis in the baby, seizures, blindness, impairments of the heart, kidneys, or brain, and infant death. Examples of food at risk are: lunchmeat, hotdogs (eat only if they are steaming hot), soft cheeses such as feta, brie, camembert, blue veined cheeses, queso blanco, queso fresco, panela (unless they are made with pasteurized milk); refrigerated pates or meat spreads, and refrigerated smoked seafood.

When you’re pregnant, eating healthy foods is more important than ever. You need more protein, iron, calcium, and folic acid than you did before pregnancy. You also need more calories. But “eating for two” doesn’t mean eating twice as much. It means that the foods you eat are the main source of nutrients for your baby. Sensible, balanced meals will be best for you and your baby. Most women need 300 calories extra a day during at least the last six months of pregnancy than they did before they were pregnant. But not all calories are equal. Your baby needs healthy foods that are packed with nutrients, not “empty calories,” such as those found in soft drinks, candies, and desserts. 

Melissa Waddell, WHNP, is a nurse practitioner at Atlantic Ob/Gyn. Please call 757-463-1234 or visit www.atlanticobgyn.com.

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