Nutrition During Pregnancy

Before you get pregnant
Eating right during pregnancy
What makes a quality prenatal supplement?
Weight gain guidelines for a healthy pregnancy
Calorie needs during pregnancy
Food safety for pregnancy
An overall healthy lifestyle during pregnancy and beyond

Your nutritional choices before and throughout pregnancy have a major impact on the long-term health of both you and your baby. A healthy pregnancy requires choosing a balanced diet, taking a high-quality prenatal nutritional supplement, gaining the right amount of weight, avoiding alcohol, tobacco and other harmful substances, and maintaining an overall healthy lifestyle including regular physical activity.


Before you get pregnant

It's never too soon to begin preparing for your baby. As soon as you are actively trying to get pregnant, start taking a prenatal supplement that provides a complete range of nutrients which includes extra folic acid and choline. These two nutrients are important to the early development of a baby's nervous system. This development often occurs even before a woman knows that she is pregnant.


Eating right during pregnancy

Mothers-to-be need to eat a variety of foods every day, as well as take a high-quality prenatal multivitamin and mineral supplement.

A balanced diet to support your healthy pregnancy consists of:

  • Fruits: Apples, pears, peaches, nectarines and melons are nutrient-dense choices (rich in vitamins and nutrients and low in calories). Since acid can cause heartburn, you may want to avoid eating too much acidic fruit such as oranges, lemons, limes and pineapple.
  • Vegetables: Leafy greens, bell peppers, eggplant, squash and mushrooms are good choices.
  • Whole grains: Whole grain breads, brown rice, and other whole grains such as barley, oats, cous cous and cracked wheat are good choices.
  • Lean protein from both plant-based and animal-based sources: Try low-fat or fat-free milk, nuts, seeds, tofu, beans, and lean meats such as chicken without skin, turkey, fish and lean pork.
  • Healthful fats: Extra-virgin olive oil, walnuts, almonds and avocadoes are good choices.

If there are healthy foods you cannot or choose not to eat, you may have difficulty meeting your increased daily nutritional requirements during pregnancy. If that's the case, consult a registered dietitian or nutrition professional about food substitutions you can make to meet your daily requirements. Avoid extra calories from sugars and fats during pregnancy, which can lead to unhealthy weight gain. Cut down on foods like soda, sweets and fried snacks, and drink plenty of water.


What makes a quality prenatal supplement?

There are many different prenatal supplements on the market. You can now find quality prenatal multivitamin and mineral supplements that smell and taste appealing, which makes them easier to take, especially on days when you feel queasy.

Make sure that your prenatal nutritional supplement has adequate levels of the following key nutrients which have been shown to promote a healthy pregnancy:

Nutrient Quality supplemental level What nutrient does
Vitamin D 2,000 - 4,000 IU Important in bone health and immune function
Folic Acid 1,000 mcg Prevents a common birth defect
DHA 250 - 300 mg Promotes baby's brain and eye development
Choline 200 mg Promotes baby's brain development
Vitamin B6 30 - 50 mg May reduce morning sickness
Iodine 200 mcg Thyroid function, brain and nerve development
Iron 27 mg Keeps iron stores adequate, prevents anemia
Biotin 30 mcg Meets increased requirements during pregnancy

Weight gain guidelines for a healthy pregnancy

Achieving and maintaining a healthy weight before and during pregnancy is important for you and your baby. Obesity during pregnancy has been linked to higher risk of gestational diabetes, high blood pressure, cesarean delivery, neural tube defects, and childhood obesity. These risks can be managed in part by gaining enough, but not too much, weight during pregnancy.

The Institute of Medicine (IOM) sets healthy weight gain guidelines for pregnancy based on your body mass index (BMI) prior to pregnancy. BMI is a measure of weight to height. If you are underweight before becoming pregnant, it is recommended that you to gain more weight during pregnancy, while if you are overweight, you need to gain less.


New Recommendations for total and rate of weight gain during pregnancy, by prepregnancy BMI
Prepregnancy BMI BMI (kg/m2)
(WHO)		 Total Weight Gain Range (lbs) Rates of Weight Gain*
2nd and 3rd Trimester
(mean range in lbs/wk)		 Total Weight Gain Range - for Twins (lbs)
Underweight <18.5 28-40 1 (1 - 1.3) Data not available
Normal weight 18.5 - 24.9 25-35 1 (0.8 - 1) 37 - 54
Overweight 25.0 - 29.9 15 - 25 0.6 (0.6 - 0.7) 31 - 50
Obese 25.0 - 29.9 11 - 20 0.5 (0.4 - 0.6) 25 - 42

Calorie needs during pregnancy

Generally, pregnant women need between 2,200 and 2,900 calories, with more calories needed as your pregnancy progresses. The American Dietetic Association breaks down the daily calorie increase needed for healthy weight gain during each trimester as follows:

  • The first trimester does not require additional calories
  • The second trimester requires an additional 350 calories per day
  • The third trimester requires an additional 450 calories per day

Food safety for pregnancy

While you are pregnant, you and your baby are at higher risk for foodborne illnesses because during pregnancy your immune system is weakened, which makes your body less able to fight off microbial attacks. A baby's developing immune system is not yet strong enough to resist an attack. So, reviewing the basics of food safety, and becoming aware of common risks, is important.

To minimize your exposure to bacteria that can cause foodborne illness:

  • Clean: Wash your hands, cooking equipment, countertop and cutting boards both before and after handing food.
  • Separate: Keep raw meats separate from ready-to-eat foods. Thoroughly wash cutting boards and plates after they have raw foods on them and before placing any other foods on the same surface.
  • Cook: Cook foods thoroughly. Beware of food kept in the danger zone between 40°F and 140°F, where bacteria grow best. Discard high-risk foods (meats and other moist protein-containing foods) left out at room temperature for more than 2 hours.
  • Chill: Keep your refrigerator below 40°F, and the freezer below 0°F. Toss perishable foods if you cannot eat them within a few days. If in doubt, throw it out.

There are three additional foodborne risks that pregnant women should be aware of. These are:

  1. Listeria is a harmful bacterium that can grow at refrigerated temperatures. It is found in refrigerated, ready-to-eat foods and unpasteurized milk, cheese and milk products. Examples of high-risk foods for listeria include hot dogs and luncheon meats, soft cheese such as feta, brie and camembert (unless made with pasteurized milk), smoked fish, and raw milk.
  2. Methylmercury is a metal found in certain fish and in the environment. It can be harmful to your baby's nervous system. The fish highest in mercury are shark, tilefish, king mackerel and swordfish, which should be avoided during pregnancy. Eating up to 12 ounces each week of low-mercury fish and shellfish (salmon, shrimp, canned light tuna, pollock, and catfish) is healthy during pregnancy. When choosing a DHA-containing nutritional supplement (from fish or marine plants), make sure it is independently tested and certified to be free of mercury and other contaminants.
  3. Toxoplasma is a harmful parasite, and causes an illness that can be difficult to diagnose. Prevent toxoplasmosis by avoiding undercooked meats, unwashed fruits and vegetables, and cat-litter boxes.

An overall healthy lifestyle during pregnancy and beyond

A healthy lifestyle that includes sound food choices, regular physical activity, and refraining from smoking and excessive alcohol or other substances will support the life-long health of your entire family. Remember, when a child reaches adulthood, they tend to eat what their parents ate, and follow other lifestyle patterns they learned early in life. So making healthy choices now has the potential to be passed on.

Most women can be moderately physically active throughout their pregnancy. In fact, a fit woman may experience an easier labor and faster recovery due to her strength and endurance. Talk to your doctor about any modifications to your exercise program that you may need to make during your pregnancy.



Sources:
Sources: The American Dietetics Association, www.eatright.org / Eating right during pregnancy
Food and Drug Administration, www.fda.gov / Food safety during pregnancy