We all want to give our children the best start in life, so it’s not surprising that a lot of pregnant mothers get a little panicky about what they should and shouldn’t be eating. In this article, we look at:
Eating for two
What to eat
Healthy recipes and snacks
The role of supplements
What not to eat
Firstly, if you’ve been following a healthy diet before you fell pregnant, chances are you won’t have to make any major changes to what you eat. However there are some particular nutritional requirements you should be aware of, as a well-balanced diet contributes to:
- normal birth weight for baby
- improved fetal brain development
- decreased chance of pregnancy complications such as morning sickness, fatigue, mood swings, anaemia and pre-eclampsia
- a speedy recovery after delivery
Eating for two
Yes, you are eating for two, but that does NOT mean increasing your kilojoule intake particularly in the first trimester. Rather, it means you will need to increase your intake of certain nutrients mainly folate, iron and calcium to maintain optimal foetal development and your own health. In the second and third trimesters you may need to increase your kilojoule intake by around 10% (or around 6000 kJ per day); but generally a healthy pregnant woman should aim to keep her weight gain around 10-15kg during the course of the pregnancy.
Pregnancy is NOT a time to aim for weight loss or restricting your diet, unless under doctor’s advice for overweight mothers, and then only under strict medical supervision. Crash diets during pregnancy are a serious risk for both mother and developing baby.
What to eat
The basis of a well-balanced diet is a balance of grains, fruits and vegetables, protein, dairy and fats. Ensure your diet contains the recommended amounts of the following food groups.
Grain products are the main source of complex carbohydrates, and should make up the majority of your diet. Complex carbohydrates provide you with energy and will keep your weight gain in check, prevent constipation and nausea, and give your baby essential nutrients including fibre, folate, Vitamin B and protein.
Eat at least six servings per day, preferably wholegrains such as whole-wheat bread, cereals, brown rice or pasta. One serving is two slices of bread, or a cup of cooked rice or pasta. Avoid refined grain products such as white bread and white rice, biscuits and cakes etc as these don’t have the same nutritional value as their wholegrain counterparts.
Fruit and vegetables will provide you with essential vitamins and minerals as well as fibre to aid digestion and prevent constipation. Vitamin A derived from green leafy veges and yellow fruits is important for the development of your baby’s bones, skin, hair and eyes; however when taken in supplement format, Vitamin A has been linked to birth deformities so it's doubly important to source it from whole foods. Vitamin C is important for bone growth and tissue repair, however your body cannot store large amounts of it so it’s important to ensure a regular intake – around 3 serves per day. Good sources include citrus, tomatoes, broccoli, melons and berries. Fruit and veges also provide you with folate, Vitamin B, iron and calcium.
Eat at least five serves of vegetables and two serves of fruit each day. One serving is a cup of salad leaves or 1/2 cup chopped non-leafy vegetables or fruit (cooked or raw), one whole raw fruit, a small glass of juice or dried fruit (such as 4 dried apricots, or 1.5 tablespoons sultanas).
Protein is composed of amino acids, the building blocks of human cells which are crucial for a developing fetus. It is also important in protecting you against developing pre-eclampsia later in pregnancy. Protein foods are also normally the iron-rich foods, which is important to keep your blood well-oxygenated.
Eat at least two servings per day. One serving equals 100g lean meat, poultry or fish; two small eggs, 1/2 cup cooked lentils, split peas, or dried beans; 1/4 cup sunflower or sesame seeds; 2 cups low-fat yoghurt; 200g tofu; 1 cup low-fat cottage cheese. Nuts are a good source of protein but be careful not to eat too many peanuts during pregnancy to avoid your baby developing a nut allergy.
Dairy The calcium found in milk products helps build your baby's bones and teeth, as well as muscle, heart and nerve development and blood clotting. If your calcium intake isn’t sufficient to meet your baby’s needs, especially later in the pregnancy, your body will draw on calcium from your bones and therefore expose you to the risk of osteoporosis. Choose at least four servings a day of low-fat milk, yogurt or cheese. A serving is one cup of milk or yogurt or two slices of cheese. If you have trouble digesting lactose, lactose-reduced milk products and calcium-fortified juice can help you get enough calcium. Another good source is canned fish with bones (such as salmon or sardines).
Fat Some fats are necessary for your baby’s development, but you should limit your intake to manage weight gain during pregnancy. Treat yourself to an occasional sweet treat: icecream, chocolate biscuit or piece of cake, but don’t include them as a daily part of your diet. Essential fats are found in polyunsaturated oils such as sunflower and soya bean oils, and monounsaturated oils such as olive and canola oils.
Water and fluids: you need to drink at least two litres of water a day; and more if you’re retaining fluid or if it’s very hot. Your need for fluids will also increase as your body’s fluids increase in the course of the pregnancy. An adequate fluid intake will help in the prevention of early labour, stretch marks, and constipation.
While water is best, you can make up some of your intake with other fluids such as juice, milk, and soup. However, try to limit caffeine-containing beverages such as coffee, tea and colas to only one cup per day.
In an ideal world we’d all be eating according to the above guidelines before we fell pregnant, if not from day one of the pregnancy. But changing from bad eating habits to good takes dedication and hard work, so if you find it difficult to follow this diet, make changes gradually. Don’t expect yourself to stick to it if you’re facing it alone: encourage your partner and family to improve their diet too.
You’ll also find it easier to eat well if you give yourself an occasional treat – so don’t beat yourself up if you indulge in a late-night hot chocolate before bed or something sweet with your morning cuppa. Wherever you can, try to make it a healthy alternative though: a slice of banana bread vs a chocolate éclair, or a fresh strawberry smoothie instead of a vanilla milkshake.
And remember that every day you improve your diet means not only a healthier baby, but long-term health effects for you, too.
Here are some suggested recipes to help you get your daily requirements:
- Carry a snap-lock bag of dried apricots, mixed nuts or sunflower seeds to beat hunger pains
- If you’re working, buy a punnet of fresh berries on your way to work and keep them on your desk for a good Vitamin C snack through the day.
If you follow the above guidelines and have no specific health issues, initially you shouldn’t need to supplement your diet in any way except for the addition of Folic acid to your diet. Ideally you should start taking 500 micrograms (mcg) of folate a day in tablet form one month before you start trying to get pregnant. If you discover you’re pregnant and haven’t been taking folate, don’t panic but do start taking it as soon as you can and continue to do so through your first trimester. Folate is essential for the development of the brain and spinal cord, and can prevent the risk of neural tube defects such as spina bifida by up to 70 percent.
In later stages of pregnancy as the baby’s nutritional needs take priority over the mother’s, it may be necessary to also take calcium and iron supplements. In the first couple of months, generally iron deficiency is not an issue because your body has stopped menstruating. However as the baby grows and its blood supply increases, anemia can set in. If you do require an iron supplement, look for one that also includes Vitamin C to aid iron absorption, and ask your health practitioner to recommend one that doesn’t cause constipation. Similarly, the third trimester is the critical time for strengthening baby’s bones and therefore if you’re finding it hard to meet your daily requirements of calcium, a supplement may be necessary. You may also wish to continue to take calcium until you’ve finished breastfeeding.
When supplements are necessary
A specialised prenatal supplement is likely to be necessary if you:
- are a vegetarian or vegan
- are lactose-intolerant or have other food intolerances
- are a teenager with an inadequate food intake
- smoke or take non-prescription drugs
- are expecting twins or higher multiples
- are obese and need to prevent further weight gain
- have diabetes, gestational diabetes or anemia,
- have a history of low birth weight babies.
If any of these conditions apply to you, speak to your health professional about what kind of supplement is best for you.
If you decide to take a supplement...
If you don’t have any health conditions but are finding it difficult to follow a balanced diet, then you may decide to take a multivitamin complex. In this case, choose a pregnancy / breastfeeding formula rather than just a general women's multivitamin. Generally, you'll find pregnancy supplements include higher levels of folate and iron, but also lower levels of potentially harmful vitamins such as Vitamin A.
What not to eat
Some foods should be limited, and others avoided altogether. But the big concern for pregnant women is the risk of eating harmful bacteria which can lead to miscarriage, early labour and toxemia. Be vigilant in following safe food preparation and storage practices, and be aware of the two big bacterial threats: listeria and salmonella.
Listeria : The bacteria Listeria monocytogenes is often present in certain foods, and in low levels may have no effect on healthy people so often goes unnoticed. However if ingested by a pregnant woman, it can lead to miscarriage, stillbirth or early labour. Foods at higher risk of containing listeria include:
- Pre-prepared cold foods that will not be reheated, including pate, deli meats like ham and salami, and pre-mixed salads
- Soft serve icecream
- Soft cheeses, such as Brie, ricotta, blue vein and Stilton
- Smoked seafood
- Any leftovers kept in the fridge for more than 12 hours
The good news however, is that the Listeria bacteria is killed by high temperature, so if you’re craving a treat of smoked salmon or soft cheese, it’s fine to eat it if it’s been cooked such as in a freshly cooked hot quiche or pie.
Salmonella is a form of food poisoning that can trigger miscarriage or premature birth, and is most often traced to undercooked poultry and meats, and raw eggs. Some freshly prepared salad dressings such as hollandaise, mayonnaise and Caesar, contain raw eggs – so be careful of these when eating out. Other foods to avoid include raw meat and seafood including sushi, sashimi and carpaccio, and hot dogs.
Other foods to be aware of:
Fish: One or two serves of fish per week is recommended for good health, particularly for Omega-3 fatty acids, but the type of fish you eat during pregnancy should be carefully monitored because some contain higher levels of mercury which can threaten the health of your baby. Fish to avoid include:
- Billfish (swordfish, broadbill and marlin)
- Shark (flake)
- Sea Perch
- Southern Blue Fin Tuna
Don’t panic if you’ve had the odd meal of fish with high levels of mercury. It is only a potential problem when eaten regularly, as it causes a build-up of mercury in the blood.
Nuts: If there is a family history of food allergies, it is best to avoid eating peanuts or products containing peanuts. Peanut allergy is a serious health concern that once developed, stays for life – and is on the increase. Exposure to peanuts during pregnancy and through breastfeeding can increase the chance of the allergy developing if your baby has a predisposition.
Vitamin A: Although vitamin A is essential during pregnancy, supplements and foods particularly high in Vitamin A are not recommended, because of the risk of birth defects. One of the highest sources of Vitamin A is liver, so this should be avoided during pregnancy.
Alcohol: excessive consumption of alcohol in pregnancy has been shown to increase the risk of miscarriage, low birth weight, and congenital deformities. However, there is not enough evidence to identify what is a “safe” amount to drink during pregnancy. As a result, it is recommended that women who are pregnant may like to consider not drinking at all or, if they choose to drink, have less than seven standard drinks in a week and no more than two standard drinks on any one day.