As a pediatrician I always love when I have “prenatal meet and greet” appointments with expecting parents on my schedule. Lately, there have been a flurry of these appointments alongside several people I know newly expecting. To all of you – congratulations!
Of course, these 9 months are a time of a lot of excitement and anticipation. It’s also a great time to take action for a healthy pregnancy and a healthy baby. In honor of the pregnant mamas, I thought I’d post a few tips on nutrition for a healthy pregnancy. Good nutrition during pregnancy helps optimize maternal health and infant health including decreasing risk of some birth defects, poor growth, and some chronic health problems in baby.
My top 5 tips for a healthy pregnancy include:
1. Fill half your plate with fruits and vegetables, 1/4 with whole grains, and 1/4 with lean protein, plus 2-3 servings of dairy or a calcium-rich dairy substitute every day. This nutritional balance will help ensure adequate nutrient intake and also support healthy weight gain during pregnancy (about 25 to 35 pounds with a little more for moms who start pregnancy underweight and a little less for moms who start pregnancy overweight). While it is often said that a pregnant woman is “eating for two”, energy needs during pregnancy increase by an average of just 300 calories per day from non-pregnant needs throughout the second and third trimesters (and there aren’t really any increased caloric needs in the first trimester). So really, it’s more like moms are eating for 1.17. Eating a varied diet also exposes baby to a variety of tastes. There is some evidence that the tastes transmit through the amniotic fluid, so a pregnant mom who eats a lot of vegetables is likely to have a baby who likes vegetables, too.
2. Eat small, frequent meals. A healthy nutrition plan in pregnancy begins with eating small, frequent meals. Replace “three square meals” with five small meals per day including breakfast, lunch, an afternoon snack, dinner, and a bedtime snack. Avoid fasting (>13 hours) and never skip breakfast due to a risk of ketosis, an increased acidity of the blood due which can lead to a heightened increased risk of preterm delivery. Importantly, dieting is never healthy during pregnancy (or really, at any time).
3. Take prenatal vitamins. Folic acid reduces the risk of neural tube defects like spina bifida if taken prior to conception through the sixth week of pregnancy and may reduce birth defects if taken later in pregnancy. Pregnant women need 600 μg of folic acid daily from fortified foods or supplements in addition to food forms of folate from foods like green leafy vegetables, fortified whole grains, and fruits like oranges and strawberries. In addition, the CDC recommends that all pregnant women take a 30mg/day iron supplement since many women have difficulty maintaining iron stores during pregnancy. Women who follow a vegan eating plan should also consider a vitamin B12 supplement or ensure adequate intake through fortified foods.
4. Avoid food, drinks, and other substances that may pose a significant health risk. A precaution throughout pregnancy and especially during the first trimester when the baby’s organs develop is to avoid alcohol consumption. Because alcohol-induced problems such as mental retardation, learning disabilities, and fetal alcohol syndrome and its associated birth defects are entirely preventable with abstinence, and it is unknown at what amount of alcohol intake damage occurs, alcohol should be avoided entirely throughout pregnancy.
Caffeine is also a potentially dangerous substance during pregnancy, particularly at high doses. Caffeine readily crosses the placenta (which develops at the end of the first trimester) and can affect fetal heart rate and breathing. While the research certainly in inconclusive on the extent of any negative impact of caffeine, most experts recommend limiting caffeine consumption to no more than 200mg per day, equivalent to about 12oz of coffee.
Pregnant women and their fetuses are at higher risk of developing foodborne illness and should take extra precautions to prevent consumption of contaminated foods by avoiding:
* Soft cheeses not made with pasteurized milk
* Deli meats, unless they have been reheated to steaming hot
* Raw or unpasteurized milk or milk products, raw eggs, raw or undercooked meat, unpasteurized juice, raw sprouts, and raw or undercooked fish
* Cat litter boxes
* Handling pets when preparing foods
* Shark, swordfish, king mackerel, or tilefish. Pregnant women can safely consume 12 ounces or less of fish or shellfish per week, provided that it is low in mercury, such as shrimp, canned light tuna, salmon, pollock, and catfish. Consumption of albacore tuna should be limited to 6 ounces or less per week.
5. Include physical activity in every day. Technically this is not a 'nutrition tip' but it goes hand-in-hand with healthy nutrition. Aim for at least 30 minutes of physical activity every day. This not only benefits an expecting mom’s mental and physical health including better sleep and improved mood alongside the cardiovascular benefits, but it also helps set the stage for healthy fetal growth and development. Listen to your body when deciding on intensity. If you already were very active before pregnancy, it is ok to continue to be very active during pregnancy, but discuss any specific questions or concerns with your ob.
If you are pregnant or shared this with someone who is, I hope that you’ve found it to be helpful guidance. Please don’t hesitate to reach out in the comments with any questions. Thank you!