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Nutrition and Pregnancy
Eat right to build the best baby
The responsibility for creating another human being is awesome. We know now that what a woman does during pregnancy, and even before, including what she drinks, eats, smokes or even breathes, can have an impact on the health and future of her baby. Some things are beyond a mother-to-be’s control but most certainly she can choose foods to eat which will give her baby a healthy start on life’s journey.
Before Conception
The journey begins even before conception. If you could become pregnant you should try to be at a healthy weight, have a good diet and moderate exercise program.
It is also important to take a supplement of folic acid. Routine use of a folic acid supplement has been strongly linked to a reduction in birth defects, particularly neural tube defects like spina bifida where the spinal column does not form completely. The spinal column closes in the first few weeks of pregnancy before most women know they are pregnant. Since 50 per cent of pregnancies are unplanned, it is very important that all women who might get pregnant take a daily folic acid supplement of at least 500 micrograms (mcg). You should also eat at least five to six servings of fresh fruits and vegetables daily as they are a natural source of folic acid.
Weight gain
For most healthy women, a total weight gain during pregnancy of 12 - 16 kilograms (approximately 25 –35 pounds) is the normal range. The weight should be gained slowly and gradually and will be distributed between you and your baby.
For instance, if you gain 12.5 kilograms (27.5 pounds), approximately five kilograms (11 pounds) would be for your baby, the placenta and amniotic fluid. The remaining 7.5 kilograms (16.5 pounds) would be for your enlarged uterus, breasts, fluid, blood and fat stores.
In the second half of the pregnancy, normal weight gain is a pound each week. In the last month, weight gain may vary for many reasons such as difficulty fitting in a full diet or excessive weight gain due to fluid retention (swelling). A good diet will help a woman gain weight appropriately.
If you are overweight as you begin your pregnancy or are overly cautious about gaining weight, remember this is not the time to use a weight reducing diet. Instead, eat nutritious foods for meals and snacks. Your growing baby will need a variety of nutrients from a healthy diet while you are pregnant and breast feeding. The best approach for women with these concerns is to avoid junk foods and treats containing lots of calories but little nutritional value.
The first trimester
In the first three months women can have a broad range of experiences. Some women breeze through it and do not even feel they are pregnant, other women suffer from mild to extreme degrees of nausea and vomiting. Being well nourished ahead of time is very important because it may be weeks or months before a woman can eat as well as she planned.
There is no specific dietary recommendation for managing the nausea and vomiting of pregnancy. Some women can only handle a few foods that still have some limited appeal. Carbohydrates (crackers, bread, noodles and cereals) are often the easiest foods to handle. Whole grain breads and cereals are rich in Vitamin B6 which has been shown to reduce nausea.
As greasy foods, spicy foods and food with strong aromas can be a problem these foods are often avoided in early pregnancy. Keeping the stomach neither full nor empty is helpful, too. If you find you are waking up nauseated, try to take a snack before bed. Keeping crackers beside the bed to eat before you get up can really help.
Don’t worry if all you can eat for a period of time is apples and dry toast. While this is not ideal, you can make up for it later. If your food choices and amounts are limited, try to make them count: bread instead of chips, fruit instead of sweets, juice instead of pop. If you can tolerate a pre-natal multivitamin, take one daily. Try a multi-vitamin without iron if you have difficulty tolerating one that contains iron.
The second trimester
The second trimester is the one many women enjoy the most. At 13 weeks most mothers-to-be feel better, have more energy and find a variety of foods appeal to them again. This may be the first opportunity a woman has to catch up by eating the foods she knows she and her baby need.
Food density
Many of us have heard about getting balanced meals from the four food groups but many people have not heard about food density. That expressions means, while occasional pleasure foods are good for the soul, most everything you eat really should count for something. For instance, at a minimum, a pregnant woman in her second trimester needs eight servings of breads and cereals daily. One serving is half a cup. A white hamburger bun would count as two servings as would a cup of instant white rice or a croissant.
But are these ideal choices? Of course not. While they are better than cookies or chips, better choices would be whole grain cereal breads and cereals. Not only do they have much higher levels of vitamins and minerals, they have considerably higher fibre. We say they have higher 'food density.'
Along with the many joys of pregnancy come discomforts - constipation and hemorrhoids are two of those. When you are pregnant, count on it, fibre is your best friend. Taking in plenty of fibre (whole grains, fruits, vegetables) and plenty of fluids (liquids like water, juice, milk, or soup) can be helpful in managing these problems. You also need to keep active by participating in activities such as walking, swimming or bicycling.
Calcium
Calcium is important for bone formation. Some women find it helpful in preventing painful leg muscle cramps in pregnancy.
You need to get about 1200 mg of calcium per day which is three to four servings of dairy products or the equivalent. One serving is one cup of milk, three quarters of a cup of yogurt, seven sardines, one half can of salmon with bones, three quarters of a cup of almonds or two cups of bok choy or other dark green vegetables. Excessive amounts of drinks containing caffeine (coffee, chocolate drinks and some soda pop such as colas) tend to filter calcium out of your body.
If you cannot meet your calcium needs by eating the appropriate foods, it is important to use a calcium supplement. Your family doctor or obstetrician can advise you about the dose of calcium supplement and whether you should also take magnesium and vitamin D.
Iron
Iron deficiency in pregnancy is serious and may lead to feeling tired and run down. The need for iron increases dramatically during pregnancy for both you and your baby. The mother needs extra iron to make more blood throughout the pregnancy. Also, in the first few months of life, the baby will depend on the iron it has stored in its body during the pregnancy.
Good iron sources include meats, fish, poultry, whole grain breads and cereals plus dark green leafy vegetables. To maximize the iron you absorb, try to eat foods rich in iron along with a source of vitamin C. Some ways to do this are to take your cereal with fruit, your meat with tomatoes or your fish with peppers. If you drink coffee or tea, keep the amounts small and take them separately from your meals (the caffeine inhibits iron absorption). Infants with low iron levels do not learn as well nor develop as well as babies with good iron stores.
Caffeine
It was thought that caffeine used by pregnant women could cause low birth weight, premature birth or other problems. There is no clear evidence that a limit of three cups of beverages containing caffeine per day during pregnancy causes problems. However, because it is difficult to prove a commonly used substance causes problems in pregnancy, it is wise for pregnant women to limit their caffeine intake. If you are a caffeine junky, try switching to lattes (half coffee and half milk) or alternate between decaffeinated and regular.
Altered taste and smell
This usually begins in the first trimester but may carry on throughout the pregnancy. Some women have such an altered taste sensation they cannot eat their favourite foods or everything tastes off to them. Bear with this, it will go away, but it can be very frustrating. Some women even start craving unusual things like dirt, clay, laundry soap, raw rice, coffee grounds or ice. These may be cultural (in some cultures women are encouraged to eat clay when pregnant, possibly for the mineral content) but are often linked to dietary deficiencies. Discuss any unusual symptoms or concerns with your doctor.
Third trimester
Almost there! By the third trimester your tummy is large and it feels like the growing baby is leaving little room inside. This means small meals frequently throughout the day. While you are not really eating for two (more like one and a bit) you will experience days when you are ravenously hungry and days when you cannot eat at all. Relax, listen to your body and just keep trying to eat well.
Heartburn
As the baby grows the womb presses upward toward your stomach. The pressure may force stomach contents (food fluids and stomach acid) backwards up the esophagus (swallowing tube) to the throat. This often causes heartburn and bitter fluid may enter your mouth. Try to eat small amounts of food at a time with liquids taken separately from food. Avoid straining and bending because these will often make the problem worse. Some women find it helps to avoid greasy foods, spicy food, caffeine and pop.
Postpartum
If you are breast-feeding you will need to keep eating as if you were pregnant, about an extra 300 calories per day. There is also a need for lots of fluids, preferably water, while breastfeeding.
Try to maintain your good eating habits - you are still building your baby! Taking good care of yourself also makes it easier for you to care for your baby. Your children will learn from you many habits they will keep for a lifetime.
