Now you are pregnant, what should you eat?

A healthy, balanced diet is essential for pregnant women and their developing babies. Here are ten tips for healthy eating during pregnancy1:

  1. Eat lots of fruit and vegetables. Aim for a wide variety and have at least five servings a day. Fresh, frozen, canned, dried and juiced: all count!
  2. Choose foods rich in protein, such as lean meat, chicken, fish, beans and nuts. These foods are also great sources of iron.
  3. Eat enough healthy starchy foods such as bread, potatoes, rice, pasta, chapattis, yams and breakfast cereals. Choose wholegrain options when available.
  4. Eat more fiber-rich foods such as wholegrain breads & pasta, brown rice, wholegrain or high fiber breakfast cereals, pulses, fruit & vegetables, to help prevent constipation and piles.
  5. Eat plenty of dairy foods such as milk, cheese and yogurts, as they are major sources of calcium, important for the healthy development of your baby’s teeth and bones. Choose low fat varieties when you can. Take care to avoid mold-ripened soft cheeses such as Brie and Camembert and blue-veined cheeses such as Stilton and Danish Blue.
  6. Ensure your snacks are nutritious. Too many ‘indulgent’ snacks can result in excessive weight gain. Healthier snack choices include: malt loaf, currant buns, low-fat yogurts, bread or vegetable sticks, breakfast cereals, milky drinks, fruit smoothies and fruit.
  7. The UK Food Standards Agency (FSA) recommends a limit of two portions of oil-rich fish per week for pregnant and breastfeeding women (and those who may become pregnant). Oil-rich fish is a rich source of long-chain omega-3 fatty acids which are thought to help protect against heart disease and are important for the development of your baby’s brain and nervous system. The upper limit on oil-rich fish consumption is to avoid the risk of exposure to dioxins and polychlorinated biphenyls (PCBs), which are environmental pollutants. Pregnant women are also advised to avoid marlin, shark and swordfish, and limit their intake of tuna due to the risk of exposure to methylmercury, which at high levels can be harmful to the developing nervous system of the baby.2
  8. You don’t need to eat for two. The average weight gain in pregnancy is 10-12 kilograms or 22-28lbs. Gaining too much weight can affect your health and increase your blood pressure, so cut down on foods high in fat and sugar. However, it is just as important not to diet during pregnancy as this will limit your baby’s nutrition. Eating healthily and being active will help moderate your weight gain. Your midwife can advise on suitable exercise during pregnancy.
  9. Drink plenty of water and other fluids. Pregnant women tend to get dehydrated faster than usual, so drinking plenty of water and other fluids is important; especially when exercising or if the weather is hot.
  10. If your appetite is poor try eating small amounts of food throughout the day rather than having three main meals. If you suffer from nausea and vomiting, or 'morning sickness', eat little and often, every two or three hours - even if you're not hungry.

Supplements

Folic acid

It is recommended that women take a supplement of 400mcg folic acid per day from the time they stop contraception until the twelfth week of pregnancy. This is to help reduce the risk of neural tube defects such as spina bifida. It is also important to eat foods rich in folic acid or folate such as green leafy vegetables, pulses, oranges, and fortified bread and breakfast cereals.

Vitamin D

Vitamin D is needed for the absorption of calcium which is important for the development of your baby’s bones and teeth. Most of our vitamin D comes from the action of sunlight on our skin. It is also found in fish, meat, eggs and fortified foods such as margarine and breakfast cereals. Pregnant women may need more therefore a supplement of 10mcg per day is recommended.

Iron

Your body needs more iron when you are pregnant so it is important to eat plenty of iron-rich foods. These include lean meat, fish, pulses, dark green leafy vegetables, dried fruit, nuts and seeds and fortified bread and breakfast cereals. Have foods rich in vitamin C (e.g. a glass of orange juice) at the same time as this will help you absorb the iron. Some women need iron supplements during pregnancy but you should check with your healthcare provider before taking supplements.

Omega-3 fatty acids3

Omega-3 fatty acids, especially DHA omega-3 (docosahexaenoic acid), are important for the development of your baby’s brain, nervous system and retina. In fact, experts recommend that pregnant and nursing women should consume an additional 100-200 mg DHA daily above the 250 mg recommended omega-3 intake for adult cardiovascular health. Dietary sources of DHA include:

  • Algae - Certain microalgae are natural sources of DHA. While most people believe that fish produce their own DHA, in fact, it’s the algae they feed on that make them a rich source of DHA
  • Fatty fish including anchovies, salmon, herring, mackerel, tuna and halibut
  • Organ meat such as liver
  • Fish oil
  • Small amounts are found in poultry and egg yolks
  • There is a common misconception that foods like walnuts and flaxseed oil are dietary sources of DHA. However, these foods are sources of another omega-3 fatty acid, alpha-linolenic acid, or ALA, a precursor of DHA. Compared to DHA, ALA has no known independent benefits on brain or eye development and function (as DHA does). Although the human body can convert ALA to DHA, the process is inefficient and varies.

If you decide to take an omega-3 supplement, choose one specially formulated for pregnant women. Be careful to avoid supplements containing fish liver oils as they also have high doses of vitamin A which can be harmful to the unborn baby.

Food safety issues

Some foods should be avoided during pregnancy as they contain bacteria that may be harmful to your baby.

Listeria

Foods to avoid: paté; mold-ripened soft cheeses such as Brie, Cambozola and Camembert and blue-veined cheeses such as Blue Brie, Danish Blue, Gorgonzola, Roquefort, Stilton; unpasteurized milk and milk products.

Cooked chilled meals and ready cooked chicken can also contain listeria. Always make sure they are re-heated thoroughly.

Salmonella

Foods to avoid: raw eggs and foods containing them such as homemade mousse and mayonnaise; and soft whip ice cream.

Only eat eggs which have been cooked until both the white and yolk are solid. Cook all meat, particularly poultry, thoroughly.

Toxoplasmosis

Foods to avoid: raw and undercooked meat; unpasteurized milk and milk products.

Always wash your hands after handling raw meat. Make sure fruit and vegetables are thoroughly washed. Wear gloves when gardening and changing cat litter trays. Wash your hands after handling cats and kittens.

You should also avoid:

Vitamin A

Too much vitamin A may be harmful to your unborn baby. You should avoid liver, liver products e.g paté, supplements containing vitamin A, and fish liver oil supplements.

Alcohol

Avoid drinking alcohol when you are pregnant.

Caffeine

Limit your caffeine intake to 300mg per day. That’s about four cups of average strength instant coffee or six cups of tea. Remember chocolate, and some fizzy drinks contain caffeine too.

Some types of fish

Although eating fish is good for you and your baby, there are some types of fish you should avoid during pregnancy because of the potential levels of mercury. Shark, swordfish, and marlin should all be avoided. Tuna should be limited to no more than two steaks or four medium-sized cans per week.

Avoid raw shellfish when you are pregnant as there is a risk of food poisoning. However, you can eat shellfish that has been thoroughly cooked.

Peanuts

If you, your baby’s father, or any of your other children suffer from asthma, eczema, hay fever or food allergies you may want to avoid peanuts and peanut products.

1 Food Standards Agency. When you’re pregnant. Available at: http://www.eatwell.gov.uk/agesandstages/pregnancy/whenyrpregnant, accessed 12.02.07
2 British Nutrition Foundation, http://www.nutrition.org.uk/home.asp?siteId=43&sectionId=1275&parentSection=341&which=5
3 Williamson, C. (2006) Nutrition in pregnancy: latest guidelines and advice. PrimaryHealth Care. 16(7): 23-28.

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