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Nutrition During Pregnancy
Dr. Laura Stachel
Obstetrics & Gynecology
Pregnancy is a terrific opportunity to focus on your health and well-being. Knowing that a new life is growing inside you is a powerful motivating factor when it comes to improving your diet and nutrition.
Optimally, good nutrition should begin before conception. Having a healthy diet means eating a wide range of nutritious foods from different food groups, and avoiding potentially harmful substances. Whole grains and fresh vegetables are certainly preferable nutrition to fast foods with high amounts of fats and foods with chemical additives. Alcohol and cigarette use should be discontinued—alcohol can cause birth defects and cigarettes have been shown to increase the risk of miscarriage, low birth weight, and other problems.
Certain birth defects can be reduced by taking nutritional supplements before you conceive and during the early months of pregnancy. You should take at least 400 micrograms of folic acid to reduce the chances of problems with neural tube development. Prenatal vitamins always contain at least this amount of folic acid. If you have a history of a child with spine or skull defects, higher doses of folic acid (4 milligrams daily) are advised during your pregnancy.
Weight Gain
Weight gain is a natural part of pregnancy, and a healthy woman should expect to gain between 25 and 35 pounds during an entire pregnancy. Women carrying twins should expect to gain between 35 and 45 pounds. If you're underweight you should gain slightly more during your pregnancy; if overweight, somewhat less. During the first trimester of pregnancy, 3 to 5 pounds of weight gain is typical. Later, a pound of weight gain per week is common.
Where does all the pregnancy weight go? If we break down your weight-gain by the end of pregnancy, it might look like this:
Daily Calories
You'll need to increase your daily calorie intake by about 10 – 15%; for most women this will mean around 300 calories a day. That's the equivalent of one glass of milk or an extra lean portion of meat per day, not quite the 'eating for two' extravaganza you might imagine! (Women carrying twins should try to take in an extra 500 calories a day.)
Planning your Meals
The Food Guide Pyramid offers a handy way to help you choose appropriate nutrition, showing the number of servings you need to eat from each food group in a single day. Sometimes eating small meals and snacks throughout the day is an easier way to obtain the right total number of servings than forcing yourself to eat three big meals a day.
Fluids
Increasing your fluid intake is important during pregnancy, in order to keep the body well hydrated. This is especially true while you're exercising. Of course, your bladder may not be happy with this situation, and you'll need to urinate frequently. Drink 8 – 12 cups of liquid a day, but be careful of drinking juices—they have a lot of calories and can contribute to excessive weight gain. Dilute juices with water, or switch to water altogether. Avoid soft drinks and diet drinks, and limit drinks with caffeine.
Vitamin Supplements
If you are vegetarian and not eating dairy, fish or eggs, vitamin B-12, calcium and Vitamin D may be necessary nutritional supplements during your pregnancy. Ask your doctor or a nutritionist to help you evaluate your diet, and to decide whether nutritional supplements are needed.
If you are lactose intolerant, calcium supplements are especially important during pregnancy and easy to obtain without a prescription. You should have 1,200 milligrams of calcium daily to meet your nutritional needs.
Iron is often advised during pregnancy to help your body manufacture hemoglobin to produce new blood cells for you and the baby. If you are anemic, you will need more iron than most prenatal vitamins supply. Ask your doctor about which nutritional supplement you should take.
Caffeine
Pregnant women need to keep in mind that caffeine is a stimulant that does cross the placenta. Caffeine in limited amounts is probably safe during pregnancy, but limit yourself to no more than two cups of coffee, tea or cola a day. Also remember that drinking caffeine may interfere with your ability to fall asleep.
Fish Consumption
If you're pregnant or lactating, avoid consuming large amounts of ocean fish due to concerns about mercury contamination, which can cause harm to the nervous system of a developing baby. Avoid shark, swordfish, king mackerel, tilefish and limit tuna and canned fish to no more than 6 ounces a week. Limit all other species to 12 ounces a week.
In addition, the Environmental Protection Agency has concerns about contamination of fish caught recreationally; ask your local health department for any specific advisories.
Food Safety
Pregnancy is a time to be especially aware of food contamination and safety. If you're unsure if a food is spoiled or contaminated, don't take any chances. Handwashing is especially important during food preparation. Work surfaces and utensils should be cleaned with soap and warm water with each use, especially when preparing raw meat or eggs.
Foods to avoid include:
uncooked or rare meats, uncooked seafood or shellfish, foods containing raw or undercooked eggs, alfalfa and other sprouts, unpasteurized milk products and juices, soft cheese
Packaged foods and 'junk foods' have artificial flavors, colors and preservatives–they're often high in calories and low in nutrition. It's best to minimize your intake of these foods, and choose more natural foods with higher nutritional value. The good habits you develop during your pregnancy will be ones to pass on to your growing child later on.
Optimally, good nutrition should begin before conception. Having a healthy diet means eating a wide range of nutritious foods from different food groups, and avoiding potentially harmful substances. Whole grains and fresh vegetables are certainly preferable nutrition to fast foods with high amounts of fats and foods with chemical additives. Alcohol and cigarette use should be discontinued—alcohol can cause birth defects and cigarettes have been shown to increase the risk of miscarriage, low birth weight, and other problems.
Certain birth defects can be reduced by taking nutritional supplements before you conceive and during the early months of pregnancy. You should take at least 400 micrograms of folic acid to reduce the chances of problems with neural tube development. Prenatal vitamins always contain at least this amount of folic acid. If you have a history of a child with spine or skull defects, higher doses of folic acid (4 milligrams daily) are advised during your pregnancy.
Weight Gain
Weight gain is a natural part of pregnancy, and a healthy woman should expect to gain between 25 and 35 pounds during an entire pregnancy. Women carrying twins should expect to gain between 35 and 45 pounds. If you're underweight you should gain slightly more during your pregnancy; if overweight, somewhat less. During the first trimester of pregnancy, 3 to 5 pounds of weight gain is typical. Later, a pound of weight gain per week is common.
Where does all the pregnancy weight go? If we break down your weight-gain by the end of pregnancy, it might look like this:
| Baby | 7½ pounds |
| Breasts | 2 pounds |
| Your fat and protein stores | 7 pounds |
| Placenta | 1½ pounds |
| Uterus | 2 pounds |
| Amniotic fluid | 2 pounds |
| Your extra blood | 4 pounds |
| Increased body fluids | 4 pounds |
| Total | 30 pounds |
Daily Calories
You'll need to increase your daily calorie intake by about 10 – 15%; for most women this will mean around 300 calories a day. That's the equivalent of one glass of milk or an extra lean portion of meat per day, not quite the 'eating for two' extravaganza you might imagine! (Women carrying twins should try to take in an extra 500 calories a day.)
Planning your Meals
The Food Guide Pyramid offers a handy way to help you choose appropriate nutrition, showing the number of servings you need to eat from each food group in a single day. Sometimes eating small meals and snacks throughout the day is an easier way to obtain the right total number of servings than forcing yourself to eat three big meals a day.
 |
| Food Groups | Servings/ day | Example of serving size |
| Bread, cereal, rice and pasta | 6 – 11 | 1 slice bread, ½ cup cooked cereal |
| Vegetables | 4 | 1 cup salad, ½ cup cooked vegetables, 1 cup raw vegetables |
| Fruit | 2 – 4 | 1 medium apple, 4 ounce glass of orange juice |
| Poultry, fish, dried beans Meat, eggs and nuts | 3 – 4 | 1 egg, 2 tablespoons peanut butter, 2 – 3 ounces of Cooked, lean poultry or fish |
| Milk, yogurt and cheese | 4 – 5 | 1 cup of milk or yogurt, 1 ½ Ounce low fat cheese |
Fluids
Increasing your fluid intake is important during pregnancy, in order to keep the body well hydrated. This is especially true while you're exercising. Of course, your bladder may not be happy with this situation, and you'll need to urinate frequently. Drink 8 – 12 cups of liquid a day, but be careful of drinking juices—they have a lot of calories and can contribute to excessive weight gain. Dilute juices with water, or switch to water altogether. Avoid soft drinks and diet drinks, and limit drinks with caffeine.
Vitamin Supplements
If you are vegetarian and not eating dairy, fish or eggs, vitamin B-12, calcium and Vitamin D may be necessary nutritional supplements during your pregnancy. Ask your doctor or a nutritionist to help you evaluate your diet, and to decide whether nutritional supplements are needed.
If you are lactose intolerant, calcium supplements are especially important during pregnancy and easy to obtain without a prescription. You should have 1,200 milligrams of calcium daily to meet your nutritional needs.
Iron is often advised during pregnancy to help your body manufacture hemoglobin to produce new blood cells for you and the baby. If you are anemic, you will need more iron than most prenatal vitamins supply. Ask your doctor about which nutritional supplement you should take.
Caffeine
Pregnant women need to keep in mind that caffeine is a stimulant that does cross the placenta. Caffeine in limited amounts is probably safe during pregnancy, but limit yourself to no more than two cups of coffee, tea or cola a day. Also remember that drinking caffeine may interfere with your ability to fall asleep.
Fish Consumption
If you're pregnant or lactating, avoid consuming large amounts of ocean fish due to concerns about mercury contamination, which can cause harm to the nervous system of a developing baby. Avoid shark, swordfish, king mackerel, tilefish and limit tuna and canned fish to no more than 6 ounces a week. Limit all other species to 12 ounces a week.
In addition, the Environmental Protection Agency has concerns about contamination of fish caught recreationally; ask your local health department for any specific advisories.
Food Safety
Pregnancy is a time to be especially aware of food contamination and safety. If you're unsure if a food is spoiled or contaminated, don't take any chances. Handwashing is especially important during food preparation. Work surfaces and utensils should be cleaned with soap and warm water with each use, especially when preparing raw meat or eggs.
Foods to avoid include:
Packaged foods and 'junk foods' have artificial flavors, colors and preservatives–they're often high in calories and low in nutrition. It's best to minimize your intake of these foods, and choose more natural foods with higher nutritional value. The good habits you develop during your pregnancy will be ones to pass on to your growing child later on.
