Pregnancy and Nutrition

How should my diet change now that I am pregnant?

What are the Recommended Dietary Allowances (RDAs) for pregnant women?

Should I take a multi-vitamin during my pregnancy?

I’ve heard that I will need iron supplements. Is that true?

What about Folic Acid?

Should I avoid drinking alcohol while I am pregnant?

Should I avoid caffeine?

What should I make sure to include in my diet?

Why do pregnant women crave certain foods?

Do I really need to "eat for two?"

What about diabetes and pregnancy?

How much weight should I gain during my pregnancy?

Is it difficult to lose weight after pregnancy?

Why do I get morning sickness and nausea, and what can I do about it?

Is it safe for me to exercise during pregnancy?

What types of exercise are best when I’m pregnant?

What should I be careful about when it comes to exercising?

     Also See:

                   Prenatal Care

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How should my diet change now that I am pregnant?

Even before pregnancy begins, nutrition is a primary factor in the health of mother and baby. If you are eating a well-balanced diet before you become pregnant, you will only need to make a few changes to meet the nutritional needs of pregnancy.

According to the American College of Obstetricians and Gynecologists (ACOG), pregnant women should increase their usual servings of a variety of foods from the four basic food groups to include the following:

• Four or more servings of fruits and vegetables for vitamins and minerals

•  Four or more servings of whole-grain or enriched bread and cereal for energy

• Four or more servings of milk and milk products for calcium

• Three or more servings of meat, poultry, fish, eggs, nuts, dried beans and peas for protein

Eating a well-balanced diet while you are pregnant will help to keep you and your baby healthy. Most physicians agree that the Recommended Daily Allowances (RDAs), except those for iron, can be obtained through a proper diet.

What are the Recommended Dietary Allowances (RDAs) for pregnant women?

The following is a chart that outlines the RDAs for by age group as well as the RDAs for pregnant women.

Should I take a multi-vitamin during my pregnancy?

The nutritional requirements for pregnant women vary based on individual needs. Discuss whether you need to take a multi-vitamin with your doctor.

I’ve heard that I will need iron supplements. Is that true?

Iron is needed in larger doses, especially in the later stages of pregnancy. This mineral is essential to the formation of healthy red blood cells. It is difficult for a woman to consume enough of it from foods to maintain an adequate supply from the mother, often leaving her anemic and exhausted. Anemia can make the mother less able to fight off infections and unable to handle hemorrhaging during the birth. An iron supplement can alleviate this condition, but first discuss whether you need additional iron with your doctor.

What about Folic Acid?

Pregnancy doubles a woman’s need for folate (folic acid or folacin). Folic acid has been shown to be important in preventing neural tube defects, such as spina bifida and anencephaly and is essential to the formation of red blood cells. Severe folate deficiency can result in a condition called megaloblastic anemia, which occurs most often in the last trimester of pregnancy. In this condition, the mother’s heart, liver and spleen may become enlarged which and can threaten the life of the fetus. Folic acid can be found in many foods, including kidney beans, leafy green vegetables, peas, and liver. Women in their childbearing years should consume plenty of these foods. In fact, folate is so important to the health of women and their babies that the Food and Drug Administration (FDA) recently required the addition of folic acid to prepackaged bread and cereals.

However, there is not universal agreement on the necessity of folate supplements for all pregnant women. Some doctors prescribe the supplements primarily for pregnant women who are smokers, drug users, alcohol drinkers or strict vegetarians. While research continues, your doctor will continue to recommend supplements based on your individual health profile.

Should I avoid drinking alcohol while I am pregnant?

Remember that what you eat and drink can affect your baby. Avoid drinking any alcoholic beverages while you are pregnant. Alcohol can cause Fetal Alcohol Syndrome (FAS), which is an condition that can affect your baby for its entire life. FAS is a preventable cause of birth defects and mental retardation.

Should I avoid caffeine?

Caffeine is a stimulant found in colas, coffee, tea, chocolate, cocoa, and some over-the-counter (OTC) and prescription drugs. Consumed in large quantities, caffeine may cause irritability, nervousness and insomnia as well as low-birth-weight babies. Caffeine is also a diuretic and can dehydrate the pregnant woman's body of valuable water. Some studies do indicate that caffeine intake pregnancy can harm the fetus. Until more is known, caffeine should be avoided. Caffeine is an ingredient in many OTC and prescription drugs. Before taking any drugs, a pregnant woman should consult her physician.

What should I make sure to include in my diet?

As a pregnant woman, you need more nutrients to help your baby grow and be healthy. Besides folic acid and iron, which we have already discussed. There are other dietary additions you will need:

Calcium: Pregnant and lactating adult women require an additional 40% of calcium a day (1200-1500 mg per day). Almost all of the extra calcium goes into the baby's developing bones. To get this extra calcium, 3 extra servings (3 cups) of milk or dairy products are needed. If you are lactose intolerant, you can still get this extra calcium. There are several low-lactose or reduced-lactose products available. In some cases, your doctor might even prescribe a calcium supplement.

Sodium: This is important during pregnancy. 2,000 to 8,000 milligrams of sodium a day is recommended during pregnancy. There are 2,325 milligrams of sodium in one teaspoon of salt, and because salt is in most foods, the increased need for it during pregnancy is not too difficult to achieve. Sodium helps to regulate the water in the body.

Fluids: Drink plenty of fluids, especially water, during pregnancy. A woman's blood volume increases dramatically during pregnancy. Drinking at least eight glasses of water a day can help prevent common problems such as dehydration and constipation.

To find out what other nutrients are important during pregnancy and how much you need, ask your healthcare provider any questions you may have.

Why do pregnant women crave certain foods?

The "pickles and ice cream" choices and other appetite cravings of pregnant women may be reflections of the changes in nutritional needs. The fetus needs nourishment and the mother’s body begins to absorb and metabolize nutrients differently. These changes help ensure normal development of the baby and fill the demands of lactation (nursing) after the baby is born.

Do I really need to "eat for two?"

While you are pregnant, you will need additional nutrients to keep you and your baby healthy. However, that does not mean you need to eat twice as much. An increase of only 300 calories per day is recommended. For example, a baked potato has 120 calories, so getting those extra 300 calories should not be that difficult. Make sure not to restrict your diet during pregnancy because you might not be getting the right amounts of protein, vitamins, and minerals that are necessary to properly nourish your unborn baby. Low-calorie intake can cause the mother's stored fat to break down, leading to the production of substances called ketones. Ketones, which can be found in the mother's blood and urine, are a sign of starvation or a starvation-like state. Constant production of ketones can result in a mentally retarded child.

What about diabetes and pregnancy?

Diabetic women should be closely monitored to make sure their blood sugar levels are at or near normal. If maternal blood sugar rises too high, the increased sugar crossing into the placenta can result in a large, over developed fetus with defects or an infant with blood sugar level abnormalities. Diabetic women may also suffer from a greater loss of some nutrients. It is important to maintain tight control of blood sugar before and during pregnancy.

Gestational diabetes is a form of diabetes that begins during pregnancy and usually goes away after the birth of the baby. If you have gestational diabetes, this means that you have a high amount of sugar in your blood. This form of diabetes can be controlled through diet, medication and exercise but if left untreated, gestational diabetes can cause health problems for both you and your baby.

How much weight should I gain during my pregnancy?

Weight gain during pregnancy should be gradual with the most weight being gained in the last trimester. According to the ACOG, you should gain about 2 to 4 pounds during the first three months of pregnancy and then 3 to 4 pounds per month for the rest of your pregnancy. Total weight gain should be about 25 to 30 pounds. This will decrease the risk of delivering a low-birth-weight baby. The Institute of Medicine recommends that women who have a low Body Mass Index (BMI) - the ration of weight to height - should gain 28 to 40 pounds during pregnancy and women who have a higher BMI should gain 15 to 25 pounds. Check with your doctor to determine how much weight gain during pregnancy is healthy for you.

Weight gained includes 6 to 8 pounds for the weight of the baby. The remaining weight consists of a higher fluid volume, larger breasts, larger uterus, amniotic fluid, and the placenta. Make sure to visit your doctor throughout your pregnancy for an assessment of your weight gain. Your doctor can make recommendations about how much weight you should be gaining to ensure that your pregnancy is progressing smoothly and that you are getting the right amount of nutrients.

Is it difficult to lose weight after pregnancy?

It can be if there is too much weight gain. During pregnancy, fat deposits may increase by more than a third of the total amount a woman had before she became pregnant. If the weight gain was normal, most women lose this extra weight in the birth process and in the weeks and months after birth. Breastfeeding helps to deplete the fat deposited during pregnancy. A woman who breastfeeds expends at least 500 more calories than one who doesn’t. The woman who nurses her baby also has increased needs for specific nutrients, and should not be on a weight loss diet.

Why do I get morning sickness and nausea, and what can I do about it?

Morning sickness and nausea are common to about 70% of pregnant women. Most nausea occurs during the early part of pregnancy and, in most cases, will subside once you enter the second trimester. The changes in your body might cause you to become nauseous or sick when you smell or eat certain things, when you are tired or stressed, or for no apparent reason at all. For some women, it might last longer than the early stages of pregnancy or even throughout the entire nine months.

Nausea in early pregnancy is a condition that often can be managed nutritionally:

• Eat small meals

• Avoid going long periods without food

• Drink fluids between, but not with, meals

• Avoid food that are greasy, fried or highly spiced

• Avoid foul and unpleasant odors

• Rest when you are tired

Severe nausea and vomiting in pregnancy is rare, but if it occurs, it may cause you to become dehydrated. If you feel that your nausea or vomiting is keeping you from eating right or gaining enough weight, consult your doctor.

Is it safe for me to exercise during pregnancy?

It is probably safe but you should check with your doctor first. Although some questions have been asked about the effects of exercise on pregnant women, there is no proof that gentle exercise has any bad effects on pregnancy. Studies haven’t shown any benefits for the baby, but gentle exercise might help you feel better and maintain your weight.

What types of exercise are best when I’m pregnant?

The most comfortable exercises are the ones that don’t require your body to bear extra weight. Swimming and stationary cycling can be continued throughout pregnancy. Walking and low-impact aerobics are usually well tolerated. You and your doctor should decide what is best for you and the baby.

What should I be careful about when it comes to exercising?

Be careful to avoid activities that increase your risk of falls or injury, such as contact sports or vigorous sports. Even mild injuries to the "tummy’ area can be serious when you’re pregnant. After 3 months of pregnancy, it is best to avoid exercising while lying on your back, since the weight of the baby may interfere with blood circulation. Also avoid long periods of standing.

When the weather is hot, exercise in the early morning or late evening to help you avoid getting overheated. If you’re exercising indoors, make sure the room has enough ventilation. Consider using a fan to help keep yourself cool. Drink plenty of fluids, even if you don’t feel thirsty.

Make sure you’re eating a well-balanced diet. Normally, pregnancy increases your food requirements by at least 300 calories a day, even without exercise.

from The Office On Women's Health - US Department of Health and Human Services

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