PREGNANCY AND A HEALTHY DIET

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Why is a healthy diet important during pregnancy?
How should my diet change now that I am pregnant?
Should I limit how much fish I eat when I’m pregnant?
What other nutrients do I need for a healthy pregnancy?
Should I take a multivitamin during my pregnancy?
How much weight should I gain during pregnancy?
Is it hard to lose weight after pregnancy?
Should I avoid drinking alcohol while I am pregnant?
Should I avoid caffeine while I am pregnant?
Why do pregnant women crave certain foods?
Do I really need to "eat for two?"
What about diabetes and nutrition during pregnancy?
Why do I get morning sickness and nausea, and what can I do about it?

See also:

• Healthy Pregnancy
• Folic Acid
• Fetal Alcohol Syndrome

Why is a healthy diet important during pregnancy?

When you become pregnant, what you eat isn't only important for your own health, but for the health of your baby. Healthy foods are the building blocks for your growing baby since pregnancy is a complex time of developing new tissues and organs. Throughout pregnancy, try to make most of your food choices healthy ones. Eating too many foods that are high in fat during pregnancy leads to too much weight gain for you without meeting your increased need for nutrients.

How should my diet change now that I am pregnant?

If you are eating a well-balanced diet before you become pregnant, you may only need to make a few changes to meet the nutritional needs of pregnancy. According to the American Dietetic Association, pregnant women should increase their usual servings of a variety of foods from the four basic food groups (up to a total of 2,500 to 2,700 calories daily) to include:

• Fruits and Vegetables – Seven or more servings of fruits and vegetables combined (three servings of fruit and four of vegetables) daily for vitamins and minerals. Fruits and vegetables with vitamin C help you and your baby to have healthy gums and other tissues, and help your body to heal wounds and to absorb iron. Examples of fruits and vegetables with vitamin C include strawberries, melons, oranges, papaya, tomatoes, peppers, greens, cabbage, and broccoli. A variety of fruits and vegetables also add fiber and other minerals to your diet, and give you energy. Plus, dark green vegetables also have vitamin A, iron, and folic acid.
  
  
  One Serving Size Fruit = 1 medium apple, 1 medium banana, ½ cup of chopped fruit, ¾ cup of fruit juice
  
  One Serving Size Vegetable = 1 cup raw leafy vegetables, ½ cup of other vegetables (raw or cooked), ¾ cup vegetable juice
• Whole-grains or Enriched Breads/Cereals – Nine or more servings daily for energy. These contain iron, B vitamins, some protein, and other minerals. Try to eat whole grains, like whole-wheat breads and cereals because they have more vitamins and fiber. Many whole-grain products are also fortified with folic acid.
  
  
  One Serving Size = 1 slice bread, ½ cup of cooked cereal, rice, or pasta, 1 cup ready-to-eat cereal
• Dairy Products - Four or more servings of low-fat or non-fat milk, yogurt, or other dairy products such as cheese for calcium. You and your baby need calcium for strong bones and teeth. Dairy products also have vitamin A and D, protein, and B vitamins. Vitamin A helps growth, resistance to infection, and vision. Pregnant women need 1,000 milligrams (mg) of calcium each day. If you are 18 or younger, you need 1,300 mg of calcium each day. Try to have low-fat or non-fat milk and milk products to lower your fat intake. Other sources of calcium include dark green leafy vegetables, dried beans and peas, nuts and seeds, salmon and sardines (with bones), and tofu. If you are lactose intolerant or can’t digest dairy products, 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.
  
  
  One Serving Size = 1 cup of milk or yogurt, 1 ½ oz. natural cheese, 2 oz. processed cheese
• Proteins – Two or more servings of cooked lean meat, poultry without the skin or fish. Don’t eat uncooked or undercooked meats or fish. These can make you sick. Eggs, nuts, dried beans, and peas also are good forms of protein. Most women in this country have no problem getting at least this amount of protein each day. Protein builds muscle, tissue, enzymes, hormones, and antibodies for you and your baby. These foods also have B vitamins and iron, which is important for your red blood cells. Your need for protein in the first trimester is small, but grows in your second and third trimesters when your baby is growing the fastest, and your body is working to meet the needs of your growing baby.
  
  
  One Serving Size = 2-3 oz. of cooked lean meat, poultry, or fish
  
  1 oz. meat also = ½ cup cooked dried beans, 1 egg, ½ cup tofu, 1/3 cup nuts, 2 T. peanut butter

Should I limit how much fish I eat when I’m pregnant?

Some fish have mercury, which, in high doses, can hurt your baby’s growing brain and nervous system. There are some fish you should NOT eat if you are pregnant. Here are some guidelines:

• Do not eat any shark, swordfish, king mackerel, and tilefish (also called golden or white snapper) because these fish have high levels of mercury.
• Many of us enjoy tuna. But, to be safe, don’t eat more than six ounces of “white” or “albacore” tuna or tuna steak each week.
• If you can, buy “light” tuna. But don’t eat more than 12 ounces of light tuna or other cooked fish each week.

Fish low in mercury include shrimp, salmon, pollock, and catfish.

What other nutrients do I need for a healthy pregnancy?

Folic acid: Folic acid, or folate, is the most vital nutrient pregnant women need. Folic acid is a B vitamin that helps prevent neural tube defects (defects of the spine, brain, or their coverings) and other birth defects like cleft lip and congenital heart disease. Because one half of all pregnancies are unplanned, be sure to consume at least 400 micrograms of folic acid every day before getting pregnant and in the first three months of pregnancy. At your first prenatal visit, your doctor can prescribe a prenatal vitamin for you that has this amount of folic acid. You also can buy folic acid pills at the drug store or grocery store. Folate is found in dark-green leafy vegetables (like spinach or kale), beans and citrus fruits, and in fortified whole-grain cereals and breads. To consume enough folic acid, it is best to take a daily vitamin that contains it because it is hard to know if you are getting the right amount from food alone.

Iron: Iron is needed to keep your blood healthy for you and your baby. Iron also helps build bones and teeth. A shortage of iron can cause a condition called anemia. A symptom of anemia is feeling very tired. Your doctor can check for signs of anemia through the routine blood tests that are taken in different stages of your pregnancy. It is recommended that all pregnant women take a low-dose iron supplement, beginning at the first prenatal visit. This amount of iron is usually in the prenatal vitamin your doctor can prescribe for you. If your doctor finds that you have anemia, he or she will give you a higher dose of iron supplements to take once or twice a day. You can help prevent anemia by eating more iron-rich foods like lean red meat, fish, poultry, dried fruits, whole-grain breads, and iron-fortified cereals.

Water: Water plays a key role in your diet during pregnancy. It carries the nutrients from the foods you eat to your baby, and also helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Drinking enough water, especially in your last trimester, prevents you from becoming dehydrated. Not getting enough water can then lead you to have contractions and premature, or early labor. Pregnant women should drink at least six eight ounce glasses of water per day, and another glass for each hour of activity. You can drink juices for fluid, but they also have a lot of calories and can cause you to gain extra weight. Coffee, soft drinks, and teas that have caffeine actually reduce the amount of fluid in your body, so they cannot count towards the total amount of fluid you need.

Should I take a multivitamin during my pregnancy?

Each woman’s nutritional needs are different depending on her health history and other individual factors. During pregnancy, most women take a multivitamin in addition to eating a healthy diet to ensure they get enough nutrients. Discuss taking a multivitamin with your doctor.

How much weight should I gain during pregnancy?

All weight gain during pregnancy should be gradual, with most of the weight gained in the last trimester. You should gain about two to four pounds during the first three months of pregnancy. Then you should gain three to four pounds per month for the rest of your pregnancy. The average total weight gain should be about 25 to 30 pounds. But the amount you gain might be slightly less or more, depending on your weight before you became pregnant and your height.

According to the American College of Obstetricians and Gynecologists (ACOG):

• If you were underweight before becoming pregnant, you should gain between 28 and 40 pounds.
• If you were overweight before becoming pregnant, you should gain between 15 and 25 pounds.

Check with your doctor to find out how much weight gain during pregnancy is healthy for you.

Recent research shows that women who gain more than the recommended amount during pregnancy and who fail to lose this weight within six months after giving birth are at much higher risk of being obese nearly 10 years later. Total weight gained during pregnancy includes six to eight 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 so he or she can check on your weight gain.

Is it hard to lose weight after pregnancy?

It can be hard to lose weight after you have your baby if you gained too much weight during pregnancy. During pregnancy, fat deposits may increase by more than one-third of the total amount you had before becoming pregnant. If weight gain during pregnancy is normal, most women lose this extra weight in the birth process and in the weeks and months after birth. Breastfeeding also can help to deplete the fat gained during pregnancy by helping the body to expend at least 500 more calories each day. For more information on diet and nutrition while breastfeeding go to: http://www.4woman.gov/Breastfeeding/print-bf.cfm?page=235

Should I avoid drinking alcohol while I am pregnant?

There is no time during pregnancy when it is safe for you to drink alcohol. When you are pregnant and you drink beer, wine, hard liquor, or other alcoholic beverages, alcohol gets into your blood. The alcohol in your blood goes to your baby through the umbilical cord. When the alcohol enters the baby's body, it can slow down the baby’s growth, affect the baby’s brain, and cause birth defects. Fetal Alcohol Syndrome (FAS) is a group of birth defects caused by drinking alcohol during pregnancy. Children with FAS have many physical, mental and behavioral problems and may be mentally retarded. They are small, underweight babies. As they get older, they often have trouble with learning, attention, memory, and problem solving. They may have poor coordination, be impulsive, and have speech and hearing problems. The effects of FAS last a lifetime. If you are pregnant and have been drinking alcohol, stop drinking now to protect your baby. If you need help to stop drinking, talk with your doctor or nurse. For more information on FAQ, go to: http://www.4woman.gov/faq/fas.htm

Should I avoid caffeine while I am pregnant?

Caffeine is a stimulant found in colas, coffee, tea, chocolate, cocoa, and some over-the-counter 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 your 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 over-the-counter and prescription drugs. Talk with your doctor before taking any drugs or medicines while pregnant.

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, or breastfeeding, 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 hard.

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 a pregnant 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 nutrition during pregnancy?

If you already have diabetes and would like to get pregnant, your chances of having a healthy baby are good. But, it’s important to plan your pregnancy and follow these steps:

• Bring your diabetes under control before you get pregnant. Try to get your blood sugar under control three to six months before you get pregnant.
• Keep your blood sugar under control during your pregnancy. Keep food, exercise, and insulin in balance. Talk with your doctor or a registered dietician to help you follow a special meal plan. Remember, as your baby grows, your body changes, which will affect your sugar levels. If your blood sugar rises too high, the increased sugar crossing into the placenta can result in a large, over developed fetus with birth defects or an infant with blood sugar level problems.

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. If you develop gestational diabetes, you should talk with your doctor or a registered dietician who can help you with special meal plans to control your blood sugar.

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

Morning sickness and nausea are common problems for pregnant women. Most nausea occurs during the early part of pregnancy and, in most cases, will subside once you enter the second trimester. For some women, morning sickness and nausea might last longer than the early stages of pregnancy or even throughout the entire nine months.

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. Nausea in early pregnancy is a condition that often can be managed by changing when and what you eat. You can try:

• Eating smaller meals each day, such as six to eight small meals instead of three larger ones
• Avoiding being without food for long periods of time
• Drinking fluids between, but not with meals
• Avoiding foods that are greasy, fried, or highly spiced
• Avoiding foul and unpleasant odors
• Resting 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, talk with your doctor.

For More Information…

You can find out more information about pregnancy and nutrition by contacting the National Women's Health Information Center or the following organizations:

American College of Obstetricians and Gynecologists (ACOG) Resource Center
Phone Number: (202) 863-2518
Web Site: http://www.acog.org

U.S. Department of Agriculture
Food and Nutrition Service
Phone Number: (703) 305-2286
Web Site: http://www.fns.usda.gov/fns/

National Maternal and Child Health Clearinghouse
Phone Number: (703) 356-1964
Web Site: http://www.nmchc.org/

All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.

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October 2004