Food: in pregnancy it can be your worst enemy or your best friend. Some women can suffer with nausea and vomiting that prevents them from eating what and when they want. Some women are constantly hungry from the minute the pregnancy test turns positive. Your relationship with food and eating when you are pregnant is important. The smells and tastes of food can be different. The times that you can and cannot eat may change. And what you should be eating changes too.
The health of yourself and your growing baby depends on what you consume and how much you eat. Some dietary issues should even be addressed prior to becoming pregnant. If you are even thinking of trying to get pregnant it is important to take a good look at your eating, drinking and medication habits early. It is also important to be on a complete multivitamin with folic acid or a prenatal vitamin before getting pregnant.
“Eating for two” is a saying that needs to be retired. Pregnancy complications can happen when women gain too much weight during pregnancy, but they can also occur if you do not gain enough weight. How much extra eating should you be doing each day? A woman of normal weight who is pregnant with one baby should not increase the amount of calories that she eats in the first trimester. In the second and third trimesters she should only increase her daily calorie intake by 300 calories (kcal)/day.
The National Institutes of Health have released weight gain recommendations for pregnancy. The amount of weight that you should gain throughout the whole pregnancy is calculated based on what you weighed before you got pregnant. Your pre-pregnancy body mass index (BMI) determines what is a safe amount of weight to gain. Your BMI is calculated by your weight and height and places you in one of four categories: underweight, normal weight, overweight, obese. And the total weight gain depends on that category.
- Underweight (BMI <18.5): 28-40 pounds
- Normal weight (BMI 18.5-24.9): 25-35 pounds
- Overweight (BMI 25-29.9): 15-25 pounds
- Obese (BMI >30): 11-20 pounds
Now that you know what the total amount of weight you should gain is, we can talk about what you should and shouldn’t be eating to gain it.
Your calorie intake should be divided between protein, carbohydrates and fats. You also need more iron, calcium, folic acid, Vitamins A, B, E, C, D and zinc. Most of the vitamins and minerals can come from a good well-rounded diet with a complete prenatal vitamin. There are risks to taking an excess amount of some vitamins and this should be avoided. Also, most “herbal” supplements are not recommend in pregnancy so talk with your OB about everything you are taking, even over the counter “all natural” supplements.
Women with special circumstances (history of gastric bypass, diabetes, previous baby with spina bifida) will need more specific dietary changes and supplements. Some women have diets that restrict certain food groups such as vegetarians and vegans. Some women choose to fast for religious or cultural regions for long periods of time. These issues should also be addressed early on in pregnancy so that your doctor is aware.
Every woman wants to know what is and isn’t safe to eat. The reason that we advise that you avoid certain foods is because of their risk of carrying toxins, bacteria or parasites that can be harmful to you and you baby.
Let’s review a few of the foods to avoid:
- Uncooked or undercooked meats, fish, poultry
- Large ocean fish that are high in mercury: shark, swordfish, king mackerel, tilefish
- Unwashed fruits or veggies
- Raw sprouts (alfalfa, radish, mung bean)
- Unpasteurized dairy products
Cook these well:
- Low mercury fish and shell fish: shrimp, canned tuna, salmon, catfish, pollock, fresh lake fish
- Deli meats, processed meats (hot dogs), smoked meats and cheeses
You may have to decrease your intake of:
- Caffeine: limit to 200 to 300 mg per day (1 to 2 servings a day)
- Fish: 2 to 3 servings a week of low mercury fish (see above)
- Artificial sweeteners
Increase your intake of:
- Iron rich foods
- Washed fruits and veggies
Be very aware of clean food handling practices, washing all fruits and veggies, washing your hands frequently, avoiding contamination with uncooked meats, and cleaning food prep areas well.
As always if you have questions about healthy pregnancy eating please ask your OB/GYN. Many women like to talk with a nutrition specialist early in pregnancy, which can be arranged at your request.