What foods should I eat?
You will need an additional 200 to 300 extra calories from nutrient-dense foods such as lean meats, low fat dairy, fruits, vegetables and whole grain products. It will be important to carefully consider the foods you consume during your pregnancy. This is a time to eat more foods that are nutrient-dense, and fewer sweets and treats. Eat a variety of foods. Use the website www.choosemyplate.gov as a guide to choose the amounts of foods in each food group.
Daily guidelines for eating healthy during pregnancy
Calcium: Calcium is needed in the body to build strong bones and teeth. Calcium also allows the blood to clot normally, nerves to function properly, and the heart to beat normally. The American College of Obstetricians and Gynecologists (ACOG) recommends 1,000 milligrams (mg) per day for pregnant and lactating (breastfeeding) women. Women 19 years or younger need 1,300 milligrams a day. Eat or drink four servings of dairy products or foods rich in calcium. Dairy products are the best source of calcium. Other sources of calcium are dark, leafy greens, fortified cereal, breads, fish, fortified orange juices, almonds and sesame seeds.
Folic acid: Folic acid is used to make the extra blood your body needs during pregnancy. ACOG and the March of Dimes recommend 400 micrograms (mcg) per day for pregnant women. This amount is included in your prenatal vitamins. The March of Dimes suggests that 70 percent of all neural tube defects can be avoided with appropriate folic acid intake. Foods rich in folic acid include lentils, kidney beans, green leafy vegetables (spinach, romaine lettuce, kale, and broccoli), citrus fruits, nuts and beans. Folic acid is also added as a supplement to certain foods such as fortified breads, cereal, pasta, rice and flours.
Iron: Iron is an important part of red blood cells, which carry oxygen through the body. Iron will help you build resistance to stress and disease, as well as help you avoid tiredness, weakness, irritability, and depression. ACOG recommends you receive 27 total milligrams of iron a day between food and your prenatal vitamin. Good sources include whole grain products, lean beef and pork, dried fruit and beans, sardines and green leafy vegetables.
Vitamin A: ACOG recommends you receive 770 micrograms of Vitamin A daily. Foods rich in Vitamin A are leafy green vegetables, deep yellow or orange vegetables (e.g., carrots or sweet potatoes), milk, and liver.
Daily recommendations: Include two to three servings of vegetables, two servings of fruits, at least three servings of whole grain bread, cereals, pasta, two to three servings of lean protein (e.g., meat, fish, and poultry).
Protein: Protein is an important nutrient needed for growth and development. Protein is needed for energy and to build and repair different parts of your body, especially brain, muscle and blood. A pregnant woman needs additional protein for her baby's growth. Each person needs different amounts of protein depending on their size. A woman weighing 150 pounds needs 75 grams of protein every day. (To estimate, use your pre-pregnant weight and divide by two.) Choose a variety of protein-rich foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds. Use labels on packaged food to determine how many grams of protein each food provides.
Avoid alcohol: Alcohol has been linked with premature delivery and low birth weight babies, as well as Fetal Alcohol Syndrome.
Caffeine: It is recommended to limit your caffeine intake. You may choose: two 5-ounce cups of coffee, three 5-ounce cups of tea, or two 12-ounce glasses of caffeinated soda.
Eat salty foods in moderation. Salt causes your body to retain water and could lead to an elevation in your blood pressure.
Do not diet! Even if you are overweight, your pregnancy is not an acceptable time to lose weight. You or your baby could be missing essential nutrients for good growth.
Are there foods that are harmful to eat during pregnancy?
There are specific foods that you will want to avoid during your pregnancy. Hormonal changes during pregnancy can have a negative effect on your immune system and put you at greater risk for contracting a foodborne illness. The Centers for Disease Control and Prevention (CDC), has found that contracting the foodborne illness Listeria during pregnancy can cause premature delivery, miscarriage, and even fetal death. Pregnant women are 20 times more likely to contract Listeria.
You can decrease your chances of contracting Listeria by using caution with hot dogs, luncheon meats, cold cuts, or other deli meats (e.g., bologna), or fermented or dry sausages unless they are heated to an internal temperature of 165°F or until steaming hot just before serving.
Avoid getting fluid from hot dog and lunch meat packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats.
Do not eat soft cheese such as feta, queso blanco, queso fresco, brie, Camembert, blue-veined, or panela (queso panela) unless it is labeled as made with pasteurized milk. Make sure the label says, "MADE WITH PASTEURIZED MILK.”
Pay attention to labels. Do not eat refrigerated pâté or meat spreads from a deli or meat counter or from the refrigerated section of a store. Foods that do not need refrigeration, like canned or shelf-stable pâté and meat spreads, are safe to eat. Refrigerate after opening.
Other foods that are more likely to cause foodborne illnesses include sushi, rare or undercooked meats and poultry (chicken), beef, raw eggs, Caesar dressing, and mayonnaise. For more information on Listeria, go to the CDC.
Another food of concern for pregnant women is fish. Although fish is a low-fat, healthful protein choice, there are certain fish that have elevated levels of methyl mercury or Polychlorinated Biphenyls (PCBs), a pollutant in the environment.
Consuming fish with high levels of methyl mercury during pregnancy has been associated with brain damage and developmental delay for babies.
Eating identified safe fish one time a week is safe for pregnant women.
The March of Dimes recommends pregnant women should avoid all raw and seared fish. Raw fish includes sushi and sashimi, undercooked finfish, and undercooked shellfish (such as undercooked oysters, clams, mussels, and scallops).
Avoid shark, swordfish, king mackerel, and tilefish even when cooked as they have higher levels of mercury.
The March of Dimes cautions against eating fish that may contain higher levels of PCBs. Fish in this category include bluefish, bass, freshwater salmon, pike, trout, and walleye.
For more information on safe fish, go to the CDC, or the March of Dimes.
How much weight should I gain?
Gaining the right amount of weight during pregnancy by eating a balanced diet is a good sign that your baby is getting all of the nutrients he or she needs and is growing at a healthy rate.
Weight gain should be slow and gradual. In general, you should gain about two to four pounds during your first three months of pregnancy and one pound a week for the remainder of the pregnancy. A woman of average weight before pregnancy can expect to gain 15 to 35 pounds during the pregnancy. You may need to gain more or less depending on whether you are underweight or overweight when you get pregnant. Recommendations also differ if you are carrying more than one baby.
Where does all the weight go?
Baby, 6-8 pounds
Placenta, 2-3 pounds
Amniotic fluid, 2-3 pounds
Breast tissue, 0-3 pounds
Blood supply, 3-4 pounds
Fat stores for delivery and breastfeeding (remainder of weight)
Uterus increase, 2-5 pounds
TOTAL: 15 -35 pounds.
What if I am gaining too much weight?
Try to get your weight back on track. Don't consider losing weight or stopping weight gain altogether. You should try to slow your weight gain to recommended amounts, depending on your trimester. During the first trimester, you should gain two to four pounds total; during the second and third trimester, you should gain one pound per week. Consider trying these diet changes to gain weight more slowly:
Eat the appropriate portion size and avoid second helpings.
Choose low-fat dairy products.
Exercise; consider walking or swimming on most if not all days.
Use low-fat cooking methods.
Limit sweets and high-calorie snacks.
Limit sweet and sugary drinks.
What if I am not gaining enough weight?
Every woman is different and not everyone will gain at the same rate. You should talk to your doctor if you are concerned that you are not gaining enough. Weight gain can be hindered by nausea and morning sickness. (See suggestions for when you are not feeling well.) Excessive vomiting can be a symptom of hyperemesis gravidarum, which you should discuss with your doctor. Consider trying these diet changes to gain weight within appropriate ranges:
Eat more frequently. Try eating five to six times per day.
Choose nutrient and calorically dense foods such as dried fruit, nuts, crackers with peanut butter, and ice cream.
Add a little extra cheese, honey, margarine, or sugar to the foods you are eating.
What can I eat if I am not feeling well?
Pregnancy symptoms vary. Some women may have difficulty with morning sickness, diarrhea, or constipation. Here are a few suggestions on how to deal with these symptoms. You may also see the “Medication Guidelines During Pregnancy” section of this book for safe over-the-counter medicine that may assist with symptoms.
Morning sickness: For morning sickness, try eating crackers, cereal, or pretzels before you get out of bed. Eat small meals more frequently throughout the day. Avoid fatty, fried foods.
Constipation: Increase your fiber intake by eating high fiber cereal and fresh fruits and vegetables. Also, make sure you are drinking plenty of water--at least 10-12 glasses per day.
Diarrhea: Increase your intake of foods containing pectin and gum fiber to help absorb excess water. Good choices include applesauce, bananas, white rice, oatmeal, and refined wheat bread.
Heartburn: Eat small, frequent meals throughout the day, eat slowly and chew thoroughly, avoid spicy or rich foods, and caffeine. Do not drink a lot of fluids with your meal, drink fluids in between meals. Try not to lie down after eating a meal, and keep your head elevated when lying down. Refer to the “Medication Guidelines During Pregnancy” section in this book for safe heartburn medications.
Are cravings normal?
Many women will have food cravings during pregnancy, but there are others who do not. If you have food cravings, it's okay to indulge as long as it fits into a healthy diet and does not occur too often.
If you are craving non-food items such as ice, laundry detergent, dirt, clay, ashes, or paint chips, you may have a condition known as pica. You should discuss this with your doctor immediately. Eating non-food items can be harmful to you and your baby and may be a sign of a nutritional deficiency such as iron deficiency.
