Happy Pregnancy…!

By: Pallavi Vathiar. Practicing Clinical Nutritionist, Mumbai.

Email: fihealthie@gmail.com

Did you know that a baby’s teeth begin to develop between the third and sixth months of pregnancy? That’s why making smart food choices now can help set your child up to be Mouth Healthy for Life. During your pregnancy a sufficient quantity of nutrients—especially vitamins A, C, and D, protein, calcium and phosphorous—are needed. A pregnant woman needs more calcium, folic acid, iron and protein than a woman who is not expecting.

Nutritional Requirements

Folic Acid

Also known as folate when the nutrient is found in foods, folic acid is a B vitamin that is crucial in helping to prevent birth defects in the baby’s brain and spinal cord, known as neural tube defects.

It may be hard to get the recommended amount of folic acid from diet alone. Recommendation for  women who are trying to have a baby take a daily vitamin supplement containing 400 micrograms of folic acid per day for at least one month before becoming pregnant. During pregnancy, they advise women to increase the amount of folic acid to 600 micrograms a day, an amount commonly found in a daily prenatal vitamin (1).

Food sources: leafy green vegetables fortified or enriched cereals, breads and pastas, beans, citrus fruits.

Calcium

This mineral is used to build a baby’s bones and teeth.

If a pregnant woman does not consume enough calcium, the mineral will be drawn from the mother’s stores in her bones and given to the baby to meet the extra demands of pregnancy. Many dairy products are also fortified with vitamin D, another nutrient that works with calcium to develop a baby’s bones and teeth. Pregnant women age 19 and over need 1,000 milligrams of calcium a day; pregnant teens, ages 14 to 18, need 1,300 milligrams daily, according to ACOG.

Food sources: milk, yogurt, cheese, calcium-fortified juices and foods, sardines or salmon with bones, some leafy greens (2).

Iron

Pregnant women need 27 milligrams of iron a day, which is double the amount needed by women who are not expecting, according to ACOG. Additional amounts of the mineral are needed to make more blood to supply the baby with oxygen. Getting too little iron during pregnancy can lead to anaemia, a condition resulting in fatigue and an increased risk of infections.

To increase the absorption of iron, include a good source of vitamin C at the same meal when eating iron-rich foods, ACOG recommends. For example, have a glass of orange juice at breakfast with an iron-fortified cereal (3).

Food sources: meat, poultry, fish, dried beans and peas, iron-fortified cereal.

Protein

More protein is needed during pregnancy, but most women don’t have problems getting enough protein-rich foods in their diets as  it helps to build important organs for the baby, such as the brain and heart (4) .

Food sources: meat, poultry, fish, dried beans and peas, eggs, nuts, tofu.

Nutrition Tips

  • Eat a variety of healthy foods, such as fruits; vegetables; whole-grain products such as cereals, breads or crackers; and dairy products like milk, cheese, cottage cheese or unsweetened yogurt.
  • Eat fewer foods high in sugar, including candy, cookies, cake, and dried fruit; and drink fewer beverages high in sugar, including juice, fruit-flavoured drinks, or soft drinks.
  • For snacks, choose foods low in sugar such as fruits, vegetables, cheese and unsweetened yogurt.
  • Read food labels so you can choose foods lower in sugar.
  • If you have trouble with nausea, try eating small amounts of healthy foods throughout the day.
  • Drink water or milk instead of juice, fruit-flavoured drinks or soft drinks.
  • Drink water throughout the day, especially between meals and snacks. Drink fluoridated water (via a community fluoridated water source) or if you prefer bottled water, drink water that contains fluoride.
  • To reduce the risk of birth defects, get 600 micrograms of folic acid each day throughout your pregnancy. Take a dietary supplement of folic acid and eat foods high in folate and foods fortified with folic acids, including:
  1. Asparagus, broccoli and leafy green vegetables such as lettuce and spinach
  2. Legumes (beans, peas, lentils)
  3. Papaya, tomato juice, oranges or orange juice, strawberries, cantaloupe and bananas
  4. Grain products fortified with folic acid (breads, cereals, cornmeal, flour, pasta, white rice) (2)

Tips For Eating Well

  • Don’t eat for two: First things first, the whole ‘eating for two’ thing is a myth. During pregnancy you don’t need to consume any extra calories for your baby, until the final trimester. At that point you need an extra 200 calories only.
  • Choose slow release foods: Choose foods that release their energy slowly, rather than give you an energy spike, which ends with a crash (think sugary things like biscuits, cakes). Multigrain or granary bread, Basmati rice, Potatoes – new, boiled, baked – and eat the skin, Sweet potatoes, Wholemeal pasta.
  • Breakfast like a king: Don’t skip breakfast. People who eat breakfast are better able to manage their weight. Choose sugar-free wholegrain cereals.  Try and get some of your 5 a day in if possible by adding fruit. During pregnancy, it can also help ease morning sickness by boosting your blood sugar levels and is likely to stop you overeating later in the day.
  • Stay active: Another pregnancy myth is that exercise might harm your baby. It won’t. Staying active will benefit both you and your baby, and help get your body ready for labour.
  • Healthy food swaps: When you get a craving for sweet foods, it’s easy to reach for a comforting slice of cake. That’s fine as a special treat once in a while, but you and your baby will benefit from some more nutritious calories. Try these simple food swaps.
  • Drink right: Your body needs extra fluids to keep up with the demands of pregnancy. Water is the best choice, but if you need to mix it up try to avoid sugary drinks like cola and stick to one glass of fruit juice a day.
  • High in natural sugar, fruit juice can make your blood sugar levels fall and rise rapidly. Choose fresh juice with pulp, and avoid shop-bought juices with added sugar, or ‘made from concentrate’.
  • Calcium is great for you and your baby, but when drinking milk, choose semi-skimmed, not full-fat.
  • Eating smaller meals throughout the day can help in all sorts of ways. It can:
  1. Prevent nausea and sickness
  2. Help with indigestion and heartburn
  3. Make you feel more comfortable as the baby gets bigger
  4. Keep sudden pregnancy cravings under control (5).

Summary of Tips

  • Talk to your health care professional about how much weight you should gain during your pregnancy, and regularly track your progress.
  • Consume foods and beverages rich in folate, iron, calcium, and protein. Talk with your health care professional about prenatal supplements (vitamins you may take while pregnant).
  • Eat breakfast every day.
  • Eat foods high in fiber, and drink fluids (particularly water) to avoid constipation.
  • Avoid alcohol, raw or under cooked fish, fish high in mercury, under cooked meat and poultry, and soft cheeses.
  • Do moderate-intensity aerobic activity at least 150 minutes a week during your pregnancy. If you have health issues, talk to your health care professional before you begin.
  • After pregnancy, slowly get back to your routine of regular, moderate-intensity physical activity.
  • Gradually return to a healthy weight (6).

Weight Gain During Pregnancy

“Weight gain during pregnancy often has ebb and a flow over the nine months.” It’s hard to measure where pregnancy weight is going, a scale does not reveal whether the pounds are going to a woman’s body fat, baby weight or fluid gains.

In general, underweight women need more calories during pregnancy; overweight and obese women need fewer of them. The Institute of Medicine (IOM) guidelines for total weight gain during a full-term pregnancy recommend that:

  • Underweight women, who have a Body Mass Index (BMI) below 18.5, should gain 28 to 40 lbs. (12.7 to 18 kilograms).
  • Normal weight women, who have a BMI of 18.5 to 24.9, should gain 25 to 35 lbs. (11.3 to 15.8 kg).
  • Overweight women, who have a BMI of 25.0 to 29.9, should gain 15 to 25 lbs. (6.8 to 11.3 kg).
  • Obese women, who have a BMI of 30.0 and above, should gain 11 to 20 lbs. (5 to 9 kg).

Rate Of Weight Gain

The IOM guidelines suggest that pregnant women gain between 1 and 4.5 lbs. (0.45 to 2 kg) total during their first trimester of pregnancy. The guidelines recommend that underweight and normal-weight women gain, on average, about 1 pound every week during their second and third trimesters of pregnancy, and that overweight and obese women gain about half a pound every week in their second and third trimesters of pregnancy.

Twins

The IOM guidelines for pregnancy weight gain when a woman is having twins are as follows:

  • Underweight: 50 to 62 lbs. (22.6 kg to 28.1 kg).
  • Normal weight: 37 to 54 lbs. (16.7 to 24.5 kg).
  • Overweight: 31 to 50 lbs. (14 to 22.6 kg).
  • Obese: 25 to 42 lbs. (11.3 to 19 kg) (7).

Reference:

  1. https://www.marchofdimes.org/pregnancy/folic-acid.aspx
  2. https://www.eatright.org/
  3. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy
  4. https://www.livescience.com/53044-protein.html
  5. https://www.tommys.org/pregnancy-information/im-pregnant/nutrition-pregnancy/7-tips-eating-well-pregnancy
  6. https://www.niddk.nih.gov/health-information/weight-management/healthy-eating-physical-activity-for-life/health-tips-for-pregnant-women
  7. http://www.iom.edu/pregnancyweightgain

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