The Importance of Healthy Nutrition Throughout Your Pregnancy

Adequate nutrition during your preconception and prenatal periods is important for a healthy pregnancy and healthy baby. Achieving a normal body mass index (BMI) prior to your pregnancy as well as improving your nutritional status prior to and during your pregnancy can lower your risk of pregnancy complications such as gestational diabetes and pre-eclampsia. Remember, you are not eating for two; you only need to increase your calorie intake by 300-500 calories. You should gain weight gradually during your pregnancy, with most of the weight gained in the last trimester.

Read your food labels! What are you consuming to help with your baby’s growth?  Food labels will tell you what nutrients are in the foods you eat. The letters RDA, which you find on food labeling, stand for recommended daily allowance, or the amount of a nutrient recommended for your daily diet. When you’re pregnant, the RDAs for most nutrients are higher.

Pregnant women need a balanced diet including:

• Whole grains: Breads, cereals, pastas and brown rice.
• Fruits: All types of fruits, fresh, frozen or canned without added sugar.
• Vegetables: Eat a variety of colorful vegetables, fresh, frozen or canned with no added salt. Raw sprouts should be avoided.
• Lean protein: Choose lean protein from meat, poultry, fish, eggs, beans and peas, peanut butter, soy products and nuts. Pregnant women should avoid eating tilefish, shark, swordfish and king mackerel, and limit white (albacore) tuna to 6 ounces per week. Deli, luncheon meats and hot dogs should be reheated if consumed.
• Low-fat or fat-free dairy: This includes milk, cheese and yogurt. Unpasteurized milk and some soft cheeses that are made from unpasteurized milk should also be avoided.
• Healthful fats: Vegetable oils including canola, corn, peanut and olive oil are good choices.

Avoid extra calories from added sugar and fats, which can lead to unhealthy weight gain. Cut down on foods such as regular soda, sweets and fried snacks. These are empty calories and of no nutritional value.

Key Nutrients for Healthy Pregnancy

• Folate/Folic Acid: Folic acid reduces the risk of birth defects that affect the spinal cord. All women of childbearing age and pregnant women should consume 800 micrograms of folic acid each day. Sources include fortified foods such as cereals, pastas and breads, supplements and natural food sources of folate, including legumes, green leafy vegetables and citrus fruits.
• Iron: Maternal iron deficiency is the most common nutritional deficiency during pregnancy.  A pregnant woman needs 27 milligrams a day. Your body uses iron to make hemoglobin, a protein in the red blood cells that carries oxygen to your tissues. During pregnancy your blood volume expands to accommodate changes in your body and help your baby make his or her entire blood supply, doubling your need for iron.

If you don’t get enough iron, you may become fatigued and more susceptible to infections. The risk of preterm delivery and low birth weight also might be higher.

Foods with high and moderate amounts of iron include red meat, chicken and fish, fortified cereals, spinach, some leafy greens and beans. For vegetarians and women who do not eat a lot of meat, increase iron absorption by combining plant-based sources of iron with vitamin C-rich foods. For example, try spinach salad with mandarin oranges or cereal with strawberries.

• Calcium: During pregnancy, calcium is needed for the healthy development of a baby’s teeth, bones, heart, nerves and muscles. When a pregnant woman does not consume enough calcium, it is taken from her bones for the baby. It is important to consume adequate amounts of calcium daily before, during and after pregnancy. The recommended amount of calcium during pregnancy is 1,000 milligrams per day for adolescents 14 to 18 years old and 1,300 milligrams per day for women aged 19 to 50. That means at least three daily servings of calcium-rich foods such as low-fat or fat-free milk, yogurt or cheese or calcium-fortified cereals and juices.

Vitamin D Promotes bone strength and helps build your baby’s bones and teeth.  Fatty fish, such as salmon, is a great source of vitamin D.  Other options include fortified milk and orange juice.

There has been many studies recently revealing how common it is women of childbearing age are either insufficient or deficient in their levels of Vitamin D. This can cause an adverse outcome in pregnancy if not addressed.  Your vitamin D3 level should be > 40 ng/ml for a healthy pregnancy and for breastfeeding. Ask your healthcare provider to include your 25-OH-D concentrations of your Vitamin D level in your initial prenatal lab work.

Prenatal vitamins currently contain only 400 IU of Vitamin D3 which is inadequate.

 Protein is crucial for your baby’s growth, especially during the second and third trimesters. You need 71 grams/day. Good sources of protein include: Lean meat, poultry, fish and eggs are great sources of protein. Other options include dried beans and peas, tofu, dairy products, and peanut butter.

When you look at your food choices on your plate, you should have a variety of color!

Fine-tuning your eating habits to ensure you are receiving adequate nutrition for the health of you and your baby is key. Healthy eating during pregnancy is critical for a healthy pregnancy, healthy mom and baby!

Shelia L. Kirkbride,  MS, NC, VE.

 

References:

Mayo clinic.org-Nutrients in pregnancy

maternal vitamin D supplementation reduces the risk of premature birth

http://tinyurl.com/q83koe6

https://www.vitamindcouncil.org/newsletter/newsletter-pregnancy-and-gestational-vitamin-d-deficiency/

Building a Strong Foundation for Your Pregnancy

Contemplating pregnancy?  Nutritional and optimal health should be priority number one!  Women contemplating pregnancy must keep in mind that healthy eating habits and healthy lifestyle behaviors should be established before pregnancy to make sure proper nutrient levels for early embryo development and growth.

Eating a balanced diet that includes the proper amount servings of protein, grains, fruit, and vegetables is key. Protein is essential to the very foundation of your baby’s growth. Eating enough protein ensures that your little one, from the very beginning, is getting adequate food stores to support cell growth and blood production.  Regular exercise should also be incorporated in your daily routine to prepare your body for the demands of pregnancy. Habits such as drinking or smoking must be avoided to allow for optimal health and development of the child during pregnancy and after birth.  Good habits should  include taking a daily multivitamin or a daily prenatal vitamin.  Even if you are consuming healthy foods daily, you can miss out on key nutrients.  A daily prenatal vitamin — ideally starting three months before conception — can help fill any gaps.  A quality, fast absorbing prenatal vitamin is necessary for all the basic micronutrients needed during pregnancy.

Through the course of pregnancy there is an increased need for nutrients and calories to make sure proper fetal growth. The increased need for vitamins and minerals such as folate, calcium and iron is necessary to prevent birth defects, ensure proper bone formation/retention, and to reduce the risks of preeclampsia or anemia. Folic acid intake increases to a daily amount of 800 mcg, calcium to 1200 mg, and iron to 30 mg. Your Vitamin D levels should be checked with your initial prenatal labs to be sure you levels are not insufficient or deficient.  Fetal needs for vitamin D increase during the latter half of pregnancy, when bone growth and ossification are most prominent. Vitamin D travels to the fetus by passive transfer, and the fetus is entirely dependent on maternal stores. Your body needs vitamin D to maintain proper levels of calcium and phosphorus, which help build your baby’s bones and teeth. A vitamin D deficiency during pregnancy can cause growth retardation and skeletal deformities. It may also have an impact on birth weight.  Therefore, maternal status is a direct reflection of fetal nutritional status.

Researchers believe that a vitamin D deficiency during pregnancy can affect bone development and immune function from birth through adulthood.

Blog by Shelia Kirkbride

Limiting Weight Gain during Pregnancy

How much weight should I gain? Gaining the right amount of weight during pregnancy by eating a healthy, balanced diet is a good sign that your baby is getting all 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 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy, unless otherwise directed by your healthcare provider. Your healthcare provider will tell you how much weight you should gain during pregnancy. A woman of average weight and height and/or normal BMI before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your healthcare provider recommends. It is not necessary to “eat for two” during pregnancy. It’s true that you need extra calories from nutrient-rich foods to help your baby grow, but you generally need to consume only 200 to 300 more calories than you did before you became pregnant to meet the needs of your growing baby. Follow the guidelines below if you are gaining weight too quickly during pregnancy. What if I have gained too much weight? If you have gained more weight than recommended during the beginning of your pregnancy, DO NOT try to lose weight. It is never safe to lose weight during pregnancy — both you and your baby need the proper nutrients in order to be healthy. Be sure to eat a variety of foods to get all the nutrients you and your baby need. Follow the guidelines and serving recommendations on The Food Guide Pyramid to avoid further excess weight gain. Think about the foods you eat and avoid those foods that will not give you and your baby the nutrition you both need. Follow the glycemic index,which is simply a measurement of the impact carbohydrates have on your blood sugar levels. Check out http://tinyurl.com/8vqbtv. Make sure you are active and getting adequate time in for exercise. Keep in mind that you will lose some weight during the first week your baby is born. You’ll be surprised at how quickly you lose the remaining weight by following a balanced diet and exercising. If you are gaining weight too fast during pregnancy… When eating out at a fast food restaurant, choose lower fat items such as broiled chicken breast sandwich with tomato and lettuce (no sauce or mayonnaise), side salad with low-fat dressing, plain bagels or a plain baked potato. Avoid fried foods such as french fries, mozzarella sticks or breaded chicken patties.Avoid whole milk products. You need at least 4 servings of milk products every day. However, using skim, 1 or 2 percent milk will greatly reduce the amount of calories and fat you eat. Also choose low-fat or fat-free cheese or yogurt.Limit sweet or sugary drinks. Sweetened drinks such as soda, fruit punch, fruit drinks, iced tea, lemonade or powdered drink mixes provide many calories with little nutrients. Choose water, club soda, or mineral water to avoid extra calories. Do not add salt to foods when cooking. Salt causes your body to retain water. Limit sweets and high calorie snacks. Cookies, candies, donuts, cakes, syrup, honey and potato chips provide many calories with little nutrition. Try not to eat these types of foods every day. Instead, try fresh fruit, low-fat yogurt, angel food cake with strawberries, or pretzels as lower calorie snack and dessert choices.Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream and cream cheese. Try the lower fat substitutes that are available for these foods.Prepare meals using low-fat cooking methods. Frying foods in oil or butter will increase the calories and fat of that meal. Baking, broiling or boiling are healthier, lower fat methods of cooking. Read Labels of food you purchase! Exercise. Moderate exercise, as recommended by your healthcare provider, can help burn excess calories. Walking or swimming is safe, effective exercises for pregnant women. It is perfectly safe for you to walk 30 to 60 minutes every day. Wear comfortable shoes and clothes. Open your front door and walk away from your house for 15 minutes as fast as you can. If you can sing while you walk, you are not walking fast enough. Be sure to talk to your healthcare provider before starting an exercise program.

Tips for Morning Sickness

by Angel J. Miller, MSN, CNM

Nausea, with or without vomiting, is known as “morning sickness” but may occur any time of the day or night. Although we do not know exactly why women experience morning sickness, some thoughts are:

• hormonal changes during pregnancy
• low blood sugar
• gastric overload
• slowed movement of the intestines
• enlarged uterus
• emotional factors

Take heart! In most cases morning sickness goes away by the 14th week of pregnancy.

Try the following comfort measures to ease the symptoms:

 Eat small, frequent meals (5-6 a day or on the average of every 2 hours)
• Avoid foods that do not have an appealing smell or taste to you at the time. Eat whatever sounds good. Let someone else do the cooking!
• Avoid strong or offensive odors, spicy, fried or greasy foods
• Restrict fat intake

 Dry crackers, cereal or bread—every time you are up to pee at night and first thing in the morning.
• On bad days, have crackers at the bedside even before getting/sitting up

 Drink or sip ice cold beverages. Some women do better just sucking on ice, and some do better when they add a splash of lemon juice to their cold water.
• Do not drink fluids with meals, do so after
• Do not drink large amounts of fluids at one time; sip on small amounts frequently between meals

 Eat a protein snack just before going to bed, such as cheese & crackers, or peanut butter & toast.

Stop your vitamins and iron supplements (temporarily) if you think they are adding to your morning sickness problem, or try taking the vitamin at bedtime with a snack.

Take a vitamin B6 (pyridoxine) tablet-30-50mg, 3 to 4 times a day-every day initially, then 1-2 times per day until problem has subsided
• Ovaltine is enriched with vitamin B6
• Another suggestion is to take Unisom (doxylamine) 1 tablet
(25 mg) at bedtime-with the vitamin B6. In the morning take ½ a tablet (with the B6). At 2 pm, ½ tablet with vitamin B6. Ask your pharmacist to help you find this medication. It is available over-the-counter and some brands are less expensive that others. In order for this to help, you need to take it regularly not just when you feel sick.

• Or you can take Vitamin B6, 100mg, po, three times a day with Magnesium 500mg, po, twice a day

Sea-Bands (seasickness prevention wrist bands) which are available at most drug stores help many women. Some women swear by them, and others do not find them helpful

• Take ginger. You can find this spice in the health food or vitamin stores. Get the 250 mg capsules. Take one capsule 4 times each day, or try nibbling on ginger snap cookies, sip on ginger tea
• Papaya or papaya tablets, as directed on the bottle
• Suck on fireballs or lemon balls; chewing cinnamon gum
• Alfalfa tablets—2 at bedtime, 2 late in day
• Basil, chamomile, spearmint, or peppermint tea

DO NOT SKIP MEALS EVEN IF YOU ARE NAUSEATED OR HAVE NO APPETITE! Graze…

If these suggestions do not work ask your health care provider about prescription medications that are available. They can make you sleepy; therefore it is wise to try the other remedies first.

**If you ever find that you are among the very few who are unable to keep anything down for 48 hours (even liquids) give us a call. In these extreme cases we recommend that you come into the hospital for IV fluid therapy.

Limiting Weight Gain during Pregnancy

How much weight should I gain? Gaining the right amount of weight during pregnancy by eating a healthy, balanced diet is a good sign that your baby is getting all 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 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy, unless otherwise directed by your health care provider. Your health care provider will tell you how much weight you should gain during pregnancy. A woman of average weight before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your health care provider recommends. It is not necessary to “eat for two” during pregnancy. It’s true that you need extra calories from nutrient-rich foods to help your baby grow, but you generally need to consume only 200 to 300 more calories than you did before you became pregnant to meet the needs of your growing baby. Follow the guidelines below if you are gaining weight too quickly during pregnancy. What if I have gained too much weight? If you have gained more weight than recommended during the beginning of your pregnancy, DO NOT try to lose weight. It is never safe to lose weight during pregnancy — both you and your baby need the proper nutrients in order to be healthy. Be sure to eat a variety of foods to get all the nutrients you and your baby need. Follow the guidelines and serving recommendations on The Food Guide Pyramid to avoid further excess weight gain. Think about the foods you eat and avoid those foods that will not give you and your baby the nutrition you both need. Keep in mind that you will lose some weight during the first week your baby is born. You’ll be surprised at how quickly you lose the remaining weight by following a balanced diet and exercising. If you are gaining weight too fast during pregnancy… When eating out at a fast food restaurant, choose lower fat items such as broiled chicken breast sandwich with tomato and lettuce (no sauce or mayonnaise), side salad with low-fat dressing, plain bagels or a plain baked potato. Avoid fried foods such as french fries, mozzarella sticks or breaded chicken patties.Avoid whole milk products. You need at least 4 servings of milk products every day. However, using skim, 1 or 2 percent milk will greatly reduce the amount of calories and fat you eat. Also choose low-fat or fat-free cheese or yogurt.Limit sweet or sugary drinks. Sweetened drinks such as pop, fruit punch, fruit drinks, iced tea, lemonade or powdered drink mixes provide many calories with little nutrients. Choose water, club soda, or mineral water to avoid extra calories. Do not add salt to foods when cooking. Salt causes your body to retain water. Limit sweets and high calorie snacks. Cookies, candies, donuts, cakes, syrup, honey and potato chips provide many calories with little nutrition. Try not to eat these types of foods every day. Instead, try fresh fruit, low-fat yogurt, angel food cake with strawberries, or pretzels as lower calorie snack and dessert choices.Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream and cream cheese. Try the lower fat substitutes that are available for these foods.Prepare meals using low-fat cooking methods. Frying foods in oil or butter will increase the calories and fat of that meal. Baking, broiling or boiling are healthier, lower fat methods of cooking. Exercise. Moderate exercise, as recommended by your health care provider, can help burn excess calories. Walking or swimming is generally safe, effective exercises for pregnant women. Be sure to talk to your health care provider before starting an exercise program.