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Good Nutrition in Pregnancy

A nutritious, well balanced diet is vital during pregnancy for both you and your growing baby.

What is a Healthy Diet for Pregnancy?

During pregnancy, your needs for protein, Calcium, Iron, Folate and other vitamins and minerals are increased, but you need only slightly more energy (kilojoules). In other words, it is particularly important time to choose healthy foods rich in the nutrients you and your baby need. Use the "Australian Guide to Healthy Eating" (figure 1) and the Healthy Eating Guidelines (table 1) to guide your choices:

Figure 1: 'The Australian Guide to Healthy Eating'

Table 1: Healthy Eating Guidelines During Pregnancy

More Healthy Diet Tips

• A weight gain of 9-13 kg is generally advisable. "Dieting" to limit weight gain is not generally advisable as there is a risk that you or your baby are not getting the nutrients required for a healthy diet. If you are overweight or underweight at the beginning of the pregnancy, then smaller or larger weight gains respectively, are recommended. A teenager, who is still growing, would have to gain at least 13 kg.
• For Iron include some meat, poultry, or fish daily (and add a food rich in vitamin C, which helps your body absorb iron). It you are vegetarian or vegan (no animal foods whatsoever); you will need to ensure that your intake of protein, iron and vitamin B12 is adequate.
• A 0.4-0.5 mg daily Folate supplement is recommended one-month prior and 3 months post conception. Folate is especially important for normal growth, prevention of anaemia and to help prevent birth abnormalities like spina bifida. Folate occurs widely in a variety of foods including leafy vegetables, citrus fruits, nuts, liver and wholegrain bread.
• Avoid alcohol.
• Avoid smoking.
• Ensure your food is freshly prepared wherever possible and avoid:
  • soft cheese such as brie or camembert or ricotta;
  • pate;
  • raw and smoked seafood (including frozen seafoods), such as oysters, smoked salmon, sushi. (Canned seafood is safe);
  • ready made salads from a salad bar or prepackaged from the deli or supermarket;
  • ready - cooked cold meats, including chicken from a deli, supermarket or sandwich bar; as these foods could contain a bacteria called "Listeria" which is harmful to your baby.
• Continue (or establish) an appropriate exercise routine. Keeping active is important.

Do I need to take supplements?

As mentioned above, 0.4 - 0.5 mg of Folate is recommended 1 month prior and for the first 3 months during your pregnancy. Some doctors routinely recommend Iron supplementation during pregnancy. Otherwise, if you eat well (as outlined in the Healthy Eating Guidelines for Pregnancy), are only expecting 1 child (not twins or triplets) and are in good health, then supplements are generally not required.

Unless recommended by your doctor, be aware that any type of supplement taken regularly or in large amounts is potentially harmful. This includes "natural" supplements, so always consult with your doctor first.

Special Eating Problems!

Just when nutrition becomes so important it seems as though pregnancy simultaneously creates eating problems such as nausea, vomiting, constipation and heartburn. All these are normal pregnancy experiences, but understanding why they occur and how food affects them will help you worry less and develop healthy habits.

Morning Sickness

Morning sickness is usually caused by the hormonal changes of pregnancy, and can affect you at any time of the day. If you experience frequent and severe vomiting you should see your doctor as you may become dehydrated.

Tips to help with Morning Sickness:

• Get plenty of sleep and rest.
• Eat a dry biscuit or piece of toast before you get out of bed in the morning. Sip non-alcoholic drinks between meals eg. Dry ginger ale, flat lemonade, soda water, and plain water. Drink between meals, not with meals. Ensure you drink plenty of fluid.
• Try gelatin desserts, such as flavoured jelly, as these may be well tolerated and a good source of fluid.
• Avoid citrus drinks first thing in the morning.
• Eat small meals throughout the day - an empty stomach can cause nausea. Choose low fat foods and drinks. High fat foods take longer to digest and may make you feel worse.
• Avoid being around the smell of cooking if it makes you feel nauseous.
• Try cold or freshly prepared foods like salads, sandwiches, breakfast cereals, cheese and biscuits and fruit.
• Limit caffeine intake eg. coffee, tea and cola drinks, it stimulates acid secretion in the stomach and is dehydrating.
• If Iron supplements upset your stomach, delay taking them for a few days.
• If none of these food approaches work, eat whatever you can keep down.

Constipation

Many women suffer constipation during pregnancy. It may be caused by a number of factors:

• Hormones relax intestinal muscle tone, causing food to move more slowly;
• Pressure of the baby on the lower part of the intestine;
• Iron tablets;
• Lack of exercise;
• Low fibre intake;
• Low fluid intake.

Tips to help with Constipation:

• Fibre helps make bowel motions bulky and soft, so increase your fibre intake by choosing:
  • Wholegrain breads and cereals, dried peas, baked beans, nuts and lentils;
  • Fruit and vegetables (raw, cooked or fresh salads);
  • Bran (unprocessed) - may be introduced slowly if desired, but should have no more than 1-2 tablespoons per day.
• Drink plenty of fluid (at least 8 glasses, preferable water).
• Exercise regularly - you should check with your doctor about what type of exercise is appropriate for you.
• Laxatives should not be taken unless you have consulted your doctor.
• If you are not anaemic, discuss ceasing the use of Iron supplementation with your doctor.

Heartburn

Many pregnant women experience this burning sensation in the middle of the chest and at the back of the throat. It is caused by a number of factors:

· Increasing pressure on the stomach as the baby grows; · Hormones of pregnancy; · Certain foods.

Tips to relieve Heartburn:

• Avoid the foods that aggravate heartburn such as: chocolate, coffee, peppermints, onions, and some spicy or high fat foods.
• Eat small meals more slowly and eat slowly.
• Drink fluids between meals instead of with meals.
• Do not lie down or bend over for 1-2 hours after eating.
• Sleep propped up on a couple of pillows.
• Sips of milk may relieve the pain. Check with your doctor before using antacids.
• Wear loose fitting clothing.

Heamorrhoids

Haemorrhoids are enlarged veins that protrude through the anus. They can be painful and\or itchy and can bleed. Haemorrhoids occur in pregnancy due to the weight of the baby on the lower bowel.

Tips to help with Haemorrhoids:

• Prevent constipation.
• Where possible, put your feet up and rest to relieve the pressure on your digestive tract.

Cravings

Food cravings and specific food dislikes or intolerances are common during pregnancy. The cause of this unknown, but the overall effect on nutrition is probably not significant. One exception is a food craving known as "pica", where non-food items such as ice, dirt or even detergent is desired. "Pica" can be a symptom of a nutrient deficiency and therefore you should inform your doctor.

MOST IMPORTANTLY, TRY TO ENJOY THIS VERY SPECIAL TIME IN YOUR LIFE!

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