By Melanie Haiken, M.J.
Now that you're pregnant and eating for two, you probably wonder a bit about your diet and whether you're getting the nutrients you need. And if you suffer occasional bouts of nausea or morning sickness, your diet is even more of a concern.
Here are some of the most common questions about nutritional needs during pregnancy.
How much weight should I gain during pregnancy?
Every woman is different. A healthy level of weight gain for you will depend partly on how much you weighed before becoming pregnant. Your doctor may not recommend a specific number of pounds to gain, but instead will let you know if you're gaining too much or too little. A weight gain of between 25 and 35 pounds during pregnancy is about average.
If you were thin before pregnancy, however, you might gain more than that -- as much as 40 pounds -- depending on your doctor's advice. If you were overweight before becoming pregnant, your doctor may suggest that you limit your weight gain to between 15 and 25 pounds. Excessive weight can put you and your baby at risk for pregnancy complications.
According to the American Congress of Obstetricians and Gynecologists (ACOG), your body needs between 100 and 300 extra calories a day to provide sufficient energy for you and your baby. That's not as much as it sounds, unfortunately. The truth is, 300 calories is approximately the amount found in a small peanut butter and jelly sandwich or a half bagel with cream cheese. It's certainly not enough to double your portions or switch to four meals a day.
However, pregnancy is not the time to diet or restrict your intake of fat or carbohydrates. Instead, think in terms of adding healthy snacks to your diet -- or replacing high-fat and sugary snacks with healthier ones. This will help keep your blood sugar stable and also help fight nausea, which can come on stronger when you're hungry.
What types of foods should I eat to help my baby grow?
The best way to get a balanced diet is to focus on eating a wide variety of foods, including plenty of fresh fruits and vegetables, protein, and whole grains. Experts say a balanced diet is drawn from the four basic food groups (the exact amount you need of each depends on your age, sex and activity level):
Carbohydrates for energy. About six ounces of breads, cereals, and grains, preferably whole grain rather than white flour
Fruits and vegetables for vitamins, minerals, and antioxidants. At least five cups of fresh fruits and vegetables, especially those high in vitamins C and A.
Dairy products for calcium. At least three cups of low-fat milk, cheese, yogurt, and other milk products
Meat, beans, and nuts for protein. About five to six ounces of lean meat, poultry, fish, eggs, nuts, and dried beans or peas
Also, make sure you are getting enough fiber in your diet. Fiber, along with lots of water, can help prevent constipation and hemorrhoids, a common complaint of pregnancy. Good sources of fiber are whole grains, beans and other legumes, and fresh fruits and vegetables.
This might sound like an overwhelming amount of food, but a typical serving size is smaller than you might think. One egg -- not two -- is a typical serving of protein, for example, while one slice of cheese counts as a serving of dairy. You may find, in fact, that following the diet recommended above is not that different from how you already were eating!
Should I take an iron supplement?
Anemia, or iron deficiency, is one of the more common complications of pregnancy because your need for iron increases. Anemia can lead to preterm delivery and low birth weight. You can try to get more iron from the food you eat, especially if you don't mind eating a lot of red meat and spinach, but the Institute of Medicine recommends pregnant women get at least 27 mg of iron a day. Some of this can come in the form of a prenatal vitamin. However, if you're becoming anemic, your doctor may suggest that you take iron supplements.
Do I need any extra nutrients while I'm pregnant?
Your doctor will likely recommend a prenatal vitamin that includes additional calcium and folic acid. These two nutrients are very important in pregnancy, and most of our diets do not supply them in sufficient quantities. If, for some reason, you are not able to take a prenatal multivitamin, you can take folic acid and calcium supplements.
The Institute of Medicine recommends that all women of childbearing age take at least 400 micrograms of folic acid a day, the amount contained in many multivitamins. Pregnant women should get at least 600 mcg a day, according to the institute. However, most prenatal vitamins contain 800 micrograms, which is the amount recommended for pregnant women by the U.S. Food and Drug Administration (FDA).
The institute also recommends that pregnant women over 18 get at least 1,000 milligrams of calcium. Those under 18 need even more, about 1,300 mg, although your doctor may prescribe more than this.
Are there any foods I should avoid while pregnant?
Avoid candy, chips, and sugar-laden juices and sodas -- chips and candies aren't nutritious for you or your baby, and too much sugar is unhealthy.
Experts advise pregnant women to avoid certain kinds of fish due to their high mercury content. Mercury is dangerous to your baby's developing brain and nervous system. An FDA issued advisory recommends that pregnant women avoid eating four types of fish that are particularly high in mercury: swordfish, shark, mackerel, and tilefish.
However, it's safe for women who are pregnant or nursing to eat up to 12 ounces of seafood that is low in mercury, such as salmon, each week, according to the FDA. Shrimp, pollock, trout, tilapia, and canned chunk light tuna are other kinds of low-mercury fish.
Be careful, though: Albacore ("white") tuna has more mercury than canned light tuna, so if that's the type you prefer, restrict yourself to no more than six ounces a week.
Experts also advise avoiding undercooked or uncooked meats or fish, such as sushi. In addition, avoid raw eggs, use only pasteurized dairy products, and avoid unpasteurized soft cheeses -- some of them can become contaminated by listeria, a bacteria that could do serious harm to your unborn child. (Check the labels -- Mexican-style soft cheeses like queso blanco sold in markets are sometimes not pasteurized.) Finally, don't drink beer, wine, cocktails or any other kind of alcoholic beverage -- there is no level of alcohol that is considered safe for your developing baby. (And don't smoke -- cigarette smoking has been linked to premature birth and other problems.)
Are there any exceptions to these nutritional guidelines?
There are a few exceptions to the recommended nutritional guidelines for expectant moms. You should talk to your healthcare practitioner about your individual nutritional needs, including any of these conditions:
- If you're a teenager who's still growing, you'll need more food to support your baby's growth, as well as your own.
- If you're expecting twins or multiples, you'll need to eat more to fuel their growth.
- If you're vegetarian or vegan, you'll need to focus on getting enough protein from non-meat and nondairy sources.
- If you have diabetes, you'll need to closely monitor your blood sugar levels.If you develop gestational diabetes during your pregnancy, you'll also need to closely monitor your blood sugar levels.
March of Dimes. Weight Gain. Sept. 2009.http://www.marchofdimes.com/pnhec/159_153.asp
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