Further information

Healthy Diet during Pregnancy

Nutrition is the foundation of life:

Remember your growing baby eats what you eat, but don’t wait until you are pregnant before you change or modify your diet because the most important first few critical weeks of development could easily be lost. Many prospective mothers do not realise that they are pregnant until after this time. This is the most active period of cell division, when the baby is already forming. The critical period for neural tube development happens before most women know they're pregnant. By the end of the first month of pregnancy the neural tube should have closed and fused, this becomes the spinal cord and brain. If the neural tube does not close or fuse properly then it can lead to a range of defects covered by the term spina bifida.

It is a recognised fact that good nutrition, and consequently a healthy diet, helps in preparing a woman's body for the complex process that takes place during pregnancy and even whilst breastfeeding.

Nutrition is not only important during pregnancy but also in the months prior. This period is particularly crucial because the nutritional status of the mother before birth and even before conception can affect greatly the quality of the first 6 to 12 months of a baby's life. The baby relies on mother for all of its nutritional needs. If the nutrients are unavailable, the foetus will suffer.
These periods require a rich supply of protein, vitamins and minerals for both mother and child.

Before conception:

Change your diet whilst you are trying to conceive, try to follow a more balanced approach to food intake, and:

• Quit the pill some time before you start, as this can alter the levels of nutrients in your body; particularly vitamin B6, folate (folic acid) and zinc.
• Try to avoid fatty foods, particularly trans fatty acids
• Reduce caffeine intake (tea, coffee, some soft drinks)
• Stop drinking alcohol. effects of alcohol
• Stop smoking. effects of smoking
• Stop drugs (unless prescribed by your doctor) effects of drugs

Diet and nutrition is just as important for the prospective father as it is for a mother-to-be particularly before conception. Malef fertility and diet for father to be

During Pregnancy:

You do not need to eat for two, women of average weight only need to increase their calorie intake by 200 – 300 kcal per day from about the 3rd month of pregnancy. This is the equivalent of only two slices of toast, 1 glass of milk or a jacket potato with cheese or baked beans.
Weight gain of around 25 – 35 lbs is quite normal for a woman of average weight during pregnancy, but this obviously varies from woman to woman.
Don’t diet during pregnancy as this could cause deficiencies in essential nutrients or fats.

Follow a balanced, varied diet by taking foods from all of the major food groups:

• Bread, potatoes and cereals – these are a primary source of carbohydrates, choose un-refined / complex carbohydrates (such as wholemeal bread, brown rice, wholegrain cereals, whole wheat pasta, baked potatoes) which provide good sources of energy, vitamins, minerals and fibre. They are slowly digested and do not cause large fluctuations in blood sugar levels, as can occur from eating simple carbohydrates (such as sugars for more information). Controlling blood sugars. Aim to eat 5 to 7 portions per day.

• Fresh fruit and vegetables - provide minerals/ vitamins and fibre. Aim to eat at least 5 portions per day. Buy your produce as fresh as possible (organic if possible) and use quickly. Wash and, where practical, peel things like carrots and apples before eating as the skin may contain potentially harmful pesticides and fertilizers. Eat them raw or lightly cooked - without additional salt. Where possible steam for a very short time only. Over cooking will reduce their nutrient content.

• Meat, poultry and alternatives group – these foods include lean meat, fish, pulses, eggs, milk, cheese, cereals, nuts and seeds they provide a good source of protein. Most women in the western world already obtain more than 60g protein per day, which is equivalent to or more than some governmental recommendations for pregnant women. It may not be necessary to increase your intake of these foods, aim for 2 portions per day. Try to eat more fish in place of red meat. Don’t forget foods rich in essential fatty acids - such as oily fish, nuts and seeds. These are vital for your baby’s growing brain and nervous system.
  
  Vegetarians can substitute pulses, grains, cereals, nuts and seeds for fish and meat.

• milk and dairy foods – these include milk, cheese, yoghurt and fromage frais which are rich in calcium. Aim to eat 2 to 3 portions per day. Do not increase dairy and egg products during pregnancy (these could cause food allergies or intolerance).

• Foods and drinks with fat and sugar – these foods include butter, margarine, cooking oils, salad dressings, crisps, cakes as well as soft drinks and sweets. Sugary foods and drinks can lead to ‘sugar spikes’, try to reduce these and replace then with foods and drinks that will not have this affect, regulating sugars is the key, for more information on balancing blood sugars, balancing blood sugars. Reduce intake of these foods particularly those containing trans fatty acids.

Increase fibre intake
Ensure that you eat lots of fruit, vegetables, grains, cereals and legumes. This increases the amount of dietary fibre in your diet and could avoid potential problems of constipation and piles.

Drink at least 6 – 8 glasses of water per day.
Water acts as the body’s transportation system, and carries nutrients through the blood to the baby and also flushes out the system carrying waste out of the body.

But possibly the most important reason to drink water is to keep the body hydrated, dehydration in pregnant women can be very serious. Particularly in the third trimester when the blood volume increases by nearly double and demands for replenishment of amniotic fluid increases.

Water is just as essential during breastfeeding to ensure mother and baby have sufficient fluids.

Nutrient alert:

Watch out for these particular nutrient levels

Proteins
The recommended increase for protein is only 10g more than the non-pregnant state. During pregnancy, the body conserves protein, especially in the last half of pregnancy when the demand is greatest. Protein deficiency during pregnancy can have serious consequences for development of the foetus. Metabolism is altered if the quantity and/or quality of protein is inadequate.

Protein is found in many foods: lean meat, chicken, fish, eggs, pulses, cereal, nuts and tofu. Dairy foods, such as milk, cheese and yoghurt all of which contain high levels of calcium are also good sources of protein.

Try to eat fish at least twice a week, including some oily fish, such as salmon, mackerel, sardines and trout. The UK Food Standards Agency (FSA) recognises the health benefits of eating fish but advises that pregnant women should not eat shark, marlin or swordfish and limit intake of tuna because of pollutants such as mercury.

Folate (folic acid)
Folate deficiency can lead to birth defects referred to as neural tube defects (NTD’s), this lack of Folic acid can keep the neural tube from closing properly; in later pregnancy this becomes the spinal cord and brain. This should happen by the end of the first month of pregnancy. For this reason it is recommended that most women take 400mcg 3 months prior to conception and continue this through the first 3 months of pregnancy.

Folate is found in dark green leafy vegetables, cabbage, fish, nuts, liver, walnuts, orange juice and wheat germ.

Vitamin B12
This vitamin is essential during pregnancy for normal cell division and therefore for normal growth and development of your baby, it is critical during fetal development.
2.2µg to 2.6µg of vitamin B12 a day are required during pregnancy and breastfeeding. Vegetarians may have reduced levels because of a lack of dairy products, eggs and yeast extract.

It is found in animal products such as egg, brewer's yeast, liver, fish, and, wheat germ, whole grains, meat, milk, soya beans, milk and margarines.

Iron
Demands are higher because of both the increase in mother’s blood volume and the blood formed in the foetus, this is needed to prevent anaemia.

During pregnancy the need for iron is increased particularly during the later stages (2nd & 3rd trimester), recommended intake increases to 30mg during this period.
Vegetarians should be more vigilant as vegetable sources of iron are not as well absorbed as animal sources.

Vitamin C helps to aid absorption. The tannin in tea can inhibit iron absorption so try to reduce intake during pregnancy.
Some doctors prescribe iron tablets.

Wholegrain cereals, pulses, green veg and dried fruit, lean meats, fish, and poultry.
Is found in bananas, egg yolks, kidneys, liver, shellfish, red meat, molasses, apricots, haricot beans, raisins, prunes, pumpkin and sesame seeds.

Calcium & Vitamin D
Calcium is important, particularly in the later stages of pregnancy, for proper fetal bone development. If the woman does not get enough calcium during pregnancy then the growing baby will draw it from her bones and teeth leaving her at risk in later life of osteoporosis, this risk obviously increases with each subsequent pregnancy.

Calcium absorption becomes more efficient during pregnancy but some vegetarians and vegan women may need to increase intake because of low consumption of dairy products.

The requirement for calcium increases by 50% to 1,200 mg per day during pregnancy.
Sources include: milk, hard cheese, broccoli, peanuts, walnuts, salmon, sardines, sunflower seeds, green leafy vegetables, almonds, sesames seeds, wholegrain cereals and pulses.

Vitamin D is involved in the process of cell division, promotes the absorption of calcium from the intestine and helps the incorporation of calcium from the blood.

Deficiency leads to skeletal defects such as rickets in children.
Sources include: Butter, eggs, liver oils, fish, milk, mushrooms, oily fish, and, exposure to sunshine activates a pre-vitamin in the skin.

Zinc
Zinc is one of the trace elements necessary for health and growth. Deficiency is also related to complications of labour and delivery. The importance of zinc for healthy fetal bone growth and development of the immune system is well documented. But even before birth is has been shown to be necessary for the formation of sperm, ovum, ovulation and even to aid fertilisation. The recommended intake of zinc increases by 50 percent during pregnancy and breastfeeding. Studies have indicated that Iron supplements can reduce zinc absorption so it may be necessary to ensure adequate intake levels.

Zinc is found in egg, liver, nuts, onions, pumpkin, peanuts, red meat, shellfish, sunflower seeds, wheat germ, whole wheat and wheat bran.

Essential Fatty acids
Fatty acids are an integral part of every membrane. Many women start pregnancy deficient in EFAs, particularly if they have given birth before.
There are several families of EFAs including omega 3 and omega 6.
Omega 3 DHA (docosahexaenoic acid) is particularly important as it is used in large amounts during your baby’s growth and is vital for the development of his/her brain, central nervous system and retina.

The last trimester is important because it requires a substantial amount of DHA, since 50% of the LCP in the brain is DHA.
The dietary intake recommended for an adult woman in the UK is 100mg/day, the minimum benchmark daily amount recommended by the ISSFAL (International Society for the Study of Fatty Acids and Lipids) is 300mg/day for pregnant and breastfeeding women.

Blockages can also inhibit the absorption of dietary fatty acids. blockages to EFA pathways.
A woman would need to eat at least one portion of oily fish a day not two a week as recommended by the Food Standards Agency (FSA). The FSA warns pregnant women about eating too much oily fish during pregnancy because of the high levels of mercury pollution it contains. mecury and pregnancy. Therefore the only practical solution is to take essential fatty acids (or omega-3 fish oil) supplements, which can provide women a pure alternative source of these essential fatty acids that they might otherwise lack due to their diet. essential fatty acids in diet.

What to avoid

The placenta brings important things, such as oxygen and nutrients, to your baby and it removes the waste products that your baby produces while in your womb.
However the placenta cannot stop harmful substances such as alcohol and nicotine from smoking, crossing from you to your baby.

• Avoid alcohol - this can lead to Fetal Alcohol Syndrome.
• Avoid caffeine – this can reduce absorption of certain nutrients
• Avoid smoking – this can cause problems for mother and baby. smoking during pregnancy .
• Avoid drugs & medicines – only take prescribed medicines but always consult your doctor before doing so or if you are unsure. drugs during pregnancy.
• Avoid herbal supplements – the effects of some herbal drugs are not known, always consult your doctor if you are unsure.
• Avoid fish at risk of contamination by mercury - this means such fish as fresh tuna, swordfish, shark, king mackerel or tilefish. mecury intake during pregnancy
• Avoid fish at risk of contamination by chemicals such as PCBs (industrial pollutants): bluefish, stripped bass, salmon, trout, walleye. Supplements can offer a pure source of essential fatty acids. mecury soucres in fish.
• Avoid foods at risk of contamination by listeriosis bacteria: unpasterised milk, soft cheese (such as brie, camembert, cambozola & stilton), raw vegetables and raw seafood (such as crabs, oysters, prawns)
• Avoid foods at risk of contamination by other bacteria: raw meat such as sushi, seafood (shellfish), rare or uncooked meat or poultry.
• Avoid raw egg foods such as caesar dressing, mayonnaise, home made ice cream or custard, tiramisu or hollandaise sauce.
• Avoid foods such as liver (pate or liver sausage) and fish liver oils (cod liver oil) which contain high levels of vitamin A, excess levels of which have been shown to be harmful to growing babies. Avoid liver and liver products, however, due to the risk of vitamin A toxicity.
• Avoid excess salt intake - cut back on your intake of table salt (sodium chloride) by avoiding obviously salty foods, checking labels of pre-bought foods (75 per cent of dietary table salt is hidden in processed foods) and avoid adding it during cooking or at the table
• Avoid trans fatty acids – this includes highly processed foods and foods that have been cooked using oils taken to very high temperatures (hydrogenation). These are not only associated with high cholesterol but also the reduction in absorption of essential fatty acids, for more information trans fatty acids. Use olive oil or rapeseed oil during cooking, do not re-use oils. When you need a snack try fruit or raw vegetable nibbles instead of pastries, cakes, biscuits or crisps.
• Avoid refined sugars and try to regulate sugar intake, keep your intake of sweets, chocolates and sugary, fizzy drinks to a minimum.

Some of these foods are very difficult to eliminate but you must try to reduce them if you can.

Some last tips – Good Housekeeping

• Keep your kitchen clean and dry
• Keep fridge temperatures below 5°C (41°F) and freezer below -18°C (0°F)
• Wash hands thoroughly before preparing foods
• Store raw meat at the bottom of the fridge, covered, and keep it separate from cooked foods
• Defrost frozen produce thoroughly before cooking
• Cook foods thoroughly, and throw away any that have passed their use-by dates
• Finally, keep pets out of the kitchen at all times.