Nutrition for a healthy pregnancy
If you are pregnant or thinking of getting so, it is important to eat a balanced diet and make sure you are taking the right advice
Proper nutrition during pregnancy is a topic that most women think they are experts on, especially if they have already had children, or have mothers and mothers-in-law who ‘always know best’. This is probably true but there are many issues and misconceptions that need to be dealt with.
Weight gain
Weight gain is important during pregnancy to provide nutrition for the developing baby and to provide the mother with nutrition for breastfeeding later on.
The amount of weight that should be gained depends on pre-pregnancy weight.
> If a pregnant woman has a healthy weight, gain should be between 11.5 and 16kg
> If underweight, weight gain should between 12.5 and 18kg
> If overweight, weight gain should be between 7 and 11.5kg
The rate of weight gain is also important. This also depends on pre-pregnancy weight. If a woman is at a healthy weight before pregnancy, she should gain between 1.5 and 2kg in the first trimester (first three months). Afterwards in the second and third trimester, weight gain should be about 0.5kg a week. Weight gain should be as steady as possible, as the baby requires a daily supply of nutrition throughout the pregnancy.
It is extremely important that a pregnant women does not lose weight during pregnancy. Additionally if a woman does not put on enough weight, complications may occur. A baby born in such a case may be considered “small for gestational age”, that is, it might have been malnourished during pregnancy. This may cause problems for the child later on in life, including various eating disorders.
Gaining too much weight can also be harmful, causing problems such as backache, leg pain, increased tiredness, varicose veins, natural birth many be difficult making a caesarean the only alternative, and of course the excess weight may be difficult to lose.
Making healthy choices
It is a common misconception that women think because are pregnant they are able to eat “for two”. In fact, only an extra 100 calories is needed during the first trimester, and then 300 calories extra in the second and third trimesters. 100 calories is equivalent to a small sandwich with a filling like cheese or peanut butter.
During pregnancy, special attention should be given to folate, calcium, vitamin D, and iron.
> Folate
Women who are pregnant require more folate to be able to meet the demands of the extra tissue growth during pregnancy and to prevent the risk of the fetus getting a condition called Neural Tube Defect (NTD). Most foods such as flour and pasta are enriched with folic acid. Folate can also be found in various types of legumes and vegetables. Food alone cannot provide the required amount, thus a supplement is needed.
> Calcium and Vitamin D
Pregnant and lactating women need calcium and vitamin D to maintain their bone health and ensure the proper bone development of the baby. Furthermore calcium and vitamin D are essential for the production of breast milk.
Calcium and vitamin D should be taken together as vitamin D assists in the absorption of calcium. Depending on the nutritional status of the pregnant woman, usually supplementation is not required. Calcium-rich sources include milk (all types – 250ml), 30g cheese or ½ cup plain yogurt, canned salmon, or sardines, broccoli, oranges, almonds, or cottage cheese.
> Iron
Additional iron is needed during pregnancy. Low iron stores are also associated with anemia and fatigue in the mother, and sometimes low-birth weight babies.
An iron supplement is not usually needed during the first trimester if the mother has adequate iron stores; however, it may be required during the second and third trimester if low iron stores are suspected. A dietician or doctor can help decide whether an iron supplement is required.
Excellent sources of iron include cooked legumes such as white beans, lentils and chickpeas, pumpkin, sesame or squash seeds, and enriched breakfast cereals. Good sources include beef, dried apricots, enriched breads and pastas etc.
Overall healthy eating
The recommended amounts of the special nutrients of concern mentioned above can be achieved by eating a well balanced diet.
Choose foods from the fruits and vegetables group and grain products groups, and at least three to four servings of dairy products daily. Ensure that you also choose foods that contain protein, for example, meat, fish, chicken, and legumes.
Choosing foods from all the food groups not only ensures the adequate amount of fibre, vitamins and minerals, but also ensures that a pregnant woman receives enough energy for the growth of the baby.
Most women tend to have cravings for a variety of different foods throughout their pregnancy. It is best not to ignore the craving as this will lead to overindulgence later on. A chocolate bar can be eaten by all means but it should not be made into a habit. It is okay to indulge once in a while, but an overall balanced diet should be stuck to including the foods groups mentioned above.
It is also important to drink plenty of water and other types of fluids such as herbal teas throughout pregnancy.
Exercise during pregnancy
Exercise helps women get through a pregnancy more smoothly. It helps in the return to pre-pregnancy weight and it helps keep mother and baby healthy. Pregnant women should try and incorporate about 30mins of physical activity into their routine, three to five days a week. Low-impact exercises should be chosen, such as stretching, walking or swimming.
Other considerations during pregnancy
Alcohol should be avoided during pregnancy. Research shows that babies born to women who drink may suffer damages leading to learning disabilities later on in life. What the research is not clear on however is how much alcohol it takes to do damage. Therefore, no alcohol at all is safest.
Smoking should be avoided during pregnancy. Smoking during pregnancy increases the risk of miscarriage, complications during pregnancy and delivery, low-birth weight babies, pre-mature birth to name a few. Smoking also lowers the quantity and quality of breast milk. Second-hand exposure to smoking should be minimised as much as possible.
Coffee should also be avoided.
Alexia Stephanou is a Clinical Dietician. IASI Medical Centre. Tel: 99 884155, 22 441300
