Top Tips for Pregnancy Nutrition

Which vitamins and nutrients are key to your baby's health?

From the WebMD Archives

Good nutrition during pregnancy improves your chances of having a healthy baby. It may even reduce the risk of certain chronic conditions in your child, long after he has grown.

Eating for Two During Pregnancy

Whether you waited months for a positive pregnancy test or this pregnancy took you by surprise, you'll probably need to make over your eating habits. Many women begin pregnancy with shortfalls of nutrients central to a healthy pregnancy, including iron, calcium, and brain-building fats.

"Never in a woman's life is nutrition so important as when she's pregnant and nursing," says Elizabeth Somer, MA, RD, author of Nutrition for a Healthy Pregnancy.

Indeed. Research suggests that, along with other healthy habits during pregnancy, eating right influences a child's well-being at birth, and beyond.

"We've discovered that a child isn't only what she eats, but also what you ate during pregnancy, and possibly what your mother ate," says Randy Jirtle, PhD, a researcher in the field of epigenetics. Increasingly, research shows that mom's lifestyle affects her baby's chances for conditions such as obesity, diabetes, and heart disease.

Focus on Folic Acid During Pregnancy

Getting adequate folic acid is one way of helping your child become the healthiest person possible. During the first month of pregnancy, folic acid reduces the risk of neural tube defects, including spina bifida.

Be sure to take a daily multivitamin with 400 micrograms folic acid until you replace it with a prescription prenatal vitamin and mineral supplement. Choose grains fortified with folic acid, including breakfast cereals, breads, rice, and pasta, every day too.

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Multivitamins Have Multiple Effects During Pregnancy

Multivitamins do more than supply the necessary folic acid for growing babies, according to a population study conducted at the University of Pittsburgh.

Researchers there found that women in early pregnancy who took a multivitamin or prenatal vitamin regularly reduced their risk of preeclampsia by 45%. Preeclampsia, which causes elevated blood pressure and protein in the urine, is a leading cause of premature delivery and fetal death.

Despite the benefits, you may find swallowing pregnancy supplements difficult. The pills are often large, and they contain high doses of iron that can irritate your stomach and cause constipation.

"If you find yourself having trouble taking prenatal vitamins or you're having unwanted side effects, talk to your doctor about other, safe options," advises Jennifer Shu, MD, pediatrician and co-author of Heading Home with Your Newborn: From Birth to Reality.

And always tell your doctor or midwife about all the dietary supplements you take, including herbal remedies.

Make Calories Count During Pregnancy

During the first few months of pregnancy, you may not notice a big weight gain.

Some women may even lose weight during the first trimester of pregnancy because of queasiness that prevents them from eating and drinking normally. Tell your doctor if you experience persistent vomiting or nausea – you may become dehydrated. So-called morning sickness can last for the entire pregnancy, but it typically starts to dissipate after about 13 weeks.

As your baby begins growing, you'll need to make sure your extra calories are nutritionally rich. Pregnancy is not a license to overeat, however. A pregnant woman only needs an additional 300 calories a day. "Three hundred calories sounds like a lot, but it's about the amount in two large apples," Somer says.

Of course, it's OK to splurge on a hot fudge sundae on indulge pregnancy food cravings from time to time. On a daily basis, here's how to make those 300 additional calories matter most:

  • 16 ounces 1% low fat milk
  • 2 slices bread; 2 ounces chicken; 1 teaspoon reduced fat mayonnaise
  • 8 ounce vanilla non-fat yogurt mixed with 1/2 cup fruit and 1 ounce whole grain crunchy cereal

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Weighty Matters During Pregnancy

Gaining the recommended number of pounds limits pregnancy and delivery complications and ensures a healthy infant. Women who start pregnancy at a normal weight can expect to put on between 25 and 35 pounds. For twins, expect to gain between 34 and 45 pounds.

Underweight women may need to gain more, while overweight moms may be advised to put on fewer pounds.

In addition, "Overweight women tend to have heavier babies that are more difficult to deliver," says obstetrician Erin Tracy, MD.

Overweight moms should not diet during pregnancy. Work closely with your health care provider and a registered dietitian to determine a pregnancy eating plan tailored to your needs.

More Nutrients of Note During Pregnancy

Every nutrient that's important to you as a woman is necessary for your baby's growth and development. Yet, certain nutrients stand out as particularly important to your child, especially as pregnancy progresses.

Protein: Protein is the structural material of every cell in your baby's body.

Insufficient protein during pregnancy restricts fetal growth. And it may even affect your child's chances for high blood pressure later in life, according to a study in The New England Journal of Medicine.

Pregnancy protein needs climb 25 grams a day above what was needed before you were pregnant, for a total of about 70 grams -- the amount found in three eight-ounce glasses of milk or about seven ounces of cooked meat, chicken, or seafood.

Iron: You require about 50% more iron when you are pregnant. Iron is important in the formation of hemoglobin, which is the oxygen-carrying protein on red blood cells. In pregnancy your need for iron and hemoglobin goes up, especially in the second and third trimesters.

Iron-deficiency anemia during pregnancy can cause fatigue in mom, and possible problems for baby. "Some studies show severe iron deficiency anemia in mom is linked to low birth weights and iron-deficient infants," says Tracy.

Calcium: The baby needs calcium for development. If you don't consume enough calcium, your body will take it from your bones. This can cause a decrease in bone mass and increase your risk for osteoporosis.

Docosahexaenoic Acid (DHA): DHA is important for brain and eye development. Fish harbors this omega-3 fatty acid, but there's a catch.

Women in their childbearing years, and pregnant and nursing women, should steer clear of shark, swordfish, king mackerel, and tilefish because of methylmercury, a heavy metal that's toxic to a developing baby's neurological system. Safer DHA-rich sources include salmon and fortified eggs. Ask your doctor whether you may need a DHA supplement.

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Rethink Your Drink During Pregnancy

Pregnant women require about 10 cups of fluid every day. Although plain water is preferable, milk and juice count toward your fluid quota too.

Beer, wine, and spirits work against a healthy baby, however. Drinking alcohol during pregnancy promotes physical and mental birth defects.

"There is no known safe level for alcohol when you are expecting, so the best thing to do is avoid it," Tracy says. If you're worried about taking a drink before you knew you were expecting, talk with your doctor or midwife about your concerns.

What about caffeine? Its effects on developing babies is a subject of debate. Limit coffee to one or two eight-ounce cups a day to be on the safe side, advises the March of Dimes.

Juice seems like a healthy alternative to soft drinks, and it is. However, juice is laden with calories that can cause unwanted weight gain. Other soft drinks, such as soda, supply about as many calories as juice, and may also contain caffeine.

Your Pregnancy Eating Plan

Prescription prenatal pills may provide what your diet lacks on any given day, but when you're pregnant, healthy eating takes center stage. A balance of nutrients is key, according to Jirtle.

"Just because a little of something is good does not mean a lot is necessarily better," Jirtle says.

Moderately active women who start pregnancy at a healthy weight need about 2,400 calories a day. Here are some ideas of what to include on a daily basis:

Grains: 8 servings, such as 1 slice whole wheat bread, 1 cup whole grain cereal; 1/2 cup cooked pasta or rice. (Choose high fiber whole grains often to reduce pregnancy constipation.)

Vegetables: 4 or more servings, such as 2 medium whole raw carrots; 1 cup dark leafy greens; 1 cup cooked broccoli or cauliflower.

Fruits: 2 to 4 servings, such as 1 small apple, orange, pear, or banana or 1 cup berries.

Dairy: 3 servings, such as 8 ounces milk or yogurt or 1 1/2 ounces hard cheese.

Meat, poultry, fish, eggs, nuts, and beans: 2-3 servings, such as 2-3 ounces cooked meat, poultry, or seafood.

Fats, oils and sweets: sparingly.

WebMD Feature Reviewed by Louise Chang, MD on October 01, 2008

Sources

SOURCES: Elizabeth Somer, MA, RD, nutrition consultant and author, Salem, Ore. Randy Jirtle, PhD, professor of radiation oncology at Duke University Medical Center in Durham, N.C. Jennifer Shu, MD, pediatrician, Altanta, Ga. Erin Tracy, MD, assistant professor, Harvard Medical School; American Dietetic Association; National Academies Press; Keller, et al. New England Journal of Medicine, January 9, 2003, vol 348: pp 101-108. Bodnar, et al. American Journal of Epidemiology, online June 13, 2006. The Pocket Idiot's Guide to the New Food Pyramids.

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