Nutrition

Nutrition in Pregnancy

(please check with your health provider before changing or modifying your nutritional needs)

There is no greater foundation for your and your baby's well being at this time than excellent nutrition. A high-protein diet rich in vitamins and minerals is the best way to grow a healthy mom, placenta, and baby. For the mom, an inadequate diet can lead to a more difficult pregnancy (some pregnancy complications, such as toxemia/preeclampsia are nutrition related), labor, and can lead to postpartum illnesses. (Recurrent mastitis, also known as a breast infection, is one illness which can strike a postpartum breastfeeding mom when she is "run down" from fatigue, stress, and/or poor nutrition.) For the baby, a poor diet could lead to low birth weight, prematurity and miscarriage/death.

Parts of the Balanced Diet

Protein--A lack of protein has been recently traced as a cause for toxemia/preeclampsia which occurs in the second half of the pregnancy. High sources of protein are eggs, peanut butter, red meat, fish, beans, nuts, and dairy products.
Carbohydrates--Carbohydrates are needed for energy. Many of the foods which contain carbohydrates contain valuable vitamins and nutrients that you need. Potatoes, a "no-no" for the Atkins diet, also contain protein and Vitamin C--especially when the skin is consumed as well. If you find that you are adding too much fat to your body during pregnancy, cut out all white flour, sugar, and anything containing them rather than go "carb-free". Energy filled foods are pastas, breads, and potatoes.
Fats--Just as the food pyramid shows, your body needs a very small amount but not a lot.
Vitamins--Vitamins play many roles in the diet, which include, but are not limited to: taking part in maintaining a healthy immune system, strengthening your veins and circulatory system, and repairing itself in injuries. For the excellent diet, most of the vitamins should come from food sources, not prenatal vitamins/supplements. Vitamin rich foods include vegetables, fruits, and nuts.
Folic Acid--Folic Acid supplements (found in your prenatal vitamin) in the first 12 weeks decrease the risk of your baby having a spina bifida or a neural tube defect by 70%. Other sources of folic acid are broccoli, spinach, and dark green, leafy vegetables.
Iron--Anemia can be very common in expecting moms due to increased blood volume. Your doctor/midwife will often check levels at 28 weeks and if needed, closer to the end of pregnancy. If iron rich foods (egg yolk, beans, dark leafy vegetables, red meat) aren't enough to keep your hemoglobin count high enough, you may need an additional supplement. Typical iron supplements prescribed often have a side effect of constipation. For a non-constipating, easier absorbed formula, Floradix Liquid Iron Plus Herbs works very well for most women. Also, be sure to take any prenatal vitamins containing iron or iron supplements with a vitamin C source as this maximizes absorption. Do NOT take an iron supplement with a calcium containing food/drink as calcium keeps the iron from absorbing.
Calcium--Aside from giving you stronger bones and teeth, calcium helps your blood clot more efficiently and helps your muscles work smoother. And yes, may also aid the ease of the uterus working in labor. Cocoa (as well as spinach) reduces the bodies absorption of calcium. Some research also suggests that an abundant amount of dairy foods (high in calcium) may lead to a heavier baby at birth. If you take a calcium supplement, it should contain Vitamin D for absorption, and if possible, magnesium.
Magnesium--Often low in pregnancy, a low intake of magnesium can lead to muscle cramps. Good sources are cereals, milk, soy beans, nuts, fish, and meat. There may be some truth in a glass of milk aiding in a restful sleep during pregnancy!
Zinc--If your diet is lacking in zinc, your baby is at risk for miscarriage, growth retardation (stunted growth), stillbirth, or congenital handicaps. Some studies also suggest that zinc is needed to maximize the efficiency of contracting muscles (uterus). This could, thereby, lead to a longer labor. Zinc, however, can counter the absorption of iron supplements. Foods high in zinc include bran, hard cheeses, and meat.

Weight Gain and Caloric Intake

During pregnancy, it is recommended for the mother to gain about 25-35 pounds and to consume 2500 calories daily. This weight is made up of:

baby-38%
placenta-9%
amniotic fluid-11%
increase in weight of uterus and breasts--20%
increased blood volume--22%

(Sheila Kitzinger--The Complete Book of Pregnancy and Childbirth)

This may vary somewhat depending on the mother's pre-pregnancy weight. Her weight gain is no indicator of how large her baby will be. On a personal note, I had my smallest baby (6 lb. 15 oz.) with a weight gain of 45 pounds (I was severely underweight), and my largest baby (9lb. 2 oz.) with a weight gain of 20 pounds!

The rate that each woman gains varies greatly from woman to woman AND even from a same woman's pregnancy to pregnancy. Many mothers will actually lose weight during the first trimester due to nausea and vomiting. When you are building back up from losing weight at this time, you should not count the weight gain "back up to your pre-pregnancy weight" as part of your overall weight gain.

A Few Special Situations...

Many women suffer from an increased frequency of vaginal yeast infections during pregnancy because the pregnancy hormones can cause an imbalance in the vagina--making yeast able to thrive much easier. An acidophilus capsule or pearl taken daily as well as avoiding sugars (yeast feeds off of sugar--even natural sources in fruit) and tight clothing can often rectify the problem. You can obtain these acidophilus products at a natural health store. Wal Mart also contains these supplements but it is difficult to say that the cultures will be live since they are not refrigerated. To ensure that the cultures are live, ask for a brand that is refrigerated which will most likely, only be at a health food store. (Acidophilus, or probiotics, are made of live GOOD bacteria (flora) which your body needs to maintain a healthy balance. These live cultures are also found in PLAIN yogurt. An ample amount of acidophilus/good bacteria keeps the harmful bacteria "in check" and prevents them from taking over and causing infection and illness. In essence, the more good bacteria in your body, the smaller amount of harmful bacteria your body will contain. You cannot overdose on these pills; these are not a vitamin or mineral supplement. I had a very stubborn yeast infection with my last pregnancy that kept recurring in the beginning. I was told by my midwife to take 20 of the pills at one time and to continue taking 2 each day after that. It worked beautifully! One word: if you have a yeast infection, do not get flavored yogurts as a source of acidophilus since the sugar contained in the yogurt will continue feeding the yeast. The benefits of the live cultures are canceled out by the harmful effects of the sugars.)
Acidophilus is also a recommended method of prevention in Group B Strep during pregnancy. Group B Strep is a potentially harmful bacteria. Acidophilus can halt the growth or even reduce the amount of GBS by building up your flora counts. (See Group B Strep)
If your doctor/midwife were to inform you that you "spilled protein" in your urine, increase your intake in protein rich foods. (see above list) If the body consumes an inadequate amount of protein, it reads the consumption as incomplete. What little you did take in (even if it was only a little less than what is needed), your body will discard ALL of it, which will then show up in your urine.
During pregnancy, you should avoid all substance abuse--all illegal drugs--if it is not safe for the mother, it won't be for the baby either, smoking, and alcohol.
Certain prescription medication may also be contraindicated in pregnancy; be sure to mention them at your prenatal visits.
Nicotine (either from first or second hand smoke) makes blood vessels constrict, including those of the placenta, which enables less oxygen and nutrients to reach the baby. It also speeds up the fetal heart rate and interferes with the baby's respiratory movements he/she makes as the delivery draws closer. Smoking is a major reason of prematurity and low birth weight. "It also increases the chances of bleeding, miscarriage (women who smoke are twice as likely to miscarry as those who do not), premature rupture of membranes, premature separation of placenta, hemorrhage before or early in labor, congenital abnormality, stillbirth, and death of the baby in the week following delivery." (Kitzinger, The Complete Book of Pregnancy and Childbirth) These risks are also correlated to HOW MUCH the woman smokes or is exposed to second hand smoke.
Alcohol, in even small consumptions, will cross the placenta to the unborn baby. The risk to the baby depends on the frequency and quantity in which the mother drinks as well as the time of pregnancy she drinks. In early pregnancy (1st trimester), even one binge can prove devastating to the developing baby. There is no "safe" limit of alcohol use during pregnancy. To prevent a baby being born with Fetal Alcohol Syndrome (a disorder in which the baby has very distinct facial features and may be mentally and developmentally retarded), avoid all use of alcohol during your pregnancy.