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Published on May 28, 2020

Eating for a Healthy Pregnancy

pregnancy woman eating grapes

Eating Well for Two – Baby and You

Contrary to the popular notion, being pregnant doesn’t really mean that you get to eat for two, according to registered dietitian Susie Wang of EvergreenHealth's Maternal Fetal Medicine clinic.

It is a time, she says, to make sure that you’re eating well to give you and your baby a healthy pregnancy.

“What you eat affects your baby,” Susie says. “You want to have a healthy diet to give your baby a good start in life.”

During pregnancy, women only need an extra 200-300 calories per day during the second and third trimesters, not twice the calories that “eating for two” implies.

“It doesn’t take much to get those extra calories,” Susie says. “A piece of cheese and whole grain crackers, a piece of fruit and some nuts, a few of glasses of milk, or a healthy sandwich will give you the extra nutrition that you and your growing baby need.”

Susie recommends following medical guidelines for how much weight you should gain during pregnancy:

If You Are You Should Gain
Normal weight 25 - 35
Underweight 25 - 40
Overweight 15 - 25
Obese 11 - 20

source: Institute of Medicine

You can reduce the risk of complications such as developing hypertension or gestational diabetes by starting your pregnancy at a healthy weight and not gaining too much,” she says. “The healthier you are at the beginning and throughout your pregnancy, the better able you’ll be to pass good health on to your baby.”

When to Eat

Small, frequent meals and snacks help you and your baby stay nourished throughout the day. Eating frequently can also help reduce nausea and decrease heartburn and indigestion. Keep your snacks as healthy as your meals – try fruit and nuts, cheese and whole grain crackers, or vegetables with hummus.

What to Eat

“Eat good healthy food!” Susie says. If you are already eating a basically healthy diet, you should continue. If you are not, now is the time to improve it.

The USDA's guidelines are a good place to start.

Susie recommends a balanced diet with an emphasis on fruits and vegetables that also includes whole grains, lean proteins, and healthy fats.

It’s also important to limit foods containing added sugars and unhealthy fats.

“It is most important that you choose good, healthy foods,” Susie says. “Then, if you are able, it is nice to choose organic – even better to choose locally grown produce when available.”

Here are the kinds of foods it is important to consume during pregnancy:

Protein – Most pregnant women need only an extra ounce or two of protein per day. “It’s not usually a problem to get that unless you are a vegan,” says Susie.

Nuts, legumes, eggs, poultry, meat, and fish are the best sources, but make sure to follow these safety guidelines:

  • Eat only fish that is low in mercury
  • Fully cook all meats, poultry, fish, and shellfish
  • Heat hot dogs and deli meats to steaming to eliminate listeria bacteria
  • Fully cook eggs to avoid salmonella, and stay away from raw egg products such as hollandaise sauce or Caesar dressing

Carbs – “Choose good carbs, not ‘no carbs,’” Susie says. Carbs are needed to provide fuel for you and your baby, along with important vitamins, minerals, and fiber.

You need at least 175 grams of carbs per day, and they should come primarily from whole grains, fruits, vegetables, and legumes rather than sweets, refined starches, and sugars.

Fiber – Eat plenty of fiber-rich foods to give you nutrients; fiber will also help battle the constipation common in pregnancy (and with iron supplements).

Healthy carbs – whole grains, fruits, vegetables, legumes – will provide you with lots of fiber. Susie suggests eating a variety of colors of produce, too.

Fats – Choose healthy, unsaturated fats like olive and canola oils, nuts, and fatty fish such as salmon.

As with any healthy eating plan, avoid trans fats and limit saturated fats from fatty meats, high-fat dairy, and many processed snack foods.

Fluids – Pregnant women need to get adequate fluids to support extra blood and tissue volume.

Susie recommends water and some milk over juice or soda. “Don’t drink too many of your calories!” she explains.

Key Nutrients

There are several key nutrients that pregnant women need to be sure they are getting:

Folic acid – Your need for folic acid doubles during pregnancy. Women of childbearing age should get 400-800 mcg daily, even before becoming pregnant, to ensure proper fetal brain development.

Good sources include dark leafy greens, citrus fruits, legumes and beans, whole-grain cereals, and fortified foods, such as items made with enriched flour.

Even with all these sources, many women need more folate than they get through their diet, Susie says, which is one of the reasons most should take a prenatal vitamin.

Iron – Your iron requirement also doubles during the second and third trimester. You need 30 mg of iron daily during this time, though extra iron in the first trimester can aggravate morning sickness.

According to researchers, extra iron is necessary to support increased blood volume and development of the placenta.

Top sources include liver and shellfish, but dried herbs, sunflower and sesame seeds, and even cocoa powder are good sources. If you don’t eat enough iron-rich foods, you may need a supplement.

Vitamin D –More scientific studies are emerging on the importance of vitamin D to good health. This is particularly important for women living in the Northwest who are at a greater risk for vitamin D deficiency because of a lack of sun exposure, especially in the winter.

Most should take a daily vitamin D supplement of at least 600 IU, maybe up to 2000 IU if you live further north, as we do.

Prenatal vitamins often have 400-600 IU of vitamin D. Some vitamin D can also be found in enriched dairy foods.

Calcium – Calcium is necessary for the development of your baby’s bones. Pregnant women need the same amount as other women – 1000 mg per day – but they must be sure to get it regularly.

You can get enough calcium from four dairy servings per day or from non-dairy sources like broccoli, some tofu and greens, soy beans, molasses, and fortified orange juice and soy milk.

What not to eat

What you don’t eat can be as important as what you do eat when you’re pregnant. Eat healthy foods and skip those with empty calories like soda, desserts, and fried foods. Be sure to avoid these potentially dangerous foods while you are pregnant:

Seafood high in mercury – Seafood is a great source of protein, and the omega-3 fatty acids that it contains promote your baby's brain development.

Some fish and shellfish, however, contain potentially dangerous levels of mercury, which could damage a growing baby’s nervous system. Pregnant women should avoid swordfish, shark, king mackerel and tilefish.

Safe fish include shrimp, crab, salmon, pollock, catfish, cod, tilapia and canned light tuna.

Make sure that your seafood is cooked thoroughly. Avoid raw fish and shellfish as well as refrigerated smoked fish like lox.

Unpasteurized dairy foods – Low-fat and nonfat dairy products can be a healthy part of your pregnancy diet. What you need to avoid, however, are products containing unpasteurized milk, which could contain bacteria such as salmonella, E. coli and listeria.

Avoid these soft cheeses unless they are labeled “pasteurized”: brie, feta, camembert, blue cheese, and Mexican-style cheeses, such as queso blanco.

In addition, don’t drink unpasteurized juice.

Too much vitamin A – While vitamin A is good for you, too much of a good thing can be bad for your baby. The Institute of Medicine recommends that pregnant women get 2,565 IU per day, but more is not necessarily better, because too much vitamin A may cause birth defects.

Naturally occurring vitamin A – in the form of beta carotene – is not a problem, so you don’t need to shy away from carrots or sweet potatoes.

Most women can get enough vitamin A by eating the right foods, such as bright-colored fruits and vegetables and should not take a vitamin A supplement.

Caffeine – Limit caffeine to no more than 200 milligrams per day – about the amount in one 12-ounce cup – or four 8-ounce cups of tea.

Caffeine can cross the placenta into the baby’s bloodstream and affect the heart rate. Studies have found that too much caffeine during pregnancy could cause an increased risk of miscarriage.

Alcohol – Drinking alcohol during pregnancy can cause miscarriage, impair your baby’s brain development and lead to fetal alcohol syndrome.

No level of alcohol is considered safe for your baby, so it is best to avoid alcohol completely during pregnancy.

Supplements – Susie says to be careful with any herbal supplements that your doctor doesn’t know about or recommend. These common supplements can be harmful if taken during pregnancy:

  • St. John’s Wort, often used to treat depression, can cause miscarriage or stillbirth.
  • Ginseng, often used to lower the glucose level in those with diabetes, can cause early labor.

Always remember to check with your doctor before you take any supplement.

In addition, Susie says certain foods common in some ethnic cuisines, such as bitter melon, bitter gourd, and fenugreek, should be avoided late in pregnancy to avoid the risk of preterm labor.

When it comes to eating well for you and your baby, make healthy choices about what to eat and what to avoid. Making good choices for you and your baby will set your little one on the right path to eating well.


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