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Nutrition Before, During, and After Pregnancy

Nutrition should always be a priority, but when you're having a baby it becomes even more important. At this period in your life it is vital to stick to good health habits. Ensuring you receive all of the nutrients your body needs will help to promote a safe pregnancy and a healthy environment for your baby.

Pregnancy and Weight Gain
Proper weight gain is vital to a healthy baby and a safe pregnancy. A baby's birth weight is directly related to the weight you gain throughout your pregnancy. A woman who is at a healthy weight at the onset of pregnancy should expect to gain anywhere from 25 to 35 pounds during the course of the pregnancy. Women who are underweight are advised to gain 28 to 40 pounds, and women who are overweight are advised to gain 15 to 25 pounds. If you are expecting twins, your doctor may advise a weight gain of 35 to 45 pounds.

Essential: Restricting weight gain can result in a baby with a lower birth weight. Babies who are born weighing less than 5½ pounds are at greater risk for developing difficulties and illnesses than babies who weigh more.

Not only is gaining a healthy amount of weight important, but the rate at which you gain is also notable. Woman should expect about a two- to four-pound weight gain during the first trimester and about a one-pound gain per week for the remainder of the pregnancy.

Baby 7-8 pounds
Placenta 1-2 pounds
Amniotic fluid 2 pounds
Breasts 1 pound
Uterus 2 pounds
Increased blood volume 3 pounds
Body fat 5 or more pounds
Increased muscle tissue and fluid 4-7 pounds
Total minimum 25 pounds

Pregnancy and Calorie Needs
Calorie needs increase during pregnancy to help support a woman's maternal body changes and the baby's proper growth and development. The RDA for energy intake during pregnancy is an additional 300 calories per day for the second and third trimester, in addition to maintenance needs. For example, if you require 2,000 calories per day to maintain your weight, you will need about 2,300 calories during pregnancy.

All the calories you consume during pregnancy should be healthy calories that contain plenty of protein, complex carbohydrates, fiber, vitamins, and minerals. Complex carbohydrates such as fruit, whole-grain starches, cereal, pasta, rice, potatoes, corn, and legumes should be the main source of energy.

ALERT! Dieting or skipping meals during pregnancy can have serious effects on the development of the baby. It takes more than 85,000 calories over the course of a nine-month pregnancy, in addition to the calories the mother needs for her own energy needs, to produce a healthy, well-developed baby.

Protein Power
Protein needs increase when you are pregnant, to help develop the body cells of the growing baby. Other changes that are taking place in your body during pregnancy also require protein, such as the building of the placenta. You need an extra 10 grams of protein above your extra daily calories, or about 70 grams of protein daily, compared with 60 grams for women who are not pregnant. Ten grams of protein is equivalent to a an ounce-and-a-half serving of lean meat, about 10 ounces of fat-free milk, or 1½ ounces of tuna canned in water.

Most women do not have a problem meeting their protein requirements. Consuming plenty of lean meats, fish, tuna, eggs, and legumes, as well as increasing your dairy servings, will ensure you meet your protein needs. If you are a vegetarian, consume a variety of legumes, grain products, eggs, low-fat or fat-free dairy products, vegetables, fruits, and soy foods to ensure proper protein intake.

Adjusting Your Eating Plan
Getting the extra calories your body needs for pregnancy just takes a small adjustment in a healthy eating plan. Adjust your eating plan using the following guidelines for the minimum number of servings in each food group:

Also be aware of increased fluid needs. Water is an important nutrient and is essential for the nourishment that passes through the placenta to the baby. Drink at least 8 to 12 cups daily, and more if you are thirsty.

ALERT! Raw foods can increase your risk for bacterial infection. Avoid anything raw, including sushi and other raw seafood, undercooked meat or poultry, beef tartar, raw or unpasteurized milk, soft-cooked or poached eggs, and raw eggs (possibly found in eggnog). Vitamin and Mineral Needs
Vitamin and mineral needs also increase with pregnancy. Unlike calorie needs, your increased need for vitamins and minerals is immediate. Certain ones are especially important, such as folate, calcium, and iron.

Folate is especially important for women during the first three months of pregnancy. The body uses folate to manufacture new cells and genetic material. During pregnancy, folate helps develop the neural tube, which becomes the baby's spine. Because most women do not know immediately that they are pregnant, and because the neural tube and brain begin to form so soon after conception, taking enough folate on a regular basis is important if you are of childbearing age. Taking enough folate can help to greatly reduce the risk of neural tube birth defects like spina bifida and birth defects of the brain (anencephaly). The National Academy of Sciences recommends that women of childbearing age get 400 micrograms (mcg) of folate each day, especially one month prior to conception.

Fact: National surveys show that the average folic acid intake by women of childbearing age is about 230 micrograms daily. Folic acid intake should be kept below 1,000 micrograms per day to avoid excessive intake.

Most women get folic acid daily through fortified products and other foods. To get more folic acid in their diets, women anticipating pregnancy should eat more citrus fruits and juices, leafy dark-green vegetables, legumes, and fortified breakfast cereals. To ensure adequate intake, woman can take a multivitamin that contains folic acid, in addition to eating a healthy diet.

Not all vitamin supplements contain folic acid, so check the label to be sure. Also, not all multivitamin supplements are optimal before or during pregnancy. Pregnant women and those anticipating pregnancy should consult their doctor for advice about taking folic acid or any other vitamin or mineral supplement.

Vitamin A
Vitamin A is important for promoting the growth and health of cells and tissues throughout your body and the baby's. A healthy diet should provide enough vitamin A during pregnancy so there is no need for a supplement.

New research has shown that consuming too much vitamin A—in excess of 10,000 IU daily—may increase the risk of birth defects. This is twice the RDA. Eating foods such as fruits and vegetables that are high in beta-carotene is not a problem, because beta-carotene does not convert to vitamin A when blood levels of vitamin A are normal.

Other Vitamins
With your increase in calorie intake, your increased need for most of the B vitamins will be met through your dietary intake. Vitamin B12 is found in animal foods such as milk, eggs, meat, and cheese. Women who are vegetarian and don't consume any type of animal foods need to make sure they consume a reliable source of vitamin B12, such as fortified breakfast cereals and/or a B12 supplement. If you don't feel you are meeting your B12 needs, talk to your doctor before taking supplements.

Vitamin C needs increase slightly during pregnancy, but can be met easily with a glass of orange juice, an orange, or another citrus fruit. Vitamin C is important because it helps the body absorb iron from plant sources, and iron needs almost double during pregnancy.

Vitamin D is essential because it helps the body to absorb extra needed calcium. A glass of vitamin-D fortified milk will take care of your extra needs. For vegetarians who do not consume dairy products, your doctor may prescribe a supplement. Make sure your doctor knows your eating habits!

Pumping Up Calcium and Iron
Two minerals that deserve special attention are calcium and iron. If you don't consume enough of either of these minerals during your pregnancy, the baby will actually use the calcium in your bones and the iron in your blood.

Essential! The estimated calcium needs for pregnant girls under eighteen is 1,300 mg per day. For pregnant adult women aged nineteen to fifty, the recommended intake is 1,000 mg per day. There is also an Upper Tolerable Limit for pregnant women set at 2,500 mg per day.

Although it is important to get calcium throughout your life, it is especially important during pregnancy. Calcium helps ensure that your bone mass is preserved while the baby's skeleton develops normally. Consuming plenty of calcium before, during, and after pregnancy can also help reduce your risk for osteoporosis later in life. Good sources of calcium include dairy products and some green leafy vegetables. If you are vegetarian or lactose intolerant and do not consume dairy products, consume plenty of other good calcium sources, such as calcium-fortified orange juice or calcium-fortified soy milk, along with special lactose-reduced products.

The increase in the blood volume of a pregnant woman greatly increases her iron needs. A woman's need for iron increases to 30 mg per day. Several foods supply iron, including meat, poultry, fish, legumes, and whole-grain and enriched grain products. Iron needs during pregnancy can be more difficult to meet because iron isn't always absorbed well, and many women have low iron stores before they get pregnant. Most prenatal vitamins contain iron, and your doctor may also prescribe an iron supplement. Keep in mind, though, that supplements are just to help out; you still need to eat a diet rich in iron. Iron from plant sources is not as easily absorbed as that from animal sources. Eating a good source of vitamin C, such as citrus fruits or juices, broccoli, tomatoes, or kiwi with meals will help the body absorb the iron in the foods that you eat. The absorption of iron from supplements is best when the stomach is empty or when taken with juice containing vitamin C.

Handling the Discomforts of Pregnancy
Because of the many changes that are going on in your body during pregnancy, you may feel the occasional discomfort of morning sickness, constipation, heartburn, and swelling.

The first discomfort most pregnant women experience is morning sickness. For many women this is not just something that takes place in the morning. Many women feel sick all day long.

There is no exact known reason why some women get morning sickness so much worse than others, or why women get morning sickness at all. For some women, but not all, the feeling of nausea will gradually begin to improve at around twelve to fourteen weeks of pregnancy.

If you know for sure that your nausea is normal morning sickness, you can follow some of these tips to help ease your discomfort:

ALERT! If you begin to experience episodes of vomiting more than twice daily, contact your doctor immediately.

Constipation can be another discomfort that is very normal during pregnancy. Hormonal changes relax muscles to accommodate the expanded uterus, and this can cause a slowdown in the action of your intestine. This as well as iron supplements can be the culprits of aggravating constipation. To help ease this discomfort, try the following:

Heartburn and acid reflux can be other nagging discomforts of pregnancy, especially during the last three months. Heartburn usually occurs because the baby is putting pressure on the digestive organs. Acid reflux happens because the valve between your stomach and esophagus becomes more relaxed, making it easier for food to occasionally reverse direction.

To help relieve these discomforts, try these tips:

Swelling can also cause some discomfort during pregnancy, especially during the last three months. Your body retains water primarily in your feet, ankles, and hands, as a reservoir for the expanded blood volume.

To help relieve some of the discomforts of water retention, try these tips:

If your swelling is excessive, it could be a sign of complications like eclampsia or toxemia. With these conditions you may have other symptoms such as high blood pressure, sudden weight gain, headaches, and abdominal pain. Consult your doctor immediately if you have any of these symptoms. Pregnancy and Diabetes
Gestational diabetes occurs in approximately 4 percent of all pregnancies. Gestational diabetes is distinguished by an elevated glucose, or blood sugar level, during pregnancy. Women are routinely tested between the twenty-fourth and twenty-eighth weeks of pregnancy to make sure they are not showing symptoms of gestational diabetes. The risk is usually higher for women who have a family history of diabetes, who are overweight, or who have had problem pregnancies in the past. Gestational diabetes is usually diagnosed during the second or third trimester of pregnancy. Women who have known diabetes before pregnancy are not diagnosed as having gestational diabetes. This type of diabetes disappears in 90 percent of women after giving birth.

ALERT! Women who experience gestational diabetes are at an increased risk, as much as 60 percent, for developing Type 2 diabetes later. Women can decrease their risk by maintaining a healthy weight after their pregnancy.

The nutritional goals for women with gestational diabetes are to provide adequate calories, optimal nutrition, and normalized blood sugar levels. Monitoring blood sugar on a regular basis is essential to knowing if normal blood sugar levels are being achieved. Guidelines for treating this type of diabetes vary and are very individualized, but one constant recommendation is limiting carbohydrate intake at breakfast. Most women with gestational diabetes cannot tolerate large amounts of carbohydrates in the morning, but are generally able to tolerate them later in the day. Foods high in total amounts of carbohydrate are also limited. Eating small, frequent meals throughout the day, as well as getting regular exercise, can also help to normalize blood sugar levels during pregnancy.

If you are diagnosed with gestational diabetes, your doctor and/or a dietitian should work with you closely to help you develop a meal and lifestyle plan that will help you to control your blood sugar levels.

For Women Who Breastfeed
If you are breastfeeding, good nutrition after giving birth is as important as ever. The fuel supply that helps produce your breast milk comes from energy stored as body fat during your pregnancy and from extra energy from food choices. Your body uses about 100 to 150 additional calories per day to produce breast milk. While breastfeeding, a woman needs an additional 500 calories per day, beyond nonpregnancy maintenance needs. In other words, if you needed 2,000 calories to maintain your weight before pregnancy, you need 2,700 calories per day while you are breastfeeding. Trying to lose weight through a strict weight-loss regimen is not recommended while you are breastfeeding. If your caloric intake goes lower than 1,800 calories, you probably will not get enough of all the nutrients your body needs for proper breastfeeding.

As in pregnancy, the need for most nutrients increases while breastfeeding. It is important to pay extra close attention to your protein, calcium, magnesium, zinc, vitamin B12, vitamin D, folate, and vitamin B6 intake. If your nutrient intake is low, you can still produce breast milk sufficient enough to support your baby's health, but only at the expense of your own body's nutrient reserves. Also remember your fluid intake during this time: continue to get at least 8 to 12 cups of fluids daily, and more if you are thirsty.

Alcohol can pass into breast milk, so it is not advised during breastfeeding. It is also advised that you not smoke. Nicotine does pass into breast milk. It can reduce your milk supply and increase your baby's risk for developing colic or a sinus infection. If you do smoke, avoid smoking for two and a half hours before nursing, and never smoke around the baby. Some medications, both prescription and over-the-counter, can be passed through breast milk. It is advised to consult your physician before taking any type of medication when breastfeeding.

Copyright © 2002 by Kimberly A. Tessmer. Excerpted from The Everything Nutrition Book: Boost Energy, Prevent Illness, and Live Longer with permission of its publisher, Adams Media Corporation.

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