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Pregnancy Nutrition

What you eat right before and during your pregnancy can affect the health of your growing baby. Even before you start trying to get pregnant, you should take special care of your health. Eat healthy meals and snacks and take a multivitamin every day. If you're unsure about eating healthy during pregnancy, talk to your doctor.

Do I really need to "eat for two?"

While you are pregnant, you will need additional nutrients to keep you and your baby healthy. But, that does not mean you need to eat twice as much. You should only eat an extra 300 calories per day. A baked potato has 120 calories. So getting these extra 300 calories doesn't take a lot of food.

Make sure not to restrict your diet during pregnancy either. If you do, your unborn baby might not get the right amounts of protein, vitamins, and minerals. Low-calorie diets can break down a pregnant woman's stored fat. This can lead to the production of substances called ketones. Ketones can be found in the mother's blood and urine and are a sign of starvation. Constant production of ketones can result in a mentally retarded child.

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How should my diet change now that I'm pregnant?

If you are eating a healthy diet before you become pregnant, you may only need to make a few changes to meet the special nutritional needs of pregnancy. According to the American Dietetic Association (ADA), a pregnant woman needs only 300 calories a day more than she did pre-pregnancy. The ADA recommends that pregnant women eat a total of 2,500 to 2,700 calories every day. These calories should come from a variety of healthy foods.

But what pregnant women eat is more important than how much. A pregnant woman needs more of many important vitamins, minerals and nutrients than she did pre-pregnancy. To get enough nutrients, pregnant women should take a multivitamin or prenatal vitamin and eat healthy foods from the four basic food groups everyday including:

Fruits and VegetablesPregnant women should try to eat 7 or more servings of fruits and vegetables combined (for example: 3 servings of fruit and 4 of vegetables) daily.

Fruits and vegetables are rich sources of fiber, vitamins and minerals. Fruits and vegetables with vitamin C help you and your baby to have healthy gums and other tissues. Vitamin C also helps your body to heal wounds and to absorb iron. Examples of fruits and vegetables with vitamin C include strawberries, melons, oranges, papaya, tomatoes, peppers, greens, cabbage, and broccoli. Fruits and vegetables also add fiber and minerals to your diet and give you energy. Plus, dark green vegetables have vitamin A, iron, and folate, which are important nutrients during pregnancy.

One Serving Fruit = 1 medium apple, 1 medium banana, 1/2 cup of chopped fruit, 3/4 cup of fruit juice One Serving Vegetable = 1 cup raw leafy vegetables, 1/2 cup of other vegetables (raw or cooked), 3/4 cup vegetable juice

Whole-grains or Enriched Breads/CerealsPregnant women should eat 6 to 9 servings of whole-grain or enriched breads and/or cereals every day.

Whole-grain products and enriched products like bread, rice, pasta, and breakfast cereals contain iron, B vitamins, minerals, and fiber. Some breakfast cereals are enriched with 100% of the folic acid your body needs every day. Folic acid has been shown to help prevent some serious birth defects. Eating breakfast cereals and other enriched grain products that contain folic acid is important before and during pregnancy.

One Serving Cereal/Bread = 1 slice bread, 1/2 cup of cooked cereal, rice, or pasta, 1 cup ready-to-eat cereal

Dairy ProductsPregnant women should try to eat 4 or more servings of low-fat or non-fat milk, yogurt, cheese or other dairy products every day.

Dairy products provide the calcium you and your baby need for strong bones and teeth. Dairy products are also great sources of vitamin A and D, protein, and B vitamins. Vitamin A helps growth, fight infection, and vision. Pregnant women need 1,000 milligrams (mg) of calcium each day. If you are 18 or younger, you need 1,300 mg of calcium each day.

Try to eat low-fat or non-fat milk and milk products to lower your fat intake. Other sources of calcium include dark green leafy vegetables, dried beans and peas, nuts and seeds, and tofu. If you are lactose intolerant or can't digest dairy products, you can still get enough calcium. There are several low-lactose or reduced-lactose products available. In some cases, your doctor might recommend a calcium supplement.

One Serving Dairy = 1 cup of milk or yogurt, 1 1/2 oz. natural cheese, 2 oz. processed cheese

ProteinsPregnant women and their growing babies need 10 grams of protein more than non-pregnant women. Pregnant women should eat 60 grams of protein every day.

Two or more 2-3 ounce servings of cooked lean meat, fish, or poultry without skin, or two or more 1 ounce servings of cooked meat contain about 60 grams of protein. Eggs, nuts, dried beans, and peas also are good sources of protein. But don't rush out and buy high protein drinks! Women in the United States regularly eat more protein than they need. So you probably won't have to make an effort to eat the needed 60 grams of protein a day.

Don't eat uncooked or undercooked meats or fish. These can make you sick and may harm your baby. Pregnant women should also avoid deli luncheon meats.

Protein builds muscle, tissue, enzymes, hormones, and antibodies for you and your baby. Protein-rich foods also have B vitamins and iron important for your blood.

One Serving Protein = 2-3oz. of cooked lean meat, poultry, or fish, 1 oz. meat also = 1/2 cup cooked dried beans, 1 egg, 1/2 cup tofu, 1/3 cup nuts, 2 T. peanut butter

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What other nutrients do I need for a healthy pregnancy?

Folic acid: Pregnant women need 400 micrograms (400 mcg) of folic acid every day to help prevent birth defects.

Folic acid is important for any woman who could possibly become pregnant. Folic acid is a B vitamin that helps prevent serious birth defects of a baby's brain or spine called neural tube defects. Getting enough folic acid can also help prevent birth defects like cleft lip and congenital heart disease.

Getting enough folic acid is most important very early in pregnancy, usually before a woman knows she is pregnant. So, at least one month before you try to become pregnant you should make sure you're getting enough folic acid. Women who are already pregnant need to get enough folic acid every single day.

An easy way to get enough folic acid is to take a multivitamin every day. Most multivitamins sold in the U.S. contain enough folic acid for the day. But be sure to check the label! Choose a multivitamin that contains 400 mcg or 100% of the Daily Value (DV) for folic acid.

Another way to get enough folic acid is to eat a serving of breakfast cereal that contains 100% DV for folic acid, every day. Check the nutrition label on the box of cereal to be sure. It should say "100%" next to folic acid. Orange juice, spinach and legumes are also good sources of folic acid.

Iron: Pregnant women need twice as much iron — 30 mg per day — than other women.

The Centers for Disease Control and Prevention (CDC) recommends that pregnant women start taking a low-dose iron supplement (30 mg/day) or a multivitamin with iron beginning at the time of their first prenatal visit. Ask your doctor what she recommends. Prenatal vitamins prescribed by your doctor or those you can buy over-the-counter usually have the amount of iron you need. But be sure to check the label to make sure. Pregnant women should also eat lots of iron-rich foods. Some good sources of iron include lean red meat, fish, poultry, dried fruits, whole-grain breads, and iron-fortified cereals.

Pregnant women need extra iron for the increased amount of blood in their bodies. Iron helps keep your blood healthy. Plus, your baby will store iron in his body to last through the first few months of life.

Too little iron can cause a condition called anemia. If you have anemia, you might look pale and feel very tired. Your doctor checks for signs of anemia with the routine blood tests taken at different stages of your pregnancy. If your doctor finds that you have anemia, she will give you a special iron supplements to take once or twice a day.

Calcium: Pregnant women aged 19 to 50 years should get 1,000 mg/day of calcium. Younger pregnant women need even more — 1300 mg/day.

Most women in the U.S. don't eat enough calcium. So many pregnant women will have to change their diets to get their fill of this important mineral. Low-fat or non-fat milk, yogurt, cheese or other dairy products are great sources of calcium. Eating green leafy vegetables and calcium-fortified foods like orange juice and breakfast cereal can also provide calcium. If your diet is not providing 1,000 mg/day of calcium, talk to your doctor about taking a calcium supplement.

Water: Pregnant women should drink at least six eight-ounce glasses of water per day. Plus, pregnant women should drink another glass of water for each hour of activity.

Water plays a key role in your diet during pregnancy. It carries the nutrients from the food you eat to your baby. It also helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Drinking enough water, especially in your last trimester, prevents you from becoming dehydrated. Not getting enough water can lead to premature or early labor.

Juices also contain water. But juice also has a lot of calories that can cause you to gain extra weight. Coffee, soft drinks, and teas with caffeine actually reduce the amount of fluid in your body. So caffeinated drinks do not count towards the total amount of water you need every day.

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Should I take a multivitamin during my pregnancy?

Yes. Most doctors recommend that pregnant women or those trying to get pregnant take a multivitamin or prenatal vitamin every day. This ensures that you and your baby get enough important nutrients like folic acid. Folic acid helps prevent serious birth defects of your baby's brain and spine. These birth defects often happen before most women know they are pregnant.

Even women who plan carefully to eat healthy every day sometimes fail to get important nutrients. Taking a daily multivitamin or prenatal vitamin will guarantee you daily dose of needed nutrients. But don't overdo it. Taking more than one multivitamin daily can be harmful.

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Should I eat fish when I'm pregnant?

Fish and shellfish can be part of a healthy diet. They are a great source of protein and heart-healthy omega-3 fatty acids. But almost all fish and shellfish contain a harmful substance called mercury.

Mercury mainly gets into our bodies by the fish we eat. Only high levels of this metal seem to be harmful to developing babies. So the risk of mercury in fish and shellfish depends on the amount and type you eat.

By following some tips you can get the healthy protein and omega-3 fatty acids in fish and avoid mercury. Use these guidelines:

  • Do NOT eat any shark, swordfish, king mackerel, or tilefish (also called golden or white snapper) because these fish have high levels of mercury.
  • Do not eat more than six ounces of "white" or "albacore" tuna or tuna steak each week.
  • Do not eat more than 2 servings or 12 ounces total of fish per week.
  • Choose shrimp, salmon, pollock, catfish, or "light" tuna as they contain less mercury.

Check out the Fish Eating Guide for handy tips on eating fish while pregnant. And visit the Center for Food Safety and Applied Nutrition for more information on how much mercury is in different kinds of fish.

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How much weight should I gain during pregnancy?

The American College of Obstetricians and Gynecologists (ACOG) recommends an average weight gain of 25 to 30 pounds during pregnancy. But the amount of weight you should gain depends on your weight before you became pregnant and your height.

According to ACOG:

  • If you were underweight before becoming pregnant, you should gain between 28 and 40 pounds.
  • If you were overweight before becoming pregnant, you should gain between 15 and 25 pounds.

Check with your doctor to find out how much weight gain during pregnancy is healthy for you.

You should gain weight gradually during your pregnancy, with most of the weight gained in the last trimester. Doctors suggest women gain weight at the following rate:

  • 2 to 4 pounds during the first trimester
  • 3 to 4 pounds per month for the second and third trimesters

Recent research shows that women who gain more than the recommended amount during pregnancy and who fail to lose this weight within six months after giving birth are at much higher risk of being obese nearly 10 years later.

Total weight gained during pregnancy includes six to eight pounds for the weight of the baby. The remaining weight consists of fluid, larger breasts, larger uterus, amniotic fluid, and the placenta. Make sure to visit your doctor throughout your pregnancy so he or she can check on your weight gain. You also may elect to join a prenatal fitness program to help keep you toned and in the ideal weight during your pregnancy.

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Is it hard to lose weight after pregnancy?

If you gain too much weight during pregnancy it can be hard to lose weight after you have your baby. During pregnancy, fat deposits can increase by more than 33 percent. Most women who gain the recommended amount of weight lose the extra weight in the birth process and in the weeks and months after birth. Breastfeeding also can help you lose extra weight by burning extra calories. Breastfeeding burns at least 500 calories each day. Find out more about what you should eat and avoid while breastfeeding. In addition, you may consider being pro-active and taking fitness classes to help burn calories, get you toned and back into your pre-pregnancy body.

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Should I avoid alcohol while I'm pregnant?

There is no safe time during pregnancy for you to drink alcohol. There is also no known safe amount of alcohol to drink during pregnancy. When you are pregnant and you drink beer, wine, hard liquor, or other alcoholic beverages, alcohol gets into your blood. The alcohol in your blood gets into your baby's body through the umbilical cord. Alcohol can slow down the baby's growth, affect the baby's brain, and cause birth defects.

Fetal Alcohol Spectrum Disorders (FASD) is a term describing a range of effects that can occur in a person whose mother drank alcohol during pregnancy. Some people with FASD have abnormal facial features and growth and central nervous system problems. People with FASD may have problems with learning, memory, attention span, communication, vision, and/or hearing. These problems often lead to problems in school and social problems. The effects of FASD last a lifetime.

If you are pregnant and have been drinking alcohol, stop now and talk to your doctor. Avoiding alcohol will help keep your baby healthy. If you need help to stop drinking, talk with your doctor or nurse. Find out more about the dangers of drinking alcohol during pregnancy.

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Can I drink caffeine while I'm pregnant?

Caffeine is a stimulant found in colas, coffee, tea, chocolate, cocoa, and some over-the-counter and prescription drugs. Large quantities of caffeine can cause irritability, nervousness and insomnia as well as low birth-weight babies. Caffeine is also a diuretic and can rob your body of valuable water.

Some studies show that drinking caffeine during pregnancy can harm the fetus. Other research suggests that small amounts of caffeine are safe. Talk to your doctor before drinking caffeine during pregnancy. Caffeine is an ingredient in many over-the-counter and prescription drugs. Talk with your doctor before taking any drugs or medicines while pregnant.

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Why do pregnant women crave certain foods?

The desire for "pickles and ice cream" and other cravings might be caused by changes in nutritional needs during pregnancy. The fetus needs nourishment. And a woman's body absorbs and metabolizes nutrients differently while pregnant. These changes help ensure normal development of the baby and fill the demands of breastfeeding once the baby is born.

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I have diabetes. How should I eat while pregnant?

If you already have diabetes and would like to get pregnant, your chances of having a healthy baby are good. But, it's important to plan your pregnancy and follow these steps:

  • Get your diabetes under control before you get pregnant. Try to get your blood sugar under control three to six months before you get pregnant.
  • Always keep your blood sugar under control during your pregnancy. Keep food, exercise, and insulin in balance. Talk with your doctor or a registered dietitian to help you follow a special meal plan. Remember, as your baby grows, your body changes, and these changes will affect your sugar levels. If your blood sugar rises too high, the increased sugar crossing into the placenta can result in a large, over-developed fetus with birth defects or an infant with blood sugar level problems.
  • Be sure to get enough of the B vitamin folic acid, every day. Women with diabetes might be at increased risk for having a baby with a serious birth defect. Getting enough folic acid each day can help reduce this risk.

Gestational diabetes is a form of diabetes that begins during pregnancy and usually goes away after the birth of the baby. If you have gestational diabetes, this means that you have a high amount of sugar in your blood during pregnancy. This form of diabetes can be controlled through diet, medication, and exercise, but if left untreated, gestational diabetes can cause health problems for both you and your baby. If you develop gestational diabetes, your doctor will refer you to a registered dietitian who can help you with special meal plans to control your blood sugar.

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Why do I get morning sickness and nausea, and what can I do about it?

Morning sickness and nausea are common in pregnant women. Most nausea occurs during the early part of pregnancy. In most cases this discomfort improves when you enter the second trimester. For some women, morning sickness and nausea might last longer, even for the entire nine months.

The changes in your body can cause nausea and vomiting when:

  • you smell certain things,
  • you eat some foods,
  • you are tired,
  • you are stressed,
  • or for no apparent reason

You may be able to reduce nausea by changing when and what you eat. Try these tips:

  • Eat smaller meals, such as six to eight small meals instead of three larger ones each day.
  • Don't go for long periods of time without eating.
  • Drink fluids between, but not with, meals.
  • Avoid foods that are greasy, fried, or highly spiced.
  • Avoid strong, foul and unpleasant odors.
  • Rest when you are tired.

Severe nausea and vomiting in pregnancy is rare. But constant vomiting can cause you to lose needed water and become dehydrated. If you feel that your nausea or vomiting is keeping you from eating right or gaining enough weight, talk with your doctor.

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The information was reviewed by Christine Prue, PhD, Joe Mulinare, MD, Katie Kilker, BS, CHES, and Patricia Mersereau, MN, CPNP at the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC).



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