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diet and pregnancy

Alternative Names 
nutrition and pregnancy

Definition
Pregnancy is the period of time between conception and birth. Measured from the start of a woman's last normal menstrual period, or LMP, it usually lasts about 40 weeks, or roughly 9 calendar months. The process of childbearing, though, can be said to last longer. Often, it is divided into three stages:
  • preconception, which is the months before pregnancy
  • antenatal, which is the months during pregnancy
  • postpartum, which is the months after the birth
During preconception and pregnancy, a woman's diet makes a big difference to her health and to the health and growth of the foetus. After her baby's birth, what she eats affects breast milk if she is breastfeeding. It has a big effect on her health and energy levels, too.

What is the information for this topic? 
Key concerns about diet during each of the three stages are outlined below.

Preconception

In the months before a woman gets pregnant, her food choices are important. What she eats and the vitamins she takes can help ensure that mother and foetus will have nutrients that are essential from the very start of pregnancy.

Some diets and activities affect key nutrients and hormones. A woman should talk to her doctor before trying to get pregnant if she:
  • is a strict vegetarian
  • is a long-distance runner or does other kinds of strenuous exercise
  • is dieting to lose weight
  • has, or has had, anaemia
  • feels her eating pattern has been irregular or inadequate
A B-vitamin called folate can help prevent certain birth defects of the spine and brain called neural tube defects. The neural tube starts to form soon after conception. Many women do not know they are pregnant until a few months into the pregnancy. For that reason, experts advise all women of childbearing age to get at least 400 micrograms (mcg) a day of folic acid, a synthetic form of folate. This has been shown to help cut down the risk of neural tube defects. One multivitamin a day should supply this amount. Low dose supplements (500 mcg = 0.5 mg) of folic acid are available at pharmacists and health food stores. You do not need a prescription. Take them at least one month before conception and during the first three months of pregnancy.

Antenatal

Just as it is important to stay active and get plenty of sleep during pregnancy, a woman needs to eat well, too. Her body and her growing foetus have special nutritional needs. The best way meet these needs is to eat a variety of foods from all the food groups.

Skipping meals, eating poorly, and trying to diet while pregnant can be serious threats to the development of the foetus. After the first trimester, in fact, a woman should add about 1200 kilojoules a day of healthy foods to her diet. She should expect to gain between 12 - 14 kilograms during her pregnancy.

Below is a list of special nutritional needs during pregnancy. A woman who is not sure if she is meeting these needs should consult her doctor.

Carbohydrates give the foetus the constant supply of energy it needs for growth. Most of a woman's extra kilojoules during pregnancy should come from carbohydrates. Foods such as fresh fruit, whole grain cereals and breads, rice, potatoes, and beans are good sources.

Iron supports the growth of the foetus and helps a woman produce more blood. If the mother does not get enough iron, the foetus will take the iron it needs from her blood. Pregnant women should get about 22 - 36 milligrams (mg) of iron a day. Most women do not embark on pregnancy with enough iron in their blood. An iron supplement may be prescribed to prevent iron deficiency anaemia. Foods that contain iron include meat, poultry, fish, legumes such as beans, and whole-grain and fortified cereals. Iron from animal products is better absorbed by the body than that from plant sources. Eating good sources of vitamin C, such as citrus fruit, broccoli, and tomatoes, can help the body absorb iron.

Folic acid is important for the developing spinal cord. It helps make new cells and genetic material. Its most important job is helping to prevent neural tube defects, such as spina bifida.

During pregnancy, the recommended daily amount of folic acid rises to 400 mcg. Based on the woman's medical history and test results, the doctor may recommend 500 - 5000 mcg of folic acid a day. Many foods are fortified with folic acid, including breakfast cereals and bread. This makes it easier for a woman to get all the folic acid she needs before and during pregnancy. Food sources include green leafy vegetables such as spinach, asparagus and broccoli, dark yellow vegetables, and fruits such as mangoes, pawpaw, peaches and pumpkin, beans and fortified grain products, nuts and avocado.

Protein is needed for the growth and repair of muscles and body cells in mother and foetus. During pregnancy, the RDI (recommended dietary intake) for protein is an extra 6 grams a day. Good sources of protein include lean meats, fish, legumes, eggs, and skinless poultry. An eating plan that follows the Australian Guide To Healthy Eating should provide enough protein for a healthy pregnancy.

Calcium and phosphorous help to form the bones of the foetus. The RDI for calcium is 1300 mg for most pregnant women. If she does not get enough calcium, the foetus will take what it needs from calcium stored in her bones. Milk, yoghurt, and other dairy products are the best sources of calcium. Other sources include tofu made with calcium, sardines, salmon with bones, and dark green leafy vegetables. Vitamin D works to help the body use calcium and phosphorous. Vitamin D is found in milk and from sunshine.

Other vitamins and minerals are also needed in higher amounts than usual during pregnancy. Except for iron, folic acid, and calcium, most of the nutrients needed during pregnancy can be taken in by making healthy food choices. However, a doctor may prescribe a vitamin and mineral supplement. If so, it should be taken only as directed.

Constipation is a common problem during pregnancy. Coupled with pressure from the baby, it can sometimes lead to haemorrhoids. To help prevent constipation, a woman should try to:
  • eat foods high in fibre, such as raw fruits, raw vegetables, beans, bran, and whole-grain breads. Prunes, prune juice, and figs are also helpful.
  • drink 8-12 glasses of fluid a day. Water is an excellent choice. Milk and some juices are helpful, too. Drink more water if the weather is hot or you are in air-conditioning.
  • be physically active. A woman should first check with her doctor before starting any type of exercise during pregnancy.
Many pregnant women experience the nausea and vomiting known as morning sickness. Diet can be a good way to help ease these symptoms. A woman may find it helps to:
  • just eat foods that she finds appealing. A woman may find she prefers salty or sour, crunchy or smooth textures. In the early months of pregnancy, getting enough kilojoules is more important than eating a perfectly healthy diet. Odd combinations sometimes help a woman break the cycle of nausea and low appetite. When morning sickness wanes, usually around the end of the first trimester, a woman should start to focus on healthy foods again.
  • avoid strong smells - stay out of the kitchen if possible
  • try to eat something, such as crackers, plain toast, dry cereal, or anything that appeals, before getting out of bed in the morning
  • eat often and before she feels hungry. When the stomach is empty, it triggers nausea. It is helpful to eat small, frequent meals during the day rather than skipping meals.
  • try to avoid high-fat and fried foods during this time
  • eat in bed to keep the stomach full and the blood sugar even. Before going to sleep and before getting out of bed, she may want to eat a high protein snack such as yoghurt or milk.
A woman who is vomiting more than twice a day should consult her doctor.

Postpartum (after the birth)

In the months after a baby's birth, it is important to keep eating a balanced and healthy diet. Just by doing so, many women will lose weight in the first 4 weeks.

If a woman chooses to bottle feed, her body no longer needs the extra kilojoules that helped her during pregnancy. If a woman is breastfeeding, she continues to need extra fluid, kilojoules, protein and other nutrients.

A nursing mother needs the foods normally required for her own body, plus extra food to produce milk for the baby. She should be eating about 2000 more kilojoules a day than her body needed before pregnancy. Calcium is very important for nursing mothers. Milk, yoghurt, cheese, custard, and dark green leafy vegetables are good sources of it.

About 20% of all pregnant women suffer from iron deficiency anaemia. It usually occurs later in pregnancy because of increased foetal requirements. If there is any unusual postpartum bleeding, this can become worse. Pregnant women at highest risk are those who are inadequately nourished before and/or during pregnancy. As well as having a diet high in iron-rich foods such as red meats, dried beans and peas or fortified cereals, many expectant mothers are prescribed iron supplements.

Vitamin A is needed for growth of bones and teeth. However, it is not excreted in the urine, so overdoses can produce toxic effects such as birth defects. The RDI for vitamin A is 750 mcg per day.

Author: 
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 12/06/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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