Everything you need to know about nutrition in pregnancy

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 Photo: Getty Images

There is still a lot of confusion about nutrition and other health issues during pregnancy - and if you've just learnt you're pregnant, working out what you should avoid or keep to a minimum can be daunting.

To dispel some of the many myths and keep the fact from fiction, here's some advice from renowned expert Dr Taraneh Shirazian, an assistant professor of obstetrics and gynaecology at NYU School of Medicine, and the founder of Saving Mothers.

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How much weight should I gain?

According to the Institute of Medicine, a woman who is of normal body weight or body mass index should gain between 11.3 and 15.8 kilograms. A woman who is normally underweight should gain between 12.7 and 18.1 kilograms during pregnancy.

If you begin your pregnancy overweight or obese, you should pay specific attention to your weight gain in order to minimise pregnancy-related complications. A woman who begins pregnancy overweight should gain 6.8 to 11.3 kilograms, while a woman who is obese should gain between 4.9 and 9 kilograms.

What are the healthiest foods to east during pregnancy?

Foods high in iron, such as spinach, broccoli, beans, 100 per cent whole grains, eggs and peanut butter.

Asparagus has lots of nutrients, including vitamin B6, folic acid, thiamine, fibre, and potassium, which can help regulate blood pressure.

If you're already eating a balanced diet, aim for 1250 extra kilojoules each day (170 to 220 grams of food high in protein, such as eggs, red meat, chicken, fish, beans, cheese, nuts and dairy foods).

You need 1000 milligrams of calcium each day (from milk, yoghurt, cheddar or Swiss cheese, broccoli and greens).

Have four 28-gram servings of 100 per cent whole-grain bread or cereal, 4 to 5 servings of fruits and vegetables every day.

Oranges and other fruits, such as berries, papayas and kiwi, which are high in vitamin C.

What should I avoid during pregnancy?

Smoking during pregnancy is the single most preventable cause of illness and death among mothers and infants.

Alcohol passes through the placenta, so when you drink, your unborn baby drinks with you. There is no known safe amount of alcohol to drink while pregnant.

Avoid harmful drugs and medications; consult your obstetrician before continuing any prescribed medications. Contact MotherSafe if you have any worries or questions about prescription or over-the-counter medications.

Avoid unpasteurised juices and dairy products, such as raw milk and cheese, as well as raw fish, meat and eggs, because they may contain listeria, a bacteria that can be harmful to the baby. Also avoid deli meats and soft cheeses, such as brie and feta, which can also harbour listeria. Learn more about foods to avoid here.

Eat fewer than 340 grams of fish a week and avoid swordfish, tilefish, shark and king mackerel, which may contain very high levels of mercury. Types of fish that are OK to eat include salmon, shrimp and sardines. Fish is high in omega-3 fatty acids and is good for your baby's brain and eye development.

Limit caffeine intake to one to two cups of coffee per day. Keep in mind that other products, including chocolate, soda and some medications, also have caffeine.

What should I do if I am too nauseated to eat?

Nausea is very common early in pregnancy and usually goes away after the third month. Here are some strategies for battling morning sickness:

  • eat crackers or dry toast before getting out of bed
  • try to move slowly in the morning
  • drink fluids between meals instead of with meals.
  • avoid fried foods and very spicy foods
  • eat many small meals a day.

What about hydration?

The Institute of Medicine recommends that women in temperate climates consume 12 to 13 glasses of water a day. Stay away from alcohol, avoid sugary beverages and limit caffeinated drinks.

Which vitamins and nutrients to pregnant women need the most?

Folic acid is a B vitamin that can help prevent major birth defects. Take a vitamin containing 400 micrograms (mcg) of folic acid every day, before and during pregnancy.

What are the best forms of exercise during pregnancy?

Regular exercise has benefits for both you and the baby. Aim for at least 30 minutes of moderate exercise every day.

Stress:

Pregnancy stress can be minimised by doing yoga or deep-breathing exercises. Photo: iStock

If you are used to swimming, jogging or yoga, you can safely continue these activities.

Avoid exercise that can cause you to fall, such as horseback riding, skiing and contact sports.

Stretching, belly breathing, proper posture and relaxation are all beneficial.

Sitting on an exercise or birth ball can help with stomachaches and back pain. You can sit on it, lean on it or bounce on it to help relieve pain.

What health complications can occur during pregnancy, and how can I avoid them?

• Obesity: Try to begin pregnancy at a healthy weight and monitor weight gain.

• Gestational diabetes: Work with your doctor, and try to control gestational diabetes with diet and exercise. Incorporate at least 30 minutes of exercise into your day every day and avoid sweets, white bread and white pasta. Switch to fresh fruits and vegetables, brown rice, whole-wheat bread and pasta

• Pre-eclampsia: If you have high blood pressure before pregnancy, get your blood pressure checked. You may need blood pressure medication if it's not controlled. Pre-eclampsia, when a pregnant woman develops high blood pressure and large amounts of protein in the urine, can lead to health and delivery complications for the mother and baby.

• Premature birth: Make sure to start your prenatal care as soon as you know you are pregnant. If you've already had a preterm birth you may need to see an expert in high-risk pregnancy. Call a healthcare provider if you notice any changes in vaginal discharge (water, mucus, blood); pelvic/lower abdominal pressure; constant low, dull back pain; mild cramps, contractions or ruptured membranes (water breaking).

• Low energy levels: Take short naps and rests during the day. Sleep with extra pillows for support while sleeping on your side (best on your left side).

• Constipation: Drink plenty of liquids. Eat uncooked fruits and vegetables. Dried fruits and prune juice can help, too. Consume whole grain breads, cereals and bran. Exercise regularly.

• Frequent urination: Frequent urination is a common and normal side effect of pregnancy. If you feel burning or pain when you urinate, talk to your doctor because you may have an infection.

• Stress: According to the Johns Hopkins Bloomberg School of Public Health, moderate levels of stress later in pregnancy are okay. Try to avoid stress early and throughout the pregnancy by signing up for a yoga class or doing stretching and deep-breathing exercises at home. Eat a healthy and balanced diet that includes omega-3 essential fatty acids, vitamins and minerals. Drink six to eight glasses of water per day, snack on nuts, fresh chicken/turkey, seeds, eggs, yoghurt and cheese.

Try to incorporate 30 minutes of daily exercise into your life. Get enough sleep (go to bed earlier). Ask friends and loved ones for help. Cut back on chores and responsibilities. Do relaxing activities such reading or taking a nap. Join a support group. If you are doing these things and still feel overwhelmed, talk to your healthcare provider about getting additional help to manage stress and anxiety

• Heartburn: Fats can cause heartburn. Try to consume food that has been baked, grilled or broiled, and avoid fried foods. Drink a half-cup of nonfat milk after meals and before lying down at night. This can help reduce the stomach acid that causes heartburn. Stay upright for an hour or so after eating

• Shortness of breath: This may occur toward the end of pregnancy due to the growing uterus. Don't lie flat on your back when you sleep. Use an extra pillow at night and try to sleep on your left side. If the shortness of breath worsens, consult your physician.

• Lower back pain: Wear low-heeled shoes. Be aware of your posture. Do stretches that target the muscles in your lower back. Your back muscles work much harder during pregnancy to keep you upright.

• Depression: Talk to a friend or family member about how you're feeling. Talk to your healthcare provider if you feel isolated and alone, or call or visit BeyondBlue.

MCT