If you’re pregnant, or trying to fall pregnant, following a healthy diet is a top priority. Good nutrition can have a big impact on your own health, and the health of your unborn baby.
Calorie Requirements During Pregnancy
The energy (calories) you require during pregnancy varies considerably from person to person. This reflects wide differences in the energy needs and exercise frequency between individuals. For most women, the additional calories required when pregnant aren’t huge – only around 100 to 300 extra calories per day.
In women who substantially reduce their exercise when pregnant, their need to consume extra calories may be minimal. Even towards the end of the pregnancy, the average woman only needs around 2400 calories daily (compared to the average of 2100 calories daily for non-pregnant woman).
While few extra calories are required during pregnancy, the body does require significantly more nutrients. It’s important to choose nutrient-dense foods, and avoid high fat, and calorie-dense foods such as biscuits, confectionery and soft drinks throughout pregnancy.
Vitamin/mineral supplementation, particularly of iron, folic acid and zinc is usually prescribed as a safeguard to ensure you’re getting adequate nutrients during pregnancy.
|Average Calorie Needs|
|(Average Activity)||Normal Weight||Overweight|
Extra 100-150 calories
(eg. one large banana)
|2200 Cals||1800 Cals|
Extra 200-300 calories
(eg. two crackers with cheese)
|2300 Cals||1800 Cals|
Extra 300 Calories
(eg. one chicken sandwich)
|2400 Cals||2000 Cals|
Dieting During Pregnancy
While it’s important to maintain healthy eating habits during pregnancy, it’s not recommended that you attempt to lose weight during this time. Losing weight places the health of your growing foetus at risk, particularly if the baby is of a low birth weight.
Further reasons you shouldn’t diet during pregnancy include:
- Inadequate energy intake could ‘starve’ the foetus of nutrients, especially during the third trimester, and increase the risk of your baby having a low birth weight.
- Excessive weight loss can produce ketones, a by-product of fat breakdown, which may be detrimental to the baby’s development.
- The mother runs the risk of ill health, both during pregnancy and in subsequent years, for example inadequate calcium obtained during pregnancy can increase the risk of osteoporosis (brittle bones) in later years.
- Inadequate nutrition during pregnancy can severely affect your milk production during lactation. Adequate protein and energy intake is essential to support optimal growth of the mammary glands. Even obtaining adequate nutrition during lactation might not be enough to overcome the lack of mammary gland growth that occurred during pregnancy.
Special Nutritional Requirements
During pregnancy, nutrients are vitally important in meeting both the developing foetus and the mother’s nutritional needs. It’s important to ensure your diet provides adequate nutrients to support your needs. However, most pregnant women don’t meet their nutritional needs through diet alone, and require a vitamin and mineral supplement to meet these demands.
There are many supplements designed specifically for pregnant women. Talk to your health care provider about the right supplement for you.
The following is a guide to some important nutrients that often require supplementation:
Inadequate calcium intake during pregnancy can increase a woman’s risk of developing osteoporosis later in life. It is therefore important to ensure that your calcium intake is adequate throughout your pregnancy, and during the breastfeeding period.
Pregnant women require 1200 mg of calcium per day.
You may find that you can obtain adequate amounts of calcium from your diet alone if you include two or more servings of dairy foods per day. However, you may also require a supplement – discuss your needs with your doctor.
Folate is important for preventing neural tube defects (NTDs), such as spina bifida, in newborn babies. 70% of NTDs could be prevented by women increasing their folate intake to 0.5 mg per day at least a month prior to conception, and during the first three months of pregnancy. The timing is essential as NTDs occur in the first few weeks of pregnancy, when the baby’s brain and spinal cord are forming.
Folate is a form of a water-soluble B vitamin, occurring naturally in many foods. Folic acid is the synthetic version of folate, found in supplements and fortified foods.
To increase your folate intake:
- Eat foods that rich in folate, such as green leafy vegetables, citrus fruits, berries, bananas and legumes.
- Include foods that have been fortified with folate in your diet, such as breakfast cereals.
- Try a folic acid supplement. Don’t rely on your normal multivitamin to provide the required daily amount of folate as most supplements only contain minimal amounts.
During pregnancy, extra iron is required to support the increase in the mother’s blood volume, and the normal growth of the foetus and placenta. Since it can be difficult to consume the required amount of iron from food alone, a daily supplement may be prescribed. The extra iron intake promotes adequate stores in the mother’s body, which can be used during breastfeeding. An iron supplement may also be beneficial for combating fatigue.
Potential Food Hazards
During pregnancy, there are certain foods you should avoid due to the health risks they pose to the developing foetus. Below is a guide to some potential food hazards. If you’re concerned about any of the recommendations or your intake of any of these foods, discuss your concerns with your doctor.
Excess alcohol by a mother intake during pregnancy can lead to physical, mental or behavioural problems which may affect the child throughout his or her life. Studies have shown that consuming alcohol during pregnancy can harm the developing child’s brain, and maybe even their DNA.
The most serious problems manifest as Foetal Alcohol Syndrome, or FAS. Children with FAS may experience the following:
- Small birth weight
- Difficulties eating and sleeping
- Problems with sight and hearing
- Struggle to follow directions and learn how to do simple things
- Have trouble paying attention and learning in school
- Difficulty getting along with others and controlling their behaviour
- Require medical care throughout their lives
It’s best to avoid alcohol throughout your pregnancy. Consider:
- If you’re drinking alcohol, so is your baby.
- If you were drinking before you knew you were pregnant, stop drinking now.
- If you’re planning to get pregnant, stop drinking alcohol now, as you may not know you’re pregnant until weeks into the pregnancy.
Alcohol in cooking: It’s okay to add some wine to a casserole or risotto, just ensure your food is extremely well cooked. Cooking for an hour or more burns off the actual alcohol content in wine, and leaves the flavour intact.
Listeria is a bacteria found in certain foods, with the dangers it poses becoming much more widely known over the past decade. While incredibly uncommon, listeria can be very dangerous for pregnant women as this bacteria can be transmitted to the foetus. If the unborn child is infected with listeria, it may result in miscarriage, still birth, premature birth or a very ill baby.
Unfortunately, the symptoms of listeria can be difficult to recognise, or may not even show up at all. The symptoms often resemble those of a bad flu or food poisoning, such as vomiting or diarrhoea, muscle aches and pains and headaches. It’s difficult to test for listeria, although it can be treated with antibiotics once diagnosed.
Preventing listeria is easy if you avoid certain foods and treat food safely throughout your pregnancy. Use good food hygiene practices at home, and be particularly vigilant in the foods you choose when eating out.
Here are some foods to avoid:
- Soft cheeses, such as brie, camembert and ricotta (these are safe if cooked and served hot)
- Takeaway cooked chicken, served cold, as used in chicken sandwiches or sushi
- Cold meats, including ham and salami
- Pre-prepared salads, such as coleslaw or pasta salad from the deli or a smorgasbord
- Raw seafood, such as oysters and sashimi
- Smoked seafood, such as smoked salmon or smoked oysters (canned smoked oysters are safe)
Listeria bacteria is killed by heat, so hot foods can be consumed safely. So you can eat ham on a pizza, if it is very hot. When you consume hot food, make sure it is really hot. If you reheat leftovers, make sure they’re steaming hot throughout.
Don’t eat food that is served lukewarm. It’s best to avoid places like smorgasbords or salad bars, but if you can’t, be sure to choose only steaming hot foods.
Here are some tips for good food hygiene:
- Always thaw frozen food in the fridge or microwave, not at room temperature on the kitchen bench.
- Keep raw meat covered and separate from any ready-to-eat food. Don’t let the juices from raw meat drip onto other food.
- Wash your hands, knives and cutting boards after handling raw food to avoid cross-contamination with cooked or ready-to-eat food.
- Thoroughly cook all animal foods.
- Keep hot food very hot (above 60°C) and cold foods very cold (at or below 5°C).
- Don’t let cooked foods cool down before serving.
- Thoroughly reheat food until it is steaming hot.
- Avoid unpasteurised milk, or foods made from unpasteurised milk
- Use cooked foods, such as leftover chicken or meat, within 12 hours of cooking, or freeze immediately.
- Wash all fruits and vegetables thoroughly before consuming.
- Follow the label instructions on any products that must be refrigerated or have a ‘use by’ date.
- Keep the inside of the refrigerator, counter tops, and all utensils clean.
Contact your doctor or local health authority for more information on listeria.
There has been much controversy around the mercury content of fish and the potential risks it may pose for pregnant women.
Unborn children who are exposed to mercury while in the womb may experience subtle side effects after birth, such as delayed development, particularly when it comes to walking and talking. The most dangerous time for a baby to be exposed to mercury is during the third and fourth months of pregnancy.
For this reason, pregnant women (and women considering getting pregnant) are advised not to eat more than four servings of certain types of fish each week.
These fish are:
- Orange roughy
- Southern bluefin tuna
- Fish caught in geothermal waters
These fish are all large fish located at the top of the food change. They tend to live longer, and therefore have more time to accumulate mercury in their flesh.
All other types of fish and shellfish are safe, including canned tuna. In fact, pregnant women could eat as many as 119 servings (of 150 g each) of salmon, including canned salmon, per week before they exceeded safe levels of mercury.
Eating a variety of fish is recommended, rather than sticking to just one type.
However, keep in mind that smoked salmon or smoked oysters, and raw fish such as sashimi or raw oysters aren’t recommended.
It’s also important to remember that fish is highly nutritious and contains essential nutrients, such as omega-3 fatty acids. Omega -3 fatty acids act as building blocks for cell membranes, and produce prostaglandins – hormone-like substances required for energy metabolism, cardiovascular and immune health. Omega-3s also help maintain balanced hormone levels and keep the skin and other tissues supple and healthy. So before you exclude fish from your diet altogether, note that fish is extremely good for you and your baby.
Eating a variety of fish during pregnancy may help prevent high blood pressure, and can help enhance the baby’s brain development.
Food or Diet-Related Pregnancy Conditions
During pregnancy, your body undergoes major changes and can develop many temporary conditions. Some of these conditions are related to the digestive system, and can be eased by making small changes.
Constipation is common during pregnancy. Your digestive system slows, so the elimination of waste takes longer than usual. Stools can become harder, drier and more difficult to eliminate. Constipation and straining when going to the toilet can also contribute to haemorrhoids, another common condition that develops during pregnancy.
To avoid constipation, aim to increase both your fluid and fibre intake throughout your pregnancy.
Note: Some iron supplements may also contribute to constipation, so speak to your doctor if you’re taking supplements and struggling with constipation.
Here are some tips for avoiding constipation:
- Breakfast is a good opportunity to increase your daily fibre intake. Choose high-fibre breakfast cereals, such as bran-based cereals, muesli or rolled oats. Then, add two to three tablespoons of unprocessed bran if required. Be patient, it may take several weeks to experience the full benefits of your increased fibre intake.
- Eat wholegrain or wholemeal bread and less white bread. One slice of wholemeal bread contains more fibre than three slices of white bread. Similarly, choose wholemeal pasta and brown rice over the white alternatives.
- Eat fresh fruit, keeping the skin on where possible, rather than choosing fruit juice. Keep the skin on potatoes too, as this is where most of the fibre in fruit and veg is found.
- Eat more salad and vegetables – especially dried beans (even baked beans), avocado, broccoli, cabbage, carrots, celery, peas, tomatoes and lettuce.
- Add unprocessed bran to soups, gravies, stews, yoghurt, dessert, biscuits, cakes. Also, use wholemeal flour instead of white flour in your cooking.
- Drink eight or more glasses of fluid each day. Fibre absorbs many times its own weight in water. Your fluid requirements are greater during pregnancy already, so make sure you’re drinking enough water or other fluids daily.
- Exercise regularly to strengthen your abdominal muscles and stimulate the gut. Walking and swimming are ideal.
- Avoid using laxatives. These can overstimulate the intestinal muscles and may make normal bowel activity impossible. See your doctor for more advice regarding laxatives.
A gradual increase in fibre is often more comfortable than the rapid addition of large amounts of fibre to the diet. Note that excess fibre can interfere with your absorption of minerals such as calcium, iron, magnesium and zinc, which can upset the nutritional balance. Aim for between 30g to 40g of fibre per day.
2. Indigestion and Heart Burn
These uncomfortable and sometimes painful conditions can occur during pregnancy. These are often caused during pregnancy by hormonal changes which relax the valve between the oesophagus and stomach, allowing digestive acids to flow out of the stomach into the oesophagus, throat and mouth.
This can be very uncomfortable as the acids burn the sensitive lining of your oesophagus. These conditions may be worse during the later stages of pregnancy as the uterus is taking up more space, compressing the stomach, and slowing the digestion of food.
Here are some tips to ease indigestion and heartburn:
- Stay upright as you digest. For many women, heartburn or indigestion is worse at night when they lie down horizontally. Try to eat your evening meal several hours before you go to bed, giving your body time to digest your food. Propping yourself up in bed with a few pillows or books under your head or mattress may help you stay more upright, yet comfortable enough to sleep.
- Eat frequently. Have five or six small meals throughout the day, instead of the normal three meals a day.
- Eat slowly. Take your time to chew properly and give your body time to digest your food.
- Avoid spicy and fatty foods. You may find simple foods are more agreeable to you. Some foods, such as cabbage, chocolate, garlic, onions or caffeine may worsen the problem.
- Try to drink fluids between meals rather than with meals. This can prevent bloating and indigestion. You may find that sipping water helps.
- Check with your doctor regarding any antacids or medications that may be helpful for you.
3. Morning Sickness
Some women experience no morning sickness at all, while others feel sick morning, noon and night for months on end! For many women, the nausea and vomiting ease off by the end of the first trimester, yet for an unlucky few, morning sickness will continue throughout the whole pregnancy.
Strong smells can cause nausea, as can different foods. Experiment with your diet to find foods you’re comfortable with, and try to eliminate foods that make you feel ill. A food diary may help you track foods and their relationship to your nausea.
Many women find that crackers, bread, lemonade or ginger tea help to ease the nausea. If you feel particularly ill in the morning, try having a small snack before you get out of bed.
Eat small, frequent meals and drink plenty of fluids to manage morning sickness. Try to avoid going for long periods without food, as this may make the nausea worse.
Talk to your doctor if your morning sickness is severe and you’re vomiting several times a day.
4. Gestational Diabetes
Gestational diabetes is a temporary form of diabetes, which begins during pregnancy and usually disappears after delivery.
Any woman can develop gestational diabetes during pregnancy, though there are a number of strong contributing factors. These include:
- Family history of diabetes
- Having had a large baby previously
- Having had a stillbirth
- Having had a child with a birth defect
- Having too much amniotic fluid (polyhydramnios)
- Being older than 25 (small indicator)
Women who experience gestational diabetes have a greater risk of developing diabetes later in life (50-60% if a healthy life style is not followed), as well as experiencing further gestational diabetes in future pregnancies.
If you’re believed to be at risk of gestational diabetes, your doctor will recommend a test in the 26th to 28th week of your pregnancy.
Gestational diabetes can be managed through diet and exercise. If this condition is managed well, it poses little risk to your baby. If not managed properly, gestational diabetes can result in a larger-than-normal baby, and the baby may develop low blood sugar levels soon after birth.
Children whose mothers had gestational diabetes are at higher risk for certain health problems:
- As babies, they are at higher risk of Respiratory Distress Syndrome (RDS), a disease that makes it hard for the baby to breathe.
- They are more likely to be obese as children or adults, which can lead to other health problems.
- They are at higher risk for getting diabetes, or experiencing high blood sugar, as they get older.