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Pregnancy and Nutrition
PREGNANCY
AND NUTRITION
Source: National Women's Health Information Center
Frequently Asked Questions
Q. How should my diet change now that I am
pregnant?
A. Even before pregnancy begins,
nutrition is a primary factor in the health of mother and baby. If you are eating a
well-balanced diet before you become pregnant, you will only need to make a few changes to
meet the nutritional needs of pregnancy.
According to the American College of
Obstetricians and Gynecologists (ACOG), pregnant women should increase their usual
servings of a variety of foods from the four basic food groups to include the following:
- Four or more servings of fruits and vegetables
for vitamins and minerals
- Four or more servings of whole-grain or
enriched bread and cereal for energy
- Four or more servings of milk and milk products
for calcium
- Three or more servings of meat, poultry, fish, eggs,
nuts, dried beans and peas for protein
Eating a well-balanced diet while you are pregnant
will help to keep you and your baby healthy. Most physicians agree that the Recommended
Daily Allowances (RDAs), except those for iron, can be obtained through a proper diet.
Q. What are the Recommended Dietary
Allowances (RDAs) for pregnant women?
A. The following is a chart that
outlines the RDAs for by age group as well as the RDAs for pregnant women.
Female
RDA |
Cals |
Protein |
E |
K |
C |
Thia. |
Ribo. |
Niacin |
B6 |
Folate |
B12 |
Iron |
Zinc |
Sel. |
15-18 |
2200 |
44 |
8 |
55 |
60 |
1.1 |
1.3 |
15 |
1.5 |
180 |
2.0 |
15 |
12 |
50 |
19-24 |
2200 |
46 |
8 |
60 |
60 |
1.1 |
1.3 |
15 |
1.6 |
180 |
2.0 |
15 |
12 |
55 |
25-50 |
2200 |
50 |
8 |
65 |
60 |
1.1 |
1.3 |
15 |
1.6 |
180 |
2.0 |
15 |
12 |
55 |
51+ |
1900 |
50 |
8 |
65 |
60 |
1.0 |
1.2 |
13 |
1.6 |
180 |
2.0 |
10 |
12 |
55 |
Pregnant |
+300 |
60 |
10 |
65 |
70 |
1.5 |
1.6 |
17 |
2.2 |
400 |
2.2 |
30 |
15 |
65 |
Q. Should I take a multi-vitamin during my
pregnancy?
A. The nutritional requirements for
pregnant women vary based on individual needs. Discuss whether you need to take a
multi-vitamin with your doctor.
Q. I've heard that I will need iron
supplements. Is that true?
A. Iron is needed in larger doses,
especially in the later stages of pregnancy. This mineral is essential to the formation of
healthy red blood cells. It is difficult for a woman to consume enough of it from foods to
maintain an adequate supply from the mother, often leaving her anemic and exhausted.
Anemia can make the mother less able to fight off infections and unable to handle
hemorrhaging during the birth. An iron supplement can alleviate this condition, but first
discuss whether you need additional iron with your doctor.
Q. What about Folic Acid?
A. Pregnancy doubles a woman's need
for folate (folic acid or folacin). Folic acid has been shown to be important in
preventing neural tube defects, such as spina bifida and anencephaly and is essential to
the formation of red blood cells. Severe folate deficiency can result in a condition
called megaloblastic anemia, which occurs most often in the last trimester of pregnancy.
In this condition, the mother's heart, liver and spleen may become enlarged which and can
threaten the life of the fetus. Folic acid can be found in many foods, including kidney
beans, leafy green vegetables, peas, and liver. Women in their childbearing years should
consume plenty of these foods. In fact, folate is so important to the health of women and
their babies that the Food and Drug Administration (FDA) recently required the addition of
folic acid to prepackaged bread and cereals.
However, there is not universal agreement on the
necessity of folate supplements for all pregnant women. Some doctors prescribe the
supplements primarily for pregnant women who are smokers, drug users, alcohol drinkers or
strict vegetarians. While research continues, your doctor will continue to recommend
supplements based on your individual health profile.
Q. Should I avoid drinking alcohol while I
am pregnant?
A. Remember that what you eat and
drink can affect your baby. Avoid drinking any alcoholic beverages while you are pregnant.
Alcohol can cause Fetal Alcohol Syndrome (FAS), which is an condition that can affect your
baby for its entire life. FAS is a preventable cause of birth defects and mental
retardation.
Q. Should I avoid caffeine?
A. Caffeine is a stimulant found in
colas, coffee, tea, chocolate, cocoa, and some over-the-counter (OTC) and prescription
drugs. Consumed in large quantities, caffeine may cause irritability, nervousness and
insomnia as well as low-birth-weight babies. Caffeine is also a diuretic and can dehydrate
the pregnant woman's body of valuable water. Some studies do indicate that caffeine intake
pregnancy can harm the fetus. Until more is known, caffeine should be avoided. Caffeine is
an ingredient in many OTC and prescription drugs. Before taking any drugs, a pregnant
woman should consult her physician.
Q. What should I make sure to include in my
diet?
A. As a pregnant woman, you need
more nutrients to help your baby grow and be healthy. Besides folic acid and iron, which
we have already discussed. There are other dietary additions you will need:
Calcium: Pregnant and lactating
adult women require an additional 40% of calcium a day (1200-1500 mg per day). Almost all
of the extra calcium goes into the baby's developing bones. To get this extra calcium, 3
extra servings (3 cups) of milk or dairy products are needed. If you are lactose
intolerant, you can still get this extra calcium. There are several low-lactose or
reduced-lactose products available. In some cases, your doctor might even prescribe a
calcium supplement.
Sodium: This is important during
pregnancy. 2,000 to 8,000 milligrams of sodium a day is recommended during pregnancy.
There are 2,325 milligrams of sodium in one teaspoon of salt, and because salt is in most
foods, the increased need for it during pregnancy is not too difficult to achieve. Sodium
helps to regulate the water in the body.
Fluids: Drink plenty of fluids,
especially water, during pregnancy. A woman's blood volume increases dramatically during
pregnancy. Drinking at least eight glasses of water a day can help prevent common problems
such as dehydration and constipation.
To find out what other nutrients are important
during pregnancy and how much you need, ask your healthcare provider any questions you may
have.
Q. Why do pregnant women crave certain
foods?
A. The "pickles and ice
cream" choices and other appetite cravings of pregnant women may be reflections of
the changes in nutritional needs. The fetus needs nourishment and the mother's body begins
to absorb and metabolize nutrients differently. These changes help ensure normal
development of the baby and fill the demands of lactation (nursing) after the baby is
born.
Q. Do I really need to "eat for
two?"
A. While you are pregnant, you will
need additional nutrients to keep you and your baby healthy. However, that does not mean
you need to eat twice as much. An increase of only 300 calories per day is recommended.
For example, a baked potato has 120 calories, so getting those extra 300 calories should
not be that difficult. Make sure not to restrict your diet during pregnancy because you
might not be getting the right amounts of protein, vitamins, and minerals that are
necessary to properly nourish your unborn baby. Low-calorie intake can cause the mother's
stored fat to break down, leading to the production of substances called ketones. Ketones,
which can be found in the mother's blood and urine, are a sign of starvation or a
starvation-like state. Constant production of ketones can result in a mentally retarded
child.
Q. What about diabetes and pregnancy?
A. Diabetic women should be closely
monitored to make sure their blood sugar levels are at or near normal. If maternal blood
sugar rises too high, the increased sugar crossing into the placenta can result in a
large, over developed fetus with defects or an infant with blood sugar level
abnormalities. Diabetic women may also suffer from a greater loss of some nutrients. It is
important to maintain tight control of blood sugar before and during pregnancy.
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. 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.
Q. How much weight should I gain during my
pregnancy?
A. Weight gain during pregnancy
should be gradual with the most weight being gained in the last trimester. According to
the ACOG, you should gain about 2 to 4 pounds during the first three months of pregnancy
and then 3 to 4 pounds per month for the rest of your pregnancy. Total weight gain should
be about 25 to 30 pounds. This will decrease the risk of delivering a low-birth-weight
baby. The Institute of Medicine recommends that women who have a low Body Mass Index (BMI)
- the ration of weight to height - should gain 28 to 40 pounds during pregnancy and women
who have a higher BMI should gain 15 to 25 pounds. Check with your doctor to determine how
much weight gain during pregnancy is healthy for you.
Weight gained includes 6 to 8 pounds for the weight
of the baby. The remaining weight consists of a higher fluid volume, larger breasts,
larger uterus, amniotic fluid, and the placenta. Make sure to visit your doctor throughout
your pregnancy for an assessment of your weight gain. Your doctor can make recommendations
about how much weight you should be gaining to ensure that your pregnancy is progressing
smoothly and that you are getting the right amount of nutrients.
Q. Is it difficult to lose weight after
pregnancy?
A. It can be if there is too much
weight gain. During pregnancy, fat deposits may increase by more than a third of the total
amount a woman had before she became pregnant. If the weight gain was normal, most women
lose this extra weight in the birth process and in the weeks and months after birth.
Breastfeeding helps to deplete the fat deposited during pregnancy. A woman who breastfeeds
expends at least 500 more calories than one who doesn't. The woman who nurses her baby
also has increased needs for specific nutrients, and should not be on a weight loss diet.
Q. Why do I get morning sickness and nausea,
and what can I do about it?
A. Morning sickness and nausea are
common to about 70% of pregnant women. Most nausea occurs during the early part of
pregnancy and, in most cases, will subside once you enter the second trimester. The
changes in your body might cause you to become nauseous or sick when you smell or eat
certain things, when you are tired or stressed, or for no apparent reason at all. For some
women, it might last longer than the early stages of pregnancy or even throughout the
entire nine months.
Nausea in early pregnancy is a condition that
often can be managed nutritionally:
- Eat small meals
- Avoid going long periods without food
- Drink fluids between, but not with, meals
- Avoid food that are greasy, fried or highly
spiced
- Avoid foul and unpleasant odors
- Rest when you are tired
Severe nausea and vomiting in pregnancy is rare, but
if it occurs, it may cause you to become dehydrated. If you feel that your nausea or
vomiting is keeping you from eating right or gaining enough weight, consult your doctor.
Q. Is it safe for me to exercise during
pregnancy?
A. It is probably safe but you
should check with your doctor first. Although some questions have been asked about the
effects of exercise on pregnant women, there is no proof that gentle exercise has any bad
effects on pregnancy. Studies haven't shown any benefits for the baby, but gentle exercise
might help you feel better and maintain your weight.
Q. What types of exercise are best when I'm
pregnant?
A. The most comfortable exercises
are the ones that don't require your body to bear extra weight. Swimming and stationary
cycling can be continued throughout pregnancy. Walking and low-impact aerobics are usually
well tolerated. You and your doctor should decide what is best for you and the baby.
Q. What should I be careful about when it
comes to exercising?
A. Be careful to avoid activities
that increase your risk of falls or injury, such as contact sports or vigorous sports.
Even mild injuries to the "tummy" area can be serious when you're pregnant.
After 3 months of pregnancy, it is best to avoid exercising while lying on your back,
since the weight of the baby may interfere with blood circulation. Also avoid long periods
of standing.
When the weather is hot, exercise in the early
morning or late evening to help you avoid getting overheated. If you're exercising
indoors, make sure the room has enough ventilation. Consider using a fan to help keep
yourself cool. Drink plenty of fluids, even if you don't feel thirsty.
Make sure you're eating a well-balanced diet.
Normally, pregnancy increases your food requirements by at least 300 calories a day, even
without exercise.
For More Information&
You can find out more information about pregnancy
and nutrition by contacting the National Women's Health Information Center (NWHIC),
visiting their "Healthy Pregnancy" web site at: http://www.4woman.gov/pregnancy,
or by contacting the following organizations:
American College of Obstetricians and
Gynecologists (ACOG) Resource Center
Phone Number: (202) 863-2518
Web Site: http://www.acog.org
Food and Nutrition Service
Phone Number: (703) 305-2286
Web Site: http://www.fns.usda.gov/fns/
National Maternal and Child Health
Clearinghouse
Phone Number: (703) 356-1964
Web Site: http://www.nmchc.org/
All material contained in the FAQs is free
of copyright restrictions, and may be copied, reproduced, or duplicated without permission
of the Office on Women's Health in the Department of Health and Human Services; citation
of the source is appreciated .
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