What should I eat during pregnancy?

Does a pregnant woman need to eat twice as much?

It has often been said that a pregnant woman should eat for two people, but this is not true.

What is true is that during pregnancy a woman has to provide good nutrition for two individuals. The growing baby gets all its nourishment from its mother through the umbilical cord, so diet is very important. If the mother is lacking in any vitamins and nutrients her baby might lack them too.

If a woman has had trouble keeping her weight up or down before the pregnancy, she should make a nutritional plan with the help of her doctor or midwife.

How much energy does a woman need during pregnancy?

* A woman who is not pregnant needs approximately 2100 calories per day.

* A pregnant woman needs approximately 2500 calories per day.

* A breastfeeding woman needs approximately 3000 calories per day.

* Calories are sometimes called Kilocalories or KCals.

What sort of food should pregnant women eat?

A well-balanced diet should contain something from all the food groups: dairy products, fruit, vegetables, fish, meat, eggs, fat and carbohydrates. A pregnant woman needs to eat something from all these food groups every day in order to get the proper amounts of energy.

* Approximately 10 per cent of calories should come from protein. Protein is mainly found in meat, fish, eggs, dairy products and beans.

* Approximately 35 per cent of calories should come from fat, which is mainly found in butter, oils, margarine, dairy products and nuts.

* Approximately 55 per cent of calories should come from carbohydrates, which are found in bread, pasta, potatoes, rice, corn and other grain products.

What other vitamins and minerals are essential during pregnancy?

Folic acid

During the first three months of pregnancy (and preferably before becoming pregnant) a woman needs folic acid. This is one of the B-group vitamins and is also known as vitamin B9. It is important during pregnancy for the creation of the baby's nervous system.

Folic acid can help prevent neural tube defects such as spina bifida and other congenital malformations such as cleft palate or cleft lip.

Good natural sources of folic acid are barley beans, fruit, green vegetables, orange juice, lentils, peas and rice. It is recommended that all pregnant women take a daily 400 microgram supplement of folic acid a day for two months before conception and three months into their pregnancy.

The dosage of the supplement should be larger - 5mg per day - if a woman has previously given birth to a child with a neural tube defect, if she or her partner has spina bifida or a family history of neural tube defects, or if she has coeliac disease (or other malabsorption state), diabetes mellitus, sickle-cell anaemia, or is taking antiepileptic medicines. She should discuss this matter with her doctor.

Iron

During pregnancy, a woman's body needs more iron than usual to produce all the blood needed to supply nutrition to the placenta. Good sources of iron are green vegetables such as broccoli and spinach, strawberries, muesli and wholemeal bread.

Iron is more easily absorbed if it is taken in conjunction with vitamin C - either as a supplement or in citrus fruit or juice. Tea and coffee can interfere with the body's absorption of iron.

It is often recommended that all pregnant women take an iron supplement every day from the 20th week of pregnancy. This is not necessary if a woman has a good diet and routine blood tests show that she is not anaemic. Iron supplements may cause constipation.

Zinc and calcium

The minerals zinc and calcium are also needed for the development of the embryo. However, it is usually possible to obtain enough zinc and calcium by following a varied diet.

What foods should be avoided during pregnancy?

It is important to avoid vitamin A during pregnancy because it may cause damage to the embryo. Foods containing large amounts of vitamin A include liver, and should be eaten on an occasional basis only. Unpasteurised cheeses, blue-veined cheeses and pâté are also not recommended because of the possible risk of transmission of infectious diseases such as Listeria.

How to avoid constipation

Constipation during pregnancy can be caused by hormonal changes that cause the intestines to move less. Iron supplements can also cause constipation.

To avoid constipation, eat lots of fibre-rich foods such as fruit, vegetables, wholemeal bread and cereal, prunes and prune juice. Drinking 2 to 3 litres of water each day will also help prevent constipation by keeping stools moist.

Regular exercise will also help get the intestines moving. About 20 to 30 minutes' swimming or brisk walking two to three times a week is a good level of exercise to aim for.

A pharmacist will be able to provide advice about over-the-counter preparations that are safe to use during pregnancy to relieve constipation.

How much weight should a woman gain during pregnancy?

It is considered normal to gain 10 to 12kg (22 to 26lb).

For practical reasons the pregnancy is divided into three periods:

* the first period runs from week 0 to 12 where it is normal to gain 1 to 2kg (2 to 4lb).

* the second period runs from weeks 12 to 28 in which it is normal to gain 300 to 400g (10 to 14oz) a week.

* the third period runs from weeks 28 to 40 and it is normal to gain 1 to 3kg (2 to 6lb) a month.

It is not necessary to be obsessive about your weight during pregnancy. Many obstetricians have stopped weighing women other than at their first visit because the information is of little use in detecting problems with the mother or her baby.

However, excess weight gain is probably best avoided since most women will want to return to the same dress size within a few months of delivery.

Where do the extra kilos come from?

* A total weight increase of about 11.2kg (24lb) is normal.

* A baby weighs approximately 3.5kg (7lb 11oz) before birth.

* The uterus grows to approximately 900g (1lb 14oz).

* The placenta weighs approximately 650g (1lb 6oz).

* The amniotic fluid weighs approximately 800g (1lb 12oz).

* The woman's breasts grow by approximately 400g (14oz).

* The weight of the extra blood is approximately 1.25kg (2lb 12oz).

* Water retained in the body tissues weighs approximately 2kg (4lb 6oz).

* The layer of fat beneath the skin weighs approximately 1.7kg (3lb 11oz).

Based on a text by Vibeke Maniche, paediatrician, PhD
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