Nutrition during Pregnancy
by Amy V. Haas
© 2002 Midwifery Today, Inc. All rights reserved.
[Editor’s Note: This article first appeared in Having a Baby Today Issue 5, Spring 2002.]
Photos by Jennifer Rosenberg
The single most important thing that you can do for your baby is to eat a healthy, well-balanced diet. A well-balanced diet is one that includes foods from all food groups in appropriate amounts, so as to ensure proper nutrition. Proper nutrition ensures that all essential nutrients (carbohydrates, fats, protein, vitamins, minerals and water) are supplied to the body to maintain optimal health and well-being. Good nutrition is essential for normal organ development and functioning; normal reproduction, growth and maintenance; for optimum activity level and working efficiency; for resistance to infection and disease; and for the ability to repair bodily damage or injury. While pregnancy is a normal alternative condition for the female body, it is stressful, and all nutritional needs are increased in order to meet the needs of the pregnancy.
Dr. Tom Brewer found through more than 30 years of research that each day, pregnant women need a well-balanced, high-quality diet that includes 80 to 100 grams of protein, adequate salt (to taste), and water (to thirst), as well as calories from all of the food groups. The World Health Organization recommends that a pregnant woman eat a minimum of 75 grams of protein per day, but protein is just a marker for a nutritious diet. It must be obtained from a wide variety of whole food sources in order to get all of the important nutrients a woman needs during pregnancy. While the government’s food pyramid is a good example of a well-balanced diet, pregnant women need more protein and calories in general. This means including:
- 2 to 3 servings of meat, fish, nuts or legumes, and tofu
- 2 to 3 servings of dairy (milk, eggs, yogurt, cheese)
- 2 servings of green vegetables; 1 serving of a yellow vegetable
- 3 servings of fruit
- 3 servings of whole grain breads, cereals, or other high-complex carbohydrates
- salt to taste
- 6 to 8 glasses of clean, filtered water each day.
While this may seem like a lot of food, it will supply the 2000 to 3000 calories needed per day to make a healthy baby.
A study conducted at Harvard University found that by eating at least 75 grams of protein per day, pregnant women could prevent diseases of pregnancy such as preeclampsia (metabolic toxemia of late pregnancy). During pregnancy a woman’s blood volume increases as much as 40 to 60 percent, and in order to reach this necessary level and maintain it, a woman’s body needs adequate protein, salt, calcium, potassium and water from her diet. In April of 1996 the Journal of the American Medical Association published an article indicating that calcium may also help reduce the incidence of preeclampsia. Other recent research indicates that pregnant women need adequate folic acid (a B vitamin) to prevent neural tube birth defects such as spina bifida. The Food and Drug Administration now recommends that breads and pastas be fortified with folic acid to ensure that all women of childbearing age get enough of it. Four hundred micrograms of folic acid a day is recommended. This can be obtained by eating whole grain breads, citrus fruits and dark green leafy vegetables.
As long as junk food and excessive sweets (sugar) are avoided, or kept to a minimum, weight gain should not be an issue. The diet listed above (or something similar) should provide all of the necessary nutrients, and a woman should have little problem obtaining everything she needs. A "whole food" is one that is unprocessed and is as close to its natural state as possible. While vitamin supplements are very popular these days, there are risks to taking supplements of certain vitamins while pregnant (i.e., vitamin A), and others are simply poorly assimilated (i.e., calcium or iron). The B vitamins, for example, must be taken in congress (B complex supplement), as absences, insufficiencies or excesses of one or another can cause problems. Check with your care provider before taking anything while pregnant. Vitamins and minerals should be obtained from natural, whole sources whenever possible, to ensure quality and proper assimilation by the body. A qualified nutritional expert should assess special dietary needs.
Cravings for foods are common in pregnancy and, in theory, can indicate a need or deficit in a diet. Cravings for healthy foods can be indulged, but cravings for non-food substances such as clay or laundry starch, a condition known as "pica," can be harmful and should be reported to your care provider.
Milk, eggs and other dairy products are inexpensive sources of calcium and protein. For those who are vegetarian, or simply to provide variety in an omnivorous diet, soy products, beans and nuts can be substituted. Dark green vegetables provide carbohydrates, water, bulk fiber, vitamins A, C, and B, calcium, iron, and magnesium; the darker green, the better. It is best to eat these vegetables raw whenever possible, but steaming or baking will also retain most of the nutrients. Citrus and berry fruits provide a great deal of vitamin C, and yellow fruits and vegetables such as cantaloupe, sweet potato, carrots and mango are good sources of vitamin A. Both of these vitamins are important for fighting infection, boosting the immune system, cell structure development and preventing placental detachment (abruption). Zinc is another important mineral for pregnant women, as it aids in supporting the immune system. According to the Journal of the American Medical Association, zinc also helps to improve birth weight and certain aspects of fetal development.
Iron Needs and Pregnancy:
Iron supplements are an easy way to remedy iron deficiency anemia during pregnancy, but some women find them hard on the stomach. If you experience difficulties, consider supplementing with carbonyl iron which is naturally regulated by the body and may be easier to digest.
While a vegetarian diet is a good, healthy choice when well balanced, vegetarians do have to work harder to obtain all the protein needed to increase their blood supply. If a woman follows a strict vegan diet, it may be even more difficult to get the necessary protein, but it is possible with diligence. See the supplemental reading list for sources of information on this subject.
Protein: chicken, fish, beef, pork, turkey, tofu, nuts, legumes (beans), milk, eggs, cottage cheese, whole grains, wheat gluten, soy cheese
Whole grains: brown rice, kasha (buckwheat groats), whole oats, whole wheat bread, whole grain cereals, quinoa, wild rice, wheat gluten, wheat germ, whole wheat pastas
Fruits: strawberries, kiwi fruit, apples, oranges, bananas, mangos, cantaloupe, pears, grapefruit, plums, nectarines, and peaches
Green vegetables: spinach, broccoli, zucchini, dark green lettuces, kale, Swiss chard, green beans, asparagus, arugula, lambs lettuce
Dairy: milk, yogurt, hard cheese, cottage cheese, egg
Other good whole foods: baked potatoes, sweet potatoes, carrots, squash, green peas, soy products, corn
Iron: red meats, organ meats, eggs, fish poultry, blackstrap molasses, cherry juice, green leafy vegetables, dried fruits (raisins, apricots, etc.)
Zinc: pumpkin seeds, squash seeds, sunflower seeds, seafood, organ meats, mushrooms, brewer’s yeast, soybeans, eggs, wheat germ, meats, turkey
Folic acid: spinach, asparagus, turnip greens, Brussels sprouts, lima beans, soybeans, organ meats, brewer’s yeast, root vegetables, whole grains, wheat germ, bulger wheat, kidney beans, white beans, salmon, orange juice, avocado, milk
Trained and certified as a Bradley® Method Childbirth Educator in 1995, Amy Haas’ educational history includes a Bachelor of Arts in Sociology from Plattsburgh State University of New York. For the past six years she has taught Bradley® classes to pregnant families, empowering them to make healthful decisions. Amy’s article, "How to Stay Healthy and Low Risk during Pregnancy and Birth" appeared in the Winter 2001 issue of Having a Baby Today. The original version of this article was shared through The Rochester Birth Network.
- Dunne, Lavon J., ed. 1990. The Nutrition Almanac. 3rd ed. New York: Nutrition Search, Inc., McGraw-Hill Publishing.
- Brewer, Gail Sforza and Tom Brewer. 1985. What Every Pregnant Woman Should Know: The Truth about Diet and Drugs in Pregnancy. New York: Penguin Books.
- Frye, Anne. 1993. Understanding Diagnostic Testing in the Childbearing Year. 5th ed. Portland, OR: Labrys Press.
- Frye, Anne. 1995 Summer. Unraveling Toxemia. Midwifery Today 34: 22–24.
- Frye, Anne. 1995. Holistic Midwifery, Vol. 1. Portland, OR: Labrys Press.
- American Medical Association. 1996 Apr 10. JAMA. 275(14).
- American Medical Association. 1995 Aug 9. JAMA. 274(6).
Other Recommended Reading:
- The Brewer Pregnancy Hotline by Gail Sforza Krebs and Dr. Tom Brewer (http://ebooks.kalico.net/)
- Pregnancy, Children, and the Vegan Diet, by Michael Klaper, MD
- Diet for a Small Planet, by Frances Moore Lappé
- The Birth Book, by William Sears, MD, and Martha Sears, RN
- The Pregnancy Book, by William Sears, MD, Martha Sears, RN, and Linda Holt, MD
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