Nutrition during Pregnancy

Editor’s note: This article first appeared in Having a Baby Today Issue 5, Spring 2002.
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photo 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.

photo by Jennifer Rosenberg

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.

photo by Jennifer Rosenberg

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.

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.

Good Sources

photo by Jennifer Rosenberg

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, bulgur wheat, kidney beans, white beans, salmon, orange juice, avocado, milk

Sources:

  • 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

High Fiber Muffins/Bread

  • 1 c molasses
  • 2 tsp Baking soda
  • 3 c butter milk (low fat, powdered works fine)
  • 2 1/2 c whole wheat flour
  • 2 c bran cereal (or any other whole grain cereal you like)
  • 1 c whole oats
  • 1/2 c wheat germ

(Variation: Use 2 cups of whole oats, 1 cup wheat germ, and 1/2 cup bran cereal for a slightly different muffin.)

Mix all ingredients together and add these optional ingredients (to taste): 1 cup chopped nuts, 1 finely chopped apple, 1 very ripe banana, 1/2 cup raisins or other dried fruit.
Pour into greased pans. Makes two loaves or 24 muffins plus one small loaf (which will need 45 minutes to bake). Bake muffins at 350 degrees for 30 to 35 minutes; regular sized loaves should bake for one hour.

Spinach and Cheese Enchiladas

  • photo by Jennifer Rosenberg

    1 large bunch of fresh spinach or Swiss chard

  • 8 to 10 oz Of Monterey Jack or Cheddar Cheese
  • 1 container of Ricotta cheese
  • 1 can of black beans
  • 3 cloves garlic
  • one large jar of salsa picante
  • 6 flour tortillas (whole wheat if possible)

Vegetarian option
(In place of cheeses or added to above for a larger batch)

  • 16 oz firm tofu
  • 1 can of black beans

Chop garlic finely. Wash, de-stem and chop spinach. Grate cheese. Place one tablespoon of olive oil in skillet, heat and add garlic, cook for 1 to 2 minutes. Add spinach, cook 1 minute until wilted. Add ricotta and 1/2 of the grated cheese and mix together. Turn off heat. Let mixture stand. If using tofu, crumble and season well. If adding black beans, rinse first and add to tofu and/or ricotta. Add tofu/cheese and beans to spinach mix and blend well.

To assemble: Hold a flour tortilla in one hand and fill with mixture. Roll and place each enchilada into a greased 9″ x 13″ pan. Top with salsa and remaining cheese. Bake at 350 degrees until cheese is melted and enchiladas are warmed through, 25 to 30 minutes.

Approximately 18 grams of protein per enchilada with black beans; 15 grams protein per enchilada with cheese or tofu only; 409 mg of calcium in the cheese version.

Jen’s Ultra Protein Taco Salad

photo by Jennifer Rosenberg

Salad base:

  • Large handful (plateful) of fresh spring greens (or organic salad-in-a-bag)
  • Small handful of baby carrots
  • 1/2 a cucumber, chopped
  • 8 or so fresh green beans, chopped
  • 1 roma tomato, or other good quality tomato, cut into chunks

Toppings:

  • 1/2 avocado
  • 1 serving (12 to 13 chips) Mexisnax Sesame Corn Tortilla chips (or other quality corn chips made with whole corn and lime)
  • 1 cup prepared Cha Cha Chili from Fantastic Foods (or other low-fat chili with beans and yes, I put the chili on hot, it doesn’t make the greens wilt too much) Note: Cha Cha Chili is a magnificent fast food for anyone who needs lots of protein and fiber.
  • 3 tablespoons fresh salsa

This provides 5 to 6 servings of fresh vegetables, 18 to 20 grams of protein (add cheese, cooked meat or hard boiled egg for even more protein) and exactly the kinds of fats needed. It also provides most of the daily requirement for fiber, lots of iron, calcium (even without the cheese) and other important nutrients.

This is a large meal, but not a heavy or particularly fatty one. I estimate that without avocado it has only about 7 grams of fat, mostly from the corn chips. Use Beano and Super Papaya enzymes if you have trouble with gas from any of the ingredients.

Using the same salad base, one could do a similarly nutritious salad with any number of ingredients. For example, one could add canned salmon for a hit of Omega 3 fatty acids and calcium (leave the bones in, they taste good!) or a hard-boiled egg and some good quality olives.

This makes a great lunch anywhere you have access to boiling water and a fridge.

Submitted by Jennifer Rosenberg

photo by Jennifer Rosenberg

About Author: Amy V. Haas

Amy V. Haas was trained and certified as a Bradley Method® Childbirth Educator in 1995. She holds a BA in sociology from Plattsburgh State University and a certification as a paralegal from Adelphi University, both in New York. For the past eight years she has taught Bradley® classes to pregnant women and their families, empowering them to educate themselves to make healthy decisions.

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