Nutrition in Pregnancy

Being told 'you must eat healthily' when all you want to eat is bizarre combinations of food or, even worse, have your head stuck down the toilet, is not the most useful and tactful thing you can be told. Equally as unhelpful is that common myth "You should be eating for two now."

Whilst metabolic changes do occur and you will increase your calorie requirements, this increase is by a small amount - around 200 - 400 calories per day. Recommendations vary - and this will depend a lot on your starting weight and health which is why you will be measured at the beginning of your pregnancy and should be given the opportunity to talk to your health advisors on what's recommended for you. Post birth, if you are breast feeding, you will use around an extra 450 extra calories a day.

Being aware of certain nutrients and how they can enhance you and your baby's well being is as important at this time as during the preconception and pregnancy stages.

We all know that we should be eating healthily, but, as I have said before, every women and every pregnancy is different. Guidelines on nutrition will also vary from country to country. This guide therefore is not definitive - you will need to consult your health carer for recommended daily amounts. It will however highlight the important nutrients that you need to know and give you ideas on how you can maximise their pregnancy power.

Hormones play a huge part, not only on your baby's development but also on wellness, mood, taste buds and hunger levels... It's a fascinating area and one that needs to be looked at, not just from a pregnancy point of view but from the population as a whole. According to studies, the female sex hormones - oestrogen and progesterone can have varying effects on our feelings of satiety. Considering the fact that during pregnancy these hormones can increase 300 fold, it's no wonder that, as pregnant women, we feel like alien creatures within our own bodies. Oestrogen suppresses appetite while progesterone can increase it. We have evidence of this in normal hormonal levels during the menstrual cycle - at pre-ovulation, oestrogen levels rise and appetite appears to be suppressed, where as post-ovulation, when progesterone levels increase, appetite increases.

Other interesting research looks at pregnant female aversions and cravings for sugars and salt. Oestrogen for example is reported to increase our 'sucrose threshold' which could explain why many of us lose our 'sweet tooth' during pregnancy, opting for sour and salty tastes instead. These aversion, coupled with morning sickness - which should be called all day/night sickness can be seriously depressing and debilitating. If you are ill and not getting any sympathy from employers, doctors or family/friends - be rest assured - this is not psychosomatic.

Many of the nutrition guidelines that apply during pregnancy should be started in the preconception stage. The following focus on nutrients therefore will start with pre-conception and pregnancy and we will tackle postnatal issues a little later. It's worth mentioning now that many pregnancy needs, continue into the postnatal stage - some to note are Calcium, Vitamin D, C and Iron.

Folic acid is essential for your baby’s health, not just in the earliest days of pregnancy but also before you conceive. You’ll find folic acid in green leafy veg, citrus fruits and nuts but you should also , to be on the safe side, you should be taking a supplement also - this is specific to the very first few weeks when your baby's spinal chord development is most crucial. New schools of thought think it unnecessary to take a supplement beyond the first trimester - ask your health carer whether you should be doing so.

Calcium is an essential bone building nutrient for your growing baby. It's also vital for the preconception stage. Important to mention here that this is essential for YOU as well as your baby and that generally we don't get enough calcium - which is why you need to focus on it now. Your baby has the advantage of being able to rely on your body's calcium to sustain his/her growth. This can leave you vulnerable and is one of the reasons why so many women suffer greatly from osteoporosis - i.e.. brittle bones - later in life. Calcium can be found, not just in dairy products but soy products, broccoli, sesame seeds, canned fished such as sardines with bones and fortified sources i.e. ‘calcium added’ products such as orange juice. The value of dairy products in terms of helping with conception is something that is much debated and not yet conclusive. It may be wise therefore to vary your sources as much as you can, particularly during pregnancy. Another lovely hormonal side effect is that you tend to produce more mucous when pregnant. As dairy products can acerbate your snottiness - you'd be wise to look at a variety of calcium rich sources rather than relying on dairy alone.

Vitamin D - is vital for bone growth. whilst some vitamin D can be found in oily fish and some fortified foods such as breakfast cereal - your main source of vitamin D is through sunlight. This doesn't mean going out and sunbathing all day - you can get enough vitamin D from the sun before you start to tan or burn. If your skin is covered up most of the time then you probably need a supplement. Recent figures have shown that many women and children are not getting nearly enough vitamin D so double check with your midwife or GP as to whether you fall into this category.

Manganese is reportedly good for reproduction so important in the preconception stage and essential in pregnancy for a range of functions including bone and cartilage development. Good sources are spinach, carrots, broccoli, whole grains, nuts bananas and raisins.

Zinc is crucial for conception and pregnancy and a deficiency could impair fertility. It is vital for a variety of hormonal activities including growth and sex hormones and is as important for your partner as it is you for you. It is also essential for growth, wound healing and immune function and is involved in cell replication. Low intake during pregnancy have been associated with low birth weights in babies. You’ll find zinc in meat sources, almonds, beans, wheat germ, oats, corn, eggs and cooked shellfish - especially oysters and why oysters are perhaps considered a perfect aphrodisiac?!

Antioxidants are important for protecting your body’s functions and improving your health...

Vitamin C, beta carotene, selenium and the vitamin E13 have been shown to protect sperm against damage so make sure your partner is partaking in your preconception eating regime!

Vitamin C is present in lots of fruits, particularly citrus and fruits such as kiwis. You can also find Vitamin C in sources of green leafy veg, bell peppers, and berry fruits. Good for both you and your partner to stave off bugs but also helps with the absorption of iron which is very important for you (see below)

Beta Carotene - a powerful antioxidant is found in many source of foods such as spinach, yellow peppers, carrots and fruits such as melons and apricots,

For vitamin E13 your partner should be looking towards wheat germ, nuts and seeds and brazil nuts are reported to have very high levels of selenium – so get your partner nibbling on them!

Iron is an essential mineral that during pregnancy is in great demand due to the increase blood volume - up to as much as 50%. A lack of it can lead to anaemia and it is one of the first things that your GP or midwife will check for when you are pregnant. Boosting it before conception and maintaining during and after is essential. You’ll find iron rich sources in lean red meat, fish, egg yolks, whole grains, greens, and also in fortified breakfast cereals (read the packet). You should be aiming in this to eat oily fish 1 - 2 x a week to ensure you are getting enough of the essential fatty oils. It's also worth taking note that the amount of iron in a piece of red meat is going to far exceed many other sources so the odd steak dinner here and there is going to do you lots of good. Many women do however find themselves needing an iron supplement - during and after pregnancy. The downside of iron supplements is that they are not always readily absorbed and can make you constipated. I would therefore really recommend looking at natural sources of liquid iron. Taken with a glass of Vitamin C rich juice, it is far more likely to be absorbed and less likely to have you sitting on the loo for hours. Ask your local pharmacy or health food shop for recommended suppliers.

As much as there are foods we should eat - there are also foods to avoid.....

Avoid:

Caffeine - excessive levels will impair fertility, effects the absorption of essential vitamins and minerals and there are studies relating high caffeine intake to miscarriage. Usual recommendations are a maximum 2 - 3 cups of coffee or tea per day or 300 mg of caffeine.

If you are lucky - you may find the taste of tea and coffee quite abhorrent anyway so trying to keep these down is not always and issue. Where you can switch to safe herbal teas instead (ones to avoid in pregnancy are pennyroyal, devils claw, rue, scotch broom , golden seal and sassafras). Also make sure you are drinking plenty of water - 2 - 3 litres per day.

Alcohol - You really should avoid alcohol or keep it to low levels during preconception, although there is something to be said for the need to be able to relax and enjoy oneself - just as long as it's an odd occasion and not a drinking habit! During pregnancy, guidelines will vary from country to country, but on the whole you will be advised to only have 1 - 2 units per week but again - you are better off avoiding it completely.

Foods to Avoid...

You may find in your local area that some of the following food avoidances are not necessary - the important factor is to understand why. Find out from your doctor exactly what the rules are and make sure that you and your baby are safe....

Raw shellfish – can contain bacteria and viruses that may cause food poisoning so best avoided. Well cooked shellfish is fine.

Some types of cheese such as rind cheeses, un-pasturised and soft cheeses such as brie, camembert and blue vein cheese such as stilton can contain a bacteria called listeria which can be harmful to your baby. Hard and/or processed cheeses such as cheddar, cottage cheese are fine.

Pate also can contain listeria so best avoided.

Raw or partially cooked eggs can contain salmonella so always cook your eggs through thoroughly and avoid eating foods that may contain raw egg such as home made mayonnaise.

Raw or under cooked meat or fish are not a good idea so avoid rare cooked meats and make sure that foods cooked on a barbecue are always thoroughly cooked through.

Some types of fish contain high levels of mercury which can affect the development of your baby’s nervous system. Avoid shark, marlin, swordfish and limit tuna to one fresh steak or two medium tins a week .

Avoid eating peanuts if you or your partner have food allergies or there is a history in your family, including other allergies that can trigger conditions such as hay fever and asthma.

Eat a healthy balance of fats and avoid processed foods. High levels of sodium found in processed foods has been shown to increase mineral and nutrient imbalances, not helpful for fertility or your pregnancy. Eat therefore good sources of natural fats, such as those found in oily fish, nuts and seeds. The fresher your food, the less treated, even at soil level, the better the nutrient level – all things to consider when shopping at the supermarket.

Make sure you also wash fresh fruit and vegetables very thoroughly.