PRENATAL NUTRITION

PRENATAL NUTRITION

Hillary Cecere MS, RDN

When I was about 8 months pregnant with my first baby, I was in a coffee shop waiting for my order when a random man came up to me and very bluntly said “should you really be drinking coffee? Think about your baby.” This irked me so bad, but I simply replied, “most medical professionals agree that 200 milligrams or less of caffeine a day is acceptable and safe.”

The significance of that story is that people, complete strangers even, will comment on your body, food and lifestyle choices when you are pregnant. I don’t know why people feel that pregnancy is an appropriate time to provide advice and judgement, but I wanted to use this blog post to reassure all the expecting mamas out there and clear up any confusion on prenatal nutrition.

Prenatal nutrition is so cool because what you eat is what your developing baby BRO is eating too.  This is the only single time that what you eat directly affects another person, SO LET’S DO IT RIGHT!  A lot of doing it right is just listening to your body and trying a little harder to fit in nutrient dense foods once you can stomach them. 

WEIGHT GAIN

Don’t be scared to put on some LBs because it’s so essential for your baby’s growth. Weight gain guidelines vary depending on your pre-pregnancy weight.  Underweight women are recommended to gain 28-40 pounds.  Average weight women are recommended to gain 25-35 pounds.  Overweight women are recommended to gain 15-25 pounds.  Obese women are recommended to gain 11-20 pounds.  Aim for steady weight gain in the second and third trimesters, about 1 pound per week.  This can be achieved through a balanced diet and being active.

Thirty pounds may seem scary, but I think this breakdown will provide you with some comfort:

• 7.5 pounds = baby’s weight at the end of pregnancy
• 1.55 pounds = weight of the placenta
• 4 pounds = increased fluid volume
• 2 pounds = weight of the uterus
• 2 pounds = weight of breast tissue
• 4 pounds = increased blood volume
• 2 pounds = amniotic fluid
• 7 pounds = maternal fat stores

CALORIES

Calories should be increased in the second and third trimesters.  The recommended number of extra calories varies depending on the source, but most nutritional and medical professionals recommend the following:

• First trimester: no increase
• Second trimester: increase by 300-340 calories
• Third trimester: increase by 300-450 calories

FOODS TO FOCUS ON

All the fetal body systems use protein as a major building block. Good sources of protein are lean meat, poultry, seafood, eggs, Greek yogurt, cottage cheese and beans.

Carbohydrates are the major source of energy. Usually carbohydrates are tolerated well during the first trimester because they are easy to digest.  Some of the best sources are whole grain bread, brown rice, fruit, butternut squash, sweet potatoes and oats.  Choosing more whole grains, fruits and veggies will also provide fiber.  Aim to get 25-35 grams of fiber which will help prevent pregnancy related constipation.  Side note:  If you are diagnosed with gestational diabetes, carbohydrates may have to be monitored.  Talk to your doctor or dietitian about a healthy diet for managing gestational diabetes!

Fats are important for brain development and for some vitamin absorption. My favorite sources are fatty fish, walnuts, natural peanut butter, avocado and extra virgin olive oil. Omega-3 fatty acids such as docosahexaenoic (DHA) have been linked to higher infant IQs.

Some of the micronutrients that are important during pregnancy are folate, iron, calcium, vitamin D, vitamin C and choline.  Check out this table to learn more!

FOODS TO AVOID AND FOOD SAFETY

During pregnancy, the immune system is repressed, and a weakened immune system makes you more susceptible to foodborne illnesses. Certain foodborne illnesses put your baby at risk.  Increasing food safety measures becomes especially critical in protecting yourself and your little BRO.  Be sure to cook all meats, poultry, seafood and eggs thoroughly to proper internal temperatures.  Avoid foods like sushi, pate, over easy eggs, homemade eggnog, raw dough or batter, deli salads, cold deli meats, cold hot dogs, cold smoked fish, raw sprouts, and unpasteurized milk, cheeses and juices.

It’s also important to wash your hands, wash produce well, check expiration dates, avoid cross contamination, and store and thaw foods properly.

Learn more about safe internal cooking temperatures and food safety here: https://www.foodsafety.gov/sites/default/files/2019-05/food-safety-infographic-pregnant-women.jpg

Other foods that should be avoided are high mercury fish like shark, swordfish, king mackerel and tilefish. Canned tuna should only be eaten in moderation.  Alcohol should also be avoided, and caffeine should be limited to 200 mg or less.

MORNING SICKNESS

Ugh, morning sickness is the worst!  The best way I can describe it is as feeling extremely hungover without the party the night before. It includes nausea, vomiting, headache, fatigue and dizziness. That hungover feeling can last all day for weeks. Usually morning sickness begins around 6 weeks and lasts until 13-16 weeks, but every pregnancy is different and there is no set window.

The term morning sickness came from the thought that typically nausea is worse when your stomach is empty, like in the morning.  But it can strike at any time of the day.  I found that my morning sickness usually peaked in the evening.

To help ease morning sickness, try to eat regularly and drink water throughout the day.  I found keeping snacks in my bag and car helped me from ever getting too hungry.  Eating before bed, especially protein, can help ease morning nausea.  My go to bedtime snack when I was pregnant were Greek yogurt with berries and granola or an apple with peanut butter. I also discovered that I tolerated cold foods better than hot ones and sucking on ginger candy gave me some relief.

CRAVINGS AND AVERSIONS

I loooove coffee (see opening story). I literally have always looked forward to a few quiet moments to myself while I sip on my coffee in the morning.  But, when I was pregnant with second baby, the mere smell of coffee would turn my stomach. I thought it was disgusting and was literally offended when my husband would drink coffee around me.  Food aversions during pregnancy are for real! 

I also craved foods I normally wasn’t that into before pregnancy.  My cravings were cereal with milk, bagels with cream cheese, fruit smoothies and oatmeal with brown sugar.  We don’t know why cravings and aversions happen, but it is thought that hormones are to blame.

My best advice for dealing with aversions and cravings is to cut yourself some slack. Avoid the foods that are making you feel sick.  Enjoy the foods you are craving if they are safe to eat.  If you’re craving an especially unhealthy food, try to indulge in that craving only sometimes and look for healthier alternatives.

AND REMEMBER, YOU ROCK

To all my pregnant BRO mamas, you are insanely strong.  Growing a new life is super incredible, but it isn’t easy.  Dealing with all the symptoms and discomforts isn’t easy.  Seeing your body change isn’t easy.  Hearing comments from other people about your body isn’t easy.  Just remember, you are so beautiful, you totally got this, and it will be so worth it.