Nutrition Basics for Pregnancy

Paige Mandel, MS RD CDN

 

“The message that a mother’s nutrient intake during pregnancy affects the development of her baby is well accepted across multiple nutrition philosophies and among traditional cultures”1. While this is true, this also puts an immense amount of pressure on a mother, especially a first-time mom or a mom who has struggled with her own relationship with food. As mentioned in our previous blog, while this is an exciting time, it is also a time when you are facing many physical, mental, emotional changes, that can make it hard to know what is best. You are not expected to have all the answers, especially with how crowded the nutrition space is on social media for mamas-to-be. Our dietitians at Laura Cipullo Whole Nutrition are here to support you and your needs, as well as educate you on how to adequately nourish yourself and your growing baby in a way that best fits your lifestyle and preferences. It is most important to recognize and note, that our society has created a “standard” process for pregnancy guidelines. Yet, it is really most essential (and will serve both you and your baby best) for you to tune into your own needs and requirements physically and mentally.

 

Top 5 FAQ’s:

 

 

  1. Should I “Eat for Two”?1

In short, no, not necessarily, as this is a common myth. Many people assume that as soon as you become pregnant your nutrition needs double, and you have to “eat for two”. Research tells us that caloric needs do not increase for the mother to support the fetus until the second trimester.2 An additional 340 calories per day are recommended starting in the second trimester (that’s roughly the calorie count of a glass of skim milk and half a sandwich)3. “Women carrying twins should consume about 600 extra calories a day, and women carrying triplets should take in 900 extra calories a day”2. An additional 450 calories more per day is recommended in the third trimester.

 

  1. What Foods Should I Limit or Avoid?

Many women who are pregnant have had the basic knowledge of what foods to avoid: soft cheeses, unpasteurized milk, raw seafood, undercooked meat and poultry, eggs with runny yolks/raw eggs, and deli meats1,4. Yet, many do not know why these common foods make the “no, no” list. Ultimately, it is for food safety reasons. This is because during pregnancy, your immunity is slightly decreased, making you more susceptible to food poisoning, which could lead to further complications in pregnancy1.  Due to the fact that strictly cutting out all of these foods leaves you with less options to meet your nutrition needs, it is most important to understand that it is in the prep that is the key. At LCWNS, we always encourage our clients to find the shade of gray, to challenge the black and white thinking. The same holds true for the “foods to avoid” list in pregnancy. You could safely eat many of these foods with more mindfulness in the way they’re prepared:4

Food to “Avoid” How to Safely Eat
Raw seafood Fish cooked to 145 degrees F
Unpasteurized milk Pasteurized versions
Soft cheese and cheese made from unpasteurized milk (brie, camembert, blue cheese, gorgonzola) Hard cheese and cheese made with pasteurized milk (American, cheddar, pepper jack, mozzarella, muenster, provolone, swiss, gouda, parmesan, cottage cheese or any other cheeses (cow, goat, sheep) made using pasteurized milk5)
Undercooked eggs Eggs with firm yolks
Premade deli salads Make these dishes at home i.e, chicken salad, tuna salad
Deli Meats Reheat to steaming hot or 165 degrees F
Undercooked Meat and Poultry Cook well done, at or above USDA internal temp.

 

  1. How to Handle Nausea and Food Aversions?

It can be extra challenging to meet your nutrition needs when you are experiencing morning sickness or nausea throughout your pregnancy. Our biggest piece of advice- be your own detective and be curious if there is a trigger to your nausea. You may benefit from smaller more frequent meals versus a more standard 3 meals a day with snacks, to prevent you from getting too hungry or overfull. If you need to opt for more bland foods such a toast, try your best to incorporate even a small portion of protein or fat (i.e., nuts, cheese, Greek yogurt, avocado, scrambled eggs) to avoid a blood sugar spike1. You can try things like smoothies or smoothie bowls if a liquid, cold texture is more tolerable to your palate that solid foods, plus a good way to sneak in some extra nutrients or greens without flavor. It is ok if all you can tolerate is plain carbs. This won’t be the last time you hear this- fed is best. Cravings and aversions can come with guilt and self judgement, do your best to practice self-compassion and remember this will pass.

 

  1. How Much Weight Should I Gain?

This question comes with lots of controversy. As mentioned earlier, our society has created what feels like a standardized process, that feels very controlled and leaves little room for deviation from the “norm” without red flags raised. Medical doctors may mention your rate of weight gain in your visits, this is your reminder that it is most important to listen to your body and your needs, nobody knows your body better than you. While there are “weight gain guidelines” that exist, published by the CDC from the Institute of Medicine, these are simply broad ranges and average recommendations.

“If before pregnancy you were, you should gain”6

  • Underweight:28 to 40 pounds
  • Normal:25 to 35 pounds
  • Overweight:15 to 25 pounds
  • Obese:11 to 20 pounds

For twins, the recommendations naturally go up:

  • Normal:37 to 54 pounds
  • Overweight:31 to 50 pounds
  • Obese:25 to 42 pounds

 

In fact, these standards differ widely around the world, in some countries they do not use weights as any parameter. It is most important to consult with your doctor, dietitian and medical team to determine what rate of weight gain is healthy for YOU. There is no one range that is right or wrong, healthy or unhealthy. Some women may gain most of their pregnancy weight in the first trimester, some in their final weeks, some may gain slow and steady, and some not at all. Just as there is no “right” weight you should be while not pregnant, the same holds true for pregnancy.

 

  1. What are the best dietary sources of the key nutrients?

Nutrition for Pregnancy “Cheat Sheet”

Adopted from The American College of Obstetricians and Gynecologists3

Nutrient (Daily Recommended Amount) Why You and Your Fetus Need It Best Dietary Sources
Calcium (1,300 milligrams for ages 14 to 18; 1,000 milligrams for ages 19 to 50) Builds strong bones and teeth Milk, cheese, yogurt, sardines, dark green leafy vegetables
Iron (27 milligrams) Helps red blood cells deliver oxygen to your fetus Lean red meat, poultry, fish, dried beans and peas, iron-fortified cereals, prune juice
Iodine (220 micrograms) Essential for healthy brain development Iodized table salt, dairy products, seafood, meat, some breads, eggs
Choline (450 milligrams) Important for development of your fetus’s brain and spinal cord Milk, beef liver, eggs, peanuts, soy products
Vitamin A (750 micrograms for ages 14 to 18; 770 micrograms for ages 19 to 50) Forms healthy skin and eyesight

Helps with bone growth

Carrots, green leafy vegetables, sweet potatoes
Vitamin C (80 milligrams for ages 14 to 18; 85 milligrams for ages 19 to 50) Promotes healthy gums, teeth, and bones Citrus fruit, broccoli, tomatoes, strawberries
Vitamin D (600 international units) Builds your fetus’s bones and teeth

Helps promote healthy eyesight and skin

Sunlight, fortified milk, fatty fish such as salmon and sardines
Vitamin B6 (1.9 milligrams) Helps form red blood cells

Helps body use protein, fat, and carbohydrates

Beef, liver, pork, ham, whole-grain cereals, bananas
Vitamin B12 (2.6 micrograms) Maintains nervous system

Helps form red blood cells

Meat, fish, poultry, milk (vegetarians should take a supplement)
Folic acid (600 micrograms) Helps prevent birth defects of the brain and spine

Supports the general growth and development of the fetus and placenta

Fortified cereal, enriched bread and pasta, peanuts, dark green leafy vegetables, orange juice, beans. Also, take a daily prenatal vitamin with 400 micrograms of folic acid.

 

If you are pregnant, or plan on becoming pregnant and have more questions or concerns, reach out to a LCWNS dietitian. We are here to empower you to feel your best, navigate this exciting yet confusing time, and meet your perinatal nutrition needs, before, during and after pregnancy for you and your baby.

 

References:

  1. Nichols L. Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition. First edition.; 2018.
  2. Healthy Weight during Pregnancy. Accessed April 13, 2022. https://www.eatright.org/health/pregnancy/prenatal-wellness/healthy-weight-during-pregnancy
  3. Nutrition During Pregnancy. Accessed April 1, 2022. https://www.acog.org/en/womens-health/faqs/nutrition-during-pregnancy
  4. Affairs (ASPA) AS for P. People at Risk: Pregnant Women. FoodSafety.gov. Published April 28, 2019. Accessed April 13, 2022. https://www.foodsafety.gov/people-at-risk/pregnant-women
  5. Cheese and Pregnancy: What to Eat and What to Avoid. Healthline. Published October 27, 2020. Accessed April 13, 2022. https://www.healthline.com/health/pregnancy/cheese-pregnancy
  6. Weight Gain During Pregnancy | Pregnancy | Maternal and Infant Health | CDC. Published May 26, 2021. Accessed April 13, 2022. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-weight-gain.htm


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