What do we know about Nutrition in Pregnancy?

  • We know that prenatal nutrition impacts short and long term health in mothers and babies.
  • Many scientific questions remain unanswered, there are limited high quality scientific research in pregnancy.
  • baby-in-the-bathThe basics include eating three meals daily consisting of several servings of vegetables, fruits, whole grains, low fat dairy products, and a few sources of protein.
  • Try not to skip several meals and avoid soft drinks, snack foods such as chips and fast foods.
  • You should increase your protein intake during pregnancy (ADI 1.1 g/kg/day of protein for women who are pregnant).

Infection and pregnancy

  • Being pregnant reduces the bodies ability to fight infection, in some ways you are immunosuppressed. Careful attention should be used when washing your hands, washing  food and cleaning the counter.
  • This will help reduce the risk of food-borne illness.

 

  • Avoid uncooked foods such as vegetables and meats, as this increases your risk of exposure to certain bacteria (toxoplasmosis).
  • Avoid unpasteurized foods for the same reason (Brucellosis)
  • Try to avoid processed deli meats as it also increases risk of exposure to certain bacteria (Listeria)
  • Avoid eating raw sprouts as may harbor bacteria.
  • Avoid exposure to mercury as it can cause central nervous system damage, leading to intellectual and motor impairments. Both the FDA and Environmental Protection Agency (EPA) recommend that pregnant women (or woman who might become pregnant or who are nursing) should:
  • Avoid eating any shark, swordfish, king mackerel, or tilefish because they may contain high levels of mercury.
  • Eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish that are lower in mercury which include shrimp, canned tuna, salmon and catfish. Albacore (white) tuna has more mercury than canned light tuna.

Vitamins and pregnancy

  • The Centers for Disease Control and Prevention (CDC) recommend multivitamin supplements for pregnant women who do not consume an adequate diet. Women at higher risk for dietary deficiencies include those who are lactase deficient, those with multiple gestation, heavy smokers, adolescents, complete vegetarians and  substance abusers.
  • The multi-vitamin should contain iron and  calcium. The RDA for elemental calcium is 1000 mg per day in pregnant and lactating women. The vitamin should also contain folate (see below) and zinc as well as vitamins A, B complex, E, C and D. There are different forms of vitamin D. Vitamin D3 may be more efficiently absorbed than D2. Zinc deficiency has been associated with growth retardation.
  • The United States Preventive Services Task Force (USPSTF) recommends that women take a supplement containing 0.4 to 0.8 mg of folic acid one month before and for the first two to three months after conception to reduce their risk of having a child with a neural tube defect. After the first trimester a RDA of 0.6 mg is recommended to meet the growth needs of the fetus.
  • An increase in calcium and iron is important for bone and red blood cell development,
  • The World Health Organization (WHO) recommends iodine intake of 250 mcg for both pregnant and lactating women.

Talk to your doctor about iron supplementation which is needed to build up the red blood cells. This is especially needed in those who are anemic. Although we prescribe prenatal vitamins containing iron for our patients, there is no convincing evidence that iron supplementation in non-anemic pregnant women improves maternal or child clinical outcomes.

Calcium and pregnancy

  • Women who are breastfeeding should increase their daily caloric intake by 300 to 500 kcal above pre-pregnancy levels and consume 1000 mg/day of calcium.

Can too many vitamins be toxic?

  • Note that too many vitamins may be harmful. 
  • There have been reports of excess vitamin A and  vitamin D which can cause a elevated calcium.
  • Too much vitamin A (greater than 10,000 international units per day) should be avoided as it may lead to birth defects.
  • All dietary changes and supplement use should be discussed with your doctor.

Caffeine and pregnancy

  • The literature is inconsistent when it comes to caffeine intake.
  • Limiting the amount of caffeine drinks such as coffee and soda  errs on the side of safety.

Gluten and pregnancy

  • Women with celiac disease should avoid gluten.
  • For women without celiac, there is no evidence that following a gluten-free diet has any significant health benefits.

Herbal remedies and pregnancy

  • The lack of safety and efficacy studies of herbal remedies preclude their use in any woman who is pregnant, contemplating pregnancy, or lactating.

Food that may cause allergy and pregnancy

  • There is controversy about whether to avoid or increase the amount of specific antigens that can cause an allergy such as peanuts, but the bulk of evidence does not support either approach. 

Sugar substitutes and pregnancy

There is no evidence that use of  sugar substitutes such as aspartame (Nutrasweet), sucralose (Splenda) and saccharin (Sweet ‘N Low) during pregnancy increases the risk of birth defects above the baseline risk in the general population. 

The ADI does recommend limits for these sugar substitutes.

I avoid sugar substitutes, I think or bodies are exposed to enough chemicals!

What suggestions do you have?

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