Nutrition plays a vital role in healthy conception and pregnancy. Dietitian Melanie McGrice looks at some of the ways you can give your baby the best start in life through what you eat.
Finding out that you’re pregnant can be an exciting time, but trying for a baby can be a source of stress for some. We all know that eating a balanced and healthy diet is important for pregnancy, but the latest research tells us it’s even more important than we thought. What you eat before conception matters too.
The first 1000 days
There’s a critical time window labelled the ‘first 1000 days’, which runs from conception until baby’s second birthday. Before conception is when nutrition can really affect the ‘epigenetics’ of your baby, that is, the way the genes you pass on to your child are expressed (without altering the underlying DNA).
But what to eat during the lead-up to conception, during pregnancy and after birth can be confusing, especially when you’re facing hormone fluctuations, morning sickness and an array of conflicting advice from friends and family members.
Research has clarified some of the most important dietary changes you can make during those very important first 1000 days.
Trying to fall pregnant
If you’re planning to start a family, or have been trying for some time, the simplest thing you can do is set out to improve your diet and lifestyle.
The earlier you make healthy changes the better but, in reality, six to 12 months prior to conception is usually ideal. The following four steps will help prepare your body for having a baby.
1. Get on top of your health
Several health conditions with a dietary aspect may affect your ability to conceive, including polycystic ovary syndrome (PCOS), hypothyroidism, Crohn’s disease, endometriosis and coeliac disease. Check in with your doctor to make sure you’re on all the right treatments to get you in the best health.
2. Maintain a healthy weight
For every point over a body mass index (BMI) of 29, your chance of becoming pregnant decreases by 4 per cent. So, a woman with a BMI of 45 has around 60 per cent less chance than if she reduced that to a BMI of 29 or less.
Regardless of BMI, too much or too little body fat can also reduce the health of your eggs, your ability to ovulate and even the likelihood of your embryo implanting.
3. Eat a more nutritious diet
Research by Harvard Medical School found women who adopted five healthy lifestyle changes, including diet, having a BMI of 20 to 24.9 and being physically active, recorded a 69 per cent reduced infertility rate compared with women who made no changes.
Try to choose monounsaturated fats, eat more plant-based protein, reduce your consumption of added sugars and include daily dairy products.
4. Boost your micronutrient intake
Most women are advised to start taking an 800mcg folic acid supplement one month prior to trying to conceive. It’s also wise to get a blood test to check whether any other micronutrients need to be supplemented. Once pregnant, continue the folic acid for the first trimester. While pregnant and breastfeeding, take a daily 150mcg iodine tablet.
Baby on board
You need to maintain a nutritious diet throughout your pregnancy, but what about the well-worn theory that you have to eat for two? And how much weight gain is too much?
Eating for two
Contrary to popular belief, being pregnant doesn’t mean literally ‘eating for two’. In fact, unless you’re underweight before falling pregnant or you will have a multiple birth, you don’t need to gain any weight in the first trimester, but up to 2kg is fine.
By week 12, your baby is only the size of a plum, so he or she doesn’t need a whole extra bowl of pasta. From the start of the first trimester, however, your requirements for many vitamins, minerals and omega-3 fats will increase, so focus on eating quality, nutrient-rich food. During the second and third trimesters, increase your dietary intake slightly with an extra daily serve of protein foods, such as lean meat, chicken, eggs, nuts or legumes, and an extra serve of whole grains.
Healthy weight gain
Women’s pregnancy weight gain goals will vary depending on their BMI at conception and how many babies they are having. If you have a healthy BMI at conception (18.5 to 25), aim for 11.5kg to 16kg total weight gain during pregnancy or, approximately, 400 grams per week throughout the second and third trimesters.
- Did you know? Of women giving birth in 2015, 54 per cent were overweight or obese when they first registered with their primary care provider.
Too much weight gain during pregnancy can raise your risk of gestational diabetes, miscarriage or tearing during birth, as well as your baby’s risk of childhood obesity. So, focus on eating a nutritious diet and watching your portion sizes.
Nausea is usually one of the first hurdles a woman encounters when she becomes pregnant. While some get away with feeling a bit nauseous now and again, others find they have to endure morning sickness throughout their pregnancy (hyperemesis gravidarum).
Although it sounds wrong, eating is one of the easiest ways to reduce nausea. If you’re battling nausea, try having smaller meals and graze on small, regular portions during the day. Make an effort to eat light meals and snacks such as fresh fruit, avocado on wholegrain toast, nuts, cereal and milk, and vegetable soup… and always drink plenty of water. If you’re vomiting a lot, or lose more than 5 per cent of your normal weight because of sickness, it’s important to speak with your midwife or doctor.
What to avoid
There is an abundance of myths about what you can and can’t eat while you’re pregnant. The main reason to avoid certain foods is to reduce the likelihood of food poisoning, which can affect your unborn baby.
It’s best, therefore, to avoid:
- Soft cheeses
- Soft-serve ice cream
- Cold processed meats
- Raw eggs
- Salad bars
- Unpasteurised milk
- Raw seafood
Your midwife or GP will be able to give you leaflets about how to eat safely during pregnancy, for you and baby.
Dad’s diet matters too
Men have equal responsibility for healthy baby making. Research shows what your man eats can affect both the likelihood of conception and your baby’s health. Dads-to-be can follow these dietary tips:
- Lose excess weight: High-kilojoule diets contribute to a reduction in sperm quality. Skip takeaways and limit high-kilojoule sugary snacks.
- Eat a nutrient-rich diet: Micronutrient deficiencies can affect sperm health. Prevent these with a diet rich in veges, fruit, dairy, grains, healthy fats, fish, (not too much) meat and meat alternatives.
- Limit alcohol: Alcohol can affect the health of sperm, although this can be improved by avoiding alcohol in the lead-up to conception.
- Swap to healthy fats: Foods rich in good (mono and polyunsaturated) fats, such as oily fish, nuts and olive oil, have been found to significantly improve sperm quality and quantity.
The ‘fourth’ trimester
Welcome to sleepless nights and newborn cuddles! While it’s easy to focus on your new baby’s requirements ahead of your own needs, the two are inextricably linked.
Fuel for breastfeeding
After giving birth, your dietary requirements will change yet again, especially when breastfeeding. Your protein needs will remain higher than usual to help heal any tears or surgical scars. When breastfeeding, your fluid needs also increase significantly.
Aim to have an additional tub of reduced-fat yoghurt or glass of milk, and at least seven serves of grains each day. A serve of grains can be one slice of bread, one cup of pasta or half a cup of cooked brown rice or porridge. Choose wholegrain options if you can.
Mums who are not able to breastfeed won’t need these additions to nutrition so, after you’ve fully healed, you can go back to your usual healthy diet.
Losing baby weight… sensibly
After your baby is born, most weight loss usually occurs in the first three months. The average woman burns about 2000kJ (480cal) per day to make breast milk when exclusively breastfeeding her baby, so expect to lose around 500g per week.
When you have a new baby in your arms and you’re getting very little sleep, eating a healthy diet can be challenging. Try to keep easy-to-snack-on foods such as biscuits, chips and chocolate out of the house. Instead, fill your pantry with equally quick but extra nutritious snacks such as nuts, yoghurt, vegetable sticks and wholegrain crackers. Keep a jug of water on the kitchen bench and carry a water bottle with you. And try to avoid snacking during the night when you’re getting up to attend to your baby.
What about food allergies?
Current research suggests that if you include well-known allergens such as eggs, fish, nuts and wheat in your diet before, during and after pregnancy, this can also help expose your baby to these allergens in tiny amounts. This increases your baby’s tolerance, so they are later less likely to develop intolerances when you introduce solids. If there’s a strong history of anaphylactic allergies in your family then have a chat to your midwife or GP about any concerns.
The most important thing to remember about your diet during this important time is that you will face many challenges, so don’t be too hard on yourself, just do your best. And if you need help, ask for it.
Mum’s day on a plate
Getting up with baby? Have a big glass of water.
Between 6.30 and 7.30am: Eat a satisfying breakfast
Enjoy a small bowl (1 cup) of Bircher muesli made with oats, fruit and yoghurt. Top with chopped nuts for fibre and healthy fat.
10.30am: Snack happily
A great morning pick-me-up is a piece of wholegrain toast topped with sliced banana. Have a big drink of water, too. Head outside with baby for a gentle walk, if the weather’s fine.
12.30pm: Lunch nutritiously
Fill a wholemeal roll with canned tuna, tomato, cucumber, mushroom and baby spinach. If you are breastfeeding, add a handful of almonds or a tub of plain yoghurt.
3.30pm: Refuel and refresh
Have a wholegrain cracker topped with hummus or avocado and sliced tomato, plus a big glass of water to keep you going.
7.00pm Enjoy a dinner full of protein
Throw together a tasty stir-fry. Make sure you serve yourself at least 150g lean meat. Serve with wholegrain noodles or brown rice, and plenty of veges.
8.30pm Satisfy sweet cravings
Treat your sweet tooth to a tub of reduced-fat plain yoghurt with mixed berries, or a small bowl of rice pudding. Make sure you’ve had at least two servings of dairy or high-protein dairy alternatives today.
Article sources and references
- Buttle N & King J. 2005. Energy requirements during pregnancy and lactation. Public Health Nutrition 8:1010-27https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221984/
- Chavarro J. 2007. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics and Gynaecology.110:1050-8https://www.ncbi.nlm.nih.gov/pubmed/17978119
- De-Regil LM et al. 2015. Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database of Systematic Reviews 12:DC007950https://www.ncbi.nlm.nih.gov/pubmed/26662928
- Esmaeili V et al. 2015. Dietary fatty acids affect semen quality: A review. Andrology 3:450-61https://www.ncbi.nlm.nih.gov/pubmed/25951427
- Fertility Society of Australia. 2016. Micronutrient (Folic Acid, Iodine and Vitamin D) Supplements Pre-Conception and During Pregnancy, fertilitysociety.com.au Accessed January 2018https://www.fertilitysociety.com.au/wp-content/uploads/FSA-Micronutrient-Folic-Acid-Iodine-and-Vitamin-D-Supplements-Pre-Conception-and-During-Pregnancy.pdf
- Gabrielsen J & Tanrikut C. 2016. Chronic exposures and male fertility: The impacts of environment, diet and drug use on spermatogenesis. Andrology 4:648-61https://www.ncbi.nlm.nih.gov/pubmed/27230702
- Gaillard R et al. 2013. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy. Obesity 21:1046-55https://www.ncbi.nlm.nih.gov/pubmed/23784909
- HealthEd. Folic Acid and Spina Bifida/Iodine and Iodine Deficiency, healthed.govt.nz Accessed March 2018
- Institute of Medicine. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Presshttps://www.ncbi.nlm.nih.gov/pubmed/20669500
- La Vignera S et al. 2013. Does alcohol have any effect on male reproductive function? A review of literature. Asian Journal of Andrology 15:221-5https://www.ncbi.nlm.nih.gov/pubmed/23274392
- Ministry of Health. 2006 (revised 2008). Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women: A background paper. Wellington: Ministry of Healthhttps://www.health.govt.nz/publication/food-and-nutrition-guidelines-healthy-pregnant-and-breastfeeding-women-background-paper
- Ministry of Health. 2014. Guidance for Healthy Weight Gain in Pregnancy. Wellington: Ministry of Health.https://www.health.govt.nz/publication/guidance-healthy-weight-gain-pregnancy
- Ministry of Health. 2017. Report on Maternity 2015. Wellington: Ministry of Health.https://www.health.govt.nz/publication/report-maternity-2015
- Ministry of Health. Folate/folic Acid, health.govt.nz Accessed March 2018
- Overcash RT et al. 2015. Early second trimester weight gain in obese women predicts excessive gestational weight gain in pregnancy. Maternal and Child Health Journal 19:2412-18
- Rato L et al. 2014. High-energy diets: A threat for male fertility. Obesity Reviews 15:996-1007https://www.ncbi.nlm.nih.gov/pubmed/25346452
- Van Der Steeg JW et al. 2008. Obesity affects spontaneous pregnancy in subfertile, ovulatory women. Human Reproduction 23:324-8https://www.ncbi.nlm.nih.gov/pubmed/18077317