Pregnancy is an incredible journey and a time when you experience ups and downs like never before. And it can play havoc with your diet. HFG Nutritionist Claire Turnbull shares her story.
I recently had my first baby, so I know first-hand that one of the most difficult things can be navigating all the advice you’re given, and working out what is and isn’t important. Here’s what I discovered.
You need to eat for two
Straight up, you don’t need to eat enough for two people!
In the first trimester, you don’t need any more energy (kJ) than normal and it isn’t necessary to gain too much weight either (usually less than 2kg).
However, your requirements for many vitamins, minerals and omega-3 fatty acids do increase right from the beginning, so your focus needs to be on eating quality, nutrient-rich food. This can be very tricky if you are feeling sick, but it’s just about doing the best you can without being anxious about it.
Energy needs increase as your pregnancy progresses. In the second trimester, your body needs an additional 1400kJ and in the third trimester, 1900kJ — the equivalent of a moderate meal. Be careful, this isn’t an excuse to hit the biscuit tin.
Protein-packed snacks will stabilise your blood sugar levels and keep you feeling full. You could try a glass of trim low-fat milk, low-fat yoghurt with added nuts and seeds, wholegrain toast with cottage cheese or no-added-sugar-or-salt peanut butter, homemade smoothies, edamame beans or hard-boiled eggs.
Morning sickness only lasts for the first trimester (or morning sickness is only in the morning)
Sadly, this isn’t the case. While some people get away with feeling a bit nauseous now and again, others have to endure symptoms of morning sickness throughout their whole pregnancy.
Morning sickness usually arrives when food seems to taste different, and looking at or smelling some foods might make you want to run to the bathroom. Here are some ideas for light, healthy snacks.
- Sweet fixes: Orange wedges, kiwifruit, apple or pear slices, or frozen banana chunks.
- Savoury satisfiers: Rice crackers, wholegrain toast, crackers with Marmite and avocado, nuts, homemade potato or kumara wedges, wholegrain cereal with trim milk, falafels, edamame beans or chicken and vegetable soup. If evening meals you normally love aren’t appealing, try quick healthy options such as eggs or beans on toast, an omelette or a toasted sandwich.
Drinks: Sliced ginger or a squeeze of lemon in cold or hot water, soda water or a 3:1 soda water cranberry juice drink. Ginger or peppermint teas are also refreshing — but it’s recommended to enjoy no more than one a day due to the unknown effects of herbs on the unborn baby.
You need to avoid canned fish, soft cheese, nuts and hummus
The guidelines from Food Safety NZ suggest avoiding certain foods to reduce the likelihood of food poisoning, which can affect your unborn child. There are, however, a few specific foods that many women avoid when they don’t need to.
- Fish: It is recommended to limit the amount of fish that are known to be high in mercury but plenty of fish are safe, such as blue cod, flounder, gurnard, hoki, john dory, monk fish, farmed salmon, skipjack tuna and tarakihi. Click here for information.
- Soft cheeses: If you buy pasteurised soft cheeses in the manufacturers’ original packaging that are well within their use-by dates, eating a small amount as soon as it is opened is OK.
- Nuts: There is no reason to avoid nuts or nut butters during pregnancy, as there is no known link between nut consumption during pregnancy and nut allergies in children.
- Hummus: The reason we are advised to avoid this is actually because tahini, an ingredient in hummus, has been linked to outbreaks of salmonella and listeria. But if you make your own hummus at home without tahini, and eat it the day you make it, it is safe.
I won’t be able to exercise
As well as your changing weight, there are many other changes that happen when you are pregnant. Your resting heart rate and blood pressure can change and your ligaments loosen to prepare for the birth. As a result, your body responds differently to exercise but the good news is, it doesn’t mean you can’t do it.
Exercising when you are pregnant can help with weight control, allows you to maintain your fitness and can have a positive impact on your mood. In general, healthy women with an uncomplicated pregnancy can continue to do moderate exercise after consulting their GP or lead maternity carer (LMC). As your pregnancy progresses, you will likely decrease the intensity of exercise due to your increased size and fatigue, and it’s important that exercises are modified for your own safety. For many women walking, pregnancy yoga, modified gym workouts, swimming and aqua jogging seem to work well.
If you do, however, have any bleeding, dizziness, extreme fatigue or other issues during exercise, it is important to contact your LMC for advice on the best course of action.
I can’t drink tea or coffee
While too much caffeine in pregnancy has been linked to low birth weight babies, for most women, it isn’t necessary to avoid it altogether.
As being pregnant slows down the rate at which caffeine is metabolised, the Ministry for Primary Industries recommends keeping caffeine intakes to no more than 200mg per day. Your average cup of tea has 10-50mg caffeine, one teaspoon instant coffee 60-80mg and one cup percolated coffee 60-120mg.
To keep your caffeine intake down, try decaffeinated tea and coffee or herbal teas. Some herbal teas may contain some caffeine, and some are not recommended during pregnancy so it is important to read the packet.
It doesn’t matter how much weight I put on, I’ll lose it all when I’m breastfeeding
It can be tempting as your bump (and appetite) grows to allow yourself to eat whatever you like, whenever you like. Sure, you need a little extra food but it’s easy to get carried away.
The current recommendations for weight gain during pregnancy for someone with a body mass index (BMI) of 18.5-24.9 is 11.5–16kg, and only a couple of kilos of what remains after the birth will be body fat (after things have settled down). Many women gain a lot more, making it extremely challenging to lose it afterwards.
Breastfeeding can help to shift the odd kilo if you put on a lot more weight but it may not be the magic answer you hoped it would be. It’s best to try to avoid gaining too much weight in the first place.
What you need more of
There are many nutrients you need more of when pregnant and the additional food you’re eating to meet your energy needs will cover most of them. There are, however, some nutrients that need special attention.
Folate and iodine
Folic acid and iodine supplements are recommended for all women planning a pregnancy or in the early stages of pregnancy. Both are subsidised and available at pharmacies.
Higher folate intakes are recommended before and during the first 12 weeks of pregnancy to help prevent neural tube defects. It’s extremely difficult to meet the recommended folate amounts with food alone.
Iodine is particularly important for normal brain development in the foetus as well as in infants. Low iodine levels are common in pregnant women because of changes in hormone function affecting the thyroid gland. An iodine supplement is recommended throughout pregnancy and breastfeeding.
- Sources: As well as taking the recommended supplements, boost your folate by eating plenty of green vegetables, yeast spreads, wholegrain bread and having breakfast cereals which have been fortified with folate. Iodine is found in seaweed (you can chop a nori sheet up and sprinkle it over your salad), bread (as the salt used in most breads is iodised), fish, eggs and milk.
If you’re low in vitamin D, your baby can be born with low vitamin D levels too, which can affect growth and even cause rickets (which can lead to deformed and broken bones). Some vitamin D is found in food but we produce most of it ourselves when our skin is exposed to the sun so make sure you allow some skin to be exposed to natural light every day (outside of the higher risk burning hours). People with darker skin or who get little sun exposure are at higher risk of low vitamin D levels. Discuss this with your doctor who can prescribe a supplement if necessary.
- Sources: Fatty fish and eggs contain some vitamin D but the big message is to make sure you get outside every day.
Iron needs are 50 per cent higher when you’re pregnant. This is needed for foetal development and also to support your increased blood volume.
- Sources: Meat and fish are the best sources of iron. Vegetarian sources include wholegrain breads and cereals, vegetables and legumes, dried fruit, nuts and seeds. Boost iron absorption by eating vitamin C rich foods with iron-containing foods and avoid drinking tea at meals. Some women will need an iron supplement but be sure to get your LMC’s advice.
Hormonal changes during pregnancy mean constipation may be a problem. If that’s you, aim to increase your dietary fibre intake (along with increasing fluid intake) and increase physical activity.
- Sources: Eat plenty of vegetables and a couple of servings of fruit every day (ideally, five-plus servings of vegetables is the way to go!). Try to include legumes such as chickpeas, kidney beans and lentils – add them to salads, soups or include as part of your evening meal. Oats, quinoa, wholegrain breakfast cereals/bread and crackers also boost your fibre.
Long-chain polyunsaturated fatty acids are necessary for normal brain growth and development in infants, especially in the last trimester.
- Sources: Green leafy vegetables, nuts and seeds, oily fish such as canned tuna, sardines, salmon, mackerel, eel, warehou and kahawai, and oils such as soybean, canola, flaxseed and walnut oils. These foods and oils can replace foods with high saturated fat content. Fish oil supplements are useful for people not eating oily fish, but again take advice from your LMC before taking a supplement.
Click here for the latest guidelines on food safety in pregnancy.
Article sources and references
- American College of Sports Medicine. Exercise during pregnancy. www.acsm.org Accessed October 2014https://www.acsm.org/
- Best Practice Journal. 2010. Iodine supplements now funded. www.bpac.org.nz Accessed October 2014https://bpac.org.nz/
- Lake R et al. 2010. Salmonella (non typhoidal) in high lipid foods made from sesame seeds, peanuts or cocoa beans. http://foodsafety.govt.nz Accessed October 2014https://www.mpi.govt.nz/nzfoodsafety/
- Ministry for Primary Industries. 2012. Caffeine information sheet. http://foodsafety.govt.nz Accessed October 2014https://www.mpi.govt.nz/nzfoodsafety/
- Ministry for Primary Industries. Information for pregnant women. www.foodsmart.govt.nz Accessed October 2014https://www.mpi.govt.nz/food-safety/
- Ministry of Health. 2006. 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. 2013. Vitamin D and your pregnancy. www.health.govt.nz Accessed October 2014https://www.health.govt.nz/your-health/healthy-living/food-activity-and-sleep/healthy-eating/vitamin-d
- Ministry of Health. 2014. Guidance for Healthy Weight Gain in Pregnancy. www. health.govt.nz Accessed October 2014https://www.health.govt.nz/
- Sports Medicine Australia. Exercise in pregnancy. http://sma.org.au Accessed October 2014https://sma.org.au/