Diet During Pregnancy

________________________________________________________________________

KEY POINTS

• When you are pregnant, eating the right foods can help you and your stay baby healthy.
• Know what foods to include, and which foods to limit or avoid when you are pregnant.
• There may also be certain foods you can eat or avoid to help reduce nausea, heartburn, diarrhea, or constipation during your pregnancy.

________________________________________________________________________

Diet during pregnancy does not mean cutting calories or trying to lose weight. Dieting to lose weight during pregnancy can be harmful to you and your baby if you don’t get enough vitamins and minerals.

What foods do I need to eat?

Eating regular, well-balanced meals before and during your pregnancy is important. What you eat provides nutrition for you and your baby.

Eat a variety of whole, fresh foods every day. You may need more or fewer servings each day.

• Protein: 5 and 1/2 to 7 ounces a day of protein from healthy sources, such as beans, peas, eggs, and lean meats
• Grains: 6 to 8 ounces every day (Eat less processed food and more whole grains, such as oatmeal, whole-wheat bread, and brown rice.)
• Fruits: 2 cups every day
• Vegetables: 2 and 1/2 to 3 cups every day
• Milk Products: 3 cups every day (It’s best to choose fat-free or low-fat milk and milk products or soy, almond, rice, or other drinks with added calcium and vitamin D.)
• Healthy Fats: Eat fats, such as canola and olive oils, avocado, nuts, seeds, soft (no trans-fat) margarines, mayonnaise, and oil based salad dressings in moderation.
• Liquids: Try to drink at least 8 cups of liquid each day. Drinks should be low in fat, sugar, and caffeine.

Your healthcare provider will prescribe a prenatal vitamin and mineral supplement. This will help you get the vitamins and minerals you need, such as calcium, iron, and folic acid. Not enough folic acid during early pregnancy can cause birth defects, such as spina bifida, in which the spinal column does not completely close before birth.

If you do not eat any animal products, it may be harder for you to get enough important nutrients. Calcium, iron, and zinc are harder for the body to absorb from plant foods than from meat, poultry, and fish. Vitamin D is added to soy, rice, and almond milk, yogurts, some cereals, and juices. The food label will tell you if a food is fortified with Vitamin D. Your healthcare provider may ask you to meet with a dietitian to help you plan your meals. You may also need additional supplements. If you include dairy and eggs in your diet, prenatal vitamins may be the only supplements you need.

What should I avoid when I am pregnant?

• Avoid alcoholic drinks (wine, beer, or liquor), tobacco, marijuana, and illegal drugs.
• Check with your healthcare provider before you take any medicines or herbal supplements. Some medicines and supplements can cause birth defects.
• Limit caffeine. High amounts of caffeine from coffee, tea, soft drinks, and chocolate could increase the risk to your baby. Caffeine can affect your baby’s breathing and heart rate. Some healthcare providers recommend no caffeine during the first 3 months of pregnancy and no more than 200 mg a day during the rest of your pregnancy. More than 200 mg of caffeine a day (about one 12-ounce cup of regular brewed coffee) may slow the growth of your baby.
• Herbal teas with peppermint or ginger may help relieve early symptoms of pregnancy, such as nausea. Avoid herbal teas such as nettles, alfalfa, or yellow dock, unless your provider recommends them. Large amounts of some herbal teas may increase your risk for early (preterm) labor.
• Avoid raw or undercooked meat, fish, shellfish, and eggs. Avoid foods containing raw eggs, such as mousse and tiramisu. Also avoid foods from deli counters, or thoroughly reheat cold cuts before you eat them. Cook leftover foods or ready-to-eat foods, such as hot dogs, until they are steaming hot before you eat them.
• Do not eat or drink unpasteurized dairy products. Pasteurization kills bacteria called listeria, which are dangerous for pregnant women and their newborns. Do not eat soft cheeses, such as Brie, Camembert, feta, blue-veined cheeses, queso fresco or queso blanco, and panela, unless the label says they are pasteurized or made from pasteurized milk. Always check the labels. Hard cheese (such as cheddar), processed cheese slices, cottage cheese, and cream cheese are safe.
• Avoid raw vegetable sprouts and unpasteurized fruit and vegetable juices. They can carry disease-causing bacteria.

Sometimes pregnant women crave something that is not food, such as laundry starch, dirt, or clay, or large amounts of ice. This condition is called pica, and you need to tell your healthcare provider if you have this kind of craving. Pica can cause poor nutrition for you and your baby. It can also make it hard for you to gain weight and is dangerous to your health.

You usually do not have to limit your salt intake during pregnancy. You need a certain amount of salt to help keep proper levels of sodium in your body as your baby develops. Use iodized salt in moderation.

Is it OK to eat fish?

Fish and shellfish contain good protein and other nutrients. They are low in saturated fat, and many fish contain omega-3 fatty acids, which have been shown to help brain development in babies. However, many kinds of fish and shellfish contain traces of mercury. Mercury can harm an unborn baby's developing brain and nerves. Some fish and shellfish have higher levels of mercury than others. If you are pregnant, trying to become pregnant, or breast-feeding:

• Choose shrimp, scallops, salmon, pollock, cod, catfish, or light canned tuna. These types of fish and seafood contain less mercury. Eat 8 to 12 ounces of different kinds of low-mercury fish each week. For example, 6 ounces of canned white (albacore) tuna and 6 ounces of salmon per week. Cook most fish to an internal temperature of 145° F (63° C).
• Avoid undercooked or raw oysters and clams, or refrigerated smoked seafood. Don’t eat raw fish such as sushi. They may increase your risk for infection. If you eat oysters and clams, boil them for at least 4 to 6 minutes (as you should do with all shellfish). Don’t eat refrigerated smoked seafood unless it is cooked, such as in a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, and cod may be called nova-style, lox, kippered, smoked, or jerky. Canned smoked seafood is usually OK to eat.
• Don’t eat shark, swordfish, king mackerel, or tilefish (also called golden or white snapper). These fish contain the highest levels of mercury.

What if I gain too much weight?

Talk to your healthcare provider about how much weight you should gain throughout your pregnancy and how many calories you need each day. The number of extra calories that’s right for you depends on how much you ate and weighed before you got pregnant. If you are gaining too much weight:

• Eat the same number of servings for all of the food groups, but make lower fat choices.
• Avoid high-fat, high-sugar treats and high-calorie drinks, such as chips, cookies, soda, or large servings of juice.
• Exercise as recommended by your healthcare provider.

What if I have problems when I eat?

Morning sickness

Many women have morning sickness during the early months of pregnancy. Despite its name, you can have morning sickness at any time, day or night. In early pregnancy, the changes in your body can cause you to feel sick to your stomach when you eat or smell certain foods or when you get tired or anxious. In most cases, symptoms of nausea and vomiting are less common by the second trimester. When you feel sick, it may help if you:

• Eat a few crackers, pretzels, or dry cereal before you get out of bed in the morning.
• Eat small meals often.
• Avoid greasy, fried, or spicy foods that may upset your stomach.
• Drink plenty of liquids, but between meals rather than with just with meals. Try crushed ice, fruit juice, or fruit-ice pops if water makes you feel sick to your stomach. Try adding lemon to water.
• Avoid unpleasant odors.
• Get enough rest.

Ginger or peppermint has been shown to help some women have less nausea. Talk to your healthcare provider before you add ginger or peppermint to your diet.

Constipation

To help relieve constipation:

• Eat more fresh fruits, vegetables, high-fiber breads, and cereals.
• Drink lots of water throughout the day.
• Stay active. Talk with your healthcare provider about ways to get as much as exercise as you can. Walking and swimming are good choices.
• Talk with your healthcare provider about fiber supplements such as psyllium powder, Metamucil, or Citrucel if added fiber from your diet is not enough to relieve constipation. (You must drink plenty of water when taking these products.) Do not use any other laxatives unless your healthcare provider tells you to.

Diarrhea

If you have diarrhea for a day or two:

• Try eating rice, dry toast, bananas, whole grains, lean protein such as chicken breast, or yogurt with active cultures.
• Drink enough water to keep your urine light yellow in color.
• Talk with your healthcare provider if you have diarrhea for more than 2 days. Don’t take nonprescription medicines to treat diarrhea unless your healthcare provider tells you to.

Heartburn

For heartburn you should:

• Eat 5 or 6 small meals a day instead of 2 or 3 large meals.
• Avoid foods that commonly cause symptoms, such as spicy and fried foods, high fat foods, orange and grapefruit juices.
• Limit or avoid peppermint, chocolate, and licorice because these may increase heartburn symptoms.
• Bake or broil your food instead of frying it.
• Cut down on soft drinks, chocolate, coffee, and other drinks with caffeine. Drink instead water, low-fat milk, and apple or cranberry juice.
• Don't lie down for at least 1 to 2 hours after you eat. If heartburn gets worse when you lie down, raise the head of your bed 4 to 6 inches.
• Ask your healthcare provider if you can use a non-prescription medicine to treat heartburn.

For more information, see:

• USDAChooseMyPlate.gov
  Health & Nutrition Information for Pregnant & Breastfeeding Women
  https://www.choosemyplate.gov/moms-pregnancy-breastfeeding