What to Eat When You’re Expecting
Brittany Peats

Proper nutrition during pregnancy is important for the health of the developing fetus and that of the mother. You should begin eating sufficient amounts of a few key vitamins and minerals three months before conception and continue through the entire pregnancy. A supplement is often recommended as a way to get sufficient daily amounts of folate, calcium, protein, and iron. As always, it is important to eat a balanced diet; suggestions for very healthy foods to consume while pregnant are listed below.

There are certain foods which should be avoided as they have negative consequences for the pregnancy. Many women experience food cravings which may occur for a variety of reasons. It is okay to indulge in these cravings as they may be the body’s way of showing that it needs more of a certain food but be sure that the food is healthy and eaten in moderation. Never eat non-food items that you may crave and seek a doctor’s help if this is a continuing problem as you may have pica. Before you start eating for two, remember that at first the fetus is only the size of a grain of rice so you only need to consume about 300 extra calories a day during your pregnancy.

Important Vitamins and Minerals

Pregnant women should eat a balanced diet, high in fruits, vegetables and whole grains. During pregnancy a woman needs high doses of folate, calcium, protein, and iron and to ensure that you are getting enough of these and other essential vitamins and minerals, a prenatal vitamin supplement is recommended. Ideally you should begin taking this daily three months before conception. Your doctor can recommend an over-the-counter brand or prescribe a prenatal vitamin for you; your doctor may recommend special supplements if you follow a strict vegetarian diet or have any chronic health conditions. If you're considering an herbal supplement, make sure that you ask your doctor first about any side effects. Even when taking a prenatal multivitamin, it is important to eat foods high in folate, calcium, protein, and iron everyday. Here is a list of why these nutrients are important, food sources which contain the nutrients, and how much you should have every day.

Folate and folic acid

Folate is a B vitamin that helps prevent neural tube defects, and serious abnormalities of the brain and spinal cord like spina bifida. Lack of folate also may increase the risk of preterm delivery, low birth weight and poor fetal growth. The synthetic form of folate found in supplements and fortified foods is known as folic acid.

How much you need: 1 milligram (1,000 micrograms) of folate or folic acid a day before conception and during pregnancy.

Good sources: Fortified cereals are great sources of folic acid. Dark leafy green vegetables, citrus fruits, veal, and legumes (lima beans, black beans, black-eyed peas and chickpeas and dried beans and peas) are good sources of naturally occurring folate.

Calcium

You and your baby need calcium for strong bones and teeth. Calcium also helps blood to clot normally, muscles and nerves to function properly, and the heart to beat normally. Your growing baby needs a considerable amount of calcium to develop. If you do not consume enough calcium to sustain the needs of your developing baby, your body will take calcium from your bones, decreasing your bone mass and putting you at risk for osteoporosis later in life. Osteoporosis causes dramatic thinning of the bone, resulting in weak, brittle bones that can easily be broken.

How much you need: 1,000 milligrams a day.

Good sources: Dairy products are the richest sources of calcium. Many fruit juices and breakfast cereals are fortified with calcium.

Protein

Protein is crucial for your baby's growth, especially during the second and third trimesters. Protein also repairs your cells as your body changes.

How much you need: 71 grams a day.

Good sources: Lean meat, poultry, fish and eggs are great sources of protein. Other options include dried beans and peas, tofu, dairy products and peanut butter.

Iron 

During pregnancy --when your blood volume expands to accommodate changes in your body and your baby must make his or her entire blood supply -- your need for iron nearly doubles. The body absorbs iron more efficiently during pregnancy; therefore it is important to consume more iron while you are pregnant to ensure that you and your baby are getting enough oxygen. Iron is a mineral that makes up an important part of hemoglobin, the substance in blood that carries oxygen throughout the body. Iron also carries oxygen in muscles, helping them function properly. Iron helps increase your resistance to stress and disease and helps you avoid symptoms of tiredness, weakness, irritability and depression. If you don't get enough iron, you may become fatigued and more susceptible to infections. The risk of preterm delivery and low birth weight also may be higher.

How much you need: 27 milligrams of iron a day.

Good sources: The iron from animal products, such as lean red meat, poultry, and fish is most easily absorbed. Enriched rice and pasta, soft pretzel, and whole grain and enriched or fortified breads and cereals are good sources of iron. Vegetables such as lack-eyed peas, broccoli, Brussel sprouts, collard and turnip greens, lima beans, sweet potatoes, and spinach contain iron while fruits such as all berries, apricots, dried fruits, including prunes, raisins and apricots, grapes, grapefruit, oranges, plums, prune juice, and watermelon are also good sources. Also try eating legumes like dry beans and peas, lentils, and soybeans and other foods like molasses, peanuts, pine nuts, pumpkin or squash seeds. To enhance the absorption of iron from plant sources and supplements, eat the food or take the supplement with a food or beverage high in vitamin C — such as orange juice, tomato juice, cantaloupe, strawberries, tomatoes or bell peppers.

Besides those important nutrients it is recommended that you eat foods high in fiber that are enriched such as whole-grain breads, cereals, pasta, rice, fruits and vegetables. Eat at least 70 mg of vitamin C every day; this can be found in oranges, grapefruits, strawberries, honeydew, papaya, broccoli, cauliflower, Brussel sprouts, green peppers, tomatoes and mustard greens. Try to eat foods containing vitamin A regularly but know that excessive vitamin A intake (>10,000 IU/day) may be associated with fetal malformations. Sources of vitamin A include carrots, pumpkins, sweet potatoes, spinach, water squash, turnip greens, beet greens, apricots and cantaloupe.

Great Foods to Eat 

Listed below are five foods that are great to eat during pregnancy:

All Bran Cereal with Extra Fiber

In research conducted at the Swedish Medical Center in Seattle, doctors found that 24 grams of fiber daily reduced risks of preeclampsia (a dangerous form of high blood pressure) by a whopping 51%. Plus, the extra fiber can reduce constipation and help you avoid another common pregnancy problem: hemorrhoids. Most important, many high-fiber cereals are also rich in folic acid. This is important to reduce the risk of birth defects. Cereals containing high fiber and 100% of your daily folic acid need include: Kellogg's All Bran, Total Wheat Flakes, Total Corn Flakes, Total Raisin Bran, Product 19, Multigrain Cheerios, and Smart Start.

Orange Juice

Just 2 cups a day can reduce your blood pressure by up to 10 points, according to experts at The Cleveland Clinic. This could be critical if your pressure rises during pregnancy. The high vitamin C count may also help reduce your risk of preeclampsia (see Banana Strawberry Smoothie). If you choose a brand fortified with calcium, such as Minute Maid or Tropicana, you'll be adding an additional nutritional boost. Orange juice contains a good amount of folic acid – about 15% of the recommended amount of folate each day in an 8-ounce glass.

Banana Strawberry Smoothie

This drink is so packed with baby-friendly nutrients it could help reduce pregnancy complications. In a study published in the journal Epidemiology doctors found pregnant women who consumed lots of C-rich foods - such as bananas and strawberries -- had a lower risk of preeclampsia. Studies from the University of North Carolina at Chapel Hill show women lacking vitamin C during pregnancy may have an increased risk of premature rupture of membranes -- a leading cause of premature birth. Plus, experts say high-calcium foods like yogurt and milk may help control fluid retention which may further decrease your risk of high blood pressure. To make a smoothie: Combine strawberries and bananas with low-fat milk, or yogurt, plus some ice, in a high-speed blender. Blend until creamy and smooth -- and drink up!

Salmon

Although the FDA advises limiting salmon to 12 ounces per week, studies published in the BMJ showed just 6 ounces weekly reduces the risk of premature birth from 7.1% to just 1.9%. To help your newborn sleep soundly, try eating more fish during pregnancy. Indeed, research published in the Journal of Clinical Nutrition showed babies of mothers who consumed fatty acids found in fish during their last trimester, had healthier sleep patterns. The key component here is a fatty acid known as DHA, which is abundant in cold-water fish such as salmon.

Low-Fat Yogurt

The obvious pregnancy benefits here include high calcium and high protein -- both important to your developing baby. But these same foods might also help reduce muscle cramping, a sometimes troubling problem during pregnancy. Calcium can also reduce uncomfortable bloating and water retention. In addition, medical literature indicates that, anecdotally, eating yogurt during pregnancy appears to reduce the risk of yeast infections -- another common pregnancy problem.

Foods to Avoid While Pregnant

Seafood

Seafood can be a great source of protein and iron, and the omega-3 fatty acids in many fish can help promote your baby's brain development. In fact, a British study suggests that skimping on seafood during pregnancy may contribute to poor verbal skills, behavioral problems and other developmental issues during childhood. Women of childbearing age, in particular, should include fish or shellfish in their diets because of the nutritional benefits.

However, some fish and shellfish contain potentially dangerous levels of mercury. Too much mercury may damage your baby's developing nervous system. However, Ashton reminds us that high levels of mercury contamination could turn eating some seafood into a serious risk with the potential to harm the nervous system of your developing baby. As such, in 2004 the FDA and the Environmental Protection Agency warned pregnant women, those looking to get pregnant, nursing mothers, and children, to avoid all seafood high in mercury. The bigger and older the fish, the more mercury it may contain. Avoid eating shark, swordfish, King mackerel, and tilefish. Do not eat anything caught in polluted water.

Do not eat any kind of raw fish or shellfish - especially oysters and clams - during pregnancy since it can harbor bacteria and parasites that are very dangerous during pregnancy. Refrigerated smoked seafood is also off-limits, unless it's an ingredient in a casserole or other cooked dish. Most fish should be cooked to an internal temperature of 145 F. The fish is done when it separates into flakes and appears opaque throughout. Cook shrimp, lobster and scallops until they're milky white. Cook clams, mussels and oysters until their shells open. Discard any that don't open.

Safe types of seafood are those that contain little mercury. Although concerns have been raised about the level of mercury in any type of canned tuna, the FDA says you can safely eat up to 12 ounces (two average meals) per week of fish that is lower in mercury. This includes shrimp, canned light tuna, salmon, pollack, and catfish. The FDA, however, suggests limiting albacore (white) tuna, and tuna steak to 6 ounces per week. These two contain more mercury than canned light tuna.

Unpasteurized Cheeses and Lunch Meats

During pregnancy, changes in your metabolism and circulation may increase the risk of bacterial food poisoning. Your reaction may be more severe than if you weren't pregnant and rarely, your baby may get sick, too. Both deli meats and unpasturized cheeses have the possibility of containing the bacterium known as Listeria monocytogenes which causes the form of food poisoning known as listeriosis. If a mother contracts Listeriosis, it can increase the risk of miscarriage, premature birth, or stillbirth. A newborn baby exposed to Listeria can become seriously ill and die.

To prevent food-borne illness, fully cook all meats and poultry before eating. Look for the juices to run clear, but use a meat thermometer to make sure. Skip medium or rare burgers and sausages. Cook hot dogs and heat deli meats such as ham, turkey, salami, or bologna until they're steaming hot — or avoid them completely.

Pasteurization kills the Listeria bacterium, so any soft cheese made from pasteurized milk, like mozzarella cheese and cottage cheese can be a healthy part of your diet. Pasteurized milk is fine to drink. Anything containing unpasteurized milk or unpasteurized fruit juices is off-limits. These include soft cheeses such as feta, Brie, Camembert, Roquefort, blue-veined, and Mexican-style cheeses, such as queso blanco, queso fresco, queso de hoja, queso de crema and queso asadero.

Caffeine

During pregnancy, moderate caffeine intake — no more than 300 milligrams a day, about the amount in two to three cups of coffee — seems to have no adverse effects. Sodas such as Coke, Pepsi, and Mountain Dew as well as certain medications such as Anacin also contain caffeine, so be sure to count them into your daily tally as well.

Some studies have shown that caffeine could pose risks to the fetus. Caffeine can cross the placenta and affect your baby's heart rate and breathing. Some studies suggest that heavy caffeine intake may be associated with a small decrease in birth weight or an increased risk of miscarriage and stillbirth. Other studies haven't reported the same risks. Caffeine is also a mild stimulant and a diuretic, both of which are not ideal during pregnancy.

Herbal tea

Although herbal tea may be soothing and be marketed specifically to pregnant women, ask your health provider before drinking it. There's little data on the effects of specific herbs on developing babies and large amounts of some herbal teas, such as red raspberry leaf, may cause contractions.

Alcohol

Though recently some doctors suggested moderate drinking during pregnancy, now it is advisable to avoid it altogether because it is unknown what the threshold is for alcohol in pregnancy. In February 2005, the U.S. Surgeon General said that no amount of alcohol can be considered safe during pregnancy.

The risks for those who drink while pregnant include a higher risk of miscarriage and stillbirth. Alcohol increases a baby's risk of fetal alcohol spectrum disorder (FASD) -- a series of developmental problems that can affect a child's ability to learn throughout their lifetime. In its most extreme form fetal alcohol syndrome (FAS) can cause varying degrees of birth defects and mental retardation.

If your pregnancy was a surprise -- and you unknowingly consumed alcohol during the first several weeks after conception -- experts say don't panic. If you stop drinking the moment you discover you're pregnant, and meet your daily requirement of folic acid (400 micrograms) you can dramatically decrease your baby's risk of any serious consequences. If you're concerned or you think you need help to stop drinking, talk with your health care provider.

Saccharin

While some doctors are leery about using any artificial sweetener during pregnancy, the one that is of most concern is saccharin. It has been shown to cross the placenta and end up in your baby's bloodstream which is of concern because some animal studies have shown that in high enough amounts saccharin may increase the risk of bladder cancer. Since research on monkeys has shown that a developing fetus is much less effective at clearing saccharin from the blood than an adult, at least theoretically, amounts of the artificial sweetener can build to a dangerous level. As to other artificial sweeteners: There is no specific evidence to show harm to mother or baby.

f you were consuming saccharin before you knew you were pregnant, don't panic; the risks are small during the early weeks of pregnancy. As long as you don't consume any more, your baby's health should not be affected.

Sources:

Pregnancy: Eating Healthy for 2

Reviewed by Louise Chang, MD

http://www.webmd.com/baby/features/pregnancy-eating-healthy?page=1

Pregnancy nutrition: Foods to avoid

By Mayo Clinic Staff  
Jun 1, 2007

http://www.mayoclinic.com/health/pregnancy-nutrition/PR00109

Graphs courtesy of the USDA National Nutrient Database for Standard Reference