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Nutrition During Pregnancy

Pregnancy is a new beginning for both the mom-to-be and her baby. Maternal nutrition has a significant role in optimizing a woman’s own health as well as for the growth and health of her baby.

by Peter Van Eerden, MD, Sanford Clinic Maternal-Fetal Medicine

Pregnancy is a new beginning for both the mom-to-be and her baby. Maternal nutrition has a significant role in optimizing a woman’s own health as well as for the growth and health of her baby.

The well-being of our children begins in the uterus. It is the most important time to give them a healthy start. Events that occur in the uterus can make a drastic difference in the long-term health as an infant, child and adult. Poor nutrition during pregnancy has been associated with low birth weight and may increase the risk for chronic disease later in life. A poor intrauterine environment can increase the risk of childhood obesity, diabetes and heart disease later in life. Thus, maternal dietary changes may have significant benefit across a woman’s lifecycle and also help reduce the risk for chronic medical problems in the infant and child.

Nutritional requirements during pregnancy are not significantly different from the pre-pregnancy recommendations. Women should eat three meals a day consisting of several servings of vegetables, fruits, whole grains, dairy products and protein (including meat, fish, eggs, dried peas or beans). In addition, pregnancy requires 8-12 cups of fluid daily. Pregnant women can continue to eat their favorite foods in moderation.

During pregnancy, women should consume 100-300 additional calories per day. Pregnant women should also increase their protein intake by 5-6 grams per day. Animal foods are considered complete proteins because they contain all nine essential amino acids. Plant-based foods are deficient in one or more essential amino acids. Use of soy products, complementary food and/or dairy products can help correct this deficiency. A vegetarian diet may not provide adequate amounts of essential amino acids, iron or complex lipids. Consultation with a registered dietician is suggested for vegetarians.

Women without anemia need to increase their iron intake by 15 milligrams per day, an amount available in most prenatal vitamins. Calcium is required during pregnancy for the development of the fetal skeleton, especially in the third trimester. The RDA during pregnancy is 1,000 milligrams. Multivitamin supplementation is suggested in women who do not consume an adequate diet. The daily vitamin should include iron, zinc (15-mg), copper (2-mg), calcium, vitamin B6 (2-mg), folic acid (0.6-mg), vitamin C (50-mg), and vitamin D (200 IU).

All fertile women in their childbearing years should take at least 400 micrograms of folic acid daily to reduce the risk of neural tube defects (including spina bifida). The benefit of folic acid has been well documented in research studies and is one of the most important recommendations for women considering a pregnancy. Fortification of flour and cereal products since 1998 has also helped reduce this risk. Higher doses are recommended in women who may be at an increased risk for neural tube defects.

Gestational diabetes may occur during pregnancy. This results from high levels of hormones made by the placenta that makes the body’s own insulin less active. Dietary changes may be necessary to keep sugar levels from rising and therefore prevent complication from occurring during pregnancy. For women with pre-existing diabetes, it is very important to be under optimal growth prior to you pregnancy to prevent complications such as miscarriage or birth defects.

Certain food should be limited or avoided in pregnancy due to potential toxic effects. These include certain types of fish, high caffeine intake, unwashed fruits and vegetables, unpasteurized dairy products and undercooked meats. Although caffeine has recently been associated with miscarriage, drinking caffeine in moderation (up to 300-mg daily) is acceptable and considered safe during pregnancy.

Pregnancy is a time to gain control of your health as well as that of your children. It is important to optimize your nutritional status prior to pregnancy. Eating a well-balanced, healthy meal three times a day is suggested. This can have a remarkable and long lasting effect on the health of both yourself and your child.