Pay Your BillGuide for a Healthy Pregnancy
PRENATAL NUTRITION GUIDE
| FOOD GROUP | FOOD SOURCES/ SERVING SIZE |
# OF SERVINGS PER DAY | MAJOR NUTRIENTS | WHY? | |
|---|---|---|---|---|---|
PROTEIN FOODS |
Poultry, lean meat, fish, liver - 2 oz. Eggs - 2 Dried peas, beans, lentils - ½ cup cooked Nuts and seeds - ½ cup Peanut butter* - 4 tbs. Tofu (soybean curd) - 5 oz. Cottage cheese - ½ cup |
3* | Protein Iron |
Protein is the basic building material for the growth of your baby. Iron helps build healthy blood. |
|
MILK and MILK PRODUCTS |
Whole, low fat, skim milk - 1 cup (8 oz.) Evaporated or nonfat dry milk (mixed with water) - 1 cup Cheese - 1 ½ - 2 oz. Yogurt - 1 cup Ice Cream - 1½ cups |
4* | Calcium Protein |
Calcium helps build strong bones and teeth. | |
BREADS and CEREALS (whole grain/ enriched) |
Bread - 1 slice Cooked cereal, rice, pasta, noodles - ½ cup Cereal, ready to eat - ¾ cup Rolls, buns, bagels, muffins - one half Pancakes - 1 medium Corn or flour tortilla - 1 Crackers - 5 |
4+ | Iron B-Vitamins Carbohydrates Fiber |
Carbohydrates and B-vitamins provide you with energy and help your body work properly. |
|
VITAMIN C
|
Orange - 1 Orange, grapefruit juice - ½ cup Grapefruit - one half Strawberries - ½ cup Cantaloupe - 1 medium Papaya - 1 cup Broccoli - 1 stalk Tomato - 1 Tomato juice - 1 cup Peppers - ½ medium Baked potato - 1 medium |
1 | Vitamin C Fiber |
Vitamin C keeps gums healthy and helps your body use iron. Fiber helps prevent constipation. | |
VITAMIN A RICH
|
Spinach, collards, kale, mustard greens Bok choy, Swiss chard - ½ cup Broccoli - 2 stalks Carrots - 1 cup Winter squash - 1 cup Sweet potato - 1 small Cantaloupe - ½ melon |
1 | Vitamin A Fiber |
Vitamin A keeps eyes and skin healthy. | |
OTHER FRUITS and VEGETABLES |
Cucumber Corn, green beans, legumes Lettuce Apple or Applesauce Banana Grapes Plums |
2 | Other vitamins and minerals | All fruits and vegetables provide other vitamins and minerals to make the body work properly. | |
FATS, OILS, SUGAR |
Mayonnaise, butter, margarine, salad dressing, lard Candy, pastry, cookies, chips, Kool-aid, soda (tonic), fruit punch |
TO BE USED IN LIMITED AMOUNTS | These foods are high in calories, sugar, fat and salt. | ||
| WATER AND OTHER LIQUIDS: Drink 6 to 8 glasses every day. | |||||
| Pregnant teenagers should add one more serving of protein foods and one more serving of milk products to the above recommendations per day. | |||||
*Some experts think women with bad allergies should avoid peanuts during pregnancy and breastfeeding. It is thought this may reduce your baby’s chance of developing peanut allergy.
Eating for a Healthy Baby
A healthy diet is one of the most important gifts you can give to your baby. Food that is good for you is good for the baby too. Not eating well during pregnancy can affect your baby’s growth and your health. The vitamins, minerals, and nutrients your body takes in pass into your bloodstream. They reach your baby through the placenta, a disk-shaped organ on the wall of the uterus. It is linked to your baby by the umbilical cord.
Eating well while you are pregnant is all about balance. Choosing a variety of foods in the right amounts is important to a healthy pregnancy. Carbohydrates, protein and fat provide the fuel for a healthy pregnancy. They provide calories and energy you need during your pregnancy. Vitamins, minerals, and water are equally important. Vitamins oversee many of your body’s functions that keep you and your baby’s growth on track.
Part of a nutritious, well-balanced diet includes:
- Avoiding junk food, soda, and caffeine.
- Eating fruit, vegetables, and whole grains (such as rice or grains found in bread, tortillas, or cereal). High fiber foods like whole grains and cereals are not only part of a healthy diet, but also help with constipation.
- Consuming dairy foods like low-fat milk, cheese and yogurt.
- Eating protein-rich foods like lean meat, poultry, fish, eggs, beans, tofu, and peanut butter.
Talk with your clinician if you eat a vegetarian, macrobiotic or non-dairy diet, or if you need help bringing your weight into a healthy range.
Foods for a Healthy Baby
The following paragraphs explain what and how much you need to eat each day. Eating a variety of foods helps you get everything you need.
During pregnancy, you need about 300 extra calories a day. (For example, a glass of skim milk and half a turkey sandwich is about 300 calories.) When you don’t eat enough, your baby may not get enough nourishment to grow properly. Be aware, however, that excess weight gain sometimes increases the risk of pregnancy complications. It is best to follow a healthy diet during your pregnancy.
Appetite can be hard to predict during pregnancy, so eat healthy foods first before having any less healthy treats.
Protein
Protein is very important in your diet. Protein gives you the nutrients your body needs for your muscles and other tissues. It helps grow, maintain, and repair them. It also helps build your baby’s cells during pregnancy. Most women should eat 45 grams of protein a day. Pregnant women need a little more – approximately 60 grams a day. Protein comes from animal food. You get your protein from meat, fish (see section on food safety,) poultry, and dairy products. Plant products such as grains and legumes also can be good sources of protein. If you don’t eat any meat, dairy products or eggs, talk to your doctor about ways to get more protein.
Fluids for Two
You need lots of fluids during pregnancy. Fluid needs increase when pregnant, in part to keep up with an expanding blood supply, the bulk of which is water. They keep your kidneys working well, and help you cut down on swelling and avoid constipation. You should not cut down on fluids to stop swelling during pregnancy.
Pregnancy requires at least 64 ounces (eight 8-ounce cups) of fluid each day. Water is the most obvious fluid source and the most desirable. Try to choose nutritious fluids like low-fat or skim milk, soup, and fruit juices like 100% orange or apple juice. Caffeinated beverages, including coffee, tea, and soft drinks cause your body to lose water and should not be counted toward fluid intake. Try to avoid these when possible.
Vitamins and minerals
It can be hard to get all the extra vitamins and minerals you need during pregnancy, so some clinicians prescribe a prenatal vitamin. Iron and folic acid (a B vitamin) are two very important nutrients found in prenatal vitamins or sold separately as pills. Certain vitamins in excess can harm your baby. Follow your clinician’s advice, and don’t take extra vitamins or minerals without first discussing it with them. Keep in mind, also, that vitamins cannot make up for a poor diet. Some women get upset stomachs when they take prenatal vitamins. It helps to take them with food or late in the day, not right after you get up in the morning. If you still feel sick, talk to your clinician about other ways to get the vitamins and minerals you need.
Folic Acid (a B vitamin)
Pregnant women need to get enough folic acid, especially in the early weeks of pregnancy. This B vitamin helps prevent birth defects of the spinal cord and brain and create blood cells for the baby. Experts recommend at least 0.4 (milligrams) or 400 µg (micrograms) of folic acid every day, starting three months before you get pregnant. You can get this amount in most daily multivitamins.
Ways to get folic acid
- Eat dark green, leafy vegetables like spinach and broccoli, whole-grain or fortified cereals, chickpeas, peanuts, orange juice and fruits.
- There is folic acid in most prenatal vitamins.
Salt
Salt is one of the minerals that help your heart beat normally. It also helps keep the right level of water in your body, conducts nerve impulses, and makes your muscles contract.
Ways to get salt
- The average diet easily meets the salt needs of pregnancy.
- If you have certain medical problems, your clinician may ask you to cut back on salt. Do not cut salt from your diet unless your clinician tells you do so.
DHA
DHA (docosahexaenoic acid) is an omega-3 fatty acid that may have positive effects on the growing fetus. However, randomized trials have not proved benefit from supplemental DHA during pregnancy. The main dietary source of DHA is fish and although concerns of mercury ingestion make some fish problematic for pregnant women, there are some safe fish (see Food Safety) as well as other dietary sources: DHA-enriched eggs, walnuts, and canola oil. Fish oil supplements can provide DHA and EPa (another omega-3 fatty acid); USP-approved fish oil products or those carried in HVMA pharmacies such as 21st Century Brand Fish Oil 1000 mg (with 120 mg DHA + 180 mg EPA per capsule) are available over the counter and meet strict purity standards.
Calcium
Calcium plays a very important role in building your baby’s bones and teeth. If you don’t get enough calcium from a well-balanced diet, your baby will use the calcium from your bones. This can lead to osteoporosis (fragile bones) later in life. Calcium also helps regulate your heartbeat, makes your muscles contract properly, and aids in forming blood clots. Pregnant women should get 1,000 milligrams of calcium each day. Good sources of calcium include milk, cheese, and yogurt. You can also get calcium from fortified orange juice, nuts and seeds, sardines, and salmon with bones.
See the following table for calcium rich foods and serving sizes.
| FOOD TYPE | SERVING SIZE | CALCIUM (mg) |
|---|---|---|
Dairy Foods Buttermilk |
8 oz. |
285 |
Fish, Shellfish, and Crab Bass, freshwater, raw |
3 oz. |
68 |
Fruit, Juice and Vegetables Artichoke |
1 medium, boiled |
135 |
Cereal All-Bran, Kellogg’s |
½ cup |
100 |
Nuts, Seeds, Beans and Tofu Almonds, Blue Diamond |
1 oz. |
79 |
Iron
Getting Enough Iron
Anemia means having a low red blood count. Iron deficiency and iron deficiency anemia are the most common nutritional deficiencies in humans. During the years they are having their periods, some women may experience iron deficiency related to blood loss from menstruation. Pregnant women have an increased need for iron, because the growing baby uses the mother’s iron.
Why Iron is Important
Iron is needed by everyone to help form a substance in red blood cells known as hemoglobin. Hemoglobin carries oxygen to every cell in the body and keeps you functioning well. Women with low blood counts sometimes are tired.
How Much Iron to Take
Women eating a balanced diet who have normal periods do not generally require extra iron. The recommended amount of iron supplementation in pregnancy is 30 mg per day (of “elemental” iron).
Prenatal vitamins contain 27 mg of elemental iron, which is close to this amount. If your clinician recommends that you take a certain amount of elemental iron each day and you are already taking prenatal vitamins, remember to count the iron in the vitamin as part of your daily iron supplement. Other iron preparations are available over-the-counter. Ferrous gluconate (325 mg tablets) contain 36 mg of elemental iron and ferrous sulfate (325 mg) tablets contain 65 mg of elemental iron. Generally clinicians recommend anemic women take a total of about 60 mg of elemental iron per day.
When to Take Iron
Iron is best absorbed on an empty stomach, so take it at least one hour before or after meals if you can. Vitamin C rich foods improve iron absorption. Therefore, take iron or vitamins with orange, grapefruit, cranberry or tomato juice.
What Foods to Avoid when Taking Iron
Avoid drinking milk or tea or eating high fiber foods or spinach at the same time you take your iron supplement. They interfere with iron absorption.
What Foods Have Iron
It is important to include meat, poultry, fish, green leafy vegetables, dried beans and peas, legumes and canned beans, iron-fortified cereals, bread and pasta, and dried fruits in your diet. Cooking acidic foods, such as tomato sauce, in an iron skillet can also provide iron.
What are the Possible Side Effects of Taking Iron
Many people have no problems while taking iron tablets, however, others do experience side effects. These may include constipation, diarrhea, stomach upset and/or nausea. Iron can darken or blacken your stool. If constipation becomes a problem, you may try unprocessed bran or high fiber cereal (daily) or a fiber supplement such as Metamucil® or Fibercon® (use as directed). Be sure to drink plenty of fluids (ideally, eight glasses of water daily). Taking the iron tablet with a slice of bread may alleviate stomach upset, nausea, or diarrhea.
If you cannot tolerate the iron pill daily, try every other day. If side effects continue, taking iron once a week still has its benefits or, your clinician may suggest other specially formulated iron supplements.
The following table lists foods that are rich in iron.
| FOOD TYPE | SERVING SIZE | Iron (mg) |
|---|---|---|
Meat Sources Beef Liver NOTE: If pregnant, all meats must be well done. |
3 oz. |
7.5 |
Non-Meat Sources Bran flakes, enriched |
½ cup |
6.2 |
Weight Gain
A healthy weight gain
The right weight gain for you during pregnancy depends upon many things. Most women should gain at least 25-30 pounds. If you were overweight when you got pregnant, your clinician may suggest you gain 15-25 pounds. If you were underweight, you probably need to gain 28-40 pounds. If you’re carrying twins, you can expect to gain more.
Pre-pregnancy BMI* |
Recommended Gain |
Underweight |
28-40 lbs |
Normal weight |
25-35 lbs |
Overweight |
15-25 lbs |
Obese |
11-20 lbs |
*BMI is a calculation that includes your height and weight. If you don’t know yours, ask your clinician.
Your clinician will check your weight at each visit and help you change your diet, if necessary. You should not try to lose weight while pregnant. Wait to start any weight loss program until after you give birth and after you stop breastfeeding. If you worry that a higher weight gain means a bigger baby and a harder labor, talk to your clinician.
It may seem hard to gain weight if you feel nauseous (so-called morning sickness is common in early pregnancy). Having many small meals and snacks may help to control nausea and allow you to eat well. In the first few months of pregnancy, getting enough calories is more important than eating certain foods. So if you crave a certain food, have it!
Call your clinician if you are vomiting three or more times a day, or you are not gaining weight or are losing weight. You may need help with your diet so you get enough food and fluids. Please ask your clinician for the more detailed handout about not gaining weight or losing weight during pregnancy.
The pattern of weight gain
During the first three months, weight gain usually should be three to four pounds. (It may be more if you’re eating to relieve nausea.) The rate at which you gain weight will vary depending on your recommended total weight gain. During the second trimester you should average 1.5 to 2 pounds per month. During the third trimester you should average 2 to 5 pounds per month, though this may slow down in the last month of pregnancy.
Healthy weight gain is due to more blood and water in your body, heavier breasts, and of course, the growing baby and its support systems. Excess weight gain may increase the risk of pregnancy complications.
Tips if you are gaining weight too fast
Try these simple ways to change your diet:
- Don’t skip meals, but do cut down on fats. Switch from whole milk to 1% or skim milk, for example, and limit foods that are fried or sautéed in butter or oil.
- Watch portion sizes. Fill out a meal with vegetables and salad.
- Choose fresh fruit for snacks or desserts, rather than sweets.
- Drink plenty of water, and cut down on soda, sweet drinks, and juices.
- Use herbs and spices for seasonings. Avoid seasonings with lots of salt or calories.
- Be more active.
Tips if it’s hard to add pounds
Try these simple ways to add healthy pounds:
- Eat snacks every two hours.
- Try adding nutritional drinks, like Carnation Instant Breakfast, Ensure, and milkshakes.
- Choose high-calorie, protein-rich foods, such as steak, eggs, ice cream, pizza, cheeseburgers and chicken salad.
- Select nuts such as walnuts, almonds and pecans to add extra calories and good quality fats.
- Keep a food diary of all you eat and drink for a few days, and review it with your clinician. If you’re not getting enough calories or need certain nutrients, your clinician can suggest ways to eat better and refer you to a nutritionist.
Registered dietitians
Sometimes pregnant women need special help with their diets. If you have diabetes, for example, your clinician may suggest that you see a registered dietitian (RD). RDs are trained in medical nutrition therapy, food chemistry, and ways to change eating habits. They are skilled at designing diets to meet nutrition and health goals.
If you feel a visit with a registered dietitian might help, talk with your clinician.
