Keeping Nutrition Top-of-Mind While Pregnant

Maria LaNasa, D.O., OB/GYN

If you’re pregnant, chances are you may feel like the menu has expanded for you in a sense. You may be indulging in food items you previously only ate sparingly, find yourself craving things you’ve never craved before, or subscribing to the classic saying “I’m eating for two.” While there aren’t many things that should be taken off the menu while pregnant, there are a few things, however, that you should be mindful of. That’s why we spoke with Maria LaNasa, D.O., an OB/GYN and physician on the medical staff at Texas Health Frisco and at be. Women’s Health & Wellness, to discuss what’s OK to eat, what to avoid, and how to keep nutrition top-of-mind while pregnant. 

 

Prioritize Quality over Quantity

While pregnant, you might feel this newfound freedom to eat whatever sounds good, and with all those hormones making it hard for you to say ‘no’ to cravings, it can be extra hard to make mindful food choices. While gaining weight is beneficial for your pregnancy, it’s best to focus on the quality of foods you’re eating versus quantity, especially since your recommended calorie intake doesn’t increase as much as you might think. 

“The old saying that a pregnant woman is eating for two is actually false. The recommended number of added calories for women in pregnancy is only about 500 extra per day,” LaNasa explains. “Think of it as adding one piece of bread with peanut butter per day.”

LaNasa adds that you actually need more calories after baby comes if you’re breastfeeding because breastfeeding requires about 1,000 extra calories per day, which is double what is recommended while pregnant. 

Eating well is one of the best things you can do during pregnancy because good nutrition helps you handle the extra demands placed on your body as your pregnancy progresses. The goal is to balance getting enough nutrients to support the growth of your baby and maintaining a healthy weight.

During pregnancy you need folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C. While many of these items can be found in your average prenatal vitamin, it’s not an excuse to choose non-nutritious food items because your prenatal has you covered. It’s always best to try to get these items from food sources instead of relying on supplements. 

  • Folic acid – helps prevent birth defects and supports the overall growth and development of both the baby and placenta.

    • You can find adequate sources of folic acid in fortified cereal, enriched bread and pasta, peanuts, dark leafy greens, orange juice and beans. 
  • Iron – helps red blood cells deliver oxygen to your baby.

    • You can find a good source of it in lean red meat, poultry, fish, dried beans and peas and prune juice. 
  • Calcium – essential for building strong bones and teeth.

    • You can find adequate sources in milk, cheese, yogurt, sardines and dark leafy vegetables. 
  • Vitamin D – Helps build your baby’s bones and teeth, and promotes healthy eyesight and skin. 

    • Adequate sources include sunlight, fortified milk and fatty fish such as salmon.
  • Choline – Important for the development of your baby’s brain and spinal cord.

    • Find adequate sources in milk, beef, liver, eggs, peanuts and soy. 
  • Omega-3 fatty acids – Important for fetal brain development.

    • Adequate sources include fatty fish, such as salmon, sardines and tuna, broccoli, cantaloupe, kidney beans, spinach, cauliflower, and walnuts.
  • B vitamins – B vitamins help form red blood cells, maintain the nervous system and helps the body use protein, fat and carbs.

    • Adequate sources include beef, liver, pork, fish, poultry, milk, whole grain cereals and bananas.
  • Vitamin C – Promotes healthy gums, teeth and bones. 

    • Find good sources in citrus, broccoli, tomatoes and strawberries.

But what about if you’re nauseous and vomiting? Getting the appropriate nutrition and calories can be difficult when you’re not feeling up to eating anything or you can’t keep anything down. LaNasa says the best thing to do is to pivot towards what you have the best chance of tolerating, even if that means turning towards a liquid meal replacement such as Ensure®. 

“Ensure® or smoothies are packed full of healthy nutrients and calories and are a good way to keep nourished,” she explains. “Iron is incredibly important to prevent anemia so add a lot of dark, leafy greens, and almonds and nuts are always a good source of energy throughout the day.” 

 

Is there anything I should avoid nutrition-wise? 

While we noted above that fish is a good source of many nutrients, especially Omega-3’s, some fish contain high levels of mercury, and therefore should be avoided because mercury has been linked to birth defects. Do not eat bigeye tuna, king mackerel, marlin, orange roughy, shark, swordfish, or tilefish. 

That being said, women should eat at least two servings of fish or shellfish per week while pregnant and while breastfeeding. A serving of fish is 8 to 12 ounces but be mindful to limit white (albacore) tuna to only 6 ounces a week. In addition, LaNasa says women should avoid eating raw fish, such as sushi.

LaNasa adds that pregnant women should avoid any raw or undercooked meats or non-pasteurized cheeses, milks or fruit juices to reduce your risk of infection from bacteria or parasites. That also means things such as deli meat or hot dogs, which can be surprising. 

Of course, it’s advised to completely avoid drinking alcohol when pregnant, as it increases the risk of miscarriage and stillbirth. Even a small amount can negatively impact your baby’s brain development. Drinking alcohol during pregnancy can also cause fetal alcohol syndrome, which involves facial deformities, heart defects and intellectual disability.

While some health care providers advise avoiding caffeine, while others OK a small amount, most experts state that consuming fewer than 200 mg of caffeine (one 12-ounce cup of coffee) a day during pregnancy is safe, according to the American College of OB/GYNs.

Below is a list of typical amounts of caffeine in common drinks:

  • 8 oz of brewed coffee is about 137 milligrams of caffeine
  • 8 oz of instant coffee is about 76 milligrams of caffeine
  • 8 oz of brewed tea is about 48 milligrams of caffeine
  • 8 oz of instant tea is about 26-36 milligrams of caffeine
  • 12 oz caffeinated soda is about 37 milligrams of caffeine
  • 1.45 oz of dark chocolate is about 30 milligrams of caffeine

 

How to plan healthy meals 

Stick to meals and snacks that focus on protein, vegetables and fruits, healthy fats, and fiber-rich carbohydrates like whole grains, beans, and starchy vegetables. And while that may seem easier said than done, there are many resources to help you plan healthy meals. 

One useful tool is the MyPlate food-planning guide from the U.S. Department of Agriculture. It can help you learn how to make healthy food choices at every meal.

The MyPlate Plan can help you learn about choosing foods from each food group to get the vitamins and minerals you need during pregnancy. The MyPlate Plan also can help you limit calories from added sugars and saturated fats.

Another great resource is taking a prenatal care class offered by Texas Health. The interactive online class covers multiple topics including nutrition. You can also ask your OB/GYN or midwife for a referral to a nutritionist who can help you create healthy meal plans and keep you on track. 

 

Bottom line

When you’re pregnant, it can be easy to indulge, especially when you’re craving something not-so-healthy. While it’s OK to indulge every now and then and is definitely something you shouldn’t beat yourself up about later, it’s also essential to prioritize nutrition during this time. It not only provides proper nutrition for you but your growing baby as well! 

For more help and guidance about what to expect during your pregnancy, visit Women and Infant Services.

 

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