In this discussion you will learn why you need a well-balanced diet while you are pregnant and what foods you should eat. You will also find out foods you should avoid and foods that will help some of the unpleasant side effects of pregnancy. < xml="true" ns="urn:schemas-microsoft-com:office:office" prefix="o" namespace="">

What foods do I need to eat?

Eating regular, well-balanced meals is more important when you are pregnant than at any other time of your life. What you eat provides food for your baby as well as yourself.

You need about 200 to 300 more food calories a day than when you were not pregnant. Most pregnant women need about 2200 to 2300 total calories each day. Your health care provider will suggest a range of weight that you should gain. The usual recommended gain is about 20 to 35 pounds.

Your need for protein increases to 60 milligrams a day when you are pregnant. Your needs for most vitamins and minerals, particularly folic acid and iron, also increase. These nutrients are important for your baby's growth and development. They give your baby strong bones and teeth, healthy skin, and a healthy body.

Foods that are excellent sources of protein and vitamins are:

• beans and peas
• nuts
• peanut butter
• eggs
• meat
• fish
• poultry
• cheese, milk, and yogurt.

Good sources of folic acid (also called folate) are:

• leafy green vegetables, such as collard greens, spinach, kale, and mustard greens)
• broccoli
• asparagus
• breakfast cereals
• beans
• oranges and strawberries
• yellow squash
• tomato juice.

Foods rich in iron are:

• lean red meats, pork, chicken, and fish
• fortified cereals
• dried fruit
• green, leafy vegetables
• beans
• eggs
• liver
• kidneys
• whole-grain or enriched bread.

If you need financial help buying nutritious foods, a government program called the Special Supplemental Food Program for Women, Infants, and Children can help you buy foods like milk, eggs, cheese, and bread.

How do I know if I am eating a balanced diet?

Eat a variety of whole, fresh foods. Use the following as a guideline for what you should eat every day.

Meat, poultry, fish, beans, or eggs

• You need 2 to 3 servings every day.
• One serving of meat is 2 to 3 ounces of lean meat, poultry or fish.
• One serving of other, nonmeat foods is 1 cup cooked beans, 2 eggs, 2/3 cup nuts, or 1/4 cup of peanut butter.

Grains, rice, pasta, bread

• It is good to have 9 servings every day.
• One serving is 1/2 cup pasta, 1/2 cup cooked cereal, or 1 slice of bread.

Protein, a major nutrient in this group, is necessary for growth of new cells and replacement of old ones.

Fruits

• You need 3 or more servings of fruits every day.
• One serving of fruit is 1 medium apple, 1 medium banana, 1/2 cup chopped fruit, or 3/4 cup fruit juice.

Fruits such as oranges, grapefruit, melons and berries are the best sources of Vitamin C. Deep yellow fruits like papaya and mango are good sources of Vitamin A. It is easy to eat three or more servings of fruit a day: juice or fresh fruit for breakfast, fresh or dried fruit for a snack, a fruit salad with lunch and a fruit dessert with dinner

Vegetables

• You need 4 or more servings of vegetables every day.
• One serving is 1 cup of raw, leafy vegetables, 1/2 cup of other types of raw or cooked vegetables, or 3/4 cup of vegetable juice.

Vegetables provide vitamins A and C among other vitamins, minerals and fibre, which can help relieve constipation. Foods rich in Vitamin C are citrus fruits, cabbage, potatoes, spinach, green beans and tomatoes. Eating foods rich in Vitamin C helps the body absorb the iron in foods. The body does not store Vitamin C, so these foods are needed daily.

Milk, cheese, or yogurt

• You need 4 servings every day.
• One serving is 1 cup of milk, 1 cup of yogurt, or about 2 ounces of cheese.

Dairy products provide numerous nutrients and are especially high in calcium and proteins. Calcium is essential in the formation of bones and teeth. If your intake isn’t sufficient, your baby can withdraw calcium from your bones, making you more at risk of developing osteoporosis later in life. If you don’t like to drink milk, try flavouring it with chocolate or a drop of vanilla or serving it chilled over ice. The other ways to enhance milk intake is to take milk products in place of milk as such. These include curd, cheese, butter, etc. One cup of curds contains the same amount of calcium as a cup of milk, so include it with snacks and meals or substitute plain curd for some of the mayonnaise in salad dressings. Another way to add milk to your diet is to choose pudding desserts.

Do I need to take dietary supplements?

Your health care provider will most likely prescribe a prenatal vitamin and mineral supplement. This will help make sure you get the vitamins and minerals you need, such as calcium, iron, and folic acid.

• Calcium. Calcium needs for pregnant women are the same as nonpregnant women: 1000 mg a day for adult women and 1300 mg a day for adolescents. Many women do not get enough calcium in their diet, so it's important to make sure you're meeting your calcium needs every day. Dairy products such as milk, yogurt, cheese, and smoothies are great sources of calcium.

• Folic acid. Folic acid is important for spinal cord development of the baby. Pregnant women need 600 micrograms (mcg) a day. Synthetic folic acid added to fortified foods and vitamin supplements is almost twice as well absorbed as the folic acid in natural foods. It is recommended that pregnant women get 400 (mcg) of folic acid from fortified foods (cereals and whole grains) and supplements, in addition to eating foods that are good sources of folate, such as legumes and leafy green vegetables. Read labels. Many foods are supplemented, and you should not have more than 1,000 mcg each day. Ask your provider if you need a folic acid supplement.

• Iron. Women need 30 mg of iron a day during the last half of pregnancy. An iron supplement may be necessary to meet this need. Women carrying twins, women with low iron in their blood, and large women may need more than 30 mg of iron a day. Iron supplements can be harmful if taken inappropriately, so ask your provider before you start taking an iron supplement.

What substances should I avoid when I am pregnant?

• Avoid alcoholic drinks, tobacco, and drugs.
• Check with your provider before taking any medicines or herbal supplements. Some medicines and supplements can cause birth defects.
• Limit caffeine to less than 300 mg a day, or 2 cups of coffee. High amounts of caffeine from coffee, tea, soft drinks, and chocolate could increase the risk to your baby.
• Avoid herbal teas unless your health care provider recommends them. Some herbal teas, if drunk in large amounts, may cause early contractions and increase your risk for early (preterm) labor.
• Avoid meat, fish, shellfish, and eggs that are raw or undercooked. 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.
• Don't eat unpasteurized soft cheeses, such as Brie, Camembert, feta, blue-veined, Mexican-style, and Roquefort cheese because of the increased danger of listeria infection during pregnancy. Although most cheeses are pasteurized, don't eat imported cheeses or semi-soft cheese unless you are sure they are pasteurized. For the same reason, don't drink unpasteurized milk. It is OK to eat hard cheeses, processed cheeses, cream cheese, cottage cheese, and yogurt.
• Avoid raw vegetable sprouts and fresh (unpasteurized) fruit and vegetable juices. They can carry disease-causing bacteria such as E. coli and Salmonella.

You do not have to eat less salt during pregnancy, as was thought in the past. A moderate amount of salt helps keep proper levels of sodium in your body as your baby develops. Use iodized salt.

Is it OK to eat fish?

Fish and shellfish are an important part of a healthy diet. They contain high-quality protein and other essential nutrients. They are low in saturated fat and contain omega-3 fatty acids that can contribute to heart health.

However, nearly all fish and shellfish contain traces of mercury. Some fish and shellfish contain higher levels of mercury that may harm an unborn baby's developing brain and nerves. The Food and Drug Administration (FDA) advises women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish with high mercury levels. Instead, they should eat fish and shellfish that are lower in mercury.

Here are some guidelines for eating fish:

• Do not eat shark, swordfish, king mackerel, or tilefish (also called golden or white snapper) because they contain high levels of mercury.
• Do eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury. Five commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish. Fish sticks and fast-food fish sandwiches are commonly made from fish that are low in mercury, so they are also usually safe to eat.
• Don't eat more than 6 ounces per week of canned albacore (white) tuna or tuna steaks because they have more mercury than canned light tuna. Eating oysters and clams may increase your risk for getting a harmful bacterial or viral infection. You should avoid eating them or make sure to boil them for at least 4 to 6 minutes (as you should do with all shellfish).
• Check local advisories about the safety of fish caught in local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish caught from local waters, but don't eat any other fish during that week.

What should I do if I don't feel like eating or if I have other digestive problems?

Morning sickness

Many women have morning sickness during the early months of pregnancy. (In most cases, symptoms of nausea and vomiting are less common by the second trimester.) In early pregnancy, the changes in your body can cause you to feel nauseated when you eat or smell certain foods or when you get tired or anxious. It may help if you:

• Eat 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 them.
• Try crushed ice, fruit juice, or fruit-ice pops if water makes you feel nauseous.
• Avoid unpleasant odors.
• Get enough rest.
• Ginger has been shown to help some women have less nausea, but you should talk to your health care provider about this before you add ginger to your diet.

Constipation

To help relieve constipation:

• Eat more fresh fruits, vegetables, high-fiber breads, and cereals.
• Get as much as exercise as you can. Walking and swimming are good choices.
• Try fiber supplements such as pysllium powder, Metamucil, or Citrucel. (You must drink plenty of fluids when taking these supplements.)
• Drink more liquids.
• Do not use laxatives unless your health care provider tells you to.

Diarrhea

• Try eating more yogurt, rice, dry toast, or bananas.
• Ask your health care provider about taking Pepto-Bismol or Maalox.

Heartburn

For heartburn you should:

• Eat 5 or 6 small meals a day.
• Avoid foods that commonly cause symptoms such as spicy and fried foods, orange and grapefruit juices, peppermint, garlic, and onions.
• Cut down on soft drinks, chocolate, coffee, and other drinks with caffeine. Drink instead water, 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 health care provider which antacids you can take.

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