Healthy Eating For Pregnancy and Lactation
Healthy Eating for Pregnancy and Lactation
Pregnancy is a time of tremendous change for a woman’s body. There are many factors that contribute to a healthy pregnancy. This article will focus on the nutritional needs during a woman’s pregnancy.
Calorie Requirements
Adequate caloric intake is very important during pregnancy. But how much extra does a woman really need? Weight gain during the first trimester occurs at a slower rate than weight gain during the second and third trimester, if at all. Many women may only gain between 3-4 pounds. Caloric intake is based on several factors including height, weight, activity level and nutritional status. To support the growth of the fetus, approximately an additional 300 calories a day is needed over pre-pregnancy requirements during the 2nd and 3rd trimester. However calorie needs of a pregnant women who started with a normal body mass index, may see their needs increase to as much as 500 calories a day more than their pre-pregnancy requirements in the final trimester due to a gradual increase in their resting metabolic rate throughout pregnancy.
300 extra calories looks like:
• Dry cereal with nonfat milk and a banana
• Peanut Butter sandwich (2 slices of bread, 1 Tbsp peanut butter)
• Plain Bagel
• Non-fat yogurt with a small spoonful of granola
Weight Gain
So how much weight should a woman really gain? The following numbers are basic guidelines to follow regarding weight gain. However each woman is different, with the key being that either too little or too much weight gain can be detrimental to the baby as well as the mother.
Underweight Women (BMI<19) 28-40 pounds
Average Women (BMI 19-24) 25-35 pounds
Overweight Women (BMI >25) 15-25 pounds
Twins 35-45 pounds
(How to calculate BMI: wt. in pounds/ht. in inches2 x 705)
Macronutrient Needs During Pregnancy
The proper combination of nutrients is just as important as the amount of nutrients a pregnant woman is consuming. Eating adequate amounts of carbohydrates as well as healthy fats and protein is very important for a positive pregnancy outcome. A pregnant woman should focus on nutrient dense carbohydrate foods such as whole grains, fruits and vegetables, and heart healthy fats as well as omega-3 fatty acids which aid in proper fetal development. Omega-3 fatty acids are needed for sufficient brain, vision and nervous development, especially during the last trimester when brain growth is the most rapid. The mother is the fetus’ sole source of omega-3; therefore it is very important to incorporate these into your diet.
• Good sources of omega-3: salmon, shrimp, white fish such as flounder, canola, flaxseed and soybean oil, walnuts, broccoli, spinach and pinto beans.
As far as protein requirements are concerned there is some debate as to how much is enough, especially if a pregnant woman is an athlete (which will be discussed in a later article). A good rule of thumb is to strive for approximately 1.0 g/kg of body weight per day. (weight in lbs. / 2.2 = weight in kg).
• Good Sources of protein include: lean meats, fish, poultry, nuts, eggs, beans, soy products, milk, cheese and yogurt.
Micronutrient Needs During Pregnancy
Pregnant women also need to focus on micronutrient needs. Not only should women include a daily pre-natal vitamin, but other nutrients need to be focused on such as folate and iron rich foods, as well as calcium. Folic Acid needs vary depending on a woman’s pregnancy status. Normal needs are 400 mcg/day, while needs are Pregnant 600 mcg/day and Lactating needs are 500 mcg/day
• Good sources of Folic acid: green leafy veggies, whole grain bread, enriched grains such as bread, cereal, pasta, also oranges and orange juice, nuts, seeds, dried beans/peas, and lentils
Iron needs increase as well when a woman is pregnant from a normal need of 18 mg/day to 27 mg/day when pregnant. A woman’s needs increase due to increase in blood volume. Iron is needed to make hemoglobin, which is found in blood and helps carry oxygen to the cells in the body, including your baby’s oxygen supply.
• Good sources of iron include: lean meats, poultry, fish, legumes, whole grains, dried fruit, and enriched grain products.
Meat sources of iron are best absorbed. To aid in absorption of meat/non-meat iron sources, consume iron with food that contains a good source of Vitamin C. Example: beef and broccoli.
Calcium needs are approximately 1000 mg day. Calcium is especially important in the 3rd trimester and during breastfeeding.
• Good sources of calcium: milk, yogurt, cheese, some tofu, green leafy veggies, fortified orange juice, and broccoli.
Fluid Needs
Proper amounts of fluid are also very critical during pregnancy. At least 8-10 cups of fluid a day are recommended. Food sources can also help meet this requirement through the consumption of fruits, vegetables and other foods that contain high water content. As far as caffeine consumption is concerned studies are conflicting. Some studies have shown caffeine to be detrimental especially in early pregnancy while others have not. A safe rule to thumb is to consume no more that one serving of caffeine a day or none at all.
Calorie Requirements During Breastfeeding
As a general rule of thumb, an additional 200 calories beyond your 2nd and 3rd trimester pregnancy intake, for a total of 500 calories, is recommended for adequate milk production during breastfeeding. This amount may vary depending on a woman’s activity level. It is also especially important to keep up with adequate protein and fluid intake during this time.
Other Breastfeeding Tips:
• Calcium is very important during breastfeeding. If you are not taking enough in, your body takes away from your own stores to give to the baby.
• Pay attention to the food you are eating as your baby may not tolerate all the flavors that are passed through your breast milk. Usual poorly tolerated foods are chocolate, spicy foods and caffeine.
• Aerobic exercise at 60-70% of maximal heart rate has no effect on lactation; however strenuous exercise, 80-90% of maximal heart rate, can result in lactic acid production and should be completed around 90 minutes prior to breastfeeding. Lactic acid can result in sour tasting milk that babies may not like. Many women express their milk prior to exercising to give to their babies after exercise.
• Nursing mothers should avoid shark, swordfish, king mackerel and tilefish. Shellfish, canned fish and smaller ocean fish or farm raised fish are best to choose from. 12 oz. of cooked fish a week is safe. Sushi should still be avoided to reduce the risk of viral and bacterial illness.
References:
Kline DA. Macronutrient Requirements during Pregnancy. Today’s Dietitian. January 2004, 6:1.
Dunford, Marie. Sports Nutrition, 4th edition. 2006; 318-333.
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