Pregnancy

PREGNANCY
During pregnancy and lactation, a healthy diet providing vitamins and minerals is important to support the growth of the foetus. There are increased nutrient requirements due to tissue development specific for pregnancy. Healthy eating prior to conception and during pregnancy can prevent problems that may arise during pregnancy such as nausea and vomiting.

What nutritional issues are important for pregnancy?

Before pregnancy: Folate is a vitamin that should be included in a healthy diet if planning a pregnancy. This vitamin helps protect against neural tube defects such as spina bifida. Choose foods such as bread and breakfast cereals fortified with folate. It is also recommended if you have diabetes to take a supplement of 5mg as soon as contraception is ceased or at least 2 months before conception. The folate supplement should be continued in the first three months of pregnancy.

Nutrition during pregnancy: A healthy balanced diet should be consumed to provide adequate energy, vitamins and minerals to support the growth of the foetus throughout pregnancy. In particular a woman's diet during pregnancy should include adequate calcium and iron. Pregnant women require 1100mg of calcium and 22-36mg of iron per day.

Tables 1 & 2 list foods that are high in iron and calcium.
If iron or calcium intake cannot be met, a supplement may be required.
Speak to you doctor or dietitian for further advice.

Table 1: Sources of Iron in the Diet

Haem Iron
Liver (85g)
Lean steak (100g)
Lamb chop (85g)
Lean pork (100g)
Lean chicken (100g)

Non Heam Iron
Bran flakes (1 cup)
Cashew nuts (40g)
Spinach (1/2 cup)
Baked bean (1/2 cup)
Lentils/chick peas (1/2 cup)

Iron (mg)
5.5
3.0
2.0
1.0
1.0

8.1
2.4
2.2
2.0
1.8

Haem iron is absorbed much more readily than non haem iron.
To assist in iron absorption include foods rich in vitamin C eg fruits, fruit juice.

Table 2: Sources of Calcium in the Diet

Food
1 Cup of milk (250mls)
5 Canned Sardines (75g)
½ Cup Canned salmon (105g)
1 Tub of Yoghurt (200g)
1 slice of cheese (20g)
½ cup of custard (140g)

Calcium (mg)
310
285
280
255
155
140

Are there any other issues I should be aware of during pregnancy?

Morning Sickness: during pregnancy, morning sickness may occur. To relieve nausea, try eating a dry piece of toast in the morning. Avoid drinking liquids with meals, drink these between meals. Try and eat small meals that are not greasy or spicy.

Alcohol: the effects of alcohol on an unborn baby are not well understood. It is recommended that alcohol intake should be minimised or avoided during pregnancy.

Listeria: is a type of bacteria that can affect your unborn baby. It is found in animals such as cows and sheep. This bacteria can be spread into meat and dairy products. Cooking food properly will kill this type of bacteria. It is recommended that foods such as soft cheeses (eg. Brie, Camembert or blue-vein) or unpasteurised milk are not consumed during pregnancy. Hard and processed cheeses (cream cheese, cottage cheeses) and yoghurt are safe to eat. Also avoid cold processed meats and prepared salads. If you are eating out, make sure hot food is heated thoroughly before eating.

Caffeine: during pregnancy can travel across the placenta to the developing foetus. Drinks such as coffee, tea and cola all contain caffeine. During pregnancy it is recommended that you consume no more than 2-3 cups of these drinks per day.

Herbal Teas: the effects of herbals teas have not been studied during pregnancy. It is therefore best to avoid these during pregnancy.

Mercury: is present in the environment due to industrialisation. Some investigations show mercury may have a potential adverse effect on an unborn baby. Pregnant women should therefore, as a precaution, limit their dietary mercury intake. Higher levels of mercury may occur in some larger types of fish (flake, swordfish, barramundi, ling or southern blue fin tuna). It is recommended that intake of these particular fish be limited to 4 small serves per week (1 serve=130g)

Nutrition after Pregnancy Nutrient requirements are still increased after giving birth, especially if breastfeeding. Calcium is one of the most important nutrients when breastfeeding, 1200mg of calcium is required every day. This equates to approximately 4-5 serves of calcium rich foods per day (refer to table 2). It is also important to increase your calorie intake as extra energy is required to make breast milk. Breastfeeding is an excellent way to assist you in returning back to your pre-pregnancy weight. Remember the extra calories you need during breastfeeding should come from healthy low fat foods.

Hypoglycaemia can be a problem in women with diabetes who are breastfeeding. This is often due to irregular timing of meals. Eating regular meals and snacks containing carbohydrate will help control blood glucose levels. Healthy carbohydrate snacks could include fruit bread, fruit, yoghurt and milk. It is important to have appropriate carbohydrates, such as jelly beans or ordinary soft drink close by to treat hypoglycaemia. If you are on insulin, doses may need to be adjusted. See your doctor or diabetes educator for further advice.