This is a big topic for one blog so I have saved all of the discussions on recommended use of vitamin and mineral supplements in pregnancy for a separate blog. I have also assumed you will have come across the long list of foods to avoid in pregnancy and made your own decisions as to alcohol.
In this blog I wanted to concentrate on helping you get the best out of your diet for your baby. I hope you find it useful.
What difference will good nutrition during pregnancy make?
The links between nutrition in the uterus (and early life) and later health outcomes of both the child and future grandchild, are complex and fascinating. The concept of ‘nutritional programming’ suggests that there are particular periods in early development whereby nutrient supply (or lack of) may alter the future risk of chronic diseases in the child. If you are a bit of a geek (like me!) you can find out more about this from the SACN report on ‘Early Life Nutrition’. This isn’t anything to be overly anxious about. Looking after yourself and eating a good quality diet needn’t be rocket science.
What does healthy eating during pregnancy look like?
In short it looks a lot like healthy eating at any other time……and it’s not all about eating Wheatgrass, Chia seeds and Kale!
You want to be including all of the major food groups in the diet.
You want to be eating regularly throughout the day and avoiding long periods without food.
There is no good time for faddy diets, but pregnancy is a particularly risky time to be following any type of restrictive eating pattern! Avoid very low carbohydrate diets or those that promote exclusion of any food group unless this is clinically indicated e.g. in the case of coeliac disease or food allergies, where it might be worth getting some additional advice to ensure your baby won’t be lacking any key nutrients as a result.
Top tips for healthy eating:
- Have a regular meal routine of three meals each day with one or two planned snacks.
- Include a sensible portion of carbohydrate at each mealtime. Wholegrain varieties may help with constipation. Ensure breakfast cereals are Iron fortified. Particular care to avoid very large portions of carbohydrates will be required for those with gestational diabetes, who might also benefit from choosing those carbohydrates with a lower glycaemic index.
- Aim for at least five servings of fruit and vegetables per day, but more if possible. You can use fresh, frozen, tinned and dried fruit and vegetables.
- Include milk, cheese or yogurt three times per day. This is to ensure adequate calcium and particularly iodine which is important for your baby’s brain development. Note: non-dairy milks such as soy milk, nut milks and oat milks contain virtually no iodine. If you use these regularly in place of dairy you’ll need to make sure you eat other good sources of iodine such as eggs and fish
- Include two to three servings a day of protein-rich foods such as meat, fish, eggs, nuts, beans, lentils and pulses. Limit your intake of processed meat (i.e. meat preserved by smoking, curing or salting or addition of chemical preservatives) such as bacon, sausages etc.
- Go for unsaturated fats such as olive and rapeseed oils and spreads and use sparingly.
- Good snack choices include – Fresh or dried fruit, nuts, Vegetable sticks e.g. carrot, cucumber, pepper, baby corn and dips based on yogurt, cream cheese or hummus, Wholegrain breakfast cereals with milk, Cheese with crackers or crispbread, Nut butter on Toast, Yogurts, Crumpets, scones, currant buns, teacakes and scotch pancakes
- Aim for around six to eight drinks per day (1.5-2 litres) to provide adequate fluid to prevent dehydration. More drinks may be needed in hot weather and after physical activity.
Particular foods I get asked about a lot when it comes to nutrition and pregnancy
Oily Fish –
Oily fish is important in the diet in pregnancy as the particular Omega-3 fatty acids it contains are important for the developing baby. It is also a valuable source of Iodine and Vitamin D, both of which can be difficult to source elsewhere in the diet (particularly if you avoid dairy). However, the potential for exposure of the foetus to high levels of methylmercury (MeHg) in the uterus when consuming certain types of fish have made this a confusing area for pregnant women to know what to do for the best.
Current advice is for pregnant women to eat at least two servings of fish per week, one of which should be oily fish. You should avoid eating shark, marlin or swordfish, and limit consumption of fresh tuna to two 140 g portions/week. Limit consumption of canned tuna to four 140 g portions/week.
Examples of low mercury oily fish are mackerel, herring, pilchard, sardine, trout and salmon. Other low mercury fish are cod, haddock and plaice. Generally speaking the smaller fish tend to accumulate less mercury, so sardines on toast is a good way to go (and this rings true for when you introduce fish to your baby’s diet during weaning as well). Walnuts are also a good source of Omega-3 and are a useful snack option for those who dislike oily fish.
Current guidance is to limit caffeine intake in drinks and food to less than 200mg/day, e.g. four small cups of tea or two mugs of instant coffee. Also consider that cola, energy drinks and chocolate will also be sources of caffeine.
This advice came about as a result of two studies which indicated that high maternal caffeine intake is associated with an increased risk of adverse birth outcomes (spontaneous abortion, stillbirth, low birth weight and small for gestational age) but not preterm delivery. However, the evidence surrounding this remains inconclusive.
Soya Products –
When taken in amounts commonly found in foods, soy is safe to eat during pregnancy. In fact, it is a valuable source of protein and calcium for many women who avoid or limit their intake of animal products.
Soy protein or isoflavone supplements are not recommended during pregnancy as a high intake of isoflavones are mildly estrogenic and could potentially adversely affect fetal development.
Flaxseed has the potential to exert mild estrogenic effects during pregnancy due to the phytoestrogen effect of the lignans. Until more information is known it is prudent for pregnant women to limit their daily intake of flaxseed and flaxseed oil to amounts commonly found in foods and avoid using very large doses of whole or ground flaxseeds and their oils (up to 2 tbsp/day of flaxseed or 1tbsp/day of oil should be safe).
Artificial Sweeteners –
The following sweeteners have been approved by the E.U. for use during pregnancy and breastfeeding at or below their Acceptable Daily Intake (i.e. in sensible amounts): Acesulfame potassium, aspartame, stevia glycosides, sucralose, cyclamate and saccharin, sorbitol, sorbitol syrup, hydrogenated starch hydrolysates, mannitol, isomalt, malititol, maltitol syrup, lactitol, xylitol and eryritol. These represent the sweeteners commonly available in the UK food industry.
In Summary –
Pregnancy is often a time when we start to think a bit more about the foods we eat. Taking some time to reflect on your current patterns of eating, and adopting some healthier habits where you need to, can be very beneficial for both you and your babies wellbeing, especially when you consider that in a year’s time your baby will be developing their own relationship with food and using you as a role model! Scary stuff!
Carly Atkinson is a Registered Dietitian with 14 years post-graduate experience working in the NHS and an MSc in Advanced Dietetic Practice. She currently runs workshops in Cheltenham for parents and carers on Weaning and Fussy Eating, and delivers training and menu guidance to Early Years Settings. Her aim is to provide evidence-based, accessible and practical information on infant nutrition to parents and carers to provide the best start for the children they care for. You can find out more at facebook.com/babybrightstart or babybrightstart.com