As soon as you become pregnant it can feel like you're suddenly traipsing through a nutrition minefield. You MUST eat this! You MUST NOT eat that! Menu options get whittled down as rare steak sandwiches and soft cheeses are dodged.
Although pregnant women are no longer advised to eat for two in terms of quantity, when it comes to the quality of food, it's actually really important to remember whatever you're putting in your body needs to benefit your baby, and also not pose any danger to them. In fact, most of the foods pregnant women are told to avoid don't cause significant risk – but a risk is there, nevertheless.
Diet in general
A good diet consists of lots of fruit and vegetables, starchy carbohydrates (pasta, bread, rice, potatoes and so on), grains, protein-rich foods (not only meat and oily fish, but also pulses), and dairy (milk, yogurts and cheese).
We've all heard about the five-a-day rule, but the Food Standards Agency has also developed the eatwell plate, which illustrates the ideal proportions of each food group.
The general consensus is that we should eat three nutritious meals a day, and have healthy snacks in between if necessary. When you're pregnant though, the amount you eat, when you eat and what you can stomach can vary wildly. As long as you are eating sensibly, not letting yourself get hungry, and not scoffing too many sugary, fatty and salty foods, you should do just fine, and gain the correct amount of weight as your pregnancy progresses.
Should I take supplements?
Normally, a well-balanced diet would provide you with all the essential vitamins and minerals your body needs. However, during pregnancy, it is advisable to top up on certain nutrients.
It's recommended that mums-to-be take 400mcg of folic acid each day during their first trimester (many women start taking it before conceiving, too). Although certain foods (including green leafy vegetables and brown rice) contain the substance, an additional dose can help to prevent neural tube birth defects, including spina bifida.
It is also recommended that pregnant women take a vitamin D supplement, 10mcg a day. Vitamin D will help to keep your bones strong and healthy during pregnancy, and will also give your baby a boost of vitamin D for the first few months after they are born.
It's not uncommon for pregnant women to lack a little in iron (your blood might be checked from time to time) and this is called anaemia – it will leave you tired and lacking in energy. An iron supplement can fix the problem and you midwife will advise you. And calcium can also be beneficial – growing your baby's bones and teeth can really take it out of you, so topping up is a good idea.
Obviously, with all those to consider, it makes sense to opt for a multi-vitamin – but do make sure whatever you buy is suitable for pregnancy; normal multivitamins might include vitamin A (retinol), which can be harmful for unborn babies in large quantities. Incidentally, only the retinol (animal-derived) form of vitamin A is potentially harmful; vitamin A that comes from beta carotene (found in carrots, for example) is fine – carrot and coriander soup can stay on the menu.
If you are vegetarian or vegan, your midwife might refer you to a dietician to evaluate your diet, and to give you extra supplements that might be considered lacking.
What should I avoid?
There are various foods best avoided when pregnant because they might pose a risk to your unborn baby:
Soft cheeses and dairy
You should not eat any cheese with a white rind (such as brie or camembert) or with blue veins (such as stilton), because all these contain mould, which can contain listeria.
Although rare, listeriosis during pregnancy can cause miscarriage, stillbirth and serious illness in newborns.
You may eat hard cheeses, and non-mould cheeses as long as they are made with pasteurised milk. In terms of other dairy products, such as milk and ice cream, avoid anything unpasteurised.
Undercooked eggs and meats
There is a small risk that eating undercooked eggs could lead to salmonella poisoning, so always make sure they are cooked right through. The Department of Health is also now advising that pregnant women should not eat rare meat of any sort, because there is a small risk it could lead to toxoplasmosis, an infection which could harm your baby. So all meats need to be cooked thoroughly, and steaming hot.
Liver and paté
Don't eat any liver while you are pregnant, as it can contain high levels of retinol. Paté must also be avoided – and not only liver paté – even vegetable patés might contain listeria.
Fish and shellfish
Some fish contain high levels of mercury and should not be eaten: shark, marlin and swordfish. Those three might not make a regular appearance on your dinner plate anyway, but tuna might do, and this too needs to be limited – no more than four small-medium cans (or two fresh tuna steaks) a week. Shellfish can be eaten, as long as it is thoroughly cooked – don't eat raw shellfish, such as oysters. And sushi can be eaten but ONLY if the fish which has been used to make it has been previously frozen (because the freezing kills any parasitic worms which might be present).
If you're a coffee fiend, you'll be pleased to know you don't have to cut it out completely, but you do need to watch the amount of caffeine you consume (because too much can cause low birth weight) – you should be having no more than 200mg daily.
A mug of instant coffee is likely to contain around 100mg. Of course, caffeine is not only found in coffee – it's also in tea, cola and energy drinks, and chocolate. Some medications for colds and flu contain caffeine, but you should not take these during pregnancy before speaking to your midwife or GP.
The best advice is to avoid alcohol completely, but if you do drink any, keep it to one or two units, once or twice a week.
Is my baby getting everything they need?
If you eat a balanced diet, and take the recommended supplements, then yes! Growing a new human being is hard work, but when you are pregnant, your body becomes amazingly efficient in terms of distributing and using the energy you gain from your food.
At various stages during your pregnancy you might feel ravenously hungry, or no more hungry than usual; during the final trimester, you might need to eat an extra 200 calories or so per day (which might come in the form of an extra snack), but let your appetite guide you.
If you are concerned because morning sickness is making it impossible to keep food down, see your doctor.
Be sure to attend all your antenatal appointments, when the midwife will measure your bump to see your baby is growing well. And take the opportunity, if you are worried about any aspect of your diet, to ask for advice.
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