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Why is nutrition so important?

• Meet increased nutrient demands
• Provide needed energy
• Prevent or minimize common pregnancy-related
  problems
• Reduce risk of birth defects
• Supply needed nutrients for babys growth
• Ensure healthy birth weight
• Maintain a healthy weight

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Key Components of a Healthy Pregnancy

• Appropriate weight gain
• Consumption of a variety of foods
• Vitamin and mineral supplementation
• Avoidance of alcohol, tobacco and other harmful
  substances
• Safe food handling

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Recommended Weight Gain

• Underweight 28-40 lbs
• Normal weight 25-35 lbs
• Overweight 15-25 lbs
• Obese at least 15 lbs
• Twins 35-45 lbs
• Triplets 50 lbs

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Normal Pregnancy Weight Gain

• Breast 1-1.5 lbs
• Blood 3-4.5 lbs
• Extra water 4-6 lbs
• Uterus 2.5-3.0 lbs
• Placenta/amniotic fluid 3.5-5.5 lbs
• Baby 7-8 lbs
• Fat stores 4-6.5 lbs
• Total 25-35 lbs

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Risks of Low Weight Gain

• Low weight gain in second or third trimester
  increases risk of intrauterine growth retardation
• Low weight gain in third trimester increases risk
  of preterm delivery

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Guidelines for teenagers

• Higher weight gains and greater postpartum weight
  retention is common if mother is still growing
• Maternal growth in multiparous teenagers is
  associated with lower birth weights

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Consume a variety of foods

• Grains
• Vegetables
• Fruits
• Milk
• Meat and Beans

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Typical Plate
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Reconstruct Your Plate
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MyPyramid
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Minimum Servings During Pregnancy

• Grains (9 ounce equivalents)
• Vegetables (3 ½ cups)
• Fruits (2 cups)
• Milk (3 cups)
• Meat and Beans (6.5 ounce equivalents)
• Pregnant teenagers may need an additional
  serving from this group

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Eating for Two!!

• 300 calories/day during 2nd and 3rd trimester
• 300 calories
• ½ sandwich 1 c. milk/yogurt OR
• 1 c. cereal 1 c. milk banana OR
• Peanut butter on 2 slices toast 1 c. milk

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Proper nutrition

• Major Nutrients
• Carbohydrates
• Protein
• Fat
• Vitamins
• Minerals
• Water

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Carbohydrates

• Sugars and starches
• Bodys primary source of energy
• Fruits, breads, some vegetables, grains, milk
• Should make up 60-70 of total daily calories
• Carbohydrates do not make you fat

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Fat

• Source of stored energy burned during
  activity
• Makes you feel full and no longer hungry
• Helps the body absorb fat soluble
  nutrients
• Choose healthy fats
• 20-25 of total calories (use sparingly)
• Contains most calories per gram

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Protein

• Builds and repairs the body
• Used for energy if the diet is inadequate in
  carbohydrates
• Found in fish, poultry, meats, tofu, nuts, beans,
  eggs, milk, cheese
• Need 10 grams more per day in pregnancy
• 10-20 of total calories

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Water

• 60-75 of body weight
• Stabilizes body temperature
• Carries nutrients to and waste away from cells
• Needed for cell function
• 8-10 cups/day

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Fiber

• Fiber Whole grains, fruits, vegetables
• Wheat bread check the label
• Fruit vs. Juice
• Stabilizes blood sugar
• Protection from diabetes, constipation and
  diverticulosis
• lowers LDL cholesterol
• 25-35 grams/day

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Vitamins and Minerals

• Body does not make most vitamins
• Good source Deep colored fruits and vegetables
• Fresh, frozen, canned
• Multivitamin/Multi-mineral supplements
• B Vitamins
• Iron

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• Special Interest Nutrients

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Vitamin B12

• Generally adequate amounts are obtained through
  animal products
• Fish, eggs, milk, meats, etc.
• Vegans that do not have any animal products in
  their diet need supplementation
• Works with folic acid in cell growth and is
  essential to the normal development of the infant

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Folic Acid

• A supplement taken 1-3 months prior to conception
  and during first 6 weeks gestation reduces the
  risk of neural tube defects, cleft palate/lip
• 400 micrograms per day of synthetic folic acid
  needed per day (pregnant women and those of
  childbearing age)
• Folic acid in fortified foods and supplements is
  better absorbed by the body
• Needed for rapidly dividing cells, protein
  metabolism, and formation of red blood cells

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Food Sources of Folic Acid

• Fortified breakfast cereals
• Dried beans
• Liver/meats
• Spinach and green leafy vegetables
• Citrus fruits and juices
• Whole-wheat bread

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Iron

• Needed for the formation of red blood cells
• 15 milligrams a day for woman during childbearing
  years recommended
• Iron supplement (30 mg/d) recommended for
  pregnant women
• Typical American diet 10-11 milligrams a day

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Food Sources of Iron

• Meats
• Fish
• Poultry
• Legumes

• Whole-grain and enriched breads
• Iron-fortified cereals
• Dark greens
• Dried fruits

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Calcium

• Calcium absorption doubles early in pregnancy
• Is used in the formation of fetal bones
• Will be absorbed from maternal bones if not
  enough calcium in diet
• Calcium absorption increases with Vitamin D
• Calcium and vitamin D supplements sometimes
  needed

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Food Sources of Calcium

• Milk (skim, low-fat)
• Yogurt (low-fat)
• Oysters
• Shrimp
• Calcium-fortified apple and orange juice

• Collard greens
• Broccoli
• Turnip greens
• Sesame seeds

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Multivitamin and Mineral Supplements

• Recommended for
• Women who smoke or abuse drugs
• Women with iron deficiency anemia or poor quality
  diets
• Women who eat animal products rarely or not at
  all (such as vegans)
• Vitamin B 12 supplement important for vegans

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Food Additives and Ingredients

• Use of sweeteners that are Generally Recognized
  as Safe (GRAS) is acceptable
• Pregnant women should moderate intake of
  saccharin
• Aspartame intake within Food and Drug
  Administration guidelines is safe during
  pregnancy
• Women with PKU should avoid aspartame
• Moderate consumption of cured meats and other
  foods rich in nitrosamines
• MSG consumption not thought to pose a health risk
  to mother or child

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Foods to Avoid

• Fish containing high levels of mercury (shark,
  swordfish, king mackerel, and tilefish)
• Raw or undercooked fish
• Raw or undercooked shellfish
• Raw eggs or dishes containing raw or partially
  cooked eggs

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Foods to Avoid (cont.)

• Raw or undercooked meat and poultry
• Sushi
• Pate
• Soft or blue-veined cheeses
• Unpasteurized cheeses and juices
• Deli meats

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Things to Avoid During Pregnancy

• Alcohol
• Cigarettes
• Recreational drugs
• Over-The-Counter Medications or Herbal
  Supplements
• Consult health care provider
• Caffeine
• Consult health care provider

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Alcohol

• Women who are or may become pregnant should not
  drink alcohol
• A safe level of alcohol intake has not been
  established at any stage during pregnancy

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Risks of Drinking During Pregnancy

• Major birth defects (Fetal Alcohol Syndrome)
• Mental retardation
• Learning disabilities
• Impaired fetal growth
• Lower Apgar scores
• Possible reduction in fertility

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Smoking during Pregnancy

• Limits oxygen supplied to the fetus
• Reduces birth weight of the infant
• Increases the risk of pre-term delivery
• Increases the risk of perinatal mortality
• Passive exposure to tobacco smoke may also reduce
  infant growth
• Associated with mental retardation and nicotine
  addiction in the fetus

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Herbal and Botanical Supplements

• Consider herbal treatments as suspect until
  safety during pregnancy is confirmed
• American Academy of Pediatrics recommends
  limiting consumption of herbal teas (two 8-oz
  servings in filtered tea bags) during pregnancy

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Common Pregnancy Problems
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Nausea and Vomiting

• Avoid strong odors
• Eat before getting out of bed crackers, plain
  toast, or dry cereal
• Avoid an empty stomach
• Eat easy-to-digest foods
• Eat slowly
• Snack before bed
• Try lemon, ginger tea, lemonade, ginger ale,
  Sprite, 7-up etc. to settle stomach

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Constipation

• Hormonal changes slow down the intestine
• Drink 8-12 glasses of water everyday
• Eat high-fiber foods
• Try dried plums, prune juice, or figs
• Be as physically active as possible
• Do not use laxatives unless prescribed by health
  care provider

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Heartburn

• Eat small meals frequently
• Cut down on caffeinated and carbonated beverages
• Eat slowly in a relaxed environment
• Do not lie down after eating
• Prop head of bed up
• Wear loose-fitting comfortable clothes
• Avoid gaining too much weight
• Talk to doctor before taking antacids

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Swelling

• As blood supply increases, legs, feet, and arms
  may swell
• Drink plenty of fluids, especially water
• Avoid diuretics, unless prescribed by health care
  provider
• Elevate your feet whenever possible
• Wear loose-fitting shoes and clothes

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Pica (nonfood cravings)

• Some pregnant women develop cravings for nonfood
  substances like clay, dirt, ice, or laundry
  starch
• This does not reflect a physiological need for a
  particular nutrient
• Pica is especially common in African American
  women
• Pica may lead to iron-deficiency anemia,
  malnutrition and lead exposure (brain damage)

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Gestational Diabetes

• Some women develop diabetes during pregnancy
• Gestational diabetes occurs in the latter half
  (after 24 weeks) in 7 of pregnancies
• Increases risk of delivering infants large for
  gestational age

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Pregnancy-induced Hypertension

• Calcium Supplements may be beneficial
• Risk factors include
• Chronic Hypertension
• Preeclampsia in a previous pregnancy
• First Pregnancy
• Younger than 20 years old
• Older than 40 years old
• Obesity
• Genetic factors

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Questions??
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References

• Position of the American Dietetic Association
  Nutrition and lifestyle for a healthy pregnancy
  outcome
• Krauses Food, Nutrition, and Diet Therapy
• Nutrition for Women The Complete Guide
  Elizabeth Somer, MA, RD
• What to Expect When You Are Expecting Eisenberg,
  Murkoff, and Hathaway