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Pregnancy nutrition - Healthy eating

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Pregnancy Nutrition; Yes mum, I am looking after myself

Eating healthily during pregnancy helps baby’s growth and development and well-being.  Not only must you eat well, but you need to eat carefully (avoiding unsafe foods) and eat more as baby grows (not a whole lot, but some).

Pregnancy and breastfeeding are nutritionally very taxing. Your body is making extra demands due to an increase in blood volume, cardiac output and changes in breast tissue to prepare for breastfeeding, hormonal changes, growth of the placenta and changes in a number of your major organs. It’s vital therefore that you eat well, ensuring not only your good health but that of your developing baby.

General recommendations for nutrition during pregnancy

Eating while pregnant is not that different from general healthy eating practices: your diet should be sensible, clean, varied and healthy. More specifically though, while pregnant, be sure to include the following:

  • Ample fruit and vegetables.
  • Lots of wholegrain breads and cereals (food is best if it resembles its original state, ie. same colour and so on).
  • Include lean meat, chicken and fish regularly and some protein in each main meal.
  • If you are vegetarian ensure you protein-combine and have at least two or more protein sources to get all the essential amino acids eg. Mexican bean burrito with cheese and low-fat cream cheese spread and salad.
  • Try to include some vegetarian meals each week (ensuing protein-combining principles).
  • Look for healthy fats such as those from nuts, seeds and fish and keep the unhealthy fats under control (pastries, processed meats and so on).  Enjoy a small handful of nuts and seeds each day.
  • Ensure you get healthy calcium-containing foods from dairy, tinned fish and calcium-fortified drinks.
  • Limit your sugar intake by cutting-down on foods with added sugar and by reducing the sugar you add to your meals and baking.  
  • The same goes for salt.

A special note on nutrition for teenage pregnancy

Adolescence is a period of dramatic growth and development in any young woman’s life. If you’re pregnant during this time you’ll need additional nutrients to support you. Unlike pregnant post-adolescent women, you and your baby may compete for the nutrients in your diet. Adolescent mums-to-be should consider this when planning meals; make sure you are eating enough to meet your own growing needs as well as your bub’s. Eating well will help you avoid undue stress and reduce the chances of your child being born premature or under-weight.

Is there anything I should avoid?

Yes, some foods should be avoided, such as certain cheeses, fish and even meat; we suggest you also review our safe eating in pregnancy tip sheet for more on this topic.  In general, it’s best to avoid a restrictive diet while pregnant or breastfeeding as it can affect the health and well-being of both mother and baby. Nutrient deficiencies will impact on a developing baby, and they can also affect your state of mind and overall health.  Stick to a good healthy diet and stay active (in relation to your pregnancy).

How many servings a day should I have of food groups?  

Government agencies have given serving guides of food groups for pregnant woman.

They include:

  • Three to four servings of fruits and vegetables (see Figure 1 for examples).
  • Nine servings of wholegrain or enriched bread, cereal, rice or pasta for energy.
  • Three servings of milk, yoghurt and cheese for calcium.
  • Three servings of meat, poultry, fish, eggs, nuts, dried beans and peas for protein.

Figure 1     Example servings for Pregnant Women

Cereals, breads etc (4-6 servings) Vegetables and Legumes (5-6 serves)
2 slices of bread Starchy Vegetables
1 medium roll 1 med potato or yam
1 cup of cooked rice, pasta, noodles ½ med sweet potato
1 cup porridge 1 med parsnip
1 cup breakfast cereal
½ cup muesli Dark Green Leafy Vegetables

½ cup cabbage, spinach, silverbeet, broccoli,
cauliflower or Brussels sprouts



Legumes and other vegetables

1 cup of lettuce or salad vegetables

½ cup broad beans, peas, green beans, zucchini, mushrooms,
tomatoes, capsicum, cucumber, sweetcorn, turnips, swede,
sprouts, celery, eggplant etc.


Fruit (4 serves) Milk, yoghurt, cheese & alternatives (2 servings)
1 piece med sized fruit eg. Apple, orange,
banana, mango, mandarin, pear, peach etc.		 250ml glass / 1 cup of milk (fresh, l/life or reconstituted)
2 pieces of small sized fruit eg. apricots,
kiwi fruit, plums, figs		 ½ cup of evaporated milk
Approx 8 strawberries 250ml (1 cup) custard
1 cup of diced or canned fruit 200g (1 small carton) of yoghurt
½ cup of fruit juice 1 cup of calcium-fortified soy milk
½ med sized melon (rockmelon, honeydew) 30-40g of hard cheese (2 slices)
Dried fruit eg. 4 dried apricots ½ cup pink salmon (with bones)
1 ½ tablespoons sultanas 1 cup almonds
Approx 20 grapes or cherries
Lean meat, fish, poultry, nuts & legumes(1 ½ serves) Extras/ “treats” (0-2 ½ serves)
65-100g cooked meat or chicken (eg. ½ cup mince,
2 small chops or 2 slices roast meat)		 1 med piece of sponge or bun cake
80-120g cooked fish fillet 3-4 sweet biscuits

Half a regular sized chocolate
Alternatives 60g jam, honey (1 tablespoon)
2 small eggs 30g potato crisps (1 small snack packet)
1/3 cup cooked beans, lentils, chick peas,
split peas or canned beans		 ½ slice of pizza
1/3 cup peanuts or almonds 1 can of soft drink

2 glasses of cordial

2 scoops of ice cream

1/3 of a meat pie



           Source:  Adapted from “Food for Health” - Dietary guidelines for Australians (Australian Government)

What about fish? How much is safe?

One of the concerns about eating fish is exposure to toxins, namely mercury, which can be dangerous to your bub. So, while the dietary guidelines recommend one to two fish meals a week, this can vary depending on the type of fish.  However, fish such as billfish (swordfish/broadbill and marlin), shark/flake, orange roughy and catfish are in a different league, there are clear limitations on the consumption of these fish.

FSANZ advises that pregnant women, women planning pregnancy and young children continue to consume a variety of fish as part of a healthy diet but limit their consumption of certain species which are listed below.  Keep in mind that this advice is based on fish in Australian waters and population, so if you are purchasing fish from other regions this may not be relevant. 

According to Food Standards, a pregnant women should:

  • Limit to one serve (150g) per fortnight – billfish (swordfish, broadbill and marlin) and shark (flake), with no other fish eaten in that fortnight.
  • Limit to one serve (150g) per week – Orange roughy (deep sea perch) or catfish, with no other fish eaten that week.
  • Don’t worry if you’ve had the odd meal of fish with high levels of mercury. It’s only a potential problem if you eat that type of fish regularly as this can cause a build-up of mercury in your blood.

Go to the American Pregnancy Association website for an extensive listing of mercury levels in fish.

Alcohol in pregnancy - What about the odd tipple?

There is clear evidence that consuming alcohol during pregnancy can affect your baby as it’s linked to low birth-weight, miscarriage, and other serious concerns.  Recently, most agencies have updated their recommendations to suggest the avoidance of alcohol during pregnancy.  

Do I need to eat for two?

Thankfully, that myth is being dispelled!  During your first trimester you aren’t required to eat any more than normal.  Once you are into your second and third trimesters you may require a few more calories (about 600kJ or 140 calories a day, this is equivalent to a small snack). We can’t be any more specific about quantities as each individual’s needs will vary. But if you make nutritious food choices, you should ensure a healthy diet.

What extra foods and nutrients do I particularly need?

Folic acid (folate)

Folate is a B-group vitamin found in a variety of foods. Folate (B9) reduces the chance of your baby developing brain and/or spinal cord defects, and is therefore essential not only in a pregnant woman’s diet but in the diet of any woman of child-bearing age (15-45).  This vitamin is required for the normal development of the nervous system, particularly the closure of the neural tube which occurs during the first 6 weeks of pregnancy.  Women may not know that they are pregnant for up to 4 weeks, so ensuring adequate nutrient intake of folate around the time of conception is also important. For this reason the National Health and Medical Research Council (NHMRC) recommends that all women planning a pregnancy should take at least 400 mcg of folate daily for one month prior to planned conception (women at higher risk may be advised to take more). Supplementation should continue throughout the first trimester. If the neural tube fails to properly close, birth defects such as spina bifida can occur – these defects affect one in five hundred pregnancies in Australia.

When folate is added to food it’s known as folic acid, and many labeled products are now fortified with B9. Many of our breakfast cereals, breads and juices are fortified with folic acid.

 Sources of folate

Food Groups

Excellent Source

Very Good Source

 Good Source
Vegetables Asparagus Leeks Parsnips
Legumes Broccoli Cabbage Potato
Nuts and beans Brussel Sprouts Cauliflower Parsnips

Chick Peas Peas Potato

Dried Beans Wheat Germ

Spinach Leeks

Asparagus Cabbage

Broccoli Cauliflower

Brussel Sprouts



As well as including folate in your diet, supplementation is also worthwhile.   Pop in to see your local chemist to discuss which supplement is best for you and your baby.  

What about iron?

Despite not having a menstrual cycle while you are pregnant, your baby will be busily storing iron that he or she will use for up to 6 months after birth.

Foods such as red meat, liver, kidney, broccoli, peas, bran, oats and enriched breads are great sources of iron and should be incorporated into your daily diet. Alternatively, vegetarians can obtain some iron through tofu, pumpkin seeds, peaches, sesame seeds or tahini.

Keep in mind that vitamin C assists in the absorption of iron, so enjoy vitamin C-rich foods such as guava,  red capsicums, blackcurrants, strawberries, oranges, watercress, cabbage (savoy), Brussel sprouts, kiwi fruit, paw paw, broccoli, cooked tomatoes, cauliflower and so on.

It is general practice that you will have your iron levels checked twice during your pregnancy.  While iron is commonly low in pregnant women, it’s also important to understand how much you need in order to keep your iron within a healthy range.  More is not better.  Check with your healthcare professional for the recommended dosage.

Not too much vitamin A

Excessive vitamin A intake can be detrimental to the development of your baby, hence we recommend that you avoid taking supplements (vitamin pills) unless approved by your healthcare professional. Your vitamin A requirements do not change during pregnancy, but it may be wise to keep an eye on how much vitamin A-rich food you consume.

Do I need more calcium?

The latest guidelines now suggest that even though there is a ‘shift’ of calcium from you to baby – who is laying down bone structure during the third trimester – it seems your body copes by improving its ability to absorb calcium from your diet.

So, the recommended dietary intake for non-pregnant women (1,000mg per day for women aged 19–50 years and 1,300mg per day for adolescents) remains unchanged during pregnancy and breastfeeding. Dairy foods such as milk, cheese and yoghurt; calcium-fortified soymilk; and tinned fish with bones are excellent dietary sources of calcium.

Should I take a multivitamin supplement?

It’s always advisable to seek professional advice if you’re considering taking a supplement during pregnancy and breastfeeding.  In some cases, vitamins and minerals can mask deficiencies or even interact with medications. 

Your healthcare professional might recommend a multivitamin supplement if you fit into the following categories:

  • Vegetarians.
  • Teenagers who may have an inadequate food intake.
  • Women with an inadequate diet or under stress or those who smoke or are exposed to other chemicals either by trade or geography.
  • Substance misusers (of drugs, tobacco and alcohol).
  • Obese pregnant women who are restricting their energy intake to prevent large weight gains.

Tips to cope with nausea and vomiting during pregnancy

Most expectant mothers experience only mild morning sickness, yet for some mothers-to-be this is not the case.  Even this author can count herself as one of the unlucky few who experienced the extremes of morning sickness.  So, while of course some of these tips may help, in honesty sometimes nothing short of intervention (for example by medication) can relieve extreme morning sickness. 

Naturopaths suggest that it is the hormonal changes and increased hormonal activity that places a burden on the detoxifying functions of the liver, leading to an ‘overflow’ that causes morning sickness.  Although this certainly makes perfect sense to me, it’s a little bewildering because as a pretty clean-living person who rarely drinks or eats junk and doesn’t smoke, why doesn’t my liver cope better? Medically, it is still considered unclear.  Some practitioners believe it is a blood sugar issue, therefore the advice to eat before rising and to consume low-GI foods. 

So, here are my tips:

  • Eat a protein-containing snack before retiring at night, for example, a smoothie with yoghurt and fruit.
  • Eat a dry cracker or toast before rising from bed and get up slowly.
  • Stay well-hydrated, but drink in between meals rather than with to avoid bloating.
  • Eat small but very regular meals (this will also be helpful when bub starts to encroach on the abdominal space).
  • Sea-sickness wrist bands (available from chemists).
  • My personal favourite was acupuncture.
  • There are some nutritional supplements made for morning sickness that have B6, ginger and other elements.
  • Ginger is commonly used for nausea and sea-sickness so you may like to trial a tea made with freshly grated ginger or a pinch of ginger powder; you also might add it to cooking.
  • Eat ginger biscuits.
  • Drink flat ginger ale.
  • Watch out for fatty and spicy foods as they can upset your tummy further.
  • Relaxation techniques may help.
  • Slowly sipping on a fizzy drink has been helpful for some.

Heartburn

You may find as you progress through your pregnancy and space is at a premium that heartburn becomes an issue.  Try to:

  • Avoid too much tea and coffee (or, at the very least, opt for naturally decaffeinated brands).
  • Try not to eat late at night.
  • After eating avoid too much bending, lifting or lying down.  Try to stay partially upright to allow the passage of food to move down with the assistance of gravity.  
  • You may also like to talk to a healthcare professional, for example a naturopath, about some digestive enzymes such as plant-based enzymes or other nutritional supplements that aid digestion.

Happy pregnancy, birth and beyond!

references:

This information has been provided by Leanne Cooper from Cadence Health. Leanne is a qualified nutritionist and mother of two very active boys. Thank you to Christian McErvale for his research

This information should not replace the expertise of qualified health professionals.  Always check for relevant credentials when sourcing fitness and health professionals.