Healthy Eating and Pregnancy

Although a healthy diet is important to everyone, it is especially important when trying to conceive or if you are pregnant.

A healthy diet requires regular meals and snacks.  You should aim to eat food that comes from each of these areas:

Fruit and Vegetables are a great source of vitamins and minerals and also fibre which aids digestion and helps to prevent constipation.  You should aim to have at least five portions a day.  It is important to make sure that you always wash your fruit and vegetables carefully.

Carbohydrates are foods like bread, rice, potato, pasta, couscous, noodles, oats, maize, breakfast cereals and other starchy foods.  This type of food can be very filling but do not have too many calories.  They are a good source of fibre and vitamins.  These foods should be the main part of every meal.

Protein comes from meat, fish, eggs, beans and pulses.  You should eat a moderate amount of protein every day as these are good sources of nutrients.  You should try to eat two portions of fish each week and aim for one of these to be oily fish – however there are some types of fish that need to be avoided in pregnancy – please see ‘Foods to be avoided’.  It is vital that you ensure all meat, fish and eggs are cooked properly and that there is no pink meat or juices.

Dairy foods include milk, cheese and yoghurt.  These are important foods as they contain calcium and other nutrients that you baby needs to grow.  You should aim to eat/drink two or three portions every day.  It is recommended to use the low-fat version if possible, e.g semi-skimmed milk.  However – again there are some cheese that must be avoided in pregnancy.  Please see ‘Foods to be avoided’ below.

Fat -rich and sugary foods should be eaten with caution and in small amounts.  These include all spreading fats, oils, salad dressings, cream, cakes, chocolate and fizzy drinks.

Fluid – It is important to have at least eight medium glasses of fluid – such as water – a day.
Eating for two
You may find yourself getting hungry more often than you used to.  However, there is no need ‘to eat for two’; your energy needs only actually increase during the third trimester and only by approximately 250 calories a day.

However, if you do feel more hungry, you could try having smaller amounts at each meal and trying to have a few healthy snacks throughout the day.  There are many snacks that you can try including

•    Fresh Fruit
•    Salad vegetables e.g. carrot/celery
•    Low fat yoghurt
•    Hummus with bread/vegetable sticks
•    Ready-to-eat apricots, figs
•    Vegetable soups
•    Porridge or ‘healthy’ cereals

Foods to be avoided
There are a few foods that are best avoided when pregnant because they may make you ill or harm your baby.  However, if you have eaten some of these foods before knowing you were pregnant, do not worry or panic, ask your midwife for advice if you are worried and avoid them in future.

  • Some types of cheese – You should not eat any unpasturised mould-ripened soft cheeses such as brie or camembert.  You should also avoid any soft unpasturised blue-veined cheese.  These cheeses are made with mould and therefore can contain a type of bacteria called listeria, though many of the supermarket bought soft cheese are pasturised and therefore safe to eat – check the packaging to make sure.  Listeriosis is a rare infection but even a mild bout of it can cause miscarriage, stillbirth or severe illness in a new-born baby.  However – you can eat hard cheeses such as cheddar or parmesan and also processed cheese if it is made from pasteurized milk, for example mozzarella, cottage cheese and cheese spreads.
  • Raw or undercooked meat – It is important to make sure that all meat is cooked properly and thoroughly.  However, it is okay to eat steak and other whole cuts of beef or lamb rare, as long as the outside has been properly cooked or sealed.
  • Raw or partially cooked eggs – It is important to make sure that eggs are thoroughly cooked and that both the yolk and the white are solid.  Avoid foods that contain uncooked egg such as home-made mayonnaise.
  • Pate – Pate can contain listeria.  It is best to avoid all types of pate including vegetable pates.

Liver products and Vitamin A – Do not eat liver or liver products as these contain a lot of vitamin A.  Also avoid any vitamin supplements that contain fish liver oil or vitamin A. Whilst some Vitamin A is important in pregnancy but too much can cause birth defects and liver toxicity.

  • Unpasteurised milk – Do not drink unpasteurised milk or products that contain it.  If you find yourself in a situation where only unpasteurised milk is available; boil it before drinking.
  • Some types of fish – Most fish is okay in pregnancy and recommended, however, do not eat shark, marlin or swordfish.  You must also limit the amount of tuna that you consume in a week, no more than two tuna steaks a week (170gram when raw) or four (140gr drained) tins of tuna.  These types of fish contain high levels of mercury which can damage a growing baby’s nervous system.  Also, you must limit oily fish to two servings a week.  Oily fish includes fresh tuna, salmon, mackerel, sardines and trout.
  • Raw shellfish – It is fine to eat shellfish cooked, however raw shellfish can contain bacteria and viruses that cause food poisoning.
  • Peanuts – In the past, the government advised women that they may wish to avoid peanuts during pregnancy if there was an allergy in the family.  This included food allergy, eczema, asthma, hay fever or another allergy.  However, this advice has now been changed as it has been proven that eating peanuts during pregnancy does not affect the chance of your unborn baby developing an allergy.  Therefore, if you wish to eat peanuts or peanut products during pregnancy you can as long as it is part of a healthy, well balanced diet and that YOU are not allergic to them.  If a Healthcare professional advises you against eating them, it is important that you follow their advice.
  • Alcohol – The Department of Health recommends that you avoid drinking alcohol when pregnant as too much alcohol can reach your baby through your blood stream and placenta.  If you do not want to cut it out completely it is advisable that you limit the amount you consume to one or two units, once or twice a week.
  • Caffeine – Although evidence on caffeine is not clear, it is advisable that you limit your intake of coffee, tea and cola like fizzy drinks.  It has been suggested that too much caffeine can increase the risk of baby being born with having a low birth weight and may also be linked to miscarriage.

Preparing foods
It is important to ensure that you wash all fruit, vegetables and salads before eating them.  This is because they are likely to contain traces of soil, which may contain a parasite that can cause toxoplasmosis, an infection that can harm your unborn baby.  It is also important that after preparing raw meat that you thoroughly wash all surfaces and utensils.  It is also important that you always use a separate chopping board for raw meats.

It is also necessary for you to look at how you store your food.  It is important that raw foods are stored separately from cooked or ready-to-eat foods.  This is to stop contamination and to avoid food poisoning.

Although freshly made meals are best, if you are heating ready-made meals, it is important for you to make sure that they are piping hot before serving.
Vitamins and Minerals
It is always best to get all the vitamins and minerals from the food that you eat, however, when you are pregnant there are some vitamins and minerals that are especially important and it is advised that you take the following supplements:

  • 10 micrograms of Vitamin D every day throughout your pregnancy and also during breastfeeding
    • 400 micrograms of Folic Acid.  It is advised that you take this supplement from before conception until the end of the first trimester.

As previously stated, do not take a Vitamin A supplement or a multivitamin that contains Vitamin A.

Folic Acid – Can be found in foods including leafy green vegetables, peas, Brussel sprouts, chickpeas, fortified breakfast cereals and brown rice.  You may find that some breads and margarines also have added folic acid.  Folic acid is a B vitamin which is needed for the development of health red blood cells.  Ensuring you get enough folic aciddaily reduces the risk of your baby being born with a neural tube defect, such as spina bifida.  It is advised that a woman takes a Folic Acid supplement before conception as your baby’s neural tube develops very early in pregnancy.  However, if you did not take Folic Acid before you conceived, it is recommended that you start as soon as possible.

If you have previously had a baby with a neural tube defect or there is a family history of it, have diabetes, are taking medicine for epilepsy, have thalassaemia or coeliac disease, it is likely that you will need a higher daily dose of Folic Acid.  It is important that you speak to your doctor or midwife for more advice as quickly as possible.

Vitamin D – It is important that you get enough vitamin D throughout your pregnancy.  It is used to keep your bones healthy and your baby needs reserves from you for the first few months of their lives.  Vitamin D is essential because it helps absorb and regulate calcium and phosphate in your body and you need these to keep your teeth and bones healthy and strong.  Children with a Vitamin D deficiency can have soft bones which will lead to rickets.

The best source of Vitamin D is from sunlight.  However, there is no need to ‘sunbathe’ just walking in the sun for a short while will be sufficient.  There are a few foods that contain Vitamin D and they include oily fish, fortified margarines and some fortified breakfast cereals.

Iron – If you find yourself becoming very tired often, it may be possible that you are deficient in iron.  This can lead to you becoming anaemic.  If your midwife or doctor feels that your iron levels in your blood are too low; they will advise you to take an iron supplement.  Iron can be found in green, leafy vegetables, meat, dried fruit and some breakfast cereals have added iron.
Calcium – It is vital that you have a good calcium intake.  Calcium is used for making your baby’s bones and teeth.  Although dairy products are the main source of calcium, other sources include fish with edible bones, breakfast cereals, dried fruit, tofu and green leafy vegetables.

Vitamin C – Vitamin C helps your body to absorb iron.  Citrus fruits are a good source of iron.  A glass of orange juice a day will help your intake of iron.

by Jenny, mum to William and James

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