Pregnancy Nutrition

Nutrition and Supplements for the First Trimester
Excellent nutrition is a primary element of maintaining a healthy pregnancy.  It is never too late to start eating healthy for yourself and for your baby and the first trimester is a great time.  Proper nutrition will help guarantee your health as well as your baby’s health while they are growing inside you and in the future.  


A highly nutritious diet is the most important aspect of maintaining a healthy pregnancy.  Fresh vegetables, lean meats and whole grains will give you and your baby the energy needed to thrive.  There are four nutrients that are most important during the first trimester; folic acid, vitamin B-6, calcium and iron. A prenatal vitamin contains some value of folic acid, vitamin B-6 and calcium, however a well balanced diet will help a pregnant women obtain the optimal level she needs for she and her baby.  

Folic Acid
Folic acid helps protect babies against neural tube defects and is incredibly important. Most breads and cereals have folic acid in them, however if you don’t eat much of this type of food then a supplement is very important to ensure your baby does not suffer due to a lack of nutrition.  A folic acid supplement whether in prenatal vitamins or taken by itself is recommended to make sure you are getting a sufficient amount for your baby.  Foods with folic acid in them consist of the following:
Food
Micrograms (μg)
% DV^
*Breakfast cereals fortified with 100% of the DV, ¾ cup
400
100
Beef liver, cooked, braised, 3 ounces
185
45
Cowpeas (blackeyes), immature, cooked, boiled, ½ cup
105
25
*Breakfast cereals, fortified with 25% of the DV, ¾ cup
100
25
Spinach, frozen, cooked, boiled, ½ cup
100
25
Great Northern beans, boiled, ½ cup
90
20
Asparagus, boiled, 4 spears
85
20
*Rice, white, long-grain, parboiled, enriched, cooked, ½ cup
65
15
Vegetarian baked beans, canned, 1 cup
60
15
Spinach, raw, 1 cup
60
15
Green peas, frozen, boiled, ½ cup
50
15
Broccoli, chopped, frozen, cooked, ½ cup
50
15
Broccoli, raw, 2 spears (each 5 inches long)
45
10
Avocado, raw, all varieties, sliced, ½ cup sliced
45
10
Peanuts, all types, dry roasted, 1 ounce
40
10
Lettuce, Romaine, shredded, ½ cup
40
10
Wheat germ, crude, 2 Tablespoons
40
10
Tomato Juice, canned, 6 ounces
35
10
Orange juice, chilled, includes concentrate, ¾ cup
35
10
Turnip greens, frozen, cooked, boiled, ½ cup
30
8
Orange, all commercial varieties, fresh, 1 small
30
8
*Bread, white, 1 slice
25
6
*Bread, whole wheat, 1 slice
25
6
Egg, whole, raw, fresh, 1 large
25
6
Cantaloupe, raw, ¼ medium
25
6
Papaya, raw, ½ cup cubes
25
6
Banana, raw, 1 medium
20
6


* Items marked with an asterisk (*) are fortified with folic acid as part of the Folate Fortification Program.

^ DV =
Daily Value. DVs are reference numbers developed by the Food and Drug Administration (FDA) to help consumers determine if a food contains a lot or a little of a specific nutrient. The DV for folate is 400 micrograms (μg).  The percent DV (%DV) listed on the table indicates the percentage of the DV provided in one serving. A food providing 5% of the DV or less is a low source while a food that provides 10-19% of the DV is a good source.

Vitamin B6

Vitamin B6 helps your body metabolize protein, fats and carbohydrates.  It also helps develop your baby’s brain and nervous system by forming red blood cells, antibodies and neurotransmitters.  Some research shows that it can help relieve nausea or vomiting for some women during pregnancy, which can happen quite a bit in the first trimester.  
Pregnant women need 1.9mg per day, which is an average amount per day over the course of a week.  


Vitamin B6 is found in a wide variety of foods including fortified cereals, beans, meat, poultry, fish, and some fruits and vegetables.  Foods with Vitamin B6 in them consist of the following:
Food
Milligrams (mg)
per serving
% DV*
Ready-to-eat cereal, 100% fortified, ¾ c
2.00
100
Potato, Baked, flesh and skin, 1 medium
0.70
35
Banana, raw, 1 medium
0.68
34
Garbanzo beans, canned, ½ c
0.57
30
Chicken breast, meat only, cooked, ½ breast
0.52
25
Ready-to-eat cereal, 25% fortified, ¾ c
0.50
25
Oatmeal, instant, fortified, 1 packet
0.42
20
Pork loin, lean only, cooked, 3 oz
0.42
20
Roast beef, eye of round, lean only, cooked, 3 oz
0.32
15
Trout, rainbow, cooked, 3 oz
0.29
15
Sunflower seeds, kernels, dry roasted, 1 oz
0.23
10
Spinach, frozen, cooked, ½ c
0.14
8
Tomato juice, canned, 6 oz
0.20
10
Avocado, raw, sliced, ½ cup
0.20
10
Salmon, Sockeye, cooked, 3 oz
0.19
10
Tuna, canned in water, drained solids, 3 oz
0.18
10
Wheat bran, crude or unprocessed, ¼ c
0.18
10
Peanut butter, smooth, 2 Tbs.
0.15
8
Walnuts, English/Persian, 1 oz
0.15
8
Soybeans, green, boiled, drained, ½ c
0.05
2
Lima beans, frozen, cooked, drained, ½ c
0.10
6



Calcium
Calcium is an essential mineral to life. It is the most abundant mineral in your body and is necessary for bone initiation and growth in the developing fetus and throughout life to maintain optimal bone health and structure. Calcium from the mother's body is used by the developing baby, putting increased demands on the mother's supply. During pregnancy, calcium transfer from mother to developing baby reaches 270 mg daily, on average, by the third trimester. Additional calcium may be needed for both mother's and baby's health.  A recent analysis of 14 scientific studies, published in the Journal of the American Medical Association, found that women with initially who took about 1,500 mg of 2,000 mg of supplemental calcium every day while they were pregnant had a significantly lower risk of preeclampsia, a leading cause of premature birth.

Preeclampsia is a disorder that occurs during pregnancy and affects both the mother and the developing baby. Affecting at least 5-8% of all pregnancies, it is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. It can possibly result in serious consequences for both mother and child.

Most prenatal formulas contain only about 200 mg of calcium and pregnant women need as much as 1,500 mg per day. In addition to a calcium supplement, TUMS® is the daily calcium supplement recommended by most doctors, as well as a safe and effective treatment for heartburn during pregnancy.

We tend to think of dairy when we think of foods high in calcium, however calcium is found in many other foods.  
  • Milk, yogurt, and cheese are the main food sources of calcium for the majority of people in the United States.
  • Kale, broccoli, and Chinese cabbage are fine vegetable sources of calcium.
  • Fish with soft bones that you eat, such as canned sardines and salmon, are fine animal sources of calcium.
  • Most grains (such as breads, pastas, and unfortified cereals), while not rich in calcium, add significant amounts of calcium to the diet because people eat them often or in large amounts.
  • Calcium is added to some breakfast cereals, fruit juices, soy and rice beverages, and tofu. To find out whether these foods have calcium, check the product labels.

Iron
Iron is the only recommended nutrient for which requirement s cannot be reasonably met buy diet alone during pregnancy.  Thirty milligrams of iron is recommended for a pregnant woman.  Since your baby can be pulling from your iron reserves, it is important to make sure you are getting your recommended dose.  A lack of iron from your diet can result in anemia, which can put both you and your baby at risk.  Anemia refers to a condition whereby your body lacks the appropriate amount of hemoglobin, or red blood cells. Red blood cells are an important part of the body’s blood system as they carry oxygen to other cells in your body. Having a shortage of these blood cells means that your body must work harder to get oxygen to your organs and tissue.  This can lead you to be more lethargic and irritable.  
Iron rich foods are found in the following below.  
  • clams, cooked, 3 oz (23.8 mg)
  • tofu, 1/2 cup firm (13.2 mg)
  • raisin bran, ready-to-eat, 3/4 cup (4.5 mg)
  • sirloin steak, cooked, 3 oz (2.9 mg)
  • shrimp, cooked, 3 oz (2.6 mg)
  • black beans, boiled, 1/2 cup (1.8 mg)
  • chickpeas, canned, 1/2 cup (1.6 mg)
  • turkey breast, 3 oz (0.9 mg)
  • bread, whole wheat, 1 slice (0.9 mg)
  • chicken breast, skinless, 1/2 breast (0.9 mg)

Nutrition and Supplements for the Second Trimester
During your second trimester, your food requirements will change from your first trimester, but not drastically.  You should be over your morning sickness bump, so you should be feeling hungrier than you ever have.  Eating for two is a myth however; you should only have an extra 300 calories a day.   The extra calories should be made up of nutritious food and not junk. Tips for eating an extra 300 calories a day are:
  • Make sure you eat a wide variety of veggies and fruits during every meal.  
  • Eat smaller meals, 5-6 times a day.  If you don’t have time to eat this many meals, eat breakfast, lunch and dinner with 2-3 small snacks.  
  • Eat protein, carbohydrates and vegetables.
  • Drink water, drink water, drink water.  


Staying on top of health and nutrition during the second trimester means avoiding certain foods.  You should avoid certain types of fish that may contain high levels of mercury such as the list provided below. A good alternative to fish is a supplement called DHA or an omega 3 fatty acid.  Current research suggests adequate levels of DHA may help increase a developing baby's cognitive functioning, reduce the risk of pre-term labor and decrease the risk of postpartum depression.  Why do pregnant and lactating women, who so critically need DHA, find it difficult to get the recommended amount of this crucial nutrient in their diets? There are two primary reasons. First, during pregnancy the daily requirements of DHA increase from 220 mg to somewhere between 300 and 1,000 mg (depending on which expert you consult). Second, DHA isn't easy to get in your diet, especially when you are pregnant. Significant amounts of DHA are found in animal organ meats and fatty fish.   Not the typical menu for most pregnant women and we're told to limit our intake of fish due to concerns over toxins. 

A good source of DHA besides fish is flax seeds, which you can by ground and put them in oatmeal and smoothies.   You can also take a DHA supplement such as fish oil, which can be found at any drug store or grocery store.


Fish Containing the Highest Mercury
AVOID Eating
Grouper
Marlin
Orange roughy
Tilefish
Swordfish
Shark
Mackerel (king)

Fish Containing High Mercury

Eat no more than three 6-oz servings per month
Bass saltwater
Croaker
Halibut
Tuna (canned, white albacore) See tuna chart below
Tuna (fresh bluefin, ahi)
Sea trout
Bluefish
Lobster (American/Maine) 

You should also avoid uncooked meats or seafood, as these can put you at greater risk for listeria or salmonella.  You should avoid all deli meats and hot dogs for these reasons as well.  Raw eggs and items made from raw eggs like salad dressings and mayonnaise should be avoided too.  Soft cheeses are also dangerous because of the bacteria levels formed.  

Protein

During this stage of your pregnancy, when your baby is undergoing so much growth, you must ingest the proper amounts of amino acids. The best way to do that is by eating protein with every meal. You can incorporate protein by eating eggs at breakfast, lean organic protein at lunch and dinner, and have raw nuts or nut butters as a snack.

Eating enough protein will also help keep you feeling full throughout the day, and help keep your energy levels high. Once you are over morning sickness, eating enough protein becomes a much easier task.

Cravings

You may be experiencing cravings during the second trimester.  It is important to indulge in your cravings, but only on a reasonable basis.  No one knows for sure what causes cravings.  They could be hormone driven or they could be the body’s way of telling you that you are deficient in something.  Cravings can also increase as a result of a poor diet to start with.  It is very important to maintain a healthy diet full of the colors of the wheel so that there are less cravings throughout pregnancy.  

Below is a list of healthy snack options you can choose from when cravings arise:


Smoothies Greek Yogurt
Pretzels Fruit
Popcorn   Raw vegetables
Low-fat pudding Whole grain toast
Jell-O Whole grain breakfast cereal
Trail Mix Cottage Cheese
Nuts Frozen Fruit Sorbet

Nutrition and Supplements for the Third Trimester
As the third trimester of pregnancy arrives, consider yourself in the “home stretch.”  Weeks 28-40 mark a time of rapid fetal growth.  Your baby needs more calcium, iron and protein at this point, so be aware of these nutrients as you eat throughout the day.  Good nutrition is extremely important in your third trimester.  If your diet is lacking in essential ingredients of prenatal health, you’ll be cheating yourself and your little one.  Your baby is going through a tremendous growth spurt, which may lead to a nutritional deficit for yourself.  Your maternal body will supply your baby’s extra nutritional needs before your own.  
   
B-complex vitamins like B6 and B12 along with calcium and iron are extremely important during your final prenatal months. B6 helps your body metabolize protein, which builds your baby’s muscular system. B vitamins are also great stress relievers. Eating a nutrient-rich diet can also help your body recover and repair itself after you give birth. So, fill your plate (even a small one) with things like lean meat, legumes, soybeans, fish and broccoli, as well as other healthy foods.

It may feel like you're spending your life in your restroom these days, you’ve got a baby pressing on your bladder. But that doesn't make proper hydration any less important. In fact, it can even help reduce or prevent constipation. So keep on downing those 10 cups of water a day if not more.