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Pregnancy Diet
Pregnancy Diet Diet

Good nutrition during pregnancy will help to keep a developing baby and its mother healthy. The need for certain nutrients such as calcium, iron and folate is increased at this time but only a small amount of extra energy (kilojoules) is needed. Women should be encouraged to eat to their appetite and monitor their weight. A normal weight gain is around 10-13kg for women who are a healthy pre-conception weight.

Healthy foods for pregnant women
It is important to choose a wide variety of foods to ensure the nutritional needs of both mother and baby are met. Try to eat:

Lots of fruit and vegetables, wholegrain breads and cereals
Moderate amounts of low fat dairy foods and lean meats
Small amounts of foods high in fat, sugar and salt
Lean meat, chicken and fish
Dried beans and lentils
Nuts and seeds
Low fat milk, cheese and yoghurt
Green leafy vegetables.
Folate supplements
As well as a healthy diet, it is also recommended that a folate supplement be taken prior to conception and for the first three months of pregnancy to help reduce the risk of neural tube defects such as spina bifida.

Anaemia and iron intake
Pregnancy increases the need for iron in the diet. The developing foetus draws enough iron from the mother to last it through the first five or six months after birth so a woman has an increased need for iron during pregnancy.

Iron losses are reduced during pregnancy because women are no longer menstruating and so are able to absorb more iron from the gut during pregnancy. It is useful to include foods that are good sources of iron in the diet every day (for example red meat) and to have foods that are good sources of vitamin C (like oranges) to help absorb the iron.

Recommended daily iron intake
The recommended daily intake (RDI) of iron during pregnancy is 22-36mg (10-20mg more than that for non-pregnant women). The amount needed depends on the amount of iron the mother has 'stored' in her body prior to pregnancy. If a woman's iron stores are very low, she may need to get more from supplements. However, iron supplements can cause constipation.

Calcium
The RDI of calcium during pregnancy is 1,100mg per day (300mg per day more than for non-pregnant women). During the third trimester of pregnancy, there is a large shift of calcium to the baby as it starts to develop and strengthen its bones. If the mother isn't getting enough calcium in her diet, the calcium needed by the developing baby is drawn from the mother's bones.

Most women rapidly replace this bone loss once the baby has stopped breastfeeding. The woman should make sure she has enough calcium in her diet during pregnancy, as this should protect her bone mass while also meeting the needs of the foetus.

Dairy foods, such as milk, cheese and yoghurt, and calcium fortified soy milk are excellent sources of calcium.

Folate and neural tube defects
All women who are capable of getting pregnant, who are planning a pregnancy or who are in the early stages of pregnancy should increase their folate intake to 0.4-0.5mg per day.

Folate (also known as folic acid) is a B-group vitamin found in a variety of foods listed in the table below. Some breakfast cereals have been fortified with folate and this will be listed on the labels.

If the woman does not consume enough folate during pregnancy, the baby may develop neural tube defects such as spina bifida. Folate taken before conception and during the first few weeks of pregnancy can prevent seven out of 10 cases of neural tube defects.

Folate in your diet
Excellent food sources of folate include:
Asparagus
Bran flakes
Broccoli
Brussels sprouts
Chick peas
Dried beans
Lentils
Spinach.
Very good food sources of folate include:
Cabbage
Cauliflower
Leeks
Oranges
Orange juice
Parsley
Peas
Wheat germ
Wholegrain bread.
Good food sources of folate include:
Hazelnuts
Vegemite
Parsnips
Potato
Salmon
Strawberries
Tomato
Unsalted peanuts
Walnuts.
Although liver is high in folate, it should not be recommended to women who are, or could be pregnant, because of its high vitamin A content. There is also a risk of listeriosis from raw or undercooked liver, for example pate. Both are a risk to the developing foetus.

Vitamin A
Although vitamin A requirements do increase during pregnancy, vitamin A supplements are rarely recommended for pregnant women. This is because they may cause birth deformities.

The best way to increase your intake of vitamin A, if it is low, is through food sources like milk, fish, eggs and margarine. Liver has too much vitamin A in it and this has been associated with birth defects so liver should be avoided during pregnancy.

Vitamin D
Vitamin D is essential to help absorb calcium from the gut. Margarine, cheese, fatty fish and eggs all contain vitamin D.

Vitamin supplements
Multivitamin and calcium supplements may be recommended for the following pregnant women: vegetarians, teenagers who may have an inadequate food intake, substance abusers (of drugs, tobacco and alcohol) and obese pregnant women who are restricting their energy intake to prevent large weight gains.

Eating for two
There is no need to eat more food during pregnancy. Experts recommend that, for the first trimester, a woman's kilojoule intake should remain about the same as it was prior to the pregnancy. During the second and third trimesters, the kilojoule intake could increase by about 10 per cent or so, which is about an extra 600kJ a day. But remember, it is the nutritional quality of the diet not the kilojoule intake that is important.

The dangers of dieting
Some women fear the extra weight gain of pregnancy and decide to eat sparingly to avoid putting on body fat. Restricted eating or crash dieting in any form can seriously compromise a woman's health and that of her baby.

Pregnancy in adolescence
Pregnant adolescents need more nutrients than adult women, because they are still growing. Adolescents may give birth to smaller infants because they are competing with the growing foetus for nutrients.

Anaemia is more common among adolescents than older women. Calcium intake is also important because young women have not yet reached their peak bone mass and inadequate calcium intake may increase the risk of osteoporosis developing later in life.

Nausea and vomiting
Nausea and vomiting, especially 'morning sickness' are common during pregnancy, particularly in the first trimester. Small carbohydrate snacks (a sandwich or fruit) every two to three hours may provide some relief. The following suggestions may also help:
Eat some dry bread, biscuits or cereal before getting up in the morning. Get up slowly, avoiding sudden movements.
Drink liquids between rather than with meals to avoid bloating which can trigger vomiting.
Avoid large meals and greasy, highly spiced foods.
Suck something sour like a lemon.
Relax, rest and get into the fresh air as much as possible. Keep rooms well ventilated and odour free.
Slowly sip a fizzy drink when feeling nauseated.
Try food and drinks containing ginger as these sometimes relieve nausea.
Heartburn
Heartburn is common in pregnancy because as the baby grows there is more pressure on the abdomen. Small, frequent meals may be better than large meals. Try to avoid:
Eating late at night
Bending, lifting or lying down after meals
Excessive consumption of tea, coffee or alcohol.
You may also like to try sleeping with your bed head raised a few inches. You can do this by putting a folded blanket or pillow under your mattress.

Alcohol during pregnancy
There is general agreement that women should not drink alcohol excessively during pregnancy. Excessive drinking in pregnancy increases the risk of miscarriage, low birth weight, congenital deformities and effects on the baby's intelligence. However, there is not enough evidence to identify what is a safe amount to drink during pregnancy.

The Australian Alcohol Guidelines recommend that women who are pregnant or considering pregnancy should never become 'drunk', may like to consider not drinking at all or, if they choose to drink, have less than seven standard drinks in a week and no more than two standard drinks on any one day.

Listeria infection
The bacteria Listeria monocytogenes can contaminate some foods. Healthy people may experience no ill-effects at all, but the risks are substantial for pregnant women. The greatest danger is to the unborn baby, with increased risk of miscarriage, stillbirth or premature labour. A listeria infection is easily treated with antibiotics, but prevention is the best. Some foods are more prone to contamination than others; exclude these foods from your diet if you are pregnant:
Precooked or ready prepared cold foods that will not be reheated- for example, pre-prepared bought salads, pate, quiches, delicatessen meats like ham and salami
Unpasteurised foods
Soft serve icecream
Soft cheeses, such as Brie and Camembert.
The organism that causes listeria is destroyed by heat, so properly cooked foods are not a risk.

Salmonella
Salmonella is a cause of food poisoning that can trigger miscarriage. The most likely sources of salmonella are raw eggs and undercooked poultry. Good food hygiene is the best way to reduce risk of salmonella and listeria infections. Suggestions include:
Always wash your hands before and after preparing food.
Keep your kitchen surfaces clean.
Do not let uncooked food contaminate cooked food.
Wash fruit, vegetables and salad before eating.
Cook food thoroughly.
Keep pets away from kitchen surfaces.
Wear rubber gloves when handling cat litter trays or gardening.
Store food at correct temperatures.
Mercury in fish
The Australian Dietary Guidelines advise eating one or two meals with fish every week for good health. Pregnant women can safely eat one or two meals of fish each week but they should choose the type of fish carefully.

There are a few types of fish that need to be limited because they contain high levels of mercury, which is dangerous for the developing foetus.

Pregnant women should:
Avoid fish with high levels of mercury - these are billfish (swordfish, broadbill and marlin), shark (flake), orange roughy (sea perch), gemfish, southern blue fin tuna and catfish.
Limit other fish, such as tuna steaks, to one portion per week or two 140g cans of tuna per week (smaller tuna contain less mercury).
There is no restriction needed on the amount of salmon, including canned salmon, which is eaten.

Women should not be worried if they've had the odd meal of fish with high levels of mercury. It is only a potential problem when that type of fish is eaten regularly, which causes a build-up of mercury in the mother's blood.

Where to get help
Your doctor
Midwife
Obstetrician
Dietitian.
Things to remember
A pregnant woman needs to boost her nutrient intake, rather than her intake of kilojoules.
Pregnancy creates extra demands for certain nutrients including iron, calcium and folate.
Good food hygiene is particularly important during pregnancy.



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