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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 baby’s
growth
Ensure healthy birth weight
Maintain a healthy weight
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
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
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
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
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
Consume a variety of foods
Grains

Vegetables

Fruits

Milk

Meat and Beans


Typical Plate
Reconstruct Your Plate
MyPyramid
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
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
Proper nutrition
Major Nutrients
Carbohydrates
Protein
Fat
Vitamins
Minerals
Water
Carbohydrates
Sugars and starches
Body’s 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
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
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
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
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
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
Special Interest
Nutrients
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
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
Food Sources of Folic Acid
Fortified breakfast cereals
Dried beans
Liver/meats
Spinach and green leafy vegetables
Citrus fruits and juices
Whole-wheat bread
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
Food Sources of Iron
Meats Whole-grain and
enriched breads
Fish
Iron-fortified
Poultry
cereals
Legumes
Dark greens
Dried fruits
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
Food Sources of Calcium
Milk (skim, low- Collard greens
fat)
Broccoli
Yogurt (low-fat)
Turnip greens
Oysters
Sesame seeds
Shrimp
Calcium-fortified
apple and orange
juice
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


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
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
Foods to Avoid (cont.)
Raw or undercooked meat and poultry

Sushi

Pate

Soft or blue-veined cheeses

Unpasteurized cheeses and juices

Deli meats
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
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
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
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
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
Common Pregnancy
Problems
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
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
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
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
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)
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
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
Questions??
References

Position of the American Dietetic Association: Nutrition


and lifestyle for a healthy pregnancy outcome

Krause’s 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