Nutrition for a Healthy Pregnancy

• Eating for 2
• How much to eat?
• Canada’s Food Guide to Healthy Eating
• Vitamins and Minerals
• Food Safety
• Common Discomforts

Infant Nutrition
Child Nutrition

Nutrition for a Healthy Pregnancy
Do you really need to “eat for two”?

Many have heard the saying “eating for two” to describe eating during pregnancy. This saying is only partially true. It is true that everything that the baby needs to grow and develop must come from the mother. But, you must remember that you are eating for one adult (mom) and one baby – not two adults. Eating well is more important than ever, but there is no need to double the amount of food that you eat. Drinking lots of fluids is beneficial too. Those 8 – 10 glasses of water a day are even more important now.

How much to eat
The best guideline is to follow your appetite for how much to eat, and to make sure that your food choices are providing lots of vitamins, minerals, and other nutrients for baby’s growth and development. Also, a few key nutrients need special attention. If you aren’t sure that you are eating the right amount, look at Eating well with Canada’s Food Guide.

Eating between 5 to 10 fruit and vegetable choices, 5 to 12 grain choices, 4 milk choices, and 2-3 meat and alternate choices is a good rule of thumb during pregnancy.

Vitamins and Minerals Needing Special Attention
Folate, Iron, Calcium and Vitamin D are all especially important during pregnancy.

Folate:
This is important during pregnancy because it plays a key part in baby’s brain and spinal chord development. Not having enough folate raises the risk of neural tube defects such as Spina Bifida. Folate from foods does not seem to be enough. Getting 400 micrograms (0.4mg) from a vitamin supplement is recommended for all women of childbearing age including pregnant women. Most prenatal vitamin and mineral supplements have this amount, but be sure to check your bottle and/or ask your Pharmacist.

Iron:
Iron plays an important part in supplying the baby with oxygen by Mom’s red blood cells. It is also important that baby gets iron now to store for using later in the first 6 months after birth. If you have good iron stores before pregnancy, then iron supplements aren’t needed in the first trimester. If your iron stores are low before pregnancy (e.g. anemia) your doctor may recommend taking an iron supplement in the first trimester. By the second and third trimesters all women are recommended to take an iron supplement. Most prenatal vitamin and mineral supplements have this amount. But, be sure to check your bottle and/or ask the Pharmacist.

Calcium and Vitamin D:
These are important for helping the baby form bones while protecting Mom’s bones from weakening. 1000mg of calcium and 5mg (200IU) of vitamin D are recommended every day for women older than 18 years. For pregnant women less than 18 years old, 1300mg calcium and 5mg (200IU) vitamin D are recommended. The best sources of calcium are dairy products. One glass of milk or ¾ cup of yogurt has approximately 300mg of calcium. So, if you don’t have enough milk, yogurt, or get calcium from other sources each day, a calcium supplement containing vitamin D is recommended to top you up to 1000mg (or 1300mg if less than 18 years old). This may mean that you need a separate calcium & vitamin D supplement in addition to your prenatal multivitamin because most of these don’t contain much calcium.

Food Safety
Some food and drinks should be limited or avoided during pregnancy.

Caffeine: Caffeine can be found in coffee, black and green tea drinks. Colas and chocolate also have some caffeine, as do some over the counter medications. Having up to the equivalent of 3-4 small cups of coffee (or a maximum of 1, 20oz coffee) is considered safe.

Herbal Teas: Some herbal teas are known to be harmful, some are considered to be safe, and the safety of most is just not known. The safety of having more than 2 – 3 cups per day of any herbal tea is not known. To be on the safe side only have a maximum 2 - 3 cups of teas containing:

• citrus peel
• ginger
• lemon balm
• orange peel
• rose hips

Artificial Sweeteners:
Artificial sweeteners are considered safe at low amounts. However, many foods that contain artificial sweeteners are low in vitamins, minerals, and other nutrients that are healthy for growing babies. Be sure that 80% of your foods are from the four food groups in Canada’s Food Guide to Healthy Eating and limit artificially sweetened foods to the treats that make up the other 20% or less of your choices.

Tuna, Swordfish, and Shark:
Swordfish, shark, and non-canned tuna should be limited to once per month or avoided all together during pregnancy. These fish are at increased risk of containing higher levels of mercury that can damage a developing baby’s brain. Canned tuna is not as likely to have high levels of mercury and can be eaten up to once per week. This is because the tuna used for canning are generally smaller, younger fish. This limitation does not apply to canned salmon.

Food Poisoning: Preventing food poisoning is a concern for everyone but is especially important during pregnancy. Eating spoiled or unsafe food increases risk for Listeriosis that is caused by eating food contaminated by a bacteria. Foods contaminated with this bacteria do not look, smell, or taste different. To reduce your risk, don’t eat raw hotdogs and follow safe food preparation (e.g. wash your hands before handling or eating food). Also, contact your doctor if you get flu-like symptoms.

Common Discomforts

Pregnancy pains
Many women experience negative effects of pregnancy, such as nausea & vomiting, constipation, heartburn, and cravings to eat non-foods (such as dirt). Good nutrition can help with all of these.

Nausea & vomiting:
Hunger often makes nausea worse, so plan ahead. Eat small meals/snacks every 2 – 3 hours choosing your favourite foods and avoiding any foods that make you queasy. Having a snack before bedtime can help with nausea in the morning, as can waking up in the middle of the night for a snack. Make snacks as healthy as meals – just smaller, choosing foods from 3 or 4 of the food groups. If you are having a hard time keeping anything down contact your doctor.

Constipation:
Many pregnant women experience this. There are three ways topromote regularity – water, fibre, and activity. Drinking 8 to 10 glasses of water helps to keep things soft and moving. Fibre found in fruits, vegetables, beans, and whole grains promotes regularity. When increasing your fibre, be sure to get enough water too – otherwise you may slow things down even more. Unless your doctor has told you differently, moderate activity is safe and healthy.

Heartburn: Heartburn during the first part of pregnancy is caused by hormones. By later pregnancy, the baby fills up some of the space that Mom’s stomach used to be in. To reduce heartburn, eat smaller frequent meals instead of a couple of big meals. Eating lower fat meals also helps reduce heartburn, as does avoiding spicy foods. Drink fluids separate from meals to avoid filling the stomach with fluids and not food. Eat slowly, chew food well, and try to avoid stress while eating. Lastly, don’t lie down immediately after eating, let gravity help keep food and stomach acid down. If heartburn is preventing you from eating, tell your doctor.

Pica (cravings for non-foods):
Some women crave eating non-foods, such as dirt. Although it is not understood why this happens, you can end up eating things that can harm you and your baby. Tell your doctor if you are experiencing this so that you work together to find ways to handle your cravings.

9 Super Foods for the Mom-to-Be

Infant Nutrition
Breast-feeding or bottle-feeding exclusively for the first 6 months of baby's life is recommended. If breast feeding, a vitamin D supplement is recommended for baby. After this point, it is recommended to continue to breast-feed but it is a good time to introduce iron-fortified infant cereals, starting with rice-based, the least allergenic. At the six- to seven-month point, pureed vegetables and fruits (in that order) can be introduced. Seven to eight months is when finger foods like bread or toast become appropriate as well as pureed meat, fish, poultry and legumes together with cheese, yogurt and egg yolk. After eight months, should you or your baby be ready to wean, you can begin gradually introducing whole milk. After one year, a variety of foods prepared in an age-appropriate method can be served. Whole eggs or egg whites are appropriate at this point. Be aware of foods with a high choking risk for toddlers: berries, grapes, nuts, peanut butter, wieners, popcorn, carrot sticks, hard candies, dry cereals and certain crackers and biscuits.

Child Nutrition

A great book on feeding children is How to Get your Kid to Eat…But Not Too Much by registered dietitian and sociologist Ellyn Satter. You may also want to check out her website at www.ellynsatter.com. The author discusses the principles of a normal, healthy feeding relationship from infancy up to adolescence. As a parent or caregiver, she suggests you are responsible for providing healthy food for your children in a form they can easily handle. What your child chooses to eat and whether or not he or she eats at all is your child's responsibility. This is not to suggest that you need to run a restaurant and give them made-to-order meals. However, be aware that beginning in infancy, we are all the boss of our own bodies and our internal hunger and fullness cues. No one can make us eat if we aren't hungry or don't want to eat. Remember what you were like as a kid? Many parents struggle with all kinds of child feeding problems. Most originate from crossing the line of the feeding relationship.

And what exactly is that relationship? As a parent, you are responsible for the following:
• Providing a variety of healthy options representing all of the food groups.
• Providing quality foods.
• Introducing your child to as much variety in tastes, textures and food combinations as you can in their first two years of life.
• Serving food in age-appropriate ways your child can handle; eating with fingers and hands should be allowed.
• Setting a reasonably structured pattern of meals and snacks; most children respond well to structured mealtimes.
• Making family mealtimes as comfortable, calm and relaxed as possible.
• Maintaining standards of behaviour at the table.

To enhance your child's interest in eating, consider these nine strategies:

1. Involve children in meal preparation: The sooner kids take an active role in helping to make meals, the more they begin to accept new foods and the less picky they are. Kids as young as two to three can be involved by scrubbing potatoes, tearing lettuce for a salad, arranging vegetables on a platter, shaping cookies or stirring the pancake batter. Older children can cut up vegetables, shape burger patties or set the table. Involvement helps build a child's self-esteem.

2. Allow kids to serve themselves at the table: Don't dictate what foods the kids must have. If all they choose to put on their plate is bread, don't worry. The less of an ordeal that is made, the better. How do you like it when someone dishes out what you should eat?

3. School-age children should pack their own lunch: If not the whole thing, at least get the children involved in packing part of the lunch. This way they are more likely to eat it and not throw it out or bring it home untouched. Suggest they include foods from at least three if not all four of the food groups and perhaps a treat if desired. Letting them pack their own lunch may take more patience, but it's worth it if they actually eat the lunch.

4. Eat meals at the table with the television turned off: The fewer distractions at mealtime, the better. When your children are finished eating, they can either excuse themselves or help with the cleanup.

5. Save uneaten meals for a snack later: Everyone will eat just about anything if they are hungry enough. If your child refuses to eat at mealtimes but comes back an hour afterward saying she's hungry, offer the dinner leftovers as the only choice.

6. Limit after-school snacking: Usually kids are famished after school so allow them to snack. Just set a limit on the amount they eat so they don't displace their appetite for dinner. After school, when kids are ravenous, may be the best time for them to eat vegetables or other foods they're least likely to get the rest of the day. Try offering a vegetable platter with dip.

7. Limit the junk food stocked in the house: It's often simply a case of out of sight, out of mind. If the kids know there is no junk food to snack on, that usually leaves healthier options like fruit or vegetables.

8. Don't run a restaurant: If you have prepared a healthy meal but your child refuses to eat it, don't feel obliged to provide other options.

9. Don't expect kids to eat what you won't: If dad hates vegetables, it will be hard to get your child to eat them. If mom hates milk, chances are your child won't like it either. Be a good role model.

For more information Ask our Nutritionists