Diet, Nutrition, Exercise

Eating well during your pregnancy is important to the health of your developing baby.

Moms need an additional 340 to 450 extra calories a day to meet the nutritional requirements of pregnancy. It is more important to focus on the specific nutritional intake not the calories.  The average calorie requirement for pregnant women is 2200 to 2900 which can be meet by consuming a balanced daily diet consisting of the following: 2-2.5 cups of fruit, 3-3.5 cups of vegetables, 6-10oz of grains, 6-7oz of protein and 3 cups of dairy.  All women can benefit from taking a prenatal vitamin to ensure all nutritional needs are met for pregnancy.

The total weight gain recommend for pregnancy is based on your pre pregnancy BMI (body mass index).

If your BMI is 18.5 to 24.9 (normal weight) you should gain 25-35lbs, BMI of 25 to 29.9 (overweight) 15 – 25lbs, BMI >30 then 11-20lbs.

I will outline below what nutrients both macro and micro are needed for a healthy pregnancy.

Calcium: Your baby relies on this for healthy bone development. The recommend daily amount is 1000mg. The following foods are a good source of calcium: almonds, spinach, kale, collard greens, broccoli, leafy green vegetables and low fat milk products.

Vitamin B9 (folic acid): This is an essential component of prenatal vitamins and has a role in reducing birth defect of brain and spinal cord. The daily recommend amount in .4 to .6mg. The following foods are a good source of folic acid: leafy green vegetables like spinach and broccoli, beans, chick peas, almonds and fortified cereals.

Iron: Is essential to prevent anemia of pregnancy and for baby / placenta development. The daily recommend amount is 30mg. The following foods are a good source of iron: eggs, spinach, leafy green vegetables, walnuts, lean beef, pork, chicken and turkey. Note: it helps to take iron supplements with vitamin C rich foods or orange juice for better absorption and avoid constipation.

Vitamin D: This helps with fetal bone health. The daily recommendation is 600 international units. Vitamin D can be found in fortified milk, fish (salmon, tuna) and eggs

Choline: This is essential for the development of the baby’s central nervous system. The daily recommend dose is 450mg. The following foods are a good source of choline: eggs, meat, fish and diary.

Iodine: Is necessary for fetal thyroid development. The daily recommend dose is 250 micrograms. Dietary iodine intake comes from iodized salt and seafood.

Omega 3 fatty acids: May have benefit in fetal brain development. Fish is a good source of omega 3 fatty acids. Fish should be thoroughly cooked to avoid harmful organisms, sushi grade raw fish is safe if it was frozen appropriately. Certain predator fish (shark, swordfish, marlin, orange roughy, mackerel, tile fish) can contain mercury and should be avoided. For the latest information on contaminated fish visit nrdc.org/sites/default/files/walletcard.pdf

Fluid intake: The recommended daily intake is 2 liters per day which equivalent to 10 cups of water per day. This is necessary to meet volume requirements of pregnancy.

Caffeine intake: Recommend limiting to less than 200mg per day. Caffeine content: 8oz coffee has 133mg, 8oz tea 53mg, 12oz coke has 35mg, 12oz mountain dew has 71mg, 5hr energy drink has 215mg.

Tips to avoid food borne illness:

Practice good personal hygiene with hand washing, fully cook meats, fish and poultry, avoid unpasteurized dairy products, thoroughly rinse fruits and vegetables under running water for 30 seconds and avoid eating raw sprouts.

Things to avoid:

Alcohol, marijuana and tobacco- there is no safe amount in pregnancy.

You should avoid high-calorie low nutrient choices like sweets, processed foods and sodas.  Be careful not to exceeded the daily recommended amount of fat soluble vitamins (D, E, A, K).  No evidence that sweeteners (nutra sweet, Splenda, sweet n low, sunett or stevia) increases risk of birth defects.

Exercise during pregnancy:

Being physically fit during pregnancy can help you prepare for labor, minimize general aches and pain of pregnancy and help keep your energy up.

It is recommend if you are physically active to maintain a moderate exercise program during pregnancy if not this is a great time to start an exercise program. Begin slowly with goal to work up to 30 minutes exercise per day. Aim for a combination of aerobic, strength and flexibility exercises. Walking is great exercise and water aerobics are gently on joints.

Remember to take it easy, do not overdue it or exercise to exhaustion. Avoid overheating when exercising. Drink plenty of water and eat to avoid drops in blood sugar.

Avoid activities that involve bouncing, jumping, or balance. Avoid contact sports, scuba diving, skiing and activities that require you to lie flat on your back.

Specific pregnancy exercises:

The tailor stretch: This exercise is designed to stretch and tone your thigh muscles. Sit on the floor with the soles of your feet together, gently let your knees move apart toward the floor till you feel a mild stretch, relax and hold stretch for 5 seconds, repeat 5 to 10 times.

Pelvic rocking: This helps strengthen your abdominal muscles and relieve back pain. Get on your hands and knees with your back straight, breath in and tuck your head downward arch your back like a cat, hold for 5 seconds, breathe out and bring your head up, repeat 5 times.

Kegel exercise: This helps strengthen your pelvic floor muscles. Firmly tighten muscles around your vagina as you would to stop urinating, hold tight for 10 seconds, release muscles and relax, repeat 10 times and due 3 times per day.

Joseph Stalfire M.D., FACOG