I would have to say that one of the biggest differences between this pregnancy and my first is that I’m a lot less strict about what I’m eating. The first time around I cut caffeine cold turkey, obsessed about calories (was I getting too little? Too much?) and tried to avoid heavily processed foods as much as possible. I was so worried that the smallest glitch in my diet would produce a baby who wasn’t healthy, and I didn’t want to be responsible for doing anything to potentially harm her.
Now even though I still make sure I’m eating as healthy as possible to give both myself and my growing baby the nutrients we need, I’ve definitely learned that balance is okay. I’m also trying to not focus so hard on what I shouldn’t be eating, and more on what I should be eating. When I know I can’t have something, it makes me want it even more. All I want is a deli sandwich for lunch and a large plate of sushi with wine for dinner. Why is it that the foods I know I can’t have are the ones I crave the most??
Most OB doctors and midwives spend a good deal of time talking with expecting mothers about the foods that are off limits. Rarely is there time spent on reviewing the foods and nutrients that bring benefits to expecting mothers and babies- even though it’s just as important!
Pregnancy is a time of high metabolic and nutrition demands. It’s important to remember that even though you are feeding both yourself and baby, the baby is not the size of another adult. Calorie needs are higher during pregnancy, but you don’t need to literally “eat for two.” Conversely, it’s important to meet the higher calorie needs to support a healthy growing environment for your baby. Eating too little can cause intrauterine growth restriction, low birth-weight, and may even set metabolic markers in place that results in the baby being more likely to become obese as an adult. There’s evidence that if that baby’s not getting adequate nutrition in utero, it causes their tiny bodies to think they will have very little to survive on. This can result in their metabolism being impacted long term. A poor diet during pregnancy can also put the baby at risk for insulin resistance, type 2 diabetes mellitus, and cardiovascular disease later in life. So what can you do to make sure you are giving your growing baby and body everything it needs?
What you need
This important nutrient is found in all prenatal supplements. In fact, it’s role in neural tube defect prevention is largely why practitioners say taking a prenatal vitamin is so important! I actually recommend that women of childbearing age aim to get an ample amount of folic acid in their diets, either from foods or a supplement, before trying to get pregnant. The reason? Because of the amount of development that happens in those first few weeks post-conception, you’ll want to make sure that you aren’t folic acid deficient from the start. Food sources of folic acid include orange juice, fortified cereals, beans, lentils, leafy greens, and whole grains.
Iron needs are high during pregnancy due to increased blood volume, fetal development, and the possibility of blood loss during delivery. Iron needs increase as the pregnancy progresses. It’s important for proper brain function, especially in the development of the hippocampus (which is responsible for memory formation and emotional regulation). Because the baby’s brain experiences a growth spurt in the 3rd trimester and then relies on iron stores obtained in utero to sustain growth for the first sixth months of life, consistent and adequate iron intake is essential during pregnancy. Children who aren’t exposed to enough iron prenatally have been shown to have poor cognitive and motor skill development due to improper gray-matter organization. Iron-deficient children tend to suffer learning and behavioral problems and also show abnormal cognitive development into their late teens.
Iron is found in a variety of plant and animal foods as well. The type of iron found in animal foods (red meat, seafood) is referred to as heme iron, and is absorbed best by our bodies. Nonheme iron is found in many plant foods, the best sources being spinach and other leafy greens, dried fruits, beans and peas, tofu, seeds, nuts, soy milk and fortified breakfast cereals. Nonheme iron has a decreased rate of absorption by the body, so if you are getting most of your iron from non-animal sources try consuming a good source of Vitamin C in the same meal. The acidity will help to absorb the iron. Avoid consuming nonheme iron sources with foods high in tannins and phytate (coffee, tea, bran, soy and pinto beans, potatoes) because they compete for absorption and reduce iron availability. Iron isn’t commonly found in prenatal supplements, since the calcium found in these will bind to it and reduce absorption. If you are anemic you may need to take an iron supplement throughout your pregnancy.
Calcium absorption is increased in pregnancy, which typically results in positive calcium balance. You will still want to get calcium from food sources, because prenatal supplements only provide about 500mg (the maximum amount that can be absorbed by the body at once). Aim for at least 2 extra servings of calcium per day. Aside from cow’s milk, good sources include yogurt, leafy greens, beans, soy/nut/rice/hemp milk and fortified juices and cereals.
Vitamin D deficiency during pregnancy is currently the focus of ongoing research. It has been suspected to be linked to preeclampsia, low birth weight, poor postnatal growth and higher incidence of autoimmune disease in babies. The best food sources of Vitamin D is oily fish, fortified foods (some dairy products, soy milk, cereals), egg yolks and cheese.
The omega-3 fatty acid DHA is a necessary part of cell membranes and is important for brain development. Babies born with higher umbilical cord plasma levels of DHA have been found to have higher memory function once they are school-age. Sources of DHA include fatty fish (salmon, herring, anchovy), fish oils, and fortified egg and dairy products. ALA is a fatty acid that is converted to DHA, and is found in flax seed, hemp seeds, walnuts, canola oil and leafy greens. The conversion of ALA to DHA can be reduced by having an excess of omega-6 fatty acids in the diet. Sources of omega-6 fats include animal meats, eggs and vegetables oils (corn, safflower, soybean and sunflower). Aim for obtaining fats from DHA and ALA sources, and less from omega-6 sources.
Strive for balance and variety
Eating a well balanced diet when pregnant may result in having a child who’s more inclined to try and accept a larger variety of foods. Around 21 weeks post conception, babies start talking gulps of the amniotic fluid surrounding them- and it actually tastes like the foods and beverages mom has consumed in the past couple of hours! It was hard for me to pass up sweets in my first pregnancy- and my firstborn loves them (but then again, what kid doesn’t love sugar??). But she also loves and is willing to eat about any vegetable I put in front of her. Something else I ate a lot of when I was pregnant with her!
To make sure you are getting the most balance and variety in your diet as possible when pregnant, aim for lots of color in your meal. The more colorful your meal, the more nutritious it is! Try to avoid an all brown or all white plate. I know this can be hard in the first trimester- I lived off buttered pasta and bread for two months straight! Once the nausea wears off and food tastes good again, really try to focus on that good nutrition. It’s when it matters the most.
You’ll want to ask yourself each meal if you are getting all of the major nutrients (fat, carbohydrate, protein). Aim for carbohydrates that are high in fiber like fruits and whole grains. Reach for lean proteins and healthy fats. I know I feel much more energetic when I eat a healthy balanced meal- especially in that 3rd trimester! With my last baby, it was extremely difficult to eat a full meal once I was past 30 weeks. Especially since I was so pregnant in the heat of the summer! I have a short torso, and eating the littlest bit made me feel overly full. Instead of focusing on meals, I tried to make the most out of snacking. I would snack about once every 1-2 hours, still incorporating a variety of all the major nutrients. Smoothies were my best friend! Much easier to eat spinach and fruits blended together with flaxseed than making myself eat a big salad or heavy meal.
Balance doesn’t just mean eating that perfect plate. It’s about treating yourself a little bit too! My sweet tooth definitely comes out when I’m pregnant, and it can be hard to control at times. I remember having one of those huge cupcakes from a food truck in Austin, TX when I was about 27 weeks pregnant with Carli. I told myself I would only eat 1/2 and finish the rest later, but I couldn’t stop from eating the whole thing. It was delicious and Carli seemed to enjoy it too- the gymnastics she did in my belly from the sugar rush kept me up until almost 2AM that night!
Eating a healthy diet during pregnancy isn’t about being perfect. It’s about doing what you can to provide the best nutrition for yourself and your growing baby. I’ve definitely had to give up the guilt I’ve had for not passing up my morning coffee or being too tired to make anything other than a bowl of cereal for dinner (or..ahem..ice-cream) some nights. I just make sure that 80-90% of the time I’m filling my body with the best nutrition I can give it- and in just 13 more weeks, I’ll be enjoying that big plate of sushi and tall glass of red.