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Leeds, Grenville & Lanark District Health Unit
Leeds, Grenville & Lanark District Health Unit

  Preconception/Pregnancy
- Prenatal Nutrition

During pregnancy your body is going though many changes. To support these changes and the growth of your baby, you will need more nutrients and energy.

 

Healthy Eating

Enjoy healthy balanced eating to get all the nutrients you need to prepare for pregnancy and breastfeeding. Eat a variety of foods from the 4 food groups: Vegetables and Fruit, Grain Products, Milk and Alternatives, and Meat and Alternatives. Women who are pregnant need more food in the second and third trimester to meet their higher nutrient and energy needs.

  • Eat lots of colourful vegetables and fruit. Try to eat at least one dark green (e.g., broccoli, green peas or beans, spinach, romaine lettuce) and one orange (e.g., carrots, sweet potato, squash) vegetable each day. Choose whole fruit, water or low-fat milk over juice. If you do choose to drink juice, choose 100% fruit juice.

  • Choose whole grains more often. Whole grain products, like whole grain bread, oatmeal, brown rice, quinoa, whole wheat pasta or bulgur, are higher in fibre, vitamins and minerals than refined grains.

  • Choose lower-fat milk and alternatives. Include skim, 1% or 2% milk, or fortified soy beverage, and lower-fat yogurt and cheese. Aim to drink 2 cups of milk or fortified soy beverage each day to get the calcium and vitamin D that you and your baby need. Try to also include other non-dairy sources of calcium in your diet, such as canned salmon with bones, broccoli and almonds.

  • Eat lean meat and alternatives. Meat and meat alternatives (e.g., legumes, lentils, chickpeas, eggs, tofu, nuts and nut butters) are excellent sources of iron and protein. Choose leaner cuts of beef and pork, and take the skin off poultry. Choose meat alternatives often, and try to eat low-mercury fish twice per week.

  • Balance your meals using the healthy plate.
    • Fill of your plate with colourful vegetables and fruit, and include more vegetables than fruit
    • Fill of your plate with whole grains
    • Fill the last of your plate with lean meat or meat alternatives
    • Add a glass of milk or fortified soy beverage

    Image of Portion Sizes

  • Eat regular meals. Try to eat at least every 3-4 hours. Include breakfast every day. Breakfast is important because you have gone all night without eating. Remember, if you don't eat, your baby doesn't either.

  • Have healthy snacks between meals. Try to include at least 2 of the 4 food groups in each snack. Pregnant women in their second and third trimester need extra food each day. This extra food could be an extra healthy snack, like hummus and raw vegetables, an orange and a few whole grain crackers, or a piece of toast with peanut butter and glass of milk (or fortified soy beverage). Healthy snacks are a great way to meet your extra nutrient needs.

  • Follow your appetite. When you are hungry between meals, choose healthy foods such as yogurt, fruit, vegetables, homemade bran or oatmeal muffins, whole grain crackers with cheese, nuts, etc.

  • Take a prenatal supplement each day. Look for one with 400 mcg (0.4 mg) of folic acid and 16-20 mg of iron. Remember, a prenatal supplement does not replace healthy eating. It will help you get the extra vitamins and minerals you need while you are pregnant.

The Health Unit can help support your healthy eating habits by providing access to registered dietitians and connecting you to programs like Good Food for a Healthy Baby, which provides free prenatal vitamins and grocery vouchers. If you would like more information please call 1-800-660-5853.

For a list of all food-related programs available in Leeds, Grenville and Lanark, visit the Food Inventory by foodcoreLGL or call 1-800-660-5853.





Folic Acid

Folic acid, or folate, is an important B vitamin needed for healthy growth during pregnancy. It helps build blood for your baby, and it is essential for your baby’s brain, spine and skull to grow properly. Getting enough folate before and during pregnancy helps protect your baby from Neural Tube Defects (NTDs). NTDs are serious birth defects that affect the baby's spine, brain or skull, such as spina bifida.

Along with eating foods rich in folate, you will need extra folic acid from a supplement. Look for a multivitamin with at least 400 mcg (0.4 mg) of folic acid. Take a multivitamin every day for at least 3 months before pregnancy. If you find out you are pregnant, switch to a prenatal supplement with at least 400 mg or 0.4 mg of folic acid. Take the prenatal supplement throughout your pregnancy and while breastfeeding, or for 6 weeks postpartum if you have made the informed decision to not breastfed.

Some women need more than 400 mcg (0.4 mg) of folic acid per day; talk to your health care provider about the amount of folic acid you should take. Do not take more than 1000 mcg (1 mg) per day unless advised by your doctor.

Since many pregnancies are unplanned, all women who could become pregnant should take a multivitamin with 400 mcg (0.4 mg) of folic acid and eat foods rich in folate every day.

*Taking a multivitamin does not replace the need to eat foods rich in folate. For more information:

 



Iron

You need extra iron when you are pregnant. Iron helps build healthy blood for you and your baby. It is important that your baby is born with enough iron to last the first 6 months of life. If you do not get enough iron during pregnancy, your baby may be born with a low supply of iron.

If you do not get enough iron you may feel tired, have a hard time concentrating, be more likely to get sick, and have a higher risk of complications during pregnancy and delivery.

There are two types of iron in food: heme iron and non-heme iron.

  • Heme iron is found only in animal products, like meat, poultry and fish. It is the easiest form of iron for the body to absorb.

  • Non-heme iron is found in animal products as well as eggs and plant-based foods, like legumes, vegetables, nuts, whole grains and iron-fortified grains. Our bodies do not absorb non-heme iron as well as heme iron.

Tips for getting more iron:

  • Eat a variety of foods rich in iron every day.
      • Beef, pork, poultry, fish, seafood, game meat
      • Legumes (beans, peas, lentils), eggs, tofu, nuts, seeds
      • Iron-fortified foods (cereals, breads, pastas)

  • Take a daily prenatal supplement with 16-20 mg of iron.

  • Eat foods rich in vitamin C throughout the day. Vitamin C helps your body absorb more iron from food. Try to eat 1 source of vitamin C at each meal. Vitamin C is found in most vegetables and fruit.

  • Look at the Nutrition Facts table on food packages. Choose foods that have 15% Daily Value (DV) or more for iron.

  • Do not take a calcium supplement or calcium-containing antacid during a meal. Wait 1-2 hours after a meal so it will not interfere with iron absorption.

  • Drink tea or coffee 1-2 hours after meals rather than with meals. These drinks interfere with iron absorption. Learn more about caffeine during pregnancy.

If your iron stores were low before becoming pregnant, talk to your health care provider as you may need more iron.





Calcium and Vitamin D:

Calcium and vitamin D help keep your bones healthy. They also help build strong bones and teeth for your baby. You need 1000 mg of calcium and 600 IU of vitamin D during pregnancy.

Eat foods rich in calcium and vitamin D every day.

Good sources of calcium:

  • Milk, cheese, yogurt, kefir
  • Fortified soy beverage*
  • Tofu, beans
  • Sardines or salmon (canned with bones)
  • Collards, spinach, turnip, kale

*There are many plant-based (non-dairy) beverages available. If you choose one, make sure it is fortified or enriched, meaning vitamins and minerals have been added to it.

There are only a few food sources of vitamin D: milk, fortified soy beverage, fortified yogurt and fish. A prenatal supplement will also provide vitamin D for pregnant women.





Omega-3 Fats and Fish


You need more omega-3 fats when you are pregnant. Omega-3 fats are needed for your baby’s eyes, brain and nerves. There are different types of omega-3 fats in food:

  • ALA (alpha-linolenic acid)
    • Found in: canola oil, flax oil, walnut oil, walnuts and flax seeds.
  • DHA (docosahexaenoic acid)
    • Found in: fatty fish
  • EPA (eicosapentaonoic acid)
    • Found in: fatty fish

Our bodies can convert ALA into DHA and EPA, but it is important to include foods sources of ALA, DHA and EPA in your diet.

Tips to get more omega-3 fats:

  • Eat fish at least twice a week and include fatty fish, like: salmon, trout, mackerel, sardines, herring and char. Choose fish that are low in mercury.
  • Sprinkle walnuts and flaxseeds on yogurt, cereal, oatmeal or salads.
  • Cook with canola or flaxseed oil, or use them in a salad dressing.
  • Choose omega-3 eggs, or other foods fortified with omega-3 (e.g., milk, yogurt).

Talk to your health care provider before taking a fish oil supplement. Fish oil supplements should not be considered equivalent to eating fish. Avoid taking cod liver oil with prenatal supplements. The amount of vitamin A from both supplements combined could be enough to harm your growing baby.

 


Vegetarian Eating

A well-planned vegetarian diet can provide all of the nutrients that you and your baby need. If you do not eat any foods that come from animals, it can be harder to meet your needs during pregnancy.

Here are some tips to help you get the nutrients you and your baby need:

  • Mix up your meat alternatives (e.g., beans, peas, lentils, tofu, eggs, nuts, seeds) to help you get enough protein.
  • Drink milk or fortified soy beverage to get calcium and vitamin D.
  • If you do not eat any foods that come from animals, you may need extra nutrients when you are pregnant. These include: protein, vitamin B12, vitamin D, calcium, iron, zinc and omega-3 fats.

Talk to a registered dietitian or your health care provider about vegetarian eating during pregnancy.

 

 

Healthy Weight Gain for Pregnancy

Women come in many shapes and sizes, all of which can be healthy. Most women have a healthy weight gain during pregnancy if they follow a few general tips:

  • Eat a variety of healthy foods from the four good groups, including:
      • Colourful vegetables and fruit
      • Whole grains
      • Lower fat milk and alternatives
      • Lean meat and alternatives
  • Be active while you are pregnant.
  • Eat when you are hungry and do not cut back on food.
  • Maintain a healthy mental and emotional state while pregnant by managing stress (pg 48).

Visit these resources for more information:

It is important to gain a healthy amount of weight for both you and your baby. This amount will depend on your weight before becoming pregnant and many other factors, like genetics, health conditions and lifestyle. Talk to your health care provider about your healthy weight gain during pregnancy.

There are risks to gaining too little or too much weight during pregnancy. It is also important for women to pay attention to how quickly they gain weight. Weight gain is usually slow in the first trimester. After the first trimester, it is normal for women to put on weight steadily, as they gain lean and fat tissues.

During pregnancy you will gain weight in many areas. Below is a list of the average weight gain in each area during a typical pregnancy. You may be surprised that only 5-8 pounds of this weight gain is fat. The fat is stored for extra energy that you will need while you are pregnant and breastfeeding.

Average weight gain in each area during a typical pregnancy:

  • Blood – 4 lbs
  • Extra fluids/fluid retention – 2 to 3 lbs
  • Energy stored as fat for pregnancy and breastfeeding – 5 to 8 lbs
  • Placenta and amniotic fluid – 4 to 6 lbs
  • Baby – 6 to 8 lbs
  • Breasts – 2 to 3 lbs
  • Uterus – 2 to 3 lbs 

NOTE: If you have gained more weight than recommended in your pregnancy, do not diet to lose weight. Cutting out food and calories can put you and your baby at risk. Please see your health care provider if you have any questions or concerns.





Caffeine

Too much caffeine isn’t good for your baby. When you’re pregnant, caffeine stays in your body longer and passes through the placenta to your baby. Too much caffeine can affect your baby’s growth and the nutrients your baby gets.

If you are pregnant, breastfeeding or may become pregnant, have less than 300 mg of caffeine per day. This is the amount of caffeine in about 2 eight oz. (250 mL) cups of coffee.  Remember, other drinks and food may have caffeine, like tea, cola and chocolate. If you consume other caffeine containing food and drinks they will add to your total caffeine intake for the day. Read food labels and choose products that have low or no caffeine.

**Drinks that contain caffeine should not take the place of more nutritious drinks, like milk, fortified soy beverage or water.

Withdrawal & Cutting Back: If you stop taking caffeine suddenly you could experience withdrawal symptoms like headache, fatigue, irritability and depression. Cut back on caffeine gradually to avoid these symptoms. Tips to cut back:

  • Use a smaller cup
  • Mix regular and decaf coffee
  • Brew tea for a shorter time
  • Try a café-au-lait made with half coffee and half low fat milk
  • If you drink soft drinks, choose ones that are caffeine free

Energy drinks should be avoided during pregnancy and breastfeeding. Energy drinks are high in caffeine and have other ingredients that may harm your baby. Energy drinks are also not recommended for children due to their high caffeine content and possible side effects like, irregular heartbeat, nervousness, restlessness and trouble sleeping.

 



Herbal Teas


Be careful if you use herbal teas or drinks while you’re pregnant. Not all herbal teas have been tested for safety during pregnancy. Some can harm your baby or cause early labour. Herbal teas should not take the place of more nutritious drinks, like milk, fortified soy beverage or water.

Herbal teas that are generally considered safe in moderation (no more than 2 to 3 cups per day):

  • Bitter orange/citrus peel
  • Ginger
  • Rose Hip
  • Echinacea
  • Peppermint
  • Red Raspberry Leaf
  • Rosemary

*All other herbal teas should be avoided.

 

Food Safety & Foods to Avoid

Both you and your baby are at a higher risk of food poisoning when you are pregnant. Food poisoning is caused by food that has been contaminated by bacteria, viruses or parasites. Certain bacteria, viruses and parasites can harm your baby.

Keep Foods Safe:

  • Separate – keep meat, poultry, fish and seafood separate from other food in your grocery cart and refrigerator.
  • Clean – wash your hands before, during and after handling food.
    • Clean surfaces (counter, plate, utensil, etc.) that have been in contact with raw foods before using it again.
    • Wash fresh produce well before eating or cooking.
  • Chill – keep cold foods cold.
    • Thaw food in the refrigerator, microwave or in cold water and not on the counter.
    • Don’t refreeze thawed foods.
    • Never leave raw meat, fish, poultry, seafood or leftovers on the counter for more than 2 hours. Cool leftovers quickly by placing them into shallow containers and refrigerate as soon as possible.
  • Cook – cook meat, poultry, fish and seafood well. Use a food thermometer to make sure the food has reached a safe internal temperature. Remember to keep hot foods hot.
  • Follow “best before” dates. Do not use foods past their “expiry” date.
  • Eat refrigerator leftovers within 2-4 days. Avoid reheating the same leftover more than once.

Foods to Avoid:

  • Undercooked meat, poultry, fish, seafood or hotdogs
  • Raw fish, sushi made with raw fish, and raw shell fish
  • Pâtés, meat spreads, smoked fish products, non-dried deli meats (e.g., bologna, roast beef, turkey breast)
  • Unpasteurized milk products and foods made from them
  • Raw soft and semi-soft cheese (e.g., Brie, Camembert), all blue-veined cheese
  • Raw or lightly cooked eggs and food made from them
  • Raw sprouts
  • Unpasteurized juice and cider

For more information:





Nausea and Vomiting

Many women may feel sick during their pregnancy. It often happens during the first few months and subsides by the second trimester. Feeling sick, or not being able to eat well in the first few weeks of pregnancy has not been shown to affect your growing baby.

The following tips may help you feel better:

  • Eat what appeals to you.
  • Eat several small meals throughout the day instead of 3 large meals. Avoid skipping meals as you may feel worse if your stomach is empty.
  • Try eating crackers, bread or dry cereal.
  • Have a small, healthy snack before bedtime.
  • Drink fluids before or after meals, not with meals.
    • Try to drink at least 2 litres of fluid per day, in small, frequent amounts. Contact your health care provider if you start to notice signs and symptoms of dehydration, such as: thirst, dry mouth/skin, reduced urine, cracked lips, headache, dizziness, etc.
  • Avoid spicy, fatty or fried foods, or foods with strong odours.
  • Get some fresh air and avoid getting too warm.

Talk to your health care provider before using any over-the-counter medications or alternative therapies. Also talk to your health care provider if you cannot stop vomiting, you feel too sick to eat at all, or you are experiencing weight loss or dehydration.

Call the Motherisk Nausea and Vomiting in Pregnancy Helpline for more ideas:
1-800-436-8477





Heartburn

Heartburn is common during pregnancy. It happens because of the pressure of your growing baby against your stomach and hormone changes.

The following tips might help with heart burn:

  • Eat several small meals throughout the day rather than 3 large meals.
  • Wait at least 1-2 hours after eating before lying down.
  • When you do lie down, raise your head and shoulders.
  • Drink fluids before or after meals, not with meals.
  • Choose lower fat foods.
  • Avoid coffee, colas, alcohol and smoking.

Talk to your health care provider before taking antacid medicine. Not all antacids are safe during pregnancy.





Constipation

Many women get constipated during pregnancy. It happens because food moves through your body more slowly when you are pregnant so you can absorb the extra nutrients you and your baby need.

To prevent constipation eat foods that are high in fibre and drink more fluids. Choose water and milk, and warm or hot fluids may help. Physical activity is also important.

High fibre foods include:

  • Vegetables and fruit
  • Whole grains (e.g., whole grain bread, cereal, brown rice, whole wheat pasta, quinoa, bulgur)
  • Cooked or canned beans
  • Peas and lentils

Talk to your health care provider before taking any laxatives. Some laxatives are not safe to use during pregnancy.

 


Reducing the Risk of Food Allergies

There is no need to avoid common food allergens during pregnancy in the hopes of preventing your baby from having food allergies, regardless of family history of food or environmental allergies.

Only avoid the foods that you are allergic to. You do not need to avoid the food allergies of the biological father.

 

Resources

The Health Unit can help support your healthy eating habits by providing access to registered dietitians and connecting you to programs like Good Food for a Healthy Baby, which provides free prenatal vitamins and grocery vouchers. If you would like more information please call 1-800-660-5853.

For a list of all food-related programs available in Leeds, Grenville and Lanark, visit the Food Inventory by foodcoreLGL.




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