Healthy Eating in Pregnancy
As soon as you are pregnant, you may find yourself googling what you can and cannot eat. We'll, don't worry Mumma, we have the answers for you!
We spoke to Pippa Morrish, who is a registered and practicing midwife. Pip currently works as a Delivery Suite Sister in an NHS hospital and is also studying for her master’s degree in Professional Development. Pip has a wealth of experience in assisting and supporting mothers through pregnancy and birth and is passionate about empowering women through antenatal education. You can find more on her Instagram @midwife_pip
Why is nutrition important in pregnancy?
The mother of a newborn baby focuses much time and thought on ensuring that their baby is fed in the most nourishing way possible. Utilising the power of breastmilk and as the weening period begins seeking out the most nutritious and colourful fruits, vegetables and organic ingredients. Yet often in pregnancy women do not focus this degree of care and attention to what they are consuming. However, nutrition in pregnancy should be valued as highly as what is consumed when pregnant provides the nutrient stores for babies to use for growth and development.
There is lots of evidence around the first 1,000 days of life- that is, the nine months of pregnancy and the first two years of the baby’s life. This time is seen as a critical window of opportunity for getting sufficient nutrition and it is a period during which mothers can make the most important contribution to their child’s healthy future.
There are direct links between inadequate nutrition and increased pregnancy complications, such as preterm birth and low birth weight babies. The maternal diet must provide sufficient energy and nutrients to meet her usual requirements and the needs of her growing baby and also to enable the mother to lay down stores of nutrients required for lactation and breastfeeding.
How many calories should you consume in pregnancy?
Eating for two is most definitely a myth, in fact calorie requirements in pregnancy do not increase until the 3rd trimester. Even then only an extra 200-300 extra calories a day is recommended. This is roughly equivalent to a pitta bread with hummus, ½ cup of almonds, 2 poached eggs on toast or a banana smoothie.
Often in pregnancy women feel focused on what you cannot eat but actually the list of foods is marginally small compared to all the foods that can be eaten so you need not feel restricted.
What should you eat in pregnancy?
Our diets are made up of 3 macronutrients- carbohydrates, protein and fat. We then have multiple vitamins and minerals that are essential to health and wellbeing.
Incorporating these important nutrients should not be isolated to pregnancy and should form your diet in all periods of your life but the impact of a healthy diet in pregnancy is when it is often most powerful.
Macronutrients:
Carbohydrates should be your body’s main source of energy. Carbohydrates are broken down into glucose (sugar) and absorbed into your blood so the glucose can enter your cells and be used by your body for energy.
Protein is composed of amino acids which are often referred to as ‘the building blocks of life’. This is because they are found in every cell of the body and are responsible for repair and growth of cells. Protein requirements increase in pregnancy to 1g/kg of body weight.
Fats, specifically the ‘good’ or un-saturated versions are essential to health and the absorption of certain vitamins such as vitamin A, D and E. some energy but also growth and repair of tissues.
Each meal should contain foods from each of these groups to make a balanced and varied diet. Using complex carbohydrates over refined, white versions gives you extra fibre and helps to maintain your blood sugars. For example, brown rice and pasta, wholemeal bread, oats and leaving skins on potatoes. Aim to limit your saturated fat intake from foods such as butter, cakes and chocolate and increase your unsaturated fats from sources including nuts, seeds, fish, avocados and olive oil.
There is some evidence emerging that a healthy gut microbiome in pregnancy can lead to a reduction in asthma, eczema and allergies in children. Having variety is key to a healthy gut microbiome, so including a wide range of fruits, vegetables, legumes and grains is important. Try mixing up your normal regime to boost your gut health. For example, swap an apple for a pear, switch orange carrots for purple carrots, buy the mixed frozen berries for your smoothie over a single type and use pack of mixed seeds over individual types.
Micronutrients:
If you are eating a balanced, varied diet encompassing each of the 3 macronutrients then you should be getting the necessary amount of micronutrients in too.
Iron is an essential micronutrient, however 1/3 of women of childbearing age have low iron stores. Iron is important in making red blood cells which transport oxygen around the body as well as other body functions such as gastrointestinal and immune systems. Deficiency in iron may lead to anaemia which may make you feel very tired and lethargic, cold, short of breath and generally weak. Pregnant women with low iron may also be more prone to infection because it supports the immune system and it is also associated with low birth weight infants and preterm birth.
Iron requirements increase in pregnancy (27mg/day) - because red blood cell production increases dramatically to provide your baby with the oxygen and nutrients to grow
There are two main sources of dietary iron- haem iron (found in animal-based food) and non-haem iron (found in plant-based food). Haem Iron sources include- beef, pork, lamb, eggs and some fish including mackerel, tinned tuna and prawns. Non- Haem sources include- chickpeas, kidney beans, tofu, figs, almonds, brazil nuts, peanut butter, sesames seeds, sunflower seeds and green leafy veggies (spinach, broccoli, kale etc). To aid your body’s ability to absorb iron in food eat it with Vitamin C rich foods such as fruits and veggies.
Some of the other micronutrients that are important in the development of a healthy baby and pregnancy are:
Vitamin A- for cell growth, eye health and nervous system support. Too much in pregnancy however is linked to birth defects so avoid supplementation. A healthy amount can be obtained from a balanced diet. Sources include- eggs, milk, butter, apricots, carrots, tomatoes, spinach and many other fruits and vegetables
Zinc- helps to form the baby’s organs, skeleton, nerves and circulatory system. Sources include- canned sardines and tuna, eggs, meat, prawns, milk, beans and lentils, tofu, nuts, wholemeal bread
Iodine- helps regulate metabolism and thyroid function. Iodine deficiency is believed to be the biggest cause of learning disability in children. Sources include- butter, cheese, milk, yogurt, eggs, fish
Choline- is essential in the development of your baby’s brain. Sources include- eggs, meat, vegetables, toft, nuts, seeds
Vitamin C- building block for skin and is also an antioxidant to help protect cells against damage. Sources include- fruits and vegetables
Thiamin- plays an important role in the development of the baby’s nervous system. Sources include- chicken, eggs, nuts, potatoes, oatcakes, wholemeal bread
Omega 3 fatty acids- Many benefits for mothers such as; improved heart, eye, brain and mental health. And they are also the building blocks for the baby’s brain and eyes. Studies linking omega 3 intake in pregnancy may lead to improved IQ and cognition of children. Sources include- oily fish (sardines, salmon, mackerel) nuts and seeds, plant oils (flaxseed).
Do I need to take supplements in pregnancy?
A balanced diet should enable you to obtain the micronutrients that you and your baby need. However, there are two recommended supplements for pregnancy:
Vitamin D - is important for bone develop for mother and baby and levels cannot be met through diet alone, most adults make their vitamin D through sunlight exposure of which we don’t tend to get a lot of in the UK.
Folic Acid - recommended ideally 3 months prior to conception and in first trimester to reduce risk of neural tube defects
This post was written by Pip Morrish who is a registered and practicing midwife. You can find more on her Instagram @midwife_pip
References:
Valdes, A. (2018) Role of the gut microbiota in nutrition and health. BMJ. 316 (1) pp. 36-44. RCOG (2015) Advice on Nutrition in Pregnancy. Available from: https://www.rcog.org.uk/en/news/rcog-statement-advice-on-nutrition-in-pregnancy/ [Accessed 25th June 2020].
RCOG (2014) Healthy Eating and Vitamin Supplements in Pregnancy. Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-healthy-eating-and-vitamin-supplements-in-pregnancy.pdf [Accessed 25th June 2020].
WHO (2018) Weekly iron and folic acid supplementation as an anaemia-prevention strategy in women and adolescent girls. Available from: https://www.who.int/nutrition/publications/micronutrients/WIFS-anaemia-prevention-women-adolescent-girls/en/ [Accessed 25th June 2020].
WHO (2013) Essential Nutrition Actions. Available from: https://www.who.int/nutrition/publications/infantfeeding/essential_nutrition_actions/en/ [Accessed 25th June 2020].
WHO (2019) Nutrition Counselling During Pregnancy. Available from: https://www.who.int/elena/titles/nutrition_counselling_pregnancy/en/ [Accessed 25th June 2020].