Patient education: Nutrition before and during pregnancy (The Basics)

Will I need to change the way I eat when I am pregnant? — Probably. In fact, you will probably need to change the way you eat before you get pregnant. You will also need to start taking a multivitamin that has folic acid in it.

If you want to get pregnant, see your doctor or nurse before you start trying. They will explain how your diet needs to change and outline the steps you can take to have the healthiest pregnancy possible.

Eating the right foods will help your baby's development. Your baby will need nutrients from these foods to form normally and grow.

Eating the wrong foods could harm your baby. For example, if you eat cheese made from unpasteurized milk or raw or undercooked meat, you could get an infection that could lead to a miscarriage. A miscarriage is when a pregnancy ends on its own before the baby can live outside the womb. Likewise, if you take too much vitamin A (more than 3,000 micrograms or 10,000 international units a day) in a vitamin supplement, your baby could be born with birth defects.

Making healthy food choices is important for your health, too. As your baby grows and changes inside you, it will take nutrients from your body. You will have to replace these nutrients to stay healthy and have all the energy you need.

Which foods should I eat? — The best diet for you and your baby will include lots of fresh fruits, vegetables, and whole grains, some low-fat dairy products, and a few sources of protein, such as meat, fish, eggs, or dried peas or beans. If you do not eat dairy foods, you will need to get calcium from other sources.

You can eat types of fish and seafood that are very low in mercury. In fact, eating these kinds of fish is good for your baby's development, as long as you don't eat them too often. Each week, experts suggest eating:

●2 to 3 servings of fish very low in mercury – These include shrimp, canned light tuna, salmon, pollock, and catfish.

or

●1 serving of fish low in mercury – These include bluefish, grouper, halibut, mahi mahi, and yellowfin tuna. Tuna steaks are also OK to eat, but only 1 time a week.

You should avoid fish that are high in mercury (see below).

If you are a vegetarian, speak to a nutritionist (food expert) about your food choices. Vegetarian diets can sometimes be missing nutrients that are important for a growing baby.

Should I prepare food differently? — Maybe. It's important to be extra careful about avoiding germs in your food. Getting an infection while you are pregnant can cause serious problems.

Here's what you should do to avoid germs in your food:

●Wash your hands well with soap and water before you handle food.

●Make sure to fully cook fish, chicken, beef, eggs, and other meats.

●Rinse fresh fruits and vegetables under lots of running water before you eat them.

●When you are done preparing food, wash your hands and anything that touched raw meat or fish with hot soapy water. This includes countertops, cutting boards, and knives and spoons.

To reduce the risk of germs in food, you should also avoid certain foods that can easily carry germs. These include:

●Raw sprouts (including alfalfa, clover, radish, and mung bean)

●Milk, cheese, or juice that has not been pasteurized (also called "unpasteurized")

Which foods should I avoid? — You should avoid certain types of fish and all forms of alcohol. You should also limit the amount of caffeine in your diet, and check with your doctor before taking herbal products.

●High mercury fish – You should not eat types of fish that could have a lot of mercury in them. These include shark, swordfish, king mackerel, marlin, and tilefish (from the Gulf of Mexico). Mercury is a metal that can keep the baby's brain from developing normally.

Check with your doctor or nurse about the safety of other types of seafood, including fish caught in local rivers and lakes. The US Food and Drug Administration (FDA) also has more information about specific types of fish on their website (www.fda.gov/food/consumers/advice-about-eating-fish).

●Alcohol – You should avoid alcohol completely. Even small amounts of alcohol could harm a baby.

●Caffeine – Limit the amount of caffeine in your diet by not drinking more than 1 or 2 cups of coffee each day. Tea and cola also have caffeine, but not as much as coffee.

●Sugary drinks – Avoid or limit drinks with lots of sugar, such as soda and sports drinks. These are not good for your health at any time.

●Herbal products – Check with your doctor or nurse before using herbal products. Some herbal teas might not be safe.

●Cannabis products – Edible cannabis products are legal in some places. But most doctors and nurses recommend avoiding them during pregnancy. As with smoking marijuana, eating products that contain cannabis could cause problems for a baby, either at birth or later in life. More research is needed to better understand how cannabis affects pregnancy.

What are prenatal vitamins? — Prenatal vitamins are vitamin supplements that you take the month before and all through your pregnancy. These vitamins, which also contain minerals (iron, calcium), help make sure that your baby has all the building blocks they need to form healthy organs. Prenatal vitamins help lower the risk of birth defects and other problems.

What should I look for in prenatal vitamins? — You can buy prenatal vitamins from a store or pharmacy. Choose a multivitamin that's labeled "prenatal" and that has at least 400 micrograms of folic acid. Folic acid is especially important in preventing certain birth defects. Show your doctor or nurse the vitamins you plan to take to make sure the doses are right for you and your baby. Too much of some vitamins can be harmful.

Your doctor can also prescribe a prenatal vitamin for you. Prescription vitamins often have more of some vitamins and minerals than the ones found in stores. For example, your doctor might give you a prescription if they think you need extra iron. It's important to get enough iron while you're pregnant. This can help prevent a condition called "iron deficiency anemia."

How much weight should I gain? — This depends on how much you weigh to begin with. Your doctor or nurse will tell you how much weight gain is right for you. In general, a person who is a healthy weight should gain 25 to 35 pounds during pregnancy. A person who is overweight or has obesity should gain less weight.

If you start to lose weight, for example, because you have severe morning sickness, call your doctor or nurse.

What if I can't afford to eat well? — If you can't afford healthy food, ask your doctor or nurse for information about programs that can help you. In the United States, there is a government program called "WIC" that helps pregnant people and their families get the nutrition they need. Many states and towns also have local programs to help those who are pregnant or nursing.

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Patient education: Health and nutrition during breastfeeding (Beyond the Basics)