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Prenatal

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Prenatal Nutrition

**As soon as you think you are pregnant, see a doctor. Nothing can help your baby more than prenatal care.**

Changes

Morning Sickness

  • Morning sickness is nausea and/or vomiting which occurs at any time of the day during pregnancy.
  • It usually begins around the 6th week of pregnancy and often ends around the 12th week.
  • Morning sickness is a common discomfort during pregnancy.
  • Many doctors believe morning sickness is good for both the mother and the baby.  It protects the baby from food contamination and also helps prevent harmful chemicals from reaching the baby which could effect the baby’s development. This is why certain smells and certain foods cause nausea more than others.
  • Women who experience morning sickness are less likely to have a miscarriage.
  • Exercise can help reduce morning sickness. Ginger is also useful in reducing morning sickness, so drink ginger ale or eat ginger snaps.
  • If your morning sickness is extremely bad and you are even losing weight, please see your doctor.
  • For a list of other helpful tips to reduce the effects of morning sickness, please visit this site:  http://www.americanpregnancy.org/pregnancyhealth/morningsickness.html

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Growing Baby

  • You should only gain between 25 and 35 pounds during pregnancy.
  • If you are underweight prior to pregnancy, you should gain between 28 and 40 pounds.
  • If you are overweight prior to pregnancy, you should gain between 15 and 25 pounds.
  • Typically you will gain 2-4 pounds during the first trimester.
  • You will gain 3-4 pounds per month for the second and third trimesters:
  • Uterus: 2 pounds
  • Breasts and hips: 7 – 11 pounds
  • Total: 25 – 35 pounds
  • If you are having twins, you will gain more weight.
  • Ask your doctor and/or WIC staff if you have any questions or concerns.

Check out the following sites to learn about what happens during each month of pregnancy for both the mom and the baby

Common Discomforts During Pregnancy

The following are common discomforts that most women feel during pregnancy
  • Fatigue and insomnia
  • Breast Changes
  • Nausea and Vomiting
  • Varicose Veins
  • Stretch Marks
  • Headaches
  • Backaches
  • Swelling in hands and feet
  • Vaginal discharge
  • Bleeding gums and nose bleeds
  • Heartburn and Indigestion
  • Constipation and Hemorrhoids
  • Lower abdominal or pelvic pain

While all of these are common pains, it is important to also know what a common discomfort is and what can be a sign of preterm labor or another serious health problem. For instance, headaches are normal during pregnancy, but headaches that do not go away even after taking medicine or are accompanied by blurred vision can be a sign of preterm labor. Contact your doctor if you are unsure and to find ways to relieve some of these pains. While no one expects a pregnant woman to feel completely comfortable during pregnancy, you don’t have to suffer from constant pains either.

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Possible Health Concerns

Gestational Diabetes

Gestational diabetes is diabetes that occurs only during pregnancy or shortly after delivery. Gestational diabetes can cause problems for both the mother and the baby including the baby growing so rapidly as to need a C-section. It can typically be treated through diet and exercise. Insulin is rarely needed. A glucola tolerance test should be done by your healthcare provider between 24 and 28 weeks of pregnancy. Women who are considered at risk for gestational diabetes are those

  • Who become pregnant past 30 years of age
  • Are overweight
  • Have a family history of diabetes
  • Who had a previous pregnancy with gestational diabetes
  • Of African American, Hispanic, Native American, or Asian descent

If a woman's gestational diabetes is not kept under control, there is a chance she could have a stroke and die. Gestational diabetes can usually be prevented by proper diet and exercise before becoming pregnant.

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Hypertension/High Blood Pressure/Pregnancy Induced Hypertension

Blood pressure is the force of your blood pushing against the arteries in your body. When this pressure gets too high it is called hypertension. Having high blood pressure or hypertension at any age can cause health problems. Signs usually begin around 20 weeks of pregnancy.

Hypertension may narrow the blood vessels in the uterus that supply your baby with oxygen and nutrients. This causes serious risk for both you and your baby. You can be at risk for a stroke or heart attack. Your baby can be at risk for slow growth and low birth weight. There is also a much greater chance of premature birth. Also, placental abruption can happen during delivery. This happens when the placenta separates from the uterine wall causing heavy bleeding and shock. This could possibly lead to death.

These issues are very treatable and preventable with help from your doctor.

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Preeclampsia/Eclampsia/HELLP

Preeclampsia is a condition that can be diagnosed during pregnancy in which a woman has higher than normal blood pressure levels and high levels of protein found in her urine. This condition can lead to Eclampsia which is a more serious version of the same illness. A woman diagnosed with preeclampsia is also at risk for HELLP (an acronym for Hemolysis, Elevated Liver enzymes, and Low Platelet count) syndrome. After 20 weeks, your physician should be able to assess whether you are at risk for preeclampsia or not.

No one knows for sure what causes Preeclampsia, Eclampsia, or HELLP syndrome.

You might be at risk for these conditions if you meet the following criteria:
  • Are older than 35 or younger than 20.
  • Are African American
  • Having a multiple pregnancy (twins, triplets)
  • Have a family history of blood pressure problems, kidney disorders, diabetes, or blood clotting disorders
  • Are overweight

These conditions can cause seizures, premature labor, future problems with your kidneys or liver, pulmonary edema (fluid in the lungs), and possibly death to the mother and/or the fetus. These conditions also increase one’s risk for heart problems later in life.

These conditions can be treatable during pregnancy. For more information on these conditions, speak with your doctor.

Many women with preeclampsia are often given magnesium sulfate as the treatment (which can also be used to delay preterm delivery). Magnesium sulfate has the following side effects:
  • Flushing
  • Nausea
  • Vomitting
  • Palpitations
  • Headache
  • Muscle weakness
  • Lethargy
  • Constipation

If you are experiencing more severe complications, please see your doctor immediately.

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Premature Births

  • Premature babies are babies born before 37 weeks of gestation.
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Sources of Preterm Labor
  • Spontaneous Labor
  • PROM - Premature Rupture of Membranes
  • Indicated (iatrogenic)

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Lifestyle

Diet

  • Go to http://www.mypyramid.gov/mypyramidmoms/pyramidmoms_plan.aspx and fill in the blanks as instructed.  This site will tell you for your body weight, height, age, and lifestyle exactly how much of each food group (grains, vegetables, fruits, meat & beans, and milk) you need during each trimester.  Make sure to also click on the food groups and the tips for more information including lists of foods that are good to eat during pregnancy and how to make better food choices.
  • In your 2nd and 3rd trimesters, eat 300 – 400 more calories.
  • Protein and calcium are still extremely important during this time.
  • Fresh fruits and vegetables are better than canned.  If buying canned vegetables, watch for too much sodium.  Try to buy those cans which are lower in sodium or have no salt added.  For fruits, look for "no sugar added" or "in its own juice."
  • Eating a variety of foods from each of the main food groups will give you the best nutrition, because you will be able to meet all your food requirements including important vitamins and minerals.
  • Poor nutrition during pregnancy can lead to the child having a higher risk of chronic diseases later in life such as heart disease, high cholesterol, diabetes, etc.
  • No smoking – smoking can lead to premature birth and other health problems for the baby.
  • No alcohol – alcohol can lead to fetal alcohol syndrome.
  • No illegal drugs.
  • Drink lots of fluids especially water.  Drink at least 8 – 10 (8 oz.) glasses of water each day.  Many premature births and miscarriages happen when you do not drink enough fluids and become dehydrated.
  • Calcium is extremely important during pregnancy for both the mother and baby.  If possible, drink milk or eat other dairy products every day.
  • Limit fruit juices.  When buying fruit juices, look for "all natural", "no sugar added", or "100% fruit juice" products.
  • Limit caffeine.
  • Make sure to properly wash all fruits and vegetables.
  • Keep raw and cooked meat away from each other to avoid contamination.
  • Choose lean meats like turkey and chicken.
  • Try for optimal nutrition during pregnancy, not perfect, because there is no perfect womb.

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Healthy Eating Guidelines

  • Eat healthy before getting pregnant.

  • Keep your own body healthy – food goes to the baby through you.

  • Eat balanced meals with more protein than usual.

  • Adopt a plan of eating small meals more often, and keep healthy snacks with you.

  • Don’t try and keep your pre-pregnancy weight.

  • Don’t let yourself gain too much weight.

  • In the second and third trimesters, you will need about 300 more calories per day than before you were pregnant.

  • Eat foods high in iron and vitamins, and if your doctor recommends it, take a multivitamin or a prenatal vitamin.

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Exercise

  • Exercise is recommended during pregnancy.

  • Benefits of exercising:
  • Easier labor and delivery
  • Faster labor and delivery
  • Helps deal with stress
  • Helps with mood swings
  • Helps reduce pregnancy side effects such as morning sickness
  • Baby is typically more relaxed at birth
  • Walking is strongly encouraged during most pregnancies.

  • If you are not used to exercising, please talk to your doctor before beginning an exercise program.

  • Talk to your doctor about warning signs to look for that tell your body to stop exercising.

  • When exercising:
  • Don’t get overheated
  • Drink lots of fluids, especially water.
  • If you feel pain, stop!
  • There are some cases when a woman should not exercise during pregnancy, so you should discuss this with your doctor. Some reasons for not exercising during pregnancy include:
  • History of miscarriages
  • Incompetent cervix
  • Premature labor or a history of premature labor
  • Pregnancy-induced hypertension
  • Twins or other multiple pregnancy
  • For a complete list, please ask your physician.

  • Here are some other lists for warning signs of when to stop exercising:
  • http://www.marchofdimes.com/pnhec/159_637.asp
  • http://health.state.tn.us/WIC/PDFs/Women/Exercise_During_Pregnancy.pdf

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Doctor's Visits

  • Make sure to keep all doctor appointments.

  • Routine check-ups and examinations during pregnancy are extremely important.
  • For the first 6 months, see your doctor once a month
  • For months 7 and 8, see your doctor every 2 weeks
  • For month 9, see your doctor once a week until your baby is born
  • If you are over 35 or considered a high-risk pregnancy, you may need to schedule more frequent doctor’s appointments.

  • Discuss family history with your doctor.


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WIC

  • Stands for Women, Infants, & Children.

  • WIC Program provides nutritious foods, healthy eating information, and doctor referrals to low income women and their children up to the age of 5.

  • Vouchers are given to buy certain foods each month including items such as milk, eggs, and cheese.

  • WIC does support breastfeeding, so breastfeeding moms are strongly encouraged to join the WIC program.

  • To find out if you’re eligible and for more information about WIC, either go to http://www.fns.usda.gov/wic/ or contact WIC at the Memphis/Shelby County Health Department.


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Nutrients

Prenatal Vitamins

  • Make sure the vitamin has at least 400 micrograms of folic acid.

  • Should begin taking a multivitamin before becoming pregnant but if not, start as soon as you discover you are pregnant.

  • Brand name vitamins are not better than store brand vitamins, so you can save money by buying the store brand product. Just check the nutrient information to make sure the two products are very similar.

  • Do not get a vitamin with extras (like herbal supplements), because it will cost more and they may cause harm to you or the baby.

  • Synthetic vitamins can be more expensive and aren't any better than natural vitamins:
  • http://www.marchofdimes.com/pnhec/173_15354.asp

Nutrients Needed During Pregnancy and Lactation

Nutrients Needed During Pregnancy and Lactation

Important Nutrients
Why You Need It
Where It's Found
Amount Needed During Pregnancy Amount Needed During Lactation
Protein Extremely important because protein is necessary for almost all parts of growing baby including the heart, muscles, and nerves. It is also needed for cell growth, blood production, and for building a strong placenta. Lean meat, fish, poultry, egg whites, beans, tofu, and
peanut butter 		60 grams/day 60-65 grams/day
Carbohydrates Provides daily energy as well as keeps the fetus' pancreas from working too hard. Breads, cereals, rice, potatoes, pasta, fruits, and vegetables 2500 Kcal 2500-2700 Kcal
Calcium Needed for fetus' developing bones and teeth and also to strengthen your own. Calcium is also important for development of the fetus' heart, muscles, and nerves. It is necessary for muscle contraction and nerve function. Milk, cheese, yogurt, sardines or salmon with bones, and spinach Between 1000 and
1300 mg/day 		Between 1000 and
1300 mg/day
Iron Extremely important for healthy blood in both mom and fetus because iron provides oxygen to both. Iron will help prevent anemia. It is needed for the fetus' muscle, heart, and nerve development. Lean red meat, spinach, iron-fortified whole- grain breads, and cereals 27 mg/day 15 mg/day
Vitamin A Needed building a strong placenta and for healthy cell growth, healthy skin, strong bones, and good eyesight. It is also needed for the development of the fetus' heart, nerves, and muscles. Vitamin A also helps fight or prevent infection by regulating the fetus' immune system. Carrots, dark leafy greens, and sweet potatoes 750-770 micrograms/day 1300 micrograms/day
Vitamin C Needed for building the placenta and important for fetus' new tissues, strong bones and teeth, and cell repair. Fresh fruit (especially citrus) and vegetables (especially dark green ones), broccoli, tomatoes, and fortified fruit juices 85 mg/day 120 mg/day
Vitamin B6 Needed for strong bone and tissue growth and also in the development of the fetus' heart, nerves, and muscles. Vitamin B6 is extremely important in red blood cell production which increases the amount and quality of oxygen. Pork, ham, whole-grain cereals, bananas, eggs, lean meat, oatmeal, nuts, and dried beans and peas 1.9 mg/day 2.8 mg/day
Vitamin B12 Needed for strong bones and tissue growth and the development of the fetus' muscles, nerves, and heart. Vitamin B12 is vital for the production of new DNA, because it helps in cell reproduction. Meat, fish, poultry, milk, eggs, and cheese 2.6 micrograms/day 2.6 micrograms/day
Vitamin D Extremely important for strong bones and teeth for both mother and baby. It is also needed for the development of the fetus' heart, nerves, and muscles. Fortified milk, dairy products, cereals, and breads 5 micrograms/day 5 micrograms/day
Folate
(Folic Acid) 		Folic Acid or Folate is considered the most vital nutrient. It is needed for building the placenta, for DNA synthesis, blood production, enzyme function, and development of fetus' nervous system. If taken before conception and during the first 6 weeks of pregnancy, folic acid can reduce the chance of neural tube defects. Green leafy vegetables, dark yellow fruits and vegetables, beans, peas, and nuts 600 micrograms/day 500 micrograms/day
Fat Needed for energy. Meat, whole-milk, dairy products, nuts, peanut butter, margarine, and vegetable oils Keep as minimal
as possible 		Keep as minimal
as possible
Zinc Important for the fetus developing a healthy immune system, muscles, nerves, and heart and for tissue growth. Zinc is needed for DNA reproduction; therefore, it is important for wounds healing. Deficiency of zinc while pregnant could lead to improper brain development and low birth weight. Whole grains, nuts, dried beans, meat, and eggs 11 - 13 mg/day 19 mg/day
Fiber Needed to reduce constipation and also has been found to lower a person's risk of colon cancer. Fruits and vegetables, brown rice, nuts, cereals including oats, beans, peas, and pulses 28 grams/day 28 grams/day
Vitamin E Needed for building the placenta and is an antioxidant which helps in DNA repair, immune function, and various metabolic processes. Vitamin E protects cells from becoming damaged. Nuts, broccoli, spinach, kiwi, mango, soybean oil, and corn oil 15 mg/day 19 mg/day
Magnesium Needed for fetus' muscle and nerve function, heart rhythm, immune system, and strong bones. It also helps regulate blood sugar levels. Artichokes, black-eyed peas, broccoli, cashews, green beans, halibut, navy beans, pinto beans, tofu, tomato juice, spinach, and sunflower seeds Between 350 and
400 mg/day 		360 mg/day
Chromium Needed to regulate fetus' blood sugar. Whole grains, meats, and brewer’s yeast 29-30 micrograms/day 44-45 micrograms/day
Selenium Important to prevent cell damage and helps regulate the fetus' immune system and thyroid. Meats, nuts, grains, eggs, cooked fish, and cheese 65 micrograms/day 75 micrograms/day
Water Extremely important in preventing premature or early labor which occurs in many cases due to dehydration.Water also delivers nutrients from mom to fetus. It will also help with constipation, hemorrhoids, swelling, and bladder infections. At least 6 to 8
glass per day 		At least 6 to 8
glass per day

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Disclaimer:  This information is meant for educational purposes only and cannot replace medical advice.  Contact your doctor about any concerns you have.

Limits

Stress

  • Puts your baby in danger.
  • Slows your baby’s brain and body development.
  • Leads to depression and mental disorders.
  • Increases the risk of heart disease.

    • How to stop stress before it starts:
  • Eat healthy, balanced meals. As the baby grows, the baby will squeeze the stomach and makes it harder to eat a lot of food at one time. The solution is to eat small, healthy snacks often, just as you did in early pregnancy.
  • Keep hydrated. Make sure that you have plenty of water and healthy fruit juices.
  • Some stress fighting activities:
  • Exercise
  • Progressive relaxation
  • Meditation
  • Yoga


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Caffeine

  • Caffeine is a stimulant found in many drinks such as coffee and soda.

  • Limit caffeine intake to no more than 200 milligrams per day (about 2 cups of coffee) while pregnant.

  • Found in tea, coffee, chocolate, most soft drinks (such as Coke, Pepsi, Dr. Pepper), and energy drinks (like Red Bull). It is also found in some over-the-counter medicines (like Excedrin Migraine).

  • Drink de-caffeinated coffee and soda.

  • Drink more water, milk, and fruit juice, because these are better for you and your baby.

    • Sources

Medicine During Pregnancy



Disclaimer:  This information is meant for educational purposes only and cannot replace medical advice.  Contact your doctor about any concerns you have.

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