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Healthy eating during pregnancy

Healthy eating during pregnancy—a practical guide.

Eating well when you are pregnant is important—a balanced diet, plus a supplement that contains folate and iodine is essential. Following a healthier lifestyle is a positive change you can make at this time. You might like to start thinking about a general health overhaul as well as following a nourishing diet, getting more exercise, quitting smoking (if you smoke), and cutting back on alcohol. These are all helpful changes for you to make, both your good health, as well as for your growing baby.

What nutrition services are available for me at Mater Mothers' Hospital?

Mater Mothers' Hospital dietitians run a program specially tailored for women who are pregnant. This starts with a workshop: The Healthy Start to Pregnancy, which is facilitated by a dietitian who specialises in maternal health.

We acknowledge that just because you are pregnant, your busy life does not stop. This can make it hard to juggle all of your hospital appointments. Following your attendance at our workshop you are welcome to have regular contact with a dietitian—this can either be face to face or as via a phone appointment in our scheduled phone clinic. We will organise this following your group attendance. We provide this as we recognise that ongoing contact and support with an expert maternal health dietitian is the best way to achieve long lasting change.

What's the background to The Healthy Start to Pregnancy workshop?

This workshop was recently evaluated through a research trial at Mater Mothers' Hospital. We found that women who attended the session managed to successfully change their daily routine, including their diet, and ate a more nutritious diet (in line with pregnancy recommendations) even if they didn't start that way.

Even though exercise and activity levels usually drop during pregnancy, women who attended this group learnt and applied more strategies to keep doing exercises they liked during their whole pregnancy—this has great links with lower stress levels, more energy and better sleep, as well as less lower back pain, less nausea and less heartburn. Good news for pregnant women.

Women who attended also told us they also felt more confident at managing their weight gain, using the Mater Personalised Pregnancy Weight Tracker. Our workshop has a strong focus on offering supportive advice and tried-and-tested strategies to help women achieve healthy pregnancy weight gain, no matter what weight they are at the beginning of their pregnancy. The Tracker tells you how much weight you should gain in your pregnancy and assists you to track your progress weekly.

Should I bring anything to The Healthy Start to Pregnancy workshop?

Healthy eating during pregnancy booklet

Please bring along the Healthy Eating during Pregnancy booklet that you will receive at your first antenatal visit (from your midwife). This workshop extends the information in this booklet and helps you personalise pregnancy recommendations to your own preferences through activities and discussions. Your partner or a family member is welcome to attend with you too.

Our full booklet and workshop covers:

  1. Go for 2&5 versus Go for 4&5. We all know fruit and vegies are important—how do you measure up to the Go for 2&5 guideline? Find out about what you need from all of the food groups when pregnant.
  2. Folate, iodine, iron, and vitamin D. Why are they so important?
  3. Getting moving. Being active in your life has many benefits, beyond weight management.
  4. The facts about mercury, caffeine and alcohol.
  5. Tips for coping with morning sickness, constipation and heartburn.
  6. Why do I have to avoid cold deli meats when pregnant? Find out the details on Listeria.
  7. Weight gain guidelines for pregnancy—how to have the healthiest pregnancy possible.

This is accompanied by the Mater Personalised Pregnancy Weight Tracker to guide your week to week gain.

Folate

Why is folate important?

Folate is needed for healthy growth and development. Taking folate reduces the chance of neural tube defects (e.g. spina bifida) in your baby. It is recommended that women trying to conceive take an extra 400 µg/day of folic acid. The best way to get this is from a supplement. It is important to take this at least one month before and three months after you become pregnant. You still need to eat foods that contain folate. Rich dietary sources of folate include green vegetables, fruit, and fortified cereals.

Iodine

Iodine is a nutrient we need in very small amounts. It is part of thyroxine, a hormone of metabolism, growth and development. We need more iodine when pregnant and breastfeeding. This is for growth and development, especially of your baby's brain. Mild iodine deficiency can lead to subtle cognitive and neurological problems. Studies show that the Australian population is mildly iodine deficient.

How much iodine do I need?

  • Pregnant women need 220 micrograms of iodine (also written as µg).
  • Breastfeeding women need 270μg.
  • All women should take a supplement with 150μg during pregnancy and breastfeeding.

What are good sources of iodine?

  • Some pregnancy and breastfeeding multivitamins–check the label.
  • Breads and cereals–these are now made with iodised salt.
  • Fruit, vegetables, fish, iodised salt.

Iron

The amount of iron you need increases during pregnancy. Good dietary sources of iron include red meats, fortified breads and cereals, green leafy vegetables, legumes and some nuts. You can help your body absorb more iron from non-meat sources by including vitamin C rich foods at the same meal e.g. tomato, capsicum, citrus fruits and kiwifruit.

It can be hard to get enough iron from your diet. An iron supplement could be useful and may be recommended by your dietitian, midwife or doctor.

Vitamin D

What is vitamin D and why is it important?

Vitamin D keeps your bones and teeth healthy and strong, by maintaining your blood calcium level.

What are the effects of vitamin D deficiency?

A blood test will tell you if you do not have enough vitamin D in your blood. Side effects of vitamin D deficiency include:

  • In children–fits due to low calcium levels in the blood and soft bones which lead to bent limbs (rickets).
  • In adults–thin bones (osteoporosis), soft bones (osteomalacia), body pains, and muscle weakness.

Where does vitamin D come from?

The sun—most of the vitamin D your body needs comes from the action of sun on your skin. Fair skinned people need their face, hands and arms exposed to sunlight for six to seven minutes in summer and 15 to 19 minutes in winter, four to six times a week to ensure their body makes enough Vitamin D. Darker skinned people need more time in the sun to get the same amount of vitamin D. Do not get sunburnt as this will increase your risk of skin cancer.

Supplements—some pregnancy-specific multivitamins are a good source of vitamin D—we recommend these during your pregnancy. (Cod liver oil and liver are usually good sources, but are not recommended in pregnancy)

Food—there is a small amount of vitamin D in foods including:

  • margarine that has vitamin D added to it—check the label
  • milk that has vitamin D added to it— check the label
  • oily fish e.g. salmon, sardines, tuna, herring and fish roe
  • eggs.

Fish, omega-3 and mercury

Fish is an important part of your diet. It contains an excellent source of protein and is low in saturated fat. It also has high amounts of omega 3 and is a good source of iodine. However, a small number of fish contain higher amounts of mercury. Food Standards Australia New Zealand has set the following guidelines for safe fish intake in pregnancy:

Pregnant women and women planning pregnancy: 1 serve = 150 g
one serve per fortnight of shark (flake) or billfish
(swordfish/broadbill and marlin) and no other fish that fortnight
OR
one serve per week of orange roughy
(Deep Sea Perch) or catfish and no other fish that week
OR
two to three serves per week of any other fish and seafood not listed above.

Caffeine

Limit drinks containing caffeine during pregnancy. Cola, Mountain Dew soft drink, tea, coffee, chocolate, chocolate-flavoured beverages, cocoa and guarana energy drinks all contain caffeine. It is best to not have more than three serves per day of these food and drinks.

Alcohol

There is no known safe level of alcohol intake during pregnancy. Alcohol crosses the placenta and can lead to physical, growth and intellectual problems in some babies. It is recommended to avoid all alcohol during your pregnancy.

Morning sickness

Most women suffer from sickness early in their pregnancy. This is usually due to hormonal changes of pregnancy and can affect you at any time of the day. Symptoms usually disappear or become much milder by around 16 weeks.

Some tips to help you manage your morning sickness include:

  • eating small amounts every two hours as an empty stomach can cause nausea
  • avoiding smells and foods that make you feel worse
  • eating healthier carbohydrate foods such as dry toast, crackers, breakfast cereals or fruit
  • eating fewer fatty and sugary foods.

Listeria

When you become pregnant, it is important to be careful with food that might be contaminated with Listeria. These bacteria move into the placenta and can cause premature birth or miscarriage.

Foods that might carry Listeria and should be avoided include:

  • raw/uncooked/smoked meat and seafood, ready to eat chilled seafood
  • deli meats, cooked cold meat, pate, meat spreads
  • leftovers (more than 24 hours after cooking)
  • pre-prepared salads, smorgasbords, buffets
  • unpasteurised milk and soft serve ice cream
  • soft cheeses (brie, camembert, ricotta, feta, blue). Hard cheeses like cheddar and tasty are safe Processed cheese, plain cream cheese and plain cottage cheese are fine if purchased sealed and stored in the fridge
  • unwashed raw fruit and vegetables
  • raw eggs or foods containing raw or partially cooked eggs.

It is easy to make safe choices by following these tips:

  • Freshly prepared and cooked foods have low levels of bacteria. Bacteria grow over time, so avoid eating food if it has been made more than 24 hours since being prepared. Always reheat to steaming hot.
  • Raw fruit and vegetables should be washed thoroughly before eating.
  • Listeria is destroyed in normal cooking, so freshly cooked hot food is safe if eaten straight away.

Even those foods listed above that are higher risk can be eaten safely if heated above 74 degrees Celsius for over two minutes.

Weight gain guidelines for pregnancy

How much weight should I gain when I become pregnant?

If I am a healthy weight?

As a general guideline, you can expect to gain between 11½ and 16 kg during pregnancy. Aim to gain about 400 g a week after your first trimester.

If I am underweight?

Women who are underweight before they become pregnancy need to put on a little more weight in pregnancy. Aim for an average of 500 g a week in the last two trimesters.

If I am above the healthy weight range?

Now is not the time to try to lose weight. Going on a weight loss diet may harm your baby's development. Aim for no more than 300 g per week in the second and third trimesters.

Using the Mater Personalised Pregnancy Weight Tracker to guide your week to week gain takes the guess work out of healthy pregnancy weight gain. You will get this at your first antenatal visit appointment. All women will find out their personal recommended weight gain range during their pregnancy and we will assist you in meeting this goal with lifestyle changes tailored to your personal preferences.

How much weight should I gain?

The weight you should aim to gain depends on what your weight was before you became pregnant. Body mass index (BMI) is the number used to work out what is the recommended amount for you. You can work this out by following the steps below.

  1. My pre-pregnancy weight: ________ kg
  2. My height: ___________ m (e.g. 165 cm is 1.65 m)
  3. BMI = weight/(height x height) = ____kg/m²
If your pre-pregnancy BMI was You should gain
Less than 18.5 kg/m² 12.5 kg to 18 kg
18.5 to 24.9 kg/m² 11.5 kg to 16 kg
25 to 29.9 kg/m² 7 kg to 11.5 kg
Above 30 kg/m² 5 kg to 9 kg

Further information

For further information or to make a booking for our pregnancy nutrition classes please phone Allied Health reception on 07 3163 8585 and ask about the Healthy Start to Pregnancy workshop.

Mater acknowledges consumer consultation in the development of this patient information.
Last modified 03/11/2015.
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