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    Prenatal Nutrition

    The following guidelines were established to assist you with optimal nutrition for you and your baby. However, the guidelines are only recommendations and may need adjusting if you are under or overweight; unable to eat or have special dietary needs or allergies; if you are carrying more than one baby. If you are concerned about controlling weight gain or need help using a food guide, discuss seeing a prenatal nutritionist with your healthcare provider.

    Recommended Weight Gain During Pregnancy

    Weight gain usually occurs at a smooth, gradual rate during pregnancy. For the first three months, expect to gain a total of 2-5 pounds. During the remaining six months, the normal rate of weight gain is about 2-6 pounds per month, or one pound per week. The average expected weight gain is 25-35 pounds if you began your pregnancy at a desirable weight and are carrying only one baby.

    A variety of weight gain levels can result in healthy babies. What is important is to gain sufficient weight so that both mother and baby remain healthy. The amount of weight gain needed depends on your weight and height before becoming pregnant.

    Range of Weight Gain
    Women who are shorter than 5'2” should gain weight within the lower ranges. Teenagers and women who smoke should gain weight within the upper ranges. You never want to lose weight while pregnant.

    • If you start pregnancy underweight, recommended total weight gain is: 28-40 pounds

    • If you start pregnancy at a desirable weight, recommended total weight gain is: 25-35 pounds

    • If you start pregnancy overweight, recommended total weight gain is: 15 to 25 pounds

    • If you start pregnancy very overweight, recommended total weight gain is: at least 15 pounds

    • If you are pregnant with twins, recommended total weight gain is: 35-45 pounds

    A Note on the Psychological Aspects of Pregnancy Weight Changes
    The weights provided here are recommended as guidelines only, and are not intended to be focused on specifically as a number. The topic of weight and weight gain can be a source of concern and anxiety for some women. However, pregnancy is the ideal time to embrace your body as it gradually changes in shape and size.

    Remember, pregnancy is a temporary state. With good nutrition and exercise, there is every reason to expect that you will return to your pre-pregnant weight after the baby is born and your body has recovered from the birth.

    Where Does the Weight Go?
    Every pound you gain is needed for a specific purpose while your baby is growing inside of you. Your baby accounts for only part of the weight you must gain. Your own body must add blood, muscle, fluids and tissue necessary for your baby's development.
    • Increase in Mother's Tissues

      • Breast Changes: 3 pounds

      • Blood Volume: 4 pounds

      • Body Fluids: 2 1/2 pounds

      • Body Stores: 4-8 pounds
    • Baby's Needs

      • Placenta (afterbirth): 1 pound

      • Baby's Weight: 7 1/2 pounds

      • Amniotic Fluid (bag of water): 2 pounds

      • Uterus (womb): 2 1/2 pounds
    Weight Gain Range: 25-35 pounds

    Please Note:
    Your baby gains the most weight during the last trimester. If you have already gained more than is recommended, it is important to continue eating for your baby. You never want to lose weight while pregnant. Eliminate high calorie foods and pay close attention to portion sizes.

    Commonly Asked Questions

    Should I eat for two?
    No. It is a fallacy that a pregnant woman must eat for two. Your body becomes more efficient during pregnancy and therefore absorbs more nutrients. Although pregnancy increases the body's need for calories and nutrition, the amounts are NOT doubled. About 300 calories per day are needed above your normal intake during the second and third trimesters of pregnancy. You can easily add 300 calories when you eat a piece of bread, an ounce of cheddar cheese, and an 8oz. glass of low fat milk.

    I feel sick all the time, and I'm not able to eat much. I'm worried my baby may not be getting the proper nutrition; what should I do?
    Nausea during the first part of pregnancy is very common. Eat what you can tolerate. (This might be only a couple of food items. Be patient, it usually is a temporary condition.) Get plenty of fresh air, drink fluids between rather than with meals and try eating several small meals a day. Try sucking on a lemon before meal time. Many women have found this helpful. Also, sit up for at least a half hour after eating. (See Common Discomforts of Pregnancy section for more information).

    Can I safely crash diet if I gain too fast?
    No. You should never lose weight while pregnant. A severe calorie restriction may harm your baby's development. Do not go on fad diets or ever use diet pills.

    If I'm gaining too fast, can I take calcium supplements instead to limit calories?
    No. Calcium rich foods provide calcium as well as a significant amount of protein which would otherwise need to be obtained by consuming more protein rich foods. Choose nonfat or low-fat dairy products and other low calorie calcium-rich foods.

    What should I do if I am gaining too much weight?
    It is desirable to prevent excessive weight gain to minimize delivery risks as well as for your own health. Consider the following suggestions to keep within your recommended weight gain:

    • Eliminate sugars and sweets which provide lots of calories, but have limited nutritional value.
    • Limit the amount of fat you add to your foods such as butter, margarine, mayonnaise, salad dressings, sour cream, sauces and gravies.
    • Eat three small meals and three snacks daily (at 2- or 3-hour intervals).
    • For snacks and desserts, choose fresh fruit, raw vegetables and nonfat dairy products instead of sweets. For example, instead of pound cake, ice cream and cookies, try angel food cake, frozen non-fat yogurt and vanilla wafers.
    • Select lean protein foods: part skim cheeses, plain non/low fat yogurt, poultry (without skin), fish and veal.
    • Cook foods without oil: bake, broil, stir-fry, grill or boil foods instead of frying.
    • Watch the portion size of protein foods eaten for the day. Seven servings of protein can be obtained by eating one cooked egg, one 4 oz. hamburger, and one chicken thigh.
    • Limit fruit juices (which are high in calories) to 6oz./day. Instead, eat whole pieces of fresh fruit.
    • Incorporate more activity and exercise into your day.
    • Avoid high fat luncheon meats (bologna, salami, spam, sausage, corn beef, hot dogs). Instead, eat turkey, ham, salmon or tuna.
    • Get help planning meals that you and your family will enjoy and still be low fat. Call (415) 600-BABY for a referral to a prenatal nutritionist.
    • Increase your water intake to at least 8-10 glasses/day.

    Should I drink whole milk to obtain the most nutrients?
    No. Nonfat and low fat milk have the same amount of vitamins, minerals and protein, but much less fat calories. Therefore, nonfat and low fat milk are considered better sources of calcium and protein.

    I don't like or can't tolerate milk or dairy products. How can I add calcium to my diet?
    Calcium supplements are an option. 1000 mg of calcium is recommended every day during pregnancy Look for elemental calcium in the form of calcium citrate, lactate or gluconate as these are best absorbed. Avoid calcium supplements containing bone meal, dolomite, and oyster shells because they may be contaminated with harmful substances like lead, calcium and mercury. Remember, if you take calcium supplements, you will need to consume extra portions of protein-rich foods.

    Are artificial sweeteners OK during pregnancy?
    Research has shown that Nutrasweet is safe during pregnancy, but always avoid saccharin. Check the ingredients on low calorie and “light” foods for artificial sweeteners.

    It seems like so much food. How can I possibly eat it all?
    Eat small, frequent meals and try combining foods from all the food groups while cooking. Review the suggested portion sizes as your serving sizes may be larger than those recommended. You may already be eating adequate amounts.

    If I'm taking prenatal vitamins, won't they supply me with my daily needs?
    No, prenatal vitamins alone don't supply protein, fiber, minerals and energy (calories) necessary for a healthy pregnancy. Vitamins are considered supplements, not substitutes for a healthy diet.

    Do I really need to take a vitamin and mineral supplement?
    It is recommended that all pregnant women in their second and third trimester take a daily iron supplement containing 30 mg of elemental iron. You may not need to take other vitamins and mineral supplements depending upon the quality of your diet.

    If vitamins are good for me and my baby, shouldn't I take a lot of them?
    No. Too much of certain vitamins may actually cause harm to youand your growing baby. It is recommended that supplementation with high doses of vitamins A, C, D, E, and B6 should be avoided. Choose a multivitamin supplement with no more than 100% recommended daily allowance (RDA) for each individual mineraland vitamin.

    I've heard a lot in the news about folic acid. How important is folic acid?
    If you eat a balanced diet which includes fruits, green vegetables and whole grains, you are probably obtaining enough folic acid. However, if you have a family history of neural tube defects (such as spina bifida) or have previously given birth to a baby with a neural tube defect, folic acid supplementation of 400 micrograms is recommended before conception and throughout the first trimester of pregnancy. Check with your health care provider for further information.

    Folic-rich foods include:

    • Breakfast cereals (1 serving): 100-400 micrograms folic acid
    • Asparagus (1/2 cup cooked): 88 micrograms folic acid
    • Spinach (1/2 cup cooked): 110 micrograms folic acid
    • Brussel sprouts (1/2 cup cooked): 46 micrograms folic acid
    • Orange juice (1 cup): 109 micrograms folic acid
    • Orange (1 medium): 39 micrograms folic acid
    • Black beans (1/2 cup cooked): 128 micrograms folic acid
    • Lentils (1/2 cup cooked): 179 micrograms folic acid
    • Pinto beans (1/2 cup cooked): 147 micrograms folic acid
    • Sunflower seeds (2 Tbsp.): 40 micrograms folic acid

    I have a very busy schedule. How will I find the time to eat so often?
    Planning ahead is necessary and important. A few suggestions for between meal snacks include yogurt and fresh fruit, cheese and crackers, raw vegetables and yogurt dip, a glass of milk and half a sandwich, a baked potato or rice. Keep experimenting.

    When I looked at what I ate one day, I realized that I wasn't coming close to eating what I should. Is this a problem?
    Because of the varying appetite and tolerance that accompanies pregnancy, it is helpful to evaluate your nutritional intake over the period of a week. It is common to discover that some days are more balanced (nutritionally) than others. If over the course of a week, your diet includes roughly 15% protein, 65% carbohydrates and 20% fat made up of sound nutritional choices, as well as plenty of water, you are doing an excellent job of providing nutrition for yourself and your baby.