Nutrition in Pregnancy

As always, remember to use good judgement in the application of this information. These are only suggestions. Sources for further information are listed at the end. Being responsible for your own well being may sometimes mean seeking the advice of a health care provider for conditions that persist despite your efforts. Also, what follows is taken from handouts I've used in class for the last 10 years. I have used information from many sources, changing them when new material becomes available. I know for sure that Anne Frye, Midwifery Today Magazine and the ALACE curriculum guidelines were the major source for what I now have, but I have no way of knowing how much it has been altered over the years. If anything is too close to copyrighted material, someone let me know so that I can credit the author or change it sufficiently. Thanks.

Listed are vitamins and minerals, the RDA for pregnancy women, and the RDA for non-pregnant when there is no recommendation for pregnant women. There is a short synopsis of what that particular nutritional component provides in pregnancy and natural sources for each.

Vit. A (5,000 IU) Bone and tissue growth, cell development, maintains health of skin and mucus membranes for mom and baby through pregnancy. Natural sources (NS): Carrots

Vit. B complex B-complex refers to a variety of water-soluble vitamins that are found together, including Biotin, Choline, Folic Acid, Inosital and PABA. One B vitamin never exists alone. The RDA's different for each B. Consult with your caregiver, a nutritionist, or a good book, like Vitamins & Minerals for a Healthy Pregnancy (and a healthy baby!) by Richard F,. Gerson, Ph.D., which is where this material was compiled from. B vitamins are important in nervous system development and energy production. NS: Brewer's Yeast, vegetables, whole grains. Sugar, alcohol and stress deplete B vits...AVOID THEM!

Vit. C (80 mg) Tissue formation, immune system boost, increases iron absorption. NS: Citrus fruit, cantaloupe, green pepper, broccoli, papaya, strawberries.

Vit. D (400-600IU) Helps build strong bones and teeth. NS: Eggs, sunlight, milk, bone meal, organ meats, canned tuna or salmon.

Vit. E (15 IU) Tissue growth, cell wall development, circulation. NS: Dark green veggies, wheat germ oil, tomatoes, peanuts, vegetables oils, oatmeal,wheat germ, organ meats, eggs.

Vit. K (300-500mcg) Aid in blood clotting. NS: Blackstrap molasses, yogurt, oatmeal, green leafy veggies, safflower oil, beef liver.

Calcium (1,200-1,600 mg) Builds bones, teeth, aids muscle contraction, blood clotting and regulation of heartbeat. NS: Mild, cheese, almonds, yogurt, molasses.

Chromium (50-200mcg) Aids glucose regulation and carbohydrate metabolism. NS: Brewers yeast, corn oil, clams, whole grain cereals.

Copper (2-4 mg) Helps form nerves, aids metabolism. NS: Molasses, legumes, nuts, raisins, soybeans, seafood, organ meats.

Iodine (100-150 mcg) Controls energy usage, aids thyroxin production. NS: Seafood, kelp, salt

Iron (60mg) Combines with protein to form hemoglobin, helps sustain energy level. NS: Blackstrap molasses, eggs, shredded wheat, wheat germ, fish, poultry, organ meats.

Magnesium (450 mg) Helps cellular metabolism, muscle actions and tissue growth. May be an important factor is preventing toxemia) NS: Bran, honey, green veggies, nuts, seafood, spinach, kelp, peanuts, tuna.

Manganese (300-350 mg) Aids in insulin production and prevents muscular disorder. NS: Bananas, bran, celery, cereals, egg yolk, green leafy veggies, legumes, nuts, pineapple, whole grains.

Phosphorus (800-1,200mg) Bones and teeth. NS: Eggs, fish, grains, poultry, yellow cheese, milk, yogurt, meat.

Potassium (100-300 mg) Proper muscle contraction. NS: Dates, figs, peaches, tomato juice, peanuts.

Selenium (50-200 mcg) Heart function, helps synthesize protein, may protect against cancer/SIDS. NS: Fish, whole grains, cereals, brazil nuts.

Sodium (100-300 mg) Proper muscle contraction. No supplementation should be necessary if food is salted to taste. NS: Salt, milk, cheese, seafood.

Zinc (20-25 mg) Skeletal system and nervous system. Immune function. NS: Brewers yeast, soybeans, sunflower seeds, mushrooms, spinach, seafood, liver. This is not a comprehensive list. It's only a start. It is up to you to learn about what your body needs to maintain health and grow a healthy baby. I highly suggest seeking the services of a good nutritionist, or at the very least a good book on how to eat well in pregnancy.

Pregnant women may have an iron requirement up to 4 times higher than the non-pregnant RDA. This means that a diet that supplies 50 or 60 mg of iron is optimal. Both dulse and kelp are available in powdered forms. Dulse is the milder tasting of the two; both are high in minerals, including calcium and iodine.

Nettle tea is also high in iron. There are some commercial brands of pregnancy tea that contain nettles, or it may be prepared by steeping 1 tbsp. dried nettles in 1 cup hot water for about 4 minutes.

To optimize your iron intake:

• Niacin, B1, B2, pantothenic acid, choline, B12, folic acid, calcium, cobalt, and copper are involved in the absorption, assimilation and utilization of iron. Get adequate amounts of these nutrients.
• Eat meals high in iron (or your iron supplements) with vitamin C or foods high in vitamin C, such as orange juice. (Taking 200 mg to 500 mg of vitamin C nearly doubles iron absorption.)
• Avoid antacids. Iron is better absorbed in an acid stomach; antacids neutralize stomach acids.
• Use leavened whole grains: yeast in the fermentation process makes iron available (whole unleavened grains contain phytates that bind to iron and prevent its absorption).
• Cast-iron cookware adds iron to food, especially if the food is acidic (like tomato sauce).
• Regular aerobic exercise improves iron absorption, due to the body's grater need for oxygen carrying capacity.
• Choose iron supplements carefully (see below).
• Don't count on iron fortified foods; iron used by manufactures is often a phosphate compound not soluble in the human digestive tract.
• Avoid laxatives as they decrease the length of time food remains in the upper intestine: this decreases the amount of time the body has to absorb iron.
• Tannic acid, caffeine, and phosphates in caffeinated teas, coffee, and sodas inhibit iron absorption. If you consume these beverages, do so at times other than with high iron meals.
• Minimize consumption of refined carbohydrates (sugars and white flour). High in calories and low in nutrients, they cause the secretion of more alkaline digestive juices, which decrease the acidity of the stomach, decreasing the absorption of iron.
• Avoid taking iron supplements or high iron meals with dairy products. Dairy neutralizes the stomach acidity, decreasing the absorption of iron.
• Minimize exposure to cigarette smoke and other air pollutants; they rob the body of vitamin C or otherwise deplete the body of iron.
• Large doses of supplemental zinc or calcium interfere with iron absorption.

Supplement Considerations

1. Avoid ferrous sulphate! It is poorly absorbed, and is associated with miscarriages, nausea, constipation, and the destruction of vitamin E (which is active in preventing red blood cell death and subsequent anemia).
2. Avoid time released iron. It causes most of the iron to be released after it can be absorbed.
3. Chelated iron is more easily absorbed than no-chelated iron.(Chelated iron is iron chemically bonded to another substance more easily absorbed than iron; it acts as a carrier of iron through the intestinal wall.) Floridix Iron and Herb Formula are good choices.
4. Iron is more easily absorbed when complexed with a mild organic acid-such as ferrous gluconate, ferrous fumerate or ferrous lactate. Ferrous phosphates, ferrous carbonates, and ferric forms of iron are poorly absorbed.
5. Iron supplements are best taken with food. This slows movement through the digestive tract, increasing the amount of time it has to be absorbed )as sell as stimulating acidic digestive juices). Pregnant women find iron supplement more tolerable if taken with the evening meal, when the blood sugar is less likely to be low, so they are less likely to be nauseated.
6. Excesses of certain nutrients can cause deficiencies in other. Before taking megadoses of any supplement, seek the opinion of a health care provider who is knowledgeable about nutrition.
7. Excessive amounts of iron supplements can be toxic. Keep iron supplements in jars with childproof caps, out of children's reach. Symptoms of iron overload are: headaches, shortness of breath, fatigue, dizziness, and graying skin. Greater than 100 mg of iron daily over an extended period of time can be toxic.

Daily Minimums:

1. One quart (four glasses) of milk, any kind: whole milk, low-fat, skim, powdered, or buttermilk. If you don't like milk, substitute with yogurt.
2. Two eggs (or egg whites if you are watching fat content)
3. Two servings of protein...beans, textured vegetable protein, fish, shellfish, chicken or turkey, lean beef. Good plant source combinations include:
   Rice with: beans, cheese, sesame seeds, milk
   Cornmeal with: beans, cheese, tofu, milk
   Beans with: rice, bulger, cornmeal, wheat noodles, sesame seeds, milk
   Peanuts with: sunflower seeds, milk
   Whole what bread or noodles with: beans, cheese, peanut butter, tofu, milk.
   For each serving of meat you can substitute these quantities of cheese:
   Brick- 4 oz.
   Cottage- 6 oz.
   Cheddar- 3 oz
   Swiss- 3 oz.
   Monterey Jack- 4 oz.
4. Two servings of fresh, green leafy vegetables: mustard, beet, collard, dandelion or turnip greens, spinach, lettuce, cabbage, broccoli, kale, swiss chard.
5. Five servings of whole grain breads, rolls, cereals, or pancakes: Wheatena, bran flakes, granola, shredded wheat, wheat germ, oatmeal, buckwheat or whole wheat pancakes, corn bread, corn tortillas, corn or bran or whole wheat muffins, waffles, brown rice.
6. Two choices from: a whole potato, any style, large green pepper, orange, grapefruit, lemon, lime, papaya, tomato (one piece of fruit, or one large glass of juice)
7. Three pats of margarine, vitamin A enriched, or butter, or oil (as in cooking)
8. Also include a yellow or orange colored vegetable or fruit 5 times a week
9. Liver once a week if you like it
10. Table salt; salt your food to taste
11. Water: drink to thirst...8-10 glasses at least.

Take your vitamin and iron supplements, but keep in mind they cannot take the place of a sound, balanced diet of nutritious foods.

Note: This may seem like a tremendous amount of food...take note of what a serving size actually is...for example, a serving size of cottage is 1/2 cup...a serving size of a banana is 1/2 a piece of the fruit...a serving size of most vegetables is one piece, or 1/2 - 1 cup...a serving size of cereal is usually 1/3 cup. What you have always thought of as a serving may be 3 times what it actually is.

Most fruits, vegetables and beverages will contain only trace amounts of protein. Sweeteners contain none.

This list can give you a rough idea whether you are getting the 80-100 grams of protein a day that pregnant women need.

Please note that all protein is not created equal! Much of the protein from animals is not absorbed, and it leaches calcium from your body besides. Equal amounts of tempeh and animal are equal in protein, but the fat content is vastly different! Choose wisely!

My other creations.
Y2Kid Considerations...my musings on parenting in the new millenium
Prenatal Testing
Maternity Matters...Enjoying the journey and growing a healthy baby
Discomforts of Pregnancy & Helpful Hints
But What If...? Questions often asked of homebirth-ers