Leading up to and throughout pregnancy it is vital
that women eat a healthy diet for the proper growth and development of baby, as
well as their own health. This is a time when it is especially important that
women eat a wide variety of foods in accordance with dietary guidelines, such
as those issued by the Australian National Health and Medical Research Council.
Some nutritional requirements are increased during pregnancy, such as folic
acid and iron, and it is recommended that women take these as supplements, in
addition to a nutritious balanced diet. Discuss supplementation options and
products with your GP or accredited practising dietitian (APD).
Folic Acid To Prevent Neural Tube Defects
It is vital that folate levels are adequate during
the initial stages pregnancy, in particular for the development of the baby’s
brain and spinal cord. It is recommended that all women take a folic acid supplement
for at least one month before and for three months after conception. Folate is
essential for DNA synthesis and the rapid growth of the foetus requires a high
level of this vitamin, particularly during brain and spinal development in the
first six weeks.
For women with a family history of neural tube defects
a daily supplement of 5mg of folic acid will protect against neural tube defects
(NTD) such as spina bifida or anencephalus. For women who have no family
history of NTDs the current recommendation is 0.4mg daily of supplemental folic
acid in addition to consuming dietary sources of folate. Australia introduced
mandatory folic acid fortification of bread flour, except for organic products
in 2009, which is expected to reduce the number of NTD affected pregnancies by
up to 14% each year. Many breakfast cereals are fortified with folic acid,
whilst leafy green vegetables are a good source of folate.
The NHMRC currently recommends that pregnant women
have a daily calcium intake of 1000mg. For
teenage pregnancies the recommendation is 1300mg to support the continuing
development of the mother’s bones. Calcium is essential for bone and tooth
development as well as proper nervous system and heart function. Calcium
requirements can be met by eating 3 serves of low fat dairy products or calcium
fortified foods as part of a healthy and varied diet. One serve is equivalent
to 250mL of milk or calcium fortified soymilk, two slices (40g) of cheese or a
200g tub of yoghurt. Check the nutrition information panel on products to check
the amount of calcium you are consuming.
The calcium in dairy foods is easily absorbed, and
diary has many other health benefits. Low fat and reduced fat dairy products are
recommended for adolescents and adults. There are many other dietary sources of
calcium, including canned fish with bones, dark green leafy vegetables, tofu, and
almonds. Where dietary intake is inadequate a calcium supplement is
recommended. Discuss supplementation with your GP.
Iron deficiency is a significant health problem in
Australia, particularly during pregnancy, when daily requirements increase significantly
to meet the needs of the placenta, baby and the mother. Adequate iron levels
are essential to prevent anaemia, which compromises oxygen delivery to baby and
adversely affects the health of the mother.
It is recommended that pregnant women take an iron supplement throughout
their pregnancy, as their iron needs are not likely to be met through dietary
sources alone. Before taking an iron supplement women should speak with their
doctor and an accredited practising dietitian (APD) to discuss a supplement
that is appropriate for them.
Supplementation with 20mg of iron daily has been
found to be effective in preventing iron deficiency without significant side
effects. The recommended dietary intake is 27mg per day during pregnancy. There are two types of dietary iron, haem and
non-haem iron. Heam-iron is more readily absorbed. The best dietary sources of heam-iron
are red meats, such as lean beef and lamb. Chicken, game and fish also contain
haem-iron but in smaller amounts. Non-haem iron in legumes, whole grains,
fortified breakfast cereals, nuts and green leafy vegetables also plays an
important role. Optimise the absorption of non-haem by having vitamin C rich
foods in the same meal.
Iodine is an essential part of the thyroid hormones
required for normal growth and development of babies, including development of the
central nervous system. Even mild iodine deficiency may result in mental
impairment. There is concern that iodine intake is inadequate in Australia.
Research has demonstrated that residents in Sydney and Tasmania may have mild
iodine deficiency due to inadequate levels of iodine in our food supply.
Major food sources of iodine are fish, seafood, and
iodised table salt. Salt added to processed foods is generally not iodised. If you
are taking a multivitamin supplement for pregnancy, be sure that it contains adequate
iodine. The recommended dietary intake of iodine in pregnancy is 220mcg per day.
Omega 3 Fatty Acids
Omega-3 fatty acids (EPA and DHA) are required for
brain and visual development of the foetus. The best sources of EPA and DHA are
fish oil supplements and oily fish such as salmon (canned or fresh), fresh
tuna, mackerel, and sardines. During pregnancy, three serves of fish per week
are recommended. Mercury toxicity is of concern in pregnancy and consumption of
species such as shark (flake), tuna, marlin and swordfish should be limited to
one serve once or twice per fortnight.
Cereals And Breads
During pregnancy most women will require up to 8
serves of breads, rice, noodles, pasta and cereals per day. You may require
more or less than this, depending on your energy requirements. One serve is equivalent to 1 slice of bread or
½ a cup of cereal, rice, pasta or noodles.
Fruit and Vegetables
It is recommended that women eat 2 serves of fruit and
least 5 serves of vegetables per day during pregnancy. One serve of fruit is
equivalent to 1 medium banana or 2 small kiwi fruits. One serve of vegetables
is equivalent to ½ a cup of cooked or 1 cup of raw (e.g. salad) vegetables. Fruit
and vegetables are excellent snack foods. Choose fruit and vegetable snacks
instead of energy dense, nutrient poor packaged and processed snacks.
Most women should aim to include 3½ serves of
protein rich foods each day to support the growth of the baby and maintenance
of the mothers muscle mass. Protein rich foods include lean meats, fish,
poultry, nuts and/or legumes. One serve is equal to 65 to 100g of cooked meat,
2 small eggs or 1 cup of legumes. Having a vegetarian day once weekly using
legumes or beans as a meat substitute has many health benefits.
Alcohol, Caffeine And Other Drugs
Smoking during pregnancy has detrimental effects on
the baby and mother and should be completely avoided. Alcohol and caffeine may
be consumed in small amounts. Alcohol in excess causes permanent physical and
intellectual disabilities (foetal alcohol syndrome) and even a moderate intake
increases the likelihood of miscarriage. Many women chose to avoid alcohol completely
during pregnancy. Caffeine has been found to be safe in amounts of up to 3 to 4
cups of instant coffee per day. The consumption of illicit drugs, as well as
many prescribed and over the counter medications, including natural therapies,
by a mother during pregnancy may be harmful to the foetus.
Enjoy eating a nutritious diet, during pregnancy knowing
you are doing your best for your developing baby!
1. National Health and Medical Research Council.
Nutrient Reference Values for Australia and New Zealand; including recommended
dietary intakes. 2006.
2. http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_066.pdf. Accessed 23/11/2007
3. National Health and Medical Research
Council. Dietary guidelines for Australians. 2005.