NUTRITION ADVICE FOR PRE, DURING AND POST PREGNANCY

18 Feb NUTRITION ADVICE FOR PRE, DURING AND POST PREGNANCY

Posted by Craig Brown

“Good nutrition is crucial for optimum child development throughout the first 1000 days of life and beyond.” – Black et al. (2016)

“There is a wealth of scientific research, which establishes beyond any doubt that the First 1000 Days are by far the most influential on a child’s future.” – NCT, First 1000 Days

Take a moment to read those comments again… Isn’t it just incredible how important the early days are to your child’s development? And, even more so, the responsibility that’s on you to ensure your child gets the best start in life through proper nutrition, both in the womb and out.

This may seem a little daunting, but it need not be. The aim of the article is to shed some light on nutrition and training pre-conception, during pregnancy and post-pregnancy, and how you can, by making some small adjustments, fuel your body optimally during this happy, growing time. We’ll also explore just how vital your good nutrition is to your baby’s development and how to ensure it.

REMEMBER, NONE OF MY ADVICE SUPERSEDES THAT OF YOUR DOCTOR OR DIETICIAN.
 

Pre-Pregnancy 

Ok, let’s be fair… 90% of us fall pregnant and well oops, “Guess what honey, look two bars.” Obviously it would be optimal to plan on falling pregnant when you get to the, “Ok this is it, we want a bundle of chaos in our lives” stage. If so, there are some things you can do to “prep” your body beforehand.  

Remember during the pregnancy the baby will always take precedence of all your vitamin, mineral and nutritional stores before you, which can lead YOU to have insufficiencies later on.

So if you are in the planning stages, make sure you are eating a well-balanced nutritious diet and that you are topped up with:

• Iron
• Iodine
• Calcium 
• Folic Acid 
• Vitamin D 

Supplementing 400mcg folic acid daily before pregnancy and then throughout the first 12 weeks of pregnancy, reduces the risk of neural tube defects such as spina bifida. 10mcg or 400iu daily of vitamin D is also recommended from pre-conception, during pregnancy and then post pregnancy.

If you are overweight or obese, I would strongly advise you to shed 5-10 % weight before trying to fall pregnant. Or, even better, would be to get into the BMI range of 18,5-24,9 before conception, which provides better health outcomes for mother and baby. I do realise this is not always possible, so if you have a BMI above 30, you will show significant improvements to your health by just shedding that 5-10% before conceiving. 

Pregnancy 

Well, now you’re pregnant… “Damn you Harry. It’s all your fault!”

My advice here is to simply continue eating a healthy balanced diet with some changes and foods to avoid and some to limit.

Are you eating for two? NOOOOO.

This is a common misconception. Energy requirements do not change during the first 6 months of pregnancy (first and second trimester), so eating at maintenance calories is just fine. During the third (and last) trimester, energy requirements change by approximately 200 calories per day, so you’ll need to up your intake a little then.

Examples of 200 calories are:

• 2 medium bananas 
• 2 x 200ml glasses low fat milk 
• 2 x slices bread
• A small snickers bar ( small SMALL SMALL) 

Foods to avoid during pregnancy:

• Soft blue cheeses like roquefort and camembert – the mould in these cheeses can contain listeria.
• Liver – organ meats, liver products and fish liver oils and or any other supplement containing vitamin A. Too much animal-based vitamin A can be toxic to baby.
• Sword fish, marlin or shark – these types of large fish contain high levels of mercury which may be harmful to baby.
• Pate, including vegetable pate, as this too could contain listeria.
• Raw or undercooked foods including meats, fish, chicken, shellfish, eggs and ready meals.
• Unpasteurised foods or foods which may contain raw egg such as mayonnaise or homemade ice-cream or cheesecake. These foods may cause toxoplasmosis, salmonella or other types of food poisoning. Pregnant women are more susceptible to food poisoning and should cook foods thoroughly. Foods should be hot throughout and meats should have no pink or undercooked patches… Sorry ladies, rare steaks are off the table.

Foods to limit during pregnancy:

• Oily fish such as salmon, trout, sardines, fresh tuna, pilchards etc – no more than 2 portions per week.
• Caffeine –  too much caffeine can increase the risk of miscarriage and low birth weight, so watch how many cuppas you’re having a day. The general guideline is no more 200mg a day.
• Alcohol – alcohol can increase the risk of miscarriage and low birth weight and if consumed in large amounts it can cause fetal alcohol syndrome, a condition that can lead to facial deformitites, heart defects and mental retardation. My advice – avoid alcohol altogether during pregnancy. 

Foods pregnant women do not need to avoid:

• Shellfish (including prawns) unless you have an existing allergy. But ensure they are well-cooked! NB
• Live or bio yoghurt, probiotic drinks or soured cream 
• Spicy foods, unless it disagrees with you and gives you heartburn (which is no fun).
• Mayonaise, ice-cream and salad dressing (as long as they do not contain raw egg) 
• Honey 
• Many types of regular cheeses such as cheddar, feta, cream cheese, mozzarella and cottage cheese
• Peanuts 
• Most herbal teas 

“EAT A WELL BALANCED DIET, ALWAYS.” 

Weight gain during pregnancy 

There are no weight gain guidelines for women during pregnancy… Weight gain during pregnancy can vary hugely depending on:

• The unborn child 
• Placenta and amniotic fluid 
• Increases in maternal blood and fluid volume 

Body fat is often a small component of maternal weight gain.

Weight management during pregnancy 

• Extreme dieting during pregnancy is not recommended, even for overweight or obese women, as this can be harmful to the unborn baby.
• All pregnant women are advised to eat a healthy, balanced and varied diet and take part in regular physical activity.
• For overweight and obese women, making small improvements in their diet during pregnancy may mean they do not gain any weight during the gestational period of pregnancy and may even lose a small amount of weight – THIS IS NOT HARMFUL. 

Weight management after pregnancy 

• I encourage women to breastfeed (if they are able to), coupled with a healthy diet and regular physical activity after birth.
• Gradual weight loss (0.5-1kg per week) after pregnancy will not affect your ability to breastfeed or affect the quality or quantity of the milk produced.
• However, it is advisable to wait until your 6-8 postnatal check before embarking on any exercise regimen. 
• It’s good to return to your pre-pregnancy weight (as long as it was a healthy weight) but expect this to happen gradually. Fad diets, quick fixes and crash diets are not recommended, nor are they healthy to you and your nursing baby.

Breastfeeding 

• As mentioned, breastfeeding is encouraged and, optimally, it should be exclusive for the first 6 months of baby’s life. The added bonus is that it’s been shown to burn an extra 625 calories per day for the first 5 months for mom. However, there are a lot of factors at play here (such as returning to work) so ladies, do what you can, but don’t add unnecessary pressure on yourself to “get it perfect.” I have heard (in my limited experience in this area 🙂 that breastfeeding is natural, but it doesn’t come naturally. Advice to new moms from other moms is that it’s okay to take time to get used to it and to do it for as long as you can manage. A lactation consultant is a great way to help you get and stay on track with breastfeeding.
• EAT A BALANCED AND VARIED DIET. You need to ensure you are eating well (and enough) in order to keep up with the demands of feeding a little one and sleepless nights. Food is often an after-thought for a frazzled new mommy. A healthy diet packed with life-giving nutrients for you and baby is essential during this time. Try pre-prep a range of healthy snacks that you can eat on go, especially during those first few weeks as you settle with new baby.
• Aim to have regular drinks throughout the day (water and milk are good options). Your thirst will increase as your body produces milk for baby, so make sure you keep hydrated.  
• Alcohol WILL pass through breastmilk to baby and should be avoided. If you are consuming alcohol, try limit it to 2 units per week, and no less than 2 hours before breastfeeding. Or avoid it altogether.
• Caffeine can also pass to the baby when breastfeeding and may cause the baby to become unsettled. If you have a mizzy baby, see if caffeine could be a cause.

When it comes down to it, food is our fuel for everything – energy, growth and development during every phase of life, but most importantly during pregnancy and early childhood. It’s never to late in your pregnancy to make a healthy change. Implement these steps, even one at a time, to give you and your baby the best start you can.

And that’s it folks! If you would like more information, or have me assist with your nutrition, please visit www.csbbodyfusion.co.za and a big thank you goes out to Mac Nutrition Uni on clarifying some important aspects on the advice above.