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Pregnancy Diet: Eating (Well) for Two

Eating right during your pregnancy prepares you for the rigors of labor, delivery, and, ultimately, motherhood, while also helping your baby develop during nine months of enormous change. "Even with all the diagnostic tests and fancy equipment now available, good nutrition is still the most important factor in giving your baby a healthy start in life," says Bridget Swinney, M.S., R.D., author of Eating Expectantly: A Practical and Tasty Guide to Prenatal Nutrition.

You're ahead of the game if you started eating well from the beginning of your pregnancy, but don't worry if you didn't mainline vegetables right after conception. What's important is that you focus on creating healthy eating habits as soon as you can.

Food for Tot
Experts advise that you see a nutritionist during your pregnancy if you are significantly over- or underweight, a teenager, pregnant with multiples, or nursing while pregnant, because you may have special nutritional needs that can best be met by following a custom diet. "Strict vegetarians should also consult with a dietitian," says Brenda Danner, R.D., C.D., outpatient dietitian at St. Francis Hospital and Health Center in Indianapolis, IN. "Those who don't eat eggs or milk may lack vitamin B12 -- which is found only in animal products -- as well as iron, calcium, and other nutrients."

For the majority of women, however, professional advice isn't necessary -- you just need to rethink your usual eating habits. Start by changing your definition of a meal. "If you're used to a glass of juice as a morning meal," says Glade B. Curtis, M.D., a board certified ob-gyn who practices in Salt Lake City, UT, and author of Your Pregnancy Week by Week, "make an effort to eat a real breakfast every day." According to Dr. Curtis, a balanced diet of four or five small meals throughout the day is the best way to nourish your baby and maintain a high level of energy. (It will also help counter morning sickness; see next page.) It might sound like a lot of food, but you need the extra calories: The American College of Obstetricians and Gynecologists recommends pregnant women take in an additional 300 calories each day.

But that doesn't mean chowing down on every high-calorie, high-fat treat in sight. To get the best results, go easy on fats, oils, and sweets, and stick to lean, low-fat, nutrition-packed foods. If you're unsure of just what to eat every day, here's a guideline:

  • 9 slices of bread or 9 ounces of grains (a major source of thiamin, iron, niacin, and zinc)
  • 4 cups of raw or 2 cups of cooked vegetables (provides vitamins A and C, folic acid)
  • 3 medium pieces of fruit (provides vitamins A and C, folic acid)
  • 3 to 4 8-ounce cups of milk or other dairy products (for protein, calcium, riboflavin, B12 and D)
  • 2 3-ounce servings of lean meat (for protein, iron, thiamin, B6 and B12, folic acid, and zinc).

Read ahead for pregnancy weight concerns

Weighty Issues
In addition to providing nutrients and energy, all those calories will help you gain weight during pregnancy. The recommended gain for an average-size woman is 25 to 35 pounds. (Experts advise overweight women to stay in the lower end of the range, and underweight moms-to-be should aim for the higher end.)

While consciously putting on pounds is an unappetizing thought for many women, this is one time when you should cut yourself a break. "It's not a time to be concerned about the weight," says Los Angeles-based Kathy Kaehler, fitness consultant for DietSmart.com and a mother of three. "Focus on the fact that you are giving yourself and your baby quality nutrition, and let the weight do what it will."

Undereating or sticking to a weight-control diet while you are pregnant is not a wise choice. "When you don't eat, your baby may not have the energy and nutrients it needs and will use up your own nutrient stores," says Swinney.

But by the same token, don't feel like you can gain as much weight as you want; it won't just melt off after childbirth. "Cut out the empty calories," says Danner. If you overdo it, she says, "you're going to feel extra stress to shed those pounds later."

To accurately monitor your weight during pregnancy:

  • Weigh yourself weekly, not daily (no need to worry about small fluctuations);
  • Weigh yourself at the same time of day and under the same conditions (i.e., every Saturday morning, after using the bathroom, wearing the same nightgown);
  • Use the same scale each time for accuracy.

Tummy Trouble
Nausea and morning sickness are likely to strike during the first three months of your pregnancy. "Eating small meals five to six times a day can help," says Danner, since an empty stomach often triggers nausea, as can eating too much at one sitting. "Drink fluids between meals, not with meals, to avoid extra movement in the stomach." If morning is your queasiest time, "eat a little something to jump-start the digestive process before you get out of bed," she adds. "Keep crackers or pretzels by the bed. They help settle the stomach because they are low in fat and easy to digest."

If your prenatal vitamin is making nausea worse, "try taking it with meals or at night as opposed to first thing in the morning," says Dr. Curtis. If you really have trouble tolerating the supplement, he suggests talking to your doctor about alternatives -- like chewable prenatal vitamins -- but don't give up on getting these essential nutrients into your system.

If you are vomiting often, "eat whatever you can to get through it, and try to stay hydrated," says Swinney. "Don't feel guilty that you're not eating a power-packed meal" while you're sick, assures Dr. Curtis. Some foods that are usually well-tolerated during serious bouts of morning sickness include turkey or chicken breast, raw fruits, raw vegetables, juices, caffeine-free soda, skim milk, popsicles, Jell-O, Kool-Aid, pudding, yogurt, cereal, rice, and pasta. If you experience heartburn in the last trimester of pregnancy, drink plenty of fluids, keep active, and focus on consuming fiber-rich foods.

Read ahead for what not to eat during pregnancy

To Eat or Not to Eat
Pregnant women should definitely steer clear of raw fish (it could contain harmful bacteria) and alcohol (which could lead to fetal alcohol syndrome). You should also avoid soft or mold-ripened cheeses (like Brie and Stilton) because of the risk of listeria, and raw eggs, which might contain salmonella. Talk to your doctor about caffeine, which a recent study has linked to an increased risk of miscarriage.

As for concerns about the danger of pesticides, Danner recommends giving fresh produce a good 20- to 30-second wash with warm water to remove dirt, germs, and any trace amounts of pesticide residue. If you're really worried, you can always go organic, but most experts say that produce from your local grocery store is just fine. "In my opinion, we have one of the safest food supplies in the world," she says. "I would hate for moms-to-be to completely avoid fresh fruits and vegetables."

Tracey Zemitis is a freelance writer based in Santa Monica, CA.

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