Nutrition and Exercise

Eating healthfully, exercising and controlling your weight during pregnancy go a long way toward giving your baby a healthy start in life. The foods you eat help your baby develop and grow. By eating healthfully, you will provide your baby with the nutrients it needs to build its bones and organs. Exercising during pregnancy keeps you in good shape and ready to do the work of labor and delivery. Controlling your weight (not gaining too much weight but gaining enough) makes sure your developing baby is getting the nutrients it needs. One study showed 95% of the women who had good-to-excellent diets delivered babies in good-to-excellent health. Only 8% of those women who ate poor diets (lots of junk food) had babies in good-to-excellent health. One of your main goals in pregnancy is to give birth to the healthiest baby you can. Your nutrition during pregnancy has a great effect on your baby's health. Exercise and weight control add to your overall health and thus to the health of your baby.

Some women get the false idea they can eat all they want during pregnancy. Don't fall into this trap! You don't want to gain more weight than your doctor recommends during pregnancy—it can make you uncomfortable and it is harder for you to lose the extra pounds after your baby is born. Increase the number of calories you consume now you're pregnant. Most experts agree a normal-weight pregnant woman needs to increase her caloric intake by 300 to 800 calories a day. These extra calories are important for tissue growth in you and your baby. Your baby uses the energy from your calories to create and to store protein, fat and carbohydrates, and to provide energy for its own body processes. Expect some weight gain during your pregnancy—it's natural and normal. Eat a variety of foods every day to supply you with the nutrients you need. You'll want to eat dairy products, protein foods, fruits and vegetables, and breads and cereals.

Cravings During Pregnancy

For many women, cravings during pregnancy are normal. Cravings for particular foods during pregnancy can be both good and bad. If you crave foods that are nutritious and healthy, eat them in moderate amounts. If you crave foods that are high in sugar and fat, and loaded with empty calories, be very careful about eating them. No one knows why some women develop cravings during pregnancy, especially cravings for foods they might not normally eat. But many believe it is because of the hormonal and emotional changes that occur during pregnancy. It's not uncommon during pregnancy to be nauseated by foods you love to eat normally. The hormones of pregnancy have a significant impact on the gastrointestinal tract, which can affect your reaction to certain foods.

Artificial Sweeteners

Aspartame and saccharin are the two most widely used artificial sweeteners. Recently there has been controversy over the safety of aspartame. I advise you to substitute foods that do not contain the sweeteners for products you usually use because currently we just don't know about its safety for pregnant women and their developing babies. Also, aspartame is a source of phenylalanine in the diet. Pregnant women who suffer from phenylketonuria must follow a low-phenylalanine diet or their babies may be born mentally retarded and suffer from delayed development. Saccharin is not used as much today as in the past, but it is still found in many foods, beverages and other substances. The Center for Science in the Public Interest reports saccharin is not safe for use during pregnancy. Without further evidence, it is probably better to avoid using this product while you're pregnant.

A Healthy Eating Plan During Pregnancy

It's a good idea to eat a variety of foods throughout your pregnancy. Below is a list of daily servings from six food groups.

• Dairy products—4 to 5 servings a day
• Vegetables—at least 4 servings a day
• Fruits—2 to 4 servings a day
• Protein sources—3 to 4 servings a day
• Carbohydrates (breads, cereal, pasta and rice)—6 to 11 servings a day
• Fats/flavorings—3 to 5 servings a day
• Dairy Products

Drinking During Pregnancy

Drink 6 to 8 glasses (64 ounces; 1.9 liters) of liquid every day. Water is the best choice. I advise all my patients to drink plenty of water every day. Some patients tell me they don't like drinking so much water, but it really is important during pregnancy. Water is necessary for your body to process nutrients, develop new cells and sustain blood volume. You will probably feel better if you drink more fluid than you normally do. Your blood volume increases during pregnancy; drinking extra fluids helps you keep up with this change. Drinking water throughout the day can help you in other ways too. Many women who suffer from headaches, uterine cramping and various other problems during pregnancy find increasing their fluid intake helps resolve some of their symptoms. It also helps avoid bladder infections. Drink 6 to 8 glasses (64 ounces; 1.9 liters) of liquid every day. Water is the best choice. When your urine is light-yellow to clear, you're getting enough water. Dark-yellow urine is a sign you need to add more fluid to your diet.

Drinking Coffee During Pregnancy

Drinking as few as 4 cups of coffee a day (800mg of caffeine) by a pregnant woman has been associated with decreased birthweight and a smaller head size in newborns. Although an exact "toxic" amount for caffeine has not been determined, it makes sense to limit your caffeine intake. Caffeine is found in many beverages and foods, including coffee, tea, cola drinks and chocolate. Some medications, such as cough medicines and headache medicines, also contain a lot of caffeine. It's important to read labels. Caffeine is a central-nervous-system stimulant. There are no known benefits for you or your unborn fetus from caffeine. Caffeine can also affect calcium metabolism in both you and your baby. Limit your caffeine intake during pregnancy and if you breast-feed. Read labels on foods, beverages and over-the-counter medications to find out about caffeine content. Eliminate as much caffeine from your diet as possible. Some medications, such as cough medicines and headache medicines, contain a lot of caffeine. It's important to read labels.

Vitamins and Minerals in Pregnancy

As I said before, it's very important to take your prenatal vitamin throughout pregnancy. Prenatal vitamins contain the recommended daily amounts of vitamins and minerals you need during pregnancy. They are taken to ensure your health and your baby's health. However, they aren't a substitute for food or a good diet. The main difference between prenatal vitamins and multivitamins is that prenatal vitamins also contain iron and folic-acid supplements.
The only mineral that needs to be supplemented during pregnancy is iron. The average woman's diet seldom contains enough iron to meet the increased demands of pregnancy. Blood volume increases by 50% in a normal pregnancy, and iron is an important part of blood production in your body.

Iron
You may be advised to take iron supplements during pregnancy. Prenatal vitamins contain some iron but you may need to take extra iron. Your healthcare provider will test you for anemia early in your pregnancy. If he or she determines you need an iron supplement, you must take it for your health and your baby's health. Most prenatal vitamins contain 60mg of elemental iron. Some women worry that taking iron may cause constipation. Constipation can be a side effect. Work with your doctor to find the correct amount of iron to help lessen side effects.

Fluoride
The use of fluoride and fluoride supplementation during pregnancy is controversial. Some researchers believe fluoride supplementation during pregnancy results in improved teeth in your child, but not everyone agrees. However, no harm to the baby has been shown from fluoride supplementation in a pregnant woman. Some prenatal vitamins contain fluoride.

Sodium
Sodium is a chemical that works to maintain the proper amount of fluid in your body. During pregnancy, it can also affect your baby's system. Sodium is found in salty foods (such as potato chips and dill pickles) and in processed foods, from soups to meats. You need some sodium; you just don't need too much. Read food labels to discover just how much you're getting! During pregnancy, keep your consumption of sodium under 3g (3000mg) a day. Too much sodium causes water retention, swelling and high blood pressure. Any of these can be a problem for you. It's difficult to avoid something unless you know where to find it. With sodium, that can be tricky. It's in the salt shaker and in salty-tasting foods, such as pretzels, chips and salted nuts. (Table salt is about half sodium.) You may be surprised by the amount of sodium present in foods that don't taste salty. Sodium is found in canned and processed products, fast foods, cereals, desserts and even soft drinks and some medications! See the chart opposite for a listing of the sodium content in a variety of foods.