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Nutrition in Pregnancy
Aka: Nutrition in Pregnancy, Pregnancy Related Nutrition, Dietary Guidelines in Pregnant Women
- See Also
- First Trimester Education
- Second Trimester Education
- Third Trimester Education
- First Obstetric Visit
- Prenatal Visit
- Physiology: Adequate Weight Gain in Pregnancy
- Prevents Intrauterine Growth Retardation (IUGR)
- Especially in third trimester
- Weight gain distribution over multiple components
- Fetus
- Placenta, amnion, and Uterus
- Edema and Increased Blood Volume
- Breast engorgement
- Approach: Weight Gain in Pregnancy
- Normal conception weight (BMI = 19.8 - 26)
- Total weight gain: 11.25 - 15.75 kg (25 - 35 lb)
- Gain 1st trimester: 1.35-2.25 kg (3-5 lb) per month
- Gain 2nd/3rd: 0.45-0.90 kg (1-2 lb) per week
- Overweight at conception (BMI 27-29)
- Total weight gain: 6.75 - 11.25 kg (15 - 25 lb)
- Gain 1st trimester: 0.90-1.80 kg (2-4 lb) per month
- Gain 2nd/3rd: 0.45 kg (1 lb) per week
- Morbidly Overweight at conception (BMI >29)
- Total weight gain: 6.8 kg (15 lb)
- Low weight at conception (BMI < 15)
- Total gain: 15.75 - 18 kg (35 - 40 lb)
- Indications: Intensive Nutrition Counseling
- Weight gain <0.90 kg (2 lb) per month
- Weight gain >2.92 kg (6 lb 8 oz) per month
- Weight gain < 4.5 kg (10 lb) by mid-pregnancy
- Approach: Postpartum Weight Loss (Gradual!)
- Weight loss 0.36 - 0.45 kg (13 oz - 1 lb) per week
- Guidelines: National Research Council RDA Recommendations
- Non-Pregnant Women Example
- Daily Caloric Intake: 2200 KCals
- Daily Protein intake: 55 grams
- Pregnant Women: First Trimester Example
- Daily Caloric Intake 2300 KCals (100 additional calories per day)
- Equivalent of 100 additional calories/day
- One and one half slices of bread per day
- One Cup of milk or fruit juice
- One Banana
- Pregnant Women (Second and third trimester) Example
- Daily Caloric Intake: 2500 KCals (300 additional calories/day)
- Daily Protein intake: 60 grams
- Lactating Women Example
- Daily Caloric Intake: 2600 KCals (400 additional calories/day)
- Daily Protein intake: 65 grams
- Guidelines: Specific Components and Additives
- See Folic Acid Supplementation in Pregnancy
- Artificial Sweeteners
- Avoid Saccharin (crosses placenta and may deposit in fetal tissue)
- Sucralose and Acesulfame-K are likely safe in pregnancy
- Aspartame is likely safe in pregnancy but has the theoretical risk of exposing an undiagnosed fetus with PKU to phenylalanine
- Caffeine
- Limit Caffeine to <150-300 mg/day (due to association with low birth weight and Spontaneous Abortion)
- Herbal teas
- Avoid chamomile, licorice, peppermint, raspberry leaf (risk or Preterm Labor, Spontaneous Abortion)
- Vitamin A Toxicity
- Avoid liver products
- Toxins
- See Mercury Content in Fish
- Various pollutants in farmed salmon (polychlorinated biphenyls, dioxins)
- Guidelines: Foodborne Illness Prevention
- Listeria and Toxoplasosis risk
- Unpasteurized dairy and soft cheeses (e.g. Feta, Brie, Caembert, Blue cheese)
- Unwashed fruits and vegetables
- Listeria risk
- Deli meats or meat spreads
- Under cooked meats
- Left-overs
- Smoked seafood
- Salmonella risk
- Raw eggs
- Parasites and Norovirus
- Raw fish or shellfish
- References
- Cogswell (1999) Obstet Gynecol 94:616-22 [PubMed]
- Zolotor (2014) Am Fam Physician 89(3): 199-208 [PubMed]