Eating Right When Pregnant

Eating Right When Pregnant

Good nutrition during pregnancy, and enough of it, is very important for your baby to grow and develop. You should consume about 300 more calories per day than you did before you became pregnant.
Although nausea and vomiting during the first few months of pregnancy can make this difficult, try to eat a well-balanced diet and take prenatal vitamins. Here are some recommendations to keep you and your baby healthy.

Goals for Healthy Eating When Pregnant

• Eat a variety of foods to get all the nutrients you need. Recommended daily servings include 6-11 servings of breads and grains, two to four servings of fruit, four or more servings of vegetables, four servings of dairy products, and three servings of protein sources (meat, poultry, fish, eggs or nuts). Use fats and sweets sparingly.
• Choose foods high in fiber that are enriched such as whole-grain breads, cereals, pasta, rice, fruits, and vegetables.
• Make sure you are getting enough vitamins and minerals in your daily diet while pregnant. You should take a prenatal vitamin supplement to make sure you are consistently getting enough vitamins and minerals every day. Your doctor can recommend an over-the-counter brand or prescribe a prenatal vitamin for you.
• Eat and drink at least four servings of dairy products and calcium-rich foods a day to help ensure that you are getting 1000-1300 mg of calcium in your daily diet during pregnancy.
• Eat at least three servings of iron-rich foods per day to ensure you are getting 27 mg of iron daily.
• Choose at least one good source of vitamin C every day, such as oranges, grapefruits, strawberries, honeydew, papaya, broccoli, cauliflower, Brussel sprouts, green peppers, tomatoes, and mustard greens. Pregnant women need 70 mg of vitamin C a day.
• Choose at least one good source of folic acid every day, like dark green leafy vegetables, veal, and legumes (lima beans, black beans, black-eyed peas and chickpeas). Every pregnant woman needs at least 0.4 mg of folic acid per day to help prevent neural tube defects such as spina bifida.
• Choose at least one source of vitamin A every other day. Sources of vitamin A include carrots, pumpkins, sweet potatoes, spinach, water squash, turnip greens, beet greens, apricots, and cantaloupe.

• Foods to Avoid When Pregnant

• Avoid alcohol during pregnancy. Alcohol has been linked to premature delivery, mental retardation, birth defects, and low birth weight babies.
• Limit caffeine to no more than 300 mg per day. The caffeine content in various drinks depends on the beans or leaves used and how it was prepared. An 8-ounce cup of coffee has about 150 mg of caffeine on average while black tea has typically about 80 mg. A 12-ounce glass of caffeinated soda contains anywhere from 30-60 mg of caffeine. Remember, chocolate contains caffeine -- the amount of caffeine in a chocolate bar is equal to 1/4 cup of coffee.
• The use of saccharin is strongly discouraged during pregnancy because it can cross the placenta and may remain in fetal tissues. But, the use of other non-nutritive or artificial sweeteners approved by the FDA is acceptable during pregnancy. These FDA-approved sweeteners include aspartame (Equal or NutraSweet), acesulfame-K (Sunett), and sucralose (Splenda). These sweeteners are considered safe in moderation so talk with your health care provider about how much non-nutritive sweetener is acceptable during pregnancy.
• Decrease the total amount of fat you eat to 30% or less of your total daily calories. For a person eating 2000 calories a day, this would be 65 grams of fat or less per day.
• Limit cholesterol intake to 300 mg or less per day.
• Do not eat shark, swordfish, king mackerel, or tilefish (also called white snapper), because they contain high levels of mercury.
• Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese. These cheeses are often unpasteurized and may cause Listeria infection. There’s no need to avoid hard cheese, processed cheese, cream cheese, cottage cheese, or yogurt. 
• Avoid raw fish, especially shellfish like oysters and clams.

What to Eat When Pregnant and Don't Feel Well

During pregnancy you may have morning sickness, diarrhea, or constipation. You may find it hard to keep foods down, or you may feel too sick to even eat at all. Here are some suggestions:

• Morning Sickness: Eat crackers, cereal, or pretzels before getting out of bed; eat small, frequent meals throughout the day; avoid fatty, fried, and greasy foods.
• Constipation: Eat more fresh fruit and vegetables. Also drink 6 to 8 glasses of water a day.
• Diarrhea: Eat more foods that contain pectin and gums (two types of dietary fiber) to help absorb excess water. Examples of these foods are applesauce, bananas, white rice, oatmeal, and refined wheat bread.
• Heartburn: Eat small, frequent meals throughout the day; try drinking milk before eating; and limit caffeinated foods and beverages, citric beverages, and spicy foods.

Can I Diet While Pregnant?

No. Do not diet or try to lose weight during pregnancy -- both you and your baby need the proper nutrients in order to be healthy. Keep in mind that you will lose some weight the first week your baby is born.

Can I Eat a "Low Carb" Diet When Pregnant?

Low carbohydrate diets, such as Atkins and the South Beach Diet, are very popular. There have been no studies of the effects of a low carbohydrate diet on pregnancy, so its effect on the fetus, if any, are unknown. While you are pregnant, you should eat a balanced diet from all of the food groups.

Can I Maintain My Vegetarian Diet When Pregnant?

Just because you are pregnant doesn't mean you have to diverge from your vegetarian diet. Your baby can receive all the nutrition he or she needs to grow and develop while you follow a vegetarian diet if you make sure you eat a wide variety of healthy foods that provide enough protein and calories for you and your baby.
Depending on the type of vegetarian meal plan you follow, you may need to adjust your eating habits to ensure that you and your baby are receiving adequate nutrition (you should consume about 300 more calories than you did before you became pregnant).

Why Do I Need More Calcium When Pregnant?

Calcium is a nutrient needed in the body to build strong teeth and bones. Calcium also allows blood to clot normally, muscles and nerves to function properly, and the heart to beat normally. Most of the calcium in your body is found inside your bones.
Your growing baby needs a considerable amount of calcium to develop. If you do not consume enough calcium to sustain the needs of your developing baby, your body will take calcium from your bones, decreasing your bone mass and putting you at risk for osteoporosis. Osteoporosis causes dramatic thinning of the bone, resulting in weak, brittle bones that can easily be broken.
Pregnancy is a critical time for a woman to consume more calcium. Even if no problems develop during pregnancy, an inadequate supply of calcium at this time can diminish bone strength and increase your risk for osteoporosis later in life.
The following guidelines will help ensure that you are consuming enough calcium throughout your pregnancy:

• The U.S. Recommended Daily Allowance (USRDA) for calcium is 1000 mg per day for pregnant and breastfeeding women over age 18. The USRDA for teenage girls up to age 18 is 1300 mg of calcium per day.
• Eating and drinking at least four servings of dairy products and calcium-rich foods a day will help ensure that you are getting the appropriate amount of calcium in your daily diet.
• The best sources of calcium are dairy products including milk, cheese, yogurt, cream soups, and pudding. Calcium is also found in foods including green vegetables (broccoli, spinach, and greens), seafood, dried peas, and beans.
• Vitamin D will help your body use calcium. Adequate amounts of vitamin D can be obtained through exposure to the sun and in fortified milk, eggs, and fish.

How Can I Get Enough Calcium If I'm Lactose Intolerant?

Lactose intolerance is the inability to digest lactose, the sugar found in milk. If you are lactose intolerant, you may have cramping, gas, or diarrhea when dairy products are consumed.
If you are lactose intolerant, you can still receive the calcium you need. Here are some suggestions:

• Try consuming small amounts of milk with meals. Milk may be better tolerated with food.
• You may be able to tolerate certain milk products that contain less sugar including cheese, yogurt, and cottage cheese.
• Eat non-dairy calcium sources including greens, broccoli, sardines, and tofu.
• Use Lactaid Milk fortified with calcium. Talk to your dietitian about other lactose-reduced products.

Should I Take a Calcium Supplement During Pregnancy?

If you have trouble consuming enough calcium-rich foods in your daily meal plan, talk to your doctor or dietitian about taking a calcium supplement. The amount of calcium you will need from a supplement depends on how much calcium you are consuming through food sources.
Calcium supplements and some antacids containing calcium, such as Tums, may complement an already healthy diet. Many multiple vitamin supplements contain little or no calcium; therefore, you will need an additional calcium supplement.

Why Do I Need More Iron During Pregnancy?

Iron is a mineral that makes up an important part of hemoglobin, the substance in blood that carries oxygen throughout the body. Iron also carries oxygen in muscles, helping them function properly. Iron helps increase your resistance to stress and disease.
The body absorbs iron more efficiently during pregnancy; therefore it is important to consume more iron while you are pregnant to ensure that you and your baby are getting enough oxygen. Iron will also help you avoid symptoms of tiredness, weakness, irritability, and depression.
Following a balanced diet and including foods high in iron can help ensure that you are consuming enough iron throughout your pregnancy. In addition, the following guidelines will help:

• The U.S. RDA for iron is 27 mg per day for pregnant women and 15 mg for breastfeeding women.
• Eating at least three servings of iron-rich foods a day will help ensure that you are getting 30 mg of iron in your daily diet. One of the best ways to get iron from your diet is to consume a highly fortified breakfast cereal such as Total, which has 18 mg of iron. Note that iron intake is not equal to iron absorption. Absorption of iron into the body is greatest with meat sources of iron such as liver.
• The best sources of iron include enriched grain products, lean meat, poultry, fish, and leafy green vegetables.

What Are Good Sources of Iron?

• Meat and Seafood: Lean beef, chicken, clams, crab, egg yolk, fish, lamb, liver, oysters, pork, sardines, shrimp, turkey, and veal.
• Vegetables: Black-eyed peas, broccoli, Brussel sprouts, collard and turnip greens, lima beans, sweet potatoes, and spinach.
• Legumes: Dry beans and peas, lentils, and soybeans.
• Fruits: All berries, apricots, dried fruits, including prunes, raisins and apricots, grapes, grapefruit, oranges, plums, prune juice, and watermelon.
• Breads and Cereals: Enriched rice and pasta, soft pretzel, and whole grain and enriched or fortified breads and cereals.
• Other Foods: Molasses, peanuts, pine nuts, pumpkin, or squash seeds.

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Getting Pregnant: Easy Ways to Encourage Fertility

For some couples, getting pregnant is quick and easy. For others, things are not as easy.
Sometimes, problems are linked to such specific physiological issues as blocked fallopian tubes in the woman or low to no sperm count in the man -- problems that can be addressed by a fertility specialist and subsequent treatments like in vitro fertilization (IVF) or insemination.
For many others, however, reasons behind their infertility are much harder to define.
"Often, problems are subclinical -- meaning we know something is wrong, it's just not showing up on the radar," says Staci Pollack, MD, a reproductive endocrinologist at the Montefiore Medical Center's Institute of Reproductive Medicine and Health.
Pollack says standard fertility treatments can usually help, but in some cases, so can a host of other, less costly techniques -- some of which couples can try on their own.
The key to success: Knowing when to try -- and when it's time for more serious medical treatment. The good news: Doctors say both options can be clearly mapped out with the help of a medical fertility workup. Designed to rule out specific causes that require medical care, test results can also help you decide if any of these low-tech treatments are worth a try.
And what if you aren't anticipating a problem but just want to give your fertility a boost? Some of these low-tech methods can work for you as well. Just keep in mind that the American Society for Reproductive Medicine says if you don't get pregnant after 12 months of regular unprotected intercourse -- or six months if you are a woman over 35 -- it's time to seek help from a fertility specialist.

Fertility Booster No. 1: Eat Healthfully

Among the most common causes of unexplained infertility in women is "ovulatory dysfunction" -- an

Fertility Booster No. 2: Weight Control

Whether or not you eat the so-called "fertility foods," maintaining a healthy weight is another way to enhance your fertility.
Studies show that having either a very low or very high BMI (body mass index) disrupts ovulation and may also affect production of important reproductive hormones.
"One of the first things I counsel women about is the role of their weight in influencing their fertility," says Janet Choi, MD, a reproductive endocrinologist at the Columbia Presbyterian Medical Center in New York City.
For many women -- particularly those who are overweight -- problems are traced to ovulatory dysfunction, often caused by PCOS. That said, a recent Dutch study of some 3,000 women found excess weight could also interfere with fertility even if a woman is ovulating normally.
Reporting in the journal Human Reproduction, researchers documented a 4% decrease in conception odds for every point in BMI above 30. For women whose BMI was higher than 35, there was up to a 43% overall decrease in the ability to conceive.
The good news: Losing those extra pounds may preclude the need for pricey fertility treatments.
In fact, the British Fertility Society in 2007 issued new guidelines urging members to defer fertility treatments in very obese women (BMI over 35) until they gave weight loss a try.
At the same time, being too thin can also keep you from conceiving. "Women who are extremely lean often have a problem getting pregnant because they are not able to sustain a regular menstrual cycle -- for these women, it is more beneficial to gain weight," Chavarro says.

Fertility Booster No. 3: Reduce Stress

Although links between stress and infertility have been long debated, evidence continues to mount that the two are intertwined.
In studies conducted by Alice Domar, PhD, at Harvard's Mind-Body Institute, women who underwent stress reduction therapy saw dramatic increases in their ability to get pregnant. In fact, even women who were already undergoing fertility treatments had more successful outcomes when stress was kept under control.
More recently, research conducted at Magee Women's Hospital in Pittsburgh by Sarah Burga, MD, linked stress to a condition known as functional hypothalamic amenorrhea (FHA). Affecting some 5% of women in their reproductive years, it causes irregular or absent menstrual cycles.
Choi says, "I don't advocate quitting your job just to get rid of stress, but if you can try to get better day-to-day management of your anxieties, I believe it can work in conjunction with other methods to encourage fertility."
What can you do to reduce fertility-related stresses? Experts say anything that makes you feel relaxed can help -- be it listening to music, doing yoga, getting regular massages, writing in a journal, reading, gardening -- even chatting on the phone with friends.
You can also think outside the box for some unique ways to reduce stress. One recent study published in the journal Psychological Science found the simple act of holding hands with your spouse can drop stress levels dramatically. Or you might try renting a stack of romantic comedy videos.
If you're tempted to handle your stress by smoking or drinking alcohol, experts say don't. Numerous studies have shown that smoking contributes to both male and female infertility and can even impair the outcome of fertility treatments. Excessive alcohol consumption can impair ovulation in women and sperm production in men.

umbrella term encompassing problems with ovulation.
Though a number of factors can be responsible, many doctors now believe diet is one of the keys. In a study of some 17,000 women conducted by the Harvard School of Public Health, researchers were able to define a group of "fertility foods" able to improve conception odds.
Which dietary tenets were significant for increasing fertility?

• Eating more monounsaturated fats (like olive oil) and less trans fats (like the kind found in many baked goods or fast foods).
• Increasing intake of vegetable protein (like soy), while reducing animal protein (like red meat).
• Eating more high fiber, low-glycemic foods -- like whole grains, vegetables, and some fruits, while reducing the intake of refined carbohydrates and sugars.
• Consuming moderate amounts of high-fat dairy products -- like ice cream, whole milk, and cheese.

Jorge Chavarro, MD, a study researcher, believes diet made a difference because the majority of women experiencing ovulatory dysfunction were also suffering from undiagnosed or subclinical PCOS (polycystic ovary syndrome), a condition related to insulin resistance that also affects ovulation.
"It responds well to diet, so that could be one of the reasons these foods were so helpful," says Chavarro, who translated his medical study findings into a book called The Fertility Diet.
Pollack believes it's worth giving the diet a try but says, "You should not depend on it alone -- make it just one part of your overall efforts to conceive."

Fertility Booster No. 4: Acupuncture

Studies linking acupuncture to conception have by and large been conducted on women undergoing fertility treatments. Still, many experts are quick to point out that this ancient Chinese medical art may also work to help encourage fertility overall -- even for those couples trying to conceive naturally.
"I sometimes recommend acupuncture, in conjunction with stress reduction activities such as yoga, to help encourage pregnancy," Pollack says.
"I wouldn't advise a couple to rely only on acupuncture, or to try it without first getting a fertility workup, but if everything checks out OK, acupuncture can be helpful," she says.

Fertility Booster No. 5: Ovulation

While being intimate during the "right time of the month" won't do anything to increase your fertility, it can increase your chances of getting pregnant -- simply by ensuring you and your partner connect during the time conception is possible.
Timing is crucial, says Pollack, because "an egg only lives for 24 to 36 hours." But sperm can live in the lower portion of a woman's reproductive tract a lot longer -- often up to five days. So to increase your chances of conceiving you should be intimate with your partner beginning three to four days prior to ovulation, and continuing up to 24 hours after ovulation.
But how do you know when you're about to ovulate? Experts say there are several methods you can use to approximate.

1. Chart your basal body temperature (BBT): Your BBT, which is the lowest temperature your body reaches during the day, is affected by the hormones that influence ovulation. Just prior to egg release, your BBT drops about a half degree and then rises again after you ovulate. So by carefully monitoring and keeping track of your daily temperature for one or two months, Pollack says you will notice a pattern take shape. If you have intercourse during the days when your temperature drops, then there is a good chance you will be within your fertility window.
2. Chart your cervical mucus: Corresponding to changes in body temperature are changes in cervical mucus. Just prior to ovulation, the mucus will seem more copious, thinner, and clearer than on other days. You might even be able to pull it apart so that it looks somewhat like rubber cement -- a phenomenon known as "spinbarket." By checking your cervical mucus daily and coordinating its consistency with your BBT, you can further nail down your most fertile time.
3. Use an ovulation predictor kit (OPK): These over-the-counter kits, costing from $20 to $75 a month, check for the hormonal changes found in urine prior to ovulation. Some use a color-sensitive dipstick while newer OPKs have digital readouts that may be easier to interpret. OPKs can alert you to ovulation up to two days in advance. Once the OPK is positive, Pollack says, you would "have intercourse that day and every day for three days to help increase your chances of conception." Another device that may predict fertility is the "ferning" microscope, which can be used to detect changes in saliva that precede ovulation. However, experts say this approach may not be as reliable as an OPK.
4. Buy a fertility monitor: At $200 to $400, they are not cheap. But a fertility monitor can indicate as many as six or seven fertile days each cycle. That can give you a clearer sense of your fertility window and potentially increase your odds of conceiving. Try a wristwatch fertility predictor, which detects chemical changes on the skin that indicate ovulation. These fertility watches help women identify the four days prior to ovulation.

Fertility Booster No. 6: Conception Kits and Other Tests

A kit that helps predict ovulation may tell you when it's the best time to have intercourse, but most did little else to foster fertility -- until now.
A new kit developed by Conceivex not only offers ovulation prediction, but it also contains a small latex-free cervical cap to actually help you conceive. The idea here is to concentrate an ejaculate into the cap and insert it into a woman's body directly at the opening of the cervix. In a kind of do-it-yourself mini-insemination, it does away with the need for sperm to swim through a sometimes chemically "hostile" vaginal canal, placing them instead right at the palace gates.
Shari Brasner, MD, who has recommended the kit to patients, says it's most useful for women with previous cervical issues or for men with low sperm volume or performance anxiety.
"Short of diagnosing a cervical infection, we don't really have a test for cervical factor infertility -- and it is my belief that this could be the problem for many women with a past history of treatment for an abnormal Pap smear," Brasner says.
Though she says Conceivex won't repair any defects, it is a way around them. "It's also an important aid for men with sperm concentration problems," she says.
Although Conceivex requires a prescription, it can be purchased online after completing a questionnaire reviewed by their medical doctors. The cost is $300.
A second new kit is called Fertell. While the female version is simply an ovulation predictor kit, the male version is an at-home test able to measure sperm motility -- the ability of sperm to reach a woman's fallopian tubes. It sells for $99 and does not require a prescription. Other do-it-yourself sperm motility tests are available.
"There is no harm in trying these kits, or any of the other methods to encourage fertility. But if you don't get pregnant within the suggested time frame, then don't wait -- see a fertility specialist," Pollack says.