Eating well before and during pregnancy gives your baby a good start in life. Healthy eating for pregnancy is no different from at any other time of your life however there are some special considerations. There is no need to eat for two, but there is a need to plan your food intake carefully. You will require more vitamins and minerals during pregnancy, but only a little extra food energy. The eating plan for pregnancy is one where food choices should be made carefully to ensure that your micronutrient needs are met – but that your energy needs are not exceeded. It is only in the last trimester that you need extra food energy (and then the amount is not much, equivalent to a sandwich).The ‘Guidelines for healthy eating’ can be used as a basis for planning meals, with quality and quantity of foods taken into consideration. Good planning in advance of meal times makes this easier. 

Make starchy foods the basis of most meals Bread, rice, potatoes, pasta, cereal, porridge and other starchy foods should make up the main part of each meal. Choose wholegrain or high fibre options where possible.  Bread and maize in South Africa is fortified by law, and are also good choices. 

Eat plenty of vegetables and fruit every day Many people fall down on this guideline, if you are one of them now is a good time to correct this. Vegetables and fruit in their fresh, frozen, tinned, dried and juiced form  all contribute; but do not overdo the juice intake, this can push up your total energy intake beyond your needs.

Eat dry beans, peas, lentils and soy regularly This important group of plant foods are under utilized by many people. By making them a regular part of your eating plan gain important nutrients and health benefits from this food group. If you have not eaten these often previously start with small portions regularly, rather than large portions occasionally – this will help your body to adjust to digesting these foods, and prevent gastrointestinal discomfort. 

Chicken , fish, milk, meat and eggs, could be eaten daily. It is possible to get most of the nutrients you need without eating these foods, but it is more challenging during pregnancy. These foods contribute to the intake of protein, iron and calcium, as well as other vitamins and minerals. Aim to use 3 cups of milk a day (or alternatives such as cheese or yoghurt), and include chicken, fish, lean meat or eggs several times a week.

Use fat sparingly Excess fat intake will contribute to excess weight gain, so foods chosen from the groups above should be low fat or lean versions. Some foods that supply essential fats must be included such as fatty fish, avocado, nuts and plant oils. 

Special considerations:

Folic acid: To help prevent neural tube defects (NTD) it is important that a daily supplement of 400mcg is taken when stopping contraception and up to the 12th week of pregnancy. In addition to this folate rich foods (green vegetables, fortified bread and cereals) should be eaten. 

Weight gain: The recommended weight gain during pregnancy is approximately 10 to 12 kg. This is approximately 1-2kg in the first trimester, 300-400g a week in the second trimester and 1-3kg per month in the third trimester.This will however vary.  If you are overweight at the start of your pregnancy you should not start a strict reducing diet, as this will limit your nutrient intake, but it is   important you do not gain too much weight. 

Do not take supplements that contain vitamin A because too much vitamin A can cause foetal abnormalities. Some foods like liver and liver pate are high in vitamin A, and too much of this food can provide too much vitamin A.  

Caffeine Have no more than 200mg caffeine daily. Take care with coffee, tea, cola, high energy drinks and chocolate. one mug of instant coffee: 100mg  

  • one mug of filter coffee: 140mg  
  • one mug of tea: 75mg 
  • one can of cola: 40mg  
  • one can of energy drink: 80mg  
  • one 50g bar of plain (dark) chocolate: around 50mg 
  • one 50g bar of milk chocolate: around 25mg 

Nuts: It was previously advised that pregnant women avoid eating peanuts during pregnancy if there was a history of allergy (such as asthma, eczema, hay fever or food allergy) in their baby’s immediate family but this advice has now changed. The latest research shows that there’s no clear evidence that eating peanuts during pregnancy affects the chances of your baby developing a peanut allergy.  If you want to eat peanuts or foods containing peanuts (such as peanut butter) during pregnancy, you can do so as part of a healthy balanced diet, unless you’re allergic to them or your health professional advises you not to.

Can I drink any alcohol? – It is unknown what level of alcohol is safe in pregnancy. Alcohol is best avoided throughout pregnancy and especially if planning a pregnancy and during the first 3 months. If you do choose to have alcohol, limit it to one or two units once or twice a week however the safest approach is to not drink at all.

Common complaints during pregnancy:

How can I prevent constipation? Eat minimally processed and high fibre starchy foods, plenty of vegetables and fruit and eat dry beans, peas, lentils and soy regularly. Drink lots of clean, safe water. 

How can I stop feeling nauseous? Eating little and frequently through the day;   choose mainly starchy foods such as toast or crackers. Cold, bland, non-greasy foods are often better tolerated than hot flavourful foods.  Consuming ginger-rich foods or drinks may help. In most cases the nausea should have eased by 16 – 20 weeks. 

For heartburn: Try eating small regular meals and snacks and avoid large meals. Avoid fatty, fried and spicy foods. 

Protect the safety of your food

Bacterial infections such as listeriosis, salmonella and toxoplasmosis can be dangerous for pregnant women and their unborn babies. The bacteria can harm the unborn baby and interfere with its normal development. Taking the following the steps can help you to avoid harmful bacteria: 

Salmonella: Avoid raw shellfish, undercooked meats and chicken and raw and partially cooked eggs and dishes containing these e.g. homemade mayonnaise, mousses and ice-cream. Always wash hands after handling raw meats and poultry and store raw foods separately from cooked foods

Listeria: Soft ripened cheeses (including Brie, Camembert), blue veined cheeses (e.g. Stilton, Danish Blue) and all unpasteurised dairy products are a source of listeria. Takeaway and ready meals must be heated thoroughly. Chilled food should be stored at the correct temperature (below 5°C) and foods should not be eaten after their ‘use by’ date.

Contaminants: e.g. mercury is found in high levels in shark, marlin, swordfish and tuna. These should be avoided and tuna should be limited to two fresh steaks /week or 4 medium cans/week. 

 

In summary

Eating well and making healthy food choices during your pregnancy will not only affect your health but also the health of your baby. Remember you don’t need to eat for two as it is only in the final three months when you need extra calories. Be guided by your appetite. When you feel hungry between meals, choose a healthy snack such as fruit, yoghurt or a bowl of cereal.