• Part 1: Off to a good start - Preconception Nutrition
• Part 2: The Right Weight
• Part 3: The Do’s: Grow a healthy HAPPYBABY with a healthy diet
• Part 4: The Don’ts
• Part 5: Tips for Getting Through the Rough Patches of Pregnancy
• Part 6: Meal and Snack ideas

Part 1: Off to a good start – Preconception Nutrition

Start ensuring a healthy future for your baby even before you concieve!

Some nutrients are thought to support fertility, while others are so important for developing babies that it's recommended you have a good supply from the very first day of your pregnancy. If you're trying to become pregnana, it's a good idea to take a prenatal vitamin each day. Here are some vitamins and minerals of particular interest before (and during) pregnancy:

• Antioxidants - Prevent cell damage that may not play a role in infertility. Diets rich in fruits, vegatables, and whole grains are highest in antioxidants like selenium, vitamin E and vitamin C.
• Folic acid - Prevents neural tube defects like spina bifida. The body won't store up extra folic acid--you need it every day. Since it's role in fetal development is so early in pregnancy, it's recommended that all women of child-bearing age get at least 400 mcg per day. It's in prenatal vitamin supplements, and also found in fortified grains and cereals, leafy greens (e.g., spinach), broccoli, oranges, beans, peas, and peanuts.
• Zinc - This mineral plays a role in sperm production by men, and ovulation and fertility in women. It's recommended that you get 15 mg per day. Good sources include beef, lamb, pumpkin seeds, yogurt, spinach, broccoli, peas, and leafy greens.
• Iron - Pregnant women are at risk for becoming iron-deficient and anemic. By making sure you have good sources of iron in your diet now, you can start with a good supply of this important mineral. Food sources include: lean red meats, beans, tofu, fortified cereals, leafy greens, and shitake mushrooms.

The pre-pregnancy cleanse

Many of the chemicals in the environment and toxins in the food supply accumulate in the body in fatty tissues. This means that exposures to chemicals before conception may cause Baby to be exposed as well. Now is a great time to clean up your diet and immediate surroundings in preparation for pregnancy. Here are some great first steps:

• Eat Organic! Reduce your exposure to synthetic pesticides, synthetic hormones, and antibiotics by choosing organic foods.
• Avoid Mercury - Steer clear of these fish, which are highest in the contaminant methylmercury. This can build up in your body and cause neurological damage:
  - Tilefish
  - King mackerel
  - Swordfish
  - Shark
  
  Instead, choose these safe, low-mercury fish (the ones with a * are particulary rich in omega-3 fatty acids):
  - Anchovies*
  - Catfish
  - Founder
  - Halibut* (limit to fewer than 6 servings per month)
  - Herring*
  - North Atlantic Mackeral*
  - Pollack
  - Salmon
  - Sardines*
  - Shrimp
  - Tilapia
  - Trout*
  - Tuna: canned, chunk light* (limit to fewer than 2 cans per week)
• Choose kitchen plastics carefully - Avoid polycarbonate plastic, the hard clear plastic coded with the number 7 that may leach a hormone-disrupting chemical called BPA into foods and drink. Instead, choose safer plastics like those labeled with a 1, 2, 4, or 5. Better yet: avoid plastics in favor of stainless steel, aluminum, and glass.
• Test your drinking water - Most municipal tap water is considered safe; however, studies indicate some sources may have contaminants like chlorine, bacteria, and industrial chemicals. Plus, old pipes may leach lead into your water. Pick up a simple home-testing kit at your local hardware store and test your water for safety. If you have a well that provides your drinking water, a licensed well contractor can test both the well and the pump for contamination.

Give yourself a pre-pregnancy diet makeover

The eating style that is recommended during pregnancy is basically the same as the one all adults should be consuming - fruits and vegetables, whole grains, lean proteins, healthy fats, not too much refined sugar or processed foods. If this doesn't sound like your diet, don't wait until you see a positive pregnancy result to do a diet overhaul. Start today, and you'll have time to ease into these healthy habits:

• Aim for a healthy weight with a balanced diet and moderate exercise.
• Eat whole foods; avoid highly processed foods.
• Wean off high amounts of caffine (i.e. more than 2 cups of coffee per day.)
• Seek help for dependency on alcohol, tobacco, or other drugs.
• Talk to a professional about an eating disorder.

Part 2: The Right Weight

A healthy diet during pregnancy will help Mama gain just the right amount of weight to support Baby’s growth and development.

Weight gain recommendations are based on your pre-pregnancy weight. Some of the weight gained in pregnancy is actual baby weight – the weight of your baby’s developing body. Other weight comes from amniotic fluid, extra blood to support your body’s needs, and extra fat to provide energy for the amazing task at hand.

Women who are overweight or obese don’t need to accumulate as many fat reserves, so their weight gain recommendations are lower. Women who are underweight may need additional stored energy, so it’s recommended that they gain more weight. See the table below for details about healthy weight gain during pregnancy.

Weight Gain Recommendations

(Source: National Institute on Medicine, May 2009)

Where does all the weight go?

Baby: 7 to 8.5 pounds
Placenta: 1.5 pounds
Breasts: 1-3 pounds
Amniotic fluid: 2 pounds
Blood volume increase: 3.5 pounds
Maternal fluid: 3 pounds
Uterus: 2 to 3 pounds
Maternal fat stores: 8 to 10 pounds
Total: 28-35 pounds

Your doctor or midwife will check your weight periodically throughout pregnancy. If he or she is concerned, you’ll be advised to cut back on extra calories in your diet, or to be more active with regular light to moderate exercise.

Avoiding excess weight gain is important, because too much weight in pregnancy may result in:
An increase in your risk of gestational diabetes,
More stretch marks, varicose veins and backaches,
Elevated blood pressure,
A larger size baby, resulting in a more difficult delivery and recovery after birth, and
A more difficult time losing the weight

The bottom line on weight gain: It’s important to keep it under control, but there’s no need to obsess. Eat right, stay as active as you can, and your weight should stay in an ideal range.

Part 3: The Do’s: Grow a healthy HAPPYBABY with a healthy diet

As the saying goes, “you are what you eat.” When you’re pregnant, your diet not only supplies you with sustenance and health, but it supplies Baby, too. Here are prenatal eating tips to help you create the optimal diet for you and Baby.

Eat organic. Organic foods are grown without the use of chemical pesticides, chemical fertilizers, artificial hormones, antibiotics, and genetically modified organisms (GMOs). By choosing organic foods, you reduce your exposure to pesticides and other chemicals, and you reduce your baby’s exposure, too. Given how vulnerable developing babies are to toxic exposures, many experts believe that pregnancy is a most crucial time for choosing organics over conventionally produced foods. See “Why Organic?” for more information.

Eat Just Enough. Make food choices with your baby in mind, but don’t “eat for two” – you’ll eat too much! During the 1st trimester your body doesn’t need extra calories. (Baby is only the size of a shrimp!) During the 2nd and 3rd trimesters you do need 300 extra calories per day. You may be surprised to learn that it’s not so much extra food. Here are ideas for 300-calorie additions to your daily diet:
8 oz low fat yogurt with ¼ cup low fat granola
1 tablespoon peanut butter on 1 slice whole wheat toast with 1 cup skim milk
½ cup premium ice cream
1 ounce cheddar cheese and ¼ cup hummus (chickpea spread) with 8 – 10 wheat crackers
1 ounce pretzels with an apple and 1 cup low fat chocolate milk
granola bar with an orange and ½ cup low fat milk
1 oz (about 15-20 halves) walnuts with ¼ cup raisins and 1 chocolate kiss or a few chocolate chips

Smart Supplementation. Certain vitamins and minerals are so essential that most practitioners recommend supplements to ensure proper intake. These include folic acid and iron:
Folic acid - Required for the development of your baby’s neural tube – the tissues that become the brain and spinal cord. You need 600 to 800 mcg of folic acid each and every day, the amount provided by prenatal vitamins. (If you’re not taking a prenatal multivitamin, ask your doctor or midwife about taking a folic acid supplement.)
Iron - Produces hemoglobin, which carries the oxygen in your blood to your body tissues. A deficiency causes anemia (you should be tested for this during your 2nd trimester). You need between 15 and 30 milligrams of iron per day – a recommendation that may be difficult to meet with your diet alone. Most prenatals contain 60 mg.

Get sufficient protein. It’s essential for maintaining your musles and growing tissue like the placenta and umbilical cord. Choose 3 servings of protein rich foods each day during the 2nd and 3rd trimesters when your body needs at least 60 grams of protein each day. Many protein rich foods like beef, shellfish, and chickpeas, are also good sources of zinc, an important mineral. Here are examples of one serving of protein foods. (Non-meat sources tend to contain less protein so the serving size is larger to meet the recommended intake.)
2 ½ to 3 ounces poultry, pork, or beef
3 to 3 ½ ounces fish or shrimp (equivalent to about 14 large shrimp)*
7 egg whites
3 whole eggs plus 1 white
1 cup egg substitute
2 ½ cups (20 ounces) of milk
2 cups yogurt
3 ounces aged cheese (e.g., cheddar, swiss)
¾ cup cottage cheese
9 ounces (1 cup) tofu
1 ½ cups beans or chickpeas

Focus on Fruits, veggies, and grains. Just as before you’re pregnant, these healthy foods should make up the foundation of your daily diet during pregnancy. Be sure to include sources of beta carotene, a powerful antioxidant found in yellow and orange foods like yellow squash, papaya, apricots, pumpkin, cantaloupe, sweet potatoes, and carrots. And eat sources of vitamin C, too. This antioxidant is not only good for the immune system but it also helps your body absorb iron. Sources inlude citrus fruits like oranges, grapefruit, tangerine, orange or grapefruit juices, tomatoes and tomato products and potatoes.

Bone up on your calcium needs. Calcium strengthens bones and teeth – both yours and Baby’s. It may also prevent high blood pressure. You need 1000 to 1500 milligrams per day – not too much different than your requirements before pregnancy. Your prenatal vitamin will provide about 400 to 500 milligrams. In your diet, aim for four servings of calcium-rich foods like low fat milk (including lactose free milk), yogurt, cheese, fortified cereals and juices.
Choose calcium-rich snacks like string cheese, low fat yogurt, or smoothies made with frozen fruit and low fat yogurt.
Instead of coffee, try a decaf latte or a steamed skim milk.
Have some chocolate milk when you’re craving sweets
Top a potato or bowl of soup with shredded low fat cheese.
Try cottage cheese topped with granola for a tasty breakfast.
Make an easy dip for veggies – add fresh herbs to plain yogurt.

Go Fish. Many varieties of fish provide DHA, the essential omega-3 fatty acid which will be a major building block for Baby’s brain and eyes. Choose these safe, low-mercury fish. The ones with a * are particularly rich in omega-3 fatty acids.
Anchovies*
Catfish
Flounder
Halibut* (limit to fewer than 6 servings per month)
Herring*
Mackeral* (North Atlantic Mackeral, not King Mackeral which is highest in mercury)
Pollack
Salmon*
Sardines*
Shrimp
Tilapia
Trout*
Tuna, canned, chunk light* (limit to fewer than 2 cans per week)

For vegan Mamas:

If you eat zero animal products (i.e., no meat, no milk, no eggs) you need supplemental vitamin B12 during pregnancy. Seek out good sources including fortified cereals, fortified soy milks, and nutritional yeast, and ask your OB or midwife if you should be taking a supplement.

Part 4: The Don’ts

From very early in your pregnancy both you and your baby are vulnerable to toxins in the food supply and food-borne bacteria. Here’s a rundown of things to limit and avoid:

Go easy on the…

Avoid…

Avoid undercooked meats, fish, and shellfish. If you’re ordering at a restaurant ask for your meats to be on the well-done side. At home, pick up a meat thermometer and test the doneness of your meats before eating:

Part 5: Tips for Getting Through the Rough Patches of Pregnancy

The joys of expecting are many, but unfortunately, with ups often come downs! Nausea, vomiting, constipation, heartburn… Not always so much fun. Here are some tips for getting through these not-so-joyful moments of motherhood.

Nausea and Vomiting
Although it’s been called “morning sickness” many Mamas know that these symptoms aren’t confined to the early hours of the day. While up to 75% of women have nausea with or without vomiting, luckily 90% will feel relief during second trimester.
Don’t run on empty – an empty stomach can worsen your symptoms. Grazing throughout the day may help you feel better, and eat a snack before bed so you don’t wake up starving and keep dry cereal or crackers near your bed to eat when you wake.
Sniff a lemon. The smell of lemon helps reduce nausea. Carry around a slice in a baggie and sniff it when confronted by bad smells when you’re out and about.
Many women find relief with tart fruity flavors – try small tart sucking candies.
Try foods and beverages made with fresh ginger. Soak fresh ginger in hot water to make giner “tea” or try ginger sucking candies. (Don’t go overboard, though. Excessive amounts can be dangerous. If you want to use ginger medicinally talk to your doctor first.)
Don’t take your prenatal vitamin on an empty stomach. If you can’t get it down, as your OB or midwife for a prescription for a chewable kind that you can hide in applesauce or ice cream.
Try accupressure wristbands, commonly used for seasickness. They are sold at pharmacies and and travel stores.

Constipation and Heartburn
The hormones of pregnancy cause digestion to slow a bit, leading to constipation and heartburn. The iron in your prenatal vitamin supplement can make these symptoms even worse. (Don’t stop taking it, though!)

To avoid and combat constipation you need a healthy intake of fiber, ideally 25-35 grams each day. If you are not used to eating many foods that are high in fiber, increase the amount of fiber in your diet gradually so it is not a shock to your system. And drink plenty of fluids with this fiber-rich diet so that your body can process it comfortably.

Best Sources of Fiber

To minimize heartburn, try the following:
Eat small amounts throughout the day instead of 3 large meals.
Remain upright after meals – use gravity to keep those acids down.
Avoid clothes that are too tight around your midsection.
Avoid the foods that make it worse. Common offenders include acidic foods like tomato juice and spicy or greasy foods.
Most over-the-counter antacids are safe during pregnancy. Ask your doctor or midwife which product is the best option for you.

Aversions and Cravings
Many pregnant women find that they can’t stomach foods they once loved. Or they crave foods they would never expect to want.

If there are whole good groups that you’re avoiding, be sure to find other sources of the nutrients found in those foods, so that you’ll still have sufficient… For example, if you can’t stomach chicken, turkey or beef, you’ll need to find other sources of iron, protein, and zinc. If you’re avoiding raw vegetables, make sure you have other sources of fiber.

As for cravings, the good news is that not giving in to a craving will not hurt your baby. The Chinese food you feel you MUST have… it’s not physically necessary for you or your child. Feel free to indulge your cravings, in moderation. The exception: If you’re craving clay, dirt, ice or other non-foods of this nature, it may be pica, a condition that signals an iron deficiency. Talk to your doctor or midwife.

Part 6: Meal and Snack ideas

As you’re planning out your meals or choosing snacks, use this checklist to see if you are getting enough of the key nutrients for pregnancy:
3 – 4 servings of protein sources, iincluding at least 1 serving of fish each week.
7 – 8 servings of breads, cereals, rice, and pasta (1 serving = 1 slice bread, ¾ cup cereal, rice or pasta, 1 ounce crackers, 1 small tortilla). Aim for at least three of those to be from whole grains.
1 vitamin C rich fruit or vegetable.
1 vitamin A rich fruit or vegetable.
3+ other fruits and vegetables. A serving equals ½ cup cooked or chopped, 1 cup raw leafy greens, or 1 small piece of fruit.
3-4 servings low fat dairy products or good sources of calcium.

Meal ideas
To come

Great snacks
Try some of these snacks or small meals to provide some energy along with protein, vitamins and minerals:
Hummus with pita or sliced vegetables
Slice of cheese melted on whole wheat toast
Peanut butter on whole wheat toast or on apple slices
Low fat popcorn with 1 to 2 ounces of cheese
Veggies and a low fat dip
Whole grain, low sugar cereal with skim or 1% milk
Low fat or nonfat yogurt with ½ cup granola sprinkled on top
A handful of roasted nuts with a few raisins or dried apricots
Cottage cheese with fresh or canned fruit (choose fruit canned in water or juice instead of heavy syrup)
Tortilla chips and salsa or vegetarian refried beans
Granola bars
String cheese or sliced cheese
Rice or popcorn cakes
Graham crackers with peanut butter
Low fat chocolate milk