NUTRITION FOR A HEALTHY PREGNANCY

Many of us postpone well-intentioned health regimes - but pregnancy is one time when, dietarily, there is no tomorrow. What we eat, drink and do during those vital nine months will affect another tiny little person.

FIRST TRIMESTER
Many women do not know that they have conceived until they are several weeks into the pregnancy and may have carried on drinking, or even smoking, at this time. At 12 weeks the baby is fully formed, but is still only the size of a small plum. These first weeks are crucial in nutritional terms so it is best to think about lifestyle changes as early as possible, pre-conceptually if possible. Some substances cross the placenta and, unfortunately, this includes many things that do not serve the baby well. In particular alcohol, caffeine and drugs (prescription or over-the-counter) can cross the placenta and affect the baby - check with you doctor to see if you really need medication.

Despite all the publicity about the need for adequate folic acid to avoid neural tube defects such as spina bifida, 39% of women are still unaware that government guidelines advise taking 400mcg supplementally 6 weeks prior to conception and for the first 12 weeks of pregnancy.

Morning sickness is often a problem at this time and is related to hormonal swings. An excellent anti-nausea tip is to drink ginger tea: Grate a bit of fresh ginger root into a cup, poor boiling water over it and let it steep for about three minutes.

SECOND TRIMESTER

This is usually the best time during pregnancy - it is fun watching a bump develop, you have got used to the hormone levels, you are not big enough to hamper activity and energy levels are often improved by adrenaline from the baby.

Some women will develop water retention problems and this should be dealt with to avoid discomfort. To help this drink lots of water, avoid coffee, tea and soft drinks, and avoid salt and all packaged products (a bowl of cornflakes has twice as much salt as a packet of crisps).

If you have a sweet tooth, you may increase risk of pregnancy related diabetes, if you are susceptible. Keep sweets, sugar, biscuits and puddings to a minimum and indulge yourself with mixed dried fruit and nuts, yoghurt with chopped fruit, baked apples or oatcakes with 100% fruit jam. Pregnancy related diabetes usually disappears, but is an early warning sign of an increased risk of diabetes later on in life.

You may notice food cravings - some say that this is a sign of deficiency. A craving for spinach or red meat may mean a need for iron, a craving to eat chalk (yes it can happen) could indicate a need for calcium. The strangest craving I have heard of is for sardine and jam sandwiches!

THIRD TRIMESTER

You are into the home run now. The final three months is when the baby is putting on most of it’s weight. The majority of pregnancy related problems at this stage relate to the sheer bulk of a baby pushing up against organs, and a mother may notice heartburn and changes in bowel habits. It is best to eat little and often so as not to have too full a stomach, and if constipation is a problem avoid added wheatbran, opting instead for gentler psyllium husks or linseeds.

Anaemia during this month is a frequent complication, but it may be inadvisable to take iron supplements or tonics unless a blood test has confirmed that iron is needed. Iron is vital at this stage and may well be necessary, but excess iron can interfere with zinc levels which is equally important for growth of the baby.

Pre-eclampsia is a serious condition encountered by 5-10% of mums-to-be and your doctor will check for it. However, research tells us that it can generally be avoided by supplementing with magnesium and vitamins C and E during the pregnancy. Magnesium can also help with muscle cramps which are quite common at this time.

A HEALTHY DIET FOR MUM

A pregnant woman needs around 2500 calories a day to feed both her and her passenger - this is not a time to lose weight or restrict calories, but it is a time to eat healthily. A nutrient rich diet will also help to ensure that breast milk quality is good, and to speed post-natal recovery.

• Plenty of fresh fruit and vegetables - 5 to 7 portions a day.

• Fibre rich foods such as beans, pulses, brown rice, oats and dried fruit.

• Drink at least 2 litres of filtered or mineral water a day.

• Snack on fresh pumpkin or sunflower seeds and fresh almonds and walnuts - all have beneficial oils, zinc, calcium and magnesium for the developing child.

• Eat plenty of oily fish - 3 or 4 portions a week - the oils they contain are used for brain development in the developing baby.

• Substitute herbal teas and coffees for the regular sort, and avoid alcohol.

• Around 1,200mg of calcium a day is needed, so an extra couple of plain, live yoghurts a day will help. Good sources of calcium include: green leafy vegetables, nuts and seeds, tinned sardines and salmon, eggs, figs, carrots, broccoli, soya beans, dates and raisins, bread and fruit such as oranges, blackberries and apples.

WHAT TO AVOID

During pregnancy some foods, which may not be obviously damaging, are no-nos. Soft cheeses, unpasturised milk and uncooked eggs may harbour listeria and salmonella which can be dangerous to a developing baby. Liver has levels of vitamin A which could be harmful (beta-carotene in orange coloured fruit and vegetables - carrots, cantaloups, squash - is safest as it converts to vitamin A as needed). Peanuts should be avoided as they can establish a peanut allergy in the baby even before birth. Alcohol and caffeine deplete zinc, low levels of which are linked to nerve abnormalities and low birth weight. Maternal caffeine intake has been linked to infant cot death syndrome in some studies.

VITAMINS AND MINERALS

Before and during pregnancy it is probably a good idea to take a specially formulated supplement as a form of health insurance. It is important not to take a normal formula as this may contain components that are not advised during pregnancy, such as high levels of vitamin A or some herbs. Special pregnancy products will give a balanced formula with beta-carotene instead of vitamin A and adequate amounts of folic acid, zinc, calcium, magnesium and iron. I would suggest you consult a qualified nutritionist before embarking on a supplement programme other than a specially formulated product.

Pregnancy should be a fulfilling experience, but with the pressures of modern life we frequently do a little too much, especially if we are holding down a job, have older children or are suddenly having to cope with one income instead of two. This is the time to take care of yourself and, if you feel tired, take a break and give yourself a treat - a hot bubble bath, a gentle walk, a lie-in or a new book to read with your feet up - soon you will have a wonderful, but very demanding, little person who won’t wait while you take 10 minutes extra in the bath!