Nourishment for two: the key to a trouble-free pregnancy and a healthy baby

Pregnancy is a wonderfully exciting and transformative experience. It’s a time filled with anticipation and plans for a future family life together. Most importantly, it’s the time to ensure that both you and your baby receive the right nutrition. Proper nourishment during pregnancy isn’t just beneficial, it’s essential for keeping both mother and baby happy, healthy and well.

Unfortunately, many women experience health challenges during their pregnancy, such as morning sickness, miscarriage, preterm labour, gestational diabetes and pre-eclampsia; even a very difficult high-intervention birth; or followed by post-natal depression. Many of these scenarios are preventable and more and more midwives and obstetricians nowadays are adopting a holistic approach to pregnancy, birth and the postnatal after-care of mother and baby, which includes nutritional advice.

The good news is that the right diet and food supplements taken during pregnancy can help towards a plethora of positive outcomes, not just for your health & wellbeing but also to reduce the risk of pregnancy complications. Just as importantly, this can positively influence your baby’s long-term health and development.

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The startling truth about pregnancy nutrition

Recent research from the University of Southampton has uncovered a concerning trend: nearly 90% of women living in high-income countries, including the UK, New Zealand and Singapore experience nutritional shortfalls during pregnancy. This isn’t just a minor issue; it’s a significant nutrition gap that can affect both maternal and infant health.

There are also concerns that many women embark on pregnancy overweight and gain even more during pregnancy which can lead to complications for mother and baby. Our modern diets of predominantly ultra-processed foods (UPF) can lead to both weight gain and undernourishment in terms of vitamins, minerals and omega-3 fatty acids. UPF foods can also have a pro-inflammatory effect and pose a higher risk for the development of gestational diabetes and pre-eclampsia. Aim to keep the ingestion of UPF (such as shop-bought convenience foods, snacks, sweetened or diet drinks and ready meals) to below 20% of your overall diet.

A diet that consistently and substantially restricts any food groups should also be avoided during pregnancy, unless this is monitored closely and supported with food supplements. ‘Fad’ diets may be especially harmful during pregnancy such as intermittent fasting, cutting out macronutrients (carbohydrates, proteins and fats) and calorie restriction because of the resulting nutrient imbalance and consequent nutrient deficiencies. If you are plant-based or eat very few animal products then extra care will be needed to ensure you get enough iron, calcium, iodine, choline, omega-3 and B vitamins.

What to eat for a healthy pregnancy

Navigating through the myriad of dietary advice can be overwhelming, so here’s a simplified guide to help you and your baby thrive through pregnancy and the months after the birth.

Pile on the leafy green salads and green vegetables – aim to eat these twice a day.
Eat plenty of other varieties of brightly-coloured vegetables every day, such as red onions, bell peppers, mushrooms, beetroot, carrots, squash, sweet potato, celeriac, swede, peppers and radishes. These contain polyphenols and fibre which support the gut microbiome.
Enjoy a wide range of fruits daily to keep up the vitamin C and antioxidants – think berries, citrus fruits, apples and pears, cherries, peaches, nectarines, melons, pineapples, mangoes, passionfruit, bananas, pomegranate seeds and kiwi fruit.
Switch to wholegrains such as wholemeal seeded bread, wholegrain pasta, brown rice, oats and quinoa.
Add pulses and beans such as chickpeas, red lentils, butter beans, black beans and cannellini beans into your food to add iron and fibre. Try hummus, black bean chilli or a red lentil curry.
Include a wide range of nuts and seeds such as walnuts, brazil nuts, almonds, cashews, hazelnuts, macadamia nuts. For seeds, include sunflower, pumpkin, sesame, chia, hulled hemp and flax.
Choose grass-fed or organic meats and poultry (where possible) which provide iron, omega 3 and vitamin D.
Eggs (both yolk and white) – try boiled, poached, fried, scrambled or in an omelette or frittata. These eggs can be from chicken, duck, goose or quail.
Eat plenty of omega-3 rich foods – especially oily fish such as salmon, sardines, anchovies and mackerel as well as walnuts, chia seeds, flax seeds and organic whole milk.
Include good quality dairy such as whole organic whole milk, hard cheeses, cottage cheese, cream cheese, ricotta, live full-fat yoghurt, kefir and butter.
Soya is a good plant-based source of protein, iron and calcium. Think tofu (including silken), tempeh, miso, edamame beans and Tamari soya sauce.
Switch from refined sugar to honey, maple syrup or coconut sugar. Check out my recipe pages for healthy and delicious sweet snacks.

What to avoid whilst pregnant

Pasteurised or unpasteurised mould-ripened soft cheeses with a white skin, such as brie, camembert and goats cheese (unless cooked until steaming hot); pasteurised or unpasteurised soft blue cheeses including gorgonzola and roquefort (again unless cooked until steaming hot).
Unpasteurised raw cow’s milk, goat’s milk, sheep’s milk or cream.
Raw or partially-cooked chicken, duck, goose or quail eggs. Chicken eggs that are not British Lion stamped or produced under the Laid in Britain scheme.
There’s a small risk of getting toxoplasmosis if you eat raw and undercooked meat or cured meats, which in turn can cause miscarriage.
Liver and liver pâté have lots of vitamin A in them which in excessive amounts can be harmful to the baby.
Don’t eat more than 2 tuna steaks (about 140g cooked or 170g raw) or 4 medium sized tins of tuna (about 140g when drained) per week due to risk of mercury toxicity.
Drinking alcohol during pregnancy can potentially lead to long-term harm to your baby. If you’re pregnant, the safest way is not to drink any alcohol at all.

Important supplements for a healthy pregnancy

Meeting the increased nutritional needs during pregnancy can be challenging through diet alone, so supplementation can be helpful.

Methylated folate – as well as eating plenty of greens, eggs and pulses, a folate supplement should be taken during the first trimester (the first 12 weeks) to help prevent birth defects such as neural tube defects, including spina bifida. Choose folate that is in the most bioavailable form and look out for one which is labelled methyl tetrahydrofolate or calcium l-folinate (vs synthetic folic acid) as these are particularly easy to absorb and synthesise. Aim for around 600mcg of folate daily through a combination of food and supplements.
B vitamins – optimise B vitamin intake by using a multivitamin or topping up with a vitamin B complex. The study carried out at Southampton University found that many pregnant women were low in the vitamins B2, B6 and B12 which are key for both the mother and baby’s nervous system and child development, as well as blood sugar balancing. Low vitamin B6 status has been found in women who experience morning sickness.
Vitamin D – a vitamin D deficiency may well increase the risk of morning sickness, pre-eclampsia, gestational diabetes, low birthweight and preterm birth. It is a vital vitamin for bone health and immune function as well as mood. There are small amounts in oily fish, organic whole milk and mushrooms. However the main source is from sun exposure. In the UK we do not get enough from the sun during the winter months, so it’s important to top up with a supplement during this time. Regardless of diet and sun exposure 15mcg/600iu vitamin D supplementation is recommended daily whilst pregnant. The maximum level of supplementation whilst pregnant, as advised by NIH, is 4000iu daily.
Vitamin C – ensure the diet is rich in vitamin C as supplementing during pregnancy has been associated with a reduced risk of placental abruption as well as lower risk of pre-eclampsia, intrauterine growth restriction and maternal anaemia. It is also helpful for overall immunity as well as skin elasticity. One orange yields 60mg of Vitamin C, the maximum daily Vitamin C intake whilst pregnant is 2,000mg.
Iron – higher risks of placental abruption, preterm birth, severe postpartum haemorrhage and still birth are associated with anaemia, which will be tested for through your pregnancy blood tests. Anaemia is when ferritin, a measure of your iron stores, is found to be under 12ng/mL. Ferritin levels should ideally be at least 70ng/mL to feel well, and for the best outcomes for you and your baby as iron helps to support your increased blood volume as well as your baby’s brain development. One study found that women with moderate anaemia had a 59% greater chance of having a child with a low IQ below 70 at 7 years of age. It can also help with postnatal anxiety, low mood and poor energy levels. Aim for 27mg daily intake through iron-rich foods such as red meat, green veg, pulses and eggs as well as supplements whilst pregnant.
Zinc – found in meat, fish, dairy products, eggs, nuts and seeds this is the second most abundant mineral in the central nervous system. Maternal zinc deficiency during pregnancy has been linked to preterm delivery, stillbirth and fetal neural tube defects. This is also a key mineral for the baby and has been found in lower than optimal levels in babies who are later on down the line diagnosed with specific learning difficulties and developmental differences such as dyslexia, ADHD and autism. Aim for 11mg daily through food and supplements whilst pregnant, the maximum is 40mg per day.
Choline – the demand for choline significantly increases during pregnancy as it is involved in vital processes such as neural tube formation and brain development. Look for it in your pregnancy multi nutrient ingredients; and also aim to eat plenty of choline-rich foods on a regular basis which include eggs, fish, beef, shiitake mushrooms, soya beans, cruciferous veg, cottage cheese, sunflower seeds, tofu and peanut butter. It can help babies with their overall development if they have had brain damage during pregnancy or birth. Choline may play a role in establishing a child’s intelligence quotient (IQ), their ability to pay attention as well as their processing speed, visuospatial memory and ability to self regulate. Suggested daily intake is 450mg choline per day during pregnancy through diet and supplementation and 550mg choline per day during breastfeeding.
Omega-3 fatty acids – Research from Professor Michael Crawford of Imperial College (who is the “godfather” of omega 3) suggests that a woman needs to consume plenty of oily fish like salmon, mackerel, sardines and anchovies and supplement during pregnancy and after the birth to nourish both the mother and baby. Studies on omega-3 supplementation during pregnancy has shown it can play a role in preventing a pre-eclampsia, pre-term birth and low birth rate. Women with too much omega-6 and not enough omega-3 can pose a greater risk for developing gestational diabetes. Omega-3 is also vital for the baby’s eye and brain development. Dietary omega-3 can also enhance the nutrition of your breast milk, however plant based forms of omega-3 such as flax, chia, hulled hemp seeds and walnuts are not enough to populate breast milk with the important DHA form of omega 3. It seems that this is only achieved by regularly eating oily fish or topping up with a fish oil or vegan marine algae supplement. Try and include 1,400mg daily from diet and supplements overall.

Round-up

Your pregnancy is a unique and special time, and your nutrition is a critical part of this journey. By focusing on the right foods and supplements, you’re setting the stage for a healthy pregnancy and a thriving baby. The choices you make now will have lasting effects during the pregnancy, at the birth and during the first few months of motherhood, as well as your little one’s long-term development. So embrace this opportunity to nourish both yourself and your baby with the best that nature has to offer.

If you are struggling with any aspect of your nutrition during pregnancy, then our NatureDoc pregnancy and postnatal team are there to support you all the way. We can arrange a full nutritional screening and provide 1 to 1 support all the way from the pre-conception stage onwards.

Take a look at my other blogs on pregnancy:
The Three Trimesters – Our Top Tips for a Happy and Healthy Pregnancy
How to stay well nourished if you are pregnant or breastfeeding and plant-based
Folic Acid: Friend Or Foe? How The MTHFR Genetic Variation Can Affect Your Fertility & Pregnancy

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References

Responses

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T Fri, 23rd Aug 2024

Thanks for this great blog post. Can you please advise on gluten free flours while pregnant? Is tapioca / cassava ok as they are in a lot of GF products and the Good Grain and Keto breads. Thanks.