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Pregnancy Diet

Patient Education

Your health in pregnancy

WHAT SHOULD YOU EAT?


A healthy diet is an important part of a healthy lifestyle at any time, but particularly if you are pregnant or are planning a pregnancy. Eating healthily during pregnancy will help your baby develop and grow and will help keep you fit and well. You donít need to go on a special diet, but make sure that you eat a variety of different foods every day in order to get the right balance of nutrients that you and your baby need. You should also avoid certain foods to be on the safe side.
Thereís no need to Ďeat for twoí when you are pregnant. Itís the quality not the quantity thatís important. With a few exceptions you can continue to eat all the foods you enjoy. Eating healthily often means just changing the amounts of different foods that you eat rather than cutting out all your favourites.

Eat plenty of fruit and vegetables as these provide the vitamins and minerals, as well as fibre which helps digestion and prevents constipation. Eat them lightly cooked in a little water or raw to get the most out of them. Frozen, tinned and dried fruit and vegetables are good too. Aim for at least five portions a day.

Starchy foods like bread, potatoes, rice, pasta, chapatis, yams and breakfast cereals are an important part of any diet and should, with vegetables, form the main part of any meal. They are satisfying, without containing too many calories, and are an important source of vitamins and fibre. Try eating wholemeal bread and wholegrain cereals when you can.

Lean meat, fish, poultry, eggs, cheese, beans and pulses are all good sources of nutrients. Eat some every day.

Dairy foods like milk, cheese and yoghurt are important as they contain calcium and other nutrients needed for your babyís development. Choose low-fat varieties wherever possible, for example semi-skimmed or skimmed milk, low-fat yoghurt and half-fat hard cheese. Aim for two to three servings a day.

Try to cut down on sugar and sugary foods like sweets, biscuits and cakes and sugary drinks like cola. Sugar contains calories without providing any other nutrients the body needs. It also adds to the risk of tooth decay.

Cut down on fat and fatty foods as well. Most of us eat far more fat than we need. Fat is very high in calories and too much can increase the risk of heart disease, and it can contribute to being overweight. Avoid fried foods, trim the fat off meat, use spreads sparingly and go easy on foods like pastry, chocolate and chips which contain a lot of fat.

Lean meat, green, leafy vegetables, dried fruit and nuts contain iron. Many breakfast cereals are fortified with iron. If you are short of iron, youíre likely to get very tired and may suffer from anaemia. If the iron level in your blood becomes low, your GP or midwife will advise you to take iron supplements.

Citrus fruit, tomatoes, broccoli, peppers, blackcurrants and potatoes are good sources of
vitamin C, which you need to help you to absorb iron. Some pure fruit juices are also high in vitamin C.

Dairy products and fish with edible bones like sardines are rich in
calcium, which is vital for
making bones and teeth. Bread, almonds and green vegetables are other good sources.

The best source of
vitamin D is summer sunlight. Only a few foods, e.g. margarine, oily fish (like sardines) and taramasalata, contain it. You need vitamin D to keep your bones healthy and to provide your baby with vitamin D to last during the first few months of life. You do not need to sunbathe to make enough vitamin D. Just 15 minutes in the sun, two or three times a week, during the summer months can produce enough vitamin D. Make sure that you wear 15+ factor sunscreen and never burn.

VITAMIN SUPPLEMENTS

Itís best to get vitamins and minerals from the food you eat. Supplements of vitamin D and folic acid are needed during pregnancy. Some people, like those on a restricted diet, may need extra.

Vitamin D: Pregnant women must make sure they have enough vitamin D to protect their babies from deficiency. If you have dark skin or always cover your skin, you may be particularly
at risk of vitamin D deficiency. Ask your midwife or doctor about vitamin D supplements.

Folic acid: This vitamin is special. You need to take a 400 microgram (0.4 milligram) tablet
every day until youíre 12 weeks pregnant. Even if you didnít take folic acid before conceiving,
itís worth starting as soon as you find out that youíre pregnant, and continue to do so until youíre 12 weeks pregnant. If you have had a baby with spina bifida before, are taking edication
for epilepsy, are diabetic or have coeliac disease, you will need to take a bigger dose of folic
acid. Speak to your doctor about this.

Vitamin A: Donít take vitamin A supplements without advice as too much could harm your baby.
You should avoid eating liver while youíre pregnant because it contains high levels of vitamin A.

All women who could get pregnant are advised to take a 400 microgram folic acid tablet every
day. You need the extra folic acid until the 12th week of pregnancy. This can help prevent birth defects, which are known as neural tube defects, such as spina bifida. You also get folic acid from green, leafy vegetables, but donít overcook them as this destroys the vitamin. Some breakfast cereals, breads and margarines have had folic acid added to them, so look at the label.


HEALTHY START VITAMINS FOR WOMEN

Your primary care trust and local pharmacies may sell this supplement which contains vitamins C and D and folic acid.

VEGETARIAN, VEGAN AND SPECIAL DIETS

Providing a vegetarian diet is varied and balanced, it will provide adequate nutrients for you and your baby during pregnancy. However, iron and vitamin B12 can be hard to obtain from a vegetarian diet. Talk to your doctor or midwife about ways to increase intakes of these important
nutrients. If you are vegan (i.e. you cut out all animal products from your diet), or you follow another type of restricted diet, such as gluten free, because of food intolerance (e.g. coeliac disease) or for religious reasons, talk to your doctor. Ask to be referred to a dietitian for advice on how to make sure you are getting all the nutrients you need for you and your baby.

TAKE CARE WITH SOME FOODS
Besides eating a wide variety of foods, there are certain precautions you should take in order to safeguard your babyís well-being as well as your own.


Cook all meat and poultry thoroughly so that there is no trace of pink or blood and wash all surfaces and utensils after preparing raw meat. This will help to avoid infection with oxoplasma, which may cause toxoplasmosis and can harm your baby


Wash fruit, vegetables and salads to remove all traces of soil which may contain Toxoplasma.

Make sure eggs are thoroughly cooked until the whites and yolks are solid, to prevent the risk of Salmonella food poisoning. Avoid foods containing raw and undercooked eggs like homemade Mayonnaise, ice-cream, cheesecake or mousse.

HEALTHY SNACKS

Sandwiches or pitta bread filled with grated cheese, lean ham, mashed tuna, salmon or sardines and salad

Salad vegetables washed thoroughly

Low-fat yoghurt and fromage frais

Hummus and bread or vegetable sticks

Ready-to-eat apricots, figs or prunes

Vegetable and bean soups

Unsweetened breakfast cereals or porridge and milk

Milky drinks or unsweetened fruit juices

Fresh fruit

Baked beans on toast or baked potato

Avoid eating all types of patť, including vegetable patťs, and mould-ripened soft cheese, like Brie and Camembert, and similar blue-veined varieties, like Stilton or Danish blue, because of the risk of Listeria infection. You can eat hard cheeses such as cheddar and parmesan, and other cheeses made from pasteurised milk such as cottage cheese, mozzarella cheese and cheese spreads. Although Listeria is a very rare disease, it is important to take special precautions during pregnancy because even the mild form of the illness can lead to miscarriage, stillbirth or severe
illness in the newborn.

Drink only pasteurised or UHT milk
which has had the harmful germs destroyed. If only raw or green-top milk is available, boil it first. Donít drink unpasteurised goatsí or sheepís milk or eat their milk products.

Donít eat liver or liver products
, like liver patť or liver sausage, as they may contain a lot of vitamin A. Too much vitamin A could harm your baby. You should also avoid high-dose multivitamin supplements, fish liver oil supplements or any supplements containing vitamin A.

Avoid eating peanuts and foods containing peanut products
(e.g. peanut butter, peanut oil, some snacks, etc.) if you or your babyís father or any previous children have a history of hayfever, asthma, eczema or other allergies. Read food labels carefully and, if you are still in doubt about the contents, avoid these foods.

Avoid eating shark, marlin and swordfish and limit the amount of tuna you eat, as these types of fish contain high levels of mercury which can damage your babyís



PHYSICAL ACTIVITY


The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and get back into shape after the birth. If you feel tense after a hard dayís work, physical activity is an excellent way of relaxing, and it will help you to sleep soundly. Keep up your normal daily physical activity or exercise (sport, or dancing, or just walking to the shops and back) for as long as you feel comfortable. Donít exhaust yourself and remember that you may need to slow down as your pregnancy progresses, or if your doctor advises you to. If in doubt, consult your doctor.




If you were inactive before you were pregnant, donít suddenly take up strenuous exercise. Remember, exercise doesnít have to be strenuous to be beneficial.

Try to keep active on a daily basis. Building in half an hour of activities like walking can help to

keep you active. If you canít manage that, any amount is better than nothing.

Avoid any strenuous exercise in hot weather.

Drink plenty of fluids.

If you go to exercise classes, make sure your teacher is properly qualified, and knows that youíre pregnant and how far your pregnancy has progressed.

You might like to try swimming because the water will support your increased weight. Some local swimming pools provide aquanatal classes with qualified instructors.


EXERCISES FOR A FITTER PREGNANCY


Every pregnant woman should try to fit these exercises into her daily routine. They will strengthen muscles to take a bigger load, make joints stronger, improve circulation, ease backache and generally make you feel well.

Stomach strengthening exercises

These strengthen abdominal muscles and ease backache, which can be a problem in pregnancy. As your baby gets bigger you may find that the hollow in your lower back increases. This can give you backache.

Start in a box position (on all fours) with knees under hips, hands under shoulders with
fingers facing forward and abdominals lifted to keep the back straight;

pull in the abdominals and raise the back up towards the ceiling, curling the trunk and allowing
the head to relax gently forward. Donít allow elbows to lock out;

hold for a few seconds then slowly return to the box position;

take care not to hollow the back. The back should always return to a straight/neutral position;

do this slowly and rhythmically ten times, making your muscles work hard and moving your back carefully. Only move your back as far as you can comfortably.

Pelvic tilt exercises.


Stand with your shoulders and bottom against a wall. Keep your knees soft. Pull your belly button towards your spine, so that your back flattens against the wall. Hold for four seconds and release. Repeat up to ten times.

Pelvic floor exercises help strengthen the muscles of the pelvic floor which come under great strain in pregnancy and childbirth. The pelvic floor consists of layers of muscles which stretch like a supportive hammock from the pubic bone (in front) to the end of the backbone. If your pelvic floor muscles are weak, you may find that you leak urine when you cough or sneeze. This is quite common and you neednít feel embarrassed. However, you can strengthen the muscles by doing the following exercise:

close up your back passage as if trying to prevent a bowel movement;

at the same time, draw in your vagina as if you are gripping a tampon, and your urethra as if
to stop the flow of urine;

do this exercise quickly Ė tightening and releasing the muscles immediately;

then do the exercise slowly holding the contractions for as long as you can
(not more than ten seconds) before you relax;

repeat both exercises ten times, four to six times a day.






Foot exercises can be done sitting or standing.

They improve blood circulation, reduce swelling in the ankles and prevent cramp in the calf muscles.

Bend and stretch your foot vigorously up and down 30 times.

Rotate your foot eight times one way and eight times the other way













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