A balanced, varied diet is important before, during and after pregnancy, especially if breastfeeding (see modified Food Pyramid on this page). Pregnant teenagers are still growing, so they need even more calories and nutrients (e.g., calcium, zinc) than pregnant women do. For example, teens may need an extra serving of dairy foods everyday (four servings instead of three).
Weight gain: Dieting to lose weight is not recommended in pregnancy. Overweight women are at higher risk for medical complications like premature births, hypertension and diabetes. They should try to lose excess weight before pregnancy.
During the first trimester, only 2-4 lb. weight gain is advised for women and 4-6 lb. for teenagers. Afterward, gaining 3/4- to 1-lb. per week is desirable. According to the American Dietetic Association (ADA), most pregnant women need about 2,500-2,700 calories daily. Requirements vary with age, weight, height and activity level.
Optimal weight gain is 25-35 lb. for normal weight women during pregnancy. If overweight, gaining 15-25 lb. is probably sufficient. If underweight, gaining 28-40 lb. may be better. For twins, gaining 35-45 lb. is advised.
Where does the weight go? A minimum 25-lb. weight gain is distributed as follows: baby (7-8 lb.), placenta (1-2 lb.), amniotic fluid (2 lb.), blood volume (3 lb.), uterus (2 lb.), breasts (1 lb.), body fat stores (5 lb. or more) and other fluids (4-7 lb.).
Food cravings: Food cravings (e.g., salty and sweet foods) and aversions (e.g., meat, eggs, coffee) are common during pregnancy. Taste changes may be caused by hormonal changes. Unless you avoid an entire food group, food cravings and aversions are usually harmless. Eating small servings of a food you crave may ease the craving and prevent binge eating.Cravings for non-food substances (e.g., dirt, clay, cornstarch, ashes, paint, chalk) called "pica" may be dangerous. It can lead to iron-deficiency anemia, malnutrition and lead exposure (brain damage).
Morning sickness: No single remedy relieves nausea and vomiting. Vitamin B6 supplements are usually not effective and may cause nerve damage. Instead, try these dietary tips:
Eat small, frequent meals every two hours to avoid an empty stomach.
Drink liquids between, not with, meals.
Keep dry toast, cereals or crackers near the bed. Eat them when you wake up, and get up slowly. High carbohydrate foods may be easier to digest.
Avoid spicy and fried foods, caffeine and strong-smelling foods.
Eat a high protein snack like a peanut butter sandwich at bedtime.
Drinking herbal teas (e.g., ginger, peppermint, chamomile) may help. But, safety and effectiveness have not been proven. The American Academy of Pediatrics (AAP) advises limiting herbal teas (filtered bags) to two 8-oz. servings daily.
(Note: Nausea and vomiting may be signs of food-borne illness. Pregnant women are susceptible. To reduce risk, wash hands, cook foods thoroughly and store foods safely.)
Constipation and hemorrhoids: Hormonal changes and iron supplements may cause constipation. Avoid laxatives. Instead, exercise (e.g., walk) daily and consume more fluids (at least eight cups daily) and fiber-rich foods (e.g., 30 g./day) like dried or fresh fruits, vegetables, beans, and whole grain breads and pasta, bran cereals and brown rice.
Vitamin-mineral supplements: To meet increased nutrient needs, a multivitamin-mineral supplement (100%-200% Daily Value) is recommended for pregnancy and breastfeeding. Supplements are especially beneficial for teenagers, women who smoke or abuse alcohol or drugs, and strict vegetarians. The latter may need more Vitamin D, calcium, zinc, iron and Vitamin B12.
Pills do not substitute for a healthy diet but may provide insurance. Iron (at least 30 mg./day) and folic acid (400 mcg./day) supplements are usually prescribed. Folic acid helps prevent neural tube (brain and spinal cord) defects. Iron may help prevent anemia.
Safety concerns:
- Caffeine may cause irritability and poor sleep in babies of nursing women. Research is inconclusive that caffeine causes complications like birth defects. High levels of caffeine may reduce iron absorption or delay conception. Limiting caffeine to 300 mg. daily (three 5-oz. cups of coffee) is considered safe.
- Artificial sweeteners—The Food and Drug Administration (FDA) considers sweeteners like aspartame (NutraSweet), saccharin and acesulfame-K safe during pregnancy. Moderation is advised. (Exception: Women who have the rare genetic disease PKU should avoid aspartame.)
- Fish—The FDA advises pregnant and nursing women to eat a variety of fish, but avoid eating large, predator fish like shark, swordfish, king mackerel and tilefish which may contain unsafe mercury levels that can cause nerve damage. Also, limit consumption of other cooked fish to 12 oz. (2-4 servings) per week, and avoid raw fish and raw shellfish. (Contact your local health dept., EPA or FDA for more information.)
Breastfeeding benefits: Breastfeeding mothers have lower rates of breast and ovarian cancer and osteoporosis and may regain their pre-pregnancy figures faster. Infants who breastfeed have improved immunity (e.g., less infections, allergies, and respiratory and gastrointestinal diseases), better nutrition and higher IQs (intellectual ability). They also may be at lower risk for asthma, child leukemia, obesity, diabetes and Sudden Infant Death Syndrome (SIDS).
Breastfeeding women need about 500 calories per day more than usual (2,700-2,900 calories/day). They also need extra vitamins, minerals and fluids.