This week I gave a talk at ACAC on prenatal nutrition, and I figured I would share my 10 tips for prenatal nutrition in a blog post as well. Years ago, I wrote a post on Baby KERF on Prenatal Nutrition. While there is some overlap with today’s post (like taking a prenatal), my emphasis this time is more on food choices and less on individual nutrients.
**These are general recommendations and you should always talk to your OB before making any significant changes to your dietary intake**
Take A Prenatal Before, During + After Pregnancy
Look for a whole food-based prenatal that contains folic acid, vitamin D, and iron. Bonus if you can find one with probiotics and omega-3s too. Most prenatals that I’ve seen have a 3-pill-a-day dosage, and it’s best to space those out throughout the day to maximize absorption. New Chapter makes one that has probiotics too, and I liked Garden of Life brand, which I had no trouble with during my morning sickness phase. Note that gummy prenatals often don’t have everything you need. (Although they are yummy!) I prefer the whole food composition more than a capsule, because they are easier to sink and swallow. Lastly, if your prenatal doesn’t have probiotics or omega-3 (200-300 mg), consider supplementing with those. One last extra to consider is vitamin D on top of your prenatal, especially in the winter. Check with your doctor first!
Morning Sickness = Survival Mode
I’ve had horrible morning sickness with each pregnancy that had me dependent on taking Unisom and Vitamin B6 to be able to function. While the first trimester is very important, think big picture. If you’re not able to eat huge kale salads topped with wild salmon (I certainly couldn’t even think about that), do not stress. Focus on eating the healthy foods that do sound good (antioxidant-rich berries, for example). Eat what you can tolerate and talk to your doctor if things get extreme. Pretend you’re a picky two-year-old and blend veggies into smoothies, sauces, or soups so you don’t know they’re there. I could tolerate a blended vegetable tomato sauce ok, but couldn’t think about a raw salad. Any way you can get nutrients in helps. Get creative with recipes – if pancakes sound great but eggs turn your stomach, make a pancake with eggs in it so you’re still getting those egg nutrients.
Second Trimester = Focus on Quality over Quantity
When your appetite is (hopefully) back, focus on making the best choices that you can. Don’t stress out too much about weight gain if you’re focusing on mostly whole foods. When cravings do hit, swap junk food for healthier options like a thick smoothie made with fruit and peanut butter before running out to your nearest milkshake bar. Choose whole grains whenever possible, such as whole grain cereals for those cereal cravings, a grilled cheese made with sprouted bread, or even whole wheat mac and cheese. Make grass-fed burgers at home instead of going through the drive-through. Look for ice creams with a simple ingredient list and lower sugar, such as Breyer’s Vanilla, over loaded candy bar flavors. Olives make a great solution for salty food cravings, and if you’re NEEDING chocolate, choose a pure dark chocolate bar instead of rummaging through the leftover Halloween/Easter candy. Now is the time to go organic on the dirty dozen and buy organic, local, and/or pastured meats and eggs. They cost more, but your goal is to maximizing nutrition and minimize pesticides and toxins during this time.
Hydrate Like An Athlete
When you have to pee every 10 minutes, you might not want to drink a lot of water, but it’s so important to prevent dehydration. I’ve been extra thirsty so drinking more water has come naturally. Of course, plain water is the best way to hydrate. I have a Hydroflask that I love that keeps water super cold even in summer heat and fits a good 32 ounces. Whatever will get you to drink more, do it! Have lemons and limes precut in the fridge, mix a splash of lemonade into plain water (just a little as to not overdo it with sugar), make iced herbal tea like peppermint, or enjoy seltzers. And never leave the house without your water bottle! Watch your caffeine intake – one small cup of coffee under 200 mg is considered fine (checkwithyourdoctor) but be mindful of sodas and black teas that can go down easily in hot weather because the caffeine can add up fast.
Eat + Drink For Insomnia
When people are telling you to “sleep now while you can,” insomnia and uncomfortable restless sleeping can be a drag. I have found insomina to be quite connected to what I eat (or don’t eat) at bedtime. A protein and fat focused snack at bedtime can help fight middle of the night hunger. Some ideas include almonds, Greek yogurt, dark chocolate, trail mix, and nut butters. And if you do wake up and can’t get back to sleep, try a few sips of juice (this is when juice is your friend) or a piece of dried fruit with water. Most of the time this little boost in blood sugar will put me back to sleep.
You Are Not Eating For Two (Sorry)
Mindful eating is just important when your goal is to slowly put on weight. Women need about 300 extra calories in their 2nd and 3rd trimesters. That’s the difference in slightly bigger portion size at your 3 meals and snacks – not adding in extra snacks or treats 10 times throughout your day. Try your best to listen to your hunger cues. If you’re starving during what appears to be a growth spurt week, get those extra calories through satisfying and nourishing foods. Instead of eating easily digested refined carbs, choose protein and fat-focused foods that will help fill you up and provide energy-dense nutrition. If you’re craving sugar nonstop, you might need more satisfying healthy fats, like nuts, whole milk dairy, eggs, or avocados.
Mind The Food Rules
It’s hard to talk about prenatal nutrition without at least mentioning some of the foods you shouldn’t be eating. Deli meat, raw animal products, undercooked foods, unpasteurized cheeses, high-mercury fish, alcohol (ahem) – most women know the list. Kelli wrote an excellent post on food safety a few weeks ago that touches on pregnancy rules as well (she is due the same week as me!) There are ways around most of these things: steam deli meat until it’s at least 165 degrees and then enjoy a turkey and cheese melt, eat your burgers but make sure they’re cooked throughout, look for cheeses that are pasteurized, choose low-mercury fish like sardines and wild salmon, order sushi that is cooked or vegetarian, and get tipsy (the pretend kind) on mocktails. My drink of the summer has been a virgin margarita. I don’t even miss the tequila. (Well, maybe just a little.) Seedlip makes alcohol-free spirits that are wonderful blended into a mocktail with some fresh herbs and seltzer.
Eat More Sardines
DHA + EPA are essential long-chain fatty acids that we have to get from food. You’ll find them mostly in fish and directly from algae, but you can also get them from fortified foods and supplements. Wild salmon and herring top the list of the most omega-3 per three ounces at 1800 mg. Following those are anchoives (1200 mg), rainbow trout (1000 mg), and sardines (800 mg), which also have calcium, vitamin D and iron – all great pregnancy nutrients! Shrimp and canned tuna have about 250 mg of omega-3 each. This site has a great overview of best choices taking into account omega-3s, mercury, and sustainability.
As Stomach Space Shrinks, Turn to Mini Meals with Balanced Macros
Each mini meal should contain protein + carbs + fat to stabilize blood sugar and maximize satiety. Again, if you fill up what little stomach space you have on too many refined carbs, you’ll likely be hungry within the hour. Focusing on more satisfying foods will stretch that time and will lead to more nutrient and energy-dense choices when stomach space is lacking. Some ideas include nut butters, avocado, olives, trail mix, Greek yogurt (2 or whole %), oatmeal, half a sandwich on whole grain bread, hummus with veggies, whole grain crackers with cheese, a glass of milk, or small cup of whole grain cereal with milk. Steer away from snack foods like goldfish, cookies, or chips since they won’t make you full.
Don’t Give Up At The End
This is a reminder to myself as much as to you! I remember with Mazen when I hit 35 weeks I thought: “I’ve made healthy choices this whole pregnancy so I’m going to loosen up a bit and eat whatever I want.” I think I had a little too much ice cream during those dog days of summer! Little did I know I had a whopping six weeks to go until Mazen was born, and I think I put on the most “mommy weight” during that time. Don’t throw nutrition out the window and loosen up on everything just because you’re getting close to the end. Your calcium needs increase for baby’s bone development (2/3 of calcium deposits go to baby in third trimester!) Milk, yogurt, cheese, and all the leafy greens all provide calcium. There is also an increase in magnesium near the end of pregnancy. Take an Epsom Salt bath to absorb it through your skin. Now is a great time to enjoy eggs because your baby needs choline and lutein for his brain and eye development. Continue to follow your hunger and fullness cues and practice eating intuitively. Of course, enjoy some ice cream when you feel like it, but make it a delicious cone of your favorite flavor that you enjoy mindfully.