If you're expecting a baby, chances are, you've cut back on caffeine, ditched alcohol, and you're staying clear of raw sushi and deli meats. But what about making sure that you're covering all of your bases nutrition-wise? Contrary to popular belief, prenatal nutrition is more complicated than just taking a prenatal multivitamin. There are certain nutrients that you’ll want to pay extra attention to when you’re pregnant. These nutrients are not only important for helping your baby grow and develop optimally, but also to maintain your health!
Your protein requirements increase during the 2nd and 3rd trimester of pregnancy. This makes sense since you are literally growing another human! If your diet isn’t high enough in protein during pregnancy, your placenta may not function properly in order to prevent harmful substances passing from you to your baby’s bloodstream. Many protein-rich foods also supply important nutrients like Iron, Vitamin B-12 and Zinc. You should be consuming approximately 0.8-1.2 grams of protein per kilogram of body weight. For an average-weight woman who is recreationally active (~135 lbs), you should be aiming for approximately 50-70 grams per day (pre-pregnancy and in your first trimester). Because your protein requirements increase in your 2nd and 3rd trimester, you should aim to consume an additional 25 grams of protein per day, the equivalent to 3 oz of cooked meat, poultry or fish. When you hear that you should increase your calories in the 2nd and 3rd trimester, those extra calories should be coming mostly from protein-rich foods such as meats, eggs, dairy products, beans, lentils and nuts and seeds.
Iron is important for oxygen transport throughout your body and it also helps to reduce the risk of pre-term birth as well as low birth weight. When you become pregnant, your iron needs triple (think about all of that extra blood that you have circulating in your body). It’s important that you consume foods that are high in Iron everyday while pregnant. Animal sources of iron include all meats, poultry, fish, and eggs. These forms of iron are the best absorbed— this type of Iron is called Heme Iron. Plant sources of iron (non-heme iron) are are not as well absorbed, so it’s important that you pair them with foods that are high in Vitamin C, such as oranges, strawberries, cantaloupe or kiwi fruit, as Vitamin C increases non-heme Iron absorption. It’s hard to obtain this extra iron from diet alone, so what’s recommended is 27 mg per day. Most pre-natal multivitamins contain this amount. If you become anemic during pregnancy (which is not uncommon), your Doctor, Dietitian or Midwife may recommend an additional Iron supplement.
Folic Acid is extremely important to help protect your baby against neural tube defects (which turn into brain and spinal cord defects) in those first days and weeks after conception when many women are not aware that they are pregnant yet. What's recommended is 400-1000 micrograms (mcg) or 0.4-1.0 mg per day (most pre-natal supplements contain 1000 mcg or 1.0 mg). If you have delivered a baby who has had spinabifida or another neural tube defect, your doctor may recommend that you take a higher dose of Folic Acid during pregnancy. It’s important to start taking Folic Acid before you become pregnant, because your baby’s neural tube will form just three to four weeks after conception, when many women don’t even realize that they’re pregnant. Folic acid is the synthetic form of Folate, or Vitamin B9. Natural food sources of Folate are spinach, broccoli, asparagus and fortified breakfast cereals.
Calcium is most important for the maintenance and structure of healthy bones and teeth. It is also important for proper muscle function, nerve transmission and hormonal balance. Calcium is especially important during pregnancy, because you are not only maintaining your own bone health, but also growing another human being inside of you who needs calcium. Your baby will take what he or she needs in terms of calcium from you, therefore, you will be the one who suffers if you do not consume enough. What’s recommended by Health Canada is an intake of 1000 mg of calcium per day (if you are over the age of 18) and 1300 mg of calcium if you are between the ages of 14-18. Dairy products (and calcium-fortified dairy alternatives) are the best dietary sources of calcium that we have. One serving of milk (1 cup) or yogurt (3/4 cup) or cheese (1.5 oz) contains approximately 300 mg of calcium. Your pre-natal multivitamin likely contains another 200-300 mg of calcium and if you are eating a balanced healthy diet, you will likely be consuming another 200-300 mg of calcium from non-dairy foods. That is about 600-900 mg covered already. What’s recommended is that pregnant women consume 2-3 servings of milk, yogurt or cheese per day to meet the recommended amounts.
Vitamin D helps our bodies use calcium and phosphorous to build and maintain strong bones and teeth. It can be synthesized by the body after exposure to the sun, however, in Canada, because of our climate, the positioning of the sun, and the fact that we wear sunscreen, we do not synthesize a whole lot of Vitamin D from sun exposure. Too little vitamin D can cause calcium and phosphorus levels in the blood to decrease, leading to calcium being leeched from the bones to help maintain stable blood levels. This can cause rickets in children and osteomalacia (softening of the bones) or osteoporosis (fragile bones) in adults. During pregnancy, it’s important that you receive enough Vitamin D for proper health and a healthy pregnancy. The recommended amount is 600 IUs (international units) per day. There are very few natural sources of vitamin D in our food supply and because of this, it’s important that you taking a supplement. Your pre-natal multivitamin will likely have between 200 and 400 IU’s. You may need to top up with another 400 IU’s per day to meet your recommended amounts. I often recommend that pregnant women take 400-1000 IUs on top of their diet and prenatal multivitamin to make sure that they are getting enough. According to Health Canada, the Tolerable Upper Limit for pregnant and breastfeeding women is 4000 IUs per day, so 1000-2000 IU’s total is well below this.
Omega 3 fatty acids are essential for proper health in both infants and adults. Specifically when it comes to pregnancy, recommended amounts of Omega 3 have not been established yet, however it is known that Omega 3 fatty acids (especially DHA and EPA) are important for proper brain, eye and nerve development in a growing baby in utero. What’s recommended in Canada is consuming 5 oz of fatty, low mercury fish per week to obtain enough Omega 3 fatty acids. Types of fatty fish that are also low in mercury and high in Omega 3s include salmon, light flaked tuna, halibut, and trout. If you are not a fish eater, it is recommended that you take a regulated Omega 3 fish oil supplement during pregnancy containing between 500-900 mg of DHA and EPA combined per day.