Expert Help on Pregnancy Nutrition Qs

Besides these, many vitamins and minerals are required. Please ask your doctor about required vitamins and mineral supplements during pregnancy.

Q.6. What should I know about eating fish during pregnancy?

Fish and shellfish are a good source of protein and omega-3 fatty acids; hence, they can be an important part of a healthy diet. Experts say that lesser consumption of fish is related to depression in women during and after pregnancy.

Women need 12 ounces (340 gm) of fish during pregnancy and lactation to achieve the health benefits. But some women avoid fish during pregnancy and nursing as certain fish are known to contain mercury. Mercury is a metal and if it is at high levels, it can impair the brain development of the unborn baby. But the risk of mercury exposure is influenced by the amount and type of seafood you eat.

Women during pregnancy can safely eat a wide range of cooked seafood, by avoiding fish having high levels of mercury.

Following are the tips to avoid high level of mercury:

• Do not consume these fish as they are high in mercury
  • King mackerel
  • Swordfish
  • Tilefish
  • Shark
• You can eat about 6 ounces (about 1 serving; 170gm) per week of the following: Canned albacore or chunk white tuna.
• You can eat up to 12 ounces (about 2 servings; 340gm) per week of cooked fish and shellfish that have less or no mercury, such as:
  • Crab
  • Oysters
  • Pollock
  • Salmon
  • Scallops
  • Shrimp
• Do not eat uncooked fish or shellfish including the refrigerated uncooked seafood.
• If you are uncertain about the safety of a fish eat only 6 ounces per week (170gms) and don’t have any other fish that week
• Eat a wide variety of cooked seafood.

Q.7. What is folic acid and how much amount of it is required daily during pregnancy?

Folic acid, also called as folate, is a vitamin B that is particularly essential for pregnant females or those who are planning to get pregnant. It is known as a ‘pregnancy superhero’. Folic acid is water-soluble and your body does not store folic acid, and therefore, there is a constant need of vitamin B from the food you eat. Food rich in folic acid include fortified cereals, spinach, lentils, etc.

Folate helps your body to develop new healthy cells. Consumption of folic acid before and after pregnancy helps to prevent birth defects that can affect the baby's brain and spinal cord. Main role of folic acid is to develop red blood cells and aid the baby’s neural tube for getting developed into his/her brain and spinal cord. Moreover, deficiency of folic acid can also lead to problems such as diarrhea, graying of hair, ulcers in the mouth, poor growth and swelling in the tongue.

During 3-4 weeks of pregnancy, birth defects can occur. So, early supplementation with folic acid before you get pregnant and at the time of first trimester helps to prevent birth defects. It also minimizes the chances of miscarriage and protects your baby from premature birth and low birth weight.

Current dietary guidelines recommend that pregnant females must receive at least 600 micrograms of folic acid every day from all sources. If you are taking a multivitamin daily, it is essential to check whether it has the recommended amount of folic acid. During pregnancy, the amount of folic acid you need daily is as follows –

• 400 micrograms: When you are trying to conceive
• 400 micrograms: During first three months of pregnancy
• 600 micrograms: During months 4 to 9 of pregnancy
• 500 micrograms: While breastfeeding

Q.8. What is the importance of iron during pregnancy? How much iron do pregnant women need?

Iron is an important mineral that is used by your body to make haemoglobin, a substance in blood which carries oxygen throughout the body. It also carries oxygen in muscles, and helps for their proper functioning. It also increases your body’s resistance to stress and disease.

Did you know that about 50% of pregnant females do not get adequate amount of iron. During pregnancy, your body tends to absorb iron more efficiently. So, there is more requirement of iron in pregnant females, and it is essential to make sure that you and your baby ultimately get enough of oxygen. Developing iron-deficiency anemia puts your baby at risk of being born too early or too small. Sufficient intake of iron helps to reduce symptoms of irritability, tiredness, weakness, and depression.

You can ensure that you are getting adequate amount of iron throughout the pregnancy by following a balanced diet, including food items rich in iron. The recommended dietary allowance (or RDA) for iron among Indian pregnant women is 35 mg/day, and in lactating women, it is 25 mg/day during 0 to 12 months of lactation.

You can get enough iron in your diet by:

• Consuming at least three servings of iron-rich foods. Important sources of iron are enriched grain products, lean meat, fish, poultry, and leafy green vegetables. Other food items are red meat, poultry, fish, kidney beans and peas, iron-fortified cereal and oatmeal, and soy beans.
• Eating fortified breakfast cereal.

Also, the absorption of iron is more if iron-rich food are eaten along with vitamin C-rich food, such as citrus fruits and tomatoes. On the contrary, there are certain food items that can prevent the absorption of iron in your body, which include coffee, tea, milk, whole grains, and dairy products.

Q.9. What is calcium and how much amount of it is required daily during pregnancy?

Calcium is an essential mineral that is required by the body for building up strong bones and teeth. This mineral helps for normal clotting of blood, normal functioning of muscles and nerves, and normal working of your heart. During pregnancy, calcium plays an important role and it helps to build your baby’s teeth and bones.

Substantial amount of calcium is needed by your growing baby. While you are pregnant, if you do not get calcium to fulfill the needs of your developing baby, then calcium is taken up from your bones, which decreases the bone mass. This may put you at risk to develop osteoporosis – a condition where you have thinning of bone that results in weak and brittle bones that can break easily. It is also important to know that even if you do not develop any problem during pregnancy due to inadequate supply of calcium, it can lessen your bone strength and put you at risk of developing osteoporosis later in life.

The recommended dietary allowance for calcium in pregnant women is 1200 mg/day. To get 1200 mg of calcium from your diet, you must have at least four servings of dairy products and calcium-rich food each day. Food rich in calcium mainly include milk, cheese, yogurt, and cream soups. Seafood, beans and dried peas also provide good amount of calcium. Your body needs vitamin D to absorb calcium, and therefore, you can get adequate amount of vitamin D by correct sun exposure and by consuming fortified milk, eggs and fish. If you cannot digest milk or are lactose intolerant, then having broccoli, dark and leafy green vegetables, or a calcium supplement can be very useful to maintain proper calcium levels.

Many pregnant women are advised to have calcium supplements. Talk to your doctor about this.

Q.10. What is vitamin D and how much amount of it is required every day during pregnancy?

Vitamin D is an important vitamin that shows several health benefits. In general, getting enough vitamin D helps to maintain bone health and is also known to decrease the risk other alarming conditions such as cancer, heart disease, stroke and diabetes. During pregnancy, it is essential for mothers to get enough amounts of vitamin D for their as well as their baby’s well-being. This vitamin together with calcium helps in the development of baby’s teeth and bones. Vitamin D deficiency in mothers can result in pre-eclampsia.

Vitamin D is known to benefit your overall health. It improves immunity and maintains good bone health. This vitamin is required mainly for the absorption and metabolism of minerals such as calcium in your body. During pregnancy, at least 600 international units of vitamin D each day should be consumed.

Healthy diet with food rich in vitamin D during pregnancy will help you get enough of this vitamin. It is also recommended that throughout the pregnancy you may need 10 micrograms of vitamin D, which should also be continued after delivery and if you breastfeed. However, food rich in vitamin D are fewer in number, and so, a majority of pregnant women tend to have vitamin D deficiency. Sun exposure is the natural source to obtain vitamin D. Food items rich in vitamin D include oily fish such as salmon (rawas) and mackerel (bangda), eggs, milk fortified with vitamin D and fortified cereals.

Q.11. How much weight should you gain during your pregnancy?

During pregnancy, it is essential to have a balanced healthy diet. It is true that you eat for yourself and your child, but that does not mean that you should eat twice than you normally eat. So, correct amount of food with correct calories helps your baby to get enough nutrients to grow in a healthy manner. In general, there is requirement of 300 healthy calories each day in a pregnant woman (from the 3rd month of pregnancy) as compared to women who are not pregnant, to help her to gain a healthy body weight during pregnancy.²

During pregnancy period, the recommended amount of weight gain is dependent on your pre-pregnancy health and your body mass index (BMI). Your baby’s health also determines your weight. The general amount of weight gain that you must consider during pregnancy is shown below in a Table 1.

Table 1: Recommended amount of weight gain

In general, during the first three months of your pregnancy, you must gain about 1 to 2 kg, and approximately 0.5 kg per week throughout the pregnancy. Also, it is essential that you gain 15 to 20 kg during your pregnancy, if you are expecting twin babies. Follow the tips below to gain appropriate weight when you are pregnant:

• Having 5 to 6 small meals each day
• Always keep quick, easy snacks in your hand, such as nuts, cheese and crackers, raisins, dried fruits or ice cream
• Your diet may also include addition of non-fat powdered milk to mashed potatoes, scrambled eggs, and hot cereal.
• Complement your meals with butter and cheese

Q.12. What are the risks of being overweight or obese during pregnancy?

In general, when your body mass index (BMI) is 30 or over, then you are very overweight or obese. It will be shocking for you to know that about 15-20% of pregnant women are overweight or obese. Moreover, it majorly affects your health and baby’s health if you are obese during pregnancy. Risk of pregnancy problems is also higher if you are overweight or obese, and affects both mother and child. These are some of the problems you may encounter if you are obese or overweight during pregnancy: 

• Gestational diabetes - Increased risk of diabetes is seen in women who are obese during pregnancy as compared to normal women.
• Preeclampsia - It is a pregnancy complication that develops in women who are obese, which is characterized by increase in blood pressure and signs of damage to organs, especially kidneys.
• Cesarean delivery – Being obese increases the likelihood of c-section delivery, and also increases the risk of complications during cesarean delivery such as wound infections.
• Infection – There is an increased risk of urinary infections among women who are obese during pregnancy.
• Miscarriage – There is also an increased risk of loss of pregnancy in pregnant obese women.
• Overdue pregnancy – Risk of pregnancy getting delayed is also seen in women who are obese.

Several health problems are also seen among babies of overweight and obese mothers, where they show increased risk of birth defects, macrosomia (infant who is larger than normal infant), and childhood obesity. Therefore, losing extra weight before you become pregnant protects your and your baby’s health. By doing this, it also reduces the risk of pregnancy problems that develop due to being overweight or obese.