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TODAY
updated 11/8/2007 11:36:06 AM ET 2007-11-08T16:36:06

Pregnant? Now that your growing baby is absorbing everything you're eating, you’ll have to make some dietary modifications. (Hint: Eat your veggies!) Although you should discuss your diet with your doctor, Elizabeth Somer’s 8 dos and don’ts will help get you started.

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DOS:

1. Make every bite count
It takes about 55,000 extra calories to make a healthy baby. That might seem like a lot, but it’s only 300 extra calories a day (the equivalent of a glass of low-fat milk, a slice of bread and an apple), and that’s only in the last two trimesters. Calorie needs don’t budge an inch in the first trimester when your baby grows no longer than a green bean. Your vitamin and mineral needs, however, have skyrocketed. For example, folic acid, the B vitamin that helps prevent birth defects, is more important than ever. That means: 1) Focus on “real” foods — colorful fruits, vegetables, whole grains, legumes and nonfat milk; 2) Little room for extra chocolate cake; and 3) Take a moderate-dose multivitamin AND mineral that contains at least 400mcg of folic acid to cover your bases on the days when you don’t eat perfectly.

2. Consume ample calcium-rich foods
As most people know, calcium helps build bones in the baby and prevent bone loss in the mom. Calcium also helps prevent pregnancy-induced high blood pressure and is important for normal functioning of nerves and muscles.

The pregnant mom needs 3 or more glasses of low-fat or nonfat milk or fortified soymilk every day before, during, and after pregnancy if she plans to nurse her little one. You can cook your rice or oatmeal in milk instead of water to sneak more calcium into your diet. Also, look for non-conventional sources of calcium, such as foods fortified with calcium. Aim for at least 1,000mg a day.

3. Get enough fluid
Getting enough nourishing fluids, like water, is important during pregnancy to prevent constipation and provide for the expanding blood volume that carries oxygen and nutrients to both the mother and baby. So, carry a water bottle, take 8 swigs of water every time you see a water fountain (1 swig = 1 ounce), and drink a glass of water between each meal and snack. Also, drink nutritious beverages, such as reduced-sodium V8, orange juice, or nonfat milk to get your fluids.

4. Focus on iron-rich foods
Protein-rich foods, like extra-lean meat, chicken without the skin, fish, or cooked dried beans and peas, are important sources of iron. This mineral is one of the most difficult nutrients to get enough of during pregnancy, yet is critical for maintaining normal oxygen supply to the baby, for normal development and growth, and for preventing premature delivery. Make sure you include several iron-rich foods in the daily diet, cook in cast iron pots, and take a multivitamin that includes iron.

DON’TS:

1. Give up on seafood
This is one of the hottest topics in nutrition for pregnant women right now. Here’s the good stuff: The fats in fish, called omega-3 fats, are essential for brain and vision development in the baby. Babies whose mothers consumed ample omega-3s, in particular DHA (97% of the omega-3s in the brain are DHA), score higher on IQ tests later in life, while low intake is associated with developmental delays. Omega-3s also might help prevent preterm births, as well as allergies and asthma later in life.

But, here comes the bad: All fish contains mercury, a toxic metal that can cause serious nervous system damage. Hundreds of studies have shown that the more fish you eat, the higher the mercury levels. As a result, pregnant women have been told to limit fish consumption to no more than 12 ounces/week and to avoid altogether the worst offenders — shark, swordfish, mackerel and tilefish. But many woman have taken this recommendation so seriously that they avoid fish altogether, which explains why 75% of the population consumes no DHA on a given day.

This “Don’t” includes a very important “Do.” You absolutely do need the omega-3s, especially DHA. Fish get their DHA by eating DHA-rich algae. If you are concerned about contaminants like pesticides and mercury in fish, can’t afford or don’t like fish, you can get that same DHA in foods that are fortified with algal-based DHA. Or, take a DHA supplement. Aim for about 300mg a day. Be careful, some foods are fortified with omega 3s, but it is the wrong one. The omega-3 ALA in walnuts, flax and soy is good for your heart, but won’t give your baby the “brain” boost that you get only from DHA.

2. Drink alcohol, coffee, colas, teas or eat soft cheeses
The information on alcohol is cut in stone: Alcohol causes irreversible birth defects. No safe limit has been established.

Consumption of coffee and other caffeinated beverages is not quite as clear-cut. Recent studies show no effect of caffeine on birth weight or birth defects. However, studies in the past have found a possible link between caffeine consumption and miscarriage, low birth weight and growth retardation.

Also, feta, Brie, Camembert, or Mexican-style cheeses such as Queso Blanco Fresco are prime candidates for bacterial contamination (listeriosis), which causes fever, miscarriage and other complications during pregnancy, so avoid these during pregnancy.

Soft, unpasteurized cheeses like feta, Brie, Camembert, and goat — as well as ready-to-eat meats like hot dogs and deli meats — may contain listeria, bacteria that cause mild flu-like symptoms in most adults but can be very dangerous for unborn babies. Listeriosis, the infection caused by the bacteria, can cause miscarriage, premature birth, or severe illness or death of a newborn. Feta is safe if it is made with pasteurized milk, which should be clearly identified on the label.

3. Follow fad diets, like a low-carb diet
This is not the time to experiment with unbalanced diets. You need 40+ nutrients in the proper proportion to build a healthy baby today and in the future. The developing baby is much more sensitive to the mother’s nutritional status than previously thought, and some health consequences don’t show up until much later in life. So skip the low-carb or food-combining diets and stick to tried-and-true healthy eating.

4. Gain too much weight
Excess body weight entering pregnancy or accumulated during pregnancy can affect whether a woman conceives and also might increase the risks for pregnancy complications, such as gestational diabetes, pre-eclampsia, stillbirth, very-preterm birth and cesarean delivery. Many women are entering pregnancy overweight, gaining too much during pregnancy, and then not losing the weight after the baby is born — a pattern that contributes to this country's #1 health problem — obesity.

Optimal weight gain is an individual matter. In general, a normal-weight woman should gain about 25 and no more than 35 pounds during her pregnancy. Women who are overweight entering pregnancy (i.e., more than 25% of body weight is fat tissue) should gain no more than 15 to 25 pounds during their pregnancies, while underweight women should gain approximately 28 to 40 pounds depending on their height and degree of leanness prior to pregnancy.

Also, it is not just total weight gain, but the pattern of weight gain that is important — with a slow gain in the first trimester of about 2 to 5 pounds total (more if you are thin, very active, or tall and less if you are overweight, sedentary, or short), followed by a steady increase to approximately three-quarters to one pound a week in the last 2 trimesters. Sudden changes in weight should be discussed with your OBGYN.

Elizabeth Somer, M.A., R.D., is the author of “Nutrition for a Healthy Pregnancy.”

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