Navigating the world of pregnancy can be a bit tricky, to say the least—especially for first timers! With so much advice, suggestions and stories out there, it’s easy to feel confused, overwhelmed or both.
Particularly when it comes to eating and proper nutrition, you may hear a lot of conflicting information. So, we spoke with Shira Sussi, Clinical Nutritionist at New York-Presbyterian, for her expert advice for all moms-to-be.
Are You Really Eating for Two?
While its customary for pregnant women to chalk up some overeating to “eating for two,” they’re essentially wrong. Sussi explains, ”I think the misconception is when you’re eating for two you can eat whatever you want, and in much larger quantities than before you were pregnant. This can lead to excessive weight gain during pregnancy, which can have both adverse outcomes on the fetus and mother.”
The surprising reality is that during the first trimester, you don’t need any additional calories and then you’ll need, “about 340 more calories during the second trimester, and about 450 additional calories during the third trimester.” Sussi advises that all this really amounts to is just an additional snack (Greek yogurt with fruit and nuts /granola) or an additional serving at a meal. It’s important to remember that the extra needed calories should come from nutritious foods like, “lean meats, lower fat dairy, fruits, vegetables and whole grains.”
Changing Nutrition Needs
It’s not surprise that your body undergoes incredible changes nearly every day as you grow a baby. Sussi explains, “In the simplest of terms, pregnancy is a time of significant physiological change for the mother and intense fetal growth and development. Nutrition (macro and micro nutrients) help promote these changes.”
Limitations and Cautions
It might seem that from the minute you find out you’re pregnant (or even before) family, friends, and even strangers will start to tell you what you can and can’t do. Some of those warnings may have merit, while others may be old wives’ tales. When asked about any limitations pregnant women should adhere to, Sussi responds, “I recommend limiting fish with high mercury levels such as shark, swordfish, king mackerel and tile fish. Overall eat no more than 12 oz. of fish or shellfish per week (so 4 servings of 3 oz. portions, about the size of a deck of cards) that have lower concentrations of mercury—the Environmental Working Group has a great safe fish list.”
Additionally, she recommends limiting the most obvious, alcohol, and excessive caffeine, which the Institute of Medicine recommends less than 200mg, equaling two cups a day. Other foods that are not recommended due to food safety concerns include, "raw or unpasteurized milk and cheeses, cheese with mold running through it (gorgonzola or blue cheese), raw meat, fish or eggs, raw sprouts, unpasteurized apple cider or juices."
Increase These Food Groups
Sussi advises that nearly all food groups are increased during pregnancy, “but most specifically, a woman’s carbohydrate intake increases to 175 gm/day—again, mainly from fruits, vegetables and whole grains; and protein needs increase to 1.1 gm/kg/d to support the fetus and placenta, which consumes approximately 1 kg of protein/day (majority in the last 6 months). Ideally you want to get your protein from animal and plant based protein vs protein powder and high-protein beverages.” There are also micronutrients that should be increased during the prenatal time as well. “Mainly folate for neural tube defect prevention and iron to support the increasing red blood cell development for both mom and fetal/placental growth and adequate amounts of calcium, Vitamin A, D, C, E, all B vitamins, zinc and iodine.“ Sussi points out this is why, “it’s so important to take a prenatal vitamin in additional to a healthy, balanced diet.”
Hydrate, Hydrate, Hydrate
By now you know how important proper hydration is to be healthy, but it’s even more important while pregnant. Sussi explains, “Fluid needs increase during pregnancy to support fetal circulation, amniotic fluid and a higher blood volume. Water is always the preferred beverage, and it’s recommended to have 10-12 8oz cups/day.” She recommends limiting any juice and smoothie consumption to 1 cup a day, and to eliminate caffeinated drinks, teas, energy drinks as much as possible. She added, “Increasing your fluid intake can also help with constipation, a common side effect of pregnancy.”
The Early Months
Nutrition is of course important in the early phases of pregnancy, but what’s a woman to do when morning sickness, nausea, and smell sensitivity strike? While acknowledging the importance, Sussi says, “But my philosophy is it’s more important to listen to your body and not judge yourself if you’re experiencing severe morning sickness or nausea and the concept of eating a salad for lunch immediately makes you feel ill.”
She continues, "Side effects during the first trimester (it usually tapers off for most women around 12-14 weeks) present themselves in a huge range—some women experience no changes, others are vomiting 3-4x (or more!) per day."
So, if you find yourself being prevented from eating healthfully, try not to stress. Instead, she suggests, “be kind and practice self-care in other ways to alleviate the stress or symptoms. On days or at times where you are feeling well, optimize your nutrition by choosing a nutrient dense snack or small meal (generally smaller, frequent snacks and meals work better for nausea).”
It might be tempting (or not) but greasy, high fat foods will likely make you feel worse. Sussi stresses, “The most important thing during this time is making sure you take your prenatal vitamin—if you can take it with a small meal or snack to help better tolerate and absorb it that’s preferred, but again if all you can do is stomach it with a few saltine crackers, that’s okay too! This time in a woman’s life can be extremely overwhelming, especially if it’s your first pregnancy.”
Pregnancy is not the time to concern oneself with weight loss. “I never recommend my moms to lose weight during pregnancy,” Sussi says. “Instead, I work with them to gain the appropriate and recommended amount of weight (11-20 lbs. for BMI >30).” She believes that avoiding excessive weight gain is a main focus for obese patients, as opposed to prevention of inadequate weight gain or weight loss for patients under her prenatal care.
As with any medical related experiences, it’s important to always address any personal or unique questions or concerns with your personal physician.