Staying Healthy
Nutrition
In general, to meet the metabolic demands of your pregnancy, you need an increased caloric intake of 300 calories/day. This is not “eating for two” but instead a modest increase in calories. Please see the weight gain recommendations for further guidance.
Please limit caffeine and artificial sweeteners to 2 servings/day or less.
We recommend 1200-1500 mg of calcium daily during pregnancy and with breastfeeding either in your diet or with supplements. If you use supplementary calcium, please avoid bone meal, dolomite, or oyster shell products as these may contain lead.
Do not take additional vitamin supplements unless directed by your MD to do so. During the first trimester (3 months), do not worry a lot about the nutritional aspects of your diet. Sometimes you just need to eat whatever sounds good to control your nausea. Prenatal vitamins can be difficult to tolerate because of nausea in the first trimester. If this is the case for you, please substitute just folic acid – this will not contribute to nausea.
Pregnant women should limit consumption of undercooked meat, deli meat, sushi, and unpasteurized cheeses because of a rare disease called Listeria that can have detrimental effects on a pregnancy.
The American College of Obstetricians and Gynecologists (ACOG) suggest the following food guideline:
| Category | Type | Number of Servings |
|---|---|---|
| Protein | 3-4 | |
| Meat, Poultry, Fish | 2-3 | |
| Legumes/Nuts | 1-2 | |
| Fruits and Vegetables | 5 | |
| Vitamin C | 2 | |
| Vitamin A | 2 | |
| Other | 1 | |
| Whole Grain Products | 4 | |
| Milk (or at least 1000 mg calcium supplement) | 4 | |
| Others | 2 |
Omega-3/Fish Oil and Pregnancy
Omega-3s are felt to have a role in fetal brain and retina (eye) development.
Diet access to omega-3s in fish is restricted in pregnancy due to the contamination of some fish with mercury and other heavy metals. There are guidelines to allow for some omega-3 consumption but limit intake of heavy metals.
AVOID shark, swordfish, mackerel, tilefish, tuna
Canned light tuna is ok; white albacore tuna is NOT ok as it may have higher mercury levels
Please see the Minnesota Department of Health Fish Consumption handout or website for more details of these guidelines and information about other fish.
We recommend supplements to get adequate, safe Omega-3s.
Fish Oil / Omega-3 supplements: 100 – 500 mg DHA per day (depending on brand, 124-250 mg twice a day) Remember, these are supplements, not medications, so they are NOT regulated by the FDA. Expecta is an Omega-3 supplement made by a baby formula company – many of our patients take this brand. Side effects: fish breath, bloating, flatulence, diarrhea, heartburn. Consider stopping supplements a few weeks before your due date because of possible increase in bleeding on these supplements.
Weight
Amount of weight gain recommended during pregnancy depends on your starting BMI (body mass index). Your BMI is a calculation based on your height and weight. You can calculate your BMI with an internet calculator.
- BMI less than 19, you are underweight
- BMI from 19 to 24.9, you are normal weight
- BMI from 25 to 29.9, you are overweight
- BMI 30 or more, you are obese
Recommendations for weight gain during an uncomplicated single baby pregnancy are as follows. This information is based on your BMI at the beginning of pregnancy.
- If your BMI is less than 19, you should gain 28 to 40 lbs
- If your BMI is from 19 to 24.9, you should gain 25 to 35 lbs
- If your BMI is from 25 to 29.9, you should gain 15 to 25 lbs
- If your BMI is 30 or more, you should gain 11-20 lbs
Starting pregnancy over or under weight and too much or too little weight gain during pregnancy have both been associated with high or low baby birth weights. Over or underweight babies can have more health issues and complications during pregnancy, delivery, and after. Women who gain weight within the recommended guidelines are less likely to deliver infants who are too small or too big. Extra weight gain is also associated with an increased chance of c-section and birth injury to baby.
Weight Distribution
| The average baby weighs | 7 1/2 pounds |
| The placenta | 1 1/2 pounds |
| Increased fluid volume | 4 pounds |
| Increased weight of uterus | 2 pounds |
| Increased weight of breast tissue | 2 pounds |
| Increased blood volume | 4 pounds |
| Maternal stores of nutrients | 7 pounds |
| Amniotic fluids | 2 pounds |
| Total 30 pounds |
Alcohol
Whatever goes into your body affects your baby, too. Avoid alcohol while you’re pregnant. Babies affected with fetal alcohol syndrome have mental and physical problems, including slow growth and development, small heads, abnormal eye features, and mental retardation.
Coloring Hair, Permanents/Self Tanners, Sunscreen/Bug Spray
There is no good scientific information regarding the safety of self tanners and hair coloring. They are likely to be safe but some people avoid using them during pregnancy. Sunscreen is recommended all the time including during pregnancy.
Insect repellent is recommended due to the risk of mosquito-transmitted viruses. You may use insect repellents with a low concentrations of DEET (up to 27% is considered a low concentration) and wear long sleeves and pants.
Dental Care
Caring for your teeth during pregnancy is very important and routine dental examination and treatment is encouraged. Due to hormonal changes, you are more susceptible to cavities, bleeding gums, and gum infections. Tell your dentist that you are pregnant. Local anesthesia injections are safe, but avoid general anesthesia/nitrous oxide. Use a lead apron if x-rays are necessary.
Exercise
Women in good health with an uncomplicated pregnancy should engage in regular, moderate intensity exercise for 30 minutes, most days of the week. Women who have been exercising regularly prior to pregnancy may generally continue their regimen. Women who have not been regular exercisers should undergo a gradual progression of increasing exercise up to the 30 minutes per day. Light to moderate weight lifting and flexibility exercises are ok. Pregnancy is not a time in which women should try to markedly improve their physical fitness.
Regular exercise may decrease the risk of gestational diabetes, preeclampsia and excessive weight gain. It may also improve your blood sugars if you already have gestational diabetes.
Most women will have to decrease their exercise intensity and/or duration as the pregnancy progresses. Women should pay attention to ensure they are not over heating and are staying hydrated while exercising. Exercise which has a higher risk of falling or of abdominal trauma should be avoided (examples: downhill skiing, biking, etc). There is no evidence that exercise causes preterm labor or delivery, but it can be associated with uterine contractions.
Fetal Movement Counts (aka “kick counts”)
In the third trimester (after 28 weeks), you should pay attention to your fetus’ movements. Fetus’ go through sleep and wake cycles so are not always moving. During active times for your fetus and when you are paying specific attention to the activity, you should feel 10 movements in 2 hours. Any movement counts – i.e. kicks, wiggles, and rolls. If you do not feel this amount of movement, please call our office ASAP as it can be a sign of fetal stress.
Hot tubs/Saunas/Whirlpools/Tanning beds/hot yoga
Please avoid these due to the risk of overheating. However, warm baths and showers are safe.
Nails
You may paint or have your nails done professionally.
Painting/Cleaning
We recommend that you use only latex paint and that you avoid paint strippers. Low VOC (Volatile Organic Compound) paint is best. Keep the area well ventilated where you are cleaning or painting. If you can easily smell fumes, you shouldn’t be in the room.
Pets
If you have a cat at home, don’t empty the litter box while pregnant. If you must, wear gloves, cover your mouth and nose with a handkerchief and empty the box at least every 24 hrs. Cats can carry an organism in their feces that causes toxoplasmosis. If you get this infection during pregnancy, it can cause serious health issues for your baby.
Seat Belts
Please always wear your seatbelt during pregnancy. Wear the lap belt low across your hips (under your belly) and keep the shoulder harness on.
Sexual Relations
For healthy pregnant women without complications, sex is safe up to delivery.
Smoking
Please DO NOT smoke during pregnancy. Tobacco smoke is a major source of carbon monoxide, which can interfere with the oxygen supply to the fetus. Your baby will have twice the level of carbon monoxide that you have. Smoking increases the risk of premature delivery, stillborn infants and miscarriages. Smoking even results in a ten times increased risk for SIDS (Sudden Infant Death Syndrome).
Swimming
Swimming is fine, and may be helpful for sore muscles, back pain, and swelling. Sunburn can make you feel terrible during pregnancy. Use sunscreen.
Travel
Generally, travel is ok up to approximately 35 weeks gestation in an uncomplicated pregnancy, but please check with your provider before planning any trips near the middle or end of pregnancy or if you have high risk issues with your pregnancy. Any travel during pregnancy is at your own risk and it is recommended you know a hospital at your destination and bring a copy of your prenatal chart with you should you need care on your trip.
You are more prone to blood clots in your deep veins when you are pregnant and these can be life threatening. To decrease this risk, anytime you are traveling, please get up and walk around every 1.5 to 2 hrs. Also remember to stay hydrated.
Violence
Physical, emotional, and sexual violence and abuse against women are more common during pregnancy. If you do not feel safe or someone is hurting you in any manner, please let us know so we may help to ensure your safety and that of your baby.