Nutrition in pregnancy By Alana Juman Blincoe One of the most vital instances when a balanced diet and good nutrition are needed is when a women is about to become pregnant or is pregnant. It is well noted that women who have poor diets, have a greater tendency to give birth to babies who have a low birth weight. A baby born at fulwl term weighing less than 2.5kg is likely to suffer from illnesses and may have difficulty feeding ( There is also mounting evidence suggesting a mother’s diet can also have more far reaching effects for the fetus, leading to ill heath for a child in later life. It is therefore, of great importance that women about to conceive or who have conceived are educated about the necessary dietary requirements for optimum nutrition, both for themselves and their unborn child. Foods to eat n Based on information from the World Health Organisation, the government recommends we all eat at least five portions of fruit and vegetables per day. A variety of fruit and vegetables are best and different coloured fruit should be included to provide different combinations of vitamins, fibre and minerals. n Fibre sources can be found in wholegrain bread, rice, pasta and pulses. Large amounts of fibre during pregnancy can help to prevent constipation, n Starches (complex-carbohydrates) are foods like pasta, rice, potatoes and bread. n Two to three daily servings of protein are adequate. Foods include well-cooked eggs, lean meats, chicken and fish. Two servings of fish are recommended per week, including one of oily fish. Fish to eat in moderation are sardines, herring, mackerel, salmon and trout. This is due to mercury levels. If high they can harm a developing nervous system. Tinned tuna is not an oily fish, whereas fresh tuna is. Pulses like beans and lentils are good protein providers and a good source of iron. n For calcium at least two to three portions of dairy should be eaten, such as milk, yoghurt and cheese. Low-fat dairy products provide as much calcium as full-fat ones. For those who may suffer lactose intolerance, soya or sheep alternatives can replace those derived from cow’s milk. Pregnant women are advised to avoid goat’s milk or cheese, as it is unpasteurized. Foods to avoid: n The bacterium Listeria can cause miscarriage, stillbirth and severe illness in newborns. Avoid soft mould-ripened cheeses like Brie, all blue-veined cheese and Camembert. Cheddar, cottage cheese or other processed cheeses are fine. n Avoid meat or vegetable patés. Although tinned paté can be eaten. n Uncooked or under-heated ready meals should be avoided. n Organ meat, particularly liver or liver products (like paté) shouldn’t be eaten due to high levels of the retinal (animal) form of Vitamin A. Vitamin A is essential in pregnancy, but too much in the early stages is detrimental. Vitamin A or cod liver oil supplements should be avoided, including high-dose multi vitamins. n Avoid shark, marlin and swordfish. Shellfish can be eaten if cooked and part of a hot meal. n Daily caffeine limits are 300mg. High levels can cause low birth rate and miscarriage.(Klebanoff et al, 1999; Cnattingius et al 2000) Caffeine is in tea, coffee, soft drinks and chocolate. n The FSA (Food Standards Agency) advises pregnant women avoid drinking alcohol. n To prevent food poisoning such as salmonella, campylobacter and Escherichia coli 0157, always wash hands after handling raw meat. Only eat meat if thoroughly cooked; take specific care with minced meat and sausages. Store raw food separately from ready-to-eat foods; avoid raw shellfish, oysters and some sushi dishes. Don’t eat raw eggs or food containing raw or partially cooked eggs. n Biscuits and cakes should be cut down because of their high fat and sugar content British Journal of Midwifery, march 2006, Vol 14, No 3