Your perfect pregnancy diet

Obviously you’re putting on weight – you’re pregnant! But just how much weight is really OK? And how much more do you really need to eat?

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Pregnant woman eating

Never has nutrition mattered quite so much as in the nine months of your pregnancy.

You may no longer be encouraged to “eat for two” in terms of quantity - but it’s still true that everything you eat goes towards maintaining your and your baby’s good health. Read on for our expert guide to eating well for during pregnancy.
 
If you have a well-balanced diet prior to pregnancy you should have good stores of most of the vitamins and minerals needed for a healthy baby, in which case there will only be a few minor adjustments that you need to make.
 
If however your diet has been poor in the lead up to pregnancy, you will need to be a bit more careful in order to avoid anaemia or other vitamin deficiencies.

‘Many women also put on a huge amount of weight during pregnancy,’ says GP Dr Beth de Sousa, author of family health guide The Health Compass

‘But your growing baby is only small and requires feeding in proportion to its size. In addition to this, women’s guts absorb nutrients more efficiently during pregnancy. It is quality of food, not quantity that is important,’ she explains.
 
You may be surprised to hear that the optimum weight gain during pregnancy is only 12.5kg (27lb). During the first trimester (the first three months) there should be little or no weight gain. From then on, a pound a week is what you should aim for.

But these days midwives tend not to weigh mums-to-be - they’ve found it only serves to make them anxious. ‘A normal weight woman can safely gain between 25-35lb during her pregnancy,” says registered dietician Sarah Almond. ‘It’s a huge range.

‘And weight gain can be due to several factors, such as how much body fat you have to start with, whether you have a lot of amniotic fluid or have battled with severe morning sickness. Every woman is slightly different.’

That’s not to say you should throw caution to the wind and settle down to a tub of ice cream, though. ‘Being overweight during pregnancy increases your risk of high blood pressure, pre-eclampsia, gestational diabetes, varicose veins and joint problems,’ warns Sue Jacob, a midwife with the Royal College of Midwives.

‘It’s trickier for your midwife to gauge the size and position of your baby, and you’re more likely to have a difficult or complicated labour and a longer recovery time, too.’
 
And it’s not just you that’s affected. ‘Larger ladies tend to have bigger babies, and if your child is born with these additional fat cells, she’s predisposed to diabetes and high blood pressure in later life,’ says Sue.
 
But dieting is not recommended during pregnancy, so if you are overweight it’s best to increase the amount of activity you do instead, advises dietician Sarah. ‘Be very careful and don’t start any difficult new or exhausting sports or exercises. Just increase the amount of time spent doing general activity such as walking to ensure you don’t do yourself any damage.’

‘If you want to do something new, it’s best to limit it to a gentle exercise such as swimming or antenatal yoga. If you’re very concerned about your weight, ask your GP to refer you to an NHS dietitian. Or you can find a private dietitian in your area via www.dietitiansunlimited.co.uk.’
 
And what about the other end of the scale? Being overly thin has its own set of complications. Women who are underweight may find it hard to conceive in the first place because a lack of fat alters ovulation and the normal menstrual cycle. But when underweight women do become pregnant, they’re likely to be lacking in vital nutrients.

‘Your baby will always take what she needs but that means I see very thin pregnant women who are sorely deficient in nutrients and, more often than not, anaemic,’ says Sue.

‘If you don’t eat enough you won’t lay down fat. That’s going to affect the growth of your baby and the smaller she is at birth, the more vulnerable she is.’

If you’re very underweight and suffering an eating disorder, now more than ever is time to get some professional help from a counsellor, therapist or your GP. If you’re worried about being underweight generally, you could also ask your GP, midwife or a dietician about a healthy eating plan and possible supplements, especially iron.
 

The balancing act

So, short of checking into a health farm for the next nine months, how can you make sure your baby’s getting all the nutrients she needs? Just how much – and what – should you be eating?

‘A healthy diet during the first and second trimester should consist of three meals and two to three snacks per day,’ Sarah advises.

Avoid snacking on foods which fill you up but don’t contain much nutrition, such as sweets, crisps and fizzy drinks. Instead opt for carbohydrate-rich snacks such as cereal bars, dried fruit, hot cross buns and sandwiches.

‘Meals should be based on wholegrain low Glycaemic Index (GI) carbohydrate foods which won’t cause your blood sugar to peak and trough. That way you’ll keep your energy levels steady for longer. Good examples of low GI carbs are porridge, pasta, fruit and vegetables especially beans and pulses,’ Sarah advises.

If you’re having cravings, particularly if they’re for very unhealthy foods high in fat and sugar (for example, that tub of ice-cream), Sarah’s tip is to try to distract yourself and perhaps have something healthy to eat instead. Sadly, there’s no truth in the old wives’ tale that cravings are for nutrients that you really need.

‘Cravings don’t mean that the food you want is essential for your baby,’ she says. ‘But if you’re still longing for that particular food after 20 minutes, then go ahead and have a small portion – but don’t go crazy.’

If you’re suffering morning sickness in the early days of your pregnancy, however, it’s best go with whatever you can manage to keep down and eat little and often. ‘Try to avoid getting “over-hungry” as this will make you feel worse,’ says Sarah.

‘You could start the day with a couple of ginger biscuits in bed, as ginger combats nausea and having something in your stomach will make you feel better.

‘Cold foods are often tolerated better than hot foods and you could also try to avoid food smells. Ask your partner – or a friend – to help out with the cooking. Or prepare foods in advance which you can eat straight from the fridge’.

If you really can’t keep anything down you may have a condition called hyperemesis gravidarum – severe nausea and vomiting – which can lead to dehydration. It’s worth letting your GP or midwife know as it may need medical management.
 
During the third trimester you do need to eat more than usual, but only an additional 200 calories a day. ‘It’s not a lot more and can best integrated into an already-healthy pregnancy diet by increasing your healthy snacks to three a day or making the carbohydrate portions of your meals a little larger,’ says Sarah.
 

The weighting game

And now for the question that obsesses most new mums once the baby has safely arrived. How long should it <really> take to shed your pregnancy weight?
 
‘Nothing beats breastfeeding when it comes to post-birth weight loss,’ explains midwife Sue. ‘It uses between 500 and 700 calories a day, and if you eat sensibly too, you should drop about a pound a week.’

Don’t starve yourself though, as you’ll need all the energy you can get to care for your newborn, especially if you’re breastfeeding, says dietician Sarah. ‘Breast milk needs to contain enough fat and calories to nourish your baby and ensure he grows well. This is certainly not a time for dieting.’
 
GP Beth says you can start a gentle exercise regime soon after giving birth. ‘Walking with your baby in a push chair or a sling is great post-birth exercise. So is swimming, as soon as your bleeding has settled.

‘But take care with running or high-impact exercises as ligaments softened by pregnancy can take sometimes up to a year to recover. Aqua aerobics is a gentle way of not putting strain on the ligaments and so is cycling. You could get an exercise bicycle to use at home if that’s easier when your baby is tiny.’


How much weight should I gain?

Registered dietician Sarah Almond says that, based on your pre-pregnancy body size, a healthy weight gain to aim for is:

- Underweight - gain 28-39lb
- Normal - gain 25-35lb
- Overweight - gain 15-25lb
- Very overweight - gain at least 15 lb

 
Where does it all go?

It’s not all baby you know… Here’s how to account for those extra pounds gained in pregnancy, based on the average woman
 
Bump: The average baby weighs 7lb, your placenta counts for 1.5lb and even the wall of your womb weighs an extra 2lb. Add to that 2lb of amniotic fluid.

Breasts: You can expect to gain up to 2lb of breast tissue.

All over fat, especially hips and bottom: Your body will store up to 7lb of fat and protein as your pregnancy progresses, to help your baby get all the nutrients he needs and for the energy you’ll need to produce breast milk.

Blood: You’re producing an extra 4lb of blood during your pregnancy.

Water retention: Extra fluid tips the scales by a further 4lb.


Your guide to a healthy pregnancy diet.

Aim for:

- Five portions of fruit and vegetables a day. These provide fibre as well as vitamins and minerals and so can help manage pregnancy-related constipation
- Ensure all meals contain wholegrain carbohydrate foods such as oats, granary bread, pasta, basmati rice, couscous or potatoes
- Three servings of protein per day - lean meat, fish, eggs, nuts beans, lentils, soya or tofu. Nuts are OK however if there is a family history of allergy, eczema or asthma you may wish to avoid peanuts.
- Two portions of fish per week (but only one of these should be oily fish due to possible pollutants).
- A pint of milk a day  - or exchange a 1/3 of a pint for a yoghurt, fromage frais or matchbox-sized portion of cheese.