Nutrition and Supplements

“Eat moderately, have an ordinary mixed diet, and don’t worry.” -Robert Hutchinson, 1932

In most instances, how well you choose to eat during your pregnancy is the number one thing that will affect your overall health and comfort during your pregnancy and into the postpartum period. Not only will your choice to eat healthy foods and plenty of them benefit your baby by providing all the building blocks your body needs for his growth and development, they also help you to remain strong and healthy as your body does this amazing and hard work of growing a baby inside you!  

General Guidelines

  • Plan to gain some weight.  Healthy, normal pregnant women who neither restrict calories nor constantly overindulge during pregnancy usually gain between 25 and 40 pounds.  Remember you’re not just growing a baby: you also have an expanding uterus, a placenta, amniotic fluid, extra blood volume, breast tissue, and you need a few extra pounds of fat to help make milk once your baby is born.
  • By 28 weeks, you’ll need about 75 grams of protein daily.  The more diverse the sources, the better.  Meats like beef, pork, chicken, and fish are good, but you can also get lots of protein from milk, cheese, Greek yogurt, nuts, beans, and eggs.  
  • Hydrate: a minimum of 64-96 oz of water daily is required to be properly hydrated.  The better hydrated you are, the less likely you are to faint, get bladder infections, and have irritating contractions.  If you struggle to drink that much, invest in a water bottle with a straw!  It is easier to drink more that way.  Feel free to add lemon, lime, or orange slices or other fresh fruits and veggies to liven up the flavor.  Herbal teas also count toward your water requirement, and can be good hot or iced.  Try to make sure that 32 ounces of your daily water has electrolytes in it: this can be as simple as a pinch of pink salt, or as fancy as a liquid IV packet or similar product.  

How and What to Eat

On average, you need about 300 extra calories per day, just to support your pregnancy.  When looking at what to eat, and how often, we generally say, “eat like a hobbit”.  That means breakfast, 2nd breakfast, “elevenses”, lunch, afternoon snack, tea, supper, and bedtime snack.  Okay, maybe not quite that many meals, and not necessarily hobbit-size portions either.  But, eating smaller amounts of food every 2-3 hours will keep your energy levels up, blood sugar on an even keel, and help you feel great while your body grows your baby.  

Remember, eat when you are hungry, drink when you are thirsty, and try to make sure all your meals and snacks contain some source of protein.  Here are some minimal daily nutritional needs.

Protein: 4 servings daily (75 grams daily). Protein provides the raw material for making the baby, placenta, and a strong uterus. It also contributes to the formation of breastmilk and is essential for healthy blood coagulation. Protein is not stored well in the body, so it is important to maintain a continual supply. For protein to be used optimally by the body complete proteins should be consumed. To make complete proteins pair foods together: meat and dairy, grains and legumes.

Veggies and Fruits Green leafy, yellow and orange: 3 servings daily. Other veggies and fruits: 2-3 servings daily. Rich in vitamins and minerals essential for a healthy nervous system and metabolism. They promote healthy skin, strong bones, rich blood, and a well-nourished body.

Carbohydrates: 4-6 servings daily (90-120 grams whole grains, or vegetable sourced starches such as sweet potato, carrots, etc.) Carbohydrates are the main source of energy for the body. If carb intake is insufficient the body will use protein and fat for energy.

Vitamin C: 2 servings daily Vitamin C is essential for collagen production which is needed for a healthy placenta, capillaries, and cell walls. It helps prevent varicose veins and hemorrhage and aids in the assimilation of other nutrients. Vitamin C is important in preventing and healing infections and is quickly used up in stressful times.

Iron: Some iron-rich food daily. Iron combines with other nutrients to create hemoglobin. It builds blood, increases resistance to stress and disease and allows for proper muscle contraction. It also aids in protein metabolism, and improves respiration.  Iron rich foods include red meat, dark leafy greens, seeds, and dried fruits. 

Quality Fats: 3-4 servings daily. Needed for optimal brain development in the fetus, and for absorption of fat-soluble vitamins. Also makes calcium available to the body tissues.  High quality fats include real butter, full fat dairy, high quality cheeses, oily fish such as salmon, avocado, olive, and coconut oils.  

Calcium: 4 servings daily Calcium is essential for the formation of the baby’s bones and teeth, and also for the maintenance of maternal bones, teeth, and connective tissue. It is essential for blood coagulation, healthy nerves, normal metabolism, mineral balance, and regular heartbeat. Calcium increases the pain threshold and is productive in relaxation.

Salt: daily in moderation to taste

If you want to go deep into evidence-based prenatal nutrition, we recommend, Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition, by Lily Nichols.    Not only does her book go through in detail the nutritional needs of pregnancy, she also has meal plans and other helpful tips for eating your best during pregnancy. 

Supplements

Supplements can be helpful, but they are not a substitute for a healthy diet.  Food or plant-sourced supplements are easier for the body to absorb.  While a prenatal vitamin isn’t absolutely necessary, most mamas take one, so look for one that contains at least the following vitamins and minerals:

  • Omega-3s : 3 grams
  • Vitamin D 5,000-10,000 IU
  • Calcium: 120 mg
  • B Vitamin Complex
  • Vitamin E: 400 IU
  • Vitamin C: 500 mg
  • Iron: 75 mg
  • Magnesium: 600 mg
  • Zinc: 20 mg

In addition, we also recommend eating cultured foods like yogurt, sauerkraut, pickles, kombucha or kefir at least a few times a week.  If you don’t like cultured foods, consider adding a probiotic supplement to your daily routine.

We often recommend additional supplements based on specific symptoms or situations.  While not a comprehensive list, the most common recommendations are:

  • Magnesium It comes in many forms, and it tends to be good for all kinds of discomforts in pregnancy. We do recommend taking Magnesium in conjunction with Calcium, as the two together are generally more effective.  
    • Magnesium Citrate will help with indigestion and constipation.  
    • Magnesium gluconate helps with irritating contractions, and relaxation
    • Magnesium glycinate helps with anxiety, stress, and sleep
  • Some brands we love:
  • Iron  We do a thorough assessment of your iron when you come to care: not only assessing for anemia now, but the likelihood of anemia in the future.  Depending on your hemoglobin and ferritin numbers, we might ask you to take an iron supplement.  Iron deficiency has many symptoms: tiredness, dark circles under your eyes, restless legs, itching, hair loss.  If we do put you on an iron supplement, we will recommend taking it every other day as studies show that it is absorbed better that way.  The downside to taking iron supplements is they can be constipating, but these brands use vegetable sources of iron which usually minimizes that side-effect.  Brands we love:
  • Low-Dose Aspirin!  If this is your first pregnancy or you had preeclampsia or blood pressure issues in previous pregnancies, or contract Covid-19 during your pregnancy, it is strongly recommended that you take a low dose (81 mg) aspirin daily.  There is a wealth of research that shows that LDA helps prevent circulatory system issues like pre-eclampsia, pregnancy induced hypertension, blood clots and placenta issues during pregnancy.  There is also good evidence that Covid-19 raises the risk of  these issues during pregnancy.  Please consider adding LDA to your supplements if you meet any of the above criteria.   
  • Vitamin C!  Vitamin C is good for your immune system, your circulation, and your amniotic sac.  We often recommend taking an extra 500mg  to 1,000 mg of vitamin C daily in your third trimester to help avoid having your waters break before labor starts.