Nutrition during pregnancy

The complex processes that occur during pregnancy require a rich supply of protein, vitamins and minerals for both mother and child. If you've built up good stores of nutrients in the months and years before conception through a healthy, balanced diet, the added demands of pregnancy can be met with modest adjustments. If, however, your nutrient stores are low, you run a greater risk of diet-related problems during pregnancy, such as anaemia.

But while your need for certain nutrients does increase during pregnancy, the old adage 'eating for two' doesn't necessarily mean you should eat twice as much food, for a number of reasons:

Your growing baby isn't as big as an adult.

During pregnancy, your body becomes more efficient at absorbing nutrients in the digestive system.

Your body also doesn't excrete nutrients - instead, it builds up stores of vitamins and minerals.

It's the quality of your diet that's important, not the quantity.

Energy

The theoretical energy cost of pregnancy has been estimated to be 80,000 calories, but there's no need to increase your overall energy intake until the last trimester, when all that's needed is an increase of just 200 calories a day. This is the equivalent of a couple of slices of toast with low-fat spread and a glass of milk.

Protein

There is no need to increase your protein intake, as long as you follow general healthy eating principles and include some lean meat, fish or poultry, dairy products, grains, nuts and pulses.

Fibre

It's particularly important to increase your fibre intakes when pregnant to avoid the common pregnancy niggles of constipation and piles (haemorrhoids). Increase your fibre intake by eating lots of fruit and vegetables, wholemeal bread and cereals, brown rice, wholemeal pasta and pulses. You should also increase your fluid intake. Increasing fibre without adequate fluid can exacerbate constipation.

Folic acid

This is particularly important before conception and during the first trimester of pregnancy. Mothers who are deficient in folic acid are at increased risk of having a baby with a neural tube defect (NTD), such as spina bifida.

From the moment you start trying to conceive until the end of week 12 of pregnancy, you should take a daily 400mcg supplement of folic acid. Women with a history of NTDs should be prescribed a 5mg supplement.

These supplements should be in addition to dietary intakes, which should be about 200mcg per day. You can boost your folic acid intake by choosing foods such as:

Fortified breakfast cereals

Wholemeal and wholegrain breads and rolls

Green leafy vegetables - cabbage, broccoli, spinach, Brussels sprouts, spring greens, kale, okra and fresh peas

Pulses - chickpeas, black-eyed beans and lentils

Folic acid is easily lost during cooking, so steam vegetables or cook in only a little water for a short time to retain as much goodness as possible.

Iron

Many women of child-bearing age have low iron stores. Your iron levels will be measured throughout pregnancy, and if found to be low you'll be prescribed an iron supplement. Nevertheless, it's important to try to maintain a good iron intake during pregnancy.

Vitamin

Although liver and liver products, such as paté and liver sausage, are good sources of iron, they can also contain very high concentrations of vitamin A. If taken in excess, this vitamin can build up in the liver and cause serious harm to a growing baby.

As a result, the Department of Health advises all pregnant women to avoid liver and liver products. You should also be aware that some vitamin supplements are high in this vitamin, so always choose a specially prepared pregnancy supplement.

However, the form of vitamin A derived from green, orange, and yellow fruit and vegetables - known as carotene - has very positive health benefits, and is plentiful in red, yellow and orange peppers, mango, carrots, sweet potatoes, apricots, tomatoes and watercress.

Calcium

It is important to eat sufficient calcium-containing foods. Good sources include milk and dairy foods such as cheese, yoghurt and fromage frais. Pregnant women should aim to have three servings of foods from this group every day (typical servings include a glass of milk, milk with cereal, a small chunk of cheese and a small pot of yoghurt). Other sources include bread, green vegetables, canned fish with soft, edible bones (salmon, sardines and pilchards), dried apricots, sesame seeds, tofu, fortified orange juice and fortified soya milk.

A balanced diet

Most of the additional nutrient needs of pregnancy can be met by eating a well-balanced and varied diet. With a few exceptions, you can continue to eat a normal, healthy diet in keeping with the Balance of Good Health. This includes regular meals and snacks, and a sensible healthy eating regime containing:

Plenty of starchy carbohydrates - bread, rice, pasta, breakfast cereals, chapattis, couscous and potatoes.

Plenty of fruit and vegetables - at least five portions a day.

Lots of milk, yoghurt, fromage frais and pasteurised cheeses.

Enough protein, such as meat, fish, eggs (well-cooked), beans and pulses.

Not too many fat-rich and sugary foods.

Aim to have at least eight glasses of fluids per day.