Your Guide to Nutrition and Supplements in Pregnancy
Your health during pregnancy can is a stepping stone in developing your child’s health. Focusing on your health and diet years before conceiving can help influence outcomes relating to your pregnancy and child’s health. Nevertheless, when you’re pregnant, it’s always a good time to make positive lifestyle changes if you have the ability to do so.
As soon as you become pregnant, your body and nutritional requirements change as well. As your child’s organs are developing, you may need to increase certain nutrients or avoid specific foods. Whereas as baby grows, you may need to supplement with extra nutrients to ensure both you and your child have what you need.
Important Nutrients in Pregnancy
Folate
You’re probably well aware of how important folate is and why you should be supplementing it as soon as you begin trying to conceive. Folate/Folic Acid is necessary for DNA synthesis, building red blood cells, and amino acid metabolism.
Specifically in pregnancy, it’s needed for neural tube development and should be supplemented within less than a month after conception happens/early first trimester. This is why we often recommend taking a prenatal a few months before you try to conceive. It also helps with the development of the placenta.
Supplementing with folate may also decrease the risk of adverse fetal outcomes like stillbirth, miscarriage and neonatal death.
Folate Food Sources
Green leafy vegetables (like kale and spinach), beets, broccoli, cauliflower, peas, avocado, fortified cereals, oranges, strawberries, pasta, beans, and nuts.
Folate Dosage in Pregnancy
400mcg - 1 mg daily.
Iron
Iron is an important trace mineral needed for transportation of oxygen. As blood volume expands in pregnancy to meet the needs of your growing baby, the amount of iron needed increases as well. This makes iron deficiency very common during pregnancy.
Risks of low iron in pregnancy (and early postpartum) include preterm labour, low birth weight, and impaired neurological development in children.
Iron Food Sources
There are two types of iron - heme and non-heme.
Heme iron is more highly absorbed and is found in meat, poultry, and fish.
Non-heme iron is less absorbed and is found in eggs, legumes, tofu, nuts, seeds, and grains.
Absorption of iron can be increased by combining you food or supplements wth vitamin C.
Iron Dosage in Pregnancy
The recommended dosage of iron in pregnancy is 27mg per day. However, because iron deficiency is so common in menstruating individuals, having your ferritin and CBC tested will give us an idea if you need additional supplementation. I commonly recommend having these done in the preconception period or early in pregnancy.
Furthermore, iron deficiency can affect postpartum mental health, which is another reason to test and supplement during pregnancy.
Calcium
Calcium is needed to maintain the maternal skeleton, smooth muscle contractions, as well as fetal bone and tooth development. Calcium is incredibly important in the third trimester as about 80% of calcium is transferred from you to your baby.
Calcium Food Sources
Dairy-rich foods like milk, yogurt, cheese, and fortified non-dairy alternatives. Foods like almond butter, canned fish (with bones), dark green vegetables, nuts and tofu contain calcium as well.
Calcium Dosage in Pregnancy
Ideal calcium levels can usually be achieved from dietary sources. Additional supplementation might be considered in those with gestational hypertension or preeclampsia.
Vitamin D
Vitamin D is an incredibly important vitamin in life, not just pregnancy. It helps with calcium regulation, supports fetal bone and tooth development, as well as the immune system. In the preconception period, it can also be protective against recurrent pregnancy loss.
It’s very common (and accepted) to be deficient in vitamin D. This isn’t ideal because a vitamin D deficiency can be associated with numerous adverse events in pregnancy and the postpartum.
In pregnancy, a vitamin D deficiency can be a risk factor for gestational diabetes, preeclampsia, preterm birth, emergency cesarian section. In infants a deficiency can be a risk factor for low birth weight, and asthma.
Vitamin D Food Sources
Dietary sources are limited. They include direct sun exposure, egg yolk, salmon, cod liver oil, and fortified dairy.
Vitamin D Dosage in Pregnancy
This is one vitamin where supplementation depends on your blood levels. I often encourage people to have their vitamin D levels tested in the preconception period or early pregnancy. This is because it may have an impact on reducing the risk of developing gestational diabetes. Furthermore, a deficiency of vitamin D can affect postpartum mental health, another reason to test and supplement during pregnancy.
Iodine
Iodine is a mineral needed for thyroid hormones which regulate metabolic processes, and skeletal and nervous system development in the fetus.
Iodine requirements increase significantly in pregnancy. Until about halfway in pregnancy, the fetus relies the thyroid hormones from its mother.
A deficiency in pregnancy can lead to miscarriage or stillbirth. In infants it can be a risk factor for impaired physical and cognitive development.
Iodine Food Sources
You may be at risk for an iodine deficiency if you have hypothyroidism (especially with anti-thyroid antibodies) or if you are vegan. Does that mean you should supplement? Not necessarily. Excessive iodine intake can affect thyroid function.
Food sources of iodine include iodized salt, freshwater fish, eggs, and dairy.
Iodine Dosage in Pregnancy
The daily requirement for iodine in pregnancy is 220 mcg per day.
Choline
Choline is an essential nutrient required for placental health and fetal neurodevelopment. It also plays a role in neural tube development.
Choline Food Sources
Choline is found in eggs, beef, chicken, fish, dairy, cruciferous vegetables, leafy greens, beans, nuts, and seeds (like flax seeds, pumpkin seeds, and cashews).
Usually two eggs per day can give you the recommended daily dosage of choline.
Choline Dosage in Pregnancy
The ideal daily dose of choline is 450mg. It should be noted that very few prenatal supplements contain choline. And if they do, it’s rarely at the recommended amount. Therefore an additional supplement may be needed.
Omega-3 (EPA and DHA)
Omega-3 polyunsaturated fats include eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). It’s been shown that supplementation can support healthy birth weight and reduce the risk of preterm birth.
In pregnancy, DHA is essential during the third trimester for neural and visual development as it incorporates into the cell membranes of the brain and retina.
Omega 3 Food Sources
EPA and DHA are found in fish and shellfish as well as walnuts and flaxseed.
Because fish contain mercury (which can affect brain development in high doses), choose fish that contain lower amounts of mercury like:
Salmon
Trout
Herring
Haddock
Canned light tuna
Pollock (Boston bluefish)
Sole
Flounder
Anchovy
Char
Hake
Mullet
Smelt
Atlantic mackerel
Lake white fish
Health Canada recommends that women continue eating at least 150 grams (5 ounces) of cooked fish each week during pregnancy.
Avoid fish that contain high amounts of mercury like:
Fresh/frozen tuna
Shark
Swordfish
Marlin
Orange roughy
Escolar
Health Canada advises that women who are pregnant should limit consumption of these particular fish to 150g per month. For women who are pregnant, canned albacore (white) tuna consumption may lead to mercury exposure. This is limited to 300g per week. This does not apply to canned light tuna, which is relatively low in mercury.
Omega 3 Dosage in Pregnancy
A minimum of 200 mg of DHA per day in pregnancy is recommended.
Final Thoughts
I hope this information was helpful in helping you determine which foods to incorporate as part of your diet in pregnancy. If you’re looking for addition nutrition support during pregnancy, feel free to book an appointment with me.