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Health During Pregnancy

Important signs to watch for if you are pregnant [hide]
  • Bad cramps or stomach pains that don't go away
  • Bleeding or a trickle or gush of fluid from your vagina
  • Lower back pain/pressure or change in lower back pain
  • A feeling that the baby is pushing down
  • Contractions or change in the strength or number of them
  • An increase in the amount of vaginal discharge
  • Fever, chills, dizziness, vomiting or a bad headache
  • Blurry vision or spots before your eyes
  • Sudden or severe swelling of your feet, hand or face
  • A significant change in your baby's movements

Go to a hospital right away and contact your doctor/midwife if you have any of these symptoms!

Adapted with permission from:
Best Start: Ontario's Maternal Newborn and Early Child Development Resource Centre

Last Reviewed: August 2013

Eating Healthy

Eating healthy to have a healthy baby

Pregnant lady with a glass of milk

Every woman wants to have a healthy baby. Eating healthy is important when you are pregnant. Eating a variety of foods from Canada's Food Guide will help you get most of the vitamins, minerals and nutrients you need for you and for your baby. A prenatal vitamin/mineral supplement is recommended when you are pregnant to make sure you are getting enough vitamins and minerals.

Healthy eating while you are pregnant can:

  • give your baby the nutrition he needs to be healthy
  • help you gain a healthy amount of weight
  • help you and your family develop healthy eating habits for life
  • reduce your chance of developing health problems like high blood pressure or low iron in your blood

How much should I eat?

You will need extra calories during your pregnancy so that you have a healthy weight gain. How much more? In the first 3 months of pregnancy, most women do not gain much weight so you may only need to eat more in the second and third trimester. On average, you need to eat an extra 2-3 servings per day from any of the food groups from Canada's Food Guide.

You can get 2-3 extra servings each day by adding healthy snacks to your day or by adding extra servings to your meals. For example, two extra servings may be eating a fruit for snack and an extra glass of milk with supper.


What to eat

To make sure you are getting all the nutrients you need to have a healthy baby, choose a variety of foods from Canada's Food Guide and follow its recommendations.
* Remember that pregnant (2nd & 3rd trimester) and breastfeeding women need an extra 2-3 servings from any of the food groups from Canada’s Food Guide.

Canada's Food Guide recommends that you eat the following foods every day (for women 19-50 years of age):

7-8 Servings Vegetables and Fruit

Vegetables and Fruit provide fibre, vitamins and minerals and energy. Try vegetables and fruit of different colours to get great nutrition. You should eat at least one dark green and one orange vegetable or fruit each day. Have vegetables and fruit more often than juice.

6-7 Serving Grain Products

Grain Products are a great source of vitamins (especially B vitamins), minerals, fibre and energy. Bread, rice, naan, bagels and pasta are all part of the Grain Products food group. Choose whole grain varieties that are lower in fat, sugar and salt. Try to have at least half of your daily grain intake come from whole grains.

2 Servings Milk and Alternatives

The Milk and Alternatives food group can provide calcium, vitamin D, protein and other nutrients. To get enough vitamin D, everyone (over two years of age) needs to drink 2 cups (500 mL) of milk every day. Choose lower-fat varieties like skim, 1% or 2% milk or lower-fat yogurt (under 2% M.F.) and cheese. If you do not drink milk, choose fortified soy beverages, rice beverage or calcium-fortified orange juice (pasteurized). Some fortified beverages contain calcium but not vitamin D; check the label!
* Note: teenage girls (14 – 18 years of age) need 3-4 servings of Milk and alternatives everyday

2 Servings Meat and Alternatives

The Meat and Alternatives food group can provide protein, iron, energy, minerals and vitamins. Choose lean lower fat meats and meat alternatives—dried peas, beans, tofu and lentils—made with little or no added fat or salt. Prepare and cook Meat and Alternatives with little or no added fat or salt. This food group can also provide a very good source of fibre if you choose legumes like dried peas, beans and lentils, nuts and seeds.

Fish has omega-3 fatty acids which can help your baby’s brain, visual and nerve development. Choose at least two servings of fish per week. Choose fish that are low in mercury such as salmon, sole or trout.

For more information on healthy fish choices, visit Eat Fish for Health or call:

Region of Peel-Public Health   
905-799-7700
Monday to Friday 8:30 a.m. to 4:30 p.m.
Caledon residents call free of charge at 905-584-2216


Important nutrients to have a healthy baby

Some nutrients are very important when you are pregnant like iron, folic acid, calcium, vitamin D and omega 3 fatty acids. It is sometimes hard to get enough of these nutrients from your diet. An extra vitamin/mineral supplement may be recommended by your doctor or dietitian.

Folic Acid

Folic acid, also known as folate or folacin, is a B vitamin that is needed during pregnancy to help make blood. Folic acid is very important in the first few weeks of pregnancy because that is when the baby’s spine, skull and brain develop. It can help prevent neural-tube defects, like spina bifida, which are birth defects that affect the development of the spine and brain.

It is recommended that all women who could become pregnant take a multi-vitamin/mineral supplement containing a 0.4mg (400 microgram) of folic acid. Once you are pregnant, start taking a prenatal vitamin/mineral supplement (which already contains folic acid) and stop taking the regular multivitamin/mineral supplement. Your doctor may recommend that you take larger amounts of folic acid (more than 1 mg) for medical reasons. Do not take more than one daily dose of vitamin supplements unless recommended by you doctor/midwife.

Vegetables, fruit and fortified cereals are the best sources of folic acid. Food like spinach, orange juice, broccoli, peas and Brussels sprouts are excellent sources of folic acid. However, even when you eat the best sources of folic acid it is difficult to get enough from food alone. Taking a multi-vitamin/mineral vitamin every day containing 0.4mg of folic acid following Canada's Food Guide will ensure you are getting what you need to have a healthy baby.

To get more information on the importance of folic acid and your health before pregnancy and your baby:

Folic Acid - Why you need it (Region of Peel - Public Health)

Folic Acid
Public Health Agency of Canada


Iron

Iron is important to make healthy blood for you and your baby.  When you are pregnant, your body needs to make more blood, almost double, for your body, your growing baby and placenta. During your pregnancy your blood iron may become low (anemia). Low iron in the blood can cause you to feel tired, have pale skin, and be more likely to catch colds and infections.  Iron, in the form of hemoglobin, carries oxygen to your body’s cells and gives you more energy. Iron deficiency can affect brain development, behaviour and general health of children.

The following chart outlines daily iron requirements, otherwise called the Dietary Reference Intake (DRI):

Age Recommended Amount of Iron (mg)/day
Pregnant Women (adults and teens): 27 mg
While Breastfeeding:  
14-18 years
10 mg
19-50 years
9 mg
Adults:  
Male 19 years and over
8 mg
Female 19-50 years
18 mg
Female over 50 years
8 mg
Teens:  
Male 9-13 years
8 mg
Male 14-18 years
11 mg
Female 9-13 years
8 mg
Female 14-18 years
15 mg
Children:  
1-3 years
7 mg
4-8 years
10 mg

During pregnancy, it is hard to get enough iron from food. Taking a prenatal vitamin can help you make sure you get the iron you and your baby need. Your prenatal multivitamin should contain 16 – 20 mg of Iron (Health Canada, 2009)

There are two types of iron – heme iron (animal sources like meat, fish and poultry) and non-heme iron (foods like eggs, whole grains, dark green vegetables, nuts, seeds and legumes). Your body absorbs heme iron better than non-heme iron.

Sources of heme iron:

  • red meat - beef, pork, lamb, veal
  • turkey and chicken
  • fish and seafood
*note - liver is high in iron but is not included because one Food Guide Serving of liver (75g) contains more vitamin A than is safe during pregnancy.

Sources of non-heme iron:

  • eggs
  • breakfast cereal (fortified with iron)
  • breads and pasta (whole grain and enriched)
  • beans, lentils, dried peas
  • seeds and nuts
  • dark leafy green vegetables
  • dried fruit

How to get the most from the iron in your food
You can help your body absorb iron at each meal by:

  • eating foods rich in vitamin C (found in foods like kiwi, citrus fruit or juice, cantaloupe, strawberries, broccoli) with your iron containing foods
  • eating some meat, fish or poultry (foods with heme iron) with non-heme iron foods
  • avoiding coffee or tea with your meals - they contain tannins that reduce non-heme iron absorption

    *Sources: Merck Manual,NIH,DRI (ION)

Your doctor/midwife may advise you take an iron supplement in addition to your prenatal vitamin if your iron levels are low. Take the iron supplement with meals or a glass of 100% juice (pasteurized) that is high in vitamin C. Avoid taking an iron supplement at the same time as a calcium or zinc supplement.


Calcium & Vitamin D

Calcium and vitamin D work together to build healthy bones and teeth for you and your baby. Vitamin D is needed for our bodies to absorb calcium.

Your baby gets the calcium it needs from your blood. Any extra calcium is stored in your bones to prepare your body for breastfeeding. If your body does not have enough calcium, then your bones may be affected and become thinner in the future.

Women (19–50 years old, even during pregnancy) need 1000mg of calcium per day. Teens (14–18 years old) need 1300 mg/day. The best sources are Milk and Alternatives fortified with vitamin D. Two cups of milk will provide enough calcium for you during pregnancy. Other sources like legumes, nuts, seeds and some dark green leafy vegetables also contain some calcium. Vitamin D helps calcium absorption, whereas, oxalic acid found in some vegetables like spinach, rhubarb, chard, lowers the absorption of calcium. Stress and caffeine intake also tend to decrease calcium absorption.

If you do not drink milk, then drink fortified beverages like goat’s milk, fortified orange juice, soy and/or rice beverages. Check the label to make sure the beverages have calcium and vitamin D added to them. Other sources of calcium are legumes, some vegetables and almonds.

The recommended daily intake of vitamin D for pregnant and non-pregnant women ages 14 – 50 years is 200 IU everyday. Vitamin D can be found in cow’s milk, some yogurts, fortified soy/rice beverages goat’s milk, fatty fish (i.e. salmon), egg yolk and margarine. Your body also makes Vitamin D when your skin is exposed to the sun. However, during the long winter days (November–March), we cannot produce vitamin D naturally from the sun. The use of sunscreens to prevent skin cancer also decreases the production of vitamin D.


Essential Fatty Acids

Certain types of fats, called essential fatty acids are necessary for you and your baby’s growth and development. There are two types: omega-3 and omega-6.

They are found in vegetable oils and soft margarines, nuts, seeds and fatty fish. Your body does not make these fats so you must get them from your food.

Include essential fatty acids in your diet by:

  • Eating salmon for supper or a salmon sandwich for lunch
  • Choosing salad dressing made from oils such as canola oil
  • Using vegetable oils in cooking and baking
  • Sprinkle nuts and seeds in your meals or yogurt

Certain types of omega-3 fatty acids, called DHA and EPA, are important for healthy development of your baby’s eyes, brain and nervous system. The best source of DHA and EPA is fatty fish, mostly salmon and fish oils. Other sources are DHA-enriched eggs, DHA-enriched milk, DHA and EPA supplements. Before taking any supplements, check with your doctor or dietitian and buy from reputable stores. Also, check the expiry date.

Water and Other Fluid

It is important for you to drink plenty of water while you’re pregnant.

Water:

  • carries nutrients to your body and to your growing baby
  • takes away waste from your baby and from you
  • keeps you cool
  • helps prevent constipation
  • helps to control swelling

Drink plenty of fluids every day, including water, milk, 100% juice (pasteurized) and soup. Drink water regularly and drink more in hot weather or when you are active.


Foods to avoid during pregnancy

It is important to eat a variety of foods when you are pregnant but there are some foods best to avoid because they can be contaminated with bacteria or parasites.

When you are pregnant is better to avoid:

  • Raw fish, especially shellfish such as oysters and clams
  • Undercooked meat, poultry, seafood and hot dogs
  • All foods made with raw or lightly cooked eggs
  • Unpasteurized milk products and foods made from them
  • Soft and semi-soft cheeses like Feta, Brie, Camembert and blue veined cheese
  • Unpasteurized juices, such as unpasteurized apple cider
  • Raw sprouts, especially alfalfa sprouts

    Source: Health Canada

Make sure you wash your hands often, disinfect your counters and do not use the same preparation area and utensils for uncooked and cooked meat.

For more information about food safety and pregnancy:

Also during your pregnancy it is best for you and your baby to avoid

  • Low-nutritious and high-fat foods: Foods like chips, candies, cookies, pop, and energy drinks provide you with calories, but not the nutrients you and your baby need. It can also lead to an unhealthy weight gain and lead you to eat less of the nutritious food you and your baby need.

  • Alcohol: There is no safe level of alcohol during pregnancy, so avoid all alcoholic drinks.

    For more information:
    Be Safe: Have an Alcohol-Free Pregnancy

  • Caffeine: Caffeine found in coffee, tea, pop and some energy drinks can affect your baby and you. Limit your caffeine intake in pregnancy to 300mg/day (which is not more than 1.5 - 2 cups/day).

    For more information:
    Caffeine and Pregnancy

  • Herbal Teas: Some herbal teas are not recommended during pregnancy. For a list of herbal teas considered safe visit Herbal Teas and Supplements


Weight gain

The recommended amount of weight gain for a healthy baby depends on your weight before pregnancy. Your weight gain supports:

  • The growth of the fetus
  • The growth of placenta
  • The production of amniotic fluid
  • The increase in mom's blood, protein, fluids and fat stores and size of uterus and breasts.

A healthy weight gain can help make a full-term, healthy baby weighing 6.8 to 7.9 pounds (3.1 to 3.6 kg). Most women will need to gain between 25-35 pounds, some a little more, some a little less. Recommendations for weight gain can be different from woman to woman depending on her pre-pregnancy Body Mass Index (BMI).  BMI is a measure that relates weight to height and risk of health problems.

Women who gain too much weight may have health problems during pregnancy and are at risk for a having baby being born preterm or larger than normal. Women who gain too little weight may have a low birth weight baby, which can affect baby’s health. Ideally, the next pregnancy should happen once mom’s weight has gone back to a normal and her nutritional status is healthy.

Recommended weight gain*

Pre-pregnancy BMI category

Recommended range of total weight gain

BMI <18.5
underweight

12.2-18 kg (28-40 lbs)

BMI 18.5-24.9
normal weight

11.5-16 kg (25-35 lbs)

BMI >25-29.9
overweight

7-11.5 kg (15-25 lbs)

BMI >30
obese

5-9 kg (11-20 lbs)

* Canadian Gestational Weight Gain Recommendations (Health Canada 2009)

For more information on weight gain:
Healthy Weight Gain during Pregnancy


For more information about healthy eating in pregnancy:

Region of Peel-Public Health
905-799-7700
Monday to Friday 8:30 a.m. to 4:30 p.m.
Caledon residents call free of charge at 905-584-2216

To speak to a Public Health Nurse or Registered Dietitian

| Healthy Pregnancy |
Health Canada



Prenatal Classes/Programs | Taking Care of Yourself | Eating Healthy
Medical Concerns | Teen Pregnancy | Just for Dads | Contact Us

Revised: Friday January 31 2014

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