We all know that alcohol and pregnancy don’t mix, but is healthy nutrition during pregnancy as simple as just eating more?  Over the years, women have been well informed about the food components to avoid, alcohol and high mercury fish for example.  But, there are many essential nutrients that women need to focus on consuming as opposed to just increasing their caloric intake.  Nutrition during pregnancy has been shown to impact not only the birth weight, gestational age, and nutritional status of the fetus but it also impacts chronic disease states later in the unborn child’s life.   

Facts about Calorie Needs: While women are ‘eating for two’, their calorie needs are not based on this popular phrase.  It’s commonly simplified and said that a woman should increase her calories by 300 a day.  However, the new Daily Recommended Intakes (DRI’s) suggest that a woman’s needs actually begin to increase primarily during the 2^nd and 3^rd trimester to 350 calories a day and then 450 calories a day respectively.    

Boning up with Calcium:  Growing up, we’re encouraged to drink milk for strong bones.  This is even more important for the expectant mom!  The stress of pregnancy on a woman’s bones places calcium at the top of the list of necessary nutrients to consume.  Calcium is needed for bone and tooth formation of the fetus, blood clotting, and blood pressure regulation.  Calcium needs increase as the pregnancy progresses with 80% of the calcium needed during the 3^rd trimester for fetal bone mineralization.  If the mother’s diet is lacking in calcium, calcium will be mobilized from her bones to maintain serum calcium often referred to as “bone thinning”.    

A Closer Look at Folic Acid:  Folate is a B-complex vitamin functioning in the synthesis of amino acids.  Complications in pregnancy such as spontaneous abortions, malformation of the fetus including neural tube defects, and antepartum hemorrhage have been linked to folate deficiency in the mother.  Because of these concerns, the Institute of Medicine recommended in their 1998 report that “women capable of becoming pregnant consume 400 mcg of folic acid daily from supplements, fortified foods or both in addition to folate from a varied diet”.  The 400 mcg daily intake in addition to a varied diet is due to differing absorption rates from sources.  Approximately 50% of folate is absorbed from food, 85% absorbed from fortified foods, and 100% absorption from a supplement.   

Focus on Iron:  Iron is a necessary nutrient thru pregnancy as it functions in red blood cell production, development of the placenta and fetus, and maintaining maternal blood volume.  The need for iron is not consistent thru pregnancy with the greatest demands during the 3^rd trimester.  Iron deficiency anemia can cause several complications in pregnancy including: altered metabolism, decreased oxygen transfer to tissues, higher incidence of premature delivery, and perinatal mortality.  Dietary sources of iron are often not sufficient to meet the increasing needs.  The CDC recommends starting oral, low-dose (30mg/day) iron supplements at the first prenatal visit to help combat anemia.   

The New Kid on the Block: Ω-3 Fatty Acids:  Research on Ω-3 fatty acids is fairly new and has not conclusively shown the necessary intake of a mother during pregnancy.  What we do know is if a woman consumes a diet high in Ω-3s, EPA and DHA are incorporated into the fetus’ cell membranes.  A correlation has also been found between intake of DHA and birth weight.  As the fetal and cord levels of DHA increase, so does the baby’s birth weight.   Even though research is still inconclusive, it’s an exciting emerging nutrient.  Optimal levels of intake have yet to be determined, but most experts are currently recommending a supplemented intake of 200 – 300 mg of DHA per day, which appears to be safe consumption.  Good sources of DHA are found in marine oils and fish, specifically: sardines, mackerel, trout, bluefish, and salmon.   

DRIs in Pregnancy for Women ages 19 – 50 years

While an expectant mom doesn’t have the calorie needs of “eating for two”, she should follow this philosophy in how she choose the types of food she consumes.  As you can see from our closer look into several nutrients, what food mom chooses impacts her baby directly.  Help babies come to the world with one step ahead in their health!