Nutrition Guide:
Preconception, Pregnancy, and Postpartum
What's on the Menu?

By Ann Douglas

Wondering how your nutritional needs change once you start trying to conceive?

Flip through this menu for the lowdown on healthy eating from preconception through pregnancy and new motherhood.

Starters
Pre-baby menu

While appetizers don't always get the respect they deserve, on our menu, the pre-baby menu gets star billing. And why not? The most critical period of human development occurs during the first days following conception, long before many women even suspect that they could be having a baby.

So what do you need to know to give your baby the healthiest possible start nutrition-wise? Focus on healthy, balanced eating (use the health tools at myfoodpyramid.com if years of crash dieting have skewed your ideas of "healthy" and "balanced"); ramp up your intake of folic acid; start taking a prenatal vitamin supplement; eliminate alcohol from your diet; and moderate your intake of caffeine. 

You'll also want to skip ahead and read the material in the pregnancy nutrition section because most of that information appears to soon-to-be-pregnant moms, too. Besides, you can never predict when you'll switch from "hoping to conceive" to "actually pregnant" mode. And once you start trying to conceive, you should assume you're pregnant until proven otherwise.

SPECIAL FEATURES!

Pay particular attention to these all-important nutrients.

Folic Acid: Folic acid can reduce by 50 percent your chances of giving birth to a baby with serious—even fatal—birth defects of the brain or spine. You need to consume 0.4 mg of folic acid for at least three months before you intend to start trying to conceive and throughout the first trimester of pregnancy. If you've previously given birth to a baby with a neural tube defect, you will need a dose ten times as high.) The easiest way to ensure that you're consuming enough folic acid is to take a folic acid supplement. A standard prenatal vitamin contains 0.3 mg of folic acid. Food sources of folic acid include legumes, leafy green vegetables, liver, citrus fruits, juices, and whole wheat bread.

Zinc: A reproductive all-star, this trace mineral plays a behind-the-scenes role in ovulation and fertilization in women while maintaining correct semen volume and blood testosterone levels in men.

TIP: Taking a prenatal vitamin before and during pregnancy is a sensible way to hedge your nutritional bets if morning sickness or less-than-ideal eating habits may be making it difficult for you to provide your baby with all the key nutrients through food sources alone. And here's something else you need to know: popping that prenatal vitamin pill may also reduce your baby's odds of developing certain types of childhood cancers, according to a study reported in the journal Clinical Pharmacology & Therapeutics. The researchers involved in the study reported that taking prenatal vitamins before pregnancy and during early pregnancy reduced the likelihood of a child developing childhood leukemia by 36 percent, neuroblastoma (a malignant tumor found in nerve tissue) by 47 percent, and childhood brain tumors by 27 percent.

Entrees:
Eating for two

Pregnancy nutrition means eating with your baby's nutritional needs in mind: investing the extra 300 calories that your body needs each day into nutrient-rich foods. Of course, nutrition may seem like a moot point during early pregnancy, when your definition of a nutritionally successful day may mean venturing beyond soda crackers and flat ginger ale. 

Calcium: Calcium plays a key role in the formation of your baby's skeleton. While it can be obtained through food sources such as milk, dairy products, tofu, vegetables (broccoli), and fish bones (canned salmon and sardines), it doesn't function as a solo act. It relies on its nutritional co-stars phosphorus and vitamin D in order to work its magic, so you'll want to ensure that you're consuming enough of all three nutrients.

Fiber and fluids: Your body's need for fiber jumps to 28 grams per day during pregnancy—up from 20 grams per day during your pre-pregnancy days. To avoid constipation (a problem for 11 percent to 38 percent of moms-to-be) you'll want to ensure that you're balancing that fiber with some physical activity (unless your doctor or midwife advises otherwise, of course) and your recommended daily allotment of fluids (12 cups of liquid per day, which can be in the form of water, milk, juice, or soups).

What's Not on the Menu?  

Certain types of foods are not on the menu for moms-to-be or breastfeeding moms either. Foods that should be avoided include unpasteurized soft cheeses; uncooked deli meats, uncooked hot dogs, liverwurst, pates; raw fish, including oysters, mussels, clams, and sushi; fish containing high levels of mercury (check with your state or provincial health department).

Portion sizes

You don't want to go overboard in the weight gain department, but gaining too little weight can be a problem, too. Not gaining enough weight may program your baby's body to store food in way that can lead to obesity later in life. Researchers have found that fetuses that sense famine-like conditions as a result of their mother's low calorie intakes may program their bodies to store fat more efficiently. When those babies are born into anything-but-famine conditions, they are less sensitive to sensations of fullness, and tend to grow more quickly and store more fat. Your healthcare provider will likely recommend that you gain between 25 and 30 lbs.—and possibly a little more or less, depending on your pre-pregnancy weight; more if you're carrying multiples. You should aim for slow and steady weight gain, with the majority of your weight gain occurring during the last half of your pregnancy. 

Afters:
New Mom Nutrition

Baby is here and everything has changed, including what's on the menu. Meals typically involve shoveling down mouthfuls of a hastily tossed together meal with a baby on your knee or at the breast.

Stay on track nutritionally while caring for your baby. It takes an extra 200 to 500 calories a day to make enough breast-milk to feed your baby, which means most breastfeeding moms need between 2200 and 2900 calories per day. The top nutritional priorities? Liquids (15 cups worth per day) and plenty of iron-rich foods (to help combat new-mom fatigue).

Iron-Rich Foods: Many new moms are slightly anemic by the time they've had their babies, as a result of the blood loss associated with giving birth and the iron-depletion that can occur during pregnancy. Because being low in iron affects your energy level, and you'll need energy as a new mom, it's important to focus on rebuilding your iron stores. Build your meals around iron-rich foods like meat, tofu, beans, lentils, dried fruit, and fortified cereals. Take an iron supplement for at least three months or longer. Team iron-rich foods with foods and beverages that are rich in Vitamin C (which aid in iron-absorption) and avoid consuming foods like coffee and tea that block iron-absorption with your meals.

Food and Mood: Up to 80 percent of new moms experience some degree of the "postpartum blues." Fifteen percent experience symptoms of postpartum depression that are severe enough to require professional help. Here are some ways you can use food to ease your symptoms. 

• Boost your intake of iron-rich foods (or take an iron supplement). Being low in iron may be a risk factor for depression.
• Eat more carbohydrates. If your diet is too low in carbohydrates and your blood insulin level drops too low, you may experience some of the symptoms of postpartum depression.
• Up your intake of omega 3 fatty acids (flax seeds and flax seed oil, canola oil and soy oil, fatty fish like salmon or trout, eggs containing omega 3 fatty acids). These foods may help to prevent and reduce symptoms of postpartum depression.

Weight loss after baby: It took you all those months to gain your pregnancy weight, so it's unrealistic to expect those pounds to disappear overnight—or even by the time you weigh in at your six week checkup. Sure, you want to lose those extra pounds, but there's a right way and a wrong way to do it. Going on a crash diet that brings your daily food intake below 1500 calories is definitely the wrong way to do it: that kind of restrictive eating can reduce the volume of your milk supply, affecting your baby's growth. Your best bet is to combine exercise with a healthy eating program and to find ways to make fitness part of your new family's regular routine. That way, you won't have to make extra time to be physically active (always a challenge when you're a busy new mom): fitness will be come something you do as a family. And you'll be walking the talk of active living for your child. 

Great choice, mom.

Ann Douglas is the author of The Mother of All Pregnancy Books, The Mother of All Baby Books, and numerous other books about pregnancy and parenting.