Healthy Mom, Healthy Baby. Drea Woliczko, MPH Health Education Worksite Consultant Kaiser Permanente

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1 Healthy Mom, Healthy Baby Drea Woliczko, MPH Health Education Worksite Consultant Kaiser Permanente

2 Pregnancy and Nutrition While you are pregnant, you supply everything your baby needs to grow. Eating a healthy diet during pregnancy is one of the best things you can do for yourself and your baby. After all, the food you eat is your baby's main source of nutrition. Smart choices about pregnancy nutrition can help you promote your baby's growth and development

3 Foods Tips During Pregnancy Raw or uncooked meat, chicken, or fish Cook ready to eat meats such as hot dogs and deli meats (ham, bologna, salami, and corned beef) until they are steaming hot. Do not eat refrigerated pate, meat spreads, or smoked seafood. Canned or shelf stable pates, meat spreads, or smoked seafood may be eaten Eat Tuna in moderation (no more than 2 days a week- 5-6oz per week) Avoid fish with high mercury levels such as shark, swordfish, king mackerel, and tilefish.

4 Foods Tips During Pregnancy The U.S. FDA advises that pregnant women, women of childbearing age, nursing mothers, and young children can safely eat 12 ounces per week of cooked fish (about 2 or 3 meals). Do not drink raw (unpasteurized) milk or foods that contain unpasteurized milk. Do not eat soft, unpasteurized cheeses. Hard cheese, processed cheese, cream cheese, and cottage cheeses are safe. Do not eat raw sprouts, especially alfalfa. Limit the amount of liver you eat. Liver is the only food that excessive amounts of vitamin A. Limit caffeine to mg per day.

5 Eating for Two.Not Really! The Institute of Medicine Recommendations for Energy Intake while pregnant: 1 st Trimester: no additional calories 2 nd Trimester: 340 kcals 3 rd Trimester: 452 kcals Breastfeeding: 500 kcals Quality over Quantity - Choose high quality healthy food options that are nutrient rich. - Be mindful of the amount of high calorie nutrient poor foods in the diet - The developing baby is directly impacted by the nutrient quality of the food the mother eats - Educate family members of the needs during pregnancy My Plate:

6 Food Groups Bread and other whole grains Examples: 1 slice of bread 1 tortilla 1 cup dry cereal ½ cup hot cereal ½ cup cooked rice, noodles, or pasta 6 whole grain crackers Vegetables 1 cup raw or cooked vegetables 1 cup green salad 1 cup steamed broccoli Recommended Amounts You Need Every Day 6-10 servings For example: 2 slices of bread from sandwich = 2 servings 2 ½ - 3 ½ cups For example: 1 cup raw carrots = 1 vegetable serving Fruits 1 medium piece of fresh fruit 1 cup fresh fruit 1 ½ - 2 ½ cups For example: 1 4oz apple or ½ banana = 1 fruit serving Milk and Milk Products 1 cup low fat or non-fat milk or yogurt 1 ½ oz low fat cheese 2 cups cottage cheese 1 cup soy milk (Calcium fortified) 3 cups For example: 1 cup low fat yogurt = 1 milk serving Meat and Beans 1 oz lean meat, chicken, turkey, or fish 1 cup cooked beans or lentils ½ cup tofu 1 egg 1 tbsp peanut butter ¼ cup nuts and seeds 5-7 oz = 5-7 servings For example: 1 oz turkey from sandwich = 1 oz of meats and beans

7 Nutrients of Concern There are 3 vitamins and minerals that are especially important for you and your growing baby: calcium, iron, and folate. All women at child bearing age should be supplementing with a prenatal multivitamin Calcium Iron Rich Foods Folate Rich Foods Daily Need: 1200mg per day Dairy products Tofu (calcium fortified) Almonds Broccoli Green Leafy Vegetables Daily Need: 30-60mg per day Lean Beef Chicken Turkey Green leafy vegetables Lentils and beans Iron fortified cereal Dried Fruits (raisins, prunes, apricots) Daily Need:.4 milligrams per day Dark green leafy vegetables Broccoli Asparagus Folate fortified breakfast cereals Peanuts and almonds

8 Sample Menu Breakfast ½ cup sliced melon 2 slices of whole wheat toast 1 boiled egg 1 tsp margarine 1 cup nonfat or lowfat milk Morning Snack 6 whole grain crackers 1 tbsp peanut butter Lunch 1 bowl of black bean soup 1 roll 1 cup salad with 1 Tbsp. dressing 1 cup nonfat or lowfat yogurt Afternoon Snack 1 corn tortilla 1 ½ oz lowfat cheese Dinner 3 oz sliced chicken 1 cup mixed vegetables (like chopped peppers, carrots, and broccoli) ½ cup steamed rice Evening Snack 1 medium peach 6 oz plain greek yogurt

9 Healthy Weight Gain What is a healthy weight gain? The recommended amount of weight you should gain throughout your entire pregnancy is about 25-35lbs. Recommended to gain 1lb/ month in the first 3 months Recommended to gain 1lb/ week during the last 6months Women who gain too much weight are at increased risk of Having a premature baby Larger than average baby Diabetes and high blood pressure Weight status at beginning of pregnancy Underweight (BMI less than 18.5) Normal (BMI ) Overweight (BMI ) Obese (BMI 30 or greater) 1 st trimester 2 nd Trimester 3rd Trimester Over 9 months 1 4.5lbs Slightly over 1lb/ wk Slightly over 1 lb/ wk 28-40lbs 1 4.5lbs About 1 lb/wk Slightly over 1 lb/ wk 25-35lbs 1 4.5lbs Slightly over ½ lb/wk Slightly over ½ lb/ wk 15-25lbs 1 4.5lbs Slightly under ½ lb/wk Slightly under ½ lb/wk 11-20lbs

10 Do Not Diet During Pregnancy Your weight gain is very important for the normal growth and development of your baby. If you do not eat enough of the right foods, your baby may not get important nutrients he/she needs. Eat recommended amounts of healthy foods Do not try to lose weight. Wait until after you finish breastfeeding to try to loose weight. Here is an approximate breakdown of your weight gain: Weight Distribution 7.5 pounds Average baby s weight 7 pounds Extra stored protein, fat, and other nutrients 4 pounds Extra blood 4 pounds Other additional body fluids 2 pounds Breast enlargement 2 pounds Uterine enlargement 2 pounds Amniotic Fluid 1.5 pounds The placenta

11 Common Nutrition Related Problems Associated with Pregnancy Nausea and Vomiting/ Hyperemesis Dietary modification are the first line treatment: Eat small, frequent meals Avoid smells or textures associated with nausea Often bland tasting, cold, high carbohydrate, low fat meals are the best tolerated. Eat higher carbohydrate in the morning often helps Sour and tart (ex. Light Lemonade, Pregipops, Pregidrops) Supplementation of B6 has also been associated with relief of symptoms. Consult Practitioner. Reflux Tums can assist in alleviating symptoms and are considered safe Keeping upright for 1-2 hours after a meal Eating smaller meals Drinking between meals instead of during meals Avoid or limit coffee, acidic foods, minty foods, and chocolate

12 Common Nutrition Related Problems Associated with Pregnancy Cravings and Aversions Several theories as to why women experience cravings and aversions. If you crave Try eating... Ice Cream Cola Doughnuts/pastry Doughnuts/pastry Cake Sugar-coated cereal Nonfat frozen yogurt, sorbet, or sherbet Mineral water with fruit juice or lime Whole-grain bagel with fresh fruit jam Whole-grain bagel with fresh fruit jam Low-fat banana or zucchini bread Whole-grain cereal or oatmeal, with brown sugar Potato chips Low-sodium, low-fat chips, popcorn, or pretzels Sour cream Sundae toppings Canned fruits in heavy syrup No-fat sour cream or non-fat plain yogurt flavored with herbs Fresh berries or bananas Fresh fruit, frozen unsweetened fruit, fruit packed in water Lunch meats Low-fat or fat-free meats, turkey or soy Bologna, beef hot dogs Whipped cream Ice cold no-fat milk whipped with a hand-held immersion blender

13 Common Nutrition Related Problems Pica Associated with Pregnancy Pregnant women may occasionally crave nonfood items such as ice, flour, corn starch, dirt, clay, paper and even paint chips. Signal of iron deficiency A women experiencing these cravings needs to resist the craving and speak with physician immediately.

14 Healthy Mommy, Healthy Baby Take care of Mommy to Be. Take a prenatal multivitamin / mineral supplement Eat well balanced meals with a variety of healthy food. Avoid fast food with high fat and calories. Keep healthy snacks available to eat during the day. Read labels so you know what you are eating. Drink oz glasses of water Limit or omit coffee, tea, and other caffeinated drinks (like colas). Stay active! Do some physical activity every day such as walking unless your practitioners tells you to rest more. Let go of the superwoman syndrome at home and at work. Ask your partner and other family members for help with housekeeping and cooking.

15 Childbirth Preparation Classes Kaiser Permanente Health Education Childbirth Preparation Classes A wonderful class where moms to-be and their birth partner. 3 classes Baby care basics, breast feeding with success, and expectant parent class Classes offered at Van Buren Medical Building 3 evenings or 2 Saturday classes Call Health Education at to schedule Fee: FREE

16 References Bouchez, C. Your Perfectly Pampered Pregnancy: Health, Beauty and Lifestyle Advice for the Modern Mother-To-Be. Brown, Lisa S Chapter 1: Nutrition Requirements During Pregnancy. Jones and Bartlett Publishers, LLC. Institute of Medicine Dietary Reference Intakes for Life Stages. Retrievedhttp:// ty%20files/nutrition/dris/5_summary%20table%20tables%201-4.pdf. The Permanente Medical Group, Inc Healthy Beginnings: Prenatal Newsletter. Issue 1:6-10weeks.