Pregnant people experience much distress about eating well. Symptoms like nausea, odor aversion, and increased or decreased appetite are common in the first trimester. Many women report a distaste for certain healthy foods like vegetables and protein and experience cravings for foods with poor nutritional value like potatoes, crackers, and other carbohydrates. When you combine these common changes with the genuine and often intense desire to eat well for the growing baby, it is truly a recipe for disaster. What’s more, the common practice of taking prenatal vitamins may complicate the situation. Women with nausea and poor appetite may feel strongly about taking vitamins out of concern for not getting adequate food intake. Yet, the vitamins may contribute to worsening nausea and vomiting. In the clinic, midwives hear women describe guilt or shame when they are unable to meet their own nutritional expectations.
What is a mama to do?
First, it is important to note that nausea and appetite preferences often improve at the end of the first trimester. In the clinic, I often delay nutritional counseling until the second trimester. In the 1st trimester, I encourage eating small frequent meals. You should include foods that you tolerate well and prioritize foods that are also nutrient-dense. Ask your midwife or doctor about symptoms like nausea. Although it is a common and normal discomfort of pregnancy, we may have strategies to help you feel better. To be concise, the first trimester is mostly about survival, eating what you can.
As your symptoms improve in the second trimester, a good approach is to focus on what healthy foods to include in your diet rather than what to avoid. The physiologic changes that occur in pregnancy cause increased nutritional demands. For example, anemia is common. This happens because your circulatory system is changing dramatically. Your body converts a lot of its stored iron into hemoglobin (the oxygen-carrying part of the red blood cell). This causes your circulatory system has to expand so that it can take care of sending oxygen and nutrients to the new baby. This can cause us to use up iron stores and to continue to need even more iron (half of the building block of hemoglobin). Therefore, iron-rich foods are essential to a healthy pregnancy. Women who are anemic when pregnant experience more fatigue, headaches, and dizzy spells. Below are some ideas to help you in getting more iron.
Good sources of heme iron (from animal sources), easiest to absorb iron:
- Chicken liver
- Beef (chuck roast, lean ground beef)
Good sources of nonheme iron (from plants):
- Raisin bran (enriched)
- Instant oatmeal
- Beans (kidney, lima, Navy) Lentils
- Whole wheat bread
- Peanut butter
- Brown rice
- These tips can improve iron absorption:
- Eat vitamin C containing foods with iron.
- Try not to eat Calcium-rich foods or take a Calcium supplement with iron-containing foods, as it can slow the absorption of iron.
- Cook high acid foods (like tomato sauce), in a cast-iron skillet, as the acid will leach the iron into the sauce.
Another important part of a healthy diet is protein. Protein is one of the essential building blocks of the human cell and helps with the growth of your baby’s tissues and organs. Meat is naturally high in protein. You can add eggs, fish, Greek yogurt, or add protein powder to smoothies if you have difficulty tolerating meat.
Probiotics are helpful in pregnancy and may play a role in preventing gestational diabetes and GBS colonization. Also, they improve immune system function, which is great for pregnant women who have suppressed immune systems. Food sources of probiotics include Nancy’s yogurt, Activia, Danactive, Culturelle, Good Belly, Kefir & traditionally fermented foods like sour kraut and Kimchi.
You will likely feel better about your diet if you focus on adding beneficial foods; rather than obsessing about the ways your diet may be lacking. Simple diet approaches are often the best. Try incorporating more whole foods (fruits & veggies, nuts) and taking special care to add iron-rich foods, probiotics, and additional protein. Honor and recognize the real limitations that come along with being pregnant. This may mean eating french fries occasionally because they taste good or buying frozen veggies because you are too tired to wash and chop fresh produce. Above all, enjoy your meals as a time to nourish yourself and your baby!
by Angie Chisholm, CNM
photo by Emily Rumsey, CNM