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  • Maternal Health

    Being an expectant parent can be an exciting yet anxious time of our lives.

    Endless questions and opinions surround the topics of what and how to eat and this article aims to provide an overview surrounding the latest research into nutrition and exercise recommendations to ensure optimal health for you and your baby.

    Which nutrients are key during pregnancy?

    Vitamin D and calcium are essential, as they are needed to develop the baby’s teeth and bones in the 3rd trimester, as well as for your own health and reducing the risk of osteoporosis. If you are low in calcium, your baby will usually take what it needs first so it could be you that suffers from insufficient intake.

    Iron can also be a key nutrient, as without sufficient amounts we are likely to feel fatigued and low-energy.

    Iodine, as well as omega-3 fatty acids, are also fundamental nutrients, especially in the 3rd trimester when brain development is accelerated. Dairy is a key source of iodine, and if you do not eat dairy, make sure to opt for iodine fortified non-dairy products. Sources of omega-3 include oily fish such as salmon, as well as DHA-enriched eggs and seaweed. If you are plant-based or do not consume oily fish, it may be worth taking an algal oil supplement containing 500mg of EPA and DHA (combined) per day. However, oily fish can contain pollutant chemicals so it is best to limit intake to a maximum of twice a week during pregnancy.

    When trying to conceive, remember that the nutrition of your male partner is also a part of the puzzle, and a sufficient intake of nutrients and minerals is essential to produce healthy sperm and thus a baby. Reducing alcohol intake is also recommended for the male partner.

    Should I take a supplement?

    It is recommended to begin taking a daily 400ug (micrograms) folic acid supplement from when you are looking to conceive, combined with increasing the folate in your diet so that when you do become pregnant you have adequate stores. Rich sources of folate include dark leafy greens, lentils, and nuts. Folate helps with the foetus’s early development and spine formation, so taking a folic acid supplement until around week 12 of pregnancy should be sufficient. Specific groups such as diabetics or those suffering from epilepsy may require a higher dose than this – so ensure you check with your GP.

    It is recommended like the rest of the UK population to take a daily 10ug (micrograms) or 400 unit vitamin D supplement in winter months (October – April) when UV rays from the sun are not adequate to provide us with vitamin D.

    There is also the option of taking a pregnancy multivitamin to safeguard your nutrient intake when pregnant. Always keep in mind however that a multivitamin is not a replacement for a balanced diet, and you should still aim to eat a rich and varied diet whenever possible.

    What foods should I eat?

    Research suggests that a Mediterranean diet can be beneficial during pregnancy as it follows the recommended principles of eating wholegrain carbohydrates, nuts, seeds, as well as fruits, and vegetables.

    Diarrhoea and constipation can be common during pregnancy so these foods are additionally high in fibre, which may help to decrease the severity of gut symptoms. You could try grating some apple into a porridge, or having a small side of vegetables or salad alongside your dinner.

    How much should I be eating in each trimester?

    Whilst ‘eating for two’ is a habitual comment you may hear in regards to pregnancy, current guidelines recommend that in trimester 1 and 2, eating as you normally would is sufficient. Only in the 3rd trimester is it recommended to aim for an extra 200 calories (kcal) per day. This could look something like:

    – Half of a sandwich
    – A boiled egg or baked beans with a slice of toast
    – One medium-sized avocado
    – A small to a medium-sized smoothie

    Our demands for calcium and iron increase slightly during the final trimester, so it’s important to try to incorporate these nutrients in when you can.

    Be sure to listen to your body and honour your hunger first and foremost – if you are feeling tired, a snack may be beneficial, but on other days you may not feel hungry enough to eat more and that is ok.

    What should I avoid?

    – Liver and liver products including cod liver oil
    – Supplements containing Vitamin A
    – Cured and uncooked meats
    – All types of pate (including vegetarian)
    – Mould-ripened soft cheeses and blue cheeses such as Brie, Camembert, and Gorgonzola.
    – Swordfish, shark, marlin and other predatory fish as they may contain high levels of mercury
    – Limit oily fish to no more than 2 portions per week and tuna steaks to 2 per week (or 4 cans of tuna per week)
    – Raw or partially cooked eggs
    – Limit caffeine to 200mg a day. This usually amounts to around 3-4 cups of tea or 2-3 coffees. If you are buying your drink from a café however, you may want to check the caffeine amounts with your barista, as they can be significantly higher.
    – All alcohol. Whilst there is some evidence that small amounts of alcohol may cause no harm to your baby, there is still no proven safe level at any point in pregnancy.
    – Ibuprofen is not recommended during pregnancy, but paracetamol is – ensure that it is not a ‘plus’ or ‘extra’ variety, as this may contain high amounts of caffeine.

    Can I exercise?

    In short, the answer is yes. This could look very different between individuals so recommendations are to do what feels comfortable and achievable for you.

    Physical activity during pregnancy has been shown to allow women to cope better with the bodily changes that take place during this period. Furthermore, research has been shown to decrease the odds of developing major complications including high blood pressure, pre-eclampsia, gestational diabetes by up to 40%, as well as depression by 70%.
    Current guidelines recommend that for healthy women, up to or within 150 minutes of moderate aerobic or strength activity per week poses no risk to pregnancy, birth, or postnatal outcomes for mother or baby.
    Exercise is not recommended in excessive heat or humidity, as well as exercises that involve physical contacts such as rugby, or pressure changes such as scuba diving or high altitudes (unless acclimatised).

    Remember that some exercises may need to be amended or modified to protect your body – particularly joints, the abdominal wall, and the pelvic floor.

    How can I alleviate symptoms such as nausea, heartburn, constipation, and diarrhoea during pregnancy?

    – Allow adequate rest
    – Light exercise is recommended
    – There is anecdotal advice that herbal teas such as ginger, lemon, mint, and chamomile can help, but there is no solid research surrounding this and the NHS recommends limiting intake to 4 cups/day.
    – Find out if there is a trigger for you – e.g. juices, spicy or fatty foods, and try to cut this out of the diet to see if there are improvements
    – Opting for more plain and bland foods such as crackers or toast may help to provide nutrients without triggering a nausea reflex.
    – Eat smaller and more often – you still need energy throughout the day, but this may stop you from feeling too over-full or overeating when having 3 larger meals.
    – Ask your Kamsons pharmacist for recommendations of over-the-counter preparations to help manage your symptoms
    – Speak to your GP who may be able to prescribe anti-sickness or anti-acid medication.

    If you are not passing urine or managing to keep anything down, seek medical assistance as soon as possible.

    References:

    https://www.nhs.uk/conditions/pregnancy-and-baby/healthy-pregnancy-diet/

    https://www.nhs.uk/conditions/pregnancy-and-baby/pregnancy-exercise/

    https://www.nhs.uk/conditions/pregnancy-and-baby/foods-to-avoid-pregnant/