Pregnancy guide


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Pregnancy guide

  1. 1. Your Wellbeing, LLC Pregnancy Guide The following are a list of educational material available to Your Wellbeing, LLC patients. This information (including diet plans) can be found on Your Wellbeing’s health portal under the Diet section tab. Please note that each educational listing is specifically designed to assist a patient’s eating habits based off the correlating condition specified in the diet. These diets may not be used by anyone and everyone. If you have other health related issues that might be affected by our diet plans please contact a doctor for further guidance. DIET DURING PREGNANCY AND LACTATION Purpose: The diet in pregnancy and lactation is designed to promote optimal nutrition for the woman and fetus in pregnancy and for the mother and infant during lactation Use: It is used to meet the increased nutritional needs of the pregnant or lactating woman. Research indicates that well-nourished women are more likely to produce healthy, normal babies. During pregnancy, your body requires additional calories and nutrients to nourish you and your baby. After pregnancy, nutrition remains important, especially if you plan to breast-feed your baby. Also, make sure to drink plenty of fluids to prevent constipation; try juice, milk, or water. Check with your doctor about taking a multi-vitamin with iron. Dietary Guidelines During Pregnancy • A healthy diet for a pregnant woman should be nutrient-dense and will require more calories, protein, iron, calcium, folate and, for some women, vitamin D. • Maintain a steady rate of weight gain. Aim for about three to four pounds total during the first trimester and then about three to four pounds each month during the second and third trimesters. An average-sized woman can expect to gain between 25 and 40 pounds overall. • Excessive use of salt should be restricted in order to avoid high blood pressure. • Avoid food that has raw and rarely cooked ingredients. Foods such as soft cheese (feta and Brie) and unpasteurized milk and juices (these foods have not been pasteurized, meaning they have not gone through the process to kill the germs present) and raw cookie dough (salmonella can be present in the eggs). • Wash all fruits and vegetables before preparing. This removes the pesticides and bacteria that may be present on them. • Avoid shark, swordfish, king mackerel, tilefish, and most fresh fish. They contain high levels of mercury, which may cause birth defects. • Excessive caffeine should be avoided. You should drink no more than one cup of coffee a day. GENERAL MEAL PLAN FOR PREGNANCY AND LACTATION FRUITS AND VEGETABLES (1/2 cup, 1 piece) 5-9 servings each day Include at least 1 vitamin C rich source and 1 vitamin A rich source- See list below for rich sources of vitamins C and A in fruits and vegetables Vitamin C Rich Foods Each serving provides 30 milligrams vitamin C. In addition, many of these foods are also good sources of vitamin B6 and folate, as well as vitamin A and fiber. Fresh, frozen, or canned forms may be used. Choose at least 1-2 servings/day
  2. 2. • 6 oz. orange, tomato, vegetable, lemon, or grapefruit juice • 6 oz. fruit juices enriched with vitamin C • 1 orange, kiwi, guava, or lemon, mango, papaya, • 1/2 cup strawberries • ½ cup cubed cantaloupe • 1 medium sapote • 1/2-cup broccoli, cauliflower, cabbage, snow peas, or Brussels sprouts, cooked • ½-cup sweet, hot or chili peppers, cooked, • 2 medium tomatoes • 1/2 cup tomato puree, or paste • 2 medium tangerines • 1/2 grapefruit • 2 tbsp. hot peppers, raw Vitamin A Rich Foods Each serving provides 2000 IU vitamin A. In addition to vitamin A, all these foods contain fiber, and the dark leafy vegetables are also generally good sources of vitamin B6, folate, and magnesium. Choose at least 1-2 servings/day • 6 oz. apricot nectar or vegetable juice • 3 medium or ¼ cup dried apricots • 1/4 cup cantaloupe or mango • 1/2 cup carrots • ½ cup cooked Swiss chard, bok choy • 3/4 cup raw or 1/2 cup cooked spinach or bok choy • 2 medium tomatoes • 1/2 cup cooked greens, dandelion, kale, mustard, turnip, collards • 1/2 cup sweet potato, winter squash, or pumpkin • 1/2 papaya BREADS & GRAINS (1 slice, 1 oz. or 1/2 cup) 6 (7 for lactation) -11 servings each day • Whole-grain or enriched breads, bagels, tortillas, English muffins, crackers, hamburger/ hot dog buns, dinner rolls, and pita bread • Whole-grain or enriched ready-to-eat cereals and cooked cereals such as oatmeal, grits, and farina • Whole-grain or enriched rice, spaghetti, macaroni, or other type of noodles • Pancakes, waffles, pretzels, and rice cakes MILK & DAIRY (1 cup or 1 oz.) 4 cups or more each day • Milk and milk products like yogurt, cheese and cottage cheese • Soymilk MEAT (1 oz. or 1 egg) 7 servings or 1-4 servings of Meat Substitutes each day
  3. 3. • Beef such as sirloin, round, chuck • Pork such as tenderloin • Lamb such as chops or leg • Veal, chicken and turkey • Canned light tuna; salmon (farm raised or wild salmon) • Eggs (Or) MEAT SUBSTITUTES (1-4 servings each day) Bean and Soy Products (3 to 4 servings/day) • 1/2 cup cooked beans and peas, tofu, tempeh (3/4-1 cup) • 4 ounces tofu or tempeh • 8 ounces soymilk Nuts, Seeds, Wheat Germ (1 to 2 servings/day) • 2 tablespoons nuts or seeds • 2 tablespoons peanut butter • 2 tablespoons wheat germ FATS & SNACKS 3 servings a day Foods in this group add flavor and pleasure to eating but provide mostly calories with few or no nutrients. Include moderate amounts occasionally: bacon, butter, candy, cream, cream cheese, frosting, fruit drinks, gelatin desserts, honey, jam, jelly, lard, margarine, mayonnaise, molasses, popsicles, salad dressings, shortening, soft drinks, sour cream, sugar, syrup, vegetable oil While all nutrients are important at these times, your body has increased needs for folate (a vitamin), iron, and calcium. You need to plan your diet to include foods rich in these nutrients. Iron Rich Foods: A high intake of vitamin C will help increase iron absorption • Liver, beef, pork, veal, Lamb, turkey • Iron enriched breads and cereals • Dried beans, brewer’s yeast, green leafy vegetables raisins, dried prunes, apricots • Blackstrap molasses • Nuts and seeds Women in the second half of pregnancy have very high iron needs and may need to take a supplement regardless of the type of diet they follow. Your health care provider will discuss iron supplements with you. Folacin Rich Foods: • Green leafy vegetables (spinach, beet, and turnip greens), kidney, liver, beef, brewer’s yeast, wheat products, eggs. Calcium Rich Foods: • Milk group (milk, yogurt, cottage cheese, cheese). • Fish with bones (canned salmon), tofu • Dark leafy vegetables, bok choy, broccoli, beans • Figs, sunflower seeds, tahini, almond butter
  4. 4. • Calcium fortified soymilk, juices and cereals NAUSEA & VOMITING DURING PREGNANCY Nausea or vomiting, sometimes called morning sickness, may occur during the early months of pregnancy. It usually disappears after the third month. These suggestions are not to be followed if you have diabetes.  If you have this problem, try the following: • Before you get out of bed in the morning, eat a few crackers, a handful of dry cereal, or a piece of toast or dry bread or a slice of ginger. Put these within reach of your bed the night before • Try a snack (e.g., yogurt, milk, juice, bread, a small sandwich) before going to bed or during the night • Avoid brushing your teeth immediately after eating and the first thing in the morning • Get up slowly in the morning. Avoid sudden movements. • Try drinking mint tea • Eat 5 or 6 small meals a day. Never go for long periods without food • When you feel nauseated between meals, drink small amounts of apple juice, grape juice, nectars, or carbonated beverages • Avoid greasy and fried foods. These include butter, margarine, mayonnaise, bacon, gravies, piecrusts, pastries, fried meats, and French fries • When you cook, open windows or use the exhaust fan to get rid of odors • Be sure to have plenty of fresh air in the room when you sleep • Drink fluids, including soups, one hour before or after eating. Avoid liquids with meals. • Eat foods that are simple to prepare such as broiled, baked, or boiled meals • Eat unseasoned and mild-flavored foods. Avoid foods cooked with pepper, chili and garlic. • Eat slowly and chew food well • Rest after meals, but do not lie down for at least two hours after eating • Try frozen fruit-juice bars, or ice cubes made from clear fruit juices since they can be soothing • Try freezing favorite beverages in ice cubes • Try pudding pops, puddings, custards, and gelatin desserts • Sip beverages through a straw to avoid overpowering aroma • Try chilled foods such as cottage cheese with fruit, chicken or tuna salad • When you are feeling good, eat complete meals to help tide you over during the periods when you do not feel like eating • Drink clear, cool beverages (such as ginger ale, lemon-lime soda, Kool-Aid, punch, and apple juice) and try clear soups (such as broth) and gelatin, particularly between meals. LEG CRAMPS DURING PREGNANCY Leg cramps are very common among pregnant women in the second and third trimesters. Fortunately, there are ways of both preventing and alleviating leg cramps. While the cause of leg cramps during pregnancy is unknown, it is thought that they may be due to a neuromuscular irritability caused by an excess of phosphorus and a shortage of calcium circulating in the
  5. 5. blood. It has also been suggested that a shortage of magnesium may be responsible. Magnesium aids in the function of nerves, bones and muscles; muscle spasms are a classic symptom of magnesium depletion. Normalizing of the levels of calcium, magnesium, and phosphate in the body may thus prevent leg cramps. 1. Increase your intake of calcium and magnesium. If dietary intake is inadequate, taking a calcium supplement (up to 600 mg daily) and a magnesium supplement (320 mg daily) may be helpful. Supplements containing calcium phosphate should be avoided. 2. Eat three servings of milk products or nondairy calcium-rich foods daily to ensure adequate intake of calcium. Additional servings should be avoided, because the extra calcium and phosphorus provided may decrease magnesium absorption. 3. Avoid excessive intake of protein and phosphorus (phosphate) in the diet. Do not eat more than the recommended number of servings of protein foods and of milk products from the General Meal Plan for Pregnant Women . Decrease intake of processed foods and carbonated beverages. Protein and phosphorus may decrease absorption and retention of calcium and magnesium. 4. If you do get a cramps in your calf, straighten your leg and flex your ankle and toes slowly up toward your nose. Try not to point toes, particularly while lying in bed.  This should lessen the pain. Standing on a cold surface sometimes works as well. Don’t message or apply heat. HEARTBURN DURING PREGNANCY Early in pregnancy your body produces large amounts of progesterone and estrogen, which tend to relax smooth muscle tissue everywhere, including the stomach.  As a result, food sometimes moves more slowly through your system, resulting in bloating and indigestion.  Heartburn results when the ring of muscle that separates the esophagus from the stomach relaxes, allowing food and harsh digestive juices to back up from the stomach to the esophagus. The symptom is most likely to occur when lying down or bending over, particularly during the last months of pregnancy when the baby puts pressure on the digestive organs.  Try the following suggestions to help prevent heartburn: • Eat small, frequent meals (eat every few hours) • Avoid gas-forming foods such as broccoli, cabbage, cauliflower, onions, green peppers, Brussels sprouts, beans, and carbonated drinks • Go easy on greasy, fried, and spicy foods • Try sipping on water, milk, or eating a tablespoon of yogurt • Eat slowly and chew foods well • Drink liquids, including soups, one hour before or after meals rather than with meals • Do not lie down for two hours after eating • Go for a walk after eating • Cut down on beverages that contain caffeine such as coffee, tea, chocolate and colas • Avoid  cigarettes • Drink plenty of fluids (at least six 8-oz glasses) daily • Try wearing comfortable clothing that is loose around the waist • Try sleeping and resting with the head slightly elevated CONSTIPATION DURING PREGNANCY
  6. 6. Constipation is a common problem during pregnancy. Constipation refers only to bowel movements that are hard in consistency or painful to eliminate. Infrequent bowel movements (e.g., less than once daily) are not unusual.  During pregnancy the muscles in your intestines become more relaxed causing constipation.  In the last months of pregnancy, the growing baby puts pressure on the lower intestines and this may also cause constipation.  Medication can induce constipation such as supplemental iron and calcium.   Other contributing factors include hormonal changes that cause the intestinal tract to slow down, prolonged immobilization (bed rest), little exercise, inadequate intake of fiber and fluids, irregular eating habits, and possibly stress.  Suggestions for preventing or treating constipation are as follows:  • Increase your intake of high-fiber foods such as unrefined grains, fresh fruits, and vegetables. • Try softer high fiber foods such as oatmeal, applesauce, legumes, bran muffin, cooked prunes, prune juice, and barley to help soften the stool. • Try 2 tsp. of unprocessed bran with meals. • Drink plenty of liquids (at least six 8-oz glasses daily). • Exercise daily such as a half-hour walk after meals • Eat small meals and chew foods well. • Try several cups of warm-to-hot liquid in the morning to distend the stomach and stimulate the bowels. Constipation and straining may lead to hemorrhoids.   Tell your doctor or nurse if you have painful or bleeding hemorrhoids.  They will tell you the best way to take care of yourself. Medicines to Avoid Do not use of any type of laxative other than bulk-producing ones unless under the supervision of the health care provider. Some (e.g., castor oil, Ex-Lax, Cascara, Senokot, Bisacodyl suppositories) may be too strong or may contain substances that could be harmful to the baby.