Nutrition before, during, and after pregnancy

You are what you eat!

Good nutrition before, during, and after pregnancy will have a big impact on your baby’s health. Good nutrition will also help you to cope with the physical and emotional demands of nurturing a new life. Before conception, building up your nutrient intake will boost your chances of conceiving. During pregnancy, your baby will be growing and developing rapidly. If you wish to breastfeed your baby after delivery, you also need to make sure that you are well-nourished to cope with the nutritional demand for your growing child.

To better your chances, also encourage your partner to follow a well-balanced diet. This is especially important if you are planning to conceive. If you are making the switch to a healthier diet, it is easier to stay on track if you have someone close to you to keep you motivated. This also allows you both to support each other, and may bring the two of you closer together.

Special dietary considerations

If you are vegetarian or vegan, you are more prone to becoming deficient in some nutrients. Try to maintain your protein intake from a combination of plant sources such as nuts, beans, lentils, and seeds. These foods are also full of complex carbohydrates and fibre, which are good for you. Also be careful to avoid deficiencies in vitamins and minerals, especially vitamin B2, B6 and B12, zinc, iron, and calcium.

1. Before conception

Ensure that you and your partner eat a balanced diet. Good nutrition is essential for optimal fertility for you and your partner. This in turn will reduce the chance of your baby developing abnormalities during the first few weeks after conception.

Ideally, you and your partner’s diet should include a variety of fresh fruits and vegetables, which provide vitamins, minerals and fibre. It should also include food rich in protein, such as lean meat, eggs, beans, and food rich in complex carbohydrates and fibre, such as cereals, bread, pasta, and potatoes. Try to keep your intake of animal fats, salt and sugar to a minimum.

Some of the nutrients that are vital for reproductive health include the A, B group, C, and D vitamins; and minerals including zinc, magnesium, and iodine. Many of these nutrients, including vitamins C and E, are antioxidants. Antioxidants have protective properties, reducing the risk of chemical damage to sperm and eggs. Other nutrients, such as iodine, are critical for your baby’s early development.

It’s worth considering taking supplements containing a good quality fish oil high in DHA, as well as folic acid supplements while you try to conceive. Increased levels of DHA and EPA fatty acids (as contained in fish oil), are associated with fertility. Folic acid (folate), is known to reduce the risk of your baby developing neural tube defects (see below), and some evidence suggests that taking enough folic acid could prevent babies being born underweight.

Neural tube defects

The neural tube is the part of the developing baby that will eventually become the brain and spinal cord. Research has shown that sufficient folic acid in the mother’s blood is essential for the formation of the neural tube. Insufficient folic acid can lead to various forms of neural defects, such as spina bifida and hydrocephalus, which can cause long-term disability for your child.

Spina bifida is a condition where the vertebrae do not develop properly. Normally, your vertebrae act to protect your delicate spinal cord. When the vertebrae do not develop completely, the spinal cord can be exposed and susceptible to damage. Depending on where the defects occur on the baby’s spine, spina bifida can be mild in severity, with no major disability, to more severe cases with leg paralysis, loss of sensation and bladder control.

Hydrocephalus is a condition where excess fluids accumulate within the brain. The pressure build-up from the extra fluids can damage brain tissue and prevent proper brain development. Hydrocephalus can occur by itself, or in combination with spina bifida

You should also avoid certain foods (see below) when trying to conceive, as well as during pregnancy. Many of these foods may contain potential toxins and infections that can harm you and your baby.

Avoid these foods during pregnancy

Unpasteurised milk and milk products, such as soft cheeses
Animal liver and liver products, including pâté and liver sausage
Raw and uncooked cured meat
Raw or partially cooked eggs
Raw shellfish
Unwashed fruit, vegetables and salads
Shark, swordfish, king mackerel

You should also avoid alcohol, tobacco, caffeine, and recreational drugs. Smoking is associated with infertility, difficulty to conceive, and miscarriage. Alcohol can also increase the chance of miscarriage and birth defects. The effect of alcohol is greatest during early pregnancy when your baby and their organs develop rapidly. So it is best to avoid alcohol before conception and throughout pregnancy. Caffeine affects your body’s fluid and mineral balance, so this is best avoided as well.

2. During pregnancy

If you have started to incorporate a healthy and well-balanced diet as part of your pre-conception plan, there is good reason to continue this habit throughout your pregnancy, and beyond.

The first trimester

The first trimester is perhaps the most crucial time for your baby’s healthy development. Around 12 weeks after conception, your baby is fully formed, and the foundation for all the organs, limbs, muscles, bones, the brain and nervous systems will be laid down.

During the first trimester, the mother needs a large amount of protein. You should also make sure you eat enough complex carbohydrates, such as cereals, pasta, and bread, to maintain your energy levels. Folate and iron are two nutrients that are crucial during this time. Folate is required for cell division and the formation of your baby’s nervous system, and you are strongly recommended to take folate supplements to prevent neural tube defects, because it is often difficult to get enough folate from diet alone. Iron is required by your red blood cells to transport oxygen around your body and to your developing baby, as well as for energy generation. Your demand for iron increases during pregnancy because of your increased blood volume during this time.

The second trimester

During the second trimester, you will notice that you have gained weight, and your blood volume will continue to increase. Hormonal changes during this time will start laying down fat deposits in preparation for milk production. By now, your baby’s body “blueprint” will be in place, and will start maturing. Its nervous system continues to develop, with brain cells multiplying at a very rapid rate. The baby’s skeleton will also start to mineralise and strengthen. Key nutrients you will need at this time include calcium, phosphorus, and magnesium.

Calcium is required for strong bones and teeth, to support muscle development, and to control your baby’s nerve and muscle function. Phosphorus, like calcium, is also needed for healthy bones and teeth, energy generation, and milk production. Magnesium is needed for your baby’s liver and heart function, as well as for protein and carbohydrate metabolism. Magnesium also acts in combination with calcium to build muscles and nerves.

The third trimester

During the third trimester, your blood volume is still increasing, so make sure you maintain your iron levels by eating iron-rich foods and vitamin C for good absorption. At the same time, fat deposits continue to be laid down in preparation for milk production. It is better to choose plant-derived oils and oily fish to obtain your fatty acid needs, as these sources contain polyunsaturated (the “right kind” of) fats.

Your baby’s brain is growing faster than ever during this time. Your intake of polyunsaturated fats will also help your baby’s brain to develop. Two types of polyunsaturated fats, the omega-6 and omega-3, are essential for brain function. Good sources for omega-6 include seeds and their oil, while linseed, pumpkin seeds, and oily fish such as tuna are rich in omega-3.

Docosahexaenoic acid, or DHA for short, is one type of omega-3 fatty acid. DHA is incorporated into cell membranes, becoming a major component of brain and eye cells, and promoting good connections between neural cells. DHA may also protect against pregnancy-induced high blood pressure, reduces the risk of premature birth, improves your baby’s brain and eye development, and provides protection against heart disease.

3. After delivery and breastfeeding

A healthy and nutritious diet after birth is equally important as it was before and during your pregnancy. Your body will require energy and nutrients to recover, and to heal, especially if you’ve had a Caesarean section delivery. For breastfeeding mothers, energy and nutrients are required to support milk production. At the same time, you will be adjusting to the additional changes and responsibilities associated with the new baby, such as sleep deprivation. With all this happening around you, it may be difficult to find the time to plan and prepare healthy meals. It may be worth preparing meal plans as part of your preparation for delivery.

Nutrition during breastfeeding

Drink plenty of water, because you can lose more than half a litre of fluid a day. As the main supplier of nutrients to your baby, you should also maintain your intake of the following:

Nutrient	What is it for?	Food sources
Vitamin A	vision, cell reproduction, immune function, growth, reproduction, bone metabolism, skin health, cardiovascular health, antioxidant	liver, carrots, green leafy vegetables, eggs, cheese, apricots, pumpkin, sweet potato, butter, cantaloupe/rock melon
B vitamins (including folate/ folic acid)	red blood cell formation, brain and nerve function, DNA, RNA and protein synthesis, cell metabolism and function, blood sugar maintenance, muscle tone, brain and cardiovascular health	meat, poultry, vegetables, eggs, milk, nuts, wholegrains, green leafy vegetables, seeds, nuts, potatoes, bananas, lentils, chilli peppers, tempe, liver oil, liver, turkey, tuna, yeast
Vitamin C	wound healing, immunity, iron absorption, antioxidant, cofactor for vital enzymatic reactions, carnitine biosynthesis	fresh fruits such as citrus fruits and berries, tomatoes, peppers
Vitamin D	calcium absorption, healthy bones and teeth	milk, oily fish, brown rice
Vitamin E	immunity, cardiovascular health, cell structure integrity and signaling, potent antioxidant	wheat germ oil, nuts, safflower oil, corn oil, soybean oil, olives, and green leafy vegetables
Vitamin K	blood clotting, cardiovascular health	green leafy vegetables, avocado, cauliflower, broccoli, kiwifruit/gooseberries
Calcium	bone health, cell metabolism	milk, nuts, green vegetables, wholegrains, yoghurt seaweed, nuts, oranges, figs
Iodine	metabolism (thyroid hormone regulation) for growth and energy, antioxidant	iodised salt, algae, seafood, seaweed (kelp & nori), animal derived foods (eggs, meat, dairy products)
Iron	red blood cell oxygen delivery, immunity, protein synthesis, enzyme reactions, metabolism	red meat, poultry, dried fruit, green leafy vegetables lentils, beans, tofu, chickpeas
Magnesium	building bones, manufacturing proteins, releasing energy from muscle storage, and regulating body temperature	cereals, grains, vegetables, meat, poultry, fish, nuts, dairy products
Selenium	facilitates vitamin E absorption, elevates antioxidant levels, beneficial for cardiovascular and immune health	plant foods, brazil nuts, tuna, beef, and poultry
Zinc	wound healing, regulates enzyme activity and metabolic activities, cell structure integrity and cell function	red meat, poultry, seafood, eggs, nuts, whole grains, fortified breakfast cereals, and dairy products
DHA	development and maintenance of brain, eye, cardiovascular and immune health, antioxidant	oily fish, flaxseeds, walnuts, soybeans, and tofu
EPA	development and maintenance of brain, cardiovascular and immune health, antioxidant	oily fish, flaxseeds, walnuts, soybeans, and tofu

As with pregnancy, you should avoid alcohol, tobacco, caffeine and recreational drugs while you breastfeed, because these substances will end up in your breast milk. You should also consult your healthcare practitioner before you take any prescription or over-the-counter medication.