Pregnancy should be a happy and positive experience for all women.
A positive pregnancy experience involves sound antenatal care along with adequate nutrition both before and during pregnancy.
Good nutrition during pregnancy begins with a healthy diet containing adequate amounts of protein, vitamins and minerals obtained through eating a variety of foods including fruit, vegetables, meat, fish, nuts and whole grains. Not only will healthy eating help to prevent excess weight gain during pregnancy but also has the potential to improve pregnancy and birth outcomes.
Unfortunately, many expectant mothers do not manage to meet their daily nutrient requirements during pregnancy. This is why the World Health Organisation recommends all pregnant women supplement with iron, folic acid and calcium daily1 to support both their own and their unborn baby’s nutritional needs.
Iron contributes to the normal function of red blood cells and haemoglobin. During pregnancy, iron requirements increase because of the increase in blood volume and the requirements of the baby and the placenta. Pregnant women with lower blood iron levels are vulnerable to developing anaemia. Additionally, low maternal blood iron levels have been linked to both low birth weight and preterm births.
Red meat, pulses, nuts, eggs, dried fruits, poultry, fish, whole grains and dark green leafy vegetables are all sources of iron. In the United Kingdom both brown and white flour is fortified with iron by law and many breakfast cereals are also fortified. However levels may not be sufficient for all pregnant women and supplementation should be discussed with your healthcare practitioner.
Folic acid supplement intake increases maternal folate status. A low maternal folate status is a risk factor in the development of neural tube defects (spina bifida and anencephaly) in the developing foetus/baby.
Foods rich in folic acid include broccoli, spinach, beans, asparagus, avocados, oranges, lentils, poultry and liver, so try to add a few of these to your shopping list and experiment with some new recipes.
Folic acid supplementation should be started as early as possible (ideally before pregnancy) to prevent neural tube defects2. This is especially true in the United Kingdom where foods are not fortified with folic acid. A recent UK study found that only 31% of women take a folic acid supplement prior to conceiving3, a worrying figure considering the UK government recommends daily supplementation of 400 mg of folic acid starting 3 months prior to trying for a baby and continuing throughout pregnancy.
Calcium has various health benefits in the body including contributing to normal blood clotting, playing a role in cell division and the maintenance of normal bones and teeth. It is also vital for making your baby's bones and teeth. Most British adults get their calcium from dairy product consumption, according to the British Nutrition Foundation but there are other good sources too including kale, spinach, tofu, almonds and sardines (with bones). A recent study found that the average daily calcium intake in the United Kingdom is approximately 994 mg daily4 which is quite high when compared to other countries but still falls short of what pregnant women need daily.
Taking a multivitamin and mineral supplement formulated for pregnant women which includes folic acid, calcium and iron daily will help to support the body’s increased nutritional demands during pregnancy and should be discussed with your healthcare practitioner. Combining this with an Omega-3 supplement rich in DHA may be a good option too, as a recent Cochrane review found that Omega- 3 supplementation may reduce the incidence of preterm births.5
Taking supplements does not replace a healthy and well-balanced diet and exercise programme.
1. World Health Organization (2016). WHO recommendations on antenatal care for a positive pregnancy experience. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/250796/9789241549912-eng.pdf?sequence=1. Geneva, Switzerland.
2. Wald NJ, Morris JK and Blakemore C. Public health failure in the prevention of neural tube defects: time to abandon the tolerable upper intake level of folate. Public Health Reviews. 2018: 39:2
3. Bestwick JP, Huttly WJ, Morris JK, Wald NJ. Prevention of neural tube defects: a cross-sectional study of the uptake of folic acid supplementation in nearly half a million women. PLoS One. 2014; 9(2): e89354
4. Balk EM, Adam GP, Langberg VN, Earley A, Clark P, et al. Global Dietary calcium intake among adults: a systemic review. Osteoporosis International. 2017 Oct; 28 (12): 3315-3324
5.Middleton P, Gomersall JC, Gould JF, et al. Omega-3 fatty acid addition during pregnancy. Cochrane Database Systemic Review. 2018 Nov 15;11: CD003402