By: Kate Brown, BSHN
Disclaimer: This post was written as an educational tool and guide for the healthy woman during pregnancy. It is not intended to be used as a substitute for professional help or to diagnose or prescribe for any illness or disease. The author is not a medical or naturopathic doctor and does not dispense medical advice or prescribe the use of diet, herbs, supplements, or other healing modalities as a form of treatment for any person or symptom of disease. If you choose to use any of the information contained in this publication without the approval of a health professional, that is your right. If you feel you have a disease or condition during pregnancy, you should seek the advice of your medical doctor.
My sister in law called me the other day with a question that many pregnant women in their third trimester ask, “Is it normal for my feet and hands to be swollen? What do I do about it?” I asked her if her doctor had anything to say and she said that pregnancy nutrition was not discussed, especially as a remedy to a “pesky” problem like swollen feet.
However, I told her that her symptoms, that are generally regarded as a “normal part of pregnancy,” can be a sign of protein deficiency that could become more serious if ignored and to include one more protein rich snack before going to bed each night. It helped almost immediately. Simple right? Nutrition can be that profound. A lack of nutrition during pregnancy can be equally impactful – especially when the female body is morphing, changing, preparing for breastfeeding, and growing inside of them a developing human being.
Pregnancy Nutrition in the United States
Nutrition is not a topic commonly discussed in great detail from physician to patient in our Western medical model. The subject is given slightly more credence if the patient is a woman-with-child, but even then, conventional ideas about nutrition are insufficient to inspire a wide culture of fertility and vibrant health during pregnancy.
In fact, the contrary is sad but true. The U.S. ranks as one of the lowest in fertility rates and 26th for infant mortality rates compared to 171 other countries! As “advanced” as we are in America, you’d think we could do better than that. I believe we can.
Most American women do not meet the daily recommended intake values for power nutrients important during pregnancy.
Unfortunately, it seems the stories of women with healthy enjoyable pregnancies and deliveries are shadowed by the anxiety and fear projected into our collective consciousness and birth culture. I believe this fear is even being capitalized on in our current system and we have come to treat pregnancy as a pathological event rather than a normal healthy physiological process.
The ailments experienced in birth – while many of them common – are not normal when most can be easily prevented or addressed with proper nutrition. And most American women in general (especially during pregnancy) do not meet the Daily Recommended Intake values for the power nutrients important in all trimesters including B6, D, E, folate, iron, zinc, calcium, magnesium, protein, trace minerals, water, and healthy fats.
The Basics of Nutrition During Pregnancy
Before exploring the unique nutritional needs of each trimester, let’s begin with a simplified overview of the basics to make sure your pregnancy nutritional needs are covered:
1. Eat a whole foods based diet, ideally with a primal/paleo approach.
Eliminate processed foods and sugars and include dairy and grains only on a minimal basis and only if well tolerated. Follow this general pregnancy nutrition guide for each meal:
- Fermented (sourdough)
- Organic (raw or non-homogenized, when available)
- Grass-fed butter like KerryGold or Anchor brands are a great choice.
- Base meals on 3-4 ounces of well-sourced meat, fish or eggs
- Many practitioners advise their pregnant clients to aim for a daily protein intake of 80-100 grams for best outcomes.
Fruits and Vegetables:
- Eat a copious amount of vegetables (especially green)
Enjoy few lower sugar fruits
Why Are Whole Foods Ideal for Pregnancy Nutrition?
Research has shown that pregnancy complications can be directly caused by malnutrition. Eating a balanced whole foods diet (unprocessed nature-made foods) is the best assurance of a healthy pregnancy. Protein during pregnancy is of highest priority. Most of the body, and that of the baby’s, is made from the “building blocks” of protein and life called amino acids. These are the primary material used for the development of muscle, nerves, bone, blood, organs, glands, skin, hair, and nails. Of the 22 amino acids that make up human tissue, eight of them are essential because they cannot be made by the body. They must be supplied by the diet from complete protein sources.
Tom Brewer, M.D., co-author of What Every Pregnant Woman Should Know, the Truth About Diet and Drugs During Pregnancy, researched the cause of toxemia (preeclampsia) during pregnancy. He found that he could eliminate it even in high-risk demographics by supplementing the mother’s diet with animal-based meat and protein products like cheese and eggs.
Dr. Brewer also did not advise a reduction of salt as most physicians do. With these unconventional nutritional guidelines, Dr. Brewer was able to almost entirely eradicate toxemia of pregnancy in his practice.
2. Avoid sugar, soda, juice and other sweet beverages.
Why Should You Avoid Sugar?
Modern food culture is governed primarily by processed and manufactured foods – many of which are considered “anti-nutrients,” or foods that actually rob the body of nutrients versus providing them. Therefore, what you don’t eat is just as important as what you do eat.
3. Supplement with a whole foods based Pre-Natal Vitamin, Chelated Minerals, Essential Fatty Acids, and Probiotics (at minimum).
Why Are Supplements Important for Pregnancy Nutrition?
The way I see it, taking a multi-vitamin outside of pregnancy is not a high priority for those eating a balanced whole foods diet. A multi-mineral on the other hand is a different story. During pregnancy, however, taking a pre-natal vitamin can serve as insurance, especially when appetite changes, nausea, hormones and cravings can affect how you eat. Also, certain deficiencies like folate have been known to cause neural tube congenital disabilities. The best pre-natal vitamins are derived from whole foods ingredients for best absorption. My favorite pre-natal, MyKind Organics from Garden of Life, does not have to be prescribed and can be found at any good health food store.
While vitamins can still be sourced from the food we eat, minerals are known to be deficient from our food supply – even organics. The ways of the modern farmer have depleted the soil of its mineral content and therefore the food we eat from it. Similarly, many of our modern ailments (many during pregnancy) are caused by simple mineral deficiencies that when supplemented in the diet can improve. My favorite is the Chelated Mineral from Healthy for Life.
Essential Fatty Acids (EFAs):
For general health (especially during pregnancy), I recommend a high-fat diet. Confusion on what makes a fat ‘healthy’ as well fat being a very fragile nutrient makes it common that most women fall short of receiving enough unadulterated/unprocessed EFAs from their diet. This is why I always encourage added supplementation. Buyer beware: most fish oil products are oxidized and rancid by the time they reach the consumer. Sally Fallon, of the Weston A. Price Foundation – a website and organization run by ancestral and nourishing foods experts, recommends Fermented Cod Liver and Butter Oil. I would like to include an organic plant-based EFA supplement from Healthy for Life that supplies the body with its preferred source of “parent omega oils” as another option.
Recent and ongoing research of the “gut-microbiome” is fascinating. For the majority of my clients, I spend 90% of my time educating them on healthy digestion, healing the gut, and how it leads to a healthy body. During pregnancy, it is very important to have a good balance of healthy gut-flora to pass onto the baby during vaginal birth. I like a product by Prescript-Assist which contains both prebiotics and probiotics to help the body maintain a healthy GI-tract microfloral ecology, promote normal bowel function, support the gut immune-system, assist in stabilizing the gut mucosal barrier, and support normal absorption and assimilation of nutrients in the gut.
Pregnancy Nutrition Guide for Each Trimester
Now that we have laid a solid foundation let’s take a closer look at each trimester.
Nutrition in the 1st Trimester
What the Body is Doing:
Building the infrastructure that supports the baby in the womb. The body fortifies the placenta and the blood vessels that feed it to establish the lifeline of nutrients from you to your baby.
- Morning sickness (dehydration)
- Food aversions
What the Body Needs:
With little energy being spent developing and growing the baby, very little energy increase is needed calorically during this trimester. Think quality of food for nutrition over quantity, as unnecessary weight gain during this trimester is not healthy for you or your baby. Choose foods that have fewer calories but contain more vitamins and minerals.
Start making nutritional upgrades to your current foods – like spinach or arugula for iceberg lettuce, purple potatoes for white potatoes, grass-fed beef for conventional beef, and organic whole milk cheeses for pasteurized cheese products (like American cheese). In short, make the switch to a clean, whole foods diet as best as you can, but keep your portions normal sized and resist the temptation to “eat for two” when it is not necessary at this stage.
Begin building your meals around a 3-4 ounce piece of well-sourced meat or fish (safe low-mercury varieties like sockeye salmon, rainbow trout, halibut, sardines, tilapia, anchovies, and chunk light tuna) and stock up on non-meat protein sources that might be more enjoyable to consume if food aversions occur. Try bone broth, organic whole-fat cottage cheese, organic whole-fat plain (Greek or regular) yogurt, even a quality well-sourced protein powder to mix into green smoothies if dairy is tolerated.
Often overlooked, water is one of the most important nutrients during the first trimester, especially if morning sickness is experienced. Dehydration can occur and is very serious. Also common in the first trimester, is a slowing down of digestion which can become worse without adequate fluids. While everyone is different in their needs, aim to consume 2-3 quarts a day of total fluid with at least half of that being filtered water. Other accepted healthy fluids included in this would be herbal teas like red raspberry, bone broth, and unsweetened coconut water.
ADDED NUTRIENTS / SUPPLEMENTAL SUPPORT:
Iron, B12, B6, folic acid, C, E, Zinc, and Vitamin D can be of added help during the 1st trimester if indicated by your medical provider. Don’t forget the basics: prenatal vitamins, minerals, EFAs, and probiotics.
Nutrition in the 2nd Trimester
What the Body is Doing:
This is often when the pregnant woman feels her best and has the most energy if she is eating right and exercising. The development of all major organs and systems is either started or completed by the beginning of the second trimester, and both the baby and mama will begin to gain weight.
- Overconsumption (of sugary or carbohydrate-laden foods) with increased appetite
- Iron-deficiency (anemia)
What the Body Needs:
The average weight gain for a healthy pregnancy is about 25-35 lbs. which puts the added caloric increase during this period at about 340 extra calories per day for mothers with BMIs in the “normal range.” All this varies depending on your previous trimester’s nutrition and your activity levels. It is important to understand that this increase in energy is not that much and can be simply achieved by a small increase in portion size and the addition of a balanced snack when needed. A continued effort to focus on water (at least 2-3 quarts) and protein intake (80-100 grams) is very important to build the blood supply and to be sure there is enough amniotic fluid for the baby.
ADDED NUTRIENT / SUPPLEMENTAL SUPPORT (always discuss with medical provider and base intake off of proper labs):
Supplement levels may need to be adjusted due to the increase of blood volume up 50% by weeks 24-28. Incorporate iron-rich foods like well-sourced grass-fed liver (or supplement with Vital Proteins Liver capsules), organic dried plums/prunes, blackstrap molasses, and brewer’s yeast. Try a blood building tea with herbs like yellowdock, nettles, raspberry leaf, and comfrey root.
Hormone changes can create constipation, so an emphasis on higher-fiber foods like fruits, vegetables, chia seed, psyllium, hemp hearts, flax seed, or a fiber supplement containing any of these ingredients are good additions.
Anti-inflammatory in nature, essential fats are most important during this time when managing stress can become more difficult with hormonal fluctuations. Choose (low mercury) cold-water fish, walnuts, chia seed, and flaxseed and discuss the possibility of increasing your EFA supplement with your provider.
Nutrition in the 3rd Trimester
What the Body/Baby is Doing:
Growth, growth, and more growth! All that is left is for baby to increase body fat and weight, strengthen their bones, expand the brain and further develop the nervous system.
- High blood pressure
- Gestational diabetes
What the Body Needs:
The basic dietary needs are very similar to the second trimester, but it is important to realize that the most severe complications can manifest during this time so don’t lose focus. Build upon your good health and nutrition all the way to delivery!
ADDED NUTRIENTS / SUPPLEMENTAL SUPPORT (always discuss with medical provider):
Sodium/Electrolytes & Minerals –
Needed for blood pressure maintenance and to support the growing demands from strengthening bones. Don’t forget to add Redmond’s Real Salt to your food for an added boost of 60+ trace minerals.
Folate, B6, B12, Calcium, Vitamin D, Zinc, Magnesium, Probiotics –
Needed to prevent or treat preeclampsia. My preferred calcium supplement at this time is Bone Up by Jarrow Formulas because it contains a great combination of the nutrients listed to support bone/structural growth for baby and replenishing for mom.
Iodine, DHA, Choline –
Needed for proper brain development. Choline can be found in grass-fed beef and pasteurized eggs. Not all prenatal vitamins contain Choline so eat plenty of these foods. Also, the parent oils found in the Healthy for Life EFA supplement supply the body with the necessary “parent” essential fats that can then be used for DHA and EPA production.
Important for the developing retina and the brain, but is often already found in standard formulations of most prenatal vitamins. Also found in dark leafy greens and eggs.
Get the Right Nutrition During Pregnancy
In closing, remember that pregnancy can be overwhelming. Resist the urge to over think it. Supply your body with whole foods and the basic foundational supplements and then take each week at a time. Women all over the world are doing what you are doing (often with far fewer options). Your body is made for this! My parting advice is to relax, keep things simple, and return to the basics – often.
For more resources and in-depth education consider my ebook, Nutrition for a Healthy Pregnancy: 3 Tips Every Mom Should Know!