The pregnant woman should take prenatal vitamins. Prenatal vitamins are essential because they contribute to the healthy development of the fetus. Prenatal vitamins contain necessary levels of iron (30mg daily), vitamin D, vitamin B6, vitamin C, potassium, zinc and folate/folic acid (600 mcg), which are essential for fetus development.
Foods rich in vitamin C will assist in the absorption of iron. Monitor for problems related to abdominal discomfort and constipation as iron needs to be taken on an empty stomach. For this reason, encourage a diet high in fiber.
An increase in folate is necessary not only during pregnancy due to the increase in RBC production, but is an important supplement for women planning to become pregnant. It is recommended that a woman consume 50% more folate while pregnant, which is about 600 mcg per day. If planning on becoming pregnant, 400 mcg per day is recommended.
It is essential for the pregnant woman to gain an appropriate amount of weight dependent on her BMI. Underweight women should gain approximately 12.5-18 kg (28-40 lbs), normal-weight women should gain roughly 11.5-16.5 kg (25-35 lbs), overweight women should gain 7-11.5 kg (15-25 lbs), and obese women should gain 5-9 kg (11-20 lbs).
During the first trimester, there is no additional kcal intake recommended. The second and third trimester require 340-452 kcal/day increase in intake. This is not a large amount of food; typically one additional serving from the following food groups: dairy/milk, fruit, vegetable, and bread (rice, cereal, or pasta).
Most well nourished women have high protein intake, so they may not need to increase protein intake during pregnancy based on their current diet. However, if this is not the case, guidelines recommend a 25 gram protein increase. A careful diet history can determine if the adequate amount of protein is available in the woman’s diet.
The pregnant woman should avoid several substances due to their harmful effects on the fetus. These include items such as coffee and other caffeinated beverages, alcohol, cigarettes, and excessive sugar intake.
Woman desiring to be pregnant and those newly diagnosed as pregnant should avoid fish that are high in mercury, such as shark, swordfish, king mackerel, and tilefish and should limit intake to 6 ounces per week. Up to 12 ounces per week of the following fish can be consumed, as they are considered to have low levels of mercury: shrimp, salmon, pollock, catfish, canned light tuna (limit intake of albacore or white tuna to 6 ounces).
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