While we often view pregnancy as a “glowing” time, for many women the first trimester brings nausea, food aversions, and fatigue. Mom-to-be may also feel anxious during pregnancy, especially if they’ve previously experienced fertility struggles or miscarriage.
Now that you know I’m in the 2nd trimester of my pregnancy with Baby #2 & #3, I thought it would be fun to talk about what I’ve learned about my body and mindful eating during the first trimester.
MY MORNING SICKNESS VS MINDFUL EATING
People typically think of morning sickness as throwing up in the morning. The truth is that it can happen any time or, for some unfortunate people, like me, ALL DAY. Sometimes you just have constant bouts of nausea without throwing up, I had that and it’s the worst feeling. It stays in the back of my throat and I feel like puking, but I just can’t.
In addition, during the first trimester, foods I didn’t usually crave were suddenly finding their way into my grocery cart, and foods I normally love and want to eat all the time were push to the back of the fridge. My cravings also changed more quickly than I could keep track off. One minute I was cooking lunch for my son, next I can’t even think about eating that right now.
Your body will let you know what it wants.
Pregnancy is a really amazing time to practice mindful eating because your body is going to tell you exactly what it needs. Before getting pregnant, I was in a good routine with my eating where I was still being mindful, but I didn’t have to pay quite as much attention because I generally needed food around the same time most days, and I had learned what types of foods usually felt best for me at certain times.
But things change in pregnancy. In my first trimester, I pretty much couldn’t eat or smell anything.
BUT, why am I hungry all the time?
Getting “hangry” was always something I was susceptible to, but having hangry also come paired with a face smack of nausea.
Not only did I need to eat more often (with small portion size), but it was much more urgent.
I was totally turned off cooked vegetables, difficult to eat foods high in fat like meat, water or soup fill me up and made me nausea. So, I actually lived off bran cereal with milk, crackers, lemon water, fruit smoothie, pao , etc. I was nauseous but hungry all day long, so bland foods like cereal and milk were my BFF. I was probably dehydrated so smoothie and lemon water were my go-tos. I off fatty foods for a while since these are typically harder on body to digest and I constantly burping.
Pregnancy hunger can sometimes feel chaotic and out-of-control. But it doesn’t have to be this way. The truth is mindful eating can be helpful.
Our body is fully capable of doing what it needs to do to keep us and our baby healthy, and most of all, our body can be trusted.
Mindful eating is the practice of learning to pay attention to (and honouring) your body’s natural cues in regards to food. This means nourishing your body when it’s hungry, noticing and stopping when you’re full, and honouring your cravings.
Up until now, when I am feeling hungry, I eat something. When I am getting full, I slow down, take few minutes, and decide if it’s time to stop eating.
No matter what changes your body is going through, you can learn how to dial in to exactly what your body needs and feel confident to give your body just that.
MY BODY WILL GAIN WEIGHT AT ITS OWN PERFECT PACE
Pregnancy has been a really good lesson in surrendering to my body. Week by week, some weeks subtle and others not, my body has literally changed before my eyes. One day I would worry I was gaining weight too fast, and the next, I would worry I’m not gaining enough and that something was wrong with babies. I’ve spoken with so many of my friends and I came to realize that this is just one of the brutal realities of being a woman, not just in pregnancy when body changes come fast and furious, but pretty much all throughout the life cycle. But as I near the end of my second trimester, I’ve learned to make peace with the chaos. My body will gain weight at its own perfect pace. It may not be the precise 0.5-1 kg each and every week.
I know that for me, some weeks I gain nothing, and others I’ll jump 1 or 2 kg on the scale. But if you’re listening to your body, just know that your body is doing what’s best for you and baby and your weight will find its happy place in the end.
MY BODY DOESN’T JUST CHANGE OVERNIGHT WHEN I SKIP THE EXERCISE ROUTINE
Before getting pregnant, I work out every day for at least 30 min to an hour. But I was just anxious at the beginning of my pregnancy that I took about 3 months off the exercise routine. Not 3 days or 3 weeks, it is 3 months. Obviously, it was all worth it. But taking that much time off kind of freaked me out.
Would I lose all of the strength I had worked so hard to build and have to start from scratch again?
Would I gain 20kg?
Would I just fall out of the habit for good and never go back?
After first trimester, I started doing light yoga stretching and leg exercise. I keep telling myself, I have two babies growing inside me, don’t feel guilty because I took 3 months off the exercise routine. It doesn’t have to be all or nothing. Just listen to my body when I’m ready to get back on my yoga mat.
IT’S OKAY TO FEEL EMOTIONAL
When I found out I was pregnant, I was more terrified than excited. The fear of bleeding, cramping, not hearing heartbeat, it all messes with my head in a way that no one can really understand unless they’ve been there.
Every doctor’s visits are also scary. Every time I have an appointment, I have to take deep breaths to try to stay calm and positive. I find myself constantly thinking about the babies’ movement and heartbeats. To handle fear in the moment, I am taking one day at a time and feel grateful for every day of my pregnancy, allow myself to enjoy things like a positive ultrasound or big kicks.
Now moms and moms-to-be, can you tell me, what are some of the pregnancy lessons you’ve learned along the way that have helped you through your journey? Leave me a comment below and help a fellow mom-to-be out!
看别人分享怀孕，生孩子，坐月子的文章看多了，但是网络上确实很少看到文章分享和谈论不孕和流产的话题。事实上，4-6对夫妇里就会有一对夫妻面对不孕症问题，10-20%的女性曾经有过流产经历，所以我希望此文章能给正在备孕的姐妹们一些希望和正能量 ，you are not alone!
MY FIRST PREGNANCY
一直长居加拿大的我在2011 年硕士毕业后，得到了一份很好的 job offer，于是就打包好行李独自一人来到了新的工作和居住环境，一个人生活。一直以来我和现任老公都是远距离恋爱，我过我的自由生活，他过他的忙碌打工日子。直到2012年的 Chinese New Year，他买了机票就这样飞了一天一夜来到了这个冰天雪地的国家，这是他第一次踏入北美洲，也是他第一次看见雪。短短的两个星期的假期，我被求婚了！
由于 Dr. A 只负责 IUI treatment。于是，家庭医生又refer 我到另外一家fertility centre 做咨询。疗程讲解，抽血，ultrasound，可以做的都做了。这次的fertility doctor – Dr. S 在验血检测里多加了一样就是 AMH (anti-mullerian hormone) (here)。
当一个极度想要怀孕却总是每个月看到白板的人，这个时候只要一打开自己的社交媒体账号，朋友圈里的所有朋友都好像同一时间怀孕；只要一走在shopping mall一定会看到经过你身边的每一个人都是大肚婆；在工作上每个星期都会接到关于prenatal and postnatal care 的referral cases；就连身边已年过40岁的两个朋友本来就不打算怀孕生小孩的也怀孕了！这个时候，我的世界只有我一个人，天天都在问自己到底那里出错了！
2019年2月，我拿了2个月半的假期回国。在决定回国前，老公已经到几间 fertility centre 去听课也 survey 了费用。回来后，我带着一份份厚厚的体检报告来到了 fertility centre 见 Dr. H。医生给我的诊断结果是 “unexplained infertility”。因为一边的输卵管堵塞了，如果真的要自然怀孕，有可能需要靠点运气和漫长的等待。又抽了一瓶又一瓶的血，所有的指数，子宫内膜厚度，卵子的成长大小都很理想，医生建议不如这个cycle再试试看吃排卵药，打排卵针和直接进入IUI 疗程。
做了一些 research 后，我决定在进入IUI 疗程前，再尝试多一次针灸疗法来增加受孕几率。毕竟，当时在加拿大咨询的中医师并不是专注于助孕疗程。
针灸真的有用吗？我有吃中药吗？
首先，我咨询过 Dr. S 和 Dr. H，两个医生都没有明确的说不建议或不鼓励，他们处于中立态度，完全取决于我的budget和我的时间。我也翻阅了一些研究报告，在临床研究上，针灸确实能辅助子宫血液循环。不过，我也曾听过一些国内的 fertility doctor 是不鼓励中医疗法也会督促在进行疗程的女性不要乱吃中药以免影响疗程效果。
到了大约8-9 weeks 时，我带着忐忑不安和期待的心情去做 dating ultrasound。在房间里sonographer 照了很久很久，我不敢发出任何声音但又很想知道到底有没有双胞胎。结果 sonographer 让我去上厕所，要做阴超。上厕所时，我心里一直在祈祷。在做阴超的时候sonographer 还是一样的安静，照了很久很久，整个房间的气氛很奇怪很凝重，我开始有点不安。结束后，她让我换上衣物，然后对我说：“对不起，我们没有听到宝宝的心跳，胚胎的大小刚好停留在8 week 3 days (正是我做ultrasound 的前一天)，你需要尽快咨询你的家庭医生”。
当下，我的脑袋是一片空白的，一时之间不知道如何反应过来，“没有心跳” 是什么意思？验孕棒不是 positive了吗？HCG 很高呀？在回家的路上，我一面开着车，一面留着眼泪，一直不断的回想，前一天我做了什么，吃了什么，是因为什么原因导致宝宝没有心跳？回到家我整个人瘫坐在床边，一面哭，一面上网查询 “when can we hear baby’s heartbeat?”
这一次，因为不想明年再交 freezing fee，也不想再为了生育这个问题搞得我们夫妻压力重重。干脆直接移植最后两颗胚胎。如果不成功，可能我们会从新开始新的 IVF 疗程，或认命。既然上天给了我一位那么可爱，乖巧，暖心的男孩儿，我不应该要求那么多。所以直接拼了！Dr. H 很随和，她不会给任何太过主观的意见（除非是她真的觉得不适合，她会直接和我说），她也知道我的专业，我在做任何决定前，一定是已经 research 好了，才来告诉她。当时，我和她说想要移植最后两颗胚胎的时候，她给了我很正能量的鼓励同时叮咛我有可能是双胞胎，也告知了怀双胞胎的风险！
A common concern of new mothers is losing the weight gained during pregnancy.
How much weight to lose after the birth of your baby is associated with how much weight you gained during pregnancy. If you gained more weight than recommended, it may take longer to lose it. That weight did not get put on overnight (it took 9 months to get there, remember!!) and time will be needed for the weight to be lost. So, patience is important. This is one reason it is advised that women do not exceed the recommended pregnancy weight gain.
The longer you keep extra weight on, the less likely you are to lose it.
To help you achieve a gradual, healthy weight loss, make small changes to your eating and physical activity habits. Here are 10 simple and easy ways to shed your baby weight while taking care of your new bundle of joy.
DON’T SKIP MEALS ESPECIALLY BREAKFAST
You’re busy with your new baby and lack of sleep. So, it’s understandable if it seems easier to skip breakfast or lunch and eat large portion in long intervals of time. Don’t make it a habit.
Eating a healthy breakfast containing protein can help you to control your appetites and cravings all day, and prevents unhealthy snacking later in the day and into the evening. It also gives your metabolisms a kick-start first thing in the morning. I know how easy it is to get caught up in morning survival-mode with babies and toddlers, so having something quick and easy to grab like a overnight oat that was made the night before or smoothie, may come in handy.
My confinement meal.
CHOOSE & EAT RIGHT
You’ll need around an extra 350 kcal a day to have the energy to produce milk. Choosing the right foods – vegetables, fruits, whole grains, lean protein and dairy, focusing on eating foods that are rich in iron, protein and calcium for energy and milk stimulation.
Iron rich foods include lean meats, eggs, beans, lentils, dark-leafy green vegetables, whole grain products. The best way for a body to absorb iron is by combining foods high in iron with foods high in vitamin C (like citrus fruits).
Include protein at each meal, such as lean meat, eggs, dairy, beans, lentils, and seafood low in mercury.
Calcium isfound in dairy products (milk, yogurt, and cheese), as well as tofu, leafy-green vegetables and calcium-fortified or enriched cereals, soy milk and soy yogurt.
Eat foods high in fibre. Consume at least 2 cups of fruits and 2 – 3 cups of vegetables per day.
Continue taking your prenatal multivitamins.
PLAN HEALTHY SNACKS
Six months postpartum, I eat small portion but frequent meals to keep my energy intake up. The goal is to stop buying all the junk food (empty calorie foods). I listen to my hunger cues and choose healthy snacks, such as fresh fruit, nuts, greek yogurt with granola, hummus with vegetables or a protein bar/ball (recipe, recipe), lactation cookies.
BREASTFEEDING
If you’re able to breastfeed, it will definitely help you in the postpartum weight loss. Aside from the many benefits of breastfeeding, you will also burn up to 500 extra calories per day, some of which comes from the body’s fat that built up during pregnancy.
Wait until breastfeeding is going really well (baby is 4 months old) before trying to lose weight. A weight loss between 0.5 kg and 1 kg (~ 1 – 2 lbs) a week is safe and shouldn’t impact your milk supply. If you notice a change in your milk supply, talk to your doctor or dietitian.
A diet that is too low in calories and nutrients can affect the quality of your breastmilk.
UP THE FLUIDS
During labor, a woman loses an incredible amount of fluids and blood. Drinking enough water is not only crucial for maintaining your milk supply, for proper digestion and for staying hydrated, but it’s also important for losing weight.
Drink at least 8 glasses of water per day.
EAT MINDFULLY
I know, you are trying to get your chores done – washing dishes/bottles, laundry, pumping breastmilk, cleaning the house, cooking etc. I remember my first 3 months postpartum life was breastfeeding, eating and sleeping, even though my mom provided help. I was so easy to get distracted, I wolfed my meals down without chewing, and ran to my crying baby.
Distracted eaters tend to eat more food in one sitting than people who are paying attention to their food.
This study shows mindful eating approach may encourage postpartum weight loss without weighing, measuring, recording and assessing dietary intake. Here are my mindful eating tips:
Relax before eating. Breathe deeply for one minute, or bless your food before picking up your fork. This time will allow you to become aware of how hungry you actually are.
Put food on a plate and sit down at the table.
Try to place your eating utensil down with each bite. Take at least 20 minutes to eat your meal.
Avoid distractions when eating, such as phone calls, radio, TV, and reading. These diminish the experience of eating. Pay attention to the texture, color, flavor, and temperature of your food. You will be more aware of your hunger level if you pay attention as you eat.
Use smaller plates. By using smaller plates and bowls, you will automatically serve yourself less, but still feel like you’re having a satisfying amount of food.
BE ACTIVE
Exercise can help tackle postpartum depression, improve the mood, reduce stress and boost the confidence. Finding time to exercise is one of the biggest issues new moms face when losing weight after childbirth.
After recovering from delivery (which may take a couple month or you doctor says it’s ok), find a perfect workout plan that suits your schedule and personality. There are so many options when it comes to exercising but the best option is the one that YOU will enjoy the most.
Walking may be the perfect postpartum activity because it’s easy to do, not strenuous and can include baby (in a stroller). You can incorporate weigh lifting or a resistance routine (such as yoga or using exerics bands) once you regain your strength and your baby is a little older. The goal should be to enjoy your alone time and get your body moving for at least 10-30 minutes, 3 times a week. That is only 30-90 minutes for the whole week!
AVOID WEIGHT LOSS FADS
Educate yourself about nutrition, not diets. It is easy slip into the “I want to lose weight fast” mentality. Most fad diets restrict certain food groups and portions, which result in quick weight loss but impossible to sustain. This is the main reason why people on fad diets end up regaining the weight they lost. This also damage health in the long run and your self-esteem.
This is why I really recommend seeing a dietitian. As much as you can Google nutrition tips, the guidance of a dietitian can help provide you with personalized nutrition information that is right for YOU.
SLEEP , SLEEP, SLEEP
This study found that mums who slept five or less hours per night were more likely to hold onto their extra baby weight – This is because when you’re sleep deprived, your body releases the stress hormone cortisol, which can promote weight gain around your belly.
LOVE YOURSELF
If you are a new mom or a mom of two or three, that doesn’t mean that you can neglect your own health. Your well-being is just as important as your child’s well-being. I truly believe that part of being a good mom or new mom means taking care of myself, and slowly getting back to my healthy and comfortable weight is part of that. Don’t beat yourself up if you’re not bouncing back as quickly as you’d like.
BOTTOM LINE
Having a baby not only changes your life but also bring about many changes in your body including the weight gain. It is not easy to take care of yourself with a new baby. Having a Chinese culture background, I view the first 3 months postpartum as recovery. The focus should be on eating for energy, physical and emotional recovery, rather than weight loss.
Food allergies are on the rise. In the past, some expert recommended that dairy products and other common food allergens like eggs, peanuts and fish not be introduced until after an infant’s first birthday. More recently, evidence has shown that there is no reason to delay introduction of these foods beyond 6 months of age. In fact, delaying the introduction of these foods may increase your baby’s risk of developing allergies (here).
Current recommendations for solid food introductions are to wait until around 6 months of age. Look for your child’s readiness cues and provide only breast milk or formula until that time. There are no hard and fast rules as to what order or exactly what age to introduce certain foods to a baby. Babies really can go to town and eat what the rest of the family are eating (making sure the foods are an appropriate texture to avoid choking).
A food allergy is when the body’s immune system mistakes a food as harmful and this cause a reaction. A food allergic reaction appear after a few minutes of giving a food and often will happen within two hours of having the food. Signs can also show up hours or days later. They can be mild (flushed face, abdominal pain, rash/hives, stuffy/runny nose) to severe (vomiting, diarrhea, blood in stools). The most extreme allergic reaction is anaphylaxis, where the throat starts to close and there is difficulty breathing.
Which Foods are Most Likely to Cause an Allergic Reaction?
So should you feed your baby these foods? or avoid it? As of now, here’s what you need to know…
Risk of Developing Food Allergies?
Your baby may be at high risk for developing food allergies if a parent, sister or brother has an allergic condition such as: food allergies, eczema, asthma or hay fever. Your baby is at lower risk if no parent, sister or brother has an allergic condition.
What to Eat When Pregnant and Breastfeeding
When you are pregnant or breastfeeding, good nutrition is extremely important, and you should continue to eat all of the nutritious foods that you usually eat. You do not need to avoid common food allergens while pregnant or breastfeeding. Go ahead and eat peanuts or drink a milkshake. Avoiding potential allergens will not decrease your baby’s chance of having an allergy to these foods. Breastfeeding itself maybe protective against food allergies.
If you choose to avoid certain foods while pregnant or breastfeeding, speak with a Registered Dietitian or your health care provider to make sure you are getting all the nutrients you and your baby need.
When Can You Feed Babies Highly Allergenic Foods
For low risk baby, there is no benefit to delaying common food allergens past 6 months.
For high risk baby, there is no reason to wait until the baby is older before introducing highly allergenic foods, and some studies suggest that it may even be helpful to introduce foods early. Talk to your allergist about whether it would be help to do a food allergy test before feeding these foods to your baby or speak with your dietitian about a personalized plan for food introduction.
The goal is to choose foods that provide the most nutrition.
Here are a few steps that you could follow:
Try other food first
The first foods that you give your baby should not be the most allergenic ones. Start with other single ingredient foods, such as rice or oat cereal, yellow and orange vegetables (sweet potato, squash and carrots), fruits (pears, banana, apples) and green vegetables (peas, broccoli, spinach), tender meat. Once things are going well with these other foods you can then start to introduce the common food allergens.
Go slowly
Introduce just one food at a time, and then wait 3-5 days before trying the next new food (whether it is a highly allergenic food or not).
Choose the right time
When you are ready to introduce a highly allergenic food, pick a time when you’ll be at home and you will be able to watch your baby closely for any signs of reaction. Along these lines, it may be better to do this earlier in the day and not right before a nap or bedtime. Do not try these foods right before you need to leave the house to go somewhere, such as to drop the baby off at day care or take your other children to school. Although many babies react the first time they eat a food, you should be cautious for the first two or three times that your baby tries an allergenic food. After that you can relax knowing the chances of a reaction are extremely small.
Start with a small quantity
Don’t give your baby a full serving of a highly allergenic food on the first feeding. Start with a just a little. If there does not appear to be a reaction, then you can gradually increase the quantity during the next few feedings.
Use nut butters, not nuts
Never feed nuts to a baby. Babies can choke on nuts. To introduce nuts into your baby’s diet, use nut butters or pastes.
You can do so in small amounts and can even try rubbing some of the food on their chick and then lip to see if it produces a rash, before giving/feeding that food.
Bottom Line
If your baby has severe allergic reaction, carry an epi pen. Make sure your baby is on a balanced diet, if it is quite restricted, please talk to your dietitian. Also, you will need to become an expert on reading food label and searching for all of the various names for the food you are avoiding.
If the allergies are mild, you can always try re-introducing the food after a few months.
If you have questions about food allergies. Contact Me about starting a nutritional counselling program.
We want to do what’s best for our growing baby inside of us. Once we get that positive pregnancy result, we clean up every bit of our lives to be sure our babies have the healthiest start possible. And so many of us wonder: is it safe to drink coffee while pregnant?
I’m not a coffee drinker, but I’ve seen the love, devotion, and urgency many mamas have around their morning Joe. We can give up a lot when we’re pregnant, but please don’t touch our caffeine!
Caffeine is a drug and it will cross the placenta. It can limit blood flow to the placenta, as well as increase blood pressure and blood sugar levels. It also puts additional strain on the liver, which is already busy processing the increased hormonal demands related to pregnancy.
Caffeine should be limited since some studies have linked high intake of caffeine may be associated with growth restriction, reduced birth weight, preterm birth or stillbirth.
WHO advises all women of reproductive age to consume no more than 300 milligrams of caffeine per day.
One small (8 ounce) cup of coffee has 80 to 179 milligrams; the same serving size of weakly brewed tea has 25 to 45 milligrams.
Other sources of caffeine include chocolate milk, cola drinks, and energy drinks.
WHAT ABOUT HERBAL TEA?
Be careful if you’re planning to switch from coffee to herbal tea. Not all herbal teas are safe during pregnancy.
In general, tea with Ginger, Orange Peel, Red Raspberry Leaf, Peppermint Leaf and Rose Hip are considered safe during pregnancy, if taken in moderation (no more than 2 to 3 cups per day).
NOTE: Pregnant women should ask their physician before consuming any natural/complementary health product or herbal therapy.
Are you pregnant? Not sure what to eat or drink? You want to learn more about healthy eating during pregnancy? Contact Me , I can help you meet the nutrition needs of both you and your growing baby.
Weight gain during pregnancy is a hot topic and commonly discussed in parenting or women’s health magazines. Most women who are planning to conceive or pregnant are unsure as to how much weight they should safely gain during this period. Today, I am going to give you some nutrition tips and guidance to reduce your stress.
Weight gain is an important part of pregnancy. The recommended amount of weight gain during pregnancy depends on your Body Mass Index (BMI) before pregnancy. Knowing the range of weight gain that’s right for you will help you gain enough weight without gaining too much.
Using the following formula: BMI = weight (kg) / height (m2)
Talking to your healthcare provider or Dietitian
The table below will help you find out how much weight gain will be healthy for you and your baby.
If you were overweight, you need to gain less weight. If you were underweight or you are having twins or triplets, you need to gain more weight. Talk to your doctor, dietitian or nurse about the right weight gain for you.
WHERE IS THE WEIGHT GOING?
Most women need to gain about 11.5 – 16 kg in pregnancy. It’s common to gain very little weight in the first trimester. In second and third trimesters a gradual increase of about 0.5 kg a week is normal since the baby and supporting tissues continue to grow.
IF YOU GAIN TOO MUCH WEIGHT
Women who gain too much weight tend to have:
More difficulty giving birth
Babies who are born large for their age or who have a high birth weight (more than 4.1 kg)
Babies who have problems with being overweight or obese later in childhood
More troubles losing weight after pregnancy
Increased risk of high blood sugar and high blood pressure during pregnancy
IF YOU GAIN TOO LITTLE WEIGHT
Women who don’t gain enough weight tend to have:
Babies who are born early
Babies who are born small for their age or who have a low birth weight (less than 2.5 kg)
HEALTHY EATING TIPS DURING PREGNANCY
Consuming a well balanced and varied diet will help ensure you consume food sources of folic acid, iron and calcium, which are especially important nutrient during pregnancy.
Eat “twice as healthy”, not “twice as much”
Eating every 2-4 hours while awake gives your growing baby a steady supply of nutrients. It may also help you feel better if you’re having trouble with nausea.
Avoid skipping meal. Skipping meals makes it hard for you and your baby to get all of the nutrients you both need.
Aim for 3 meals a day with healthy snacks in between.
First trimester: No extra calories. Normal healthy eating.
Second trimester: About 350 extra calories per day.
Third trimester: About 450 extra calories per day.
Breastfeeding: 350-400 extra calories per day.
Here are some examples of snacks that contain about 350 kcal:
Yogurt parfait – 3/4 cup yogurt, 1/2 cup berries, 1/2 cup granola
Here are some example of snacks that contain about 450 kcal:
1 slice of whole wheat toast with 1 tbsp of natural peanut butter, 1 banana and 1 cup of milk
It is not recommended to lose weight or follow a weight loss diet during pregnancy.
BOTTOM LINE
Eating a healthy diet and staying active when pregnant ensures you and your baby receive the nutrients you need while maintaining healthy weight gain. If you look and feel healthy, just give yourself a break. One of the joys of pregnancy is be able to unbeaten those jeans and glory in the elastic waistband. There is no point in sucking in your stomach, or squeezing into a cocktail dress, or trying to look good in a bathing suit. You’ve got a bump, and that’s just how it is.
So, You’re having a baby?Contact Me, I can help you meet the nutrition needs of both you and your growing baby.
Gestational Diabetes Mellitus (GDM 妊娠期糖尿病) is when you have high blood sugar during pregnancy. It means you are not able to make enough of a hormone called insulin (胰岛素). Insulin is made in your pancreases (胰腺), an organ located behind your stomach. Without enough insulin, your body can not properly use and store carbohydrate (碳水化合物 or sugar) from foods that you eat.
During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called Insulin Resistance. Insulin Resistance increases your body’s need for insulin. If your pancreases can’t make enough insulin, you will have gestational diabetes.
All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant, usually because they are overweight. These women start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.
RISK FACTORS FOR GDM
You are more likely to have GDM if you have one or more of the risk factors below:
Age over 35 years
Previous pregnancy with GDM
Previously delivery of large baby over 4 kg or 9 lbs
Someone in your family with diabetes (Parent, brother, sister with Type 2 Diabetes)
A previous stillbirth
Being overweight before pregnancy or gaining too much weight during your pregnancy
Being from a high risk ethnic group (Aboriginal, Hispanic, South Asian, Asian or African descent)
More than one baby in this pregnancy (twins, triplets)
Have a hormonal disorder called PCOS (Polycystic Ovary Syndrome)
HOW WILL GDM AFFECT MY BABY?
If you have high blood glucose levels because your GDM is not under control, your baby will also have high blood glucose. Your baby’s pancreases will have to make extra insulin to control the high blood glucose. The extra glucose in your baby’s blood is stored as fat.
Untreated or uncontrolled GDM can cause problems for your baby, such as
Being born with a larger than normal body (a condition called macrosomia), which can make delivery difficult and more dangerous for your baby
Having low blood glucose (called hypoglycemia), right after birth
Having breathing problems (called respiratory distress syndrome)
Having a higher chance of dying before or soon after birth
Your baby will be more likely to become overweight and develop Type II Diabetes as he or she grows up
HOW WILL GDM AFFECT ME?
GDM may increase your chances of:
Having high blood pressure and too much protein in the urine (a condition called preeclampsia)
Have C-section due to large baby
Mayhave gestational diabetes in your next pregnancy
Higher risk of having Type II Diabetes later in your life
Finding out that you have Gestational Diabetes can be scary. As a mother-to-be, following your management plan will help make sure you have a healthy pregnancy.
HOW IS GDM DIAGNOSED?
Screening for GDM
Most pregnant women are screened between the 24th to 28th week of pregnancy. If you are at a high risk of GDM your doctor may screen earlier than 24 weeks, and again later if that test is negative.
Tests for GDM
At least one of the following tests are done to determine if you have gestational diabetes:
a) Screening test for GDM: is a 1 hour blood sugar measurement following a 50 gram carbohydrate drink, given at any time of day.
If your blood sugar is less than 7.8 mmol/L, you DO NOT have GDM and no further testing is required.
If your blood sugar is over 11.1 mmol/L, GDM is diagnosed and you will need treatment.
If your blood sugar is 7.8-11 mmol/L, your MAY have GDM. Your will need a 75 gram Oral Glucose Tolerance Test (OGTT 75 g) to diagnose GDM.
b) 75 gram OGTT:measures fasting blood sugar after nothing to eat for 10 hour. Blood sugar is tested again 1 and 2 hours after you have been given a 75 gram carbohydrate drink. There are 2 possible results:
You have GDM is two or more values below are met or exceeded
You have Impaired Glucose Tolerance if one value below is met or exceeded.
Fasting blood sugar over 5.3 mmol/L
1 hour blood sugar over 10.6 mmol/L
2 hour blood sugar over 9 mmol/L
If you are diagnosed with either or these conditions you will need a management plan to help you have a healthy pregnancy.
MANAGEMENT PLAN
Blood Sugar Target
You will be meeting with your team of dietitians, nurses, and doctor to discuss your management plan. You blood sugar targets are:
Fasting blood sugar (before breakfast): less than 5.3 mmol/L
1 hour after meals: less than 7.8 mmol/L
2 hour after meals: less than 6.7 mmol/L
Nutrition Management
Eat 3 meals and 3 snacks every day
Spread carbohydrates over the day
Limit sweet foods and drinks with added sugar
Choose higher fibre foods more often
Eat foods higher in protein at each meal and evening snack
Get enough Calcium and Vitamin D from the foods and drinks you have every day
Thinking about getting pregnant? Since many pregnancies are not planned, all women who could become pregnant should take a daily prenatal multivitamin.
It is recommended to start taking your supplement at least 3 months before you get pregnant.
Your nutrient requirements are much higher during pregnancy, it is important that you start taking a prenatal multivitamin before you become pregnant to fill any nutritional gaps. You may say “I eat very healthy and balanced”, however, it’s impossible to meet all of your requirements with food alone. This doesn’t mean that you have to spend a lot of money on buying branded supplements from the health food store .
In fact, I often recommend generic brands from local pharmacies or supermarkets as long as the supplement is government regulated and it contains what it says it contains. So I will give you some tips and what to look for when buying a prenatal multivitamin.
FOLIC ACID
Folic acid is super important to help prevent Neural Tube Defects (e.g., spinal bifida – when nerves in the spinal cord are exposed and damaged) in your baby. Choose a prenatal multivitamin that has0.4-1.0 mg (400-1000 mcg) of folic acid.
Food High in Folic Acid: whole grain breads, leafy green vegetables, legumes (beans and lentils), citrus fruits and juices and most cereals (fortified with folic acid).
IRON
Your iron requirements increase during pregnancy. Your body makes an extra 2kg of blood during pregnancy. In your third trimester of pregnancy, your baby is building iron stores for the first six months of his or her life. Therefore, you need more iron to make the extra blood and to help your baby store enough iron.
When you’re pregnant, it is very difficult to get the amount of iron you need just from diet alone, so choose foods high in iron and take a prenatal multivitamin containing iron (16-20 mg). Your body absorbs iron from meat, poultry, and fish better than iron in other foods. To increase iron absorption, eat a food containing Vitamin C (e.g., strawberries or oranges) and food containing iron at the same time. For example, have vegetables with meat (e.g., chicken stir-fry) or have an orange with a bowl of oatmeal. Coffee and tea can interfere with iron absorption. Limit these drinks and have them between meals rather than at meals.
Best Sources of Iron: beef, pork, chicken, lamb, fish, sardines, shrimp, oysters, mussels.
Good Sources of Iron: legumes (lentils, beans, chickpeas), tofu, whole grain and enriched cereals.
Anemia during pregnancy has been linked to decreased weight gain, preterm birth and babies with a low birth weight. If you become anemic during pregnancy (which is very common), your doctor or dietitian may recommend an additional iron supplement. Iron supplements can make you constipated, so be sure to increase your intake of fibre and fluids.
CALCIUM
Your calcium needs are very high during pregnancy. Calcium helps keep your bones strong. It also helps your muscles and nerves to work properly and helps your blood to clot. During pregnancy, calcium helps your baby build strong bones and teeth.
Most prenatal multivitamins contain about 300 mg of calcium. A prenatal multivitamin will not support all of your calcium needs, so it is important that you’re including calcium rich foods in your diet.
Food High in Calcium:milk, yogurt, calcium-fortified beverages such as soy, rice or orange juice.
Other Food Sources of Calcium: cheese, canned salmon or sardines with bones, tofu made with calcium.
VITAMIN D
Vitamin D is important in pregnancy. It helps keep your bones strong and builds strong bones in your baby (enhance calcium absorption). It also helps your baby build vitamin D stores to use during his or her first few months.
If you have a dark skin, cover most of your skin with clothing or sunscreen, don’t go outside very often or don’t eat very many vitamin D rich foods (see below) you may need to take extra vitamin D supplement.
Food High in Vitamin D: milk, fortified soy beverages, fish such as salmon, trout, herring, Atlantic mackerel, sardines, and Vitamin D fortified orange juice.
Not all milk products are high in vitamin D. In Canada, milk, margarine and some yogurts have vitamin D added to them. In Malaysia, please check you nutrition fact label.
VITAMIN A
Too much Vitamin A can cause birth defects in your baby. If you are taking a prenatal multivitamin (which has vitamin A included), do not take any additional vitamin A supplements. You will get enough Vitamin A from a combination of your food (e.g., carrots, broccoli and squash) and your prenatal multivitamin.
BOTTOM LINE
Healthy eating and taking a prenatal multivitamin helps you prepare a healthy pregnancy. Do not take more than 1 daily dose of a prenatal multivitamin. Supplement do not take the place of food and healthy eating. If you are vegan, on a restricted diet, food allergies or you avoid certain foods, you may be missing important nutrients you and your baby need. Talk to you doctor or dietitian.
So, You’re having a baby?Contact Me, I can help you meet the nutrition needs of both you and your growing baby.
A healthy, well-balanced diet is important during pregnancy. Most fresh foods are completely safe for pregnant women, however, some foods should be avoided during pregnancy or if you’re trying to conceive, because most pregnancies are unplanned. I’ve compiled a list of foods to avoid during pregnancy to serve as a quick guide.
WHY WE SHOULD AVOID THESE FOODS DURING PREGNANCY?
Food may carry germs that can make you sick. Your ability to fight off infections is decreased when you’re pregnant. Food poisoning (Food-Borne Illness) can also affect your unborn baby, such as listeriosis (李斯特菌病), salmonellosis (沙门氏菌病), toxoplasmosis (弓形虫病), campylobacteriosis (弯曲杆菌病). Handling, preparing and storing food properly can reduce the chance of getting sick from food poisoning.
Pregnant women are 10 times more likely than other people to get Listeria infection. Listeria infection can cause miscarriage, stillbirths, and preterm labor (here).
Raw or Undercooked Meat
All meat needs to be thoroughly cooked during pregnancy because of the risk of infection from several bacteria or parasites, including, Salmonella (沙门氏菌), E.Coli (大肠杆菌), Listeria (李斯特菌) and Toxoplasma (弓形虫).
Try to cook meat, poultry and fish to a safe internal temperature and avoid contamination through cutting boards and cooking utensils as well.
ground beef 71°C (160°F )
poultry 74°C (165°F)
Fish 70°C (158°F)
Raw or Undercooked Seafood and Shellfish
Raw or undercooked fish (including sushi, sashimi), especially raw shellfish (raw oysters, mussels and clams), should be avoided during pregnancy because of potentially harmful bacteria (Listeria) and parasites.
Smoked seafoods are safe to eat when they are an ingredient in a cooked meal such as casserole (as it reaches an internal temperature of 74°C (165°F) to kill harmful germs). So, it is safe to eat smoked seafood during pregnancy if it is canned, shelf-stable or an ingredient in a casserole or other cooked dish.
A cooked sushi is fine.
Deli Meats and Hotdogs
It’s advised to avoid all deli meats and hotdogs, if possible, due to potentially contaminate withListeria. This bacteria can be killed through heat, so if you still want to eat deli meat during pregnancy, be sure to heat the meat until it’s steaming hot, at least 74°C (165°F).
The middle of the hot dog should be steaming hot or 74°C.
Another reason to avoid these foods is the effects of nitrites on a developing fetus are still unknown (deli meats and hotdogs often contain these ingredients).
Raw or Undercooked Eggs
Eating raw or undercooked eggs can put pregnant women at an increased risk of Salmonella poisoning. Make sure both the yolk and white are cooked through. Certain sauces, spreads and drinks such as homemade Caesar salad dressing, hollandaise sauce, homemade mayonnaise, unpasteurized eggnog, Tiramisu, custards and homemade ice cream may contain raw eggs.
It is recommended the use of pasteurized egg products when a recipe calls for raw eggs.
Unpasteurized Dairy Products and Juices
Raw (unpasteurized) milk is milk from any animal (goat, cow, etc) and has not been pasteurized to kill harmful bacteria. Raw milk may contain bacteria such as Campylobacter, E.coli, Listeria, Salmonella, or Toxoplasma. To avoid getting these food borne illnesses, only consume pasteurized milk.
Avoid unpasteurized soft semi-soft, blue-veined cheese such as Feta, Brie, Camembert, havarti, Queso blanco, Queso fresco and Panela unless they’re made with pasteurized milk. These cheese made with unpasteurized milk may contain Campylobacter andListeria. It is important to read labels carefully, to make sure that the milk being used in these products has been pasteurized. Instead of eating soft cheese, eat hard cheese such as Parmesan, cheddar or Swiss.
Homemade ice cream are made with an egg-based custard that isn’t completely cooked. If you are using pasteurized eggs are okay. Commercially manufactured ice cream is typically fine.
Also, avoid unpasteurized juices such as unpasteurized apple cider. Double check fresh pressed juice and cold pressed juice to be sure. Home-squeezed juices are safe if the vegetables and fruits are washed in cold, running water. I’m a bigger fan of smoothie during pregnancy because you can pack so much more nutrition into them, and you can get the fibre part of the fruits and veggies, not just the juice.
If the cheese is coming in from another country, it may not be pasteurized.
High Mercury Fish
Fish offers many health benefits to both pregnant mothers and their unborn babies. Fish is a good source of protein and healthy fats that help the development of your baby’s brain and eyes.
Eat at least 2 servings of fish per week.
Mercury is toxic to a developing fetus and can linger in a woman’s blood stream for over a year.
Raw sprouts including alfalfa, clover, radish or mung bean sprouts may be contaminated with Salmonellaor E.coli. According to FDA, cook sprouts thoroughly can kill harmful bacteria and reduce the risk of illness.
Unwashed Vegetables and Fruit
It’s important to make sure that your vegetables are thoroughly washed to avoid any risk of Toxoplasmosis, because the soil in which vegetables are grown may be contaminated with E.coli or Salmonella.
Eat at least 4-5 servings of vegetables per day and 2-3 servings of fruit per day while pregnant (as well as when you aren’t pregnant). Keep cut vegetables and fruit in the fridge.
Flax Seeds and Flaxseed Oil
Flax seed may adversely affect pregnancy due to its mild extrogenic effects but there is insufficient reliable clinical evidence about the effects of flax seed on pregnancy outcomes (here). There is some evidence about the flaxseed oil is associated with an increased risk of preterm birth. Due to the insufficient evidence, flax seed should be avoided in very large quantities and flaxseed oil should be completely avoided during pregnancy, but it is still safe to consume flax seed in the amounts commonly found in foods, such as flax seed bread.
Artificial Sweeteners
Artificial sweeteners are ingredients that add sweetness to foods. Sweeteners are ingredients in soft drinks, desserts, candies, and pastries. Moderate use of artificial sweeteners during pregnancy is considered safe. It is recommended that pregnant women avoid excessive consumption of products containing artificial sweeteners as such food could replace nutrient dense, energy-yielding foods. So far, Saccharin (Hermesetas®) and Cylamate (Sugar Twin®, Sweet N’Low®) are not safe to use during pregnancy (here).
Liver
Liver is rich source of iron. However, it contains a high level of Vitamin A. Large amounts of Vitamin A can be harmful to the baby (here).
Limit liver to 75g (2.5 oz) every two weeks.
Alcohol
Drinking alcohol can be harmful to the baby. No one knows what level of alcohol is safe for an unborn baby.
While you’re pregnant, or thinking about becoming pregnant, it’s safest not to drink any alcohol.
Alcohol is passed from the mom through the placenta to the growing baby. Baby’s liver is not capable of breaking down alcohol, increasing the risk of miscarriage, preterm labor, low birth weight, and Fetal Alcohol Spectrum Disorder (FASD) that can lead to growth problems, development delays, learning disabilities, and deformed facial features.
Alcohol used in cooking, such as Chinese rice wine, may be safe to consume if the food has been simmered or baked for at least an hour.
Caffeine
Caffeine has been associated with miscarriage, especially during the first trimester. However, small amounts of caffeine during pregnancy are fine for most people.
Limit your caffeine intake to about 300 mg per day or less (no more than 500 mL or 2 cups).
High caffeine intake during pregnancy has been shown to increase the risk of low birth weight and impaired fetal growth. Caffeine is also found in tea (green and black teas contain about 30-50 mg per 250 mL or 1 cup), cola (23-40 mg per 250 mL or 1 cup), and chocolate (3-50 mg per 1 bar).
Herbal Teas
You may be thinking you should switch to herbal tea if you’re trying to cut back on caffeine, but that may not necessarily be your best pregnancy drink. Herbal teas can be made with fresh or dried flowers, leaves, seeds and/or roots.
Even though tea is all “natural”, the research on herbal tea is sparse and in some cases, there is concern that if consumed in excess, it could be problematic for a wide range of reasons. Some herbal products may stimulate uterine contractions, or increase the risk of birth defects. Again, it’s likely just a concern if you’re drinking large amounts daily, but always speak to your doctor first before making anything a regular part of your routine. (here, here).
BOTTOM LINE
Although there are foods to limit or avoid during pregnancy, the most important consideration is providing a nutritious prenatal diet.
