MASSACHUSETTS GENERAL HOSPITAL NUTRITION & FOOD SERVICES

Nutrition During Pregnancy: The Basics

How Much Weight Should I Gain?
Guidelines depend on your pre-pregnancy weight and height or Body Mass Index (BMI). Ask your doctor or a Registered Dietitian for your BMI value. Underweight BMI Healthy BMI Overweight BMI Obese BMI Twins or Multiples 28-40 pounds total 25-35 pounds total 15-25 pounds total 11-20 pounds total 37-54 pounds total

How much extra do I need to eat?

An extra 300 calories per day during the second and third trimesters. Typically this is just one extra snack each day. For a twin pregnancy an extra 450-500 calories per day is needed during the second and third trimester. *WHAT you eat is more important than simply HOW MUCH you eat.* Try eating something every 3-4 hours 3 meals and 2-3 snacks every day Protein o 3-4 servings/day o One serving is: o 3 oz meat/fish/poultry o 1 cup dried beans o 3-4 T nuts or peanut butter o 2 eggs o 4-6 oz tofu or soy protein o cup cottage cheese Try adding some protein into every meal and snack. A few ways to add protein rich snacks to your day are: Trail mix of cereal and nuts or seeds String cheese with fruit or crackers Carrot sticks or apple slices with peanut butter or cottage cheese Whole grain crackers or pita bread with a bean dip or hummus.

MGH Nutrition Services

K Ferguson 8/2010

Calcium 3-4 servings/day A twin pregnancy should get 4-5 servings/day One serving is: o 1 cup milk or calcium fortified juice or soy milk o 1.5-2 oz hard cheese o 1 cup yogurt o 1-1.5 cups pudding or ice cream o Dark green vegetables also have calcium but it is harder to absorb. Folic Acid All women able to become pregnant should take a supplement with 400 mcg of folic acid and eat folate from foods. 600 mcg per day during pregnancy Food sources of folate: o Fortified cereals and breads o Spinach o Legumes o Asparagus o Orange juice o Broccoli

Iron

27 mg/day Most women will take a supplement of 30 mg per day after the 12th week. (Ask your OB or Registered Dietitian for more information) Iron content of foods: o > 5 mg per serving: 3 oz liver*, 1 oz iron-fortified cereals. o 3-5 mg per serving: 3 oz beef, 1 cup legumes o 1-3 mg per serving: 4-5 pieces dried fruit, 1 egg yolk, 3 oz fish or chicken.

* Limit the amount of liver to occasional use so you do not get too much vitamin A. It is okay to eat unlimited amounts of beta-carotene, the form of Vitamin A in fruits and vegetables. Choose a variety of brightly colored fruits and vegetables every day!

Water 2 liters of water every day is the goal 4 bottled waters at least Try adding lemon, lime or berries to give your water more flavor!

MGH Nutrition Services

K Ferguson 8/2010

What are the food safety basics?

Wash your hands often after using the bathroom, before cooking, before eating, after handling any raw meat Avoid cross contamination keep utensils or cooking equipment used for raw meat separate from those for other foods Cook all meat, poultry and seafood until well-done 160 F hamburgers/pork 170 F steaks 180 F poultry 145 F seafood

Reheat leftovers or ready-to-eat meats (hot dogs/deli meat) until steaming hot Heat refrigerated smoked-fish (ex: lox, nova-lox) until steaming hot Wash fruits and vegetables under running water Avoid the following completely: o Pt o Raw eggs or raw egg products o Raw sprouts o Unpasteurized milk or cheeses (Brie, Feta, Camembert, Blue cheese, Queso Fresco) *Hard cheeses, yogurt and cream cheese are allowed* o Unpasteurized juices/ciders

What about fish?

Fish is a great source of protein and omega-3 fatty acids that are an important part of a healthy diet during pregnancy. However, fish and shellfish do contain some mercury that can be harmful to the developing baby when eaten in high amounts. o Avoid swordfish, tilefish, king mackerel, and shark completely these fish have the highest level of mercury. Limit tuna steaks or canned tuna fish to 6 oz per week that is 1 can of tuna/week Limit all other fully cooked fish/shellfish to 12 oz per week (white fish, farm raised freshwater fish, wild/canned salmon, shrimp, scallops, clams, crab) *3 oz is the size of a deck of cards* Those are the basics for a healthy, safe and nutritious pregnancy! For more information consult your OB and Registered Dietitian!

MGH Nutrition Services

K Ferguson 8/2010