1. Eating Right: For You & Your Baby
This show by Food and Health Communications, Inc. will help you learn how to eat healthy before, during and after pregnancy. It will guide you to choosing foods that are nutrient dense and just right for you and your baby.

2. Did You Know?
Q: What is your baby’s main source of nutrients for growing?
A: You!
Essential nutrients come from:
- What is stored in your tissues
- What you eat
Speaker – show the question and see if the audience knows the answer before you show it (slide show animation is turned on for this slide).
Your nutritional state prior to becoming pregnant will determine how “packed” your vitamin and mineral stores become.
A healthy diet gives your baby a better start.

3. Are You Ready?
In this section we will help you learn what to eat and what to avoid before getting pregnant
This section will deal with what to eat before you get pregnant.

4. Get Ready Assess your current eating plan
Most women do not include enough:
folic acid
high-calcium foods
iron
fruits and vegetables
Preparing at least three to four months prior to conception is a good idea.
The best way to assess your current eating plan is to take a look at our healthy pregnancy eating plan coming up in one of the next slide.
Speaker – have your audience write down what they ate yesterday. Have them set it aside until we get to the healthy pregnancy eating slide and compare how they are doing.

5. Prevent Birth Defects
Q: How many babies are born in the US every year with a neural tube defect?
A: 1 in every 1000 babies
Neural tube defects are the second leading cause of death among infants who die from birth defects in this country.
Getting enough folate can help prevent these birth defects.

6. Folate Helps Prevent Birth Defects
Folate is needed both before and in the first weeks of pregnancy
It can help reduce the risk of neural tube defects
400 mcg per day before pregnancy
600 mcg per day while pregnant
Folate is a B vitamin found in a variety of foods and added to many vitamin and mineral supplements as folic acid, a synthetic form of folate. Folate is needed both before and in the first weeks of pregnancy and can help reduce the risk of certain serious and common birth defects called neural tube defects, which affect the brain and spinal cord.
Other maternal factors also may contribute to the development of neural tube defects. These include:
family history of neural tube defects
prior neural tube defect-affected pregnancy
use of certain antiseizure medications
severe overweight
hot tub use in early pregnancy
fever during early pregnancy
diabetes.
Any woman concerned about these factors should consult her doctor.

7. Which Foods are the Best Source of Folate?
Chicken liver, fortified breakfast cereals, beans, asparagus, broccoli, green leafy vegetables, oranges and wheat germ
Beans include pinto, black, white beans, etc – they are the mature dried seeds of legume plants – this does not include green beans.
Liver is high in cholesterol so we don’t recommend eating large amounts of it.

8. Which Foods Are The Best Sources of Calcium?
Skim milk
Fat free ricotta cheese
Yogurt
Fortified soy milk
Calcium fortified orange juice
Sardines with bones
Read the label. A food is rich in calcium if it contains 10% or more of the daily value for calcium. It is high in calcium if it contains 20% or more.
For comparison purposes, skim milk contains about 30% of the daily value or 300 mg of calcium.
In an upcoming slide, we will see the healthy pregnancy eating plan and this will show you that you should get 2-3 servings per day

9. Where’s the Iron?
Liver, meat, fortified breakfast cereal, spinach, beans
Women of child bearing age tend to be iron deficient because of menstruation. It is important for your health and that of your baby. Eating a well balanced diet will help you get enough iron.

10. Tips for More Fruits & Vegetables
Try to include fruits and or vegetables with every meal
Include fresh fruit with breakfast
Take bananas and apples with you for snacks
Eat a big salad for lunch
Eat vegetables at dinner
Make a fruit/yogurt smoothie for dessert
Fruits and vegetables contain many important nutrients as well as fiber.

11. Do I Need A Supplement? Assess your current eating plan
Take supplements several months prior to conception if food intake for folic acid and iron is not optimal
Be careful about eating a lot of fortified foods if you are taking supplements. Some studies have indicated that a high intake of vitamin A can cause birth defects. Always check with your physician or a registered dietitian before taking supplements.

12. Exercise Check with your physician Begin before you are pregnant
Modify your program during the second and third trimesters
Benefits:
Improves your sense of well-being
Helps you control your weight
More timely onset of labor
Less difficulty with labor pain
Talk to your doctor before beginning any rigorous exercise plan, especially if you have been sedentary for a long time. Always start slowly and be consistent. The old saying, “no pain, no gain” is simply not true.

13. Here’s what you need to know about eating when you are pregnant
I’m Pregnant!
Here’s what you need to know about eating when you are pregnant
In the following slides we will show you everything you need to know about eating healthy for you and your baby.
Speaker – it may be fun to ask everyone how they found out they were pregnant and how they told their spouse/significant other.

14. Healthy Pregnancy Eating Plan (HPEP)
8 or more servings of complex carbohydrates
4 or more servings of vegetables
3 or more servings of fruits
3 servings of dairy
2-3 servings of extra-lean meat, poultry, fish and/or legumes
Here is a healthy pregnancy eating plan. It will ensure that mother and baby get all of the nutrients they need without adding excessive calories to the diet. Foods should be consumed in their whole state.
This plan is based on the food guide pyramid.
There are six exceptions to the recommended pregnancy food formula. Each mom-to-be should talk with her healthcare practitioner about her particular nutritional needs:
• the overweight woman, who — with professional guidance — may do better with fewer calories
• the significantly underweight woman, who will almost certainly need to eat more
• the teenager, who is still growing and has greater-than-average nutritional requirements herself
• the expectant mother of multiples, who will have extra food needs for each baby
• the diabetic mother-to-be, who will need to closely monitor her blood sugar levels
• the woman who develops gestational diabetes during her pregnancy, who will also need to closely monitor her blood sugar levels

15. 8 or More Servings of Complex Carbohydrates
100 % whole wheat bread
Oatmeal and other whole grain cereals
Whole wheat noodles or pasta
Brown rice
Potatoes and sweet potatoes
Barley
Fortified grain products*
Fortified grain products, such as enriched breads, pasta, rice, waffles, cereals and cereal bars are rich sources of folic acid, the synthetic form of folate.
*Rich in folic acid

16. 4 or More Servings of Vegetables
Asparagus*
Bean Sprouts
Green Beans
Beets
Broccoli*
Cabbage
Carrots
Cauliflower
Chard*
Eggplant
Kale*
Spinach*
Tomato
Turnip Greens*
*Rich in folate
Many vegetables are good sources of folate along with other vitamins and minerals.

17. 3 or More Servings of Fruit
Bananas
Blueberries
Cantaloupe*
Grapefruit*
Grapes
Kiwi*
Melon
Oranges
Papaya
Peach
Pineapple
Strawberries*
Watermelon
*Rich in folate
Fruits are an excellent source of many vitamins and minerals too.

18. 3 Servings of Nonfat Dairy
Skim milk
Yogurt
Lowfat cheese
Lowfat ricotta cheese
These dairy products are the best sources of calcium. They also contain protein. Milk contains vitamins A and D. Fortified soy milk and fortified orange juice also contain calcium.
These are the best sources of calcium

19. 2 Servings of Lean Protein Foods
Beans and peas*
Lentils*
Lean chicken
Seafood
Tofu
Lean red meat
Try to include beans, peas and or lentils in your diet each week. We will show tips on fish and seafood in an upcoming slide.
*Rich in folate

20. Seafood
Do not eat shark, swordfish, king mackerel, or tilefish because they contain high levels of mercury
Eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish that are lower in mercury
Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish
Another commonly eaten fish, albacore (“white”) tuna has more mercury than canned light tuna
So, when choosing your two meals of fish and shellfish, you may eat up to six ounces (one average meal) of albacore tuna per week
Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers and coastal areas
If no advice is available, eat up to six ounces (one average meal) per week of fish you catch from local waters, but don’t consume any other fish during that week
This is the latest advisory from (03/19/2004)

21. Fluids Needed for baby:
Building your baby’s body cells & circulatory system
Delivery of nutrients
Excretion of wastes
It is important that you drink plenty of water and other liquids while you are pregnant.

22. Fluids
Needed for you:
Helps to combat constipation
Regulate body temperature
Reduces risk of urinary tract infections
Consume at least 8 cups of fluids per day (water, juice, decaffeinated beverages)
You might need more fluids during hot weather or exercise.

23. Foods to Limit or Avoid Alcohol Caffeinated beverages Candy
Cookies/cakes/pies/doughnuts
Drinks made with sugar or high-fructose corn syrup
Meats that are less than 95% fat-free
Chips and other snack foods high in fat and salt
Alcohol can cause fetal alcohol syndrome.
The FDA advises that pregnant women restrict their caffeine consumption. Caffeine is found in coffee, tea, soda and chocolate. There are plenty of delicious caffeine free versions of coffee, tea and soda.
Cookies, cakes, pies, donuts, and sugary drinks are all high in calories and low in nutrients. Any excessive weight you put on now will have to come off after the baby – you will have less time and energy after the baby arrives so it is better to eat smart now.
Chips, fatty snacks and fatty meats are high in calories.

24. Avoid Drugs
Use of street drugs can affect fertility and have lifelong and serious consequences
Optimal nutrition might help, but it can not fully compensate for the harsh effect of drugs
Never self-medicate when you are pregnant
Always check with your physician
Always check with your doctor before taking any kind of medication. If you are on street drugs, talk to him or her to help yourself get off of them.

25. Eat Frequently Aim for 3 meals and 2 to 3 snacks
Eat every 2-3 hours or 5-6 times per day
Take food with you
Eating habits will change as pregnancy progresses
You may eat more or less depending on how you’re feeling each day!
Eating smaller, more frequent meals will help you avoid indigestion and help you have a more constant supply of energy during the day.

26. Calorie Needs Calorie needs will vary per person First trimester:
Average of calories
Second & third trimester:
Increase by 300 calories
Average of 2,300-2,500 calories
Vitamin and mineral needs are high
Consume foods as close to their natural state as possible
Individual calorie needs will vary according to a person’s size and activity level. These are estimates of what the average person will need.
It is important to consume whole foods instead of processed foods – these are lower in fat and higher in fiber and nutrients. They are also usually lower in sodium too.

27. Weight Gain Expectations
Pregnancy is not the time to diet
Expect weight gain of pounds*
Pattern of weight gain is important:
slow gain in the 1st trimester (2-4 pounds)*
3/4 to 1 pound a week for the last 2 trimesters*
*(for women in normal weight range)
Talk to your physician if you have any questions or concerns regarding your weight gain.
Tips: for how much weight you should gain: If overweight:  lb.
Underweight lb.
Expecting twins lb.

28. Side Effects That May Be Lessened by a Proper Diet
Fatigue
Morning Sickness
Constipation
Varicose Veins
Tooth and Gum Problems
Leg Cramps
Irritability
Skin Problems
Colds and Infections
Mild Depression
Nose Bleeds
Mood Swings
These side effects may be lessened by a proper diet. Getting plenty of rest is important too. You should try to wash your hands often, before eating and before handling food.

29. First Trimester Follow Healthy Pregnancy Eating Plan
Expect weight gain of 2-5 pounds
Discuss supplement needs with your physician or dietitian
Stop drinking alcohol, using tobacco, or taking drugs not approved by your physician
Discuss exercise regimen with physician, adjust if necessary
These are all tips for you in your first trimester.

30. Morning Sickness
Eat what and when you can but try to make it nutritious, if possible
Nibble on salt-free crackers and dry cereal
Eat frequently to avoid hunger
Avoid offensive cooking odors
Drink fluids
Consume beverages and soups between meals
Avoid coffee, tea, and spicy or acidic foods
Try to eat often and find bland foods that agree with you. Small amounts of food in the stomach decrease morning sickness. We have tips for dealing with nausea on the next slide.
If you are really having a hard time keeping anything down, be sure to consult your physician so you don’t become dehydrated.
Hang in there – it usually gets better after the first trimester. Getting plenty of rest may be helpful.

31. Nausea Occurs often in the first trimester
Try to determine which foods will be appetizing and tolerable for you
Mashed potatoes, soups, pretzels, oatmeal, pudding, graham crackers, rice, or pasta may be soothing
Sips of soda water with lemon or ginger ale may be helpful for overcoming pangs of nausea
Many women say that the nausea that comes with pregnancy is actually worse than just getting sick. It may occur in the morning, in the evening or all day. These tips may be helpful for dealing with this discomfort.
If extreme nausea and vomiting occur, eat what and when you can; hang nutrition; then add in more nutritious choices as can tolerate.

32. Constipation
Consume ample fruits, vegetables, whole grains, and legumes
Increase fluids, especially water
Daily exercise helps keep things moving
Try 1 tsp of wheat bran if fruits/veggies don’t help
Use laxatives only as a last resort and under medical supervision
Not drinking enough water, eating low-fiber foods, or not exercising daily may worsen constipation
Pressure of growing baby on intestines and rectum and iron supplements contribute to the problem

33. Fatigue Take a nap, go to bed early if possible
Eat well, exercise, listen and respond to your body’s needs
Avoid sugary foods and caffeine, or other temporary “quick fixes”
Eat every few hours, always eat breakfast, drink plenty of fluids
If fatigue continues, talk with your physician about a blood test for iron
It is a fact that you will be more tired and need more rest when you are pregnant. Instead of trying to do more, do less and give in to your body’s cues to take a nap, go to bed early or sleep in.

34. Food Cravings Common among pregnant women
Sweet, sour, salty, and spicy foods
Aversions may make it difficult for you to tolerate your favorite foods
Cravings may be based on an underlying nutritional need such as iron deficiency i.e. craving ice or dirt
Food cravings are common among pregnant women. Everyone has funny stories about what their mother or friend craved during their pregnancy.
Try to be creative and find healthy low-cal solutions to cravings. One example is to make a creamy smoothie using yogurt, skim milk and some fruit instead of having a big bowl of ice cream. Or eating a healthy meal before giving into a craving might help you eat less of something high in calories.

35. Crave-Control Tips Eat frequently Set aside a calorie allotment
Abstinence may lead to binge eating
Choose small servings of your favorite foods
Try to choose a healthful version of the craved food, e.g. smoothie instead of ice cream
For chocolate cravings, consider using light chocolate syrup over fresh fruit such as strawberries or bananas.

36. Avoid Food Poisoning Clean: Separate - don’t cross contaminate:
Wash hands frequently
Keep all food surfaces very clean
Use paper towels instead of a sponge
Separate - don’t cross contaminate:
Wash hands and food surfaces after preparing raw meat, poultry, fish and eggs
Don’t store these raw ingredients over ones that will be served without cooking
Keep your kitchen safe so you avoid food poisoning. IN this and the next slide, we show you the basics of a safe kitchen.

37. Avoid Food Poisoning Chill: Heat: Refrigerate leftovers promptly
Heat or cook foods quickly and to the right temperature
Cook meat and poultry to the right temperature
Bring reheated foods to a boil before serving
Don’t allow food to sit out and always reheat leftovers thoroughly to avoid food poisoning brought on by improper temperatures.
Avoid food poisoning:  keep hot foods hot; cold foods cold.

38. Second Trimester Continue to follow HPEP
Increase calories by about 300 per day
Expect weight gain of ¾ - 1½ pounds a week for a total of pounds
Exercise daily, but adjust the routine, intensity, or duration as needed
To increase your calories by 300, go for 2 extra carbohydrates like 2 fruit, and 2 veggies – this does not mean more cookies! This is just a guideline – calorie intake will vary by individual and should be adjusted if too much weight is being gained.
Continue to take supplements if necessary

39. Heartburn Usually occurs in the 2nd trimester
Aggravated by large meals, foods that produce gas such as beans and cabbage, and fatty or spicy foods
Avoid discomfort by eating small, frequent meals, eat a light dinner at least 3 hours before bedtime, chew and eat slowly
Heartburn can be very uncomfortable. Follow these tips to avoid it. Talk to your physician if it becomes too hard to manage.

40. Heartburn Decrease or limit problematic foods like:
coffee
chocolate
processed meats
rich pastries
fried foods
alcohol
carbonated beverages
Avoid lying down after eating a large meal
A sedentary lifestyle, rushed meals, and tight clothing may also aggravate the condition

41. Third Trimester
Follow HPEP (don’t forget your additional 300 calories)
Expect weight gain of .7 to 1.4 pounds a week for a total of 9 to 19 pounds
Continue taking a supplement if necessary
Exercise daily
Rest!
Now you are almost there. Most of the troubles of the first two trimesters (nausea, morning sickness and heartburn) will have subsided but your big belly will make it harder for you to get around. Rest a lot and read up on breastfeeding. Now is the time to get ready for your baby.

42. What Makes Up Weight Gain?
Maternal stores: 7 pounds
Tissue fluid: 5-6 pounds
Maternal tissue: 3-4 pounds
Baby/fluid/placenta: pounds
Maternal stores are primarily fat
Fluid is primarily blood and water
Maternal tissue is mostly the uterus
This totals about pounds gained

43. Gestational Diabetes Diabetes that exists only during pregnancy
Resolves itself after delivery
Arises after 20 weeks of gestation
May affect as many as 5-10% of all pregnancies
Symptoms: increased urination, increased thirst, high blood glucose
Most physicians use a 50-g oral glucose challenge to screen for the condition between 25 to 28 weeks

44. Gestational Diabetes
It is treated largely through diet changes and moderate exercise to achieve weight control
Gestational diabetes can be controlled, thus resulting in a healthful pregnancy
Infant is at risk of perinatal (before birth) mortality and prematurity
Women are at risk for developing diabetes later in life
Risk is increased if close family member has diabetes

45. Pregnancy Induced Hypertension
Usually develops in the third trimester
Affects about 7-8% of pregnant women
Diagnosis:
Systolic blood pressure of 140 or a diastolic pressure of 90, or both
A rise of in systolic pressure or in diastolic pressure, or both, on two or more occasions 6 hours apart
May develop into preclampsia – a condition characterized by high blood pressure, swelling and protein in the urine. This is also called toxemia.

46. Pregnancy-Induced Hypertension
Cause is unknown
Development is associated with lack of prenatal care and poor nutritional status
Incidence is higher in those with low calcium intake
Limit your physical activity, continue to eat well, and rest frequently
Proper prenatal care can help you manage your blood pressure. Ask your doctor about how much water to drink and how much salt to eat. While you would want to lower your salt intake when not pregnant to reduce blood pressure, this is not necessarily the case when you are pregnant.
Calcium intake is important – make sure you are consuming 2 to 3 nonfat dairy products a day. Skim milk, nonfat plain yogurt and nonfat ricotta cheese are the best sources. Calcium fortifed skim milk has even more calcium than regular milk.

47. After the Birth
Here are some tips to help you with breastfeeding after you have your baby
Give you baby the best start with breast milk.

48. Breast is Best Nutritionally superior to any alternative
The least allergenic of any infant food
Promotes good jaw development
Costs less than commercial formulas
Promotes close mother-child contact & bonding
Always safe and fresh
Helps prevent infections
Better weight management and reduced risk of cancer for mom
Breast milk is nutritionally superior to any alternative. It contains substances which can prevent infections. It is easy and many mothers report that they really enjoy the bonding that occurs between them and their baby.

49. Breast is Best
Comes with a heartbeat just like baby is used to hearing in the womb
The milk is just the right temperature
The breast refills automatically
It’s unbreakable and can't be dropped
The milk is ready when baby is
These nipples that don't need sterilizing and come with a lifetime guarantee of durability
Breast milk is nutritionally superior to any alternative. It is easy and many mothers report that they really enjoy the bonding that occurs between them and their baby.

50. Eating Tips for Breastfeeding
Continue healthy pregnancy eating plan, but increase calories by about 500 per day
This will increase your protein, fat, and vitamin and mineral requirement to the appropriate level
Eat and drink enough to satisfy your hunger and thirst
You will need to eat and drink substantially more when you are breastfeeding. Take water and food with you in your diaper bag. Inform your friends and loved ones of your needs so they may support you.
Instead of just counting calories, make sure you are eating healthy, nutritious foods. In other words, plenty of whole grains, fruits, vegetables, nonfat dairy, lean protein, etc.

51. Tips to Keep Your Milk Volume High
Milk production is affected primarily by frequency of feeding
Get plenty of bed rest
Aim for 2 to 3 quarts of liquids per day
Oral contraceptives may suppress lactation, especially in the first 6 to 10 weeks
Try to nurse your baby as soon as you deliver
Room with the baby in the hospital so you can feed on demand.
Work with a lactation specialist or nurse to learn proper latch on procedures
Spend time in the beginning with the baby and nurse frequently. Keep friends’ visitations short and make sure you get enough food, water and rest.
Call a lactation consultant immediately if you have any problems or questions.

52. Weight Loss and Breast Feeding
Don’t consciously try to lose weight until at least 2 months post-partum
Eat a healthy diet and exercise
Many women who breastfeed find it makes losing weight easier
Avoid foods that are laden with sugar and fat
Instead of trying to limit the amount of food you consume, you should limit the amount of sugary and fatty foods you consume. Concentrate on eating healthy, eat when you are hungry and get enough rest and fluid.
The La Leche League recommends you give yourself at least 2 months to recover from child birth before you try any active weight loss strategies.
Do not try fad diets or liquid meals. Lactation is not the time to go on a crash diet. You and your baby need nutritious foods and plenty of water.
FMI see

53. Common Myths You can’t get pregnant while breastfeeding
You need to “toughen” your nipples before your baby is born
Small breasts don’t produce as much milk as large ones
Breastfeeding will ruin the shape of your breasts
All babies should be weaned before their first birthday
These are common myths about breastfeeding. Often they are believed and proclaimed by well-meaning friends and family members. Reading good literature will help you educate yourself and support team. If you have any questions, don’t hesitate to seek the advice of a lactation specialist – you can find one at a local hospital or ask your doctor for a recommendation.
The Womanly Art of Breastfeeding by La Leche League is a good place to start.

54. “Dedicate some of your life to others
“Dedicate some of your life to others. Your dedication will not be a sacrifice. It will be an exhilarating experience because it is an intense effort applied toward a meaningful end.”
Dr. Thomas Dooley