1. Nutrition in Pregnancy
Presented by
Dee Anne Domnick, CPM, LM, MH

3. Throughout Pregnancy & While Breastfeeding:
Make most of your food choices healthy ones.
Eating too many foods that are high in fat during pregnancy leads to too much weight gain for you without meeting your increased need for nutrients.

4. Some nutrient requirements more than double during pregnancy, while caloric needs increase only about 15 percent

5. Why is a healthy diet important during pregnancy?
For the health of both the pregnant woman and the developing baby
Healthy foods are the building blocks of the growing baby since pregnancy is a complex time of developing new tissues and organs.

6. Approximately half of all pregnancies in the United States result in prenatal or postnatal death or an otherwise less than healthy baby.
Major developmental defects, such as neural tube and heart deformities, occur in approximately 120,000 of the 4 million infants born here each year.
Exposure to toxic chemicals, both manufactured and natural, cause about 3 percent of all developmental defects
At least 25 percent might be the result of a combination of genetic and environmental factors.

7. Monitoring of Weight Gain is Important —Especially of Underweight Women
In addition to the growth of the fetus associated with maternal weight gain, pregnant woman store fat to prepare the mother for lactation.

8. Weight Gain During Pregnancy
An additional pounds is considered desirable for the benefit of both the mother and developing infant
Recommended by the National Academy of Sciences /Institute of Medicine

9. Women who are underweight when they conceive
should gain about pounds

10. Those who are overweight
should gain no more than pounds

11. Short women (under 62 inches)
should set lower goals for weight gain, pounds

12. Extremely Obese Women
should gain no more than 15 pounds

13. Young Adolescents
should gain between 28 and 40 pounds, regardless of their pre-pregnancy weight and height

14. Women Carrying Twins
should gain pounds, regardless of pre-pregnancy weight and height

16. Four or more servings of milk and milk products for calcium
According to the American College of Obstetricians and Gynecologists (ACOG), pregnant women should increase their usual servings of a variety of foods from the four basic food groups to include the following:
Four or more servings of fruits and vegetables for vitamins and minerals
Four or more servings of whole-grain or enriched bread and cereal for energy
Four or more servings of milk and milk products for calcium
Three or more servings of meat, poultry, fish, eggs, nuts, dried beans and peas for protein

17. Is it necessary to take a vitamin/mineral supplement during pregnancy?
Though it’s possible to meet the requirements for most nutrients through a balanced diet, most experts recommend pregnant women take daily vitamin supplements, including iron & folic acid, as a safe guard.

18. According to the National Academy of Sciences/ Institute of Medicine, supplementation should begin at the start of the second trimester at the following levels:
Iron milligrams (mg)
Folic Acid micrograms (mcg)
Calcium ………………250 mg
Vitamin C………………...……50 mg
Vitamin B12…….....…………...2 mcg
Vitamin D………..…………….5 mcg
Copper………………………….2 mg
Zinc………………………..…..15 mg
Vitamin B6………………..……..2 mg

19. Vegans
Add an additional:
10 mcg of Vitamin D
2 mcg of Vitamin B12

20. About Folic Acid
Folic acid in a vitamin supplement, when taken one month before conception and throughout the first trimester, has been proven to reduce the risk for an NTD-affected pregnancy by 50% to 70%.
Folic acid, a B-vitamin, is necessary for proper cell growth and development of the embryo.

21. Newborn with Spina Bifida

22. Anencephaly

23. Cleft Lip & Palette

24. Folic Acid--important in cell development (a water soluble vitamin)
Recent research suggests that taking folic acid before and during early pregnancy can reduce the risk of spina bifida and other neural tube defects (NTD’s) in infants.
The U.S. Public Health Service recommends that all women of childbearing age that are capable of becoming pregnant should consume 400 micrograms (mcg) of folic acid daily to reduce their risk of having an NTD-affected pregnancy.

25. How Can Women Get Enough Folic Acid?
There are three ways women can get enough folic acid to help prevent spina bifida and anencephaly. They can choose to:
Take a vitamin supplement containing 400 micrograms of folic acid daily.
Eat a fortified breakfast cereal daily which contains 100% of the recommended daily amount of folic acid (400 micrograms).
Increase consumption of foods fortified with folic acid (e.g., “enriched” cereal, bread, rice, pasta, and other grain products) in addition to consuming food folate from a varied diet (e.g., orange juice and green vegetables).

26. Foods rich in folate include:
orange juice from concentrate,
dark-green leafy vegetables:
(spinach, broccoli, asparagus, romaine lettuce)
other vegetables:
(carrots, tomatoes, potatoes)
beans and pulses like black-eyed beans & lentils
whole grains (i.e. brown rice & some cereals)
citrus, bananas, kiwis and strawberries,
liver
fish
eggs
milk

27. Vitamin A supplementation is not recommended during pregnancy
Excessive levels of Vitamin A can be toxic to the fetus
Adequate levels of Vitamin A are available through a balanced diet

28. Calories--To support the rapid growth of the fetus, pregnancy demands an additional 300 calories a day over pre-pregnancy needs
This is approximately the same number of calories as supplied by
2 ½ cups of low-fat milk OR
1 cup of ice cream OR
A bagel with cream cheese OR
A tuna fish sandwich

29. Protein Both the expectant mother and developing fetus need increased amounts of protein.
It is recommended that pregnant women consume 60 grams of protein a day.
This is only 10 grams more than non-pregnant women.
Since most Americans regularly consume more than they require, most women will not need to consciously increase their protein consumption during pregnancy.

30. Protein Sources Seeds Nuts Beans, legumes Grains Sprouts Eggs
Dairy Products
Fish
Lean Meats
Fowl

31. Suggestions for Complementing Proteins (they do not need to be consumed at the same meal as believed) These are menu ideas for vegetarian dishes:
Stir fried tofu and rice
Tomato, rice and beans
Rice-bean casserole
Wheat-soy bread
Lentil curry on rice
Corn-soy bread
Bean or pea curry on rice
Corn tortillas and beans
Pea soup and toast
Legume soup with bread
Bread made with milk or cheese
Pasta with milk or cheese
Rice and milk pudding
Cereal and milk
Rice-cheese dishes or casseroles
Cheese sandwiches
Yogurt and barley soup
Sesame and milk
Sesame seeds in bean soup
Lentils and rice
Wheat bread with baked beans

32. Iron The iron requirement doubles during pregnancy:
30 mg/day during the second and third trimesters.

33. Additional iron is needed as a result of increased maternal blood volume.
Also, the fetus stores enough iron to last through the first few months of life.

34. What is anemia?
Anemia is a blood disorder that is defined as:
a level of red blood cells (RBCs) that is below normal, or
a level of hemoglobin that is below normal (hemoglobin is the oxygen-carrying protein in red blood cells).

35. There are several forms of anemia, such as:
iron deficiency anemia
hemolytic anemia (destruction of RBCs)
vitamin B-12 deficiency anemia
folic acid deficiency anemia
Vit. E deficiency anemia
Vit. C deficiency anemia
anemias caused by inherited abnormalities of RBCs (for example, sickle cell anemia and thalassemia)
anemia caused by chronic (ongoing) disease, such as rheumatoid arthritis.
and more

36. To Get the Most of Iron from One's Diet:
Eat high-iron meals with vitamin C or foods high in vitamin C.
(Taking mg. of Vit. C nearly doubles iron absorption).
Tannic acid, caffeine, and phosphates inhibit iron absorption; avoid them.
Avoid antacids; they neutralize stomach acids, which enhance iron absorption.
Minimize use of laxatives, which decrease the amount of time the body has to absorb iron.
Minimize consumption of refined carbohydrates; they cause the secretion of more-alkaline digestive juices, which decrease the acidity of the stomach.
Do not take iron supplements or high-iron meals with dairy products, which neutralizes stomach acidity.
Niacin, B1, B2, pantothenic acid, choline, B12, folic acid, cobalt, and copper are involved in the absorption, assimilation, and utilization of iron.
Use leavened whole grains; yeast in the fermentation process makes iron available.
Do not rely on iron-fortified foods; iron used by manufacturers is often a phosphate compound not soluble in the human digestive tract.
Large doses of supplemental zinc or calcium interfere with iron absorption.
Cast-iron cookware adds iron to food, especially if the food cooked in it is acidic.
Minimize exposure to cigarette smoke and other air pollutants.
Regular aerobic exercise improves iron absorption because of the body's greater need for oxygen-carrying capacity.
Choose iron supplements carefully.

37. You can help reduce your risk of iron deficiency anemia by eating foods that contain iron all throughout pregnancy. These include:
Red meats
Shellfish
Poultry (dark meat)
Eggs
Fortified breakfast cereals & whole grain breads
(check the container to see if the cereal or bread contains iron)
Oatmeal
Blackstrap molasses
Green leafy vegetables
Baked potato, with skin
Cooked beans
Raisins, dates, prunes, figs, apricots

38. The iron in fruits, vegetables, cereals & eggs is not absorbed as efficiently as iron from meat, fish & poultry.
Iron absorption from these non-flesh foods is enhanced when consumed with foods high in Vitamin C (such as orange juice) or served with meat, fish or poultry.

39. Selected Food Sources of Heme Iron
Food Milligrams per serving % DV*
Chicken liver, pan-fried, 3 ounces
Oysters, canned, 3 ounces
Beef liver, pan-fried, 3 ounces
Beef, chuck, blade roast, lean only, braised, 3 ounces
Turkey, dark meat, roasted, 3 ounces
Beef, ground, 85% lean, patty, broiled, 3 ounces
Beef, top sirloin, steak, lean only, broiled, 3 ounces
Tuna, light, canned in water, 3 ounces
Turkey, light meat, roasted, 3 ounces
Chicken, dark meat, meat only, roasted, 3 ounces
Chicken, light meat, meat only, roasted, 3 ounces
Tuna, fresh, yellowfin, cooked, dry heat, 3 ounces
Crab, Alaskan king, cooked, moist heat, 3 ounces
Pork, loin chop, broiled, 3 ounces
Shrimp, mixed species, cooked, moist heat, 4 large
Halibut, cooked, dry heat, 3 ounces
*DV = Daily Value. DVs are reference numbers developed by the Food and Drug Administration (FDA) to help consumers determine if a food contains a lot or a little of a specific nutrient. The FDA requires all food labels to include the percent DV (%DV) for iron. The percent DV tells you what percent of the DV is provided in one serving. The DV for iron is 18 milligrams (mg). A food providing 5% of the DV or less is a low source while a food that provides 10–19% of the DV is a good source. A food that provides 20% or more of the DV is high in that nutrient. It is important to remember that foods that provide lower percentages of the DV also contribute to a healthful diet. For foods not listed in this table, please refer to the U.S. Department of Agriculture's Nutrient Database Web site.

40. Selected Food Sources of Non-Heme Iron
Food Milligrams per serving % DV*
Ready-to-eat cereal, 100% iron fortified, ¾ cup
Oatmeal, instant, fortified, prepared with water, 1 packet
Soybeans, mature, boiled, 1 cup
Lentils, boiled, 1 cup
Beans, kidney, mature, boiled, 1 cup
Beans, lima, large, mature, boiled, 1 cup
Ready-to-eat cereal, 25% iron fortified, ¾ cup
Blackeye peas, (cowpeas), mature, boiled, 1 cup
Beans, navy, mature, boiled, 1 cup
Beans, black, mature, boiled, 1 cup
Beans, pinto, mature, boiled, 1 cup
Tofu, raw, firm, ½ cup
Spinach, fresh, boiled, drained, ½ cup
Spinach, canned, drained solids ½ cup
Spinach, frozen, chopped or leaf, boiled ½ cup
Raisins, seedless, packed, ½ cup
Grits, white, enriched, quick, prepared with water, 1 cup
Molasses, 1 tablespoon
Bread, white, commercially prepared, 1 slice
Bread, whole-wheat, commercially prepared, 1 slice

41. Iron tea Drink daily for iron maintenance. Take with Vit
Iron tea Drink daily for iron maintenance. Take with Vit. C & folic acid supplements for persistent anemia.
Mix equal parts:
Yellow Dock root
Nettles
Red Raspberry leaf tea
Dulse
Drink 1 cup daily

42. Parsley Nutritionally: the culinary multi-vitamin;
a nutrient powerhouse.
Contains high levels of:
beta carotene
vitamin B12
Chlorophyll
Calcium
more vitamin C than citrus fruits
and just about all other known nutrients.
is just like an immune-enhancing multi-vitamin and mineral complex in green plant form. It is one of the most important herbs for providing vitamins to the body. Parsley is made up of proteins (20 per cent), flavonoids (maintain blood cell membranes, antioxidant helper), essential oils, iron, calcium, phosphorus, manganese, inositol, sulphur, vitamin K, beta carotene, and especially vitamin C.

43. Iron Tincture Dandelion root Yellow Dock root Nettle leaf
(This is an alternative to iron supplements)
Dandelion root
Yellow Dock root
Nettle leaf
Take 1-2 droppers/day
(depending on degree of anemia).

44. Calcium Rich Foods Leafy Greens Tofu Almonds Beans Sesame seeds
Black strap molasses
Figs
Cheese and milk
Sardines and salmon
Hard water

45. Factors Increasing Calcium Absorption
Body needs—growth, pregnancy, lactation
Vitamin D
Milk lactose
Acid environment—hydrochloric acid, citric acid, ascorbic acid (vitamin C)
Protein intake and amino acids such as lysine and glycine
Fat intake
Exercise
Phosphorus balance

46. Factors Decreasing Calcium Absorption
Vitamin D deficiency
Gastrointestinal problems
Hypochlorhydria (low stomach acid)
Stress
Lack of exercise
High fat intake
High protein intake
Oxalic acid foods
(beet greens, chard, spinach, rhubarb, cocoa)
Phytic acid foods (whole grains)
High phosphorus intake

47. Calcium Stew Slippery Elm bark Borage Comfrey leaf and/or root
(This is an alternative to calcium supplements)
Slippery Elm bark
Borage
Comfrey leaf and/or root
Oatstraw

48. What Is Preeclampsia?
Preeclampsia is a condition that typically starts after the 20th week of pregnancy and is related to increased blood pressure and protein in the mother's urine (as a result of kidney problems).

49. Metabolic Toxemia of Late Pregnancy
Preeclampsia, toxemia, and eclampsia are all symptomatic degrees of the same disease that Dr. Tom Brewer calls "metabolic toxemia of late pregnancy" (MTLP)
Brewer, Tom [1982].

50. Metabolic Toxemia of Late Pregnancy is evidenced by symptoms of:
High blood pressure
Edema
Sudden weight gain
Proteinuria
Spots before the eyes
Headaches
Elevated liver enzymes
in the most severe cases
eclamptic seizures.

51. Preeclampsia
affects the placenta, and it can affect the mother's kidney, liver, and brain.
Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth.

52. Eclampsia
When preeclampsia causes seizures, the condition is known as eclampsia--the second leading cause of maternal death in the U.S.

53. The Brewer Diet for Pregnancy adapted from: What Every Pregnant Woman Should Know by Tom and Gail Brewer
•4 exchanges of milk (1 cup each): whole milk, low fat, skim, buttermilk. If using soy milk, 1.5 cups per serving. One serving of cheese is approximately 1.25 ounces.
•2 calcium replacements for each serving of unfortified soy: almonds, walnuts, sunflower seeds, brazil nuts, broccoli, molasses, wheat germ*
•2 eggs
•6 exchanges of fish, liver, chicken, lean beef, lamb or pork, any kind of cheese. Beans, grains, nuts and seeds and vegetables may also be included in this area, but do not count an item twice. (Average exchange is 1 ounce meat or hard cheese, 1/4 cup of tuna or soft cheese, 1 cup of milk, 1 egg, 1/2 cup beans or grains, 2 to 3 ounces of nuts, and about 5 ounces of most vegetables.)
•2 exchanges of fresh, dark green, leafy vegetables: broccoli, brussels sprouts, spinach, romaine lettuce... (Average exchange is 1/2 to 1 cup)
•5 exchanges of whole grain bread, starchy vegetables and fruits. (An average exchange is 1 slice bread, 1/2 cup cereal, pasta or rice, and 1/2 piece of fruit.)
•2 exchanges Vitamin C foods. (Average exchange is 1 fruit or 1/2 cup.)
•5 exchanges fats and oils. (1 tablespoon butter, oil or mayonnaise)
•1 exchange Vitamin A food
•Drink to thirst
•Salt foods to taste
•Liver (4 ounces) once a week (Though some people object to eating any organ meat during pregnancy because of the risk of toxic chemicals supposed in organ meats.)

54. Who Is More Likely to Develop Preeclampsia?
Women with chronic hypertension (high blood pressure before becoming pregnant)
Women who developed high blood pressure or preeclampsia during a previous pregnancy, especially if these conditions occurred early in the pregnancy
Women who are obese prior to pregnancy
Pregnant women under the age of 20 or over the age of 40
Women who are pregnant with more than one baby
Women with diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma.

55. Vegetarian Guidelines for Pregnancy The list below should be used only as a guide. A serving refers to a normal sized portion that you would have for a meal or a substantial snack. For example, a cereal serving can be two small slices of bread, a portion of pasta or a large potato. A fruit serving is equivalent to one whole piece and a vegetable serving is about 3.5 oz (100g). If you are gaining weight normally, the size of a serving can be based on appetite.
Food Group: Cereals (wheat, oats, rice, barley, rye etc.) Servings / day : Four
Food Group: Pulses (beans, chick peas, lentils etc.) Servings / day : One - two
Food Group: Nuts & seeds (almonds, peanuts, nutbutters, sesame seeds etc.) Servings / day : One - two (small servings)
Food Group: Leafy greens, Red & yellow vegetables, Fresh fruit, Dried fruit Servings / day : Four - five
Food Group: Dairy products & Soya products (soy milk, tofu, etc.) Servings / day : Three - four
Food Group: Vegetable oils & fats Servings / day : Two (small servings)
Food Group: Yeast extract & other B12 fortified foods Servings / day : One

56. Vegetarian Pregnancy by Sharon Yntema
Provides excellent information on pregnancy nutrition, and not just for vegetarians!

57. Incredible Vegan Recipes
Gentle World, Inc. P.O. Box 238 Kapa'au, HI, U.S.A.
fax: (808)

58. Treatment of High Blood Pressure
It is important to take steps to keep your blood pressure under control.
The treatment goal is blood pressure below 140/90 and lower for people with other conditions, such as diabetes and kidney disease.
Adopting healthy lifestyle habits is an effective first step in both preventing and controlling high blood pressure.

59. Magnesium and Hypertension
Magnesium is a potent vasodilator:
Displaces calcium from smooth muscle cell surfaces
Interferes with acetylcholine at the myoneuronal junction
Low blood levels commonly found in hypertensives, especially diabetics
50% of magnesium-depleted individuals are hypertensive
Magnesium deficiency causes influx of calcium into vascular muscle cells increasing contractility
Magnesium deficiency pontentiates constrictor effect of humoral pressor agents
Supplementation most useful in patients on diuretics (6-12mm Hg additional lowering)

60. Magnesium Rich Foods Leafy Green Vegetables
Nuts and Seeds, esp. almond, pumpkin, cashew
Beans and Legumes
Wheat Germ
Avocado
Potatoes
Chocolate
Hard Water

61. Calcium and Hypertension
Hypertensives tend to consume less calcium than normotensives.
Hypocalcemia is correlated with blood pressure.
The relationship between dietary low potassium and high sodium and hypertension correlates more with low dietary calcium.
Calcium’s hypotensive effect may be associated with increased sodium excretion.
Calcium supplementation studies have produced conflicting results (modest lowering at best).

62. The Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) Consumer Advisory on Methylmercury in Fish Revised March 19, 2004
Fish and shellfish contain high-quality protein and other essential nutrients, are low in saturated fat, and contain omega-3 fatty acids.
Some fish and shellfish contain high levels of mercury that may harm an unborn baby or young child's developing nervous system.
Women might wish to modify the amount and type of fish they consume if they are planning to become pregnant, are pregnant, nursing, or feeding a young child.
By following the following recommendations for selecting and eating fish or shellfish, women will receive the benefits of eating fish and shellfish and be confident that they have reduced their exposure to the harmful effects of mercury.

63. FDA & EPA recommendations for reducing the exposure to high levels of mercury in women who may become pregnant, pregnant women, nursing mothers, and young children:
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.

64. Fish from Local Waters
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, it should be safe to 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.

65. "I don't see the fish I eat in the advisory. What should I do?"
If you want more information about the levels in the various types of fish you eat, see the FDA food safety website:
or the EPA website:

66. Listeria In the rare case that a woman become sick from Listeria, the baby that she’s carrying could get sick or die.
Although Listeria bacteria are killed with thorough cooking, these "tough bugs" can grow in the refrigerator and survive in the freezer.

67. Symptoms of Listeria Infection can develop from 2 to 30 days after having eaten contaminated food. If the infection spreads to the unborn baby, it could trigger early labor.
Tell your doctor or midwife right away if any of these symptoms develop:
fever and chills, or other flu-like symptoms
headache
nausea
vomiting

68. To prevent Listeria infection, take these precautions:
If eating meat: eat only thoroughly cooked meat, poultry or seafood.
Thoroughly reheat all meats purchased at deli counters, including cured meats like salami, before eating them.
Wash all fruits and vegetables with water.
Follow label instructions on products that must be refrigerated or that have a "use by" date.
Keep the inside of the refrigerator, counter tops, and utensils clean.
After handling raw foods, wash your hands with warm soapy water, and wash the utensil you used with hot soapy water before using them again.
Use hard cheeses, like cheddar, instead of soft cheeses during pregnancy.
If you do use soft cheeses during pregnancy, cook them until they are boiling (bubbling).
Use only pasteurized dairy products. It will state "pasteurized" on the label.
If you do use hard cheeses made from unpasteurized milk, use only those marked "aged 60 days" (or longer).

69. Do you have any questions about Listeria?
Call: 1-(800) FDA-4010
Department of Health and Human Services
Food and Drug Administration (HFI-40)
5600 Fishers Lane, Rockville, MD 20857
DHHS Publication No. (FDA) S

70. Pregnant women should use caution with vitamins A, C, and D in higher doses than the recommended daily allowances.
Synthetic vitamin A in some drugs used for acne and psoriasis can cause birth defects in the developing fetus.
The concern with toxicity of vitamin D in pregnancy is calcification of the placenta and other soft tissues. The mother is also more prone to developing kidney stones.
Vitamin C taken in extra large doses is thought to cause miscarriage in the early weeks of pregnancy and can cause harm to the baby after birth.
Anne Frye has this to say about megadoses of vitamin C in pregnancy:
"High doses of any water-soluble vitamin may, in some cases, produce marked symptoms of deficiency in the newborn because of the rapid drop in blood levels once the baby is not being supplied with nutrients via the umbilical cord. For example, a baby whose mother takes more than 5 grams of vitamin C daily throughout pregnancy may develop scurvy (vitamin C deficiency disease) shortly after birth."
[Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice Vol. l, Care During Pregnancy, l995 Labrys Press, p. 252]

71. Pica— a rare craving to eat substances other than food, such as dirt, clay, ice, laundry starch or coal. Speculated to be psychological, cultural, or even physiological.
The craving may indicate a nutritional deficiency such as anemia, or may result in anemia.
In some cases interferes with adequate nutrient intake or absorption
Should be discouraged.

72. Caffeine in Pregnancy
Some studies suggest that drinking more than 2 to 3 cups of coffee daily increases the chances of low birth weight.
Watch for hidden caffeine in teas, soft drinks, & chocolate products.
As with other diuretics, caffeine consumption should be discussed with one’s healthcare practitioner

73. Should sodium intake be restricted during pregnancy?
Answer: No. In fact, sodium requirements increase during pregnancy.
The sodium provided by the average diet is likely to be adequate for expectant mothers.
Use of additional salt is rarely warranted.
Excessive sodium intake does contribute to high pressure in some people.

74. Is it safe to have an occasional cocktail, beer or glass of wine?
Because the effects of occasional alcohol consumption during pregnancy are unknown, most health authorities recommend not drinking alcohol during pregnancy.
Habitual alcohol consumption does affect the developing infant.
Studies show that pregnant women who drink 1-2 drinks per day tend to have smaller babies.

75. Alcohol Use in Pregnancy
Women who use alcohol during pregnancy have a greater risk of giving birth to babies with fetal alcohol effects (FAE) or the more serious fetal alcohol syndrome (FAS).

76. Fetal Alcohol Syndrome (FAS)
Characterized by:
Growth retardation
Facial malformations
Heart malformations
Small head size
Mental deficiency
FAS affects about 40 percent of babies born to women who drink heavily throughout pregnancy.

77. Tips for Reading Food Labels Check out those little stickers on the fresh fruits and vegetables in your market.
A five digit code beginning with a 9 means that produce was grown organically.
A five digit code beginning with an 8 identifies genetically engineered produce.
A label with four digits indicates conventionally grown food.
For further details, read "Talking Fruit" at
Packaged food with the USDA ORGANIC symbol must follow these labeling guidelines: * 100 Percent Organic = 100% * Organic = at least 95% * Made with Organic = at least 70%
To learn more, read "How to Read the New Organic Labels" at

78. Increase omega-3 and omega-6 fatty acids
vegetable, nut, seed oils
salmon, herring, mackerel, sardines,
walnuts
flaxseed oil, evening primrose oil, black currant oil

79. Many superfoods are high in anti-oxidants that fight free radicals in the body.
Free radicals may sound a little like an extremist terrorist sect evading capture and wreaking havoc across the globe and in fact within the context of your body this would be right.
They are, in part, a natural occurrence through metabolism however extra and unnecessary free radical load can be put on our bodies by external factors including pollution, cigarette smoke, radiation, burnt foods, deep fried fats and cooked foods.
When enough of these free radicals invade our immune system problems occurs.
This is when you need antioxidants to build up the immune system and fight off the free radicals in the form of superfoods or supplements.
(See more on SuperFoods within your supplemental reading list).

81. Pregnancy presents a good opportunity for nutrition education.
The basic principles of good nutrition—balance, variety and moderation—should be encouraged during pregnancy and as lifetime habits.
Clients should be counseled to enjoy a variety of nutrient-rich foods for their own good health and the health of their unborn children.