Feeding the Bump

Nutrition & Recipes for Pregnancy

By Lisa Neal

Allen & Unwin

Copyright © 2008 Lisa Neal
All rights reserved.
ISBN: 978-1-74175-371-4

Contents

Acknowledgements,
Praise for Feeding the Bump,
Introduction,
Part One: Food and Nutrition for Pregnancy,
The Importance of diet during pregnancy,
Foods to avoid,
How to fill a pregnant belly,
Nutrients for two,
Pregnancy superfoods,
Preconception,
Part Two: Recipes for Pregnancy,
About the recipes,
First trimester — weeks 0 to 13,
Second trimester — weeks 14 to 29,
Third trimester — weeks 29 to birth,
General recipes for pregnancy,
Part Three: When baby makes two,
Breastfeeding and beyond,
Special thanks,
Resources,
Index,

CHAPTER 1

The Importance of Diet During Pregnancy

Your baby is solely dependent upon you to supply all of the nutrients required for growth, energy and development. A nutrient deficiency obviously also has an affect on your own health. It can also compromise your ability to maintain the pregnancy and nourish your growing baby. Every aspect of your reproductive health, including the uterus, placenta and breast milk, is directly affected by what you eat. By eating well, you diminish these concerns.

Friends and colleagues often remark that women have been successfully delivering babies for thousands of years without folate supplements or dietary advice. This is true, but if you look back throughout history (and still today in some cultures) pregnant women were nurtured, protected and even restricted to bed, with pregnancy regarded as a very special phase of life. Today, women work in more high-profile jobs and choose to have children at a later age. We have more demanding and stressful lifestyles, access to an unlimited range of processed foods and, unless you are eating only organic foods, the fruits and vegetables available today are perhaps not as nutritionally rich as our ancestor’s choices were. It is for all of these reasons that we need to place more focus on diet during pregnancy.

Your growing baby essentially eats the food you eat. Food is broken down, absorbed and distributed as energy and nutrients via the bloodstream. The placenta draws nourishment directly from your bloodstream and in turn nourishes the foetus. It will absorb everything that enters your body. This is why alcohol is a particular worry. The foetus absorbs alcohol from your bloodstream, but in a much more concentrated form. Compare your body mass to that of your unborn and you can understand the concern.

Dieting and skipping meals can also be dangerous. As blood sugar levels drop from lack of food, not only do you deny yourself energy, you also deprive your baby of the fuel it needs to grow and develop. A foetus never stops growing and needs this constant supply of energy. In fact, the best and most common advice given about planning a pregnancy diet is to eat small, regular meals, and you can prevent most of the complaints of pregnancy by doing so.

Try to eat every two to three hours, five to six times a day, and make breakfast the most important meal of your day. No one, pregnant or otherwise, should skip breakfast. It refuels your body after a fast and keeps blood sugar levels in check from the word go. If you find it difficult to eat in the morning, have a single slice of toast or a healthy smoothie until you can stomach something more substantial.

Studies carried out at Harvard School of Public Health have proven how much a newborn’s health is a result of its mother’s diet during pregnancy. Of the women in the study who had nutritionally balanced diets, 95 per cent gave birth to babies in excellent health. Only 8 per cent of women with poor nutritional diets gave birth to babies in good to excellent health.

Looking after yourself goes hand in hand with producing a healthy baby. Your body works harder during pregnancy than at any other time in your life. Your major organs function faster and more efficiently to cope with the increased blood supply required in pregnancy. Your heart works 40 per cent harder, pumping extra blood around your body. Your lungs keep this blood enriched with oxygen and your kidneys clean and filter it. A well-nourished diet ensures excellent health and strength of your organs and constantly replenishes essential nutrients. This is important because kidneys cannot distinguish between waste and nutrients. Water-soluble nutrients (vitamins C and B-group) are excreted and lost at a much higher rate when pregnant as the body flushes more fluids out more quickly.

The benefits of being healthy

Inadequate nutrition in the first trimester can impair your baby’s development. Inadequate nutrition in the third trimester can hinder your baby’s growth. Inadequate nutrition throughout the entire pregnancy can compromise immune function, leaving you vulnerable to infections. Well -nourished mothers, though, are more likely to produce babies of a correct birth weight and their babies are generally more mentally alert and have a stronger resistance to disease.

Many people claim they don’t have time to be healthy, and with fad diets and conflicting information it can seem daunting and time -consuming to eat. It may seem a whole lot easier to take advantage of time-saving meal options, but this usually means highly processed choices.

The challenges of pregnancy — nausea, fatigue and food aversions — can make planning a wholesome meal totally undesirable. But you need to make sure that every meal you eat during your pregnancy will be the best choice for you and your baby, in fact the whole family. A healthy diet has many rewards. You will feel great and add longevity to your life, all the while knowing you are doing the best for your baby. Fresh food also tastes so much better than processed foods and if you follow a highly nutritious diet you can happily enjoy the occasional (and naughty) treat. We are, after all, only human. A healthy diet can:

• reduce a mother’s risk of developing anaemia, pre-eclampsia, hypertension and long-term diseases, including diabetes and osteoporosis

• contribute to a more comfortable pregnancy by avoiding or minimising symptoms such as fatigue, nausea, constipation, leg cramps, reflux and heartburn

•help prepare for labour and delivery — energy stores help you endure labour, while a healthy uterus can ‘push’ more effectively and well-nourished women are less likely to deliver early

• stabilise your emotional state — a balanced diet helps moderate mood swings and anxiety

• lend towards a quicker recovery — a healthy body seems to bounce back faster, with an easier return to pre-pregnancy body weight

• ensure nutritional breast milk for a happy, healthy baby

• provide you with more energy to enjoy your newborn — a quick recovery leaves you less fatigued and less likely to suffer postnatal depression.

A well-nourished woman is also more likely to experience a more comfortable pregnancy. There are discomforts or symptoms common to being pregnant namely morning sickness, fatigue, digestive problems, constipation and stretch marks. And there are the more serious conditions of hypertension, anaemia, gestational diabetes and pre-eclampsia. The good news is that all of these conditions can be relieved, and even avoided, by good diet.

Food is medicine. It’s a natural remedy that encourages your body to cure and heal itself while building up resistance to infection and disease. Food remedies have been curing illness and ailments for centuries. But the proof is in the pudding. I practice this philosophy in my life and I can’t remember the last time I took any form of prescriptive medicine and I rarely get sick. Eating fabulous food keeps me healthy.

A nourishing diet is the best form of preventative medicine. This is especially relevant when pregnant as it is generally not recommended to take medication while expecting, not even a cold and flu tablet! So it is easy to conclude that a well-balanced diet is your best bet for a healthy and happy pregnancy.

A Weighty matter

Many obstetricians and midwives do not like to place too much emphasis or importance on a specific weight gain for each trimester. Some practitioners even choose not to weigh their patients, unless there are signs of extreme weight loss or gain. They will, though, still monitor your weight, if not by scales then by sight, to ensure you are progressing within the healthy range.

Most women will gain between 9 to 13 kilograms (19 to 28 pounds) — more for twins — during their pregnancy. Most of this weight is attributed to the placenta, increased blood supply, fat stores for lactation and an expanded uterus to support the growing baby.

Gradual weight gain will ensure your baby will grow steadily and be born at a healthy birth weight. It will also ensure you have more control over the more serious conditions of pregnancy (diabetes, hypertension and pre-eclampsia), and help you to return to your pre-pregnancy weight more easily.

Controlled weight gain can reduce the risk of complications that may arise from being either too under-or overweight. Concerns related to underweight women include:

• trouble conceiving

• higher risk of premature delivery and low birth weight babies, who can be more susceptible to disease and infection throughout their life

• high metabolism of protein and fat stores make up for lack of energy and this process can produce toxins known as ketones that are hazardous to the foetus

• inadequate breast milk as fat stores are essential to breastfeeding.

Concerns related to overweight women include:

• larger babies that can lead to difficult childbirths and higher incidence of stitches, tears and wound infections for the mother

• high risk of developing pelvic inflammation due to excess weight and pressure on the uterus

• diabetes

• varicose veins and stretch marks

• haemorrhoids

• high blood pressure and pre-eclampsia

• backaches and leg cramps

• additional stress and strain on skeleton and all organs (especially heart and kidneys)

• low energy levels.

Not much weight is generally gained during the first trimester, maybe 1 to 2 kilograms. Food intake should not need to increase too much in the first months, unless you have been professionally advised to or your appetite indicates otherwise. The body is very clever in making known its needs, so listen to it and (sensibly) feed it what it needs.

As your pregnancy progresses, so does your need for extra energy. The third trimester sees the most weight gained, with a rapidly growing baby triggering an increase in appetite. On average an extra 600 kilojoules are needed per day towards the end of pregnancy. This is easily achieved by adding one of the following to your daily intake:

• an extra glass of milk

• 2 slices of cheese

• 1 x 200 g/7 oz tub of yoghurt

• 2 slices of bread

• 2 pieces of fruit

• 2 slices of lean meat.

Your body will only demand what it needs to meet extra energy needs. Nutritional requirements however, double, so you need to meet this quota without doubling food intake. Every mouthful counts. Every recipe — even snacks and drinks — need to be loaded with nutritional goodness.

While a moderately low-fat diet should be followed, pregnant women should never follow a restricted calorie diet. Dieting denies the baby adequate energy for proper growth and development. By eliminating ‘good’ fats from your diet, you limit the essential fatty acids that are vital to a healthy pregnancy.

Do not miss a meal. And never fast during pregnancy. You are simply starving your baby by doing so. Inadequate calories can increase the risk of miscarriage and premature delivery. It can promote abnormalities and slow foetal growth. Skipping meals causes blood sugar levels to drop and that can trigger nausea, fatigue and put you at high risk of developing gestational diabetes. Eat regularly, every two to three hours, before you get hungry.

Low GI Foods

The recipes in this book are based on the low GI philosophy. The glycaemic index (GI) is a measurement of the rate at which sugar enters the bloodstream. Low GI foods are recommended in a healthy diet as they are foods that are digested well and release energy at a slow and steady rate. This helps to control blood sugar levels and diabetes. It also helps to satisfy the appetite for longer periods.

High GI foods are digested quickly and cause blood glucose levels to rise and then fall rapidly. This can result in an energy slump or fatigue. On rare occasions, high GI foods can play a role in the pregnancy diet. Blood pressure or blood sugar can unexpectedly drop, making you feel dizzy or faint. A natural sugar fix — fresh or dried fruit — can ease these symptoms immediately.

Including low GI foods in the diet also helps to prevent diabetes, obesity and heart disease and lower blood fats and sustain energy levels. Low GI food choices include most of the foods already recommended for pregnancy, such as:

• unrefined wholegrain products — oats, buckwheat, barley, sourdough bread and dense breads with visible grains. It is important to note that wholemeal bread has a high GI count as opposed to wholegrain, which is low

• durum wheat pasta, basmati rice and doongara rice

• all legumes, including lentils and chickpeas

• low-fat milk, soy milk and yoghurt

• all non-starchy vegetables, including dark green leafy vegetables, cauliflower, celery, leeks, mushrooms and sweet potato

• apples, bananas, berries, pears, prunes, kiwi fruit, mangoes, stone fruit (especially apricots) and oranges.

CHAPTER 2

Foods to Avoid

An expectant mother is bombarded with countless contradicting claims about what she should and should not do, especially regarding diet. However, obstetricians, dietitians and government health organisations do agree about what foods should be avoided, or minimised from your diet during pregnancy.

• You must avoid: raw fish, uncooked meats, organ meats and soft, unpasteurised and imported cheeses.

• You need to minimise: sugar, alcohol, caffeine and processed or refined foods that contain chemicals and preservatives.

Fish

Fish is an excellent source of nutrition. It is rich in protein, zinc, iodine, omega 3, vitamins B12 and D and many minerals and is very low in saturated fat. It is important to make it a regular, essential part of the pregnancy diet. Having said that, there has been a lot of concern about the effect of high mercury levels found in fish.

A foetus is much more susceptible to the toxic effect of mercury than an adult. It can affect the development of the baby’s central nervous system and cause kidney damage. Fish species at the top of the food chain, such as shark, swordfish and fresh tuna fillets, do usually contain higher mercury levels. These species should either be avoided or eaten minimally. To be safe, Food Standards Australia New Zealand make the following dietary recommendations:

1 serve per fortnight of shark, broadbill, swordfish, marlin, fresh tuna (and no other fish that fortnight)

OR 1 serve per week of deep sea perch (orange roughy) or catfish and no other fish that week

OR 2 to 3 servings per week of any fish or seafood not listed above.

There are many seafood recipes to choose from in this book, using fish species with low recorded mercury levels. You can therefore enjoy all the benefits of eating seafood up to three times a week! The following fish are high in omega 3 and low in mercury levels: Atlantic salmon, canned salmon and tuna, sardines (fresh and canned), mackerel, silver warehou, snapper and trevally.

Canned fish is an excellent and convenient source of fish and canned tuna is safe to eat during pregnancy. The smaller species of tuna generally used for canning have much lower levels of mercury than fresh tuna steaks. Food Standards Australia New Zealand has calculated that is it safe to consume 95 grams (3½ ounces) canned tuna every day when no other fish is eaten.

Shellfish must always be cooked when eaten during pregnancy. Mussels are a fantastic source of the essential mineral zinc, so cook and enjoy. Always ensure you purchase your seafood fresh and from reputable suppliers.

Healthy food preparation and hygiene

• Wash your hands with soap before preparing food and between touching raw meats and cooked food.

• Thoroughly wash and dry raw fruit and vegetables, removing all traces of soil prior to use.

• Thaw frozen foods in the refrigerator, not at room temperature. Bacteria thrive at room temperature.

• Keep food hot or cold. Do not leave food at room temperature for more than 30 minutes.

• Store raw meat separately from all other foods and thoroughly wash utensils used in preparation.

• Thorough cooking destroys listeria. Ensure all food is cooked through — this includes all red and white meats and fish, which must be cooked until flesh turns opaque. Hold the medium/rare requests for now.

• Re-heat food until steaming hot throughout. Do not re-freeze food once thawed.

• Aim to eat freshly cooked food. When eating out, try to avoid smorgasbords and salad bars.

• Do not eat any food if there is any doubt about its hygienic preparation or storage.

• Discard food with any sign of ageing or mould. Cutting off a contaminated section is not enough as bacteria may have penetrated the whole food.

• Keep your refrigerator clean. Wipe spills and keep temperature below 5°C/40°F.

• Do not cut or prepare raw meat on wooden chopping boards. Wash all boards in hot soapy water after use.

• Avoid any foods that are past their ‘best before’ or ‘use by’ date, especially refrigerated foods.

(Continues…)Excerpted from Feeding the Bump by Lisa Neal. Copyright © 2008 Lisa Neal. Excerpted by permission of Allen & Unwin.
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