azOF PREGNANCY

& NUTRITION

A guide for mums-to-be

A quick and practical guide

to looking after you and your
baby during preconception,
pregnancy and breast-feeding.

f rom

the UK’s number one pregnancy supplement SCIENCE OF HEALTHY LIVING

 Congratulations!
Trying for a baby and pregnancy is an exciting
time, and a special journey to producing a
new life. It is also a time when what you eat
and drink becomes more important as you are
preparing your body for providing nutrition
for both you and your baby.
This practical guide is designed to help you understand your nutritional needs, how
they change and the best foods to choose during preconception, pregnancy and
breast-feeding. You don’t need a special diet during pregnancy, but you do need to choose
a diet that is healthy, balanced and full of the extra vitamins and minerals that you and your
baby need.

As your baby grows, their nutritional requirements will change, so your diet should
reflect this. Whilst you need a diet that is packed with nutrients, vitamins and minerals,
it’s important not to fall into the trap of ‘eating for two’ as your need for extra calories
only really increases during the third trimester of pregnancy, and even then, not by a
great deal.

In addition to eating well, it is also important to take care of yourself in other ways, such as
ensuring adequate rest and relaxation time and keeping active. Pregnancy is demanding;
both physically and emotionally so don’t be afraid to ask those around you for extra help
and support, whether at home or work.

Every woman’s experience of pregnancy is different and it passes sooner than you think,
so take the time to enjoy your changing body, to eat well and to pamper yourself – after all,
nothing is more special than bringing a new life into the world.

Wishing you a healthy and happy pregnancy.

From the Pregnacare Team

2 3
 TRYING FOR A BABY - Additionally:
• T ake a 400µg folic acid supplement and choose foods rich in folates from before

what to eat when you conception until at least the twelfth week of pregnancy. Some women are advised by
their GP to take more folic acid (see next page).

are planning to conceive

• Avoid too much vitamin A
• Take a daily supplement of 10µg vitamin D
• Take at least 2.5µg vitamin B12
Making the decision to plan for a pregnancy is the ideal time
for you and your partner to review your diet and lifestyle
In addition to eating a healthy diet, some women also choose to take a multivitamin and
and make changes in order to achieve optimal health
mineral that is specifically designed for preconception, such as Vitabiotics Pregnacare®.
before conception. It is also a good time to ensure
your intake of micronutrients are increased, You should avoid taking regular multivitamins as these may contain vitamin A and
particularly those known to be at greater insufficient folic acid and vitamin D.
demand during pregnancy including folic
acid, vitamin D, calcium and iron. Pregnancy specific supplements such as the Vitabiotics Pregnacare range contain the
recommended level of 400µg folic acid and 10µg vitamin D, plus the vitamins and minerals
What you eat and drink can make a vital for mother and baby, and are suitable for conception, for all of pregnancy and whilst
difference to both female and male
fertility and the basics are the same for breast-feeding. Pregnacare Plus includes additional Omega-3 capsules providing DHA.
both mums and dads-to-be: Maternal intake of DHA helps support normal fetal brain and eye development. 1

• Consume a balanced and varied diet, Supporting Vitamin D levels is especially important during autumn and winter, for women
rich in vitamins and minerals with darker skin and those who wear a full body covering when outside, due to reduced
• Eat
 plenty of fruit and vegetables exposure to sunlight.
(at least 5 portions each day) to boost
vitamin and mineral intakes The Healthy Start scheme helps low income families by providing vouchers for free
• C
 hoose iron rich protein foods such as plain fresh or frozen fruit and vegetables, milk, infant formula milk, basic vitamin
lean meats, eggs, beans and lentils supplements for women with vitamin C, D, folic acid. For more information visit
• T ry to include one portion of oily fish each www.healthystart.nhs.uk or ask your midwife.
week, e.g. salmon, trout, mackerel, sardines
• A
 void shark, swordfish and marlin, and limit tuna (fresh
and canned) due to high mercury content
• Include low fat dairy foods every day for extra calcium, Also take a look at the Do’s and Don’ts of Eating
such as low fat milk and yoghurts in Pregnancy section on pages 8-9 for additional
• Choose healthier snacks, such as fresh fruit, dried fruit and fortified breakfast cereals guidance on specific food choices.
• Avoid caffeine and alcohol
• Give up smoking
• Be active on most days
• Have your Rubella antibodies checked by your GP
• Drink lots of water
• Take time for both physical activities and mental wellbeing, focusing on reducing
stress and building emotional resilience
1
A beneficial effect is obtained with a daily intake of 200mg DHA in addition to the
recommended daily intake of 250mg DHA/EPA for adults.

4 5
 Vital Vitamins & Minerals Vital Vitamins & Minerals cont’d
During preconception and pregnancy, the vitamins and minerals you are For many women intakes of magnesium, zinc, copper and potassium are also below
most likely to be deficient in are: ideal levels. As a result, many women are at risk of not meeting the increased vitamin and
mineral requirements during pregnancy. You may choose to take a pregnancy specific
REQUIREMENT ROLE IN CONCERNS RICH SOURCES multivitamin and mineral supplement, such as Vitabiotics Pregnacare Original (tablets or liquid)
PER DAY PREGNANCY or Pregnacare Plus to boost dietary intake and ensure that your baby is receiving everything
that they need. You may be eligible for free vitamins – just ask your midwife.
Folic Acid Contributes to
maternal tissue growth
Women should take a 400µg
folic acid supplement from
Black eye beans,
brussels sprouts, beef
400µg supplement

Healthy Eating during Pregnancy

during pregnancy. the time contraception or yeast extract, kidney,
plus 300µg from
Supplemental folic stops and until at least the kale, spinach, spring
food per day
acid intake increases twelfth week of pregnancy greens, granary bread,
75% of women fail to
eat enough in their
maternal folate status. and also choose foods rich broccoli and green Healthy eating during pregnancy is no different to healthy eating at any other time – it’s just
Low maternal folate in folates. GPs may prescribe beans. Also added to particularly important to ensure that you are eating enough of the essential nutrients, such as
diet and over half do
status is a risk factor a higher dosage of folic acid some soft grain breads
not take a folic acid
in the development to women with diabetes, a and breakfast cereals.
protein, carbohydrates, vitamins and minerals, for both you and your baby.
supplement prior
of neural tube defects BMI over 30, taking epilepsy A balanced diet includes a wide range of foods from 5 different food groups:
to confirmation of
in the developing medication, with a coeliac
pregnancy. - Starchy carbohydrates (bread, cereals, rice etc.) - Protein (meat, poultry, fish, beans, nuts, soya etc.)
foetus.* disease or with a previous
instance of neural tube - Fruit and vegetables; - Foods containing fat and sugar
defects. - Dairy foods (milk, cheese, yoghurts etc.)

Vitamin D Contributes to normal As outlined by the The main source is

Eatwell Guide
10µg per day
absorption/utilisation
of calcium.
UK Department of Health, all
pregnant and breast-feeding
sunlight. Also found in
oily fish, eggs and full
Check the label on EATWELL GUIDE
packaged foods Use the Eatwell Guide to help you get a balance of healthier and more sustainable food.
Up to 100% of women It shows how much of what you eat overall should come from each food group.
Contributes to the women should take a 10µg fat dairy products. Also Each serving (150g) contains
6-8
fail to consume Energy Fat Saturates Sugars Salt
Choos a day
maintenance of vitamin D supplement daily. added to margarines, 1046kJ 3.0g 1.3g 34g 0.9g
y day e wh
ever
250kcal
oleg
sufficient amounts LOW LOW HIGH MED

bles
rain
normal bones and some yoghurts and 13% 4% 7% 38% 15%
veg
eta Pota
toes
or h
igh
from their diets. of an adult’s reference intake
an
d , br er Water, lower fat
teeth. breakfast cereals. Typical values (as sold) per 100g: 697kJ/ 167kcal
uit
ead
, ri
fib
re milk, sugar-free
Choose foods lower f fr Raisins ce
,p
ve
rsi
drinks including
in fat, salt and sugars tyo b les as on tea and coffee
ta
rie ta s all count.

Iron va ge a w
Contributes to normal Anaemia (not enough All meat, especially red ve
Potatoes nd
ot Limit fruit juice

ith
d

a
of
formation of red blood haemoglobin) is common meat, fortified breakfast and/or smoothies

les
he
ta
ns
14.8mg per day

rs
to a total of

sa
ui
rtio

ta
Fr
150ml a day.
cells and haemoglobin. during pregnancy, affecting cereals and white

dd
rch
po
Chopped

ed
8 out of 10 women eat
t omatoe s

yc
t5
Haemoglobin both the mother’s and baby’s bread, beans, chick

fat,
arb
leas
too little. 2 in 5 women Whole

salt
ohy
grain Cous
transports oxygen in wellbeing. peas, baked beans,

Eat at
cereal Cous

drate

and su
enter pregnancy with
red blood cells. eggs, dried fruit, nuts

s
Bagels
an iron deficiency. Frozen

gar
peas
and seeds. Whole
wheat
pasta
Porridge

Calcium Needed for the

maintenance of
Most of a baby’s calcium is
laid down in bones during
Milk, cheese, yoghurt,
fortified soya milk and
Lentils
Rice

700mg per day Beans

normal bones and the third trimester. soya products, canned lower
salt
50% of women don’t Spaghetti
L o w f at
and s o f t ch e es e

teeth. fish e.g. pilchards and

s ugar
Tuna
eat or drink enough. n
sardines. Calcium is also Plain
nuts
Chick
peas
Leaince
m
Veg

added to white bread,

O il
Semi
skimmed Soya Lower fat d
sprea
Crisps milk drink Plain
Low fat
y o g hu r t

beans and baked beans, Sauce Be

ans s Oil & spreads
, tive
almonds and hard Ea puls rna
so t mor
es, fi alte
sh, e
Dairy
and
fat and Choose unsaturated oils
red urced e beans ggs, m
wer tions and use in small amounts
tap water. and fish and
eat and other proteins
se lo
Choo ugar op
proc per we pulses, 2 portions of sustainably s
esse ek
d mea, one of which is oily. Eat less lower
Eat less often and t

Iodine Contributes to normal

production of thyroid
During pregnancy, your
iodine requirement increases
Fish, shellfish, eggs and
dairy products such as
in small amounts
Per day 2000kcal = ALL FOOD + ALL DRINKS
200µg per day
hormones and normal from 150µg to 200µg per day. cheese and milk. Source: Public Health England in association with the Welsh Government, Food Standards Scotland and the Food Standards Agency in Northern Ireland

Source: Public Health England in association with the Welsh government, Food Standards Scotland and the Food Standards Agency in Northern Ireland
© Crown copyright 2016

Two thirds of women

thyroid function, as This is providing that thyroid
have a mild deficiency
well as contributing to status and iodine stores are The diagram above gives you an indication of balance in terms of the quantities of each
during pregnancy.
the normal growth of adequate before pregnancy.
children.
food group required. You need to be eating more fruit and vegetables and starchy
carbohydrate foods, moderate amounts of dairy and protein foods and just a few
*
A beneficial effect is obtained with a supplemental folic acid daily intake of 400µg for at least one month and up to three months after conception.
fatty and sugary foods.
6 7
 DO’S AND DON’TS OF EATING DURING PREGNANCY
Do’s Don’ts
In addition to eating a wide variety of foods, there are certain precautions Some foods pose a particular risk during pregnancy, either because
you should take to safeguard your baby’s wellbeing. Your immune system of the way they are produced, or high levels of certain nutrients
tends to be slightly less effective during pregnancy, leaving you more Reduces or substances they contain. The foods below are best avoided
vulnerable to tummy bugs and upsets so extra care is needed. during pregnancy. Risk of
risk of
• Cook all meat and poultry thoroughly so that there is no trace of pink or • Don’t eat any type of pâté, including vegetable pâté, and mould-
blood, and wash all surfaces and utensils after preparing raw meat. Store raw T S ripened soft cheeses, such as Brie, Camembert, and blue varieties, L
meats at the bottom of the fridge and use a separate chopping board. such as Danish blue.
• Wash fruit, vegetables and salads thoroughly, even pre-packaged types
that are washed and ready to eat.
T • Don’t eat raw, undercooked, or cured meats (like salami or Parma ham). T

• Make sure eggs are thoroughly cooked to reduce the risk of salmonella only
• Don’t eat liver or liver products such as liver pâté or liver sausage, as they Vitamin A
eat British Lion eggs (eggs with a lion stamp on them). These can be eaten fully S
may contain large amounts of vitamin A, which could harm your baby. Avoid toxicity
cooked, partially cooked and raw (e.g. fresh mayonnaise and mousse).
supplements containing vitamin A – check the label. Betacarotene is safe.
• Only drink pasteurised or UHT milk or if only raw or unpasteurised milk is
available, boil it first. Don’t drink unpasteurised goat’s or sheep’s milk or eat L • Don’t eat shark, marlin and swordfish and limit tuna intake to no more High levels
their milk products. than 2 servings if fresh, or 4 small cans a week, because the mercury levels of mercury
in these fish are high and can damage your baby’s developing nervous
• Reheat ready-to-eat poultry and cooked chilled meals thoroughly and system. This also applies before conception and during breast-feeding.
ensure they are piping hot before they are eaten.
S

• Make sure that raw foods are stored separately from ready-to-eat foods • Don’t have more than two portions of oily fish a week, such as salmon, High levels of
to reduce the risk of food poisoning.
S mackerel, sardines and trout. Do however include one portion every week contaminants
for important Omega-3.
• Wash your hands thoroughly before and after handling any food, after going
to the toilet and before eating.
S
• Don’t eat raw shellfish, as it may contain harmful bacteria and viruses that Food
cause food poisoning. However shellfish that is part of a hot meal and has poisoning
• Wear gloves when gardening or changing the cat’s litter tray. T been thoroughly cooked is fine.

• Limit caffeine to no more than 200mg a day. Don’t forget that cola, • Don’t drink alcohol. The Chief Medical Officers for the UK recommend that Alcohol
hot chocolate, chocolate bars and energy drinks also contain caffeine. if you’re pregnant or planning to become pregnant, the safest approach is affects
See p16 for more information. not to drink alcohol at all to keep risks to your baby to a minimum. Drinking a baby’s
in pregnancy can lead to long-term harm to the baby, with the more you growth and
drink, the greater the risk. development

Salmonella: a common cause of food poisoning which can cause severe • Don’t smoke. If you smoke it’s important to give up as soon as Poor growth
S symptoms during pregnancy and can lead to miscarriage and stillbirth. possible as this can be very harmful to your baby. This includes and low
partners too, as passive smoking can be just as dangerous to your birth weight
Listeria: a bacteria which causes mild tummy upsets or flu like symptoms.
L Can also lead to miscarriage and stillbirth.
unborn baby. Speak to your GP or midwife for help and
in smoking cessation for both parents.
support

Toxoplasmosis: an infection caused by a tiny parasite that is found in soil,

T cat faeces and infected meat (raw, undercooked and cured). In rare cases
this can cause brain damage, blindness, epilepsy, miscarriage and stillbirth.

8 9
 COMMON DIETARY TEN BASICS OF HEALTHY EATING DURING PREGNANCY

Myths 1
Base every meal on starchy foods like bread, potatoes, rice, pasta, chapatis, yams
and cereals. These provide energy for you and for your baby to grow. They can also be a
good source of fibre, help you feel full and combat fatigue.
Now that I’m eating for two, can I eat twice as
much as before? Eat lots of fruit and vegetables. Aim for a wide variety and at least 5
2 servings every day. Fresh, frozen, canned and dried all count.
In short, no. Falling for the myth of eating for
two is likely to result in excessive weight gain, Choose foods rich in protein such as lean meat, chicken, fish, eggs,
which is not good for you or your baby. Your 3 soya, beans and nuts. These foods are also great sources of iron.
body becomes more energy efficient during
pregnancy in order to meet the increased energy Eat more fibre rich foods such as wholegrain breads and pasta,
needs, so you only need to eat slightly more
4 brown rice, wholegrain or high fibre breakfast cereals, pulses,
e.g. the odd extra slice of bread or one or two healthy fruit and vegetables to help prevent constipation and piles.
snacks each day. Eat plenty of dairy foods such as milk, cheese and yoghurts.
5 Dairy foods are a major source of calcium, important for your and
I’ve been having strong food cravings – does this mean I
your baby’s teeth and bones. Choose low fat varieties when you can.
am deficient in something?
If you prefer dairy alternatives, such as soya drinks and yoghurts, go for
Cravings or aversions to food vary between women and even between pregnancies for the same unsweetened, calcium-fortified versions.
woman. We don’t really know why food cravings or aversions occur, but they are likely to be
Make snacks nutritious. Snacking is common during pregnancy. However too
caused by hormonal changes to taste and smell rather than any specific deficiencies for vitamins 6 many indulgent snacks can result in excessive weight gain. Healthier snack choices
or minerals.
include: low-fat yoghurts, ready-to-eat apricots, figs or prunes, a small bowl of
For many women food cravings or aversions are unlikely to be harmful but if the craving is for
unsweetened breakfast cereal, or porridge with milk, crisp bread or vegetable sticks,
unusual foods or excessive quantities, then it is important to discuss this with your midwife or GP.
hummus, vegetable and bean soups.
Eating spicy food will bring on labour. Is this true? Aim for two portions of fish each week, one of which should be oily. Oily fish includes
7 salmon, trout, sardines and pilchards, which are important for supplying the baby with
No. Eating spicy food close to a due date may cause tummy upsets but that is as close to bringing
on labour as you might get. So if you enjoy spicy foods you are safe to carry on eating these long-chain fatty acids (AA, EPA and DHA). Maternal intake of DHA contributes to the
throughout the whole pregnancy. normal development of the eyes and brain of the foetus. 2 If you never eat oily fish
speak to your midwife about taking a pregnancy supplement which contains
I’ve been feeling sick all day - why is it called morning sickness? Omega-3, such as Vitabiotics Pregnacare Plus.
The cause of morning sickness is thought to be due to the rise in hormone levels during
Get active and try to maintain a healthy weight. The average pregnancy weight gain
pregnancy. For many women nausea and sickness are at their worst in the mornings hence 8 is 10-12kgs or 22-28lbs if your pre-pregnancy weight is in the normal range. Gaining too
the name morning sickness, but it can indeed be ‘any time of day sickness.’ Most cases are much weight can affect your health and blood pressure. Equally, it’s important to avoid
resolved by the end of the first trimester, but may continue after this time. Women who dieting when pregnant as this can limit your baby’s access to nutrition. Being active not
are severely affected should speak to their midwife for advice on how to cope with this only helps to moderate weight gain, but also prepares the body for birth.
troublesome problem.
Drink plenty of water and other fluids. Pregnant women dehydrate more quickly
9 than normal so drinking plenty of water and other fluids is important, especially when
exercising or if the weather is hot.

Don’t skip breakfast. Breakfast provides a vital boost to energy and nutrient levels,
10 so make sure you get every day off to a great start for you and your baby.
2
 beneficial effect is obtained with a daily intake of 200mg DHA in addition to the
A
recommended daily intake of 250mg DHA/EPA for adults.
10 11
 az
Now that you are pregnant, you are sure to have lots of
questions about the journey to motherhood.
antacid
Antacids counteract stomach acidity and are often used as a treatment for heartburn.
This A to Z of pregnancy and nutrition provides many of Heartburn occurs as a result of increased abdominal pressure, relaxation of the
the important answers for mums-to-be. gastro-oesophageal sphincter due to pregnancy hormones and altered gastrointestinal
It covers everything from flatulence and weight gain to function. 3 Symptoms are often aggravated by lying down, or by eating certain foods, particularly
OF PREGNANCY cravings and vitamin supplements.* those that are spicy, fatty, fizzy or acidic. Symptoms will often be less severe with small
& NUTRITION frequent meals and snacks rather than larger meals. Avoid spicy, rich or fatty foods, eating just
If you have any further questions, don’t be shy to ask
your midwife or GP. before bedtime and try to limit the use of antacids to manufacturers’ directions. If you’re taking
iron supplements as well as antacids, don’t take them simultaneously. Antacids can stop iron from

a
being absorbed by your body.

antenatal care
is for... Antenatal care means ‘care before birth.’ It aims to monitor and promote the wellbeing of a
mother and her developing baby. Midwives and doctors provide information, advice and
reassurance as well as monitoring, screening and treating where necessary.
Antenatal care is a vital medical service and it is important to attend all
appointments to ensure all is well with you and your baby through the
alcohol pregnancy and pick up any problems early.
Women who are pregnant or planning to become pregnant should not drink alcohol
at all. Drinking alcohol in pregnancy can lead to long-term harm to the baby, with
the more you drink, the greater the risk.
aspirin
It’s safe to take aspirin as a painkiller in the first 6 months of
pregnancy (up to 30 weeks).
amniocentesis Do not take aspirin for pain relief after 30 weeks of pregnancy.
Amniocentesis is one of several diagnostic tests that may be offered during It can cause complications - including breathing and blood
pregnancy. It is used to detect chromosome abnormalities in the unborn clotting problems - in the newborn baby. For most women,
child that may cause Down’s syndrome or other congenital problems. In paracetamol is the best painkiller to take in late pregnancy.
amniocentesis, a sample of the amniotic fluid that surrounds the foetus is If you’ve taken aspirin after week 30 of pregnancy, especially if
removed and analysed. This test is performed from week 15 of pregnancy you’ve taken it for a long time, tell your doctor
onwards. or midwife straight away so they can
check the health of your baby.

anaemia
Anaemia is characterised by a low level of a substance called haemoglobin
which contains iron and is responsible for transporting oxygen in red blood * While every attempt has been made to ensure that the
cells. During pregnancy, anaemia is quite common because the demands information contained in this guide is accurate and reliable,
this is intended as a guide only and not a substitute for advice
for iron change, so routine blood tests are carried out during pregnancy
from a health professional. Please note: Vitabiotics cannot
to check if you will need iron supplements. It is important that pregnant guarantee the reliability of facts obtained from other third
women eat an iron-rich diet to ensure the production of extra red party information sources. Information correct at time of
going to print (May 2020).
blood cells so that the foetus and placenta receive enough oxygen.
3
Dowswell T, Neilson JP (2008) Interventions for
Iron rich foods include red meats, fortified breakfast cereals, dried Heartburn in pregnancy Cochrane Database
fruits, pulses and bread. Syst Rev 2008 Oct 8;(4): CD007065

12 13
b
body mass index
is for... There are no UK guidelines for weight gain in pregnancy
but some studies have provided the information in the
table below. You should not try to lose weight during your
pregnancy but it is also important not to put on excess
weight either.
back pain Body mass index is a measure of weight in relation to height. It is
Back pain experienced by pregnant women is caused by the ligaments between the pelvic bones calculated using the following equation.
softening and joints loosening in preparation for the baby’s passage through the pelvis. BMI = weight kg ÷ (height m)2
This movement can cause considerable discomfort on either side of the lower back,
often with walking, and especially when going up and down stairs. During the Pre-pregnancy Body Mass Index Recommended Weight Gain
second trimester, the uterus becomes heavier and changes the woman’s centre Less than 18.5 (underweight) 12.5-18kgs (28-40lbs)
of gravity. Gradually - and perhaps without being aware of it - women begin
18.5-24.9 (normal weight) 11.5-16kgs (25-35lbs)
to adjust their posture and the way in which they move.
These compensations can result in back pain, strain or other injury. 25-29.9 (overweight) 7-11.5kgs (15-25lbs)
The separation of the muscles along the front of the abdomen during 30 or more (Obese) 5-9kgs (11-20lbs)
pregnancy may also contribute to back pain during pregnancy. These two
parallel sheets of muscles run from the rib cage to the pubic bone. As the
The average pregnancy weight gain for women in the normal weight category is 10-12kgs
uterus expands, they sometimes separate along the centre seam, which
or 22-28lbs. Generally, women gain 1.1-4.4lbs during the first trimester. During the second
can make back pain worse. Careful lifting and carrying during pregnancy is
and third trimester, women of a ‘normal weight’ will gain an estimated 1lb a week, with
important to prevent injury.
obese women gaining 0.5lb.

birth weight bowel movements

The average birth weight in the UK is 3.5kgs (7.6lbs), but this can be reduced if
Constipation (difficulty passing bowel movements) is common in pregnancy
you are expecting your first child, or if your baby is a twin or triplet.
due to hormones slowing the gut and the physical pressures of the baby.
Your midwife will check the size of your baby by measuring your bump at After child birth some women may experience bowel problems. An
intervals throughout your pregnancy. They may need to arrange an adequate fibre and fluid intake should help with this, but see your GP if
ultrasound scan to check the health of your baby if they measure you have any concerns.
smaller than expected.

breast-feeding
bloating Breast milk is the best possible nutrition for your baby. During
The sensation of bloating occurs during pregnancy because breast-feeding, your baby is entirely dependant on you as
of hormones that slow your digestion and the pressure their only source of nutrition. By ensuring your diet contains
of your growing uterus on your stomach and intestines. adequate levels of specific vitamins and minerals, your baby
Eating plenty of fibre and drinking adequate amounts of will receive all the nutrients they need. Some women
fluid may help to alleviate this. choose to take a multivitamin and mineral supplement
that is specifically designed for pregnancy and
breast-feeding, for extra peace of mind and to
safeguard their own nutritional requirements,
such as Vitabiotics Pregnacare.

14 15
c is for...
coffee
Coffee contains caffeine - see opposite for caffeine guidelines.

common cold
Some women may find themselves more vulnerable to colds while pregnant
as the immune system is working hard and may be less effective than usual.
caffeine Coughs and colds are usually caused by viruses, which do not benefit from
Whilst pregnant, caffeine intake should be limited to no more than 200mg a day antibiotics, so must run their course. Cold remedies can relieve symptoms so
because high levels of caffeine can result in low birth weight, or even miscarriage. that you feel better, but they won’t make you get better any faster. The majority
Caffeine occurs naturally in tea, coffee and chocolate and is also added to some of over-the-counter cold remedies are not recommended during pregnancy.
soft drinks and ‘energy’ drinks. Try decaffeinated tea or coffee as an alternative. Except for treating fever, it is fine to simply ride out your cough or cold if you
don’t want to take any medications. Always check with the pharmacist before
The amount of caffeine found in some foods and drinks is as follows:
taking any cold remedy (including tablets, capsules, powders or cough mixtures) during
• One mug of instant coffee: 100mg pregnancy as most are not recommended. The flu vaccine is advised during pregnancy and
• One mug of filter coffee: 140mg whooping cough vaccine also advised from 16 weeks up to 32 weeks of pregnancy.
• One mug of tea: 75mg
• One can of cola: 40mg constipation
• One can of energy drink: up to 80mg Constipation is a common problem during pregnancy and is caused by a combination of
• One 50g bar of plain chocolate: up to 50mg hormone changes e.g. higher levels of progesterone slowing the activity of the digestive tract,
• One 50g bar of milk chocolate: up to 25mg the physical impact of pregnancy, dietary changes and reduced levels of physical activity.
Alleviation of constipation often requires a combination of approaches, mostly focused on
dietary changes to increase fibre and fluid intake, increased moderate physical activity (which
calcium aides digestion and movement of food and residues along the digestive tract), and where
Calcium intake during breast-feeding is particularly important, as calcium is needed for
necessary the use of faecal bulking agents. If you are struggling with constipation speak
the maintenance of normal bones. Breast-feeding is estimated to use 200-400mg/day. 4 to your midwife or GP.
Recommended intake of calcium during lactation is 1250mg/day, considerably higher than
the 700mg/day required during pregnancy. 5 For younger women and adolescents who are still
developing their own bone mass, calcium requirements may be higher. crackers
To alleviate nausea, try eating crackers before getting out of bed in the morning.

calorie intake
Energy needs only rise slightly during pregnancy because the body undergoes cravings
adaptations allowing increased energy needs to be met from only a very Food cravings are common during pregnancy and are defined as ‘a
small increase in calorie intake. The recommended increase in energy compulsive urge for a food for which there was no previous excessive
intake for pregnant women in the UK is just 191kcals per day during desire.’ There is no harm in indulging a craving as long as it is eaten
the third trimester. 5 in moderation and alongside a healthy and balanced diet.

citrus fruit
In order to help your body absorb and effectively use iron
and other nutrients from your food, you should eat plenty  rentice A, 2003. Pregnancy and lactation. In: Pediatric Bone: Biology and Diseases.
P
4

Eds Pettifor J, Juppner H and Glorieux F. Academic Press, London, UK, 249-269.
of vitamin C rich foods such as oranges, tangerines, 5
S cientific Advisory Committee on Nutrition (2011) Dietary Reference Values for
grapefruit, lemons and tomatoes. Energy. The Stationary Office.

16 17
d is for... e is for...
dairy products eating during labour
Pregnant and breast-feeding women are encouraged to eat moderate amounts of dairy foods Hospital policies on eating during labour vary. It may be a good idea to try to eat a meal during
such as milk and cheese which contain calcium, protein, vitamin D and zinc. Also see L, for Listeria. early labour to help keep up your energy. Let your body tell you whether to eat, but don’t forget
to drink regularly to avoid dehydration.
dehydration If you do feel hungry during labour, stick to slow releasing carbohydrates that are lighter on
Remember to The increased metabolism during pregnancy leaves women more the digestive system and will provide you with energy throughout your contractions.
continue drinking vulnerable to dehydration so an adequate fluid intake is important, Take snacks with you such as biscuits, fruit, dried fruit etc.
plenty of fluids especially when it is hot or when exercising. Never limit fluid intake to
throughout avoid frequent trips to the toilet - dehydration can lead to premature
your pregnancy
and while
contractions and can contribute to fatigue and dizziness. eating for two
Severe morning sickness can also lead to dehydration so monitor Falling for the myth of needing to eat for two is likely to result in
breast-feeding.
fluid intake if this occurs. excessive amounts of weight gain, as energy needs during
pregnancy only rise slightly. This is because the body undergoes
dental care adaptations allowing increased energy needs to be met eggs
Pregnancy can aggravate dental problems. Gingivitis (an inflammation of the gums) is a common from only a very small increase in calorie intake. The
To reduce the
problem, which may be the result of increased blood flow to the gums caused by pregnancy recommended increase in energy intake for pregnant
risk of salmonella
hormones and may require treatment. It can lead to bleeding gums and has been associated women in the UK is just 191kcals per day during the third
with complications of pregnancy, such as premature birth. Brush your teeth with a soft-bristled trimester. only eat raw (e.g.
toothbrush after meals or at least twice a day to help prevent cavities and gingivitis. fresh mayonnaise and
Flossing regularly and avoiding sugary drinks and food will also help to protect your gums. mousse), partially cooked
NHS dental care is free during pregnancy and until 1 year after your due date, so see your dentist energy - (lack of!) and fully cooked British
regularly and make sure they know you are pregnant. Energy requirements during pregnancy will vary from
Lion eggs (eggs with
woman to woman according to pre-pregnancy body
diabetes weight, work and leisure activity levels. Extra energy a lion stamp on
The combination of diabetes and pregnancy increases the risk of complications for both the is needed for fetal growth and development and for them).
mother and baby. 6 For women with diabetes, the risk of complications can be considerably extra maternal tissues such as the placenta, amniotic
reduced with optimal control of diabetes from the time of conception – this includes healthy fluids and additional body fat. In addition, an increase in
eating and nutrition. Gestational diabetes occurs in around 3-5% of pregnancies so all women are energy expenditure is required to maintain these tissues and
routinely monitored during pregnancy for increasing glucose levels. Specialist advice and carry out physical activities at a higher body weight.
monitoring is offered to women who show signs of gestational diabetes. If you are deemed a
Energy demands are not equally distributed throughout pregnancy, with energy
risk of developing gestational diabetes or you show signs, you may be offered a test for it
needs being far higher during the second and third trimesters because the bulk
during your pregnancy.
of new tissues are laid down as protein or fat in these periods. However, the actual increase
in energy needed from the diet is quite low as the body adapts to the increased energy needs
diarrhoea of pregnancy. See eating for two above.
Most often, diarrhoea in pregnancy is a result of changing hormone levels - predominantly
increased levels of progesterone. However if accompanied by a fever or vomiting, and if it
persists for more than 24 hours, you may wish to speak to your midwife or GP to eliminate other 6
www.NHS.uk

potential causes such as food poisoning.

18 19
f is for...
feeling faint
TIPS FOR AVOIDING WIND DURING PREGNANCY
• Don’t eat big meals. Instead, eat several
small meals throughout the day.
• Don’t talk while you’re eating. Take
your time and chew food thoroughly.
• Limit your fluid intake during meals
(but don’t forget to make up for it
• Exercise. Even a brisk walk can help
your sluggish digestive tract.
• Don’t smoke (this is a habit you should
break before getting pregnant).
• Consider practicing yoga for relaxation
and good breathing techniques. (Some
Feeling faint when you stand for too long or get up quickly is caused by low blood pressure between meals). people tend to swallow more air when
(BP). The pregnancy hormone progesterone relaxes the walls of your blood vessels causing they’re excited or anxious if they’re
• Limit fizzy drinks.
low blood pressure, however, low BP tends to return to normal during the last few weeks of prone to hyperventilating). 7
pregnancy. Avoid lying on your back as pregnancy progresses; as the growing uterus becomes • Drink from a glass, not a bottle or a straw,
• Try drinking a cup of peppermint tea,
increasingly heavy it can press on a very large blood vessel if you do. This reduces blood to and don’t gulp your drinks.
as it can ease wind and bloating.
the brain and makes you feel faint. If this does happen, turn onto your side and
the faint feeling will quickly pass.
fetal growth
Your baby soon grows from a group of cells to a fully developed baby. Track their growth
fish using the table below:
Fish is a great source of protein and oily types provide Omega-3
fatty acids. However whilst pregnant avoid eating shark, marlin and Time Period Size of foetus
swordfish and limit the amount of tuna you eat to no more than
20 days A pinhead
two tuna steaks a week (weighing about 140g cooked or 170g raw)
or four medium-size cans of tuna a week (with a drained weight of 4 weeks A grain of rice
about 140g per can). This is because of the levels of mercury in these 8 weeks A tomato
fish. At high levels, mercury can harm your baby’s developing nervous
12 weeks A pear
system. This also applies during breast-feeding.
Try to have one, but don’t have more than two portions of oily fish a week. 16 weeks A grapefruit
Oily fish includes salmon, trout, mackerel or herring. Remember that eating 20 weeks 20cm long and looks like a tiny newborn
fish is good for your health and the development of your baby, so you should
still aim to eat at least two portions of fish a week, including one portion of oily fish. 25 weeks Baby now weighs 450g (1lb)

Avoid raw shellfish because it may contain harmful bacteria and viruses that cause 30-31 weeks Baby is around 24cm long and weighs around 1.6kgs (3lbs 5oz)
poisoning. However, shellfish that is part of a hot meal that has been thoroughly cooked is fine.
40 weeks The average newborn weighs 3.5kgs (7.6lbs)
Whilst pregnant you are able to eat smoked fish such as smoked slamon and trout. Also raw or
lightly cooked fish in sushi, if the fish has been frozen first.

folic acid
flatulence Women are currently advised to take a 400µg folic acid supplement prior to conception and
The average person passes wind 5-15 times a day and this can increase during pregnancy because for at least the first twelve weeks of pregnancy, but the benefits of folic acid supplementation
increased levels of hormones, such as progesterone which can cause the smooth muscles in your extend throughout the whole of pregnancy. Women with multiple pregnancies or a previous
body, including your gastrointestinal tract, to become relaxed. This relaxation process slows down history of neural tube defects should take more. Pregnacare Original, Pregnacare Liquid and
your digestive processes, which causes burping and flatulence, especially after a big meal. Pregnacare Plus contain 400µg folic acid as well as other important vitamins and minerals vital
for mother and baby. Please see page 6 for information on folic acid dosages.
The foods most likely to cause wind include beans, broccoli, sprouts and asparagus, as well as
fizzy drinks. However, it is important that you eat a balanced diet so simply cut back on the www.babycentre.co.uk
7

foods that cause you the most discomfort.

20 21
 g is for...
food aversions gastroenteritis
Food aversions are ‘a definite revulsion against food and drink not previously disliked.’ The immune system works hard during pregnancy leaving you more vulnerable to tummy bugs
The most common aversions appear to be to tea, coffee, alcohol, fried foods, eggs, and on and gastroentestinal infections such as listeria and salmonella. Most gastroentestinal infections in
occasion sweet foods in later pregnancy. pregnancy only require rehydration and fetal monitoring.
If you have a tummy upset it is important to remain well hydrated by constantly sipping diluted
foods to avoid squash or water. If symptoms are severe or last longer than 24 hours speak to your GP or midwife.
Some foods pose a particular risk during pregnancy, either because of the way they are produced,
or because of the high levels of certain nutrients or substances they contain. The following
foods are best avoided during pregnancy (see Do’s and Don’ts of Eating during Pregnancy, p8):
gestational diabetes
Gestational diabetes is high blood sugar (glucose) that develops during pregnancy and usually
• All types of pâté, including vegetable pâtés, and mould-ripened soft cheese because disappears after giving birth. It happens when your body cannot produce enough insulin - a
of the risk of listeria infection. Although listeria is a very rare disease, it is important to hormone that helps control blood sugar levels - to meet your extra needs in pregnancy. Dietary
take special precautions during pregnancy because even mild forms of the illness can lead to advice is to consume regular meals and eat starchy foods that release sugar slowly, plenty of fruit
miscarriage, stillbirth or severe illness in the newborn.
and vegetables, avoid sugary foods and drinks and eat lean
• D
 o not eat liver or liver products such as liver pâté or liver sausage, as they contain high levels sources of protein. Careful monitoring of food intake, regular
of vitamin A. Too much vitamin A can harm your baby. Avoid cod liver oil supplements or any weighing and blood glucose testing are required if you
supplements containing vitamin A. Pregnacare does not include vitamin A for this reason. are considered at risk of developing it.
• A
 void shark, marlin and swordfish and limit the amount of tuna you eat to no more than two
tuna steaks a week (weighing about 140g cooked or 170g raw) or four medium-size cans of
tuna a week (with a drained weight of about 140g per can). This is because of the mercury ginger
contained in these fish. At high levels, mercury can harm a baby’s developing nervous Ginger is an alternative remedy for the relief
system. This also applies during breast-feeding. of morning sickness, which has been shown
• D
 on’t have more than two portions of oily fish a week. Oily fish includes salmon, trout, to work in a number of studies.
mackerel or herring. But remember that eating fish is good for your health and the
development of your baby, so you should still aim to eat at least two portions of fish a week,
including one portion of oily fish. glucose screening
It is important that pregnant women with
• A
 void raw shellfish because it may contain harmful bacteria and viruses that cause poisoning.
diabetes have their blood glucose monitored
However shellfish that is part of a hot meal that has been thoroughly cooked is fine.
regularly to ensure optimal care for both
themselves and the growing baby. Each time you
fruit & vegetables visit your GP or midwife they will check your urine for
Current advice is to aim for at least 5 servings of a variety of fruit and vegetables every day. sugar and may take a blood test as well.
Fresh, frozen, canned, dried and juiced all count (although juice can only be counted as
one serving each day no matter how much is drunk). Always wash fresh fruit and vegetables
carefully.

22 23
h
healthy snacks
is for... Women often feel the need to eat more frequently during
pregnancy hoping to combat morning sickness, and
to meet the energy demands of the growing
baby due to altered blood sugar control.
However eating too many indulgent snacks,
hand washing such as cakes and biscuits, may result in
too much weight being gained. Keep
To prevent illnesses wash your hands regularly and thoroughly, especially:
these as treats and try to make healthier
• Before and after handling any food, especially • After gardening, even if you have worn
snack choices such as: sandwiches or pitta
raw meat and fish and before eating gloves
bread with low fat fillings, low-fat yoghurts,
• After going to the toilet • After coming in from outside/work/public
transport hummus and bread or vegetable sticks, a
• After touching dogs, cats, kittens or their litter
small bowl of unsweetened breakfast cereal, or
porridge with milk, milky drinks, fruit, including
headache fresh, ready-to-eat apricots, figs or prunes, tinned
Headaches are a common discomfort and may occur at anytime during pregnancy but tend to in juice or dried such as raisins or apricots, vegetable and
be most common during the first and third trimesters. An increase in headaches during the first bean soups.
trimester is believed to be caused by the surge of hormones along with an increase in the volume
of blood circulating throughout your body. These headaches may be aggravated due to stress,
poor posture or changes in your vision. Other causes of headaches during pregnancy may involve heartburn
one or more of the following: Gastro-oesophageal reflux, the basis of heartburn during pregnancy, is very common,
• Lack of sleep • Dehydration • Stress (too many affecting up to three-quarters of pregnancies. It can start as early as the first trimester, but is
• Low blood sugar • Caffeine withdrawal changes) generally worst in the third trimester.
A severe persistent headache during pregnancy may indicate raised blood pressure so always Heartburn occurs as a result of increased abdominal pressure and the relaxation of the
speak to your midwife or GP if this occurs. gastro-oesophageal sphincter due to pregnancy hormones, allowing stomach acid to rise into
the lower oesophagus sometimes resulting in a severe burning sensation. 9 Some women may

healthy eating find milk and yoghurt soothing, but the most common remedy is antacids (see p13).

During pregnancy, your diet should be focused on bread, other cereals, potatoes and fruit
and vegetables with smaller amounts of meat, fish and dairy products. Foods that are high in high blood pressure
fat and sugar should be eaten less often and be considered treats. See Healthy Eating during High blood pressure can indicate a potentially serious condition called pre-eclampsia and is
Pregnancy on p7-9 for more information. routinely tested during pregnancy. If you have pre-existing high blood pressure, (‘essential
hypertension’), your GP can prescribe tablets to keep it under control during pregnancy which
healthy eating voucher won’t affect your baby in any way.
You may be entitled to free plain fresh or frozen fruit and vegetables, milk, infant formula milk,
basic vitamin supplements for women with vitamin C, D, folic acid and children with vitamin A, C
and D under the Healthy Start scheme.
You qualify if you’re at least 10 weeks pregnant8 or have a child under four years old and you or
your family receives any of the following:
• Child Tax Credit (with a family income • Income-related Employment
of £16,190 or less per year) and Support Allowance
• Universal Credit (with a family take home • Income-based Jobseeker’s Allowance
income of £408 or less per month) • Pension Credit 8
www.healthystart.nhs.uk
• Income Support 9
Dowswell T, Neilson JP (2008) Interventions for Heartburn in pregnancy Cochrane Database Syst Rev 2008 Oct 8;(4): CD007065

24 You also qualify if you are under 18 and pregnant, even if you don’t get any of the above benefits. 25
i indigestion
is for... j is for...
jaundice
The hormones involved in pregnancy relax the sphincter between the stomach and the Some pregnant women experience severe itching often during pregnancy. This symptom can be
oesophagus, which may cause indigestion. The problem might also be gastric reflux. Keeping due to a condition called intrahepatic cholestasis of pregnancy (ICP). The main symptom of ICP is
something in your stomach is the best way to prevent it. Eat frequent small meals throughout
itching, usually without a rash. For many women this is more noticeable on hands and feet but
the day instead of fewer large ones. Some women find certain foods make indigestion worse
can be all over the body and worse at night. Mild jaundice (yellow colouration of skin and eyes),
such as spicy, rich, fatty or acidic foods and fizzy drinks.
dark urine and pale poo can also occur in this condition. Both the itching and the jaundice occur
Sleeping with your head elevated may also help. You might
want to try peppermint tea, which can help calm the influenza because the liver becomes up to 30 times less efficient at getting rid of bile (a
Complications from flu greenish-yellow fluid that is partly a waste product, and partly used to digest
gastrointestinal tract. Antacids (p13) can also help some
people. Try to eat slowly and allow time to digest food during pregnancy can fat) during pregnancy. Always speak to your midwife or GP if concerned
before rushing around. Not eating just before bedtime and occur because the woman’s about itching as this should be investigated to eliminate ICP. 10
immune system will be
avoiding stress, when possible, may also prevent discomfort.
weaker at this time. Speak
to your GP or midwife juice
insomnia about a flu vaccination to Drinking juice is another way to make sure you get the
Many women suffer from insomnia and other sleep protect you and your baby. recommended intake of eight glasses of water per day. Vitamin C
problems during pregnancy and most often it is caused requirements increase in pregnancy so a glass of fresh juice also
by not being able to get comfortable, frequent trips to the
helps to top this up. Be aware that fruit juice has a high sugar
bathroom, leg cramps, excitement and anxiousness about the
content and should be consumed in moderation.
baby’s arrival. Try to avoid tea, coffee or cola drinks in the evening, as the caffeine can make it

l
harder to go to sleep.
Worrying about your lack of sleep will only compound the problem so try the following methods

is for...
to get a good night’s sleep:
1. Start winding down before climbing into bed by taking a warm bath or get your partner
to give you a massage. You can also try a pre-bed relaxation technique such as progressive
muscle relaxation or guided imagery.
2. Make sure your room is a comfortable temperature for sleeping. Is it dark and quiet enough?
liver
Do not eat liver
Heavy or dark-coloured curtains can help keep out unwanted light, and sound machines
can help mask the drone of traffic with white noise. listeria or liver products,
During pregnancy, Listeria can cause miscarriage, stillbirth or such as liver pâté or
3. If you aren’t asleep within 20 to 30 minutes after getting into bed, get up and go into
severe illness in the newborn. It is a very rare disease, occurring liver sausage, as they
another room. Read a magazine or listen to music until drowsy, then get back into bed.
in about 1 in 30,000 births in the UK. However it is important to contain high levels

iron reduce the risk by avoiding some uncooked soft cheese made with of vitamin A. Too
much vitamin A
The demand for iron during pregnancy is high and pregnant women can become mould or a rind (including brie and camembert), unpasteurised milk
or dairy products and any type of pâté. Also remember to wash fruit can harm your
iron deficient, so make sure you eat plenty of iron-rich foods. Try to have some food
or drink containing vitamin C, such as fruit or vegetables or a glass of fruit juice, with and vegetables thoroughly and re-heat ready meals or pre-cooked baby.
iron-rich meals to help your body absorb the iron. foods until they are piping hot. If you’re pregnant, you should also
If the iron level in your blood becomes low (see anaemia, p12), your GP or midwife avoid close contact with farm animals that are giving birth or have
will advise you to take iron supplements. Good sources of iron include: lean meat, green recently given birth.
leafy vegetables, dried fruit, nuts and fortified breakfast cereals. 10
Palmer DG, Eads J (2000) Intrahepatic cholestasis of pregnancy: a critical review. J Perinat Neonatal Nursing 14: 39-51
26 27
m
milk
is for...
There’s no need to switch from skimmed or semi-skimmed milk to whole milk as the only
nutrient whole milk contains that skimmed milk doesn’t, is fat. And while fat is important during
pregnancy, you’re probably getting enough unless you’re consciously eating a low-fat diet. You
should avoid any unpasteurised cow’s milk, goats’ milk or sheep’s milk and any foods made from
these products such as soft goat’s cheese.
To get adequate amounts of calcium and vitamin D during pregnancy, drink four 8fl. oz (236ml)
meat glasses (32fl. oz or 946ml) of pasturised skimmed milk each day, or eat a variety of other calcium rich
Meat provides protein and iron but make sure you cook all meat thoroughly (be especially careful foods such as 1 cup (245g) plain pasturised skimmed milk yoghurt, 1 cup (225g) non-fat pasturised
with poultry, pork, sausages and burgers) so that there is no trace of pink or blood. Always wash cottage cheese, and 1 cup (250ml) calcium-fortified orange juice.
hands thoroughly and clean all surfaces and utensils after touching raw meat. This will help to
avoid infection with Toxoplasma, which may cause toxoplasmosis, which can harm your baby. minerals
Make sure that raw foods are stored separately from ready-to-eat foods, otherwise there is a risk Minerals help your body use the energy provided by food for both yourself and your baby.
They also help repair and maintain cells and tissues. You can get most of the vitamins and
of contamination which may cause other types of food poisoning from meat including
minerals you need from a healthy diet, however many women find it difficult to get enough iron,
Salmonella, Campylobacter and E.coli 0157. Also make sure you use a separate chopping board
folic acid and calcium from food and choose to take a pregnancy specific vitamin every day such
for raw meats. as Pregnacare.

menstrual cycle mood swings

It is quite common to have fluctuating moods and emotions during pregnancy. Although
Breast-feeding delays your periods returning or restarting. If you have a baby who sleeps through
progesterone and oestrogen are thought to be partly responsible, feelings of moodiness are
the night from an early age, your periods are likely to return sooner — typically in three to eight often simply due to the fact that pregnancy is a time of tremendous change.
months. In other words, the more often your baby nurses, the longer it will be before you get your
It’s common for women to experience mental ill health for the first time in pregnancy. Women
period again. However breast-feeding is not a reliable form of contraception so don’t rely on this may feel more vulnerable and anxious. Pregnancy and birth can trigger depression in some
if you want to avoid unexpected surprises! women. If you are worried, talk to your midwife or GP.

migraine morning sickness

It is estimated that approximately 80% of pregnant women experience discomfort from the
If you are prone to getting migraines you may experience stronger headaches or find that they nausea and vomiting associated with pregnancy, which can actually occur at any time of the
diminish whilst pregnant. Some women also experience a migraine for the first time when they day or night. Most cases spontaneously resolve by the end of weeks 16 to 20 of your pregnancy,
are pregnant. Some studies have found a slight correlation between migraines and hormones. however one in five women experience nausea and vomiting for a much longer period
of time. A small number may develop hyperemesis gravidarum (severe nausea, vomiting and
Common triggers may include but are not limited to:
dehydration) which requires specialist care. If you are at all concerned about morning
• Stress • Coffee sickness speak to your GP or midwife.
• Chocolate • Weather
There are a great deal of theories on why women suffer from morning sickness during pregnancy,
• Cheese • Hormones
the most popular being:

Common home remedies for migraine headaches include: • A combination of the changes in the body - rapidly increasing oestrogen levels, an
enhanced sense of smell, excess stomach acids and fatigue.
• Applying a cold towel to your head • You may need to consult
• Increased stress and emotion levels.
• Taking a cold shower your GP about the best
form of pain relief • The build-up of hCG (human chorionic gonadotopin) in your system. hCG is a hormone
• Taking a nap
medication for your produced after implantation takes place. It continues to increase until about the
• Exercise migraines. 12th week of your pregnancy, at which point the levels of hCG start to decrease.
• Biofeedback (ask your doctor) This is usually when morning sickness ceases.
• Relaxation such as meditation or yoga Morning sickness will not affect your baby as long as you eat a well balanced diet and avoid
dehydration by drinking lots of fluids (see dehydration, p18). The best approach to morning
sickness is to eat plain carbohydrate foods frequently. Eating crackers or ginger biscuits before
28 getting out of bed in the morning also helps some women. 29
n is for... s is for...
neural tube defects salmonella
The neural tube forms the baby’s brain and spinal cord in the first 28 days of pregnancy. Salmonella is the most common cause of food poisoning in the UK, and in
Insufficient folic acid can cause the neural tube not to develop properly, and may cause
severe cases may cause miscarriage or premature labour. The foods most likely to carry salmonella
neural tube defects such as spina bifida.
are raw eggs or partially cooked eggs that are not British Lion or undercooked poultry. Therefore
The UK Department of Health recommends all pregnant women and women trying for a baby
pregnant women are advised to only eat raw (e.g. fresh mayonnaise and mousse), partially
take 400µg folic acid every day. Not having enough folic acid in your body before and during
cooked and fully cooked British Lion eggs (eggs with a lion stamp on them). Food hygiene
pregnancy can cause neural tube defects. You should also try to eat foods that contain folate (the
natural form of folic acid), such as broccoli, spinach and chickpeas. should be tightened especially with raw and cooked meats. Wash hands thoroughly with
antibacterial soap after handling raw meat and use a separate chopping board for raw and

p
See p21 for further benefits of folic acid.
cooked meat products.

salt intake
is for... Most of us consume too much salt, which in the long-term can have negative effects on blood
pressure. More than two thirds of the salt in our diets comes from pre-packaged and processed
foods. Limited evidence from one systematic review found no significant difference in the risk of
pre-eclampsia with a low salt diet compared with a normal diet. 11

pâté
Avoid all types of pâté, including vegetable, because it may contain Listeria. Pâté
made from any type of liver should also be avoided due to its high vitamin A content.
sex
Because your body doesn’t change that much in the first trimester, sex can pretty much continue
piles as it has in the past. If you’re having a normal pregnancy, sex is considered safe during all stages of
Piles (haemorrhoids) are a common problem for pregnant women and are caused by the pregnancy. Many expectant mothers find that their desire for sex fluctuates during certain stages
weight of the uterus pressing on major blood vessels. This leads to a pooling of blood and in the pregnancy, with some finding that sex becomes uncomfortable as their bodies get larger.
ultimately causes the veins to enlarge and swell. In addition, the hormone progesterone relaxes
Your baby is fully protected by the amniotic sac (a thin-walled bag that holds the foetus
the veins and allows the swelling to increase. Piles are best prevented by eating a high fibre diet
accompanied by plenty of fluid. If you have problems with piles, speak to your GP or midwife. and surrounding fluid) and the strong muscles of the uterus. There’s also a thick mucus
plug that seals the cervix and helps guard against infection. The penis does not come into
placenta contact with the foetus during sex, so it is safe to continue having sex throughout the
The placenta is the organ that nourishes the foetus by transporting nutrients from your blood and whole of pregnancy. If you experience bleeding at any stage during pregnancy you should
removing waste products. contact your midwife as soon as possible.
poultry After your baby is born
Poultry is a food that unless handled properly can carry an increased risk of salmonella. Always store Generally, you should wait at least six weeks after birth before having sex. The uterus and cervix
uncooked and cooked meats separately and check that all meats are cooked thoroughly (with no undergo significant changes during the process of delivering a baby and they need time to heal.
signs of pink or blood) before eating. Handle pre-cooked poultry with care. Only buy from a reputable
During this healing phase the lining of the uterus, especially the site where the placenta was
source and ensure that it is kept thoroughly chilled and never eat if beyond its use before date.
attached, is susceptible to infection. Sex, douching, tampons and anything placed in the
prolactin vagina may introduce bacteria, and cause an infection.
Prolactin is the hormone that tells your breasts to produce milk for your baby. It is stimulated by
Duley L, Henderson-Smart DJ, Meher S (2005) Altered Dietary salt for preventing pre-eclampsia and its complications
11
suckling, so frequent feeding on demand will help to get milk supply established in the early weeks. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD005548. DOI: 10.1002/14651858.CD005548.
30 31
 skin spicy food
The most common skin changes in pregnancy are:
It’s fine to eat spicy or hot food whilst pregnant or
• Chloasma: brown, clearly defined patches on the face, typically on the cheekbones and
nursing, as long as you feel fine while you’re eating it.
forehead.
Although a tiny fraction of what you ingest is transferred
• Darkening of the nipples and external genitals (pubic area).
into your milk supply, it’s unlikely that eating spicy food will
• Darkening of existing moles. affect your baby.
• Linea nigra: a dark line that appears on the abdomen, running straight down from the
umbilicus (belly button). Eating garlic may even be beneficial to breast-feeding. Two studies have shown that the infants
of mothers who eat garlic tend to feed for a longer time, and many babies seem to prefer
• Striae gravidarum (stretch marks of pregnancy): red lines or bands that can appear on the
abdomen during pregnancy, or the breasts after breast-feeding, which later become white, a variety of flavour in breast milk.
smooth, shiny and flattened. Go by trial and error. If you suffer from heartburn after you’ve eaten a fiery curry, or your baby
• Veins near the skin can become more obvious. seems upset or irritable, then opt for a milder diet until they are slightly older.
• Varicose (swollen) veins can appear on the legs. Women from parts of the world where spicy dishes are the cultural norm don’t make big
• An increase in the number of skin tags (small, harmless skin outgrowths that occur especially changes to their diet when they become pregnant or are nursing, the key is to stick to a healthy,
on the neck, but can be found on any part of body). varied diet, and avoid foods that make you feel uncomfortable.
• Acne can worsen.

sleeping starchy food

According to one study, 97% of pregnant women have difficulties getting to sleep or Starchy foods including bread, rice, pasta and potatoes are carbohydrates and are satisfying,
staying asleep. It can happen at any time, say the US researchers in the Journal of Obstetric, making you feel fuller for longer and providing you with energy. As they are bulky, you are less
Gynecologic and Neonatal Nursing. Problems in the study group of 127 women likely to overeat and gain weight on starchy foods, so include one at every meal and
ranged from restlessness, wakefulness and tiredness in the day. Sleep problems are very choose a starchy food over fatty and sugary snacks wherever possible. Wholegrain
common during pregnancy for all sorts of reasons. In early and late pregnancy in particular, versions are especially nutritious and the fibre helps to prevent constipation (see p17).

t
you may need to get up in the night to use the bathroom. As you get bigger, finding a
comfortable position to sleep can be difficult. Your body’s ‘thermostat’ can seem permanently

is for...
set to ‘over-heat.’ You may find it too hot for bedcovers, but then wake up feeling cold. Backache
can also keep you awake. Putting a pillow under your bump can help in late pregnancy.
You may also experience ‘restless leg syndrome’ which isn’t uncommon and is exactly what
it sounds like: jerking or twitching of the legs, particularly when lying down. Leg cramps
are also a common complaint. Sleeping on your side after first trimester has a significant effect
on reducing stillbirth. teeth & gums
The combined effect of increased blood supply and pregnancy hormones can make
smoked meat your gums very soft and spongy. They may bleed when you brush your teeth or eat
Some countries advise pregnant women not to eat cold meats because of the risk of Listeria
something hard like an apple. Make sure you brush your teeth with a soft brush and floss gently
(see p27). In the UK, women are not advised to avoid these products because the risk is very
at least twice a day (after every meal if you can), paying particular attention to the area where
low. Pregnant women should take care when eating cold cured meats such as salami, pepperoni,
your teeth meet your gums and avoiding sugary drinks and food will also help. NHS dental care
chorizo and Parma ham because these meats are not cooked but cured and fermented so they
is free during pregnancy and until 1 year after your due date, so see your dentist regularly and
may contain toxoplasmosis-causing parasites. For ready-to-eat meats, you can reduce the risk
make sure they know you are pregnant, since it is best to avoid x-rays, if possible.
from parasites by freezing cured meats for four days at home before you eat them. Freezing kills
most parasites and so makes the meat safer to eat. Gum problems can occur throughout pregnancy, but your gums should get back to normal soon
after your baby’s birth.
soft cheese
Mould-ripened soft cheeses, such as Brie and Camembert, may contain Listeria (see p27), which tiredness
is a type of bacteria that can lead to pre-term birth, miscarriage, and/or flu-like symptoms. These A variety of factors can cause tiredness during early pregnancy, including insomnia, anxiety
should therefore be avoided during pregnancy. However it is fine to eat other soft cheeses such and poor diet. Anaemia may also develop in pregnancy if there is an insufficient intake of
as cream cheese, ricotta or cottage cheese, as long as they’re made from pasteurised milk. If you iron (see p26). Combat symptoms by eating a well balanced diet and resting as and when
32 are unsure – stick to a hard cheese such as Cheddar and parmesan. you can. 33
u
vitamins & minerals
is for... Possible deficiencies during pregnancy include:

Folic Acid which contributes to maternal tissue growth during

pregnancy.
400µg supplement plus 300µg
from food/day

Vitamin D which contributes to normal absorption/utilisation of calcium. 10µg/day

underweight Iron contributes to normal formation of red blood cells and haemoglobin. 14.8mg/day
Women who are severely underweight during pregnancy and who are not eating enough are at 700mg/day during pregnancy and
Calcium which is needed for the maintenance of normal bones and teeth. 1250mg/day while breast-feeding13
an increased risk of miscarriage, premature birth, gastroschisis (when the baby’s stomach doesn’t
develop properly), the baby having a low birth weight, which can have serious long term effects Iodine which is needed for the normal production of thyroid hormones 150µg/day
on their health. and normal thyroid function, crucial in early pregnancy.

unpasteurised milk vitamin supplements

Campylobacter is another common cause of food poisoning in the UK, which is commonly found
The Healthy Start scheme helps low income families by providing vouchers for free plain fresh
in poultry and unpasteurised milk. Infections during pregnancy have been associated with
or frozen fruit and vegetables,milk, infant formula milk, basic vitamin supplements for women
premature birth, spontaneous abortion and stillbirths. Always ensure that any milk and cheeses
with vitamin C, D, folic acid and children with vitamin A, C and D. Ask your midwife for an
consumed during pregnancy have been pasteurised.

v
application form, or visit www.healthystart.nhs.uk
Many women choose to take a comprehensive pregnancy specific multivitamin and
mineral supplement, such as Vitabiotics Pregnacare Original, Pregnacare Liquid or Pregnacare

is for...
Plus in order to safeguard dietary intake.

vegetables
Eat plenty of fruit and vegetables (at least 5 portions each day) to
boost vitamin and mineral intakes whilst pregnant. Wash or peel fruit and vegetables before
eating (see healthy eating during pregnancy, p7-8).
w is for...
vegetarian & vegan diet water intake
Drink plenty of water and other fluids, as pregnant
Vegetarian and vegan pregnant women can still enjoy a carefully planned vegetarian/vegan diet.
women dehydrate more quickly than normal.
There are many health benefits to vegetarian and vegan diets, but pregnant women need to take
Drinking plenty of fluids is important, especially
extra care to get enough of the nutrients more easily supplied in non-vegan/vegetarian diets,
when exercising or if the weather is hot.
especially protein, iron, zinc, vitamin D, calcium and vitamin B12.

vitamin K weight loss after pregnancy

Vitamin K is offered to the baby after birth either orally (3 doses) or injection (1 dose) to help Just as it’s best to put on weight slowly and steadily during your pregnancy, you need
prevent a rare bleeding disorder called haemorrhagic disease of the newborn. Your midwife to be slow and steady in losing weight after your pregnancy. If you are breast-feeding you
should discuss the injection with you while you are pregnant. should not follow a weight reducing diet. A general rule for weight loss is to aim for around
This is because newborns are born with low levels of vitamin K which contributes to normal blood 1lb per week. It might not sound much, but it quickly adds up and gives your body chance to
clotting. This leads to a decrease in vitamin K-dependent blood coagulation factors, making some recover and skin time to gradually shrink back. Breast-feeding can help you lose weight
newborns more susceptible to haemorrhage in the first several days of life until vitamin K is naturally with a well balanced diet.
manufactured in their bodies. 12 Babies will produce their own vitamin K as they start digesting 12
(Cunningham et al. 1989:611).
milk, therefore, early and regular (or unrestricted) feeding is important. British Nutrition Foundation Nutrition Bulletin, 30, 253.
13

34 35
 DIET AFTER BIRTH GETTING BACK INTO SHAPE
& breast-feeding after the baby is born
Breast milk is the best choice for your new baby. It provides all of the nutrients your baby will Most women are keen to get back into shape after pregnancy and wear their normal clothes.
need as well as extra immunity against infection. It also helps your body return to normal after However labour and the following sleep disturbed nights will take their toll on even
the birth and utilise the extra body fat stored during pregnancy. In the first year your baby the most energetic of women. Therefore, it’s essential to balance maintaining energy
grows an impressive amount, so not surprisingly the nutritional requirements of breast-feeding levels and the stamina to keep going with any attempts to lose weight. If you are
are quite high. Looking after a new baby can be exhausting in terms of breast-feeding, now is not the time to diet. It is as important to eat a healthy balanced
disturbed nights and loss of sleep, so try to make sure you get all of diet and to keep well hydrated as it was during the pregnancy.
the help and support you need in order to get adequate rest during
The best way to approach getting back into shape is to take it slowly, starting with some
the day, especially during the first few weeks.
gentle exercise, such as a short daily walk combined with a healthy balanced diet that
The basics of healthy eating after birth remain exactly the same is low in fat with a mix of protein, carbohydrates, fruit and vegetables. Opt for low-fat,
as during your pregnancy, however your energy needs will be high-fibre foods and healthy snacks such as fresh fruit to stave off hunger. Don’t forget
higher so you may need to include regular snacks in addition the importance of pelvic floor exercises to regain the strength of these muscles following
to meals if breast-feeding. Not only are you providing your pregnancy. If you are unsure ask your midwife or health visitor about these.
baby with vitamins and minerals, but you will also be replacing
If you have had a caesarean section you should follow advice from your midwife and avoid
those lost from your body during pregnancy so it is important
abdominal exercise for the first six weeks.
to continue eating a diet that is rich in vitamins and minerals.
At your six week check, your GP will tell you if it is okay to resume normal activities such as
Many women choose to continue taking a one-a-day
swimming, aerobics etc.
multivitamin and mineral supplement that is suitable for
breast-feeding in order to boost their diet and for peace of mind that All of the high-risk foods that were off limits during pregnancy can now make a welcome
they are safeguarding their diet with all the nutrients they need. return to your diet, such as soft and blue cheeses, liver, etc. as the baby is no longer at risk
and your immune system will be returning to normal. You can choose to eat peanuts
It is particularly important to eat plenty of calcium rich foods whilst breast-feeding as your
or foods containing peanuts (such as peanut butter) when breast-feeding as part
requirements increase by an extra 500mg per day 14 (equivalent to needing an extra pint of milk
of a healthy balanced diet, unless you are allergic to peanuts or your health professional
every day). Also try to continue eating oily fish once each week (such as salmon, trout, sardines or
advises not to.15 If you are breast-feeding, alcohol and caffeine still needs to be limited,
avocados and nuts), and choose foods that have added Omega-3 such as some types of milk or
and if you are not breast-feeding, don’t forget that after 9 months of abstinence you will
eggs.
probably be very susceptible to the effects of alcohol and caffeine.
The UK Department of Health also recommend that all pregnant and breast-feeding women The guidelines for eating fish remain the same during
should take a daily supplement containing 10µg of vitamin D to ensure the mother’s requirements breast-feeding (see fish p20).
are met and to build adequate fetal stores for early infancy.
If you are tired and lacking sleep, eating little and
often will help to keep energy levels up. And
Don’t forget that you need to drink extra fluids to avoid dehydration as if friends offer to help, it is a great idea to ask
well as tiredness and headaches. Try to remember to drink an extra glass them to bring round a freshly cooked meal
of water, milk or fruit juice every time you feed your baby. that you can simply re-heat, or pop into
the freezer for another day.

Alcohol and caffeine both pass into breast milk so continue to limit your intake of these. What you
eat and drink will pass all sorts of flavours in your milk to your baby, helping to prepare them for
weaning. However some babies may be sensitive to highly spiced or strong tasting foods so if you 14
British Nutrition Foundation Nutrition Bulletin, 30, 253
15
www.NHS.uk
notice that certain foods upset the baby then it’s best to avoid them.
36 37
 Notes 2

With you
every step
of the way

BEFORE DURING PREGNANCY AFTER

Pregnacare® Conception with 21 nutrients Pregnacare® Original with19 nutrients Pregnacare® Breast-feeding with
including folic acid as recommended for including folic acid and vitamin D as recommended 21 nutrients including 10μg vitamin D
all women trying to conceive. by the Department of Health. and 300mg DHA for mums during lactation.1

Questions to ask your midwife:

More than just folic acid
Most trusted by mums2
Helping to make healthy mums and babies for over
30 years, Pregnacare® provides the recommended level
of folic acid,3 along with vitamin D which is
advised by the UK Department of Health throughout
pregnancy.4 It also provides a range of micronutrients,
and is supported by unique clinical research with
mums-to-be.5,6 BEFORE DURING AFTER

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1. Journal of the American College of Nutrition, Vol.18, No.5, 487-489 (1999). 2. For more information on this research, please visit www.pregnacare.com/mostrecommended. 3. Folic acid contributes to maternal tissue growth during
pregnancy. Pregnacare® has always contained 400mcg folic acid, the level recommended for all women from the start of trying to conceive until the 12th week of pregnancy. 4. Source: www.NHS.uk. 5. Agrawal, R. et al. Prospective
randomised trial of multiple micronutrients in women undergoing ovulation induction, Reproductive BioMedicine Online December 2011. 6. L Brough et al. Effect of multiple-micronutrient supplementation on maternal nutrient
status, infant birth weight and gestational age at birth in a low-income, multi-ethnic population. British Journal of Nutrition (2010), 104, 437-445. *UK’s No.1 pregnancy supplement brand. Source: Nielsen GB ScanTrack Total Coverage Value and Unit Retail Sales
38 52 w/e 22 February 2020. To verify contact Vitabiotics Ltd, 1 Apsley Way, London, NW2 7HF. 39
 Expert nutritional care for every stage of pregnancy
Worldwide studies have shown that even with a good diet, extra nutrients may
be necessary before and during pregnancy. Vitabiotics Pregnacare Original,
Pregnacare Liquid and Pregnacare Plus have been carefully developed
to support women who are trying for a baby, right through pregnancy to
breast-feeding and the postnatal period.

Pregnacare Original and Pregnacare Liquid provide the recommended level of 400µg folic
acid and 10µg vitamin D, plus essential vitamins and minerals including iron and vitamin
B12. They are both suitable before conception, for all of pregnancy and whilst breast-feeding.
Pregnacare Liquid is ideal for those who prefer not to swallow tablets.

Pregnacare Plus combines the Pregnacare Original tablets with Omega-3 capsules for even greater
care. The comprehensive multivitamin tablet delivers essential nutrients for pregnancy, including
the recommended level of 400µg folic acid plus iron and vitamin D. The additional Omega-3
capsules provide a rich source of the important fatty acids,
including Docosahexaenoic Acid (DHA). Maternal intake of DHA
contributes to normal brain and eye development of the foetus. *

Comprehensive 19 vitamins &

vitamins & minerals minerals, plus
Omega-3 DHA

For further information

contact Vitabiotics Ltd, 1 Apsley Way,
London NW2 7HF
telephone 020 8955 2600
email [email protected]
visit www.pregnacare.com

This guide has been

developed by
BRPRGTKA5AZWL7E

*A daily intake of 200mg DHA is required in addition to the recommended daily intake of 250mg DHA/EPA for adults.
While every attempt has been made to ensure that the information contained in this guide is accurate and reliable, this is intended as a
guide only and not a substitute for advice from a health professional. Please note: Vitabiotics cannot guarantee the reliability of facts
obtained from other third party information sources. Information correct at time of going to print (July 2020).