What to Expect: Eating Well When You're Expecting, 2nd Edition

Part 1

Eating Well

Chapter 1

Why Eat Well?

Congratulations! The pregnancy test (and the 3 you took afterward, just to be sure) is positive—and the big (but still very little) news has started to sink in. You’re pregnant. As you sit back and take it all in, you’re probably equal parts overjoyed and overwhelmed by the enormity of what has just happened . . . and what is about to happen. That and, more than likely, a little queasy.

Ready or not, you’re about to grow a baby—from a shapeless blob of cells not yet visible to the human eye to a dimpled, suitable-for-snuggling newborn.

Much of that work will take place without you lifting a finger—or a fork. In many ways, your pregnant body (especially if it’s a healthy one) will rely on biological-business-as-usual to transform the rapidly dividing bundle of cells that’s just burrowed into your uterus into a warm bundle of baby you’ll hold in your arms in about 8 months’ time, give or take. Nature is good at what it does, no matter what a mom does or doesn’t do—which means your baby already has an excellent chance of arriving in those welcoming arms of yours fully developed and completely healthy.

Still, there’s no reason to take a backseat to your body’s pregnancy autopilot. In fact, there are many convincing reasons to jump up front (while you can still jump), take the wheel, and help guide your baby to a healthy start in life and a healthy future.

How? Chances are, you probably know many of the basics of healthy baby making—and if you were planning this pregnancy, you may have implemented many (or all) of them before sperm even met egg: See an ob or midwife for regular prenatal care, adjust your lifestyle as needed (cut back on caffeine, cut out alcohol, smoking, marijuana, and any other recreational drug use), finesse your fitness routine, and take a close look at the supplements and medications you take, adjusting as recommended by your prenatal practitioner. And, of course, eat well.

Seeing as you’ve picked up this book, you’re probably already committed to eating well when you’re expecting—or at least, you’re curious why you should think about committing. Maybe you don’t need any facts or figures to convince you that feeding yourself and your baby right during pregnancy is a priority.

But the connection between pregnancy eating and pregnancy health may be even more compelling and far-reaching than you’d imagine. And it’s growing, too. Almost daily, scientists make a stronger case, discovering just how many aspects of a baby’s development and future wellbeing can be influenced by a mom-to-be’s diet. What’s more, what’s good for a baby is also good for mom. Research continues to show that healthy eating can make pregnancy safer, less likely to become complicated, and (important from where you’re sitting, queasy, tired, gassy, constipated, and bloated) more comfortable. Talk about win-win . . . and more win!

Eating Well: What’s in It for Baby

No news flash here: Your body will be changing plenty during the 40 weeks of pregnancy. And growing, too—in places you’d expect (your breasts, your belly), and places you probably wouldn’t (like your feet). But consider how much your baby will be changing and growing over those same 40 weeks (really, 38 weeks counting from conception). Cells dividing at an unbelievable rate, organs (that heart, that brain, those lungs, that stomach) and systems (circulatory, urinary, digestive) rapidly developing, the senses (hearing, sight, taste, and smell) taking shape, along with those perfect 10 little fingers, 10 little toes, and those little girl and boy parts. Bones, muscle, skin, and eventually fat forming, hair sprouting. All in life’s first and most fantastic journey, taking fertilized egg to blastocyst to embryo to fetus and finally, to ready-to-deliver baby.

What fuels that journey? Actually, the fuel source is you. Your baby—and the complex, ingeniously designed baby-making factory your body runs—is fueled primarily by what you eat and what you drink. Vitamins, minerals, calories, protein, fluids, and other nutrients necessary for healthy baby production—and a healthy pregnancy—come mostly from your diet. Though your body can use backup reserves of some resources, like calcium from your bones and calories from stored fat, it’ll spoon up (or suck up) most from what you’re eating and drinking—and the more nutrients you take in, the more you’ll dish out to your baby. Though most babies grow and develop normally even when their moms don’t eat all that well, study after study shows that, on average, healthier eaters have healthier pregnancies and healthier babies.

Think of healthy eating as one of the first and best gifts you can give your baby-to-be. And it’s a gift that keeps on giving. Your diet can impact many components of your little one’s health in many ways—in both the short and the long term—including:

Your baby’s organ development. With all those body parts developing from tiny cells (the heart, liver, lungs, kidneys, and nervous system, just to name a few), and only 9 months in which to accomplish this phenomenal growth, your baby-making factory is working full steam, day and night. Most of the raw materials needed to turn a fertilized egg into a fully equipped bouncing baby are supplied through your diet.

Fortunately, those raw materials aren’t hard to come by. The average American diet provides enough of most nutrients to ensure a healthy, bouncing baby—but, not surprisingly, extra-good nutrition can offer extra insurance that all will develop according to plan. At the other extreme, a diet that’s severely deficient in certain types of nutrients (uncommon in the United States) increases the risk that a baby may not develop normally. For instance, a deficiency in folic acid can result in neural tube defects (defects in the brain or spinal cord), such as spina bifida. Happily, the number of babies born with these defects has decreased since folic acid supplementation has become routinely recommended for women of childbearing age—a great case for taking a prenatal vitamin before and during pregnancy.

Your baby’s brain development. While the development of most organs is relatively complete midway through pregnancy, your baby’s brain will have its greatest growth spurt during the last trimester and beyond (brain development continues at a mind-boggling pace for the first 3 years of a baby’s life). Since protein, calories, and omega-3 fatty acids are particularly crucial to optimal brain development, taking in enough of these nutrients—especially during those final 3 months of baby growing—may boost your baby’s brainpower. So it’s smart to reach for that bowl of walnuts or that dish of fish.

Your baby’s birthweight. How much and how well you eat can impact how your baby measures up—and weighs in—at delivery. While genetics definitely plays a role in baby’s birthweight and beyond, a mom’s diet during pregnancy does, too. Eating too little can keep a baby from growing to potential in utero, sometimes resulting in a low birthweight (also known as small for gestational age or SGA). Eating too much can lead to a baby growing too much too fast, and being born too large for gestational age. Very small babies have an increased risk of complications and health problems at birth and sometimes later on. Extra-large babies are more likely to arrive early and/or via c-section (because they’re too big to fit through mom’s pelvis) and are more likely to have complications and health problems, including low scores on the Apgar test (which measures a baby’s wellbeing at birth), an increased risk of breathing problems and hypoglycemia, and a greater chance of needing a stay in the neonatal intensive care unit, or NICU. Very large babies are also predisposed to obesity and Type 2 diabetes later in life. Not surprisingly, following a just-right formula—eating a healthy number of calories and gaining about the right amount of weight—can help fuel just the right amount of growth for your baby. See Chapter 6 for more on weight gain.

But it’s not only the quantity of food (or calories) you eat that matters to your baby’s bottom line. The quality matters, too. Too little iron can slow a baby’s growth. So can too little zinc. Falling short on folate (folic acid) or being generally malnourished can lead to restricted fetal growth (aka Intrauterine Growth Restriction or IUGR) and a baby being born small or even with signs of malnutrition. Eating the right amounts of the right foods will help give your baby what he or she needs to grow on—and contribute to a bouncing baby birthweight.

Your baby’s arrival time. There are many reasons why a mom might deliver prematurely that have nothing to do with diet. Still, on average, moms who lack enough key nutrients like iron, zinc, vitamin C, vitamin D, and magnesium may be more likely to have a preterm birth than well-nourished moms. Ditto for moms who don’t get enough folate in their diets. On the other hand, moms who eat well and gain the right amount of weight can boost their chances of carrying to term. Not surprisingly, full-term babies are more likely to be healthy babies.

Your baby’s sleep habits. There’s some evidence that newborns whose moms get their fill of omega-3 fatty acids during the last trimester are better overall sleepers than other babies. Does feasting on fish late in pregnancy guarantee you a full night’s sleep in your baby’s first months? No—and in fact, spoiler alert: Newborns aren’t supposed to sleep through the night. But it may promote healthier sleep patterns. So may having a daily serving of dark chocolate during your last trimester, which some research links to babies who sleep better and cry less (and, obviously, to happier moms).

Your baby’s eating habits. Fast-forward to future family dinners, and you can definitely see how your tastes might affect your baby’s. After all, little monkeys tend to mimic their moms and dads in many ways, including whether they savor salad or favor fries. But did you know that how you eat during pregnancy can also help shape your baby’s future eating habits? Because your baby’s taste buds develop at about 16 weeks of pregnancy, he or she can become accustomed to flavors that make their way from your meals into the amniotic fluid he or she swallows. Which means that baby’s food favorites can form before he or she even takes a first bite of solids. This concept, sometimes referred to as flavor learning, has been boosted not only by word of mom (“I ate nothing but watermelon, and my baby loves watermelon!” or “I craved hot sauce and so does my kid!”), but also by studies. For instance, one study found that babies of moms who drank a lot of carrot juice during pregnancy were more likely to lap up cereal mixed with carrot juice than those whose moms didn’t touch the orange stuff. Other studies have shown that babies of moms who went gangbusters on garlic and other strong flavors while they were expecting were more likely to scarf down scampi or curry, and those of moms who brought on the broccoli and other “bitter” vegetables were more likely to be sweet on those bitter tastes. The moral of these studies: If you’d like your baby to eat his or her leafy greens later, consider going green now. And keep going green later, too, since flavor learning continues as baby becomes acclimated to the changing taste of breast milk, which is also flavored by a mom’s diet.

Your baby’s long-term health. So you know your baby has a lot of growing and developing to do during those 9 months in your womb. And you know that your little one is a miraculous work in progress—and that you can help that progress along by eating well and eating enough. But did you know that this early progress—and your efforts to fuel it—may go a long way beyond birth, laying the foundation not only for a healthy start in life, but also a healthy lifetime?

Researchers have provided plenty of food for thought on how a mom’s diet during pregnancy (and even, to a certain extent, before conception) can affect her baby’s long-term health. A person’s predisposition to certain diseases (cancer, for instance, or schizophrenia) or to chronic conditions such as diabetes, hypertension, and heart disease may be related to his or her mom’s nutritional intake during pregnancy. A striking example: Studies show that babies who are undernourished in the first trimester or who are overfed in the third trimester may be at greater risk for obesity later in life. Other research suggests a link between a mom’s low intake of calcium and other bone-building nutrients and her child’s risk for osteoporosis later in life. Nutrition during pregnancy, say researchers, may influence a baby’s health not only at birth, but years later, even into adulthood.

Eating Well: What’s in It for You

Baby’s not the only one benefiting every time you brake for breakfast, crunch on carrots, or choose the grilled chicken salad over the finger-licking nuggets and fries. There’s plenty in eating well for you, too. Among the many possible perks of healthy pregnancy eating for moms-to-be:

More comfort. Let’s face it: The average pregnant woman doesn’t really walk around for 9 months with a rosy glow. In fact, in the first few months, she’s more likely to walk around with a greenish tint. And morning sickness is just one of the many miseries pregnancy can serve up. Other uncomfortable symptoms your body may have in store for you: fatigue, constipation, hemorrhoids, heartburn, headaches, backaches, varicose veins, pregnancy pimples (even the dreaded bacne), bleeding gums, swollen ankles—and that’s just naming a few. Will you have every symptom in the book or just a handful? Will they be majorly miserable or just moderately? Your individual pregnancy comfort (or discomfort) quotient will largely be decided by factors you can’t control, like your genes (thanks, Mom!), the work you do (say, standing all day on the job), or the weather you’re weathering (like sweltering heat and humidity). But at least some of it will be up to you—and influenced, to some extent, by how you eat. Grazing on the energy-boosting combo of protein and complex carbs can ease fatigue, minimize headaches and mood swings, even keep some of the queasies at bay. Filling up on fiber and fluids can clear up constipation, and curbing sugar while focusing on healthy fats may help clear up your complexion. Cutting the grease can cut back on heartburn. For more on eating well to feel well during pregnancy, see Chapter 7.

Fewer complications. It’s as simple as this: Pregnancy complications are less common among moms who eat well. For instance, good dietary habits—eating plenty of fruits and vegetables, lean protein, beans, and whole grains, and limiting sugar and refined grains may lower the risk of gestational diabetes. Top-notch nutrition—including enough magnesium—may reduce the chances of developing preeclampsia.

Staying well hydrated can help prevent excessive swelling and preterm contractions. Getting enough iron can help reduce the risk of anemia and postpartum complications. And because eating well is likely to lead to healthy weight gain, the risks of all kinds of pregnancy complications, from developing gestational diabetes to having a c-section, are lowered. Bottom line: A healthy pregnancy diet gives you the right balance of vitamins, minerals, and other vital nutrients, paving the way for a healthier pregnancy.

Birthing benefits. Can eating well help you order up an easier labor and delivery? Not exactly (though wouldn’t that be a nice app to have?). But an overall healthy diet—one that provides a balance of baby-friendly nutrients and about the right number of calories (leading to the right amount of weight gain)—may help prevent a too-early birth. Especially beneficial when it comes to keeping a baby bun baking until term: iron, zinc, vitamin C, vitamin D, and magnesium. Deficiencies in those nutrients have been linked to premature labor. And though there are definitely no sure things when it comes to labor and delivery, here’s another possible birthing room benefit: In general, moms who are well nourished handle whatever childbirth happens to hand them better than those who are low on nutrient stores—just as a well-nourished athlete is able to perform better and endure better than one who’s nutrient-deprived. (And when it comes to athletic events, there’s none more challenging than childbirth. Just ask any Iron Woman who’s also a mom.)

A faster route to recovery. A baby’s not the only thing you can expect after delivery, though it’s definitely the best thing. No, you’ll also take home a host of postpartum symptoms as your body attempts to recover from 9 long months of pregnancy, the grueling marathon of labor, and the pounding it might have taken while delivering 7, 8, or even more pounds of baby (or having major surgery, if you end up with a c-section). Add to your body’s challenges overall exhaustion and the cumulative toll of new-parent sleep deprivation—plus the energy needed to care for and feed your baby (particularly if you’re breastfeeding)—and you’ll understand why it’ll need all the help it can get. Eating well during pregnancy allows your body to store resources that will help you meet the physical and emotional challenges of new mom life, speed your postpartum recovery, and provide the get-up-and-go you’ll need to keep on getting-up-and-going. That, and help supply your little one’s fast-growing demand for breast milk. (See Chapter 10 for more on eating well postpartum.)

Better bone health. All ready to put your baby’s needs ahead of your own? The truth is that your pregnant body has other plans when it comes to divvying up the nutrients from incoming food—giving you first dibs on most of them, then serving leftovers to your baby. One nutrient this mom-first policy doesn’t cover: that essential bone-builder, calcium. If you don’t take in enough calcium when you’re pregnant, your body will drain this vital mineral from your own bones to help build baby’s. This potential shortfall could set you up for bone loss later in life, and even for osteoporosis.

Better overall health. It’s probably not a shocker, but healthy eating habits can improve overall health. Embracing healthy eating habits for baby’s sake now can—if you stick with them later—gift you with a lowered risk of all kinds of diseases, from chronic hypertension to heart disease, Type 2 diabetes to cancer. Share those healthy eating habits at home, and you’ll be sharing those possible long-term health benefits with your whole family—including your baby-to-be.

Chapter 2

The Nutrients That Make a Baby

You can’t see them. You can’t smell them. You can’t even taste them. But they’re in just about every bite you take. They’re nutrients, substances your body needs to survive and thrive—the vitamins, minerals, protein, carbohydrates, and fats in the salmon and strawberries and broccoli and cereal (and yes, even in the ice cream, chips, and chocolate bars) you eat. Whether these nutrients find their way into foods naturally (like the vitamin C and lycopene in that juicy vine-ripe tomato) or thanks to fortification (for instance, the vitamin D in that glass of milk, the B vitamins added to that slice of bread), whether they’re found in the healthiest sources (that kale salad) or the least healthy ones (those gummy bears), they all play an important role in the making of your little baby bun. Wondering how? Read on to learn what’s behind all the nutrients in the foods you eat every day and what makes them so vital to the growth and development of a fetus. Don’t want to get in the weeds with your nutrients, and just want to get busy eating well? Skip ahead to Chapter 3, “The Pregnancy Diet.”

From A to Zinc: An Encyclopedia of Vitamins and Minerals

Few people digging into their morning oatmeal or tucking into their lunchtime sandwich give a first—never mind a second—thought to the vitamins and minerals they’re about to consume and absorb. But every food you eat contains at least some of these essential nutrients, each of them vital to your health (clearly, some foods deliver more nutrients and come in more nutritious packages than others). During pregnancy, the mission of the nutrients you consume becomes even more important, since they must fuel the needs of two bodies, including a rapidly growing one. Which means you’ll need to take in more vitamins and minerals than ever before. You’ll get a good supply from your prenatal vitamin-mineral supplement, but you’ll benefit even more from getting nutrients from their natural sources. Knowing how each vitamin and mineral contributes to making a healthy baby—and where you can find them—can help inform (and, hey, inspire!) the food choices you make. Here’s a guide to the most important nutrients your body needs.

Vitamins