What to Expect: Eating Well When You're Expecting

The Dish on Eating Well

Ever notice that when it comes to nutrition, the more things change, the more they stay the same? Sure, you can yo-yo with fad diets (low-carb? That’s so last week … low-fat? Week before last … raw foods? … raw deal), but if you step off the diet treadmill and take stock, you’ll notice that the basics of healthy eating haven’t changed all that much over time. A balanced diet of lean protein, calcium-rich foods, whole grains, fruits and vegetables, and healthy fats is what nutritionists, doctors, and Mom herself have been quietly touting for years while the conflicting nutrition books duke it out on the bestseller lists, only to be forgotten the moment the newest diet craze makes headlines.

And what about for pregnant moms? Have the fundamentals of eating well when you’re expecting changed much over the years? They haven’t really—and mostly because eating well for two isn’t all that much different from eating well for one. The proportions may shift a bit (to accommodate a growing baby’s proportions), but the basics are still pretty basic.

So if eating well when you’re expecting is really just a matter of sticking to a balanced diet, why would you need a book to show you how?

To answer that question, let me backtrack a few years. Make that twenty-two (gulp) years. Six weeks into my first pregnancy (due to some cycle wrinkles, it was a little late in the game when I first got the news), I was determined to make up for lost time—and make the most of the rest of my seven-and-a-half months of baby growing. I was a healthy twenty-three-year-old who lived a healthy lifestyle and ate a healthy diet—and I was pretty sure I knew what it took to feed myself and my baby healthfully. So I stocked our fridge and prepared our meals with nature’s best baby-building materials: fresh chicken breasts, fish, dairy, whole grains, and a plethora of produce.

And then I ran to the bathroom to throw up.

The chicken breasts, my usual protein of choice, were the first to go—victim of a sudden aversion to flesh foods (funny, I’d never thought of chicken as flesh before). The salmon didn’t stand a chance, of course—the smell (that’s before I even took the fillets out of the wrapper) sent me reeling (and back to the bathroom). Got milk? I did, but definitely couldn’t bear the thought of drinking it. The whole grains were welcome to stay (in bread form, toasted within an inch of their life, thank you very much), as was the fruit (with the possible exception of the honeydew, which had somehow become a honey-don’t). But the broccoli I used to gobble with a rabbit’s abandon turned my stomach.

I knew that I was supposed to eat a certain number of green vegetables a day, but nobody (not even my OB) could tell me how to eat them without turning greener than they were. I knew protein was the building block of human cells (which meant that building a baby would take protein aplenty), but I had no idea that cottage cheese could stand in for those dreaded flesh foods until the first-trimester aversions had worn off. Or that microwaving the salmon zapped its offensive odor. Or that calcium did not have to come with a white mustache (and a side of bloat). Or that dried apricots quelled the queasies while simultaneously satisfying my baby’s requirement for vitamin A (turns out babies don’t need broccoli after all) or that I could drink my vitamin C in a smoothie instead of a glass of tummy-churning OJ. Or that I could take my baby out to eat almost anywhere (except maybe that Italian place, where just a whiff of the scampi could inflict third-degree heartburn).

So I spent the rest of my pregnancy eating the best I could—gagging down the milk, choking down the chicken, and, most of the time, worrying that my best wasn’t nearly good enough. If only I knew then what I know now. That eating well when you’re expecting doesn’t have to be torture—and that it doesn’t even have to be challenging. It can be fun, easy, and, most of all, delicious—no matter what pregnancy symptom has got you down (or is keeping food from staying down). You can coddle your cravings, pander to your aversions, mollify your morning sickness, indulge your indigestion—and still feed yourself and your growing baby exceptionally well.

Enter (twenty-two years too late for me, but hopefully right on time for you) Eating Well When You’re Expecting, everything you need to know to feed yourself and your baby well in the real world—the world where nausea dictates what’s on the menu (even if that’s two crackers and an extra-cold glass of ginger ale); where heartburn can burn a hole in your resolve to eat your vegetables; where temptations (glazed, iced, fried, chocolate-covered, creamed, or super-sized) lurk around every corner; where “lunch” meetings in the conference room are catered by Doughnuts-by-the-Dozen; where airline flights aren’t catered at all. Everything you need to make eating for two half the effort and twice the pleasure—from savvy shopping to smart snacking, dining out strategies to pregnant party protocol, brown-bag lunches to breakfasts on the fly. Everything you need to put it all together, including 175 recipes that neatly package all your nutritional requirements into gourmet—yet quick and easy—dishes, while taking into account the special needs of your often tender tummy. In short, everything you need to eat well when you’re expecting.

Wishing you a delicious and nutritious nine months of eating well!

—Heidi

PART ONE

EATING WELL

CHAPTER ONE

Eating Well for Two

CONGRATULATIONS! The line on that pregnancy test you brought home from the drugstore turned pink, your visit to the practitioner confirmed the results, and you’ve marked your due date on the calendar with a big red circle. And now as you sit back to take it all in, you’re probably joyful, but somewhat staggered (make that floored) 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 and your body are about to embark on life’s most fantastic voyage—pregnancy. In the next eight months or so, your baby will grow from a single cell into billions, from a shapeless blob not yet visible to the human eye to pounds of dimpled, suitable-for-hugging newborn.

What can you do to make this voyage as safe as possible? How can you help that wildly dividing bundle of cells transform into the warm bundle of baby you’ll one day hold in your arms? And how can you make sure that bundle will arrive as healthy as he or she can be?

There are many ways to give your baby a head start in life, even this early in the voyage—even while that little pink line (and, maybe, those bouts in the bathroom) remains the only concrete evidence that there actually is a baby along for the ride. Like getting good medical care, right from the beginning. Like giving up smoking, drinking, and other habits that can derail baby’s chances of being born healthy. And like eating well during your pregnancy.

Of course, you probably already know that maintaining a healthy diet during pregnancy helps make a healthy baby. Chances are you’ve already decided that feeding your baby well while you’re expecting is a priority. Maybe you don’t need any facts or figures to convince you.

But the connection between good nutrition and good pregnancy results is compelling—and more far reaching than you may realize. Almost daily, scientists make a stronger case, discovering just how many aspects of a baby’s development and future well-being can be influenced by a mother’s diet. And as luck would have it, what’s good for baby has also turned out to be good for mom. Research continues to show that healthy eating can make pregnancy safer and more comfortable.

Eating Well: What’s in It for Baby

Think you’ll be undergoing lot of changes during the nine months of pregnancy? Consider what’s happening to your fetus during those 40 weeks. Cells are dividing at an unbelievable rate; organs are forming; the circulatory, digestive, urinary, and other systems are developing; the senses—hearing, sight, taste, and smell—are taking shape. And through your diet, your baby will have to receive all the vitamins, minerals, calories, protein, fluids, and other nutrients necessary for all that growth and development. Though most babies do grow and develop even when their mothers eat a diet that’s only so-so, study after study shows that, on average, healthier diets yield far healthier babies.

Think of healthy eating as one of the best gifts you can give your baby-to-be. And it’s a gift that keeps on giving. Your diet can affect so many aspects of your baby-to-be’s health, including the following:

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. Since protein, calories, and omega-3 fatty acids are particularly crucial to optimal brain development, ensuring an adequate intake of these nutrients becomes even more important in the last months of pregnancy. Even if you find you’ve gained more weight than you would have liked in your first six months, the last trimester will not be the time to cut back. And even if you haven’t been eating particularly well during the early months of pregnancy (many women find that the first trimester queasies keep them from eating anything, never mind eating anything healthy), making a concerted dietary effort in the last trimester will fuel that amazing brain expansion.

Your baby’s personality. Believe it or not, much of your baby’s personality is being formed in your uterus, partly owing to fetal DNA and partly, according to some studies, because of what you’re eating. Researchers have found that babies born to malnourished mothers smile less and are drowsier compared with babies born to well-nourished mothers. There is also evidence that newborns whose mothers consume enough omega-3 fatty acid during the last trimester exhibit healthier sleep patterns than do other babies (something you’ll definitely appreciate come 3 A.M.).

Your baby’s eating habits. Research shows that what you eat during pregnancy (and while breastfeeding) affects not only your baby’s health—it also affects your baby’s tastes. Because a fetus can taste and become accustomed to the flavors that make their way from its mother’s meals into the amniotic fluid, a baby’s food preferences can be formed before he or she ever takes a spoonful of solids. In one study, infants whose mothers drank carrot juice while pregnant eagerly lapped up cereal mixed with carrot juice, while infants of mothers who steered clear of the orange stuff were more likely to turn up their little noses at the carrot juice–cereal mixture. The moral of the study: If you’d like your child to eat his broccoli later, you might be well advised to eat yours now. (And since breast milk picks up flavors, too, influencing a nursing baby’s future gastronomic preferences, the same principle holds true during breastfeeding.)

Your baby’s birth weight. Eating too little (or not eating enough of the right foods) can keep your baby from growing well in the uterus; eating too much can make your baby grow too big, too fast. Babies who are born small for their gestational age stand greater chances of having health problems after delivery than do babies of normal weight. Babies born too large can complicate delivery, making it more likely that an instrument (forceps or vacuum) or surgical (cesarean) delivery will become necessary. Eating just the right amount to maintain a steady and moderate weight gain for you (see Chapter Three) can keep your baby’s weight gain on target.

It’s not only the quantity, but also the quality of the food you eat that can impact how baby weighs in. Inadequate zinc intake is linked to low-birth-weight babies. A diet deficient in folic acid can cause fetal growth restriction (among many other problems). Eating the right amounts of the right types of food can help give baby a good bottom line at delivery.

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

Fortunately, those raw materials aren’t hard to come by. Even the average American diet today provides enough of most nutrients to ensure a healthy bouncing baby—and extra-good nutrition can offer extra insurance that your fetus will receive everything it needs to develop well. On the other hand, a diet that’s severely deficient in the right types of nutrients (and such a diet is thankfully rare during pregnancy in this country) increases the risk that a baby may not develop normally. For instance, a lack of vitamin D and calcium can interfere with proper bone and tooth growth. An inadequate intake of folic acid can result in neural tube defects, such as spina bifida (a condition that has become far less common since folic acid supplementation has become routinely recommended for women of childbearing age).

Possibly, your baby’s long-term health. Though still in its infancy—and still somewhat controversial—the study of how maternal nutrition during pregnancy affects a baby’s long-term health has provided researchers and mothers-to-be with plenty of food for thought. Some studies have found that a predisposition to certain diseases (such as cancers and schizophrenia) and chronic conditions (such as diabetes, hypertension, and heart disease) may be programmed while the baby is still developing in the womb, if it received inadequate nutrition during pregnancy. Scientists have found that both babies who are undernourished in the first trimester and those who are overfed in the third trimester may be at greater risk for obesity. Nutrition during pregnancy, say some researchers, not only influences a baby’s health at birth, but also affects his or her health years later, even into adulthood.

Eating Well: What’s in It for You

Baby’s not the only one who benefits each time you grab a piece of fruit, make time for breakfast, or opt for a grilled chicken salad over a greasy taco. Eating well while you’re expecting isn’t actually as selfless as it may seem. In fact, what many moms forget is that eating well for their baby affects them, too. What you eat will have a profound effect on how well your body copes with and recovers from the physical and emotional challenges of carrying and delivering a baby.

A nutritious, well-balanced diet during pregnancy will have an impact on:

Your comfort during pregnancy. Let’s face it: Most pregnant women don’t really walk around all nine months with a rosy glow. In fact, in the first few months, they’re more likely to walk around with a greenish tint. And morning sickness is just the tip of the iceberg. Other pregnancy symptoms include fatigue, constipation, hemorrhoids, heartburn, varicose veins, complexion problems, gum problems, swelling, and leg cramps—and that’s just naming a few. While some of these symptoms are par for the pregnancy course (influenced by hormones and other factors, such as fluid retention or genes), many pregnancy inevitables are not inevitable at all. And some that are inevitable don’t have to be inevitably miserable. Good nutrition can minimize, eliminate, and even prevent many unpleasant side effects of pregnancy. A diet with adequate complex carbohydrates, for instance, can reduce fatigue. A diet low in fatty foods can decrease heartburn. One rich in fiber and fluids can relieve (or even prevent) constipation. A diet with enough vitamin B⁶ can lessen nausea and vomiting. Even complexion problems can be flushed out by adequate fluids and overall good nutrition. For more on minimizing pregnancy discomforts through nutrition, see Chapter Two.

The safety of your pregnancy. No controversy here. It’s really as simple and straightforward as this: Research shows that pregnant women who are well nourished are more likely to have a safe and uncomplicated pregnancy than women who are not well nourished. And studies continue to show strong links between deficiencies in diet and pregnancy complications. For instance, anemia, a common pregnancy complication characterized by low levels of red blood cells, is directly connected to iron deficiency. Some cases of another pregnancy complication, preeclampsia (high blood pressure), have been linked to a variety of deficiencies in a pregnant woman’s diet. Researchers have found that high amounts of sugar and polyunsaturated fats increase the risk of preeclampsia. Others studies have found that women who have a low intake of vitamin C are twice as likely to develop preeclampsia. Still other research has linked some cases of preeclampsia to deficiencies in vitamin E and magnesium.

The flip side to this research is also the bright side: Eating a well-balanced nutritious diet—adequate in vitamins, minerals, and other nutrients—will reduce your risks of pregnancy complications, ensuring a healthier pregnancy. And that’s something to toast your orange juice to.

Your labor and delivery. Not only will a good diet benefit you during the 40 weeks leading up to labor and delivery, it may benefit you during labor and delivery, too. First of all, a good pregnancy diet may help prevent labor from striking too early. Though all nutrients in a balanced diet are important in helping a woman carry to term, research links deficiencies in zinc, vitamin A, vitamin C, and magnesium to an increased risk of premature labor. Second, childbirth is labor intensive, so to speak, requiring a prodigious amount of energy. Though a well-nourished woman won’t necessarily experience a pain-free or shorter labor, she’s likely to better cope with the labor she’s dealt than the woman whose body lacks sufficient stores of nutrients—in much the same way a well-nourished athlete is able to perform better and endure longer than one who hasn’t been eating well. (And when it comes to athletic events, there’s none more challenging than childbirth. Just ask any Iron Woman who’s also a mom.)

Your postpartum recovery. A baby’s not the only thing you can expect after delivery, though it’s definitely the best thing. Whether your labor and delivery turn out to be enviably effortless or disappointingly difficult, the effects of childbirth will be enormous. In the days, weeks, and even months postpartum, your body will need significant resources to recover from a variety of physical insults, ranging from stretching and tearing to blood loss and sleep deprivation—while simultaneously caring for a newborn. One of the best ways to speed that recovery (and find the energy you’ll need to keep up with the endless demands and challenges of new motherhood) is to eat a nourishing diet throughout pregnancy and to continue to do so after delivery. (See Chapter Ten for more on eating during the postpartum period.)

Your long-term health. When it comes to most nutrients, nature first takes care of an expectant mom’s nutritional needs from incoming food, then serves up the leftovers to her fetus. But that’s not true when it comes to that essential bone-builder, calcium. If you don’t take in enough calcium when you’re pregnant, your body will drain this important mineral out of your own bones to help strengthen baby’s—possibly setting you up for osteoporosis later on. That’s yet another good reason to eat well for your own health, as well as for baby’s well-being, when you’re expecting. But keep in mind that good eating habits that continue even after your pregnancy ends can do even more to ensure you a healthier future—reducing your chances of developing a wide variety of diseases, from hypertension to diabetes to cancer. By setting up the groundwork for a lifetime of healthy eating, good nutrition during pregnancy offers you and your family benefits that extend far beyond delivery day.

So What Does Eating Well Really Mean?

Just what is a healthy pregnancy eating plan? What foods should you be eating? Which ones should you be avoiding? And how are you supposed to make sure your baby’s getting all the vitamins, minerals, and other nutrients he or she needs to grow to potential and arrive in good health while you’re experiencing nausea you never could have imagined, aversions to everything green and/or leafy, cravings for foods you never knew existed, and heartburn no greasy spoon could ever hope to dish out—even on Liver and Onions Night?