Maternal Diet & Health During Pregnancy & Lactation

McKenzie Pediatrics

A mother’s nutritional status, diet and lifestyle influence pregnancy and lactation outcomes, and can have lasting effects on her offspring’s health. This educational handout reviews current nutrition and nutrition-related recommendations for women during pregnancy and lactation.

Before Pregnancy

To optimize conception and pregnancy outcomes, women should strive to enter pregnancy with a Body Mass Index (BMI) within the normal range (18.5-24.9). The recommended weight gain during pregnancy ranges from 25 to 35 pounds if a normal pre-pregnancy BMI, 15-25 pounds if overweight (BMI 25-29.9), and 11-20 pounds if obese (BMI >30).

During Pregnancy

Alcohol should still be avoided, because there is no known safe level of consumption.
Caffeine intake should be limited to <200 mg/day (an 8-oz cup of coffee contains between 80-150 mg depending on how brewed, a cup of tea about 70 mg, and an average can of soda about 40 mg)
Increase consumption of DHA-rich foods, especially salmon (Pacific only!), and, to a lesser degree, tuna (but only buy U.S. west-coast caught tuna). Strive for 8 to 12 ounces per week.
Fats should supply 20 to 35 percent of a woman’s daily energy needs during pregnancy and lactation.
Increase daily calorie consumption by about 100 calories in the first trimester, 300 calories in the second, and 500 calories in the third
Ideally consume about 34 grams of fiber per day
The U.S. Dietary Reference Intakes recommends about 0.8 grams per kilogram per day of dietary protein for non-pregnant women (to determine your kilogram weight, divide your weight in pounds by 2.2). Starting in the second trimester, increase your protein intake to 1.1 grams/kilogram/day.
Consider taking a daily Vitamin D supplement (1000 IU per day)
Mandatory is a daily prenatal vitamin (especially to meet the increased iron and folic acid requirements of pregnancy)
Engage in moderately-intense (heart rate increasing) aerobic activity (such as brisk walking) for at least 150 minutes per week (which may be divided up into five, 30-minute walks per week)
Be especially careful to avoid foodborne illnesses (by properly cleaning fruits & vegetables before consumption, and thoroughly cooking meats), E.Coli from petting farm animals, and Toxoplasma from changing cat litter boxes or working bare-handed in a garden where cats may have defecated.

During Lactation

Consume an extra 500 calories daily above your typical pre-pregnancy diet for the first 6 months of lactation
Continue taking your prenatal vitamin daily
Consider a daily Vitamin D supplement during the months of October through May
You may consume an occasional alcoholic beverage, such as a beer or a small glass of wine.
Consume about 1.3 grams per kilogram per day of protein (more than during the second and third trimesters of pregnancy)