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Pregnancy & Morning Sickness
Where can I find a dietitian who works with pregnant or nursing women or women who have morning sickness?
I am a dietitian working in a women's hospital. I noticed in one of your FQAs that you stated that you do not know how many calories are needed with twins. I too have found nothing via Medline on calorie needs during multiple babies (twins, triplets, etc) during pregnancy. We have based our recommendations on the suggested 45 pound weight gain, requiring approximately 5 pound for the first trimester and approximately 1 pound per week during the second and third trimesters. I just wanted to run this idea by you and get your opinion, if you don't mind.
The math doesn't add up. Since pregnancy is figured on 40 weeks, if a person gained 5 pounds during the first 12 weeks and 1 pound per week for the remaining 28 weeks, that would only equal 33 pounds, not the 45 pounds you were aiming for. A woman carrying twin fetuses would need to gain 1.6 pounds for the remaining 28 weeks to equal 45 pounds.
Second, I don't know that 45 pounds is the total pregnancy weight goal as I have not seen weight gain recommendations for twin or multiple births.
I just found out that I am pregnant and I went on your Healthy Body Calculator and it said I was over weight. I'm 5 feet 2 inches", 128 pounds, very active and I look good. I'm a size 6 and I am really worried that it said that I should gain to 158-168 pounds during my pregnancy. I'm pretty muscular so that's why I think I weigh that much. Can you give me any different info on my weight gain, now knowing more in-depth information? Thanks!
You can continue to exercise during your pregnancy. Discuss this with your doctor on your next visit. Also, if you know your percent body fat, enter that into the calculator. If you have not been tested, leave it blank.<
I'm wondering if you can answer my question in regard to calories and pregnancy. I am 23 weeks pregnant and would really like to know how many calories are adequate for someone in my situation.
I exercise everyday. I do weight work for 20 to 30 minutes and also cardiovascular (treadmill and bike) for 1/2 an hour to 45 minutes. I also take my dog for a 1/2 hour walk after the gym. On days that I don't go to the gym which is usually a Friday or Saturday I take my dog for 1 hour to 1 1/2 hour walk.
I tend to be hungry quite a lot and also wonder if this is due to my exercising combined with my pregnancy. I would appreciate if you could answer my question. By the way I am only 4 feet 11 inches and when not pregnant weigh about 44 kilograms with a small to medium frame.
You can monitor your weight and calorie requirements with the Healthy Body Calculator. Click on the calculator link in the upper left corner. Works with metric measures as well as U.S. measures. Just click metric and your pre-pregnant weight and due date. It calculates weight gain as well as calorie and vitamin / mineral requirements for pregnancy.
Try to accurately estimate your activities as that can over or under estimate your calorie requirements. Write back if you have any problems.
Hi I hope you can answer my question. I'm 180 pounds 5 feet 2 inches and just mound out I'm pregnant with my second child. During my first pregnancy, I gained 70 pounds and reached 230 pounds which caused me to have hypertension and deliver my baby 5 weeks early. I'm scared of these and other possible problems happening again. My doctors seem to think I'm not overweight, but I disagree. I know I can't go on a diet, but is there a way I can lower the risk of these potential problems by a certain eating plan?
Please respond before I blow up again. Thank you.
You are overweight, but you still need to gain weight as this is the best predictor of delivering a healthy full term baby. Try my Healthy Body Calculator as it works for pregnant women as well. It will add an appropriate weight gain based on your pre-pregnant weight, even if you are overweight to begin with. Come back every 2 - 4 weeks for a weight gain check-up to keep yourself on track with gaining enough, but not too much. Check Your Nutrition Facts on page 3 of the calculator for calories / nutrients you need to grow a healthy baby.
Sounds like you had pre-eclampsia or toxemia and probably was restricted to bed during your pregnancy. You can reduce this from happening again by paying attention to your eating habits (eat enough protein) and slowing your weight gain. Why not talk to a Registered Dietitian about now when it is early in your pregnancy? You've been down this path before and you know what not to do. Why not find out what you should do?
Recently my midwife, (I currently have a sinus infection and am 32 weeks pregnant), informed me to avoid dairy products, avoid sweets and fruits to lessen the congestion in my sinuses. I question her advice "avoid fruits" - she indicated that fruits (I'm assuming it's the sugars in fruits) increase more mucous. Is this correct? Or is my midwife offering advice bordering on quackery? This has been bothering me for two weeks now.
A sinus infection is usually treated with antibiotics, but since you are pregnant, that is probably going to be the last course of treatment. What does your doctor recommend for treatment?
First I would recommend you increase your intake of water. Dairy products will increase mucous production, but you need good food sources of calcium, vitamin D and riboflavin. There was some research years ago that homemade chicken soup did help break up mucous secretions so you could try eating that once a day.
Fruits and sweets (other than dairy based sweets like ice cream) do not increase congestion nor mucous production. Fruits contain lots of vitamin C, beta carotene and folacin so I would not recommend cutting out a whole food group. I would recommend you include 5 fruits and vegetables each day for your and your baby's health.
My daughter is 7 months pregnant and the corners of her mouth are so cracked that the skin is growing back crooked. I'm concerned that she has a vitamin deficiency, although she takes vitamins. Any advice or a cream that will help her? Thank you.
Hi, great page, thanks for the info, especially on iron! I am currently pregnant and was told that I am low in iron 11.9-12.2 and absolutely cannot take iron pills for fierce constipation / cramping (also my levels never increase anyway). The only thing that works for me is red meat and liver. However my family is very upset with me eating beef liver due to its "waste concentration" and high cholesterol. What shall I do? Do you recommend eating liver?
Yes, eat red meat i.e. beef and especially liver. Glad you like it (I do too). Other foods high in iron are pork, chicken, lamb and turkey liver, Braunschweiger (liver sausage) and pate (chicken liver spread). Dry cereals that contain 100% of the Recommended Dietary Allowances for iron would be another good iron source as well as a containing fiber.
Don't know what you mean by waste concentration, as liver is where your body stores fat soluble vitamins. It is a very nutritious food to eat. Your liver processes toxins into substances that can be excreted by the body and are not stored in your liver. Your liver de-toxifies substances like alcohol, however alcohol is not recommended during pregnancy.
For now, don't worry about cholesterol, even if you eat 4 oz of liver per week. You can offset the cholesterol by cutting out 2 egg yolks for every 4 ounces of fried liver you eat. Persons who want to limit cholesterol usually limit egg yolks to 4 per week. If you choose other low fat, nutrient rich foods, I wouldn't worry about your cholesterol going up. Your body needs cholesterol to make hormones and your hormones are elevated during pregnancy.
A therapeutic dose of iron is 30 to 60 mg per day. If iron supplements constipate you, have you tried switching to whole wheat bread, whole grain cereals (oatmeal or oat based dry cereals), more beans and legumes as well as fresh fruits and vegetables? All these foods are high in fiber and would help offset the constipating effect of iron supplements.
Also, since the amniotic fluid your baby is floating in completely changes every 24 hours, remember to drink enough liquid. Are you drinking enough water? Constipation can occur from an inadequate fluid intake even if you are eating some fiber because of your body's demands to continually produce amniotic fluid.
Thanks for your comments.
Hello. Thank you for your informative web site. One question. What would you suggest the protein intake for a pregnant woman be? Thanks for your attention.
The RDA for protein is 60 grams during pregnancy, but does not consider your current weight as it treats all women the same regardless of weight.
I recently began taking a colloidal mineral supplement daily. I heard the tape "Dead Doctors Don't Lie" by Dr. Joel Wallach. Now I find I am pregnant. I am looking for information concerning taking these supplements during the pregnancy. I would appreciate any advice you can give me. Thank you.
Colloidal minerals are molecules of minerals floating in a liquid. Nothing in the research suggests that colloidal minerals are more or less absorbable than mineral supplements in pills. In fact I have not seen any research on absorption of colloidal minerals after checking what is available in a Medline search and many nutrition reference texts.
I have listened to the tape and have numerous doubts, the first of which why is the person providing nutrition information also selling supplements? Another question is why recommend nutrients that have no proven requirement by humans? The statements that our soils are completely depleted of minerals are absurd. Many plants need minerals for their own survival. Generally, a lack of a nutrient would cause deficiency symptoms in plants and animals as evidenced by cows that graze on selenium poor soils. But not all cows have a deficiency of selenium. Last question is when did the human body adapt to run on pills and supplements that have only been available during the last century? If you want a vitamin and mineral packed food, eat liver. Unless you can find documented research that states colloidal minerals are safe to be taken during pregnancy, I could not recommend it.
Your obstetric doctor will probably prescribe pre-natal vitamins that include iron, vitamin c (improves iron absorption) and Folacin (folic acid or folate) to prevent neural tube defects. The only vitamin that you should not take in excess of the RDA while pregnant is Vitamin A which should be limited to 800 RE ( = 4000 IU) daily. You should include in this limited total any supplement that contains Vitamin A in addition to the Vitamin A in the foods you eat.
Another nutritional concern is that you gain weight because that helps determine your baby's weight gain and development. Have you tried my Healthy Body Calculator? It will calculate a healthy weight gain, calories and nutrients for your pregnancy.
Congratulations & Best Wishes.
Hi. My wife Cyndee and I are expecting triplets! We're excited, but concerned that Cyndee can't seem to eat as much as is recommended in the literature we've received from the "Triplet Connection." During her first pregnancy Cyndee didn't have any problems with nausea, but this time it is much different (it took 3 babies to make her sick!). Anyway, someone recommended that we try Ensure Plus, so we bought the Wal-Mart brand and she seems to do fine with that as an extra supplement between meals and when she doesn't feel so well. I know that there has been concern about getting too much vitamin A (more than 20,000 I.U. a day) in pregnancy, but I calculate if she were to drink 6 cans daily and take her prenatal vitamins (Prenate 90) she might be getting 10,000 I.U. daily. She actually drinks about 3 to 4 cans a day (360calories/can) along with eating whatever she can. My question is, "Is Ensure O.K. to use as we have for this pregnancy or do you have a better recommendation?" We'll be seeng a specialist in a couple of weeks, but she is already about 16 weeks along and I'd like to make sure that we do the right thing early on. Thanks.
WOW! Don't know the Wal-Mart brand, but Ensure Plus is good. If you check the Wal-Mart Nutrition Facts label against an Ensure label and the percent RDAs are the same, the Wal-Mart brand is probably OK. Also, read the list of ingredients which should be mostly milk products, sugar, oil (to increase the calories) and added vitamins.
You are right about the excess Vitamin A. Most prenatal vitamins though only contain folic acid, iron and vitamin C to improve iron absorption. Most medically recommended liquid supplements have 100% of the RDA in 1800 calories or about 1200 ml (or about 8 cups). So between pre-natal vitamins, liquid supplements and her regular food, she is probably OK as long as she doesn't take beta-carotene or another Vitamin A supplement.
Check out the Healthy Body Calculator. It will calculate the calories Cyndee needs for pregnancy and predict a healthy weight gain. However, I do not know how the calorie needs increase with multiple babies. Also if she decides to breast feed, it will calculate the calories for lactation. But again, I don't know how the calorie needs increase with breastfeeding multiple babies. An average baby consumes about 1 quart of breast milk per day.
I'm three months pregnant and have gained nine pounds in two months. I'm not sure what I should eat. Fruits, especially citrus fruits are good, aren't they? My doctor gave me a list with haddock and whitefish on it. I don't eat those. What should I eat?
You should slow your weight gain as you have six months yet to go before delivery. All pregnant women are encouraged to gain 22 to 28 pounds. Normally, a pregnancy lasts 40 weeks. If you set a goal of at least 20 pounds, you should gain one half pound per week or two and one half pounds per month. Actually, your weight gain in the first three months should be the least because the fetus is so small and calorie needs are not as high. However, the first three months are when cells are becoming organized into different systems of the body and cell number is increasing. During this critical period, you want to make sure that the nutrients needed for cell growth are present in your diet. Weight gain during the last three months should be the greatest because the fetus is putting on weight during this time.
A pregnant woman's first nutritional needs are to take care of maintaining and repairing her body. Then we add the additional needs of a growing fetus. A fetus is developing muscle, lean tissue, bones and blood. The biggest nutritional needs are for added protein, calcium, phosphorus, magnesium, iron, folacin, vitamin B6 and zinc. The amount of calories needed to supply these additional nutrients is not that much.
A pregnant woman needs an extra 300 calories which could be achieved by eating three ounces of meat and drinking an extra eight ounce glass of milk. The additional vitamin and minerals could be reached by eating dark green leafy vegetables, whole cereal grains and fruits, especially citrus fruits that are excellent sources of vitamin C and folacin.
I would suggest that you ask your doctor for nutritional counseling to help plan your food intake during your pregnancy. The weight that you gain over about 28 pounds may be fat that you will have to lose after delivery.
My doctor told me I should gain 20 to 24 pounds during my pregnancy. I just found out I'm pregnant and I was on a diet to lose weight. So far, I have lost 10 pounds and I'm discouraged that I have to gain again.
Listen to your doctor. He/she can guide you through your pregnancy to the healthy outcome of your baby. I understand your wish to keep losing weight, but for the health and growth of your baby, do as your doctor suggests.
Doctors have learned that during pregnancy, the minimum weight gain of baby, amniotic fluid, placenta and increased uterine and breast weight is 18 to 20 pounds. The four to six additional pounds is necessary for replenishment of nutrients used during the pregnancy.
We used to think that the mother's body would first fulfill the baby's nutritional needs before the mother's own needs were met. Instead, we have found that there is a maternal sparing mechanism, which prevents the mother from depleting her nutritional stores to a critically low level. Weight reduction during pregnancy is not advised even for very overweight women.
Follow the nutrition guidelines set out by your doctor. Limit your weight gain to 22 to 28 pounds total. Then after delivery, resume your weight loss program. If you plan to nurse your baby, you need a very slow weight loss diet so as to ensure the nutrient content and quantity of your breast milk.
I'm pregnant and my doctor prescribed iron supplements for me. They constipate me so I quit taking the pills. What foods are high in iron so I can make sure I don't become anemic?
First, discuss your problem with your doctor. He/she is the most appropriate person to suggest other supplements.
The increased iron requirements of pregnancy (30 milligrams) cannot be met by the iron content in your diet or by your existing iron stores in your body. An iron and folacin supplement is usually prescribed for pregnant women. So the bottom line is you still need the iron supplement.
Unfortunately, iron supplements often cause constipation. This presents added discomfort to the pregnant woman since her growing uterus is further cramping her intestines. You should increase the fiber and fluid content in your diet to help relieve the constipation.
High fiber foods are whole wheat bread, whole cereal grains, fresh fruits, fresh vegetables, dried beans and peas. Start including one or two high fiber foods in your daily diet.
Your fluid intake should be at least eight glasses of water per day. The fluid your baby is floating in changes completely every eight hours. The replacement water has to come from your body or your diet.
You should be eating more foods higher in iron. Liver, red meat, fortified cereals, prune juice, dried beans and peas are the best sources of iron. Raisins and other dried fruits, liver sausage, prunes, spinach and beet greens, broccoli, peas, molasses and whole grain breads are moderate sources of iron. Many of these foods are also high in fiber, which would also help your problem with constipation.
I have morning sickness and am only about two months pregnant. This is my first pregnancy and I don't know what to eat to get rid of this nausea. What should I eat?
Morning sickness does cause nausea and vomiting. It does not always occur in the morning however and may last the entire pregnancy. Most women only have morning sickness from about week 10 to week 16 during their pregnancy. The cause of morning sickness is not known and food tolerance varies from individual to individual.
If you get nauseated in the morning, try keeping some salted crackers by your bedside. Eat three to six crackers before you get up. Having some dry food in your stomach may help decrease the nausea.
You can also try eating your meals without liquids and drink the liquids about two hours after a meal. This is called a dry diet. Having solids and liquids moving around in their stomach together nauseates some people.
You should discuss your nausea and vomiting with your doctor. If the vomiting continues, you could become dehydrated which could affect your pregnancy.
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