Originally published on: https://www.myhealth.london.nhs.uk/maternity/seven-steps-healthy-pregnancy
Now you are pregnant it is more important than ever to adopt a healthy lifestyle for the sake of your health and that of your baby.
Watching what you eat and drink as well as taking regular exercise are among the best ways of going about it, according to research at Barts and the London School of Medicine and Dentistry and Queen Mary University of London.
1. Eat well
‘Your body becomes more efficient at absorbing nutrients, such as calcium, needed for strong bones and teeth, so there’s no need to eat for two,’ says Jacque Gerrard, the Royal College of Midwives Director for England. ‘However, you do need to ensure your diet is nutrient-rich.’
Make sure you include:
Starchy carbohydrate foods such as whole-grain breads, rice, pasta, breakfast cereals, chapattis, couscous and potatoes for energy.
Five-a-day or more servings of fresh fruit and vegetables for their vitamins, mineral and plant nutrient content.
Two portions of lean protein found in meat, fish, poultry and/or vegetarian sources such as well-cooked eggs, pulses such as lentils, chickpeas, haricot beans, kidney beans, quorn and tofu.
Omega-3 fatty acids found in oily fish to help your baby’s brain, nervous system and eyes develop. Aim for two portions a week. 1 portion = 140g, cooked weight. (But see below for cautions.)
Two portions of low- or reduced-fat dairy products a day. 1 portion = 180ml or one-third of a pint of milk, 150g yoghurt, 25g cheese.
2. Stay a healthy weight
Excess maternal weight is hard to lose after birth and can increase your risk of problems such as miscarriage, pregnancy diabetes, high blood pressure, as well as giving birth prematurely. Babies and children of overweight or obese women, meanwhile, are more likely to become overweight or obese themselves.
As a rule of thumb, if you started pregnancy a normal weight, aim to gain no more than two stone (12kg). If you were overweight at the start, aim for about one stone (6kg). However, if you started pregnancy underweight you can afford to have a weight gain around three stone (19kg).
3. Take the recommended supplements
It’s essential that you and your baby get plenty of vitamins and minerals during pregnancy. Most of these can be from a healthy diet but you should also take the following supplements:
400 micrograms folic acid every day until week 12 of your pregnancy. Folic acid is a B vitamin, found in green leafy vegetables, needed for the development of a healthy nervous system. Taking a supplement can help your baby avoid defects of the brain and spinal cord (neural tube defects) such as spina bifida.
10 micrograms vitamin D every day to meet your needs and ensure your baby builds up stores of this essential vitamin needed for healthy bones, teeth and many other functions. Vitamin D is made in your skin from sunlight and also found in foods such as oily fish, eggs, fortified spreads and cereals. Taking a vitamin D supplement can reduce the risk of your baby developing rickets, in which there is a softening and weakening of the bones. Ask your doctor or midwife if you are eligible for free 'Healthy Start' multivitamins.
*A word of caution: Avoid over-the-counter medicines unless advised by your GP or midwife.
4. Avoid risky foods
‘There are very few foods you need to avoid altogether but some can be harmful to your unborn baby as they can cause food-acquired infections such as listeriosis, salmonella and a condition know as toxoplasmosis, which are potentially harmful to you and your baby. If in doubt get further advice from your midwife about these foods.
What to avoid:
Pâté may contain listeria bacteria, which are harmful to your unborn baby.
Raw or undercooked meat, including cured meat such as prosciutto and salami can contain bacteria that cause food-borne illnesses.
Liver contains high levels of vitamin A, which can be dangerous to your baby.
Fish and shellfish. Avoid shark, marlin and swordfish as they can contain high levels of mercury which can harm the baby's developing nervous system. Limit fresh tuna steaks to two a week and canned tuna to four medium cans a week. Avoid raw shellfish which carry a risk of food poisoning.
Soft rind cheeses such as Brie and Camembert, and blue-veined cheeses such as Blue Stilton and unpasteurised soft cheeses such as goats’ cheese can contain listeria bacteria, although this is rare.
Raw or partially cooked eggs such as scrambled egg, homemade mayonnaise and products containing raw egg such as home-made chocolate mousse can carry a risk of salmonella. Shop-bought mayonnaises and dressings should be safe as they are made with pasteurised eggs but check if you are eating out at a restaurant.
5. Go easy on the alcohol
Scientists are still arguing over how much it is safe to drink during pregnancy. ‘It’s not known for certain how much alcohol is safe during pregnancy,’ says Jacque Gerrard. ‘However, we do know that heavy or binge drinking – more than five standard drinks or 7.5 UK units– could put your unborn baby’s health at risk as well as increasing the risk of pregnancy problems.
‘Avoid alcohol if you are trying to get pregnant and during the first 12 weeks of pregnancy and avoid binge drinking or getting drunk at any time. If you do choose to drink alcohol during pregnancy, limit yourself to no more than one or two units once or twice a week,’ she adds.
A unit is half a pint of ordinary strength lager or beer or one (25ml) shot of spirits or a small (125ml) glass of wine.
Recreational drugs of any kind such as cannabis are definitely to be avoided in pregnancy.
As for medicines, always make sure your GP has taken into account that you are pregnant before prescribing a medication for you, and check with the pharmacist before taking any medicines that you can buy over the counter (without a prescription).
6. Keep active
Staying active during pregnancy and exercising helps your body adapt to the changes it’s going through. ‘If you are used to exercising, low-impact activities such as walking, dancing, yoga, Pilates and so on can be continued as long as you remain healthy and low risk,’ advises Jacque Gerrard.
‘If you haven’t been active before, start with a gentle activity such as walking and build up gradually.’
Whether or not you’re used to exercising, you should avoid any activity where you could fall or be hit, such as judo or squash.
If you go to a gym or exercise class always seek advice from your midwife before continuing. You may wish to tell the instructor you are pregnant and ask for information on exercising safely and the use of machines and equipment.
7. Quit smoking
Chemicals from cigarette smoke can reach your baby via the placenta and can increase the risk of pregnancy complications, low birth weight, premature birth and a host of long-term complications that can last throughout your child’s life, so it really is well worth making an effort to quit if you are a smoker.
There’s lots of support available to help you quit.
Ask your midwife about your local stop smoking services, visit NHS Smokefree Smoking and pregnancy for help and advice or call the NHS Pregnancy Smoking Helpline on 0800 169 9 169.