Special Dietary Needs and Pregnancy

By Joanne Stone, Keith Eddleman, Mary Duenwald

Try as you may to follow all the rules of healthy nutrition, you may encounter certain problems with digestion, such as constipation or heartburn. Or you may find that you need to tailor the rules to fit your particular eating habits — for example, if you’re a vegetarian.

Eating right, vegetarian-style

If you’re a vegetarian, rest assured you can produce a healthy baby without eating steak. But you do have to plan your diet more carefully. Vegetables, whole grains, and legumes (peas and beans) are rich in protein, but most don’t have complete proteins. (They don’t contain all the essential amino acids that your body can’t produce by itself.)

To get all the necessary protein, you can combine various proteins; for example, whole grains with legumes or nuts, rice with kidney beans, or even peanut butter with whole-grain bread. The combination doesn’t have to occur at the same meal, only on the same day, but a good rule of thumb is to try to get some protein with each meal.

If you don’t eat any animal products, including milk and cheese, your diet may not provide enough of six other important nutrients: vitamin B12, calcium, riboflavin, iron, zinc, and vitamin D. Bring up the topic with your doctor. You may also want to discuss your diet with a nutritionist.

Staying healthy, vegan-style

Vegans, like vegetarians, do not consume meat, fish, or poultry, but take it even further by eliminating all animal products from their diet. So, no milkshakes or eggs-over-easy for vegans! Because many vegans consume fewer calories and may start their pregnancy with a lower BMI, they need to pay extra attention to make sure they are getting enough calories and nutrition for themselves and their growing baby.

Here are some helpful hints for those vegan preggies out there:

  • Vitamin B12 deficiency is not unusual for vegans, so make sure you are getting enough vitamin B12, and speak with your doctor about possible supplementation.

  • Good sources of protein can be found in soy products, beans, whole grains, lentils, and tofu.

  • Pay attention to calcium, since calcium and vitamin D are needed for you and your baby’s bones. Good sources of calcium for vegans include calcium-fortified soy milk and juice, calcium-set tofu, soybeans and soy nuts, green leafy vegetables, Chinese cabbage, kale, mustard greens, and okra. Dry cereals are a source of Vitamin D.

  • Iron is super important during pregnancy, because your body needs to increase its blood supply for the pregnancy. You can find iron in dried beans, green leafy vegetables, and tofu.

  • Folate is another important factor that has been shown to reduce the chance of the baby developing a condition called a neural tube defect. It’s important to have enough folate on board before the pregnancy starts and especially through the first trimester. Folate can be found in enriched breads, pasta, cereals, and orange juice.

  • DHA (docosahexaenoic acid) is great for the developing fetal brain. Many people think of DHA as occurring only in fish, but a form of DHA can also be found in flaxseed, flaxseed oil, canola oil, walnuts, and soy nuts.

Maintaining a gluten-free diet

For women with celiac disease, following a gluten-free diet is essential to maintaining good health. A gluten-free diet typically avoids foods made from gluten-containing grains such as wheat, rye, barley, and oats. Many women worry that a gluten-free diet may be problematic in pregnancy.

For expectant mothers, it’s important to keep in mind that a gluten-free diet may be low in calcium, iron, fiber, zinc, B vitamins, and magnesium, and that gluten-free vitamin and mineral supplementation may be needed for adequate nutrition.

Pregnancy in general often causes constipation, and pregnant women with celiac disease may find this to be a particular issue. You can, however, find fiber in foods such as quinoa, teff, and millet. Rest assured that you can have a healthy pregnancy even if you eat gluten-free — just remember that supplementation may be key in ensuring adequate nutrition.

Combating constipation

Progesterone, a hormone that circulates freely through your body during pregnancy, can slow down your digestive system and thus cause constipation. The extra iron from your prenatal vitamin only makes matters worse. Women who are on bed rest because of pregnancy complications are at particular risk for constipation because they’re so inactive.

You can counteract constipation by drinking plenty of fluids, eating adequate fiber (in the form of fruits, vegetables, beans, bran, and other whole grains), and, if possible, getting exercise every day. Keep in mind, however, that some women experience abdominal discomfort, bloating, or gas from eating too much of foods high in fiber.

You may have to use a little trial and error to see which fiber-rich foods you tolerate best. If constipation bothers you, your practitioner may recommend a stool softener.

Dealing with diabetes

If you’re diabetic or if you develop diabetes during pregnancy, adjust your diet so that it includes specific quantities of proteins, fats, and carbohydrates to ensure that you maintain a normal level of blood glucose (sugar).