Expert Guide to Pregnancy Nutrition: 40 questions answered

Pregnant mum eating healthy

When it comes to eating for two, every day is a new food journey, some days are a degustation while others are more famine than feast (thanks morning sickness). So when we were asked to host a live chat with dietician and nutritionist Jaime Rose Chambers, thanks to our friends at aquamamma®,  we jumped at the chance.

Jaime spent an hour in the Mum’s Grapevine Due Date pregnancy groups chatting with over 6000 mum-to-be’s, answering everyone’s nutritional questions across a range of topics from pregnancy constipation to healthy snacks to beat mummy munchies and crazy cravings.

 


Jamie Rose NutritionistJaime Rose Chambers is an accredited dietician and nutritionist who regularly contributes to The Australian Women’s Weekly and Today Tonight.

Jaime hosted live chats in two Mum’s Grapevine Due Date groups and spent a couple of hours answering questions relating to the topics below.


If you missed the live chat, we’ve picked out a selection of 40 questions across a range of topics Jaime covered and posted them below, along with her expert answers.

QUICK TIP: Click a topic above and go to that section


Blood pressure and helpful foods

Q: ‘Are there any foods to help regulate blood pressure? I have had low blood pressure during pregnancy which leads to dizziness so just wondering if there are any diet pointers that could help?’ – Sammi

A: Yes, great question. The main recommendations are to make sure you’re well hydrated because the fluid we drink becomes our blood volume. You could include a little salt into your diet but best to check with your healthcare team on that one. I always like to mention the importance of stabilising your blood sugar levels too with small and frequent meals and snacks that contain healthy carbs.


Breastfeeding and nutrition

Q:What are some nutritional key points from pregnancy and then early breastfeeding? Are there aims for focus? Carbs, fats, and proteins? And for vitamins and minerals, what are some good focus on? Iron, calcium?’ – Malinda

A: There are definitely some main nutrients to focus on during pregnancy and breastfeeding that can easily become deficient. Those are folate, iron, calcium, vitamin D, omega 3 fatty acids. All other nutrients are of course important but are often well covered in a ‘normal’ diet. Folate is usually well covered in pregnancy supplements and in green leafy veg. Calcium you need to grow a tiny skeleton and maintain your bone density so 3 serves diary per day is important. Iron requirements double in pregnancy because blood volume increases by about 50 per cent by the end of pregnancy. Vitamin D is mainly from safe sun exposure but you can also get from fatty fish, mushrooms and eggs. Omega 3 fats are mainly from fatty fish also but you can take a high-quality supplement if you can’t get enough in your diet.

Q: ‘Does my diet need to change much from pregnancy to breastfeeding?’ – Misty

A: Your diet will stay much the same in the early days when bubba is born. You may find you’re more hungry when your milk kicks in and you will need more fluids (up to 2.6L) and generally more calories.

Q: ‘I’m really interested in foods (besides the typical oats and brewers yeast) that can help with milk production! And is it beneficial to eat them prior to delivery to get a head start!’ – Paula

A: The foods that may help increase milk supply are unfortunately not fully backed by any good research but are known as galactagogues and anecdotally may help with milk production. They include the oats and brewers yeast you mentioned as well as other wholegrain, flaxseeds, fennel and fenugreek and papaya. The most important thing for milk production is making sure you’re generally eating enough food/ calories and drinking enough fluids. A great lactation consultant can help too with feeding technique which is essential.

Q: ‘Do you have snack suggestions for breastfeeding that can be pre-made but nutritionally valuable.’ – Malinda 

A: Yes one of my favourites is bliss balls and muesli slices that can be made in batches and kept in the fridge. Add oats, nut butters, coconut, dried fruits.

Q: ‘What are some quick and healthy snacks for when the munchies take hold while breastfeeding?’ – Sammi

A: I loved Vitaweats and cheese when I was pregnant. Peanut butter or avo on toast, a small tub of yoghurt, bliss balls, trail mix with dried fruit nuts and seeds, crackers and hummus dip, a piece of fruit or punnet of berries.


Constipation in pregnancy

Q:‘Any advice/tips on relieving constipation? And kinds of foods I should be focusing on eating or staying away from with regards to helping constipation?’ – Courtney

A: In pregnancy, constipation is generally caused by the change in hormones but often exacerbated by the change in diet, based on food aversions. The first thing to do is check you’re doing the three: 25-30g fibre which you can count on My Fitness Pal app plus meeting fluid requirement of 2.3L per day or more and doing gentle movement every day. Often you can get some relief by just trying to be consistent with that.

Q: ‘One-word CONSTIPATION! It’s killing me – what can I do?’ – Rhiannon 

A: Oh –  it’s a shocker. A few things to consider first if you haven’t already – are you getting enough fibre? You need 25-30g per day. Are you getting enough fluids? You need 2.3L per day. Are you doing enough movement such as walking or swimming most days?

Q: ‘Is psyllium husk okay to have for constipation, if yes how much can I have? And prune juice – how much can I have if constipated?’ – Sammi

A: Yes, psyllium husks are perfect to use for constipation. Start small with 1-2 tsp in a big glass of water and build it up slowly over days. Make sure you’re having plenty of fluids and doing some daily movement too. See your OB or doctor if you still have no relief.

Q: ‘I’d like to ask the best things to do for constipation as well. I seem to be going from one extreme to the other and can’t find a good middle balance. Any help would be great!’ – Courtney 

A: Yes – this is so common in pregnancy. As a first line treatment, you want to make sure your fibre, fluids and movement are adequate. 25-30g fibre per day plus 2.3L fluids plus daily gentle movement. If these are a bit out of whack which isn’t uncommon in pregnancy, then your bowels might be too. Of course, then throw hormones into the mix and it can be really tricky. Make sure to see your doctor if it persists.

Q: ‘Any foods/meals to assist digestion? Pregnancy seems to slow digestion down.’ – Mary 

A: Yes it sure does, that’s those pesky hormones. The three main things to consider first are: are you having your 25-30g fibre each day? Are you having 2.3L fluids per day and are you doing some gentle movement each day?


Eating for two

Q:‘I’m really struggling to eat a healthy balanced diet. To the point where husband and I are purely making sure I’ve had protein every day. Will our baby still be getting what he needs from supplements I take and what foods I can eat and keep down? Will he be ok? Or am I a terrible mum?’ – Bianca

A: Firstly, you are absolutely not a terrible mum! This is so very common. Start by working with what foods you can manage and keep down, like your protein. Then think within the food groups like vegetables for example – what veg do you think you can manage and in what form like roasted or with melted cheese over them? Fruits are great in smoothies are a great way to get in a heap nutrition too.

Q: ‘I have gained weight a lot quicker this pregnancy how much of each food group roughly should I be eating daily? Veg/fruit/carbohydrates/dairy?’ – Ana-Maria

A: Your diet needn’t change much at all in pregnancy. The only change is you’ll need about 350-450 extra calories per day towards the latter half of your pregnancy. So still aim for your >5 serves veg, 2 serves fruit, 3 serves of dairy and 6-8 serves of good quality carb.

Q: ‘Looking for more options for weight gain. 32 weeks pregnant still classified as underweight. Good diet and Ensure with enriched milk taken 2-3 times a day. No medical reasons or issues, bloods are perfect and baby is perfect size. Is there anything else I can do to try and gain weight? Worried that bubs will be early due to me still being underweight and having little to no kgs gained at 32 weeks.’ – Desiree 

A: I’m glad to hear bub is tracking well. It’s not uncommon to have weight gains and weight stability at different stages of pregnancy. The main thing is you’re meeting yours and bub’s nutritional needs so don’t fill yourself more than you need to. Some general advice on weight gain that I give my patients is to: eat small and frequent meals and snacks, add high and good quality calories with low volume to your food (olive oil, avocado, nut butters, coconut, full cream dairy) and drinking your calories can be helpful too so smoothies or the Ensure drinks.

Q: ‘I’m finding it hard to sit down to a meal and I tend to snack on my meals throughout the day instead of a sitting, is this okay? Or should I be having my three meals a day.’ – Tenae Evans 

A: As long as you can meet your nutritional needs, that is fine! There are no rules that you must have 3 meals a day, just aim for a variety of foods with a focus on your fruit, veg, protein, dairy and wholegrains and healthy fats.


Energy-boosting foods

Q:’32 weeks and exhaustion has hit me hard again. I have a 3.5 yr old and 16 month old, what can I do, food wise, to get some energy back?’ – Rebekah-Jayne

A: I’m tired just reading this! From a food perspective, the main thing to boost your energy is eating good quality carbohydrates (our fuel source) regularly through the day. Try to refuel every 2-3 hours – great carbs are wholegrain sourdough, quinoa, sweet potato, oats, barley, fruit and fresh dairy like milk and yoghurt. Make sure you’re well hydrated as well because being dehydrated can make you feel really tired. Smoothies are my go-to for pregnancy nutrition, fluids and energy because you pack so much goodness into them.


Foods to avoid

Q:‘What are some good ideas for eating/taking out with me while out to avoid eating fast food out of avoiding foods we are ‘not allowed to eat’ eg. Sushi, pre-made salads.’ – Rachel Pontello 

A: Yes that’s a tough one but as a general rule, you’re looking for foods that are well-cooked. So slow-cooked stews, soups, casseroles that have been cooked through. Choose vegetables that have been baked or well cooked like baked jacket potato, steamed asparagus or spinach.

Q: ‘There has been much discussion in our group about what we can and can’t eat. Most of us seem to know the obvious and this is my fourth bub but yet I still worry about what I am preparing, such as fresh salads and fruit smoothies. Mums-to-be are worried about things like frozen berries, for example, are they clean enough? Safe? What about eating whole fruits and food such as apples or carrots … even if they are washed there is a lot of people saying it is not enough to kill bacteria’s etc. It is a nerve wrecking world out there when it comes to food handling and safety and I think most of us need some advice and reassurance.’ – Kimberley 

A: This is a really good question and I completely understand where you’re coming from. The tricky thing is you just never really know so that’s why it’s best to be as vigilant as you can. But we know some foods have better environments for growing particularly nasty bugs like listeria and that’s why you want to mostly follow the typical recommended foods to avoid like soft cheeses and making sure your food is very well cooked through are your two main food safety strategies.

Q: ‘What foods/drinks would you suggest we avoid during breastfeeding?’ – Sarah Jane 

A: As far as the research goes, it is suggested and recommended to eat a ‘normal’ diet whilst breastfeeding according to the Australian Breastfeeding Association. Otherwise, my experience is that foods that may bother bub are quite personal and what bothers one bub, doesn’t bother another. It is a little trial and error, unless of course bub has reflux or a food allergy response and you will need to see your paediatrician first.


Sugar Cravings

Q:‘I’m craving a lot more sugar than I would normally eat. I have a BMI of 18.6 and eat a balanced diet however if I continue to indulge in sweets every night (chocolate etc) am I susceptible to GD or is that based on weight, genetics etc?’ – Amy

A: As long as your base diet is balanced, it’s ok to enjoy some sweets here and there. Naturally, I would encourage you to replace it with other better alternatives where you can like yoghurt or fruit. Eating too many sweets is not a major risk factor for GD.


Healthy breakfast ideas

Q:‘Any good gluten free, quick, high protein breakie ideas?’ – Rhiannon

A: Yes sure! Well, eggs are one of my favourites. For speed you can pre-hard boil them in batches so they’re ready to use quickly. You can also crack them into a bowl and microwave for a couple of minutes and they work a treat. A smoothie is great too with milk, Greek yoghurt and fruit.


Healthy lunch ideas

Q:‘Do you have some lunch ideas please? Feel that I am having a healthy breakfast and dinner each day but when lunch comes around I am a bit stuck.’ – Carla 

A: Yes lunch can be a tricky one. My favourite go-to is leftovers from dinner (reheated well). Another easy one is two pieces of toast with avo or hummus/ tinned fish and some sliced tomato. A quick omelette with cheese and toast is delish. A microwave pouch of brown rice with some tinned 4 -bean mix is a yummy one too.

Q: ‘I would love some vegetarian ideas for lunch.’ – Jessica

A: If you eat eggs then I’d try to add them in where you can – either on toast or as an omelette. If not, tinned legumes or lentils with brown rice is yum, hummus/ avo/ cheese on toast. Leftovers that can be reheated are great too – tofu curries, bean stews, bean nachos, lentil and veg soups.

Q: ‘What are some quick but nutritious meal ideas when you can’t stomach cooking, please?.’ – Carla

A: Yes a great question. I like to think of it as ‘constructing’ rather than cooking. Wholegrain toast with avo, hummus, tinned fish, sliced tomato or two eggs made into a quick omelette, or even baked beans on toast with a sprinkle of grated cheese or microwave brown rice and a tin of beans or lentils.


Healthy pregnancy snack ideas

Q:‘I’d love to be pointed in the right direction for some healthy nutritional meal and snack ideas and recipes. I’m really struggling to eat enough for two.’ – Jess

A: There is no need to be eating for two at any stage in pregnancy. In the second and third trimester, you need only about 350-450 extra calories per day so that’s the equivalent of about two snacks or a healthy meal. So just keep up your normal healthy diet as much as you can and add in the extra if and when you need it. Great snack ideas are always best from whole foods like fresh and dried fruits, nuts and seeds, wholegrain toast/ crackers with peanut butter, avo or cheese, smoothies are awesome.

Q: ‘What’s a really really simple and fast healthy snack that I can grab instead of sweet things from packets?’ – Leesa 

A: Without sounding too daggy – how about a piece of fruit or a punnet of berries? A little dried fruit is good too like dried apricots and dried apples. You could try bulking out the fruity snack by having chopped fruit and yoghurt or dried fruit with nuts and seeds or make a big smoothie with milk, yoghurt and fruit with a little honey

Q: ‘I am interested in any family meals that can be frozen in advance, recipes that can be made in advance to help produce more milk and night snacks that can help level out blood sugar levels overnight.’ – Lee

A: Yes absolutely. Generally, meals that are slow cooked in a sauce can freeze very well such as soups, stews, casseroles and curries. You can add fresh or frozen veg to them when you eat them if you’d like or cook the veg into them. Include ingredients like brown rice, barley, oats and spinach and flavour with fennel and fenugreek and they say brewers yeast can help too. Remember none of this has been backed by science. The main thing it to eat enough calories and carbohydrate for energy and fluids to make milk.

Night snacks that are great are home-made bliss balls that contain oats, nuts, dried fruits which can help give you a slow release of sugars. Yoghurt and fruit or yoghurt and nuts is another good one, a slice of wholegrain toast with nut spread, avo or cheese.

Q: Any easy, cheap snacks that can help with brain power and energy?’ – Wame

A: Energy and brain powder come from good quality carbohydrates and some omega 3 fatty acids. You could try tinned fish on a slice of wholegrain toast, home made muesli slice using flaxseeds and walnuts, a hard boiled egg on wholegrain crackers?


Hydration in pregnancy

Q:‘How can I make myself drink more? I wasn’t a big drinker (water or anything) before being pregnant and I’m trying but still don’t think I’m drinking the recommended amount?’ – Carlie 

A: You can sneak fluids in other ways that aren’t water. Such as soups, smoothies, tea and herbal tea.

Q: ‘Would love to know your thoughts on drinking coffee while pregnant. Any risks from having one cafe bought flat white each day? Would also love some healthy protein snack ideas for pregnancy. I feel like I am snacking on way too much fruit and just mindful of fructose.’ – Carlie 

A: The general recommendations are one small coffee per day is fine in pregnancy. It’s also a good way to get a serving of dairy in. That milky coffee is a good protein snack, surprisingly! Hard boiled eggs are great, nut butters, bliss balls, Greek yoghurt and smoothies with milk and yoghurt are all grea high protein snacks.

Q: ‘Are there any supplement type drinks we can have to help with an energy boost. I’ve been having lots of banana smoothies with greens powder but I’m still feeling run down … maybe it’s having three other kids?’ – Kimberley 

A: I don’t know if there is a drink to outrun three kids! Smoothies are awesome! Have you tried aquamamma®? It’s a low sugar drink formulated for pregnancy and breastfeeding with added electrolytes and folic acid in it.

Q: ‘Hydration! I’m having so much trouble with it. Water, milk, juice, hot chocolate, nothing goes down smoothly either making me instantly heave or leaving me with hours of reflux’ – Jess

A: Oh dear – you poor thing. I wish I could say there was something that might help but it may just be a matter of time. I would definitely however try the aquamamma® pregnancy drinks and ginger tea if you haven’t already!

Q: ‘How much water should I be drinking each day and how can I mix it up to keep it interesting?’ – Carly

A: The recommendation for pregnancy women is 2.3L fluids per day. Of course, this will differ for each woman. Getting that all in the form of water can be tricky, I get it. For those total fluids they can include mostly water but if you can’t manage all your fluids from water you can also have tea, herbal teas (chilling herbal tea is nice too), sparkling water, soups and milk. If you really need a sweetened drink, instead of cordial or juice, there’s a great drink on the market called aquamamma® which is a specific pregnancy beverage which is low in sugar, no artificial flavours or colours and has added electrolytes and folic acid.

Q: ‘What’s the recommended water intake during pregnancy and when breastfeeding?’ – Lisa

A: The recommended water intake in pregnancy is 2.3L and up to 2.6L while breastfeeding. Naturally, this will fluctuate depending on how regularly you’re feeding.

Q: ‘Is there an option to Gatorade that is lower in sugar? I’ve just been diagnosed with gestational diabetes. I do a five-hour shift in a heated indoor pool providing aquatic therapy and get soooo dehydrated and have found that Gatorade helps me rehydrate so I don’t feel as terrible later in the day. But now looking for other options. I try and drink water whenever I can but it just doesn’t seem to cut it!’ – Veronica

A: Yes! aquamamma® is a great drink that’s been formulated by an OB and contains some pregnancy-specific vitamins, is very low in sugar, naturally sweetened with stevia and no artificial colours or flavours. It’s best to check with your healthcare provider if aquamamma® would be suitable for you, depending on your allowable daily sugar intake.

Q: ‘Liquids of most kinds seem to be my aversion so I am always dehydrated. I ate fruit the first four months but now can’t eat it. Is there any other food groups I can try to help keep my hydration up?’ – Wame 

A: Oh dear that’s such a tricky one! Have you tried soups? Smoothies? Ginger tea? aquamamma® pregnancy drinks?


Immunity-boosting foods

Q:‘Just wanting to know foods that we should include in our diet to boost our immunity to protect us against colds and flus?’ – Tara 

A: Pregnancy changes our immune system so we become more prone to colds and flu. But we can put in some preventative measures before going into labour because having cold while you’re pregnant is the pits.

The immune system is a complex system of many parts. Boosting your diet with a variety of foods and their nutrients that support all parts of your immune system is a great way to help lay a strong foundation so if you are exposed to any bugs, your body is best equipped to fight them off.

Making sure your gut environment is healthy is important too as it forms a protective barrier from nasty outside invaders.

Some food specifics are:
Vitamins A & C – from your citrus but also found in berries, capsicum, green leafy veg and broccoli as well as anything bright red or orange in colour like sweet potato, carrot and tomato.

Minerals Zinc & Selenium – found in animal and seafood (fish, mussels, red meat, poultry and dairy) as well as some legumes like chickpeas. Selenium is rich in brazil nuts, go for 4-5 nuts per day.

Vitamin D – this comes mostly from a little, safe sun exposure but small amounts of Vit D are also found in fatty fish like salmon and tuna, mushrooms and eggs.

Folate is important too but usually covered in pregnancy with a pregnancy multivitamin. You can also get plenty of folate from green leafy veg, legumes and lentils.

For your gut – you can try a pregnancy probiotic and yoghurt and kefir are a good source of probiotics. Foods rich in prebiotics are possibly even more important to help feed the good bugs in your gut like onion, garlic, asparagus, cashews, pistachios, beetroot, cabbage, legumes and lentils, fruit with edible skin like apples and peaches, dried fruit and wholegrains like rye bread and oats.


Intolerances and bub

Q:I have a sensitivity to lactose and have for a few years now. Is this something that can transfer across to the baby? I try to have a bit of dairy every couple days but sometimes I just can’t.’ – Misty 

A: Have you tried lactose-free dairy products like Zymil? They should be easier to digest if you have a lactose-intolerance. In terms of transferring to bub, a lactose-intolerance can be partly genetic but if you’ve developed it in recent years, it could also be due to many other factors.

Q: ‘Can restricting food groups during pregnancy cause intolerances in the baby?’ – Ellie 

A: I don’t believe so however, my understanding is this is not yet known for sure. You’re best to check this one with your OB or doctor to be sure, particularly if you have any family history.


Iron-rich foods for pregnancy

Q:‘I can’t look at meat or eggs let alone eat it without being sick, how I’m supposed to keep my iron and protein levels safe for the baby? I take Elevit religiously every day but it’s really stressing me out!’ – Anna 

A: You poor thing. I hope it subsides soon. I will start with the easy ones, have you tried minced meat in bolognaise, nachos, meatballs in sauce etc? If you absolutely can’t get any of it down, I’d say don’t muck around and just get yourself onto a good iron supplement safe for pregnancy. You can have your iron levels checked with your GP too just for peace of mind.

Q: ‘What’s the best way to get more iron into my diet without having to eat a whole cow?’ – Georgie

A: Ha Georgie! It kind of feels like that because iron requirements double in pregnancy. You can get iron from other meats like chicken and pork as well as fish. Combining plant iron sources like green leafy veg with foods with vitamin C like lemon or tomatoes can help too. If you’re really stuck and you just can’t keep your iron levels up, you may need to consider a supplement.


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Sipping aquamamma® throughout the day is an easy (and tasty) way to stay hydrated throughout pregnancy and beyond. Not just a thirst quencher, aquamamma® is specially created with the needs of pregnant women and breastfeeding mums in mind.

Available online from aquamamma® or your local pharmacy.

 

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