a guide to Prenatal Nutrition

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Table of contentsKey nutrients 4

Fatigue during pregnancy 6

Constipation during pregnancy 8

Healthy calorie intake during pregnancy 10

Weight gain during pregnancy 12

Exercise during pregnancy 13

Eating fish during pregnancy 14

Eat right to sleep tight 15

Pregnancy superfoods for a super-pregnancy 18

Water: your pregnancy BFF 27

Foods and habits to avoid during pregnancy 28

Benefits of DHA and lutein during pregnancy 30

Planning to feed your baby: the benefits of breastfeeding 32

Breastfeeding tips before bringing your baby home 34

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Welcome to this exciting time in your lifeWherever you are on the path of motherhood, we know you are committed to supporting your little one with excellent nutrition. That is why we are excited to share this prenatal education guide with you. It covers everything from nutrition for you while you are pregnant and breastfeeding, to the latest science behind important nutrients for infant nutrition and development — such as lutein, DHA, and vitamin E.

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CALCIUM

IRON

PROTEIN

Why you and your baby need them, and where to get them

During pregnancy, your blood volume is increasing and so is your baby’s. As blood quantity increases, so does your need for iron. Iron is necessary to carry oxygen to active and growing cells. The daily recommended dose of iron during pregnancy is 27 mg. Iron can be absorbed more easily if iron-rich foods are eaten with vitamin C-rich foods, such as citrus fruits and tomatoes. You can get iron from eating red meats, beans, lentils, and fortified grains, and from taking an iron-fortified prenatal multivitamin.

This same mineral that is good for your bones and teeth is good for your baby’s developing bones and teeth as well. You should get around 1,000 mg of calcium per day. Milk and dairy products, such as cheese and yogurt, are the best sources of calcium. If you have trouble digesting milk products, you can get calcium from other sources, such as broccoli, canned salmon, dark leafy greens, sardines, or a calcium supplement.

Your baby’s muscles, tissues, and organs are all constructed of this primary building block. During the third trimester, your baby is growing faster than ever, so protein is especially important. Fortunately, most women get plenty of protein in their diets from foods such as meats, chicken, and fish, as well as milk, beans, peas, lentils, nuts, and tofu.

Key Nutrients

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VITAMIN D

VITAMIN C

Many pregnant women in Canada don’t get enough vitamin D. Vitamin D works with calcium to help your baby’s bones and teeth develop. During pregnancy, the mother transfers vitamin D to the baby, so if she is deficient in vitamin D, the baby is too. The vitamin D recommendation for pregnant women is 600 IU/day. Good sources are milk and other beverages fortified with vitamin D and fatty fish, such as salmon. Exposure to sunlight also converts a chemical in the skin to vitamin D. Check with your health care professional to see if the prenatal multivitamin he or she might recommend contains an adequate amount of vitamin D. In addition, most types of milk (except for evaporated) are fortified with vitamin D.

Vitamin C is especially important during the third trimester. Vitamin C promotes healthy gums and also helps your body absorb iron. In addition to being abundant in citrus foods, vitamin C is also found in broccoli, tomatoes, peppers, kiwis, and berries.

Other vitamins and mineralsMany other vitamins and minerals (such as folic acid) can be just as important towards the end of your pregnancy as they were earlier. As labour approaches, your body needs a strong immune system, antioxidants, and nutrition for optimal functioning and healing. Keep eating your fruits and vegetables. If you are having trouble eating all your servings during meals, try eating several small snacks a day that include these food groups. And if your doctor recommended a prenatal multivitamin, keep taking it.

Beyond these essential vitamins and minerals, there are two other dietary components to consider adding to your diet, which we will cover in the next section: DHA (the acronym for docosahexaenoic acid) and lutein.

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Fatigue during pregnancyYou can’t make an omelet without breaking eggs and you can’t be pregnant without feeling tired at some point. Follow our nutrition and lifestyle advice and put pregnancy fatigue to bed.

While pregnancy is a wonderful, amazing experience, it is also sometimes tiring. Fatigue is one of the most common symptoms, particularly in the 1st and 3rd trimesters, and while nothing can 100% zap fatigue, fueling your body with the right nutrients can help give you the energy boost that you need.

Why are you so tired? If you have concerns about ongoing pregnancy fatigue, talk to your doctor to rule out anemia or other possible causes. Once these have been eliminated, think about the fact that your body is working hard to support a new life and adapt to the physical changes that come with the development of a baby. See? Feeling tired is a good thing. It means that your body is taking care of your baby. So if increased progesterone, lower blood sugar levels, and lower blood pressure sap your energy, give yourself a pat on the back. Your baby is getting bigger.

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Keys to fighting pregnancy fatigue When fatigue strikes, try these tips to help reduce symptoms.

Choose nutrient- and protein-rich foods like low-fat milk, yogurt, beans, chicken breast, or peanut butter. Always skip the quick fix, like donuts, candy, or sugary drinks (we know, they are really tempting, aren’t they?). They might do the trick in the short term, but eventually they will leave you feeling more tired than before. Energy drinks should be thought of as dietary supplements and might not be safe for your baby. Check with your doctor before using these types of products.

Eat every four hours if you can, beginning with a balanced breakfast. Try to include at least one serving of whole grain and one fruit or vegetable with each mini-meal or snack.

Vitamins and minerals (especially iron) are important too. Get as much as you can from iron-rich and nutrient-dense foods, and make sure to take your prenatal supplements as directed by your doctor.

Limit caffeine. The Public Health Agency of Canada recommends no more than 300 mg of caffeine (or about two cups of coffee) a day while pregnant. Oh, and tea and sodas count, too.

Exercising regularly (with your doctor’s guidance) can also be what you need to help you get that boost of energy to make it through the day.

Water, water, water. Drink at least ten cups of water or other fluids daily.

Now here’s a big one: listen to your body, and get the rest you need. It sounds simple, but it can be easy to forget.

Follow this advice and you can hope to look forward to a pregnancy where fatigue won’t become a major drag.

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Constipation during pregnancyHalf of all pregnant women get constipated at some point, and this could be due to hormones, diet, or the pressure of a growing uterus. What can you do about it?

Here are some tips for easing constipation during pregnancy Eat high-fibre foods such as whole grain cereals and breads, brown rice, beans, and fresh fruits and vegetables every day. Adding a couple of tablespoons of unprocessed wheat bran (available at health food stores) to your cereal in the morning and following it with a glass of water can help. Be patient as it may take a few days before you notice a difference.

Don’t forget to drink plenty of water. Try to drink 2.5 L (10 cups) of water or other beverages every day. Your urine should be clear or pale yellow – a sign of proper hydration. You can always try some prune juice. Some people find that drinking a warm beverage right after waking up helps too.

Iron can cause constipation. You may want to check with your health care provider about switching to a supplement with less iron.

Another pregnancy tip: your bowels are most likely to be active after meals, so make time for the bathroom after you eat. Listen to your body. Never put off going to the bathroom when you feel the urge.

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Moving might also help to… get things moving. Exercise regularly. Walk, swim, ride a stationary bike, and do yoga. All of these can help ease constipation and leave you feeling more fit and healthy. And if none of the above helps, talk to your doctor about taking an over-the-counter fibre supplement or stool softener. Do not use a laxative without checking with your doctor or nurse first. Laxatives can trigger the onset of labour contractions.

Experiencing pregnancy constipation? Relax, follow the tips above, and you will soon be a regular “expert” at managing it.

TIP: Breaking up your daily food intake into

five or six smaller meals can help with constipation relief.

Can constipation be serious? Not usually, but occasionally, it can point to another problem. If you have severe constipation that is accompanied by abdominal pain or that alternates with diarrhea, or if you pass mucus or blood, call your doctor or midwife immediately.

Also, straining during a bowel movement or passing a hard stool can lead to or worsen hemorrhoids. Hemorrhoids can be extremely uncomfortable, though they rarely cause serious problems. In most cases, they go away fairly soon after the baby is born. However, if the pain is severe or you have rectal bleeding, you should see your doctor or midwife for an evaluation.

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Healthy calorie intake during pregnancyAt each stage of pregnancy, eating nutritious foods and making sure to get the right amount of calories is good for your baby’s health — and yours.

During the 1st trimester, experts recommend that you eat pretty much like you did pre-pregnancy. During this early period, your baby has high nutrient needs but he* is not growing very fast, so focus on quality, not quantity, and make every bite count.

In the 2nd trimester, your baby is starting to grow quickly, so you really are eating for two. Unfortunately, this doesn’t mean that you need to eat twice as much. In fact, it is recommended that you increase your intake by just 350 calories per day, which is approximately equal to 250 mL (1 cup) of 2% M.F. milk, 1 slice of whole grain bread and 1 large egg.

Rapid development needs the right support. Your 3rd trimester is the home stretch. Your body is changing, your hormones are fluctuating, and your baby’s growth is accelerating. In your 3rd trimester, nutrition plays a critical role in your health and the development of your baby. Continue choosing foods of high nutritional quality to support your growing baby. In the 3rd trimester, you can include an extra 450 calories per day (yay!). That is approximately equal to 1 fruit, 175 g (¾ cup) of 2% M.F. fruit yogurt, 35 g (¼ cup) of nuts, and an extra serving (70 g or ½ cup) of vegetables. Having smaller and more frequent meals during the day may be easier to digest than larger meals at traditional mealtimes. You may also want to prepare quick, healthy snacks in advance for when you are too tired to fix anything.

In general, if you include 2 to 3 additional Canada’s Food Guide servings per day from any of the 4 food groups in the 2nd and 3rd trimesters, you should be able to reach these extra calorie goals.

* This brochure alternates between “he/him/his” and “she/her/hers” when referring to babies.

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These same rules apply if you are carrying more than one baby. More meals of smaller amounts will help you maintain a nutrient-rich diet. You can consult Eating Well with Canada’s Food Guide and get a personalized copy for you. The Food Guide is based on 4 food groups and shows you the amounts to aim for each day. But make sure to add an extra 2 to 3 servings per day during pregnancy.

You can find Eating Well with Canada’s Food Guide at: https://www.canada.ca/en/health-canada/services/food-nutrition/canada-food-guide/get-your-copy.html and obtain your Food Guide at: http://www.healthycanadians.gc.ca/eating-nutrition/healthy-eating-saine-alimentation/food-guide-aliment/my-guide-mon-guide/index-eng.php?_ga=2.154988984.1676562903.1502717243-1447615975.1500404652.

Here are some examples of 2 extra Food Guide servings:

1 fruit and 175 g (¾ cup) of yogurt

1 slice of toast at breakfast and 250 mL (1 cup) of milk at supper

½ bagel with 50 g (1 ¾ oz) of cheese

30 g (½ cup) of cereal with 250 mL (1 cup) of milk

spinach salad made with 250 mL (1 cup) of spinach, 1 hard-boiled egg, and 30 mL (2 tablespoons) of walnuts

1 bowl of cooked oatmeal (175 mL or ¾ cup) made with 30 mL (2 tablespoons) of ground almonds, 60 mL (¼ cup) of applesauce, and cinnamon to taste

1 bowl of plain popcorn (500 mL or 2 cups) sprinkled with your favourite flavouring (such as cinnamon, garlic powder, curry powder, hot sauce or finely grated parmesan cheese), paired with a tall glass of soda water, mixed with 125 mL (½ cup) of orange juice and a squeeze of lemon juice

½ English muffin topped with 1 slice of Swiss cheese and ½ sliced pear

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Weight gain during pregnancyGaining weight is a natural part of pregnancy. This extra weight is attributed to your changing body, your growing baby, as well as the extra stores that you will need to prepare your body for breastfeeding.

https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/prenatal-nutrition/healthy-weight-gain-pregnancy.html

Your weight gain during pregnancy, however, impacts your baby’s health and your well-being both during and after pregnancy. Too little weight gain during pregnancy increases the risk of preterm birth and of having a low-birth-weight baby, and may even lead to difficulty initiating breastfeeding.

On the other hand, too much weight gain could mean difficulty losing weight after pregnancy, increased baby size (which might require caesarean section delivery), and gestational diabetes or hypertension.

Estimated weight gain during pregnancy How much is my baby? How much is me?Pregnancy weight gain is different for every woman and depends on your body mass index before you become pregnant.

Extra blood, fluids, and protein: 3.5 kg

Breasts and energy stores: 3 kg

Uterus: 1 kg

Placenta: 1 kg

Baby: 3.5 kg

Amniotic fluid: 1 kg

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If you want to read more, consult Health Canada - Food and Nutrition - Nutrition and Healthy Eating - Prenatal Nutrition - Healthy Weight Gain During Pregnancy.

But try not to worry too much. Normal pregnancy weight gain varies from woman to woman and is based on how much you weigh before becoming pregnant. Ask your doctor to help you determine how much weight you should gain.

Exercise during pregnancyThroughout your pregnancy, a balanced exercise program can be as important as a balanced diet. Check out the Healthy Pregnancy Guide – Physical Activity and Pregnancy, published by the Public Health Agency of Canada: http://www.phac-aspc.gc.ca/hp-gs/guide/04_pa-ap-eng.php.

Pregnancy puts extra physical demands on your body. Focusing on muscles in your lower back and stomach may be particularly beneficial when preparing for pregnancy. However, be sure to check with your doctor before beginning any new exercise routine.

TIP: Swimming is an excellent exercise during pregnancy

and perfect for managing weight.

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Eating fish during pregnancyMyth: It’s not safe to eat fish during pregnancy.

Truth: Many fish are safe to eat during pregnancy, in moderation. Fish contains high-quality protein, omega-3 fatty acids (like DHA), and other essential nutrients.

The omega-3 fatty acids in fish play a role in your baby’s brain and eye development. It is safe and encouraged for you to consume at least 150 g of fish per week while pregnant, as recommended by Eating Well with Canada’s Food Guide.

These fish and shellfish contain higher levels of these fatty acids and are also low in mercury: anchovy, capelin, char, hake, herring, Atlantic mackerel, mullet, pollock (Boston bluefish), salmon, smelt, rainbow trout, lake whitefish, blue crab, shrimp, clam, mussel, and oyster.

You should limit your intake of the following fish to no more than 150 g per month as they contain higher levels of mercury: fresh or frozen tuna, shark, swordfish, marlin, and orange roughy. Canned “white” and “albacore” tuna should also be limited to 300 g per week.

Ensure you thoroughly cook your fish and seafood, including smoked products.

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Eat right to sleep tightThe last few weeks of your pregnancy are an exciting time, but try not to lose sleep over it. The right nutrition can help you get a good night’s sleep. Here are some healthy eating tips:

Eat light dinners. Big dinners might make you drowsy and can play havoc with digestion (try sleeping while your stomach is doing an impression of a thunderstorm). Instead, try eating your biggest meal before mid-afternoon, and eat a light evening meal.

Eat an evening snack. Choose a light grain-and-dairy snack, such as crackers with low-fat cheese and fruit, or low-fat yogurt with toast and apple butter. Wait an hour before lying down. These healthy pregnancy foods will digest quickly so that you (and your stomach) can rest.

If you love spicy food, go for it, but only for breakfast or lunch. A spicy dinner might make you toss and turn into the wee hours of the morning.

It is common for women to experience heartburn during pregnancy. That uncomfortable burning feeling is caused by stomach acid moving backwards up the esophagus. Heartburn may become more frequent during pregnancy due to hormonal fluctuations in combination with the pressure of the baby on your digestive system. Be sure to check with your doctor or pharmacist before using an antacid. Here are some things you can try to clear it up on your own:

Don’t drink any beverages with your meal. Instead, drink fluids in between each meal.

Instead of eating large meals, try to eat smaller, more frequent meals, and try to eat slowly.

Remain upright after eating a meal, as laying down after you eat can trigger heartburn.

Avoid fried food.

Avoid caffeinated or carbonated beverages.

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Reference: Public Health Agency of Canada. Healthy Pregnancy – Heartburn. 2008. http://www.phac-aspc.gc.ca/hp-gs/know-savoir/heartburn-eng.php.

What to eat when pregnant

Whole grains, such as whole-wheat or multigrain breads

Fruits and vegetables, including berries, apples, pears, carrots, and spinach

Low-fat, nutrient-rich proteins, such as lean meats and poultry, low-fat yogurt, or water-packed tuna fish

Unsaturated fats, such as olive oil, canola oil, or sunflower oil

What not to eat when pregnant

Raw fish (especially shellfish, oysters, and clams)

Undercooked meat, poultry, seafood

Hot dogs and deli meats (for example, non-dried deli-meats, pâté, refrigerated smoked seafood and fish)

Raw or lightly cooked eggs (for example, homemade Caesar vinaigrette, runny eggs)

Unpasteurized milk products, soft and semi-soft cheeses (like Brie or Camembert)

Unpasteurized juices, unpasteurized apple cider

Raw sprouts (especially alfalfa sprouts)

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Pregnancy superfoods for a super-pregnancyEating a healthy, well-balanced diet during pregnancy has benefits for both you and your growing baby. Your first big job as a mom is making good nutrition decisions. Some nutrients are absolutely critical for the healthy growth and development of your baby. Follow Eating Well with Canada’s Food Guide each day to make sure that you and your baby eat smart, paying particular attention to the following key nutrients:

Folic acid

Protein

Iron

Calcium

Vitamin D

Omega-3 fats, like DHA

Other key nutrients

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Folic acid and pregnancyRole/Benefits: Folic acid during pregnancy is essential for the normal early development of your baby’s spinal cord and brain.

In addition to the folic acid you get in a varied diet, health care professionals recommend that all women who could become pregnant, and those who are pregnant or breastfeeding, take a multivitamin containing 0.4 mg of folic acid every day.

Pregnancy superfood sources include: Green vegetables, dried peas, beans and lentils, orange juice, nuts and seeds, and folic acid fortified bread, cereals or pasta.

Protein and pregnancyRoles/Benefits: Protein intake during pregnancy is important. Protein is the building block of your baby’s each and every cell and also of your placenta.

During the 2nd trimester, your protein needs increase by 40–50% (about 71 g) daily. Pump up your salad with meat or alternatives and swap jam for nut butters to meet your body’s protein needs.

Pregnancy superfood sources include: Meat, fish, seafood, poultry, eggs, legumes (dried peas, beans, lentils, chick peas, etc.), nuts, peanut butter, tofu, and milk products.

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Iron and pregnancyRoles/Benefits: Iron intake during pregnancy is critical. Your body produces more red blood cells to supply oxygen and nutrients to your developing baby and to support your baby’s normal brain growth and development. In the 3rd trimester, your baby will be stocking up her iron stores to make sure she has enough for the first six months of her life.

Iron is one of the most critical nutrients in the prevention of complications for the mother and the baby. If you are not getting enough iron, you may feel very tired and may also be more prone to getting sick. Iron deficiency can cause maternal anemia, premature delivery and even low birth weight.

A daily supplement containing 16 to 20 mg of iron is recommended during pregnancy. Ask your health care professional about the dosage that is right for you.

Pregnancy superfood sources include: Meats, seafood, poultry, fish, iron-fortified cereals, iron-fortified pasta, nuts and seeds, dried fruits, prune juice, eggs, dried beans, and dark green leafy vegetables.

When choosing non-meat sources of iron, serve them alongside vitamin C-rich foods to enhance iron absorption.

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Did you know? Although liver is an excellent source of iron, it is not recommended during pregnancy because of its high vitamin A content.

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Calcium and pregnancyRoles/Benefits: Calcium intake during pregnancy is essential for your developing baby to build strong bones and teeth, and helps protect your own bone mass.

Eating calcium-rich foods helps ensure that your baby continues to grow stronger every day. If your calcium intake is low, your body will take calcium from your bones and teeth to give it to your little one. So, if you want your teeth and bones to stay strong, make sure that you are getting enough calcium for the both of you.

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Here are some tips, from the Dietitians of Canada, to help you meet your requirements of 1,000 mg of calcium per day:

Drink low-fat milk (skim, 1%, 2%) with meals and snacks each day.

Choose low-fat yogurt (0%, 1%, 2%) for breakfast, dessert, or snacks.

Make a smoothie with low-fat yogurt and fruits. Add some skim milk powder for extra calcium.

Use low-fat yogurt as a dip, garnish, spread, or dressing.

Add low-fat cheese (less than 20% milk fat) to omelettes and scrambled eggs. Top casseroles with low-fat cheese.

Make soups with low-fat milk instead of water.

Choose calcium-fortified beverages, such as soy and rice beverages, if you don’t drink milk, and calcium-fortified orange juice.

Add canned salmon or sardines, including the bones, to sandwiches, salads, and casseroles.

Use dark greens such as spinach, collard leaves, or turnip greens in salads or add to stir-fries.

Add firm or extra-firm tofu made with calcium sulphate to stir-fries and soups.

Have an almond butter sandwich.

If you have special dietary requirements or needs, talk to your doctor about appropriate options.

Pregnancy superfood sources include: Milk, cheese, yogurt, sardines or salmon with bones, and calcium-fortified beverages (fortified orange juice, fortified soy and rice milk).

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Vitamin D and pregnancyRole/Benefits: Vitamin D during pregnancy is important for maintaining and building strong bones for both you and your baby. It also enhances absorption of calcium.

The need for vitamin D does not change during pregnancy. Be sure to include 2 servings of milk or fortified soy-based beverage (or other fortified beverages) to meet your vitamin D needs. (See Eating Well with Canada’s Food Guide for serving sizes.) If you live in Northern Canada, where you don’t have as much exposure to sunlight or do not drink milk or fortified soy beverages, you should talk to your doctor to see if you need a vitamin D supplement.

Pregnancy superfood sources include: Vitamin D-fortified milk, yogurt and margarine, fatty fish (e.g., salmon, sardines, mackerel, etc.), and fish oils.

Omega-3 fats, like DHA, and pregnancyRole/Benefits: During pregnancy, omega-3 fatty acids, such as DHA, are transferred across the placenta and have an important role in the normal physical development of the baby’s brain and eyes.

While Health Canada has not yet established dietary recommendations for DHA, it recommends that pregnant women include rich sources of DHA, such as fish, in their diet. Eating at least 150 g (5 oz) of a variety of cooked fish per week will provide you and your baby with omega-3 fats and other important nutrients for a healthy pregnancy. Follow advice from Health Canada to limit your exposure to environmental contaminants, such as mercury.

Pregnancy superfood sources include: Salmon, trout, sole, Atlantic mackerel, herring (these fish have low levels of contaminants), and omega-3-enriched foods, such as milk and eggs.

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Other superfoods during pregnancy

Reach for fruits and vegetables to get your vitamin C. Red and yellow peppers, guava, papaya, and, of course, oranges pack a vitamin C punch! Vitamin C promotes healthy gums and also helps your body absorb iron.

Choline is essential for your baby’s brain development. Eggs, lean meats, and peanuts are some foods that provide it.

Did you know? Another reason to eat your veggies: dark leafy greens and colourful vegetables are sources of lutein. Lutein is a carotenoid that is concentrated in the brain and eyes. It is believed that lutein has a role in the development of the central nervous system. Pass the spinach please!

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Water: your pregnancy BFFHydrate, hydrate, hydrate! Early in pregnancy, your fluid needs increase to support your changing body and developing baby. Drinking enough fluids helps fight fatigue and even helps with constipation.

Choose water or nutritious drinks. Think skim milk, low-fat milk, 100% fruit juices, or low-fat fruit smoothies.

How much water should you drink while pregnant?Water is one of the most important nutrients in your diet when you are pregnant.

Your fluid needs increase during pregnancy in order for your body to support the baby’s circulation, the amniotic fluid, and the higher blood volume that comes with being pregnant.

Water carries nutrients to your body and to your growing baby, and carries waste product away from the both of you. It also helps to keep you cool, prevent constipation, and control swelling. Drink plenty of fluids every day, including water, milk, 100% juice, and soup.

So how much water should you drink when pregnant? Make sure that you are getting 2.5 L (10 cups) of water a day. Drink more when the weather is hot or when you are active.

TIP: Other fluids, such as 100% fruit juices, vegetable juices, soup, and milk also count, but you still want to try to keep regular

water as your primary source of fluids.

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Foods and habits to avoid during pregnancyUnderstanding exactly why certain substances can be dangerous to both you and your unborn baby makes it easier to avoid them.

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Smoking during pregnancy Nicotine, tar, and carbon monoxide are noxious chemical substances associated with smoking. If you breathe them in, your baby gets a share. The sooner you quit, the better it will be for your baby. Get your partner and other family members to quit too, because second-hand smoke can also put you and your baby at risk.

Caffeine during pregnancy Coffee, tea, cola and some other carbonated soft drinks, energy drinks, chocolate, and some cold and head medications contain caffeine. While you don’t have to give up caffeine altogether when you are pregnant or breastfeeding, Health Canada recommends that you limit your intake to 300 mg a day. Too much caffeine could contribute to complications such as low birth weight. If you are a tea-lover, visit the Health Canada website for a detailed list of acceptable herbal teas that you can have during your pregnancy.

Alcohol during pregnancy Experts recommend that you avoid alcohol completely during pregnancy and minimize your intake while breastfeeding. Health experts simply do not know what level is safe.

Drugs Many types of drugs can affect your baby. Some can cause severe birth defects or other problems. Be sure that your health care professional knows about any drugs you were taking before your pregnancy. Also, you should not take any prescription or non-prescription drugs without first checking with your doctor or pharmacist. You can also consult motherisk.org or call the national Motherisk Helpline (1-877-439-2744) at the Toronto Hospital for Sick Children for information about the safety of prescription and over-the-counter drugs.

Natural Health Products (NHPs) & other herbal productsNatural or herbal health products are often seen as safe because they are made from plants or other natural substances, but it is very important to read the label. Many products may not be safe for pregnant women. Be sure to talk to your doctor or pharmacist before taking any natural health products during your pregnancy.

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Benefits of DHA and lutein during pregnancyDHA (the acronym for docosahexaenoic acid), an omega-3 fatty acid, is one of the building blocks of the fetal brain and eyes. Therefore, including DHA-rich foods, such as recommended fatty fish, during pregnancy is important.

During pregnancy, DHA is transferred to the baby through the placenta and accumulates in the baby’s brain and eyes, especially during the 3rd trimester, when there is significant brain growth. After she is born, the baby will get DHA through breast milk or infant formula. DHA supports the normal physical development of your baby’s brain, eyes, and nerves. While Health Canada has not published official recommendations for the amount of DHA pregnant and lactating women should consume, they are encouraged to include at least 150 g of cooked fish (see Health Canada. Food and Nutrition - Prenatal Nutrition Guidelines for Health Professionals - Fish and Omega-3 Fatty Acids. 2009) every week because they contain omega-3 fats and other important nutrients.

If you are worried about not getting enough DHA, you may want to discuss this with your doctor, who may recommend a fish oil supplement. Remember to look for a Natural Product Number (NPN) on the product label, which shows that the fish oil supplement is government-approved for safety, efficacy, and quality.

DHA and lutein: an important team for your baby’s health Lutein is an antioxidant found in breast milk. As such, it helps protect fatty acids, like DHA, from oxidative damage. In one study (Perrone et al., 2010), infants supplemented with lutein immediately after birth reduced the development of harmful oxidizing substances known as free radicals.

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What is lutein? Lutein (pronounced loo’-teen) is a carotenoid, like beta-carotene, that acts as an antioxidant. Carotenoids are a family of compounds found in different amounts in vegetables, eggs, and fruits. They are responsible for many of the colours we see in nature, such as the red in tomatoes, the orange in carrots, and the yellow in egg yolks. Your body cannot make lutein, so you must get it from your diet.

Make sure to include foods like spinach and eggs, or any of the following lutein-rich foods in your diet:

Leafy greens like kale, Swiss chard, turnip greens, collard greens, and romaine lettuce

Broccoli

Zucchini

Garden peas and Brussels sprouts

Corn

Carrots

Okra

Celery

Oranges

Tomatoes

Melons

Grapefruit

Beets

Asparagus

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Planning to feed your baby: the benefits of breastfeedingBreast milk is the ideal food for your baby, and it is all that he will need to thrive and grow for the first months of his life. Health Canada and the World Health Organization recommend exclusive breastfeeding for the first six months. With exclusive breastfeeding, your baby is fed only breastmilk and given no other food or liquid, not even water. Breast milk supplies the correct quantity, quality, and absorption of nutrients. It is suited to your baby and his needs, changing during feedings and over time as he matures. Breast milk is always available at the right temperature, doesn’t need any mixing or equipment, and it’s free.

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The benefits of breastfeeding: The benefits of breastfeeding can begin right after your baby’s birth; when he is put to your breast immediately after birth, he is comforted by the warmth and touch of your body. Hearing the familiar heartbeat, the sound of your voice, and finding a place to suck will be comforting to him, easing his introduction to the outside world.

Even small amounts of breast milk can make a significant contribution to your baby’s health. More than just a source of nutrients, breast milk also provides many important health and immune benefits. For example, it may help protect your baby from common early childhood illnesses such as colds and ear and gastrointestinal infections; especially during the early weeks and months of his life. Breastfeeding is also protective against Sudden Infant Death Syndrome (SIDS). Studies show that breastfeeding may also offer advantages later in life; breastfed babies may be less likely to develop obesity, for example.

Breastfeeding also has many advantages for you. Studies show that breastfeeding may reduce the risk of developing breast and cervical cancer. It will also help you get back into shape by speeding the return of your uterus (womb) to its normal size and by helping you burn calories. Many mothers feel that it is a beautiful way to create a close bond between themselves and their babies. Most babies can be quickly soothed and reassured by being put to their mother’s breast.

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Breastfeeding tips before bringing your baby homeWhile your baby is prepping for her first moments in the outside world, your body is making its final preparations for her first meal.

Your breasts reach their full size towards the end of your pregnancy. They might enlarge again after delivery until your milk comes in. They also might begin to leak a thick, yellowish milk called colostrum (hey, we didn’t choose the name). This is normal. Colostrum is packed with nutrients and antibodies; it will help give your baby a great start.

Plan ahead for your mealtimes If you are planning to breastfeed, you have to be as careful with your diet as you have been throughout your pregnancy. What you eat, your baby eats. Health Canada recommends that breastfed infants get a vitamin D supplement of 10 µg (400 IU) per day, so prep for that. Continue to plan your meals by following Eating Well with Canada’s Food Guide. Lactating moms can get a personalized menu plan of their own at https://www.eatrightontario.ca/en/menuplanner.aspx. Other tips for lactating moms Continue to eat 2 servings of calcium-rich foods every day to meet your daily calcium requirement of 1,000 mg.

Drink plenty of fluids to help maintain your milk supply.

Before your baby is born, plan ahead for nutritious meals after she arrives home. Try to cook and freeze a few simple meals that can be quickly reheated and stock up on nutritious foods and snacks.

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American Pregnancy Association. Fatigue During Pregnancy. 2015. Accessed March 2017.

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American Pregnancy Association. Pregnancy and Constipation. 2015.

Health Canada. Eating Well with Canada’s Food Guide. 2011. Accessed April 2017.

Government of Canada. Healthy Eating and Pregnancy. 2014.

Health Canada. Healthy Weight Gain During Pregnancy. 2012.

O’Connor DL, Blake J, Bell R et al. Canadian Consensus on Female Nutrition: Adolescence, Reproduction, Menopause, and Beyond. J Obstet Gynecol Can. 2016;38(6):508–54.

Health Canada. Pregnancy and Breastfeeding. 2011.

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Dietitians of Canada. Increasing your Calcium Intake. March 2017.

Canadian Paediatric Society Position Statement. Vitamin D

supplementation: Recommendations for Canadian mothers and infants. Reaffirmed January 2017.

Health Canada. Prenatal Nutrition Guidelines for Health Professionals - Fish and Omega-3 Fatty Acids. 2009.

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Health Canada. Mercury in Fish - Consumption Advice: Making Informed Choices about Fish. 2017.

Hammond B. Functional Food Reviews, 2012;4(3):130–7.

Dietitians of Canada. Guidelines for Drinking Fluids to Stay Hydrated. 2014.

Public Health Agency of Canada. Healthy Pregnancy - Water and Other Fluids. 2008.

Public Health Agency. The Healthy Pregnancy Guide – Smoking and Pregnancy. 2012.

Public Health Agency of Canada. Healthy Pregnancy - Alcohol and Pregnancy. 2012.

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Perrone et al. Neonatology 2010;97:36–40.

Health Canada. Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months. 2015.

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