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According to the American Academy of Family Physicians (AAFP:) “Preconception care is defined as individualized care for men and women that is focused on reducing maternal and fetal morbidity and mortality, increasing the chances of conception when pregnancy is desired, and providing contraceptive counseling to help prevent unintended pregnancies. The term “interconception care” is used when referring specifically to care provided between pregnancies. Details and risk factors associated with previous pregnancies are integral to interconception care.

For men, factors that affect sperm quality are medical conditions such as diabetes, some medications, body weight, age, genetic disorders and stress, tobacco and alcohol consumption, and exposure to environmental hazards. Like women, men should consult their doctor for details and put a plan in place to help ensure a woman’s healthy pregnancy and the baby’s health. Women generally have an obstetrician-gynecologist (OB/GYN), and men may seek their assistance, or obtain advice from their urologist or family physician.

For women, ensuring that your body is in optimal health before becoming pregnant is important for you and your baby. The consumption of a healthy diet during preconception, pregnancy, and lactation is essential to maternal and newborn health.

According to the Centers for Disease Control (CDC), the following are essential for a healthy pregnancy, so use their general pregnancy tips as a preconception roadmap:

• Making a plan and taking action
  • Develop goals and how you will achieve them
  • Use this guide from the CDC to help you outline your goals
• Seeing your doctor
  • Speak with them about your preconception health care
  • Discussion of health history and medical conditions
• Taking 400 micrograms of folic acid daily
  • Protective against the development of congenital disabilities
• Stopping smoking, using certain drugs, and consumption of alcohol
  • These items can cause complications or issues during pregnancy for both mother and baby, such as premature birth, congenital disabilities, and infant death. Consult with your doctor about any medications you take or if you have trouble stopping smoking or drinking alcohol. This discussion should include over-the-counter and prescription medications. Some herbal or dietary supplements can be harmful to the baby during pregnancy. Pain medications (i.e., opioids) can cause neonatal abstinence syndrome (NAS) if taken regularly
• Avoiding toxic substances and environmental contaminants
  • These include synthetic chemicals, metals including lead, fertilizers, bug sprays, cat and rodent feces in/around the environment
  • Avoid radiation, obviously
• Reaching and maintaining a healthy weight
  • Overweight/obesity is associated with a higher risk for many conditions, including complications during pregnancy, heart disease, type 2 diabetes and certain cancers
  • Underweight women also are at risk for serious health issues
  • Do not pursue short-term dietary changes; instead, allow a healthy diet to be a part of your lifestyle

Nutrition in Pregnancy:

During pregnancy, the motivation for eating a healthy diet is the health of the baby—a strong motivator. Most women are aware that healthy eating is important during pregnancy, but many lack the knowledge of specific dietary recommendations, may not have the skills required to improve their diet, have access to healthy food and/or the funds to purchase healthier food.

Trimester 101:

For general information purposes, the nine-month pregnancy is broken into three-time frames called trimesters.

The first trimester is when most women seek a doctor’s care. Some women experience breast tenderness, fatigue, and nausea during the first semester, which may prove to be challenging to healthy eating. This time is marked by the development of the fetus’s brain, spinal cord, and other organs. The heart also begins to beat, and fingers and toes will also start to form.

During the second trimester, most women begin to feel better if they experienced nausea, etc., in the first trimester. Signs and symptoms during this period might involve larger breasts, growing belly, and skin changes. The baby can now hear and can move often with the mom being able to feel the movements.

The third trimester is the last few months of pregnancy. This time can prove to be physically and emotionally challenging for some women as they may be uncomfortable. It’s also very exciting, as the baby will arrive soon!

Let’s begin with what foods and drinks to avoid while pregnant and why.

Decrease caffeine intake.  Caffeine is a stimulant and can increase your heart rate and blood pressure and interrupt your and your baby’s sleep. Studies have shown that caffeine intake is associated with lower birth weight, shorter birth length, and smaller head circumference. Other studies have shown that a small amount of caffeine is acceptable, but why take the risk? There are alternatives for coffee that you can purchase at the store, many are grain-based, but some are mushroom-based. You could also make your own coffee alternative with healthy chicory as its base. Chicory is prebiotic, so in this recipe, it does double duty.

Chicory Root Beverage

Makes two cups or one large mug

•  1 tablespoon roasted chicory root
• 1 cup water, boiling
• ½ cup milk of your choosing
• ¼ teaspoon cinnamon
• Sweetener to taste, optional, stevia or perhaps honey.

Place the chicory root in a French Press or tea strainer. Add the water and let steep for 3-4 minutes. While it’s steeping, heat the milk with cinnamon and sweetener. Combine the chicory and warm milk and enjoy!

Eliminate alcohol. According to the Centers for Disease Control (CDC): “Alcohol use during pregnancy can cause fetal alcohol spectrum disorders (FASDs), which are physical, behavioral, and intellectual disabilities that last a lifetime.”

Raw fish may contain parasites or bacteria, including, the most serious type of food poisoning, which can cause miscarriage, stillbirth, or preterm labor. Please note that listeria can be found in other foods. If you want to keep track of foods that have been recalled because of listeria, you may check.  Avoid sushi, sashimi, raw oysters, raw clams, raw scallops, ceviche, and refrigerated smoked seafood. Fish should be cooked to an internal temperature of 165 °F.

High mercury fish. Mercury is a dangerous neurotoxin that can disrupt brain function and harm the nervous system, especially threatening to pregnant women and their developing babies.

Larger fish can contain high levels of mercury, and too much mercury is dangerous for your baby. Fish to avoid include shark, swordfish, king mackerel, tilefish, marlin, and orange roughy. Lower-mercury fish are salmon, herring, haddock, flounder, perch, sardines, anchovies, and rainbow trout. You can look here and here.

Unpasteurized (raw) milk products have not been heated (pasteurized) to kill harmful bacteria and could contain Salmonella, E. coli, listeria, Campylobacter, and others. This topic has two distinct camps: those who believe that raw milk is dangerous and should be pasteurized to kill bacteria, and those that believe that you kill everything nutritious in the milk when you pasteurized. Here is information from the Food and Drug Administration (FDA ).

Eliminate soft cheese (generally made with unpasteurized milk) such as Havarti and blue-veined cheeses such as gorgonzola, Roquefort, and cambozola, as they may contain listeria, and replace with, respectively, cream cheese or hard cheeses such as Romano and Parmesan.

Raw or undercooked eggs may contain the bacteria salmonella. Egg dishes should be cooked to 165 °F.

Raw meat such as steak tartar or carpaccio, or very rare meat should be avoided as it might contain the bacteria E. coli, Trichinella and Salmonella or cause toxoplasmosis, which is an infection caused by a single-celled parasite called Toxoplasma gondii.

Here is a chart explaining safe cooking temperatures for meat, egg, and seafood dishes.

Raw Honey. Most people know that babies cannot have raw honey during their first year of life because it might contain bacteria that can be a health risk, and even though problems with adults and raw honey are rare, it is recommended to stay with pasteurized honey while pregnant.

Raw Sprouts. Raw or undercooked sprouts, such as alfalfa, clover, mung bean, and radish may contain E. coli or Salmonella. Cook all sprouts before consuming.

Limit or avoid refined sugar. A low-sugar intake helps to keep your blood sugar stable, along with your resulting energy level.  Eating too much sugar when you’re pregnant may increase weight, your risk of gestational diabetes and pre-eclampsia, and may increase the risk of your baby becoming overweight later in life. Sweet tooth? Have some fruit or a small piece of dark chocolate, preferably more than 70% cacao, or perhaps a glass of sparkling water with a small amount of fruit juice (1 tablespoon should do it) or even try a little protein which can help—leftover chicken or nut butter.

Avoid refined carbohydrates. Refined carbohydrates, also known as simple carbs, are quickly converted to sugar in the body, provide a quick burst of energy, but offer little in the way of nutrition, essential for your health and your baby’s health. Avoid processed foods containing refined carbohydrates. What is a simple or refined carb? Food that has been stripped of fiber (then often added back in, so watch for ‘added fiber’ as it’s being added back in because it was stripped)—not in its original intact form. Steel-cut oats are better than quick oats. Brown rice is better than white rice. Most purchased bread that is less than 2 grams of dietary fiber per slice should be avoided. There are many bread choices with 3, 4, or even 5 grams of dietary fiber per slice.

Unpasteurized juices:  There are many unpasteurized juices in the refrigerated section of the grocery store. They come with this warning: “This product has not been pasteurized and therefore may contain harmful bacteria that can cause serious illness in children, the elderly, and persons with weakened immune systems.”

So now you understand what not to eat and drink while pregnant, so let’s focus on what you can eat!

There are many ways of eating styles based on cultural preferences, personal philosophy, health reasons, etc., vegetarian, vegan, omnivore, Paleo, Keto, on and on. What is important is to make sure you are obtaining appropriate amounts of nutrients to maintain your good health and for the development of your baby. Below is some general information. Be sure to speak with your doctor about what macro and micronutrients are right for you and your baby.

The Macronutrients

An additional 300 calories per day might be needed during the second and third trimesters of pregnancy when the baby is rapidly increasing in size.

Protein needs increase by approximately 25 additional grams per day, although many women already consume adequate protein. The recommended amount is approximately 60 grams per day or about 20 to 25% of your daily caloric intake. Good protein sources include meat and poultry, cold-water fish, eggs, legumes, nuts, and seeds, and dairy products.

Complex carbohydrates are found in vegetables, fruit, intact (whole) grains, beans, and legumes.

Regarding vegetables and fruit, you need 5-9 cups of vegetables and fruits a day for good health, mostly non-starchy, and many colors, because every color vegetable and fruit has unique properties and health benefits. The recommended daily grams per day of carbohydrates can have large variations, but many believe that carbs should account for 50-60% of daily caloric intake. Dietary fiber should be approximately 25-grams per day.

Healthy fats should account for between 25-35% of daily caloric intake. Omega 3 fatty acids — long-chain omega-3 PUFA, docosahexaenoic acid (DHA)– found in cold-water fish, such as salmon, trout, and sardines during pregnancy are associated with improved developmental outcomes in offspring.

Water: Extra fluid is needed to protect the developing fetus and to support an increase in maternal blood volume. The recommended amount of water is 10 8-ounce glasses of water per day.

The Micronutrients (vitamins and minerals )

Key Nutrients You Need

According to the American College of Obstetricians and Gynecologists (ACOG), you and your baby need these key nutrients for a healthy pregnancy:

Calcium

Helps to build strong bones and teeth. Main sources include milk, cheese, yogurt, and sardines. During pregnancy, you need 1,000 milligrams (mg) daily.

Iron

Helps red blood cells deliver oxygen to your baby. Sources include lean red meat, dried beans, peas, and iron-fortified cereals. During pregnancy, you need 27 mg daily.

 Vitamin A

You need this vitamin for healthy skin, eyesight, and bone growth. Carrots, dark, leafy greens, and sweet potatoes are good sources. During pregnancy, you need 770 micrograms daily.

Vitamin C

Promotes healthy gums, teeth, and bones, and helps your body absorb iron. Good sources include citrus fruit, broccoli, tomatoes, and strawberries. During pregnancy, you need 85 mg daily.

Vitamin D

Aids your body in the absorption of calcium to help build your baby’s bones and teeth. Sources include exposure to sunlight, fortified milk, and fatty fish, such as salmon. During pregnancy, you need 600 international units (IUs) daily.

Vitamin B6

Helps form red blood cells and helps your body use protein, fat, and carbohydrates. You can find vitamin B6 in beef, liver, pork, whole-grain cereals, and bananas. During pregnancy, you need 1.9 mg daily.

Vitamin B12

Helps form red blood cells and maintains your nervous system. You can find this vitamin only in animal products. Good sources include liver, meat, fish, poultry, and milk. During pregnancy, you need 2.6 micrograms daily.

Folate (Folic Acid)

A B vitamin is important in the production of blood and protein, it also reduces the risk of neural tube defects (a birth defect of the brain and spinal cord). You can find folate in green, leafy vegetables, liver, orange juice, legumes (beans, peas, lentils), and nuts.

You must get at least 400 micrograms of folate daily before pregnancy and during the first 12 weeks of pregnancy to reduce the risk of neural tube defects. During pregnancy, doctors recommend you get 600 micrograms daily.

Other considerations:

Stress and Pregnancy

While pregnant, it is crucial to limit or reduce stress if possible; in fact, there is significant evidence that stress can lead to pregnancy complications as well as short- and long-term impacts for infants. In fact, severe stress in the first trimester of pregnancy increases the risk of congenital abnormalities (e.g., cleft palate). In addition to stress, depression and anxiety during pregnancy are related to the neurodevelopmental impacts on infants, such as impaired cognitive development and behavioral disturbances in infancy. Women who are stressed should seek the advice of a doctor, therapist, or trusted family member or friend.

Sleep and Pregnancy

We all know that sleep is necessary for us to function and thrive. Sleep provides time for our bodies to repair and restore. However, many women struggle to obtain proper sleep and often deal with sleepiness during the day. J.A. Mindell et al. observed that “across pregnancy, women experienced poor sleep quality, insufficient nighttime sleep, significantly disrupted sleep, and significant daytime sleepiness.” Frequent urination and difficulty getting in a comfortable position are also factors for lack of sleep, as are sleep disorders such as restless leg syndrome (RLS) and sleep apnea. Inadequate sleep can impact fetal, pregnancy, and postpartum outcomes, so keep your doctor informed as to how you’re sleeping.

Postpartum

After Delivery

After pregnancy, the postpartum period, diet still plays a crucial role for mother and baby. For mothers who decide to breastfeed, it is essential to maintain a nutritious, healthy diet as dietary intake during lactation influences milk composition. Breastfeeding is associated with better health outcomes for the baby and mother. If you are having trouble with breastfeeding or lactation, consult with a lactation specialist.

How Foogal Can Help

We recognize how difficult it can be to track all the above, and that’s where we can help. Keep in mind that you can schedule a week of menus so you have time to shop and prepare.

Let’s say it’s Sunday so you might have time to make recipes that take more time, so you go to the Foogal App and choose Poached Eggs with Roasted Bell Peppers, Olives and Feta for breakfast, Herbed Cream of Tomato Soup for lunch, a snack of blueberries, and Beef Stew for dinner. You peruse the nutrients and realize you need more healthy fat and dietary fiber. What to do? You add a salad to have with your soup for lunch, make a salad dressing using flax oil and you could change the beef stew to baked salmon for dinner. Now you’re within range.

Now it’s Tuesday morning-a busier day. You choose the Raspberry Pear Smoothie for breakfast, some nuts for a snack, and Avocado and Tuna Sandwich for lunch using bread that is at least 2 grams of dietary fiber or more per slice (preferably more!), an apple for an afternoon snack, and a Cheesy Sweet Potato Casserole for dinner, perhaps with a baked chicken breast.

You may decide to choose recipes that make for great leftovers to have for lunch the next day. If you make Savory Roasted Chicken Breasts with Grainy Mustard for dinner, you could slice a leftover breast to add to your nice big colorful salad for lunch (or dinner) the next day.

If funds to purchase healthy ingredients are a primary concern and you rely on your local food bank, you could choose beans and rice to have on hand for protein and dietary fiber, you could choose whatever fresh, frozen, or canned vegetables they have, and nut butter– choose whatever ingredients you can that are the least processed, then go to Foogal, and search for bean recipes, as an example.

Whatever you choose, you can look at the nutrients and make menu changes so you obtain all the necessary nutrients for you and your baby. We’ll have the delicious, nutritious recipes that you need!