Info Centre - Keeping healthy in pregnancy

Eating during pregnancy
What food should I avoid?
Drinking during pregnancy
Smoking during pregnancy
The use of drugs during pregnancy

Eating during pregnancy

When you're pregnant, mealtimes can seem a bit of a minefield. You may feel you get lots of advice about what to eat and what to avoid, but not told why, or worse, get given conflicting information. It may seem strange to be told not to eat certain soft cheeses and yet encouraged to eat plenty of dairy products. So how can you give your baby the best start in life and still enjoy your food? Reading the NCT book "Food Facts" will give you the information you need to decide.

Eating well during pregnancy means you will be providing your baby with all the nutrients he or she needs to grow and develop. You need plenty of starchy carbohydrates (bread, pasta, potatoes and so on) to give you a steady supply of energy. If you have wholemeal bread, pasta etc., you’ll also be getting dietary fibre, which can help prevent constipation. You should also aim to eat five portions of fruit and vegetables each day. These provide essential vitamins and minerals, including vitamin C to help iron absorption, and folic acid to help build healthy red blood cells. To grow healthy new cells such as muscle and skin your baby also needs protein. You can get protein from meat and fish or alternatives such as eggs and pulses. Another important nutrient is calcium, which is found in dairy foods (milk, cheese etc), as it helps build strong teeth and bones.

Even if you are feeling sick it’s still a good idea to try to eat something. Eating will generally help with the nausea. Don’t get too hung up on what you’re eating at this stage; it’s better that you and your baby are getting something than nothing at all.

Snacks

Snacks may become an important part of your diet during pregnancy. Either because of nausea, or, as pregnancy progresses, because you can’t manage large meals and need something in between. Try to choose healthy snacks such as fruit, yoghurt, breakfast cereal or a sandwich with low fat cheese or ham.

Fish

It’s not just an old tale; eating oily fish really could make your baby brainier. That’s because fish such as salmon, sardines and mackerel contain omega-3 fatty acids, which are essential for the development of your baby’s brain and central nervous system. However, they also contain dioxins and PCBs (pollutants), which may cause long term health problems if you have too much. So you have to weigh the benefits against the risks. Taking this into account, the government recommends pregnant women eat one or two portions a week.

Certain fish such as shark, swordfish and marlin shouldn’t be eaten at all during pregnancy as they contain high levels of mercury, which can damage your baby’s nervous system. Tuna has also been found to contain mercury, but in smaller amounts, so it can still be eaten in moderation. For fresh tuna, use the same guidelines as other oily fish, but canned tuna contains less oil, so you can eat up to four tins per week.

Caffeine guide

It’s fine to have some tea, coffee, cola and chocolate when you’re pregnant, but not too much. They all contain caffeine and having more than 200 mg a day of caffeine can increase the risks of low birth weight or miscarriage. The list below should help you to work out how much it is safe for you to have. If you are finding it hard to think of alternatives drink some fruit tea, diluted juice or good water. Drinking plenty of fluids can help with many common pregnancy complaints including headaches, constipation and urine infections.

2 mugs of instant coffee (100mg each)
1 mug of filter coffee (140mg each)
2 mugs of tea (75mg each)
5 cans of cola (up to 40mg each)
2 cans of 'energy' drink (up to 80mg each)
4 (50g) bars of plain chocolate (up to 50 mg each). Plain chocolate contains about twice as much as milk chocolate.

Give yourself a treat

Chocolate contains caffeine, but there’s a good excuse for giving yourself a little treat. A Finnish study found that six-month-old babies tended to smile and laugh more if their mothers ate chocolate regularly during pregnancy!

What foods should I avoid?

Some bacteria can cause serious infections as you’re more vulnerable to food-borne infections when you’re pregnant, so you’ll want to be extra careful about what you eat. This table shows you what foods you might want to avoid in pregnancy and what it’s still safe to eat. However, remember that the risk of these illnesses is rare. Listeria, for example, only affects about 1 pregnancy in 20,000.

Although very few pregnant women catch toxoplasmosis in a year, it’s useful to know this parasite can be found in soil, dirty veg and cat faeces so wear gloves when gardening or changing a cat litter tray.

Risk factor	What you can eat	Best to avoid
Listeria can cause mild flu-like illness in the mother and may result in miscarriage, stillbirth or severe illness in newborn babies.	Hard cheeses (e.g. cheddar, parmesan), cream cheese or cheese spread (e.g. Philadelphia, Dairylea) and cottage cheese Pasteurised, sterilised and UHT milk Tinned or pasteurised pâtė (except liver pâtė) Ready-meals which are piping hot throughout	Blue-veined cheeses e.g. Stilton and soft mould ripened cheeses e.g. Brie, Camembert, even if they are made from pasteurised milk. (These cheeses can be eaten if they are cooked through and piping hot.) Unpasteurised cow’s or goat’s milk Fresh pâtė (any type, including vegetable) Ready-meals which aren’t thoroughly heated
Salmonella can cause nausea, vomiting and diarrhoea in the mother, which could indirectly affect the baby if you become dehydrated.	Eggs cooked until yolk and white are solid Shop-bought mayonnaise, ice-cream and mousses	Raw or partially cooked eggs Homemade mayonnaise, ice-cream and mousses
Toxoplasmosis can cause mild flu-like illness in the mother and harm her baby e.g. baby’s developing brain and eyes.	Cooked meat Washed salads	Raw or undercooked meat including Parma ham or salami
Campylobacter can cause diarrhoea and stomach cramps in the mother	Cooked meat Pasteurised milk	Undercooked meat Unpasteurised milk
Various other bacteria can cause food poisoning and affect mother and baby	Cooked seafood e.g. prawns or mussels eaten piping hot	Seafood eaten raw or cold
High levels of vitamin A from animal sources (retinol), can affect baby’s brain and eye development	Vegetables and fruits high in vitamin A (beta carotene) e.g. carrots, apricots	Liver and liver products e.g. pâtė Supplements containing vitamin A, including most fish oils

Drinking during pregnancy

Although you may want to celebrate news of your pregnancy with a glass of champagne, downing the whole bottle is certainly something to avoid while pregnant! Heavy drinking can damage your baby as alcohol crosses the placenta quickly and easily and too much alcohol on a regular basis can cause a collection of problems for the baby (known as fetal alcohol syndrome).

But how much exactly is regarded as ‘heavy’ drinking? More than 6 units of alcohol a day would give you a very high chance of having a baby with fetal alcohol syndrome. Drinking between 2 and 6 units a day may mean you give birth to a baby with a milder form of fetal alcohol syndrome. But it is not yet clear from research exactly how much alcohol you can have before harm is caused to your baby.

There is a lot of controversy around whether it is safe to take any alcohol when you are pregnant. Current government guidelines suggest you should either stop drinking alcohol altogether or not drink more than 1 or 2 units of alcohol once or twice a week and don’t get drunk. The type of drink makes no difference, as it is the amount of alcohol in units that matters (see below).

You may find that while you are pregnant you don’t like the taste of alcohol, or feel that it’s safer not to have any alcohol at all to eliminate the risks, but if you do normally enjoy a drink and find it hard to resist the temptation then these ideas may help:

Quench your thirst with non-alcoholic drinks
Sip your drink and put it down between sips
Try alcohol-free or low-alcohol drinks
Ask family and friends to support you by not offering to pour or prepare you drinks
Make some of the days of the week alcohol free (and don’t drink more than 2 units on the other days).
If you drink a lot and are worried about how to cut down, then talk to your midwife or family doctor. Alternatively, you might prefer to call one of the helplines listed in the box opposite.

Units of alcohol

1 unit of alcohol = 10g of alcohol which is measured as:
25ml of a spirit such as vodka, gin etc. (1 ‘single’ pub measure)
100mls of wine (1 small glass)
100ml of champagne (1 small glass)
A half pint of beer or lager
A quarter of a pint of ‘strong’ beer or cider
55mls (1 sherry glass) of port, sherry or fortified wines such as Cinzano
55ml of liqueur such as Baileys
Just less than one bottle of alcopops

Smoking during pregnancy

For many women, smoking represents a brief escape from the pressures of everyday life. However, most women know that smoking harms them, as well as their unborn baby, if they smoke while pregnant, but knowing the risks doesn’t necessarily make giving up any easier.

Many women do feel more motivated to stop when they find they’re pregnant. It’s worth getting any support you think may help from family and friends or from specialist health workers. If your partner smokes as well, it can really help to stop together.

If you’re unable to give up completely, then cutting down the amount you smoke during pregnancy will help to reduce the risk to your baby. The effects of the chemicals and lack of oxygen transported to your baby when you smoke a cigarette are ‘dose-related’. This means that the more you smoke the greater the damage. The damage, however, is quickly reversed when you stop smoking.

A baby born to a smoker is:

Twice as likely to be born prematurely
More likely to suffer from placenta problems around the time of birth
Three times more likely to be underweight at birth (even if born on time)
More likely to be a victim of cot death.

Be careful about using nicotine skin patches or nicotine chewing gums to give up, as it is not clear whether these are safe for use during pregnancy. For help, talk to your midwife or family doctor. They will be able to give you details of local support groups and national helplines as well as leaflets and other sources of advice.

Whatever stage of pregnancy you’re at though, it is never too late to give up or cut down –- you and your baby will benefit immediately.

You can call the NHS Pregnancy Smoking helpline 12pm to 9pm, 7 days a week0800 169 9 169

The use of drugs during pregnancy

The term drug is used to mean any kind of tablet, medicine, suppository, inhalant, ointment or oil – either prescribed by a doctor, or other practitioner, or bought illegally. During pregnancy your baby is particularly vulnerable to the effects of any drugs you might take. This is because:

Your baby’s rapidly developing body is very sensitive to poisons in her environment
Her liver is not ready to deal with harmful substances entering her body.

In order to be as safe as possible:

Never buy over-the-counter medicines for yourself without first checking with your doctor or pharmacist. They will be able to recommend alternative drugs or other sate treatments.
Always tell your doctor, pharmacist, dentist, or anybody else advising you on your health, that you are pregnant. They will be able to help you make decisions by balancing your health needs against any possible risks to your baby.
Always check with your doctor, pharmacist or a qualified herbalist before taking any herbal medicines or tablets. Fruit and herbal teas sold in supermarkets are generally safe – but be careful with preparations brewed by family or friends, or more unusual teas sold only in health food shops.
Always check with your doctor, pharmacist or a qualified practitioner before using any homeopathic remedies, aromatherapy preparations or massage oils.

If you are taking any prescription drugs, you will need to speak to your doctor about whether these are likely to have any effect, preferably before you become pregnant. Some drugs increase the need for vitamins such as folic acid, which is vital in early pregnancy. In some cases you may be advised to change your prescription to something that is safer when you are pregnant.

Drug Addiction

If you feel that you have a drug addiction problem then do speak to your midwife or doctor. It can still be possible to give up drugs during pregnancy, although you will need skilled support. There are a number of specialist maternity departments across the country that care for women who abuse drugs. Many other hospitals also have staff specially trained to understand and help meet your needs.