Prenatal nutrition: What to eat trimester by trimester

With a whole new life growing on the inside of a mum, nutrition decisions can no longer be casual, flippant, or selfish. Which is why prenatal nutrition is important to ensure that mummy and baby are optimally nourished in the 40weeks of pregnancy, while still ensuring that prenatal weight gain is kept within the recommended range of 25 to 35lbs for a singleton.

First trimester for a good number of women is usually the rockiest, no thanks to Hyperemesis Gravidarum (HG), also known as Morning sickness with its attendant nausea and vomiting. This is as a result of the very high and rapidly increasing levels of hormones like hCG and progesterone at the start of pregnancy. Even though both hormones are very necessary for fetal development especially at the early stages, they may also affect the biochemistry of the mother’s body.

While ‘Morning sickness’ occurs in the morning for some women, others experience it all day long. In my months of directly coaching pregnant women, I have seen some unable to keep down anything including water sometimes, and so have to be nourished via IV fluids and put on bed rest. Where HG is intense, the woman is advised to continue to try out a couple of bland foods, like crackers, plain white rice, yam, potatoes and in small portions per time.

Also, women should avoid anything spicy or trying out new foods. Eating even before you get out of bed is also advised, and then every 1 to 2 hours in small portions, including water. Some women find that ginger helps with the nausea feelings and so infuse their drinking water with some ginger cubes. Also mint or peppermint leaves.However, what works for one may not work for another so it is OK to continue to try out a variety of home-based remedies until something works. Weight loss is also expected at this stage, with some women losing as much as 5kg because of reduced calories intake, but except in very severe cases, the baby usually continues to take the nutrients from the mother first and fetal development continues despite the mother’s weight loss.

By Second Trimester, most women begin to see a silver lining as hormonal levels drop significantly. Then the woman can begin to enjoy her regular foods again and may even have cravings, sometimes of the weirdest things. For example, some women crave ice, chalk, sea sand, and so on, whether to inhale or to ingest. This craving for non-food items is usually called ‘pica’. Where the cravings are food related, they are usually valid but should be indulged wisely to avoid unusual weight gain.
Cravings aside though, prenatal Nutritionists would recommend that foods high in iron be consumed regularly as iron deficiency is probable in this trimester what with the increased demands the fetus is making on the mum as growth occurs, and it is needed for blood formation. This increased iron needs can be met in a healthy diet of foods rich in iron like meats, fish, fortified cereals (that is cereals to which Iron has been added, among other minerals and it is always specified on the packaging), legumes like beans, and even the less popular vegetables like broccoli and cauliflower, both now more easily accessible in Nigeria from our local hawkers.

As always, make sure to thoroughly wash fruits and vegetables, as they are viable ground for the growth of bacteria, which can easily lead to food poisoning. And a tip to note in consuming beans in pregnancy is that even though it is rich in iron, the iron in it only gets absorbed by the body when there is a natural source of Vitamin C accompanying consumption. However, should your doctor still notice an Iron deficiency, an Iron supplement may be introduced to make up for it, as Iron is very important here.

By Third Trimester, baby’s organs are all fully developed and all that is going on now is growth, and this means that a mother’s appetite would most likely improve rapidly. This is when some mums make the mistake of eating for two, which really should not be. While there is a second child growing inside of you, that child doesn’t need the same portion of food as the woman needs.

I recall a funny but relevant illustration a midwife gave at one of my antenatal classes. She said if you usually consumed N100 worth of rice, you should increase it to N120 or N130 but definitely not up to N150. We laughed but the message was not lost on us. Also, with the baby occupying more ‘real estate’ on the inside of the mum, constipation and indigestion are most likely to occur, so eating large amounts of food will make that worse.

Another thing to avoid would be lying down immediately after eating as this usually leads to heartburn so stay propped up at 45 degrees instead. Also, eat a wide variety of foods, fruits and vegetables so the baby is exposed to them in utero.