normal weight after maybe nine months.)
Verboten foods: what’s the truth?
It’s all horribly confusing. Can you eat that kind of cheese, or not? Can you drink that glass of wine, or not? One recent survey of British women by a baby formula manufacturer7 found that most of us don’t fully understand which foods to avoid when pregnant. Indeed, we often cut out foods that are beneficial, in the mistaken belief that they are somehow dangerous. Cottage cheese, for instance, is a good, low fat source of calcium. But many women avoid it in pregnancy thinking it’s a ‘soft’ cheese, therefore verboten.
Our paranoia is understandable. For a start, the goalposts keep changing. When I was pregnant for the first time I stuffed myself with tuna, which I’d been told was an excellent source of fatty acids, protein and vitamins. Five years later, pregnant with number three, I was only allowed a couple of medium-sized cans a week. In the interim, studies had found that tuna may contain too much mercury and so harm a baby’s developing nervous system if you eat too much of it in pregnancy (see guidelines). Swordfish, marlin and shark are now officially out, for the same reasons. And some reports have recently suggested that farmed salmon may contain unacceptable levels of toxins, though the Food Standards Agency says the benefits of eating salmon outweigh any potential harm as salmon is a fantastic source of protein, vitamin D and good fats that can help your baby grow. (If you’re really worried you could try buying organic or wild salmon instead of cutting it out.)
There is, among all this confusion, some sensible evidence that certain foods should indeed be avoided during pregnancy. Mostly they are the ones that carry a very small risk of food poisoning such as listeria or salmonella, which studies have found may damage your fetus or cause miscarriage. Apart from this relatively short list of foods (see Pregnancy Eating Crib Sheet below), most doctors say you should eat basically as normal during pregnancy.
Why you should stop obsessing now
Phil Baker, Professor of fetal and maternal health at St Mary’s hospital, Manchester says, ‘I see so many women who are blaming themselves for a miscarriage or still birth when usually they could have done absolutely nothing to avoid it. It is important to have a basically balanced diet, which includes vegetables, protein, carbohydrate, fats and vitamins. If you are entirely starved it will have implications for the birth weight of your baby.’ Most of us do our best to eat more healthily when pregnant but even if we can’t – because, for instance, we’re throwing up – our bodies, says Professor Baker, should already contain good stores of certain nutrients which will get us through pregnancy. (This might explain why women with severe morning sickness, who can keep nothing down, can still produce miraculously healthy babies.)
Supplements
There is some debate over whether taking a general vitamin supplement in pregnancy is necessary or even helpful. (This does not include folic acid – see below – or iron supplements if you are anaemic.) I take a pregnancy vitamin pill each day when pregnant, but my attitude is that of the agnostic praying in times of duress: you don’t want to rule anything out. ‘You can look upon a general vitamin supplement as an insurance policy,’ says Dr Toni Steer, a nutritionist at MRC Human Nutrition Research in Cambridge, ‘but make sure that your vitamin and mineral supplement doesn’t exceed daily recommendations – don’t take megadoses of one particular vitamin.’ Many nutritionists argue that it’s the combination of nutrients in real food that produces benefits. And certainly, taking a daily dose of pregnancy vitamins, then eating crap all day is not the best option if you want a healthy baby.
Nutrition tip:
In summary, you will be fed a load of obsessive nonsense about what, how and when you should eat in pregnancy. Remember that a great many fetal and maternal health experts object to this kind of pressure – and the guilt, doubt and self-blame that result from it. Professor Baker says that most grown up women who ‘use moderation in all aspects – who don’t have particular food fanaticisms, or drink excessively’ are doing all that is necessary – nutritionally speaking – to produce perfectly healthy babies. So, the best advice is just follow the basic safety advice and get on with your life.
Where to go for help:
Drinkline 0800 917 8282 www.alcoholconcern.org.uk
The Food Standards Agency guidelines (www.food.gov.uk) offer the most up-to-date, official advice.
The Eating for Pregnancy Helpline is useful for random panics (‘Can I eat the prosciutto on this pizza?’) 01142 424084
Otherwise, this crib sheet is the best place to start.
PREGNANCY EATING
Each day try to eat a variety of foods including:
Plenty of fruit and vegetables
Plenty of starchy foods (whole grains are best, such as whole meal bread, pasta and brown rice)
Some protein (lean red meat, chicken, fish, eggs, pulses such as lentils are also good source of iron)
Some low-fat dairy products (milk, cheese, yogurt all contain calcium)
Drink lots of water
Foods you need for sure:
Your diet needs to contain plenty of iron (good foods include: red meat, pulses, leafy green vegetables, fortified breakfast cereals, dried fruit). Vitamin C helps your body to absorb iron (drink orange juice when you eat iron-rich food). Both calcium (derived from milk, cheese and yoghurt) and iron are important for the baby’s growth (anaemic mums may have low birth-weight babies).
You should take 400 mcg folic acid a day in first three months (and three months before conception if at all possible). Folic acid can protect against neural tube defects, for example spina bifida, and may protect against the failure of the placenta to work well, which can lead to pre-eclampsia, still birth or growth problems.
Things to be cautious about:
Alcohol: in the US pregnant women are told not to drink. In Britain, we are told to cut down to two to three units a week (that’s about a glass and a half of wine). All doctors survey the same literature but draw different conclusions, so do not be panicked by signs in New York bars forbidding you to have a drink when pregnant. But do talk to your GP if you can’t cut down.
Coffee: there is no conclusive evidence linking caffeine and miscarriage, so there is no need to cut out the lattes entirely; cutting down to one or two a day may be sensible. The Food Standards Agency says limit your caffeine intake to no more than three caffeinated drinks a day (coke, pepsi and chocolate all contain caffeine). In the US women are advised to have no more than one cup of coffee a day.
Stop smoking and don’t take recreational drugs as they can damage your baby.
Foods doctors say you should avoid:
Soft
