Pre-and Postnatal Supplementation
Good nutrition when you’re trying to conceive, and while pregnant or breastfeeding, is fundamental, both for your own health and for giving your baby the best start in life.
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What to eat when you’re trying to get pregnant
The first 500 days of a child’s life - from conception until six months old - is a crucial developmental period during which your baby is entirely dependent on you for nutrition via the placenta or breast milk.1 But mothers hoping to conceive should start considering their diet even earlier: pre-conception research shows that healthy nutrition is linked to healthy fertility, and improves your chances of becoming pregnant. While it’s always important to eat well, it’s recommended that you start making healthy dietary changes 3-12 months before you wish to conceive. This means maintaining a healthy weight and following a varied, balanced diet packed with fruit, vegetables, whole grains, lean meat, and low-fat dairy for optimal reproductive functioning.2 A focus on folate One of the most important nutrients for the prenatal period is folate (also called Vitamin B9, or folic acid in supplement form). Folate protects against defects to the neural tube, the foetal structure that becomes the brain and spinal cord. Neural tube defects can cause varying degrees of paralysis and intellectual disability.2,3 Folate is especially effective in the first 28 days of pregnancy when most neural tube defects occur. Because you may not realise you’re pregnant in those first 28 days, you should ensure you’re getting enough folate before conception, and throughout pregnancy.3 Folate-rich foods include dark green leafy vegetables, citrus fruits, nuts, legumes, whole grains and fortified foods e.g. some breakfast cereals.2
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Foods to avoid or limit in the prenatal period
- Alcohol, even at low levels early on when you may not yet realise you’re pregnant, can potentially harm your baby.
- Caffeine: wean yourself off caffeine (in coffee, cola, tea, chocolate) or reduce intake. Over 200-300mg per day (two cups of filter coffee) may reduce fertility by 27%. Caffeine also interferes with the absorption of iron and calcium.2
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Dietary supplements: filling in nutrient gaps
Even if you follow a healthy diet, you can miss out on certain nutrients, or not take in sufficient amounts. This is why health professionals recommend prenatal vitamin and mineral supplementation, which is generally continued during pregnancy and breastfeeding.2,3
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What to eat while you’re pregnant
Keep yourself and your baby in peak condition throughout your pregnancy by following the same basic recommendations for a healthy prenatal diet and supplementation. Note that you burn more energy when pregnant, but not much - only about 300 extra calories per day. Get these in the form of healthy snacks rather than sweets and fatty foods.3 Key nutrients for a healthy pregnancy Among the various nutrients important during pregnancy, these are especially noteworthy: Iron. Your body makes more red blood cells to supply both you and your baby during pregnancy. Iron is a key component of red blood cells, and you produce fewer when it’s lacking in your diet. This causes anaemia, a condition that can lead to fatigue and weakness.5 Good iron food sources include meat, fish, eggs, dried beans, fortified cereals, leafy green vegetables, legumes and dried fruit. To aid iron absorption, eat these foods with those high in vitamin C. e.g. citrus fruit. Cast iron pots can also add iron to food cooked in them.5,6 Calcium lowers the risk of dangerously high blood pressure and convulsions during pregnancy and birth. It’s also vital for growing your baby's bones and teeth. Calcium-rich foods include dairy products, salmon, sardines, sesame seeds, dark green vegetables, and calcium-fortified products such as cereals, non-dairy milks and tofu.1,2,6 For Calcium to be absorbed efficiently, you also need Vitamin D, produced by the body through exposure to sunlight, and found in fortified dairy, plant milks and cereals, and fatty fish (e.g. salmon).6 Omega-3 fatty acids support brain and eye development in babies and help prevent preterm birth. This nutrient may also ease symptoms of perinatal depression. Salmon, sardines, herring and farmed oysters are rich in omega-3s but lower in toxins like mercury, which can affect the developing nervous system. Two to three servings a week provide excellent nutrient value without exposing your baby to dangerous mercury levels. Omega-3s from seafood are most beneficial, but plant-based sources are also valuable e.g. walnuts, edamame.7
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Foods and drinks to avoid or limit during pregnancy
As well as nutrients, potentially harmful substances can also pass from you to your baby. Prevent this by avoiding or limiting the following:1,3,8
- Alcohol can harm your baby’s normal development and raises the risk for miscarriage and preterm birth. The safest approach: avoid alcohol completely.
- Uncooked fruits and vegetables that haven’t been peeled or washed.
- Liver is high in vitamin A; excessive amounts can harm a baby in utero.
- Caffeine: keep to 200mg per day. More can raise the risk for pregnancy complications, such as low birth weight.
- Seafood high in mercury, e.g. swordfish and marlin.
- Raw or undercooked meat, seafood, and eggs.
- Pâté, meat spreads, smoked or cured meats e.g.salami, unless cooked thoroughly
- Unpasteurised dairy products e.g. feta, Camembert, blue-veined cheeses (unless labelled “made with pasteurised milk", or thoroughly cooked).
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What to eat after pregnancy and during breastfeeding
There's no need to follow a special diet while breastfeeding. Simply continue with recommended healthy nutrition and supplementation as for before and during pregnancy, and take note of these tips:6
- Boost milk production with healthy choices: protein-rich foods, such as lean meat, eggs, dairy, and legumes; whole grains; fruits and vegetables.
- For extra energy to produce milk, you might need an additional 330-400 calories a day. Get these calories through nutrient-rich choices, such as a slice of whole-grain bread with a tablespoon of peanut butter, or a piece of fruit.
- Eating a variety of foods changes how your breast milk tastes. This exposes your baby to different flavours, which might help them accept solid foods more easily later.
- Continue taking a daily multivitamin and mineral supplement as recommended by your doctor until you wean your baby, to ensure you and your child are getting all the necessary nutrients.
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Foods and drinks to avoid or limit when breastfeeding
- No level of alcohol in breast milk is considered safe, so rather avoid it altogether. If you do drink, wait 2-3 hours for the alcohol to clear from your breast milk.
- Limit yourself to 2-3 cups of caffeinated drinks a day. Caffeine in breast milk could agitate your baby or disturb their sleep.
- Seafood is an excellent source of protein and omega-3s, but avoid fish that may be high in mercury.6
Medical References
- UNICEF South Asia. What to eat before, during and after pregnancy. (2023). Accessed from: https://www.unicef.org/rosa/stories/what-eat-during-and-after-pregnancy
- American Pregnancy Association. Preconception Nutrition. Accessed from: https://americanpregnancy.org/getting-pregnant/preconception-nutrition/
- Johns Hopkins Medicine. Nutrition During Pregnancy. Accessed from: https://www.hopkinsmedicine.org/health/wellness-and-prevention/nutrition-during-pregnancy
- Pregomega. Why supplement during pregnancy. Accessed from: https://pregomega.co.za/why-supplement-during-pregnancy/
- UCSF Health. Anemia and Pregnancy. Accessed from: https://www.ucsfhealth.org/education/anemia-and-pregnancy#:~:text=
- Mayo Clinic. Breastfeeding nutrition: Tips for moms. Accessed from: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breastfeeding-nutrition/art-20046912
- Masters, M. What to expect. Omega-3 Foods and Fish Oil During Pregnancy.(2021). Accessed from: https://www.whattoexpect.com/pregnancy/your-health/omega-3-fish-oil-during-pregnancy
- NHS. Foods to avoid in pregnancy. (Updated 2023). Accessed from: https://www.nhs.uk/pregnancy/keeping-well/foods-to-avoid/