Preparing for your babies arrival

When you have found out that you are pregnant you will probably have lots of questions about what to expect. You can make an appointment with your midwife either at your GP surgery or local children’s centre. One of the things to consider is where you would like to have your baby. It’s important to know that you have choices eg at home or in hospital and your midwife can give you advice about this. 

There are many ways you can look after yourself and your baby during pregnancy and it is important that you seek advice about diet and wellbeing, smoking and alcohol.

Diet and wellbeing

During pregnancy you need to make sure that your diet is providing you with enough energy and nutrients for the baby to grow and develop, and for your body to deal with the many changes that are taking place.

It’s important to try to eat a variety of foods including:

• plenty of fruit and vegetables (fresh, frozen, tinned, dried or a glass of juice). Aim for at least five portions of a variety each day;
• plenty of starchy foods such as bread, pasta, rice and potatoes – try to choose wholegrain options;
• foods rich in protein such as lean meat and chicken, fish (aim for at least two servings of fish a week, including one of oily fish), eggs and pulses (such as beans and lentils).These foods are also good sources of iron (see ‘Do I need extra iron?’ below);
• plenty of fibre. This helps prevent constipation and is found in wholegrain bread, pasta, rice, pulses and fruit and vegetables
• dairy foods such as milk, cheese and yoghurt, which contain calcium;
• it’s also a good idea to cut down on foods such as cakes and biscuits, because these are high in fat and sugar. This can also help you to avoid putting on too much weight during pregnancy. Healthy snacks to have instead include, malt loaf; currant buns without icing; sandwiches or pitta bread filled with cottage cheese, chicken or lean ham; low-fat yoghurts; vegetable and bean soups; and fruit including fresh, tinned in juice or dried fruit such as raisins or apricots; and
• it is also important to keep well hydrated by drinking plenty of water.

Fish

You can eat most types of fish when you’re pregnant. Eating fish is good for your health and the development of your baby. You just need to avoid some types of fish and limit the amount you eat of some others.

Avoid eating any of these fish when you’re pregnant:

• Shark, swordfish, marlin
• Limit the amount of tuna you eat to no more than two tuna steaks a week (weighing about 140g cooked or 170g raw) OR no more than four medium-size cans of tuna a week (with a drained weight of about 140g per can). This is because shark, swordfish, marlin and tuna could contain high levels of mercury which could affect your baby’s developing nervous system.
• Have no more than two portions a week of any of these fish:
• oily fish, including mackerel, sardines, salmon, trout and fresh tuna sea bream, sea bass, turbot, halibut, rock salmon (also known as dogfish, flake, huss, rigg or rock eel) and brown crabmeat. This is because these types of fish can contain low levels of pollutants that can build up in the body over time, including dioxins and Polychlorinated Biphenyls (PCBs). Canned tuna doesn’t count as oily fish but fresh does. Whether you eat canned or fresh this will count towards your total amount of tuna for the week. 

Don’t forget that eating fish is good for your health and the development of your baby, so you should still aim to eat at least two portions of fish a week, including one portion of oily fish.

Vitamins and minerals

Folic acid

You should take a daily 400 microgram (mcg) folic acid supplement from the time you stop using contraception until the 12th week of pregnancy. You should also eat foods containing folate – the natural form of folic acid – such as green vegetables and brown rice, fortified bread and breakfast cereals.  Folic acid has been shown to reduce the risk of babies developing neural tube defects such as spina bifida. If you would like to take your folic acid in a supplement that contains other vitamins, make sure it contains 400mcg folic acid and doesn’t contain vitamin (see ‘What to avoid section below.). If you have already had a pregnancy affected by a neural tube defect or have diabetes you should take a higher dose of folic acid – 5 milligrams (mg) a day – for the same period of time. Ask your midwife or GP for further advice.

Iron

Pregnant women can become deficient in iron, so make sure you have plenty of iron-rich foods. Try to have some food or drink containing vitamin C, such as fruit or vegetables or a glass of fruit juice, with any iron-rich meals because this might help your body absorb iron more effectively. Tea and coffee can make it harder for our bodies to absorb iron, so cutting down on these drinks at meal times could help to improve iron levels in the body. Your midwife will be checking the iron levels in the blood at certain points in pregnancy and any time there are concerns about iron levels.  If your iron levels in the blood are low (anaemia) you will be advised to take an iron supplement and a prescription will be arranged for you.

Good sources of iron include:

• red meat;
• pulses;
• bread;
• green vegetables; and
• fortified breakfast cereals.

Although liver contains a lot of iron, you should avoid eating it while you’re pregnant (see ‘What to avoid’ section below).
 
Vitamin D

You should take supplements containing 10mcg of vitamin D each day.
Vitamin D is found in a small number of foods but we get most of our vitamin D from summer sunlight – if you’re out in the sun, remember to take care not to burn!

If you have dark skin, if you always cover up all your skin when you’re outside, or if you rarely get outdoors, you may be particularly short of vitamin D. Ask your midwife or GP for more information.

You may be entitled to free vitamin supplements including Folic Acid and Vitamin D through the Healthy Start scheme. For more information ask your midwife or visit the Healthy Start Scheme website.

What food to avoid

There are certain foods that you should avoid when you’re pregnant, because they might make you ill or harm your baby:

Some types of cheese

Avoid cheeses such as Camembert, Brie or chevre (a type of goats’ cheese), or others that have a similar rind. You should also avoid soft blue cheeses. These cheeses are made with mould and they can contain listeria, a type of bacteria that could harm your unborn baby and make you very ill. Find out more about listeria.

Pâté

Avoid all types of pâté, including vegetable. This is because pate can contain listeria.

Raw or partially cooked eggs

Avoid eating raw eggs and food containing raw or partially-cooked eggs. Only eat eggs cooked enough for both the white and yolk to be solid. This is to avoid the risk of salmonella, which causes a type of food poisoning.
 
Raw or undercooked meat

Make sure you only eat meat that has been well cooked. This is especially important with poultry and products made from minced meat, such as sausages and burgers. Make sure these are cooked until they are steaming hot all the way through and no pink meat is left. Always wash your hands after handling raw meat, and keep it separate from foods that are ready to eat. This is because raw meat contains bacteria that can cause food poisoning.
 
Liver products and supplements containing vitamin A

You need some vitamin A but it is important to avoid having too much as this could harm your unborn baby. Therefore, you should avoid eating liver and liver products such as pâté and avoid taking supplements containing vitamin A or fish liver oils (which contain high levels of vitamin A).  Ask your midwife or GP if you want more information.

Undercooked ready meals

Avoid eating ready meals that are undercooked. Make sure you heat them until they are steaming hot all the way through.

Raw shellfish

Avoid raw shellfish when you’re pregnant. This is because raw shellfish can sometimes contain harmful bacteria and viruses that could cause food poisoning. And food poisoning can be particularly unpleasant when you’re pregnant.

Should I avoid peanuts?

If you would like to eat peanuts or foods containing peanuts (such as peanut butter) during pregnancy, you can choose to do so as part of a healthy balanced diet, unless you yourself are allergic to them or unless your health professional advises you not to. You may have heard that some women, in the past, have chosen not to eat peanuts when they are pregnant. This is because the government previously advised women that they may wish to avoid eating peanuts during pregnancy if there was a history of allergy in their child’s immediate family (such as asthma, eczema, hayfever, food allergy or other types of allergy). But this advice has now been changed because the latest research has shown that there is no clear evidence to say that eating or not eating peanuts during pregnancy affects the chances of your baby developing a peanut allergy.
If you have any questions or concerns, you should discuss these with your GP, midwife, health visitor or other health professional.

If you choose to avoid eating peanuts or foods containing peanuts during pregnancy, you can do so by reading the ingredients list on food labels, where peanut must be declared by law if it is an ingredient.

Foods you don’t need to avoid

It can be confusing trying to work out which foods you can eat and which foods you should avoid when you’re pregnant. You might find it helpful to look at this list of some of the foods you don’t need to avoid:

• Thoroughly cooked shellfish, including prawns as part of a hot meal.
• Probiotic drinks
• Fromage frais
• Creme fraiche
• Soured cream
• Spicy food
• Mayonnaise, ice-cream, salad dressing – as long as they haven’t been made using raw egg. Generally, mayonnaise, ice-cream and salad dressing you buy in shops will have been made with pasteurised egg, which means it’s safe to eat. But it’s better to avoid home-made versions if they contain raw egg. If you’re not sure about any of these foods when you’re eating out, ask staff for more information.
• Honey – it’s fine for pregnant women but honey isn’t suitable for babies under a year old
• Many types of cheese including:
  Hard cheese, such as Cheddar and Parmesan, Feta, Ricotta, Mascarpone, Cream cheese, Mozzarella,Cottage cheese and Processed cheese, such as cheese spreads.

Weight gain

Weight gain in pregnancy varies and depends on what you weighed before you became pregnant. The more weight a woman gains during pregnancy, the more likely she is to retain the weight after childbirth. Most women put on 10–12.5kg (22–28lb) over the whole of their pregnancy. If you gain too much weight, this can affect your health and increase your blood pressure. But equally, it’s important that you don’t try to diet.  If you’re concerned about your weight, talk to your midwife or GP.
You can find more information in The Pregnancy Book produced by the Department of Health and given to all first time mothers. Ask your midwife to give you a copy.

Staying active

The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. Keeping active during your pregnancy will help you to cope with labour and get back into shape after the birth.

It is recommended that pregnant women do 30 minutes or more of moderate physical activity a day.

Keep up your normal daily physical activity or exercise for as long as you feel comfortable. Don’t exhaust yourself and remember that you may need to slow down as your pregnancy progresses or if your doctor advises you.
If you did very little activity before you were pregnant and you wish to start an exercise programme, talk to your midwife or GP for advice.

Alcohol

When you’re pregnant, it’s best to stop drinking alcohol altogether. If you don’t want to stop drinking altogether it is best to avoid drinking in the first three months, and if you do drink, have no more than one or two units of alcohol, once or twice a week.  A unit is half a pint of standard strength beer, lager or cider, or a pub measure of spirit. A 175 ml (medium size) glass of wine is about two units and alcopops are about 1.5 units.

Smoking

Smoking is bad for you, your partner and especially for your baby. The truth is that every cigarette you smoke harms your baby. The sooner you stop the better, but we know that it is difficult. If you stop smoking at any stage during your pregnancy this will benefit you and your baby.

 There is plenty of help, advice and support available to help you stop and you may be able to use Nicotine Replacement Therapy. There is also an NHS Pregnancy Smoking Helpline 0800 169 9169.

Our smoking cessation midwife can give you and your family support and advice to stop smoking. Please telephone 07712 783 3781. For more information about smoking and pregnancy and how to break the habit, visit the NHS Smokefree website.

Caffeine

It’s important not to have too much caffeine. This is because high levels of caffeine can result in babies having a low birth weight, which can increase the risk of health problems in later life. High levels of caffeine might also cause miscarriage. It’s best not to have more than 200 milligrams (mg) of caffeine a day when you’re pregnant.

The amount of caffeine in food and drink will vary, but as a guide each of these contain roughly 200mg or less of caffeine:

• Two mugs of instant coffee (100mg each)
• One mug of filter coffee (140mg each)
• Two mugs of tea (75mg each)
• Five cans of cola (up to 40mg each)
• Two cans of ‘energy’ drink (up to 80mg each)
• Four (50g) bars of plain chocolate (up to 50 mg each). Caffeine in milk chocolate is about half that of plain chocolate