PRE-prenatal nutrition

introducing heather, RD
my friend heather from side of sneakers is many things: smart, gorgeous, honest, and an excellent writer. she’s also a RD, with one of several specializations in prenatal nutrition!

this lovely photo has been all over the blogosphere! heather is on the right
when i wrote a recent post regarding nutrition in the 0th trimester (ie: the pre-prenatal period, or while one is trying to conceive), heather immediately emailed and offered her services.

logo for heather’s business: learn more about personalized counseling here!
and with that, this blog’s very first guest post (other than josh keeping the streak alive while i’ve been sick!) was born. without further ado, here’s the Q & A, featuring your questions with answers provided by SoS, RD:

I was looking at a bottle of wine over the holidays, and the surgeon general’s warning said something to the effect of “don’t consume alcohol while pregnant or trying to get pregnant.” I’d never heard that last part before. I know you shouldn’t drink while pregnant, but is it really dangerous to have an occasional glass of wine while TTC?
Although more and more research is showing that alcohol isn’t as bad as we’ve always thought during pregnancy, it’s still a major no-no according to most doctors, especially in the early stages of pregnancy. The warning label likely includes “trying to get pregnant” because most people won’t know they’re pregnant until they miss a period, which is usually about two weeks after ovulation occurs [aka when you would have gotten pregnant.] Because of this, it’s best not to drink in the two weeks between ovulation and your next period. Besides that time period, drinking alcohol won’t cause harm to a fetus, but it’s debated how much alcohol affects fertility. It’s usually recommended to drink in limited moderation.

Guys don’t get off the hook here either- excessive drinking can decrease sperm count.

Is consuming caffeine (like one to two cups of coffee/day) while pregnant harmful? What about while TTC? Does drinking caffeine while nursing cause colic?
Consuming a moderate amount of caffeine while pregnant is usually ok. “Moderate” means no more than 250-300mg a day, which is 1-2 6 oz cups of coffee. It’s a big range because there are a lot of factors that can influence the amount of caffeine in one cup of coffee. For example, Starbucks is notorious for their high caffeine content. If you’re drinking coffee, make sure to take other sources of caffeine into consideration, such as soda, tea, chocolate, and Excedrin.

Caffeine is probably a bigger concern while trying to conceive. While moderation is still the recommendation, caffeine intake has been linked with decreased fertility, early miscarriage, and low birth weight babies. It’s not a bad idea to curb your intake a little, but make sure to wean off slowly – caffeine withdrawal headaches are no joke.

It’s possible that consuming caffeine while breastfeeding can be associated with colic, although it’s hard to say definitively. Babies can’t metabolize caffeine as easily as adults, so it affects them more. Drinking caffeine in moderation should be ok, but if you have a colicky baby, it doesn’t hurt to try cutting it out!

Any nutritional advice for wanna-be fathers beyond the standard “eat a healthy diet”?
Yes! Men, you are not off the hook!! A healthy weight and healthy diet are just as important for fathers-to-be as it is for moms-to-be. The number one thing would be to cut back on alcohol intake if your fellow is a heavy drinker. Alcohol decreases sperm count, which decreases the chances of you getting pregnant.

Just like women should take a prenatal vitamin as soon as they’re thinking about becoming pregnant, menshould take a multivitamin. Certain vitamins and minerals can not only help with fertility, but aid in a healthy baby. The first thing that comes to mind is zinc, which is almost always found in a multivitamin. Inadequate zinc levels contribute to a low sperm count.

What is a good way to add calories to a diet but in a healthy way? Last night, I told my husband I was going to just eat dark chocolate (yum!) to bulk up— we decided that wouldn’t be the best way.
Eating chocolate and ice cream would definitely be a fun way to bulk up, but you’re right, probably not the best way [editor’s note: damn]. Adding nutrient dense calories is the best way to go- a lot of times this can include healthy fats and proteins like peanut butter, avocado, olive oil, nuts, etc. Adding in more frequent meals can help too- instead of breakfast, lunch, and dinner, try breakfast, 1st lunch, 2nd lunch, and dinner, or substantial snacks between each meal.

Are there any vitamins and/or supplements that you would recommend to pro-actively take in the meantime?
Absolutely. The most important vitamin to be taking if you’re trying to conceive is folic acid. In fact, it’s so important that all women of child-bearing age [aka have gotten their period] should be taking it, whether they’re thinking about babies or not. Folic acid is responsible for preventing a number of birth defects, especially neural tube defects. These occur so early on in pregnancy that it may be before a test even shows up positive- therefore being proactive is the only way to go. All women should be taking at least 400 mcg of folic acid prior to pregnancy. The amount increases once you’re pregnant.

Also, the time to start taking a prenatal vitamin is when you’re trying to get pregnant- it’ll get your body ready for everything it’ll need to do during pregnancy. Most prenatal vitamins will contain folic acid, but check to make sure yours does. It doesn’t matter what kind you take, as long as you can handle taking it- over the counter is fine.

It’s a good idea to get your iron checked before trying to conceive. If it’s low, eating iron-rich foods or taking an iron supplement can help increase your iron stores before pregnancy. Pregnancy demands a lot of iron- you have to supply both you and your baby!

Vegetarians and vegans may need some help with vitamins D and B12 as well.
I could go on and on about what specific nutrients do, but Sarah would probably like her blog back at some point. 😉 [editor’s note: not when you’re on this much of a roll!]

Which are the best sources of protein? And how much does the amount of protein one takes in matter?
The best sources are lean proteins: lean meat/pork/chicken, fish [see below], nuts, low-fat cheese, beans, lentils, etc. The exact amount of protein you eat isn’t a huge deal- as long as you’re meeting your minimum needs and are at an adequate weight. Most people get more than their daily need without even trying.

Which fish are good for TTC women and which are no-goes due to mercury or other toxins?
The best thing to do about fish is to find out where the fish in your area come from, and what the mercury levels are- it can vary greatly by region. In general, the bigger the fish, the higher the mercury content. Fish high in mercury should be limited. The biggest offenders tend to be grouper, swordfish, and mackerel, while safer options include trout, tilapia, flounder, and haddock.

I have heard that full-fat dairy can help with fertility, but the saturated fat content concerns me. What is your take on full-fat dairy?
Personally, I don’t believe that fat from dairy specifically plays much of a role in fertility. I think it’s more important that you’re getting enough fat total, especially from healthy choices such as fish, nuts, avocado, etc. The benefit of dairy is that it also has calcium, but calcium can be found in other foods such as leafy greens and fortified cereal, as well as supplements. If body weight is a concern, a healthy BMI trumps dairy intake.

Other words of wisdom?
Achieving a healthy weight prior to pregnancy is extremely important. Not only does a healthy BMI increase your chances of conception, but it ups your chances of an uncomplicated pregnancy and a healthy child. Obese mothers are more likely to have c-sections, pre-term deliveries, complications like gestational diabetes and pre-eccamplsia, as well as babies that are overweight as both children and adults. Weight loss during pregnancy isn’t recommended, so pre-pregnancy is the best opportunity. Regular physical activity is important too!

a day’s worth of food
[it’s me again — you can tell from the aversion to capital letters, right?] i thought it would be interesting to photograph a day’s worth of food and have heather comment on my choices, so i spent a few extra minutes on sunday documenting every mouthful (i have no idea how the real food bloggers do it!).

2 whole grain waffles w/ almond butter + kiwi + black coffee (yep all caf . . . )
This is a great breakfast- substantial enough, with most of the nutrient groups covered: whole grains, protein, healthy fat, and fruit. If this is your only caffeine during the day (and you don’t drink the whole pot!) this is probably ok, but it wouldn’t hurt to keep an eye on your caffeine intake.

pecans + craisins
This combination of carbohydrate, protein, and fat is an example of a great snack- it’ll help keep your blood sugar stable between meals, and prevent cravings or overeating later in the day. Just remember packaged dried fruit tends to have more sugar than you think.

leftover homemade sweet potato samosa + tabbouli (actually a wimpier lunch than usual)
This is a nice mix of nutrients, but it looks a little on the small side. Increasing the amount of your side dish, or adding something on the side like veggies, fruit, or whole grains might be beneficial.

bleu cheese + 1/2 pear
Again, pairing carbohydrate with protein and fat is a good nutrition move. It’s usually recommended to stay away from blue cheese (unless you can guarantee it was pasteurized adequately) once you’re pregnant.

lamb/guinness stew with rutabegas, carrots, potato; slice of whole wheat sunflower toast
The lamb here is a good source of iron, which has been a little low the rest of the day. The whole grain toast is a good way to sneak in some fiber to help keep you from getting hungry late at night.

so delicious coconut milk ice cream sandwich (the mini kind – 100 kcals of awesomeneness)
Fabulous. [I love these]. Having something to satisfy your sweet tooth, or something you see as a ‘treat’, is important to make sure you don’t feel deprived and to round out your intake for the day.

It’s hard to judge portion sizes from pictures, but the only thing I’d be concerned about here is that you’re getting enough calories, especially if you’re active. Sarah’s on the small side, so this may be just the right amount for her, but in general, make sure you’re eating enough!

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i hope this was useful to some of you — i know it was to me (although i am sobbing into my coffee right now thinking about switching it to half-caf). heather, thank you so much for an interesting an informative post!