Friday 23 February 2018

Ask the GP: What to take and avoid when pregnant

Pregnancy is a state of health
Pregnancy is a state of health

Nina Byrnes

Advice from our GP on what to take and what to avoid while pregnant.

Question: I am pregnant at the moment. I feel well and I have been trying to be as healthy as possible, but I am aware there are a few foods I need to avoid can you review these for me please?

Dr Nina replies: Pregnancy is a state of health and you can carry on and live as you normally do. It is important to exercise regularly and to eat well. A broad varied unprocessed diet is best. There are however a few foods to avoid.

Caffeine should be reduced in pregnancy. It is advised to limit your intake to less than 200mg per day. An average espresso shot has about 40g (range 40 to 80) of caffeine, a cup of tea about 44g and a can of cola about 32g.

Caffeine passes straight through the placenta so any caffeine you ingest is also ingested by the baby.

Any alcohol can affect the baby. It is best to avoid alcohol altogether in pregnancy. Worryingly a recent study showed that Irish mothers rank among the highest in alcohol consumption in pregnancy.

There was one study that suggested that drinking low amounts of alcohol in pregnancy has not been proven to show harm to the baby. It is important to point out that low levels meant no more than one or two units per week, which equates to one bottle of beer, no more than one pint of lager or less than one-fifth of a bottle of wine.

Eggs can be a great source of iron and healthy fats but they should always be well cooked.

Avoid home-made mayonnaise and mousse which may contain raw egg. Meat, fish and poultry should all be well cooked. Dairy products should be pasteurised.

You need to avoid soft and blue cheese. Farm-fresh milk and yoghurt should also be avoided as these may be unpasteurised. If in doubt, ask the producer.

Certain fish such as swordfish can contain high levels of mercury and should be avoided. Tuna may contain small amounts but it is also a good source of protein and Omega 3. Just keep tuna to no more than two tins a week.

Liver can contain high levels of vitamin A. You should avoid liver and all-liver products such as pate and cod liver oil in pregnancy.

We used to tell pregnant women to avoid nuts. A large study last year questioned this idea as it suggested that those at risk of nut allergy were less likely to develop this if exposed to small amounts of nuts early in life.

Nuts can be a great source of protein and healthy fats and can be an easy way to get some calories in if you have morning sickness. If there is no family history of nut allergy these should be okay. If there is a strong history it may be worth consulting with your doctor.

Question: I am expecting my first baby early next year. I have been given all kinds of advice about what vitamins are important. It's hard to know which advice to follow. What vitamins and supplements, if any, do I need?

Dr Nina replies: The first point I'd like to make is that pregnancy is a state of health. Leading a healthy active lifestyle in pregnancy increases your chances of having a healthy pregnancy and having a healthy baby.

There has been a large focus on weight gain in recent times. You are not eating for two despite what some people may say. Focusing on the quality rather than the quantity of food eaten is a good place to start.

It is essential to take folic acid from pre-pregnancy up to 13 weeks. This significantly reduces the chance of spinal cord abnormalities in the developing baby. A supplement should be started ideally before you even try to conceive.

Extra iron becomes more important from the middle of pregnancy. Most women benefit from a supplement during this time. Vitamin C helps your body absorb iron.

You need five portions of dairy a day during pregnancy. vitamin D is also essential to help the bones utilise calcium effectively.

Sunlight is our best source of vitamin D - it is very hard to get enough through diet alone. Food sources include oily fish, fortified milk and cereal and some nuts and seeds. If your dairy and vitamin D intake is inadequate you may benefit from a supplement for these also.

Omega 3 fats remain an important part of the pregnant woman's diet. You may get these from oily fish, nuts and seeds. There is no substitute for healthy eating in pregnancy. If you prepare fresh unprocessed meals there is a good chance you will get most of the vitamins and minerals you need.

If you take supplements ensure they are suitable for use in pregnancy.

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