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Pregnancy and breastfeeding

Good nutrition is especially important for women when they are thinking about getting pregnant, pregnant or breastfeeding. Pregnancy is a time when your nutritional needs are greater, in order to nourish both yourself and your growing baby. Good nutrition now will benefit your children throughout their lives.

You don’t need to change your diet drastically when you are preparing for pregnancy, are pregnant or breastfeeding. You should continue to eat healthy foods, drink plenty of water and keep active. However, there are a few extra things you need to be aware of in relation to certain vitamins and minerals, alcohol, and food safety.

Eating a Balanced Diet

Eating from each of the following food groups every day helps to ensure you have all the nutrients you need to nourish yourself and your baby.

  • Have at least 5 servings of vegetables and 2 servings of fruit during pregnancy and at least 7 servings of vegetables and 2 servings of fruit during breastfeeding.
  • Have at least 8 servings of grain foods during pregnancy and at least 9 servings during breastfeeding. These foods include bread, pasta, rice and breakfast cereal.  Whole grains varieties are best
  • Have at least 2 servings of milk and milk products, such as milk, yoghurt and cheese during pregnancysame during breastfeeding.
  • Have at least 3 servings of legumes, nuts, seeds, fish and other seafood, eggs, poultry, and/or red meat with fat removed during pregnancy, and at least 2 servings during breastfeeding.

These are broad recommendations are based on Ministry of Health resources: Eating for Healthy Pregnant Women and Eating for Healthy Breastfeeding Women. For tailored recommendations, consult a dietitian or registered nutritionist.

With pregnancy, you may become constipated. Eat foods with fibre (fruit, vegetables and whole grains). Kiwifruit has laxative properties and is an excellent way to stay regular as it also is a nutritionally dense fruit.

Tips! 

It can get difficult to keep up with the servings you eat every day, especially when the recommended servings are as large as 7-9 servings. Some ways to try and reach these serving numbers are:

Vegetables and fruits:

  • Make sure that at least half of your plate every meal are vegetables
  • Keep them insight! Having a vegetable/fruit basket in the corner of your kitchen will make you think about using it more.
  • Smoothies are a great way to have a variety of vegetables and fruits in one serving!
  • Turn your favourites into healthy alternatives: brussel sprouts, zucchini or kale chips instead of potato chips

Grain foods:

  • Replace white bread/rice/pasta/cereal/muesli bars with whole-grain options
  • Know the labels in the ingredient lists: look for “whole wheat”, “brown rice”, “bulgur”, “buckwheat”, “oatmeal”, “whole-grain cornmeal”, “whole oats”, “whole rye” or “wild rice”
  • Add barley into your soups, stews, salads, casseroles
  • Use quinoa as a coating instead of breadcrumbs

General tips:

  • Instead of having one food that links with one food group, you could have something that includes a variety of food groups within one dish. For example, you could have 1/2 serving of fruit and 1 serving of grain by having a blueberry bran muffin
  • Keeping track of what you eat every day can help you eat more mindfully
  • Scroll to the bottom of the page for some examples of foods for each food group

Important minerals

Iron

Iron carries oxygen throughout the body, giving cells the energy to function and keep your body moving. Lack of iron will make you feel tired and exhausted during pregnancy and while breastfeeding.

Animal products provide the best-used iron, with red meat the richest source. Others include chicken, fish and eggs. If you do not eat meat you need to eat larger amounts of other iron-containing foods, such as tofu, whole-grain bread, nuts, seeds, dried beans, peas or lentils. Eating two or more servings of these foods each day will help you meet your iron needs. To help increase the amount of iron used from these foods, have something rich in Vitamin C at the same time, such as capsicum, tomato or fruit juice. Tea and coffee may reduce the amount of iron absorbed so avoid drinking these until about an hour after a meal, or have them between meals.

Calcium

Pregnant and breastfeeding women need extra calcium for their growing baby as well as to keep their own bones strong. Dairy foods are the best sources of calcium but if you don’t eat these, there are many other sources of calcium.

Calcium requirements during pregnancy and breastfeeding vary with age. Teenagers need more, as their own bones are still growing. An adult female will meet her needs by eating 2-3 servings of dairy products (or equivalent) each day, e.g. a glass of milk, a pottle of yoghurt and a slice of cheese. Teenagers need an extra serving. If you drink non-dairy milk check that it is enriched with calcium and vitamin B12.

Iodine

Iodine helps the baby to develop, especially the brain. Pregnant and breastfeeding women need more iodine as babies get iodines from their mothers.

Choose good sources of iodine such as low-fat milk and dairy products, eggs, fish and seafood. Most bread have iodised salt added. Although the seaweed in sushi is a good source of iodine, it is recommended that women avoid sushi during pregnancy. Choose iodised table salt for cooking.

Pregnant and breastfeeding women are recommended to take a daily iodine supplement of 150 micrograms from the start of their pregnancy until they stop breastfeeding, as well as eating foods rich in iodine. Avoid seaweed and kelp tablets as the levels of iodine they contain are extremely variable and can be high enough to be toxic. Women with pre-existing thyroid conditions should seek advice from their doctor before taking a supplement.

Important vitamins

Folic acid

Early pregnancy is a crucial time in a baby’s development, particularly for what is called the ‘neural tube’, which becomes the brain and spinal cord. This is formed in the first 27 days of pregnancy so that is why it is important to have a diet high in folate before (preconception) and during the early stages of pregnancy. Foods rich in folic acid include leafy green vegetables, fruit, wholegrain bread and cereals, yeast extracts, and foods fortified with folic acid (folate added in) , such as some breakfast cereals and bread.

In addition, women who are pregnant, or planning a pregnancy, are recommended to take a daily supplement of 800 mcg folic acid. This should be taken for at least one month before, and three months following, becoming pregnant. If the pregnancy was unplanned, take it as soon as possible.

A higher dosage of folic acid is recommended in any of these circumstances:

  • The woman has a neural tube defect
  • The woman has had a pregnancy affected by a neural tube defect, or a child or a close family member with a neural tube defect
  • Her partner is affected by or has a family history of neural tube defects
  • The woman is on insulin treatment for diabetes
  • The woman is taking medicines known to affect metabolism eg. anti-epileptics

Consult your doctor if you think it is relevant to you.

Vitamin A

While it’s important to get enough vitamin A, excessive levels of retinol (a form of vitamin A) during pregnancy are harmful to a developing baby. Liver (lamb’s fry), kidney, shellfish and some supplements are particularly high in retinol; limit liver to 100g once a week and do not take supplements containing vitamin A, including vitamin-A fish oils, unless advised by your doctor.

Vitamin B12

Vitamin B12 is essential for normal blood and nerve function. Women who are pregnant need enough B12 to meet their own needs and their baby’s needs to grow. B12 is only found in animal foods and fortified foods, so pregnant or breastfeeding women who follow vegan diets should consult the doctor for B12 supplements even if they are showing no signs of deficiency.

Vitamin D

Vitamin D helps the body to use calcium to build and maintain strong bones and teeth and helps with muscle function for you and your baby. The main source of Vitamin D is through exposing skin to sunlight and is difficult to achieve adequate intake with diet alone as only a few foods contain Vitamin D in New Zealand (oily fish, fortified foods, full-fat milk and butter, egg yolk). A woman may be at a higher risk of being Vitamin D deficient in any of these circumstances:

  • They have darker skin
  • They completely avoid sun exposure for religious, personal or medicinal reasons
  • She has liver or kidney disease or is on certain medications that affect Vitamin D levels

Women at risk of Vitamin D deficiency should consult a doctor for advice on supplements. 

Food safety

Keeping food safe from contaminants is extremely important while you are pregnant or breastfeeding. Food poisoning can affect both yourself and your baby.  If you experience diarrhea, vomiting, or flu-like illness it is important to contact your doctor or midwife immediately.

Here are some tips on handling food safely:

  • Always cook eggs until the yolk and white are solid.  Avoid undercooked or raw eggs and other raw animal products
  • Avoid buying pre-prepared sandwiches and salads from delis or supermarkets. Freshly made homemade sandwiches are the best option.
  • Avoid foods containing raw fish, shellfish, or seafood, such as sushi
  • Wash and dry fruit and vegetables before you eat them
  • Store chilled foods in a fridge below 4°C and always heat food thoroughly until it’s steaming hot, i.e. at least 70°C.
  • Avoid soft cheeses (such as brie and camembert) and unpasteurised milk

Click here to read the Ministry of Primary Industry’s guidelines for food safety during pregnancy.

Alcohol

There is no known safe level for drinking alcohol during pregnancy, as it enters a baby’s bloodstream, where it can affect development. Fetal Alcohol Spectrum Disorder (FASD) describes a spectrum of varied disabilities that can result when a developing baby is exposed to alcohol during pregnancy. The Ministry of Health strongly recommends pregnant women avoid drinking alcohol, including those who are planning a pregnancy. Breastfeeding mothers are encouraged to avoid alcohol, especially during the first month. Note that, unless you’re doing it for comfort reasons, there’s not much point in expressing breastmilk and throwing it out (otherwise known as pumping and dumping). To learn more about breastfeeding and alcohol, visit Plunket’s webpage.

For more info on pregnancy and alcohol, visit Alcohol NZ | FAQ webpage

For more advice on FASD, visit the Ministry of Health | FASD webpage

Caffeine

Pregnant women are advised to limit the amount of caffeine they consume each day to around 2 cups of coffee (<200mg caffeine), as pregnancy slows down the rate that caffeine is metabolised.  High caffeine levels have been linked to low birth weight and reduced fertility in women trying to conceive,  The caffeine content of drinks varies. Whatever you choose, be aware caffeine is a stimulant and can contribute to indigestion as well as keep you awake at night.

Drink/Food

Average Caffeine Content (mg)

Flat white (double-shot)160
Coffee (cappuccino) (260ml)105
Energy drinks (250 ml can)80-120

Instant Coffee (1 cup)

51
Black tea (1 cup)47
Cola drinks (355ml can)35
Chocolate bar (50g)33
Green tea (1 cup)31
Decaffeinated long black coffee (130ml)19
Drinking chocolate (1 cup)5

Reference: NZ Food Composition Database & FSANZ

Drinks to avoid: 

  • Energy drinks
  • Some herbal teas – aloe, buckthorn bark, chamomile, coltsfoot, comfrey, juniper berries, labrador tea, lobelia, pennyroyal, sassafras, senna leaves
  • Fermented drinks (can contain low levels of alcohol)
  • Sugary drinks

Fluid

Plain water should be your first choice over other drinks, as in most cases it is exactly what the body needs! You need more water when you are pregnant or breastfeeding as your blood volume increases during pregnancy and you need fluids to produce breast milk.

Amount of fluid you need:

  • 2.3L per day if you are pregnant (9x 250ml cups)
  • 2.6L per day if you are breastfeeding (10 x 250ml cups)

Keep in mind that these are broad guidelines, and will vary depending on the climate, your body size, and activity levels. The best way to ensure you are drinking enough is to listen to your thirst cues and aim for the color of your urine (pee) to be pale yellow.  It may help to keep a water bottle with you at all times so you can remember to keep hydrated.

Examples of food group servings

Vegetables 

A standard serving of vegetables is about 75g (100-350kj) which is about the same as:

  • ½ cup cooked vegetables (eg puha, watercress, silverbeet, kamokamo, carrot, broccoli, bok choy, cabbage, taro leaves)
  • ½ cup canned vegetables (eg beetroot, tomato, sweet corn)
  • 1 cup green leafy or raw salad vegetables
  • ½ medium potato or kumara, taewa, yam, taro, cassava
  • 1 medium tomato

Fruits 

A standard serving of fruit is about 150g (350kj) which is about the same as:

  • 1 medium apple, banana, orange, or pear
  • 2 small apricots, kiwifruits, plums
  • 1 cup diced or canned fruit (drained and with no added sugar) eg pineapple, papaya
  • 1 cup frozen fruit eg mango, berries

Grain foods, mostly wholegrain and those naturally high in fibre 

A standard serving (500kj) is about the same as:

  • 1 slice whole-grain bread
  • ½ medium wholegrain roll or flatbread
  • ½ cup cooked rice, pasta, noodles, barley, buckwheat, semolina, polenta, bulgur or quinoa
  • ½ cup cooked porridge
  • ¼ cup muesli
  • 2 breakfast wheat biscuits
  • ⅔ cup cereal flakes (wholegrain where possible)
  • 3 crispbreads or crackers (wholegrain where possible)

Milk and milk products, mostly low and reduced fat 

A standard serving (500-600kj) is about the same as

  • 1 cup low or reduced-fat fresh, UHT long life, reconstituted powdered milk or buttermilk
  • 2 slices or a 4cm x 3cm x 2cm piece of cheese such as Edam
  • ¾ cup low or reduced-fat yoghurt
  • 1 cup calcium-fortified plant-based milk alternatives (eg soy, rice, almond, oat milk) (with at least 100 mg of added calcium per 100ml)

Legumes, nuts, seeds, fish and other seafood, eggs, poultry, and/or red meat with the fat removed 

A standard serving (500-600kj) is about the same as

  • 1 cup cooked or canned beans, lentils, chickpeas, or split peas (preferably with no added salt)
  • 170g tofu
  • 30g nuts, seeds, peanut or almond butter, tahini or other nut or seed paste
  • 100g cooked fish fillet (about 115g raw) or one small can of fish
  • 2 large eggs
  • 80g cooked lean chicken (100g raw)
  • 65g cooked lean meat such as beef, lamb, pork, or veal (90-100g raw) – no more than 500g cooked red meat each week.

Last modified: June 20, 2022