As a dedicated nutritionist specializing in pre and postnatal care, Alyssa Cellini, owner of My Custom Nutrition,brings a wealth of knowledge and a specialized approach to guiding mothers through the transformative phases of pregnancy and beyond. Join us for an engaging Q&A session with Alyssa as we navigate the intricacies of nourishing both body and soul during this remarkable chapter of life. Let’s dive in!
1. What are the key nutrients that pregnant women should focus on to support both their own health and the healthy development of their baby?
a. It’s important to consume sufficient protein, fiber-rich carbohydrates to balance blood sugar, and be well hydrated. Regarding vitamins, it’s essential to get extra folate, DHA (omega-3), and minerals like calcium, magnesium, vitamin D and iron. Your body has a higher demand for these vitamins and minerals while pregnant so you often need to supplement.
2. Are there any specific foods that pregnant women should avoid or limit during pregnancy, and if so, why?
a. It’s key to avoid things that contain harmful bacteria when spoiled, which could make mom sick. Also, you want to limit foods with added nitrates and known to have heavy metal contaminants. In general, this means avoiding deli meat, tuna or other big fish, and soft-mold ripened cheese like brie and chevre. You should also avoid artificial sweeteners like sucralose (Splenda) and aspartame (Equal) that are in “diet” or “sugar free” drinks.
a. In the first trimester, it's key to have sufficient FOLATE, vitamin D, B6 and start DHA (omega 3). Your prenatal will likely contain all of these but I like to supplement with extra Vitamin D, B6 and DHA. Regarding food, there is no reason to increase calories by a certain amount. Listen to your body and eat nutritious meals when hungry. Also, stop any teas (black tea, echinacea, green tea, etc) that could sway your TH1/TH2 immune balance.
b. In the second trimester, pay attention to your iron levels in labwork and consume more iron if necessary. Most women will need more iron, but I've worked with many patients with Thalassemia making their CBC less reliable in determining iron status, so be sure to request TIBC in labwork if you’re unsure. Iron has better absorption when taken with Vitamin C so if you are craving red meat, have it with a fresh tomato salad. Keep your FOLATE, VITAMIN D, and DHA in place. B6 is optional now as it aids nausea and energy in the first trimester. Your prenatal has minerals but if you notice leg cramps or eye twitching, consider adding more MAGNESIUM; eye twitching is a sign of low magnesium. Be sure you're consuming at least 90g protein per day.
c. In the third trimester, keep the same protocol in place while being sure not to skip your DHA and get extra choline by eating more eggs. Most women notice they feel better taking Iron more often (3x week) in the third trimester. Your magnesium intake should also go up as you will likely notice you’re more prone to minor muscle cramps.
4. Are there any common misconceptions about prenatal nutrition that you often encounter, and what are the correct recommendations?
a. The first thing I tell my happy clients is that you don’t need to eat for 2 right away. Assuming you consumed at least 1200 calories/day before pregnancy, you should listen to hunger cues.
b. Second, you should eat nutritious food but don’t assume it to be the main source of your necessary vitamins. You need to supplement with quality vitamins to get the nutrients needed.
c. Third, many people assume nuts and lentils are proteins. These may contribute to your protein intake but they are much higher in fats or starch so I categorize them as such. Nuts are 80% fat by calories and lentils are 70% carbohydrate. Think of these as contributors, but not key sources of protein
5. What are some strategies for managing common pregnancy-related symptoms such as nausea, heartburn, and constipation through dietary choices?
a. Nausea can be eased with ginger and sufficient B6 (check your prenatal and consider adding extra B6 with your first meal of the day)
b. Heartburn- avoid known triggers (marinara, spicy foods) and take a PROBIOTIC (with multiple strains from bifido, lacto species as well as Sacch. Boulardii)
c. Constipation- get enough water (80+ oz/day), avoid frequent salads, eat cooked veggies, and consume high-fiber starches (quinoa, lentils, chickpea pasta).
6. How does maternal nutrition during pregnancy impact the long-term health outcomes of both the mother and the child?
a. What mom eats, baby gets, but think about it in terms of vitamins. Eating fruit while pregnant won’t make your baby love fruit. If your diet is deficient in essential vitamins/co-factors/aminos/fatty-acids, it could affect the child’s growth and health development. Studies have shown that omega-3 DHA is essential to baby brain development. Folate is essential for fetal development.
7. Are there any dietary supplements that pregnant women should consider taking, in addition to a balanced diet? If so, which ones and why?a. Definitely. We do not get sufficient vitamins in our food. I prefer a prenatal that is split into 2-a-day or 4-a-day. I also prefer prenatals that contain the active MTHF form of folate and avoid those with synthetic folic acid. Many people have MTHFR genetic mutations and are not aware which means they cannot convert folic acid into the active form of folate. Folate is extra important when pregnant. A fish-oil with higher DHA is key for brain development. Fishoil should be from a reputable source/company to avoid contamination with heavy metals. I like Designs For Health and Nordic naturals brands of DHA. If you have low-normal iron levels (in your labs) I suggest taking a chelated iron supplement but not every day; this depends on the specifics of your labs but typically IRON helps when taken once/week. Ask your doctor to test your vitamin D levels. If you are below 40, I would supplement with 2000IU Vit D every day to avoid immune system irregularities. If prone to muscle cramps, take 300mg magnesium glycinate every day. If constipated, take 300-500mg Magnesium Citrate in the evening. These are mild signs of deficiency so you’re easing symptoms but also addressing deficiencies.
8. What role does hydration play in prenatal nutrition, and are there any specific recommendations for staying adequately hydrated during pregnancy?
a. Proper hydration assures that you’re not misinterpreting symptoms of dehydration with more serious symptoms. Dehydration causes weakness, fatigue, slow toxin elimination and headaches. Everyone is different, but for people who drink a ton of water every day and still feel thirsty, I recommend salting your food and or spiking water with a clean electrolyte like LMNT.
9. How can pregnant women ensure they are getting enough protein, iron, calcium, and other essential nutrients in their diet, especially if they have dietary restrictions or preferences?
a. Regardless of dietary preferences, supplements tend to be necessary when pregnant. Your prenatal will cover the basics but because some people should not take iron, you may need to supplement that based on labwork results. Protein sources are mainly animal foods, which requires strategy for those who avoid meat, poultry and eggs.
b. My pescatarians lean on COD (low in mercury), eggs, Greek yogurt, cottage cheese and protein-pastas like BANZA. My vegan clients use COCONUT MILK YOGURT and spike it with 20g pea protein powder. They also use protein-pastas like banza and choose starches with some protein (like lentils).
c. Vegans also rely on more protein shakes than non-vegans because their protein options are so limited. Note that lentils and quinoa do not supply sufficient protein alone, lentils have a 2:1 ratio of carbs:protein; so you’ll get 60g carb for every 30g protein and an ideal meal has 45g carbohydrate or less, along with 30+grams protein.
10. What advice do you have for new mothers regarding postnatal nutrition, particularly in terms of supporting recovery, breastfeeding, and managing energy levels during the postpartum period?
a. The fourth trimester is all about your body recovering even without sufficient sleep. It’s amazing what our bodies can do- so support yourself by avoiding dehydration and caloric restriction. When you cook a meal, make extra servings to provide leftovers. Keep fruits, nut butter and crackers around the house because they will provide easy carbohydrates and fats which stabilize blood sugar when eaten together. Many moms need to take IRON for a few weeks after delivery, ask your doctor to test your TIBC (detailed iron in labs) to confirm your iron isn’t low at your 6 week check up. This can be an easy solution for fatigue if you’re deficient in iron. Get outside for walks as often as you can. The movement will help your body recover and keep the lymphatic system flowing. The sunlight will aid energy and mood. I have found that breast milk production is highly related to mama’s dietary fat intake + hydration. With that said, embrace fats like avocados, olive oil, full fat yogurts, nut butters and a good mayonnaise if you like it. Veggies are great for fiber and satiety, but they will not help you with sufficient calories, protein or fat intake. Lastly, continue to take your prenatal and DHA fish oil throughout nursing, as the baby needs those vitamins and DHA for brain development.
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