Session 2: Week 14 – We made it! Bring on 2nd Trimester!

AFP (Alpha- Fetorprotein test) Drawn between 15-20 weeks gestation, detects some chromosomal or brain and spinal cord defects in the fetus. It is not required. You will have received a brochure about this test at your first visit.

Choosing healthy foods

(Note: All of the nutrition information below is courtesy of the March of Dimes.)

How much should you eat each day when you're pregnant? The farther along you are in your pregnancy, the more food you need from certain food groups. The food guidelines below are general. Talk to your provider about what's right for you.

You only need about 300 extra calories each day to support your baby's growth.

Grains. Eat 6 ounces per day in the first trimester, 7 ounces in the second trimester and 8 ounces in the third trimester. Make half of your grains each day whole grains.

EXAMPLE: 1 ounce of grains is equal to:

• 1 slice bread
• 1 cup ready-to-eat cereal
• 1/2 cup cooked rice, pasta or cereal
• 1 small pancake (4 1/2 inches in diameter)

Vegetables. Eat 2 1/2 cups per day in the first trimester and 3 cups per day in the second and third trimesters.

EXAMPLE: 1 cup of raw vegetables is equal to:

• 1 cup raw or cooked vegetables
• 1 cup vegetable juice
• 2 cups raw, leafy greens
• 1 medium baked potato (2 1/2 to 3 inches in diameter)

Fruits. Eat 1/2 to 2 cups per day in the first trimester and 2 cups per day in the second and third trimesters.

EXAMPLE: 1/2 cup of fruit is equal to:

• 1/2 cup 100 percent fruit juice
• 1/2 cup fresh, frozen or canned fruit
• half a fruit (small orange, apple or banana)
• 16 grapes

Dairy products. Eat 3 cups per day all throughout pregnancy. Low-fat or skim is best.

EXAMPLE: 1 cup of dairy is equal to:

• 1 cup milk
• 1 cup yogurt
• 2 small slices of cheese
• 1/3 cup shredded cheese

Proteins. Eat 5 ounces per day in the first trimester, 6 ounces in the second trimester and 6 1/2 in the third trimester.

EXAMPLE: 1 ounce of protein is equal to:

• 1 tablespoon peanut butter
• 1/4 cup cooked beans
• 1 ounce lean meat, poultry or fish
• 1 egg
• 1/2 ounce nuts (12 almonds or 24 pistachios)

Here are some easy ways to help you remember serving sizes:

1 cup is about the size of a baseball

½ cup is about the size of a tennis ball

¼ cup is about the size of a golf ball

3 ounces is about the size of a deck of cards

1 ounce is about the size of four dice

2 tablespoons is about the size of a ping pong ball

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Plan your meals

• Make half your plate fruits and vegetables
• Make sure your whole meal fits on the plate. Don’t make huge portions
• Put as much color on your plate as you can with all different kinds of veggies and fruits.
• Choose whole grains like wheat bread or pasta, lean meats like chicken fish and pork
• Low-fat or skim milk
• Limit sweets salty snacks and fatty foods

What nutrients do you need during pregnancy?

Here's what you need to know about six nutrients that can help you and your baby be healthy:

Folic acid. Folic acid is a B vitamin that every cell in your body needs for growth and development. If you take it before and during pregnancy, it can help prevent birth defects of the brain and spine called neural tube defects. During pregnancy, take a prenatal vitamin each day that has 600 micrograms of folic acid in it. If you're not pregnant yet, take a multivitamin each day that has 400 micrograms of folic acid. Most women don't need more than 1,000 micrograms of folic acid each day, so talk to your provider to make sure you get the right amount.

Good food sources:

• Leafy green vegetables like spinach and broccoli
• Lentils and beans
• Cereal, bread, pasta and corn masa products, like tortillas and taco shells that have folic acid added to them
• Orange juice

Iron. Iron helps keep your blood healthy. You need more iron when you're pregnant because your body makes more blood. During pregnancy, you need 27 milligrams of iron each day. Most prenatal vitamins have this amount. You also can get iron from food.

Good food sources:

• Lean meat, poultry and seafood
• Cereal, bread and pasta that has iron added to it 
• Leafy green vegetables 
• Beans, nuts, raisins and dried fruit

Calcium. You need calcium during pregnancy to help your baby's bones, heart, muscles and nerves develop. If you don't get enough, your body takes it from your bones and gives it to your baby. During pregnancy, you need 1,000 milligrams of calcium each day. You can get this amount by taking your prenatal vitamin and eating food that has calcium in it.

Good food sources:

• Milk, cheese and yogurt
• Broccoli and kale
• Orange juice that has calcium added to it 

Vitamin D. Vitamin D helps your body absorb calcium. Your baby needs vitamin D to help his bones and teeth grow. During pregnancy, you need 600 IU (international units) of vitamin D each day. You can get this amount from food or your prenatal vitamin.

Good food sources

• Fatty fish like salmon
• Milk and cereal that has vitamin D added to it 

DHA (docosahexaenoic acid). DHA is a kind of fat called omega-3 fatty acid. During pregnancy, you need 200 milligrams of DHA each day to help your baby's brain and eyes develop. Not all prenatal vitamins contain DHA, so ask your provider if you need to take a DHA supplement. You also can eat foods that have DHA in them.

Good food sources

• Herring, salmon, trout, anchovies, and halibut
• Orange juice, milk and eggs that have DHA added to them

lodine. This is a mineral that your body needs to make thyroid hormones that help your baby's bones and nerves develop. During pregnancy, you need 220 micrograms of iodine each day. Not all prenatal vitamins contain iodine, so make sure you eat foods that have iodine in them. Ask your provider if you need to take an iodine supplement.

Good food sources:

• Fish 
• Milk, cheese and yogurt 
• Enriched or fortified cereal and bread

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Goals in Weight Gain

The World Health Organization and National Institutes of Health define weight in terms of Body Mass Index or BMI. This is based on height and weight. How much you gain during the pregnancy depends on your BMI before pregnancy.

My pre-pregnancy BMI is:                                                                                     

My target weight should be:                                                                                

By keeping weight gain within these guidelines, complications such as pre- eclampsia, gestational diabetes, large babies and cesarean delivery may all be avoided. If your BMI is >34 and you would like nutritional counseling, let us know.

• Normal Weight: BMI of 18.5 - 24.9. Pounds to add during pregnancy? 25-35
• Overweight: BMI of 25 - 29.9. Pounds to add during pregnancy? 15-25
• Class I Obesity: BMI of 30 - 34.9. Pounds to add during pregnancy? 10-25
• Class II Obesity: BMI of 35 - 39.9. Pounds to add during pregnancy?  9-10.
• Class III Extreme Obesity: BMI of  >40. Lose 9 pounds during pregnancy.

• Soft cheeses, such as Brie Camembert, blue vein cheese, feta or Mexican-style cheese. Only eat cheeses that are labeled pasteurized.
• Avoid unpasteurized milk or dairy products.
• Do not eat unrefrigerated smoked seafood, such as salmon, trout, white cod or tuna unless it is an ingredient in a cooked dish.
• Do not eat unrefrigerated patés or meat spreads (canned or shelf stable may be eaten).
• Eat hot dogs and deli meats with caution.
• Do not eat raw eggs.
• Eat peanuts/nuts in small amounts during pregnancy. Recent studies suggest this may help prevent peanut allergy in your child.

Women who are pregnant are at increased risk for domestic violence. Please review these screening questions and discuss with your provider during your one on one visit.

• Within the last year, have you been afraid of your partner or ex-partner?
• Within the last year, have you been humiliated or emotionally abused in other  ways by your partner or ex-partner?
• Within the last year, have you been kicked, hit, slapped, or otherwise physically hurt by your partner or ex-partner?
• Within the last year, have you been raped or forced to have any kind of sexual activity by your partner or ex-partner?

If you answered yes to any of these questions, please discuss with your provider, or contact the National Domestic Hotline or ACT