Eating well and doing moderate exercise during pregnancy is important for you and your baby. Seek antenatal care as soon as you suspect you are pregnant. Some pregnant women will have special nutritional needs. Ask your doctor or midwife to arrange for you to see a dietitian. It is best to seek advice if you: Are an adolescent (18 years or younger) Have a medical condition affecting your eating, such as diabetes Are having more than one baby, eg, twins or triplets Are a vegetarian or vegan

Eat A Variety Of Foods

You need a variety of foods from the four food groups every day to provide for your growing baby as well as to maintain your own health.

Vegetables and Fruit

• Eat plenty of vegetables and fruit.

• Vegetables and fruit provide carbohydrates (sugar and starch), fibre, vitamins and minerals, and are low in fat.

• Enjoy well washed, fresh, frozen or canned vegetables, and fruits which are raw or lightly cooked.

• Limit juice and dried fruit intake because these foods have a high sugar content.

Vegetables

• 1 medium potato, kumara or similar sized root vegetables such as yam or taro (135g)

• ½ cup cooked vegetables, eg, puha, watercress, parengo (go easy on butter and margarine), or corn (50-80g)

• ½ cup salad (60g)

• 1 tomato (80g)

• 1 apple, pear, banana or orange (130g)

• 2 small apricots or plums (100g)

• ½ cup fresh fruit salad (120g)

• ½ cup stewed fruit (135g)

• 1 cup fruit juice (250ml)

• 25g dried fruit, eg, 2 tablespoons of raisins or 3 dates

• Eat plenty of breads and cereals - including rice, pasta, breakfast cereals and other grain products.

• These provide carbohydrates, fibre and other nutrients.

• Choose wholemeal and wholegrain varieties which provide extra fibre (to help prevent constipation), B vitamins and minerals.

• 1 roll (50g)

• 1 muffin (80g)

• 1 medium slice rewena bread

• 1 medium slice of bread (26g)

• 1 cup cornflakes (30g)

• ½ cup muesli (55g)

• ½ cup cooked cereal (130g)

• 1 cup cooked pasta (150g)

• 1 cup cooked rice (150g)

• 1 cup cassava or tapioca (150g)

• 2 plain sweet biscuits (14g)

• Choose reduced or low fat milk, yoghurt and cheese.

• If you are drinking soy milk, choose one which is calcium fortified (check the label)

• Other foods such as wholemeal bread, peanuts, broccoli, canned salmon, sardines, spinach, baked beans and tofu contain calcium, but in lower amounts.

• 1 glass milk (250ml)

• 1 pottle yoghurt (150g)

• 2 slices cheese (40g)

• 2 scoops ice cream (140g)

• Your body needs more iron and zinc during pregnancy.

• Care must be taken with these foods. Lean meats, chicken and seafood need to be fresh and well cooked (see Listeria section).

• Choose lean meats, chicken and seafood.

• Iron in lean meats, chicken and seafood is well absorbed. Cooked dried beans, peas and lentils also contain iron but this is not so well used.

• Include foods rich in Vitamin C with your meals to help absorb iron. Fresh vegetables and fruit, especially oranges, kiwifruit, tomatoes and broccoli are rich sources of Vitamin C.

• 2 slices cooked meat (approx 100g)

• ¾ cup mince or casserole (195g)

• 1 egg (50g)

• 1 medium fillet of fish - cooked (100g)

• 1 medium steak (120g)

• ¾ cup dried, cooked beans (135g)

• 2 drumsticks or 1 chicken leg (110g)

Keep Active and Eat for a Steady Weight Gain

In early pregnancy your energy (kilojoule or calorie) needs to increase by a small amount. You can expect to eat more food as the pregnancy progresses but this does not mean you need to "eat for two".

A good indicator of whether you are eating enough is appetite and a steady weight gain, especially after the first three months. A healthy weight gain during pregnancy is best for you and your baby.

While there is no exact healthy weight gain, thin women may need to gain more weight, overweight women less. Talk to your midwife or doctor if you are concerned about your weight gain.

Dieting during pregnancy is not recommended as it may result in a smaller and unhealthy baby, and it could also affect your health. Vigorous exercise is also not recommended.

The weight you gain during pregnancy goes to the baby, but also includes:

• The growth of the placenta and uterus

• Fluid around the baby

• Breasts getting bigger for breastfeeding

• More blood being made

• Fat stores which will be needed as energy for breastfeeding.

• Spreading margarine and butter thinly.

• Choosing lean meats. Trim off the fat, skim fat off stews, remove skin from chicken and eat more grilled, boiled or steamed fish.

• When cooking: grill, steam, microwave, boil or bake foods without adding fat, as often as possible.

• Eating meals without adding extra salt.

• Choosing foods with no added sugar.

• Sandwiches - peanut butter, banana, vegemite, cheese, cottage cheese, baked beans or jam. Spread margarine or butter thinly or only on one side of the bread. Use bread rolls, rewena bread, crackers, rice cakes, crumpets, pita bread, muffins and baked bread fingers as well as bread.

• Vegetable sticks - keep these in the fridge. Serve with cottage cheese or peanut butter.

• Fresh fruit - serve whole or cut up with yoghurt.

• Frozen fruit - bananas, oranges, canned unsweetened pineapple or peaches.

• Cereals - choose cereals low in fat and sugar.

• Popcorn - pop using a little oil, margarine or butter or use a microwave. Go easy on salt.

• Yoghurt, cubes of cheese or milk.

Nausea and vomiting are common during early pregnancy and this is often the first sign of being pregnant. This is referred to as "morning sickness" but may occur at any time of the day or night, especially when you are tired or hungry.

Do the best you can. Your extra nutrient needs are small during early pregnancy and this rarely causes any nutritional problems. However, if your vomiting is severe and you are unable to keep any food or fluids down, do seek advice from your doctor or midwife.

• Eat regularly, choosing smaller meals or snacks.

• Have less high fat and spicy foods.

• Try a carbohydrate snack (such as a slice of dry toast, a cracker or fruit) before getting out of bed in the morning.

• Drink small sips of flat lemonade or ginger ale.

• Try ginger, or foods flavoured with ginger.

• Give yourself extra time in the morning. Rushing can make you feel worse.

• Try and rest more.

• If cooking smells make you feel sick, cut down on cooking as much as you can. Have someone else help with cooking. Indigestion and heartburn are common towards the end of pregnancy.

• Eat regularly choosing smaller meals or snacks.

• Have less high fat and spicy foods.

• Avoid drinking fluids with meals.

• If a certain food upsets you, leave it for the time being.

• Avoid lying down straight after a meal.

• Going for a walk may help.

• Raise the head of the bed or use extra pillows.

• Check with your doctor or mid-wife before taking antacids.

• Choose wholemeal and wholegrain breads and cereals, and vegetables and fruit, for example, bran muffins, kiwifruit, figs, corn and peas.

• Drink plenty of fluid every day.

• Go for a daily walk or exercise in some other way.

• Well washed, fresh, raw or lightly cooked vegetables

• Well washed raw fruit

• Bread and cereals, especially wholegrain

• Cooked dried beans and peas

• Yeast extracts

• Freshly cooked liver and kidney, no more than one serving a week.

• Keeping cooked foods and ready to eat foods separate from raw and unprocessed foods, so there is no cross contamination

• Eating freshly cooked food as soon as possible after cooking

• Using cooked or prepared food, that has been stored in the fridge, within two days

• Re-heating cooked food thoroughly so that it is “piping hot”, ie, above 70C. Take special care to heat thoroughly when using microwave ovens

• Washing raw fruit and vegetables thoroughly

• Washing your hands and utensils and chopping boards before using for a different food - avoid cross contamination.

• Smoked fish, pre-cooked fish and uncooked fish or seafood products that are chilled or frozen (unless reheated thoroughly and eaten hot)

• Paté

• Cold pre-cooked chicken

• Ham and other chilled pre-cooked meat products

• Stored salads and coleslaws

• Raw (unpasteurised) milk

• Surface-ripened soft cheese (eg. brie, camembert).

You and your infant are entitled to receive free Well Child care in accordance with the Well Child Tamariki Ora National Programme. This includes advice and support with your own and your infant's nutrition requirements.

This programme is delivered from conception to 2-6 weeks after the birth of your infant by your Lead Maternity Carer (an obstetrician, midwife or general practitioner). From 2-6 weeks onwards your Well Child provider (Plunket, public health service, Maori or Pacific provider) will provide this care.

Talk to your Lead Maternity Carer or Well Child provider about other information you want to know.

Other organisations for information

• Plunket Help Line, 0800-933 922

• Lactation Consultant (IBCLC)

• La Leche League for breastfeeding support and information

• NZ Multiple Birth Association, PO Box 1258, Wellington

• Parents’ Centre