Dear Dr Mitchell,
Can you provide some guidelines about how and what pregnant women should and should not eat? It would be great if you could put this in a Caribbean context, particularly as it concerns the matter of what fish we are advised to eat and avoid.
An adequate nutrition in pregnancy is important since the growing foetus is directly supplied from nutrients that the mother consumes when these are digested and absorbed into the bloodstream. An adequate intake of important foods containing iron, vitamins and minerals is extremely important.
In the early stage of pregnancy, folic acid is important to reduce the risk of developing abnormalities in the brain and spinal cord of the developing foetus. It is preferred if women who plan to become pregnant start taking folic acid supplements before conception and continue this throughout pregnancy. The critical time is in the first eight weeks of pregnancy. Ideally, all pregnant women should eat a diet rich in green leafy vegetables and should take 5mg folic acid daily in the first trimester of pregnancy (first 14 weeks).
Pregnant mothers should eat at least three main meals for the day. Ideally, it should be three main meals and two to three snacks. All meals should have foods from the three main food groups (protein, carbohydrates and fats).
There are some foods that should be avoided in pregnancy. You should avoid seafood high in mercury. Seafood is a great source of protein and omega-3 fatty acids. This helps to promote proper brain development. Bigger and older fish contain high levels of mercury which can damage the brain and nervous system of the baby. Swordfish, shark, king mackerel and tile fish should be avoided in pregnancy.
Pregnant women can safely eat up to 12 ounces (340 grams) of canned tuna per week and eight to 12 ounces of seafood per week. This amounts to about two average meals of shrimp, crab, canned light tuna, salmon, pollock, catfish, cod or tilapia.
Pregnant women should avoid raw, undercooked or contaminated seafood. Raw shellfish and raw fish should be avoided. This includes oysters and clams. Refrigerated, smoked seafood should be avoided. Seafood should be cooked properly. Undercooked meat, poultry and eggs should be avoided. All meats and poultry should be fully cooked before eating. Hot dogs, processed meats such as bologna, should be cooked until they are steaming hot or should be avoided completely. Refrigerated pâté and meat spreads should be avoided but canned and shelf-stable versions are safe.
Raw poultry that has been pre-stuffed should not be bought since this can cause bacterial overgrowth. Frozen poultry that has been pre-stuffed is safe when cooked from its frozen state. Egg should be cooked until firm since raw eggs can be contaminated with the harmful bacteria salmonella.
Avoid foods made with raw or partially cooked eggs such as eggnog and Caesar salad dressing. Unpasteurised foods should be avoided. Low-fat dairy products such as skim milk, mozzarella cheese and cottage cheese are excellent sources of protein and calcium. Unwashed fruits and vegetables should be avoided. Avoid large quantities of vitamin A. Too much vitamin A can cause birth defects.
Pregnant women age 19 and older should get 2,565 international units of vitamin A daily. Beef liver and chicken liver have high vitamin A content. Excess caffeine should be avoided since this can cross the placenta and affect the baby's heart rate. There may also be an increased risk of miscarriage.
Herbal teas should be avoided as there is not enough information on the effects of specific herbs on the developing baby. Alcohol should be avoided entirely. Mothers who drink alcohol have a higher risk of miscarriage and stillborn babies. Foetal alcohol syndrome may result from excess alcohol consumption in pregnancy. This causes facial deformities, heart problems, mental retardation and low birth weight.
The diet that you consume in pregnancy will go a long way in determining the long-term health of your child in later life and so it is important to eat healthy and be safe.