Staying healthy during your pregnancy Nutrition A healthy well balanced diet during pregnancy will help to keep a developing baby and the mother healthy. Eating a wide variety of healthy foods will ensure essential nutritional needs are met. These include: lots of vegetables wholegrain breads and cereals moderate amounts of low fat dairy foods like milk, hard cheese and yoghurt lean meat, chicken, fish and non-meat alternatives such as dried beans, lentils and eggs (cooked) nuts and seeds Avoid large meals and ideally spread your total intake across the day – breakfast, morning tea, lunch, afternoon tea, dinner, supper. Avoid sweetened, fizzy drinks and fruit juices; take-away food; chocolate and ice-cream. For more information about diet in pregnancy and healthy eating for your child, go to the Australian Government Department of Health's website Pregnancy, birth and baby pages Healthy diet during pregnancy and Healthy eating for your child. Weight gain ‘Eating for two’ in pregnancy is a myth and is neither good for the mother or the baby. In reality a pregnant woman only needs a little more energy (kilojoules) than before she was pregnant. Weight gain during pregnancy will vary and evidence now suggests the amount of weight you gain should be guided by your pre-pregnancy body mass index (BMI). How much weight you gain during your pregnancy may affect your own health. In addition, evidence now suggests that women who gain too much weight during pregnancy are more likely to have an overweight or obese child. This may also result in a greater risk of them developing diabetes and heart diseases as an adult. Weight gain in pregnancy is based on a woman’s body mass index (BMI). To calculate your BMI, divide your weight (in Kg) by your height squared (in m). For example, a woman weighing 75 kg and is 1.7 metres tall will calculate her BMI as 75 / (1.7 x 1.7) = 25.95. Some women lose weight in the first trimester due to nausea and vomiting. Recommended weight gain in pregnancy: Pre-pregnancy BMI Total weight gain range Average weight gain kg/week from 24 weeks pregnancy Underweight <18.5 12.5-18.0 0.5 Healthy weight 18.5- 24.9 11.5-16 0.4 Overweight 25-29.9 7-11.5 0.3 Obese >30 5-9 0.2 Keeping your weight well-controlled has benefits for both you and the baby during pregnancy and afterwards. Some women who are overweight may choose to put on minimal weight during a pregnancy. By the time of the birth, just over a third of your extra weight will come from your baby, the placenta and amniotic fluid. The other two thirds is a result of changes that happen to your body during pregnancy. These include: the muscle layer of the uterus grows dramatically blood volume increases extra fluid breasts are heavier more fat stores to give you energy for breastfeeding Physical activity Pregnant women without complications should aim to do at least 150 minutes of moderate intensity physical activity spread throughout the week, for example, 30 minutes most days a week. For women who are not usually physically active, 10–15 minutes of daily activity can be gradually increased to 30 minutes a day. It is important to stay well hydrated, wear comfortable and non-restrictive clothing (such as a correctly fitted bra and appropriate footwear) and where possible, avoid excessive over-heating. Walking, swimming, yoga, Pilates, and muscle strengthening exercises are good forms of physical activity. Folic acid Australian guidelines recommend that women of childbearing age take 0.5mg of folic acid supplement daily for at least one month before pregnancy and three months into the pregnancy. This helps prevent neural tube defects (NTD), such as spina bifida. Women who are at high risk of having a baby with an NTD should seek medical advice as may be advised to take ten times the minimal dose (5mg). Iodine It is also recommended that all women who are pregnant, breastfeeding or considering pregnancy should take an iodine supplement of 150 micrograms (μg) each day. Medical problems Women with pre-existing thyroid conditions, diabetes, epilepsy or other long term medical problems should seek advice from their medical practitioner to review their medication and seek advice prior to taking a supplement. Recommended immunisations in pregnancy Influenza - Pregnant women fare less well in pregnancy if they develop influenza and the injection is recommended for all women during the ‘flu' season to offer some protection. Whooping cough - Whooping cough (also known as pertussis) is a highly infectious bacterial disease that causes severe bouts of coughing. In adults, the symptoms can be mild, but if the infection is spread to a baby who is not yet vaccinated, it can be life threatening. A whooping cough combination vaccine including tetanus and diphtheria protection is recommended to be given in the third trimester of every pregnancy, ideally between 28 and 32 weeks gestation, but it can be given up until delivery.This allows your body produces antibodies that get passed on to your baby before birth. These antibodies will protect your baby until they are ready to receive their own vaccinations at 6 weeks of age. Studies have found that whooping cough vaccination during pregnancy is safe and effective for both the mother and baby. This vaccination is currently free for all women in their third trimester of pregnancy. Breastfeeding also provides some additional protection for newborns as antibodies from the milk are passed on to baby. For more information, go to the Queensland Government immunisation information page Pregnant and breastfeeding women. Smoking Smoking is not advised during pregnancy and it is best to stop smoking several months before becoming pregnant. By stopping smoking you are more likely to conceive naturally and more quickly and have less risk of having a miscarriage or delivering your baby prematurely. Smoking during pregnancy also may cause having a low-weight baby, a pre-term delivery and the baby being born with health problems. For more information, go to the Queensland Government site Smoking and pregnancy and the New South Wales Government site Smoking and Pregnancy. Alcohol While the risk of low level alcohol consumption during pregnancy is small, no safe limit can be identified. Therefore the Australian guidelines advise that not drinking is the safest option for women who are pregnant or planning a pregnancy. Alcohol crosses the placenta to the growing baby and can affect your pregnancy. Drinking alcohol during pregnancy can cause: miscarriage premature labour small babies who get sick easily slow growth and development stillbirth Drinking alcohol during your pregnancy raises the risks of birth defects, learning difficulties and behaviour problems for your baby. More about alcohol and drug use in pregnancy can be found at the Pregnancy, birth and baby page Alcohol, drugs and medicine during pregnancy. Domestic Violence - Abuse Domestic and family violence can include physical, verbal, emotional, sexual and psychological abuse. Stalking, isolation, threats, monitoring and controlling behaviours are also harmful. If you or someone you know is experiencing any of these, call 1800 811 811 or go to the Queensland Government's Domestic Violence information site, Trust your instinct, for confidential domestic violence support and advice or go to the Domestic Violence Prevention Centre website for more information.