Vegetarian diets during pregnancy. (Continuing Education)(Cover Story).

It has been our experience that an increasing number of our clients practice a vegetarian or vegan diet. For clarification, vegetarians do not eat meat; vegans also eliminate dairy products from their diet. This being the case, we have compiled the following findings for all of our expectant clients to enhance their knowledge about nutritional needs during pregnancy.

Some of the most important decisions you make during pregnancy are the choices in your eating habits. You may wonder whether or not you can continue your vegan diet. You will need to know what amounts of certain vitamins and nutrients you and your baby require and how to sort through all of the information that is available to you.

The following is a guideline to help you decipher all of the information. If you have questions, remember, every woman is an individual and you should contact your healthcare provider to find out how this information can specifically apply to you and your pregnancy.

When looking at your eating habits and deciding how they measure up to intake requirements for the expectant mother, the first thing we suggest to our clients is that they keep a food diary. Track eating habits for three days and then sit down and count items such as caloric intake, protein grams in the diet, vitamin rich foods ingested, and heavily processed foods including foods with "empty" calories. While a treat now and then is all right during pregnancy, it's important to make sure the calories you take in also include the vitamins and minerals that you and your growing baby need.

Protein provides structural elements for your body and for your baby's body. Protein assists in building your baby's tissues and organs. The current recommendation for protein in pregnancy is 60 grams a day. If you are a vegan, you may be concerned or hear concerns from those around you about getting enough protein during pregnancy. A simple way to add more protein to your diet is by eating more of the food that you are already eating. This might be easier if you were to eat six small meals a day instead of three large ones. Some good sources of protein for the vegan, or any pregnant mother, include soy products, beans and grains, tofu, and tempeh.

Folic acid has been receiving a lot of attention and you may have heard about it in the news recently. It has been found that folic acid in the diet can help to prevent neural tube defects in babies. It is now suggested that women of childbearing age take a folic acid supplement prior to pregnancy because the higher the blood folate levels in women when they conceive a baby, the less likely their babies will develop such defects. You should consult your healthcare provider regarding taking any supplements, but some great natural sources of folic acid are enriched breads, green leafy vegetables, dried beans, pasta, and orange juice.

Iron is used by the body to create the extra blood that you need. During pregnancy, your body will increase the volume of blood that you carry. Insufficient iron, or anemia, can make you feel tired. The amount of iron that your body absorbs will depend a great deal on what you are eating along with the iron rich food. Foods that help iron absorption are foods that are high in vitamin C such as citrus fruits and green peppers. Foods that hinder the absorption of iron would include milk, tea, or coffee. Some iron rich foods to include in your diet are soy beans, artichoke, chick peas, blackstrap molasses, green leafy vegetables, and tofu.

Calcium is what your baby will use to grow bones and teeth. This usually occurs in the second month of pregnancy. If there is not enough calcium in the diet, the stores will be pulled from mom's body. Choices for calcium intake in your diet may be yogurt, soy milk, milk, tofu, broccoli, turnip greens, and dark green leafy vegetables.

Calories and weight gain in pregnancy play an important role. A pregnant woman should be eating 300-500 extra calories a day, depending on her weight before pregnancy and her current activity level. Weight gain guidelines also vary from woman to woman. More important than the number of pounds a woman might gain is how she is eating. Is she making wise food choices and avoiding foods that are high in calories and have no nutritional value? How much exercise is she getting during pregnancy? Was her body at a healthy weight before the pregnancy? All of these facts play into a woman's desired weight gain during pregnancy. Many times it is helpful to ask your healthcare provider or seek the guidance of a registered nutritionist.

For many women, the hardest thing about following good nutritional guidelines is lack of time. Many of us are so busy, we do not have enough time in our day for meal preparation. We suggest that women carry healthy snacks with them so that they can get a "quick fix" for their hunger while still meeting the needs of their changing body and growing baby. Some ideas for portable snacks are sunflower seeds, peanuts, string cheese, fruits such as raisins, apples, bananas, or vegetables such as green pepper slices and carrots.

Another obstacle a woman may encounter early on in pregnancy is nausea and vomiting or "morning sickness." This time in pregnancy usually passes by the second trimester. Meanwhile, moms are concerned with weight gain and getting what they need nutritionally. Some moms find it helpful to eat low-fat, high-carbohydrate foods because they digest quickly. If it tastes good and you can keep it down, eat it! You may find that for a few days all you are able to eat is crackers and applesauce. This too will pass. In the meantime, eat what you can and try to keep your fluid intake up. Small, frequent meals may also help with nausea because sometimes nausea is caused by hunger. You can avoid this by snacking on healthy foods throughout the entire day. Some women find it helpful to eat before they even get out of bed in the morning.

Remember, all of the choices you make concerning your diet will affect both you and your baby. Taking care of yourself now will have long-term benefits to both of you. You will have a stronger body that will help you have the endurance and stores that you will need for the work ahead--labor. Although it may seem difficult at times to give up the "no-no's" and stick to the choices that you know are best, it will all seem worth it when you are gazing into the eyes of the beautiful baby that grew inside of you!

--Published in the Outpost Exchange, 9/00