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Nutrients that Are Important for You and Your Baby



During pregnancy and breastfeeding, your body has a higher demand for nutrients. The extra demand can be met by making smart food choices.

However, you do not need to eat for two. Overeating can make you put on too much weight and puts you at risk of gestational diabetes and other complications.


Key Points about Changes in Nutritional Needs



*Report of a Joint FAQ/WHO/UNU Expert Consultation 2011 recommended an extra energy requirement of 285 kcal and 475 kcal per day during the second and third trimester respectively assuming the pre-pregnant physical activity level is maintained.


Folic acid

  • Adequate intake of folic acid (folate) prevents the foetus from being affected by neural tube defect (malformations of the brain and spinal cord), as well as preventing you from developing anaemia.

  • You are advised to take a folic acid supplement of at least 400 micrograms (not more than 1000 micrograms) daily when you plan for pregnancy and during the first trimester of pregnancy.

  • During pregnancy and breastfeeding, you should consume foods that are rich in folate. You can also take supplement containing folic acid.


Major food sources of folate

  • Dark green vegetables, e.g. choy sum

  • Legumes and beans

  • Fruits, e.g. cantaloupe, oranges

  • Liver

  • Peanuts and nuts

  • Folate-fortified breakfast cereals

Vitamin A

  • Vitamin A is essential for growth, immune functions and vision

  • Colourful fruits, oranges and dark green leafy vegetables, such as cherries, tomatoes, pumpkins, carrots, and sweet potatoes, are rich in beta-carotene which can be turned into vitamin A in the body

  • A diet containing colourful vegetables and fruits, eggs and milk provides adequate vitamin A for both you and your baby

  • Iodine is necessary for the normal functions of the thyroid gland

  • Iodine is essential for your baby's growth and brain development. Iodine deficiency may cause serious health consequences for the baby


Avoid taking supplements containing large quantities of vitamin A

  • Taking large amount of vitamin A supplements, such as cod liver oil, for long period of time can damage the liver

  • Excessive intake of vitamin A can cause birth defects

Talk with your doctor or pharmacist when you plan to take vitamin or mineral supplements.


Iodine

  • Iodine is necessary for the normal functions of the thyroid gland

  • Iodine is essential for your baby's growth and brain development. Iodine deficiency may cause serious health consequences for the baby

  • Demand for iodine increases during pregnancy and breastfeeding. The World Health Organization recommends pregnant and lactating women should consume 250 micrograms iodine a day

  • Local pregnant women are not getting enough iodine from diet. To prevent iodine deficiency, you should consider taking an iodine-containing prenatal multivitamin/ multimineral supplement during pregnancy and breastfeeding

Food source of iodine

  • Seaweeds, marine fish and seafood (including prawns, mussels and oyster), egg yolk, milk and milk products are main sources of iodine

  • Seaweeds are rich in iodine content

  • Kelp, in particular, contains a very high level of iodine. Consume kelp in moderation and no more than once a week. Overconsumption of kelp for a long time can have an adverse effect on the thyroid function


*Source: Risk Assessment Studies, Report No 45, Dietary Iodine Intake in Hong Kong Adults. July 2011. Centre for Food Safety, Department of Food & Environmental Hygiene, HKSARG.


How can I get adequate iodine?

  • Take an iodine-containing supplement daily. Consult your doctor, pharmacist or dietitian. When you choose a supplement, check its iodine content;

  • Use iodised salt in place of table salt for cooking. Store the salt in a tight and coloured container and add it just before serving;

  • Consume foods with iodine, including seafood, marine fish, eggs, milk and milk products;

  • You can choose seaweed snacks with lower sodium and fat content. Kelp (or its soup) should only be consumed occasionally.

Women having an active-thyroid problem also require more iodine during pregnancy and breastfeeding. Since increase in iodine intake may affect the thyroid functions, you should inform your attending doctor. You may need a close monitoring of the thyroid function as well.


Iron

  • Adequate iron intake ensures normal foetal growth and brain development and prevents anaemia during pregnancy and after delivery

  • You need more iron in the third trimester to build up the iron reserve for the growth of the baby in the first few months of his life

  • Foods rich in iron are usually also rich in zinc. Zinc is important for your immune functions and foetal development. It also helps wound healing.

  • Consume a variety of iron rich foods. Dark green leafy vegetables, dried beans, and nuts also provide folate, calcium and dietary fibre which is good for your gut.

Food sources of iron

  • Iron in fish, poultry, seafood, egg, red meat (beef, pork, lamb) is more readily absorbed. Consume red meat in moderation. Limit intake of liver because it is high in vitamin A.

  • Green vegetables such as choy sum, pak choi, spinach

  • Dried beans such as lentils, red kidney beans, chickpeas, etc.

  • Nuts such as almond, cashew nuts, etc.

  • Iron fortified low sugar breakfast cereals.

Vitamin C

  • Vitamin C helps your body absorb iron from foods. Include a source in your diet such as fresh vegetables and fruits, e.g. oranges, kiwi fruits and strawberries.

Calcium

  • Calcium is the building block for bones and teeth

  • Pregnant and lactating women require 1000 mg of calcium daily

  • Inadequate calcium intake during pregnancy may increase the risk of preterm labour and gestational hypertension

  • During pregnancy and breastfeeding, you are advised to consume 2 glasses of milk or calcium-fortified soy milk each day and choose calcium-rich foods such as dark green leafy vegetables and tofu


Food sources of calcium

  • Milk, cheese and yoghurt. Choose low fat varieties

  • Calcium-fortified soy milk, tofu which is made traditionally with calcium salt

  • Dark green vegetables, such as choy sum, kale, bok choi, mustard green, broccoli

  • Sesame seeds and nuts

  • Dried shrimps, small dried fish and fish eaten with bones (such as sardines)

Foods provide 300 mg calcium

  • 1 cup of milk

  • 2 slices of cheese

  • 150 g of yoghurt

  • 300 g choy sum

  • 1 cup of calcium-fortified soy milk

  • ½ block of tofu set with calcium salt

  • 1 bowl of tofu dessert

  • 200 g kale, pak choi

  • 3 pieces of sardines

  • 3 tablespoons of sesame

Calcium content of other foods*



*Source of data: website of the Centre for Food Safety

Tips: Calcium in the dark green leafy vegetables is better absorbed than that of milk. Most of the calcium is found in the leaves rather than the stalks.


Vitamin D

  • Vitamin D helps calcium absorption and is essential for bone health and development

  • Expose to sunlight regularly and consume vitamin D rich foods when you are pregnant. This helps you get enough vitamin D such that your baby gets strong bones

  • Inadequate intake during pregnancy puts your baby at risk of getting vitamin D deficiency

How can I get adequate Vitamin D

  • Most of the vitamin D you need is made in your skin when you are exposed in sunlight.

  • Window glass, sunscreen and skin pigments block UV rays of the sunlight and reduce vitamin D production.

  • For most people, 5 to 15 minutes of sun exposure of hands, face and arms, about 2 to 3 times a week during the summer months is sufficient to keep vitamin D level high. People with darker skin need longer sun exposure.

  • In winter, you may need longer sun exposure because the sunlight is generally less strong.

  • You can obtain some vitamin D by eating fatty fish (such as salmon, sardines, eel), eggs, liver, milk and milk products added with vitamin D. However, diet alone is usually not sufficient to meet your need.

Pregnant women who have too little sunlight exposure should seek medical advice about vitamin D supplements.

They are:

  • Women in clothes covering the arms and face most of the time

  • Women staying indoors mostly

  • Women who have a darker skin tone and limited exposure to sunlight

Omega-3 Fatty acids

  • Omega-3 fatty acids include DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). DHA is important for the development of the brain and the eyes of your baby

  • Oily fish, such as salmon, sardine, mackerel, eel and yellow croaker etc. are rich in omega-3 fatty acids. Some fish that are available in the local markets, like golden thread, Pacific saury and pomfret, also contain a moderate level of omega-3 fatty acids

  • Vegetarians and other who avoid fish can consume foods rich in alpha linolenic acid (ALA), such as flaxseeds, walnuts and canola oil. Our body can convert ALA into DHA, yet, there is an individual variation.

  • You can consider taking DHA supplement if you do not eat fish. Talk with your doctor, nurse, dietitian or pharmacist

Issue of methylmercury in fish

  • Fish is the major source of methylmercury in our diet. High level of methylmercury may damage the developing brain of foetus, infant and young child

  • Consume fish in moderation and eat from a variety of fish can reduce the risk

  • Choose fish that are low in methylmercury, such as: salmon, sardine, Japanese jack mackerel, Chub mackerel, golden thread, Pacific saury, pomfret, grass carp, mud carp, grey mullet, horse head, big eyes, etc.

  • Fish of smaller size (less than 600 g or one catty), farmed fish and freshwater fish generally have lower level of methylmercury

Avoid eating large predatory fish and fish with high levels of methylmercury, including: Shark, swordfish, marlin, king mackerel, bluefin tuna, bigeye tuna, albacore tuna, yellowfin tuna, splendid alfonsino, orange roughy, yellowback seabream and dash-and-dot goatfish, etc.


*Data source: The First Hong Kong Total Diet Study: Metallic Contaminants, and Advice for Pregnant Women, Women Planning Pregnancy and Young Children on Fish Consumption. January 2013. Centre for Food Safety, Department of Food & Environmental Hygiene, HKSARG.


Q: Can I eat canned tuna?


Methylmercury levels in canned tuna are lower than in fresh tuna, largely due to the species or the smaller-sized of fish used. Skipjack tuna, a variety that is often canned, tends to contain lower levels of methylmercury. Consuming 4 or 5 cans of skipjack tuna within one week may exceed the tolerable weekly intake of methylmercury. Species with higher level of methylmercury, such as albacore tuna, may also be canned. Therefore, it is important to read the label carefully before purchasing and limit the intake.




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