Healthy Eating During Pregnancy and Breastfeeding

Eating a healthy and balanced diet, having regular physical activity and maintaining a healthy weight gain are essential to ensure your baby develop in the optimal nutritional environment. After delivery, provide your baby the prime nutrition and protection against infection with breastmilk. This also benefits the long term health of both you and your baby.

 

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

Stage Key Points about Changes in Nutritional Needs
1st trimester of pregnancy
(the first 13 weeks)
Demand for folate, vitamin A and iodine increases
2nd and 3rd trimester of pregnancy
(14th to 40th weeks)
The requirement for energy and protein increases for the growing baby*. Apart from folate, vitamin A and iodine, there is a higher demand for iron, zinc and omega-3 fatty acids, and a mild increase in calcium requirement
Breastfeeding The body needs an extra of 500 kcal energy a day. Sufficient intake of protein, folate, iodine, zinc, vitamin A and DHA are required to ensure an adequate level of nutrients in your breastmilk.

*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 recommended to take folic acid supplements when you plan for pregnancy and during the first trimester
  • 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

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 Organisation recommends pregnant and lactating women should consume 250 micrograms iodine a day
  • You should consider taking a prenatal multivitamin/multimineral supplement that contains iodine, as it is difficult to get sufficient iodine from food alone when you are pregnant or 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

Food

Iodine*(μg)

Food

Iodine*(μg)

1 Chicken egg (63g)

18

Seaweed snack 1g

34

Skimmed milk 250ml

20

Golden thread (fish) 100g

36

Yoghurt 100g

29

Horsehead (fish) 100g

35

Prawn 100g

44

Canned sardines 100g

19

Mussels 100g

140

Big Eyes (fish) 100g

18

*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?

  • Consume foods that provide you iodine, including seafood, eggs, milk and milk products;
  • Consult your doctor or pharmacist and take a prenatal multivitamin / multimineral supplements containing iodine;
  • Use iodised salt in place of table salt for cooking. Add the salt just before serving the dish. Be careful to limit the salt use;
  • You can consume kelp and the soup occasionally, or choose seaweed snack as your snacks regularly. Choose seaweed snacks with lower sodium and fat content.

If you have an active or a past thyroid problem and you become pregnant, you should inform your attending doctors as soon as possible. Your requirement for iodine is higher during pregnancy too. Since increase in iodine intake may affect the thyroid functions, you should follow the doctor’s advice in consuming iodine-rich foods or iodine supplements. You may need a close monitoring of the thyroid function too.

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 fetal 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.

Food sources of iron

  • Meats include: pork, beef, poultry, fish, eggs and livers.
    Livers are rich in iron, yet they contain a high level of vitamin A. It is advisable to limit intake to 100 g a day
  • Green vegetables such as choy sum, bok choi, spinach
  • Dried beans such as lentils, red kidney beans, chickpeas, etc.
  • Nuts such as almond, cashew nuts, etc.
  • Iron fortified foods such as breakfast cereals and oats. Choose those lower in sugar

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, bok choi
  • 3 pieces of sardines
  • 3 tablespoons of sesame

Calcium content of other foods*

2 slices of whole wheat bread 100 mg
15 g of almond 40 mg
An orange 60 mg
10 g of dried anchovies 59 mg
10 g of dried small shrimps 55 mg

*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 on 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 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 eyes of your baby
  • Oily fish, such as salmon, sardine, jade perch, 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 others who avoid fish can consume foods rich in alpha linolenic acid (ALA), such as flaxseeds, walnuts and canola oil. DHA and EPA can be made from ALA in our body to certain extent
  • 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 damages 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.

 

Healthy Eating During Pregnancy

  • Consume a variety of foods
  • Eat grains, vegetables, fruits, meat, fish, eggs, milk products (or the alternatives of milk products) every day
  • Choose nutritious foods
  • Avoid foods and drinks with added fats and sugar but low nutrients content e.g. soft drinks, sweeten drinks, cakes, cookies, pastries, ice-cream, processed foods like sausages and instant noodle

Tips: Taste buds emerge at 3 months of gestation. Your baby tastes the food you eat. Your food choice has an effect on his food preference.

How should I eat to meet the demand of pregnancy?

  • In the first trimester (the first 13 weeks), your body needs slightly more calories. You do not need to eat more than taking an extra piece of whole-meal bread, or a cup of low sugar calcium-fortified soy milk or low fat milk per day. You should take a prenatal multivitamin/multimineral supplement containing iodine and folic acid
  • In the second and third trimester (14th to 40th week), your body requires more calories and nutrients. While eating a bit more, it is important to improve the quality of diet by eating a variety of foods. Refer to the suggestion on the “Meal Plan for a Balanced Diet”

Meal Plan for a Balanced Diet

The meal plan food of a pregnant woman, having a normal BMI and of a weight 45 to 60 kg before pregnancy, who maintains light physical activity is outlined in the following table.

Grains

Choose brown rice and whole-meal bread instead of white rice and white bread. Whole-grain foods are rich in vitamins and dietary fibre. It provides a longer satiety effect and prevents constipation.
Servings per day before pregnancy and first trimester: 3 to 4
Servings per day during second and third trimester: 3½ to 5
Example(s) of a serving:

  • 1 bowl of rice
  • 1 bowl of rice noodles
  • 1¼ bowls of noodles
  • 1½ bowls of spaghetti/ macaroni
  • 2 slices of bread (8 slices per pound)

Vegetables

Choose more dark green leafy vegetables. Go for vegetables of different colours as well, such as carrots, pumpkins, bell peppers, tomatoes, egg plants, cauliflowers, etc.
Servings per day before pregnancy and first trimester: 3 or more
Servings per day during second and third trimester: 4 to 5
Example(s) of a serving:

  • ½ bowl of cooked vegetables
  • 1 bowl of uncooked vegetables

Fruits

Go for fruits of different colours
Servings per day before pregnancy and first trimester: 2 or more
Servings per day during second and third trimester: 2 to 3
Example(s) of a serving:

  • 1 medium size fruit (e.g. apple/pear/orange of size of a lady’s fist)
  • 2 plums/kiwi fruits
  • ½ cup diced fruit

Meat, fish, eggs and alternatives

Remove the skin and trim the fat from meat or poultry. Choose non-fried and low-salt soy products. Choose fish of lower methylmercury level (refer to “Issue of methylmercury in fish”). Avoid choosing preserved or processed foods.
Servings per day before pregnancy and first trimester: 5 to 6
Servings per day during second and third trimester: 5 to 7
Example(s) of a serving and better food choices:

  • 40 g raw meat
  • 30 g cooked meat (size of a table tennis ball)
  • 1 chicken egg
  • ¼ block of firm tofu
  • 4 tablespoons of cooked soya beans, 6 to 8 tablespoons of other cooked beans

Milk and alternatives

Servings per day before pregnancy and first trimester: 1 to 2
Servings per day during second and third trimester: 2
Example(s) of a serving (One serving provides 300 mg calcium):
Milk products: choose products that are low-fat or fat-free

  • 1 cup of milk
  • 2 slices of processed cheese
  • 1 carton (150 g) of yoghurt

Other calcium rich foods:

  • 1 cup of calcium-fortified soy milk
  • ½ block of firm tofu (set with calcium salt)
  • 1 bowl of tofu pudding
  • 3 sardines with bones
  • 3 tablespoons of sesame
  • Dark green leafy vegetables:

200 g: Kale, bok choi
300 g: choy sum

Oil, fat

Vegetable oils are recommended for cooking. Limit to 2 teaspoons a meal. Use iodised salt. Limit salt intake to no more than 5 g (1 teaspoon) a day
Servings per day before pregnancy and first trimester: in moderation
Servings per day during second and third trimester: in moderation

Fluid

Adjust according to weather and exercise level. Includes water, thin soup
Servings per day before pregnancy and first trimester: 6 to 8 cups
Servings per day during second and third trimester: 8 cups

Vegetarian Eating and Pregnancy

A vegetarian diet can meet the needs of your pregnancy as long as you take care to include enough protein, iron, vitamin B12 and calcium-containing foods. You can choose from the following foods:

Food packed with protein:

  • Eggs, dried beans (soy bean, lentils, red kidney beans, etc.), tofu, soy products, nuts and seeds

Iron rich foods:

  • Eggs, nuts, seeds and beans
  • Breakfast cereals fortified with iron, e.g. oats, and whole wheat bread
  • Dark green leafy vegetables, such as spinach, Chinese spinach, bok choi, choy sum and kale, etc.
  • Include vitamin C-rich fruits and vegetables in meals to increase iron absorption

Calcium rich foods:

  • Milk, cheese, yoghurt
  • If you do not consume milk products, choose calcium-fortified soy milk, tofu set with calcium salt, non-sugar added fruit juice fortified with calcium

Vitamin B12 rich foods:

  • Plant foods do not provide vitamin B12. Consume eggs or milk. Choose breakfast cereal added with vitamin B12 and consider taking vitamin B12 supplements if you consume plant food only

Foods provide Omega-3 fatty acids:

  • Canola, walnuts, safflower, flaxseeds, canola oil
  • Nuts and seeds, such as sesame, flaxseed

Vegetarian mothers are advised to discuss with the healthcare professionals about the needs for vitamin and mineral supplements.

Healthy Snacks

Some pregnant women need frequent but smaller meals. If you need a small snack in between main meals, here are some ideas for nutritious and convenient snacks:

Quick and nutritious snack ideas:

  • A piece of fresh fruit, e.g. one small banana or an apple
  • 30 g of dried fruits, e.g. no added sugar raisins, apricots, prunes
  • A tablespoon of roasted nuts, e.g. walnuts, almonds, peanuts
  • A small tomato and cheese sandwich (1 slice of whole-meal bread + 1 slice of processed cheese + 2 slices of tomato)
  • A small box (about half bowl) of low sugar breakfast cereal
  • A boiled egg
  • A carton (250 ml) of low sugar calcium fortified soy milk
  • A tub of low-fat yoghurt
  • A carton (250 ml) of low fat or skimmed milk

Tips: A heaped tablespoon of nuts (15 g) provides about 90 kcal, which is the same amount of energy as from 3 pieces (20 g) of soda crackers. However, the 15 g nuts contain more vitamin E, zinc, iron.

To prevent gaining weight excessively, avoid foods and drinks containing empty calories, such as chips and crisps, French fries, soft drinks, cookies and cream cakes, instant or fast foods, etc. These foods are high in sugar or fat but lacking other nutrients.

Practise Healthy Eating When Dining out

  • Choose main dishes with vegetables, or order a side dish of vegetables
  • Order steamed, boiled or grilled dishes, instead of those that are fried or sautéed in sauces or gravy to cut down the intake of fat
  • Avoid preserved foods or processed meats, such as sausages
  • For beverages, ask for water or unsweetened drinks
  • Eat slowly to avoid overeating

Q: Can I drink coffee or caffeine-containing drinks during pregnancy?

  • Coffee and tea contain caffeine.Too much caffeine may increase the risk of low birth weight and miscarriage
  • Caffeine level of some brewed coffee and Hong Kong-style milk tea in local restaurants is high. One may get too much caffeine by drinking a cup. You are advised to limit coffee and strong tea drinking and consider the decaffeinated options
  • You should also limit the intake of other foods and drinks containing caffeine, e.g. soft drinks, chocolates or tea. To reduce the risk of too much caffeine, you should also avoid energy drinks

Reference: Centre for Food Safety. Caffeine Content in Coffee and Milk Tea Prepared in Local Food Premises.

Q: Do I need formula milk designed for pregnant women?

  • A balanced diet with a variety of foods can meet the nutritional requirements of pregnancy. You need to top up for iron, iodine or other micronutrients, you can consider taking prenatal vitamin and mineral supplements
  • Maternal milk formulae have higher calorie content than low fat milk. Extra calories may cause excessive weight gain. Consider taking milk formula only when you have difficulty in taking other foods

Myths of Food Restriction During Pregnancy

Q: Is it true that avoidance of seafood and beef during pregnancy and breastfeeding can prevent my baby from developing eczema?

  • Current scientific researches show that avoidance of milk, beef, peanuts, seafood and other potential “food allergens” does not protect the babies from developing atopic dermatitis (eczema) or other allergic diseases
  • On the contrary, dietary restriction may lead to poor maternal weight gain and increase the risk of nutritional deficiency in mothers and babies
  • Therefore, unless you are allergic to the beef, seafood etc., avoidance is unnecessary during pregnancy or breastfeeding

Q. Does restricting water intake and limiting salt in diet help relieve leg and hand swelling in late pregnancy?

  • The limbs swell up because of water retention which happens as a result of the increase in female sex hormones level after mid pregnancy. It is not related to how much water you drink or salt you take
  • A healthy pregnant woman does not need to restrict water intake
  • However, you should limit the daily salt intake to no more than 5 g (i.e. a teaspoon) irrespective of whether you have leg or hand swelling. Since most foods contain some quantity of salt, you should use less salt or condiment when cooking

 

Foods to Avoid When Pregnant or Trying to Get Pregnant

  1. Alcoholic beverages
    • These include beers, wines, spirits and liqueurs
    • Alcohol is a toxic substance and can cause cancer
    • Exposure to alcohol can seriously affect your baby’s development
  2. Fish that contains high levels of methylmercury (refer to “Issue of methylmercury in fish”)
    • Examples include shark, marlin, swordfish, alfonsino, king mackerel, some species of tuna and other large predatory fish.
    • Methylmercury can adversely affect a baby’s growing brain and nervous system
  3. Raw or undercooked meat, seafood and eggs
    • All foods should be cooked thoroughly
    • When eating out, make sure the food is actually hot when served

    Ensure foods are cooked thoroughly:

    • For meat and poultry: the juice should be clear, not red; blood is not visible when you cut the cooked meat
    • Egg yolks are not runny
    • Bring soups and stews to a boil for at least 1 minute

    Q: Can I eat ice-cream during pregnancy?

    You should avoid eating soft serve ice-cream to protect yourself from listeria infection. Other ice-cream can be contaminated by germs when it is not handled or stored properly. You should be cautious.

  4. Chilled ready-to-eat and refrigerated foods:
    • These foods may be contaminated by listeria bacteria. Listeria infection during pregnancy may result in miscarriage, early death of the infant, preterm labour or the baby may suffer severe health problems.
    • When infected by listeria, the pregnant women may show flu-like symptoms, chills, fever, headache, back pain and sore throat. Even though some may be asymptomatic, the infection can still severely affect the baby
    • To reduce the risk of listeria infection, you should cook foods thoroughly and to avoid high risk food that may contain Listeria monocytogenes

Avoid high risk food that may contain Listeria monocytogenes

  • Chilled ready-to-eat seafoods and cold meat
    • Raw seafoods (such as sashimi and oysters)
    • Smoked seafoods (such as smoked salmon and oysters)
    • Pates
    • Deli meat
  • Refrigerated ready-to-eat salads (from salad bars, supermarkets or delicatessens), and sushi with salad
  • Soft ice-cream
  • Soft cheeses, such as Feta, Brie, Camembert, Blue Cheese
  • Unpasteurized milk and foods made from unpasteurized milk
  • Prepackaged refrigerated foods that have passed their shelf life

Q: Is it safe to eat sliced cheese, cheese spread, or hard cheeses?

If refrigerated and stored under suitable temperatures, they can be safely consumed.

 

Food Safety and Personal Hygiene

  1. Wash your hands and utensils thoroughly before handling foods
    • Prevention of toxoplasma infection
      The faeces of pets (such as cats) or soil may contain toxoplasma gondii. If the pregnant woman is infected with toxoplasma gondii, the fetal brain and growth can be affected. You should keep pets out of the kitchen, wear gloves when gardening or handling the faeces of pets, and wash your hands thoroughly afterwards.
  2. Separate the raw from the cooked food
    • Use separate utensils (such as knives and chopping boards) to handle raw and ready-to-eat or cooked food. Store them separately
  3. Cook foods thoroughly (please refer to “Foods to Avoid When Pregnant or Trying to Get Pregnant”)
  4. Store food under safe temperatures
    • Food should be refrigerated at 4 degree Celsius or below, or held hot at 60 degree Celsius or above
    • Do not leave cooked food and left-over foods at room temperature for more than 2 hours. Keep them refrigerated
    • Reheat leftovers thoroughly until it is steaming hot before consumption

Q: Can I eat homemade vegetable salads?

Yes. You should make sure that the vegetables and fruits are washed thoroughly, and consume the salad as soon as possible. If refrigerated, it should be consumed within the same day.

Q: What precautions should I take when eating take-away cooked chicken?

You should make sure that it is steaming hot when you buy it and consume it immediately. If it is not eaten immediately, refrigerate it within 2 hours. Reheat it thoroughly before eating and finish it within the same day.

Visit the Centre of Food Safety website for more food safety information: http://www.cfs.gov.hk/english/rc/portals/index.html

 

Staying Physically Active During Pregnancy

Have at least 30 minutes of physical exercise daily. It can be accumulated from separate sessions. Outdoor exercises helps boost the level of vitamin D in the body.

Benefits of exercise

  • Reduces fatigue, backaches, swelling and varicose veins. Improves posture and muscle strength
  • Alleviates insomnia, mental stress, anxiety and depression
  • Helps prepare your body for labour and childbirth

Consequences of lack of physical activity

  • Decline in muscular and cardiorespiratory fitness
  • Excessive weight gain
  • Higher risks of pre-eclampsia and gestational diabetes mellitus
  • More varicose veins
  • Low back pain

Suitable exercise for pregnant women

Do not exert yourself. The appropriate intensity level is that you should be able to carry out conversation while exercising. For example:

  • Brisk walking
  • Swimming
  • Cycling on a stationary bikes
  • Doing housework

Take the following precautions when you exercise:

  • Make sure the weather and the environmental conditions are suitable
  • Have a companion when you swim or having outdoor exercise
  • Reduce the intensity of exercise when approaching the due date
  • Avoid sudden and vigorous exercise if you had no regular exercise before pregnancy. You should consult your doctor concerning your fitness
  • Avoid exercises that require lying flat on your back after 16 weeks. The enlarged uterus compresses onto the great vein will interferes blood circulation
  • Terminate the exercise if you noticed any discomfort. Consult a doctor if the condition persists
  • Pregnant women with heart or respiratory disease, having risk of preterm labour or any complications should consult their doctors regarding their fitness for exercise

Weight Gain During Pregnancy

During pregnancy, you should consume a balanced diet, have regular physical exercise, and maintain an appropriate and gradual weight gain.

  • In the first trimester (up to 13 weeks), there is little weight gain. The total weight gain ranges from 0.5 to 2.0 kg
  • In the second and third trimester (14th to 40th week), the average weekly weight gain ranges from 0.4 to 0.5 kg

How much weight should I put on?

The recommended weight gain during pregnancy is related to your BMI just before pregnancy. Your pre-pregnant BMI is calculated by: Your weight before pregnancy (kg)÷Height (m)÷Height (m)

BMI before pregnancy

Weight gain during pregnancy* (applicable to Chinese women)

Below 19.0 13 to 16.7 kg
19.0 to 23.5 11 to 16.4 kg
Above 23.5 7.1 to 14.4 kg

*Source: Wong W, et al. J Am Diet Assoc. 2000:100; 791-796. It applies to women expecting one baby.

Excessive Weight Gain During Pregnancy

Excessive weight gain may have the following consequences:

Mother Baby
  • Gestational diabetes
  • Pregnancy-induced hypertension
  • Difficult delivery and increase in chances requiring Caesarean section
  • Difficulty in returning to pre-pregnant body weight, running a higher risk of developing diabetes, hypertension, heart disease later on if one persistently overweight
  • Abnormally large babies and the related complications
  • Increase in the risks of obesity, diabetes mellitus, high cholesterol, high blood pressure, cardio- and cerebro-vascular diseases in adulthood

Q: What do I do if I put on weight too quickly?

  • Cut down on intake of food high in fats and sugars to reduce the intake
  • You should have physical exercise for at least 30 minutes a day
  • Drink water instead of sweetened drinks
  • Cut back on cakes, pastries, crisp, cookies, chocolate, candies, ice-cream and other desserts
  • Limit deep-fried foods including French fries, potato chips and instant noodles
  • Opt for low-fat/skimmed dairy products
  • Trim the fat on meat and remove skin from poultries
  • Use low fat cooking methods: steaming, boiling, baking, grilling, light stir-frying

Poor Weight Gain During Pregnancy

Poor weight gain during pregnancy may result in poor foetal growth, low birth weight and increase the health risk in the child’s later life.

Q: What do I do if my weight gain is slow?

During the first trimester, it is normal that there is little weight gain. Some may have a mild weight loss due to a poor appetite and morning sickness. To ensure adequate intake, one can eat smaller meals and have regular snacks. Choose nutritious foods for snacks, e.g. a sandwich of whole-meal bread, dried fruits or nuts. Maintain adequate fluid intake. Appetite and weight gain will be generally improved in the second trimester.

Poor weight gain in later half of pregnancy may indicate that the foetus may not be growing normally. In depth assessment is necessary.

I was already overweight before pregnancy. What can I do?

You should not try to lose weight during pregnancy. This brings harm to yourself and your foetus. Changing some of the habits is helpful:

  • Eat regularly and adopt a balanced diet (refer to” Meal Plan for a Balanced Diet from Healthy Eating During Pregnancy”). Include grains, vegetables, fruits, meat and alternatives, and milk products in your meals.
  • Consume whole grain foods and eat more vegetables
  • Reduce intake of empty calories, including junk snacks, soft drinks or other foods high in fats or sugars
  • Exercise for at least 30 minutes a day, such as engaging in brisk walk, swimming, etc. This helps control your weight

 

Eating Well During Breastfeeding

Breastfeeding mothers need an extra of 500 kcal energy a day. Take foods rich in folate, iodine, zinc, vitamin A and DHA, and increase intake of meat moderately to ensure adequate nutrient level in your breastmilk.

Eating well during breastfeeding

  • Eat a variety of foods but avoid overeating
  • Choose whole grains, and eat more vegetables and fruits
  • Consume a bit more meats, fish, eggs than before pregnancy. Choose fish rich in omega-3 fatty acid but low in mercury content
  • Eat seafoods that provide you with iodine. Consume kelp occasionally. Consider taking a multivitamin / multimineral supplement containing iodine if you have problems with these foods
  • Drink appropriate quantity of milk and the alternatives
  • Ensure adequate water intake
  • Limit drinking coffee, strong tea and avoid caffeine containing drinks
  • Do not smoke or consume alcoholic drinks
  • Consult a registered Chinese medicine practitioner before taking traditional herbal medicine or health tonics

Tips: Remove the skin and trim the fat from meat and poultry to reduce the intake of extra calories

Regular physical activity

  • Have at least 30 minutes physical exercise daily. Being physically active helps your weight return to the level before pregnancy. It also benefits your mental and physical health
  • Spend some time outdoors to maintain an adequate vitamin D level. For more information, please click here for details

Refer to “Nutrients that Are Important for You and Your Baby” for suitable food choices

Daily Food Plan for Lactating Women

Food Group Servings per day Examples(s) of a serving*

Grains

4 to 5

  • 1 bowl of rice

Vegetables

4 to 5

  • ½ bowl of cooked vegetables

Fruits

3

  • An apple, an orange or 2 kiwi fruits

Meat and alternatives

6 to 7

  • 40 g raw meat/fish/chicken, or 1 egg, or ¼ block of firm tofu

Milk and alternatives

2

  • 1 cup of skimmed milk or calcium-fortified soy milk

Oil, fat, sugar, salt

in moderation

 

Fluid

10 cups

  • 1 cup of water or thin soup

1 bowl = 250 -300 ml; 1 cup = 240 ml
*refer to “Meal Plan for a Balanced Diet from Healthy Eating During Pregnancy”

What food should I avoid when I breastfeed?

  • Breastfeeding moms should take a diet of a variety. If you and your baby do not have food allergy, you do not need to have any food restriction apart from avoiding eating fish of high methylmercury level.
  • Some babies may get upset after their mothers consume strong flavoured and gas producing food such as garlic, curry or spices. If this happens to your baby, then eat less of these foods
  • Caffeine containing drinks can affect babies and may keep them awake. It is important to limit coffee, strong tea and some types of soft drinks. Try the decaffeinated options
  • You should avoid alcohol because of its adverse effect on health. Alcohol disrupts breastmilk flow. It passes through breastmilk and impairs your child’s development. If you are breastfeeding but need to drink alcohol on special occasions, you must be cautious to limit to a small amount and avoid nursing the baby within 2 hours

 

Recipes of Iodine-rich Dishes

Fried Eggs with Scallops, Seaweed and Garden peas

Ingredients (for 2 persons)

  • Garden peas ½ cup
  • Scallops 12 pieces
  • Eggs 3
  • Shredded snack seaweed 1 tablespoon
  • Ginger 2 slices
  • Garlic 2 pieces

Seasoning

  • Salt ⅔ teaspoon
  • Pepper ⅓ teaspoon

Method

Step 1: Whisk eggs. Add garden peas, salt and pepper and mix well.

Step 2: Heat 2 teaspoons of cooking oil in a non-stick pan. Add ginger and garlic.

Step 3: Stir in the scallops. Pour in the egg mixture and stir-fry quickly till done.

Step 4: When serve, put the shredded seaweed on top.

Fried Kelp with Chicken Fillets

Ingredients (for 2 persons)

  • Chicken fillet 150 g
  • Dried Kelp 10 g (15x20cm in size), (soaked and cut into strips)
  • Green & Red Bell Peppers 2, cut into strips
  • Ginger 2 slices
  • Garlic 2 pieces

Seasoning

  • Salt ⅓ teaspoon
    Pepper ⅓ teaspoon
  • Soy sauce to taste
    Cornstarch 1 teaspoon
    Sugar to taste

Method:

Step 1: Cut chicken fillet into strips. Marinade with seasoning (B) for 15 minutes.

Step 2: Heat 2 teaspoons of cooking oil on a non-stick pan. Add ginger and garlic. Add chicken and stir fry.

Step 3: Stir in bell pepper and kelp. Add seasoning (A) and stir-fry till all are done. Then serve.

The recipes are provided by the Centre for Nutritional Studies, the Chinese University of Hong Kong, Website: http://www.cns.cuhk.edu.hk/

(Content revised 11/2016)