Tag: Pregnancy Article

Why is it that after a woman gives birth, she and our Western society believe the hard part is over and pre-pregnancy life resumes as usual? This misguided perception may lead many women to miss out on a pivotal phase of recovery and nutrient repletion during the postpartum period. Immediately following the birth of your baby, your main priorities should include rest, recovery, nourishment of yourself and nourishment of your new, tiny human!

Why Nutrients May Be Needed

During labor and delivery, your body expends an incredible amount of energy to deliver your baby! You will need to concentrate on adequate nutrition to repair your muscles and tissues used throughout your pregnancy and birth, as well as your energy levels so you can focus on caring for your baby. Speaking of that precious bundle, your body transferred a significant amount of nutrients to your baby during pregnancy to ensure appropriate growth and development, but now that has likely left your nutrient stores on ‘empty!’ Finally, breastfeeding continues to place a significant demand on the body to not only make milk, but also to ensure it is nutritionally dense with everything your baby needs to grow. For these reasons, women should continue to prioritize nutrition and receive support from their partners, family and friends to experience a smoother transition into their new role as a mother.

Traditional Cultures: A Different Approach

Many traditional cultures around the world observe specific practices within the immediate postpartum period for the new mom to rest, establish breastfeeding, replenish nutrient stores and avoid physically demanding activities. Unfortunately, for those of us in Western societies, most postpartum practices do not typically last longer than the first few days or initial weeks following birth. 

In many traditional cultures, the mother is expected to participate in a period of rest lasting anywhere from 21 days to five weeks! For example, in China, women participate in what is known as zuo yue which translates to “doing the month.” Within this time period, the new mom is prohibited from participating in regular household chores and cooking or preparing meals.

Additionally, family members assume the role of caregiver for the new mom providing practical support by completing the prohibited chores and sharing elderly advice for the mother regarding her care and her baby. An interesting example of this is found in Japanese culture, where the new mom-to-be travels to her family home around 32-35 weeks to be tended to by her mother until approximately 8 weeks postpartum! 

No matter how unattainable these practices may seem, one thing that remains clear is that traditional cultures place a heavy emphasis on postpartum nutrition.

Postpartum Nutrition with Real Food

Although there seems to be some discrepancy among specific foods within various cultures related to regional differences, a commonality across the board is a woman’s intake of high quality animal products. These foods may include bone broths, organ meats, seafood or eggs as research shows the nutrients found in these foods are vital to a new mom’s healing and milk production. Furthermore, many cultures support the intake of “warming” foods to restore harmony and balance within the body. This belief may be connected to the idea that pregnancy is a state of ‘hotness,’ while postpartum is considered a cold and vulnerable state. 

For example, in China, yang foods are considered warming, while yin foods are cooling. Rich bone broth made from pig’s feet or black-bone chicken enriched with sesame oil, rice wine, ginger, and seaweed may be prepared for the mother. Other foods such as pork, chicken soup, fermented rice, eggs, ginseng, herbal teas, inner organs, and noodles in brown sugar broth are encouraged to enhance milk production or because they are believed to temper postpartum bleeding by discharging dirty blood. In many ways, the foods prioritized in more traditional cultures address the key nutrients that require repletion following pregnancy and birth such as protein, electrolytes, iron, vitamin B12, iodine, B-vitamins, zinc, choline and DHA!

A Summary of Foods to Enhance Your Recovery

Now you may be questioning whether or not you have to change your entire diet again to meet the new nutritional needs of your body and your baby. Let me set the record straight – YOU DO NOT. In fact, you can continue to eat the way you did throughout your pregnancy with a few modifications to enhance recovery and support your postpartum journey. 

One of the biggest take-aways is that you will definitely require more calories. Yes, you read that right – more, not less. Forget society’s expectation to “bounce-back” or “return to your pre-pregnancy body or weight” and honor your hunger and nutrition needs where you are today! Because the newborn stage can be a bit demanding, especially if you are breastfeeding, I would encourage you to arrange some help to have meals delivered to your home or arrange some nutrient dense freezer meals to have on hand for your partner or support person to prepare for you in a pinch.

Remember to focus on soups and hearty stews made with rich bone broth for amino acids, micronutrients and electrolytes. Aim to include foods high in iron, omega-3 fats and iodine like slow-cooked meat, butter, ghee, fatty fish, organ meats, eggs, and seafood or seaweed-infused broths. Try to prioritize soft cooked vegetables for easy digestion so your body can focus on other demanding tasks – like milk production. In addition, adequate fluid intake is crucial to support your milk supply and keep you from getting dehydrated throughout the day. An easy way to ensure this doesn’t happen is to keep a large stainless steel cup near your nursing station or have your partner bring you a glass of water or lactation tea every time you nurse!

I sincerely hope this article has been an encouraging reminder of how important it is to nourish your incredible body in the postpartum phase! Honor the fact that your body just participated in the miraculous task of growing a tiny human and the demanding marathon of birth – it needs to be replenished and well fed during this time, just as it was in pregnancy. The same foods that supported your changing body during pregnancy are the ones that will play a critical role in your recovery following birth and create the most nutrient-dense breast milk for your sweet new addition!

If you need recipe ideas, visit the BumptUp instagram for easy recipe ideas throughout all stages of pregnancy, including postpartum! If you’re interested in more personalized postpartum meal ideas, utilize the BumptUp app’s ‘Ask an Expert’ feature to speak with me, a registered dietitian, for more tailored guidance and suggestions!

Julie C. Shea, MS, RDN, LDN, CPT

1. Dennis, Cindy-Lee et al. “Traditional postpartum practices and rituals: a qualitative systematic review.” Women’s health (London, England) vol. 3,4 (2007): 487-502. doi:10.2217/17455057.3.4.487

What Are Kegels?

If you have ever been pregnant, you’ve probably been told to “do your kegels!”, but what are they? Kegels are a pelvic floor muscle exercise in which you tighten the muscles of your pelvic floor and then relax them. You may be coached to hold the contraction for a certain amount of time before relaxing or just squeeze and immediately release (sometimes called “quick flicks”). While they are incredibly effective at helping many pelvic floor symptoms, there are also situations when they are not helpful. Getting a more comprehensive exam by a qualified pelvic health physical therapist will equip you with more tools to prepare your body and pelvic floor for labor and delivery, including if doing kegels is right for you at this time.

Kegels are traditionally performed during pregnancy to help improve the function of your pelvic floor, but what is the pelvic floor? If your core is like a mason jar, the bottom of the jar is your pelvic floor. This group of muscles is designed to support the weight of the organs in your pelvis. Strengthening the pelvic floor during pregnancy may help you learn how to connect with those muscles better during labor and delivery. Some studies show that having a strong pelvic floor can help decrease urinary leakage, and reduce symptoms of pelvic heaviness.

Here’s the Kick

Not all women would benefit from doing kegels every day. Kegels help to strengthen the pelvic floor. During labor, it is the uterus that contracts to push your baby out. For this to happen, the pelvic floor needs to relax and move out of the way. If you are only practicing contracting the pelvic floor and not relaxing it, this can make labor more challenging. Muscles need to be able to move through their full range of motion.

Women experiencing symptoms of pelvic pain, pain with sex, and/or constipation should avoid doing kegels until consulting with their OBGYN or pelvic health physical therapist. A physical therapist will be able to assess the cause of your symptoms, your ability to correctly perform a pelvic floor contraction and relaxation, and then give you exercises and stretches to help prepare your pelvic floor for labor.

Additional Exercises to Try

In addition or pelvic floor specific exercises, incorporating functional training and full body strength workouts into your routine will result in other health benefits for you and your baby. I recommend practicing diaphragmatic breathing regularly. It can be done during any trimester, including immediately postpartum, and in any position. Diaphragmatic breathing promotes full body relaxation and can help your brain to connect with your pelvic floor.

Some of my favorite daily stretches are:

• Child’s Pose*
• Deep Seated Squat*
• Cat/Cow
• Runner’s Lunge*

*NOTE: If you have a history of hip pain or current hip pain, these stretches may make your symptoms worse and should be avoided until consulting with a healthcare professional.

Some of my favorite lower body strength exercises are:

• Squat
• Deadlift
• Reverse Lunge
• Glute Bridge

As you can see, preparing your pelvic floor for labor is very nuanced and is so much more involved than simply doing or not doing kegels. The body works together as a unit, never in isolation. Try some of these stretches and exercises during your next workout and watch how amazed you will be at the results! Remember, there is no better time to start than right now. Your body and your baby will thank you. You got this!

Sara French, ACSM CPT, NASM CNC

Sources

https://my.clevelandclinic.org/health/diseases/22870-hypertonic-pelvic-floor

https://www.yalemedicine.org/news/kegels#:~:text=Would%20all%20women%20benefit%20from,along%20with%20other%20muscle%20groups.%E2%80%9D

https://utswmed.org/medblog/prepare-body-labor-delivery/#:~:text=Deep%20squat-,Deep%20squats%20help%20relax%20and%20lengthen%20the%20pelvic%20floor%20muscles,deep%20squats%20you%20should%20do.

https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/kegel-exercises/#:~:text=Pregnant%20women%20who%20perform%20Kegel,knows%20you’re%20doing%20them.

Research shows that constipation affects up to 38% of women during pregnancy. If you’ve ever been pregnant and had to suffer through this annoying symptom, congratulations! You are one of the lucky 38%. Throughout this article, we will explore what can trigger constipation and discuss ways to relieve it. 

What Causes Constipation in Pregnancy?

There are a number of factors that play into pregnancy constipation. First, your hormones are all over the place during pregnancy. Progesterone increases dramatically in a very short amount of time, which causes gut mobility to slow down. Second, you are likely experiencing the extreme fatigue that comes along with growing a human. This means you are probably less active than normal, which is a big contributing factor to constipation. Third, your uterus is expanding to support that growing baby of yours. If it feels like your intestines are suddenly getting squished together, that’s because they are! You might even notice constipation being worse around the times your baby is going through a growth spurt. Fourth, your intestines absorb more water during pregnancy. This can lead to a dried out stool, which makes it harder to pass. Finally, your supplements might be inadvertently contributing to this nagging symptom. Iron and calcium are both found in prenatal vitamins, and they often worsen the symptoms of constipation in pregnancy. It seems unfair, because iron and calcium are both vital for your and your baby’s health! 

How Can I Mitigate Constipation During Pregnancy?

While stool softeners and laxatives are generally considered safe to take during pregnancy, we definitely don’t want to rely on them every single day! There are more natural steps to take first, and that is what we’ll be discussing in this section. The first and easiest thing you can do to fight constipation is to drink more water. You are likely dehydrated and should aim for 8-12 cups of water per day. It wouldn’t hurt to increase the amount of water-rich foods in your diet either! This includes things like soups, smoothies, fruits, lettuce, etc. Second, try gradually increasing your activity level. Simply walking for 30 minutes per day can have so many health benefits, one of which is relieving constipation! Gentle stretching and mobility goes a long way as well. Third, include more gut-supporting foods in your diet. This includes things like yogurt, kefir, and maybe even a high-quality probiotic! Fourth, add more fiber-rich foods to your meal plan. This includes things like fresh fruit and vegetables, nuts and seeds, oats, and sweet potatoes. Finally, avoid processed food at all costs! If you can, eat whole foods that have been cooked fresh at home. Time may not always allow that, so be sure to keep yourself accountable for how often you are eating out or cooking frozen meals! Life is all about balance, so do your best and make improvements where you can. 

Sara French, ACSM CPT, NASM CNC

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418980

https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/tog.12179#:~:text=Constipation%20affects%20up%20to%2038,bleeding%20and/or%20rectal%20prolapse.

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/pregnancy-constipation/faq-20058550#:~:text=Include%20more%20fiber%20in%20your%20diet.&text=If%20you%20take%20iron%20supplements,are%20taking%20an%20iron%20supplement.&text=With-,Myra%20Wick%2C%20M.D.%2C%20Ph.D.,below%20and%20resubmit%20the%20form.

https://unmhealth.org/stories/2023/06/5-tips-relieve-pregnancy-consumption.html

It’s standard practice to begin taking a prenatal vitamin after finding out you’re pregnant – arguably, it’s worth considering starting prior to conception. However, often for many women, besides a comprehensive prenatal multivitamin, little thought is given to other nutrients that may be beneficial for the health and development of their baby. Of note, omega-3 fatty acids! 

What are Omega-3 Fatty Acids?

Omega-3 fats are considered “essential” fatty acids because our bodies are unable to make them from other raw materials meaning they must be obtained from the diet or through supplementation. Several subtypes of omega-3 fats exist, however, the majority of scientific research has been conducted on alpha-linolenic acid (ALA) found mostly in plants, as well as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found mostly in animal products. Although EPA and DHA often work synergistically, both offer their own unique health benefits. For example, EPA supports the functions of the heart, the immune system, and the inflammatory response. While DHA is a critical component of cell membranes within the eye and brain for fetal development, egg and sperm health, and for lactation. 

Benefits of Omega-3 Fatty Acids

As you can see, omega-3 fats serve as important building blocks during pregnancy and breastfeeding, but let’s dig a little deeper! Research has shown that omega-3 fats may also function to determine length of gestation and in preventing perinatal depression. One study suggested a link between increased intake of EPA and DHA and prolonged gestation by inhibiting the production of certain prostaglandins known to influence uterine contractions and cervical ripening. Further research proposed DHA supplementation leads to a change in the ratio of omega-3 and omega-6 fatty acids, which may reduce the occurrence of spontaneous early preterm labor. 

There is some evidence to suggest omega-3 fatty acids are important for lactation as well. In one study, women who received 200mg of DHA per day for four months birthed infants who performed significantly better on a developmental assessment tool used to diagnose early developmental delays. Furthermore, fish oil supplementation during pregnancy and lactation showed a decreased risk of infant allergies. 

Which Foods Contain Omega-3 Fatty Acids?

Unfortunately, though not surprisingly, the standard American diet does not provide an appropriate amount of omega-3 fatty acids. Furthermore, approximately 95% of childbearing-age women don’t consume enough DHA often related to low intake of fish and seafood due to concerns surrounding mercury toxicity. Interestingly, fish that tend to be higher in omega-3 content – particularly cold-water, oily fish varieties such as salmon, sardines, mackerel, anchovies, herring or fish eggs (roe) – also happen to be the lower mercury options anyway. Both the FDA and ACOG support the intake of at least 12oz of seafood per week as other critical nutrients offered do appear to outweigh the negative risk of mercury exposure. Additionally, fish contains high amounts of selenium which readily binds with mercury to prevent it from leading to toxic effects in the body. That said, mercury exposure during pregnancy is a justifiable concern so obtain your seafood from trusted sources and avoid large fish that have higher tissue concentrations of mercury such as swordfish, shark, tilefish, marlin, big eye tuna and orange roughy.

Although other foods such as eggs, liver and poultry provide DHA, their concentrations are much lower, thus the intake amount of each of these foods is much larger than with salmon or roe. For example, in order to obtain the equivalent amount of DHA found in three ounces of Alaskan sockeye salmon with the skin, you’d have to consume approximately 14 pasture raised “omega-3” eggs or 2.6 pounds of grass-fed beef! Now I know what you’re thinking – “But Julie, what about hemp, chia and flax seeds?” While sources of the omega-3 alpha-linolenic acid (ALA) can be found in these plant based options, our body’s conversion rate of ALA into DHA is quite poor. For reference, in order to convert the equivalent amount of DHA in 3oz of Alaskan sockeye salmon from the ALA found in the aforementioned sources, you would need to consume approximately 1.5-2.9 cups of flax seeds or 2.8-5.3 cups of hemp seeds. I don’t know about you, but that doesn’t seem realistic to incorporate into my daily routine! 

What About Supplementation?

Don’t like seafood or can’t tolerate it in your pregnancy? Don’t worry! If you’re nervous about consuming adequate amounts of seafood or fish weekly, algae-based DHA or fish oil supplements can help you meet the recommended 200mg per day. As a Registered Dietitian, I am a big fan and advocate for FullWell’s Women’s Fish Oil supplement. It provides an appropriate balance of DHA and EPA, is sourced from sustainably wild-caught fish, and is third-party tested for heavy metals, dioxins, and polychlorinated biphenyls (PCBs). Nordic Naturals is another reputable brand that offers both a Prenatal DHA supplement, as well as an algae-based omega soft gel. Though fish oil pills do not typically have side effects, if you experience a fishy aftertaste or unpleasant burping after taking your supplement, it is worth considering another brand or fresh bottle as that particular batch may have oxidized!

Summing It Up

It can be concluded that in pregnancy, omega-3 nutrient requirements increase to support fetal growth and development. Research and data have found improved neurodevelopmental outcomes in infancy and childhood with omega-3 consumption, whether by food or supplemental intake. If you don’t include fish regularly in your weekly meals or need some recipe inspiration, visit the BumptUp instagram for an easy salmon salad recipe, perfect for any trimester, but especially in your second or third when baby’s brain development is rapidly progressing! Interested in other fish oil supplement recommendations or want more information about the benefits of omega-3 fats and DHA? Utilize the BumptUp app’s ‘Ask an Expert’ feature to speak with a dietitian for more tailored guidance and suggestions! 

Julie C. Shea, MS, RDN, LDN, CPT

1. Coletta, Jaclyn M et al. “Omega-3 Fatty acids and pregnancy.” Reviews in obstetrics & gynecology vol. 3,4 (2010): 163-71.
2. Cetin I, Carlson SE, Burden C, et al. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. Am J Obstet Gynecol MFM 2024;6:101251.
3. Burns-Whitmore, Bonny et al. “Alpha-Linolenic and Linoleic Fatty Acids in the Vegan Diet: Do They Require Dietary Reference Intake/Adequate Intake Special Consideration?.” Nutrients vol. 11,10 2365. 4 Oct. 2019, doi:10.3390/nu11102365
4. Balasundaram P, Avulakunta ID. Bayley Scales Of Infant and Toddler Development. [Updated 2022 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567715/
5. American College of Nurse-Midwives. “Omega-3 Fatty Acids during Pregnancy.” Journal of Midwifery and Women’s Health, Volume 55, Issue No 6, 21 January 2011, page 599-600, doi.org/10.1016/j.jmwh.2010.08.007. 
6. Nichols, Lily. “Omega-3 Fats: Why You Can’t Rely on Plants for All of Your Omegas.” Lily Nichols, RDN, https://lilynicholsrdn.com/omega-3-dha/. Accessed 7 August, 2024. 
7. Nichols, Lily. “Can You Eat Too Much Fish During Pregnancy?” Lily Nichols, RDN, https://lilynicholsrdn.com/fish-pregnancy/. Accessed 7 August, 2024. 
8. “Omega-3 Fish Oil and Pregnancy.” American Pregnancy Association, https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/omega-3-fish-oil-and-pregnancy/. 7 August, 2024.

Anyone who has ever been pregnant knows to expect a gestational diabetes test in the latter half of the pregnancy. To put it plainly, gestational diabetes is a condition during pregnancy when the body cannot make enough insulin. The placenta is a powerful organ that makes its own hormones to support your growing baby. Sometimes, these hormones make it harder for the body to use insulin. Gestational diabetes typically resolves itself after pregnancy, but there are definitely things you can do to help your body during pregnancy if you receive this diagnosis. In this article, we will discuss what to expect for the traditional screening, explore options outside of the standard glucola drink, and assess lifestyle changes you can make to improve your blood sugar during pregnancy. 

Routine Screening: What to Expect

Traditionally, in the United States, your OB will perform a routine screening for gestational diabetes sometime between week 24 and 28 of pregnancy. If everything goes well, you should only have to do this once. You can expect to drink a syrup-like sugar drink in a brief amount of time. After one hour, your OB will take a blood test and learn how your body responds to sugar. Ideally, your blood sugar should be below 140 mg/dL. If your blood sugar is too high, over 190 mg/dL, a follow-up test will be required in order to determine if you have gestational diabetes. 

The follow-up test is similar to the initial test. However, you will be required to drink even more sugar. Your blood sugar will then be monitored every hour for the next three hours. You will not be allowed to eat anything during this time, as your OB wants to learn how your body responds to a significant amount of sugar over a period of time. If two out of three of the readings are abnormally high, you will have a gestational diabetes diagnosis. 

You might be feeling discouraged, but there are lifestyle changes you can make immediately to help your body better respond to sugar! At this point, after failing both glucose screenings, your OB will probably recommend that you monitor your blood sugar at home with a finger prick kit. 

Exploring Alternative Screening Methods

We discussed the traditional method that OBs use to screen for gestational diabetes. Did you know you have options outside of the standard glucola drink? What happens if you fail both traditional methods at your OB office? You will likely have to check your sugars at home. Some people opt to monitor their blood sugar this way right from the start. If you choose this option, you will work closely with your birth team to establish a rigid protocol. In my experience, I took home a finger prick kit and a log to record my levels. For four days, I recorded my fasting glucose first thing in the morning. Then, I recorded what I ate for breakfast and waited two hours before testing my glucose. If I ate anything in that two hour waiting period, the clock would have to restart. I did this for lunch and dinner also. If I got any high readings, I would have had to discuss adjusting my diet. I also would have been required to measure my levels for more than four days. 

I enjoyed this screening method because it allowed my midwife to get an accurate snapshot into my everyday diet. She was able to see how my body responded to a normal amount of sugar over a set amount of days. It also enabled me to monitor everything from the comfort of my home, and I did not have to fast. 

If this method isn’t for you, but you are hesitant to drink the standard glucola drink, there is another option! First, you can ask your provider for the dye-free version of the glucola drink. If you are still unsatisfied with this method, ask about The Fresh Test. This is a more natural alternative to the glucola drink. The Fresh Test has only a few ingredients and no additives whatsoever. If you are about that holistic life, this option is for you! Your midwife or OB will not have this in their office, so you will have to order it. The Fresh Test offers different options to choose from (50g, 75g, and 100g) depending on what protocol your birth team will use. The test itself is the same as the traditional method. You just bring the fresh test to your OB’s office, drink it up, and wait one whole hour before measuring your blood sugar levels. 

Tips for Managing Blood Sugar During Pregnancy

If you have been diagnosed with gestational diabetes, don’t be discouraged. Your birth team will likely discuss some changes you can make to your lifestyle to help manage your blood sugar. First, try walking for about ten minutes after each meal. This will stimulate digestion and help level out those sugars! Second, prioritize protein at every meal. Aim for roughly 30g of protein at each meal. Lastly, if you are craving a snack that is high in carbohydrates, always pair it with a buddy! Never eat carbs by themselves, try to pair them with a protein and a fat. Following these three tips will help you better manage your blood sugar during pregnancy, which will have beneficial outcomes for you and your baby! You’ve got this momma!

Sara French, ACSM CPT, NASM CNC

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483546/#:~:text=Limitations%20of%20these%20tests%20are,those%20with%20GDM%20are%20needed.

https://www.cdc.gov/diabetes/about/gestational-diabetes.html#:~:text=Gestational%20diabetes%20happens%20when%20your,to%20develop%20type%202%20diabetes.

https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/diagnosis-treatment/drc-20355345

https://drkaylaborchers.com/holistic-alternatives-gestational-diabetes-screenings/#:~:text=Holistic%20Gestational%20Diabetes%20Screening%20Alternative,-%233:%20Blood%20Sugar&text=Another%20option%20is%20to%20work,to%20screen%20for%20gestational%20diabetes.

Ladies, whether you’re growing a tiny human, looking to balance your hormones, or improve your body composition, protein is a key nutrient to help you be successful. But let’s focus on pregnancy – what role does protein play in your baby’s health? How much protein do you really need in pregnancy? Are all sources of protein created equal? I will answer all of these questions in the following article, plus I’ll share some great high protein breakfast options to help you start your day off on the right foot for satiety and blood sugar balance! 

What Role Does Protein Play in My Baby’s Health?

Protein is considered an essential macronutrient since proteins are the building blocks of our bodies. These building blocks are known as amino acids and are responsible for building new cells. Pregnancy demands an increase in protein intake due to the expansion in blood volume and increased growth of maternal tissues. Additionally, your growing baby and brand new organ, AKA your placenta, require a substantial amount of protein for proper development. Research suggests maternal protein restriction can lead to early embryonic losses, reduced postnatal growth and decreased fetal growth, also referred to as intrauterine growth restriction (IUGR). According to other studies, inadequate protein intake has been linked to placental insufficiency, supporting the concerns surrounding IUGR. As you can see, protein is an absolute necessity to supply not only your growing baby, but your growing uterus, placenta and other tissues with adequate materials to support your pregnancy. After all, you are creating a tiny human from scratch!

How Much Protein Do You Need in Pregnancy?

Trying to find a definitive answer about protein requirements in pregnancy will prove to be a challenge, to say the least. The current Recommended Dietary Allowance (RDA) for protein during the first trimester is 0.8g/kg of body weight per day. During the second and third trimesters, RDA estimates suggest 1.1g/kg of body weight per day. Just for reference, for a 150lb woman, these suggestions would equate to approximately 54g protein per day in the first trimester and 75g protein per day for the second and third trimesters. The RDA serves as the most widely accepted standard for protein requirements, however, newer research suggests that the current dietary guidelines substantially underestimate protein requirements for optimal intake.

According to a study published in 2016 utilizing the indicator amino acid oxidation method or IAAO, researchers determined mean protein requirements to be 1.2 and 1.52g protein/kg per day during early and late gestation, respectively. The indicator amino acid oxidation method is a minimally invasive technique to determine amino acid requirements. It is important to recognize, researchers note high-quality animal proteins require far less energy intake to meet essential amino acids than plant protein sources. Let’s get into why that may be!

Are All Sources of Protein Created Equal?

As a registered dietitian, I like to advocate for a balance of both animal-sourced and plant-sourced proteins to reap the benefits of the unique nutritional profiles. That said, it should be highlighted that animal derived foods such as meat, fish and eggs are considered complete proteins, while plant foods such as beans, nuts and seeds are considered incomplete proteins. This is due to the concept of essential, non-essential and conditionally essential amino acids. It is widely accepted that “essential” amino acids are those your body cannot make and therefore must be consumed in the diet, while “non-essential” amino acids are those believed to be made from other amino acids in our bodies. However, it turns out that some research indicates “animals and humans cannot adequately synthesize NEAAs to meet optimal metabolic and functional needs under either normal or stress conditions.” Because of this finding, my recommendation is to focus on including a variety of protein-rich foods in your diet – from both animal and plant sources. Below are some high protein food sources:

• Beef, lamb, pork
• Chicken, turkey, other poultry
• Fish and seafood
• Bone broth, ideally homemade
• Eggs, cheese, whole milk
• Greek yogurt
• Various nuts (almonds, peanuts, pecans, walnuts, pumpkin seeds)
• Beans, lentils and legumes

It can be assumed, if you consume an omnivorous diet following the newer protein guideline recommendations according to the IAAO study, you likely won’t have to worry if you’re getting enough!

What Should I Eat for a High Protein Breakfast?

In my humble opinion, breakfast is the best meal of the day! I just love the routine of waking up and preparing a delicious breakfast to start my day off feeling my best. Plus, I just truly enjoy breakfast food options. I understand not everyone feels this way, especially during various stages of pregnancy when food aversions and nausea may impact your typical breakfast routine! Hopefully some of these breakfast ideas inspire you to try something outside of a “traditional” breakfast meal – newsflash: eggs, cereal or oatmeal are not your only options!

One of my favorite quick and easy breakfast options is a cup of plain Greek yogurt or cottage cheese (full-fat) topped with fresh blueberries or whatever fruit is in season near you, a sprinkle of hemp seeds and a very light drizzle of local honey. You can even mix in a scoop of unflavored or vanilla collagen powder for an added protein boost. Another quick and easy option is breakfast leftovers! That’s right, you can repurpose your dinner from a previous night. Just warm your leftovers in a skillet and mix in a fried egg or boiled egg on the side! I particularly love this one if the previous night’s dinner was some kind of casserole or hash.

Speaking of hash, adding veggies of choice (I like spinach, tomatoes and sweet peppers) to a skillet with breakfast sausage and diced potatoes makes for a delicious savory breakfast option. If you find yourself rushing out the door in the morning, try a protein rich breakfast smoothie. I like adding cottage cheese or Greek yogurt to my smoothies for extra protein and fat, along with other nutrient dense powerhouses like hemp seeds, ground flaxseed, frozen veggies like zucchini or cauliflower and frozen avocado! 

I hope some of these meal ideas inspired you to try something new in the kitchen. Eating a whole food diet does not have to be boring or repetitive! If you need more recipe ideas, visit the BumptUp instagram for easy recipe ideas throughout all stages of pregnancy, including postpartum! If you’re interested in more personalized breakfast or meal ideas, Utilize the BumptUp app’s ‘Ask an Expert’ feature to speak with me, a registered dietitian, for more tailored guidance and suggestions!

Julie C. Shea, MS, RDN, LDN, CPT

1. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 19, Protein and Amino Acids. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235221/
2. Herring, Cassandra M et al. “Impacts of maternal dietary protein intake on fetal survival, growth, and development.” Experimental biology and medicine (Maywood, N.J.) vol. 243,6 (2018): 525-533. doi:10.1177/1535370218758275
3. Hou, Yongqing, and Guoyao Wu. “Nutritionally Nonessential Amino Acids: A Misnomer in Nutritional Sciences.” Advances in nutrition (Bethesda, Md.) vol. 8,1 137-139. 17 Jan. 2017, doi:10.3945/an.116.012971
4. Murphy, Mary M et al. “Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003-2012.” Nutrients vol. 13,3 795. 28 Feb. 2021, doi:10.3390/nu13030795
5. Elango, Rajavel, and Ronald O Ball. “Protein and Amino Acid Requirements during Pregnancy.” Advances in nutrition (Bethesda, Md.) vol. 7,4 839S-44S. 15 Jul. 2016, doi:10.3945/an.115.011817
6. Pencharz, Paul B et al. “Recent developments in understanding protein needs – How much and what kind should we eat?.” Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme vol. 41,5 (2016): 577-80. doi:10.1139/apnm-2015-0549

So you’re in your first trimester of pregnancy. You might be feeling all of the symptoms by now or having no symptoms at all! Either way, you probably have some questions about exercising now that you are pregnant. The research is heavily supportive of exercising during pregnancy. If you are new to exercising, however, there are some guidelines and points to consider before you jump right in. 

Benefits of Exercising During Pregnancy

According to the American College of Obstetrics and Gynecologists, or ACOG, there is nothing wrong with beginning an exercise program during pregnancy, especially if you were inactive before getting pregnant. If you are having a healthy pregnancy and cleared by your doctor, it can only benefit you and your baby to begin exercising as soon as you can! There is a strong correlation between healthy mothers and healthy babies. ACOG recommends getting at least 150 minutes of moderate-intensity planned activity per week for the average pregnant woman. Simply put, the benefits of exercising during pregnancy outweigh the risks for the general population. Establishing healthy habits during pregnancy has been shown to have lasting benefits for both the mother and her baby even after the baby is born. Some benefits of exercising during pregnancy include, but are not limited to:

• Establishing a healthy mindset going into labor and postpartum. Think about all of those happy hormones that are released during exercise!
• Reducing constipation
• Easing back pain, pelvis pain, and tailbone pain
• May decrease risk of developing pregnancy-induced hypertension, preeclampsia, and gestational diabetes
• Promoting healthy weight gain during pregnancy
• May help with healthy weight loss in the postpartum period
• Preparing your body for labor, and may even help to shorten labor
• Improving overall fitness

Contraindications to Exercising During Pregnancy

Every pregnancy looks different for pretty much every woman. Not all experiences are the same, and some women have to be extremely careful with movement during pregnancy. There are several conditions that make it difficult, or even unsafe, to exercise during pregnancy. Indeed, some contraindications to exercising while pregnant include, but are not limited to:

• Placenta previa
• Preeclampsia
• Persistent bleeding
• Premature labor
• Ruptured membranes

Additionally, if you have been cleared to exercise during pregnancy, but experience any of the following, stop immediately and contact your doctor:

• Bleeding or amniotic fluid leakage
• Dizziness or shortness of breath
• Calf pain or unusual swelling
• Heart palpitations or chest pain

These are all unlikely scenarios, but it is good to know what to look out for. 

Powering Through Fatigue

One of the most common symptoms during the first trimester is fatigue. When I was in my first trimester, it felt like I was physically and mentally wading through fog every day. I had very little energy to perform the most basic of tasks, and that weighed me down. If this has been your experience during the first trimester, you can still find ways to be active without overdoing it. It is important to give yourself grace during this period as well. Remember that it is temporary, and you will likely see improvements in energy in the second trimester. My top tip for powering through first trimester fatigue is this: start with your warm up, and determine how you feel afterward. Warmups should be at least ten minutes long and should consist of gentle movement. I found two outcome possibilities that worked for me when I tried this method:

1. I discovered that I had enough energy to continue on to my workout once the warm up was completed. Indeed, I always felt better mentally and physically when I completed the workout.
2. Sometimes the warm up was all I could handle. In this scenario, I either continued performing mobility exercises for a little while longer, or I replaced my workout with a gentle walk. Mobility and walking was my bread and butter during the first trimester. And I felt so much better afterward!

You will notice that I felt better both physically and mentally no matter which scenario played out. Motion is lotion no matter how you look at it! It also helped to think about my “why.” On the days when motivation was lacking and fatigue was taking over, I remembered why I exercise. My “why” might look different than yours, and that is okay! Just give yourself grace and remember why you are doing this. You got this, mama!

Sara French, ACSM CPT, NASM CNC

Sources

https://www.researchgate.net/profile/Heidi-Prather/publication/233749975_Benefits_of_Exercise_During_Pregnancy/links/5a5e1380458515c03ee098c0/Benefits-of-Exercise-During-Pregnancy.pdf

https://www.acsm.org/blog-detail/acsm-certified-blog/2019/08/06/fit-pregnancy-guidelines-simple-guide

https://www.acog.org/womens-health/faqs/exercise-during-pregnancy

While summer is coming to a close, it seems the temperatures have been hotter than ever! Maintaining proper hydration is extremely important during pregnancy, especially during these warmer months. However, it isn’t as simple as just drinking water by itself. Pregnancy causes a  number of things to change in the mother’s body, and a significant increase in blood volume is just one change. This means electrolyte needs drastically increase during pregnancy in order to keep all of the extra fluid in the correct cellular balance. The main electrolytes that help to support proper hydration are: sodium, potassium, and magnesium.

Sodium

Sodium is an important micronutrient that the body requires small amounts of in order to perform many processes. It is important in maintaining fluid balance in the body’s cells, helps to maintain acid-base balance, and is vital for having normal muscle function. Additionally, sodium is necessary for aiding in proper nervous system function as well as maintaining blood pressure. During pregnancy, sodium is responsible for expanding plasma volume outside the cells. However, balancing sodium with potassium is the key to healthy hydration. Too much sodium and not enough potassium can cause health problems to both the mom and her baby.

Potassium

Potassium is another important mineral that works hand-in-hand with sodium. While sodium is more highly concentrated on the outside of the cell, potassium is busy at work on the inside of the cell. It helps muscles contract as well as sends nerve impulses. Not enough potassium can cause muscle cramps, particularly in the legs. As stated earlier, it is important to maintain the correct balance of sodium and potassium in the body. Elevated sodium levels outside the cell combined with too little potassium inside the cell can cause a number of problems, such as an increase in blood pressure. This can have negative outcomes for both mom and baby! To increase potassium intake during pregnancy, consume fruits and vegetables, as these tend to be high in potassium. A high-quality prenatal vitamin will also contain an appropriate ratio of sodium and potassium that will assist your increased electrolyte needs.

Magnesium

Most people are deficient in this important mineral, and pregnant women are no exception. Blood levels of magnesium have been shown to decrease significantly during pregnancy, so it is important to add this micronutrient to your diet. Studies have shown that low magnesium levels have been associated with an increased risk of preeclampsia, preterm labor, and leg cramps. Researchers also found a correlation between too little magnesium and pregnancy-induced hypertension. Comparatively, studies have also found that magnesium supplementation greatly reduced the onset of pregnancy-induced hypertension, as well as reduced the rate of preterm births. These studies are proof that negative outcomes of consuming too little magnesium can be avoided by eating foods rich in magnesium as well as incorporating a high-quality prenatal vitamin in the diet.

My Favorite Hydration Mocktail

½ cup organic orange juice (excellent source of potassium)

½ cup organic coconut water (excellent source of magnesium)

2 pinches of organic sea salt (excellent source of sodium)

Sara French, ACSM CPT, NASM CNC

Sources

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.12924#:~:text=14,adverse%20effects%20on%20fetoplacental%20development.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229801/#:~:text=3.6.,with%20other%20conditions%20as%20well