The IOM (Institute of Medicine) has issued new recommendations on nutrition during pregnancy in 2009.
- BMI of 19.8 to 26 prior to pregnancy is considered normal. If it is below or above these numbers, efforts should be made to adjust weight gain during pregnancy to the pre-pregnancy BMI.
- If the Pre-pregnancy BMI is below 18.5 a total pregnancy weight gain of 28-40 lbs is recommended. This is usually feasible with a weekly weight gain of about 1- 1.3 lb during the second and third trimesters.
- If the Pre-pregnancy BMI is between 18.5 and 24.9 (normal) then a 25-35 lb weight gain during pregnancy is recommended. This is usually accomplished by a 0.8-1 lb per week weight gain during the second and third trimesters.
- If the Pre-pregnancy BMI is 25-29.9 (overweight) a total pregnancy weight gain of 15-25 lbs is adequate. This can be accomplished by gaining 0.5-0.7 lbs per week during the second and third trimesters.
- If the Pre-pregnancy BMI is over 30 (obese), the total weight gain during pregnancy should not exceed 11-20 lbs and this can be accomplished by gaining 0.5 lbs per week during the second and third trimesters.
During pregnancy high-fat foods, saturated fats and sweets should be limited. Regular meals with adequate caloric intake is recommended. Calorie intake can be increased by 340 kcal per day during the second trimester and 452 kcal per day in the third trimester.
Excessive amounts of vitamin A (over 10,000 IU) should be avoided. Iron supplementation is needed in cases of iron deficiency anemia. Folic acid 0.4 mg per day before and during pregnancy is needed. Calcium intake of 1 Gm per day is required. Carbohydrate intake of 130 Gm per day is recommended. Protein intake of 0.6 Gm per pound per day is recommended. Fish safety with regards to mercury contamination is important. Information on fish and seafood contaminants can be obtained at www.fda.gov/Food/Food Safety/ Product-SpecificInformation/Seafood. Also the Environmental Protection Agency has information about local mercury threat. More information is available at www.who.it/foodsafety/publications/chem/mercury.
Caffeine, alcohol,smoking and drugs should be avoided.