Iron deficiency anaemia

An adequate intake of dietary iron can help to prevent the development of iron deficiency anaemia (IDA) during pregnancy. Data on prevalence of IDA in pregnant women are lacking in Australia. However, estimates indicate that between 4-20% of women have low iron stores and IDA is more common in Aboriginal women than in non-Aboriginal women(1). Changes in iron absorption during pregnancy means that iron supplementation may not be required for all pregnant women. Monitoring blood levels of iron during pregnancy and intervening with iron supplements when necessary will help ensure adequate iron is maintained during pregnancy. If iron deficiency anaemia is diagnosed during pregnancy, supplementation of at least 60mg/day is recommended(2).

Listeria

Listeria infection can be caused by eating foods contaminated with the bacteria called Listeria monocytogenes. Pregnant women are at risk of Listeria infection, which can cause miscarriage, still birth, premature birth or a very ill infant at birth. High risk foods for Listeria infection include:

• Pre-cooked meat products eaten without further cooking (e.g. pâté, sliced deli meat and chicken)
• Chilled seafood (e.g. smoked fish, smoked mussels, oysters and raw seafood)
• Pre-prepared salads (e.g. fruit salads and coleslaw)
• Unpasteurised dairy products and soft cheese products (e.g. camembert, ricotta, brie, and soft serve ice-cream)

It is recommended that pregnant women avoid these high-risk foods and ensure safe handling practices when preparing food(3). To learn more, visit the Food Standards website. 

Mercury

There are health benefits associated with including fish in the diet and pregnant women can still include fish as part of a healthy diet. However, mercury, which can be found in fish, can impair the development of the nervous system in the foetus if consumed in high levels. FSANZ provides guidelines and recommendations for the amount and types of fish that can be eaten by women during pregnancy. Pregnant women can consume:

“1 portion per week of Orange Roughy (Deep Sea Perch) or Catfish and no other fish that week OR 1 portion per fortnight of Shark (Flake) or Billfish (Swordfish/Broadbill and Marlin) and no other fish that fortnight.”(4)

For a patient friendly resource, click here.

Vegetarian diets and pregnancy

A well-planned vegetarian diet can support appropriate nutritional health during pregnancy. Vegetarian women frequently consume more fibre, wholegrains, and lower fat diets than non-vegetarian women. Care needs to be taken to ensure meat products are replaced with appropriate alternatives such as legumes, beans and wholegrains to help meet the additional protein, iron and zinc needs. Foods such as tofu, eggs and low-fat dairy products are nutrient rich and can help to meet nutrient needs during this time. However, it is difficult for women following a vegetarian or vegan diet to consume sufficient vitamin B12, therefore B12 supplements are recommended(2).

Alcohol

The NHMRC recognises that alcohol consumption can harm the developing foetus or breastfeeding baby(5). While the effects of heavy drinking during pregnancy are well accepted, there is no lower limit of intake that can be recognised generally as being safe. As a result, avoiding alcohol during pregnancy is the safest option. Therefore, “to prevent harm from alcohol to their unborn child, women who are pregnant or planning and pregnancy should not drink alcohol”(5). For more information, visit EveryMomentMatters.org.au.

Caffeine

Consuming too much caffeine during pregnancy is associated with a reduced birth weight or foetal growth restriction(6). Pregnant women should consume no more than 200mg of caffeine per day (equivalent to two cups of coffee per day)(7). Common sources of caffeine in the Australian diet include coffee (~100mg caffeine in a medium brewed coffee), tea (~36mg caffeine in a medium tea), cola beverages (~35mg caffeine in a 375ml can). However, ‘energy drinks’ contain more caffeine (~114mg in a 355ml Red Bull).

Food aversions and pregnancy

Some women experience a loss of appetite or aversion to particular foods during their pregnancy. Both of these are more common during the first trimester of pregnancy but can occur throughout pregnancy. It is important to work with the food likes and dislikes while trying to follow the recommendations presented in the dietary guidelines. In circumstances where a mother is struggling to meet her nutritional needs during pregnancy, a formulated supplementary food such as Nutrition for Mothers™ may be beneficial.