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This is discussed under following:

  • Nausea and vomiting
  • Hyperemesis gravidarum
  • Hypo- and hyperglycemia
  • Low maternal weight
  • High maternal weight
  • Poor appetite
  • Heartburn
  • Edema or water retention
  • Iron deficiency anemia
  • Meeting nutrient needs
  • Constipation
  • Food safety
  • Use of artificial sweeteners
  • Use of caffeinated beverages and alcohol.

Nausea and Vomiting

  • Eat small, frequent meals and snacks (every 1.5-2 hours).
  • Try to have crackers or dry toast at the bedside if nauseous upon waking.
  • Carry food and keep snacks in the car.
  • Try to have plenty of fluids between meals and nutritious shakes, if this is easier than eating solids. In general,
  • Try any foods that are appealing.
  • Try smelling fresh lemon, squeezing lemons into sparkling water, lemon sour candies, lemonade, ginger ale, or ginger tea.
  • Increase food sources of vitamin B6 (for example, meat, poultry, fish, potatoes, bananas, watermelon, acorn squash, and fortified cereal).
  • Prefer foods that are easier to digest.
  • Take the prenatal vitamin at night as a feasible option.
  • Don’t stop eating and drinking altogether even if they have no appetite because this can worsen nausea.
  • Don’t let more than 2-3 hours pass before eating.
  • Don’t take any medication, over-the- counter products, or supplements (including vitamin B6) without the PMD’s approval.
  • Don’t provide high- fat or oily foods, which take longer to digest.
  • Don’t take caffeinated beverages (coffee, some teas, and some soft drinks).
  • Don’t stay in poorly ventilated rooms or places with bothersome smells (for example, cigarette smoke or strong perfume/cologne).

Vomiting / Hyper emesis Gravidarum

  • Stay well hydrated by drinking plenty of fluids, including a rehydrating drink containing electrolytes (for example, Gatorade) and juices in small amounts throughout the day.
  • Try adding ginger root to foods and drink ginger roots tea or red raspberry tea.
  • Prefer low-fat foods that are easy to digest.
  • Recommend snacks with high water content.
  • Get psychosocial support in addition to physical support if required.
  • Don’t take caffeinated beverages (coffee, some teas, and soft drinks).
  •  

Hypo /Hyper -Glycaemia

  • Eat a diet consisting proportionally of complex, high-fiber carbohydrates (for example, whole-grain breads and cereals, brown rice, legumes, and fresh fruits and vegetables).
  • Take smaller meals with appropriate snacks between meals.
  • Include some source of protein (for example, milk, and yogurt, cheese, meat, poultry, eggs, or nut butters) in all meals and snacks.
  • Don’t eat or drink fruit juice, highly sweetened beverages and concentrated sweet foods.

Low maternal weight/ Weight loss

  • Take frequent meals and snacks consisting of nutrient-dense, high-kilocalorie foods (for example, cheese, yogurt, milk shakes, granola, dried fruits, starchy vegetables, and muffins) or what appeals to you if appetite is poor.
  • Try homemade shakes (blend yogurt, milk powder, and fresh fruit).
  • Problem solve ways to minimize stress or to slow down if you are“too busy” to eat.
  • Consult with  your doctor  if weight gain remains poor.
  • Don’t skip meals.
  • Don’t do excessive exercise or physical activity.

High maternal weight/Weight gain

  • Establish a healthy eating pattern of regular meals and snacks with nutrient-dense foods lower in calories.
  • Prefer high-fiber choices (for example, vegetable, fruits, beans, legumes, whole-grain cereals/ breads).
  • Try easy ways to get more fruits and vegetables on a regular basis.
  • Take low-fat or nonfat dairy foods, seafood, chicken, or lean meat for the patient.
  • Have  more water and caffeine-free, non-caloric beverages.
  • If you want to have soft drinks, try club soda mixed with some fruit juice.
  • Take frozen yogurt, light ice cream, and sugar- free puddings for dessert.
  • Do moderate exercise on a regular bales ( for example, walking, swimming, dancing, and prenatal yoga).
  • Find out ways to decrease stress, fatigue, and anxiety .
  • Increased food intake positively correlates with these psychosocial factors.
  • Don’t try skipping meals or calorie restrictions to lose weight

Poor Appetite

  • Have small amounts of food frequently.
  • Snacking may be easier if meals seem too difficult.
  • Try sipping fruit juices/nectars and nutritious shakes (for example, Carnation Instant Breakfast or homemade shakes using yogurt and fruit ).
  • Take advantage of times when appetite is better and have more food.
  • Remind importance  of eating for nutrition and not only for hunger or appetite.

Heartburn

  • Eat small, frequent meals and low-fat snacks in a relaxed setting.
  • Eat slowly and stay upright after eating.
  • Take a walk after meals.
  • Wait at least 2 hours before lying down and elevate the upper body when sleeping.
  • Don’t have high-fat, spicy food and foods that tend to “revisit.”
  • Don’t have spearmint, peppermint, and caffeine.

Oedema and Fluid Retention

  • Keep monitor weight gain and blood pressure.
  • Rule out hypertension and the appearance of proteinuria.
  • Assess amount of sodium in diet.
  • Elevate feet whenever possible.
  • Don’t limit fluid intake, which will only worsen the problem,
  • Don’t eat  salt foods.
  • Don’t  have processed foods and high-sodium items (for example, soups, salty snacks, pickles, cured meats, cold cuts, and some fast foods).
  • Don’t use diuretics unless prescribed by your doctor.

Iron Deficiency Anemia

  • Take high-iron foods (for example, beef, liver, fish, clams, cooked oysters, poultry, dried peas, beans, lentils, and fortified cereals); accompany with vitamin C-rich food to aid iron absorption from meats.
  • Have the iron supplement as advised by your doctor.
  • Decrease the dose if side effects (for example, nausea, cramps, constipation, and diarrhea) persist.
  • Or try a slow- release preparation at mealtime if approved by PMD. Continue with prenatal vitamin.
  • Don’t consume any raw oysters, clams, or any uncooked seafood.
  • Don’t have coffee or teas, which can inhibit iron absorption.
  • Don’t take an iron supplement with milk products.

Meeting Nutrition Needs

Increase food sources and/or supplements of the following nutrients:

  • Folate (for example, leafy, dark green vegetables, legumes dried beans and peas, citrus fruits and juices, most berries, and fortified breakfast cereals). The recommended intake of folate is 600 mg per day. A supplement of 400 mg per day of folic acid is advisable with the doctors’ approval.
  • Vitamin B12 (for example, cooked clams, oysters, liver, herring, crab, liver, salmon, lobster, beef, and all bran cereal).
  • If vegan, you must consume a reliable vitamin B12 source (for example, fortified soymilk or a supplement).
  • Zinc (for example, cooked oysters, crab ,dark meat of turkey, wheat bran flakes cereal, and cherries).
  • Don’t have supplements without approval from the doctor.
  • Don’t take fish over 12 oz. per week to avoid over consumption of mercury.

Constipation

  • Take plenty of vegetables and fruits in all meals and snacks
  • 100% whole wheat bread, bread, bran, and whole- grain cereals or muffins.
  • Take plenty of fluids (at least eight 8-oz. glasses per day).
  • Try dried apricots, prunes, and prune juice.
  • Consider how to increase iron- rich foods to substitute for the supplement which may be binding, if patient  is taking an iron supplement.
  • Do  regular, appropriate physical activity.
  • Don’t use mineral oil or other “natural” remedies.
  • Don’t take laxatives.

Use of Artificial Sweeteners

  • Use natural sugar in moderate amounts.
  • Don’t use artificial sweeteners without an approval from your doctor.
  • Women with phenylketonuria should not use aspartame.

Food Safety

  • Meats and seafood

Separate raw meat, poultry, and seafood from ready-to eat foods in the refrigerator, and while preparing and handling foods.

Cook meats and seafood thoroughly before eating.

  • Dairy and Eggs

Check labels on the entire dairy and egg products to certain they are pasteurized.

Cook eggs thoroughly until the yolks and whites are firm.

  • Fruits and Vegetables

Wash thoroughly all raw produce with running water, especially fruit rinds that are removed (for example, melons, oranges).

Serve only pasteurized juice (found in the refrigerated section of the store) or shelf- stable juices (for example, juice boxes).

Follow the 2- hour rule.

Discard perishable foods left at room temperature for over 2 hours.

On hot days, discard food after one hour.

Alcohol Use

  • Abstain from the use of any alcoholic beverages.
  • No safe level has been determined for pregnant women; therefore, most health professional organizations recommend abstaining.
  • Don’t allow any type of alcoholic beverages.

Caffienated Beverages

  • Encourage moderate intake of teas, coffee, and cola.
  • Don’t have more than a maximum of 2-3 cups per day of coffee and tea.

Dietary Recommendations

  • Eat a well-balanced, nutritious diet and be sure to get moderate exercise, fresh air, and plenty of rest.
  • Do not consume junk food, highly seasoned or fried foods, or coffee.
  • Avoid eating rate or undercooked meat, poultry, or fish. Do not eat grilled meats. Grilling has been shown to produce carcinogens in meat.
  • Do not smoke, consume alcohol in any form, or use drugs, except as prescribed by your health care provider.
  • Do not take supplements containing the amino acid phenylalanine. Phenylalanine may alter brain growth in the fetus. Also avoid food products containing the sweetener asparatame which contains high levels of phenylalanine.
  • Keep your intake of vitamin A below 10,000 international units daily.
  • Avoid activities that may endanger the abdomen, or that involve jarring, bouncing, or twisting movements. Also avoid activities involving rapid starts and stops, because during pregnancy, the body’s center of gravity changes, and it is easy to lose your balance. After the fourth month, do not exercise on your back, as this can interrupt the blood flow to the uterus and slow the fetal heart rate.
  • Do not take any preparations containing shark cartilage during pregnancy. Shark cartilage inhibits the formation of new blood vessels, which is essential during pregnancy.
  • Do not use an electric blanket. Several experts warn that the invisible electromagnetic field emanating from an electric blanket may increase the risk of miscarriage and developmental problems.