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Essential Nutrition Guidelines for a Healthy Pregnancy – Everything You Need to Know About Optimal Nutrition During Pregnancy

Welcome to our handout on nutrition during pregnancy! We understand that a healthy diet is crucial for both you and your baby’s well-being. This information sheet has been prepared to help you make informed choices about your diet and provide you with essential tips and guidelines.

Pregnancy is a time of significant changes in your body, and proper nutrition plays a vital role in ensuring a healthy pregnancy and the development of your baby. By following a well-balanced, nutrient-rich diet, you can help support your baby’s growth and development while also maintaining your own health.

This pamphlet will cover various aspects of nutrition during pregnancy, including nutrient requirements, recommended food groups, portion sizes, and tips for managing common pregnancy concerns like morning sickness. It will also address the importance of consuming essential vitamins and minerals, such as folic acid, iron, calcium, and omega-3 fatty acids, for the proper development of your baby’s brain, bones, and overall health.

Remember, every woman’s nutritional needs during pregnancy may vary, so it’s important to consult with your healthcare provider or a registered dietitian to create a personalized diet plan that suits your individual needs. We hope this information will serve as a helpful resource to guide you in making the best nutritional choices for a healthy and successful pregnancy.

Importance of a Healthy Diet

A healthy diet is crucial during pregnancy to ensure that both the mother and the developing baby receive the necessary nutrients for optimal growth and development. By providing the right balance of vitamins, minerals, and other essential nutrients, a healthy diet can support the overall health and well-being of both the mother and the baby.

Why is a healthy diet important during pregnancy?

During pregnancy, your body undergoes numerous changes and has increased nutritional needs. A healthy diet can help meet these increased needs and provide the vital nutrients that are necessary for your baby’s growth and development.

By eating a variety of nutritious foods, you can ensure that you are getting all the necessary nutrients, such as folic acid, iron, calcium, and omega-3 fatty acids. These nutrients are important for the development of your baby’s brain, bones, and organs.

Additionally, a healthy diet during pregnancy can help prevent complications such as gestational diabetes and preeclampsia. It can also reduce the risk of birth defects and low birth weight.

What should you include in a healthy diet during pregnancy?

It’s important to focus on consuming a variety of nutrient-rich foods. Include a mix of fruits, vegetables, whole grains, lean proteins, and healthy fats in your daily diet. Some examples include:

  • Fruits and vegetables: Aim for a rainbow of colors to ensure a wide range of vitamins and minerals.
  • Whole grains: Choose whole wheat bread, brown rice, and oats to increase your intake of fiber and essential nutrients.
  • Lean proteins: Opt for lean meats, poultry, fish, legumes, and tofu to meet your protein needs.
  • Healthy fats: Include sources of healthy fats such as avocados, nuts, seeds, and olive oil for the development of your baby’s brain and nervous system.

Remember to stay hydrated by drinking plenty of water and limit your intake of sugary beverages and processed foods that are high in added sugars and unhealthy fats.

For more information on a healthy pregnancy diet, consult with a healthcare professional or refer to a reputable nutrition handout or information sheet.

Essential Nutrients for Pregnant Women

During pregnancy, it is important to ensure that you are getting all the essential nutrients for both your health and the development of your baby. Below is some important information on the key nutrients you should include in your diet during pregnancy.

1. Folic Acid

Folic acid is crucial for the development of the baby’s neural tube, which eventually forms the brain and spinal cord. It is recommended to take a folic acid supplement before and during the early stages of pregnancy to prevent neural tube defects. Leafy greens, citrus fruits, and fortified grains are good dietary sources of folic acid.

2. Iron

Iron is essential for the formation of red blood cells and to prevent iron-deficiency anemia during pregnancy. Good sources of iron include lean meats, beans, lentils, fortified cereals, and leafy green vegetables. Combining iron-rich foods with foods high in vitamin C can enhance iron absorption.

3. Calcium

Calcium is vital for the development of the baby’s bones, teeth, and heart. Include dairy products, such as milk, yogurt, and cheese, in your diet. If you are lactose intolerant, there are alternative calcium-rich foods like fortified soy products, tofu, and leafy greens.

4. Protein

Protein is important for the growth and development of both the mother and the baby. Incorporate lean meats, poultry, fish, eggs, legumes, and dairy products into your diet to ensure an adequate protein intake.

5. Omega-3 Fatty Acids

Omega-3 fatty acids, particularly DHA, are essential for the baby’s brain and eye development. Include fatty fish, such as salmon and trout, in your diet. If you are vegetarian or do not consume fish, you can consider taking a DHA supplement sourced from algae.

Remember to consult with your healthcare provider or a registered dietitian for personalized advice on nutrition during pregnancy. This information sheet is just a starting point to help you make informed decisions about your diet during this important time.

Balanced Meal Plans for Pregnancy

Proper nutrition during pregnancy is crucial for the health and development of both the mother and baby. A balanced diet can provide the essential nutrients needed for a healthy pregnancy and help prevent complications. Here is some information to help you plan your meals and ensure a well-rounded diet during pregnancy.

1. Include a Variety of Foods

When planning your meals, aim to include a variety of foods from the different food groups. This will help ensure that you are getting a wide range of essential nutrients. Include foods from the following groups:

  • Vegetables and fruits
  • Whole grains
  • Protein sources such as lean meats, poultry, fish, eggs, legumes, and dairy products
  • Healthy fats from sources like nuts, seeds, avocados, and olive oil

2. Focus on Nutrient-Rich Foods

During pregnancy, your body needs increased amounts of certain nutrients. Make sure to include plenty of nutrient-rich foods in your diet, such as:

  • Dark green leafy vegetables like spinach and kale, which are high in iron and folate
  • Foods rich in calcium, like milk, yogurt, and cheese, which are important for building strong bones and teeth
  • Iron-rich foods like lean red meat, poultry, and legumes, which help prevent iron deficiency anemia
  • Foods rich in omega-3 fatty acids, like fatty fish (salmon, trout) and nuts, which contribute to the baby’s brain development

3. Stay Hydrated

Drinking enough water is essential during pregnancy. Aim to consume at least 8-10 cups of fluids per day. Water is important for maintaining the amniotic fluid, preventing constipation, and supporting overall health.

Remember to consult with your healthcare provider or a registered dietitian for personalized advice and guidance on your specific nutritional needs during pregnancy. This information sheet is only a general guide and does not replace professional advice.

Weight Gain Recommendations

One of the most important aspects of nutrition during pregnancy is achieving appropriate weight gain. Every woman is different, so weight gain recommendations may vary. However, it is vital to gain weight within a healthy range to support the growing needs of both the mother and the developing baby.

During the first trimester, weight gain may be minimal, as some women may experience morning sickness that can affect their appetite. However, it is essential to focus on consuming a well-balanced diet that includes a variety of nutrients. This diet should consist of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.

On the other hand, during the second and third trimesters, weight gain tends to increase. On average, it is recommended to gain around 1 pound (0.45 kg) per week during these trimesters. This weight gain is due to the increased development of the baby, the growth of the uterus, and the expansion of the mother’s blood volume.

It is important to note that excessive weight gain during pregnancy can lead to complications such as gestational diabetes, high blood pressure, or an increased risk for cesarean delivery. On the other hand, insufficient weight gain can contribute to low birth weight or preterm labor.

To ensure appropriate weight gain, it is essential to consult with a healthcare provider or a registered dietitian. They can provide personalized nutrition recommendations based on factors such as the mother’s pre-pregnancy weight, overall health, and individual needs.

Overall, maintaining a balanced and nutritious diet during pregnancy is crucial, not only for the mother’s well-being but also for the optimal growth and development of the baby.

Foods to Avoid During Pregnancy

During pregnancy, it is important to pay close attention to your nutrition. Certain foods can pose a risk to the health and development of your baby. This handout provides information on the foods you should avoid while pregnant.

Raw or Undercooked Meats: It is essential to avoid consuming raw or undercooked meats, as they may carry harmful bacteria such as salmonella or listeria. Make sure all meat is cooked thoroughly before consumption.

Unpasteurized Dairy Products: Unpasteurized dairy products can contain harmful bacteria, such as Listeria, which can cause serious complications during pregnancy. Stick to pasteurized dairy products to minimize the risk.

Raw or Undercooked Eggs: Raw or undercooked eggs can increase the risk of salmonella infection. Ensure that all eggs are cooked until the yolk and whites are firm before consuming.

Fish High in Mercury: Certain types of fish, such as swordfish, shark, king mackerel, and tilefish, are known to contain high levels of mercury. High mercury consumption during pregnancy can harm the baby’s developing nervous system. Choose fish with low mercury levels, such as salmon and trout.

Caffeine: While moderate amounts of caffeine are generally safe during pregnancy, excessive consumption can lead to complications. It is recommended to limit your caffeine intake to 200 milligrams per day, equivalent to about one 12-ounce cup of coffee.

Alcohol and Tobacco: It is crucial to completely avoid alcohol and tobacco during pregnancy, as they can cause severe harm to the developing fetus. These substances have been linked to birth defects, preterm birth, and other complications.

Remember, this handout provides general guidelines, but it is always best to consult with your healthcare provider for personalized nutrition recommendations during pregnancy. Following a healthy and balanced diet is essential for the well-being of both you and your baby.

Healthy Snack Ideas for Pregnant Women

When it comes to maintaining a healthy diet during pregnancy, snacking can play a crucial role. Snacks can help you meet your nutritional needs and keep your energy levels steady throughout the day. In this section, we will provide some healthy snack ideas that are both delicious and nutritious.

Snack Description Benefits
Fruit and Yogurt Parfait A layered dessert made with fresh fruits, yogurt, and granola. Provides vitamins, minerals, fiber, and probiotics for digestive health.
Vegetable Sticks with Hummus A combination of raw vegetable sticks (such as carrots, cucumbers, and bell peppers) with a side of hummus. Offers a good source of vitamins, antioxidants, and healthy fats.
Hard-Boiled Eggs Boiled eggs that are easy to prepare and portable. Rich in protein, choline, and essential vitamins.
Trail Mix A mixture of nuts, dried fruits, seeds, and whole-grain cereal. Provides a combination of protein, healthy fats, fiber, and energy.
Avocado Toast Toasted bread topped with mashed avocado and optional add-ons like tomatoes, eggs, or cheese. Offers healthy fats, fiber, vitamins, and minerals.

Remember to listen to your body’s hunger and fullness cues, and choose nutritious snacks that will keep you satisfied between meals. A well-balanced diet during pregnancy is essential for both your health and the development of your baby.

Importance of Hydration

Staying properly hydrated is of utmost importance during pregnancy. The body goes through numerous changes during this time, and adequate hydration is crucial for optimal health and well-being.

The benefits of staying hydrated

Proper hydration during pregnancy has several benefits. It helps to:

  • Support the developing baby
  • Maintain amniotic fluid levels
  • Regulate body temperature
  • Prevent constipation
  • Reduce the risk of urinary tract infections
  • Aid in digestion and nutrient absorption
  • Prevent dehydration-related complications

How much water should you drink?

There is no set amount of water that every pregnant woman should drink, as individual needs vary. However, a general guideline is to aim for about 8-10 cups (64-80 ounces) of fluids per day.

It is important to note that this includes all fluids consumed throughout the day, not just plain water. Other hydrating options can include herbal tea, fruit-infused water, and milk.

If you are unsure about your hydration levels, consult with your healthcare provider for personalized advice based on your specific needs.

Remember: Always carry a water bottle with you and sip on it throughout the day to stay hydrated.

Do not rely solely on thirst as a guide, as it may not always indicate your body’s actual hydration needs.

For more information on nutrition during pregnancy, refer to our comprehensive pregnancy nutrition handout or consult a registered dietitian or healthcare professional.

Tips for Managing Morning Sickness

During pregnancy, it is common for women to experience morning sickness, which is characterized by nausea and vomiting. While it can be an uncomfortable experience, there are ways to manage and alleviate the symptoms. Here are some tips for managing morning sickness:

1. Eat small, frequent meals

Instead of three large meals, try to have several small meals throughout the day. This can help prevent an empty stomach, which can trigger nausea. Opt for foods that are easy to digest and high in protein, such as lean meats, eggs, and yogurt.

2. Stay hydrated

Drink plenty of fluids throughout the day to stay hydrated. Sip on water, herbal teas, or clear broths. Avoid sugary and carbonated beverages, as they can worsen nausea.

3. Avoid triggers

Identify and avoid foods or smells that trigger your morning sickness. Some common triggers include spicy, greasy, or strong-smelling foods. It may help to keep a food diary to track what foods worsen your symptoms.

4. Get plenty of rest

Make sure to get enough sleep and rest during pregnancy. Fatigue can worsen morning sickness symptoms. If possible, take short naps throughout the day to recharge.

5. Consider ginger

Ginger has been used for centuries as a remedy for nausea. You can try drinking ginger tea, chewing on ginger candies, or taking ginger supplements to help alleviate morning sickness. However, consult your healthcare provider before starting any herbal remedies.

6. Try acupressure

Some pregnant women find relief from morning sickness by applying pressure to specific acupressure points. You can use sea-bands, which are wristbands that apply pressure to these points, or consult with a licensed acupuncturist for further guidance.

7. Take prenatal vitamins

Make sure to take your prenatal vitamins as prescribed by your healthcare provider. These vitamins provide essential nutrients to support your baby’s development and can help alleviate morning sickness.

8. Talk to your healthcare provider

If your morning sickness is severe and affecting your daily life, don’t hesitate to reach out to your healthcare provider. They can provide additional guidance and potentially suggest other remedies or medications to help manage your symptoms.

Food to Avoid Food to Include
Spicy foods Crackers
Greasy foods Lean meats
Strong-smelling foods Eggs
Caffeine Yogurt
Alcohol Herbal teas

Remember, every woman’s experience with morning sickness is different, and what works for one person may not work for another. It’s essential to listen to your body and make choices that best suit your needs and preferences. If you have any concerns or questions about your nutrition or pregnancy, consult with your healthcare provider for personalized information.

Factors to Consider for Vegetarian and Vegan Diets

When it comes to nutrition during pregnancy, following a vegetarian or vegan diet requires careful consideration. While these diets can provide all the necessary nutrients for a healthy pregnancy, it’s important to be mindful of certain factors to ensure you and your baby are getting the proper nutrition.

Consult with a Healthcare Provider

Prior to making any dietary changes, it’s essential to consult with your healthcare provider. They can provide personalized guidance and ensure that your dietary choices align with the recommended nutrition guidelines for pregnancy.

Educate Yourself

Being well-informed about the nutritional requirements during pregnancy is crucial for vegetarians and vegans. In addition to general nutrition information, it’s important to understand how to meet your specific dietary needs without compromising your health or the health of your baby.

  • Ensure Adequate Protein Intake:
  • Protein is an essential nutrient during pregnancy, as it plays a vital role in the growth and development of your baby. Vegetarian and vegan sources of protein include legumes, tofu, tempeh, quinoa, and nuts.

  • Pay Attention to Iron and Vitamin B12:
  • Iron and vitamin B12 are commonly found in animal products, so it’s essential to ensure you’re getting enough of these nutrients through plant-based sources or supplements. Iron-rich plant-based foods include beans, lentils, spinach, and fortified cereals. Vitamin B12 can be obtained through fortified foods or supplements.

  • Get Sufficient Omega-3 Fatty Acids:
  • Omega-3 fatty acids are crucial for brain development in your baby. While fish is a common source of omega-3s, vegetarians and vegans can obtain them from flaxseeds, chia seeds, walnuts, and algae-based supplements.

Remember that every pregnancy is different, and consulting with a healthcare provider can ensure you receive tailored advice for your specific dietary needs.

Providing this information as a handout, on a nutrition sheet, or in a pamphlet can be helpful for expectant mothers following a vegetarian or vegan diet. Including recipes, meal plans, and additional resources can further support their nutritional needs during pregnancy.

The Role of Prenatal Supplements

Getting the right amount of nutrients during pregnancy is essential for the health of both the mother and the baby. While a balanced diet is important, it can be challenging to meet all the nutritional requirements solely through food. Prenatal supplements play a crucial role in providing additional support and filling in any nutritional gaps.

These supplements are specifically designed to provide key vitamins and minerals that are important for the development of the baby. They often contain folic acid, iron, calcium, and omega-3 fatty acids, among other nutrients. Folic acid is particularly important in the early stages of pregnancy, as it can help prevent neural tube defects in the baby.

It is important to note that prenatal supplements should not replace a healthy diet. They should be taken in addition to a well-balanced and nutritious eating plan. The information provided on these supplements can be found in handouts and nutrition pamphlets available from healthcare providers.

Before starting any prenatal supplement, it is recommended to consult with a healthcare provider who can provide personalized recommendations based on individual needs. They can guide you on the appropriate dosage and duration of supplementation.

Remember that every pregnancy is unique, and the nutritional needs may vary. While supplements can be beneficial, they should always be used in conjunction with a healthy diet and lifestyle.

Managing Food Cravings and Aversions

During pregnancy, many women experience strong food cravings and aversions. These cravings and aversions can be very powerful and may lead to changes in your diet. It’s important to manage these changes and ensure that you are still providing your body with the necessary nutrients.

Here are some tips for managing food cravings and aversions during pregnancy:

1. Listen to your body: Pay attention to your body’s signals and cravings. If you’re craving a certain food, it may be because your body needs specific nutrients. However, try to make healthier choices within your cravings. For example, if you’re craving something sweet, choose fruit instead of sugary snacks.

2. Keep a food diary: Take note of your cravings and aversions. This can help you identify patterns and make adjustments to your diet. It’s also a useful tool to share with your healthcare provider during prenatal visits.

3. Stay hydrated: Sometimes, cravings can be a sign of dehydration. Make sure to drink plenty of water throughout the day to stay hydrated.

4. Plan ahead: Keep healthy snacks on hand that you enjoy and that meet your nutritional needs. This can help you resist unhealthy cravings and ensure that you’re getting the nutrients you need.

5. Seek alternatives: If you have strong aversions to certain foods, try finding alternative sources of the nutrients they provide. For example, if you can’t tolerate meat, consider getting protein from other sources such as beans, tofu, or lentils.

6. Talk to a dietitian: If you’re having trouble managing your cravings and aversions, consider seeking guidance from a registered dietitian. They can help you create a balanced diet plan that meets your nutritional needs during pregnancy.

Remember, it’s normal to have food cravings and aversions during pregnancy. Managing them is all about finding a balance and making healthy choices for both you and your baby.

Common Nutritional Concerns During Pregnancy

When it comes to pregnancy, it’s important to prioritize both your and your baby’s health. Nutrition plays a crucial role in supporting a healthy pregnancy journey.

Pamphlet and Handout

As an expectant mother, having a reliable source of information on pregnancy nutrition is essential. Consider obtaining a pamphlet or handout that provides detailed guidance on the recommended diet during pregnancy. These resources often include information on the necessary nutrients, portion sizes, and meal suggestions to ensure you and your growing baby receive proper nutrition.

Diet during Pregnancy

Your diet during pregnancy plays a key role in supporting your baby’s development and maintaining your own health. It’s important to eat a well-balanced diet consisting of a variety of nutrient-dense foods.

Some common nutritional concerns during pregnancy include:

Concern Explanation
Weight Gain While weight gain is a natural part of pregnancy, it’s crucial to aim for healthy weight gain within the recommended range. Consult with your healthcare provider to determine the ideal weight gain for your specific situation.
Vitamin and Mineral Intake Meeting the necessary vitamin and mineral requirements is essential during pregnancy. Pay particular attention to consuming adequate amounts of folic acid, iron, calcium, and vitamin D.
Food Safety Ensuring the safety of the foods you consume is crucial during pregnancy. Avoid certain foods, such as raw or undercooked meats, seafood, unpasteurized dairy products, and raw eggs, to reduce the risk of foodborne illnesses.
Fluid Intake Staying hydrated is essential for both you and your baby. Aim to drink plenty of water throughout the day and limit your intake of caffeinated beverages.
Healthy Snacking Choosing healthy snacks can help curb cravings and provide additional nutrients. Opt for nutrient-dense snacks like fruits, vegetables, nuts, and yogurt.

Remember to consult with your healthcare provider or a registered dietitian for personalized recommendations and guidance on meeting your nutritional needs during pregnancy.

By prioritizing your nutrition and following a healthy eating plan, you can ensure a healthy pregnancy for both you and your baby!

Safe Cooking Practices for Pregnant Women

When you’re pregnant, it’s essential to pay extra attention to the safety of the food you consume. Proper food handling and cooking techniques can help minimize the risk of foodborne illnesses and ensure the health of both you and your baby. This pamphlet provides important information and guidelines on safe cooking practices during pregnancy.

1. Wash Hands and Surfaces

Before preparing or handling food, make sure to thoroughly wash your hands with soap and warm water for at least 20 seconds. Clean and sanitize all surfaces, utensils, and cutting boards that come into contact with raw food, especially meat, to prevent cross-contamination.

2. Cook Food Thoroughly

Cooking food to the right internal temperature is crucial to kill any harmful bacteria or parasites that may be present. Use a food thermometer to ensure meats, poultry, seafood, and eggs are cooked to the appropriate safe temperature. Avoid undercooked or raw foods, as they may pose a greater risk of foodborne illnesses.

Remember the following safe internal cooking temperatures:

  • Chicken and poultry: 165°F (74°C)
  • Ground meats (beef, pork, lamb): 160°F (71°C)
  • Steaks, roasts, and fish: 145°F (63°C)
  • Eggs: Cook until the yolk and white are firm

By following these safe cooking practices, you can reduce the risk of foodborne illnesses during pregnancy and ensure the well-being of both you and your baby. For more detailed information on nutrition during pregnancy, please refer to our comprehensive handout on prenatal nutrition.

Exercising During Pregnancy: Nutritional Considerations

As an expectant mother, it’s important to prioritize both exercise and proper nutrition for a healthy and successful pregnancy. This nutrition sheet provides information on the essential nutrients you need to support your body during this time.

Nutrient Why It’s Essential Food Sources Recommended Daily Intake
Protein Supports fetal growth and development, builds new cells, and repairs tissues Lean meats, poultry, fish, eggs, legumes, tofu, dairy products 75-100 grams
Folate Prevents neural tube defects in the developing baby and supports cell division Leafy greens, citrus fruits, fortified cereals, beans, lentils 600-800 micrograms
Iron Helps in the production of hemoglobin and prevents iron deficiency anemia Red meat, poultry, fish, leafy greens, fortified grains 27 milligrams
Calcium Builds strong bones and teeth for both you and your baby Dairy products, fortified plant-based milks, leafy greens 1000 milligrams
Omega-3 Fatty Acids Supports fetal brain and eye development Fatty fish, chia seeds, flaxseeds, walnuts 200-300 milligrams (DHA)

Remember to consult with your healthcare provider or a registered dietitian for personalized advice on meeting your nutritional needs during pregnancy. Eating a balanced and varied diet along with regular exercise can help ensure a healthy pregnancy and the well-being of both you and your baby.

Seeking Professional Guidance: Nutritionists and Dieticians

Diet and nutrition play a crucial role during pregnancy. It is important to ensure that you are getting the right nutrients to support your own health as well as the development of your unborn baby. While there is a wealth of information available on pregnancy nutrition, it can sometimes be overwhelming to decipher what is accurate and reliable.

That is why seeking professional guidance from nutritionists and dieticians can be incredibly beneficial. These experts have a deep understanding of the specific dietary needs during pregnancy and can provide personalized advice tailored to your individual circumstances.

The Benefits of Working with a Nutritionist

A nutritionist specializes in the field of nutrition and can provide valuable insight and guidance on creating a balanced diet during pregnancy. They can help you understand the specific nutrients that are important during each trimester, as well as the foods that are best for meeting those needs.

Working with a nutritionist can help you address any specific dietary concerns or restrictions you may have. For example, if you have food allergies or intolerances, they can help you find suitable alternatives to ensure you are still getting all the necessary nutrients.

Additionally, a nutritionist can help you navigate common pregnancy-related issues, such as morning sickness or cravings. They can provide strategies and recommendations for managing these symptoms while still maintaining a healthy and nutritious diet.

The Role of a Dietician

A dietician is a healthcare professional who specializes in the field of diets and nutrition. They can provide comprehensive advice and support on all aspects of dietary planning and management.

During pregnancy, a dietician can help you create a detailed meal plan that ensures you are getting all the essential nutrients necessary for a healthy pregnancy. They can also monitor your weight gain and adjust your diet accordingly.

Furthermore, a dietician can provide education on proper portion sizes and meal timing to optimize nutrient absorption. They can also help you address any concerns related to weight management during pregnancy, whether it be gaining or losing weight in a healthy and sustainable way.

Overall, seeking professional guidance from a nutritionist or dietician during pregnancy can provide you with the knowledge and support needed to make informed decisions about your diet. They can help ensure that you and your baby are receiving the necessary nutrients for a healthy pregnancy.