Before and during pregnancy it’s important to lead a healthy life and to eat a varied diet. At the moment you discover that you are pregnant, your baby’s organs are already developing. This requires nutrients from food. Moreover you need extra vitamins and it’s important to avoid contact with harmful substances and pathogens. Listen to your body and adjust your pace and work to your pregnancy.
Fresh fruit and vegetables are rich in vitamins, minerals and fibre.
Grains are an important source of carbohydrates, protein, fibre, B vitamins, calcium and iron. Examples are whole-grain bread, breakfast cereals, potatoes, pulses, rice, pasta and couscous.
Milk, cheese, eggs, meat, chicken and fish are important suppliers of calcium and protein for the growth of the baby and for your own health. If you eat little or no meat or fish, be sure to get enough B vitamins and iron. B vitamins are mainly found in whole-grain products, potatoes, pulses, eggs and dairy products.
Halvarine, butter, margarine and fatty fish almost fully cover the needed vitamin A and D.
Be careful with fat and sugar. Don’t snack too much. It isn’t necessary to eat for two, but dieting during pregnancy is also not healthy as harmful waste products stored in fat can reach your baby through the bloodstream.
Foliumzuur and vitamine D
Folic acid is vitamin B11. You need to ingest an extra amount of this vitamin before pregnancy to decrease your baby’s chance of a neural tube defect as much as possible. During pregnancy problems in the development of the neural tube can lead to defects of the brain or spinal cord. Take 0.4-0.5 mg of folic acid every day for the first 10 weeks of pregnancy.
Vitamin D ensures your baby’s good bone development as it is needed to absorb calcium from food. Your body produces Vitamin D in the skin from exposure to sunlight and it can also be found in butter. Take 10 mcg of vitamin D daily during the entire pregnancy.
Folic acid and vitamin D tablets are available without a prescription at the drugstore or pharmacist. You may also take a prenatal multivitamin.
Do not eat raw or smoked meat, like carpaccio, steak prepared rare or medium-rare, or steak tartar. Cold cuts like filet americain, ossenworst, roast beef, raw ham, salami and cervelat should not be eaten during pregnancy. Thoroughly wash raw fruits and vegetables. The parasite that causes toxoplasmosis can be present in raw meat and unwashed fruits and vegetables. The chance that meat is contaminated with toxoplasmosis is very small, but a toxoplasmosis infection during pregnancy can have serious consequences to the unborn baby. This is why we advise you to avoid any risks.
Avoid eating unpasteurised dairy products, such as some soft cheeses. They could contain the bacterium listeria. A healthy adult person will rarely get sick from this, but it can cause miscarriage or pre-term birth. In the Netherlands most products made with unpasteurised milk will indicate that on the packaging using the term ‘au lait cru’. Listeria can also grow in other raw products kept in the refrigerator for a long time, such as vegetables, chicken, fish and meat. Cooking the food will eliminate listeria. It is therefore best to eat freshly prepared foods and store it for as short a time as possible in the refrigerator. ‘Smoked’ raw salmon and sushi may be eaten, as long as they are fresh (directly from the fish monger or good restaurant). Vacuum-packed salmon from the supermarket should be cooked before being eaten.
Organ meats contain a lot of vitamin A. Too much vitamin A can be harmful to an unborn baby. If you wish to eat these meats or meat products (leverworst, leverpastei, etc.) during pregnancy, don’t consume them daily or as your main meal
Drink 1 ½ to 2 litres of liquids every day to maintain your fluid balance. This amounts to about 10 large glasses per day.
Too much caffeine increases the risk of miscarriage and may cause low birthweight. It can also make your baby restless. As caffeine is present in coffee, tea, cola and energy drinks, drink no more than two cups of coffee or two glasses of cola per day. If you don’t drink coffee or cola, one energy drink per day is acceptable. Up to three cups of tea per day is part of a healthy diet. Substitute tea or herbal tea for other drinks, such as water.
Smoking during pregnancy is detrimental to the unborn baby’s growth and development. It increases the chance of miscarriage, premature birth, low birth weight, clubfoot, cleft palate and detachment of the placenta. After the birth, there is an increased risk of sudden infant death syndrome (SIDS) Cigarettes contain harmful substances that decrease the blood circulation in the placenta, leading to less oxygen being transported to the baby. Risks are also associated with being in an environment where others smoke. It can be difficult to stop smoking. We are happy to help during your pregnancy. For more information about stopping and to get help consult the Trimbos instituut website or see your family doctor.
Alcohol consumption during pregnancy can be harmful to the unborn baby. Studies show that the greater the amount of daily alcohol consumption the more harmful the effect on the baby. Even small amounts of alcohol can be damaging to future development. One glass of alcohol each day can lead to growth problems, learning difficulties and behaviour problems. Women are advised not to consume alcohol during pregnancy.
The use of any kind of drugs is strongly discouraged during pregnancy. The harmful substances reach the placenta, exposing the baby through the umbilical cord. The use of drugs increases the risk of birth defects, growth retardation and premature birth.
If you use medication inform your family doctor or specialist that you are planning on getting pregnant or that you are pregnant. Some substances may affect development of your baby early in the pregnancy. This is also the case with some over-the-counter medications. Consult your doctor, pharmacist or us.
If you have pain or a fever paracetamol (without caffeine or codeine) can be used safely, a maximum of 6 tablets per 24 hours.
Your dentist can administer local anaesthetic for dental work during pregnancy. Inform your dentist of your pregnancy; an anaesthetic without adrenaline will be used.
Harmful substances and radiation
You have daily contact with chemical substances, which could disrupt hormone balances. Be careful with chemical products during pregnancy. Your baby is sensitive to these outside influences. Not all chemical substances are harmful, as it is highly dependent on the type and how much you are exposed to. Try to avoid turpentine-based paints, acetone nail polish remover and pesticides. Also regularly ventilate your home. If you need an x-ray during pregnancy make it very clear that you are pregnant. In some cases it’s possible to postpone the x-ray until after the birth. If the x-ray is necessary then the procedure can usually take place normally. The uterus can often be shielded to minimize the baby’s exposure to radiation.
When gardening or cleaning the cat litter box it is very important to wear gloves and then immediately wash your hands. Cat faeces particularly from young cats may contain parasites that can cause toxoplasmosis. The chance of a cat being infected with toxoplasmosis is not great, as a cat only disperses the parasite through faeces for 2 weeks. However, the effects of toxoplasmosis can be so damaging that it is better to stick to these rules.
At least 30 minutes of physical activity per day is good during your pregnancy. If you already had an exercise routine, you can continue during pregnancy. Make sure to keep safe; listen to your body and let your coach/trainer know (if you have one). Swimming, biking and working out at the gym are all activities can do until the end of your pregnancy. Avoid working your straight abdominal muscles. The separation in the abdominal wall can increase leading to further weakening of the abdominal wall. Sports with a risk of being hit in the belly, like hockey, or sports with a risk of collision or falling, like skiing, are less advisable. Make sure to drink plenty of fluids during exercise.
Sauna and tanning
Avoid saunas and tanning during the first 14 weeks of the pregnancy. It is not known if the high temperatures are harmful. If after the first 14 weeks you decide to go the sauna or to go tanning, drink enough fluids, use sunscreen and cool off regularly.
The advice for working during pregnancy is the same as for many other activities: listen to your body and do not go over your limits. If you are not able to fulfil your job requirements as you were before you were pregnant, discuss this with your employer and potentially with the company doctor/ occupational health and safety service. More information about work and safety while pregnant can be found on the RIVM website. Information about laws and regulations concerning maternity leave can be found on the website of the Ministerie and Sociale zaken and Rijksoverheid.nl