Improving maternal and infant nutrition: a framework for action

Appendix 3: Healthy eating advice for women prior to and during pregnancy and while breastfeeding

Women are advised to comply with general healthy eating advice before and during pregnancy and while breastfeeding. In addition to eating a balanced diet there are specific recommendations on vitamin supplements during these periods. The Food Standards Agency Eat Well website provides advice on healthy eating and vitamin supplementation for women who are planning a pregnancy, those who are pregnant and those who are breastfeeding www.eatwell.gov.uk

During each of these periods women are advised to eat a variety of foods including:

• plenty of fruit and vegetables (fresh, frozen, tinned, dried or a glass of juice); aiming for five portions a day
• plenty of starchy foods such as bread, pasta, rice and potatoes; choosing wholegrain options
• protein such as lean meat and chicken, fish, eggs and pulses (peas, beans and lentils)
• at least two portions of fish each week including one of oily fish. No more than two portions of oily fish each week, this includes fresh tuna, mackerel, sardines and trout
• dairy foods such as milk, cheese and yogurt, which all provide calcium
• small amounts of foods and drinks high in fat and/or sugar.

In addition to the advice above, prior to pregnancy women are advised to:

• increase their intake of foods rich in folate and to take a supplement containing 400 micrograms of folic acid each day, for at least three months prior to conception or from the time that contraception is stopped until the 12 ^th week of pregnancy. Women who have (or their partner has) a neural tube defect, those who have previously had a baby with a neural tube defect, those who have diabetes, epilepsy or coeliac disease are advised to take a supplement containing five milligrams of folic acid each day.
• Avoid taking dietary supplements containing vitamin A or fish liver oils
• limit their intake of tuna, and avoid shark, marlin and swordfish
• avoid alcohol, but if they choose to have a drink, they should not drink more than one to two units of alcohol once or twice a week and should not get drunk.

In addition to advice before pregnancy, during pregnancy women are advised to:

• increase their intake of foods rich in folate and to take a supplement containing 400 micrograms of folic acid each day until the 12 ^th week of pregnancy. Women who have (or their partner has) a neural tube defect, those who have previously had a baby with a neural tube defect, those who have diabetes, epilepsy or coeliac disease, or a BMI above 30 are advised to take a supplement containing five milligrams of folic acid each day.
• take a daily supplement containing ten micrograms of vitamin D throughout pregnancy.
• avoid pate, certain types of cheese, raw or partially cooked eggs, raw shellfish, raw and uncooked meat.
• limit their caffeine intake to less than 200 micrograms each day which is equivalent to two mugs of instant coffee, two mugs of tea or five cans of cola.
• avoid alcohol completely.

In addition to advice on general healthy eating, breastfeeding women are advised to:

• take a daily supplement containing ten micrograms of vitamin D for as long as they are breastfeeding.