Pre-Pregnancy Nutrition Guidelines for People with Cystic Fibrosis
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Pre-pregnancy is a great time for future mothers to prepare their bodies for having a healthy baby. Adequate nutrition prior to pregnancy is important to store nutrients to help mom and the future baby grow.
Healthy Weight Pre-pregnancy weight and weight gain during pregnancy are important determinants of the baby’s birth weight. Low birth weight in newborns can be a danger to a baby’s health Also, conceiving can be more difficult when you are underweight. Ideal body weight, as indicated by a Body Mass Index (BMI) >19, is ideal prior to conception.
Maintaining a healthy weight during pregnancy will mean meeting the nutritional demands of CF and pregnancy. You will need to increase daily food intake by approximately 300 kcal/ day. It is recommended that pregnant women gain a total of 11-16 kg (25-35 lbs) through pregnancy. Your clinical dietitian will be able to assist you in reaching your target weight both before and during pregnancy. This may include adding nutritional supplements as well as other healthy food choices to your diet.
Fat Soluble Vitamins A, D, E and K
Taking your vitamins is important because you’re building your maternal stores. Having your fat soluble vitamin levels measured will ensure that adequate levels are attained/maintained for both you and your baby.
*Refer to Vitamins and Cystic Fibrosis for the specifics on the fat soluble vitamins.
Folic acid
Folate is a B vitamin that decreases the risk of neural tube defects, increases blood volume, and is necessary for the growth of maternal and fetal tissues during pregnancy. Although folate is found in many foods, an additional supplement containing folic acid (the supplement form of this vitamin) is necessary and should begin at least 3 months before becoming pregnant.
Iron
There is a need for additional iron during pregnancy in order to make the extra red blood cells that are produced during pregnancy. If there are adequate iron stores prior to pregnancy then increased needs can usually be met with an iron rich diet. Supplementation may be required in the second and third trimesters. A healthy diet that includes iron rich foods such as meat (especially organ meats such as liver), tofu, enriched cereals, eggs, whole grains, legumes and dried fruit is a necessity to build up pre-pregnancy iron stores.
Calcium Intake
Calcium and Vitamin D are important for your baby’s skeletal development. A goal of at least 3-4 servings of milk products daily is recommended. Your CF dietitian will be able to assess if your dietary intake is adequate and he/ she will inform you if a calcium supplement is needed. Vitamin D levels in your blood are routinely checked to ensure adequate levels. Supplemental vitamin D may also be necessary if blood levels are low. During the winter months, vitamin D levels may be at their lowest since there is inadequate sun exposure. Normally, sun exposure stimulates vitamin D production in our skin.
If you are considering pregnancy you will need to do an oral glucose tolerance test (OGTT). Diabetes during pregnancy is more common in women with CF. Untreated diabetes and high blood sugars may lead to a loss in energy, weight, and increase your risk for illnesses. It can also have harmful effects on your baby. If you have diabetes, monitoring your blood sugar control is necessary so that you can achieve optimal control prior to pregnancy. The OGTT will need to be repeated once pregnancy is confirmed and then again in the 2nd and 3rd trimesters.
Pre-pregnancy planning and nutritional management are crucial to ensure a healthy pregnancy for both you and your baby. Your dietitian, along with other members of the CF team, can provide this support by monitoring weight, vitamin levels and blood sugars before and during pregnancy.