What types of vitamins are recommended for a woman trying to get
pregnant?   That is, those vitamins and minerals that will result in
the highest likelihood of a healthy baby.  How about vitamin levels to
be avoided?  What types of foods can be consumed to provide the
appropriate vitamin levels?

For example, I have heard B6, B12, and iron are good, but red meat is
bad.  Isn't that a contradiction, since red meat has iron?  Some
simple explanations of the vitamin, why it's good, and what foods to
eat/avoid would be perfect.

Hi Oscarnow,

The top two vitamins for pregant women (and women trying to get
pregnant) are folic acid and iron.  The US Centers for Disease Control
recommend 400 micrograms of folic acid per day for the month before
getting pregnant and at least the first three months of pregnancy. 
This lessens the risk of neurological birth defects.  The CDC also
recommend 30 milligrams of iron to prevent anemia.  Calcium is a good
supplement as well, to develop healthy bones.

Red meat may be considered "bad" for most people - because of the
cholesterol, not the iron - but is appropriate for pregnant women.  In
fact, lots of pregnant women develop cravings for high-iron foods like
red meat and spinach during their pregnancies.

The CDC recommends a generally healthy diet for pregnant women:
"Your meals should include the five basic food groups.  Each day you
should get the following: 6-11 servings of grain products, 3-5
servings of vegetables, 2-4 servings of fruits,
4-6 servings of milk and milk products, 3-4 servings of meat and
protein foods.  Foods low in fat and high in fiber are important to a
healthy diet. "

This information can be found in many places, but I like the ABC's...
Pregnancy Tips/Having a Healthy Pregnancy from the CDC:
http://www.cdc.gov/ncbddd/bd/abc.htm.

The March of Dimes is a great source of information on preventing
birth defects - that's pretty much what they do.  Check out their page
titled "Eating for Two":
http://www.marchofdimes.com/pnhec/159_823.asp.  This discusses the
dietary guidelines appropriate for pregnant women, as well as some
foods etc. to avoid while pregnant.  The MofD strongly recommends a
prenatal vitamin rather than relying solely on dietary sources of
vitamins.  You may also be interested in the foods to avoid page:
http://www.marchofdimes.com/pnhec/159_826.asp and the food-borne risks
page: http://www.marchofdimes.com/professionals/681_1152.asp.

You may also find the following links helpful:

Cleveland Clinic: Prenatal Vitamins- What you Need to Know
http://www.clevelandclinic.org/health/health-info/docs/2800/2801.asp?index=9754

KidsHealth for Parents: Eating During Pregnancy
http://kidshealth.org/parent/nutrition_fit/nutrition/eating_pregnancy.html

NICHHD: Care Before and During Pregnancy
http://www.nichd.nih.gov/about/womenhealth/prenatal_care.cfm
This notes that you should be careful about taking too much Vitamin A.

National Women's Health Information Center: Pregnancy and a Healthy Diet
http://www.4woman.gov/faq/preg-nutr.htm

These sites are all listed in the Prenatal Care health topic of
MedlinePlus (http://www.nlm.nih.gov/medlineplus/prenatalcare.html). 
MedlinePlus is a great source of websites appropriate for
non-clinicians that I use all the time.

Please let me know if there is additional information that I can help
you find - and good luck!

Librariankt

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Request for Answer Clarification by oscarnow-ga on 22 Apr 2005 15:36 PDT

Thanks for the answer.

However, I'm still unsure as to which are the best foods a woman
should eat to obtain the folic acid and iron.  For example, a folic
acid vitamin is one way, but what about the iron?

Also, I've heard women should avoid mercury in fish.  What kinds of
fish?  I'm very much interested in the practical "eat this, don't eat
that" type of list.  It doesn't have to be exhaustive, just something
like:

1. get plenty of x, but not more than y servings per week.
2. be sure to have a vitamin supplement of Z micrograms of mineral_X each day.
... etc.

The general CDC guidelines are much too vague.  I'd like it broken
down into some sample foods, if possible.

Thanks.

---

Clarification of Answer by librariankt-ga on 23 Apr 2005 17:40 PDT

Yep, sorry, as soon as I hit post I realized I hadn't gone into detail
on the contents of some of the pages.

By far the most detailed and practical page in the list I gave you is
the one from the Women's Health Information Center
(http://www.4woman.gov/faq/preg-nutr.htm).  It has the serving size of
each food group with suggestions of which ones are best for pregnant
women.  Also which fish to avoid entirely and which to eat in
moderation.  Example:
"Whole-grains or Enriched Breads/Cereals ? 
Aim for nine or more servings. Whole grain products and enriched
products like bread, rice, pasta, and breakfast cereals contain iron,
B vitamins, some protein, minerals, and fiber that your body needs.
Some breakfast cereals have been enriched with 100% of the folic acid
your body needs each day. Folic acid has been shown to help prevent
some serious birth defects. Choosing a breakfast cereal or other
enriched grain products that contain folic acid is important before
and during pregnancy.
One Serving Size = 1 slice bread, 1/2 cup of cooked cereal, rice, or
pasta, 1 cup ready-to-eat cereal"

The article from KidsHealth for Parents
(http://kidshealth.org/parent/nutrition_fit/nutrition/eating_pregnancy.html)
offers specific foods that are good for each food group as well as
ones that will help you reach the vitamin balance you need.  Example:
"Folic acid
 blood and protein production, effective enzyme function
 green leafy vegetables, dark yellow fruits and vegetables, beans, peas, nuts"
"Iron
 red blood cell production (needed to prevent anemia)
 lean red meat, spinach, iron-fortified whole-grain breads and cereals"

There are several print publications available from your GP or OB/Gyn
that have dietary guidelines for pregnant women.  One that I've seen
is called "Great Expectations" and is published by Customized
Communications, Inc.  I strongly suggest you contact your doctor for a
copy of this or whatever publication he/she uses - as it not only
includes dietary guidelines but also information on what medications
are safe/unsafe during pregnancy.

The only strong recommendations for vitamin intake are the folic acid
(0.4 mg/day) and iron (30 mg/day).  Most doctors prescribe a prenatal
vitamin that takes care of both - as well as provides a balanced
multivitamin component.

As far as fish go - doctors don't agree on this but there are
guidlines from the EPA
(http://www.epa.gov/waterscience/fishadvice/advice.html):
"By following these 3 recommendations for selecting and eating fish or
shellfish, women and young children will receive the benefits of
eating fish and shellfish and be confident that they have reduced
their exposure to the harmful effects of mercury.
1: Do not eat Shark, Swordfish, King Mackerel, or Tilefish because
they contain high levels of mercury.

2: Eat up to 12 ounces (2 average meals) a week of a variety of fish
and shellfish that are lower in mercury.
Five of the most commonly eaten fish that are low in mercury are
shrimp, canned light tuna, salmon, pollock, and catfish.
Another commonly eaten fish, albacore ("white") tuna has more mercury
than canned light tuna. So, when choosing your two meals of fish and
shellfish, you may eat up to 6 ounces (one average meal) of albacore
tuna per week.

3:Check local advisories about the safety of fish caught by family and
friends in your local lakes, rivers, and coastal areas. If no advice
is available, eat up to 6 ounces (one average meal) per week of fish
you catch from local waters, but don't consume any other fish during
that week."

I hope that helps clarify a bit!  Please let me know if I've missed anything - 

Librariankt