Every pregnant woman wants to give birth to a baby in perfect health. Adopting a healthy diet can go a long way towards achieving that goal.

Are there foods you should eat, or not eat, during that special time of your life? If you usually follow a special diet, how does it impact your nutritional status as a pregnant woman?

Ms Kellie Kong, Dietitian from the Department of Nutrition and Diete​tics​ at KK Women's and Children's Hospital (KKH)​, a member of the SingHealth​ group, gives detailed answers to your questions.

Question by Miki

Hi, Good day to you. I was wondering is it true that eating bird nest during pregnancy period can increase nutrition and improve the overall health of the mother and baby? Does it make a difference between the bottle ones or boiled ones? What food should be avoided during pregnancy? I love to eat sushi, but not the raw ones. Should I avoid it too? I understand that pregnancy is also a critical time for a woman to consume more calcium. What are the food that contains calcium and suitable for pregnancy other than milk? Thank you~!

Answered by​ Ms Kellie Kong, Dietitian from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)​

Bird’s nest is believed to have nourishing properties and is generally regarded as safe for mothers-to-be to consume during pregnancy. However, there is still a lack of scientific evidence to show the health benefits of consuming bird’s nest during pregnancy.

Nutritionally, bird’s nest provides some protein, carbohydrate, iron and fiber. There should not be much difference between the bottled, commercially-prepared and home-prepared versions, however for home-prepared bird’s nest, you can have more options in selecting the grade of bird’s nest as well as the amount of sugar added as sweetener.

Question by gnuyzx

Dear Ms Lim,

May I know what food should I avoid during pregnant?

How can I have a balance diet during pregnant?

What kind of food is good for baby's skin?

Thank you.

Answered by​ ​ Ms Kellie Kong, Dietitian​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

Pregnant women should avoid the following foods:

Soft cheeses (e.g. Brie, Camembert, feta) and liver patesThese foods may be contaminated with the bacteria, Listeria which may lead to miscarriage and stillbirth. As pregnant women are more vulnerable to food poisoning, these foods should be avoided. Processed and hard cheeses are however, safe to consume.
Raw and undercooked poultry, eggs and seafood e.g. raw oyster, cockles,sushi, sashimi and raw or half boiled eggsThese foods should be cooked thoroughly before eating as they may be contaminated with the bacteria, Salmonella, which can cause food poisoning. Note that for eggs, they should be cooked till both the yolk and the white are solid
Large deep-sea fishes e.g. shark, swordfish, king mackerel and tilefishThese fishes may contain methylmecury, a heavy metal that is toxic to the developing fetus’ neurological system.
Unwashed saladsThere may be bacterial contamination from soil, which can cause food poisoning.​
AlcoholAlcohol should be avoided during pregnancy, as it can be passed via the placenta to the developing fetus, and may directly affect the development of the fetus. Possible adverse effects include low birth weight, mental retardation, facial deformities and heart problems. Small amounts of alcohol in cooking should be safe, but care should be taken to ensure that the food is thoroughly boiled after adding the alcohol, so that the alcohol will evaporate off
CaffeineLimit caffeine-containing beverages (e.g. coffee, tea) to a maximum of 2 cups a day, as excessive intake can increase the risk of cleft palate as well as having a baby of low birth weight
Herbal productsThese are not recommended during pregnancy, as there is a lack of scientific research to make any recommendations for their use during pregnancy.
​

​Here'​s the guide to tips on a healthy diet during pregnancy.​ https://www.healthxchange.sg/women/pregnancy/​tips-healthy-diet-during-pregnancy​​​

Food that is good for baby's skin can be found in this article:​ https://www.healthxchange.sg/women/pregnancy/pregnancy-foods-improve-babys-complexion​​

Question by chu

Hi Ms Lim,

May I know if it is true that pregnant women should avoid eating fruits such as pineapples and watermelons?

Thanks!

Answered by Ms Kellie Kong, Dietitian from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

There is no firm scientific evidence to suggest that fruits like pineapple and watermelon are harmful during pregnancy. However, if you are more comfortable avoiding pineapples and watermelons, just ensure that you still have an adequate intake of other fruits.

So long as you do not avoid an entire food group, it is fine to avoid eating 1or 2 specific foods.

Question by lizziepang

I was advise by many of my friends to take Bird's Nest during pregnancy, does taking Bird's Nest benefits both mother and baby?

And what are the chinese herbs that should be avoid during pregnancy?

Answered by Ms Kellie Kong, Dietitian​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

Bird’s nest is believed to have nourishing properties and is generally regarded as safe for mothers-to-be to consume during pregnancy. However, there is still a lack of scientific evidence to show the health benefits of consuming bird’s nest during pregnancy. Nutritionally, bird’s nest provides some protein, carbohydrate, iron and fiber. There should not be much difference between the bottled, commercially-prepared and home-prepared versions, however for home-prepared bird’s nest, you can have more options in selecting the grade of bird’s nest as well as the amount of sugar added as sweetener.

Herbal products are not recommended during pregnancy as there is still a lack of scientific studies on their use during pregnancy. Black cohosh, blue cohosh, Chinese angelica (Dong Quai) and ginseng are among some herbal products which have the potential to affect fetal development when used in concentrated levels.

Question by Jency

This is Jency.

Iam 27 years old.My first baby(girl) was born when Iam 24.I got pregnancy diabetics at the later 8 months and due to overgrowth of the baby and less fluid ,I had to undergo C-Section at 8.5 months.But the baby quite normal..

Now we are planning for the next baby.So what diet can be followed to avoid diabetics.

Scared since my father have diabetics and taking medicine.And also my C-Section was vertical section.Do I have chances for normal delivery for the next bay..Please help me.

Answered by Ms Kellie Kong, Dietitian​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH),​ and a Consultant from the Department of Obstetrics and Gynaecology at KK Women's and Children's Hospital (KKH)

In general, the risk factors for developing gestational diabetes mellitus (GDM) include increasing maternal age, family history of diabetes, history of large baby, obesity and excessive weight gain during pregnancy. In order to minimize this risk, you should maintain a healthy weight before pregnancy and avoid excessive weight gain during pregnancy. You can start working on the lifestyle changes by following a well-balanced diet and exercising regularly before planning for the next baby.

With regards to the chances of a normal delivery for you, an obstetrician would have to understand the history of your earlier pregnancy, and examine you before making any recommendation. You may wish to seek an appointment with your obstetrician to get an opinion.

Question by sbdtys

Dear Ms. Lim

I am pregnant for 4 month now. I started to have strong cravings for sweet cookies, especially chocolate chips cookie.

I took it daily after breakfast and lunch and sometimes, I can even finish one pack in a day. I am worried that I can become a diabetic by the time I delivered by baby.

Do I need to inform my doctor about this cravings ? Do you have any suggestion on type of the food that I can take in order to reduce my cravings for cookies ?

Thanks

Answered by Ms Kellie Kong, Dietitian​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

Food cravings are a well-known feature of pregnancy symptoms. There is no definite answer as to why pregnant women crave certain foods. Nonetheless, explanations like hormonal changes; temporary nutritional deficiencies etc have been put forward by researchers trying to find the key to pregnancy cravings.

It is possible to have food cravings and still provide adequate nutrients to your baby. Giving in too much or too often to your cravings for high calorie foods (in your case chocolate chip cookies) may translate into excessive weight gain. Excessive weight gain increases the chances of gestational diabetes and unhealthy blood pressure levels.

Women need to consume only about 340 extra calories per day in the second trimester and 452 extra calories per day in the third trimester compared to their usual intake before pregnancy.​​ One regular-sized chocolate chip cookie contains approximately 88 calories (equivalent to 1 slice of bread) and 4g of fat. So if taken in excess it can contribute to excessive weight gain.

Strategies to handle pregnancy cravings include:

  • Eat a balanced diet that includes whole grains, lean sources of proteins, vegetables, fruits and low fat dairy on a daily basis. When your diet is balanced a small portion of not so healthy food will not affect your overall nutritional status
  • Eat regular meals to avoid drops in blood sugar that could trigger food cravings. Taking 3 main meals and 2–3 in between snacks may help
  • If the urge to eat the chocolate chip cookie is ruling your life, try taking your mind off food by going for a walk or calling a friend
  • Limit to one cookie a day, instead of having the whole packet

If you are unable to control your food cravings and are gaining excessive amount of weight then you may want to inform your doctor so that he can monitor/test you for gestational diabetes. The key is to making sure that you are having a healthy balanced diet first and then working in those extras!

Question by pearlynwan

I am a vegetarian, should i change my diet since I am pregnant now ? My parent in law keep on complaining that if I continue with my diet, it will affect the baby as I don't take meat. It doesn't have enought nutrient for the baby. is that true ? What are the important food that I can take to supplement my vegetarian diet ? thanks a lot for your advice

Answered by Ms Kellie Kong, Dietitian​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

Vegetarian diets can be classified into:

  • Vegan diet – this diet includes fruits, vegetables, beans, grains, seeds and nuts. All animal sources of proteins- meat, fish, poultry, eggs, milk, cheese and other dairy products are excluded from the diet
  • Lactovegetarian diet – this diet includes dairy products in addition to the foods listed in the vegan diet
  • Lacto-ovovegetatian diet – This diet includes dairy products and eggs in addition to the foods listed in the vegan diet. Meat, poultry and fish are excluded from the diet

Your baby can receive all the nutrients required to grow and develop while you are following a vegetarian diet. However, you need to include food from all the food groups of the healthy food pyramid to get all the nutrients you need.

Depending on the type of vegetarian diet you are following you will need to look for other sources of protein in your daily diet. Other protein sources include soybean products (tahu/tau kwa/tempeh etc) nuts, peanut butter, legumes and lentils.

Vegetarians (especially vegans) are at a greater risk of iron and vitamin B12 deficiency you may want to inform your doctor so that he may recommend a supplement.

Good sources of iron are: pulses, dried fruits (apricots), dark green vegetables, wholemeal bread, fortified breakfast cereals and eggs for vegetarian who include them in their diet. Good sources of vitamin B12 are: fortified breakfast cereals, and yeast extract like marmite. Milk, cheese and eggs are also good sources for vegetarian who include them in their diet.

Question by janey

I am just past my early 40s and pregnant for the first time - yes, a late mother.... My question: is there any extra food/nutrition/supplements that I should take given my age? I am worried that my earlier 'party' lifestyle (drinks and late nights) could have affected my health. Right now, I do notice that my hair seems to be thinning. I am 5 months pregnant. Your advice much appreciated. Thanks ​

Answered by Ms Kellie Kong, Dietitian​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

Nutrition is important at all stages of the life cycle not only when you are pregnant but even during the time when you plan on becoming pregnant. What you eat everyday, even before you are pregnant is important for your health as well as that of your baby.

Your diet should contain all the nutrients that your body will need to help your baby develop and grow. You need over 40 nutrients per day to build a healthy baby; eat a variety of foods as no single food is able to provide you with all the nutrients. By following the principles of the healthy food pyramid one is able to meet these requirements.

Since you are in the second trimester you need to pay extra attention to certain nutrients like:

Iron: you need 19mg of iron per day to build iron stores of the baby and for blood formation. There are two forms of iron in food – heme and non-heme iron. Heme iron is 2 to 3 times more absorbable by the body than none-heme iron. Sources of heme iron are meat, fish, chicken and liver. Sources of non-heme iron are egg, whole cereal, green leafy vegetables, legumes, bean curd and dried fruits

Vitamin C: helps in iron absorption. You need 50mg of vitamin C/day. Sources are fresh fruits and vegetables. 2 serving of fresh fruits and vegetables will ensure adequate intake

Calcium: you need 1000mg/day of calcium to meet the formation of the baby’s bone and teeth and to maintain mum’s body stores. Best sources include milk, yogurt and cheese. Other sources of calcium are fish with edible bones (ikan bilis/sardine), bean curd, broccoli, spinach, nuts (almonds), fortified food and drinks (hi-calcium biscuits and hi-calcium soy milk)

Vitamin D: is necessary for calcium absorption. You need 10mcg/day. Good sources are fortified milk, margarine, and fish (sardine & mackerel). Exposure to sunlight (10-15min) helps the skin to synthesis vitamin D

Question by Judylin

Dear Ms Lim,

I would like to find out how much caffeine can pregnant women have? I'll usually have a can of green tea or diet coke together with my lunch, how much caffeine is in a can of green tea and diet coke?​

Will too much caffeine causes miscarriages?

Answered by Ms Kellie Kong, Dietitian​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

It is recommended to limit your intake of caffeine to 200mg/day. 8oz of green tea contains 50mg of caffeine and 12oz of diet coke contains 30mg of caffeine​.

Excessive consumption of caffeine increases the risk of miscarriages, low birth weight, and birth defects such as cleft palate.

It is recommended to limit your intake of caffeine to 300mg/day. 8oz of green tea contains 50mg of caffeine and 12oz of diet coke contains 30mg of caffeine.

Question by jackie

Dear Dr Ho

I have a friend trying desperately to get pregnant. Recently, someone told her to avoid tofu and food like bitter gourd as these are 'cooling' and thus would make her womb unable to conceive . Conversely, she should take more food with ginger and other 'warming' stuff like Yomeishu, etc. Is there any basis to this? I have another friend who swears that this worked for her.... Couldn't conceive until she stopped eating tofu and took more ginger instead... Or is this just a coincidence....?

Answered by Ms Kellie Kong, Dietitian​​ from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH)

Soy

is an excellent source of protein and phytoestrogens. The type of phytoestrogen in soy is called isoflavones. There are not many studies done in this field however a few studies do suggest that high levels of soy protein may decrease fertility. According to a report​ in the American Journal of Clinical Nutrition a small number of studies have shown that high levels of soy (taking 60g of soy protein for a month) can increase menstrual cycle length, decrease FSH and decrease LH. A more recent review reported in the American Journal of Clinical Nutrition states that reproductive and developmental toxicity studies did not find significant variations in fertility from soy phytoestrogen consumption in healthy couples, indicating that normal intake of soy is basically harmless to your chances of becoming pregnant. If you are having problems in conceiving it may be a good idea to limit your intake of soy to rule out any possibilities of its effect on fertility.

Bitter gourd:

taking bitter gourd may decrease your chances of conception, although this has not been confirmed in humans. Mice fed bitter gourd juice had fertility rates drop by 70%, according to a review published in February 2003 in the “American Journal Of Health-System Pharmacy”

Studies are still ongoing and there is no​ conclusive evidence for or against intake of soy and bitter gourd so it is best to take them in moderation.

Ref: O17