Vitamin supplementation

• 400 micrograms folic acid pre-conception and during first trimester
  • 5mg in obese women, diabetic patients, history of baby with NTD or FH, on anti-epileptics
  • Folates play a crucial role in many metabolic reactions such as the biosynthesis of DNA and RNA, and amino acid metabolism
• 10 micrograms vitamin D through pregnancy and continuation of breast feeding

Essential components of diet in pregnancy

• Calories - increase 70 kcal/day in the first trimester to 260 and 500 kcal/day in the second and third, with an increase of about 500 kcal/day during the first 6 months of breastfeeding
• Protein - recommended daily allowances should be increased by 1 g/day in the first trimester of gestation, 8 g/day in the second trimester, and 26 g/day in the third trimester
• Calcium
• DHA - major polyunsaturated fatty acid contained in the human brain and retinal rods
  • 2-3 servings of fish per week during pregnancy
• Vitamin D - involved in the regulation of cytokine metabolism and in the modulation of the immune system, thereby contributing to the embryo implantation and regulating the secretion of several hormones

Foods to avoid in pregnancy

• Soft cheese
• Undercooked meat, cured meats, game
• Tuna
• Raw/partially cooked eggs
• Pate
• Liver
• Vitamin and fish oil supplements