Nutrition Science and Everyday Application - beta v 0.1

NUTRITION IN PREGNANCY AND LACTATION 583
end of the first trimester, but in rare and unfortunate cases, it can continue until the baby is
born. 21
Dietary changes can help alleviate nausea and vomiting. Here are some suggestions: 22
• Choose foods that are low in fat and easily digestible, such as those in the
BRATT diet (bananas, rice, applesauce, toast, and tea). The goal is simply to find
foods that can be tolerated. It is reassuring to remember that pregnancy does not
require extra calories during the first trimester, and a prenatal supplement can
help meet micronutrient needs.
• An empty stomach can worsen feelings of nausea, so try eating a few crackers
or dry toast before getting out of bed in the morning to avoid moving around with
an empty stomach. It may also help to eat five or six small meals per day and to eat
small snacks such as crackers, fruits, and nuts throughout the day.
• Many pregnant women experiencing nausea and vomiting find meat unappetizing.
Try other sources of protein such as dairy foods (e.g., milk, yogurt, ice cream),
nuts and seeds (as well as nut butters), and protein powders and shakes.
• Ginger can help settle your stomach; it’s available in capsule, candy, and tea
form. Ginger ale, if made with real ginger, might also be helpful.
If nausea and vomiting remain unmanageable after making these dietary changes,
medications may be necessary. Hyperemesis gravidarum, though rare, can be very serious.
Constant vomiting can lead to malnutrition, weight loss, dehydration, and electrolyte
imbalance. Hospitalization may be required so that women can receive fluids and
electrolytes through an intravenous line, and sometimes a feeding tube is necessary. Getting
help for this condition can be a frustrating process of trial-and-error, and unfortunately,
there are still many unknowns about its causes and effective treatment options. 23
As pregnancy progresses, another common complaint is heartburn, caused by
gastroesophageal reflux. This is caused by the upward, constrictive pressure of the
growing uterus on the stomach, as well as decreased peristalsis in the GI tract. (See Unit 3
for management strategies.)
About 6 percent of pregnancies in the U.S. are affected by gestational diabetes (see
Unit 4). 24 This is a type of diabetes that develops during pregnancy in women who didn’t
previously have diabetes. Gestational diabetes is managed by monitoring blood glucose
levels, eating a healthy diet, and exercising regularly. Sometimes, insulin injections are
needed. If blood glucose levels aren’t well controlled in the mother, the fetus will also have
high blood glucose levels. This can cause the baby to grow too big, leading to a greater
chance of birth complications and increased likelihood of needing a cesarean birth. 25
Self-Check: