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Food, Drinks and Supplements to Avoid or Limit 71
cooking facilities. A survey (National Children’s monitored closely both during and after preg–
Home and Maternity Alliance 1995) demonstrated nancy to optimize maternal and fetal outcomes.
that there is great difficulty in providing an They are likely to have low body stores of some
adequate diet for pregnancy while living entirely nutrients and more likely to deliver infants with
on state benefits. lower birthweight, smaller head circumference,
microcephaly and small for gestational age
Nutritional risk factors more common in (Koubaa et al. 2005).
low-income pregnant women are:
Food, Drinks and Supplements to
●● maternal obesity and weight retention after Avoid or Limit
birth (Heslehurst et al. 2007b)
Vitamin A
●● low iron stores
There are two dietary forms of vitamin A:
●● not taking folic acid or vitamin D supplements
prior to pregnancy and during the early stages of ●● retinol from animal sources
pregnancy
●● beta carotene from plant sources – particularly
●● low birthweight <2.5 kg and consequently an brightly coloured vegetables and fruit.
increased risk of neonatal morbidity and
mortality Both forms are found in a healthy balanced diet
and are important during pregnancy. However,
●● poor diet associated with use of drugs or excess high doses of retinol are associated with
alcohol. teratogenesis (malformations in the fetus)
(Department of Health 1990).
Recent immigrants
To avoid high doses of retinol, pregnant women
Recent immigrants to the UK may not be able to should eat a balanced diet but avoid:
access the foods they would have eaten in their
country of origin and may not eat a sufficiently ●● vitamin supplements containing retinol
nutritious diet here. They may have poor
nutritional status if they have been subjected to ●● cod liver oil supplements and other fish oil
famine and/or parasitic infections. supplements containing vitamin A
Women with alcohol or drug ●● liver and liver products such as liver pâté as liver
problems or eating disorders contains very high amounts of retinol.
Women who have alcohol or drug problems are less Oily fish
likely to eat a balanced diet.
Oily fish should be eaten once or twice per week
Women who give up smoking should take care because it is a good source of omega 3 fats for both
not to snack on high-calorie foods in place of fetus and mother. It is limited to two servings per
smoking, as this would put them at risk of gaining week because some of these fish contain dioxins
excess weight. and PCBs (polychlorinated biphenyls) that might
affect the nervous systems of the fetus.
Women who are restricting their food intake for
reasons such as slimming or self-diagnosed food Tuna should also be limited to four medium
allergies may cut out whole food groups without sized cans of tuna a week (with a drained weight of
advice from a registered dietitian and may be about 140 g per can) or fresh tuna steaks (weighing
omitting important nutrient sources (NICE 2008a). about 140 g when cooked or 170 g raw).
Pregnant women with past or current eating Swordfish, marlin and shark should be avoided
disorders such as anorexia nervosa or bulimia due to the possibility of high mercury levels.
nervosa should be viewed as being at high risk and
