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HEALTHY EATING DURING
PREGNANCY AND BREASTFEEDING
Your Name: ___________________________________________
Your Dietitian’s Name: ___________________________________________
Dietitian Phone Contact: ___________________________________________
Best Time(s) to Phone your Dietitian: ___________________________________
Date of This Consultation: ___________________________________________
Barwon Health Location: ___________________________________________
Prompt Doc No: BAH0004997 v1.0 Page 2 of 18 Due for review by: 04/06/2017
Healthy, Balanced Eating for Pregnancy and Breastfeeding
A well-balanced diet is important to health throughout our lives, particularly during
pregnancy and when you are breastfeeding. A balanced diet includes foods from all of the
five core food groups and can help you to meet the nutritional needs of both you and your
growing baby. Women younger than eighteen are still growing themselves, so have higher
nutritional needs during pregnancy and breastfeeding.
This booklet provides general information on healthy, balanced eating during pregnancy
and breastfeeding. Please consult your dietitian if you have specific dietary restrictions or
requirements.
This booklet is divided into five sections:
- Food groups for a balanced diet
- Important nutrients for pregnancy and breastfeeding
- Safe eating during pregnancy
- Managing your weight and other changes during pregnancy
- Healthy eating for breastfeeding
Your dietitian may give you all of this booklet, or just the sections that are most suitable for
you. Ask your dietitian if there are any sections that you would particularly like to have.
‘Pregnancy Myths’ are also included through the information, to answer some of the many
questions that may come up for you. Your dietitian is one of your best sources of
information and support, so ask any questions you have when you see them.
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Food Groups for a Balanced Diet
Grain (cereal) food
Breads, cereals, rice, pasta and noodles provide energy, protein, folate and iodine, to help
your baby develop and grow. During pregnancy you need more of the folate and iodine
found in these foods.
What is a serve and how many serves do you need each day?
Number of serves
Pregnancy
Number of serves
Breastfeeding One serve
Under 18
years old
19-50
years old
Under 18
years old
19-50
years old
8 8 ½ 9 9
1 slice (40g) bread
½ medium (40g) roll or flat bread
½ cup (75-120g) cooked rice, pasta,
noodles, barley, buckwheat, semolina,
polenta, bulghur or quinoa
½ cup (120g) cooked porridge
2/3 cup (30g) cereal flakes
¼ cup (30g) muesli
3 (35g) crispbreads
1 (60g) crumpet
1 small (35g) English muffin or scone
Tips for choosing healthy grain food:
Try to select wholegrain or wholemeal varieties
Try different grains; pearl barley in soups, brown or basmati rice,
couscous or quinoa in salads
Pregnancy Myth: When you are pregnant you need to ‘eat for two.’
Pregnancy Fact: No extra food is needed until the second and third trimester when your baby is
growing faster. The amount of energy needed is only around 1000 kJ – or a slice of bread plus a
piece of fruit and a cup of low-fat milk each day. The amount of weight that you gain will tell you
whether you are eating enough, not enough, or too much – see the ‘Managing Your Weight’
section for details
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Fruits and vegetables
Fruits and vegetables are great sources of vitamins, minerals and fibre and are part of a
balanced diet for everyone.
What is a serve of fruit and how many serves do you need each day?
What is a serve of vegetables? How many serves do you need each day?
Number of serves
Pregnancy
Number of serves
Breastfeeding
One serve Under
18 years
old
19-50
years
old
Under
18 years
old
19-50
years
old
2 2 2 2
1 medium apple, banana, orange or pear
2 small apricots, kiwi fruit or plums
1 cup diced or canned fruit (in natural juice)
Or occasionally:
½ cup (125ml) fruit juice (with no added sugar)
30g dried fruit (for example 4 dried apricots
halves or 1 ½ tablespoons of sultanas or 2
dried figs)
Number of serves
Pregnancy
Number of serves
Breastfeeding
One serve Under
18 years
old
19-50
years
old
Under
18 years
old
19-50
years
old
5 5 5 5
½ cup cooked green or orange vegetables (for
example broccoli, spinach, carrots, pumpkin)
½ cup cooked, dried, or canned beans, peas
or lenti ls
1 cup green leafy or raw salad vegetables
½ cup sweet corn
½ medium potato or other starchy vegetables
(sweet potato, taro or cassava)
1 medium tomato
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Milk, yoghurt, cheese and alternatives
Dairy foods are an excellent source of calcium, protein, riboflavin and Vitamin B12 – which
are great for bui lding strong bones and teeth.
What is a serve of dairy food and how many serves do you need each day?
Tips for choosing healthy dairy foods:
Low-fat or reduced fat varieties are best
If you prefer a non-dairy milk (such as almond or soy), select a calcium-fortified
variety that contains at least 100mg calcium per 100ml.
Certain dairy foods must be avoided during pregnancy such as soft cheeses,
unpasteurised dairy products and soft serve ice-cream. These foods have a higher
risk of containing listeria or other toxins. See the ‘Safe Eating and Drinking During
Pregnancy’ section for details.
Number of
serves Pregnancy
Number of
serves Breastfeeding
One serve Under 18
years old
19-50
years old
Under 18
years old
19-50
years old
3 ½ 2 ½ 4 2 ½
1 cup (250ml) fresh, UHT long life,
reconstituted powdered milk or
buttermilk
½ cup (120ml) evaporated milk
2 slices or matchbox sized cube (40g) of
hard cheese, such as cheddar
¾ cup (200g) yoghurt
1 cup (250ml) soy, rice or other cereal
drink with at least 100mg of added
calcium per 100ml
Pregnancy Myth: ‘I need to avoid dairy, eggs, nuts during pregnancy to reduce
the risk of my baby having a food allergy’.
Pregnancy Fact: There is no evidence to support that avoiding these foods during pregnancy will
reduce the risk of your baby having a food allergy. Eating a wide variety of foods, particularly
whilst pregnant and breastfeeding, gives your baby the best chance of being healthy in the long
term.
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Lean meat and poultry, fish, eggs, nuts, seeds and legumes/beans
Meats and meat alternatives (eggs, tofu, nuts and legumes) are good sources of protein,
iron, niacin and Vitamin B12. These nutrients are important for building body tissues and
blood.
What is a serve and how many serves do you need each day?
Fish
Fish is a good source of protein, omega-3 and iodine. Some types of fish can contain
harmful toxins, such as mercury, that may damage your baby’s develop ing nervous
system. Most types of fish and seafood can be included regularly if they are eaten as soon
as they are cooked. Avoid raw fish or seafood completely.
It is okay to eat 2-3 serves of most fish per week, except if you have the following:
Shark (flake) OR
Swordfish/Broadbill
OR Marlin
Eat once per
fortnight AND
Eat no other fish
that fortnight
OR
Orange Roughy
(Deep Sea Perch)
OR Catfish
Eat once per week AND Eat no other fish
that week
Number of
serves Pregnancy
Number of
serves Breastfeeding
One serve Under 18
years old
19-50
years old
Under 18
years old
19-50
years old
3 ½ 3 ½ 2 ½ 2 ½
65g cooked lean meats such as beef, lamb, veal,
pork, goat or kangaroo (about 90-100g raw)
80g cooked lean poultry such as chicken or
turkey (100g raw)
100g cooked fish fillet (about 115g raw) or one
small can of fish
2 large (60g) eggs
1 cup (150g) cooked or canned legumes/beans
such as lenti ls, chick peas or split peas
(preferably with no added salt)
170g soft tofu
30g nuts, seeds, peanut or almond butter or tahini
or other nut or seed paste (no added salt)
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Important nutrients for Pregnancy and Breastfeeding
There are some nutrients that are needed in higher amounts when you’re pregnant or
breastfeeding. The Royal Australian and New Zealand College of Obstetricians and
Gynaecologists has recommended specific amounts for these nutrients during pregnancy
and breastfeeding. A balanced diet, in combination with some supplements, will ensure
that you have enough to keep you and your baby healthy.
Iron
Iron is a mineral needed to form red blood cells. Iron requirements are higher during
pregnancy because you are making extra blood. Your baby also relies on the stores of iron
given to it during pregnancy for the first six months of its life.
The body absorbs iron in food from animals most easily but other foods can be good
sources of iron. There are some tips to help your body absorb iron in other foods below.
Your doctor will check your iron levels at the start of your pregnancy and at around 28
weeks. Iron supplementation is not recommended in all pregnancies, but it is generally
recommended for vegetarians and women with multiple pregnancies.
Foods that contain the best sources of iron include:
lean red meats, pork, poultry, eggs and some seafood
Foods that are good sources of iron include:
leafy green vegetables wholegrain breads and cereals
iron-fortified breakfast cereals legumes
dried fruit and nuts Milo® and Ovaltine®
Tips to increase your iron absorption:
Include foods with Vitamin C - such as fruit and vegetables
- with your meals
Avoid drinking black tea with meals, as it reduces iron
absorption
Avoid taking your iron supplement with dairy foods
Avoid using antacids (indigestion medicines)
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Folate (Folic Acid)
Folate is a B-group vitamin that can reduce the chance of your
baby developing neural tube defects, such spina bifida. The
folate requirement during pregnancy is 600 micrograms per
day.
It is recommended that women take a 400 microgram folate
supplement when planning a pregnancy and in the first three
months of pregnancy.
Patients with epilepsy should consult their Doctor before taking folate supplements.
Foods that contain the best sources of folate include:
liver and kidney soya beans, chickpeas
leafy green vegetables, Vegemite TM and Marmite TM
Foods that are good sources of folate include:
bananas, strawberries and oranges
avocadoes, beetroot and tomatoes
wholegrain breads and cereals or fortified varieties
salmon nuts
Iodine
Iodine is important to your baby’s brain and nervous system development. The iodine
requirement for pregnant and breastfeeding mothers is 220 micrograms per day. It is
recommended that women take an iodine supplement containing 150 micrograms of
iodine each day. All commercially made breads in Australia are fortified with iodine.
If you have a pre-existing thyroid condition, see your Doctor before commencing an iodine
supplement.
Foods that contain the best sources of iodine include:
eggs, meat and dairy products
seafood
iodine-fortified breads
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Calcium
Calcium is a mineral used by the body to build strong bones and teeth. Calcium is used
mainly during the last two months of pregnancy when your baby’s bones and teeth are
developing. There is no increased requirement for calcium during pregnancy because
your body becomes more efficient in using calcium.
Make sure that you are getting 1000mg of calcium per day through 2-3 serves of calcium-
rich foods, otherwise your baby will take what it needs from your own teeth and bones!
Foods high in calcium are:
Milk, cheese, yoghurt and custard – from cows, sheep or goat
Fortified soy, almond, rice or oat milk
Canned fish with bones – salmon, sardines
Sesame seeds, tahini or almonds
Vitamin B12
Vitamin B12 helps your body make both red blood cells and nerve cells. Vitamin B12 is
stored in the body, but low Vitamin B12 stores in mothers can affect their baby’s
development. Vitamin B12 is only found in animal foods or products that have added
Vitamin B12.
Women who are vegans or strict vegetarians are at greater risk of having low Vitamin B12
stores, so should take Vitamin B12 supplement during pregnancy and breastfeeding.
To eat enough Vitamin B12 , vegetarians and vegans should
consume at least one, or a mixture of the options below:
3 cups of Vitamin B12-fortified soy milk (e.g. So
Natural® Extra Milky™, Sanitarium® So Good
Essential™)
2 ½ cups low fat milk
2 ½ tubs yogurt – soy or dairy, not coconut
100g swiss cheese
2-3 eggs
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Omega-3 Fatty Acids
Omega-3 fatty acids are important for brain development. There isn’t enough evidence to
support specific supplementation during pregnancy. A balanced diet will provide enough
omega-3 fatty acids to meet you and your baby’s needs.
Foods that contain the best sources of Omega-3 Fatty Acids include:
Oily fish such as salmon, sardines
Other sources include:
Lean red meat DHA or Omega-3 enriched eggs
Walnuts, flaxseed, canola Other fish
Thinking of taking a supplement?
There are many pregnancy supplements available and it can be difficult to choose
between them. The table below shows the recommended daily intakes of vitamins and
minerals for women during pregnancy. Use this table to help you choose the best
supplement for you.
Nutrient Pregnancy RDI Nutrient Pregnancy RDI
Omega 3 115 mg Vitamin D3 5 µg
B1 Thiamine 1.4 mg Calcium 1000 mg
B6 Pyridoxine 1.9 mg Iron 27 mg
Folic acid 600 µg Zinc 11 mg
Vitamin C 60 mg Iodine 220 µg
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Safe Eating and Drinking During Pregnancy
Certain foods can be risky during pregnancy as they may be contaminated with listeria,
salmonella or other toxins that can harm your baby.
Unsafe foods
pre-cooked or ready-prepared cold foods that will not be reheated
For example - pre-prepared bought salads, alfalfa sprouts, paté,
cooked prawns, quiches, deli meats (e.g. ham, salami), pre-sliced
cold meats
soft serve ice-cream
any raw meat, chicken, eggs or fish
foods or fluids past their use-by date
unpasteurised foods
soft cheeses - Fetta, blue-vein, ricotta, brie and camembert
Cottage or cream cheese can be eaten but used within 1-2 days
All cheeses can be used in cooking and eaten safely while hot
tofu eaten cold
Purchase tofu in sealed packages and if eaten cold, within 24 hours. After 24 hours
the tofu can be safely eaten if it’s been cooked and eaten hot
Unsafe food practices
Food poisoning can be dangerous for your baby. To avoid food poisoning:
always wash your hands before and after preparing food, especially raw or
uncooked meat
thoroughly wash fruit, vegetables and salad before eating
keep uncooked food separate from cooked food
always cook food thoroughly
clean all kitchen equipment well after cutting meat
Contact with some non-food items can also cause infection. Avoid any contact with
cat litter and always wash your hands after handling soil.
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Fluids
Everybody should aim for 6-8 glasses per day, with as much of this as possible being
water. Consuming plenty of fluid will help prevent constipation, which is common during
pregnancy.
Can I drink coffee while I’m pregnant?
Caffeine is absorbed into the blood stream and carried to all parts of
your body, including to your developing baby. Generally, up to 2
cups of coffee or 4 cups of tea are okay, but more than this may
affect your baby. Decaffeinated drinks are a better choice.
Avoid other foods and drinks that have high levels of caffeine such
as: cola drinks, “energy” food or drinks , guarana, dark chocolate
drinks and bars, some prescription migraine medication.
Are herbal products safe, including herbal tea?
The ingredients in these products can vary widely and there are
some common herbs that can stimulate uterine contractions.
Avoid using any herbal products until after your pregnancy unless
you have checked with your Doctor or Pharmacist.
Are artificial sweeteners safe to use?
Small amounts of artificial sweetener can be used safely in pregnancy.
These include:
Equal® (also known as aspartame, sweetener 951 or NutraSweet®)
Splenda® (also known as sucralose or sweetener 955)
Saccharin or sweetener 954 is not recommended during pregnancy.
Alcohol and pregnancy
Any alcohol that is present in the bloodstream of a pregnant woman will
pass into the bloodstream of her baby. Heavy drinking episodes and
occasional intoxication can increase the risk of miscarriage, low birth
weight, and brain defects. There is no identified level of alcohol intake
that is safe for a developing baby.
Drinking alcohol in any amount is not recommended during pregnancy.
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Managing Your Weight and Other Changes during Pregnancy
Weight and pregnancy
Healthy weight gain during pregnancy is due to extra body tissues, placenta, fluid, blood,
and your baby. The amount of weight that you would expect to gain is based on your
Body Mass Index (BMI) when you first conceive. In general, it’s healthy to gain more if you
have a lower BMI to begin with, and less if your BMI is higher to begin with.
To calculate your BMI divide your weight in kilograms by your height in metres squared
e.g. You weigh 65 kg and your height is 170 cm (1.7 metres). So weight (65kg) divided by
height squared (1.7 x 1.7) = a BMI of 22.5kg/m2
This table shows the recommended rates of healthy weight gain during pregnancy:
BMI Expected Weight
Gain
Less than 18.5 kg/m2 12.5-18 kg
18.5-24.9 kg/m2 11.5-16 kg
25-29.9 kg/m2 7-11.5 kg
More than 30 kg/m2 5-9 kg
Most women will gain 1-2kg in the first trimester, and then varying amounts over the
following months. Gaining more weight than is recommended can increase your risk of
high blood pressure or diabetes during pregnancy. Carrying extra weight may also result in
a larger baby, caesarean birth and difficulty returning to your pre-pregnancy weight.
Dieting and Pregnancy
Pregnancy is not a safe time to try to lose weight, even if you were a bit heavier to begin
with. When you are pregnant it is more important to concentrate on eating a healthy diet
so that you and your baby are getting the nutrients you both need. Weight loss is best
kept for before or after your pregnancy.
Pregnancy Myth: ‘If you eat less during pregnancy, your baby will take extra fat
off you’.
Pregnancy Fact: Dieting is not recommended during pregnancy. Dieting could prevent your baby
from getting the nutrients it needs to grow and develop, such as carbohydrates and protein. If
you are concerned about your weight, focus on limiting your weight gain during pregnancy by
making every mouthful nutritious and enjoying some gentle physical activity.
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Food cravings:
Sometimes pregnancy causes food cravings. It’s okay to satisfy your cravings, provided
you are still managing to eat a good variety of healthy foods so you do not miss out on
important nutrients.
Morning sickness:
Nausea and vomiting are common problems in pregnancy. They may occur at any time of
the day and are usually strongest between the 6th and 14th week of pregnancy. If your
nausea and vomiting become severe or you are losing weight, see your GP as soon as
possible.
The following things may help manage your symptoms:
Eat an icy pole or jelly
Sip cordial with ice
cubes, flat lemonade, or dry
ginger ale
Drink fluids between
meals rather than with them
Eat dry biscuits or toast
Avoid fatty or spicy foods
Eat small, frequent, low-fat meals
Have a small snack before getting out
of bed in the morning
Pregnancy Myth: ‘Food cravings mean you have a nutritional deficiency’.
Pregnancy Fact: We don’t know the cause of food cravings. However, research shows that they
do not occur in order to correct deficiencies in particular vitamins
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Constipation:
Hormonal changes, the weight of the baby on your bowel, and taking
iron supplements all add to constipation during pregnancy. You can
reduce constipation and the development of haemorrhoids by:
Drinking plenty of fluid (6-8 glasses per day)
Gentle exercise, such as walking or swimming
Eating foods high in fibre, such as wholegrain or high-fibre
cereals, breads and pastas, brown rice, fresh fruit and
vegetables (eat the skin where possible) and legumes.
Indigestion and Heartburn:
Indigestion and heartburn refers to a burning feeling in your chest or the back of your
throat and is caused when acid moves up from the stomach. Hormonal changes and the
decreased space in your abdomen as your baby grows make indigestion more common
during pregnancy.
To help ease indigestion and heartburn try the following:
Eat small, frequent, low-fat meals
Avoid spicy and ‘windy’ foods (e.g. cabbage, onions and beans)
Avoid drinking large amounts of fluid with meals
Elevate the head of your bed or use extra pillows
Don’t lie down, wear tight clothes or bend for at least 30 minutes after meals
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Healthy eating during breastfeeding
If you are able to breastfeed it is a fantastic way to nourish and protect your baby.
Breastfeeding protects you and your baby by:
Protecting your baby against infections (including ear, stomach and chest), diabetes,
obesity, heart disease, some cancers, allergies and asthma
Protecting you against breast and ovarian cancers, osteoporosis and other illnesses,
and helps with post-pregnancy weight loss
It’s recommended that babies be completely breastfed for the first
four to six months of life and continue to be breastfed when foods
are introduced. The longer you are able to breastfeed, the better
the health benefits for you and your baby.
It’s important to eat well during breastfeeding as your body needs
extra protein, vitamins, minerals and energy to produce milk. Refer
to the Food Groups section of this booklet to find out how to get the
right eating balance while breastfeeding.
Are there any foods I can’t eat while breastfeeding?
There are no foods that you have to avoid while breastfeeding, but you may find certain
foods upset your baby. If you suspect that a food is upsetting your baby, try avoiding it
temporarily. If your baby improves, that food may have caused the problem. However, try
to reintroduce that same food a few weeks later to be sure.
If you are avoiding certain foods it’s best to talk to your Doctor, Pharmacist, Dietitian or
Maternal and Child Health Nurse about whether you need extra supplementation to ensure
that you are meeting your nutrient needs.
Can I have caffeine?
Some caffeine will be transferred from your body into your breast
milk. It is recommended that you limit your intake of caffeinated
beverages, such as coffee, tea or cola drinks, to 2-3 cups per day in
total.
Can I drink alcohol?
Alcohol can be passed into breast milk. Not drinking alcohol at all while breastfeeding is
the safest option. If you choose to drink, limit yourself to 1-2 standard alcoholic drinks per
day, and have at least two alcohol-free days per week. Any more than this may reduce
your supply of breast milk and may cause irritability, poor feeding and sleep disturbance in
your baby.
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Contacts
If you have any difficulties with pregnancy or breastfeeding, please contact the
switchboard on (03) 4215 0000 and ask to be transferred to the Geelong Hospital
Pregnancy Care Clinic.
Geelong Hospital Pregnancy Care Clinic
Level 3, Geelong Hospital
Bellerine St
Geelong VIC 3220
If you have any further concerns regarding foods, diet or your weight you can see an
Accredited Practicing Dietitian at your closest Barwon Health Community Health Centre.
For more information please call the numbers listed below, between 8 am and 5 pm
Monday to Friday:
Anglesea: McMillan Street, Anglesea. 4215 6700
Belmont: 1-17 Reynolds Rd, Belmont. 4215 6800
Corio: 2 Gellibrand Street, Corio. 4215 7100
Newcomb: 104-108 Bellarine Highway, Newcomb. 4215 7520
Torquay: 100 Surfcoast Highway, Torquay. 4215 7800
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General references
Department of Health Public Health Division. (1999). Child and Antenatal Nutrition Manual,
Government of Western Australia, Perth.
Eastman, C. (2005). Iodine supplementation: The benefits for pregnant and lactating
women in Australia and New Zealand. Royal Australian and New Zealand College of
Obstetricians and Gynaecologists Membership O&G Magazine, 7(1), pp. 65-6.
Food Standards Australia and New Zealand (FSANZ). (2013). FSANZ homepage.
Retrieved June 4, 2014 from www.foodstandards.gov.au
Food Standards New Zealand and Australia (FSANZ). (2011). Mercury in fish. Retrieved
June 4, 2014 from
http://www.foodstandards.gov.au/consumer/chemicals/mercury/pages/default.asp x
National Medical Health and Research Council (NHMRC). (2009). Australian Guidelines:
To reduce the risks from drinking alcohol. Retrieved June 4, 2014
http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/ds10-alcohol.pdf
National Medical Health and Research Council (NHMRC) 2013, Healthy eating during your
pregnancy. Canberra: NHMRC
Polley, B.A., Wing, R.R., & Sims, C.J. ( 20020. Randomized controlled trial to prevent
excessive weight gain in pregnant women. International Journal of Obesity and
Related Metabolic Disorders, 26(11), pp. 1494–1502.
Queensland Government. (2010) Weight management in pregnancy. Retrieved 4 June,
2014 from
http://www.health.qld.gov.au/nutrition/resources/antenatal_wght.pdfRasmussen,
K.M., Yaktine, A.L. (eds).( 2009). Weight gain during pregnancy: Re-examining the
guidelines. Bethesda: National Academies Press. Retrieved 4 June 2014 from
http://www.nap.edu/catalog/12584.html
State Government of Victoria, Better Health Channel. (2014). Pregnancy & diet. Retrieved
June 4, 2014 from
www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_and diet .
The Royal Australian and New Zealand College of Obstetrics and Gynaecologists. (2013).
C-Obs 25: Vitamin and mineral supplementation in pregnancy. Retrieved June 4,
2014 from
file:///C:/Documents%20and%20Settings/sherylh/My%20Documents/Downloads/C-
Obs_25_Vitamin_and_Mineral_Supplementation_in_Pregnancy_Review_Mar_13.pdf
U.S. Department of Health and Human Services (n.d.)> Womens health homepage.
Retrieved June 4, 2014 from http://www.womenshealth.gov/
Wahlqvist, M.L.(1997). Food and nutrition: Australasia, Asia and the Pacific, 4th ed. Crows
Nest, NSW: Allen & Unwin
Women’s and Children’s Hospital. (2000). Good food for pregnancy and breastfeeding: A
guide to women starting a family. Adelaide: Women’s and Children’s Hospital.
This document was developed by the Department of Nutrition and Dietetics , Barwon Health.
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