Specialist advice on third trimester nutrition

Fertility Associates dietitian, Alice Gormack shares her advice on third trimester nutrition.

Welcome to the home stretch, mum-to-be! As you head into the third trimester of your pregnancy, your body is working overtime to nourish both you and your growing baby. It's an exciting and sometimes exhausting time, but your nutrition plays a crucial role in supporting your health and the development of your little one. Let's delve into some tips and tricks to keep you feeling your best as you count down the days to meeting your new baby.

FOOD SAFETY FIRST:  PROTECTING YOU AND BABY

Even though you're in the final trimester, it's still essential to follow the food safety in pregnancy guidelines (you can find these at healthed.govt.nz). We know it’s tedious, but it is very important to remember that your immunity to illness remains lower throughout pregnancy. But here's the good news: as soon as your baby makes their grand entrance into the world, you can resume your normal eating habits without worry. I was more excited to see a pack of raw salmon sushi than my husband after delivery of our third baby, it was a long nine months!

KEY NUTRIENTS

+ Iron: Iron becomes even more critical in the late stages of pregnancy as your blood volume increases to support your baby's growth. This mineral helps prevent anaemia and ensures proper oxygen transport to both you and your baby. Lean red meat is the best source of iron, while chicken, pork and fish are helpful too. Vegetarians should include plenty of iron-rich foods like lentils, beans, tofu, and iron-fortified breakfast cereal. Many women develop low iron in their 3rd trimester and prescription iron tablets (or an iron infusion) is the most effective way to bring your iron levels up. The amount of iron in prenatal supplements will not be enough to correct an iron deficiency.

+ Folate: Folate continues to play a crucial role in the third trimester; this B-vitamin supports your baby’s brain development. Load up on folate-rich foods like leafy greens, broccoli, citrus fruits, beans, and wholegrain cereals to ensure you're getting a good supply.

+ Iodine: This essential nutrient is necessary for your baby's brain development and thyroid function. Keep taking supplementary iodine (either as the 150 mcg prescription iodine supplement or part of a pregnancy multivitamin supplement) until the end of your pregnancy. If you choose to breastfeed, continue to take iodine until you fully wean your baby off breastfeeding.

+ Omega-3: Continue to have oily fish twice a week throughout your pregnancy for beneficial omega-3 fats. If you do not eat fish then a high quality omega-3 supplement is a good idea.

MANAGING COMMON DISCOMFORTS

+ Constipation: Constipation is common in pregnancy and quite literally a pain in the bum! Include plenty of high fibre foods each day and don’t forget to help fibre work its magic by drinking plenty of water (at least 9 cups per day). Great sources of fibre include fruit, vegetables, grainy or brown carbohydrate foods, beans and lentils. It can be useful to pack some prunes in your hospital bag to help soften that first poo after delivery of your baby. Kiwifruit is also great at easing constipation.

+ Heartburn/reflux: Reflux making an unwelcome appearance in later pregnancy? Try sitting upright after meals and go easy on spicy, fatty, or fried foods to help keep discomfort at bay. Caffeine, chocolate, peppermint, carbonated drinks and acidic foods (eg tomatoes, citrus fruits) are other common triggers for reflux. Aim to have dinner at least two hours before going to bed and consider using an extra pillow or two. By raising the head of your bed, you create a slight incline that can help keep stomach acid where it belongs.

EATING ALLERGENIC FOODS: REDUCING THE RISK

Surprisingly, eating common allergenic foods like nuts, fish, eggs, soy, wheat and dairy during pregnancy may actually help reduce the risk of food allergies in your baby. So, unless you're allergic yourself, include these foods regularly throughout your third trimester and during breastfeeding.

EXERCISE: KEEP ACTIVE EACH DAY

Even in the third trimester, exercise remains important. Not only can it help ease constipation, but it may also assist with positioning your baby for labour. Remember to listen to your body and avoid overexertion; it may help to sit and rest your back midway through a walk if there is a handy park-bench.

HOW MUCH EXTRA FOOD DO YOU ACTUALLY NEED?

In the final trimester of pregnancy, most women need around an extra 450 calories per day. This is equal to an additional two slices of toast with two eggs and avocado, or a fruit, yoghurt and milk smoothie. Opt for nutrient-rich wholefoods rather than low-nutrient foods like chips, biscuits, fried foods or chocolate. Your Lead Maternity Caregiver (LMC) can tell you the recommended weight gain for your pregnancy; this is tailored according to your Body Mass Index before you became pregnant. If you've already gained or exceeded the recommended amount of weight for your pregnancy, it is sensible to aim to keep you weight stable over the 3rd trimester. Gaining too much weight in pregnancy increases the risk of gestational diabetes, high blood pressure, and complications during labour and delivery.

EATING AND LABOUR

Despite what you might hear, spicy curries and large amounts of pineapple do not kick-start the labour process. They may well give you a stomach ache or set off reflux though! Consult with your healthcare provider about whether they are happy for you to eat during labour. Simple options like fruit, toast, a yoghurt pottle or a smoothie can provide the energy boost you need, or an electrolyte sports drink.

POSTPARTUM PLANNING

As your due date approaches, consider stocking your freezer with easy meal options for those hectic newborn days. Casseroles, soups, and freezer-friendly dishes like savoury mince, lentil Bolognese, lasagne and vegetable curry are lifesavers when you're juggling newborn duties. Wraps and pre-cooked/express rice can be useful to go along with these, they last for months in your pantry. Don't be afraid to accept offers of help from friends and family after your baby arrives. Not only does it make your life easier, but it also gives your loved ones a chance to feel useful and bond with your baby too. Newborn feeding sessions can be lengthy, so keep plenty of one-handed snacks on standby. Nuts, seeds, fresh or dried fruit, cheese and crackers, milk, and smoothies are perfect for refueling during marathon feeding shifts.

REST UP, MAMA

Finally, take advantage of these last few weeks of pregnancy to rest and recharge as much as possible. Enjoy those precious moments of decent sleep (between bathroom trips!) before your little one arrives. As you navigate the joys and challenges of the third trimester, remember to prioritise your nutrition, gentle exercise and self-care. You're doing an incredible job nurturing your growing baby, it isn’t an easy task. All the best for the final stretch – buckle in and enjoy the crazy ride that is newborn parenting.

Alice Gormack specialises in nutrition for women’s health, conception and pregnancy. She works as the Fertility Associates dietitian (since 2013) and also runs her own business Oestro Nutrition. Find out more at oestronutrition.co.nz.