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Pregnant woman on light backgroundToday’s post is served by good friend to Mark’s Daily Apple, Stephanie Greunke. Stephanie has teamed up with Melissa Hartwig of Whole30® to create the Healthy Mama, Happy Baby program.

Food aversions and nausea plague up to 80% of women during the first trimester of pregnancy, which can be really frustrating for the mama who is trying to eat a healthy, nourishing diet. While there is no one specific cause of food aversions and nausea, some of the proposed factors include increased hormone levels (specifically estrogen, progesterone, and hCG), hypoglycemia, thyroid dysfunction (specifically increased serum free T4 and decreased serum TSH), a woman’s enhance sense of smell, stress, Helicobacter pylori (H. pylori) infection, and physiological changes of pregnancy such as delayed gastric emptying and constipation.

One of the largest studies to date of pregnant women, the Collaborative Perinatal Project, found nausea and vomiting in pregnancy to be more common in younger women (the incidence is highest among women younger than 20 years old and drops significantly after age 35), women pregnant for the first time (primigravida), women with less than 12 years of education, women with multiple gestation, women carrying female infants, and women who are obese. Also, women whose mothers experienced nausea and vomiting with pregnancy are more likely to experience it.

If your “morning sickness” progresses to severe and persistent vomiting with substantial weight loss, you may be experiencing a condition called Hyperemesis Gravidarum, which is a much more severe form of this common pregnancy concern and requires management and follow-up with your provider. Please, don’t try to tough it out on your own!

At Whole30 Healthy Mama, Happy Baby, we understand that morning sickness can put a halt on your dedicated efforts to eat healthy! The good news is that most women find the worst morning sickness symptoms usually end around 12-16 weeks, and typically nausea is a good sign that the pregnancy is progressing well. Researchers have found that the presence of nausea and vomiting during pregnancy is correlated with lower rates of miscarriage. Hopefully, that fact makes you feel just a little better!

So, keep your head up, mama. Today I have six tips to help you eat healthy despite aversions and nausea.

Bring the whole darn grocery store home with you.

This tip comes from Whole30 Headmistress and HMHB co-creator Melissa Hartwig. She experienced lots of food aversions during her pregnancy and used this strategy. That’s why we love Primal Kitchen® products—you can stock your pantry and fridge with them, so you’ll always have flavorful and delicious options to make meals based on what sounds good to you in the moment. The more stocked your fridge and pantry are, the better chances you’ll have that you’ll be able to find something you can stomach. Don’t be afraid to ask your partner or a friend to run out and grab something for you when the mood strikes. You might be at the grocery store a bit more often during this time, but it usually only lasts a few weeks.

Capitalize on what and when you can eat.

Are there certain times of day when you feel better or have more of an appetite? Try to think outside of the box. Maybe you can’t imagine eating an egg immediately upon waking, but perhaps it sounds a little more appetizing as an early lunch? Some women notice that their nausea is worse in the morning but better by evening. I recommend trying to have lots of options in the fridge that could work for easy-to-prepare dinners. That way you can still make dinner based on what sounds good to you in the moment.

Avoid your major problem foods.

For example, if you know that you don’t tolerate dairy well normally, then try to avoid it throughout pregnancy. If ice cream sounds really good, but typically diary messes with your digestive system, then it’s probably going to do more harm than good. Instead of ice cream, see if a frozen, non-dairy smoothie would do. You might even be able to sneak some veggies in that way!

Balance your meals/snacks with a combination of fat/protein/and carbs.

Low blood sugar can be a trigger for nausea as well, so as best you can, try to eat throughout the day, even if you’re feeling sick. It’s commonly known that pregnant women crave carbs, and that’s okay! However, any time you can, try to combine fat, protein, and carbs, to give your body more nutrients to work with and help keep your blood sugar regulated throughout the day. Craving some gluten free crackers? Stack them with almond butter or a little rotisserie chicken and Primal Kitchen Mayo.

Stay hydrated.

Becoming dehydrated can actually aggravate symptoms of morning sickness, so try to sip on a variety of beverages throughout the day. Plain water is great, but if you find that it’s difficult to tolerate, you can try sipping on chamomile, ginger, or peppermint tea (hot or iced!). You could also try sparkling water, as some mamas say it helps settle their stomach. A small amount of ginger kombucha could be a good option as well.

Focus on key nutrients.

You don’t need to choke down an organic kale salad with wild-caught salmon to optimize your nutrition during this time. Give yourself grace and just focus on a few key nutrients for you and your growing baby during this hard time.

  • Folate (B9) is involved in making and repairing DNA as well as preventing neural tube defects, which is really important during the early weeks. Outside of liver, the best source of folate is dark leafy green vegetables (such as kale, collard greens, spinach, and dandelion leaves). You just need 2.5-3 cups of steamed spinach to meet your daily prenatal requirements. With that being said, leafy greens and liver are probably “off the menu” for most of your meals right now. You can include other sources of folate, such as chickpeas, pinto beans, lentils, avocado, and beets (if they work well for you); however, this is where a prenatal vitamin comes in handy. I like to recommend prenatal vitamins that contain a methylated version of folate (versus folic acid) for optimal absorption and utilization.
  • Omega-3 fatty acids are important for your baby’s brain and visual development. Higher intakes have been associated with improved memory, cognition, and IQ. Since the amount of these essential fatty acids baby receives depends on mom’s dietary intake, it’s important to make sure they’re included in sufficient amounts through food and/or supplements. Because of the potential for mercury contamination, it’s important to choose fish low in mercury, such as wild-caught salmon, sardines, and herring. For mamas who can’t stand the thought of fish during the first trimester (which is most), I recommend talking to your provider about adding a fish oil supplement to your regimen.
  • Vitamin B6 helps your body metabolize proteins, carbohydrates, and fats, helps form new red blood cells, and supports brain and nervous system development. It’s also well-known that vitamin B6 can help alleviate nausea and vomiting, which sets it apart as an important player in your prenatal diet during the first few months. Food sources of B6 include fish, liver, chickpeas, poultry, beef, bananas, potatoes, and pistachios. If none of these options sound good or you’re really suffering, you can talk to your provider about using a B6 supplement.
  • Choline, like folate, is important for preventing neural tube defects. It’s also important for healthy brain development and can have long-term effects on your baby’s cognitive abilities, memory, and mood regulation. According to new research from Cornell University, pregnant women who increase choline intake during their third trimester of pregnancy (930 mg/day vs. 480 mg/day), may reduce the risk of their baby developing metabolic and chronic stress-related diseases like high blood pressure and diabetes later in life. While the need for choline increases during pregnancy (and even more while breastfeeding), there aren’t many foods rich in this nutrient outside of eggs and liver. You’d need to eat about four eggs a day to reach your prenatal daily requirements. Since eggs and liver may not work for you during these tough weeks, make sure your prenatal vitamin contains choline. I like Innate Response’s Baby & Me Multivitamin.

At the end of the day, just do your best. You won’t be able to eat perfectly during this time, and that’s okay. Make sure you’re taking a good prenatal supplement (gummy versions are fine during this time!), and know that your body is relying on the stores that you had built up before you became pregnant. You’ll be able to eat your piles of green, leafy veggies again soon! Hang in there, mama—and for more information and friendly advice, check out our Healthy Mama, Happy Baby blog.

Want to take your pregnancy, pre- or post-natal nutrition to the next level? Join the Whole30 Healthy Mama / Happy Baby program. Mark’s Daily Apple & Primal Kitchen customers can use code HMHBLOVESPK to receive $40 OFF your registration!

StephanieStephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie guides and supports women locally and globally through her web-based private practice.

Thanks for stopping by today, everybody. Thoughts, questions, experience to offer on either food aversions or pregnancy health? Share them on the comment board, and have a great week!

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