A healthy diet includes folic acid
Eating a healthy diet is one of the most important things you can do to nurture your growing baby - lots of fruits and veggies, and plenty of protein (such as you find in fish, meat, poultry, beans and soya products).

You also should be sure to take folic acid, which is a member of the vitamin B family. It has been shown to prevent certain birth defects, including spina bifida, an opening in the back of the spine that can lead to paralysis and other neurological problems. Because folic acid is so important, even women who eat a good, balanced diet should take 400 mcg daily; in fact, ideally, you would have started on folic acid even before becoming pregnant. You can take over-the-counter folic acid supplements or make sure that your regular multi­vitamins contain the recommended dosage of this crucial component.

Stay away from certain foods and substances. Just as beneficial substances like nutrients and oxy­gen flow across the placenta from you to your fetus, so, too, can harmful chemicals, parasites, viruses and bacteria. Even certain foods that are usually safe to eat can prove harmful to a fetus.

The verdict's still out on some foods:
Many doctors and scientists now believe that some of the foods and ingredients that were once considered unsafe during pregnancy actually may not be so bad after all.

Aspartame:
Aspartame, an artificial sweetener found in NutraSweet and many other products, contains phenylalanine, an amino acid (amino acids are the building blocks of protein) that is toxic for children with the rare genetic condition phenylketonuria (PKU). Even if your baby has PKU, your body would break down any phenylalanine you eat before it crossed the placenta, rendering it harmless to your fetus. However, the most prudent advice is to consume aspartame only in moderation (which is a good idea even if you're not pregnant).

Caffeine:
In addition to coffee and some teas, many soft drinks and chocolate products contain caffeine, and large amounts of this substance have been linked to miscarriages in the first trimester. How­ever, one caffeinated drink a day has never been shown to be damaging, so if you crave a daily cup of coffee or an occasional cola drink, it's probably just fine.

Sushi:
This Japanese delicacy has become very popular; in fact, if they like the type of sushi made with raw fish, many of my patients find it one of the hardest things to give up when they become pregnant! If such sushi isn't handled properly or is contaminated with bacteria, viruses or parasites, yes, it can be quite dangerous indeed, and not just to pregnant women. But there have been few reports of illness resulting from sushi served in restaurants staffed by trained sushi chefs, who know how to buy, store and serve the fish and spot signs of contamination. It may be prudent not to prepare sushi at home, however, unless you can be certain of the freshness of the fish and know how to check it for parasites or other prob­lems. Besides, you can always enjoy the types of sushi made with cooked fish or vegetables.

A good diet is important - but all in good time:
If you find it difficult even coming close to eating a bal­anced diet in your first trimester, rest assured that you are not alone. To ward off queasiness, some women snack all the time (and not necessarily on the healthi­est stuff) and quickly-put on a lot of weight. Others are hardly able to get anything down and actually lose weight. And for many mothers-to-be, only a limited number of foods seem tolerable.

But don't worry:
Getting enough folic acid and preventing malnutrition and dehydration are the most important considerations in the first trimester. If a perfectly balanced diet were that impor­tant, we wouldn't have evolved to feel so nauseated during pregnancy!

Many mothers-to-be wonder whether or not they are making the best nutritional choices for their devel­oping babies. The good news is that most fetuses can make do with what they're given and grow well despite a mum's less-than-stellar diet. That said, it's still wise to take in enough good nutrition for both of you. As soon as the nausea has diminished and you feel ready to eat more healthily, drink lots of fluids and try to follow the Government's food pyramid guidelines: that is, eat plenty of whole grains, fruits and veggies; a moderate amount of dairy and meat (or other sources of protein); and sparing amounts of fats and sweets.

Babies are nutrition magnets! Drawing upon their mothers' bodies, they help themselves to everything that they need. And as they get bigger, their nutritional needs increase. That's why eating a healthy, well ­balanced diet isn't so much to ensure that your baby gets what he needs but so that you have enough left for yourself. If you have bad eating habits or are on a restricted diet, if you know you are deficient in a specific nutrient, or if you are overweight, underweight or have an eating disorder, a consultation with a nutritionist can help you and your baby stay healthy.

Supplements help ensure adequate nutrition:
After the embryonic organs have formed in the early first trimester, taking folic acid is no longer so cru­cial if you're a healthy woman who eats a balanced diet, it is reasonable to think of routine antenatal vitamins as an insurance policy against the unlikely chance that you are not getting enough of one of the many nutrients rec­ommended for pregnancy. But for many women, even a good diet and antenatal vitamins may not supply all the calcium and iron they need as their pregnancy progresses.

Iron is essential to red blood cells:
Iron is important to build the baby's blood cells, as well as to maintain yours. How much iron you need during pregnancy depends both on how much you already have stored in your bone marrow and how much you get in your diet. For meat-eaters, the amount in any multivitamin labeled with iron will probably be enough, at least in the first half of pregnancy. Most practitioners will check your blood count (or hemoglobin level) early in your pregnancy, and then again around the seventh month, prescribing extra iron if needed. Some routinely recommend extra iron tablets to all their patients throughout pregnancy, especially for those with risk factors for deficiency in this mineral, such as poor nutrition or closely spaced pregnancies.

Babies are very good at getting all the iron they need from their mothers' storehouses of the mineral. They take more towards the end of pregnancy, as they get bigger and produce more red blood cells. It is rare for a newborn to have iron-deficiency anemia (low red blood cells), even if the mother is low on iron herself.

Mothers, on the other hand, often end up slightly anemic by the end of pregnancy. There is some evi­dence that severe anemia in a pregnant woman is associated with low-birth-weight babies and preterm birth. It isn't clear if this is cause and effect, or if women who are very anemic have other problems, like poverty, that put them at greater risk.

If a woman has a low red blood cell count when she goes into labor, she may get to a dangerously low level if she bleeds more than usual during childbirth. While it is rare for a mother to need a blood transfusion around the time of delivery, it makes sense that the higher the blood count in late pregnancy, the larger the safety net.

The most common iron-related problem in preg­nancy is that taking two or more iron supplements a day can cause abdominal cramping, dark green and grainy stools, and constipation. Even the small amount of iron in an antenatal vitamin can cause some women to become constipated; conversely, some people get diarrhea from .iron. Depending on how much you need this mineral, you may be able to decrease your iron intake, or you may have to treat the intestinal symptoms so that you can continue the iron.

Pickles and ice cream, anyone:
Along with all the healthy foods and supplements mums-to-be are diligent about consuming, many report strong food cravings during their pregnancies. Some­times it's an overwhelming urge to indulge in a certain favorite food on a daily basis. Sometimes it's a sudden desire for a food they normally dislike, or for a weird com­bination of foods. And occasionally it's not for a food at all: pregnant mums have been known to develop a taste for clay, dirt or other substances not normally found on the family dinner table; these abnormal cravings are known as pica (pronounced PIE-ka).

Calcium is the key to building healthy bones:
Calcium is important in building your baby's bones as well as maintaining your own bone density. While antenatal vitamins have some calcium, none have enough to satisfy the antenatal requirement; the pill would have to be the size of a robin's egg! Usually 1,500 mg of calcium per day is recommended for pregnant women, the equivalent of five helpings of milk, cheese, yoghurt or ice cream.

Calcium intake becomes more important as the preg­nancy progresses and the baby's need for this element increases.

Be particularly careful to get enough calcium in the second half of pregnancy, as the baby gets bigger and is taking more from you. Most women in the United Kingdom don't get enough calcium in their diets, even when they're not pregnant. This is part of the reason that older women have such a high incidence of hip fractures. A woman is most able to build bone strength from her teen years through her thirties. Peak bone mass is reached by age 35 or even earlier. From then on, the best you can do with diet and exercise is maintaining your bones - they will not get stronger. In addition to the teen years, after menopause, and during breast- ­feeding, pregnancy is one of the times in your life when you really need to pay attention to calcium intake. Protect your bones. They must last you a lifetime.

Calcium supplements such as calcium carbonate come in chewable form (like Rennies antacids) or as regular pills. Some include vitamin D or other vitamins or minerals. In pregnancy, plain old calcium carbonate is fine. The biggest problem with any of the calcium supplements is constipa­tion. Pregnancy can be constipating enough without adding this insult. If you are struggling with this problem, try to get calcium from your food rather than supplements, or try some of the preventive measures for constipation in pregnancy.

If you are going to take supplements, one option is to take five or more Rennies, spaced out during the day. This method is a favorite of heartburn sufferers.

Another method is to take one 500 or 600 mg calcium pill in the morning, and then take another in the evening if you haven't got a lot of dietary calcium that day. This can increase your awareness of your diet and, with any luck, gets you enough calcium without tak­ing more pills than your GI tact can handle.