Coping with food allergies and digestive conditions in pregnancy
By Annemarie Aburrow RD
By Annemarie Aburrow RD
If you have a food allergy, you may be concerned about how to make the most of your diet during pregnancy, to help keep both you and your baby healthy. Due to hormonal changes, allergic reactions and symptoms can change during pregnancy. Some women find that pregnancy reduces their symptoms; others find they increase. This guide will explain how you can still meet your nutritional requirements during pregnancy whilst avoiding those offending foods.
Pre-conception and pregnancy is a great time to review your gluten-free diet, to make sure you are eating a good balance of foods and remain healthy. It is particularly important to stick to the diet during pregnancy. Even if you only get mild symptoms on eating gluten (found in wheat, barley, rye and oats), it can have serious complications for the body, e.g. preventing enough calcium and iron from being absorbed. You also risk having a low birth-weight baby if you don’t follow the diet properly. The following tips will help you keep a balanced diet during pregnancy:
If you’ve been formally diagnosed with coeliac disease, dermatitis herpetiformis of gluten sensitive enteropathy, you are entitled to a number of products on prescription every month. Use your prescription allowances to obtain starchy foods like pasta, bread and crackers, rather than cakes and biscuits. If your healthcare Trust have limits on prescription amounts, you may be able to access more foods during the last 3 months of pregnancy(where calorie requirements are 200kcal higher) and during breastfeeding. Your GP or dietitian will be able to give you more information on foods available on prescription.
If you are avoiding cow’s milk / dairy products because of cow’s milk allergy or lactose intolerance, it’s important to replace the milk/dairy products with other calcium-containing alternatives. Calcium requirements in pregnancy do not increase, but it is important to ensure you have 2-3 portions of dairy alternatives each day to meet requirements.
Good non-dairy alternatives to milk include soya, rice and almond milk (check the label to make sure they have added calcium). Other sources of calcium include soya yoghurts, calcium-enriched tofu, kidney beans, soya beans, chickpeas, tempeh, soya mince, tinned fish (with bones), nuts, figs and green leafy vegetables.
The benefits of including oily fish in the diet once a week are well-documented, due to their omega-3 fatty acid content. It’s important that you eat enough foods containing omega-3 fatty acids to help support your baby’s growth and developing brain. Try to include plant-based sources of omega-3 fatty acids, e.g. linseeds/flaxseeds, nuts and seeds, avocados and green leafy vegetables. Linseeds add ‘bite’ to food and can be added to foods like cereal, soup, yoghurt, bread mixes and salads. You may wish to consider taking an algae docosahexanoic acid (DHA) supplement during pregnancy and breastfeeding (providing 200mg a day).
It’s important to include 2-3 portions of protein-rich food each day. Eggs are a good source of protein and iron. If you’re avoiding eggs, be sure to include alternative sources of protein, such as meat, fish, poultry, beans, lentils, chickpeas, Quorn or tofu.
If you’re avoiding certain fruits and veggies, it’s important to consider your vitamin C intake. Vitamin C requirements are raised during the last trimester of pregnancy. Most people with OAS are able to eat well-cooked fruit, as cooking destroys the allergens. However, cooking also reduces the amount of vitamin C in foods. Steaming fruits using minimal water is the best option, and include a wide variety of different fruits. Fruits high in vitamin C include citrus fruits, berries, pineapple and other tropical fruits.
If your fruit and vegetable intake is low, or you cannot tolerate cooked fruits, you may wish to consider taking a supplement containing vitamin C. Suitable options include a pregnancy multi-vitamin supplement or Healthy Start Vitamins. It’s best to avoid single vitamin supplements as they can contain high doses which could be dangerous in pregnancy.
If you’re allergic to nuts, soya or any other foods, continue to avoid the offending foods during pregnancy. Take particular care to avoid cross-contamination. If you’re avoiding nuts or soya, be sure to include other sources of protein in your diets, e.g. meat, fish, poultry, beans and lentils. If you’re avoiding wheat, make sure you include a good variety of suitable starchy carbohydrates, like rice, potato, oats or wheat-free pasta.
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Greenberg JA, Bell SJ and Ausdal WV (2008) Omega-3 fatty acid supplementation during pregnancy. Rev Obstet Gynecol. 1(4):162-169.
McCance RA and Widdowson EM (2002) McCance and Widdowson's The Composition of Foods Sixth Summary Edition. Royal Society of Chemistry.