The Sensible Guide to a Healthy Pregnancy

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Organization: Public Health Agency of Canada

Published: by authority of the Minister of Health

Cat.: HP5-33/2017E-PDF

ISBN: 978-0-660-07156-5

Pub.: 160286

If you are pregnant, or are planning to become pregnant, this guide is for you!

Having a baby can be a wonderful experience, but it can also be a time of uncertainty. Many parents have questions and concerns as they face all the changes that pregnancy brings. With advice coming from everyone, it’s tough to know who to listen to. That’s why having accurate information is so important! It will help you to make good decisions about how to take care of yourself before, during and after your pregnancy.

In this guide, you will find important facts and questions related to a healthy pregnancy. They include:

Prenatal nutrition
Folic acid
Alcohol and pregnancy
Physical activity and pregnancy
Smoking and pregnancy
Oral health
Emotional Health
10 months of pregnancy
Resources
Canada Prenatal Nutrition Program (CPNP)
Breastfeeding
Immunization

Planning a pregnancy and being pregnant can be exciting times in your life! Using this guide can help make it a healthier experience for you and your baby.

Prenatal nutrition

Healthy eating plays a very important role in a healthy pregnancy, eat foods from a variety of sources to make sure you get all the vitamins, minerals and nutrients you and your developing baby need. Eating well will also help you feel better, give you more energy and help you gain a healthy amount of weight. It will also contribute to your baby’s healthy growth and development.

Important facts

Know what you need

During your second and third trimesters of pregnancy, you need some additional calories each day to support the growth of your baby. One extra snack is often enough. For example, have an apple or a pear with a small piece of cheese as an afternoon snack. Follow Canada’s Food Guide to eat the amount and type of food that is right for you and your baby.

Fruits and vegetables are a must!

Pregnant women need fruits and vegetables every day. Brightly coloured vegetables and fruit contain more of the kinds of vitamins you and your baby need. Eat at least one dark green and one orange vegetable each day. Make sure your fruits and vegetables are prepared with little or no added fat, sugar and salt, and choose vegetables and fruit more often than juice.

Grain products are important

You need to include grain products as part of your daily diet. This includes foods like bread, rice and pasta. Try to choose grain products that are lower in fat, sugar and salt, and look for the “whole grain” variety.

Have milk and milk alternatives for strong bones

Milk and alternatives are important for your growing baby. Opt for the low-fat variety, which will give you the high quality protein, calcium and vitamin D you need but with less of the fat and calories. Have skim, 1% or 2% milk every day and go for lower fat varieties of yogurt and cheese. Drink fortified soy beverages if you do not drink milk.

Include meat and meat alternatives

Eating meat and alternatives each day will help you and your baby stay healthy. Choose lean (less fatty) meats and meat alternatives—dried peas, beans, tofu and lentils—made with little or no added fat or salt. Fish is also important and should be eaten each week. But choosing which fish to eat, and how much, can be complicated.

Visit Health Canada’s Web site to find out how to choose fish that are low in mercury so that you and your baby can take advantage of the benefits of eating fi while minimizing the risks from mercury.

Next steps

Aim for three meals a day with healthy snacks in between.

Check out Canada’s Food Guide to see how many servings of each food group you need each day.

Take a prenatal multivitamin every day. Make sure it has 0.4 mg of folic acid and 16 to 20 mg of iron. A health care provider can help you find the multivitamin that is right for you.

Common questions about prenatal nutrition

How much weight should I gain while I’m pregnant?

It depends on how much you weighed before you got pregnant. The following recommendations are based on your Body Mass Index (BMI) before you became pregnant. BMI is a number based on a comparison of your weight to your height (BMI = weight (kg)/height (m)2).

BMI Recommended weight gain
Below 18.5 12.5 to 18 kg (28 to 40 pounds)
Between 18.5 and 24.9 11.5 to 16 kg (25 to 35 pounds)
Between 25.0 and 29.9 7 to 11.5 kg (15 to 25 pounds)
30 and more 5 to 9 kg (11 to 20 pounds)

If you are pregnant with more than one baby (twins, triplets) you will need to gain more weight. Your health care provider will be able to advise you.

Is there anything I shouldn’t eat while I’m pregnant?

  • Yes. Avoid the following foods which may be contaminated by bacteria:
  • Raw fish, such as sushi, raw oysters, clams and mussels
  • Raw or undercooked meat, poultry, seafood and hot dogs
  • Non-dried deli-meats such as bologna, roast beef, ham and turkey breast
  • Refrigerated pâté, meat spreads and refrigerated smoked seafood
  • All foods made with raw or lightly cooked eggs (for example, homemade Caesar vinaigrette)
  • The following pasteurized and unpasteurized cheeses: soft cheeses such as Brie or Camembert, semi-soft cheeses such as Roquefort or Stilton and blue-veined cheeses
  • Unpasteurized juices, such as unpasteurized apple cider
  • Raw sprouts, especially alfalfa sprouts

I often have to eat on the run. What should I grab for a snack?

There are lots of healthy foods you can eat on the run. Try pre-washed vegetables (like baby carrots, cauliflower and broccoli), low-fat cottage cheese, low-fat yogurt, trail mix (raisins, dried fruit, nuts and seeds) and cheese. Don’t forget to drink plenty of water!

For more information

Folic acid

Your baby’s brain, skull and spine form during the first few weeks of pregnancy, before you even know you are expecting! In order for them to form properly, you must have enough folic acid.

Important facts

What is folic acid?

Folic acid is one of the B vitamins important for the healthy growth of your unborn baby. It is essential to the normal development of your baby’s spine, brain and skull, especially during the first four weeks of your pregnancy. It is, therefore, important to eat a folate rich diet and to take vitamin supplements with folic acid before you get pregnant to reduce the risk of neural tube defects.

What are neural tube defects?

Neural tube defects (NTDs) are birth defects that occur when the neural tube fails to close properly during the early weeks of pregnancy, resulting in abnormalities of the spine, brain or skull that can result in stillbirth or lifelong disability. Closure of the neural tube happens early in pregnancy, often before a woman knows she is pregnant. Spina bifida is the most common NTD.

Take a folic acid supplement daily

All women who could become pregnant should take a multivitamin containing 0.4 mg of folic acid every day. To help reduce the risk of NTDs, you should start taking the vitamin supplement at least three months before you get pregnant and continue throughout your pregnancy. Talk to your health professional to find the best supplement for you

Some women are more at risk of having a baby with an NTD

If you or your partner have had a previous NTD-affected pregnancy, or have a personal or family history of NTDs, talk to your health care provider. You may be advised to take a higher dosage of folic acid.

Eat a balanced diet

Taking a daily vitamin supplement does not reduce or replace the need for a healthy, well-balanced diet according to Canada’s Food Guide. Good or excellent sources of folic acid (called folate when it is naturally occurring in foods) include dark green vegetables (broccoli, spinach, peas and brussel sprouts), corn, dried peas, beans, lentils, and oranges. Grain products fortified with folic acid such as bread and pasta also provide significant amounts of the vitamin.

Next steps

Start taking a daily multivitamin with 0.4 mg of folic acid ideally before planning a pregnancy. Talk to your health care provider or pharmacist about which multivitamin would be best for you.

Eat more foods that are good sources of folic acid (or folate).

If you are more at risk of having a baby with an NTD, see your health care provider before you plan a pregnancy to discuss your options.

Common questions about folic acid

Can NTDs be detected before birth?

Some NTDs can be detected before birth by prenatal screening tests.

If you are pregnant and wish to know more about the prenatal diagnosis of NTDs, talk to your health care provider about prenatal screening tests that can give you more information about your baby.

Is it possible to get too much folic acid?

Do not take more than the daily dose of a vitamin supplement as indicated on the product label. Increasing your daily dose of folic acid without the advice of your health care provider is not recommended. In large doses some substances in multivitamins could actually do more harm than good. This is especially true of vitamin A in some forms.

For more information

Alcohol and pregnancy

Alcohol and pregnancy don’t mix.

Important facts

There is no safe amount or safe time to drink alcohol during pregnancy or when planning pregnancy

If you drink alcohol while you are pregnant, you may be at risk of giving birth to a baby with Fetal Alcohol Spectrum Disorder (FASD). FASD is a diagnostic term that describes a range of disabilities (physical, social, mental/emotional) that may affect people whose birth mothers drank alcohol while they were pregnant.

FASD may include problems with learning and/or behaviour such as; doing math, thinking things through, learning from experience, understanding the consequences of his or her actions and remembering things. It may also affect the development of vision, hearing, kidneys, heart and bones.

No one knows how much is safe for a developing baby. When you drink alcohol during pregnancy, it rapidly reaches your baby through your bloodstream. Alcohol is known to harm the developing cells. The effect of alcohol on the developing baby can vary depending on the health of the pregnant woman and also the amount, pattern and timing of drinking alcohol during pregnancy. Binge drinking (drinking a large amount of alcohol in a short amount of time) is especially bad for the developing baby.

Next steps

Whether you are trying to get pregnant or are pregnant already, stop drinking alcohol. No alcohol is the best (and the safest!) choice for having a healthy baby.

If you need help to stop drinking, ask your health care provider for advice. Tell your partner, family, friends and community members who can all support you with this decision.

Common questions about alcohol and pregnancy

What type of alcohol should I avoid?

Everything! Beer, wine, cocktails, coolers, hard liquors (such as whiskey, gin or vodka), liqueurs or even hard ciders all contain alcohol that can hurt your developing baby. There is no alcohol that is “safe” to drink when you are pregnant.

Are there times during pregnancy when it is okay to have alcohol?

There is no known time during pregnancy when it has been determined that it is safe to drink alcohol.

How much drinking causes FASD?

No one knows for sure how much drinking causes FASD. That means that there is no safe amount of alcohol you can drink while you are pregnant or trying to become pregnant.

Can FASD be cured?

FASD cannot be cured. People live with FASD for their entire life. However, people with FASD can still do very well with helpful supports and services. Some examples include special education, vocational programs, tutors, structured environments and lifelong care. They can find paid work or go to school if given special assistance.

Can biological fathers cause FASD?

No. FASD can only be caused when a birth mother drinks alcohol while she is pregnant. However, it is known that women with partners who drink are more likely to drink themselves during pregnancy. Fathers, partners, family and friends can play a big role by supporting a woman’s choice not to drink when they are having a baby.

For more information

Physical activity and pregnancy

There was a time when pregnant women were encouraged to avoid physical activity. Fortunately, attitudes about pregnancy have changed and medical experts now recommend regular physical activity as part of a healthy pregnancy.

Important facts

Regular physical activity during pregnancy is great

It can:

  • improve your mood and self-image
  • help ensure appropriate weight gain
  • help you relax and reduce stress
  • promote better sleep
  • increase your muscle tone, strength and endurance
  • help build your stamina for labour and delivery
  • speed up your recovery after labour and delivery
  • help increase your energy levels

Start easy and progress gradually

If you’ve been inactive, start with mild activities like walking or swimming. Even five minutes a day will help. Gradually increase the time you’re active to 30 minutes a session. Before starting a new physical activity program, you should talk to your health care provider.

Don’t overdo it

You should be able to carry on a normal conversation during physical activities. If you’re feeling more tired than normal, take it easy and rest for a day.

Keep cool and hydrated

Drink lots of water before, during and after physical activity to avoid overheating and dehydration. You should also refrain from being active outdoors on overly hot or humid days.

Next steps

Build physical activity into your daily routine. The type of activity you choose is up to you, as long as you feel comfortable doing it and your health care provider says it’s okay.

Common questions about physical activity and pregnancy

I’ve never really been active. Should I start now that I’m pregnant?

Physical activity can make you feel better and be beneficial for both you and your developing baby. The decision to be active during pregnancy may be the first step toward a long-lasting healthy way of life for you and your family.

Remember to speak with your health care provider before you begin and start slowly

I’m already active, but now I’m pregnant. Can I continue to be active?

If you were active regularly before becoming pregnant, continue your program and make changes as you need to. Talk to your health care provider about your current routine to see if and when you may need to make any adjustments. Most importantly, listen to your body as it changes from one month to the next and only do what feels comfortable for you.

Can I lift weights?

Weight training is generally safe as long as the resistance is light to moderate. Using heavier weights could put too much stress on muscles and ligaments. Proper controlled breathing is also very important. After your fourth month of pregnancy, experts suggest modifying exercises that require lying on your back so they are performed on your side, or while you are standing or sitting.

How can I tell if I’ve overdone it?

If you’re really tired and you feel like stopping, then it’s time to stop. If you still feel tired, give yourself a break for at least a day. Call your health care provider if you have any of the following symptoms:

  • persistent  contractions
  • bleeding from the vagina
  • increasing back pain, pubic pain or pain in the abdomen
  • sudden swelling of the ankles, hands or face
  • dizziness or shortness of breath
  • excessive fatigue
  • difficulty walking
  • changes in usual fetal movement
  • swelling, pain and redness in the calf of one leg

For more information

Smoking and pregnancy

When you or the people around you smoke, your baby smokes too. A smoke-free environment is best for both you and your developing baby.

Important facts

When you smoke, your baby gets less oxygen and nutrients

This can cause your baby to grow more slowly and gain less weight in your womb. Babies with a lower-than-average birth weight tend to have more health problems. And the more you smoke, the higher the risk that your baby will have complications during the perinatal period (just before, during and just after birth). This is true for babies exposed to second-hand smoke too.

Cigarette smoking exposes your baby to over 4,000 chemicals found in tobacco smoke

Seventy of these chemicals are associated with cancer.

Exposure to tobacco smoke affects your baby

Smoking during pregnancy contributes to Sudden Infant Death Syndrome (SIDS).The more the mother smokes the higher likelihood of SIDS. It is estimated about one third of SIDS could be prevented if the mother does not smoke.

Smoking during pregnancy can also contribute to learning problems, more ear infections, colds and breathing problems. Being born small can affect your baby’s health into adulthood.

Smoking will increase the risks to your own health too

For example, you have a greater chance of not being able to conceive a child, miscarriage, lung cancer and cardio vascular disease.

Second-hand smoke is just as bad

Second-hand smoke contains the same toxic chemicals and carcinogens that smokers inhale. Children regularly exposed to second-hand smoke are more likely to suffer damage to their lungs and to develop breathing problems such as asthma. When you breathe in second-hand smoke, you have a greater risk of developing lung cancer, heart disease, breathing problems and irritation of the eyes, lungs and throat. Infants exposed to second hand smoke also face a greater risk of SIDS.

Next Steps

If you are currently smoking, the best step you can take is to quit! Your baby will get more oxygen and nutrients, which will help increase the baby’s birth weight and health. You will lower your blood pressure and heart rate. You can talk to your health care provider about ways to quit while you are pregnant. If you have trouble quitting, ask for help.

Avoid second-hand smoke. Make your home and car smoke-free spaces. Ask your partner, family members and friends not to smoke around you. When you are with people who want to smoke, ask them to smoke outside. Explain to them that you and your baby need smoke- free air.

Common questions about smoking and pregnancy

I only smoke a few cigarettes a day. Should I still quit?

Yes. All tobacco smoke is bad for both you and your baby. The sooner you quit completely, the better.

Don’t some mothers who smoke while they’re pregnant still have healthy babies?

Smoking during pregnancy is a gamble that puts your child at risk.

Will I gain extra weight if I quit now?

It is possible that if you stop smoking you may eat more to replace your oral habit. Chewing sugar-free gum might help. If you do gain a few pounds, don’t worry. Being physically active and making healthy food choices will help you lose the extra weight after your baby is born. You’ll also feel great knowing you gave your baby the best possible start in life.

Is it okay for me to smoke after the baby is born?

The best choice for you and your baby is to stay smoke-free. If you start smoking again, you are putting your baby at risk from the harmful effects of second-hand smoke and your own health at risk from the effects of smoking. By staying smoke-free you’re protecting both you and your baby from the harmful effects of tobacco smoke.

What can I do to help me quit?

Some people find that picking a quit day helps. On that day, you throw away your cigarettes, lighters, matches and ashtrays. In anticipation of the quit day, you can reduce the number of cigarettes you smoke per day. Set a limit and stick to it. When you feel the urge to smoke, try chewing gum, eating a piece of fruit, calling a friend or going for a walk. Stop-smoking support groups may also help.

Call the pan-Canadian toll-free quitline to talk to a trained cessation specialist. They can help you develop a plan and answer your questions about quitting. The specialist can also provide a choice of services tailored to your needs, including self-help materials, a referral list of programs in your community and one-on-one counselling over the phone.

For more information, visit Go Smoke Free or call the pan-Canadian toll-free quitline number 1-866-366-3667.

For more information

Oral health

Taking care of your teeth and gums is very important when you are pregnant. Hormonal changes during pregnancy can increase your risk of developing periodontal (gum and bone) disease. Poor oral health may also affect the health of your developing baby. Research suggests that in adults, bacteria from diseased gums may travel through the bloodstream to other parts of the body. That’s why it is especially important for women to take good care of their oral health during pregnancy.

Important facts

Pregnant women with periodontal disease may have a higher risk of delivering a pre-term or low birth weight baby

Babies who are pre-term or have a low birth weight have a higher incidence of developmental complications, asthma, ear infections, birth abnormalities, behavioural difficulties and a higher risk of infant death.

Eating well is important for your oral health

It can also help to build strong teeth and bones in your developing baby. During pregnancy, you need to eat the right kinds of food and in the right amounts — making sure to get enough calcium, vitamins A, C and D, as well as protein and phosphorous. Taking a multivitamin can help.

Regular dental checkups and cleanings by your dental professional are the best ways to detect and prevent periodontal disease

Schedule a checkup in your first trimester to have your teeth cleaned and your oral health assessed. If you require dental work, the best time to schedule it is between the fourth and sixth month of your pregnancy (the second trimester).

X-rays of your mouth should only be taken in an emergency.

Morning sickness can cause tooth decay

Stomach acid left on the teeth can damage the surface of your teeth and promote tooth decay. If you vomit, rinse your mouth with water or with a fluoride mouthwash as soon as you can.

Common questions about oral health

Will it hurt my teeth if I eat between meals?

No. It’s good for pregnant women to eat healthy snacks between meals so they can meet their daily nutritional needs. Just try to avoid soft, sweet and sticky snacks that are high in carbohydrates and sugar. And remember to clean your teeth after snacking to prevent cavities.

Is it safe to have an x-ray while I’m pregnant?

It is a good idea to avoid routine dental x-rays while you’re pregnant. In the event of a dental emergency, however, an x-ray may be essential. If this happens, your dental professional will shield your abdomen with a lead apron to protect your baby from exposure to radiation.

Why do my gums keep bleeding?

Hormone changes during pregnancy can affect the gums, making them more sensitive and inflamed in response to bacteria along the gum line. This can lead to red, swollen, tender gums that bleed easily, gums that pull away from the teeth, persistent bad breath, loose or separating teeth leading to a change in the way your teeth fit together. “Pregnancy gingivitis” often appears between the third and ninth month of pregnancy. Gently brushing along the gum line when you brush your teeth can help tender, bleeding gums. Gum problems usually disappear after childbirth. If they continue, contact your dental professional.

I’ve heard that a woman loses one tooth for every pregnancy. Is this true?

No. The calcium needed to make your baby’s teeth comes from what you eat not from your own teeth. If you do not take in enough calcium to meet your baby’s needs, your body will provide this mineral from the calcium of your bones.
Eating enough dairy products and — if necessary — taking a calcium supplement, will ensure both you and your baby will have enough of this mineral without putting your bones at risk.

Next Steps

Brush your teeth at least twice a day with a soft toothbrush using a fluoride toothpaste. Carefully clean your teeth at the gum line, where gum disease starts. Don’t forget to floss!

If you’re not sure if you are brushing and flossing correctly, talk to your dental professional. He or she can show you how, so you can care for your teeth and gums properly.

Be sure to continue with routine dental check-ups during and after your pregnancy.

Given the important connection between healthy eating and oral health, follow Canada’s Food Guide.

For more information

For additional information on oral health, visit the:

Emotional Health

When you are pregnant, the thoughts and feelings you experience can range from happiness and contentment—“I can’t wait to hold my new baby”, “I’m going to be a great mother”—to worry and stress—“Will I ever lose all this weight?”, “Can I really support a baby on this pay cheque?” It’s normal to experience these types of feelings. Your moods are changing right along with your hormones and your body. That’s why your emotional health is more important than ever!

Important facts

One in ten women suffers from bouts of depression during pregnancy

Learn the signs and symptoms of depression and contact your health care provider if you feel you may be depressed.

Could I be depressed?

It’s possible. Check with your health care provider if you have four or more of these symptoms for at least two weeks or if any of these symptoms particularly concern you:

  • inability to concentrate
  • anxiety
  • extreme irritability
  • frequent mood swings
  • sleep problems
  • extreme fatigue
  • persistent sadness
  • a lack of interest in things you used to care about
  • a sense that nothing is fun or enjoyable anymore
  • a dramatic change in appetite (up or down)

You need your rest

Your body is busy 24 hours a day as your baby develops and it’s hard work. If you’re tired, don’t skip sleep. Put your feet up, take a nap or just slow down. You’ll feel better physically and mentally.

Staying active and well can help keep your moods in check

Make sure you are eating enough to nourish your baby. Eat regularly—don’t skip meals—and make sure you drink plenty of water. You also need physical activity. A walk outside or swimming at the pool can leave you feeling refreshed.

Stay away from stress

If certain people or situations cause you stress, avoid them as much as possible. And don’t take on added responsibilities at work or in your community. Having too much to do can be stressful at the best of times. Learn to say “no!”

Next Steps

Take care of yourself by eating well, staying active and finding time to relax and rest when you need it.

Accept offers of help from friends and family.

Share your thoughts and feelings with others. If you are worried, upset, sad or anxious, talking about it can help. Confide in your partner, a trusted friend, family member or health care provider.

Common questions about emotional health

I’m fine one minute and in tears the next. Why am I so moody?

Mood swings are a normal part of pregnancy. Pregnancy triggers an outpouring of various hormones. These hormones can change the level of brain chemicals (called neurotransmitters) that, in turn, regulate mood. Some women may be moody throughout their pregnancy, but it’s most common around the sixth to tenth week and then again in the third trimester when your body is getting ready for labour and delivery.

Is it safe to have sex?

Unless your health care provider specifically advises you otherwise, sex during pregnancy is safe for both you and your baby. Intercourse can’t hurt your baby or cause a miscarriage. You may find you want to have sex more than you did before you became pregnant. On the other hand, wanting sex less is perfectly normal too. Most couples resume an active sex life sometime during the first year of their baby’s life.

For more information

10 months of pregnancy

Stages of pregnancy information was reprinted with permission from womenshealthmatters.ca © 2000–2006 Women’s College Hospital.

1st month

  • heartbeat begins
  • arm and leg buds appear
  • primitive digestive system develops
  • embryo is 5 mm (1/5th of an inch) long

Feeling Sick: Nausea and Vomiting

Feeling sick? You’re not alone! Many women experience nausea and vomiting during their pregnancy. That’s because changes in hormones can make you feel sick to your stomach. Certain smells and movements can make the nausea worse. The good news is that the nausea usually disappears after the first trimester.

To help cope with nausea and vomiting, you can:

  • Avoid having an empty stomach.
  • Eat food that appeals to you in frequent small amounts until you are feeling better.
  • Get out of bed slowly and eat soon afterward.
  • Drink fluids between meals and not with meals.
  • Choose cold foods (with less smell) or have someone else do the cooking.
  • Get plenty of fresh air.
  • Try smelling fresh-cut lemons.
  • Avoid smoke, strong odours, alcohol and caffeine

2nd month

  • brain, liver, kidneys, bloodstream and digestive system are developing
  • limbs develop
  • embryo has become a fetus: it is about 2.9 cm (1 and 1/8th inches) long and weighs 0.9 g (1/30th of an ounce)

Calcium and vitamin D

You need calcium throughout your pregnancy to build strong bones and teeth for your baby. Vitamin D is also needed to absorb and use calcium. Getting enough calcium will help your teeth and bones stay healthy too! Eat foods rich in calcium, such as milk (all types), cheese, yogurt and fortified soy beverages.

Also eat foods that provide vitamin D such as milk, fortified soy beverages, fish and margarine.

Did you know…

Your baby’s teeth start forming in the womb.

3rd month

  • facial features are present, the nose and outer ears are formed
  • movement such as head turning or sucking begins
  • all internal organs are developing
  • fetus is about 7.5 cm (3 inches) long and weighs 30 g (1 ounce)

Caffeine

Too much caffeine isn’t good for you or your baby.

For women of childbearing age the recommendation is a maximum daily caffeine intake of no more than 300 mg — a little over two eight-ounce (237 ml) cups of coffee. This total should include natural sources of caffeine, including herbs such as guarana and yerba mate.

Start trying to limit how much coffee, strong tea and soft drinks you consume. Water, and milk are good alternatives that will provide you with more of the nutrients your baby needs.

Warning! Some herbal teas, such as chamomile, aren’t good to drink when you’re pregnant. You’ll also want to avoid teas with aloe, coltsfoot, juniper berry, pennyroyal, buckthorn bark, comfrey, labrador tea, sassafras, duck root, lobelia and senna leaves.

Other herbal teas, such as citrus peel, linden flower (not recommended for persons with pre-existing cardiac conditions), ginger, lemon balm, orange peel and rose hip, are generally considered safe if taken in moderation (two to three cups per day).     

4th month

  • lanugo or fine body hair develops
  • fetus is about 15 cm (6 inches) long and weighs 110 g (4 ounces)

Constipation

Many women get constipated during pregnancy. It happens because food passes through your body more slowly when you are pregnant so you can absorb the extra nutrients you and your baby need. Eating foods high in fibre — like vegetables and fruit, whole grains and cooked or canned beans, peas and lentils — can help. So can drinking more fluids, especially warm or hot fluids. Being physically active is also important. There’s nothing like a good walk around the block to move things along!

Warning! If you are pregnant, do not use a laxative to treat constipation without checking with your health care provider first. Laxatives can trigger the onset of labour contractions.

5th month

  • finger and toe nails formed
  • responds to noise
  • hair and eyebrows are growing
  • movements become increasingly vigorous
  • fetus is about 25 to 30 cm (10 to 12 inches long), half its length at birth and weighs 220 to 450 g (8 ounces to 1 pound)

Iron

Iron is important for healthy blood. It is also needed for your baby’s brain to develop properly. You need to get enough iron so your baby can grow properly and build up a good store of iron for after the birth. Babies without enough iron may have more illnesses and problems learning. To increase your iron intake, eat foods rich in iron such as red meat; eggs and poultry; whole grain and enriched breads and cereals; cooked or canned dried beans; and peas and lentils.

Don’t overdo it! If you are taking a vitamin-mineral supplement that contains 16 - 20 mg of iron, you don’t need an extra iron supplement unless it’s recommended by your health care provider.

6th month

  • eyes are open
  • a creamy substance called vernix covers the skin
  • skin is wrinkled and the fetus appears very thin
  • fetus is about 28 to 36 cm (11-14 inches) long and weighs 0.7 kg (1 1/2 pounds)

Low Cost Nutritious Choices

Healthy eating doesn’t have to cost a fortune! Choosing basic foods that are not pre-packaged and processed will cost less and will be healthier for you and your baby. Check out these low-cost nutritious choices from the four food groups.

Milk and alternatives: milk powder, plain milk or yogurt and canned milk.

Vegetables and fruits: in-season vegetables and fruit, squash, potatoes, turnip, frozen fruit, frozen vegetables, canned fruit packed in juice, low sodium canned vegetables, apples, cabbage, carrots and vegetables from your own garden.

Grain products: bread, rice, macaroni or spaghetti, barley and rolled oats.

Meat and alternatives: baked beans, canned or fresh fish, fowl, dried beans, peas and lentils, ground beef and eggs.

7th month

  • fetus weighs about 1.1 kg (2.5 pounds) and is approximately 37 cm (15 inches) in length

Swelling (Edema)

Many women notice some swelling in their feet and ankles in the third trimester. Pregnant women naturally retain more water in their bodies, so this is perfectly normal. Now is not the time to cut back on your fluid intake. Even when you feel bloated, you still need to keep drinking water and other fluid like milk, to stay healthy.

To reduce swelling, put your feet up, avoid crossing your legs, wear loose clothing and get plenty of rest and exercise.

8th month

  • fetus weighs about 2.2 kg (5 pounds) and is 40 to 45 cm (16 to 18 inches) long

Heartburn

Heartburn is common during pregnancy. It’s caused by the pressure of the growing baby and hormone changes during pregnancy that allow stomach acid to move up to your throat.

The following suggestions might help:

  • Do not lie down after eating.
  • When you do lie down, raise your head and shoulders.
  • Avoid fried or greasy foods.
  • Drink fluids between meals, not with meals.
  • Avoid coffee, colas, alcohol and smoking.
  • Eat slowly. Take the time to chew well.
  • Eat small meals and snacks.

Some women take an antacid medicine to help with heartburn. An antacid reduces the amount of acid in your stomach.

Not all antacids are safe for pregnant women. Check with your doctor or health care provider before you take one.

9th month

  • fetus weighs 3.2 to 3.6 kg (7 or 8 pounds) and may be more than 50 cm (20 inches) long
  • skin wrinkles become less pronounced
  • eyes open and close
  • fetus responds to light

Water and Other Fluids

Your baby is always thirsty so it’s important for you to drink plenty of water while you’re pregnant. Water carries nutrients to your body and to your growing baby, carries away waste products from your baby and from you, keeps you cool, helps prevent constipation and helps to control swelling. Drink plenty of fluids every day, including water and milk. Drink more in hot weather or when you are active.

Did you know…

Water makes up about half of our body weight.

10th month

For New Parents

Having a baby can be one of the most exciting times in your life, and, at the same time, one of the most daunting. There are many changes to adjust to and many unknowns to face. With this in mind, it is important to remember that the most precious gift you can give your child is a healthy start in life.

For more information on specific topics in order to reduce the risk of injury and illness and to promote the healthy development of their infants, new parents can visit the Public Health Agency of Canada’s Healthy Pregnancy pages at https://www.canada.ca/en/public-health/services/pregnancy.html.

Resources

Canada Prenatal Nutrition Program (CPNP)

The Canada Prenatal Nutrition Program (CPNP) is a community-based program that supports pregnant women, new mothers and babies facing challenging life circumstances, such as low income, teen pregnancy, social or geographical isolation or family violence. CPNP programming includes nutrition counselling, prenatal vitamins, food and food coupons, counselling in prenatal health and lifestyle, breastfeeding support, food preparation training, education on infant care and child development and referrals to other agencies and services.

For more information or to find if there is a CPNP project near you

Breastfeeding

Today, most mothers breastfeed their babies. Breast milk is the best food you can offer your baby. For the first six months it is all the food and drink your baby needs for optimal growth and development. Breast milk is specifically designed for your baby and constantly changes to meet your child’s needs. It is easy for your baby to digest and can protect against infections and disease—benefits that last a lifetime. Breastfeeding has many benefits for the mother too and nurtures a special relationship between mother and baby.

Breastfeeding is natural but may take time for both you and your baby to learn. Pregnancy is a great time to prepare for breastfeeding once your baby is born. Talk to your health care provider for help. Contact with other breastfeeding mothers can also help build your confidence in breastfeeding.

Enjoy your baby and the special closeness that breastfeeding brings.

For more information visit the Public Health Agency of Canada

Immunization

Immunization and your baby’s health

Routine childhood vaccination is one of the best ways to protect your baby from common childhood diseases that can cause serious complications and sometimes even death. Provincial/territorial immunization programs protect all our children from diseases such as whooping cough (pertussis), tetanus, polio, measles, mumps, rubella, diphtheria, meningitis, pneumonia, chicken pox (varicella) and Hib disease (Haemophilus influenzae type b).

For information on routine childhood vaccines visit the Public Health Agency of Canada

Vaccinate on time for maximum protection

For maximum protection throughout childhood it is important to make sure your child gets all the vaccines at the right time. Some vaccines need to be given more than once to build your baby’s immunity; others require revaccination at a later age to boost immunity. Usually, children should get vaccines at 2, 4, 6, 12 and 18 months of age; and again later, between the ages of 4 and 6—before they start school.

Get all the facts

All parents have questions about the benefits and risks of vaccinating their child. If you have questions about immunization programs or about your child’s recommended immunization schedule, talk to your local health care provider or public health nurse.

Here’s how your baby gets the best protection

Example of a vaccine that needs to be given more than once to build your baby’s immunity.

The number of vaccines your baby needs can change by type of childhood vaccine.

Level of protection Vaccine number Baby’s age
Some protection 1st vaccine 2 months
More protection 2nd vaccine 4 months
Better protection 3rd  vaccine 6 months
Best protection 4th vaccine 18 months

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