“The need for weight gain during pregnancy can be very traumatic for women suffering from an eating disorder,” says Kristina Krill, MS, RD, Nutrition Therapist at Princeton Center for Eating Disorders. “Our role is to help them get the nutrition they need while explaining what each nutrient is doing for them and for the health of the baby.”
According to Krill, special nutrition considerations during pregnancy include:
Identifying the appropriate target weight. Typically, the Robinson formula is used to pinpoint normal target weight prior to pregnancy. For patients with a normal BMI, the recommended weight gain during pregnancy is 25 to 35 pounds. Underweight patients should have a weight gain of 28 to 40 pounds beyond goal weight. For example, if an underweight patient’s goal weight is 120 pounds, the pregnancy goal weight is 148 to 160 pounds.
Adding extra calories. During the second trimester, 340 extra calories per day are needed for the baby—the equivalent of an extra snack like peanut butter sandwich crackers or a nutrition shake. During the third trimester, 450 extra calories are needed per day. Framing this as an “extra requirement for baby” on the meal plan can make it seem less intimidating for patients.
“When educating patients, we avoid expressions like ‘eating for two,’” adds Krill. “This can seem scary, especially when a patient doesn’t want to eat for one.”
Ensuring fluid intake. Drinking plenty of fluids is especially important during pregnancy to prevent dehydration, which can lead to premature contractions. Starting with a base recommendation of about 2.4 liters of fluids per day, intake is adjusted based on a patient’s metabolic panel.
Getting the right nutrients. Meal plans incorporate certain key nutrients needed during pregnancy, such as:
- Folate to prevent neural tube defects
- Calcium, especially during the second and third trimesters when a baby’s bones and teeth are developing
- Iron to prevent anemia
- Zinc to help promote fetal growth
- Fiber to prevent constipation
Food safety. The kitchen at Princeton Medical Center adheres to rigorous food safety standards, and patients are educated about food precautions that should be taken during pregnancy. This includes avoiding raw fish and unpasteurized products.
"Patients also may have additional lab work to ensure that they are reaching target levels with various parameters,” says Krill. “Through these approaches—paired with biweekly dietitian meetings and three distinct nutrition groups—we make the nutritional health and safety of both mom and baby a key priority during treatment.