Pregnancy is a time in a woman’s life that has unique dietary needs. Individual nutritional requirements are unique for each person and should be discussed with the patient’s obstetrician. Ideally, optimal nutrition should be practiced before conception, since many birth defects occur before a woman is aware she is pregnant. Vulnerable periods of fetal development are indicated in the box below. The most serious damage to oral structures from exposure to toxins and nutritional deficiencies are most likely to occur beginning at 6 to 8 weeks’ gestation.7

Vulnerable Periods of Fetal Development

Image 13: Chart of vulnerable fetal development
Source: UCLA Institute of the Environment and Sustainability.13

Dietary recommendations before conception include taking a prenatal vitamin with 400 mcg of folic acid and incorporating foods rich in folate such as dark greens, citrus fruits, and fortified grains and cereals.

Dietary recommendations before and during pregnancy include an additional 300 calories/daily from the fourth month of pregnancy until delivery. (Warning: too many calories can increase a mother’s chance of developing hypertension, diabetes, preeclampsia, prolonged delivery, and congenital malformations.) Other dietary considerations include additional protein for fetal tissue development, calcium, phosphorus, and vitamin D for bone remineralization and calcification of deciduous teeth, and an additional 25% increase in fluids is necessary to support maternal blood volume.7

Foods such as raw eggs, meat, soft cheese, and unpasteurized juice should be avoided as they may cause food-borne illness and harm to the developing fetus. Stimulates such as caffeine, alcohol, tobacco, and both prescription and non-prescription drugs pass through the placental barrier and can affect growth and development.7

Cleft lip and palate occurs in about 2 out of every 1,000 babies born each year, making it one of the most common birth defects. Cleft lip and palate is associated with a severe folic acid deficiency during pregnancy. Since the effects of folic acid deficiency occur in the first few weeks of pregnancy, often women realize they are pregnant, women of childbearing age should be careful to get sufficient folic acid on a daily basis. For this reason, bread has been fortified with folic acid since 2006.1

Image 14: cleft lip
Incomplete cleft lip: rare midline type.
Source: ©2003 Lippincott Williams & Wilkins.