Nutrition and Dietetic Service

A healthy diet is important if you are planning a pregnancy. Eating well before you get pregnant helps your body store up nutrients that are vital for your baby’s early development.

Take 400 micrograms folic acid and 15 micrograms of Vitamin D as a supplement at least 3 months before trying to conceive or stopping contraception, and eat a balanced diet with lots of fresh foods. Some women need a higher dose of folic acid on prescription to help prevent neural tube defects such as spina bifida. Talk to your GP about this if you have any medical conditions such as diabetes, or you are taking medication.

BMI 

Body Mass Index is an assessment of how your weight relates to your height. It’s not a perfect measure or indicator of health, but a BMI in the range 18.5- 25 kg/m2 might make it easier to conceive because body composition has an impact on the complexities of hormones and metabolic regulation.

If you are underweight, you may need to eat a larger amount of nourishing foods with a range of carbohydrates, essential fats and proteins and be sure that you are not exercising too much so that you can bring up your BMI to within the healthy range.  Aim to have a steady weight for about 3 months before you try to conceive.

If you have an eating disorder, even if it is in remission or has not been formally diagnosed, it’s a good idea to seek support while planning your pregnancy to help you navigate the changes ahead.

If you are overweight, (BMI is over 25 kg/m2) making simple changes to improve your nourishment can be very helpful.  For example, keep foods high in fat, salt and sugar e.g. crisps, sweets, fizzy drinks and takeaways to a minimum. Eat regularly, choose a balanced diet and increase your activity levels. Aim to lose about 10% of your current weight and to have a stable weight for a few months before you try to conceive. If you need more support, some community care areas offer a free dietitian-led weight management programs. Check with your local health centre for details or ask your GP for a referral to a community dietitian.

If you are living with obesity (BMI over 30 kg/m2), talk to your GP about management options before trying to conceive.

Support from a dietitian or your doctor can help you prepare and maximise your chances of a healthy pregnancy regardless of your weight or body size.

Talk to your doctor before trying to conceive if you have any other health problems or conditions, especially diabetes mellitus or metabolic disorders. Some health conditions can reduce your fertility or affect your baby’s development in the early weeks of pregnancy.

Our classes and groups take place online.

Tús Maith (‘A Good Start’) Class

This is an online group session led by one of our Dietitians. It provides useful information and support for women starting pregnancy with a high BMI. For information on out Tús Maith (Good Start) class, please see our classes page. 

Nausea and Vomiting in Pregnancy Support Group

It’s very important that you dedicate the allocated time and a quiet place for your online group or class. 

Feeding my Baby at Home: The Early Days

This is an interactive online session for parents of babies who were born at The National Maternity Hospital. The class provides useful tips and support for parents feeding their new baby at home.

We suggest attending in the first 2 - 4 weeks after you and your baby return home from the hospital.

The class is facilitated by a Dietitian, Speech and Language Therapist and Lactation Specialist.

Topics include sleep-wake cycles, feeding cues, feeding your baby supplements, growth and common feeding issues. This is an interactive session and we encourage you to come with questions.

For more information see our classes page.

Introducing Solid Foods and Textures to my Baby after the Neonatal Unit

This is an interactive online class for parents of babies who spent time in the Neonatal Unit at The National Maternity Hospital.

We suggest attending this class from when your baby is approximately 4 to 5 months corrected age (after their due date) to help prepare for introducing solids at around 6 months corrected age.

The class is facilitated by a Dietitian, Speech and Language Therapist and an Occupational Therapist.

Topics include introducing foods to your baby’s diet, timing, baby communication and signs of readiness, postural control, advancing textures, gagging and choking, seating, utensils, food groups and foods to avoid. You are welcome to ask questions.

For more information see our classes page.

Pregnant women with a dietary problem that needs assessment or individual advice on nutrition will be offered an individual consultation with a dietitian who is an expert on nutrition in pregnancy. For example:

• If you have diabetes (see our Specialist Clinics page)
• If you have been very sick and are not managing to eat or drink, i.e. hyperemesis.
• If you are a teenager and still growing yourself.
• If you were on a special diet before pregnancy or have special medical needs (e.g. a metabolic disorder such as Phenylketonuria (PKU), cystic fibrosis, inflammatory bowel disease (ulcerative colitis or Crohn’s disease) or previous surgery on your stomach or bowel)
• If you are underweight or not gaining enough weight.
• If you are overweight or gaining too much weight.
• If you have low levels of important nutrients (e.g. anaemia, low vitamin or mineral levels).
• If you have a history of an illness or condition that might have an effect on your nourishment.
• Your unborn baby is not growing as expected.

Bookings:

Your doctor or midwife will refer you to the Nutrition and Dietetics Service with your permission if an individual consultation is advised.

You will be seen by a dietitian either during your hospital stay or as an outpatient. Your outpatient appointment may be in person or virtual depending on your needs.  

The dietitian will check your weight and height for you, so please wear shoes that are easy to take off.

The Dietitian working with the Neonatology Service provides specialist advice on nutrition for babies. The service is provided as individual inpatient or outpatient consultations and classes. 

This service is for babies with a specific nutritional issue or concern about their growth while in the Neonatal Unit or attending the Baby Outpatient Clinic under the care of a hospital consultant. You baby may be referred to a dietitian if there is a concern about their nutrition or growth.

Referral:

Your baby’s hospital doctor or nurse will refer your baby to a dietitian if there is a concern about their nutrition or growth.

The dietitian will either review your baby during their hospital stay or will offer an outpatient consultation.

If your baby is offered an outpatient appointment, details of when and where this appointment will take place will be on an appointment letter sent to your home.

After your baby is discharged from the hospital, if you are concerned about their nutrition or growth, or if you have questions about feeding your baby, contact your baby’s local public health nurse or GP for advice.  They may be able to refer your baby to a community based dietetic service, or if necessary, they may refer your baby to a hospital clinic, which may then refer your baby to that hospital’s dietitian.

Please note, the Neonatology Nutrition and Dietetics Service is only available for babies under the care of an NMH consultant and referrals can only be accepted from NMH staff.

Our dietitians work with the Diabetes Team as part of your Diabetes Care Pathway.

Your food choices are a corner stone of treatment in your diabetes care.

Pre-existing diabetes

If you have pre existing diabetes (Type 1 or Type 2), your blood glucose and nutritional needs will change throughout pregnancy.

Our Diabetes Dietitians review women with Type 1 or Type 2 diabetes as soon as possible  after they book with the hospital. They  will arrange a Dietetic appointment for you at our Diabetes in Pregnancy Clinic. Our Dietitians will work closely with you throughout your pregnancy.

Gestational Diabetes

Some women develop Gestational Diabetes during pregnancy. For most women with Gestational Diabetes blood glucose levels can be managed with suitable food choices and by being active. Some women may require medication in addition to this. The Diabetes Team will advise on your individual Gestational Diabetes Treatment Plan.

The NMH care pathway for Gestational Diabetes:

1 Gestational Diabetes online appointment

Your Gestational Diabetes virtual appointment is the first step in your Treatment Plan if you have been diagnosed with Gestational Diabetes.

This is a group appointment which takes place online on Wednesdays at 9.30am (45mins to 1 hr) and is facilitated by the Diabetes Dietitian and the Diabetes Midwife. The Diabetes Team will send you details of your appointment.

This appointment provides you with important information to help you control your blood glucose levels with food choices and physical activity at home.

The Diabetes  midwife will show you  how to use your  blood glucose monitor.

2 Gestational Diabetes Question & Answer online group appointment

The Gestational Diabetes Question and Answer online Group appointment is step two in your gestational diabetes Treatment Plan. It takes place a few days after Step 1, your online appointment.

This interactive online group appointment is led  by our  Diabetes Dietitian and Diabetes Midwife on Mondays at 11.30am (approximately 30 mins).  The Diabetes Team will send you details of your appointment.

Our Dietitian and Diabetes Midwife help you work through questions and problems you may have. These might include: 

• Why is my blood glucose high after I eat certain foods?
• I’m hungry- am I getting enough?
• I’m afraid to eat foods I enjoy in case it affects my baby’s growth
• I’m getting error messages on my tester
• I’m testing more than suggested – is that ok?
• My test readings don’t make sense to me
• I am confused about my meal plan, activity or testing goals

3 Virtual Diabetes Clinic

Step 3 in your Gestational Diabetes Treatment Plan is attendance at our Virtual Diabetes Clinic.

The Gestional Diabetes Virtual Clinic is for women who develop gestational diabetes but do not require medication. You will be referred to this service if your blood sugar needs to be monitored individually. The service also provides support and education to assist you in achieving and maintaining optimal blood glucose control from positive pregnancy test up to six weeks following birth.You will be seen by dietitian at The Virtual Diabetes Clinic as needed.

There is no routine nutrition and dietetic service at The NMH for mothers or babies who are discharged and are no longer under the care of a hospital consultant. After you and your baby are discharged from the hospital, care is available in the community through your GP and Public Health Nurse. Community Services may also be able to refer you to community based nutrition and dietetic services if required. Check with your general practitioner (GP) about a referral.

There are also dietitians who see patients privately.  These dietitians are not linked with the hospital.  If you would like to arrange an appointment with a private dietitian, there is a list of appropriately qualified dietitians available on the Irish Nutrition and Dietetic Institute website INDI.ie.  Ensure that any dietitian that you attend is registered with CORU, the professional regulator for dietitians in Ireland.