The Brewer Medical Diet

for Special Pregnancies

Sometimes, eating a good diet in pregnancy is not easy, especially when unique circumstances surround the pregnancy. Life happens. How we deal with life’s challenges can make a huge difference in the out-come. Eating well is a choice.

If you are experiencing extra health issues, or your body needs a boost to safely carry this baby to term, eating to meet the needs of both your baby and your own body is very important. In fact, it can make the difference between having a wonderful birth and having complications at the end of pregnancy and the birth. Even if complications do arise, you can be sure in your heart, that you have done everything possible to make this a safe, good experience.

Many time we as busy moms become too busy to take an accurate count of what we are eating. It is easy to assume that we are eating enough, because feeling the effects of falling behind on vital nutrients may not be apparent right away…until our blood pressure starts rising, we have excess fluid building up or our baby’s growth slows down.

When we are under stress, it can be hard to even care about food at all (or at least the right kinds!). This handout is to help keep you mentally on track for getting just what baby needs for optimum growth. Our goal here is to impress upon you the huge value in making every day count for your baby. We want you to feel and look better during pregnancy than every before and have a wonderful birth with a well-developed child… no matter what is happening in your life and the surprises it may contain.

Many changes must take place in our body in order to make your pregnancy successful. But the single most important change is one that you can’t see or feel – the expansion of your blood supply to meet the needs of the placenta. Eating correctly expands your blood volume, no matter who you are, how many babies you have had (or are having right now.)

The idea that what you eat has a direct impact on the quality of your pregnancy and the new life you carry inside you, came from Dr. James Ferguson, MD in the early 1950’s. Tom Brewer, MD, created a whole new way to looking at food and how they affect pregnancy out-comes. He devoted his life to creating easy to understand information, showing pregnancy woman how improve medical concerns in pregnancy, just be eating correctly, meeting nutritional requirements. Of the hundreds of thousands of hours Tom spent in talking and interviewing moms, charting problems in pregnancy, writing orders for high-protein diets and then carefully checking the out-come, came a new view of how very important a good diet is. This diet had to provide adequate protein, but also had to be complete in everything else: enough calories, enough vitamins, enough minerals (especially sodium), enough water, enough fiber and enough variety in food choices to remain interesting. The result was the Brewer Diet for Pregnancy.

This daily food plan should be considered a nutritional “floor” not a ceiling. The foods on the diets are listed in groups, according to the major nutrient they contain. All portions are interchangeable. Don’t just settle for a carrot every day to fulfill your Group 9 requirement. Try apricots, a piece of pumpkin pie, or sweet potato.

To keep up on providing what your baby (babies) need, it is important to eat every day, at least the amounts of food and types of food on the following lists. It is not healthful for you to go more that 12 hours without good food. At first it may seem overwhelming to eat “so much”, “so often”. The secret in coping with a special diet like this is not eating so much at one time, but eating more often. Eat a complete breakfast every morning, a snack midmorning, complete lunch, mid-afternoon snack, complete dinner, before bed snack and a snack at least once during the night to maintain a steady supply of nutrition to your developing baby.

When facing a pregnancy complication, the inability to follow a good diet is a medical emergency, requiring prompt help. It is obvious that twin pregnancy imposes a greater nutritional stress on a woman than a single one. As a result, it is commonly observed that pregnancies with twins or more are complicated by metabolic toxemia of late pregnancy, placental abruptions, premature labor and delivery, low birth weight and small-for-gestational-age babies with more congenital anomalies.

The mother of twins must eat more good foods and take more salt and water to maintain a greatly expanded blood volume throughout the entire gestation (a 100% expansion is to be desired) in order to keep two placentas well nourished enough to support two babies.

For each baby, it is recommend 500 calories and 30 grams of high-quality protein more than the Basic Brewer Plan. This handout reflects those extra nutrients. Toward the end of pregnancy, it is difficult to keep up an adequate diet like this. Again, small, frequent feedings must be resorted to and you may need someone to encourage you to keep eating enough to maintain pregnancy until term. It is common for moms with twins to gain 50, 60, or 70 pounds.

You can do this. Where there is a will, there is a way!

Group 1 (milk and milk products) – 8 choices Protein: 100 – 120 grams / day

Group 2 (calcium replacements) – 2, as needed instead of milk

Group 3 (eggs) 2 choices

Group 4 (meats, seafood, and meat substitutes) – 8 choices

Group 5 (dark green vegetables) – 2 choices

Group 6 (whole grains, starchy vegetables and fruits) – 5 choices

Group 7 (vitamin C foods) – 2 choices

Group 8 (fats and oils) – 3 choices

Group 9 (vitamin A foods) 1 choice

Group 10 (liver) – 1 choice per week

Group 11 (salt, and other sodium sources) unlimited, to taste.

Group 12 (water) unlimited to thirst.

Group 13 (additional to the menu), unlimited, after regular diet is consumed

Group 14 (supplements)

Group 1

Milk, Milk Products, and Milk substitutes

Eat 8 per day

Cow’s Milk

Buttermilk, from whole milk 1 cup

Evaporated milk, whole from can 1/2 cup

Non-fat powdered milk, powdered 1/3 cup

Non-fat powdered milk, reconstituted 1 cup

Skim milk 1 cup

2% milk 1 cup

Whole milk 1 cup

Yogurt 1 cup

Cheese

Cheddar, Swiss, Muenster, Jack, etc.. 1 ¼ oz.

Cottage cheese or ricotta ¼ cup

Parmesan, Romano, grated 3 Tbls.

Ice Milk 1 cup

Ice Cream – homemade 1 cup

Goat milk 1 1/8 cup

Soy Milk 1 ½ cup

Soybean curd 1 piece, 3” by 3” by ½”

One exchange provides approximately 8 grams of protein plus considerable amounts of calcium and other essential vitamins and minerals.

Milk products can bother some people, or maybe a different addition to make the diet more interesting is needed. Group 2 has some substitutes that might appeal better on different days.

If you use soy milk or other low-fat milk (or yogurt of cottage cheese) exchange, add two extra fat and oil exchanges.

Group 2

Calcium Replacements

(Eat as needed to replace from Group 1)

Almonds 2 oz. or 36 nuts Anchovies 2 ½ oz

Beef tripe 3 oz Bok choy, cooked 1/3 cup

Brazil nuts 2 oz or 12 nuts Bread crumbs, wheat 3 ½ oz

Brewer’s yeast 5 Tabls. Broccoli, cooked 1 cup

Carob powder ¼ cup Caviar, sturgeon 1 ½ oz

Collard greens, cooked 1/3 cup Dandelion greens, cooked ¾ cup

Eggs, whole 4 Fennel 1 large stalk

Filberts 2 oz. or ½ cup chopped Herring 3 oz

Kale, cooked ½ cup Kelp (seaweed) ½ oz

Molasses, blackstrap 2 Tabls. Muffins, wheat or corn 2

Mussels 5 oz. Mustard Greens, cooked ½ cup

Okra, cooked ¾ cup Olives, black 4 oz

Oysters 4 oz Pancakes, whole wheat 4 (5” diameter)

Peanuts, roasted 5 oz Pistachios 3 ½ oz or 2/3 cup

Sardines 1 oz Sesame seed meal 2 tabls.

Shrimp 3 ½ oz Soybeans, cooked 1 cup

Sunflower seeds 3 ½ oz or 2/3 cup Tortillas made with lime 2

Waffles, wheat 3 Walnuts, English 2 oz.

Wheat germ 4 ½ oz.

There are other foods that contain lots of calcium, but because of other factors present in those foods, such as oxalic acid, the calcium in unavailable to the body.

Group 3

Eggs

Eat 2 per day, any style

One egg provides 6 grams of protein, vitamins and minerals in abundance, including 1 milligram of well- assimilated iron and 600 units of vitamin A, the anti-infection vitamin. Added together, the milk and egg exchanges provide a baseline protein, vitamin, mineral and calorie foundation for the rest of the diet.

Group 4

Meats, Seafood and meat substitutes

Eat 6 per day

Beef, any cut, cooked 1 oz

Lamb, any cut, cooked 1 oz

Pork, any cut, cooked 1 oz

Organ meats: liver, heart, kidney 1 oz

Poultry: chicken, turkey, duck, pheasant, turkey 1 oz

Veal, any cut, cooked 1 oz

Lunch meat, 4” by 1/8” 1 slice

Hot dog 1

Fish, fresh or frozen, cooked 1 oz

Shellfish, clams, oysters, scallops 5

Canned seafood: crab, lobster , tuna, salmon ¼ cup

Sardines, canned 3

Anchovies 1 oz.

Cheese: hard or semi-hard 1 oz.

Cottage cheese or Ricotta ¼ cup

Tofu 3 ½ oz

Peanuts ¼ cup

Peanut butter 2 Tabls.

Beans with brown rice, or bulgur, cooked ¼ cup and ½ cup grain

Seeds, sesame, sunflower with rice, uncooked ¼ cups seeds and 1 cup with grain

Beans with cornmeal ¼ cup beans, with 2 muffins

Beans and seeds ¼ cup beans with 1/3 cup seeds

Brewer’s Yeast plus ¼ cup rice

Potato with milk and cheese 1 large, ½ cup milk and ½ oz cheese

Whole wheat noodles or bread with cheese 1/3 cup or 2 slices with ½ oz cheese

One exchange provides 7 grams of protein. Vegetable sources of protein are mixed in proper ratio to make their amino acid patterns equivalent to, or better than, animal sources. If you do choose a non-meat substitute, remember to add 2 extra fat- oil exchanges from group 7.

Group 5

Fresh, Dark Green Vegetables

Eat 2 per day

Broccoli, cooked 1 cup

Brussels sprouts, cooked 1 cup

Spinach, raw 2/3 cup

Greens: collard, turnip, beet, mustard,

Swiss chard, kale, dandelion 2/3 cup

Lettuce, raw (romaine is best) ½ cup

Endive, raw ½ cup

Watercress, raw ½ cup

Bok choy, raw 1 cup

Swiss chard, raw 1 cup

Sprouts, bean or alfalfa, raw ½ cup

Asparagus, cooked ½ cup

Although these contain only minimal amounts of protein and calories, they are rich is vitamins and minerals, particularly A and B complex, which is necessary to help your body use the protein in other foods. This group also contributes food fiber to aid in normal digestion and bowel movements, something most high-protein foods lack.

Group 6

Whole Grains, Starchy Vegetables, and Fruits (Carbohydrates)

Eat 5 per day

Bread, whole wheat or rye 1 slice Bagel ½

English muffin ½ Dinner roll or biscuit 1

Frankfurter or hamburger bun ½ Corn tortilla, 6” diameter 1

Corn bread, 2” and 2” and 1” 1 piece Pancake, 5” diameter 1

Waffle, 5” diameter 1 Crackers:

Buttery, snack type 5 Graham, full oblong 1

Matzo, 6” by 4” ½ Saltines 6

Rice cakes, puffed type 2

Cereals:

Shredded wheat 1 biscuit

Bran flakes ½ cup

Grainola ½ cup

Unsweetened, boxed ¾ cup

Puffed type 1 cup

Cooked, oatmeal, wheatna ½ cup

Wheat germ ¼ cup

Grits, cooked ½ cup Popcorn, popped 3 cups

Pasta, cooked ½ cup Rice, cooked ½ cup

Flour (as an ingredient) 2 12/ Tabls. Corn Kernels 1/3 cup

Corn on the cob 1 ear Lima beans ½ cup

Parsnips 2/3 cup Peas, green ½ cup

Potato, white 1 small Potato, mashed ½ cup

Potato chips 15 Baked beans, canned ¼ cup

Cooked beans, peas, lentils ½ cup

Beets, cooked 1 cup Carrots, cooked 1 cup

Carrots, raw 2 Cucumber, 1 large

Onion, raw 1 (2 1/2 “ diameter) Onion, cooked ¾ cup

Pumpkin, cooked ½ cup Sauerkraut, prepared 1 cup

Winter squash 1/3 cup Sweet potato ½

Tomato, raw 1 ½ Turnips, cooked 1 1/4

Cantaloupe ½

Cherries ½ cup

Cranberry juice ½ cup

Cranberry sauce 2 Tabls.

Dates 2

Figs, fresh or dried 2

Grapefruit ½

Grapefruit juice ½ cup

Grapes, purple 1 cup

Grapes, green or white ½ cup

Lemonade, from concentrate 1/3 cup

Orange ½

Orange juice ½ cup

Papaya 1

Peach ½

Pear ½

Persimmon ½

Pineapple ½ cup pieces

Pineapple juice 1/3 cup

Plum 2

Prunes, cooked ¼ cup

Prune juice 2 tables.

Raisins 2 tables

Raspberries ½ cup

Strawberries 1

Tangerine 1

Cornstarch 1 Tabls

Chocolate (baking) 1 oz

Tapioca, dry 1 tabls.

These sources are the prime carbohydrates you need to fuel your body. If you have too few carbohydrates, your body burns protein you eat for energy. This robs your baby and body of the fuel needed for the building blocks for tissue growth and repair. Carbs found in whole grains and starchy veggies affect you differently from the simple sugars found in candy, honey, jams, soft drinks, bakery goods and refined sugar. The complex carbs also have sources of B vitamins.

Group 7

Vitamin C Foods

Eat 2 per day

Cabbage, raw 1 cup Cauliflower, cooked 1 cup

Cantaloupe ½ medium Grapefruit, pink ½

Grapefruit juice 2/3 cup Lemon 1

Lime 1 Orange 1

Orange juice ½ cup Papaya ½ cup

Pepper, green, or red, raw 1 Potatoes, cooked in skins 2

Strawberries, fresh ½ cup Tangerines 2

Tomato 1 large Tomato juice 1 cup

Tomato puree’ 2/3 cup

Vitamin C is important for the body’s manufacture of collagen, the substance that holds tissue together. Without enough Vit. C, your uterus is less strong and may not perform well in labor. Vitamin C is also crucial in defense against infection.

Group 8

Fats and Oils

Eat 5 per day

Butter 1 Tabls. Mayonnaise 1 Tabls.

Vegetable oil 1 Tabls Avocado ¼

Coconut, grated 3 tabls. Peanut butter 2 tabls.

Chocolate 1 oz Sausage 1 link

Cream, light ¼ cup Cream, heavy or whipping 2 tabls.

Cream cheese 2 tabls Sour cream 1 ½ tables.

French fries 10 Potato chips 10

Lard 1 tabls. Bacon, crisp 2 strips

Salad dressings 2 tabls. Olives 10

Almonds, whole 20 Pecans, whole 4

Peanuts, whole 30 Walnuts 12

Needed in your diet to help your body absorb the fat-soluble vitamins, A, D, E and K. Fats and oils contribute to a fine-textured skin. They are also a concentrated source of calories, the food energy which your body needs which is greatly increased during pregnancy.

Group 9

Vitamin A Foods

Eat 1 a day

Apricots 3 Cantaloupe ½

Carrots, cooked ½ cup Nectarines 3

Peaches, dried 4 halves Pumpkin, canned ½ cup

Sweet potato or yam 1 Pumpkin, canned ½ cup

Sour cherries, canned ½ cup Winter, squash, cooked ½ cup

Vitamin a is known for its role in preventing infection. During pregnancy, when the pressure of the growing uterus on the bladder is constant, extra vitamin A helps protect you against bladder and kidney infections. During breastfeeding, it helps keep you free from breast infections.

Group 10

Liver

Eat 1 serving a week

Liver, beef, calf, chicken, pork, turkey, liverwurst or liver sausage 4 oz.

Liver is a power house of nutrition that you should have once a week if you can. Liver often poorly prepared and unappetizing, but finding a good recipe can be easy if you take an opportunity to try new ones.

Group 11

Salt and other sodium Sources

Eat: unlimited to taste

Table salt, Sea salt, Kelp powder, Soy sauce.

Cutting back on salt can cause a fall in the amount of blood circulating through your placenta, thus reducing the supply of nutrients passing to your baby. Too little salt causes leg cramps too, since all muscles of your body require sodium for efficient action.

Group 12

Water

Eat unlimited amounts to thirst

Drink to quench thirst, but do not force fluids. Fruits, veggies and juices all contain a goodly portion of water, plus additional nutrients. Forcing water may fill you up, without giving you much nutrition – a hazard in late pregnancy, when every bite counts.

Diet beverages, coffee, black teas, and imitation fruit drinks that contain mostly sugar should be avoided. If you are thirsty, drink water, herbal tea such as raspberry leaf or real juice or milk.

Group 13

Snacks and Additional Menu Choices

Eat to fill hunger after regular meals and snacks

If you are still hungry after eating everything on the above lists first, you may eat more exchanges from Groups 1 – 11, or as much as you desire of other fresh fruits and vegetables, nuts and seed, dried fruits or home-baked goods and desserts such as custard, pudding, fruit tarts, fruit tarts, fruit whips, milkshakes or novelty breads.

Group 14

Optional Supplements

Eat as needed with consultation with midwife or Dr.

Vitamin pills and other dietary supplements are not for everyone, but especially be careful to be choosing to meet your body needs through food instead of a “pill”. If you find yourself bruising easily or that your gums bleed easily when brushing teeth, take some extra vitamin C. If you are underweight before pregnancy, were taking birth control pills and not adding extra vitamin B (especially folic acid) to your diet to compensate for losses due to the Pill, if you are carrying more than 1 baby, if you are under stress, if you are a vegetarian, if you have any cold, flu or other infection during pregnancy – then you are a candidate for supplements. It is still best to get your nutrients via good food, but a little help may be in order.

Some commercial preparations are not absorbed well by our bodies. Take care to find a brand that does not cause constipation or give stomach distress. Some kinds of calcium are not well assimilated and can actually cause placenta calcifications. Calcium citrate is the best kind.

Herbal additions to the diet should be added carefully and with purpose. Alfalfa, Floridex, and other green supplements are actually food based and are great additions to assure enough iron and minerals are being absorbed.

Books to read:

What Every Pregnant Woman Should Know: The Truth About Diets and Drugs in Pregnancy – Tom Brewer, MD

The Brewer Diet for Normal and High-Risk Pregnancy – Tom Brewer, MD

Nourishing our Unborn Child - Phyllis S. Williams

Eating For Two: The Complete Pregnancy Cookbook - Isaac Cronin

Diet Sheets

Group	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday	Dates
Group 1 8-a-day Milk Products
Group 2 2-as-needed Calcium Subs.
Group 3 2-a-Day Eggs
Group 4 8-a-day Meats
Group 5 2-a-day Dark Green. Veggies
Group 6 5-a-day Carbohydrates
Group 7 2-a-day Vitamin C
Group 8 3-a-day Fats and oils
Group 9 1-a-day Vit A foods
Group 10 1-a-week Liver
Supplements

Diet Sheets

Group	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday	Dates
Group 1 8-a-day Milk Products
Group 2 2-as-needed Calcium Subs.
Group 3 2-a-Day Eggs
Group 4 8-a-day Meats
Group 5 2-a-day Dark Green. Veggies
Group 6 5-a-day Carbohydrates
Group 7 2-a-day Vitamin C
Group 8 3-a-day Fats and oils
Group 9 1-a-day Vit A foods
Group 10 1-a-week Liver
Supplements

Weekly Notes: ___________________________________________________________________________________________

____________________________________________________________________________________________

Diet Sheets

Group	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday	Dates
Group 1 8-a-day Milk Products
Group 2 2-as-needed Calcium Subs.
Group 3 2-a-Day Eggs
Group 4 8-a-day Meats
Group 5 2-a-day Dark Green. Veggies
Group 6 5-a-day Carbohydrates
Group 7 2-a-day Vitamin C
Group 8 3-a-day Fats and oils
Group 9 1-a-day Vit A foods
Group 10 1-a-week Liver
Supplements

Weekly Notes: ___________________________________________________________________________________________

____________________________________________________________________________________________

Diet Sheets

Group	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday	Dates
Group 1 8-a-day Milk Products
Group 2 2-as-needed Calcium Subs.
Group 3 2-a-Day Eggs
Group 4 8-a-day Meats
Group 5 2-a-day Dark Green. Veggies
Group 6 5-a-day Carbohydrates
Group 7 2-a-day Vitamin C
Group 8 3-a-day Fats and oils
Group 9 1-a-day Vit A foods
Group 10 1-a-week Liver
Supplements

Weekly Notes: ___________________________________________________________________________________________

____________________________________________________________________________________________

Diet Sheets

Group	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday	Dates
Group 1 8-a-day Milk Products
Group 2 2-as-needed Calcium Subs.
Group 3 2-a-Day Eggs
Group 4 8-a-day Meats
Group 5 2-a-day Dark Green. Veggies
Group 6 5-a-day Carbohydrates
Group 7 2-a-day Vitamin C
Group 8 3-a-day Fats and oils
Group 9 1-a-day Vit A foods
Group 10 1-a-week Liver
Supplements

Weekly Notes: ___________________________________________________________________________________________

____________________________________________________________________________________________