You’re pregnant. Now what do you eat? If you’re like many women I know, as soon as you find out you are pregnant, you start second-guessing your diet (I use “diet” as a term to mean all the things you eat). And then you start Googling pregnancy nutrition, and pretty soon you’re confused and have a long list of things you either “must” eat or “never” eat.
Take a deep breath.
It’s true that what you eat during pregnancy affects your energy and well-being, and can directly affect the health and development of your baby. Pregnancy is one of the key times in life when it comes to nutrition and it is important that you make healthy choices.
But there is no such thing as perfect pregnancy nutrition. When you strive for perfection, it puts unrealistic pressure on you and creates stress that does you and the baby more harm than good.
Instead of trying to hold onto everything, focus on these top 7 things to know about pregnancy nutrition.
1. Don’t eat for two!
I know, it’s a bummer. If you’re like many of my clients, you’ve been restricting what you eat since you were a teenager (or even before). Pregnancy feels like the time to throw caution to the wind and finally eat what – and how much – you want.
Unfortunately, you don’t need that many extra calories. And research suggests that when women gain excess weight it puts their babies at a higher risk of obesity later in life. Plus, they tend to keep that extra weight after giving birth.
I don’t like to emphasize calorie-counting, but I think a frame of reference is helpful for people. In your first trimester you don’t really need any extra calories. (This is good since many women are dealing with nausea and can barely get in a normal amount of calories.) In your second trimester, you need about 340 extra calories per day and 450 more in the third trimester.
2. Variety is the spice of life
As a general rule, if you focus on eating a variety of foods, you’re going to be ok. First, a variety a foods means a variety of nutrients. And bonus, your baby is actually developing taste preferences in utero from the amniotic fluid! You are literally impacting your baby’s palate with everything you eat. Think about eating the rainbow, knowing that richer colors tend to mean more antioxidants and nutrients.
3. Focus on key vitamins and minerals: folate, calcium, iron and choline
There are other nutrients to look at, but if you focus on these 4, the others aren’t hard to get in.
| Nutrient | Rationale | Tips | Dietary Sources |
|---|---|---|---|
| Folate 800 mcg | Folate helps the body make red blood cells, DNA and other genetic material. It also prevents neural tube birth defects. | Look for a prenatal with the activated form (L-methylfolate or 5-MTHF). | Enriched grains (cereals and breads) Legumes Broccoli Orange juice |
| Calcium 1,300 mg | Mom’s bones will break down to provide calcium for the fetus if inadequate calcium is consumed. | Include at least three dietary sources of calcium daily to help meet these needs. | Dairy or fortified nondairy alternatives (milk, cheese, yogurt) Cooked collard greens Tofu |
| Iron 27 mg | Iron deficiency anemia is a concern during pregnancy as maternal and fetal needs increase during pregnancy. | Combine iron- containing foods with vitamin C-foods, like citrus fruits, to enhance iron absorption. | Beef and pork Eggs Soybeans Legumes Spinach |
| Choline 450 mg | Choline is required for fetal brain development and placental function. | Choline is not often found in prenatals, so an additional supplement may be needed. | Eggs (yolk) Liver Cruciferous vegetables Legumes |
4. Get your omega-3 fatty acids
DHA and EPA are two types of omega-3 fats that are essential for the growth and development of an infant’s brain. Pregnant women need at least 300 mg DHA per day, with studies showing benefits of up to 2,200 mg DHA per day. The best way to meet these recommendations is to eat up to 12 oz seafood per week (focusing on salmon, herring, shrimp, white tuna and tilapia). If that’s not realistic, talk to a registered dietitian nutritionist about a supplement.
5. Fiber and fluids are your friend
The reality is that most women experience constipation at least occasionally during pregnancy. Fluids and fiber are two key ways to help prevent – or reduce – constipation.
Additionally, staying hydrated helps prevent headaches, kidney stones and dizziness. It can be hard to stay hydrated when you’re pregnant, but it is key for preventing preterm labor. You know you’re well hydrated when your urine is light yellow to clear.
Fiber is found in fruits, vegetables, whole grains, legumes, nuts and seeds. It also helps prevent or reduce constipation. Bonus: it can help tame that out of control pregnancy hunger and can make you feel fuller longer. Aim for 25-35 grams per day.
6. Food safety is extra important
This is where most of those “don’t eat this” rules come into play. For the most part, you want to avoid raw or undercooked meat, poultry, seafood or eggs. Same goes for unpasteurized dairy. Avoid food that’s been sitting out for over 2 hours (think: parties and social events, not just your own leftovers). Wash your produce before eating it. Your immune system is compromised during pregnancy (hello, you’re literally growing a foreign object!), making you more susceptible to foodborne illnesses. Some impact you and some can have very serious side effects on your baby. Overall, you want to step up your game from pre-pregnancy levels when it comes to food safety.
7. Know when to ask for help
These tips are for “normal” circumstances. But that doesn’t describe everyone’s pregnancy nutrition needs. If you’re coming into pregnancy underweight or significantly overweight, or have a history of disordered eating, pregnancy can trigger old habits. If you are pregnant with multiples, or have complications like hyperemesis gravidarum, your nutrient needs will increase. And if you’re also managing a chronic illness, are or have food allergies or intolerances, then you probably need more one-on-one guidance. In all of these situations, please reach out for one-on-one counseling.
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