Although nausea and vomiting during the first few months of pregnancy can make this difficult, try to eat a well-balanced diet and take prenatal vitamins. Here are some recommendations to keep you and your baby healthy.
Goals for Healthy Eating When Pregnant
- Eat a variety of foods to get all the nutrients you need. Recommended daily servings include 6-11 servings of breads and grains, two to four servings of fruit, four or more servings of vegetables, four servings of dairy products, and three servings of protein sources (meat, poultry, fish, eggs or nuts). Use fats and sweets sparingly.
- Choose foods high in fiber that are enriched, such as whole-grain breads, cereals, beans, pasta and rice, as well as fruits and vegetables. Although it’s best to get your fiber from foods, taking a fiber supplement can help you get the necessary amount. Examples include psyllium and methylcellulose. Talk with your doctor before starting any supplements. If you take a fiber supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fiber intake.
- Make sure you are getting enough vitamins and minerals in your daily diet while pregnant. You should take a prenatal vitamin supplement to make sure you are consistently getting enough vitamins and minerals every day. Your doctor can recommend an over-the-counter brand or prescribe a prenatal vitamin for you.
- Eat and drink at least four servings of dairy products and calcium-rich foods a day to help ensure that you are getting 1000-1300 mg of calcium in your daily diet during pregnancy.
- Eat at least three servings of iron-rich foods, such as lean meats, spinach, beans, and breakfast cereals each day to ensure you are getting 27 mg of iron daily.
- While you're pregnant, you will need 220 micrograms of iodine a day to help ensure your baby's brain and nervous system development. Choose from a variety of dairy products -- milk, cheese (especially cottage cheese), yogurt -- as well as baked potatoes, cooked navy beans, and limited amounts -- 8 to 12 oz per week -- of seafood such as cod, salmon, and shrimp.
- Choose at least one good source of vitamin C every day, such as oranges, grapefruits, strawberries, honeydew, papaya, broccoli, cauliflower, Brussels sprouts, green peppers, tomatoes, and mustard greens. Pregnant women need 80 - 85 mg of vitamin C a day.
- Choose at least one good source of folate every day, like dark green leafy vegetables, veal, and legumes (lima beans, black beans, black-eyed peas and chickpeas). Every pregnant woman needs at least 0.64 mg of folate per day to help prevent neural tube defects such as spina bifida. Man-made supplements of folate are called folic acid and can be an important option when you are pregnant.
- Choose at least one source of vitamin A every other day. Sources of vitamin A include carrots, pumpkins, sweet potatoes, spinach, water squash, turnip greens, beet greens, apricots, and cantaloupe.
Foods to Avoid When Pregnant
- Avoid alcohol during pregnancy. Alcohol has been linked to premature delivery, intellectual disability, birth defects, and low birthweight babies.
- Limit caffeine to no more than 300 mg per day. The caffeine content in various drinks depends on the beans or leaves used and how it was prepared. An 8-ounce cup of coffee has about 150 mg of caffeine on average while black tea has typically about 80 mg. A 12-ounce glass of caffeinated soda contains anywhere from 30-60 mg of caffeine. Remember, chocolate (especially dark chocolate) contains caffeine -- sometimes a significant amount.
- The use of saccharin is strongly discouraged during pregnancy, because it can cross the placenta and may remain in fetal tissues. But, the use of other non-nutritive or artificial sweeteners approved by the FDA is acceptable during pregnancy. These FDA-approved sweeteners include aspartame (Equal or NutraSweet), acesulfame-K (Sunett), and sucralose (Splenda). These sweeteners are considered safe in moderation, so talk with your health care provider about how much non-nutritive sweetener is acceptable during pregnancy.
- Decrease the total amount of fat you eat to 30% or less of your total daily calories. For a person eating 2000 calories a day, this would be 65 grams of fat or less per day.
- Limit cholesterol intake to 300 mg or less per day.
- Do not eat shark, swordfish, king mackerel, or tilefish (also called white snapper), because they contain high levels of mercury.
- Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese. These cheeses are often unpasteurized and may cause Listeria infection. There’s no need to avoid hard cheese, processed cheese, cream cheese, cottage cheese, or yogurt.
- Avoid raw fish, especially shellfish like oysters and clams.
What to Eat When Pregnant and Don't Feel Well
- Morning Sickness: Eat crackers, cereal, or pretzels before getting out of bed; eat small, frequent meals throughout the day; avoid fatty, fried, spicy, and greasy foods.
- Constipation: Eat more fresh fruit and vegetables. Also, drink 6 to 8 glasses of water a day. Taking fiber supplements may also help. Check with your doctor first.
- Diarrhea: Eat more foods that contain pectin and gums (two types of dietary fiber) to help absorb excess water. Examples of these foods are applesauce, bananas, white rice, oatmeal, and refined wheat bread.
- Heartburn: Eat small, frequent meals throughout the day; try drinking milk before eating; and limit caffeinated foods and beverages, citric beverages, and spicy foods.
Can I Diet While Pregnant?
No. Do not diet or try to lose weight during pregnancy -- both you and your baby need the proper nutrients in order to be healthy. Keep in mind that you will lose some weight the first week your baby is born.
Can I Eat a "Low Carb" Diet When Pregnant?
Low-carbohydrate diets, such as Atkins and the South Beach Diet, are very popular. There have been no studies of the effects of a low-carb diet on pregnancy, so its effect on the fetus, if any, are unknown. While you are pregnant, you should eat a balanced diet, from all of the food groups.
Can I Maintain My Vegetarian Diet When Pregnant?
Just because you are pregnant doesn't mean you have to diverge from your vegetarian diet. Your baby can receive all the nutrition he or she needs to grow and develop while you follow a vegetarian diet, if you make sure you eat a wide variety of healthy foods that provide enough protein and calories for you and your baby.
Depending on the type of vegetarian meal plan you follow, you may need to adjust your eating habits to ensure that you and your baby are receiving adequate nutrition. You should consume about 300 more calories than you did before you became pregnant. Discuss your diet with your doctor.
Why Do I Need More Calcium When Pregnant?
Calcium is a nutrient needed in the body to build strong teeth and bones. Calcium also allows blood to clot normally, muscles and nerves to function properly, and the heart to beat normally. Most of the calcium in your body is found inside your bones.
Your growing baby needs a considerable amount of calcium to develop. If you do not consume enough calcium to sustain the needs of your developing baby, your body will take calcium from your bones, decreasing your bone mass and putting you at risk for osteoporosis. Osteoporosis causes dramatic thinning of the bone, resulting in weak, brittle bones that can easily be broken.
Pregnancy is a critical time for a woman to consume more calcium. Even if no problems develop during pregnancy, an inadequate supply of calcium at this time can diminish bone strength and increase your risk for osteoporosis later in life.
The following guidelines will help ensure that you are consuming enough calcium throughout your pregnancy:
- The U.S. Recommended Daily Allowance (USRDA) for calcium is 1,000 mg per day for pregnant and breastfeeding women over age 18. The U.S. RDA for teenage girls up to age 18 is 1,300 mg of calcium per day.
- Eating and drinking at least four servings of dairy products and calcium-rich foods a day will help ensure that you are getting the appropriate amount of calcium in your daily diet.
- The best sources of calcium are dairy products, including milk, cheese, yogurt, cream soups, and pudding. Calcium is also found in foods including green vegetables (broccoli, spinach, and greens), seafood, dried peas, and beans.
- Vitamin D will help your body use calcium. Adequate amounts of vitamin D can be obtained through exposure to the sun and in fortified milk, eggs, and fish.
How Can I Get Enough Calcium If I'm Lactose Intolerant?
If you are lactose intolerant, you can still receive the calcium you need. Here are some suggestions:
- Use Lactaid Milk fortified with calcium. Talk to your dietitian about other lactose-reduced products.
- You may be able to tolerate certain milk products that contain less sugar including cheese, yogurt, and cottage cheese.
- Eat non-dairy calcium sources, including greens, broccoli, sardines, and tofu.
- Try consuming small amounts of milk with meals. Milk is better tolerated with food.
Should I Take a Calcium Supplement During Pregnancy?
If you have trouble consuming enough calcium-rich foods in your daily meal plan, talk to your doctor or dietitian about taking a calcium supplement. The amount of calcium you will need from a supplement depends on how much calcium you are consuming through food sources.
Calcium supplements and some antacids containing calcium, such as Tums, may complement an already healthy diet. Many multiple vitamin supplements contain little or no calcium; therefore, you may need an additional calcium supplement.
Why Do I Need More Iron During Pregnancy?
Iron is a mineral that makes up an important part of hemoglobin, the substance in blood that carries oxygen throughout the body. Iron also carries oxygen in muscles, helping them function properly. Iron helps increase your resistance to stress and disease.
The body absorbs iron more efficiently during pregnancy; therefore, it is important to consume more iron while you are pregnant to ensure that you and your baby are getting enough oxygen. Iron will also help you avoid symptoms of tiredness, weakness, irritability, and depression.
Following a balanced diet and including foods high in iron can help ensure that you are consuming enough iron throughout your pregnancy. In addition, the following guidelines will help:
- The U.S. RDA for iron is 27 mg per day for pregnant women and 9 - 10 mg for breastfeeding women.
- Eating at least three servings of iron-rich foods a day will help ensure that you are getting 27 mg of iron in your daily diet. One of the best ways to get iron from your diet is to consume a highly fortified breakfast cereal. Note that iron intake is not equal to iron absorption. Absorption of iron into the body is greatest with meat sources of iron such as liver.
- The best sources of iron include enriched grain products, lean meat, poultry, fish, and leafy green vegetables.
What Are Good Sources of Iron?
- Meat and Seafood: Lean beef, chicken, clams, crab, egg yolk, fish, lamb, liver, oysters, pork, sardines, shrimp, turkey, and veal.
- Vegetables: Black-eyed peas, broccoli, Brussels sprouts, collard and turnip greens, lima beans, sweet potatoes, and spinach.
- Legumes: Dry beans and peas, lentils, and soybeans.
- Fruits: All berries, apricots, dried fruits, including prunes, raisins and apricots, grapes, grapefruit, oranges, plums, prune juice, and watermelon.
- Breads and Cereals: Enriched rice and pasta, soft pretzel, and whole grain and enriched or fortified breads and cereals.
- Other Foods: Molasses, peanuts, pine nuts, pumpkin, or squash seeds.
Should I Take an Iron Supplement During Pregnancy?
Talk to your health care provider about an iron supplement. The National Academy of Sciences recommends that all pregnant women following a balanced diet take an iron supplement providing 27 mg of iron during the second and third trimesters of pregnancy (that's the amount in most prenatal vitamins). Your doctor may increase this dose if you become anemic. Iron deficiency anemia is a condition in which the size and number of red blood cells are reduced. This condition may result from inadequate intake of iron or from blood loss.
Other Facts About Iron
- Vitamin C helps your body use iron. It is important to include sources of vitamin C along with foods containing iron and iron supplements.
- Caffeine can inhibit the absorption of iron. Try to consume iron supplements and foods high in iron at least one to three hours before or after drinking or eating foods containing caffeine.
- Iron is lost in cooking some foods. To retain iron, cook foods in a minimal amount of water and for the shortest possible time. Also, cooking in cast iron pots can add iron to foods.
- Constipation is a common side effect of taking iron supplements. To help relieve constipation, slowly increase the fiber in your diet by including whole grain breads, cereals, fruits, and vegetables. Drinking at least eight cups of fluids daily and increasing moderate exercise (as recommended by your doctor) can also help you avoid constipation.
Food Cravings During Pregnancy
Food cravings during pregnancy are normal. Although there is no widely accepted explanation for food cravings, almost two-thirds of all pregnant women have them. If you develop a sudden urge for a certain food, go ahead and indulge your craving if it provides energy or an essential nutrient. But, if your craving persists and prevents you from getting other essential nutrients in your diet, try to create more of a balance in your daily diet during pregnancy.
During pregnancy, your taste for certain foods may change. You may suddenly dislike foods you were fond of before you became pregnant. In addition, during pregnancy, some women feel strong urges to eat non-food items such as ice, laundry starch, dirt, clay, chalk, ashes, or paint chips. This is called pica, and it may be associated with an iron deficiency such as anemia. Do not give in to these non-food cravings -- they can be harmful to both you and your baby. Tell your health care provider if you have these non-food cravings.
If you have any problems that prevent you from eating balanced meals and gaining weight properly, ask your health care provider for advice. Registered dietitians -- the nutrition experts -- are available to help you maintain good nutrition throughout your pregnancy.