You may think that anything goes regarding food during pregnancy. You may have heard friends and coworkers talk about “eating for two” or surviving on pickles and ice cream for nine months. And when you first find out you’re pregnant, you may struggle with morning sickness, where the last thing you’ll want to do is deal with your diet.

UNC Health dietitian Jennifer Paschaloudis says it’s vital to focus on eating well, even through pregnancy’s inconveniences.

“Nutrition is important to a healthy pregnancy and a healthy baby,” she says.

To help alleviate nausea, Paschaloudis advises eating crackers and bland, soft foods, and aiming for six small meals a day rather than fewer large ones. Also, cold foods may be easier to tolerate because they smell less. High-fat foods are harder to digest, so avoid them.

Although morning sickness typically goes away by the end of the first trimester, eating healthfully is important for the full 40 weeks of pregnancy. Paschaloudis shares other strategies for good nutrition during pregnancy.

The most important nutrients in pregnancy

Pregnant or not, the human body must have vitamins and minerals to function properly. That’s why a healthy, well-balanced diet is essential for everyone. During pregnancy, however, the body requires even more nutrients to support the baby’s growth and the mother’s health.

Most important, pregnant women need 600 micrograms of folic acid or folate daily to prevent neural tube defects, or birth defects of the brain and spine. Folate is found in leafy greens and other vegetables, nuts, beans, citrus and fortified cereals, but because it’s hard to get enough of this nutrient through food alone, it’s good to take a prenatal vitamin with folic acid. If you’re trying to conceive, your doctor might advise that you take a supplement of 400 micrograms daily to prepare your body for pregnancy.

“Iron needs also increase during pregnancy,” Paschaloudis says. “Iron helps your blood cells deliver oxygen to the baby.” Iron-rich foods such as lean red meat, poultry, fish, beans and fortified cereals will support this function and help to prevent anemia, or low red blood cell count, which can make you feel tired and weak.

Dairy and leafy green veggies are sources of calcium, which helps a baby’s brain develop. Vitamin D (found in milk and fatty fish) strengthens a baby’s bones and teeth, while vitamin A (found in carrots, leafy vegetables and sweet potatoes) is critical to development of skin, eyes and bone. Choline aids in brain and spinal cord development; good sources include milk, eggs and soy products.

“If you keep your plate as colorful as possible, you’ll be getting vitamins and minerals from many different sources,” Paschaloudis says. “Make your diet varied, with a mix of whole grains, fruits and vegetables, low-fat meat and dairy, and look for opportunities to get extra vitamins and minerals to support the growing baby.”

It’s also beneficial to drink eight to 12 glasses of water every day.

Prenatal vitamins can help you meet the recommended nutritional needs. Use them as directed, and don’t take an extra dose if you can’t keep food down. If you’re considering becoming pregnant, ask your healthcare provider about when you should start taking prenatal vitamins.

Weight gain during pregnancy

While pregnant women require extra vitamins and minerals, they don’t require extra calories until the second trimester. The concept of “eating for two” does not apply.

“We all have different caloric needs, but pregnancy typically doesn’t require a lot more food,” Paschaloudis says. “In the second trimester, you might increase your intake by 300 extra calories, but that’s really just half a sandwich and a cup of milk.”

Recommended weight gain during pregnancy depends on your health before pregnancy. According to the American College of Obstetricians and Gynecologists (ACOG), a person at a normal body weight before pregnancy may gain 25 to 35 pounds, while a person who is overweight or obese should aim for an additional 11 to 25 pounds.

“Women who are overweight and obese have an increased risk of complications during pregnancy, including gestational diabetes and preeclampsia,” Paschaloudis says. “A high-calorie diet that leads to excessive weight gain could result in babies that are larger and heavier, which may lead to issues during delivery.”

Paschaloudis advises that you start making healthier dietary choices before conception so it’s easier to continue eating nutritiously during pregnancy.

“It takes four to six weeks to change your habits, so if you know you’re not eating well, take the time to work on it so that healthy choices feel normal,” Paschaloudis says. “Planning is the key to success for lifestyle changes, so find nutritious recipes you enjoy, and plan your meals.”

When it comes to cravings, Paschaloudis says it’s easier not to succumb to every craving for ice cream and other treats if you don’t keep them in your house.

“You don’t have to avoid all cravings, though,” Paschaloudis says. “It’s OK to indulge from time to time, as long as it’s not every day. Enjoy the occasional milkshake, but keep your home and workplace stocked with healthy options so that it’s easy to reach for those.”

Food safety during pregnancy

Certain foods can cause illness for a pregnant woman or issues for a developing baby. These foods include:

  • Raw meat, including sushi, which can contain parasites or bacteria
  • Deli meats and hot dogs, unless heated to steaming, due to the risk of listeria infection
  • Raw and unpasteurized cheeses, including melted Mexican cheeses, feta, brie and Camembert, due to the risk of listeria infection
  • Raw eggs, due to the risk of salmonella (remember this if you’re baking cookies — no cookie dough!)
  • Sprouts, which contain bacteria in the seeds that can’t be washed off

Additionally, you should avoid alcohol during pregnancy. And if you’re trying to become pregnant, know that there is some evidence showing that moderate to heavy drinking may interfere with conception.

You might also need to watch your consumption of other food and beverages while pregnant.

“Limit seafood to no more than 12 ounces a week, due to the risks of mercury poisoning,” Paschaloudis says. Your doctor may provide you with a list of fish to steer clear of, given higher mercury levels.

Also avoid excess caffeine; ACOG suggests that less than 200 milligrams per day (one 12-ounce cup of coffee) is appropriate.

Jennifer Paschaloudis, MS, RD, LDN, is a dietitian at UNC Rex Nutrition Services in Wakefield.


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