Healthy Eating During Pregnancy

Eating well is one of the best things you can do during pregnancy. Healthy eating helps your fetus grow and keeps your body healthy throughout all the changes that pregnancy brings.

The popular saying is that when you’re pregnant, you should “eat for two,” but that doesn’t mean that you should eat twice your usual amount of food during pregnancy. Instead, you should aim to eat twice as healthy.

• Eat fresh, whole foods if you can

• Eat a variety of foods from the five food groups

• Eat fewer foods that are high in saturated fat or sugar

• Focus on getting the right amount of nutrients to support your fetus’s growth and your health

Vitamins and minerals play important roles in all of your body functions. Eating healthy foods and taking a prenatal vitamin every day should supply all the vitamins and minerals you need during pregnancy.

Folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, vitamin C, and many other nutrients are all needed to support you and your fetus during pregnancy.

The best way to get these nutrients is through the food you eat.

See the below table for recommended amounts.

Key Vitamins and Minerals During Pregnancy

Take one serving of your prenatal supplement each day. Read the bottle to see how many pills make up one daily serving. If your obstetrician–gynecologist (ob-gyn) thinks you need an extra amount of a vitamin or mineral, your ob-gyn may recommend it as a separate supplement.

No, do not take more than the recommended amount of your prenatal vitamin per day. Some multivitamin ingredients, such as vitamin A, can cause birth defects if you double or triple the dose.

• Vitamins alone aren’t a cure-all. They need support from good nutrition in order to be absorbed into the body. This is why it is important to eat many different kinds of foods from the five food groups.

• Supplements like vitamins are not regulated by the FDA. So it’s important to read the label to make sure it has what you need. Choose vitamins from companies with a long, reputable history instead of a new brand you found on social media. You can talk with your ob-gyn or a registered dietitian for recommendations.

• If you decide to take gummy vitamins, you may need an extra iron supplement. This is because gummy vitamins can’t hold the same amount of iron that is in regular prenatal vitamins. Talk with your ob-gyn about how much extra iron you might need.

Folic acid is a form of folate, a B vitamin that is important during pregnancy. Folic acid may help prevent major birth defects of the fetus’s brain and spine called neural tube defects (NTDs).

Check your prenatal vitamins to make sure that the ingredients list includes folic acid. Folic acid is the only form of folate that has been proven to help prevent NTDs.

When you are pregnant you need 600 micrograms of folic acid each day. Because it’s hard to get this much folic acid from food alone, you should take a daily prenatal vitamin with at least 400 micrograms starting at least 1 month before pregnancy if possible and during the first 12 weeks of pregnancy.

If you have already had a child with an NTD, you should take 4 milligrams (mg) of folic acid each day as a separate supplement at least 3 months before pregnancy and for the first 3 months of pregnancy. You and your ob-gyn can discuss whether you need to supplement with more than 400 micrograms daily.

Iron is used by your body to make the extra blood that you and your fetus need during pregnancy. When you are not pregnant, you need 18 mg of iron per day. When you are pregnant, you need 27 mg per day. You can get this amount in most prenatal vitamins.

In addition to taking a prenatal vitamin with iron, you should eat iron-rich foods like beans, lentils, enriched breakfast cereals, beef, turkey, liver, and shrimp. You should also eat foods that help your body absorb iron, including oranges, grapefruit, strawberries, broccoli, and peppers.

Your blood should be tested during pregnancy to check for anemia. If you have anemia, your ob-gyn may recommend extra iron supplements.

Calcium is a mineral that builds your fetus’s bones and teeth. If you are 18 or younger, you need 1,300 mg of calcium per day. If you are 19 or older, you need 1,000 mg per day.

Milk and other dairy products, such as cheese and yogurt, are the best sources of calcium. If you have trouble digesting milk products, you can get calcium from other sources, such as broccoli, fortified foods (cereals, breads, and juices), almonds and sesame seeds, sardines or anchovies with the bones, and dark green leafy vegetables.

Vitamin D works with calcium to help the fetus’s bones and teeth develop. Vitamin D is also essential for healthy skin and eyesight. Whether you are pregnant or not, you need 15 mcg (600 international units [IU]) of vitamin D a day.

Good sources of vitamin D include fortified milk and breakfast cereal, fatty fish (salmon and mackerel), fish liver oils, and egg yolks.

Many people do not get enough vitamin D. If your ob-gyn thinks you may have low levels of vitamin D, a test can be done to check the level in your blood. If it is below normal, you may need to take a vitamin D supplement.

Choline plays a role in your fetus’s brain development. It may also help prevent some common birth defects. Experts recommend that you get 450 mg of choline each day during pregnancy.

Choline can be found in chicken, beef, eggs, milk, soy products, and peanuts. Although the body produces some choline on its own, it doesn’t make enough to meet all your needs while you are pregnant. It’s important to get choline from your diet because it is not found in most prenatal vitamins.

Omega-3 fatty acids are a type of fat found naturally in many kinds of fish and shellfish. Omega-3s may be important for your fetus's brain development before and after birth.

Flaxseed (ground or as oil) is also a good source of omega-3s. Other sources of omega-3s include broccoli, cantaloupe, kidney beans, spinach, cauliflower, and walnuts.

You should eat two or three servings of fish or shellfish per week before getting pregnant, while pregnant, and while breastfeeding. A serving of fish is 4 ounces (oz).

Some types of fish have higher levels of mercury than others. Mercury is a metal that has been linked to birth defects. Do not eat bigeye tuna, king mackerel, marlin, orange roughy, shark, swordfish, or tilefish. Limit white (albacore) tuna to only 6 oz a week. You should also check advisories about fish caught in local waters.

You should also avoid raw fish and shellfish, including sushi. Raw fish has a higher risk of making you sick.

B vitamins, including B1, B2, B6, B9, and B12, are key nutrients during pregnancy. These vitamins

• give you energy

• supply energy for your fetus’s development

• promote good vision

• help build the placenta

Your prenatal vitamin should have the right amount of B vitamins that you need each day. Eating foods high in B vitamins is a good idea too, including liver, pork, chicken, bananas, beans, and whole-grain cereals and breads.

Vitamin C is important for a healthy immune system. It also helps build strong bones and muscles. During pregnancy, you should get at least 85 mg of vitamin C each day if you are older than 19, and 80 mg if you are younger than 19.

You can get the right amount of vitamin C in your daily prenatal vitamin, and from citrus fruits and juices, strawberries, broccoli, and tomatoes.

Drink throughout the day, not just when you are thirsty. Aim for 8 to 12 cups of water a day during pregnancy.

There are many tools that can help you plan healthy meals. One useful tool is the Healthy Eating Plate guide from Harvard University. This tool can help you learn how to make healthy, balanced food choices at every meal.

Your ob-gyn may recommend seeing a dietitian, who can help you plan for your specific nutritional needs.

• Grains

• Fruits

• Vegetables

• Protein foods

• Dairy foods

Bread, pasta, oatmeal, cereal, and tortillas are all grains. Whole grains are those that haven’t been processed and include the whole grain kernel. Oats, barley, quinoa, brown rice, and bulgur are all whole grains, as are products made with those grains.

Look for the words “whole grain” on the product label. When you plan meals, aim to make half of your grain servings whole grains.

You can eat fresh, canned, frozen, or dried fruit. One hundred percent fruit juice can also count as fruit, but it is best to eat mostly whole fruit.

Make half your plate fruit and vegetables during mealtimes.

You can eat raw, canned, frozen, or dried vegetables or drink 100 percent vegetable juice. Use dark leafy greens to make salads.

Make half your plate fruit and vegetables during mealtimes.

Meat, poultry, seafood, beans, peas, eggs, processed soy products, nuts, and seeds all contain protein. Eat a variety of proteins each day.

Milk and milk products, such as cheese and yogurt, make up the dairy group. For food safety, check that the dairy foods you eat are pasteurized. To avoid saturated fats, you can choose fat-free or low-fat (1 percent) varieties.

Dairy alternatives like soy, oat, coconut, and almond products are also included in this category.

Oils and fats are another part of healthy eating. Although they are not a food group, they do give you important nutrients. During pregnancy, the fats that you eat provide energy and help build the placenta and many fetal organs.

Oils in food come mainly from plant sources, such as olive oil, nut oils, and grapeseed oil. They can also be found in certain foods, such as some fish, avocados, nuts, and olives.

Most of the fats and oils in your diet should come from plant sources. Limit solid fats, such as those from animal sources. Solid fats can also be found in processed foods.

Healthy Eating Plate
Healthy eating resources from Harvard University.
https://nutritionsource.hsph.harvard.edu/healthy-eating-plate/

• Recipes and tips for your kitchen: https://nutritionsource.hsph.harvard.edu/recipes/

• Vitamins and minerals: https://nutritionsource.hsph.harvard.edu/vitamins/

Anemia: Abnormally low levels of red blood cells in the bloodstream.

Birth Defects: Physical problems that are present at birth.

Fetus: The stage of human development beyond 8 completed weeks after fertilization.

Folic Acid: A vitamin that reduces the risk of certain birth defects when taken before and during pregnancy.

Immune System: The body’s natural defense system against viruses and bacteria that cause disease.

Neural Tube Defects (NTDs): Birth defects that result from a problem in development of the brain, spinal cord, or their coverings.

Obstetrician–Gynecologist (Ob-Gyn): A doctor with medical and surgical training and education in the female reproductive system.

Oxygen: An element that people breathe in to sustain life.

Placenta: An organ that provides nutrients to and takes waste away from the fetus.