Published by PMR of NY & CT
If you're thinking about having a baby, or simply could become pregnant, what you eat now matters more than you might expect. Some of a baby's most important development happens in the first weeks of pregnancy, often before you know you're pregnant.
That's the idea behind preconception nutrition: building good habits and nutrient stores before pregnancy begins. One of the most important steps is simple: get 400 micrograms (mcg) of folic acid every day, as the CDC recommends for anyone who could become pregnant.
Why preconception nutrition matters
Your body is your baby's first environment. The neural tube, which becomes the brain and spinal cord, forms in the first few weeks of pregnancy. Problems with its development, called neural tube defects, include spina bifida. Getting enough folic acid before and during early pregnancy lowers that risk.
Starting pregnancy well nourished helps you, too. Healthy iron stores lower your chance of anemia, and steady eating habits make pregnancy's extra needs easier to meet. Since many pregnancies are unplanned, these habits are worth building whenever pregnancy is possible.
Folic acid: 400 mcg every day
This daily 400 mcg is in addition to the folate in your food. Easy ways to get it include:
- A multivitamin or prenatal vitamin that lists 400 mcg of folic acid
- Fortified foods, such as many breakfast cereals and enriched breads, pasta and rice
Folate-rich foods, such as leafy greens, beans, lentils and oranges, add to your total but don't replace the folic acid. If you've had a pregnancy affected by a neural tube defect or you take certain medicines, your doctor may recommend a different dose, so ask before changing what you take.
Build your nutrient stores
Good preconception nutrition doesn't require a special diet. Meals built around vegetables, fruits, whole grains, protein foods and dairy or fortified alternatives cover most needs. A few nutrients deserve a closer look:
- Iron: Heavy periods can drain iron stores. Lean red meat, poultry, beans, lentils and fortified cereals help rebuild them.
- Iodine: It supports a baby’s brain development. Use iodized salt at home, and check whether your vitamin contains iodine, since not all prenatal vitamins do.
- Calcium and vitamin D: These protect your bones and later help build your baby’s. Good sources include dairy, fortified soy milk and canned salmon with bones.
- Omega-3 fats: If you eat fish, choose lower-mercury options such as salmon, sardines and trout, because mercury can build up in the body over time.
What to cut back on while trying to conceive
Some changes are easier to make before pregnancy:
- Alcohol: The CDC says there is no known safe amount of alcohol while trying to get pregnant or during pregnancy.
- Smoking, vaping and cannabis: These can affect fertility and a developing baby. Ask your doctor for help quitting.
- High-dose vitamin A: Large amounts of preformed vitamin A (retinol) from supplements can cause birth defects. Check labels on multivitamins and skin supplements.
- Herbal products and other supplements: Ask your doctor or pharmacist before taking any, including herbal teas and weight-loss products.
Weight, health conditions and medicines
A higher weight before pregnancy raises the chance of gestational diabetes and high blood pressure in pregnancy, while a low weight is linked with preterm birth and low birth weight. Gradual changes in eating and activity are safer than crash diets, which can leave you short on nutrients. If pain keeps you from exercising, physical therapy can help you build strength safely.
If you have diabetes, high blood pressure, a thyroid condition, epilepsy or another chronic condition, plan ahead with your care team. Bringing blood sugar into your target range before pregnancy, for example, lowers the risk of birth defects and miscarriage. Some acne, seizure and blood pressure medicines can affect a developing baby. Never stop a medicine on your own; ask whether it should be changed before you try to conceive.
Book a preconception checkup
An OB-GYN, midwife or primary care provider can see you for a preconception checkup. It's a good time to:
- Review your medicines, vitamins and supplements
- Update vaccines such as MMR (measles, mumps and rubella) and chickenpox at least a month before you try to conceive
- Check blood pressure and, if needed, blood sugar
- Ask for a referral to a registered dietitian if you follow a vegan diet, have food allergies or have a history of an eating disorder
Frequently asked questions
How long before pregnancy should I start taking folic acid?
The CDC advises starting at least one month before you become pregnant and continuing every day during pregnancy. Because pregnancy isn't always planned, the simplest approach is to take it daily any time you could become pregnant. If you're already pregnant and haven't been taking folic acid, start now and let your OB or midwife know at your first visit.
Can diet improve fertility?
Research on diet and fertility is still developing. A balanced eating pattern, regular activity, not smoking and avoiding alcohol may support fertility, but no single food or supplement is proven to help you conceive. If you're under 35 and haven't conceived after a year of trying, or 35 or older after six months, talk with your doctor about an evaluation.
Should my partner change their habits too?
It helps. Smoking, heavy drinking and some drugs can lower sperm quality, while a balanced diet and regular activity support overall health. Making changes together, such as cutting back on alcohol and cooking more meals at home, also makes new habits easier to keep. Your partner can review any health conditions or medicines with their own doctor.
Prepare your body for pregnancy
Your OB-GYN, midwife or a registered dietitian is the right guide for preconception nutrition. If back, hip or joint pain makes it hard to stay active as you prepare, Physical Medicine & Rehabilitation of NY & CT (PMR) can help, and our prenatal chiropractic care supports you once you're expecting. Request an appointment and our team will contact you to schedule.
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