Published by PMR of NY & CT
A positive pregnancy test can bring a flood of questions, and many of them are about food. What should you eat more of? What's off the menu? Is the occasional cup of coffee still OK?
Good pregnancy nutrition comes down to three things: balanced meals, a few nutrients that matter more now, and some food safety rules that protect your baby. You don't need a perfect diet or expensive specialty foods. Your OB or midwife will guide you along the way, especially if you have a health condition or a pregnancy complication.
Pregnancy nutrition basics: build a balanced plate
The same healthy eating pattern recommended for most adults works well in pregnancy. At most meals, aim for:
- Half a plate of vegetables and fruits, in a mix of colors
- Whole grains, such as oatmeal, brown rice or whole-wheat bread
- Protein foods, such as beans, eggs, lean meat, poultry, tofu and lower-mercury fish
- Dairy or fortified soy foods, such as milk, yogurt and cheese
Water is the best everyday drink. Keep sugary drinks and sweets occasional, because they fill you up without adding much nutrition.
Key nutrients during pregnancy
Your prenatal vitamin covers some of these, and food covers the rest. Recommendations from ACOG (the American College of Obstetricians and Gynecologists) include:
- Folic acid: 600 micrograms a day from all sources to support your baby’s brain and spinal cord. Most people take a prenatal vitamin with folic acid and eat folate-rich foods such as beans and leafy greens.
- Iron: 27 milligrams a day. Iron in pregnancy helps carry oxygen to your baby. Lean meat, poultry, beans and fortified cereals help, especially with a vitamin C food.
- Calcium: 1,000 milligrams a day (1,300 for teens) from dairy, fortified soy milk or calcium-set tofu.
- Vitamin D: 600 international units (IU) a day from fortified milk, fatty fish and your prenatal vitamin.
- Choline: It supports your baby’s brain development. Eggs are a rich source, and many prenatal vitamins contain little.
- Omega-3 fats (DHA): 8 to 12 ounces of lower-mercury fish and shellfish a week, such as salmon, shrimp, cod and canned light tuna.
Foods to avoid during pregnancy
Pregnancy changes your immune system, so some foodborne infections, especially listeria, are more likely and more dangerous for you and your baby. Skip:
- Unpasteurized (raw) milk, juice and cheese, plus queso fresco and similar fresh cheeses unless heated until steaming hot
- Deli meats, hot dogs and refrigerated smoked seafood, unless heated until steaming hot
- Raw or undercooked meat, poultry, eggs and seafood, including raw sushi and raw oysters
- Raw sprouts, and fruits and vegetables that haven't been washed
- High-mercury fish: shark, swordfish, king mackerel, marlin, orange roughy, bigeye tuna and tilefish from the Gulf of Mexico
- Alcohol in any amount
Easing morning sickness, heartburn and constipation
Common pregnancy symptoms can make eating well harder. A few strategies may help:
- Morning sickness: Eat small amounts every few hours so your stomach is never empty, and keep plain crackers by the bed. Cold foods and ginger help some people. If nausea persists, ask your OB or midwife about vitamin B6 or medicine.
- Heartburn: Choose smaller meals, notice which foods set it off and wait a couple of hours after eating before lying down.
- Constipation: Add fiber from fruits, vegetables, whole grains and beans, drink plenty of water and stay active. Iron supplements can make it worse, so mention it at your next visit.
Supplements and special diets
Take only the supplements your care team recommends. Doubling up on vitamins can backfire, since too much preformed vitamin A can harm a developing baby. Herbal products and teas aren't well studied in pregnancy, so check with your OB, midwife or pharmacist first.
If you're vegetarian or vegan, plan ahead for vitamin B12, iron, iodine and omega-3s. A registered dietitian with experience in pregnancy nutrition can help you fill the gaps. Ask for a referral, too, if you're diagnosed with gestational diabetes, which ACOG recommends screening for between 24 and 28 weeks of pregnancy.
When to call your OB or midwife
Call your OB or midwife right away if you:
- Can't keep food or fluids down, are losing weight or feel dizzy when you stand
- Have fever, muscle aches or diarrhea after eating a higher-risk food
- Have a severe headache, vision changes or sudden swelling of your face or hands
Call 911 for chest pain, trouble breathing, a seizure, fainting or heavy vaginal bleeding.
Frequently asked questions
Can I drink coffee while pregnant?
Yes, in moderation. ACOG advises keeping caffeine under 200 milligrams a day, which is roughly one 12-ounce cup of coffee. Remember that tea, soda, energy drinks and chocolate contain caffeine too, and coffeehouse drinks can contain much more than home-brewed coffee. If you're not sure how your daily total adds up, check labels or ask your OB or midwife.
Is it safe to eat sushi when pregnant?
Skip sushi made with raw fish or shellfish, since it can carry bacteria and parasites. Cooked options, such as shrimp tempura rolls, eel rolls or California rolls made with cooked imitation crab, are generally fine, as are vegetable rolls. Choose a clean, reputable restaurant, and ask how each roll is prepared if the menu doesn't say.
Do I need a prenatal vitamin if I eat well?
Yes, most people do. Even a healthy diet can fall short on folic acid and iron, both of which matter a great deal in pregnancy, so a daily prenatal vitamin is standard advice. Your OB or midwife can suggest one and tell you whether you need anything extra, such as iron for anemia or vitamin B12 if you're vegan.
Feel your best during pregnancy
Your OB or midwife guides your nutrition, testing and prenatal care. If pregnancy brings lower back pain, hip pain or sciatica, Physical Medicine & Rehabilitation of NY & CT (PMR) offers prenatal chiropractic care to help you stay comfortable and active. Request an appointment and our team will contact you to schedule.
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