Published by PMR of NY & CT
Once you share the news, you'll probably hear that you're eating for two now, often with an offer of second helpings. You are nourishing two bodies, but your baby is tiny for much of pregnancy, and you need far less extra food than the phrase suggests.
For most people carrying one baby, ACOG (the American College of Obstetricians and Gynecologists) recommends no extra calories in the first trimester, about 340 extra calories a day in the second trimester and about 450 a day in the third. Quality matters more than quantity.
What eating for two really means
Your need for some nutrients, such as folic acid, iron and iodine, rises much more than your need for calories. So think of eating for two as a matter of quality, not double portions. Choose foods that pack a lot of nutrition into each bite, such as vegetables, fruits, whole grains, beans, eggs, dairy and lean proteins, and leave less room for sweets and sugary drinks.
You don't need a special plan. For most people, balanced meals plus a well-chosen snack or two later in pregnancy are enough.
Extra calories during pregnancy, trimester by trimester
Here's what those extra calories during pregnancy can look like:
- First trimester: No extra calories for most people. Focus on regular meals and your prenatal vitamin.
- Second trimester, about 340 extra calories a day: roughly one extra snack, such as Greek yogurt with berries and a small handful of nuts.
- Third trimester, about 450 extra calories a day: for example, oatmeal made with milk and topped with a banana and peanut butter.
These are averages. Your needs may differ if you started pregnancy at a lower or higher weight, are very active or are carrying more than one baby, so ask your OB or midwife what fits you.
Pregnancy weight gain: what's healthy for you
Pregnancy weight gain includes your baby, the placenta, extra blood and fluid, and energy stores for breastfeeding. Guidelines used by ACOG base the healthy range for one baby on your body mass index (BMI) before pregnancy:
- BMI below 18.5: 28 to 40 pounds
- BMI 18.5 to 24.9: 25 to 35 pounds
- BMI 25 to 29.9: 15 to 25 pounds
- BMI 30 or higher: 11 to 20 pounds
Gaining well above the range is linked with high blood pressure in pregnancy, a larger baby and cesarean birth, while gaining too little is linked with a baby born early or small. Your OB or midwife tracks your weight at each visit. Call promptly about a sudden weight jump with swelling of your face or hands or a headache, which can signal preeclampsia.
Nutrient-rich ways to add calories
When it's time to eat a little more, these habits make every bite count:
- Add a snack between meals instead of supersizing dinner
- Pair protein with fiber so snacks keep you full, such as hummus with whole-grain pita or cottage cheese with fruit
- Add healthy fats, such as avocado, nuts, seeds and olive oil
- Try five or six small meals in the third trimester, when your growing baby leaves less room for your stomach
- Drink water or milk instead of soda and sweet coffee drinks
Handling hunger, cravings and aversions
Hunger often picks up in the second trimester. Regular meals and snacks on hand keep you from getting so hungry that you overeat later.
Cravings are common and usually harmless. Enjoying ice cream or pickles now and then is fine; just keep portions reasonable. Aversions, often to meat, coffee or strong smells, are easier to work around than to fight. If meat turns your stomach, beans, eggs, yogurt and tofu can fill the protein gap.
Exercise during pregnancy and when to stop
ACOG recommends at least 150 minutes of moderate aerobic activity a week for most people with a healthy pregnancy, such as brisk walking, swimming or stationary cycling. Exercise during pregnancy may help you gain a healthy amount of weight, lower the chance of gestational diabetes and ease back pain. Check with your OB or midwife before starting. If back or pelvic pain makes moving uncomfortable, prenatal chiropractic care may help.
Stop and call your OB or midwife if you have vaginal bleeding, leaking fluid, regular painful contractions, dizziness, a headache, or calf pain or swelling. Call 911 for chest pain, severe trouble breathing or heavy bleeding.
Frequently asked questions
Do I need extra calories if I'm having twins?
Yes. Carrying twins or more raises your needs for calories, protein and other nutrients, and the recommended weight gain is higher too. For someone who started pregnancy at a healthy weight, guidelines suggest gaining about 37 to 54 pounds with twins. Your OB or midwife can set specific targets for you, and many people carrying multiples also meet with a registered dietitian.
Is it safe to lose weight during pregnancy?
Dieting to lose weight during pregnancy generally isn't recommended, because your baby needs a steady supply of nutrients. If you started pregnancy at a higher weight, your OB or midwife may suggest gaining less and focusing on food quality and activity. Don't skip meals, cut out food groups or take weight-loss products. If nausea causes you to lose weight early on, mention it at your next visit.
Is it normal to crave ice during pregnancy?
Regularly chewing ice, or craving things that aren't food, such as clay, dirt or laundry starch, is called pica. It has been linked with low iron, which is common in pregnancy. Tell your OB or midwife about these cravings, since a simple blood test can check your iron. Don't eat non-food items, as some contain harmful substances.
Stay comfortable as your body changes
Your OB or midwife is your guide for nutrition and weight gain. If a growing belly brings hip pain, back pain or aches that make it hard to keep walking, Physical Medicine & Rehabilitation of NY & CT (PMR) can help you stay active through pregnancy. Request an appointment and our team will contact you to schedule.
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