Pregnancy Nutrition Doesn't Have to Be So Stressful — Here's a Straightforward Guide
Pregnancy is often one of the most exciting times of a person's life, but it can also be stressful. Whether you're a new mom or prepping for baby number three, you might feel overwhelmed about the "rules" of prenatal care — especially when it comes to nutrition. There is so much conflicting information about what foods you can, can't, and must eat. But take a deep breath: your body is stronger than you think, and nutrition is just one piece of the pregnancy pie (and, yes, you can have a piece of pie).
"A healthy balanced diet is one of the most important things you can do during pregnancy, but you don't have to have a perfect diet to have a healthy pregnancy," says Jennifer Gustafson, MD, an ob-gyn and assistant professor in the Department of Gynecology and Obstetrics at Emory University School of Medicine. "How to eat during pregnancy can cause a lot of anxiety, but it really doesn't have to. Just keep it simple and positive."
It's more important to listen to your body and nourish it with nutritious, delicious foods, than it is to create stress or anxiety around eating, adds Karin Evans, RDN, a registered dietitian who specializes in women's health with Top Nutrition Coaching. "The woman's body is pretty resilient, and the growing baby will get everything they need if the mother is doing a relatively good job," she says. "Believe it or not, [pregnancy nutrition] can be fun and cool because your body sends you signals, and that's amazing."
In addition to eating a balanced diet, one thing ever expert agrees on is taking prenatal vitamins. "It's vital that you take your vitamins every day," says Stacea Bowen, MD, an ob-gyn at HCA Florida Institute for Women's Health and Body in Wellington, FL. Inconsistently taking your prenatal vitamin is a major problem if you're lacking vitamins and minerals from your diet; the vitamins can fill in any gaps, protecting you from deficiencies that could lead to complications for you and your baby down the line, she explains. Your diet is where most of your nutrients come from — pregnancy vitamins add an extra layer of reassurance that you're getting everything you need.
Of course, there are definitely some foods you should stay away from while you're pregnant, but experts encourage people to focus on what they're filling their plates with, not just on what they're leaving out. After all, getting adequate macronutrients for energy and micronutrients for vitamins and minerals is crucial.
That said, think about your pregnancy eating plan as small shifts, not big ones. "Pregnancy is a really important time, and it's a time where people tend to get motivated and they want to suddenly get really healthy or change a lot of things they've been meaning to change, but it's not necessary to overhaul your life," Dr. Gustafson says. "Don't put that pressure on yourself. Focus on a balanced diet, and try to think about the eating patterns you'd like to model for your kids."
This stress-free guide lays out the basics of what to know about pregnancy nutrition — but this information isn't medical advice. You should always consult your doctor regarding your health and before starting any type of eating plan or medical treatment, especially when you're pregnant.
Healthy Foods to Eat When You're Pregnant
First things first: when you're pregnant, variety is key. "You want to get macronutrients, which provide energy or calories, and that is fat, carbohydrates, and protein, and you want micronutrients, which don't contain energy but are vitamins and minerals," says Dr. Gustafson. "I encourage all of my patients to eat the rainbow of veggies and fruits, along with quality grains, legumes, and beans, and that will compose the majority of a really healthy diet and pregnancy."
While balance is crucial for a happy, healthy pregnancy, ahead are some of the most important vitamins and nutrients that pregnant women should focus on getting.
1. Folic acid
Folic acid (aka folate) is one of the most important prenatal nutrients because it prevents spina bifida and other neural tube defects, says Dr. Bowen. Folic acid is always beneficial to consume because it promotes red blood cell formation and healthy cell growth, and Evans says it can be found in beans, sunflower seeds, whole grains, and dark leafy greens like spinach, asparagus, and Brussels sprouts.
But supplementation is key. Always talk with your doctor about which folic acid supplement is best for you and when you should begin supplementing. An MD may recommend increasing your folate intake or starting to take a supplement when you're still just trying to conceive, and once you are pregnant, you should be aiming to get 600 micrograms of folic acid a day, according to the American College of Obstetricians and Gynecologists. That amount is hard to hit through diet alone, which is why ACOG recommends supplementing with a daily prenatal that contains at least 400 micrograms — but, again, talk to your doctor for advice specific to you. Because spinal cord development starts when you are four to six weeks pregnant, folic acid intake is especially important during the first trimester as your baby grows, Dr. Bowen explains.
Not only does calcium build the fetus's bones and teeth, but it also prevents bone depletion in the pregnant person, says Evans. Because calcium deficiencies are common in women, ACOG recommends a calcium intake of 1,000mg to 1,300mg per day. Your doctor may suggest a calcium supplement, and almonds, spinach, edamame, tofu, kale, legumes, and cow's milk are also great sources of the nutrient, Evans says.
Iron is used to maintain adequate oxygen levels in mom and baby and helps make the extra blood that you and your fetus need during pregnancy, explains Evans. Many prenatal vitamins contain iron; you can also try eating beans, legumes, cooked shrimp, tomato sauce, and strawberries to up your iron intake, Evans says. To enhance iron absorption, incorporate foods high in vitamin C as well, such broccoli, peppers, grapefruit, and melon.
Carbohydrates are a major energy source for both your brain and body, but not all carbs are created equal. While refined carbohydrates like bagels, pizza, fries, and white rice are fine to eat in moderation, aim to also eat complex carbs, says Dr. Gustafson. "High quality carbohydrates are really great for you, pregnant or not, and those include whole grains, beans, legumes, and whole fruits and vegetables."
"Protein is all about muscle repletion and keeping the mother's immune system functioning, but it's also important for the development of the baby," says Evans. Protein is crucial for ensuring proper growth of the baby's tissue, organs, bone structure, and brain development, she explains. While animal sources like lean meat, poultry, eggs, cheese, yogurt, milk, and cottage cheese are rich in protein, Evans also recommends incorporating nonanimal sources of protein, such as beans, peas, legumes, soy products, and nuts.
Fats are critical for brain development in the growing baby, but they also act as a stored energy source for mom, says Evans. Because labor is an intense and often a multiple-hour process, eating healthy fats during pregnancy will help boost energizing fat stores during labor and aid in postbirth recovery, she explains. Healthy fats like nuts, seeds, oils, and avocado should be prioritized over saturated fats like butter, cream cheese, or creamer, but remember everything in moderation.
Foods to Avoid When You're Pregnant
There are certainly some "off limit" foods, typically ones that have been linked to issues like birth defects. But by and large, there's no need to stress if you accidentally consume a small amount of a red flag food, says Dr. Gustafson. "If you've eaten something [that you should be avoiding] definitely don't panic and just monitor your symptoms," she says.
One wrong bite is not going to risk the health of your unborn child, adds Dr. Bowen. "Nine times out of 10 everything will be fine, even if you do eat something that you shouldn't have eaten."
If you ate a "risky" food but are feeling fine, just mention it to your doc on your next visit and try to avoid further consumption, notes Dr. Bowen. However, if you are continuously vomiting or have diarrhea, call your doctor, and stay hydrated. In the extreme case where you cannot keep anything down or go into anaphylactic shock, call 911 and go to the emergency room immediately.
Below are some "no's" of pregnancy nutrition.
1. High Mercury Fish
Certain types of fish should be completely avoided due to high levels of mercury, a toxic metal that can cause birth defects, says Dr. Gustafson. Bigeye tuna, king mackerel, marlin, orange roughy, swordfish, shark, and tilefish should not be consumed. (Anyone can develop mercury poisoning from eating these fish too often, but pregnant people carry an additional risk.)
Fatty fish including salmon, anchovies, cod, and tilapia are good, safe options due to the omega-3 fatty acids and high protein levels. Just make sure they're thoroughly cooked and never consumed raw, says Lauren Papanos, RDN, a registered dietitian and who specializes in women's health and the founder of Functional Fueling Nutrition. And talk to your doctor about how often you should be aiming to eat fish like this.
2. Processed Deli Meat
Due to the possibility of bacteria such as Listeria, Salmonella, and E. coli, which can get into the fetal bloodstream, you must be very careful when eating processed deli meat, says Dr. Bowen. "Bacteria [in lunch meat] can cross the placenta and could affect the baby causing blindness, fetal demise, or low birth weight," she explains. While it's best to avoid all together, if you're craving deli meat, make sure to heat it in the microwave until steaming hot to kill any bacteria and use clean utensils that did not previously touch the meat when eating.
You've likely heard alcohol is a hard no, but take it seriously. Not only does it increase the risk of a miscarriage or stillbirth, but it also negatively impacts development and brain functioning of the baby, according to the Center For Disease Control And Prevention. "Alcohol is one thing you don't want to mess around with," says Evans.
4. Unwashed Produce
Don't panic! Fruits and vegetables are safe (and encouraged!) to eat, but make sure they are thoroughly washed, says Dr. Bowen. Unwashed produce may be contaminated with bacteria and parasites that can harm the mom-to-be and baby, so always carefully clean your fruits and veggies, and cut away any damaged or bruised areas since bacteria can thrive in these places.
5. Unpasteurized milk, cheese, and juice
Raw and unpasteurized food and drink can contain harmful bacteria like Listeria, Salmonella and E. coli, which can be life-threatening for an unborn baby, Papanos says. These types of bacteria can also contaminate foods during the storage process, so always check expiration dates. "When you're buying food at the supermarket and you don't know what the quality is or how long they have been sitting, it's better to err on the side of caution and not buy or consume," she says.
Now you may be thinking, what about coffee? "A daily cup of coffee is fine," says Dr. Gustafson. But remember that soft drinks, tea, matcha, and chocolate also contain caffeine, and you want to keep your overall caffeine intake under 200mg a day, she adds. "A cup of a caffeinated drink a day is not going to break the bank, and you are not going to increase your risk for any prenatal problems," Dr. Bowen adds. Just be mindful of how much you consume and stick to moderate amounts.
Other foods that are commonly warned to stay away from are nut butters, high sugar fruits like mango, pineapple, and watermelon, soft cheeses like feta, brie, and ricotta, and fried foods. While these "yellow-light" (foods that are less nutrient dense) bites are usually okay to eat in moderation, be sure to talk with your doctor about what's best for your specific eating plan, Evans says.
Pregnancy Food Aversions
You've likely heard about food aversions during pregnancy, and unfortunately, they are a reality for many. While everyone is different and aversions come and go, they are most common in the first trimester when your hormones are increasing "fast and furiously" and the body is trying to adjust, Evans says.
In terms of common aversions, anything can be triggering depending on the person. "A lot of times I see people having aversions to things they used to like prior to pregnancy and now they can't stand," says Dr. Bowen. "Some have aversions to meat, coffee, teas, and even brushing their teeth because of the peppermint or spearmint taste."
Poultry and vegetables are other common aversions, notes Evans. "If you struggle to eat meat or poultry, look to other more tolerable protein sources that settle okay," she says. It's fine to not have vegetables if you can't stomach them, but you may feel constipated without the fiber, so try to eat more fruit or add a stool softener, suggests Evans.
If you do struggle with specific food aversions, talk to your doctor, who may be able to help you find different ways to get similar nutrients. Also make sure you continue to hydrate with whatever you can tolerate, says Evans. Water is optimal, but lemonade, diluted juice, and milk also work. In addition, remember to keep taking your prenatal vitamins, stresses Dr. Bowen. If it upsets your stomach, take it before bed to help eliminate any nausea. But don't take more than the recommended dose of a supplement in the hopes of bridging a gap in your diet — too-high doses of certain nutrients can be dangerous too, ACOG notes.
Like aversions, pregnancy cravings have a mind of their own. "No one fully understands why we get cravings," says Dr. Gustafson. "It may be a comfort thing, or it may be that a certain nutrient in food is lacking and your body is sending you a signal to take in more."
Cravings can truly take any form, but red meat, spicy foods, pickles, chocolate, and acidic fruit like lemons or grapefruit are some of the most common, Papanos says. And yes, despite how crazy or random a craving may seem, it's okay to indulge, Evans says. "It's not necessarily about 'indulging' in cravings as much as it is looking at your overall intake," she adds. "Having foods because you're craving them is not a bad thing and may actually help to meet a need you're unsure you have."
But if you're concerned that your cravings are unusual or you find yourself craving non-food items such as cigarettes ashes, chalk, moth balls, paper, or baby powder, then talk with your doctor right away because this may be a sign of pica, an eating disorder where a person compulsively craves things with no nutritional value or purpose. "This is something you want to discuss with your doctor immediately as these non-food items can be dangerous to you and the baby, causing deficiencies and possible pregnancy complications," Evans says.
Barring exceptions like that, remember to look at your diet holistically. "Try and build the foundation with healthy foods," says Dr. Gustafson. "It's okay to have some french fries or ice cream, but if you find it's making up a significant part of your diet, then definitely talk to your doctor or dietitian and try to find some substitutes that work.