Nutrition During Pregnancy: Foods To Include and Foods To Avoid

Getting good nutrition is always important. But when you’re pregnant, what you eat affects more than your own health. Good food choices also can encourage healthy fetal development. And other foods and beverages could pose serious risks.

It can be a lot to think about.

Eat this. Avoid that.

Don’t diet. But try to keep your weight gain managed.

And all the while dealing with pregnancy’s various effects on your body.

We get it. It’s not easy.

Even still, a healthy pregnancy diet is important. Because it can keep you nourished and, again, promote healthy fetal development. So, knowing what healthy pregnancy nutrition looks like is important.

“Certain nutrients are so essential during pregnancy that we recommend everyone take a daily prenatal vitamin to ensure you get some critical vitamins and minerals,” says nurse midwife Tamara Noy, MSN, CNM. “But prenatals alone aren’t enough. Just as important is following a healthy eating pattern during pregnancy to keep your body healthy and encourage proper fetal development.”

We talked with Noy about what to eat and what to avoid when you’re pregnant.

Daily guidelines: What pregnant people need to eat

Noy explains some of the most important nutrients to support a healthy pregnancy and how to make sure you’re getting your fill.

Calcium

Recommended intake: 1,300 milligrams (mg) per day.

Calcium helps your body build strong bones and teeth. Calcium also allows your blood to clot normally, your nerves to function as they should and your heart to beat properly. And those benefits are passed on to a growing fetus, too.

“Dairy products are the best source of calcium, but even pregnant people who are dairy-free or who don’t eat a lot of dairy can still get enough calcium. It’s just a matter of choosing the right foods,” Noy says.

Aim for eating or drinking four servings of dairy products or other foods rich in calcium, like:

• Pasteurized cheese.
• Milk (including non-dairy options, like almond milk).
• Dark, leafy greens.
• Fortified cereal.
• Fish low in mercury. (Mercury levels are important when choosing fish during pregnancy. More on that in a bit.)
• Fortified orange juice.
• Almonds.
• Sesame seeds.

Folic acid

Recommended intake: 600 micrograms (mcg) per day or more.

Folic acid is used to make the extra blood your body needs during pregnancy.

Folic acid helps encourage healthy development of the fetus’ brain, spine and spinal cord. The March of Dimes suggests that 70% of neural tube defects during fetal development can be avoided with appropriate folic acid intake. That’s important because neural tube defects are associated with conditions like spina bifida and anencephaly.

Folic acid is a major ingredient in prenatal vitamins, and yours should include the 400 mcg that are recommended for most healthy pregnancies. Your provider or a genetic counselor may recommend additional folic acid if you’re at an increased risk for neural tube defects. That includes pregnant people who have a family history of spina bifida or if you take antiseizure medicines during pregnancy.

Folic acid is also added as a supplement to certain foods, such as fortified bread, cereal, pasta, rice and flour. And it’s found naturally in foods like:

• Lentils.
• Beans.
• Green leafy vegetables (like spinach, romaine lettuce, kale and broccoli).
• Citrus fruit.
• Nuts.
• Beans.

Iron

Recommended intake: 27 mg per day.

Iron is an important part of the healthy development of red blood cells, which carry oxygen through your body, including to the developing fetus. Iron will help you build resistance to stress and disease, as well as help you avoid tiredness, weakness, irritability and depression.

Good sources of iron during pregnancy include:

• Whole-grain products.
• Lean beef and pork.
• Dried fruit.
• Beans.
• Sardines.
• Green leafy vegetables.

Noy notes that iron deficiency in pregnancy can lead to some unusual cravings. If you’re craving non-food items such as ice, laundry detergent, dirt, clay, ashes or paint chips, you may have a condition known as pica. Don’t eat non-food items, and discuss these cravings with your doctor immediately.

Vitamin D

Recommended intake: 600 international units per day.

Vitamin D works with calcium to support healthy fetal growth — particularly for developing teeth, bones, healthy skin and eyesight.

Good sources of vitamin D are milk fortified with vitamin D and fatty fish such as salmon. Exposure to sunlight also converts a chemical in your skin to vitamin D. (But, as always, make sure to wear your sunscreen!)

DHA

Recommended intake: 200 mg per day, plus prenatal vitamins.

Docosahexaenoic acid (DHA) is a powerful omega-3 fatty acid that supports the development of healthy brains, eyes and nervous systems.

Your provider will recommend taking a prenatal vitamin that contains DHA or a separate daily DHA supplement. And it’s recommended that you get an additional 200 mg of DHA each day from the foods you eat. Good sources of DHA in your diet include:

• Fatty fish low in mercury, like salmon, herring and sardines.
• Cooked shellfish.
• Omega-3 enriched eggs.
• Walnuts.
• Chia seeds.

Protein

Recommended intake: Your pre-pregnancy weight divided by two, in grams. (For example, a person weighing 150 pounds before pregnancy should aim for 75 grams of protein per day.)

Protein is an important nutrient needed for growth and development. It gives your body energy and works to build and repair your brain, muscle and blood.

During pregnancy, getting additional protein will help support healthy fetal growth and development.

Choose a variety of protein-rich foods, including:

• Low-mercury, cooked seafood.
• Lean meat and poultry.
• Eggs.
• Beans.
• Peas.
• Soy products.
• Unsalted nuts and seeds.

You can check the labels on packaged food to determine how many grams of protein each food provides.

Foods to avoid

While you’re working to increase some nutrients in your pregnancy diet, there are some things that can be especially harmful to you and the fetus during pregnancy.

Noy explains a few that should be off the menu.

Alcohol

Let’s be very clear here. No amount of alcohol is safe during pregnancy. None. Zero.

“Fetuses can’t break down alcohol in the way that adults do. Alcohol stays in their systems longer and dangerously interferes with fetal brain and nervous system development,” Noy explains.

Alcohol use during pregnancy has been linked with preterm delivery, low birth weight and fetal alcohol syndrome spectrum disorders. Those are permanent conditions that cause mental and physical defects in children who were exposed to alcohol during pregnancy.

If you’re pregnant and living with alcohol use disorder or find it difficult to stop drinking, talk with your provider for help. It’s vitally important to your health and to having a healthy pregnancy.

Listeria risks

During pregnancy, hormonal changes during can lower your immune system and put you at greater risk for contracting a foodborne illness (aka food poisoning). And while no one wants to deal with the effects of food poisoning, the risk can be much higher during pregnancy.

In fact, during pregnancy, you’re 20 times more likely to contract the foodborne illness listeria, which has been shown to increase risk of premature delivery, miscarriage and even fetal death.

“The most common causes of listeria in pregnancy are foods that contain raw eggs, uncooked proteins, processed meats and unpasteurized dairy products,” Noy explains. “So, we recommend avoiding those foods during pregnancy.”

That includes:

• Sushi.
• Rare or undercooked meats and poultry and beef.
• Undercooked and raw eggs.
• Caesar dressing.
• Mayonnaise.
• Cold deli meats, like turkey, ham, bologna or salami.
• Fermented or dried sausages.
• Cold hot dogs.
• Unpasteurized juice or cider — words like “natural” or “fresh-squeezed” are indications that they haven’t been pasteurized.
• Soft cheeses, like feta, queso blanco, queso fresco, brie, Camembert, blue-veined or panela (queso panela). Only eat cheeses that are labeled as “made with pasteurized milk.”
• Refrigerated pâté or meat spreads. Canned or shelf-stable pâté and meat spreads are safe to eat. But sure to refrigerate them after opening.

Fish with high mercury content

Fish is full of healthy fats and proteins, but some kinds should be avoided or eaten with caution during pregnancy. That’s because some fish have elevated levels of methyl mercury or polychlorinated biphenyls (PCBs), a pollutant in the environment.

Consuming fish with high levels of methyl mercury during pregnancy has been associated with brain damage and developmental delays in the fetus.

Fish to avoid include:

• Any raw or seared fish, including sushi and sashimi.
• Undercooked finfish and shellfish, such as undercooked oysters, clams, mussels and scallops.
• Shark.
• Swordfish.
• King mackerel.
• Tilefish even when cooked as they have higher levels of mercury.
• Bluefish.
• Bass.
• Freshwater salmon.
• Pike.
• Trout.
• Walleye.

Foods to be cautious about

Not all foods are black-or-white, eat-it-or-avoid-it during pregnancy. There are some gray areas. Some foods that are OK but need to be considered in moderation. Noy breaks it down.

Caffeine

It’s not that you can’t enjoy a cup of coffee during your pregnancy. But limiting your caffeine intake during pregnancy is a good idea.

That’s because high levels of caffeine can cause constriction in the blood vessels that feed the fetus. That can lead to low blood flow and inhibit fetal growth.

Noy recommends sticking to no more than 200 mg of caffeine a day during your pregnancy. That’s about two six-ounce cups of coffee or three six-ounce cups of tea. And avoid energy drinks during pregnancy. The additional additives in them may not be safe during pregnancy.

“If you’re a coffee drinker before pregnancy, you’ll want to cut back slowly,” she advises. “Going cold-turkey can make you completely miserable.”

Excess salt

A moderate amount of salt in your diet is healthy for you. In fact, salt is important for maintaining proper electrolyte levels in your blood.

But too much salt can cause your body to retain water and could lead to an elevation in your blood pressure. That can be particularly problematic during pregnancy and lead to conditions like preeclampsia. Eat salty foods in moderation.

What to eat when pregnancy has you sick

Pregnancy symptoms vary. Some people may have difficulty with morning sickness, diarrhea or constipation. What you eat can help you feel better.

Noy offers these suggestions to deal with some common pregnancy symptoms.

Foods for morning sickness

Eating small meals frequently throughout the day can help keep pregnancy nausea symptoms at bay. Eating increased protein can help, too, as can eating foods rich in magnesium or taking a magnesium supplement.

“Some people find that eating first thing in the morning, even before getting out of bed, can help,” Noy suggests. “And protein is super important. Protein changes everything.”

But morning sickness (despite its name) can show up any time of day — or night. Keep healthy, eat-on-the-tummy snacks on hand to help with morning sickness symptoms.

Avoid fatty, fried foods, and try:

• Crackers.
• Cereal.
• Pretzels.
• Unsalted nuts and seeds.

Constipation

When pregnancy has you all bound up, increasing your fiber intake can help get things moving again. Try these high-fiber foods:

• High-fiber cereal.
• Lentils.
• Split peas.
• Chickpeas.
• Raspberries.
• Blackberries.
• Pears.
• Whole-wheat pasta.

Also, make sure you’re drinking plenty of water — at least 10 to 12 glasses per day.

Diarrhea

When you have the runs, staying hydrated is your first goal, so make sure you’re drinking enough. Electrolyte-enhanced sports drinks can help if water isn’t enough.

Increase your intake of foods containing pectin and gum fiber to help absorb excess water. And keep your options bland. Good choices include:

• Applesauce.
• Bananas.
• White rice.
• Oatmeal.
• Refined wheat bread.

Heartburn

Heartburn can be a common complaint during pregnancy. Especially at later stages, as your uterus pushes your stomach out of the way.

Noy offers these suggestions for lessen the intensity of pregnancy heartburn:

• Eat small, frequent meals throughout the day.
• Eat slowly and chew thoroughly.
• Avoid spicy or rich foods, and caffeine.
• Drink fluids in between meals but not with your meal.
• Try not to lie down after eating a meal.
• Keep your head elevated when lying down.

If you’re worried about getting proper nutrition during your pregnancy, talk with a healthcare provider like an Ob/Gyn or certified nurse midwife. You deserve a happy, healthy pregnancy.