Your guide to pregnancy-friendly foods

Doctors say these are the best foods to eat – and some to avoid – when you’re expecting

food in a grocery cart with pregnant woman in background

With a positive pregnancy test in hand, you may be wondering if you need to change your diet now that you’re meeting the nutrition needs of a tiny growing human.

The good news is healthy eating guidelines are mostly the same as what you’ve heard all your life. Eat plenty of veggies, fruits, whole grains, lean proteins and low-fat or fat-free dairies.

But there are some ways your diet could or should change. Sanford Health OB/GYN specialists Lacey Krebsbach, M.D., and Jordan Coauette, M.D., share how to load up your plate in a way that’s mindful of your health needs and your baby’s.

Your relationship with food may change

In pregnancy, food can be your worst enemy or your best friend.

Some people suffer from nausea and vomiting that prevents them from eating what and when they want. Others are beset with constant hunger. The smells and tastes of food can change. The times that you can and can’t eat may be different. All of this is normal.

No matter where you fall on this spectrum, try to eat the right foods in the right amounts. Quantity and quality matter.

How much to eat

So how much extra food should a person eat while pregnant? Most people don’t need to increase their calorie intake during the first trimester. In the second and third trimesters, they should only increase their calorie intake by 300 calories per day.

The American College of Obstetricians and Gynecologists has released guidelines on how much weight people should gain during pregnancy. The amount of weight you should gain throughout your whole pregnancy is based on your pre-pregnancy body mass index (BMI).

Calculate your BMI.

Your BMI places you in one of four categories: underweight, normal weight, overweight or obese. According to obstetricians, you should gain the following number of pounds during your pregnancy based on your BMI:

  • Underweight (BMI less than 18.5): 28-40 pounds
  • Normal weight (BMI 18.5-24.9): 25-35 pounds
  • Overweight (BMI 25-29.9): 15-25 pounds
  • Obese (BMI greater than 30): 11-20 pounds

What to put on your plate

The best thing to add to your diet is a daily complete multivitamin with folic acid or a prenatal vitamin. Start taking prenatal vitamins before you get pregnant, if possible.

During pregnancy, your calorie intake should be divided between protein, carbohydrates and fats. You also need more iron, calcium, folic acid, zinc and vitamins A, B, E, C and D. Most of the vitamins and minerals can come from a well-rounded diet and a prenatal vitamin.

Increase your intake of:

  • Iron-rich foods
  • Washed fruits and veggies
  • Calcium

There are risks to taking an excessive amount of some vitamins, and most herbal supplements are not recommended during pregnancy. Talk with your OB about everything you’re taking, including over-the-counter supplements.

People with special circumstances will need more specific dietary changes and supplements. This includes people who have diabetes, had gastric bypass surgery or previously had a baby born with spina bifida. If you fall in one of those categories, talk to your doctor as early as possible on your pregnancy journey.

You should also talk to your doctor about special dietary recommendations if you restrict your diet in any way. This includes vegetarians, vegans and those who fast for religious or cultural reasons for long periods of time.

Foods to avoid while pregnant

You should avoid certain foods because of their risk of toxins, bacteria or parasites that can be harmful to you and your baby. This includes:

  • Uncooked or undercooked meats, fish or poultry
  • Large ocean fish that are high in mercury, including shark, swordfish, king mackerel and tilefish
  • Unwashed fruits or veggies
  • Raw sprouts such as alfalfa, radish and mung beans
  • Unpasteurized dairy products

These foods are safe in moderation if they are cooked well:

  • Low-mercury fish and shellfish like shrimp, canned tuna, salmon, catfish, pollock or fresh lake fish
  • Deli meats, processed meats (hot dogs) and smoked meats and cheeses

You may have to decrease your intake of:

  • Caffeine. Limit to 200 to 300 mg per day (one to two servings a day)
  • Limit to two to three servings a week of low-mercury fish (see above)
  • Artificial sweeteners

Top 5 pregnancy eating myths

Here are the most common myths about eating during pregnancy out there:

  1. Eat three healthy meals a day. Instead, you should be eating six or seven small meals (every two to three hours). Eat frequently and from all various food groups. This helps keep your blood sugar in a constant range.
  2. Decaf only. Moderate caffeine intake isn’t likely to harm you or your baby, so there’s no need to cut out your favorite brew. One small cup of coffee a day is perfectly fine. The same goes for sodas with a caffeine jolt.
  3. Cut out the cheese. Some cheeses, like cheddar and Swiss, are not harmful as they have been pasteurized. It’s the soft, unpasteurized products like Brie, feta and goat cheese that might carry food-borne illnesses. However, some supermarkets may carry pasteurized versions of those cheeses. All you need to do is start checking the labels in the dairy aisle more frequently.
  4. You’re eating for two. You shouldn’t double your calorie intake. Instead, follow the above recommendations to eat the right quantity for your health and your baby’s.
  5. Say goodbye to seafood. Chances are that if the reputable (and tasty) sushi bar you love hasn’t made you sick pre-pregnancy, it’s safe to eat there when you are pregnant. Yes, there is a greater risk of ingesting bad kinds of bacteria from raw foods so you might feel more comfortable with a cooked-shrimp roll. You should also pay attention to mercury levels. Check out the fish listed in the foods to avoid and try to choose seafood with lower mercury levels.

Other considerations

Be very aware of clean food handling practices. Make sure you’re thoroughly washing all fruits and veggies, washing your hands frequently, avoiding contamination with uncooked meats and cleaning food prep areas.

If you have questions about healthy pregnancy eating, talk to your OB/GYN. Find a doctor and explore more pregnancy health resources.

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Posted In Health Information, Pregnancy, Women's