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Nutrition During Pregnancy

Topic Overview

A balanced, nutritious diet during pregnancy is important to maintain your health and nourish your fetus. In general, pregnant women need to increase their daily caloric intake by 340 calories in the second trimester and 450 calories in the third trimester.footnote 1 This is about 2 or 3 extra food guide servings a day.footnote 2

Most women who are pregnant need 2,200 to 2,900 calories a day in their second and third trimesters.footnote 1 If you are carrying twins, triplets, or more, your calorie needs will increase. Talk to your doctor or a dietitian about your daily calorie needs because your needs depend on your height, weight, and activity level.

Your doctor may give you a nutrition plan to follow throughout pregnancy and while breastfeeding. You may also receive a prescription for a vitamin and mineral supplement or a list of recommended non-prescription supplements.

Healthy eating

Eating a variety of foods can help you get all the nutrients you need. Your body needs protein, carbohydrate, and fats for energy. Good sources of nutrients are:

  • Unsaturated fats like olive oil and canola oil, nuts, and fish.
  • Carbohydrate from whole grains, fruits, vegetables, legumes (peas, beans, and lentils), and low-fat milk products.
  • Lean protein such as fish that are low in mercury, poultry without skin, low-fat milk products, and legumes.

Eating healthy foods during pregnancy is good for your overall health and for the health of your baby. You may already have a healthy diet, or you may need to make some changes to eat healthier.

It's also important to eat plenty of fruits and vegetables. These not only give you necessary nutrients but also help you get fibre. Planning your meals can help you add healthy foods to your diet.

Limit how much liver and liver products (such as liverwurst or liver sausage) you eat. Liver is high in iron, folate, and vitamin A. Too much vitamin A may cause birth defects. If you eat liver, do not eat more than 75g (2 1/2 ounces) of cooked liver every 2 weeks.

Folic acid

Folic acid is a B vitamin. Taking folic acid before and during early pregnancy reduces the chance of having a baby with a neural tube defect or other birth defects.

Choose foods high in folate (whole grains, leafy green vegetables, beans, lentils and fortified grains)

Take a multivitamin with folate in it. Take at least .4mg (400 mcg) of folic acid every day for at least 2 to 3 months before trying to get pregnant and while you are pregnant.footnote 3 Some women need higher doses. Talk with your health professional about how much folic acid you need.

Follow your healthcare provider's advice about how to get higher amounts of folic acid. Don't just take more multivitamins. You could get too much of the other substances that are in the multivitamin.

Iron

You will need twice as much iron in your second and third trimesters as you did before pregnancy. This extra iron supports the extra blood in your system and helps with the growth of the placenta and the fetus. Your iron requirements are slight during the first trimester of pregnancy, and taking iron supplements in the first trimester may aggravate morning sickness.

Eat foods high in irion (beef, pork, chicken, fish, legumes, lentils, chickpeas and fortified grains). Most pregnant women need 16 to 20 mg of iron from a prenatal vitamin supplement each day.footnote 2 Most prenatal vitamins include iron. Women who are pregnant with twins or more may need more iron. Talk to your doctor about the amount of iron that is right for you.

Iron supplements can cause an upset stomach and constipation. Taking your iron at bedtime may decrease the chance of stomach upset. Your body absorbs iron best in small amounts when you eat it with vitamin C, so you may want to take your iron throughout the day.

Calcium

Calcium is needed for the development of the fetus's skeleton (bones and teeth). You can get enough calcium in your diet by eating or drinking foods from the milk and alternatives group each day. Good sources include:

  • Milk and yogurt.
  • Soy and rice beverages that are calcium fortified.

Other sources:

  • Cheese.
  • Greens (such as mustard and turnip greens), bok choy, kale, and watercress.
  • Broccoli and cauliflower.
  • Tofu that is "calcium-set."
  • Corn tortillas made with lime.
  • Calcium-fortified orange juice.
  • Canned fish with bones (such as salmon and sardines).
  • Cooked beans, legumes, and lentils.

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References

Citations

  1. Kaiser LL, Campbell CG (2014). Practice paper: Nutrition and lifestyle for a healthy pregnancy outcome. Journal of the Academy of Nutrition and Dietetics, 114(7): 1099-1103. http://www.eatrightpro.org/resource/practice/position-and-practice-papers/practice-papers/practice-paper-nutrition-and-lifestyle-for-a-healthy-pregnancy-outcome. Accessed November 16, 2017.
  2. Health Canada (2009). Prenatal nutrition guidelines for health professionals: Background on Canada's Food Guide. Available online: http://www.hc-sc.gc.ca/fn-an/pubs/nutrition/guide-prenatal-eng.php.
  3. Wilson RD, et al. (2015). Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid-sensitive congenital anomalies. SOGC Clinical Practice Guideline No. 324. Journal of Obstetrics and Gynaecology Canada 37(6): 534–549. http://sogc.org/wp-content/uploads/2015/06/gui324CPG1505E.pdf. Accessed July 20, 2015.

Other Works Consulted

  • American College of Obstetricians and Gynecologists (2013). Weight gain during pregnancy. ACOG Committee Opinion No. 548. Obstetrics and Gynecology, 121(1): 210–212.
  • Cunningham FG, et al. (2010). Prenatal care. In Williams Obstetrics, 23rd ed., pp. 189–214. New York: McGraw-Hill.
  • Newman RB, Rittenberg C (2008). Multiple gestations. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 220–245. Philadelphia: Lippincott Williams and Wilkins.
  • U.S. Preventive Services Task Force (2009). Folic acid to prevent neural tube defects. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsnrfol.htm.

Credits

Current as ofSeptember 5, 2018

Author: Healthwise Staff
Medical Review: Sarah A. Marshall, MD - Family Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Kirtly Jones, MD - Obstetrics and Gynecology, Reproductive Endocrinology