What to eat when pregnant? A commonly asked (not to mention important) question. Nutrition during pregnancy is important in order to give your child the healthiest possible start to life that you can provide. It is also extremely important for your own health.
During pregnancy, your body is responsible for the development of every part of your child such as the brain, heart and limbs – this is a very complex process. For this reason, the food you eat needs to provide adequate nutrients that are necessary in fuelling optimal development.
An appropriate diet is essential for achieving healthy birth weight and decreasing the risk of neural tube defects and other complications. Newborns that are born small have a heightened risk of complications later in life; such as cardiovascular disease, renal disease, diabetes, hypertension and psycho – social problems .
Commencing a healthy diet at any point during pregnancy will be of benefit. On a lighter note, it will also provide you with more energy and that glowing skin!
Table of contents
- Healthy weight gain
- What to eat when pregnant: important nutrients
- What to eat when pregnant: dietary guidelines
- Fish during pregnancy
- Is caffeine safe?
- Can I drink alcohol?
- Dietary management of side effects
- Food safety
Unfortunately, the common expression ‘eating for two’ is not a valid reason to eat in excess. [2, 3, 4]
It is only necessary to increase the amount of food you eat by a small quantity but it is of greater importance to put an emphasis on the types of nutrients you are consuming . Enough weight must be gained so that the baby is receiving adequate levels of nutrients to avoid a preterm birth . However, too much weight can increase the risk of complications such as high blood pressure, birth defects, gestational diabetes (the onset of diabetes during pregnancy) and the difficulty losing weight after giving birth .
The healthy amount of weight to gain during a pregnancy is dependent on the individuals’ weight prior to conceiving . This is determined by a calculation known as the Body Mass Index (BMI) . The following table presents the appropriate amount of weight gain for your BMI ( a dietitian or doctor can work out your BMI for you). Alternatively, you can work out your BMI using this equation:
Weight (kg)/height (meters)2 = BMI
e.g. 60kg/1.66m2= 21.77 (22) BMI
If you are overweight, you will not need to gain as much weight. However, pregnancy is not the time to try and achieve weight loss.
Table 1: Institute of Medicine recommendations for weight gain during pregnancy, based on BMI prior to pregnancy
What to eat when pregnant. The above table was sourced from the Institute of Medicine 
More detailed information on weight gain during pregnancy can be found by following this link.
Adequate folate intake is crucial for foetal development . Requirements are increased during pregnancy due to rapid tissue growth and an increase in the mass of blood cells .
In addition, folic acid is important for reducing the risk of complications such as spina bifida, low birth weight/preterm birth and neural tube defects . To meet your requirements, it is essential that a range of folate rich foods along with folate supplements are consumed daily for at least one month prior to falling pregnant and the first 3 months of the pregnancy [3, 7].
- What to eat when pregnant to boost your folate intake:
- Green leafy vegetables e.g. spinach, broccoli, salad vegetables, bok choy, brussel sprouts, asparagus, avocado
- Fruits e.g. Oranges, orange juice, strawberries
- Legumes e.g. Lentils, chick peas, dried beans
- Nuts e.g. Almonds, peanuts, hazelnuts
Also include foods that have been fortified with folic acid. These products will most commonly include breads (majority of bread types), cereals and juices .
|What to eat when pregnant: Folate
RDI (all ages during pregnancy):
600 µg/day 
A woman’s blood supply and hence iron requirements are increased during pregnancy. Additionally, this will ensure that the baby will receive enough iron from its mother’s stores to last 5 – 6 months after birth [3,7]. It is for this reason there is a significant increase the amount of iron required to ensure and promote the healthy growth of the baby and for the health of the mother . Insufficient intake of iron can lead to maternal iron deficiency anaemia which is potentially linked to preterm birth and/or low birth weight .
Furthermore, excessive iron intake can be harmful to both the mother and the baby and should be avoided. Research has shown that high levels of iron (particularly in the third trimester) can greatly encourage a preterm birth .
- The most readily available source of iron comes from animal products, in particular, lean red meat. Other good sources include:
- Green leafy vegetables e.g. broccoli, spinach, cabbage
- Poultry, fish and eggs
- Legumes e.g. kidney beans, chick peas, lentils
- Fortified products e.g. cereal
- Dried fruit
If you are vegetarian or vegan, it is a good idea to consult with a dietitian for tailored tips on how to meet your iron requirements adequately and what to eat when pregnant .
An iron supplement may be necessary during pregnancy for women who struggle to meet their requirements through dietary means. When choosing a supplement, ensure it is designed for pregnancy and always discuss its use with your doctor first . However, it is advised that you try to meet your iron requirements through diet first .
The following tips will help your body to take as much iron as possible from the foods you are eating
Tips to aid iron absorption
- Eating iron rich foods combined with foods that contain vitamin C will increase the amount of iron absorbed [2,3,7]. Examples of vitamin C containing foods are citrus foods, capsicum and tomato 
- Combine animal products with green vegetables [2, 3].
Foods that can hamper use of iron
- Avoid drinking tea and coffee whilst eating [2,3,7], certain properties in these fluids interfere with iron being used efficiently.
- Eating a lot of unprocessed bran can inhibit the uptake of iron (more than 2 tablespoons) 
- If you are on iron supplements, avoid taking them with meals that include dairy e.g. milk and yoghurt
|What to eat when pregnant: Iron
RDI (all ages during pregnancy):
Iodine requirements are increased during pregnancy to ensure the normal development of the babies’ brain . During pregnancy, insufficient intake of iodine and even mild deficiency can result in delayed physical and mental development of your child . It is recommended that an iodine supplement be taken whilst pregnant, with approval from your doctor  and iodine should still be consumed in the diet .
Good sources of iodine include
- Seafood e.g. oysters, seaweed, tinned salmon, tinned tuna (in descending order of quantity)
- Fortified bread
- Iodised salt
Organic bread is not fortified with iodine but most other bread is . Iodine fortified salt (iodised salt) does have a high iodine content but consumption of this is not recommended due to the negative health affects linked with salt intake .
|What to eat when pregnant: Iodine
RDI (all ages during pregnancy):
220 µg/day 
When you do not receive enough calcium from your diet, your body will remove calcium from the stores in your bones in order to meet your babies’ requirements . This depletion of calcium stores can increase your risk of getting osteoporosis . To ensure you are getting optimal nutrition for pregnancy and enough calcium for yourself and to support the needs of your baby, aim for 2.5 serves of calcium rich foods per day.
Good examples of high calcium foods include
- Low fat dairy products e.g. hard cheese, yoghurt, milk
- Calcium fortified products e.g. soy milk, soy yoghurt, juice (check the labelling)
- Vegetables also contain calcium but in lower levels
|What to eat when pregnant: Calcium
14-18 yr: 1,300mg/day 
19-30: 1000mg/day 
31-50: 1,000 mg/day 
Ideal nutrition for pregnancy can be achieved by eating a balanced diet including a range of foods from each of the 5 food groups. The requirements for pregnant women are outlined in the picture below.
What to eat when pregnant. Australian Dietary Guidelines.
The above recommendations were taken from the revised Australian Dietary Guidelines released in 2013. The following link will take you to an information pamphlet that goes in to more detail about the guidelines and what to eat when pregnant e.g. what constitutes a serve of each of the food groups.
It is important to note that some fish is not suitable for consumption during pregnancy, this is due to the levels of mercury present which can be damaging to the development of a baby’s nervous system . Despite this, fish plays an important role as part of your nutrition for pregnancy and should still be included, however, must be consumed in moderation. Fish will contribute to your protein, iodine and omega 3 intake and it is low in saturated fats [3,7]. All of which are essential for the growth and development of your baby, in particular, the central nervous system and eyes [3,7].
The points below outline the fish and quantity that has been approved for safe consumption by pregnant women. One serve is considered to be 150g of fish.
It is recommended that caffeine and caffeine containing products be limited or excluded during pregnancy. A large consumption of caffeine can put you at risk of miscarriage, low birth weight and a premature birth; in addition, it provides no valuable nutrition for pregnancy . It is recommended that women consume no more than 200mg of caffeine per day, according to NSW Health . If you find reducing your intake difficult, try and choose decaffeinated options.
As a guide, consumption of the following caffeinated beverages should be safe
- Up to 2-3 cups of instant coffee OR
- 1 cappuccino OR
- 4 cups of tea (medium strength)
As for other caffeinated drinks, no more than 4 cups of hot chocolate or 4 cups of coke a cola should be consumed per day [7,11]. These drinks however are not healthy choices and should ideally be avoided. Try to steer clear of energy drinks where possible as they also have a high caffeine content and other ingredients that are unhealthy choices for pregnant women .
Alcohol should be completely excluded from the diet during pregnancy. A safe level of consumption is not currently known and the potential complications can be severe . The alcohol can move through the placenta where nearly equal concentrations may be received by the foetus . This can be detrimental to the physical and mental development of your baby leading to foetal alcohol syndrome . Other complications can include still birth, miscarriage, low birth weight and a premature birth .
Many women may experience constipation during pregnancy. It commonly comes about due to the hormones relaxing the muscles of the bowel and therefore decreasing the effectiveness of peristalsis (the motion that moves digested food through your intestine) . The pressure that your growing baby exerts on your bowel then compounds this and causes slowing of bowel movements .
Constipation can be avoided or alleviated by consuming a diet high in fibre with plenty of water and regular, light exercise. To increase your fibre intake be sure to incorporate fruit, vegetables, whole grain products, nuts and seeds in to your diet. Aim for 2 pieces of fruit and 5 serves of vegetables per day.
Nausea and vomiting are normal during pregnancy and can sometimes make it more difficult to eat normally . Morning sickness can occur any time during the day but it is important to ensure you are still eating and drinking adequately. Note that going long periods without eating actually increases nausea
The following tips may help you to alleviate morning sickness
- Eat small meals frequently
- Try eating smaller meals every couple of hours
- Avoid high fat or fried foods
- Avoid spicy foods
- Avoid drinking with meals, rather drink in between meals to avoid bloating
- Eat dry, savoury foods such as plain toast, cereal and crackers
- Avoid highly odorous foods that are known to nauseate you
- Sit up right whilst eating and avoid bending down directly after meals
Food poising during pregnancy can be extremely dangerous for you and your baby. Your immune system is lowered whilst you are pregnant, putting you at a heightened risk of contracting a food-borne illness. For this reason, it is vital to be aware of the below information.
Listeria is a bacteria that can contaminate food and cause infection (listeriosis) to those who consume it . Ingestion of this bacterium can infect your baby and cause devastating outcomes such as miscarriage, premature birth, still birth and other serious damage . The cooking process kills listeria if adequate temperatures are reached for a sufficient duration of time.
What to eat when pregnant – To avoid contamination of food or listeriosis, the practices below should be followed
- Select food that is freshly prepared. This means food that has been thoroughly washed and freshly cooked. It is particularly important to put an emphasis on the washing of food that will be eaten raw such as fruit and vegetables.
- Once food has been defrosted, do not re- freeze it.
- Cook all animal protein thoroughly including fish, chicken, red meat and eggs
- Wash all utensils thoroughly after they have been in contact with raw meat, this includes washing your hands. Ensure cross contamination does not occur between raw meat and foods that aren’t being cooked.
- Eat food before it reaches its use by date.
- Ensure food does not enter the ‘danger zone’. The danger zone is the temperature range where conditions for bacteria growth are optimal. Keep food below 4 degrees Celsius or above 60 degrees Celsius.
- Cool or thaw food in the fridge, not on the bench.
- Eat leftovers within 24 hours and heat them above 74 degrees Celsius for at least 2 minutes. Leftovers must have been refrigerated soon after preparation to be considered safe.
High risk foods to avoid during pregnancy
- Avoid soft cheeses unless cooked and eaten whilst hot e.g. brie, ricotta, camembert, fetta
- Pre- prepared, ready to eat meats that are consumed cold e.g. deli meats (such as salami, ham),cold barbecued chicken
- Pre- prepared salad e.g. from a salad bar
- Freshly made fruit/ vegetable juice that you have not made yourself
- Raw/ smoked seafood
- Soft serve ice cream
- Unpasteurised food e.g. unpasteurised dairy products
- Raw sprouts e.g. alfalfa sprouts
- Raw or runny eggs
Salmonella is another type of bacteria that contaminates food and can lead to miscarriage in rare cases. Contamination can be avoided by following the above mentioned guidelines and also concentrating on proper cooking, in particular that of eggs, poultry and meat. Pork and chicken should produce only clear juices and there should be no pink areas in cooked meat. It is also advised that women exclude any type of sprout from their diet whilst pregnant e.g. alfalfa sprout, sunflower sprout [7,13].
- Wash your hands prior to eating or preparing food and afterwards. It is also important to wash your hands after handling raw meat.
- Do not let surfaces that have been in contact with raw meat come in to contact with ready to eat foods.
- Wash fruit and vegetables well, soil can also carry bacteria.
- Ensure your kitchen and eating surfaces are clean. Keep pets away from these areas and always wash your hands after handling an animal.
- Keep food out of the danger zone (5-60 degrees Celsius)
- Do not store ready to eat food below or next to raw meat where juices could come in contact with it, thereby contaminating the food.
- Follow product instructions for storage and preparation.
- If a refrigerated food item has been left out for 2 or more hours, it is not safe to eat.
Contact us for results focused nutritional advice about eating healthy
This article ‘What to eat when pregnant’ was written by our nutritionist Belinda Elwin who is a Dietitians Association of Australia member and Accredited Practising Dietitian.
If you have questions about eating healthy or for a personalised meal plan, contact your local doctor who will arrange for you to see a dietitian in Sydney. For healthy eating advice, Contact us today!
1. Department of Health and Aging. Why Is It Important? Australian Government. Updated December 20, 2012. Available from: here.
2. Better Health Channel. Pregnancy and Diet. Better Health Channel. Updated June 2011, under current review. Available from: here.
3. Queensland Dietitians/nutritionists. Healthy Eating During Pregnancy. Queensland Government. Reviewed June 2012. Available from: here.
4. Queensland Dietitians/nutritionists. Healthy Weight Gain During Pregnancy. Queensland Government. Reviewed June 2012. Available from: here.
5. Dept. of Health and Human Services Office on Women’s Health. Pregnancy and Nutrition. MedlinePlus. Updated July 2013. Available from: here.
6. Institute of Medicine NRC. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press, 2009.
7. NSW Government Food Authority. Food Safety During Pregnancy (brochure). NSW Government. Brochure. December 2005.
8. Australian National Health and Medical Research Council, the New Zealand Ministry of Health. Nutrient Reference Values. Australian Government. Available from: here.
9. Nutrition Australia. Iodine Facts. Nutrition Australia. June 2010. Available from: here.
10. Food Standards Australia New Zealand. Mercury in Fish. Standards Australia New Zealand . Updated: January 2013.
11. Department of Health and Aging. Pregnant Women. Australian Government. Updated October 2009. Available from: here.
12. National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Australian Government. Febuary 2009. Available from: here.
13. NSW Health. Salmonellosis. NSW Health. Updated July 2012. Available from: here.
For more information
The following link provides a more comprehensive list of foods that are coded by colour based on their safety to eat during pregnancy. They are broken in to – ‘don’t eat’, ‘eat with caution’ and ‘OK to eat’.
Click here. NSW Food Authority