All You Need to Know About Prenatal Nutrition
Written by: Ryah Nabielski, MS, RDN
If you are pregnant or planning to be, you might wonder what to eat.
Prenatal nutrition information is often lacking, confusing, or overwhelming. You may be taking care of toddlers or working while also dealing with fatigue, nausea, or other pregnancy symptoms. If you need help managing food, along with everything else, today’s article is for you.
You probably know that nutrition is important but may benefit from understanding why it’s so critical during this life phase and how to implement good habits.
Keep reading to learn more about:
- The importance of nutrition for pregnancy
- How much to eat
- Specific nutrients to be aware of
- Meal planning
- Prenatal nutrition tips
Let’s jump in!
During pregnancy, nutrient needs increase to support the mother’s changing body and provide the building blocks for the baby. The food you eat while pregnant becomes the structure of your baby.
The maternal diet also influences:
- Fetal development
- Pregnancy outcomes
- Postpartum health
- Lifelong health of the infant
While your baby’s genes are determined by what is passed on via the egg and sperm and cannot be changed, the expression of those genes responds to the environment. When you are pregnant, what you eat, your sleep, stress, exercise, toxin exposures, and other factors, play a role in what genes turn on and off. This is called epigenetics, the study of gene expression.
Epigenetic expression begins to take shape in the womb, affecting the infant’s health into childhood and adulthood. Pregnancy is a critical time that influences the risks of obesity and chronic disease, and conversely, builds health resilience.
Prenatal Nutrition and Weight Gain
Because nutrient guidelines change during pregnancy, you may need to eat more calories after early pregnancy. An average of 300 additional calories during the second trimester and 500 additional calories during the third trimester are recommended. However, typically there isn’t a need to count calories. Instead, focus on eating regularly throughout the day and trusting your hunger.
If you eat three meals per day, snack as needed, and choose mostly whole, unprocessed foods, you’ll have a strong foundation for prenatal nutrition. Within the context of these meals, balance your plate with:
- Protein - Learn more about protein needs during pregnancy in this article. Prenatal sources of protein include: meat, fish, eggs, tofu, tempeh, lentils, and more.
- Healthy fats such as avocado, coconut, olive oil, nuts, seeds, full-fat dairy products, eggs, fish, and natural fats found in quality meats
- Colorful veggies – Try to include a variety of colors, including dark green, each day
- Whole carbs like legumes, starchy veggies, and fruit
In addition to helping you meet your nutrient needs, balancing your meals supports balanced blood sugar, which helps prevent gestational diabetes, supports energy levels, and lowers stress signals in the body.
A lot of emphasis during pregnancy is placed on weight gain; however, specific weight recommendations can be very individual. Discuss your pregnancy weight goals with your OBGYN, midwife, or prenatal Registered Dietitian. Your individual needs may differ from the standard because everybody has unique bodies and considerations.
It’s important for you to feel supported in discussions around weight and health during pregnancy. Many women have had experiences of body shame and dismissal in medical settings. Women with a history of eating disorders may need additional attention and support around nutrition needs and body changes during pregnancy.
Critical Nutrients for Pregnancy
Within the context of a primarily whole food diet, there are some essential nutrients to keep on your radar during pregnancy. The nutrients important during pregnancy include:
- Vitamin D – Vitamin D is critical for embryo development and building the skeletal structure. Maternal deficiencies in this nutrient are associated with preterm births, low birth weight, gestational diabetes, and other adverse outcomes.
Good sources of vitamin D include egg yolks, fortified and grass-fed dairy products, fatty fish, and liver. Summer sun exposure during peak hours (without burning) promotes vitamin D production in the skin. Most pregnant people will require a vitamin D supplement dosed to optimize blood levels.
- Vitamin A – Vitamin A is required for growth, development, epigenetic expression, vision, and immune development. We want to get enough Vitamin A during pregnancy, but also not too much.
Animal sources of vitamin A like liver, egg yolks, and grass-fed dairy contain retinol, the active form of vitamin A.
Plant foods like sweet potatoes, carrots, and kale contain carotenoids (including beta carotene) that the body converts into active vitamin A. However, this conversion rate is relatively low for most people. It’s advised to get some of the active form, either through food or in a prenatal vitamin, during pregnancy. Note that Twenty2 Nutrition Prenatal contains a blend of beta carotene and retinyl palmitate, which is ideal.
- Folate and Vitamin B12– Folate and vitamin B12 are water-soluble B vitamins required for DNA replication and cell growth. They are some of the most important prenatal nutrients because of a process called methylation. Deficiencies in folate or vitamin B12 may play a role in neural tube defects, neurodevelopment disorders, and other complications.
Folate is primarily found in plant foods, including dark leafy green veggies (spinach, collard greens), avocados, lentils and other beans, and oranges.
Vitamin B12 is only found in animal foods: eggs, meat, fish, and dairy.
Taking a prenatal vitamin containing folate and vitamin B12 is also advised. Look for L-5-methyltetrahydrofolate (also called methylfolate) and methylcobalamin (also called methyl vitamin B12) on the label. These are the preferred, active forms of the vitamins.
- Choline – Choline is an essential nutrient similar to B vitamins. Choline requirements dramatically increase during pregnancy to support the construction of every cell membrane, brain and nervous system development, and genetic expression.
Both eggs (the yolks) and liver are excellent sources of choline. Other food sources include red meat, fish, poultry, broccoli, and beets. If you aren’t getting sufficient choline in the diet, supplementation may be warranted, and this may be separate from a prenatal vitamin.
- Iron – Iron is a mineral required for increasing blood volume to support pregnancy. Needs increase significantly during the second and third trimesters. In addition, many women go into pregnancy with suboptimal iron levels, making this micronutrient even more important to pay attention to.
Top sources of iron include red meat, liver, and shellfish. Iron from plant foods like leafy greens and lentils isn’t absorbed as well as the animal sources; however, you can increase absorption by consuming them with a vitamin C source like lemon juice or tomatoes.
Your provider should monitor iron levels throughout pregnancy. If you aren’t meeting your needs through food and what’s in. your prenatal, iron supplementation may be required. Chelated iron in the form of ferrous bisglycinate tends to be the best tolerated and least likely to trigger nausea compared to other forms of iron.
- Omega 3 fats. DHA typically gets the most attention during pregnancy because of the benefits to the growing baby’s brain; however, both EPA and DHA found in cold water fish and fish oil supplements are extremely important for the health of both mom and baby during pregnancy and beyond.
A quick note on pregnancy hydration: drinking enough water and staying hydrated is essential to support increasing blood volume and amniotic fluid levels.
The bottom line is that it’s helpful to balance your needs for individual nutrients while keeping in mind the benefits of eating various whole foods. There is likely so much about prenatal nutrition that we have yet to uncover and eating real food (and taking a quality prenatal) helps you cover your basis.
Meal Planning for Pregnancy
It’s one thing to know about prenatal nutrition, but often an entirely different conversation when working to implement nutrition recommendations into your daily, and likely busy, life.
We’ve got you covered. For prenatal-friendly recipes, check out Hannah Bower’s Happy Mama Happy Baby program, which has a detailed nutrition guide and 30 delicious recipes for breakfasts, lunches, dinners, and snacks.
Pregnancy may be a good time to outsource some meal prep, especially if the sights and smells in the kitchen make you nauseous. Sometimes it’s easier to eat when the food is ready and in front of you.
Consider meal delivery services, meal kits, local pre-made options, a personal chef, or asking family or friends to take over cooking duties for a while. These ideas are also helpful to have in place postpartum.
With so much nutrition information out there, it’s easy for food to become a source of stress. As a dietitian who specializes in women’s health, here is some of my best advice for navigating nutrition during pregnancy:
- Start before you are pregnant and continue afterward. It’s never too early to begin thinking about nutrition. Even if you aren’t planning children, optimizing your fertility means optimizing your health.
Focusing on prenatal nutrients during the preconception period builds nutrient stores, prepares the body for pregnancy, and provides peace of mind during pregnancy. And these same nutrition strategies provide support for postpartum recovery and breastfeeding.
- Consider supplements carefully. A quality prenatal, fish oil, vitamin D, magnesium, probiotics, and food-based supplements like greens and protein powders are generally safe to take before, during, and after pregnancy. Choosing high-quality options and nutrients in their active forms is important.
However, we don’t have much data on the use of most other supplements during pregnancy as it isn’t ethical to conduct that type of research. Please review all supplements with your provider or dietitian if you are trying to conceive or are already pregnant.
- Do your best. Food choices during pregnancy might not turn out how you envision it, and that’s okay. You may have to adjust your expectations based on how you feel and the pregnancy symptoms you experience.
Pregnancy is a time to get creative and open yourself up to experimenting with new foods, flavors, and ideas. You might discover new favorite dishes or healthy versions of the foods you crave. You might learn to let go control and lean on your partner or community for support in your nourishment. No matter how it goes, your best is enough.
- Trust your body. Although we often want to control as much as we can about pregnancy – and food is one thing we can control – part of the pregnancy experience is surrendering and trusting your body. Your body knows what it is doing. Take some time to tune into yourself and listen to your body talk to you through sensations, hunger, and symptoms. Then, listen and adjust as needed.
Pregnancy is a time of heightened motivation. We want to do the best for our children and that means taking care of ourselves. Eating well (without too much pressure) is how we begin mothering even before we meet our little ones.
Ryah Nabielski, MS, RDN is a functional nutritionist, writer, and recipe creator. Ryah helps clients use a natural, food-as-medicine approach to improve fertility, pregnancy, hormone balance, autoimmunity, and discover a healthy relationship with food and body. Learn more about Ryah and her private practice at econutrition.co.