Getting Started

You or your surrogate may not be pregnant yet, but there’s plenty you can do now to make yourself as healthy as possible for a growing baby. Consider this your preconception to-do list three months to one year prior to conception.

  • Follow a healthy eating plan:  Use myplate.gov to create a personalized eating program. http://www.choosemyplate.gov/pregnancy-breastfeeding.html.

    General Guidelines:
    Eat a wide variety of foods
    Drink 10-12 glasses of water daily
    Suggested daily servings per day:
    Fruits:  2-3
    Vegetables:  3-5
    Whole grains:  4-8
    Protein:  6-8
    Dairy:  3-5
    Flaxseeds, ground: 1-2 tablespoons daily (provides Omega-3 Fatty Acids and fiber)
    Folate: 800 mcg daily (this is in your prenatal vitamin)

    For personalized help from a Registered Dietitian Nutritionist, visit www.eatright.org/find-an-expert zip code locator tool to find an expert in your area. 

  • Maintain a Healthy Weight:  If you are 20 percent above your desirable bodyweight, gradually lose weight prior to getting pregnant.  If you are more than 10 percent below your desirable weight, gradually gain weight before conception.

  • Supplement:
    Pre-natal vitamin
    Folic acid is absorbed better through vitamins. Foods with folic acid should still be consumed for optimal nutrition. (1 cup lentils contains 358 mcg.)
    Vitamin C increases iron absorption.  Eat iron rich foods with good sources of C (i.e. rice and beans with mango).
    Pre-natal vitamins contain approximately 200 mg. of calcium.  Consider taking a separate calcium supplement or consuming 3 servings of dairy daily to achieve ~1,000 mg per day to optimize calcium stores. 

  • Safety: If you smoke or take medications or drugs not approved by your physician as safe during pregnancy, stop and seek out help for eliminating these habits.   

  • Exercise:  If you are not already exercising regularly, begin low impact exercise, such as walking, cycling, or swimming at least three days a week. 

  • Coffee:  Limit caffeine to no more than 300mg per day as it may cause fetal growth retardation.  Caffeinated beverages don’t appear to cause birth defects, pre-term labor or delivery.

  • Alcohol:  Avoid, especially if you think you may be pregnant. 

While pregnancy is a time when you are “eating for two,” your calorie needs do not double.  Furthermore, pregnancy is not the time to lose weight, even if you are overweight.  You should gain 1 to 3 pounds in the first 3 months and about ¾ to 1 pound per week after that.  Most pregnant women should eat an additional 300 kcals (1 cup of skim milk, 1 slice of bread, 1 oz. lean protein) per day over their pre–pregnancy needs during their second and third trimesters to ensure adequate weight gain for fetal development.  

Your baby’s birth weight is influenced by the weight you gain during pregnancy.  Low birth weight babies are at greater risk for developmental difficulties and illness.  Moms who gain a healthy amount of weight during pregnancy have fewer problems than those who gain too little or too much. Use the Body Mass Index (BMI) guide below to understand how much weight you should gain during pregnancy.

BMI is a measurement of a person’s body mass in relation to his/her height. It provides an indication of your weight status (underweight, normal weight, overweight or obese).  It can be calculated using a simple formula (body weight in kilograms divided by the squared height in meters) or by visiting http://bmi–calculator-online.com/.

Normal weight gain and your BMI 

BMI Category
Suggested Total Weight Gain (pounds)

Underweight < 19

28-40

Normal 19-24

25-35

Overweight > 25

15-25

Twins

35-45

The rate of weight gain is important.  Weight gain should be slow and of small amounts during the first trimester (12 weeks). 

It is essential for a healthy pregnancy and baby to gain weight during pregnancy.  Regardless of pre–pregnancy weight, all women should gain a minimum of 15 pounds.  Some women however, exceed their suggested weight gain secondary to improper diet and lack of physical activity.  Just as there are dangers for not gaining enough weight during pregnancy, there are dangers when the mother gains too much weight during her pregnancy.

In some cases a large weight gain may have little or no impact on the developing fetus, it may have detrimental effects on the mother during the pregnancy and afterward.  Women who gain excessively large amounts of weight during pregnancy are at greater risk for the development of hypertension and are more likely to require cesarean delivery.  Evidence also suggests that excessive weight gain during pregnancy may increase long-term problems in controlling weight gain later in life. 

If your weight gain is too rapid during any part of your pregnancy, use these guidelines to manage your weight:

  • Choose low-fat dairy products – skim or I% milk, low-fat cheeses, and yogurt

  • Look for unsweetened or “no sugar added” fruit and fruit juices

  • Limit liquid calories

  • Trim visible fat from meat and chicken prior to cooking  

  • Bake, broil, grill, or stir-fry vs. frying foods in large amounts of oil or shortening

  • Cut back on high-calorie, low-nutrient foods and beverages otherwise known as “empty calories” from cakes, candy, pastries and soda

  • Increase physical activity per the safe recommendations provided by your doctor 

  • Avoid extreme diets and food restriction 

Never try to lose weight while you are pregnant.  Wait until after the baby is born.  Keep in mind that you will lose 12 to 14 pounds within a week after the baby is born.  The rest of the extra weight will be lost within a year of healthy eating and usual activity.  

Of course, patterns of weight gain during pregnancy vary. It’s normal to gain less if you start out heavier and more if you’re having twins or triplets – or if you were underweight before becoming pregnant.  

Do you wonder how it’s reasonable to gain 25 to 35 pounds (on average) during your pregnancy when a newborn baby weighs only a fraction of that?  Although it varies from woman to woman, this is how those pounds may add up:

 

Source of Weight
Average weight in pounds

Baby weight

7.5

Breast enlargement

2

Extra stored protein, fat, etc.

7

Placenta

1.5

Enlargement of uterus

2

Amniotic fluid

2

Extra blood

4

Extra body fluids

4

Total

30

If you are expecting more than one baby, you should discuss what and how much to eat with your doctor or registered dietitian nutritionist.  Your nutrient and calorie needs are higher than those of women carrying one baby.  You should also visit your doctor more often than women who are expecting one baby.  Women carrying more than one baby need to be monitored more closely as these babies have a much higher risk of being born prematurely.

Eating for Two

When you are pregnant, the foods you eat also provide food for your baby.  This makes it doubly important for you to eat regular, well-balanced meals.  Protein, carbohydrates as well as vitamins and minerals such as calcium, iron and vitamin C are all-important and can be obtained by eating the right foods.

Vegetables…carrots, sweet potatoes, pumpkin, spinach, cooked greens, winter squash, tomatoes and tomato sauce and sweet peppers provide vitamin A and potassium.  Choose fresh, frozen, dried or low-sodium or no salt added canned.

Fruit…cantaloupe, honeydew, mangoes, prunes, bananas, apricots, oranges, grapefruit contain potassium and numerous vitamins including vitamin C.  Vitamin C helps with wound healing, tooth and bone development and promotes metabolic processes.  Choose fresh, frozen, dried or canned in water or 100% juice. 

Dairy…fat-free or low-fat milk or yogurt provide calcium and potassium and are often fortified with vitamins A & D.  When choosing dairy alternatives such as soy, rice or almond beverages, look for brands that are fortified.  The daily requirement for calcium during pregnancy is 1,000 milligrams per day.  Calcium is important for the baby’s developing bones, teeth, muscles, heart and nerves.

Grains…brown rice, wild rice, barley, oats, polenta, quinoa and whole grain breads or cereals provide fiber, vitamins and minerals.  Cereals are generally fortified with iron and folic acid.  Folic acid plays a key role in reducing the risk of neural tube defects, including spina bifida.  Experts suggest 600-800 micrograms per day. 

Protein…legumes, nuts, seeds, lean red meat, skinless poultry and safe fish such as wild salmon, herring and sardines provide protein and iron.  Nuts and seeds contain vitamin E.  Safe fish provides omega-3 fatty acids.   Protein is the building blocks of human cells.  Iron is needed for the baby’s blood supply and to help many pregnant women avoid anemia.  

Pre-Pregnancy and First Trimester
Weight Gain: 2-5 Pounds 

Food Groups

Minimum Servings Per Day

Actual Intake

Calcium-rich

2

 

Vegetables

5

 

Fruits (include Vit. C-rich)

3

 

Whole grains & starchy veg

6

 

Lean protein

2 (6 oz.)

 

 

Second Trimester
Weight Gain: .7 to 1.4 pounds per week

Food Groups

Minimum Servings Per Day

Actual Intake

Calcium-rich

3

 

Vegetables

6

 

Fruits (include Vit. C-rich)

4

 

Whole grains & starchy veg

7

 

Lean protein

3 (9 oz.)

 

 

Last Trimester
Eat mini meals every three hours
Weight gain: 2 pounds per week 

Food Groups

Minimum Servings Per Day

Actual Intake

Calcium-rich

3

 

Vegetables

6

 

Fruits (include Vit. C-rich)

4

 

Whole grains

7

 

Lean protein

3 (9 oz.)

 

Morning Sickness, Nausea and Vomiting…usually resolves after the first 12 weeks of pregnancy

  • Eat frequent, small meals.

  • Eat easy to digest starchy foods like plain pasta, crackers, potatoes, rice, fruit, and vegetables.

  • Avoid spicy foods.

  • Limit fried foods and foods with a lot of butter.

  • Eat a snack before going to bed.

  • Try foods like peanut butter on crackers or cold cereal and milk to help relieve morning sickness before it starts. When you awaken in the morning, get up slowly.

  • Drink beverages between meals rather than with meals.

  • If you vomit more than twice a day talk with your M.D.

Food Cravings….Food cravings and aversions to certain foods are common during pregnancy.  There is no evidence that food cravings are the result of nutrient deficiencies, and their cause remains a mystery.  There is no harm in satisfying food cravings within reason, especially when they make a nutritional contribution to the diet.

Some pregnant women have the urge to eat non-food items such as laundry starch and dirt.  In some cases cravings involve consumption of large amounts of non-food items that displace food and interfere with adequate nutrient intake.  You are encouraged not to eat non-food items and to discuss any non-food cravings with your obstetrical care provider.

Constipation…You may experience occasional bouts of constipation during pregnancy.  Constipation is caused by the relaxation and slowing down of your large intestine due to the continually expanding uterus. 

  • Gradually increase fiber consumption to total 25-35 grams per day by increasing legumes, vegetables, fruits and whole grains such as brown rice, whole grain bread or pasta.

  • Drink at least 8 cups of fluid per day.

  • Try natural laxatives such as prunes or prune juice to alleviate symptoms.

  • Seek the advice of your doctor.

Heartburn… Heartburn may become an issue as the growing baby puts pressure on the digestive organs.  For relief:

  • Eat small frequent meals.

  • Limit highly seasoned, rich and fatty foods.

  • Walk after eating

  • Sit upright after eating to promote the downward flow of gastric juices.

  • Sleep with your head elevated.

  • Wear comfortable clothes.

Safety in food preparation and storage is always important, especially to maintain good health during pregnancy.  Pregnant women are at a higher risk for infection from pathogens secondary to hormonal changes that cause a woman’s immune system to be suppressed.       

Avoiding food-borne illness requires prevention.  You can protect yourself by practicing basic safe techniques of food handling at home and following some general food safety tips below.

  • Open egg cartons before purchasing and avoid cracked or leaking eggs.

  • Choose pasteurized dairy products (milk, cheese and yogurt) and apple juice. Avoid soft cheese made from raw milk such as Feta, Brie, Camembert or queso fresco. 

  • Avoid shark, swordfish, king mackerel or tilefish during pregnancy or when breastfeeding as they contain high levels of mercury.  Limit albacore tuna to less than 6 ounces per week.  Chunk light tuna contains less mercury than albacore tuna. 

  • Buy dated foods only before the “sell by” or “use by” date and use within a few days at home.

  • Separate raw seafood, meat, and poultry into plastic bags while shopping and when storing to prevent contamination of other food products.

  • Making shopping your last errand before going home and quickly refrigerate or re-warm items.

  • Store eggs in their original container and not in the door, which is not as cold.

  • Store fresh meats, poultry, and fish on the bottom shelf of the refrigerator in plastic to avoid dripping on other foods.

  • Refrigerate or freeze foods in small containers so that it cools down faster.

  • Keep refrigerator at or below 40 F (4 C) and freezer at or below 0 degrees F (-18 C).

  • Wash hands, utensils, counters and cutting surfaces with hot soapy water to avoid contamination.  Always wash hands well with soap and warm running water for 20 seconds before handling food, after using the toilet and after touching animals.

  • Thaw foods in the refrigerator.

  • Wash fresh vegetables and fruits with water. Scrub firm-skinned produce. 

  • Store oils in a cool, dark location. Keep covered. Refrigerate if possible.  Buy only small amounts you can use within a two to three months.

  • Reach the following internal temperatures of foods during cooking: 
    –Red meats: 140 F (60 C)
    –Poultry: 165 F (74 C)
    –Eggs: cook until white and yolk are firm and dry
    –Fish: until flaky
               Reheat all foods to 165 F (74 C)
    Heat hot dogs, luncheon meats and deli meats to 165 F before eating
    Frequently stir foods reheated in microwave to allow even cooking.

Avoid or Limit 

  • Avoid raw or undercooked meats, poultry, or seafood such as sushi, oysters and clams.

  • Use separate cutting boards for animal and plant products.

  • Sanitize cutting boards and countertops by rinsing them in a solution made of 1 tablespoon liquid chlorine bleach per gallon of water. 

  • Do not wash eggs as this may cause bacteria on the outside shell to get inside the egg.

  • If food smells or looks spoiled, discard. 

  • Limit processed, salt-cured, smoked or nitrite-cured meats and foods.

During pregnancy your nutrient needs increase for calcium, folic acid and protein. Below are some superfoods to incorporate into your diet on a daily basis to optimize nutrition.

  • Spinach: One cup of cooked spinach supplies only 41 calories, yet boosts zinc intake by 2mg.  Contains calcium, iron, and folic acid.

  • Kidney Beans: One cup supplies almost one third of a pregnant women’s need for iron.

  • Strawberries: A good source of iron, fiber and vitamin C.

  • Tofu:  One-half cup supplies 13mg. of iron.  Tofu is also low in saturated fat, sodium and contains B vitamins calcium and zinc.

  • Wheat Germ: One-half cup contains half your daily intake for vitamin E.   Also contains iron and zinc.

  • Broccoli: High in folic acid, vitamin C, beta-carotene, iron, magnesium and calcium.

  • Papaya: Supplies more than twice your day’s need for vitamin C, more than your daily need for Vitamin A (as beta carotene), potassium and calcium.

  • Salmon: One of the best sources of the omega-3 fats that aid in normal development of vision and brain function in your developing baby.

  • Non-fat or low-fat Milk: Rich source of calcium and vitamin D.

  • Water:  You need at least eight glasses daily during pregnancy, more if you breast- feed.

Apps

  • WebMD Pregnancy…information on week by week development, a checklist of suggested questions for prenatal visits, weight tracker, kick counter and contraction timer

  • My Pregnancy Today…videos, articles, healthy recipes, information on different types of delivery approaches

  • I’m Expecting…track pregnancy weight, measurements, symptom tracker

Websites

Books

  • Mayo Clinic Guide to a Healthy Pregnancy: From Doctors Who Are Parents, Too!

  • Pregnancy:  For the First Time Moms, What They Don’t Tell You

  • What to Expect When You’re Expecting