What You Eat During Pregnancy Matters: The Right Foods in the Right Amounts

Families, Food and Fitness May 31, 2011 Print Friendly and PDF

Pregnancy is an exciting time! Moms want to do everything they can to assure their baby is born healthy. Making healthful food and activity choices can help achieve this important goal. Moms should choose the right foods in the right amounts to gain the right amount of weight, have an easy delivery, and more quickly return to pre-pregnancy weight after the baby is born.

picture of pregnant woman

The amount of weight to gain during pregnancy is of interest to many women. It is also a predicator of the newborn’s health. Not gaining enough weight increases the risk of having a baby with a low birth weight (less than 5 ½ pounds). These babies have greater risk for developing heart disease, hypertension and type 2 diabetes in their adult life. Gaining too much weight may lead to a difficult delivery, a greater risk of cesarean delivery and excessive bleeding after delivery. Excessive weight gain also makes it harder to lose weight after the baby is born, especially when weight is retained beyond 12 months postpartum.

The recommendations for pregnancy weight gain set by the Institute of Medicine are based on pre-pregnancy body mass index (BMI). To calculate your BMI use the calculator at http://www.nhlbisupport.com/bmi/bminojs.htm. A female of healthy weight (BMI 18.5 to 24.9) should gain 25 to 35 pounds. Women who begin pregnancy underweight (BMI < 18.5) should gain more than women who are heavier. Women expecting multiple births should consult with their health care provider.

2009 Institute of Medicine Guidelines for Gestational Weight Gain

BMI < 18.5 (underweight) 28 to 40 pounds (12.5 - 18 kg)
BMI 18.5 to 24.9 (normal weight) 25 to 35 pounds (11.5 - 16 kg)
BMI >25.0 to 29.9 (overweight) 15 to 25 pounds (7 - 11.5 kg)
BMI >/= 30.0 (obese) 11 - 20 pounds (5 - 9 kg)

To gain the right amount of weight and have a healthy baby it takes approximately 75,000 calories. These calories support the growth of the fetus and placenta. During the first three months of pregnancy, or 1st trimester, healthy women need few or no additional calories. During the 2nd and 3rd trimesters energy needs increase to 300 to 400 calories per day. Below is a list of common foods and the number of calories they contain. Notice that it does not take a lot of food to add the additional needed calories.

Calorie content of common food items

Food Item Calorie Content
1 piece of fruit 60 calories
1 baked potato 212 calories
1/2 cup broccoli 50 calories
1 cup orange juice 105 calories
1 cup low-fat milk 100 calories
1 ounce Cheddar cheese 114 calories
1 cup low-fat yogurt 130 calories
1 cup baked beans 382 calories
1 cup Raisin Bran 197 calories
1 slice bread 80 calories
3 1/2 ounces lean beef 256 calories
3 1/2 ounces skinless chicken 173 calories
2 tablespoons peanut butter 188 calories
1 chocolate chip cookie 78 calories
12 ounces soft drink 152 calories

The rate of weight gain is as important as gaining the right amount of weight. During the first trimester the recommended goal is 3 to 4 pounds or about 1 pound each month. Beginning with the 2nd trimester, recommended weight gain is about 1 pound each week, or about 4 pounds per month. If weight gain is too fast, it most likely is body fat which is not beneficial to either the baby or the mother. If weight gain is occurring too fast try one or more of the following ideas.

  • Substitute fat-free or lower-fat milk, yogurt and cheese for whole milk products.
  • Choose lean meats, poultry, and fish.
  • Use low-fat cooking methods – broil, bake, grill & stir-fry
  • Eat smaller portions.
  • Cut back on low-nutrient dense foods, choose more fruits and vegetables instead of pastries and salty snack foods.
  • Increase physical activity within doctor’s guidelines.

Nutrient needs also increase during pregnancy. The most significant increases are for protein, folate and iron. Protein needs increase because the cells of the growing baby’s body are mostly protein. Fortunately, most women in the U.S. already consume enough protein, or about 71 grams. In terms of food, this is about three 3-ounce servings of meat, chicken or fish plus one serving of milk, cheese or yogurt each day.

Folate, a B-vitamin, is needed early in pregnancy to support development of the baby’s spinal cord and brain. It also helps prevent neural tube defects such as spina bifida. These organs develop early in pregnancy, before some women may realize they are pregnant. Good sources of folate include enriched grains, fresh green vegetables, legumes, and oranges. Because it is difficult to consume enough food to provide the recommended amounts, and because about 50% of all pregnancies are unplanned, all women of child-bearing age may benefit from 400 micrograms of daily folic acid supplementation. Before taking supplements, women should visit with a health care provider about their specific needs.

Iron is necessary for the production of red blood cells in both the mother and baby. During pregnancy the mom’s blood supply increases by about 50%. If iron status is poor prior to pregnancy, it is difficult to rebuild iron stores during pregnancy. Good food sources of iron include red meat, legumes, raisins, spinach, dried fruits and green vegetables. Vitamin C (found in foods such as citrus fruits, tomatoes, broccoli, and peppers) helps the body absorb iron from plant sources. Combining vitamin C rich foods with plant sources of iron is especially important for women who choose a diet that is limited in or does not include red meat or foods from animal sources.

Calcium requirements do not increase during pregnancy. However, many women may not meet the normal requirements of 1000 mg daily (3-4 servings of calcium-rich foods). Drinking milk or eating cheese or yogurt 3 to 4 times a day will help protect women from osteoporosis later in life. Pregnant teens need 1,300 mg of calcium daily. Vitamin D is needed for the body to absorb calcium. Women with darker skin pigmentation or who keep their skin covered should visit with their doctor about supplementation.

To find an eating plan that will help you gain enough but not too much weight and get all of the important nutrients use the MyPyramid Menu Planner for Moms at http://www.mypyramid.gov/mypyramidmoms/index.html.

Pregnancy is a favorable time to improve eating habits. Healthful eating habits that are maintained after pregnancy not only benefit the new mom, but also provide a favorable eating environment in which children learn food preferences and behaviors. It’s a gift that can last a lifetime!

1. American Dietetic Association, American Society for Nutrition. Position of the American Dietetic Association and American Society for Nutrition: Obesity, Reproduction, and Pregnancy Outcomes. J Am Diet Assoc. 2009; 109:918-927.
2. Brown JE. Nutrition Though the Lifecycle. Belmont, CA: Thomas Wadsworth; 2005
3. Duyff RL. American Dietetic Association: Complete Food and Nutrition Guide. Hobeken, NJ: John Wiley & Sons, Ind; 2006.
4. Godfrey DM, Barker DJ. Fetal nutrition and adult disease. Am J Clin Nutr 2000;71:1344S-52S.
5. Kaiser L, Allen LH. Position of the American Dietetic Association: Nutrition and Lifestyle for a Healthy Pregnancy Outcome. J Am Diet Assoc. 2008; 108(3):553-560.
6. USDA. MyPyramid for Pregnancy and Breastfeeding. Available at http://www.mypyramid.gov/mypyramidmoms/index.html. Accessed February 18, 2010.
7. Siega-Riz, AM, Deierlein, A, Stuebe, A. (2011). Implementation of the new institute of medicine gestational weight gain guidelines. Journal of Midwifery & Women's Health. Retrieved May 12, 2011, from http://www.medscape.com/viewarticle/733438_3

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This work is supported by the USDA National Institute of Food and Agriculture, New Technologies for Ag Extension project.