Steps for a healthy pregnancy.

EatingWell Editors
July 30, 2009

Steps for a healthy pregnancy.

You're having a baby! Already, things are starting to feel a little out of your control: one minute you're glowing and the next you're nauseated. Half an hour later, you're hit with a sudden undeniable craving for mango. Of course, in the midst of all this, you want to nourish your growing baby with all the nutrients it needs, and you're hungry for information on the best way to do that. How can you be sure you're filling up on the right foods? Is there anything you can eat when morning sickness is making you miserable? Is fish off-limits-or a must-have food for a mom-to-be? How much do you need to eat to grow a healthy baby-but not gain excess fat that will stick around long after delivery? Here's advice on a healthful pregnancy diet, from the nutrition experts at EatingWell.

Get enough folate/folic acid

Folate, a B vitamin found in beans, green leafy vegetables and citrus fruits, plays a critical role in a fetus's development, particularly growth of its nervous system. Research has shown that supplementing with folic acid, the synthetic form of folate, reduces the occurrence of neural tube defects by up to 70 percent. (The neural tube goes on to develop into the baby's brain and spinal cord.) Thus, since 1998, grain products, including breads, cereals and rice, have been fortified with folic acid. Nutrition experts advise pregnant women to get 400 micrograms of folic acid from supplements and fortified foods-in addition to eating folate-rich foods, including spinach, citrus fruits and beans. Taking a prenatal supplement that includes folic acid will help ensure that you're getting enough.

Pump up your iron intake

Your body needs iron to make hemoglobin, a molecule in the blood that carries oxygen to cells throughout your body and to your growing baby. Because the volume of blood in your body increases during pregnancy-it's circulating nutrients to the fetus-your iron needs also increase significantly. The recommended intake for (nonpregnant) premenopausal women is 18 mg per day; during pregnancy, it's 27 mg per day. Iron-deficiency anemia is associated with risk of preterm delivery and may contribute to low iron stores in the baby, so make a point to eat more of foods that are good sources of iron. These include lean red meats, fish, poultry, dried fruits and iron-fortified cereals. The body absorbs animal-based sources of iron, such as beef, more readily than plant-based sources of iron, such as beans and spinach-but consuming a vitamin C-rich food along with a plant-based iron source increases your body's ability to absorb the mineral. So dollop some salsa on those beans!


Eat for one … who is pregnant



Keep moving


Do dairy


Dairy foods are the best sources of calcium. A cup of milk, or a 6-to-8 ounce serving of yogurt, supplies about 300 mg of calcium-so three servings of dairy daily will provide the recommended intake. Some green leafy vegetables, such as kale and collard greens, and canned salmon (bones included) are also good sources. Calcium-fortified foods, such as orange juice, breakfast cereals and soymilk, can also help you get more calcium, especially if you don't eat dairy. If you don't get enough calcium from foods, you may need to take a calcium supplement.

Go fish

Proteins supply the building blocks for your growing baby's tissues, so your needs for this nutrient increase slightly during pregnancy. No need to start blending power shakes: most Americans get more than enough protein, plenty to support a healthy pregnancy. The key is to choose healthful lean proteins that supply very little saturated fat-like fish. Fish offers not only low-fat protein but also good amounts of an omega-3 fat, called DHA, that is crucial for a baby's brain and nervous system development. However, because much of the seafood we consume contains mercury, an environmental toxin that may harm a baby's brain development, the Food and Drug Administration (along with the Environmental Protection Agency) recommends some specific guides for safe seafood consumption during pregnancy. Pregnant women should not eat shark, swordfish, king mackerel and tilefish, large "predatory" fish that tend to accumulate high levels of mercury. They can safely consume a moderate amount (12 ounces or less) of other fish each week-with no more than 6 ounces coming from albacore tuna.

Eat to manage morning sickness

Sad but true: nausea and vomiting are common during the first 12 to 14 weeks of pregnancy. "Morning sickness" can occur at any time-and strikes most often when your stomach is empty. (Problem is, when you're feeling sick, you don't want to fill it.) Bland starchy foods, such as breads or rice, may help because they don't have a strong taste or odor and are easy to digest. What works for one woman may not provide relief for another, but you might try nibbling on dry cereal or crackers (bland!) just to keep a little bit of food in your stomach.

Become a "mocktail" mixer

As you probably know, experts advise avoiding alcohol completely during pregnancy. Alcohol in your blood easily crosses the placenta to your baby, whose liver is not well enough developed to break it down. Drinking alcohol can cause your baby to be too small-and may increase the risk of preterm delivery and miscarriage. It may also affect your baby's heart and brain. Feeling left out while everyone else is sipping cocktails? Whip up one of these delicious mocktails. (They'll also help you stay hydrated-which protects against constipation and dehydration-related fatigue-and provide a dose of healthy phytochemicals.)

Limit caffeine

While all experts agree that alcohol needs to be off-limits when you're pregnant, there is not such a clear consensus on caffeine. Found in a few of our favorite vices, including coffee and chocolate, the stimulant crosses the placenta and can affect fetal heart rate and breathing. Some research links high caffeine intakes with low birth weight and increased risk of miscarriage-but in these studies it's difficult to isolate the effects of caffeine from those of smoking and drinking alcohol. And while large doses of caffeine are associated with birth defects in lab animals, there's no research to support this association in humans. Still, most experts recommend a conservative caffeine approach during pregnancy: cut it out entirely-or at least limit intake to about 300 mg a day, which generally equates to two to three cups of coffee. (Remember, a "cup" is 8 ounces, not the size of the mug you're drinking from.) A cup of tea contains about 40 mg of caffeine; one ounce of dark chocolate has 20 mg.

Carefully evaluate alternative remedies

Often, herbal products are advertised as "natural" remedies for pregnancy-related discomfort, such as morning sickness, and when your stomach never feels settled, anything that promises to cure queasiness sounds fabulous. Be warned: Very few randomized, clinical trials have examined the safety and efficacy of alternative therapies during pregnancy. Many herbal and botanical products may not be safe to take while you're pregnant or breastfeeding. Talk with your doctor before using any herbal products (even herbal teas).

Handle food safely

Pregnant women are more vulnerable to foodborne illness because pregnancy tends to suppress a woman's immune system. Why? So the body doesn't attack the baby, mistaking it for a foreign invader. (Fascinating!) What's more, an unborn baby's immune system is not developed enough to fight off harmful microorganisms, which makes it even more important to take measures that will protect both of you from foodborne "bugs," including Listeria moncytogenes, a bacteria most often found in deli meats and unpasteurized dairy products.

Listeriosis (the name of the illness caused by these bacteria) is particularly worrisome for pregnant women, who represent a third of the 2,500 annual cases. While listeriosis may not at first present as a serious condition-symptoms include fevers, chills, muscle aches and back pain, and strike several weeks after you are exposed to the bacteria-it is. One in five cases is fatal. What's more, this disease can spread to the fetus, leading to preterm delivery, miscarriage or a stillbirth. Experts advise that all pregnant women avoid foods that are most likely to be contaminated by the bacteria, including unpasteurized milk, soft cheeses, such as Brie, blue cheese and feta as well as prepared meats (e.g., hot dogs, bacon and deli meats) unless they are reheated until steaming hot.