Eating while pregnant can be a challenge, from morning all-day nausea to food aversions to heartburn and the different food safety considerations for you and your baby.
I made a few changes to my diet right off the bat, but for the most part I’m focusing on eating when I’m hungry and listening to my body for direction. Here are a few of the food changes I have made:
1) Prenatal vitamin. I’ve been taking one since I signed up for maternity insurance, about 6 months before we started trying to conceive. It’s important to get your iron and folic acid stores to optimal levels before conception. Of course real food is the best source of nutrition, but most doctors and dietitians recommend a prenatal to ensure you’re getting everything you need. I take Whole Foods brand prenatals. They are plant based, have some DHA (from algae), a few bonus nutrients like probiotics and haven’t bothered my stomach at all.
One point to note: I almost always start my day with a boost of calcium from yogurt, milk or the like. Yogurt for lunch or a snack is also a frequent occurrence. Since the body can only absorb so much calcium at once, I take my prenatals with dinner when I’m less likely to eat dairy. This helps distribute the calcium more evening throughout the day.
2) Juice [as well as lots of water!] Juice isn’t something I’d normally keep in the house because I prefer to eat whole fruit that comes with fiber and chewing power. But during the first trimester, I craving OJ out the wazoo. Perhaps because it’s a good source of folate! I discovered early in pregnancy that I wake up so thirsty and a glass of water combined with an energy boost from juice made me feel much better much faster than if I had taken the time to peel an orange and chew it (which at times sounded awful). I also use juice right after a workout (a swig here or there) for a quick replenishment or as a cure for blood sugar-induced insomnia in the middle of the night. Look for juices that are 100% juice with no added sugars if you can and keep the portion relatively small. You just need a boost, not a sugar high!
3) Protein. The average female requires about 0.8 g/kg of protein a day, whereas the requirement during pregnancy jumps to 1.1 g/kg of body weight. I tend to get my protein from dairy, beans, whole grains, cheese, eggs and a small amount of meats at dinnertime. These got me to ~50 grams no problem. But to get to closer to the 70 grams or so that I need during pregnancy, I’ve been focusing on getting more protein with every meal.
Sources I have added include eggs, almonds/nuts, meat (double boost of iron if it’s red!), sardines/fish, extra portions of beans, drinkable yogurt, string cheese and cheese, and the addition of a glass of milk to a meal.
A glass of milk is probably the easiest way to add protein to a meal with about 8 grams per cup. Soy milk is a good plant-based option, but almond and rice milks are much lower in protein (which is why I never drink them).
I bought a few protein powders (either grass-fed whey or plant based. Vega is my favorite plant kind.) but I try to choose real food as a first defense (yogurt, cottage cheese) for a smoothie before turning to protein powder. Good to have in the house though for when you’re running low on fresh things and are totally craving a smoothie.
4) Iron. Iron is very important during pregnancy due to the huge increase in blood volume. During the first trimester, I craved red meat and ground beef like crazy for a few weeks. Pregnant women craving hamburgers are probably more iron and protein cravings than “junk food” cravings (it won’t be junk food if you use good grass-fed beef or bison and keep the portion single-decker and the fries to a minimum!) We had tacos and burgers quite a few times to satisfy those cravings. After a while, my cravings went on to other things (pulled pork for instance!) but I’ve still chosen red meat more than I might normally just for the nutrition.
Leafy greens and beans are the other great iron sources (among other foods) and we try to eat them a few days a week. Note if you’re a vegetarian it’s ideal to consume these with some citrus for optimal absorption of non-heme iron! It’s a good thing I am an omnivore because I couldn’t tolerate the thought of either of these two things in the first trimester, so I was able to get iron from meat.
My prenatal also has 18 mg of iron. I asked my OB if I needed any additional iron supplementation (hoping she’d say no if I’m getting the rest of the 27mg or so that are recommended from food) and she said that my iron was great at my first appointment and they would check it again at 28 weeks when they do the glucose test, so for now I feel good.
5) Calcium. Calcium is a very important pregnancy nutrient! Aim for 1,000 mg a day to ensure your bones don’t get depleted as the baby uses calcium to build bones, teeth, etc. Milk and yogurt are my favorite sources, along with sardines (!) and veggies, but don’t underestimate cheese or ice cream! Choose a natural brand like Breyers All Natural. I was surprised to find that there is less sugar in a half cup of Breyers Vanilla Bean than in a typical fruit on the bottom yogurt! The important thing about ice cream is to keep the portion size small and choose a natural kind (not the loaded-with-candy-bar or processed ingredients kinds!) Bonus if you can find organic/grass-fed milk versions : ) This is one pregnancy craving that I enjoyed to the max.
6) Fats. Fat is important for baby’s brain and nervous system development, so now is not the time to go all fat-free on your diet. Avocados are a great source, and I’ve been trying to buy one a week to incorporate into sandwiches and lunches. Nut butters, olive oil drizzled on a green salad and cheese are also delicious ways to enjoy fats. Twinkies and trans-fats….not so much.
7) Listeria risk + raw cheese. One of the “rules” of pregnancy eating is to avoid deli meats and smoked meats that have an increased risk of containing listeria, a bacteria that can harm a fetus without you even getting sick yourself. This doesn’t mean you can’t ever have turkey or smoked salmon, but it is recommended that you heat it to steaming first. Yeah, I know steamed smoked salmon sounds like an oxymoron, but I’d rather have it steamed than not at all I love it so!
Several people have asked me how I have been able to enjoy goat cheese and blue cheese since soft cheeses are on the no-no list. It’s because it’s really unpasteurized soft cheeses that are not recommended. Here in the USA, those are rare to come by, but they do exist (my beloved goat milk feta cheese is raw, for example). So I just ask restaurants (especially fancy ones) if their cheeses are pasteurized and then you can goat-cheese away!
You can also enjoy sushi!! Just choose cooked versions and stay away from the higher mercury fish (like Yellowfin tuna, which wouldn’t be cooked anyways).
8) EPA + DHA. I’ve looked into taking omega-3 fish oil supplements many times throughout my nutrition career. My decision was finalized when I talked to one of my internship mentors who had been involved in extensive omega-3 research. She shared with me that eating a fish high in these essential fatty acids twice a week was ideal for intake. So when I asked her if she thought I should be taking a supplement, she simply asked me: “Why not just eat more fish?” Duh – that seemed like the obvious solution! Fish is a bit hard to handle in the kitchen. It’s expensive and you have to eat it the same day you buy it for optimal freshness. But canned or frozen wild Alaskan salmon and sardines are cheap and shelf stable, so they are my go-tos for omega-3s.
Since pregnancy, I’ve been trying to eat salmon or other omega-3 fish twice a week. I have to say that this wasn’t always possible (ironically salmon was one fish I could not stand during the first trimester) but now that I’m in the second and feeling much better, both are back on the menu. I’ve been buying frozen wild salmon because it’s easier to manage in our meal plan than fresh, and sardines made a comeback this week. This site was recently sent to me as a great resource to cook fish directly from your freezer. I’d much rather spend my money on a fish that comes with protein, calcium and flavor than an expensive pill I have to swallow everyday. I don’t eat fish as often as I should, but I’m working on it.
[Note: I recently blogged about Barramundi from Whole Foods that my neighbor recommended for its omega-3 content, but I discovered after I had it home that it was from Indonesia. After checking out Seafood Watch and some helpful blog comments, I realized this was not only a poor choice in sourcing but wild Barramundi is high in mercury too! I would not buy this fish again. Shame on Whole Foods for having this fish on their shelves.]
9) Mocktails. The biggest reason why I love alcohol is for the process of drinking it. I love pouring something to sip on while I’m cooking dinner or swirling around ice cubes in a glass at a party. Rather than cut out cocktails, I’ve just replaced alcohol with a variety of mocktails.
From cherries fizzing in sparling water to asking restaurants if they can make me a virgin version of one of their drinks, this has made all the difference in participating in the social aspects of drinking. While a part of me does ache for a potent glass of red wine or a few glugs of a malty and sweet Belgian strong ale, I really haven’t missed the alcohol much at all. My favorite mocktails have been the lemon/lime/simple syrup martinis I’ve had (any bar should be able to make that if you describe it!) and the Spice-a-rita made with limeade at Mono Loco. Better than the original!
10) Caffeine. The research says that 200mg or less of caffeine is safe, but since I had weaned myself off coffee due to its addicting and jittery/headache effects on my body the year before I got pregnant, giving up coffee wasn’t a big change for me. I still drink a cup of black tea nearly every morning (~40 mg caffeine) and have had several cups of real coffee and sodas with no worry because they aren’t part of my daily life. But since it’s easy enough to choose decaf coffee, I usually just opt for that over regular, more because I hate coffee’s effect on my sleep cycle and body than because I’m concerned about the safety.
11) Don’t stress. There were definitely a few days during the first trimester where I ate very poorly. Nothing green, too many carbs, too much sugar. But for the most part, I was able to sneak in nutrients even when I couldn’t stand the thought of them. Take advantage of your cravings and just do the best you can. A prime example: mac and cheese (craving!) with a small amount of greens (on the bottom) and some salmon. I took a comfort food craving and amped it up a bit with pregnancy superfoods.
Another example we had a few times: a meaty tomato sauce with spinach and zucchini (in small pieces!) stirred in over whole wheat pasta. All of those tricks people sneak into kids’ foods – use them on yourself! For a while a green smoothie was the only way I could get in salads at lunch, so I had one everyday for a week!
Now the only kind of salads I like at home are simple greens with lemon juice and a fun topping (like goat cheese! or hummus) so that’s what you’ll find on my plate most.
Many of you wisely told me this in earlier posts, but I’m here to repeat it: don’t stress too much about weight gain either. I had a big gain in weeks 12-16 when I found my appetite back and strong, putting me on the high end of weight gain charts, but I barely gained any in weeks 16-20. I really do believe that everything will balance out so long as you’re making a good effort to eat well. I’m back to eating 3 meals a day plus a snack, swig of juice or dessert here or there, and so far my doctor says my weight gain is right on track: about 10 pounds in 20 weeks.
All in all, pregnancy hasn’t changed my diet that much. Just a few tweaks here or there and a bit more conscious though into getting more of the things I need most.
Please note that while I am a Registered Dietitian, it is important to check with YOUR doctor when you have any questions regarding your pregnancy diet, as individual circumstances may differ from person to person.
) That said, any ole O’s are great for baby munching. 
