How to Keep a Healthy Diet During Pregnancy: Your Top 8 Questions Answered

A healthy diet is more important than ever when you’re pregnant. The food you eat supports your growing baby and helps you stay strong.

“Pregnancy should be a joyful time and an opportunity to focus on your health,” says Loyola Medicine OB/GYN expert, Leslie Ballard, MD. “Eating the right foods is one of the best things you can do to ensure a healthy pregnancy.”

Here, Dr. Ballard answers the top eight questions soon-to-be moms have about maintaining a healthy diet during pregnancy:

Question 1: How much weight should I gain during pregnancy?

Gaining the right amount of weight during pregnancy can be a challenge. Pregnancy is often portrayed as a time to indulge yourself. But maintaining a healthy diet for two shouldn’t be a free-for-all. Only about 30% of women gain the recommended amount of weight. About 50% gain too much and 20% don’t gain enough.

The risks of not balancing a healthy diet during pregnancy include:

• Low weight gain: If you don’t gain enough weight, your baby may be born too small. Low birth weight babies may have trouble breastfeeding or delays in their development. 
• High weight gain: When you gain extra weight, your baby may grow too large. Risks associated with high birth weight babies include complications during delivery and obesity during childhood. It’s also harder for you to lose weight after you give birth.

The amount of weight you should gain depends on your body mass index (BMI) before pregnancy. BMI is a measure of your body fat based on your weight and height.

The recommended weight gain by BMI are:

• Underweight (BMI less than 18.5): 28 to 40 pounds
• Normal weight (BMI 18.5 to 24.9): 25 to 35 pounds
• Overweight (BMI 25-29.9): 15 to 25 pounds
• Obese (BMI 30 or higher): 11 to 20 pounds

Find out your BMI with this BMI calculator

Question 2: What does a balanced diet during pregnancy look like?

During pregnancy, your nutritional needs change. Protein is especially important during this time. Dr. Ballard recommends two to three servings, or 70 grams, of protein daily. For example, an egg contains about 12 grams of protein while a small chicken breast has about 32 grams.

Women who are considered "normal weight" on the BMI scale (BMI of 18.5 to 24.9) should take in an extra 300 to 400 calories per day. You can make sure you’re getting the right kind of calories by aiming for these recommended daily servings:

• Whole grains: Five to nine servings
• Calcium: Three to four servings
• Vegetables: Four to six servings
• Fruit: Two to four servings
• Fats and oils: Use sparingly
• Sweets: Limited

Getting enough water is also something to strive for, particularly during the summer months. According to Dr. Ballard, the number of ounces of water you should drink each day is equal to your weight in kilograms. For example, if you weigh 150 pounds (68 kilograms), you should drink 68 ounces of water, or 8.5 cups.

“Tracking everything you eat and drink can be overwhelming, especially if you are a busy mom with young children,” says Dr. Ballard. “I usually lay out the basic recommendations and encourage patients to use them as a guide. A food diary can also be helpful.”

Question 3: Do I need more calories in my diet later in the pregnancy?

You should consume slightly more calories in the third trimester, says Dr. Ballard. A good option is to include an additional serving of protein or healthy carbohydrate.

“Keep in mind, your uterus presses on your stomach as it grows. You may need to eat smaller portions more frequently,” she says.

Question 4: Do I need to take prenatal vitamins before and during pregnancy?

Yes, you should be taking prenatal vitamins before and during pregnancy. A prenatal vitamin gives you most of the vitamins and minerals you need during pregnancy that you may not be getting in your diet. In some cases, your doctor may prescribe extra iron if you are anemic.

Folate, or vitamin B-9, is an essential nutrient you need before and during pregnancy. Folate helps reduce the risk of neural tube defects that affect a baby’s spine and brain development. These defects occur very early in pregnancy, usually before you know you’re pregnant.

Getting enough folate is especially important if you:

• Are planning a pregnancy: Take a prenatal vitamin at least two months before becoming pregnant
• Are of reproductive age and having regular unprotected sex: Take a daily prenatal vitamin in the event you do get pregnant
• Have had a child or family members with a neural tube defect: Talk to your doctor about higher levels of folate and when to start taking a supplement

Question 5: Should I see a nutritionist?

A nutritionist is a medical professional trained to help you manage your health through your diet. Most pregnant women don’t need to see a nutritionist. Dr. Ballard recommends nutritional counseling for women with gestational diabetes. 

Gestational diabetes is poorly controlled blood sugar that develops during pregnancy. It can lead to a large baby, cesarean section delivery and high blood pressure (preeclampsia). Nutritional counseling and exercise can help you get your blood sugar back on track if you develop this condition.

Question 6: How can I deal with cravings during pregnancy?

Over half of pregnant women experience cravings. Usually, they start during the first trimester. Doctors aren’t sure why people experience these strong desires for different foods but suggest it may be due to hormones or nutritional deficiencies.

Cravings vary widely but often include unhealthy foods such as ice cream and pizza. Dr. Ballard leads a prenatal group called Centering Pregnancy. She says the best ideas for countering cravings come from the moms in her group. They recommend:

• Limit, don’t eliminate: Don’t tell yourself you’re never going to eat ice cream at 3 am. Limit yourself to once or twice a week. 
• Plan ahead: If you find yourself starving when you come home from work, have a healthy snack waiting. 
• Substitute: Find healthy options to replace your craving. Instead of ice cream, try a glass of milk or yogurt. Instead of five peanut butter cups, try two pieces of dark chocolate.

Question 7: What foods should I avoid during pregnancy?

Some foods are not safe for you or your baby. Foods to limit or avoid include:

• Alcohol: No amount of alcohol is safe for your baby. 
• Caffeine: You can safely enjoy one cup of coffee, tea or another caffeinated beverage daily. 
• Deli meat: Though rare, deli meat contaminated with a type of bacteria called Listeria can cause problems for you and your baby. The risk of Listeria infection is 10 times higher for pregnant women than others. It’s best to avoid deli meat altogether or heat it until it is steaming before consuming. 
• Fish: Fish is an excellent source of protein, iron and omega-3 fats. But some types of fish can have high levels of mercury, a metal that can harm your baby. According to the FDA (Food and Drug Administration), fish to avoid include bigeye tuna, tilefish, shark, swordfish, mackerel, marlin and orange roughy. Limit most other fish to two to three servings per week while pregnant. 
• Sushi: The American College of Obstetricians and Gynecologists recommend avoiding raw or undercooked fish during pregnancy. 
• Unpasteurized dairy: Do not consume unpasteurized milk and cheeses, which may contain harmful bacteria.

Question 8: How can I keep a healthy diet if I have morning sickness?

Morning sickness is common during the first trimester of pregnancy. Dr. Ballard says medications can help. You can also try to identify and avoid your triggers.

For some people, this is a smell or type of food. Other effective strategies include eating smaller meals and choosing bland foods such as bread, rice and apples.

If you have severe morning sickness, you may require admission to the hospital, but that doesn’t happen very often. Most of the time, morning sickness goes away on its own and doesn’t harm the baby, Dr. Ballard says.

OB/GYN care at Loyola Medicine

At Loyola Medicine, you’ll find an integrated approach to women’s health. We offer routine and specialty care for women at all stages of their reproductive life. Our specialists have expertise in the full range of women’s health conditions, such as high-risk pregnancies, infertility problems and urogynecologic issues.

Loyola obstetrics and gynecology services are conveniently located throughout Chicago’s western and southwestern suburbs. To make an appointment, call 888-584-7888 or schedule an appointment online.

Leslie Ballard, MD, is an obstetrician/gynecologist at Loyola Medicine and is board certified in obstetrics and gynecology. Dr. Ballard received her medical degree from the Indiana University School of Medicine. She completed her residency at Loyola University Medical Center.

Dr. Ballard provides comprehensive pregnancy and gynecological care. She specializes in treating vaginal bleeding and surgical management of uterine fibroids. As a physician, Dr. Ballard is most satisfied when she can help a patient who has suffered with a condition for a long time.

Book an appointment today to see Dr. Ballard or another OB/GYN specialist by self-scheduling an in-person or virtual appointment using myLoyola.

Sources:

• CDC — Weight Gain During Pregnancy
• CDC — Facts about Neural Tube Defects
• Frontiers in Psychology — Pickles and ice cream! Food cravings in pregnancy: hypotheses, preliminary evidence, and directions for future research
• FDA — Advice About Eating Fish
• American Pregnancy Association — Deli Meats
• CDC — Listeria: People at Risk – Pregnant Women and Newborns
• ACOG — Morning Sickness: Nausea and Vomiting of Pregnancy