Pregnant? Diet changes to make right now

A quick-and-easy guide to the nutrients you need and the foods you should eat—and avoid—during pregnancy.
Health.com // Health.com

You're pregnant. Congratulations…and don't panic! If healthy eating hasn't been a habit, don't worry. Now is the perfect time to make a change you (and your family) will benefit from for decades.

And because the first trimester is one of the most important periods of your baby's development, now really means now.

But it doesn't have to be hard or overwhelming. Here are some simple diet changes that will help make pregnancy a happy and healthy time for both of you!

--By Kate Rope, Health.com

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Pick out a prenatal

"The earlier you get on a prenatal vitamin, the better,"says Frances Largeman-Roth, RD, author of Feed the Belly: The Pregnant Mom's Healthy Eating Guide, "because the nutrients in it are essential to the development of your baby's spinal cord and nerves."

In fact, doctors recommend starting a prenatal vitamin as soon as you begin trying to conceive, if possible. But if you haven't yet, get to the pharmacy now. While prenatal vitamins are available by prescription, there are also many inexpensive options over the counter.

Just check the label to make sure that it has 30 milligrams of iron and 600 to 800 micrograms of folic acid, advises Roth.

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Focus on folic acid

Folic acid is a powerhouse nutrient in pregnancy that has been proven to dramatically reduce the risk of serious birth defects and helps with the normal development of all the cells in the body.

Women who are at greater risk for birth defects, for instance those taking anti-seizure medications, will need a prescription for a prenatal with a higher amount of folic acid, says Carl P. Weiner, MD, professor and chair of obstetrics and gynecology at the University of Kansas School of Medicine in Kansas City and coauthor of The Complete Guide to Medications During Pregnancy and Breast-feeding.

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Manage morning sickness

Although nausea during pregnancy feels awful, it won't hurt your baby if you can manage to keep some food and water down. If morning sickness makes it tough to keep your prenatal down, Dr. Weiner recommends taking it at night.

And if your nausea is so severe that you cannot keep your prenatal (or much food) down, Dr. Weiner advises talking with your doctor about anti-nausea medication. You should also tell your doctor about any other vitamin supplements you are taking to avoid taking more than the recommended amount of any one nutrient in pregnancy.

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Fortify with folate

The same folic acid that prenatal vitamins are filled with also comes in foods rich in folate. The B vitamin occurs naturally in many foods including lentils, pinto and black beans, edamame, spinach, asparagus, citrus fruits and juices.

 Other foods are fortified with folate to increase the levels women eat and reduce their chance of having a baby with a birth defect. Enriched choices include cereals (Largeman-Roth likes Total, which comes with 400 micrograms per serving), bread, pasta, and flour (look for the word “enriched” or “fortified” on the label).

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Become an iron woman

The amount of blood coursing through your body increases by 40% during pregnancy, and you need more iron to produce it. But half of pregnant women are not getting enough, says Largeman-Roth, which can lead to anemia. "Severe anemia can cause preterm birth and low birthweight," she says.

Symptoms of anemia include pale skin, an irregular heart rate, cold hands and feet, and dizziness. Plus, it will make you tired. And, let’s face it, there's not a pregnant woman on the planet who needs to feel any more tired than she already does. Make sure your prenatal vitamin contains at least 30 milligrams of iron, and then shoot for another 12 or so in your diet. If you eat meat, it's easy. There are 3.5 milligrams in 6 ounces of sirloin steak and 2 milligrams in a 6-ounce chicken breast. Eggs are another terrific source for meat eaters and vegetarians.

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Pick emergency power foods

If remembering what foods will provide which nutrients gets complicated for you, follow Largeman-Roth's list of pregnancy power foods and work them into your diet as often as you can.

  • Lentils (protein, fiber, and folic acid)
  • Eggs (protein, omega-3s, iron, and choline)
  • Asparagus (folic acid)
  • Citrus fruits (folic acid and vitamin C)
  • Greek yogurt (protein and calcium)
  • Lean meats (iron and protein)
  • Salmon (protein, calcium, and omega-3 fatty acids)
  • Mango (beta-carotene, an antioxidant vital for skin and eye cell growth and immune function)
  • Fortified milk (calcium and vitamin D, which helps absorb it)
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Sober up

Here's a sobering fact to help: "Alcohol is a recognized cause of birth defects and one of the most common causes of mental retardation," Dr. Weiner says. "Though low consumption, for instance a 6-ounce glass of wine every other day, is safe for most women, in some it is enough to injure the fetus."

That's because there are genetic and other factors that can influence how much damage alcohol can do to a developing fetus. Which is why, says Dr. Weiner, "the safest approach is to avoid alcohol completely during pregnancy," which is the official recommendation of American Congress of Obstetricians and Gynecologists (ACOG).

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Cut caffeine

The good news for coffee lovers is that coffee is no longer the big no-no it used to be during pregnancy. "Caffeine has been intensively studied," says Dr. Weiner, "and although there has been harm discovered with extreme consumption, moderate amounts are fine. A cup of coffee or a cola product every 6 to 8 hours is probably safe."

Dr. Weiner says that caffeine can, in rare instances, cause an irregular fetal heart rate, but your consumption would need to be very high, and the problem is not life-threatening and can be treated by stopping the caffeine intake.

ACOG concluded that less than 200 milligrams daily (one to two cups of coffee or three caffeinated sodas) does not raise health risks in pregnancy.

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Don't eat for two

Unfortunately, the old adage "you're eating for two," isn't really right. While it would be nice if these nine months gave you a free pass on almond croissants and milkshakes, "the biggest mistake a pregnant woman can make in her diet," says Dr. Weiner, "is to assume she is eating for two or use her pregnancy as an excuse for a binge."

That's because gaining too much weight in pregnancy can have an adverse effect on a baby by increasing his or her lifelong risk of obesity, heart disease, and diabetes. In fact pregnant women only need 300 extra calories daily (a cup of milk and a half sandwich).

"That really is a challenge for pregnant women," says Largeman-Roth, "because you need a lot of extra nutrients and you can't get them all into that extra 300 calories. So, you need to be smart about your food choices all day."

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