Healthy eating in pregnancy

Covid-19 guidance for pregnant women and information on what is happening in their regional unit can be found on NI Maternity

Planning to have a baby

All women who could become pregnant, even those not actually trying for a baby, are advised to take a 400µg folic acid supplement every day from before becoming pregnant until the end of the 12^th week of pregnancy.

This will help protect your unborn baby from neural tube defects (NTDs) such as spina bifida. Folic acid is a B vitamin and occurs naturally in many foods, such as broccoli, peas, oranges, parsnips and cabbage. 

Some foods, such as breakfast cereals and breads, are fortified with folic acid. You should try to include these foods in your diet as well. However, on their own, they won’t provide enough folic acid to protect against NTDs.

If you have already had a baby with an NTD, you should discuss this with your GP, as you will need to take a higher dose of folic acid (5mg), which is only available on prescription. If you suffer from diabetes, epilepsy, coeliac disease or are obese, you should also speak to your GP as you may need a higher dose of folic acid.

Healthy eating

During pregnancy, it’s important to eat a healthy, balanced diet and give your baby all the nutrients he or she needs to grow and develop.

Research shows that diet can affect the health of the baby and can also influence a baby’s health into adulthood. If a growing baby is inadequately nourished in the womb, this increases the risk of heart disease, diabetes and high blood pressure in adulthood.

Fruit and vegetable

Try to eat five or more portions of fruit and vegetables a day as these contain important vitamins and minerals, as well as fibre, which help prevent constipation. Eating lots of different fruit and vegetables will help make sure you get the full range of vitamins and minerals, as different varieties contain different combinations. Brightly coloured fruit and vegetables contain lots of vitamins A, C and E. Dark green, leafy vegetables are a good source of iron and folate.

This food group includes fresh, frozen and canned fruit and vegetables (choose fruit canned in juice rather than syrup and tinned vegetables in water, rather than brine). Fresh juice and fruit smoothies and dried fruit count as only one portion a day, no matter how much you have, fruit juices and smoothies are acidic, which can damage tooth enamel, so they are best avoided between meals.

Remember to wash fruit and vegetables thoroughly to remove all traces of soil which may contain toxoplasma. This can cause an infection called toxoplasmosis and can harm an unborn baby.

Bread, rice, potatoes, pasta and other starchy foods

Foods from this group are a good source of energy, fibre and B vitamins.

You should aim to make these foods the basis of meals. Bread, rice, potatoes, pasta and other starchy foods like cereals are low in fat.

It is what you add to them that can add fat, such as butter on potatoes or creamy sauces on pasta. Try to mash potatoes with milk or fromage frais, and choose tomato-based sauces for pasta and rice instead of creamy sauces.

Fibre is helpful in controlling your weight because it is satisfying without adding too many calories, but it has other health benefits such as preventing constipation, protecting against some types of cancer and reducing the risk of heart disease.

Wholegrain varieties of bread, rice and pasta contain lots of fibre, so try to include granary or multigrain breads and high fibre cereals in your diet. Make a point of eating the skin on new potatoes and baked potatoes and trying brown rice or pasta for a change.

Remember, fibre is like a sponge and soaks up water, so make sure you drink plenty of fluids throughout the day (eight to 10 glasses) to allow it to pass through the body easily.

Milk and dairy foods

Milk, yogurt and cheese are important sources of calcium. Choose lower fat varieties, such as semi-skimmed milk, half fat cheddar and low fat yogurts.

Aim for three servings a day of calcium-rich foods, such as:

• a glass of milk
• pot of yogurt
• 25g/1oz of cheese

Milk in sauces and puddings and hot milky drinks are other great ways of getting enough calcium.

Extra calcium is not generally needed for women over 18 years during pregnancy as the body naturally increases the amount of calcium absorbed from food. For young women under 18, their bones are still developing and they will need extra calcium during pregnancy.

Your baby’s bones won’t suffer if there’s a shortage in the supply of calcium. However, some calcium will be taken from the mother’s bones to compensate for the shortage, which will have longer term health consequences for the mother.

All pregnant women are recommended to avoid mould-ripened soft cheese like Brie, Camembert or Stilton, as there is an increased risk of listeria infection.

Meat, fish, eggs, beans and other non-dairy sources of protein

Meat is a good source of protein, vitamin B12 and iron. A diet rich in iron will help prevent iron deficiency anaemia. Make sure all meat is cooked thoroughly to help avoid infection with toxoplasma as this can result in miscarriage.

Fish is a good source of protein. It is recommended that adults eat two portions of fish a week, one of which should be oily. Tinned fish, such as salmon, sardines, mackerel and pilchards contain lots of omega 3 fatty acids and have been proven to benefit your heart health.

White fish like cod, haddock and coley are good sources of protein but are also low in fat.

It is recommended that pregnant women do not have more than two portions of oily fish a week. Shark, marlin and swordfish should be avoided as they may contain high levels of mercury, which could damage the unborn child’s nervous system. Shellfish should be avoided as it can be infected with bacteria and viruses, which can cause food poisoning.

Eggs are a convenient and tasty alternative to meat and are extremely versatile. They can be scrambled, boiled, poached or made into an omelette.

Make sure eggs are cooked thoroughly, until both the whites and yolks are solid, to prevent the risk of salmonella.

Beans, peas and lentils are good vegetable sources of protein. They also contain fibre, B vitamins and iron. They are cheap and can be used to replace some of the meat in casseroles and stews.

Tofu and textured vegetable protein are soya-based products. They don’t have much flavour, so they need to be cooked in dishes with lots of flavour. They can be added to casseroles, curries and stews, or fried and added to salads.

Processed meats and chicken products tend to be high in fat and salt, so try not to eat them too often (once a week at most). If using processed meat products such as chicken nuggets or burgers, grill or bake on a rack rather than frying.

Foods and drinks high in fat and sugar

Eating too much from this food group can cause excess weight gain, which is not advised during pregnancy as it can result in conditions such as high blood pressure.

Use butter and spreads sparingly and go easy on fried food and sugary fatty foods such as cakes, biscuits, chocolate and ice cream. Instead of sugary drinks, try to choose water, milk, tea or coffee. No more than two mugs of coffee a day is recommended as caffeine can cause babies to be born with a lower birth weight and may cause spontaneous miscarriage.

During pregnancy, the average amount of weight gain is 10-12.5kg (22-28 lb). If you are concerned about weight gain, speak to your midwife or GP.

Important vitamins and minerals

Folic acid

All women are advised to take folic acid supplements before becoming pregnant and until at least the end of the 12^th week of pregnancy. However, if you find out that you are pregnant and haven’t been taking the supplement, it’s still worthwhile to start taking folic acid and to keep taking it until the end of the 12^th week of pregnancy.

Iron

When a woman is pregnant, her body automatically adapts to absorb extra iron from food. This is why it’s not necessary for most women to take extra iron during pregnancy. Teenagers often have low intakes of iron, so if they become pregnant they may be at risk of developing iron deficiency.

Iron deficiency anaemia during pregnancy is serious as it can increase the risk of having a very small, light baby. Children born to mothers with iron deficiency anaemia are also more at risk of developing the condition themselves during the first year or two of life. As a result, some women and all teenagers will be advised to take an iron supplement and to eat iron rich foods.

Vitamin C

Pregnant women are recommended to take an extra 10mg of vitamin C every day as it helps to absorb iron. Citrus fruits, tomatoes, broccoli and blackcurrants are all good sources of vitamin C, so try to eat some of these foods at each meal to meet the extra requirements.

Vitamin A

Taking too much vitamin A during pregnancy can harm the unborn baby, so it is important to avoid cod liver oil or supplements containing vitamin A. Women who are pregnant should also avoid eating liver or liver products such as pate, as these are rich in vitamin A.

Vitamin D

It is recommended that pregnant women take an extra 10µg of vitamin D a day. Vitamin D is important for bone development and extra vitamin D is needed during pregnancy to keep your bones healthy and to help provide your baby with enough vitamin D for the first few months after birth.

A deficiency in vitamin D can lead to a condition known as rickets. Only a few foods contain vitamin D. 

These include:

• margarine
• oily fish
• breakfast cereals

One of the best ways to get vitamin D is exposing the skin to sunlight. Supplements are also advised.

Snacking

During the last trimester (three months) of pregnancy, you will need to eat an extra 200 calories every day. Taking one extra snack will be enough to meet the additional requirement. Some healthy snack choices include:

• a sandwich or pita bread filled with grated cheese, lean ham, mashed tuna, salmon or sardines
• vegetable and breadsticks served with hummus or low-fat cream cheese dip
• a bowl of breakfast cereal served with milk
• baked beans on toast
• extra servings of fresh fruit
• natural yogurt with fresh fruit
• a scone with a cup of milk
• cheese and crackers
• yogurt

Allergies

If you would like to eat peanuts or foods containing peanuts (such as peanut butter) during pregnancy, you can choose to do so as part of a healthy balanced diet, unless you are allergic to them or your health professional advises you not to.

The government previously advised women that they may wish to avoid eating peanuts during pregnancy if there is a history of allergy in their child’s immediate family. This includes asthma, eczema, hay fever, food allergy or other types of allergy.

This has now been changed because the latest research has shown that there is no clear evidence to say whether eating or not eating peanuts during pregnancy affects the chances of your baby developing a peanut allergy.

Foods to avoid in pregnancy

There are some foods and drinks you should be careful with or avoid during pregnancy. Find out more at:

• Foods to avoid in pregnancy

More useful links

• Alcohol, smoking and drugs in pregnancy
• Healthy eating for different ages