A balanced, nutritious diet during pregnancy is important to maintain your health and nourish your fetus. In general, pregnant women need to increase their daily caloric intake by 340 calories in the second trimester and 450 calories in the third trimester.footnote 1
Most women who are pregnant need 2,200 to 2,900 calories a day in their second and third trimesters.footnote 1 If you are carrying twins, triplets, or more, your calorie needs will increase. Talk to your doctor or a dietitian about your daily calorie needs because your needs depend on your height, weight, and activity level.
Your doctor may give you a nutrition plan to follow throughout pregnancy and while breastfeeding. You may also receive a prescription for a vitamin and mineral supplement or a list of recommended nonprescription supplements.
Eating a variety of foods can help you get all the nutrients you need. Your body needs protein, carbohydrate, and fats for energy. Good sources of nutrients are:
- Unsaturated fats like olive oil and canola oil, nuts, and fish.
- Carbohydrate from whole grains, fruits, vegetables, legumes (peas, beans, and lentils), and low-fat milk products.
- Lean protein such as fish that are low in mercury, poultry without skin, low-fat milk products, and legumes.
Eating healthy foods during pregnancy is good for your overall health and for the health of your baby. You may already have a healthy diet, or you may need to make some changes to eat healthier.
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It's also important to eat plenty of fruits and vegetables. These not only give you necessary nutrients but also help you get fiber. Planning your meals can help you add healthy foods to your diet.
Folic acid is a B vitamin. Taking folic acid before and during early pregnancy reduces the chance of having a baby with a neural tube defect or other birth defects.
- Women of childbearing age should get 0.4 mg (400 mcg) to 0.8 mg (800 mcg) of folic acid from fortified food, supplements, or a mix of food plus supplements. This amount is found in most once-a-day multivitamins.
- Women who are pregnant with twins or more should take 1 mg (1000 mcg) of folic acid daily.footnote 1
- Women who have a family history of neural tube defects, who have had a baby with a neural tube defect, or who are on medicines for seizures should take additional folic acid: a daily dosage of 4 mg (4000 mcg) of folic acid is recommended. Do not try to reach this amount of folic acid by taking more multivitamins, because you could get too much of the other substances that are in the multivitamin.
You will need twice as much iron in your second and third trimesters as you did before pregnancy. This extra iron supports the extra blood in your system and helps with the growth of the placenta and the fetus. Your iron requirements are slight during the first trimester of pregnancy, and taking iron supplements in the first trimester may aggravate morning sickness.
After the first trimester, take a daily supplement containing 30 mg of iron (most prenatal vitamins include iron). A woman with a multiple pregnancy is advised to take 60 mg to 100 mg of iron daily.footnote 1 Iron supplements can cause an upset stomach and constipation. Taking your iron at bedtime may decrease the chance of stomach upset. Your body absorbs iron best in small amounts when you eat it with vitamin C, so you may want to take your iron throughout the day.
Calcium is needed for the development of the fetus's skeleton. You can get enough calcium in your diet by eating or drinking 4 servings from the dairy (milk) group each day. Good sources of calcium from nonmilk sources include:
- Greens (such as mustard and turnip greens), bok choy, kale, and watercress.
- Broccoli and cauliflower.
- Tofu that is "calcium-set."
- Corn tortillas made with lime.
- Calcium-fortified orange juice.
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- Cunningham FG, et al. (2010). Multifetal gestation. In Williams Obstetrics, 23rd ed., pp. 859–889. New York: McGraw-Hill.
- Kaiser LL, Campbell CG (2014). Practice paper: Nutrition and lifestyle for a healthy pregnancy outcome. Journal of the Academy of Nutrition and Dietetics, 114(7): 1099-1103. http://www.eatrightpro.org/resource/practice/position-and-practice-papers/practice-papers/practice-paper-nutrition-and-lifestyle-for-a-healthy-pregnancy-outcome. Accessed November 16, 2017.
Other Works Consulted
- American College of Obstetricians and Gynecologists (2013). Weight gain during pregnancy. ACOG Committee Opinion No. 548. Obstetrics and Gynecology, 121(1): 210–212.
- Cunningham FG, et al. (2010). Prenatal care. In Williams Obstetrics, 23rd ed., pp. 189–214. New York: McGraw-Hill.
- Newman RB, Rittenberg C (2008). Multiple gestations. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 220–245. Philadelphia: Lippincott Williams and Wilkins.
- U.S. Preventive Services Task Force (2009). Folic acid to prevent neural tube defects. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsnrfol.htm.
Current as of: February 11, 2020
Author: Healthwise Staff
Sarah Marshall MD - Family Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology
Current as of: February 11, 2020