Pregnancy and Diet

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When pregnant, or trying to become pregnant, ideally you should:

• Eat a healthy balanced diet.
• Include foods rich in calcium, folate, and iron.
• Avoid certain foods and drinks which can be harmful to the pregnancy.
• Watch your weight gain and aim to lose weight before becoming pregnant if you are obese.
• Cut right back on drinking if you drink alcohol.
• Take folic acid supplements.

Eat a healthy balanced diet

Eat plenty of starch-based foods (complex carbohydrates)
The bulk of most meals should be starch-based foods (such as bread, cereals, potatoes, rice, and pasta), together with fruit and vegetables. Some people wrongly think that starch-based foods are 'fattening'. In fact, they contain about half the calories than the same weight of fat.

Eat at least five portions of a variety of fruit and vegetables each day
One portion is: one large fruit such as an apple, pear, banana, etc, OR two smaller fruits such as plums, satsumas, etc, OR one cup of small fruits such as grapes, OR two large tablespoons of fruit salad, stewed or canned fruit, OR one tablespoon of dried fruit, OR one glass of fresh fruit juice (150ml), OR a normal portion of any vegetable, OR one dessert bowl of salad.

Eat protein foods in moderation
Meat, fish. pulses, chicken, and similar foods are high in protein. You need some protein to keep healthy, but most people eat more protein than is needed.

Don't eat too much fat
For example: try not to fry much food. It is better to grill, bake, poach, barbecue, or boil food. If you do fry, use unsaturated oil such as corn, sunflower or olive oil. Drain off the oil before eating. Choose lean cuts of meat. Use low fat spreads. Have low-fat milk, cheeses, yoghurts, and other dairy foods rather than full-fat varieties.

Don't have too many sugary foods and drinks
These are high in calories, and too much may cause weight gain.

Try not to eat too much salt
Use small amounts of salt with cooking, and don't add more salt at the table.

Include foods with plenty of iron, calcium and folic acid

• Iron is mainly in red meat, pulses, dried fruit, bread, green vegetables and fortified cereals.
• Calcium is found mainly in dairy products such as milk, cheese, and yoghurt. (Low-fat milk, cheeses and yoghurts usually contain just as much calcium as the full-fat varieties.)
• Folic acid is mainly in green vegetables, brown rice, fortified bread and breakfast cereals.

Avoid foods and drinks which can be harmful to the pregnancy

Don't eat anything with a lot of vitamin A
You need a small amount of vitamin A to keep healthy. However, large amounts can harm an unborn baby. So, avoid:

• liver and liver products such as liver pâté and cod liver oil supplements.
• vitamin tablets or supplements which contain vitamin A.

Don't eat food which may have high levels of listeria
Listeria is a bacterium (germ) which does not usually cause problems in people who are not pregnant. However, pregnant women are more likely to become infected with listeria, and it sometimes causes miscarriage, stillbirth, or infections in the baby after birth. Foods which are most at risk of carrying listeria are:

• undercooked meats and eggs. For example, this may occur in some pre-cooked meats and pre-prepared meals. Make sure all meat foods are cooked until piping hot. Eggs should be cooked until both the white and yolk are solid.
• soft cheeses such as brie. (Hard cheeses and processed cottage cheese are safe.)
• pâtés.
• shellfish and raw fish.
• unpasteurised milk. Note: goat's milk is often unpasteurised, and goat's milk products such as cheeses are often made from unpasteurised milk.

Don't eat fish which may contain a lot of mercury
A high level of mercury can damage the developing nervous system of an unborn baby. So:

• Do not eat shark, merlin, or swordfish.
• Limit the amount of tuna that you eat. You should eat no more than two medium sized cans (drained weight = 140 gm per can), or one fresh tuna steak per week. (This would be about six tuna sandwiches, or three tuna salads per week.)

Don't have too much caffeine
You should limit the amount of caffeine to no more than 300 mg per day. Having a lot of caffeine increases the risk of having a baby with low birth weight, and increases the risk of miscarriage. The main sources of caffeine are coffee, tea, chocolate, cola. Caffeine is also added to some 'energy' drinks and to some cough and cold remedies. As a rough guide:

• One cup of brewed coffee has about 100 mg caffeine.
• One cup of instant coffee has about 75 mg caffeine.
• One cup of tea has about 50 mg caffeine.
• One 50g chocolate bar has about 50 mg caffeine.
• One can of cola has up to 40 mg caffeine.
• One can of 'energy' drink may contain up to 80 mg caffeine.
• Check the label on medicines for quantities of caffeine.

So, you do not have to stop your favourite drinks, but you may need to limit their amount. For example, you will reach the 300 mg limit for one day if you eat two bars of chocolate, drink two cups of tea, and have a cup of brewed coffee.

Consider if you should eat peanuts
If you have an atopic disease such as asthma, eczema, or hay fever, or if a close family member has one of these conditions, then you may wish to avoid eating peanuts when you are pregnant. This may reduce the risk of your child developing peanut allergy in later life (which can be a serious and life-threatening allergy).

This advice about peanuts in pregnancy is precautionary and further research is needed to clarify this issue.

Watch your weight

When you are pregnant, don't 'eat for two' and overeat. Too much weight gain will increase your risk of developing problems with the pregnancy, and extra weight is difficult to lose after the birth. The best way to avoid weight gain is simply to eat a healthy balanced diet detailed above.

If you are already obese or overweight, ideally you should try to lose some weight before becoming pregnant. This is to reduce the risk of pregnancy complications which are more common in obese women. See other leaflets called 'Weight Reduction - How to Lose Weight' and 'Obesity and Overweight'.

Cut right back on drinking if you drink alcohol

If you have one or two drinks of alcohol (one or two units), once or twice a week, it is unlikely to harm your unborn baby. However, the amount of alcohol that is safe in pregnancy is not definitely known. So, many women have little or no alcohol when they are pregnant. It is known that if you drink heavily you have an increased risk of miscarriage, and may cause serious harm to the baby's growth and brain development.

A unit of alcohol is 10ml (1cl) by volume (8g by weight) of pure alcohol. This is about equal to:

• A half-pint of normal strength beer, cider, or lager.
• A pub measure of spirits (25ml), or of fortified wine such as sherry (50ml).
• A small glass (125ml) of wine containing 8% alcohol by volume.

Note: using the above 'rough guide' it is easy to underestimate how much alcohol that you drink. This is because many beers are now strong, and wines are often served in 175ml glasses. Many wines are also stronger than standard (some contain 12-14% alcohol by volume).

If you find it difficult to cut down or stop drinking alcohol, then seek advice and help from your practice nurse or GP.

Take folic acid supplements

You should take folic acid tablets for at least the first 12 weeks of pregnancy - even if you are healthy and have a good diet. Folic acid is a vitamin which occurs naturally in certain foods. However, you need a good supply of folic acid when you are pregnant. If you take folic acid tablets in early pregnancy you reduce the risk of having a baby born with a spinal cord problem such as spina bifida. You can buy folic acid tablets from pharmacies.

• You should start taking folic acid tablets before becoming pregnant (from the time you plan to become pregnant). If the pregnancy is unplanned then start taking folic acid tablets as soon as you know that you are pregnant.
• For most women the dose is 400 micrograms (0.4 mg) a day.
• If your risk of having a child with a spinal cord problem is increased then the dose is higher (5 mg a day - you need a prescription for this higher dose). That is, if:
  • you have had a previously affected pregnancy.
  • your partner, or a first-degree relative, have a spinal cord defect.
  • you have coeliac disease (as your intake of folate may be affected by this condition).
  • you are taking medication for epilepsy.
  • you have sickle cell anaemia or thalassaemia.

© EMIS and PIP 2006   Updated: June 2006   PRODIGY Validated

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

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