Food and nutrition tips for pregnancy

When you're expecting, it's vital that you have a balanced diet to keep you healthy and to support the growth of your baby. 

However, the guidance on what you can and can't eat when pregnant can be a bit confusing. Here are our tips to make it easier for you.

What should you eat when you're pregnant?

Eating a healthy, balanced diet during pregnancy not only helps your baby grow healthily and gives them the best start in life, but also helps you stay healthy, too.

You don't need to go on a special diet or spend loads of money on food. Instead, your diet should be balanced and consist of the following:

Fruit and vegetables

Eat at least five portions a day. It doesn't always have to be fresh veg - frozen, canned, dried or juiced also counts, and sometimes it's even better than fresh. Just be sure to avoid anything with added sugar or salt, such as fruit in syrup, and remember that while one glass of juice counts as a portion of fruit, any further juice portions do not count towards your five-a-day. 

Read more about fruit and veg: is fresh always best?

Starchy foods (carbohydrates)

These are important for energy, certain vitamins and fibre. They include bread, potatoes, rice, pasta, noodles and breakfast cereals. Choose wholemeal rather than white where possible.

Protein

Foods in this group - which includes meat, fish, poultry, eggs, beans, pulses and nuts - provide you with what your baby needs to grow. You should aim to have two portions of fish each week, one of which should ideally be oily fish, such as sardines, salmon or mackerel.

Dairy products

Foods such as milk, cheese and yoghurt are rich in calcium and contain other essential nutrients. The British Nutrition Foundation (BNF) says it's best to go for low-fat varieties, such as semi-skimmed, 1% fat or skimmed milk, low-fat yoghurts and reduced-fat hard cheese. Dairy alternatives, such as soya drinks and yoghurts, should be unsweetened and calcium-fortified.

Milk myths: eight common cow's milk myths debunked

How many calories do you need when you're pregnant?

The saying that you need to 'eat for two' when pregnant is a myth. You should eat the amount of food that you normally would, even if you're expecting twins or more. 

This means around 2,000 calories a day. The only time you need extra calories is in the final three months of your pregnancy (the third trimester), when you should have an extra 200 calories per day.

This can be surprisingly generous if you use the calories wisely, for example:

• Two slices of wholemeal toast and spread
• Half a grilled chicken breast with salad
• A slice of toast with two tablespoons of baked beans or two to three teaspoons of peanut butter
• A small handful of nuts, seeds and dried fruit
• 150g pot of plain yoghurt and six almonds
• A small can of sardines on toast
• Half an avocado on a small toasted English muffin
• Houmous and a wholemeal pitta bread 

Are we eating too much or are portion sizes unrealistic? Which? investigates

Foods you can safely eat in pregnancy

Cheese

Not all cheeses are safe to eat during pregnancy, but the following are fine:

• Certain soft or semi-soft cheeses These include cottage cheese, mozzarella, feta, cream cheese, paneer, ricotta, halloumi, some goat's cheese and processed cheeses, such as cheese spreads and cheese slices (singles).
• Cooked cheese Cooked soft cheese and goat's cheese is safe as cooking kills bacteria. Make sure it's steaming hot all the way through.
• All hard cheeses, even if they are unpasteurised or blue veined These include hard goat's cheese, stilton, cheddar, red leicester, double gloucester, wensleydale, edam, emmental, gouda, gruyère, jarlsberg and parmesan. Hard cheeses are safe to eat because they contain less water and therefore bacteria is less likely to grow.

Pasteurised dairy

Pasteurised milk and cream are perfectly fine to have in pregnancy, as are yoghurts sold in UK shops, supermarkets and restaurants.

British Lion mark eggs

Eggs produced under the British Lion Code of Practice adhere to strict hygiene and welfare standards and are therefore safe to eat - whether they're cooked, lightly cooked or raw. This also includes most shop-bought mayonnaises and dressings from large retailers because these contain pasteurised eggs. Check the label to make sure.

Non-British eggs can be eaten but should be cooked until the whites and yolks are solid to kill any salmonella bacteria.

Some fish

Apart from the fish outlined in the 'Foods to avoid in pregnancy' section (below), fish is a great source of nutrients during your pregnancy.

Cooked meat

If you are eating meat or poultry, make sure it's cooked well so there's no pink meat or blood left (no rare steaks, for example). Poultry, such as chicken or turkey, pork, sausages and minced meat (including meatballs and burgers) should be cooked thoroughly. 

It's fine to eat cold cooked meats, such as chicken, beef and turkey, or pre-packed meats, such as ham, but check the label for salt levels and choose ones that are lowest in salt if possible. 

Peanuts

Pregnant women used to be advised to avoid peanuts during pregnancy if there was a history of allergies in their immediate family because it was thought this might increase a baby's chance of developing a peanut allergy. 

However, research now suggests this isn't the case. If you want to, you can eat peanuts or foods containing them (such as peanut butter), unless you are allergic to them.

Foods to avoid in pregnancy

Non-British Lion mark eggs

• Raw or undercooked hen eggs NOT produced under the British Lion code
• Raw or undercooked quail eggs, duck eggs and goose eggs
• Eggs from outside the UK

Raw eggs from this list may still have been used in recipes such as restaurant-made or homemade soufflés, mousses, mayonnaises and some ice creams, so check if they have been made using UK Lion eggs.

Some cheeses

While some cheese is safe to eat during pregnancy, others should be avoided, including:

• Soft cheeses with white rinds These include brie, camembert and goat's cheese such as chèvre
• Soft blue-veined cheeses For example, danish blue, gorgonzola and roquefort

The reason these should be avoided is that they can contain listeria bacteria that can cause listeriosis, which is extremely serious in pregnancy. It's fine if these cheeses have been cooked all the way through as this kills any bacteria.

Unpasteurised milk and cream

Pasteurisation kills bacteria and prevents food poisoning by heat-treating the food. If you use unpasteurised or 'raw' milk (whether it's cows', goats' or sheep) and 'raw' cream sold in places such as farmers markets and farm shops when pregnant, you might end up getting ill.

In England, unpasteurised milk and cream must carry a warning saying they've not been heat-treated and may contain harmful bacteria, while in Wales additional warning must be given for vulnerable groups (including pregnant women). Drinking raw milk and cream is banned in Scotland.

Some types of fish

Some fish need to be avoided altogether when you're pregnant, while others need to be limited or eaten with care.

• Shark, swordfish and marlin These should be avoided when you're pregnant or trying to conceive because they contain high levels of mercury, which can harm an unborn baby's developing nervous system.
• Raw fish and wild fish should be eaten only under certain circumstances. Wild fish caught at sea or in UK rivers, such as wild Atlantic salmon, can sometimes contain harmful bacteria and parasitic worms. If you are going to eat raw fish, wild fish or sushi, the Food Standards Agency advises freezing the fish before eating and/or cooking thoroughly to kill any parasitic worms or bacteria that may be present. 
• Sushi that is made from farmed fish, such as farmed salmon, can be eaten because it's very unlikely to contain parasites.
• Certain oily and non-oily fish Although you don't need to avoid oily fish, you should limit how much you eat because it can also contain mercury. This is also the case for certain non-oily fish including dogfish, sea bass, sea bream, turbot, halibut and crab. You shouldn't have more than two portions of these a week.
• Tuna You should also limit how much canned and fresh tuna you eat. Aim for no more than two fresh tuna steaks (around 140g cooked or 170g raw) and no more than four medium-sized cans (around 140g per can when drained) a week.

Raw, undercooked or cured meat

Raw and undercooked meat can contain parasites that cause toxoplasmosis, so it's best to avoid them.

Raw cured meats, such as parma ham (prosciutto), salami, chorizo and pepperoni, should also be avoided during pregnancy. At home, cooking these meats can help, and freezing cured or fermented meats for four days will reduce the risk from parasites. However, when you're eating out, you won't always be able to confirm whether meats have gone through the freezing process, so you might want to avoid them to be on the safe side.

Liver and pâté

Liver and products made from liver can contain high levels of vitamin A, which could harm your baby, so they should be avoided altogether. Pâté should also be avoided as it may contain listeria bacteria, which can cause listeriosis.

What to drink during pregnancy

It's important to keep hydrated during pregnancy for both you and your developing baby's health. However, some beverages should be consumed in lower levels than others.

Pregnancy and baby charity Tommy's recommends drinking six to eight medium (200ml) glasses of water or fluid a day, equating to around 1.6 litres. It says the following count:

• Water
• Hot drinks such as decaffeinated tea and coffee
• Fruit teas
• Fresh fruit juice (stick to one glass a day)
• Skimmed, semi-skimmed or whole milk
• Plant-based 'milk' 

Drinks to avoid during pregnancy

Caffeinated drinks

As well as in coffee, caffeine can be found in tea, green tea, chocolate, some sports and energy drinks, and some cold and flu remedies. Very high levels of caffeine in pregnancy have been linked to low birth weight in babies, as well as there being a slight risk of caffeine causing miscarriage. 

Caffeine intake should be limited to around 200mg per day - roughly two mugs of instant coffee - but if you occasionally drink more than this you shouldn't worry as the risks are very small.

Fizzy drinks

As well as some of these containing caffeine (such as cola drinks), fizzy drinks or drinks labelled 'juice drinks' should be kept to a minimum as they are high in sugar. 

Alcohol

The UK's Chief Medical Officer recommends: 'If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum. Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink the greater the risk.'

If you've only drunk a small amount of alcohol before you knew you were pregnant or during pregnancy, the risk of harm to your baby is likely to be low, but you should avoid further drinking and talk to your doctor or midwife if you are worried.

Herbal and green teas

Although these might strike you as harmless because they're natural, the fact is there's lots we don't know about the safety of these infusions in pregnancy.

The Food Standards Agency suggests drinking no more than four cups a day and to stick to those made with ingredients you'd normally find in your diet, such as blackcurrant or mint. If you're unsure, speak to your GP or midwife.

Coping with morning sickness

It's very common to have sickness and nausea - morning sickness - in your first trimester, but it can also continue throughout the pregnancy.

In most cases, it passes by the time you're 16 to 20 weeks pregnant. Although it can be unpleasant (and can occur at any time of the day), in most cases it doesn't put you or your baby at risk.

The best advice is to stay hydrated and to eat a little bit of food when you can to stay well nourished.

Around 1-2% of expectant mothers develop a severe form of pregnancy sickness called hyperemesis gravidarum that may lead to dehydration and malnourishment - sometimes requiring specialist treatment or even hospitalisation. 

Should I take supplements during pregnancy?

You should be able to get most of the vitamins and minerals you need in pregnancy by eating a balanced diet. However, if you're pregnant or there's a chance you might get pregnant, you'll also need the following:

• Folic acid supplement Take 400 micrograms every day, from before you're pregnant until 12 weeks gestation. This is to reduce the risk of neural tube defects in the early weeks of your baby's development. 
• Vitamin D supplement Take 10 micrograms every day. This is vital for bone development, and most of us don't get enough from sunlight or from dietary sources. This is particularly the case if you cover your skin when outdoors or you have darker skin (for example, if you're of African, African Caribbean or south Asian origin).

A pregnancy multivitamin should contain both of these at the recommended levels, but check the label before you buy and check with your pharmacist if you're unsure. 

Don't take cod liver oil or supplements containing vitamin A (retinol) when you're pregnant, as too much vitamin A could cause your baby harm.

Vitamin D: How much should you take and who's most at risk of deficiency?

Tips for vegetarians and vegans in pregnancy

If you follow a vegetarian or vegan diet you need to ensure you're getting enough of the vital vitamins and minerals needed to support your health and that of your growing baby, including vitamin B12, iron and calcium, as well as vitamin D.

B12 sources for vegetarians include yoghurt, milk, cheese and eggs, whereas vegan sources of B12 only tend to be found in fortified breakfast cereals, fortified dairy alternatives and yeast extracts with B12 added. 

The BNF says you could always take a B12 supplement if you're not getting enough (check with your midwife or doctor first).

Iron for vegans can be found in chickpeas, lentils and other pulses, fortified breakfast cereals, tofu, sprouted beans and seeds, dried apricots and figs and wholemeal, seeded and wheatgerm bread. 

Calcium for vegetarians - vital for bones and teeth - can be found in dairy foods. For vegans it's in dairy alternatives, breakfast cereals, oranges, kale, grains, bread and broccoli.

Vitamin D is only found in a small number of foods so it can be difficult to get enough from diet alone - even from foods that are fortified or naturally contain it. 

As a result, you should consider taking a supplement containing 10 micrograms per day, particularly from October until the end of March. Vegans should check the label to make sure their vitamin D is suitable for their diet.

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