Prenatal Nutrition Guide — What to Eat & Avoid During Pregnancy

Key Nutrients During Pregnancy

Nutrient	Daily Need	Why It Matters	Best Food Sources
Folic Acid / Folate	600–800 mcg	Prevents neural tube defects (spina bifida)	Leafy greens, legumes, fortified cereals, prenatal vitamins
Iron	27 mg	Prevents anemia; oxygen transport to baby	Lean red meat, spinach, white beans, fortified cereals
Calcium	1,000 mg	Baby's bones and teeth; protects maternal bones	Dairy, fortified plant milk, sardines, tofu, kale
DHA (Omega-3)	200–300 mg	Brain and eye development	Salmon, sardines, trout, DHA-enriched eggs, algae supplements
Vitamin D	600 IU	Calcium absorption, immune function	Fatty fish, fortified milk, egg yolks, sunlight
Iodine	220 mcg	Thyroid function; fetal brain development	Iodized salt, seafood, dairy, prenatal vitamins (check label)
Choline	450 mg	Brain and spinal cord development; often low in prenatal vitamins	Eggs (especially yolk), chicken, fish, beans
Vitamin C	85 mg	Immune function; triples iron absorption from plants	Bell peppers, citrus, strawberries, broccoli
Magnesium	350–360 mg	Reduces leg cramps; blood pressure regulation	Nuts, seeds, whole grains, leafy greens, dark chocolate

Fish & Seafood: What's Safe?

🐟 Aim for 2–3 servings per week of low-mercury fish — they're among the best foods for fetal brain development (DHA). The concern is mercury, not fish itself.

Category	Fish / Seafood	Recommendation
Best choices	Salmon, sardines, trout, herring, anchovies, shrimp, canned light tuna, tilapia, catfish, cod	2–3 servings/week
Good choices	Albacore (white) canned tuna, halibut, mahi-mahi, carp, snapper	1 serving/week
Avoid completely	Shark, swordfish, king mackerel, tilefish (Gulf of Mexico), bigeye tuna	Do not eat during pregnancy
Raw fish	Sushi (raw fish), ceviche, oysters, clams, smoked seafood (unless in a cooked dish)	Avoid — risk of listeria and mercury

Foods to Avoid During Pregnancy

🥩 Raw / Undercooked Protein

Raw or undercooked meat, poultry, or seafood (risk: toxoplasma, salmonella, E. coli)
Deli meats and hot dogs (risk: listeria) — safe only if heated to steaming
Raw or undercooked eggs, runny yolks, homemade Caesar or hollandaise
Unpasteurized products: soft cheeses (brie, camembert, queso fresco), raw milk, unpasteurized juice

🌿 Produce & Other

Raw sprouts (alfalfa, clover, radish, mung bean) — high listeria risk even when washed
Unwashed produce — wash all fruits and vegetables, even pre-bagged salads
Herbal teas in excess — some herbs (blue cohosh, pennyroyal) can trigger contractions
High-dose vitamin A supplements (retinol form) — teratogenic above 10,000 IU/day

☕ Caffeine Limit

ACOG recommends keeping caffeine under 200 mg/day during pregnancy.

8 oz brewed coffee: ~95–200 mg
8 oz black tea: ~47 mg
12 oz cola: ~34–45 mg
1 oz dark chocolate: ~12 mg
Energy drinks: highly variable — read labels

🍷 Alcohol

No amount of alcohol is confirmed safe during pregnancy. Alcohol crosses the placenta and can cause fetal alcohol spectrum disorders (FASDs) — the leading preventable cause of intellectual disability and birth defects.

This includes wine, beer, cocktails, and kombucha with detectable alcohol.

Eating for Morning Sickness

What Helps

Eat before getting out of bed — keep crackers at your nightstand; low blood sugar worsens nausea
Small, frequent meals every 2–3 hours; empty stomach worsens symptoms
Ginger — ginger tea, ginger chews, ginger ale made with real ginger; shown in trials to reduce nausea
Vitamin B6 (pyridoxine) 25 mg three times daily — ACOG first-line recommendation; often combined with doxylamine (Unisom)
Cold or room-temperature foods — strong smells trigger nausea; cold foods have less aroma
Bland foods — BRAT diet (bananas, rice, applesauce, toast), protein-rich snacks, broth
Avoid triggers — identify and avoid food smells that trigger nausea (common: meat, coffee, eggs)

If you cannot keep any food or fluid down for 24+ hours, are losing weight, or have signs of dehydration — call your OB. Hyperemesis gravidarum requires medical treatment and sometimes IV fluids.

Pregnancy Weight Gain Guidelines (IOM)

Pre-Pregnancy BMI	BMI Range	Recommended Total Gain	Rate (2nd/3rd Trimester)
Underweight	< 18.5	28–40 lbs	~1 lb/week
Normal weight	18.5–24.9	25–35 lbs	~1 lb/week
Overweight	25–29.9	15–25 lbs	~0.6 lb/week
Obese (Class I–III)	≥ 30	11–20 lbs	~0.5 lb/week
Twins (normal BMI)	18.5–24.9	37–54 lbs	~1.5 lbs/week

Most weight gain occurs in the second and third trimesters. First trimester: 1–4 lbs total is typical. Gaining within recommended ranges is associated with better outcomes for mother and baby.