Congratulations on your pregnancy! What an exciting time for you and your family. During this time, what you eat plays an essential role in the development and health of your baby. While all nutrients are important, there are a few key nutrients that we focus on during pregnancy due to their important roles in foetal development.
Folate is a type of B vitamin involved in the development of your baby’s neural tube which happens very early on in pregnancy. As well as getting folate through the diet, it’s recommended to take a prenatal multivitamin containing 400mcg of folic acid, as folic acid supplementation has been proven in preventing Neural Tube Defects (NTD when taken for at least one month prior to conception.
The Recommended Daily Intake (RDI) of folate during pregnancy is 600 micrograms per day which you can get if you are including dietary sources of folate daily and supplementing with a prenatal multivitamin. For most women the supplement dose prior to conception and during pregnancy is 400µg  per day, but this can be higher for women who are overweight, smoke, have medical conditions such as Coeliac Disease or take particular medications such as those for seizures, so it’s a good idea to check your requirements with a prenatal dietitian.
Green leafy vegetables
Iodine is responsible for metabolism, hormone production as well as aiding in healthy brain and nervous system development of your baby. The World Health Organization recommends daily supplementation of iodine in pregnant women. This is because iodine deficiency can cause abnormalities to the foetus, which are preventable by supplementing with iodine, and although you can get iodine from food, many diets don’t include enough for a healthy pregnancy.
During pregnancy, the RDI for iodine is 220µg/day. Iodine comes from the soil, so you can get it from a wide range of foods however, if the soil in your area is depleted of iodine, it can be difficult to meet your increased needs during pregnancy. In some countries such as in Australia, bread is fortified with iodised salt with iodised salt by law to assist with meeting iodine requirements.
Dietary sources: * Legumes
Vitamin D helps to maintain levels of calcium and phosphate which helps build your baby’s muscles and bones. While you can get vitamin D through sunlight, it has been shown that even after 30 minutes of sunlight per day, it won’t be enough to meet the recommended pregnancy requirements.
Deficiencies of Vitamin D have been associated with pregnancy complications such as preeclampsia and gestational diabetes and can also cause low birth weight and bone development problems in babies. It’s beneficial to include foods rich in vitamin D well as sunlight, to meet your RDI of 2000-4000 IU/day. A dietitian will be able to advise you if you need to take a vitamin D supplement on top of your pregnancy multivitamin.
Dairy: e.g cheese, milk, yoghurt
Iron requirements increase substantially during pregnancy, from 18mg/day to 27mg/day due to a 50% increase in blood to supply you and your baby with nutrients and oxygen. Haem iron from animal sources is more readily absorbed in the body than non-haem iron, which comes from plant sources.
Vitamin C found in green, leafy vegetables, potatoes and tomatoes can help you to absorb non-haem iron from vegetarian foods. Iron deficiency anaemia can result in preterm labour, low birth weight and growth problems. Therefore, it is vital to ensure you have adequate iron levels before and during your pregnancy. As high iron levels during pregnancy can also be problematic, be sure to have your iron levels checked before commencing supplementation.
Red meat (haem iron)
Chicken, especially dark meat
Dark green leafy vegetables
Research has shown that zinc during pregnancy can reduce preterm birth by 14% and has roles in immune function, making proteins, and metabolism to ensure adequate growth of your baby. Low levels of zinc may result in reduced labour hormone circulation, increased infections and an increased risk of pre-term birth.
While taking a zinc supplement hasn’t been found to have significant benefits unless you’re deficient, eating a diet rich in zinc is important for your baby’s growth. During pregnancy, the RDI for zinc is 11mg/day which can be achieved by including plenty of zinc rich foods.
DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid) are the main fatty acid components found in omega-3. DHA is the main structural fat in the brain and the eyes, so it is essential during pregnancy. However, there are many other benefits of omega 3 DHA and EPA during pregnancy! Studies have shown that omega-3 during pregnancy may reduce the risk of low-birth-weight babies and may improve mental processing and hand-eye coordination later in life.
Additionally, DHA may decrease the risk of postnatal depression, as well as pregnancy complications such as preeclampsia and preterm birth. It’s recommended that you consume two to three serves of oily fish per week such as salmon to meet your omega 3 requirements of 115mg/day, although current research suggests pregnant women should aim for at least 300mg of DHA daily .
Cold water fish: salmon, tuna, sardines, pacific mackeral
Algal oil (derived from seaweed) for vegan women
During pregnancy choline has a role in foetal growth and brain development. Choline works alongside Vitamin B12 and folate through metabolic processes which is why it’s important to ensure all these nutrients are adequate in your diet. Choline has also shown to play a role in NTDs. A study has shown that despite adequate levels of folate in pregnant women, NTDs may still occur if choline is insufficient. Consuming a diet rich in choline will help you meet your needs of 440mg/day.
Protein is a macronutrient that helps to build your baby’s soft tissue, the placenta and your red blood cells. It also helps to form hair, nails, bones and organs, and is used to create the hormones that regulate every function in the body.
Experts recommend eating between 75 to 100 grams of protein each day, although your specific needs will depends on your body composition (weight and muscle mass). To make that sure you’re getting enough protein, you should include a source of protein with every meal, and snack.
Fish and seafood
So what does 100 grams of protein look like? Here’s an example of what you might eat in a day to meet your protein needs throughout pregnancy:
Breakfast: 2 eggs and 2 slices wholemeal toast = 22g
Snack: Smoothie made with fruit and cow’s milk = 7g
Lunch: Chicken, ½ cup cooked quinoa and veggies = 25g
Snack: Handful of nuts and piece of fruit = 5g
Dinner: Salmon, ½ cup cooked brown rice, veggies = 28g
Desert: Greek yoghurt and berries = 10g
=97 grams protein
Drinking enough water is always important, and during pregnancy your body needs extra hydration to form the placenta and amniotic fluid which feed nutrients to your baby. You also need water for all the extra blood volume and new tissues that you’re building. Pregnant women should aim to drink at least 8-12 glasses of water a day.
A good measurement of hydration is to check the colour of your urine. When hydrated, your urine should be pale yellow to clear. Dark yellow urine is an indication you are not drinking enough water.
When to see a prenatal nutrition specialist
Every woman should consult with a prenatal dietitian at least once during her pregnancy, ideally during the first trimester, to ensure she is eating a diet that will support a healthy pregnancy and foetal development. There is a lot of misinformation on the internet, so being able to get correct advice and tailored nutrition and supplement advice is so important during this exciting and critical time in you and your baby’s life.
Koletzko B, et al. Ann Nutr Metab 2014;65:49-80.