Your Guide to Nutrition for Pregnancy by a Prenatal Dietitian

A guide to supporting nutrition for pregnancy through each trimester 

Pregnancy can be a very exciting, but also confusing time! Whether you are pregnant or are interested in learning more about how to support your body during pregnancy, the following information is designed to guide you on how to support nutrition for both you and your baby. It is important to note that everyone’s pregnancy experience is unique! The best thing you can do is listen to your body, honour your hunger, and ensure you are eating enough to support the growth and development of your baby. 

Need personalized support? Contact our pregnancy dietitian specialists to book a free consultation to learn more about our nutrition counselling services.

Nutrition Through the Trimesters: 

First Trimester (Weeks 1-13) 

Welcome to pregnancy! The first trimester can be a time with lots of ups and downs. Some individuals breeze through with minimal symptoms whereas others can experience significant symptoms including nausea, an enhanced sense of smell, changes in taste, changes in appetite, food aversions, and constipation during this time. Fatigue can also escalate, making food preparation more difficult. Following picture-perfect nutrition advice during may feel next to impossible! It is important to be gentle with yourself, lean on support, and aim to eat enough in the day to support yourself and your growing baby.  

A few important nutrition and lifestyle pieces to consider in your first trimester:

1. Start a Prenatal Supplement:

If you have not started a prenatal supplement, now is the time! You want to ensure your prenatal contains at least 400 mcg (0.4 mg) of folic acid as this is important during the first few weeks of development to reduce the chance of neural tube defects. Blood levels of folate fall during pregnancy due to increased red blood cell production and folate needed for baby’s growth and development. Some individuals may need to take higher levels of folic acid during pregnancy. Consult with your care provider to see if this is the case for you.  

2. Keep Up on Hydration

Fluid needs increase during pregnancy. Aim to drink at least 2-3 L of fluids per day. Keep a water bottle close to you so you can sip throughout the day. If drinking water feels tricky, try the following: 

• Take 1 glass of water with your prenatal supplement 
• Add frozen fruit, mint, cucumber, or lemon to water for a flavour boost 
• Soup broth, herbal tea (such as peppermint or ginger), popsicles, and ice chips can also count towards fluid intake! If drinking water is hard to tolerate, try these instead.  

3. Be Mindful of Iron

Risk for iron deficiency increases during each trimester. It is important to do the blood work recommended by your care provider. Signs of iron deficiency include weakness, fatigue, reduced attention span, and reduced appetite. Iron deficiency occurs in ~18% of pregnancies. Aim to try to include high iron foods in your diet such as:

• Meat, poultry, fish 
• Eggs 
• Beans, lentils 
• Nuts and seeds, especially pumpkin seeds 
• Leafy greens 
• Iron fortified cereal  

Consuming a source of vitamin C such as citrus fruit, orange juice, strawberries, kiwis, tomatoes, or bell peppers with your meal can help enhance iron absorption.  

4. Avoid Alcohol

There is no safe level of alcohol to include during pregnancy. Due to the risk of potential harm to your developing baby, it is recommended to avoid alcohol during your pregnancy.  

5. Explore Joyful Movement

Move your body in a way that feels good to you throughout your pregnancy. Explore what feels good for your body! Movement is not only beneficial for your developing baby, but also for you and your mental health. 

How to support yourself with common first trimester discomforts in the first trimester:

Morning Sickness

Which could also be termed “any time-of-day sickness,” typically starts around the fourth to seventh week after your last period and ends by week twenty of pregnancy. Symptoms can vary but typically include nausea, vomiting, dry heaving, food aversions, and/or gagging. To help support morning sickness try the following: 

• Aim to include small frequent meals in the day 
• Try to avoid getting too hungry as it can make nausea worse. Placing a small snack, such as dry crackers beside your bed in the morning may help with ensuring you do not start your day off on an empty stomach. Pack snacks in your bag and aim to eat at least every 3 hours  
• If smells bother you, lean on family or your partner for support with preparing and cooking meals 
• Sometimes drinking fluids with your meal can make things feel worse. Try to keep fluids to before or after meals instead 
• Vitamin B6 may support nausea. Ask your dietitian or care provider for specific recommendations on how much to take  
• Ginger tea, ginger tablets, or ginger candies may help ease nausea  
• Try high carbohydrate, low fat meals and sour or tart liquids, as they are often better tolerated when nausea is present  
• Alternative supports such as acupuncture or sea bands may help reduce nausea 

Constipation

Due to increased levels of progesterone and elevated levels of the hormone, relaxin, gut muscles relax in pregnancy, sometimes resulting in slower movement. This can present as bloating, gas, stomach upset, and/or constipation. Some ways to manage this include: 

• Fibre: aim to include higher fibre foods in the day such as fruit, vegetables, whole grains, nuts and seeds, oats, beans and lentils. If it feels difficult to get in enough fibre you can take a fibre supplement. Ask your doctor or dietitian for specific supplement recommendations.  
• Fluids: aim to get 2-3 L of fluids daily  
• Gentle Movement: walking, gentle stretches, or yoga may help get things moving!  

If your constipation is causing significant discomfort, connect with your doctor to determine ways to help support a regular bowel regime. 

• Eating at least every 3-4 hours. This will likely look like 3 meals and 3 snacks in the day. Generally, you will need an additional 1-2 snacks from your baseline intake during the second trimester.  

• Listen to your body! If you are hungry, honour that and eat.

How to support yourself with common pregnancy discomforts in the second trimester:

Restless Legs and Muscle Cramping:

Can show up at any point in pregnancy. To support yourself, try the following: 

• Incorporate movement into the day, and gentle stretching before bed 
• Aim to include at least 2-3 L of fluids daily 
• For some individuals, magnesium supplementation may help muscle cramping and restless legs at night. Ask your dietitian or care provider before starting a supplement. 
• It has been found that individuals with iron deficiency are more at risk for restless legs at night. Continue to include high iron foods in your diet such as meat, poultry, fish, pumpkin seeds, eggs, leafy greens, nuts, dried fruit, iron fortified cereals, beans, and lentils.  

Third Trimester (Weeks 28-40+)  

You are nearing the finish line. Only about 3 months left in your pregnancy! The third trimester is a period of growth for baby as they start developing more fat and prepare for life outside of the womb. 

A few important nutrition and lifestyle pieces to consider in your third trimester:

1. Hydration

Hydration continues to be important throughout pregnancy. As baby grows, your stomach can be a bit compressed. Because of this, including fluids between meals instead of at meals may be better to allow for more space for food when you are eating.  

2. Meeting your appetite

It is normal for appetite to increase during this time. Your body is signaling to you that it requires additional calories in the day to support the growth of your baby 

• As baby grows, you may feel like you get full sooner. Eating small, frequent meals may feel best, this may look like eating every 2-3 hours  
• Generally, including an extra 2-3 snacks in the day from your baseline intake will help support increased energy and protein needs. Aim for your snacks to include a source of protein such as Greek yogurt, nuts, seeds, milk, roasted chickpeas or lentils, cheese, hummus, and peanut butter  

Some snack ideas include: 

• Pretzels with peanut butter  
• Cereal and milk 
• Trail mix  
• Steamed edamame beans  
• Fruit dipped in a yogurt dip (you can make one by mixing peanut butter butter and yogurt together)  
• An apple with sliced cheese  
• Toast with peanut butter and banana  
• A slice of banana bread and a glass of milk  

How to support yourself with common pregnancy discomforts during the third trimester: 

Heartburn/Reflux

he growing baby pushing upwards on the stomach and diaphragm as well as increased levels of progesterone and relaxin relaxing the muscles of the gut result in heartburn and reflux. To help to support this the following is recommended: 

• Small frequent meals 
• Chew well and take your time with eating  
• Fluids between meals instead of with meals 
• Remain upright for 1-2 hours after eating 
• If you notice reflux at night, you can use a wedge pillow to keep your head upright  
• Everyone has different heartburn triggers. Common triggers include tomato products, citrus, caffeine (coffee, tea, dark chocolate), onions, high fat foods, fried foods, and peppermint  

Swelling:

As pregnancy progresses, the uterus can put pressure on the blood vessels that go to your legs, resulting in swelling in your feet and ankles. Things to help reduce swelling include: 

• Elevating your feet  
• Compression stockings  
• Joyful movement  
• Keep up with your hydration  

• Include foods that contain magnesium and potassium such as bananas, leafy greens, avocado, beans, pumpkin seeds, potatoes, mushrooms, and cucumbers  

Fourth Trimester (baby is here!) 

The fourth trimester involves allowing your body to rest appropriately and nourishing it adequately with enough food and fluid to support recovery after birth. Rest and recovery are vital, regardless of how you gave birth. For more resources on postpartum nutrition, please visit our blog and search “postpartum.” 

Your Top Prenatal Nutrition Questions Answered! 

Do I need to avoid any specific food during pregnancy? 

There are a few foods to be cautious of during pregnancy. These include: 

• Soft Cheese 
• Unpasteurized honey or dairy 
• Deli meat 
• Raw or undercooked eggs 
• Raw or undercooked meat or fish 
• Raw sprouts 
• Any food that may be spoiled 

It is recommended to be cautious around these foods, not because of the foods themselves, but because these foods carry a higher risk of food bourne illness. Listeria is bacteria that can be found in soft cheese, pâté, raw fish, raw sprouts, and unpasteurized milk products. Listeria can survive and grow at refrigerator temperatures. Listeria is dangerous in pregnancy as it can harm the developing fetus. Toxoplasma gondii is a parasite that can be found in raw meat which can lead to toxoplasmosis, an infection that can pass to the fetus It can also be found in cat feces so it is recommended to avoid cleaning litter boxes or gardening (if outdoor cats may be present in your household or your neighbourhood) to minimize your risk. 

Can I drink herbal tea during pregnancy? 

There are certain herbal teas that are not recommended during pregnancy. Avoid pennyroyal, devil’s claw, scotch broom, goldenseal, and sassafras. Common herbal teas that are safe include mint, lemon balm, orange peel, and ginger tea. Red raspberry leaf tea is commonly recommended during pregnancy as it has been suggested to act on the smooth muscles of the uterus and may reduce the length of labour. Unfortunately, there is no consistent evidence that it will shorten labour. If you plan on drinking red raspberry leaf tea, let your provider know to ensure it is safe for you. As for green and black tea, be aware of drinking them in excess due to the caffeine content. It is recommended to stick to less than 200-300 mg of caffeine per day during pregnancy. One cup of black tea contains about 50 mg of caffeine and one cup of green tea contains 30-50 mg of caffeine, so sticking to less than 3-4 cups per day is recommended. 

Can I eat fish during pregnancy? 

Some individuals worry about eating fish due to the mercury content. Generally, it is recommended to limit the consumption of high mercury fish such as shark, swordfish, and tuna to one meal per month. For tuna, choose skipjack or light tuna as it is lower in mercury. Up to two 150 gram cans of skipjack or light tuna can be included per week. Fish can be a wonderful way to get omega-3 fatty acids during pregnancy, which help support baby’s brain development. Including 1-2 servings (4-8 oz) of fatty fish per week such as salmon, trout, mackerel, and sardines is recommended.  

Do I need to worry about my weight? 

Your health care provider will monitor your weight. Weight gain is important in pregnancy. It reflects the growth of the fetus, the placenta, the amniotic fluid, uterus expansion, growth of the breasts, expansion of blood volume, and creation of maternal energy stores to support breast/chest feeding. Your body is working hard to support your baby both during and after pregnancy! Trust that it is growing exactly as it needs. Restrictive dieting during and after pregnancy is not recommended as it can impact baby’s development, postpartum recovery, and breast milk supply. 

Hopefully this information on nutrition for pregnancy provides a good summary of what to focus on during each trimester. If nutrition during pregnancy is feeling overwhelming or you need further support, adding a skilled prenatal Registered Dietitian to your care team can be incredibly supportive to help you move through pregnancy confident in your nutrition!  

Looking for more information on nutrition and pregnancy? Check out these blog posts below: