Nutrition During Pregnancy

Pregnancy, or when planning a pregnancy, is a time women often look at their diet and consider nutrition more carefully – a good thing since nutrition plays an important role during pregnancy for both the mother and baby.


 Weight gain during pregnancy

  • How much weight gain is healthy?

You should follow a healthy and balanced diet during your pregnancy and gain the correct amount of weight to ensure the health of your baby.

If before falling pregnant you are:

  • Overweight – you should not gain more than 7 to about 11 kg during your pregnancy.
  • Underweight – you should gain about 12 to 18 kg during your pregnancy.
  • Normal weight – you can aim to gain about 11 to 16 kg during your pregnancy.

Energy (or calorie) requirements during pregnancy

Energy (or calorie) requirements do increase during pregnancy mainly due to your baby’s growth and an increase in your weight.

This additional energy requirement also depends on the level of your physical activity.

Your first 3 months (12 weeks):

  • During the first 12 weeks or 3 months of pregnancy you don’t actually need extra calories.
  • Be aware that you do not need to “eat for two”- this may result in too much weight gain.
  • You could aim to gain about 2 kg in these first few months.
  • It is only from the fourth month or 13th week onwards of pregnancy that your nutritional needs increase.

Four months and onwards:

During the second and third trimester your energy needs will increase but having a healthy, nutritious diet is important.

Choose foods from the following groups:

  • Try to aim for at least 5 portions of fruit and vegetables per day ( 1 portion is equal to one medium sized fruit or half a cup of cooked vegetables)
  • Unrefined carbohydrates which would include wholegrain breads and cereals, pasta, potatoes and brown rice.
  • Remember to include sources of calcium such as milk, cheese and yoghurt.
  • About 6 portions of meat and meat substitutes per day
    • Portion sizes guidelines: 1 meat or meat alternative portion is equal to 30g of meat (chicken, fish, red meat) OR 30g of cheese OR 1 egg OR 2 teaspoons of peanut butter OR half a cup of cooked dry beans.

Essential micronutrients (vitamins and minerals) during pregnancy

  • Vitamin C – found in citrus fruit, kiwi fruit, guavas, strawberries, sweet melon, mango, brussel sprouts, cabbage, peppers and tomatoes.
  • Vitamin K – found in broccoli, eggs, dairy products, cabbage, dark leafy vegetables and lettuce.
  • Iron – found in red meat, eggs, dried fruit, whole wheat products, nuts and legumes.
  • Calcium – found in milk and milk products, nuts, broccoli, sardines with bones, shrimp, salmon, eggs, legumes, cabbage, spinach, sweet potato, oranges.

Remember that calcium from milk products is better absorbed than from plant/vegetable and fruit sources.

  • Folic Acid – found in broccoli, wheat, dry beans, cabbage, asparagus, eggs and lentils.

Essential Fatty Acids

  • Essential fatty acids are important for the growth and development of your baby’s brain and central nervous system.
  • In fact growing evidence indicates that your intake of omega 3 fatty acids is beneficial for your baby’s cognitive and neurodevelopment.
  • Two to three portions of fatty fish per week during pregnancy should provide enough omega 3 fatty acids while you are pregnant.
  • Fish high in omega 3 fatty acids: snoek, salmon, anchovies, sardines, pilchards, herring.

Controversies of eating fish during pregnancy

  • Certain types of fish may contain chemicals that are associated with health risks to mothers and their unborn babies.
  • Fish with high levels of mercury in particular can harm the developing nervous system of an unborn baby.
  • During pregnancy you are encouraged to eat 2 -3 portions of fish per week that is low in mercury but still meets your nutritional needs.
  • Fish low in mercury would include: shrimp, canned tuna (in brine), salmon and snoek.
  • The FDA (Food and Drug Association) recommend that pregnant women avoid swordfish, shark, king mackerel and tilefish because these larger fish tend to have higher levels of mercury than other fish.
  • All fish that is eaten during pregnancy should be well cooked.
  • Avoid eating raw fish.

Keeping your food safe from harmful bacteria during pregnancy and breastfeeding

  • Always wash your hands before preparing food and drinks
  • Wash all vegetables and fruit thoroughly
  • Cook all meat, fish and eggs well before eating
  • Use only pasteurised milk and other dairy products
  • Thaw all foods in the refrigerator and not at room temperature
  • Boil water for one minute at rapid boil if you are unsure of the water source
  • Keep kitchen shelves, counter tops, other utensils, sponges and towels clean at all times
  • Use different cutting boards for preparing raw and cooked foods
  • Use caution when consuming food or beverages outside of the home and when travelling

Foods to avoid during pregnancy

  • Processed cold meats or deli meats unless they are re-heated until steaming hot.
  • Soft cheeses such as Brie, Camembert, Feta and blue veined cheeses unless they are labelled as made with pasteurised milk.
  • Pate or meat spreads that have to be refrigerated. However canned or shelf stable pate or meat spreads can be eaten.
  • Smoked seafood (including smoked salmon) which needs to be kept in the fridge, unless it is an ingredient in a cooked dish.
  • Fish identified as having high levels of mercury such as swordfish, shark, king mackerel and tilefish.

Use of artificial sweeteners during pregnancy

  • Some artificial sweeteners can be transmitted via the placenta.
  • There is however no scientific proof that the sweeteners pose any danger to the baby.
  • It would be considered safe to use artificial sweeteners moderately.
  • It would however be preferable to drink un-sweetened fruit juice, fat free milk or water than artificially sweetened soft drinks.

Caffeine during pregnancy

  • Caffeine should be limited to about 2 cups of coffee per day.
  • Keep in mind that some soft drinks also contain caffeine.
  • If you prefer soft drinks to coffee you can have a maximum of 2 cans (340ml) of caffeine containing soft drinks per day.

Smoking during pregnancy – know the risks

  • Research has shown that smokers are less likely to eat nutritious foods during their        pregnancy than non – smokers which in turn has a negative effect on the babies’ nourishment.
  • Smoking can also inhibit the blood supply to the growing baby and can hamper the functioning of the placenta, subsequently limiting the amount of oxygen to the baby.
  • Nicotine in tobacco is detrimental – it travels freely across the placenta and is harmful to the baby.
  • Tobacco also contains other harmful substances that can lead to the baby suffering from a lack of oxygen. This oxygen shortage is the main cause of oxygen related deaths.
  • The effects smoking can have on the baby:
  • Low weight at birth
  • Spontaneous abortion and premature birth occur more frequently when mothers smoke
  • Nervous system disturbances
  • The sudden infant death syndrome occurs more frequently when mothers smoke
  • Potential death before birth
  • The more often a mother smokes the smaller her baby and the higher the risks of these effects will be.
  • When planning a pregnancy or while pregnant couple should be advised to stop smoking.

Alcohol use during pregnancy – know the risks

  • Consuming alcohol when pregnant can lead to fetal alcohol syndrome (FAS).

Babies who suffer from this syndrome commonly have:

  • low birth weight
  • slow growth
  • impaired mental development
  • eye problems
  • face and skull abnormalities.
  • Spontaneous abortion occurs more often, as well as “abruptio placenta”, which is when the placenta tears away from the womb before birth.
  • The amount of alcohol which every individual can consume before negative effects occur differs from person to person. It is therefore difficult to specify a safe intake for all pregnant women. It is therefore recommended that no alcohol be used during pregnancy.

Digestive discomforts during pregnancy:

Problem Possible Solution Avoid or Limit
Nausea and vomiting
  • Eat small, frequent meals
  • Food is best tolerated at cool or room temperature
  • Eat dry, salty crackers, pretzels and biscuits
  • Simple foods such as rice, scrambled eggs, toast, noodles, bananas, mashed potato and custard may be better tolerated.
  • Clear, cold, non-acidic liquids
  • Low fat foods are better tolerated
  • Be sure to drink enough fluids
  • Allow plenty of fresh air into the house.
  • Disperse cooking odours.
  • Cream soups
  • Fatty or fried foods
  • Sweet desserts
  • Avoid lying down immediately after eating
Feeling full after eating only a little during last trimester
  • Eat healthy and nutrient dense foods.
  • Eat small and frequent meals
  • Discuss supplementation with your health professional
  • Diet or low energy/calorie drinks
  • Regular diet with added fibre
  • Added fibre can be wholegrains, dried fruit such as prunes, fresh fruit and vegetables and added bran
  • Drink enough water
  • Any medications not prescribed by a doctor