Pregnancy Nutrition: Folic Acid, Iron and What to Avoid

What you eat in pregnancy matters for both your own health and your baby's development. This guide answers "what should I eat and what should I avoid?" using the recommendations of trusted health bodies.

Is "Eating for Two" Right?

No. Contrary to popular belief, calorie needs in pregnancy don't rise nearly as much as people assume. According to ACOG:

• No extra calories are needed in the first trimester.
• Around +340 calories a day in the second trimester,
• Around +450 calories a day in the third.

So what matters is the quality of the food far more than the quantity.

Folic Acid: the Most Critical Vitamin

Folic acid is vital in preventing neural tube defects (developmental problems of the brain and spinal cord). The CDC recommends 400 micrograms (mcg) of folic acid a day, starting at least 1 month before pregnancy.

Those who have had a previous pregnancy affected by a neural tube defect may need a much higher dose (4,000 mcg, for example), but this should only be used under a doctor's direction.

Iron and Other Nutrients

• Iron: the daily requirement rises to 27 mg in pregnancy (18 mg when not pregnant).
• Calcium: around 1,000 mg a day.
• Vitamin D: 600 IU a day.
• DHA: around 200 mg a day.

Prenatal vitamins generally contain folic acid, iron, iodine and choline. Always consult your doctor about which supplement to take and at what dose.

Foods to Avoid

Some foods should be avoided in pregnancy because they carry a risk of infection or of toxic substances:

• Fish high in mercury: shark, swordfish, king mackerel and some types of tuna.
• Instead you can eat 8-12 ounces (2-3 portions) of low-mercury fish a week — salmon, prawns, whiting, canned light tuna.
• Unpasteurised milk and soft cheeses, and unheated deli meats: avoid because of listeria risk (the risk of listeria is around 10 times higher in pregnancy).
• Raw or undercooked meat, eggs and fish (sushi), and raw sprouted seeds: risk of toxoplasma, salmonella and listeria.

Caffeine and Alcohol

• Caffeine: ACOG recommends keeping it under 200 mg a day, roughly one cup of coffee. Limits vary between organisations.
• Alcohol: there is no safe amount of alcohol in pregnancy; it should be avoided entirely.

Eating by Trimester

Needs shift slightly in each period: folic acid and fluid intake despite nausea in the first trimester, protein and calcium in the second, and iron and fibre in the third. Eating a balanced and varied diet is the general principle.

Track Your Nutrition and Health Data

Recording your weight, symptoms and the supplements you take through pregnancy makes your check-ups easier. With Baby Wallie you can track your pregnancy week, your health data and your appointments, and put nutrition questions to the Wallie AI assistant.

If you'd like to add regular movement alongside the nutrition, we've set out the two exercises that help most in pregnancy — pelvic floor and breathing work — step by step in our Kegel and breathing exercises guide.

Always consult your doctor about your nutrition plan and supplements. This content is for general information and does not replace medical advice.