Your Pregnancy Food Guide: What to Know About Nutrition, Cravings & Nausea

At any given point in your pregnancy, you may have a completely different relationship with food. From nauseous and food-averse in the first trimester to ravenous at all hours of the day in the second trimester to experiencing both the weirdest cravings and the worst heartburn ever in your third trimester, your fluctuating appetite can be fairly annoying—and it’s all totally normal.

And through it all, you may be hearing advice from all sides about what other people think you should eat (and what you shouldn’t). But you’ve got enough on your plate already (pun intended), so we talked with experts to get the real, medically-backed advice you need to eat well during your pregnancy.

How many calories to eat while pregnant

The specific number of calories you should eat while pregnant varies depending on your pre-pregnancy weight and BMI, how much weight you’ve gained during pregnancy and what trimester you’re in, says registered dietitian Lyndsay Hall. For example, Hall says, if your pre-pregnancy BMI was 18.5-25 (considered the “healthy” range for adult women), the general guidance is to increase your daily calories by ~350 during the second trimester and ~450 calories during the third trimester. “This is essentially equivalent to an additional snack or a small meal,” Hall says.

But before you start meal planning, keep in mind that every person (and every pregnancy) is different, so you should talk to your doctor about your specific caloric needs based on your own body.

Why is BMI used in pregnancy?

While it's true that there's been recent pushback on using BMI as a measurement of health, it's still the standard for guiding pregnancy weight gain, fetal testing and certain medication dosages during pregnancy, says Dr. Tina Hendrick, board-certified ob-gyn and medical director at Pediatrix Medical Group.

This is especially important when it comes to treating pregnancy complications, since many studies use BMI as their guidelines, she says. It's how your healthcare provider can make sure you're getting the best treatment for your pregnancy according to the latest research. And it's worth noting that your BMI during pregnancy isn't taken into account—it's only your BMI before pregnancy.

What foods to eat while pregnant

So you know you’ll need to increase your daily calories throughout your pregnancy, but the average amount of additional calories isn’t a whole lot. In fact, it might be smaller than you’re expecting (the saying "eating for two" doesn't mean eating twice as much).

And while you have caloric needs for your growing baby, you also have nutritional needs. You don’t need to change your entire diet; just aim to include some key nutrients if you don’t already regularly do so. Specifically, dietitians, nutritionists and ob-gyns say your pregnancy diet should include:

• High-fiber foods: Whole grains like whole wheat bread or pasta, popcorn, oats and quinoa; fruits like berries, apples, bananas and oranges; vegetables like carrots, broccoli, artichokes and potatoes; legumes like lentils, beans and peas

• Protein-rich foods: Meat, eggs, cottage cheese, Greek yogurt, peanuts and peanut butter, pumpkin seeds

• Healthy fats: Avocados, cheese, dark chocolate, eggs, salmon, nuts, olive oil, full-fat dairy

• Calcium from dairy or calcium-fortified non-dairy alternatives

Eating a variety of foods from each of these categories every day ensures that you're meeting all of your macronutrient and micronutrient needs to support a healthy pregnancy (in addition to taking your prenatal vitamin), Hall says.

How often should you eat?

Unless advised otherwise by your healthcare provider, three square meals a day is still totally fine for pregnant people, though you may find yourself eating smaller meals and snacks more often throughout the day as your pregnancy progresses in order to keep up with your caloric needs. “I typically recommend eating every three to four hours, or as needed,” Hall says.

But, Hall says, keep in mind that “this might change depending on if there are any co-existing conditions warranting adjustments to [your] eating schedule,” like morning sickness or gestational diabetes.

Just like with caloric intake, the frequency of meals and snacks will vary from person to person and depends greatly on your individual weight gain and what trimester you’re in. But don’t base your entire diet on numbers. “Overall, it's important to utilize hunger and satiety cues as well,” Hall says. “Listen to your body; they're pretty good at directing us when we let them!”

How to eat when you have morning sickness

Growing another human being means you need to consume enough calories to support their adequate growth. But what if you just don’t want to eat? Or worse, your nausea and vomiting are so bad that you can’t keep anything down?

The expert advice: think small. Hall suggests eating small meals very frequently, along the lines of every two to three hours, “as smaller amounts of food are more tolerable and easier to consume when you're not feeling very hungry and your stomach is unsettled.”

She says to try to choose calorie-dense foods so you can pack as many calories in the smallest portion possible. These include nuts and seeds (or nut/seed butters), avocado, olive oil (drizzle over a light salad, for example), cheese, and higher-fat milk and yogurt.

Hall suggests making smoothies, too. They’re a great way to combine many of those foods into one compact, easy-to-consume package, and cold foods are likely easier for your stomach to tolerate.

If none of that sounds good to you, or you’re having a tough time eating that frequently, don’t worry about it too much. The main goal is to make sure your body is getting enough calories to help your baby grow at an adequate rate. “I encourage those with severe nausea and vomiting to eat what appeals to them,” says Dr. Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive services at Yale University School of Medicine. “If the only thing you want is chocolate cake, by all means eat the chocolate cake. The quantity of calories is more important than the quality in this circumstance.”

If your pregnancy-related nausea lasts longer than the first trimester and you’re still not able to keep food down after that point, it’s time to talk with your doctor, Hall says. You might have hyperemesis gravidarum (an extreme form of morning sickness), and you might require a prescription medication to help with your symptoms.

How much weight should a pregnant person gain?

In direct relation to how many calories your doctor recommends, the amount of weight you gain while pregnant as well as the rate at which you gain the weight will depend on your pre-pregnancy weight and BMI.

Looking for some quick guidelines? Hall recommends Health Canada’s Pregnancy Weight Gain Calculator. “This resource outlines rate of weight gain, and displays a graph depicting the amount of expected weight gain for each trimester,” Hall says. But keep in mind that while the calculator can give you a rough estimate of what you can aim for, you should base your actual calorie intake on your doctor’s specific advice, especially if you have any pre-existing nutrient deficiencies or develop any complications during your pregnancy.

What happens if you lose weight while pregnant

We'll get this out of the way now: weight loss should not be your goal during pregnancy. We get it, we live in a culture where changing your diet for weight loss is extremely common, and that can sometimes be tough to reconcile with being expected to gain weight while pregnant. But continuing to gain weight (at a healthy rate as suggested by your doctor) is what’s best for the health of you and your baby.

But sometimes, you end up losing weight without meaning to—particularly during the first trimester when it can be hard to keep food down, Dr. Hendrick says. Even if you aren't nauseous or throwing up, you may still have a tough time eating because of food aversions, she says.

But under-eating to the point where you’re at a chronic caloric deficit could lead to complications like anemia for you and low birth weight for baby. The amount of weight lost becomes concerning and potentially problematic when it reaches five to ten percent of your total body weight, Dr. Hendrick says, so if you're worried that you're not eating enough, it's important to keep an eye on your weight outside of your prenatal appointments so you can alert your healthcare provider if the scale starts looking too low.

As always, small and frequent meals are going to be your best friend for keeping first-trimester weight loss at bay. Dr. Hendrick also says to make sure you stay hydrated and remember that having an empty or overly full stomach can make your nausea worse. If you need some extra help getting enough calories, Dr. Hendrick recommends nutrition shakes like Boost to help supplement.

How to deal with pregnancy cravings

First of all, craving particular foods while pregnant is totally normal and usually nothing to worry about (unless you’re craving things that aren’t food, in which case you need to mention it to your doctor; it could be a condition called pica). In fact, one study found that as many as 90% of pregnant people experience cravings at some point. So if you’re suddenly hankering for oddly specific foods, especially in your second trimester, you’re not alone.

Second, indulging occasionally is fine, Hall says. No need to completely ignore those cravings, just don’t go overboard. Keep in mind that you want to gain weight at a steady, healthy rate in accordance with your doctor’s advice, so giving in to a couple slices of pizza or a single pickle won’t harm you, but an entire extra-large combo pizza and a whole jar of pickles every week might lead you to gain more weight than necessary for your baby’s growth.

Also, flat-out ignoring cravings could lead you to seek those calories and nutrients elsewhere. If you can curb less-than-healthy cravings with a more nutritional substitute, that’s great. “But it might be more effective to just have that bowl of chips you're craving, rather than try to curb it unsuccessfully with several other snacks,” Hall says.

Is snacking okay while pregnant?

“If you're snacking because you're hungry, then by all means continue to have something," Hall says. And she suggests you reach for protein-rich snacks to keep you fuller for longer. You need to get those calories and at least try to get some good nutrients in there, so snack away!

But if you find yourself snacking without even realizing you’re doing it, or if you’re snacking just out of habit without being hungry at all, then it’s time to break the habit, Hall says. Redirect yourself to another activity that takes the desire for snacking away, or put the snacks out of sight.

And if you’ve absolutely gotta have it, Hall suggests saving evening and late-night snacking for just on the weekends or planning some physical activity around your snack, like walking to the ice cream shop.

Doing what’s best for you

The biggest thing to keep in mind is that what you eat during your pregnancy will likely look a little different from other pregnant people, or even other pregnancies you’ve had. Your nutritional needs, weight gain needs and rate of weight gain all depend on your unique body, so be sure to communicate with your doctor about what you’re eating, and they’ll help you make sure you stay healthy and your baby is growing well.

Sources:

Babylist content uses high-quality subject matter experts to provide accurate and reliable information to our users. Sources for this story include:

• Lyndsay Hall, registered dietician

• Dr. Tina Hendrick, ob-gyn and medical director at Pediatrix Medical Group

• Dr. Mary Jane Minkin, ob-gyn and professor at Yale University School of Medicine

• WebMD: Pregnancy Cravings

• US Department of Health and Human Services: Eat Healthy During Pregnancy

• Cleveland Clinic: 11 High-Fiber Foods You Should Be Eating