What to Expect When You’re Expecting by Heidi Murkoff and Sharon Mazel (1984-2004): Food list

What to Expect When You’re Expecting (4^th Edition 2004) is a book to guide you through pregnancy, including food recommendations.

• Get enough nutrients every day – follow the Daily Dozen – protein, produce, whole grains and legumes, vitamin C, calcium, iron, fats in moderation, omega fatty acids, fluids.
• Eat enough calories to supply baby with the needed nutrients and have moderate weight gain during the pregnancy.
• Avoid or limit sugars and processed foods.
• Avoid foods which may have a safety issue for pregnant women.

Below is a description of the food recommendations in the diet.  Pregnancy |  Special diets and food preferences |  Food safety |   Morning sickness and other side effects of pregnancy  |  Multiples |  Diabetic pregnancy  |  Gestational diabetes  |  Breastfeeding  |  Losing weight after pregnancy  |  Preconception.  There’s a lot more in the book.

Use this page as a cheat sheet alongside the book. Send this page to friends, family, and anyone else who you want to understand what you’re eating on this diet.

Get a copy of What to Expect When You’re Expecting for a full explanation of what happens during pregnancy, pregnancy guidelines, what to expect at each stage of the pregnancy, supplementation, exercise during pregnancy, childbirth, breastfeeding guidelines, non-food solutions for pregnancy side effects, portion size guidelines, and more.

Get a copy of the eating plan What to Expect – Eating Well When You’re Expecting for details of why a good diet is good for baby and you, ideas for coping with pregnancy symptoms related to food, weight gain planning, nutritional requirements, strategies for cutting down on empty calories, shopping guidelines, traveling and eating out, substitutions, snack ideas, and lots of recipes.

What to Expect When You’re Expecting diet plan – what to eat and foods to avoid

Pregnancy |  Special diets and food preferences |  Food safety |   Morning sickness and other side effects of pregnancy  |  Multiples |  Diabetic pregnancy  |  Gestational diabetes  |  Breastfeeding  |  Losing weight after pregnancy  |  Preconception

Eating guidelines during pregnancy

General guidelines  |  Weight gain  |  Portion sizes / Daily Dozen  |  What to eat during pregnancy  |  Foods to limit during pregnancy  |  Foods to avoid during pregnancy

General guidelines

• For all your meals and snacks, or at least most of the time, remember that every bite you eat is an opportunity to feed your growing baby with healthy nutrients
• Choose quality of calories over quantity
  • Choose foods that are high in nutrients
  • Because fat has more than twice as many calories per gram as either proteins or carbohydrates, opting often for lower-fat foods will step up your nutritional efficiency
  • Choose lean meats over fatty ones, fat-free or low-fat milk and dairy products over full-fat versions, grilled or broiled foods over fried
  • Select foods that are high in more than one Daily Dozen category, thus filling two or more requirements at once
• Eat a variety of foods, balanced
  • A great lunch isn’t so great if you eat it every single day. A daily assortment of healthy foods will provide your fetus with a daily assortment of necessary nutrients. (An exception to the assortment rule: when you’re suffering from morning sickness, you’ll need to eat whatever you can get down – even if it’s the same sandwich three times a day, seven days a week)
  • Striking a balance – eating the appropriate amounts of foods (both the healthy and the less healthy foods) – is a cornerstone of eating well during pregnancy. Extremes in either direction are never smart
  • Paint your plate with a bold palette of (naturally occurring) colors in the produce department, and you’ll be pleasing your senses while filling your nutritional requirements
• You should eat regularly
  • A fetus can’t thrive by living off your flesh. It needs regular nourishment at regular intervals, and only you can provide it
  • Even if you’re not hungry, your baby is. So try not to skip meals
  • Mothers who eat at least five times a day (e.g. 3 meals plus two snacks or six mini-meals, the “Six Meal Solution”) are more likely to carry to term
• Carbohydrates
  • Don’t drop carbohydrates during pregnancy – eat unrefined carbohydrates for essential B vitamins, trace minerals, protein, and fiber
• Choose unprocessed or less-processed foods
  • E.g. choose fresh roasted turkey breast over smoked turkey, macaroni and cheese made with whole-grain macaroni and natural cheese over that bright orange variety, fresh oatmeal made from rolled oats over the lower-fiber and super sugary instant varieties.
• Have a treat every once in a while
  • Have another nutritional food at the same time (e.g. a slice of banana and some nuts with your ice-cream sundae, burger with a side salad)
  • Keep portions small
  • Don’t feel guilty when you do this
• Read food labels carefully
  • Look at the order of the ingredients listing to see whether the major ingredient in a cereal is a refined grain or a whole grain, and whether the product is high in sugar, salt, fat, or additives. For example, when sugar is listed near the top of the ingredients list or when it appears in several different forms on a list (corn syrup, honey, and sugar), you know the product is chock-full of sugar
  • Checking the grams of sugar on the label will not be useful until the FDA orders that the grams of “added sugar” be separated from the grams of “naturally occurring sugar” (those found in the raisin part of the raisin bran you’re considering, for instance)
  • Nutrition labels, which appear on most packaged products on your grocer’s shelves, can be particularly valuable for a pregnant woman counting her protein and watching her calories, since they provide the grams of the former and the number of the latter in each serving. The listing of percentages of the government’s recommended dietary allowance (called DRIs), however, is less useful because the DRI for pregnant women is different than the DRI used on package labels
  • Watch out for the large print as well as the small print – e.g. when a box of English muffins boasts, “Made with whole wheat, bran, and honey,” reading the small print may reveal that the major ingredient (first on the list) is white flour, not whole wheat flour, that the muffins contain barely any bran (it’s near the bottom of the ingredients list), and that there’s a lot more white sugar (it’s high on the list) than honey (it’s low)
  • “Enriched” and “fortified” are also banners to be wary of. Adding a few vitamins to a not-so-good food doesn’t make it a good food. You’d be much better off with a bowl of oatmeal, which comes by its nutrients naturally, than with a refined cereal that contains 12 grams of added sugar and a few pennies’ worth of tossed-in vitamins and minerals

Weight gain

• Dieting is out – there will be plenty of time after pregnancy to shed any leftover pounds
• Tell your practitioner or a nutritionist about any pre-pregnancy weight loss and discuss with them a game plan for keeping pregnancy weight gain under control
• Since every pregnant woman— and every pregnant body— is different, the formula for pregnancy weight gain can vary a lot
• Your practitioner will recommend the weight gain target that’s right for you and your pregnancy situation (and that’s the guideline to follow, no matter what you read here)
• Generally, weight gain recommendations are based on your pre-pregnancy BMI
  • If your BMI is average (between 18.5 and 26), you’ll probably be advised to gain between 25 and 35 pounds, the standard recommendation for the average-weight pregnant woman
  • If you start out pregnancy overweight (BMI between 26 and 29), your goal will be somewhat scaled back – to somewhere between 15 and 25 pounds
  • If you’re obese (with a BMI greater than 29), you’ll likely be told to tally a total of between 11 and 20 pounds, or perhaps even less than that
  • If you’re super skinny (with a BMI of less than 18.5), chances are your target will be higher than average – upward of 28 to 40 pounds
  • For multiples, extra babies require extra pounds
• Your metabolism, your genes, your level of activity, your pregnancy symptoms (heartburn and nausea that make eating too much like hard work; cravings for high- calorie foods that make gaining too much too easy) all play a role in helping you (or keeping you from) gaining the suggested amount of weight. With that in mind, keep an eye on the scale to ensure that you’re reaching your weight gain target
• A gradual weight gain is best for your body and your baby’s body
  • The rate at which weight is gained is as important as the total number of pounds you gain. That’s because your baby needs a steady supply of nutrients and calories during his or her stay in your womb – deliveries that come in fits and spurts won’t cut it once your little one starts doing some significant growing (as will happen during the second and third trimesters)
  • A well-paced weight gain will also do your body good, allowing it to gradually adjust to the increased poundage (and the physical strains that come with it). Gradual gain also allows for gradual skin stretching (and perhaps fewer stretch marks)
• Semester by semester
  • A good goal for trimester 1 is between 2 and 4 pounds – though many women don’t end up gaining any at all or even losing a few (thanks to nausea and vomiting ), and some gain somewhat more (often because their queasiness is comforted only by starchy, high-calorie foods), and that’s fine, too. For those who start slowly, it should be easy to play weight gain catch-up during the next six months (especially once food starts tasting and smelling good again); for those who begin gangbusters, watching the scale a little more closely in the second and third trimester will keep their total close to target
  • During the second trimester, your baby starts to grow in earnest—and so should you. Your weight gain should pick up to an average rate of about 1 to 1 ½ pounds per week during months 4 through 6 (totaling 12 to 14 pounds)
  • During your final trimester, baby’s weight gain will pick up steam, but yours may start to taper off to about a pound a week (for a net gain of about 8 to 10 pounds). Some women find their weight holding steady – or even dropping a pound or two – during the ninth month when ever-tighter abdominal quarters can make finding room for food a struggle
• There will be weeks when your appetite will rule and your self-control will waver, and it’ll be a rocky road (by the half -gallon) to your weight gain total. And there will be weeks when eating will seem too much of an effort (especially when tummy troubles send whatever you eat right back up). Not to worry or stress over the scale. As long as your overall gain is on target and your rate averages out to that model formula (a half pound one week, 2 pounds the next, 1 the following, and so on), you’re right on track
• If you find that your weight gain has strayed significantly from what you and your practitioner planned (for instance, you gained 14 pounds in the first trimester instead of 3 or 4, or you packed on 20 pounds in the second instead of 12), take action to see that the gain gets back on a sensible track, but don’t try to stop it in its tracks. Dieting to lose weight is never appropriate when you’re pregnant, and neither is using appetite-suppressing drinks or pills (these can actually be very dangerous). Instead, with your practitioner’s help, readjust your goal to include the excess you’ve already gained and to accommodate the weight you still have to gain
• If you gain more than 3 pounds in any one week in the second trimester, or if you gain more than 2 pounds in any week in the third trimester, especially if it doesn’t seem to be related to overeating or excessive intake of sodium, check with your practitioner. Check, too, if you gain no weight for more than two weeks in a row during the 4^th to 8^th months

Pregnancy Daily Dozen – foods to eat / serving sizes

1. Extra calories – You only need on average 300 more calories per day than pre-pregnancy. In the first trimester you don’t need any extra calories as the baby is tiny, in the second trimester you can aim for 300-350 extra calories, and later in the pregnancy you may need upward of about 500 extra calories a day compared to when you weren’t pregnant. If you’re overweight, you can possibly do with fewer calories, as long as you have the right nutritional guidance. If you’re underweight, you’ll need more calories so you can catch up weightwise. If you’re a teen, you’re still growing yourself, which means you have unique nutritional needs. And if you’re carrying multiples, you’ll have to add about 300 calories for each additional baby. You don’t need to count calories – weigh yourself once a week or so, and if your weight gain is going according to schedule (an average of about one pound a week in the second and third trimesters), you’re getting the right number of calories. Maintain or adjust your food intake as necessary, but be careful not to cut out nutrients you need along with calories
2. Protein foods – 3 servings daily – about 75 grams of protein every day. E.g. dairy foods, eggs, fish, shellfish, poultry, meat, vegetarian proteins (legumes, grains, and seeds and nuts)
3. Calcium foods – 4 servings daily – about 1,200 mg a day total, serving size examples in the book. E.g. dairy foods, calcium-fortified foods, canned fish, green leafy vegetables, sesame seeds, blackstrap molasses, cottage cheese, tofu, dried figs, almonds, broccoli, spinach, dried beans, flaxseed
4. Vitamin C foods – at least 3 servings daily, serving size examples in the book. E.g. grapefruit, orange, lemon, citrus juice, mango, papaya, cantaloupe, honeydew melon, strawberries, blackberries, raspberries, kiwi, pineapple, guava, red or green grapes, watermelon, dried vitamin C-rich fruit, plantain, bell pepper, broccoli, tomato, vegetable juice, cauliflower, kale, spinach, kohlrabi, watercress, asparagus, collard greens, mustard greens, turnip greens, romaine lettuce, red cabbage, sweet potato, potato, edamame
5. Green leafy vegetables, yellow vegetables, and yellow fruits – 3-4 servings daily, for vitamin A and beta-carotene; serving size examples in the book. E.g. cantaloupe, apricots, mango, papaya, nectarine, yellow peach, persimmon, pink or ruby-red grapefruit, clementine, freeze-dried yellow fruits, carrots, bamboo shoots, water chestnuts, beets, cucumber, eggplant, Jerusalem artichoke (sunchoke), mushrooms, parsnip, turnip, zucchini, radishes, broccoli, coleslaw, collard greens, Swiss chard, kale, leafy green lettuce (e.g. romaine, arugula, red leaf lettuce, green leaf lettuce), spinach, winter squash, sweet potato, yam, tomatoes, bell pepper, parsley
6. Other fruits and vegetables – 1-2 servings daily, serving size examples in the book. E.g. apples, applesauce, pomegranate, banana, cherries, cranberries, dates, figs, rhubarb, white peaches, pears, pineapple, plums, blueberries, freeze-dried “other” fruits, “other” fruit juices, avocado, green beans, mushrooms, okra, onion, parsnips, zucchini, sweet corn, iceberg lettuce, peas, snow peas
7. Whole grains and legumes – 6 or more servings a day, serving size examples in the book. E.g. whole-wheat, whole-rye, or other whole-grain or soy bread, whole-wheat pita, roll, bagel, wrap, tortilla, English muffin; cooked whole-grain cereal, such as oatmeal or Wheatena; whole-grain ready-to-eat cereal, granola, wheat germ; oats, rye, barley, corn, brown or wild rice, millet, wheat berries, buckwheat, bulgur, couscous, kasha/buckwheat groats, barley, quinoa; whole-grain or soy pasta;  beans, lentils, split peas, edamame; air-popped popcorn; whole-grain crackers or soy crisps; whole-grain or soy flour
8. Iron-rich foods – some daily. Small amounts of iron are found in most of the fruits, vegetables, grains, and meats you eat every day. But try to have some of the following higher-iron-content foods daily: beef, buffalo, duck, turkey, cooked clams, oysters, mussels, shrimp, sardines, baked potato with skin, spinach, collard greens, kale, turnip greens, seaweed, pumpkin seeds, oat bran, barley, bulgur, quinoa, beans and peas, edamame and soy products, blackstrap molasses, dried fruit
9. Fats and high-fat foods – approximately four full (about 14 grams each) or eight half (about 7 grams each) servings of fat each day, depending on your weight gain, serving size examples in the book. Note that fat is vital to your developing baby and it’s dangerous to eliminate all fat from your diet; keeping fat intake moderate is a good idea, especially eating fat with your vegetables to absorb all their nutrients. Note that the fat used in cooking and preparing fat should be counted. E.g. vegetable oil, olive oil, canola oil, sesame oil, butter, margarine, mayonnaise, salad dressing, cream, half-and-half, sour cream, cream cheese, peanut butter, almond butter
10. Focus on foods with omega-3 fatty acids/DHA – e.g. salmon (choose wild when you can) and other oily fish, such as sardines; walnuts; DHA-rich eggs (sometimes called omega-3 eggs); arugula; crab and shrimp; flaxseed; chicken
11. Fluids – at least eight 8-ounce glasses daily – as your baby’s body grows, so does its demand for fluids – e.g. water, milk (which is 2/3 water), fruit and vegetable juices, soups, decaffeinated coffee or tea (hot or iced), bottled plain and sparkling waters, fruit juice cut with sparkling water (half and half) to keep you from pouring on too many calories. Fruit and vegetables count, too (5 servings of produce net 2 fluid servings). If you’re having trouble drinking liquids, munch on some watermelon cubes (1 cup of watermelon provides you with ½ cup of liquid), suck on some ice chips, or slurp some fruit-juice Popsicles. If you’re having trouble keeping solids down but not liquids, consider drinking as many meals as possible (in the form of smoothies and soups)
12. Prenatal vitamin supplements – more details in the book

Foods to eat when you’re pregnant in What to Expect When You’re Expecting

• Proteins
  • Dairy/milk products – pasteurized and refrigerated continuously – e.g. milk, buttermilk, cheese (cottage cheese, grated cheese, hard cheese, ricotta cheese), yogurt – many of these fill calcium as well as protein requirements
  • Eggs, egg whites – not runny – cage-free, preferably DHA-rich eggs/omega-3 egg
  • Fish (low-mercury and fished in uncontaminated waters) – cooked to medium – e.g. anchovies, bass, cod, flounder, haddock, halibut, herring, ocean perch, orange roughy, pollack, red snapper, salmon (wild caught is best), sardines, sole, tilapia, tuna, trout. Canned fish with bones also go towards calcium requirements
  • Shellfish – cooked to medium – e.g. clams, lobster, mussels, oysters, shrimp
  • Poultry – cooked thoroughly – e.g. skinless chicken, duck, turkey
  • Meat (preferably grass-fed) – cooked to medium or above – e.g. lean beef, buffalo, lamb, pork, veal
  • Note that hot dogs, deli meats, and cold-smoked seafood should be heated to steaming before eating
  • Vegan proteins – you don’t have to combine vegetarian proteins, as long as you have some of each type (legumes, grains, and seeds and nuts) every day
• Legumes
  • Legumes count towards protein servings
  • Beans (e.g. black beans, black-eye peas, cannellini beans, Great Northern beans, kidney beans, navy beans, pinto beans)
  • Lentils, split peas, chickpeas/garbanzo beans
  • Peanuts, peanut butter
  • Tofu/bean curd, miso, tempeh, TVP / textured vegetable protein, soy milk, soy cheese
  • Soy pasta, soy bread, soy crisps, soy flour
  • Vegetarian “ground beef”, vegetarian “hot dog”, vegetarian “burger”
  • Edamame (counts towards vitamin C servings)
• Fruits
  • Choose fresh fruits when they’re in season, or nothing-added frozen or canned when fresh are unavailable or you don’t have time to prepare them. Freeze-dried is also nutritious
  • Try to eat some fruit every day, preferably raw
  • Wash well before eating or cooking
  • E.g. apples, apricots, banana, blackberries, blueberries, cantaloupe melon, clementine, cherries, cranberries, dates, figs, grapefruit, grapes, guava, honeydew melon, kiwi, lemon, lime, mango, nectarine, orange, papaya, peach, pears, persimmon, pineapple, plums, pomegranate, raspberries, rhubarb, strawberries, watermelon
  • Dried fruits
  • Fruit juices – pasteurized
  • Fruit puree e.g. applesauce
• Vegetables
  • Choose fresh vegetables when they’re in season, or nothing-added frozen or canned when fresh are unavailable or you don’t have time to prepare them. Freeze-dried is also nutritious.
  • Wash well before eating or cooking
  • Minimize preparation for more nutrition – try to eat some raw vegetables and fruit every day , and when you’re cooking, opt for steaming or a light stir-fry, so more vitamins and minerals will be retained
  • Green leafy vegetables – e.g. butternut squash, bok choy/Chinese cabbage, collard greens, dandelion greens, endive, escarole, kale, leafy green lettuce (e.g. arugula, baby greens, green leaf lettuce, red leaf lettuce, mâche, mesclun greens, romaine, spring mix), mustard greens, spinach, Swiss chard, turnip greens, watercress – when cooked these count towards calcium requirements
  • Non-green vegetables, e.g. asparagus, avocado, bamboo shoots, beets, bell pepper, broccoli, cauliflower, celery, coleslaw, sweet corn, cucumber, daikon, eggplant, fennel, garlic, green beans, iceberg lettuce, Jerusalem artichoke/sunchoke, kohlrabi, leeks, mushrooms, okra, onion, parsnips, peas, potato, pumpkin, radicchio, radishes, red cabbage, rutabaga, scallions, shallots, spinach, snow peas, sweet potato, tomatoes, water chestnuts, winter squash, yam, zucchini
  • Vegetable juices – pasteurized
  • Seaweed (counts towards iron)
• Herbs and spices
  • Herbs – e.g. basil, bay leaves, chives, cilantro, dill, marjoram, mint, oregano, parsley, rosemary, sage, savory, tarragon, thyme
  • Spices – e.g. allspice, black pepper, chili powder, cinnamon, cloves, cumin, curry powder, ginger, nutmeg, paprika, red pepper flakes, turmeric
• Grains
  • Whole grains count towards protein servings
  • Note that starchy foods may help reduce morning sickness
  • To get the maximum benefit, include a variety of whole grains and legumes in your diet
  • Whole-wheat, whole-rye, or other whole-grain bread, whole-wheat pita, roll, bagel, wrap, tortilla, English muffin, corn tortilla
  • Whole-wheat or whole-grain pasta, couscous
  • Whole-grain crackers, crispbreads, brown rice cakes
  • Wheat germ, oat bran
  • Whole-grain cooked cereal such as oatmeal or Wheatena
  • Whole-grain ready-to-eat cereal, granola
  • Whole and minimally processed grains and pseudograins – amaranth, barley, brown rice, buckwheat/kasha, bulgur, corn, millet, oats, quinoa, rye, spelt, wheat berries, wild rice
  • Air-popped popcorn
  • Whole-grain flour
• Fats
  • Vegetable oil, olive oil, canola oil, corn oil, peanut oil (unless you or the baby’s father has a history of allergies), safflower oil, sesame oil
  • Butter, margarine
  • Mayonnaise, salad dressing
  • Cream, half-and-half, sour cream, cream cheese
  • Peanut butter, almond butter
  • These foods are high in fat – you don’t have to officially count them in your total, but you should be aware that eating too many might pile on the extra pounds: cream sauces, full-fat cheese, whole-milk yogurt, nuts and seeds, fatty meats
• Nuts and seeds
  • Nuts and seeds count towards protein servings
  • Raw or dry-roasted, preferably unsalted
  • Nuts e.g. almonds, Brazil nuts, cashews, coconuts, hazelnuts, macadamia nuts, peanuts (unless you or the baby’s father has a history of allergies), pecans, pine nuts, pistachios, walnuts
  • Seeds e.g. flaxseed, pumpkin seeds, sesame seeds, sunflower seeds
• Beverages
  • Water, bottled plain and sparkling waters
  • Milk (which is 2/3 water)
  • Fruit and vegetable juices; calcium-fortified juice (counts towards calcium requirements)
  • Fruit juice cut with sparkling water (half and half) to keep you from pouring on too many calories.
  • Soups
  • Decaffeinated coffee or tea (hot or iced)
• Pantry and condiments
  • Baking powder, baking soda, gelatin, all-fruit preserves, vanilla extract
  • Broth, capers, low-fat coconut milk, hot pepper sauce, mustard, olives, low-sodium soy sauce, Tabasco sauce, tomato puree, vinegar, Worcestershire sauce
• Microwaves are completely safe to use during pregnancy. Precautions to take: Use only cookware that is specifically manufactured for use in the microwave, and don’t let plastic wrap touch foods during microwaving

Foods to limit when you’re pregnant with What to Expect When You’re Expecting

• Caffeine
  • Drinking up to approximately 200 mg of caffeine a day is safe during pregnancy – depending on you take your coffee (black or with lots of milk), that could mean limiting yourself to about 2 cups (give or take) a day
  • Note that you should also keep in mind caffeine from caffeinated soft drinks, coffee ice cream, tea, energy bars and drinks, and chocolate
  • Dark brews sold in coffeehouses contain far more caffeine than homemade; instant coffee contains less than drip does
• Sweeteners / unrefined sugars
  • Honey, fruit juice concentrate
  • Blackstrap molasses (counts towards calcium and iron servings)
  • See “Sugar substitutes” below for a discussion of the safety of sugar substitutes. Safe to eat in moderation – sucralose, sugar alcohols (sorbitol, mannitol, xylitol), lactose (unless you’re lactose-intolerant)
• Salt
  • Don’t avoid salt – a moderate amount of sodium is needed to maintain adequate fluid levels
  • Very large quantities of salt and very salty foods, especially if they’re consumed frequently, aren’t good for anyone , pregnant or not
  • Unless your practitioner recommends otherwise (because you are hyperthyroid, for example), use iodized salt to be sure you meet the increased need for iodine in pregnancy
• Fish moderately high in mercury
  • Chunk light tuna, freshwater fish caught by recreational fishers – limit to an average of 6 ounces (cooked weight) per week
• Saturated fat
  • Coconut oil, palm oil
  • Butter
• Foods preserved with nitrates and nitrites

Foods to avoid when you’re pregnant with What to Expect When You’re Expecting

• Unsafe foods for pregnancy
  • Sushi and sashimi, raw fish, raw shellfish e.g. raw oysters and clams, ceviche, fish tartares or carpaccios, and other raw or barely cooked fish and shellfish
  • High-mercury fish – shark, swordfish, king mackerel, tilefish, and tuna steaks
  • Fish from waters that are contaminated (with sewage or industrial runoff, for example) or tropical fish, such as grouper, amberjack, and mahimahi (which sometimes contain toxins)
  • Poultry that isn’t thoroughly cooked
  • Raw meat or meat cooked to less than medium
  • Raw or runny eggs
  • Unpasteurized milk, milk products, or cheeses, including imported soft cheeses (e.g. feta, goat cheese, blue cheeses such as Roquefort, Brie, Camembert, and soft Mexican-style cheese), unless they have been heated until bubbly
  • Cold hot dogs, deli meats, and cold-smoked seafood (unless heated to steaming)
  • Alfalfa sprouts and other sprouts, which are often contaminated with bacteria
  • Unpasteurized or flash pasteurized juice or cider
  • Herbal teas – see “herbal teas” below
  • Food from place that appear unsanitary
• Alcohol
  • There’s no evidence that a couple of drinks on a couple of occasions very early in pregnancy, when you didn’t even know you were pregnant, can harm a developing embryo
  • However, it would be prudent to avoid alcohol during pregnancy
• Sugar and foods with empty calories
  • Though empty calories are fine once in a while – even when you’re pregnant— they tend to add up a lot more quickly than you’d think, leaving less room in your diet for nutritionally substantial calories
  • Sugar, corn syrup, dehydrated cane juice
  • Instead of using sugar, substitute fruit, dried or freeze-dried fruit, and fruit juice concentrates for sugar when you can
  • See “Sugar substitutes” below for a discussion of the safety of sugar substitutes
• Processed foods
  • These contain a lot of chemicals, fat, sugar, and salt, and are low in nutrition
  • Some canned energy drinks may contain dietary supplements that aren’t safe for pregnancy use
  • Trans fats
  • MSG

Special diets and food preferences

Milk-free  |  No red meat  |  Vegetarian  |  Vegan  |   Low-carb diet  |  Cholesterol concerns  |  Junk food junkie  |  Eating out

Milk-free

• If you’re lactose-intolerant, you still might be able to tolerate some kinds of dairy products, such as hard cheeses, fully processed yogurts (choose ones with active cultures, which actually help your digestion), and lactose-free milk, in which all of the lactose has been converted to a more easily digested form. Another advantage of using lactose-free milk products: Some are fortified with extra calcium. Taking a lactase tablet before ingesting milk or milk products, or adding lactase drops or tablets to your milk, can also minimize or eliminate dairy-induced tummy troubles. Even if you’ve been lactose intolerant for years, you may discover that you’re able to handle some dairy products during the second and third trimesters, when fetal needs for calcium are the greatest. If that’s so, don’t overdo it; try to stick primarily to products that are less likely to provoke a reaction
• If you can’t handle any dairy products or are allergic to them, you can still get all the calcium your baby requires by drinking calcium-fortified juices and eating the nondairy foods listed under calcium foods above (Daily Dozen #3)
• If your problem with milk isn’t physiological but just a matter of taste, try some of the dairy or nondairy calcium-rich alternatives. There are bound to be plenty that your taste buds can embrace. Or disguise your milk in cereal, soups, and smoothies

No red meat

• The only nutrient poultry and fish can’t always compete for with meat is iron (duck, turkey, and shellfish are iron-rich exceptions), but there are plenty of other sources of this essential mineral, which is also easy to take in supplement form

Vegetarian

• Protein – make sure you get enough protein from eggs and milk
• Calcium – get enough calcium, easy to do from dairy products
• Vitamin B₁₂ – Get enough B₁₂, as well as folic acid and iron – ask your practitioner if you need more B₁₂ than what’s provided in your prenatal vitamin. Other dietary sources include B₁₂-fortified soy milk, fortified cereals, nutritional yeast, and fortified meat substitutes
• Vitamin D – found in fortified milk and juices as well as egg yolks, but not nearly enough to prevent a vitamin D deficit. Test your levels and supplement as needed

Vegan

• Make sure you get enough protein from ample quantities of dried beans, peas, lentils, tofu, and other soy products
• Get enough calcium – from calcium-fortified juices (make sure you shake them before using), dark leafy green vegetables, sesame seeds, almonds, and many soy products (such as soy milk, soy cheese, tofu, and tempeh). For added insurance, vegans should probably also take a calcium supplement
• Vitamin B₁₂ – Get enough B₁₂, as well as folic acid and iron – ask your practitioner if you need more B₁₂ than what’s provided in your prenatal vitamin. Other dietary sources include B₁₂-fortified soy milk, fortified cereals, nutritional yeast, and fortified meat substitutes
• Vitamin D – found in fortified milk and juices, but not nearly enough to prevent a vitamin D deficit. Test your levels and supplement as needed

Low-carb diet, or other diet

• Your highest pregnancy priority: getting a balance of all of the best baby-making ingredients, including carbs. As popular as they are, diets that limit carbohydrates (including fruits, vegetables, and grains) limit the nutrients— especially folic acid— that growing fetuses need
• Pregnancy is a time for healthy eating, not for dieting. So shelve those weight-loss books (at least until after you deliver) and stay well-balanced for a well-fed baby

Cholesterol concerns

• Pregnant women , and to a lesser extent non-pregnant women of childbearing age, are protected to a certain degree against the artery-clogging effects of cholesterol
• Cholesterol is necessary for fetal development, so much so that the mother’s body automatically increases its production, raising blood cholesterol levels by anywhere from 25 to 40 percent. Though you don’t have to eat a high-cholesterol diet to help your body step up production, you can feel free to indulge a bit (unless your practitioner advised you otherwise)

Junk food junkie

• Withdraw from your junk food habit
• Move your meals – e.g. have breakfast at home, so you can choose healthier options
• Plan ahead for meals and snacks. Stock your home, work-place, bag, and car with wholesome but satisfying snacks: fresh, dried, or dehydrated fruit, trail mix, soy chips, whole-grain granola bars and crackers, individual-size yogurts or smoothies, string cheese or wedges. So that the soda won’t speak to you next time you get thirsty, keep water at the ready
• Resist temptation – keep candy, chips, cookies, and sugar-sweetened soft drinks out of the house so they’ll be out of reach (if not out of mind). Step away from the pastry case before that Danish makes eye contact with you. Drive the long way home from the office if it means you won’t drive by the drive-through
• Make substitutions, e.g. bran muffin instead of Krispy Kreme, baked tortilla chips instead of Doritos, smoothie instead of ice cream
• Keep your baby on your mind – if you find it helps keep baby-feeding front of brain , put pictures of cute, well-fed babies wherever you might need a little inspiration (and a lot of willpower)
• Know your limits – some junk food junkies can handle a once-in-a-while approach to indulging their cravings, others can’t. If enough junk food is never enough for you – if a snack-size candy bar leads to king-size, if a single doughnut leads to a dozen, if you know you’ll polish off the whole bag of chips once you tear it open – you might have an easier time quitting your habit cold turkey than trying to moderate it
• Once you’ve put the effort into developing healthier eating habits, you might want to consider keeping them. Continuing to eat well after delivery will give you more of the energy you’ll need to fuel your new-mom lifestyle. Plus it’ll make it more likely that your baby will grow up with a taste for the healthier things in life

Eating out

• Look for whole grains before you leap into the bread basket. If there aren’t any in the basket, ask if there are any in the kitchen. If not, try not to fill up too much on the white stuff. Go easy, too, on the butter you spread on your bread and rolls, as well as the olive oil you dip them into, as fat adds up quickly
• Go for a green salad as a first course. Other good first-course choices include shrimp cocktail, steamed seafood, grilled vegetables, or soup
• Look to soups with a vegetable base (particularly sweet potato, carrot, winter squash, or tomato). Lentil or bean soups pack a protein punch, too. In fact, a large bowl may eat like a meal, especially if you toss some grated cheese on top. Generally steer clear of cream soups, and take Manhattan-style when it comes to clam chowder
• Get your protein the lean way (good words to look for: grilled, broiled, steamed, and poached). If everything comes heavily sauced, ask for yours on the side. Don’t shy away from special requests – chefs are used to them, plus it’s hard to turn down a pregnant woman – e.g. ask if your chicken breast can be broiled plain, instead of breaded and pan-seared or if the snapper can be grilled instead of fried
• Be selective on the side, looking for baked white or sweet potatoes, brown or wild rice, legumes (beans and peas), and fresh vegetables
• Consider a fruit finish to your restaurant meal (fresh berries can be surprisingly satisfying). If fruit alone doesn’t cut it (at least not all the time), add whipped cream, sorbet, or ice cream. If you’re craving serious sweets, share a decadent dessert with others at your table

Food safety

Sushi safety  |  Spicy food  |  Spoiled food  |  Sugar substitutes  |  Herbal tea  |  Chemicals in food  |  Fish and mercury  |  Food storage and preparation

Sushi safety

• Avoid raw fish and shellfish during pregnancy, including sushi and sashimi, raw oysters and clams, ceviche, fish tartares or carpaccios, and other raw or barely cooked fish and shellfish
• That’s because when seafood isn’t cooked, there’s a slight chance that it can make you sick (something you definitely don’t want to be when you’re pregnant)

Spicy food

• There’s no risk from spicy foods during pregnancy, and, in fact, since peppers of all kinds (including hot ones) are packed with vitamin C, many of these foods are extra nutritious
• However, you may be more likely during pregnancy to have heartburn and indigestion

Spoiled food

• Check dates carefully before you buy or eat perishables, and, of course, never eat foods that appear to have developed mold
• Though eating dairy products that have recently “expired” is never a particularly good idea, it’s rarely a dangerous one. If you haven’t shown any ill effects from the (symptoms of food poisoning usually occur within eight hours), there’s obviously no harm done

Sugar substitutes

• Though most are probably safe, some research is still inconclusive
• Sucralose (Splenda)
  • This appears right now to be the best bet for pregnant women seeking sweetness with no calories and little aftertaste
  • Keep in mind that moderation’s probably smart. Even though it seems to be safe, the product is relatively new, and no long-term data are available to confirm that
• Aspartame (Equal, NutraSweet)
  • The jury is still out on the safety of this widely used sugar substitute. Many practitioners consider it harmless and will okay light or moderate use in pregnancy. Others are less convinced of its safety and suggest that, until more is known, pregnant women be cautious in their use of this sweetener
• Saccharin
  • Not much research has been done on saccharin use in human pregnancy, but animal studies show an increase in cancer in the offspring of pregnant animals who ingest large quantities of the chemical. Whether a similar risk exists for human offspring is unclear
  • Combined with the fact that the sweetener crosses the placenta in humans and is eliminated very slowly from fetal tissues, most practitioners advise minimizing its use during pregnancy
  • Don’t worry about saccharin you had before finding out that you were pregnant because there are no documented risks
• Acesulfame-K (Sunett)
  • The FDA says it’s okay to use in moderation during pregnancy, but since few studies have been done to prove its safety, ask your practitioner what he or she thinks
• Sorbitol
  • This presents a problem in large doses: Too much can cause bloating, gas pains, and diarrhea
• Mannitol
  • Like sorbitol, it is safe in modest amounts, but large quantities can cause gastrointestinal unrest
• Xylitol
  • This has 40% fewer calories than sugar and is considered safe during pregnancy in moderation (so in other words, it’s fine to chew one pack of xylitol gum—but you might not want to chew five)
• Stevia
  • No clear research proves stevia is safe during pregnancy, so before you dip into this sweetener, check with your practitioner for his or her recommendation
• Lactose
  • For those who are lactose-intolerant, it can cause uncomfortable symptoms; otherwise it’s safe
• Honey
  • Though it’s a good substitute for sugar, honey has 19 more calories per tablespoon than sugar does
• Fruit juice concentrates
  • E.g. grape juice concentrate, cherry juice concentrate, pineapple juice concentrate, orange juice concentrate
  • These are a safe (if not low-calorie) sweetener to turn to during pregnancy

Herbal tea

• Since the effect of herbs herbs in pregnancy has not been well researched, there’s no definitive answer to the question of whether drinking herbal teas during pregnancy is safe
• Some herbal teas are probably safe, some probably not – and some, such as red raspberry leaf, taken in very large amounts (more than four 8-ounce cups a day), are thought to trigger contractions (good if you’re 40 weeks and impatient, not good if you haven’t reached term)
• Until more is known, the FDA has urged caution on the use of most herbal teas in pregnancy and during lactation. And though many women have drunk lots of herbal teas throughout pregnancy without a problem, it is probably safest to stay away from, or at least limit, herbal teas while you’re expecting – unless they’ve been specifically recommended or cleared by your practitioner
• Read labels carefully; some brews that seem from their names to be fruit based also contain a variety of herbs. Stick to regular (black) tea that comes flavored, or mix up your own by adding any of the following to boiling water or regular tea: orange, apple, pineapple, or other fruit juice; slices of lemon, lime, orange, apple, pear, or other fruit; mint leaves, cinnamon, nutmeg, cloves, or ginger (a great alleviator of morning sickness)
• The jury’s still out on green tea, which can decrease the effectiveness of folic acid, that vital pregnancy vitamin – so if you’re a green tea drinker, drink in moderation
• Chamomile is considered safe in small amounts during pregnancy and can be soothing to a pregnancy-unsettled tummy
• Never brew a homemade tea from a plant growing in your backyard, unless you are absolutely certain what it is and that it’s safe for use during pregnancy

Chemicals in food

• Steer away from processed foods, which may contain questionable or unsafe substances
• Whenever possible, cook from scratch with fresh ingredients or use frozen or packaged organic ready-to-eat foods
• Go as natural as you can, when you can
  • Whenever you have a choice (and you won’t always), choose foods that are free of artificial additives (colorings, flavorings, and preservatives)
  • Read labels to screen for foods that are either additive free or use natural additives
  • Keep in mind that although some artificial additives are considered safe, others are of questionable safety, and many are used to enhance foods that aren’t very nutritious to start with. For a listing of questionable and safe additives, go to cspinet.org/reports/chemcuisine.htm
• Generally avoid foods preserved with nitrates and nitrites (or sodium nitrates), including hot dogs, salami, bologna, and smoked fish and meats. Look for those brands that do not include these preservatives.
• Avoid high-mercury fish and fish caught in contaminated waters
• Limit animal fat
  • Choose lean cuts of meat and remove visible fat before cooking, since chemicals that livestock ingest tend to concentrate in the fat of the animal
  • With poultry, remove both the fat and the skin to minimize chemical intake
  • Don’t eat organ meats (such as liver and kidneys) very often, for the same reason
• When it’s available and your budget permits, buy meat and poultry that has been raised organically (or grass-fed), without hormones or antibiotics
  • Choose organic dairy products and eggs, when possible
  • Free-range chickens (and eggs) are not only less likely to be contaminated with chemicals, they are also less likely to carry such infections as salmonella because the birds are not kept in cramped, disease-breeding quarters
  • Grass-fed beef is likely to be lower in calories and fat, higher in protein, and a rich source of those baby-friendly omega-3 fatty acids
• Buy organic produce when possible and practical. If price is an object, pick organic selectively
  • Best to buy organic (because even after washing, these foods still carry higher levels of pesticide residue than others): Apples, cherries, grapes, peaches, nectarines, pears, raspberries , strawberries, bell peppers, celery, potatoes, and spinach
  • No need to go organic on these foods (because these products generally don’t contain pesticide residue on them): Bananas, kiwi, mango, papaya, pineapples, asparagus, avocado, broccoli, cauliflower, corn, onions, and peas
• As a precaution, give all vegetables and fruits a bath
  • Washing produce thoroughly is important no matter what (even organic produce can wear a coating of bacteria), but it’s key to removing chemical pesticides your fruits and veggies may have picked up in the field
  • Water will wash off some, but a dip in or a spray with produce wash will take off much more (rinse thoroughly afterward)
  • Scrub skins when possible and practical to remove surface chemical residues, especially when a vegetable has a waxy coating (as cucumbers and sometimes tomatoes, apples, peppers, and eggplant do)
  • Peel skins that still seem “coated” after washing
• Favor domestic produce
  • Imported (and foods made from such produce) often contain higher levels of pesticides than U.S.-grown equivalents because pesticide regulation in other countries is often lax or nonexistent
• Go local
  • Locally grown produce is likely to contain more nutrients (it’s fresh from the field) and possibly sport less pesticide residue
  • Many of the growers at your local farmers’ market may grow without pesticides (or with very little), even if their products aren’t marked “organic.” That’s because certification is too expensive for some small growers to afford
• Vary your diet
  • Variety ensures not only a more interesting eating experience and better nutrition but also better chances of avoiding excessive exposure to any one chemical
• Though it’s smart to try to avoid theoretical hazards in food, making your life stressful in the pursuit of a natural meal isn’t necessary
  • Do the best you can— and then sit back, eat well, and relax
• Eat fruits and vegetables, which are rich in phytochemicals which may counteract the effects of toxins in food

Fish and mercury

• According to the EPA and other experts, it’s smart to avoid shark, swordfish, king mackerel, tilefish, and tuna steaks. These large fish can contain high levels of methyl-mercury, a chemical that in large, accumulated doses can possibly be harmful to a fetus’s developing nervous system
• Don’t worry if you’ve already enjoyed a serving or two of swordfish – any risks would apply to regular consumption – just skip these fish from now on
• Limit your consumption of canned tuna (chunk light tuna contains less mercury than white) and freshwater fish caught by recreational fishers to an average of 6 ounces (cooked weight) per week; commercially caught fish usually has lower levels of contaminants, so you can safely eat more
• Steer clear of fish from waters that are contaminated (with sewage or industrial runoff, for example) or tropical fish, such as grouper, amberjack, and mahi-mahi (which sometimes contain toxins)
• An average of 12 ounces of cooked fish per week is considered safe according to government guidelines

Food storage and preparation

• When in doubt, throw it out
  • Make this your mantra of safe eating. It applies to any food you even suspect might be spoiled
  • Read and abide by freshness dates on food packages
• When food shopping, watch for safe foods
  • Avoid fish, meat, and eggs that are not well refrigerated or kept on ice
  • Steer clear of jars that are leaky or don’t “pop” when you open them and cans that are rusty or seem swollen or otherwise misshapen
  • Wash can tops before opening (and wash your can opener frequently in hot soapy water or in the dishwasher)
• Wash your hands before handling food and after touching raw meat, fish, or eggs. If you have a cut on your hand, wear rubber or plastic gloves while you prepare food, and remember, unless they’re disposable, the gloves need to be washed as often as your bare hands
• Keep your kitchen clean
  • Keep kitchen counters and sinks clean
  • The same goes for cutting boards (wash with soap and hot water or in the dishwasher)
  • Wash dishcloths frequently and keep sponges clean (replace them often, wash them in the dishwasher each night, or periodically pop dampened ones into the microwave for a couple of minutes); they can harbor bacteria
  • Keep utensils separate – e.g. don’t use the same knife (unwashed between uses) for raw chicken and cheese and tomatoes
• Serve hot foods hot, cold foods cold
  • Leftovers should be refrigerated quickly and heated until steaming before reusing
  • Toss perishable foods that have been left out for more than two hours
  • Don’t eat frozen foods that have been thawed and then refrozen
• Refrigerator and freezer safety
  • Measure the fridge interior temperature with a refrigerator thermometer and be sure it stays at 41°F or less
  • Ideally, the freezer should be at 0°F, though many freezers are not designed to meet that requirement; don’t worry if yours isn’t
• Thawing food
  • Thaw foods in the refrigerator, time permitting
  • If you’re in a rush, thaw food in a watertight plastic bag submerged in cold water (and change it every 30 minutes)
  • Never thaw foods at room temperature
• Marinating
  • Marinate meat, fish, or poultry in the refrigerator, not on the counter
  • Discard the marinade after use, because it contains potentially hazardous bacteria. If you’d like to use the marinade as a dip or sauce, or to baste with, reserve a portion for that purpose before you add the meat, poultry, or fish
  • Use a new spoon or brush each time you baste to avoid re-contaminating the marinade, or just cook for a few more minutes after the last basting
• Avoid raw or undercooked animal foods
  • Don’t eat raw or undercooked meats, poultry, fish, or shellfish while you’re expecting
  • Always cook meats and fish to medium (to 160°F) and poultry thoroughly (to 165°F). In general, place the thermometer in the thickest part of the food, away from bone, fat, or gristle. In poultry, place it in the dark meat
• Avoid undercooked eggs
  • Don’t eat eggs that are runny (prefer well-scrambled to sunny-side up)
  • If you’re mixing a batter that contains raw eggs, resist the urge to lick the spoon (or your fingers)
  • The exception to this rule: eggs that are pasteurized, since this process effectively eliminates the risk of salmonella poisoning
  • Don’t use an egg that is cracked when you buy it or cracks on the way home – disease-causing organisms can get in too easily
• Wash raw fruits and vegetables thoroughly (especially if they won’t be cooked before eating)
  • Those fresh blueberries from the farmers’ market might have been grown organically – but that doesn’t mean they’re not sporting a layer of bacteria
• Avoid sprouts
  • Avoid alfalfa and other sprouts, which are often contaminated with bacteria
• Stick to pasteurized dairy products, and make sure those that you use have been refrigerated continuously
  • Soft cheeses, such as imported feta, Brie, blue cheeses, and soft Mexican-style cheese made from unpasteurized milk, can be contaminated with listeria and should be avoided by pregnant women, unless heated until bubbly
  • Domestic cheese is almost always pasteurized except for those made from “raw milk.”
• Hot dogs, deli meats, and cold-smoked seafood
  • These can also be contaminated
  • As a precaution, even ready-cooked meats or smoked fish should be heated to steaming before eating (use them in casseroles)
• Juice should be fully pasteurized
  • Avoid unpasteurized or flash pasteurized juice or cider, whether it’s bought at a health food store or a roadside stand
  • If you’re not sure whether a juice is pasteurized, don’t drink it
• When eating out, avoid establishments that seem to ignore basic sanitation rules. Some signs are pretty obvious: Perishable foods are kept at room temperature, the bathrooms are unclean, it’s open season for flies, and so on.

Morning sickness

Even women who have such a hard time keeping food down that they actually lose weight during the first trimester aren’t hurting their babies, as long as they make up for the lost weight in later months

What to eat when you have morning sickness

• Carbs comfort most every pregnant woman in the first trimester
  • Whenever your taste buds permit, choose complex carbohydrates to satisfy your craving for the bland and starchy (whole-grain toast, pretzels, even saltines)
  • Some morning sickness sufferers prefer fresh fruit (including melon, bananas, sometimes citrus); others find relief in the dried variety (especially raisins and apricots)
• Add some protein
  • Though carbs are the first food group women usually turn to when they’re feeling nauseous, adding a little cheese (or another protein food) to those crackers can fight nausea even more effectively. Studies show that pregnant women experience less nausea when eating high-protein snacks than indulging in high-fat ones
  • E.g. a cheese stick, some almonds, a hard-boiled egg, or a dish of yogurt
• Eat often
  • One of the best ways to keep nausea at bay is to keep your blood sugar at an even keel – and your stomach a little filled – all the time
  • Eat small, frequent meals – six mini meals a day is ideal – instead of three large ones. Don’t leave home without a stash of snacks that your tummy can handle (dried fruit and nuts, granola bars, dry cereal, crackers, soy chips, or pretzels)
• Eat early
  • Don’t even consider getting out of bed in the morning without reaching for a nibble (crackers or rice cakes, dry cereal, a handful of trail mix) that you stashed on your nightstand the night before
  • Keeping nibbles next to the bed also means you don’t have to get up for them if you wake up hungry in the middle of the night.
  • It’s a good idea to have a bite when you rise for midnight bathroom runs, just so your stomach stays a little bit full all night long
• Eat late
  • Eating a light snack high in protein and complex carbs (a muffin and a glass of milk, string cheese and a handful of freeze-dried blueberries) just before you go to sleep will help ensure a happier tummy when you wake up.
• Eat light
  • A stuffed tummy is just as susceptible to queasiness as an empty one. Overloading – even when you feel hungry – can lead to upchucking
• Eat well
  • A diet high in protein and complex carbohydrates can help combat queasiness. General good nutrition may help, too, so eat as well as you can (given the circumstances, that might not always be so easy)
• Eat what you can
  • So the eating well thing isn’t working out so well for you? Right now, getting anything in your tummy – and keeping it there – should be your priority. There will be plenty of time later on in your pregnancy for eating a balanced diet
  • For the queasy moment, eat whatever gets you through the day (and night), even if it’s nothing but ice pops and gingersnaps. If you can manage to make them real fruit ice pops and whole-grain gingersnaps, great. If you can’t, that’s fine, too
• Drink up
  • In the short term, getting enough fluids is more important than getting enough solids – particularly if you’re losing lots of liquids through vomiting
  • If you’re finding liquids are easier to get down when you’re feeling nauseous, use them to get your nutrients. Drink your vitamins and minerals in soothing smoothies, soups, and juices
  • If you find fluids make you queasier, eat solids with a high water content, such as fresh fruits and vegetables – particularly lettuce, melons, and citrus fruits
  • Some women find that drinking and eating at the same sitting puts too much strain on their digestive tract; if this is true for you, try taking your fluids between meals
• Experiment with temperature
  • Many women find icy cold fluids and foods are easier to get down. Others favor warm ones (melted cheese sandwiches instead of cold ones)
• Use ginger
  • Use ginger in cooking (ginger- carrot soup, ginger muffins), steep it into tea, nibble on some ginger biscuits, nosh on some crystallized ginger, or suck on some ginger candy or lollipops
  • A drink made from real ginger (regular ginger ale isn’t) may also be soothing
  • Even the smell of fresh ginger (cut open a knob and take a whiff) may quell nausea
• Use lemons / sour foods
  • Many women find the smell – and taste – of lemons comforting. Sour sucking candies are the ticket to relief for others

Foods to avoid when you have morning sickness

• Avoid fatty foods
  • Steer clear of greasy, fried, and other high -fat foods, which are hard to digest and are loaded with oils that can send the nervous system into overdrive (aggravating your nausea)
• Move to another food if one starts to nauseate you
  • Often, what starts out as a comfort food (it’s the only thing you can keep down, so you eat it 24/ 7) becomes associated with nausea – and actually starts to trigger it
  • If you’re so sick of crackers that they’re actually beginning to make you sick, switch off to another comforting carb (maybe it’ll be Cheerios or watermelon next)
• If it makes you queasy, don’t go there
  • Don’t force yourself to eat foods that don’t appeal or, worse, make you sick
  • Instead, let your taste buds (and your cravings, and your aversions) be your guide. Choose only sweet foods if they’re all you can tolerate (get your vitamin A and protein from peaches and yogurt at dinner instead of from broccoli and chicken). Or select only savories if you prefer (leftover pizza for breakfast)
• Stay away from trigger smells
  • Thanks to a much more sensitive sense of smell, pregnant women often find once appetizing aromas suddenly offensive – and offensive ones downright sickening
  • Stay away from smells that trigger nausea – whether it’s the sausage and eggs your spouse likes to make on the weekends or the aftershave of his that used to make you head over heels (but now makes you head for the toilet)
  • Steer clear, too, of foods that you can’t stand the sight of (raw chicken is a common culprit)

Metallic taste during pregnancy

• A metal mouth taste is a fairly common – though not often talked about – side effect of pregnancy. Like morning sickness , that icky taste should ease up – or, if you’re lucky, disappear altogether— in your second trimester when those hormones begin to settle down
• Until then, you can try fighting metal with acid. Focus on citrus juices, lemonade, sour sucking candy, and – assuming your tummy can handle them – foods marinated in vinegar
• For more suggestions, see the book

Frequent urination during pregnancy

• Don’t cut back on liquids thinking it’ll keep you out of the bathroom. Your body and your baby need a steady supply of fluids -plus dehydration can lead to urinary tract infection (UTI)
• Do cut back on caffeine, which increases the need to pee
• If you find that you go frequently during the night, try limiting fluids right before bedtime

Heartburn and indigestion during pregnancy

Early in pregnancy, your body produces large amounts of the hormones progesterone and relaxin, which tend to relax smooth muscle tissue everywhere in the body, including the gastrointestinal (GI) tract. As a result, food sometimes moves more slowly through your system, resulting in indigestion (a feeling of fullness and bloating in the upper abdomen and chest; heartburn is a symptom of indigestion). This may be uncomfortable for you, but it’s actually beneficial for your baby. The alimentary slowdown allows better absorption of nutrients into your bloodstream and subsequently through the placenta and into your baby.

During the last two trimesters, the problem of heartburn can be compounded by your blossoming uterus as it presses up on your stomach.

Keep your weight gain down. A gradual and moderate gain will minimize the amount of pressure on your digestive tract.

For non-food suggestions to minimize heartburn and indigestion, see the book.

What to eat when you have heartburn / indigestion when you’re pregnant

• Take it small
  • To avoid digestive system overload (and backup of gastric juices), spread your eating into five or six mini meals instead of three square meals
• Eat slowly
  • When you eat too quickly, you tend to swallow air, which can form gas pockets in your belly
  • Rushing through meals means you’re not chewing thoroughly, which makes your stomach work harder digesting your food – and makes heartburn more likely to happen
  • So even when you’re starving or in a hurry, make an effort to eat slowly, taking small bites and chewing well
• Eat something to help relieve the symptoms (as an alternative to antacids)
  • Try a tablespoon of honey in warm milk, a handful of almonds, or some fresh or dried papaya
  • Chewing sugarless gum for a half hour after meals can reduce excess acid (increased saliva can neutralize the acid in your esophagus). Some people find that mint-flavored gum exacerbates heartburn; if so, choose a non-minty gum
• Try to eat at least 2 hours before going to bed at night so your body has time to digest the meal. (An easy-to-digest light bedtime snack is fine, though)

Foods to avoid when you have heartburn / indigestion when you’re pregnant

• Don’t pull the triggers
  • If a food or drink brings on the burn (or other tummy troubles), take it off the menu for now
  • The most common offenders (and you’re sure to know those that offend you) are spicy and highly seasoned foods, fried or fatty foods, processed meats, chocolate, coffee, citrus, carbonated beverages, and mint
• Don’t drink and eat
  • Too much fluid mixed with your food distends the stomach, aggravating indigestion. So try to take most of your fluids in between meals

Food aversions and cravings during pregnancy

Most expectant moms find their tastes in food change somewhat in pregnancy. Most experience a craving for at least one food (most often ice cream), and more than half will have at least one food aversion (poultry ranks right up there, along with vegetables of all varieties). To a certain extent, these suddenly eccentric (and sometimes borderline bizarre) eating habits can be blamed on hormonal havoc, which probably explains why they’re most common in the first trimester of first pregnancies, when that havoc is at its height. Hormones, however, may not tell the whole story. The long-held theory that cravings and aversions are sensible signals from our bodies – that when we develop a distaste for something, it’s usually bad for us, and when we lust after something, it’s usually something we need – often does seem to stand up.

The problem is that body signals relating to food are always hard to read when hormones are involved— and may be especially tough to call now that humans have departed so far from the food chain (and now that so many food chains sell fast food). Before candy bars were invented, for instance, a craving for something sweet might have sent a pregnant woman foraging for berries. Now it’s more likely to send her foraging for M& M’s.

Most cravings and aversions disappear or weaken by the fourth month. Cravings that hang in there longer may be triggered by emotional needs – the need for a little extra attention, for example.

What to eat when you have food aversions and cravings during pregnancy

• Spread your eating into five or six mini meals instead of three square meals
• Eating a good breakfast can prevent hunger-triggered cravings later in the day
• If you crave something that you know you’d probably be better off without, then try to seek a substitute that satisfies the craving (at least somewhat) but also satisfies a nutritional requirement (and doesn’t fill you up with too many empty calories): chocolate frozen yogurt instead of a frozen chocolate bar; a bag of trail mix instead of a bag of jelly beans; baked cheese puffs instead of the kind that turn your fingers orange. If substitutes don’t fully satisfy, try doing something else apart from eating
• If you stick with mild-tasting and mild-smelling foods during the time when aversions are strongest, you’ll accomplish two things. First, your body will be happier. Second, you may avoid bringing on brand-new aversions.

Foods to avoid when you have food aversions and cravings during pregnancy

• Some women find themselves craving, even eating, such peculiar non-food substances as clay, ashes, and paper. Because this habit, known as pica, can be dangerous and may be a sign of nutritional deficiency, particularly of iron, report it to your practitioner. Craving ice may also mean you’re iron deficient, so also report any compulsion to chew ice

Mood swings during pregnancy

These swings may be more pronounced in the first trimester (when hormonal havoc is at its peak) and, in general, in women who ordinarily suffer from marked emotional ups and downs before their periods (it’s sort of like PMS pumped up). Mood swings tend to moderate somewhat after the first trimester.

For non-food suggestions for mood swings, see the book

What to eat for mood swings during pregnancy

• Keep your blood sugar up
  • Spread your eating into five or six mini meals instead of three square meals
  • Give complex carbs and protein starring roles in your mini meals for the longest lasting blood sugar – and mood – highs
• Eat well
  • In general, eating well will help you feel your best emotionally (as well as physically), so follow the Pregnancy Diet as best you can
  • Getting plenty of omega-3 fatty acids in your diet (through walnuts, fish, and enriched eggs, to name a few) may also help with mood moderating

Foods to avoid for mood swings during pregnancy

• Keep sugar and caffeine down
  • Sugary foods and drinks will give your blood sugar a quick spike – followed soon after by a downward spiral that can take your mood down with it
  • Caffeine can have the same effect, adding to mood instability
  • So limit both, for happier results

Constipation during pregnancy

The high levels of progesterone circulating in your expectant system cause the smooth muscles of the large bowel to relax, making them sluggish – and allowing food to hang around longer in the digestive tract. The upside: There’s added time for nutrients to be absorbed into your bloodstream, allowing more of them to reach your baby. The downside: constipation.

Another reason for constipation: Your growing uterus puts pressure on the bowel, cramping its normal activity.

See the book for non-food suggestions to reduce constipation.

What to eat when you’re constipated in pregnancy

• Big meals can overtax your digestive tract, leading to more congestion
  • Spread your eating into five or six mini meals instead of three square meals
• Fight back with fiber
  • You need about 25 to 35 grams of fiber daily. No need to actually keep count. Just focus on fiber-rich selections such as fresh fruit and vegetables (raw or lightly cooked, with skin left on when possible); whole-grain cereals and bread; legumes (beans and peas); and dried or freeze-dried fruit
  • Eating green foods can also help get things going – look for it not only in the form of green vegetables, but in kiwis, a tiny fruit that packs a potent laxative effect
  • If you’ve never been a big fiber fan, add these foods to your diet gradually or you may find your digestive tract protesting loudly. (But since flatulence is a common complaint of pregnancy as well as a frequent, but usually temporary, side effect of a newly fiber -infused diet, you may find your digestive tract protesting for a while anyway)
  • If you’re really constipated, you can try adding some wheat bran or psyllium to your diet, starting with a sprinkle and working your way up, as needed. Don’t overdo these fiber powerhouses, though; as they move speedily through your system, they can carry away important nutrients before they’ve had the chance to be absorbed
• Eat live yogurt
  • The acidophilus bacteria in live yogurt will stimulate the intestinal bacteria to break down food better, aiding the digestive tract in its efforts to keep things moving.
• Drink plenty of liquids
  • Most fluids – particularly water and fruit and vegetable juices – are effective in softening stool and keeping food moving along the digestive tract
  • Try warm liquids, including hot water and lemon. They’ll help stimulate peristalsis, those intestinal contractions that help you go
  • Truly tough cases may benefit from prune juice

Foods to avoid when you’re constipated in pregnancy

• While high-fiber foods can keep things moving, refined foods can clog things up. So steer clear of the refiner things in life, such as white bread (and other baked goods) and white rice

Gas and bloating during pregnancy

See the book for non-food suggestions to reduce gas and bloating.

What to eat when you have gas and bloating during pregnancy

• Graze, don’t gorge. Large meals just add to that bloated feeling. They also overload your digestive system, which isn’t at its most efficient anyway in pregnancy. Spread your eating into five or six mini meals instead of three square meals
• Eat slowly. Don’t take meals on the run or toss down snacks while you’re cooking, or mix business with food. These can lead to air swallowing
• Chew well
• Stay regular – avoid constipation
• Sipping a little chamomile tea may safely soothe all kinds of pregnancy-induced indigestion. Ditto for hot water with lemon, which can cut through gas as well as any medication.

Foods to avoid when you have gas and bloating during pregnancy

• Don’t gulp
  • When you rush through meals or eat on the fly, you’re bound to swallow as much air as food. This captured air forms painful pockets of gas in your gut
• Steer clear of gas producers
  • Your tummy will tell you what they are – they vary from person to person
  • Common offenders include onions, broccoli, cabbage, Brussels sprouts, green peppers, fried foods, rich sauces, sugary sweets, carbonated beverages, and beans

Food guidelines for multiples – twins, triplets, and more

• Moms-to-be of multiples should indulge in an extra 150 to 300 calories a day per fetus, doctor’s orders (if you’ve started out with an average pre-pregnancy weight)
  • An extra 300 to 600 calories if you’re carrying twins
  • An extra 450 to 900 calories for triplets
• Good nutrition during a multiple pregnancy has an even greater impact on baby birthweight than it does during a singleton pregnancy
• The bigger your belly gets, the smaller you’ll want your meals to stay. Not only will grazing on five or six healthy mini meals and snacks ease your digestive overload (and your tummy crowding), but it’ll keep your energy up
• Pick foods that pack plenty of nutrients into small servings. Studies show that a high- calorie diet that’s also high in nutrients significantly improves your chances of having healthy full-term babies. Wasting too much of that premium space on junk food, on the other hand, means you’ll have less room for nutritious food
• Not surprisingly, your need for nutrients multiplies with each baby – which means you’ll have to tack on some extra servings to your Daily Dozen. It’s usually recommended that women carrying multiples get one extra serving of protein, one extra serving of calcium, and one extra serving of whole grains. Be sure to ask your practitioner what he or she recommends in your case
• Another nutrient you’ll need to ramp up is iron, which helps your body manufacture red blood cells (you’ll need lots of those for the increased blood your multiple-baby factory will be using) and helps keep you from becoming anemic, which often happens in multiple pregnancies
• Dehydration can lead to preterm labor (something moms-to-be of multiples are already at risk for), so make sure you drink at least eight 8-ounce glasses of liquid a day
• Most practitioners advise a woman expecting twins to gain 35 to 45 pounds and a woman expecting triplets to gain an average of 50 pounds (a little less if you were over-weight pre-pregnancy; a little more if you were underweight)

Pregnancy for diabetics

• The extent of your carbohydrate restriction will depend on the way your body reacts to particular foods
• Most diabetics do best getting their carbohydrates from vegetable, grain (whole is best), and legume sources rather than from fruits
• To maintain normal blood sugar levels, you’ll have to be particularly careful to get enough carbohydrates in the morning
• Snacks will also be important (even more important than they are for the average mom-to-be), and, ideally, they should include both a complex carbohydrate (such as whole-grain bread) and a protein (such as beans or cheese or chicken)
• Skipping meals or snacks can dangerously lower blood sugar, so try to eat on schedule, even if morning sickness or indigestion are putting a damper on your appetite. Eating six mini meals a day, regularly spaced, carefully planned, and supplemented as needed by healthy snacks, is your smartest strategy.

Gestational diabetes

Gestational diabetes (GD) – a form of diabetes that appears only during pregnancy – occurs when the body does not produce adequate amounts of insulin (the hormone that lets the body turn blood sugar into energy) to regulate blood sugar effectively. GD usually begins between weeks 24 and 28 of pregnancy (which explains why a glucose screening test is routine at around 28 weeks). GD almost always goes away after delivery, but if you’ve had it, you’ll be checked postpartum to make sure it’s gone.

Diabetes, both the kind that begins in pregnancy and the kind that started before conception, is not harmful to either the fetus or the mother if it is well controlled. But if excessive sugar is allowed to circulate in a mother’s blood and thus to enter the fetal circulation through the placenta, the potential problems for both mother and baby are serious. Women who have uncontrolled GD are more likely to have a too-large baby, which can complicate delivery. They are also at risk for developing preeclampsia. (pregnancy-induced hypertension). Uncontrolled diabetes could also lead to potential problems for the baby after birth, such as jaundice, breathing difficulties, and low blood sugar levels. Later in life, he or she may be at an increased risk for obesity and type 2 diabetes.

GD is fairly common, affecting 4 to 8 percent of expectant women. Because it’s more common among obese women, rates of GD are rising along with rising obesity rates in the United States. Older moms-to-be are more likely to develop GD, as are women with a family history of diabetes or GD. Native Americans, Latin Americans, and African Americans are also at somewhat greater risk for GD.

Pay extra attention to your weight gain.

What to eat when you have gestational diabetes

• Graze – Aim for at least three meals and three snacks (including a bedtime snack ) each day – spaced as evenly as possible. Avoid meal skipping
• Your most important snack of the day will come in the evening and will help ward off the lower-than-normal blood sugar levels that are common during the night in women with gestational diabetes. Before turning in, eat a snack that contains protein (such as low-fat cheese) and complex carbohydrates (such as whole wheat bread). The carbohydrates will stabilize your blood sugar level in the early night, while the protein acts as a long-acting stabilizer
• Keeping an eye on your weight gain (both before and during pregnancy) can help prevent GD
• So, too, can good diet habits (eating plenty of fruits and vegetables, and whole grains, and making sure you’re getting enough folic acid)
• Continuing these preventive steps after the baby’s born also significantly reduces the risk of diabetes occurring later in life

Foods to avoid when you gestational diabetes

• Sugars (including sugar, honey, brown sugar, corn syrup, maple syrup, turbinado sugar, high-fructose corn syrup, and molasses) top that list
  • When scanning labels for sugar, keep in mind that ingredients that end in ‘ose’ are always sugar (sucrose, dextrose, glucose)
  • You can eat foods that contain a small amount of sugar in moderation, but try to steer clear of high-sugar standards, such as pies, cakes, cookies, ice cream, candy, and soft drinks
• Fruit juices
• Refined starches, such as white rice, mashed potatoes, white bread
• High fat diets – these cause insulin to be less efficient

Breastfeeding

What to eat when you’re breastfeeding

• Try to include the following each day while you’re breastfeeding:
  • Protein: 3 servings
  • Calcium: 5 servings (that’s up 1 serving from your pregnancy requirement of 4
  • Iron-rich foods: 1 or more servings
  • Vitamin C: 2 servings
  • Green leafy and yellow vegetables, yellow fruits: 3 to 4 servings
  • Other fruits and veggies: 1 or more servings
  • Whole-grain and other complex carbohydrates: 3 or more servings
  • High-fat foods: moderate amounts— you don’t need as much as you did during pregnancy
  • At least 8 glasses of water, juice, or other non-caffeinated, nonalcoholic beverages
  • DHA-rich foods to promote baby’s brain growth (look for this fat in wild salmon, sardines, walnuts, flaxseed oil, as well as DHA-enriched eggs)
  • Prenatal vitamin daily
• Caloric intake
  • You may need to increase your caloric intake as your baby grows bigger and hungrier
  • You may need to decrease your caloric intake if you supplement nursing with formula and/ or solids, or if you have considerable fat reserves you’d like to begin burning
• Foods you can reintroduce which were unsafe during pregnancy
  • Raw fish and meat
  • Unpasteurized foods such as soft cheeses
  • Runny or raw eggs

Foods to limit when you’re breastfeeding

• Alcohol
  • It’s fine to drink within limits (a couple of glasses a week, preferably taken right after you nurse, rather than before, to allow a few hours for the alcohol to metabolize)
  • You can use Milkscreen – simple test strips that detect the volume of alcohol in your breast milk, available at any drugstore – to know if it’s safe for your baby
• Caffeine
  • More than a cup or two of coffee can make your baby jittery and keep you both from getting any sleep
• Fish with moderate amounts of mercury
• Sugar substitutes
  • Sucralose (Splenda) or aspartame are considered better bets than saccharine

Foods to avoid when you’re breastfeeding

• When you’re breastfeeding, you have a lot more menu options than you did while you were expecting – served up with some caveats
• Continue to avoid high-mercury fish, such as shark, tilefish, and mackerel
• If you have a family history of allergies, check with the doctor to see if you should avoid peanuts and foods that contain them (and possibly other highly allergic foods)
• Also watch out for herbs, even some seemingly innocuous herbal teas. Stick to reliable brands and choose flavors that are considered safe during lactation, including orange spice, peppermint, raspberry, red bush, chamomile, and rosehip. Read labels carefully to make sure other herbs haven’t been added to the brew, and drink them only in moderation

What to watch for in your baby

• A few moms find that their own diet affects their babies’ tummies and temperaments. While what you eat does indeed change the taste and smell of your milk (that happens for all mothers), this is actually a good thing since it exposes your baby to many different flavors
• Some babies can occasionally be sensitive to certain foods that end up in mom’s milk. If you suspect that something in your diet is turning baby off his or her feed (or turning his or her tummy), try eliminating the food for a few days to gauge the response
• Some of the more common troublemakers are
  • Cow’s milk
  • Eggs
  • Fish
  • Citrus fruits
  • Nuts
  • Wheat

Losing weight after pregnancy

• First 6 weeks postpartum
  • Don’t even think about the shape your body’s in during the first six weeks postpartum, especially if you’re breastfeeding. This is a recovery period, during which ample nutrition (and rest) is important for both energy and resistance to infection
  • Sticking to a healthy postpartum diet should start you on the way to slow, steady weight loss
• After 6 weeks
  • If, after six weeks, you aren’t losing any weight, you can start cutting back somewhat on calories
  • If you’re nursing, don’t go overboard. Eating too few calories can reduce milk production, and burning fat too quickly can release toxins into the blood, which can end up in your breast milk
  • If you’re not nursing, you can go on a sensible, well-balanced weight-loss diet six weeks postpartum
  • Some women find that the extra pounds melt off while they’re breastfeeding; others are dismayed to find the scale doesn’t budge. If the latter turns out to be the case with you, don’t despair; you’ll be able to shed any remaining excess poundage once you’ve weaned your baby.
  • How quickly you return to your pre-pregnant weight will also depend on how many pounds you put on during pregnancy. If you didn’t gain much more than 25 to 35 pounds, you’ll likely be able to pack away those pregnancy jeans in a few months, without strenuous dieting. If you gained 35 or more pounds, you may find it takes more effort and more time – anywhere from 10 months to 2 years – to return to pre-pregnancy weight and your skinny jeans. Either way, give yourself a break – and give yourself some time. Remember, it took you nine months to gain that pregnancy weight, and it may take at least that long to take it off.

Food guidelines before you conceive / preconception

Foods to eat before you conceive in What to Expect When You’re Expecting

• Make sure you get your folic acid
  • Whole grains
  • Leafy green vegetables
  • Folic acid supplementation
• Start to follow the Pregnancy diet (above)
  • Increase whole grains, fruits, vegetables, and low-fat dairy products
  • 2 protein servings, 3 calcium servings, and no more than 6 whole-grain servings daily until you conceive
  • Start modifying your fish consumption according to the guidelines for expectant moms
• Add or cut calories during the preconception period as needed if you’re overweight or very underweight – slowly and sensibly

Foods to avoid or limit before you conceive with What to Expect When You’re Expecting

• If you have dietary habits that wouldn’t be healthy during pregnancy, tell your practitioner – e.g.
  • Periodic fasting
  • Eating disorders, e.g. anorexia nervosa or bulimia
  • Special diet, e.g. vegan, macrobiotic, diabetic, or any other
• Cut back on junk food and high-fat foods
• Strenuous or nutritionally unbalanced dieting (including low-carbohydrate, high protein diets can make conception elusive and can result in a nutritional deficit. If you ‘ve been extreme dieting recently, start eating normally and give your body a few months to get back into balance before you try to conceive
• Cut back on caffeine – up to 2 cups of caffeinated coffee or the equivalent in other caffeinated beverages a day is fine
• Cut down on alcohol – a daily drink will not be harmful in your pregnancy-preparation phase, but heavy alcohol consumption can interfere with fertility by disrupting your menstrual cycle

As always, this is not intended to be a replacement for professional medical diagnosis or treatment for a medical condition. Consult your doctor before starting a new diet. This page describes what the authors of the diet recommend – Chewfo is describing the diet only, not endorsing it.

Get a copy of What to Expect When You’re Expecting for a full explanation of what happens during pregnancy, pregnancy guidelines, what to expect at each stage of the pregnancy, supplementation, exercise during pregnancy, childbirth, breastfeeding guidelines, non-food solutions for pregnancy side effects, portion size guidelines, and more.

 Pregnancy book
Get a copy of the eating plan What to Expect – Eating Well When You’re Expecting for details of why a good diet is good for baby and you, ideas for coping with pregnancy symptoms related to food, weight gain planning, nutritional requirements, strategies for cutting down on empty calories, shopping guidelines, traveling and eating out, substitutions, snack ideas, and lots of recipes.

 Eating plan
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