How to eat right before, during and after pregnancy

When you’re pregnant, it’s easy to adopt the mindset that you’re eating for two and can indulge in any food, any time you want. But experts say that approach may not be the best for you or your baby.

UNC Health registered dietitian Natalie Newell shares how to eat healthy before, during and after pregnancy.

First things first: Anyone who is trying to conceive or is already pregnant should take a prenatal vitamin with folate or folic acid, Newell says. (Folate helps prevent birth defects.) However, while prenatal vitamins deliver many essential vitamins and nutrients to the baby—calcium and vitamin A are especially important—it’s just as critical to eat a healthy diet.

Newell says the best way to think of nutrition before and during pregnancy is to go back to the basic food groups. Try to eat:

Newell says a good strategy is to shop the perimeter of the grocery store, avoiding the processed snacks in the middle.

Limiting processed food will also help keep salt intake down. Consuming too much salt can contribute to swelling during pregnancy. Pregnant women should aim for less than 2,300 milligrams (1 teaspoon) of sodium per day, compared with the 5,000 to 6,000 milligrams that Americans consume on average, Newell says.

“Pregnant women often have cravings, so I’m not saying you can’t ever have junk food or dessert,” she says. “Just make sure you’re enjoying it in moderation and not overindulging.”

While the “eating for two” mindset is tempting during pregnancy, it can lead to overeating and gaining too much weight.

“Excessive weight gain puts you at risk of gestational diabetes and can negatively impact how you feel,” Newell says. “And if you have a family history of diabetes or had gestational diabetes in the past, you’re at an increased risk for gestational diabetes in your current pregnancy.”

Calorie intake depends on a person’s medical history and weight at conception, but generally Newell says a good road map to follow is:

Newell says it’s best to check with your healthcare provider to make sure you are following a diet that is healthy for you. Ultimately, what you eat is more important than how much you eat.

Blood volume increases significantly during pregnancy, so it is even more important than usual to stay well hydrated. If you’re pregnant, Newell recommends drinking at least 80 ounces of water a day.

“You can use fruit, like lemon or lime, to give it a little more flavor,” Newell says.

Yes, 80 ounces might mean a lot more trips to the bathroom. But not consuming enough water can make you feel tired, and it makes it hard for your body to deliver all the nutrients the baby needs.

Newell also advises cutting back on soda, coffee and tea, since caffeine can dehydrate the body.

Pregnancy sickness and nausea can make eating healthy during pregnancy easier said than done. If you’re having trouble stomaching healthy foods, Newell recommends starting with what you can tolerate.

“First try to identify the most nutritious items that are palatable and make sure to work those into your diet every day,” she says. “Then you can try to be creative by blending vegetables into spaghetti sauce or a smoothie to hide them. There’s also a lot of organic plant-based protein powders that go great in smoothies.”

There are some foods pregnant women should avoid until they deliver, due to the possible presence of listeria bacteria. According to the Centers for Disease Control and Prevention, a pregnant woman with a listeria infection could pass it to the baby. These foods include:

Also avoid fish that are high in mercury, including tilefish, king mackerel, shark, bigeye tuna and swordfish. Too much mercury exposure during pregnancy could harm the baby’s development. It’s best to eat no more than 8 to 12 ounces of seafood every week, Newell says.

Many new moms try to lose weight shortly after giving birth, but Newell says this isn’t the time to start cutting back on calories.

“Don’t just dive back into wanting to lose weight,” Newell says. “If you are breastfeeding, you need to eat even more calories than when you were pregnant. And if you’re not breastfeeding, you still need to consume adequate protein and calories so your body can heal, repair any damaged cells from giving birth and have enough energy to care for your new baby.”

She recommends continuing all the healthy habits recommended during pregnancy, and making sure you have nutritious snacks on hand.

“During the postpartum period, you’re likely going to be tired from lack of sleep. You don’t want to have a drop in blood sugar—that will make you feel more tired. Even though it can be hard to do while taking care of a newborn, make sure you have snacks that contain protein, carbohydrates and fiber, like apples and peanut butter, every three to four hours,” Newell says.

Some babies have food allergies, such as dairy, so be prepared to be flexible with your diet if you are breastfeeding.

“It’s best if you already have healthy habits in place before getting pregnant, so then you’re ready to adjust if you have to deal with things like nausea during pregnancy or food allergies during the postpartum period,” Newell says.