Eating Right Before and After Pregnancy

Colleen Sideck MPH, RDN is a Registered Dietitian and Technical Information Specialist with the USDA Food and Nutrition Information Center (FNIC) at the National Agricultural Library, where she manages web content, social media, and outreach for the Nutrition.gov and FNIC websites. She holds a B.S. degree in Nutrition and Dietetics and a M.P.H. degree in Public Health Communications and Marketing and is the Treasurer at the DC Metro Academy of Nutrition and Dietetics. Before starting at FNIC, Colleen worked in the clinical nutrition and corporate wellness fields.

Welcome Colleen Sideck to Under the Microscope.

UM – Most women know to eat right during pregnancy, but why is it important to eat right before getting pregnant?

CS – A woman's health can impact her ability to have a healthy pregnancy and healthy baby. Nutrition is a key factor for overall health, since it allows the body to receive the calories, vitamins, and minerals that it needs to function properly and support pregnancy. Women with certain medical conditions may want to talk with their healthcare provider about their health and nutrition history before trying to conceive to support a healthy pregnancy

UM – What should healthy pre-pregnancy nutrition look like? 

CS – Most healthcare providers recommend following a healthy eating pattern and taking a daily prenatal supplement before getting pregnant. According to MyPlate, a healthy plate contains half vegetables and fruits, one-quarter grains, and one-quarter protein along with dairy products. The 2020-2025 Dietary Guidelines for Americansrecommend selecting a prenatal supplement that contains folic acid, iron, vitamin D, and iodine, which are nutrients that the body needs more of during pregnancy. The CDC advises women who are planning for pregnancy to take 400 micrograms of folic acid daily. For women with health conditions, be sure to talk with your healthcare provider to determine your specific pre-pregnancy nutrition needs.

UM – How does this compare to what women should be eating when not planning a pregnancy?

CS – It is very similar to what is recommended for all healthy women! The main difference is a prenatal supplement may not be needed by women who are not planning a pregnancy, if they are receiving adequate nutrients from food and beverages. However, since about half of all pregnancies in the U.S. are unplanned according to the CDC, healthcare providers may still recommend a folic acid supplement for women of childbearing age.

UM – How can a pregnant woman ensure she is getting the right nutrition? (Tips for meal planning?)

CS – The best way for a pregnant woman to know if her nutrient needs are being met is to work with her healthcare provider, who can review and provide feedback on her usual food intake and health history.

It can take planning to get into a healthy eating routine at home, but the effort is well worth the health benefits to the mother and baby! Meal planning can be a helpful strategy for staying on track— decide what meals to make for the week in advance, and schedule time to prepare them. Most leftovers stay fresh in the refrigerator for three to four days when stored properly. Make sure to reheat leftovers to steaming hot (165°F), and avoid consuming raw (unpasteurized) milk, juice, meat, sprouts, or cheeses to keep your baby safe from foodborne illness.

UM – What about vitamin and nutrition supplements?

CS – The Dietary Guidelinesrecommend a daily prenatal vitamin and mineral supplement for women who are pregnant, since it can be difficult to meet increased needs for folic acid, iron, iodine, and vitamin D from foods and beverages alone. Folic acid is especially important before conception and during the first trimester, as it helps to prevent neural tube defects, or birth defects of the brain and spine. Choline, which also supports development of a baby's brain and spine, is another critical nutrient during pregnancy that might require supplementation. Foods like eggs, meats, beans, and lentils can also help with meeting choline needs.

UM – Does nutrition play a role in fertility?

CS – Nutrition is important to health to prepare the body for a healthy pregnancy. The Office on Women's Health reports having a weight that is too high or too low may affect a woman's ability to get pregnant. Nutrition and exercise are two lifestyle habits that can help people to keep their bodies healthy and functioning at their best.

UM – Are there any foods that can aid fertility? What foods should women avoid in order to aid conception?

CS – Nutrient-dense foods should be the focus of any healthy diet, including when trying to conceive. This means choosing foods and beverages that provide vitamins and minerals and contain little added sugars, sodium, and saturated fats. For example, foods like vegetables, fruits, whole grains, seafood, beans, poultry, and low-fat dairy are considered nutrient-dense when prepared in healthful ways. Foods that contain folate (such as dark green vegetables and nuts), and iron (such as lean meats and beans), choline (such as eggs and seafood), and iodine (such as dairy products and iodized table salt) are also important for conception and pregnancy. Women who are trying to become pregnant should also not drink alcohol. During the first or second month when a woman may not know she is pregnant, alcohol can harm the baby.

UM – How much should a pregnant woman eat? (How can she find out how many calories she should be eating?) Is it okay to "eat for two?"

CS – "Eating for two" may be a commonly used phrase, but according to the Dietary Guidelines, healthy pregnant women may need an extra 340 - 452 calories which will vary dependent upon individual needs. This amount, which accounts for the body using more energy during pregnancy, could be achieved through one or two extra snacks per day. For example, a woman could add a yogurt cup topped with a handful of berries for a morning snack and a half tuna (canned light) sandwich for an afternoon snack. Exact calorie needs vary based on age, height, activity level, and other factors, so talk to your healthcare provider or a registered dietitian to find out your individualized needs. The Dietary Guidelines recommend eating eight to twelve ounces of seafood that is lower in mercury per week to support a baby's brain development. In addition to canned light tuna, other good options include crab, flounder, oysters, salmon, and shrimp.

UM – Why is it important for women to continue to eat right after pregnancy?

CS – Choosing healthy foods and eating regular meals allows a women's body to replenish the vitamins and minerals that were used to support the growth and development of her baby.  It also provides new mothers with the energy needed to care for their newborn and adjust to a new daily routine. For those who choose to breastfeed, maintaining a healthy eating pattern also helps to produce nutritious breastmilk.  

UM – What should post-pregnancy nutrition look like?

CS – Women who are breastfeeding need more calories per day than they did pre-pregnancy, about 330 calories for the first six months and 400 calories for the second six months. This increase accounts for the extra calories needed to produce milk. It also helps with healthy, gradual weight loss post-pregnancy. A woman's needs for certain vitamins and minerals may also decrease compared to during pregnancy, so it is important to talk to a healthcare provider to determine whether they should continue taking a prenatal supplement or switch to a multivitamin supplement instead.

In general, the MyPlate eating pattern serves as a great model for healthy eating before, during, and after pregnancy. After pregnancy, women should continue to focus on consuming a variety of vegetables, fruits, proteins, whole grains, and dairy foods that meet their personal and cultural preferences.

UM – When should a woman transition from post-pregnancy eating to standard nutrition?

CS – Healthy women who are no longer breastfeeding may be ready to transition back to a general healthy eating pattern. Before doing so, it is suggested to talk to their healthcare provider, who will be able to determine if vitamin and mineral supplements can be discontinued and if there are any special nutrition needs to consider moving forward.

The nutrition tips provided in this interview are for informational purposes only. Please consult with your healthcare provider for individualized nutrition recommendations to meet your health needs. — by Kelly A. Harmon, ARS Office of Communications