Category: Healthy Pregnancy

Coffee. Cheese. Cold cuts. The list of foods to avoid during pregnancy seems to go on and on, and it can seem like all our favorites are suddenly off the table just when we’re feeling like we could really use some comfort food.
But how many of the foods that one woman in your moms-to-be Facebook group swears you need to trash are legitimate no-nos, and how many foods do pregnant women end up avoiding due to wives’ tales and bad science? Do you really need to clean out your entire fridge and start over?
You’ve got just nine months of pregnancy (give or take), so let’s dive in and get some answers!

What’s off the menu?

You’ve already said Bye bye cute little two-door car, hello mom van. And you’re sharing your body with a growing human. So what else do you have to change?
Let’s start with the good news, shall we? “Truly, the list of foods that are big no-nos is pretty short,” says Anita Somani, MD, an OB-GYN with Comprehensive Women’s Care at OhioHealth Riverside Methodist Hospital in Columbus, Ohio.
The following foods should be avoided—that is, completely cut out of your diet—when pregnant, according to Somani:

Alcohol

Studies on how much alcohol will hurt a growing fetus send moms-to-be mixed signals, but the official stance of the American College of Obstetricians and Gynecologists (ACOG) leaves nothing up to interpretation.
The official ACOG statement warns, “Even moderate alcohol use during pregnancy can cause lifelong problems with a child’s learning and behavior. Any amount is risky for women who are pregnant or trying to become pregnant. All types of alcohol are harmful, including beer and wine.”
Drinking alcohol during pregnancy has been linked to fetal alcohol syndrome (FAS) in infants, a condition that leads to problems with brain development, lower-than-average height and weight, smaller-than-normal head size, and abnormal facial features. Conflicting headlines and studies aside, ACOG’s ruling notes, “Birth defects related to alcohol are 100 percent preventable by not drinking during pregnancy.”

Raw Meat, Raw Fish, Deli Meat, and Unpasteurized Cheese

Pregnant women are 13 times more likely to contract listeriosis, a food-borne illness caused by the listeria bacterium. According to ACOG, the disease can cause miscarriage, preterm labor, and stillbirth, as well as neonatal listeriosis and possible neonatal death.
Your favorite cold cuts, raw meats, and unpasteurized cheeses all make the list of foods with a high risk of listeria contamination—hence the suggestion that you steer clear. It’s also recommended you keep track of Food and Drug Administration (FDA) food recalls, as some fresh produce has been linked to listeriosis outbreaks in recent years. You can visit the FDA’s site regularly or sign up for recall warnings to be sent right in your email inbox.

Fish That Are High in Mercury

Mackerel, swordfish, marlin, ahi tuna, shark, tilefish, and orange roughy make the list of no-nos from the FDA, as mercury is considered a neurotoxin that can harm unborn babies.

According to the Environmental Protection Agency, exposure to mercury in the womb can “adversely affect unborn infants’ growing brains and nervous systems.” Because they’re still developing, a fetus’ systems are also more vulnerable to the effects of mercury than an adult’s would be.

Stay the course or buckle in for change?

So, if there aren’t that many foods you really need to avoid during pregnancy, you can just keep on eating the way you did when you were eating for one, right? Not so fast. Step away from the junk food aisle for a second and listen up.
The biggest dietary changes you should commit to aren’t necessarily in types of foods at all, Somani says, but in how much (or how little) a woman should be consuming during the nine-plus months she’s carrying her baby. A woman’s pre-pregnancy weight can affect her own health, so it only stands to reason that it can affect her pregnancy, from increasing her chances of developing gestational diabetes to upping her risk of preeclampsia, a pregnancy-related blood pressure disorder.
Your OB-GYN will likely ask you to hop on the scale early on, not only to record your weight for monitoring purposes, but to determine your nutrition plan for the entirety of your pregnancy. They may start talking goal weight gain…or even weight loss.
“If someone is overweight, we encourage them to lose at least 10 percent of their body weight to improve fertility, decrease the risk of diabetes and hypertension and stillbirth,” Somani says. “If someone is underweight, we encourage them to gain weight or eat more calories during pregnancy to decrease growth restriction in the fetus.”
If your pre-pregnancy weight was within healthy limits, you’re ahead of the game. “There is less risk of neural tube defects and growth issues,” Somani says.
For women in this boat, the big diet changes will depend on pre-pregnancy proclivities. If you drank alcohol, lunched on sushi or beef tartare, dined on unpasteurized cheese, or spent a lot of time bellying up to the deli for sliced cold cuts, get ready to give things up.
Otherwise, ACOG recommends moms-to-be eat a well-balanced diet that consists of protein, carbohydrates, and fats, says Yves-Richard Dole, MD, an OB-GYN at Mercy in Baltimore. In general, a mom with a body mass index (BMI) that’s considered “normal” should shoot for weight gain of about 25 to 35 pounds over the course of the pregnancy, he adds.

Controlled Cravings

Although some foods are strictly off the menu, there are others that pregnant women are told to avoid when possible but don’t have to eliminate entirely.
Seafood, for example, may be on the must-avoid list when it’s served raw or if it’s high in mercury, but ACOG has recently loosened up its rulings on grabbing your dinner from the sea. These days, the group allows for moms-to-be to eat two to three servings (8 to 12 ounces) a week of a long list of fish, including fresh-water trout, catfish, cod, and even clams and shrimp. Other fish, such as albacore tuna or monkfish, get the thumbs up if they’re limited to 6 ounces per week.
You may even want to work fish into your diet if you aren’t otherwise eating it, Somani says—at least the “good” kinds.
“Fish that are high in omega-3 fatty acids … should be eaten in pregnancy,” she notes, because those omega-3s are good for babies’ development. You may even notice they’re one of the nutrients in a variety of prenatal vitamins.
Likewise, avoiding unpasteurized cheeses doesn’t mean all cheeses make the “foods to avoid during pregnancy” list. Soft cheeses, such as feta, brie, and queso fresco, are sometimes pasteurized—you just need to check the packaging. Hard cheeses, such as cheddar, gouda, and parmesan, are almost always pasteurized, and semi-soft cheeses, like mozzarella, are typically in the clear as well.
And while your BFF may have been told no coffee or other caffeinated beverages during her pregnancy, many doctors allow for a little morning pick-me-up once you’re in your second trimester.
“Most experts state that consuming fewer than 200 mg of caffeine (one 12-ounce cup of coffee) a day during pregnancy is safe,” Somani says.
Also allowed in limited doses? Giving in to your cravings. While “eating for two” is a dangerous myth that can result in too much weight gain, Dole says there’s no reason you can’t have a family member or partner supply you with a steady stock of the foods your body is crying out for.
“Ice cream, chocolate, and french fries are common cravings that can be indulged in moderation,” he says.
On the other hand, if you’re craving dirt, chalk, sand, toothpaste, or other non-edibles, you may be struggling with a pregnancy-related condition called pica. Skip the sampling and call your healthcare provider, Dole warns.
Moms-to-be have long been warned against consuming peanuts during pregnancy, but you may find your OB-GYN giving you the all-clear to pop a can of Planters and chow down. While nut allergies have tripled in recent years, a study published in JAMA Pediatrics suggests the risk of your child developing a peanut allergy dips if you eat nuts while they’re in utero. Even better: The more peanuts and tree nuts a (non-allergic) mom ate, the lower her child’s risk, according to the study’s findings.
“Peanuts have been discouraged in the past, but now we are encouraging them to reduce the risk of nut allergies in the fetus,” Somani explains.

Good Eating

So you know what not to eat during pregnancy. You know what to eat only sometimes during pregnancy. What about all the foods you should be eating throughout your nine months?
Aside from eating a balanced diet, are there any specific foods you should be piling onto your plate? Absolutely, experts say.
If you aren’t already doing so, pregnancy is the time to hike your folic acid intake to help your fetus develop and grow. Studies have found that folate deficiency is not only very common in women of childbearing age, but it has been associated with abnormalities like anemia and peripheral neuropathy in moms-to-be and congenital abnormalities in fetuses.
The good news: Foods such as spinach, strawberries, and citrus fruits are rich in folates, Somani says, and they are “critical to preventing neural tube defects.” It’s suggested that women increase their folic acid intake to somewhere between 400 and 800 micrograms per day during pregnancy, although your OB-GYN will be able to nail down just how much you should be ingesting via food sources as opposed to vitamins and supplements.
Calcium is another nutrient that can’t be ignored during pregnancy, whether it’s consumed via the “safe” cheeses, slugging down glasses of milk to fight that pregnancy heartburn, or eating (moderate amounts of) ice cream.
Doctors still recommend taking a prenatal vitamin starting as early as possible. If you’re not pregnant yet but think it’s time to start trying to conceive, your doctor may even suggest you start with prenatal vitamins now.
“The critical period of neural tube development is in the first trimester—often before a woman recognizes she is pregnant, and that’s where preconception folic acid is so important,” Somani points out.

Keep it going.

Once baby arrives, the diet pressure is off…sort of. Of course, nourishing, well-balanced meals are a part of being a healthy mom who can juggle motherhood and everything else life throws at you. If you’re formula feeding, you can re-introduce all of the forbidden foods, provided you’re not sharing them with baby!
If you’ve opted to breastfeed, on the other hand, you will still need to abide by some of your pregnancy dietary restrictions, Dole says. “Eating well-balanced meals ensures an adequate milk supply, and it prevents mom from becoming chronically fatigued from nutritional deficiencies,” he notes. “Continuing prenatal vitamins is recommended to ensure an adequate supply of vitamins and minerals.”
Caffeine can pass through breast milk, so Dole suggests keeping your coffee intake to a minimum, and mercury is still a risk, so seafood rules remain the same during breastfeeding as they were in pregnancy. Your child’s pediatrician may also have other recommendations for your diet based on any health issues baby is exhibiting (such as allergic reactions).
But even breastfeeding moms get a break from the pregnancy-centric eating plan. The good news for breastfeeding moms?
“Cravings for sushi, deli meats and sandwiches, and that favorite glass of wine can now be satisfied,” Dole says. And breastfeeding can help the body burn anywhere from 300 to 500 calories a day, so it may help you shed some baby weight if that’s one of your postpartum goals.
Moms who are breastfeeding do still need to be wary of how much alcohol they consume and when, Dole warns. The American Academy of Pediatrics (AAP) recommends against mixing breastfeeding and alcohol, but its guidelines note that if a woman does choose to imbibe, she should do so “after she has nursed or expressed milk rather than before, and allow at least 2 hours per drink before the next breastfeeding or pumping session.”
The AAP also warns against excessive drinking, as “there are concerns about long-term, repeated exposures of infants to alcohol via mother’s milk,” and “chronic consumption of alcohol may also reduce milk production.”

The earliest weeks of pregnancy can be a tremendously exciting—and confusing—time. Your body is undergoing an enormous number of changes at a rapid clip. You probably don’t feel like yourself. You are nervous about the viability of the pregnancy and overcome with exhaustion. And chances are you’re trying to keep the whole thing a secret!
First, the basics. Pregnancy is divided into three trimesters. The first ranges from week 1 through week 13. The second trimester reaches through week 27, and the third goes through week 40. So really, pregnancy lasts 10 months, not nine, as most of us have been taught.

If you take a pregnancy test a week after missing a period and the results are positive, you are already considered around 4 to 5 weeks pregnant. This is because pregnancy is calculated from the date of your last menstrual period, not from the date of conception, which occurs two weeks later. (A pregnant woman will be asked over and over again in doctors’ appointments when the date of her last period was, so it’s vital to keep track, especially as cycles vary.)
The first trimester is often filled with the most anxiety, because up to 20 percent of pregnancies end in miscarriage. A miscarriage is a pregnancy loss that occurs before week 20; anything after that is a stillbirth. The most important thing to know, however, is that there is nothing you can do to make a pregnancy viable—and little you can do to lose a pregnancy that is viable, explains Kerry Price, an OB-GYN in Laguna Hills, California. “Whatever is going to happen first trimester-wise has nothing to do with what you’re doing.”

8 Earliest Signs of Pregnancy

Pregnancy symptoms are wildly variant from one woman to another. Even the same mother-to-be can experience two or three pregnancies completely differently—one leaving her incapacitated with nausea and another with just the slightest bit of fatigue. So don’t panic: Just because your best friend threw up every day of her first trimester doesn’t mean you will.
That said, there are some common early signs:

1. Fatigue

Growing a baby is physically akin to climbing Mount Everest. Your body is working extraordinarily hard and there are very high levels of hormones coursing through the body—specifically progesterone, which tends to make you very sleepy and nauseated.
Don’t be surprised if you find yourself falling asleep at 8 p.m. on the couch, dropping into a deep slumber for 12 full hours, and waking up feeling exhausted. Many women start experiencing the extreme fatigue really early—around 6 weeks, says Jocelyn Brown, a licensed midwife at GraceFull Birthing in Los Angeles.

If You’re Experiencing This Symptom

“If you can completely surrender to the exhaustion, build your work schedule around it,” says Brown. “If you have the luxury to take a nap, take a nap. Many women in my practice say, ‘But I have all these things to do!’ You have the rest of your life to do them. Just go to bed—you’re building a skeleton right now!”

2. Nausea

Although this is frequently referred to as “morning sickness,” many women experience it all day every day for weeks (or months) on end. This can begin as early as week 2 and last all through the pregnancy, although it begins for most women in the 4 to 6 week range and abates at the end of the first trimester. Many women feel it most acutely between weeks 9 and 11, when hormones are peaking.
The reasons for nausea are multifactorial, explains Price: Rising levels of a hormone called human chorionic gonadotropin (hCG) and progesterone (women who are on progesterone often feel even more nauseated). Progesterone slows the bowel, which can cause constipation; it also slows the esophageal sphincter, which causes acid reflux.

If You’re Experiencing This Symptom

If your nausea is run-of-the-mill morning sickness (you’re not utterly incapacitated, you can keep food down, etc.)…
Do not let yourself get too hungry. Eat small, frequent meals, and keep them bland. Think crackers, bananas, and popcorn. Keep saltines (or any snack you can stomach) with you at all times—especially by the bed. Eat a few when you get up in the morning or in the middle of the night to pee.
Brown suggests setting an alarm for every hour or two and eating even if you’re not terribly hungry. An empty stomach should be avoided at all costs, and steer clear of spicy foods. Try adding 25 mg of ginger four times a day (or ginger candy or lozenges) to your diet and taking a vitamin B6 complex. Some women find that wearing pressure bands around their wrists (airplane-style) helps. Make sure to stay hydrated.
If your nausea is incapacitating and you can’t keep anything down…
Consult your doctor or midwife right away. In the age of Kate Middleton’s well-documented hyperemesis gravidarum—a condition in which a pregnant woman is debilitated by nausea and vomiting—it is vital to seek out treatment if you cannot function.
Brown asks her patients: How much is this disrupting your life? Do you need medication or to go on disability? Do you need to be hospitalized?
Fortunately, this condition only affects 0.5 to 2 percent of pregnant women. Unfortunately, if you have it for one pregnancy, you are likely to have it for another. “We encourage people to try to go medication free,” Price says, but adds that if a woman really cannot function normally in her day-to-day life, she will prescribe it.

3. Implantation Cramping and/or Bleeding

Implantation bleeding usually occurs a few days—or up to two weeks—after implantation. In other words, before you actually know you’re pregnant.

If You’re Experiencing This Symptom

“There are a ton of pregnancies that have early trimester bleeding and turn out to be fine,” explains Price. This has to do with changes in the level of progesterone in the body, or it can be related to the cervix. If the blood is brown and painless, assume all is fine and wear a liner.

4. Heavier Bleeding and/or Cramping

This could (or could not) be a sign of something more serious, like a miscarriage.

If You’re Experiencing This Symptom

“There are 99 reasons why someone would be bleeding in early pregnancy,” Brown explains, “and only one is miscarriage.” If the blood is dark brown or pink, Brown says she doesn’t usually worry. “Bright red gets my attention.” If a woman is having cramping but no bleeding, it’s not usually a problem; and bleeding but no cramping may not be cause for alarm either. “It’s when a woman is cramping and bleeding that I worry.” If you are experiencing those symptoms, call your doctor or midwife immediately.
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5. Frequent Urination

Have to pee all the time? This is because the rise in hormonal levels brings more blood to your kidneys, which fills your bladder up more quickly. It is also caused by an increase in blood flow (50 percent more!), which means that way more fluid is being circulated through your kidneys.

If You’re Experiencing This Symptom

Stay hydrated with water, but avoid diuretics such as coffee, tea, and other caffeinated drinks. You also want to make sure to empty your bladder completely each time you pee; you can help this along by bending forward slightly when you’re on the toilet.

6. Mood Swings

Wanting to cry for absolutely no reason? Or feeling totally blissed out? Suddenly wracked with anxiety? It may be the hormones.

If You’re Experiencing This Symptom

Mild mood swings are totally normal, but if you suddenly feel markedly different from how you usually do—or if you’re feeling anxious and/or suicidal—consult your doctor or midwife immediately. They will probably refer you to a psychiatrist who specializes in pre- and postpartum depression and anxiety.

7. Breast Tenderness

This tenderness can resemble a sign of PMS, but it’s generally more acute and unrelenting. (In fact, it’s not unlike the feeling of first growing breasts.) This often begins in the 4 to 6 week range (so just when you’re taking a test) and abates at the end of the first trimester as your hormones level out.

If You’re Experiencing This Symptom

Avoid underwire bras when possible, and wear a sports bra to bed.

8. Heart Palpitations

When you’re growing a baby, your heart has to work considerably harder, and blood supply is increased, which can cause the heart rate to increase by 10 to 20 beats a minute. In some cases, this can result in heart palpitations or abnormalities.

If You’re Experiencing This Symptom

Most heart palpitations are benign, but it is wise to ask your doctor about them.

And Three More Early Pregnancy Symptoms

• Breast Changes: The areola often darkens considerably and can grow larger.
• Increase in Body Temperature: This is something that you may only notice if you’ve been charting your basal body temperature while trying to conceive. If the basal body temperature stays high, it can indicate that you are pregnant.
• Smell Sensitivity and Food Aversions: Some women report being able to smell scents from many rooms away and not being able to stand the look or smell of certain foods.

How early can I know for sure?

For most women, the earliest sign of pregnancy is a missed period, but some women can sense it even earlier. She may have incredibly tender breasts (much more so than with PMS), a little cramping, or feel uncharacteristically emotional, nauseated, or exhausted. She may already have sudden aversion to, say, coffee, which she has always loved. But the best way to know is to take a test.
An at-home pregnancy test will measure the level of hCG in your urine; this hormone is only present if you’re pregnant. According to the Mayo Clinic, the best time to take a test is one week after your missed period.
If you take it before then, the pregnancy may not be detectable, because it takes seven to 10 days for hCG to be present in the urine after successful implantation of the egg. In fact, the hCG concentration doubles every two to three days during early pregnancy, so even taking it a day after a missed period can result in a false negative.
That said, if you take it too early, you could also get a false positive. A chemical pregnancy is when you have a fertilized egg that doesn’t implant. Pregnancy tests are so sensitive these days, however, that you are given a positive result before the egg implants. A week later, your period comes, which indicates that you are not pregnant.
Although tests vary by sensitivity, if you wait a week, chances are the pregnancy results are accurate. There’s a catch, though: Positive results are almost always accurate. But you can get a false negative if you take the test too early or don’t follow the instructions on the box properly. If you get a negative result and your period still doesn’t come for a few days, take the test again.

I’m pregnant! What do I do now?

So you saw the double line or the “pregnant” sign on the test. Now what? It’s time to find yourself an obstetrician or a midwife, who will perform a blood test to confirm the pregnancy.

Self-Care During First Trimester

Eat well.

If you are feeling very sick, this can be tough. Look for protein-rich foods and eat whichever of those you can stomach. Brown suggests peanut or almond butter, salted nuts (the salt will bring up your electrolytes), hard-boiled eggs, protein smoothies (don’t worry if you can only get half of it down), or a piece of jerky.
“Pregnant women tend to go for the carbs, but this is putting the wrong kind of bacteria in your gut,” Brown explains. “Bad morning sickness can be exacerbated by poor balances of flora—a gut bacteria that’s not helping you.” She advises reducing carbs if possible because that will also decrease your sugar intake, which is good. If this doesn’t seem possible, take a probiotic; this can reduce nausea in the long run.

Continue exercising.

What were you doing before? This is usually a good gauge of what kind of strain you can put your body through while pregnant. If you were a ballet dancer, there’s no reason to stop dancing. But if you were a fan of hot spinning, hot tubs, saunas, or hot yoga, you’ll want to steer clear. If you hadn’t found time to exercise in your pre-pregnancy life, it’s a good time to start.
“I advise 150 minutes of moderate intensity exercise a week,” Brown says, “and start small.” This means 30 minutes, five times a week. It can be anything from going for walk in your neighborhood to taking a prenatal yoga class to swimming.

Take prenatal vitamins.

Folic acid supplements are the most important prenatal vitamin, since they help prevent neural tube defects like spina bifida and cleft lip. The time to take them, however, is in the first 4 to 7 weeks.
“We tell people to start taking them three months before conceiving so you have good levels of folic acid in your body already,” says Price. The usual suggestion is 400 micrograms of folate a day, says Brown. In addition to folic acid, you can also get folate from food, such as dark leafy greens, broccoli, avocado, beans, peas, and lentils. If you can’t stomach those right now, “make the ‘better than’ choice,” advises Brown.

Manage any chronic health problems, including weight.

A healthy weight can influence pregnancy outcomes, Price explains—everything from risk for C-section to postpartum depression and success with breastfeeding. This does not mean to diet or restrict your intake; it simply means to maintain an active, healthy lifestyle and address any chronic health problems, including your mental health.

Some foods should be avoided.

Many women stick to certain foods during the first trimester, and they are by and large safe.
But some to stay clear of are any raw, undercooked, or unpasteurized fish, meat, or dairy; raw sprouts (especially alfalfa, which can contain Salmonella); and alcohol. Make sure to wash raw vegetables very well and avoid eating fish with high levels of mercury (e.g., tuna, shark, and swordfish). Caffeine should be drunk minimally (no more than one cup of coffee a day).
That said, as with everything pregnancy related, these will vary from culture to culture. Women in Japan eat sushi during pregnancy, but it’s fresh. Some French women drink a minimal amount of wine.
In all things, talk to your doctor and trust your own body.