What to Eat When Pregnant: Vitamins, Weight Gain and Foods to Avoid

Vitamins and key nutrients

• Take a daily prenatal vitamin with at least 400 mcg of folic acid, ideally starting a month or more before conception, since the baby's spine forms in the first weeks. If you're already pregnant, start now. Some people need more.
• Iron: needs nearly double in pregnancy (about 27 mg a day from food plus vitamin). Lean meat, beans, lentils and fortified cereal help; vitamin C foods help you absorb it.
• Iodine (for the baby's brain): many prenatal vitamins don't contain it, so check the label and use iodized salt.
• Choline: eggs, meat, fish, dairy and soybeans. Most vitamins have little, so food matters.
• DHA (an omega-3): mostly from fish. A supplement is an option if you eat little fish.
• Don't add extra supplements, such as high-dose vitamin A, without asking.

How much to eat

• First trimester: usually no extra calories.
• Second trimester: about 340 extra a day (about a yogurt and fruit).
• Third trimester: about 450 extra a day.
• Twins, or very low or high starting weight, change the numbers; ask your provider.

Weight gain ranges (single baby, by pre-pregnancy BMI)

• Underweight (under 18.5): 28-40 lb (about 12.5-18 kg).
• Healthy weight (18.5-24.9): 25-35 lb (11.5-16 kg).
• Overweight (25-29.9): 15-25 lb (7-11.5 kg).
• Obesity (30 or higher): 11-20 lb (5-9 kg).
• Gain is usually slow in the first trimester (often 1-5 lb / 0.5-2 kg), then steadier. Your provider tracks the trend.

Foods to avoid or handle with care

• Listeria risk (can cause miscarriage or stillbirth even if you feel only mildly sick): unpasteurized milk, cheese and juice; deli meats, hot dogs and cold cuts unless heated until steaming hot (165°F / 74°C); refrigerated smoked seafood unless cooked in a dish; refrigerated pates and meat spreads; raw sprouts. Soft cheeses such as feta, mozzarella and cream cheese are fine if the label says pasteurized, but skip queso fresco-type cheeses (queso fresco, queso blanco) even when pasteurized unless heated until steaming. Eat cut melon within 2 hours or refrigerate it, and toss it after a week in the fridge.
• Undercooked meat and eggs: cook whole cuts of beef and pork to 145°F (63°C) and rest 3 minutes, ground meat to 160°F (71°C), poultry to 165°F (74°C). Cook eggs until the yolk is firm; skip raw dough, homemade mayonnaise or raw-egg dressings unless made with pasteurized eggs.
• High-mercury fish, skip entirely: king mackerel, marlin, orange roughy, shark, swordfish, tilefish (Gulf of Mexico) and bigeye tuna.
• Do eat fish: 2-3 servings a week (8-12 oz / about 225-340 g) of low-mercury choices such as salmon, sardines, shrimp, cod, tilapia, pollock and canned light tuna. Limit albacore (white) tuna to one serving a week. Skip raw fish and shellfish.
• Caffeine: under 200 mg a day (roughly one 12-oz / 350 mL cup of brewed coffee, though strength varies a lot). Count tea, soda, energy drinks and chocolate.
• Alcohol: no amount is known to be safe at any point in pregnancy, so the advice is none. If you drank before you knew, tell your provider and stop now.
• Cannabis in any form (smoked, vaped, edibles, CBD): avoid. Also avoid nicotine and vaping.
• Herbal teas and supplements: ask first; many are untested in pregnancy.

Everyday food-safety habits

• Wash hands, boards and knives after raw meat; keep raw meat away from ready-to-eat food.
• Fridge at 40°F (4°C) or colder; refrigerate leftovers within 2 hours and eat within 3-4 days.
• Toxoplasmosis: have someone else change cat litter (or wear gloves and wash hands), and wear gloves when gardening.

When nausea makes eating hard

• Small, frequent, bland snacks; something plain before getting out of bed; sip fluids between meals rather than with them; cold foods often smell less.
• Keep taking the vitamin if you can; taking it at night with a snack, or a gummy or folic-acid-only version for a while, may sit better. See the common pregnancy discomforts guide for more relief ideas.

Check in with your provider if

• You can't keep food or a vitamin down for days, aren't gaining or are losing weight, follow a vegan or restricted diet, or have had weight-loss surgery.
• You ate a high-risk food and then get fever, muscle aches or diarrhea (call the same day).