Healthy eating and keeping physically active during pregnancy is recommended for women to stay healthy and to prevent excessive weight gain. A healthy diet is particularly important during pregnancy to support the health of both mother and baby. Pregnant women do not need to go on a special diet but should be reminded it is important to eat a variety of different foods every day to get the right balance of nutrients for themselves and their baby.(1)
There is no need to ‘eat for two’, even though women might find that they are hungrier than usual.(1) Where appropriate, advice should include eating five portions of fruit and vegetables a day and one portion of oily fish (eg mackerel, sardines, pilchards, herring, trout or salmon) a week. The importance of washing fresh fruit and vegetables should also be reiterated.(2)
Most foods are safe for consumption in pregnancy, but there are some that should be avoided. Pregnant women should be advised on how to reduce the risk of food-acquired infections such as listeriosis. Pregnant women should be advised that:(1)
- only pasteurised milk should be consumed
- ripened soft cheeses such as brie should be avoided
- pâté of any sort should not be consumed
- uncooked or undercooked ready prepared meals should be avoided
- raw or partially cooked eggs or foods that may contain them (eg mayonnaise) should be avoided
- British lion eggs (with a lion stamp on them) are safe for consumption
- raw or partially cooked meat should be avoided
- raw shellfish, as well as swordfish and marlin, should all be avoided to reduce the risk of food poisoning.
Caffeine can be consumed by pregnant women in moderation. The NHS advises reducing caffeine intake to no more than 200mg a day. This is equivalent to one cup of coffee a day or two or three cups of tea.(3) The NHS recommends that if you are pregnant or planning to become pregnant, the safest approach is to avoid alcohol completely to keep risks to the baby to a minimum. Drinking in pregnancy can lead to long-term harm to the baby. It can be helpful to inform pregnant women that the risk of harm to their baby is likely to be low if they have consumed only small amounts of alcohol before knowing they were pregnant or during pregnancy.(4)
Supplementation
Those who are pregnant or intending to get pregnant should take a folic acid supplement, because it can be difficult to get the amount of folate recommended for a healthy pregnancy from food alone. It is recommended for women to take 400 micrograms of folic acid each day, starting before pregnancy occurs, until they are 12 weeks pregnant. Taking folic acid can help prevent birth defects known as neural tube defects, including spina bifida. Those at higher risk of pregnancy being affected by neural tube defects may be asked to take 5mg of folic acid.(1)
Pregnant women with low iron levels may experience tiredness and suffer from anaemia. However, iron supplementation should not be routinely offered to all pregnant women. It is recommended that pregnant women eat foods rich in iron such as lean meat, green leafy vegetables, dried fruit and nuts. Those with low iron levels may be advised by their GP or midwife to take iron supplements.(1,5)
Pregnant women should not take vitamin A supplements (above 700 micrograms) as this can be teratogenic. Women should be informed that liver and liver products may contain high levels of vitamin A, and therefore consumption should be avoided.(5)
All pregnant women should be advised to consider taking a vitamin D supplement between the months of September and March, at a recommended dose of 10 micrograms daily. Vitamin D is important in maintaining the health of bones, teeth and muscles. It can be found in some foods including oily fish, eggs and red meat. Those at particular risk of not having enough vitamin D include those with darker skin and those who do not often expose their skin to the sun. These groups may wish to consider taking a daily supplement of vitamin D all year round.(1)
Pregnant women should be informed that beginning or continuing with a moderate course of exercise during pregnancy is not associated with adverse outcomes.(5) Exercise in pregnancy can help with labour. Advice includes continuing with normal daily activity for as long as is comfortable. Tips for remaining active safely during pregnancy include staying hydrated and always warming up and cooling down.(6)
Women should be informed of the potential dangers of certain activities during pregnancy, for example contact sports, high‑impact sports and vigorous racket sports that may involve the risk of abdominal trauma, falls or excessive joint stress, and scuba diving, which may result in foetal birth defects and foetal decompression disease.(5)
