Pregnancy nutrition advice can be overwhelming. Everyone has opinions. Some of it is evidence-based; much of it is outdated or exaggerated. This guide focuses on what the research and NHS guidance actually recommend.
Important: This is general information, not medical advice. Always consult your midwife or GP for personalised guidance, especially if you have any health conditions or complications.
The Basics: You're Not "Eating for Two"
The old "eating for two" advice is misleading. Calorie needs increase only modestly during pregnancy:
First Trimester
No extra calories needed. Focus on nutrient quality, not quantity. Many women eat less due to nausea anyway.
Second Trimester
No extra calories needed for most women, though appetite typically increases.
Third Trimester
About 200 extra calories daily (equivalent to a small snack or an extra piece of fruit with yogurt).
Quality matters more than quantity. Your growing baby needs specific nutrients, not just more food.
Essential Nutrients
Folic Acid (Folate)
NHS Recommendation
400 micrograms daily as a supplement, from before conception until 12 weeks pregnant. This significantly reduces the risk of neural tube defects like spina bifida.
Some women need higher doses (5mg) - ask your GP if you have diabetes, take epilepsy medication, have a BMI over 30, or have had a previous neural tube defect pregnancy.
Food sources of folate (in addition to supplements): leafy green vegetables, fortified cereals, chickpeas, kidney beans, oranges.
Vitamin D
The NHS recommends 10 micrograms (400 IU) daily throughout pregnancy and breastfeeding. This supports your baby's bone development and your own bone health.
In the UK, it's difficult to get enough vitamin D from sunlight alone, especially in autumn and winter. A supplement is recommended for everyone, not just pregnant women.
Iron
Your blood volume increases by 50% during pregnancy, increasing iron needs. Good sources:
- Red meat (well-cooked)
- Poultry and fish
- Beans and lentils
- Fortified cereals
- Dark leafy greens
Vitamin C helps iron absorption - have citrus fruit, peppers, or tomatoes with iron-rich foods. Tea and coffee inhibit absorption, so avoid them with meals.
Your midwife will check your iron levels. Don't take iron supplements unless advised - too much can be harmful.
Calcium
Your baby needs calcium for bone development. If you don't consume enough, your body will take calcium from your bones. Good sources:
- Dairy products (milk, cheese, yogurt)
- Fortified plant milks
- Tinned fish with bones (sardines, salmon)
- Tofu made with calcium sulphate
- Green leafy vegetables
Omega-3 Fatty Acids (DHA)
DHA supports your baby's brain and eye development. The best source is oily fish (salmon, mackerel, sardines, trout). Aim for 1-2 portions per week, but limit to 2 portions due to pollutant concerns.
If you don't eat fish, consider an algae-based omega-3 supplement.
Foods to Avoid
Avoid Completely
- Raw or undercooked meat - risk of toxoplasmosis
- Raw or partially cooked eggs - unless British Lion stamped (those are safe)
- Unpasteurised dairy - risk of listeria
- Soft cheeses with white rinds - brie, camembert (unless cooked until hot)
- Blue-veined cheeses - stilton, gorgonzola (unless cooked)
- Pâté - all types, including vegetable (listeria risk)
- Raw shellfish - oysters, sushi with raw fish
- Shark, swordfish, marlin - high mercury content
- Raw or cured meat - prosciutto, salami (unless cooked)
- Alcohol - no safe level established
Limit These
- Caffeine - max 200mg daily (about 2 cups of instant coffee or 1 filter coffee)
- Oily fish - max 2 portions per week (pollutant concerns)
- Tuna - max 4 medium cans or 2 fresh steaks per week (mercury)
- Liver - avoid or limit (very high vitamin A, which can harm baby)
Safe to Eat (Despite Common Myths)
- British Lion eggs - raw or runny is fine
- Hard cheeses - cheddar, parmesan, stilton (even if blue)
- Cooked shellfish - prawns, mussels, crab (when properly cooked)
- Smoked fish - smoked salmon is safe
- Mayonnaise - shop-bought is fine (made with pasteurised eggs)
- Peanuts - no need to avoid unless you're allergic
Managing Common Challenges
Morning Sickness
- Eat small, frequent meals rather than large ones
- Keep plain crackers by your bed for before getting up
- Avoid triggers (often fatty, spicy, or strong-smelling foods)
- Stay hydrated - small sips frequently
- Ginger may help (ginger tea, ginger biscuits)
Heartburn
- Eat smaller, more frequent meals
- Avoid eating close to bedtime
- Limit spicy and fatty foods
- Sit upright after eating
Constipation
- Increase fibre gradually (vegetables, whole grains, fruits)
- Drink plenty of water
- Stay active
- Iron supplements can worsen this - speak to your midwife
Supplements: What You Actually Need
NHS-Recommended Supplements
- Folic acid - 400mcg daily, before conception to 12 weeks
- Vitamin D - 10mcg (400 IU) daily, throughout pregnancy
A pregnancy multivitamin can be convenient but isn't essential if you're eating a balanced diet and taking folate and vitamin D separately. Avoid supplements containing vitamin A (retinol).
Practical Tips
- Don't stress about perfection - especially in first trimester, eating what you can manage is fine
- Focus on nutrient-dense foods - make calories count
- Prepare for energy dips - have healthy snacks available
- Stay flexible - food aversions and cravings are normal
- Keep eating regular meals - blood sugar stability helps energy and nausea
The Bottom Line
Pregnancy nutrition doesn't need to be complicated. Take your folic acid and vitamin D, eat a varied diet, avoid the specific risky foods, and don't stress about occasional imperfection. Your body is remarkably good at prioritising your baby's needs.