Prenatal Nutrition

How to best support yourself and your growing baby through diet & nutrition

One of the hardest jobs the human body has is growing another human. As beautiful and wondrous as the idea of pregnancy is, it takes a toll on the body. According to the American Pregnancy Association, pregnancy affects all of the body systems, including the endocrine, gastrointestinal, cardiovascular, respiratory, and musculoskeletal systems. There is a maternal increase in oxygen consumption, an increase in blood volume (as much as 60 percent!) and heart rate, decreased gastric motility (i.e., constipation), and the kidneys must work harder to rid the body of waste products from both mother and baby. There may also be mood changes, including increased feelings of depression.1 A recent study puts it in perspective: Pregnancy pushes the limits of human endurance, comparable to running a marathon.2 It’s a lot, and there is never a better time to support the body with good nutrition, not just for a healthy baby, but for a healthy mom, too.

Parents Don’t Wait!

Too often, parents begin healthy habits only after conception, ultimately missing an important window of opportunity to maximize the odds of the healthiest possible outcome. At least six months prior to trying to conceive, prospective parents should treat their bodies as if they were pregnant. Focusing on the proper foods and nutrients gives a family a better chance for a quicker conception, smoother pregnancy, healthier baby, and easier recovery. It is a good idea to begin supplementing with a prenatal supplement even before pregnancy. There is evidence that women using a multivitamin-mineral formula three months prior to becoming pregnant had lower risk of neural tube defects and other congenital defects.25 26

What does a healthy prenatal diet look like?

Illustration of meats, vegetables, and fruitsOne of the first things your doctor will likely tell you when you become pregnant is to prioritize a healthy diet, which will not only provide for growing baby, but will also help your body handle the extra demands put on it. That may sound easy enough, but according to the U.S. Department of Health and Human Services, most pregnant women don’t eat enough vegetables, fruits, dairy, and whole grains and eat too many added sugars and refined grains.3 So what makes a healthy prenatal diet? Well, it mostly looks like this: an abundance of organic vegetables and low-sugar fruit, healthy protein and fats, whole grains and legumes, and minimal processed foods (and drinks), sugar, and refined grains. The Natural Grocers Regenivore Meal Wheel is a good model to follow.

Beginning in the second trimester, you should increase your daily caloric intake by 300 to 400 calories. The second and third trimesters also bring a need for more protein (according to the American Pregnancy Association, you should consume between 75 and 100 grams per day). Protein is required for the growth of the fetus, including the brain, as well as the growth of the uterus; it also plays a role in increasing your blood supply.4 Healthy sources of protein include free-range eggs, grassfed beef, bison, elk, venison, or lamb, wild-caught fish (note: raw/undercooked fish is not recommended during pregnancy), and pasture-based dairy. Additionally, eat plenty of healthy fats! Fats are so important for a growing fetus; they are required for healthy brain and eye development and for the absorption of important fat-soluble vitamins including vitamins A, D, E, and K. Healthy fats include foods like avocados, olive oil, coconut oil, full-fat dairy, olives, grassfed meats, fatty-cold water fish like salmon, and nuts. Finally, be sure to stay hydrated with purified water. Drinking plenty of water, along with eating fiber from vegetables, whole grains, and legumes, is vital to keep things moving smoothly and will help prevent constipation.

Keeping a food journal can be helpful to keep track of what you eat daily, as well as seeing patterns where there may be room to improve, and can help set the tone for a healthy diet throughout pregnancy.

A prenatal multivitamin is a must; these supplements are important too

The prenatal vitamin is a given—it will fill in nutritional gaps in your diet and ensure that your body, and growing baby, gets the vitamins and minerals it needs, including the ever-important B vitamins. But aside from that, there are other supplements that are quite important to support your body and fetus throughout pregnancy.


Illustration of choline leafThis nutrient is critical in supporting rapid cell division and growth (important for fetal growth, but also placental growth and function) and normal brain development, including that of the hippocampus, a region of the brain that controls learning, memory, and attention. Studies have shown a lasting effect too—children of mothers who had a higher intake of choline during the second and third trimesters (900-930 mg vs 480 mg/day) performed better on cognitive and memory tests. There is also evidence that children with mothers who had higher levels of choline during pregnancy are less stress reactive. According to a review published in 2019, “Most pregnant women in the U.S. are not achieving choline intake recommendations of 450 mg/day and would likely benefit from boosting their choline intake through dietary and/or supplemental approaches.”5 Choline also benefits mom—it is required to make the neurotransmitter acetylcholine, which plays a role in maintaining healthy blood pressure and heart rate, intestinal motility, muscle contraction, and memory, attention, learning, and overall cognitive health.6 To date, no human trial conducted in healthy pregnant women has reported any adverse effects of choline supplementation at levels ranging from 550 to 900 mg/day.7


image of iron supplement bottleThis mineral may not be the first that comes to mind when you think of pregnancy, but it is vitally important, and iron deficiency among pregnant women is more common that you might think.8 9 As mentioned, your blood volume increases significantly during pregnancy, which leads to increased iron requirements—your body uses iron to make hemoglobin, a protein in red blood cells that carry oxygen throughout your body, supplying you and your baby with sufficient oxygen. If you don’t maintain healthy levels, you could develop iron deficiency anemia, leading to extreme fatigue, weakness, dizziness, and shortness of breath. Severe iron deficiency also increases the risk of premature birth and is associated with low birthweight and postpartum depression. Iron is also a key nutrient that influences brain development and low maternal iron intake has been associated with poor neurocognitive and mental health in the offspring, well into adulthood.10 During pregnancy, the recommendation for iron is 27 mg/day. If you aren’t meeting that amount with food alone or through your prenatal multivitamin, consider an iron supplement.


This omega-3 fat, found in fish oil and certain types of algae, is essential for both mom and baby. It is a critical building block of the fetal brain, eyes, and immune and nervous systems, and in mom, adequate levels can reduce the risk of postpartum depression and other mood disorders. A recent study also found that 800 mg of DHA daily (vs 200 mg/day) improved heart rate and heart rate variability in pregnant women, with researchers saying this could be especially relevant for women with maternal obesity, gestational diabetes, and preeclampsia.11 Research has found that children born to moms with higher DHA levels have better attention spans and that optimal DHA levels during pregnancy can lead to better behavior, focus, and learning in children; there is also a reduced risk of preterm birth, allergies in infants, as well as a positive influence on immune development.12 During the third trimester—when the biggest growth in the fetus’ brain happens—DHA is transferred at a very high rate from mom to baby, severely depleting the mother’s levels. If you plan to breastfeed, DHA levels will continue to decrease as they are transferred to baby via your breastmilk. To optimize your levels, consider 2,000-3,000 mg of combined EPA and DHA daily, throughout pregnancy and thereafter.


During pregnancy, calcium needs double.13 A primary use of calcium is to build a baby’s bones and teeth. Supplementation with calcium may also reduce the risk of preterm delivery and pre-eclampsia.14 Pregnant women can use up to 1,500 mg of calcium per day, which includes that from food sources such as dairy products, dark leafy greens, sardines, and almonds.15 Pregnant women who fail to consume and absorb adequate calcium add to their osteoporosis risk later in life, especially if they become pregnant again.16

Plentiful good bacteria

Our inner ecology is intricately linked to immunity and intestinal health. A mother’s beneficial bacteria impact the baby during growth, birth, and breastfeeding. Babies who do not receive adequate microflora early in life are more prone to allergies, infections, food sensitivities, and malabsorption problems. Babies receive healthy bacteria through a vaginal birth and probiotic supplementation, and breast milk contains factors that support the growth of those bacteria.17 18 In one study researchers gave a group of pregnant women probiotic capsules every day for a few weeks before their due dates. For 6 months after delivery, women who breast-fed continued on the probiotics and bottle-fed infants were given the bacteria directly. All of the babies were considered to be at high risk of developing allergies, since they had either a parent or sibling that was affected. Children who had received probiotics were half as likely to develop eczema as those in a control group that received no probiotic supplementation.19 These results confirm that intestine-dwelling bacteria can train the infant’s immune system to resist allergic reactions. Besides supplements, foods that encourage the proliferation of good gut bacteria include raw cultured vegetables (like sauerkraut and kimchi), quality yogurt, and kefir.

Baby Supportive Herbs

Dandelion leaf and root, red raspberry leaf, and nettle have all been traditionally used to strengthen or invigorate organ systems or the entire body and can be taken safely every day during pregnancy. Dandelion leaf and root are rich sources of vitamins and minerals, including beta-carotene, calcium, potassium, and iron, and can support the liver.20 Red raspberry leaf is the most frequently mentioned herb for general support of pregnancy and breast-feeding. Rich in vitamins and minerals (especially iron), it is traditionally used to strengthen the uterus, increase milk flow, and restore the mother’s system after childbirth.21 Finally, nettle leaf is rich in the minerals calcium and iron and is mildly diuretic. Nettle is believed to enrich and increase the flow of breast milk and restore a mother’s energy following childbirth.22 Bear in mind, these herbs are found in tincture, capsule, or tea form, often times in combination.

Depending on one’s diet and specific situation, additional supplements may be advisable. For example, in one study, pregnant women who used a zinc-containing nutritional supplement in the three months before and after conception had a 36% decreased chance of having a baby with a neural tube defect, and women who had the highest dietary zinc intake (but took no vitamin supplement) had a 30% decreased risk.23 Vitamin E is another nutrient that may be especially important, as low blood levels have been linked with an increased risk of gestational diabetes. Gestational diabetes (GD) is a common complication during pregnancy that can lead to poor health outcomes like preeclampsia and type-2 diabetes for mothers and low blood sugar at birth in infants. Researchers found that women with low blood levels of vitamin E (even in the low normal range) had higher fasting glucose levels and a higher risk for gestational diabetes, suggesting an increased need for vitamin E-rich foods and supplementation.24


Illustration of a child sitting with fruits, vegetables, and dairy products

A Word on Organics

If you are not already choosing organic foods, now is the time to make the switch. Research has found that exposure to pesticides can increase the risk for neural tube defects, heart defects, limb defects, and oral clefts.13 According to the Environmental Protection Agency (EPA), the most common route of exposure to pesticides for the general population is through food and drinking water. It’s also important to avoid synthetic chemical-based insect sprays/repellants and household gardening pesticides.


  2. Thurber C, Dugas LR, Ocobock C, at al. “Extreme events reveal an alimentary limit on sustained maximal human energy expenditure.” Science Advances, Jun 5, 2019; vol 5(6) DOI: 10.1126/sciadv.aaw0341
  3. Anderson-Villaluz D, MBA, RD, LDN, FAND and Quam J, MSPH, RDN. “Nutrition During Pregnancy to Support a Healthy Mom and Baby.” U.S. Department of Health and Human Services, Feb 16, 2022
  5. Korsmo HW, Jiang X, Caudill MA. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients. 2019 Aug 7;11(8):1823. doi: 10.3390/nu11081823.
  7. Korsmo HW, Jiang X, Caudill MA. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients. 2019 Aug 7;11(8):1823. doi: 10.3390/nu11081823.
  8. Georgieff MK, MD. “Iron deficiency in pregnancy.” American Journal of Obstetrics & Gynecology. March 14, 2020; Vol 223(4)
  9. Zeisler H, Dietrich W, Heinzl F, Klaritsch P, Humpel V, Moertl M, Obruca C, Wimazal F, Ramoni A, Tiechl J, Wentzel-Schwarz E. Prevalence of iron deficiency in pregnant women: A prospective cross-sectional Austrian study. Food Sci Nutr. 2021 Oct 16;9(12):6559-6565. doi: 10.1002/fsn3.2588.
  10. Georgieff MK, MD. “Iron deficiency in pregnancy.” American Journal of Obstetrics & Gynecology. March 14, 2020; Vol 223(4)
  11. Christifano DN, Chollet-Hinton L, Mathis NB, et al. “DHA Supplementation During Pregnancy Enhances Maternal Vagally Mediated Cardiac Autonomic Control in Humans.” The Journal of Nutrition. Dec 2022; Vol 152(12) 
  12. Coletta JM, Bell SJ, Roman AS. Omega-3 Fatty acids and pregnancy. Rev Obstet Gynecol. 2010 Fall;3(4):163-71. PMID: 21364848
  13. Truswell AS. ABC of nutrition. Nutrition for pregnancy. Br Med J 1985;291:263–66.
  14. Villar J, Repke JT. Calcium supplementation during pregnancy may reduce preterm delivery in high-risk populations. Am J Obstet Gynecol 1990;163:1124–31.
  15. Somer, Elizabeth, M.A., R.D. Nutrition for a Healthy Pregnancy. Henry Hold and Com. 1995
  16. Rev Med Intene, 1997 vol 18.
  17. Trenev, N. Probiotics: Nature’s Internal Healers. 1998. Avery Publishing Group. New York.
  18. Chaitow, L. Probiotics: The Friendly Bacteria. Senior Lecturer, University of Westminster. 1996. Found on
  19. Kalliomäki M, Salminen S, Arvilommi H, et al: Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 2001, 357:1076-1079
  20. Gladstar R. Herbal Healing for Women. New York: Simon and Schuster, 1993, 176.
  21. Gladstar R. Herbal Healing for Women. New York: Simon and Schuster, 1993, 177.
  22. Gladstar R. Herbal Healing for Women. New York: Simon and Schuster, 1993, 177
  23. Velie EM, Block G, Shaw GM, et al. Maternal supplemental and dietary zinc intake and the occurrence of neural tube defects in California. Am J Epidemiol 1999;150:605–16
  24. Shi H, Gong X, Sheng Q, Li X, Wang Y, Wu T, Zhao Y, Wei Y. Gestational Vitamin E Status and Gestational Diabetes Mellitus: A Retrospective Cohort Study. Nutrients. 2023; 15(7):1598.
  25. Botto LD, Mulinare J, Erickson JD. Occurrence of congenital heart defects in relation to maternal mulitivitamin use. Am J Epidemiol 2000;151:878–84
  26. Czeizel AE. Reduction of urinary tract and cardiovascular defects by periconceptional multivitamin supplementation. Am J Med Genet 1996;62:179–83.