Sorry, but it’s time to set the record straight: Eating for two doesn’t mean eating times two. Growing a baby does require extra calories — just not nearly as many as most women think. Even the experts aren’t entirely in agreement on how much more you should eat. Some suggest adding 100 calories during the first trimester, others say you don’t need any additional calories for weeks one through 12. During the second trimester, the recommendation is between 250 and 350 additional calories daily, and for the third trimester, it’s 300 to 450 extra per day. That’s per kid, by the way — which means doubling or tripling up (etc.) for multiples. “It’s smart to have some framework about how much more to eat during each trimester,” says Melinda Johnson, MS, RD, a national spokeswoman on pregnancy and nutrition for the American Dietetic Association, “but fretting about adding up every last calorie isn’t the way to go.” Instead, choose foods that offer the most nutritional bang for you and your baby. And don’t forget your fluids: 48 to 64 ounces a day is recommended. Tea and coffee count (but no more than two eight-ounce cups a day); skim milk and juices are fine in moderation. But the majority should come from filtered water.
Ultimately, your weight gain is the best clue as to whether you’re getting the optimal intake of calories. According to Michael Roizen, MD, coauthor of the newly released YOU: Having a Baby, a normal-weight woman carrying one baby should aim to gain between four and six pounds in the first trimester, 10 to 14 in the second and 10 to 15 in the third. If you’re underweight, overweight or obese, ask your obstetrician for the breakdown.
Now let’s get down to business: what you should eat to ensure a healthy pregnancy and a healthy baby.
Superstar Nutrients
A well-rounded diet that provides you with a wide variety of vitamins and nutrients is paramount to a successful pregnancy. Don’t miss out on these:
Calcium
Why you need it: To help regulate your heart rhythm, blood clotting and muscle contraction. Calcium also helps your baby’s teeth and bones form, says Heidi Murkoff, author of Eating Well When You’re Expecting. It can also lower your risk for preeclampsia, a serious condition affecting 5 percent of pregnant women, marked by a spike in blood pressure and allover swelling due to fluid retention.
Recommended amount: 1,000 to 1,500 mg per day. Your prenatal vitamin will provide 100 to 200 mg.
Best sources: Skim or 1 percent milk, low-fat yogurt, part-skim ricotta, calcium-fortified orange juice or soy milk, broccoli, canned salmon. Lead-free (that is, not from oyster shells) calcium carbonate or calcium citrate supplements are another option if you’re not getting enough from food.
Vitamin D
Why you need it: Vitamin D is an immune system and mood booster, which is why it’s a must for you. Your baby needs it for bone and teeth development. “Many women don’t get enough vitamin D, especially if they’re not milk drinkers, are very dark skinned or avoid the sun or use sunscreen daily,” says Johnson.
Recommended amount: 600 IU two times per day.
Best sources: Ten to 15 minutes of unprotected sun exposes you to enough ultraviolet light to trigger vitamin D production in the body. Vitamin D–fortified milk, eggs and cereals, plus fish liver oils (including cod and salmon) are other good bets. Supplements are available.
DHA, or docosahexanoic acid
Why you need it: Eating enough DHA can reduce your risk of preterm delivery and postpartum depression. This highly unsaturated omega-3 fatty acid is also critical to the development of your baby’s central nervous system (95 percent of the brain is made up of DHA), vision and vascular system. Your body doesn’t make DHA by itself, so it’s super important that pregnant women get adequate amounts from their diets so they can pass it along to their baby.
Recommended amount: Aim for at least 220 mg of DHA. Some doctors say pregnant women can consider supplementing so they get 600 to 900 mg of DHA per day, or two grams of combined DHA/EPA (another omega-3); be sure to discuss with your doctor first.
Best sources: Salmon, herring, shrimp, catfish and sardines are great sources of DHA. But babies exposed to high levels of mercury, a metal that’s present in fish, can suffer fetal brain damage, hearing loss and learning disabilities. So women need to limit tuna and tuna steak to safe amounts of no more than six ounces per week. Twelve ounces per week of other DHA-rich fish is fine. (For info on types of fish to avoid during pregnancy, see Pregnancy No-No’s. If fish doesn’t do it for you, look for foods fortified with a sustainable, algae-based DHA or take a daily supplement — just make sure it’s made with a high-grade fish oil that contains the lowest possible levels of contaminants such as mercury and dioxin. The nonprofit Environmental Defense Fund tested 75 brands and listed their best and worst choices. A few companies now offer prescription prenatal vitamins with DHA. Ask your health care provider about them.
Folic Acid
Why you need it: Folic acid helps prevent premature delivery. For your baby, it prevents neural tube defects in the spinal cord or brain and helps your baby achieve a healthy birth weight.
Recommended amount: At least a 400 mcg (0.4 mg) supplement daily, according to the American Congress of Obstetricians and Gynecologists, though some health groups recommend more.
Best sources: Leafy green vegetables like spinach and kale; fruits including grapes, oranges and orange juice; and fortified cereals. Your prenatal vitamin provides at least 400 mcg.
Iron
Why you need it: Iron is like the train that transports oxygen throughout your body. This mineral helps you manufacture oxygen-rich hemoglobin, which keeps your muscles working efficiently and you energized and happy. Iron also helps your baby achieve a healthy birth weight.
Recommended amount: 27 mg per day, or more if you’re iron-deficient.
Best sources: Red meat, beans, oatmeal, eggs, berries and watermelon. Cooking in a cast-iron skillet also releases iron into food. (Note: Iron is notorious for making pregnant women constipated. If that’s a problem, ask your ob to recommend a stool softener.)
Heartburn, Cravings and Nausea
Besides filling your body with healthy foods — for you and for your baby’s development — you may need to eat or avoid certain foods because of three common pregnancy problems: heartburn, cravings and nausea.
If heartburn’s got you down, try eating five or six small meals instead of three large ones during the day. And avoid heartburn triggers such as chocolate, spicy foods and carbonated drinks. You might also want to ditch the tight-fitting bra or top since it can put added pressure on your chest. You can also try an over-the-counter antacid.
If you’re craving crazy things, like chalk, dirt or ice cubes, talk to your ob. Docs aren’t exactly sure what causes these weird cravings (known as pica). Some suspect it’s an iron deficiency, so your ob may retest your iron levels.
Lastly, if nausea is your constant companion, see if eating five or six small meals during the day instead of three large ones helps. This will keep blood sugar steady and your stomach full (but not overly full), which can quiet nausea. You should also avoid fatty and spicy foods, which can trigger nausea. And try wearing an acupressure wristband made with a button that puts pressure on the inner-wrist area. Traditional Chinese medicine believes that stimulating this area, known as pericardium 6, can alleviate nausea. For women with severe nausea, known as hyperemesis, regular acupuncture sessions and/or taking an anti-nausea drug called metoclopramide can help.