The antenatal diet can be defined as anything a woman eats while she is pregnant. There is no one international guideline on nutrition in pregnancy; however, national or state healthcare authorities where you are or professional bodies like RCOG and ACOG offer evidence-based and up-to-date guidance. We recognise that not every food may be covered, and guidelines can sometimes conflict. You should speak to your doctor about specific foods you’re unsure about. Remember that antenatal and other recommended vitamins (e.g., Vitamin D in darker climates) should form part of your diet. Optimising your diet for pregnancy is highly recommended, and ideally you will have begun doing so at least three months before conception. However, it’s never too late in pregnancy to start eating better, and you can start today with the following advice. Before we begin, however, we want to warmly suggest that balance rather than perfection be your goal. Your body is doing something amazing in pregnancy, and food should support you in this, not stress you out.

What do I need to eat in pregnancy?

A diet rich in fruits and vegetables, whole grains, lean meats, and fish is ideal. You need to take your folic acid three months prior to pregnancy and throughout the first trimester regardless of your diet, but you won’t always need other common pregnancy supplements, such as iron, if you are getting enough from your diet. However, because the demands pregnancy places on the body cause nutrient levels to decrease generally, it is important to seek and take medical advice on supplements.

What do I need to restrict or avoid in pregnancy?

Caffeine in pregnancy can come from foods like chocolate as well as beverages. The recommended limit in pregnancy is 200 mg per day. You don’t need to worry about caffeine in skincare the way you need to worry about avoiding retinoids, for example, as it is unlikely that it will enter your bloodstream in a way that can impact your overall caffeine intake.

Alcohol can also be used in the preparation or preservation of some foods or as an ingredient in some dishes. The amounts aren’t typically significant, but if you are trying to avoid all alcohol in pregnancy or are worried about the quantities in which you consume foods with trace amounts, it’s worth speaking to the chef or checking food labels.

Sugar in pregnancy is not necessarily harmful, and naturally occurring sugars in fruits are fine. Juicing removes the fibre content from fruit, making juice extra sugary and best enjoyed in moderation or with a source of fibre. Refined sugar sources can cause inflammation, blood sugar spikes, and poor gut health. They can increase your risk of gestational diabetes. They also tend to be low in nutrients, so they are best limited or avoided.

Meat, fish, and seafood in pregnancy are typically fine as long as they are well cooked (to avoid listeria and toxoplasmosis). Fish that are high in mercury (e.g., tuna, shark, king mackerel, and swordfish) should be avoided. Limit your oily fish intake to two per week. Chorizo, salami, and other processed meats that are traditionally prepared raw are best avoided unless you are certain they are properly cooked.

Dairy in pregnancy is usually fine unless it is unpasteurised.

Eggs should be well cooked to avoid salmonella, though the UK’s Red Lion-stamped eggs are considered safe even when runny.

Pregnancy cravings are not necessarily harmful unless you indulge them so frequently that it causes nutritional imbalances or you eat foods that go against medical guidance. In addition, pica, a phenomenon that makes pregnant women crave odd things like plastic and coal, can be extremely harmful to you and your baby and should be reported to your doctor or midwife.

Vitamin A sources in pregnancy are to be avoided because excessive vitamin A is linked to birth defects. Liver, pate, fois gras, and fish liver oils are all examples of vitamin A-rich foods.

Shouldn’t I just eat what my body tells me to when I’m pregnant?

Yes, as long as what your body is telling you to eat is consistent with nutritional guidance from your doctor, midwife, or healthcare authority, then it should be fine. “Eat what your body tells you” is common advice for pregnant women, especially from older family members. As long as what your body wants forms part of a balanced diet and is not on the “foods to avoid” list (raw fish, liver, etc.), it’s OK to trust your instincts. If you crave junk food sometimes, it’s not necessarily harmful, but it does mean you and your growing baby miss out on the nutrients that you could get from a healthier meal, so try not to eat it every day.

Can I be paleo in pregnancy?

Maybe. This depends heavily on your daily eating habits. While some research suggests that a paleo diet (which involves eating as humans would in caveman times) has a positive effect on pregnancy, it has also been linked to nutrient deficiencies in pregnancy. It’s important to remember that an unborn child’s dietary needs differ from those of an adult. A paleo diet involves cutting out wholegrains, starchy vegetables, most forms of full-fat dairy, and legumes, all of which can form part of a healthy, balanced pregnancy diet. However, the paleo guidance on avoiding refined sugar and processed food is great for pregnancy. If you feel strongly about following a paleo diet while pregnant, it’s important to speak to your doctor, who may suggest you work on an eating plan.

Can I be vegan or vegetarian in pregnancy?

Yes, veganism and vegetarianism are typically fine in pregnancy as long as you are eating a balanced diet. You can even find good-quality vegetarian and vegan antenatal vitamins. However, to avoid any potential problems, it’s important to let your doctor and midwife know you are a vegan or vegetarian and take their advice on how to eat while you are pregnant. The real worry is that you won’t get enough iron and protein in your diet, but there are many ways that your food and supplement intake can be adjusted to compensate for an absence of animal sources.

Should I be counting calories in pregnancy?

No, you shouldn’t be counting calories. If you need to manage your weight in pregnancy, it’s important to do so under medical supervision, which will not typically involve calorie counting. Other popular dieting methods, such as WeightWatchers points counting, carb counting, etc., should also be avoided. If you need to avoid gluten because you are a coeliac, your healthcare team should be aware of your medical condition and advise on your diet. If you are having psychological or emotional issues with pregnancy weight gain, it’s important for both you and your baby that you seek support. Try to keep in mind that the baby eats what you eat, and part of being a good mum is taking care of yourself.

For more advice on taking care of yourself in pregnancy, labour, and birth, check out Unii’s Antenatal Course, with prenatal video episodes taught by senior NHS midwives, an award-winning obstetrician and gynaecologist, and six other leading healthcare experts. Coming soon to unii.com.

The Definition of Antenatal Diet: Nutritional Guidelines for Expecting Mothers