The Essential Pregnancy Diet: Nutritional Medicine to Support Each Trimester
Pregnancy is a beautiful yet demanding time, physically, emotionally and spiritually. During these nine months, a woman’s body undergoes incredible changes to nurture and sustain the life growing inside her. Nutrition plays a vital role in supporting both mum and baby through every stage of pregnancy, and is one of the best ways to support the health of you and bub throughout your pregnancy.
Proper nutrition during pregnancy is about more than simply eating enough—it’s about ensuring you’re nourishing both yourself and your baby with the right nutrients at the right time. Each trimester comes with its unique needs, and by focusing on the essential nutrients outlined in this guide, you can help support a healthy pregnancy and give your baby the best start in
In this guide, we will explore the key nutrients needed during each trimester and provide you with practical tips on the best food sources and supplements to keep you and your baby nourished throughout the journey.
First Trimester (Weeks 1-12): Building the Foundations
The first trimester is when the foundation for your baby’s development is laid. During these early weeks, major organs such as the heart, brain, and spinal cord begin to form. It’s crucial to ensure you’re consuming nutrients that support cellular growth and healthy development, and ideally you will have been focusing on these nutrients in your preconception care period, too.
Key Nutrients:
Folate
Folate, or folic acid in its synthetic form, is arguably the most critical nutrient during the first trimester. It plays an essential role in DNA synthesis, cell division, and the formation of the neural tube, which later becomes the brain and spinal cord. Adequate folate intake can help prevent neural tube defects like spina bifida.
Recommended Intake: 400-600 mcg/day
Best Food Sources: Leafy greens (spinach, kale, and romaine lettuce), legumes (lentils, chickpeas), avocados, and fortified cereals.
Meal Ideas: spinach and chickpea curry, kale and lentil stew, veggie patties with black beans and spinach
Supplementation: A prenatal vitamin containing at least 400 mcg of folic acid (or folinic acid, depending on your MTHFR status) is recommended.
Vitamin B6
Vitamin B6 is vital for brain development and is also known to help reduce nausea and vomiting (AKA morning sickness) during the first trimester.
Recommended Intake: 1.9 mg/day
Best Food Sources: Poultry (chicken, turkey), bananas, potatoes, and chickpeas.
Meal Ideas: Chicken and roasted vegetables, mashed chickpea “tuna salad”
Supplementation: Some prenatal vitamins contain B6, but it can also be taken as a separate supplement if morning sickness is severe.
Iron
Iron supports the increased production of blood needed to supply oxygen to both mother and baby. Blood volume increases by around 50% during pregnancy, so supporting our red blood cell production during this time is crucial! It also helps prevent iron deficiency anemia, which is common during pregnancy. The time to start supporting your iron during pregnancy is now, as it is much easier to maintain iron levels than it is to correct a deficiency once it occurs. Our aim is always to maintain healthy iron levels and prevent needing an iron infusion, whenever possible.
Recommended Intake: 27 mg/day
Best Food Sources: Red meat, poultry, eggs, tofu, lentils, and spinach.
Meal Ideas: Lean steak and roasted or steamed vegetables, slow cooked lamb shanks, tofu steaks, lentil dahl.
Supplementation: Iron supplements may be recommended if iron levels are low, especially since iron requirements increase significantly in the second and third trimesters. Many prenatal supplements contain iron, although not all of them. Ideally we want to use a highly bioavailable, non-constipating form of iron, such as iron bisglycinate (NOT ferrograd-C!).
Vitamin D
Vitamin D is crucial for calcium absorption, supporting the development of the baby’s bones and teeth. It also supports the immune system for both mum and baby. Unfortunately, many mothers end up vitamin D deficient, and this can increase the risk of developing postnatal depression. Our ideal source of vitamin D is always going to be sunlight exposure - this is the type of vitamin D our bodies are primed to absorb and utilise, and it is typically very good at doing so. Nutritional sources pale in comparison (pun intended!). For most people with fair skin, around 15 minutes of morning sun exposure on your bare arms, chest and abdomen is plenty of exposure for maintaining healthy vitamin D levels. If you have darker skin, you may need longer than this. However, if you are already low in vitamin D, it may be necessary to increase dietary consumption and use a supplement to boost your levels more quickly.
Recommended Intake: 600 IU/day
Best Food Sources: Fatty fish (salmon, mackerel), sun-bathed mushrooms, fortified dairy products, egg yolks, and sunlight exposure.
Meal Ideas: Grilled salmon and roasted vegetables, tuna salad, mushroom frittata
Supplementation: A prenatal supplement containing vitamin D or a separate D3 supplement may be recommended, particularly if there’s limited sun exposure.
A note on sun-bathed mushrooms: exposing your mushrooms to sunlight for 15 minutes before you cook them significantly increases their vitamin D content! This is a fabulous, easy way to increase your dietary consumption of plant-based vitamin D.
Diet Tips for the First Trimester:
Eat small, frequent meals to combat nausea and keep energy levels stable. Avoid becoming too hungry or too full, as both of these states can trigger nausea
Hydrate well, particularly if morning sickness leads to vomiting. And remember, if your nausea and vomiting leaves you unable to drink water or keep hydrated, please seek urgent medical care.
Focus on whole foods rich in essential nutrients, including plenty of fruits, vegetables, whole grains, and lean proteins. An orange in its whole, natural state, is always more valuable than a vitamin C supplement!
Second Trimester (Weeks 13-26): Growth and Development
By the second trimester, most women begin to feel better as morning sickness subsides and energy levels rise. This is the time when your baby’s organs are maturing, and they begin to grow rapidly. Nutritional demands increase, and it’s important to consume a balanced diet rich in key nutrients to support this stage of development. For those who are coming out of the first trimester fog, it can be a great time to get back into eating more balanced and nutritionally dense foods, if you were unable to eat the way you wanted to during first trimester.
Key Nutrients:
Calcium
Calcium is essential for building strong bones and teeth for your baby. If your diet doesn’t provide enough calcium, your body will draw it from your bones, which can impact your bone health later in life.
Recommended Intake: 1,000 mg/day
Best Food Sources: Dairy products (milk, yogurt, cheese), fortified plant-based milks, leafy greens (kale, bok choy), almonds, and tofu.
Meal Ideas: Greek yoghurt/ soy yoghurt topped with almonds and berries, palak paneer, tofu stir fry with wilted Asian greens
Supplementation: If dairy intake is low or you are a vegan, consider a calcium supplement - most prenatals contain calcium
Omega-3 Fatty Acids (DHA and EPA)
Omega-3s, particularly DHA, play a crucial role in the development of your baby’s brain, eyes, and nervous system. The majority of people eating “Western” diets unfortunately do not get sufficient omega 3 fatty acids, so this is often a point of focus when it comes to a healthy pregnancy diet.
Recommended Intake: 200-300 mg/day of DHA
Best Food Sources: Fatty fish (salmon, sardines, mackerel), walnuts, chia seeds, and flaxseeds.
Meal Ideas: sardines or mackerel on sourdough toast, oat porridge topped with walnuts and chia seeds. Sprinkly flax seeds or hemp seeds into smoothies or on top of yoghurt
Supplementation: A prenatal DHA supplement, typically derived from fish oil or algae, is often recommended.
Protein
Protein is the building block of tissues, and as your baby grows, so does the need for more protein. It supports muscle development, the growth of the placenta, and the increased blood supply.
Recommended Intake: 75-100 g/day
Best Food Sources: Lean meats, poultry, eggs, legumes (beans, lentils), tofu, and nuts.
Meal Ideas: chicken and vegetable omelette, lentil bolognaise, scrambled tofu. Sprinkle nuts and seeds on top of salads for a boost of plant-based protein and healthy fats
Supplementation: For vegans or vegetarians, a plant-based protein powder may be a helpful addition to the diet. A plain whole hemp protein powder is an ideal supplementary protein that doesn’t contain artificial sweeteners or fillers that are best avoided in pregnancy.
Magnesium
Magnesium supports muscle function and helps prevent leg cramps, which are common during the second and third trimesters. It also plays a role in regulating blood sugar levels and maintaining healthy blood pressure. Magnesium is a frequently low mineral that many women need to boost their intake of during pregnancy, postpartum and into motherhood.
Recommended Intake: 350-400 mg/day
Best Food Sources: Nuts (almonds, cashews), seeds (pumpkin seeds, sunflower seeds), leafy greens, whole grains, and legumes.
Meal Ideas: Homemade raw muesli bars with mixed nuts and seeds, roast veg bowl with wilted greens and slow cooked lentils
Supplementation: If leg cramps are a frequent issue, a magnesium supplement may be helpful. Remember that not all magnesium supplements are created equal! Magnesium oxide is a poorly bioavailable form, but it is unfortunately frequently found in cheaper magnesium supplements available on the shelves. Look for magnesium glycinate, magnesium citrate, or magnesium gluconate.
Diet Tips for the Second Trimester:
Increase your calorie intake by about 300-350 calories per day to support the baby’s growth. This is easily achieved by adding in a small afternoon or evening snack.
Prioritize protein and healthy fats, particularly omega-3s, to support brain development. Treating snacks as “mini meals”, and including protein and fats along with carbohydrates, can help to make sure you’re getting enough of all macronutrients.
Stay active with light exercise, as it helps with digestion and boosts energy levels. A daily walk, prenatal yoga or a swim can be a great option for pregnancy-friendly activity.
Third Trimester (Weeks 27-40): Preparing for Birth
As you enter the final trimester, your baby’s growth accelerates, and they begin preparing for life outside the womb. Your nutritional needs increase to support the baby’s weight gain, brain development, and the production of breast milk. The focus in this trimester is on energy-dense foods and adequate hydration.
Key Nutrients:
Iron
Iron needs remain high as blood volume continues to increase to meet the demands of both mother and baby. Adequate iron intake also helps to reduce the risk of preterm delivery and low birth weight.
Recommended Intake: 27 mg/day
Best Food Sources: Red meat, poultry, eggs, tofu, lentils, and spinach.
Meal Ideas: Lean steak and roasted or steamed vegetables, slow cooked lamb shanks, tofu steaks, lentil dahl.
Supplementation: If you have been prescribed an iron supplement earlier in your pregnancy but your levels are still low, it may be time to adjust the timing or dosage you are on. Speak to your healthcare practitioner to discuss what’s best for you.
Vitamin K
Vitamin K is important for blood clotting and helps prepare the body for delivery by ensuring proper clotting mechanisms are in place. Babies are born with low levels of vitamin K, so ensuring adequate intake in the third trimester is key.
Recommended Intake: 90 mcg/day
Best Food Sources: Leafy greens (kale, spinach), broccoli, Brussels sprouts, and cabbage.
Meal Ideas: saag paneer, sheet pan roasted broccoli and Brussels sprouts
Supplementation: Usually, a balanced diet will provide sufficient vitamin K.
Choline
Choline is essential for brain development and helps prevent neural tube defects. It also supports the development of the baby’s liver and placenta. Studies show that adequate intake of choline during pregnancy can have lasting benefits to baby’s brain throughout infancy and early childhood.
Recommended Intake: 450 mg/day
Best Food Sources: Eggs (particularly the yolk), liver, beef, chicken, and soybeans.
Meal Ideas: roasted vegetable frittata, shakshuka, slow cooker beef or chicken stew
Supplementation: Some prenatal vitamins include choline, but if not, consider an additional supplement, especially if you are vegan or plant-based.
Fibre
As the baby grows, the digestive system may slow down, leading to constipation, which is common in the third trimester. Adequate fibre intake can help maintain digestive health and prevent constipation. Ideally you will have slowly increased your fibre intake throughout second trimester to help improve your digestive tolerance and to keep things moving throughout the later months of pregnancy.
Recommended Intake: 28 g/day
Best Food Sources: Whole grains (brown rice, oats), fruits (apples, berries), vegetables (broccoli, carrots), and legumes.
Meal Ideas: sprinkle ground flax seeds into smoothies or on top of yoghurt; stewed fruits, plenty of steamed and baked vegetables
Supplementation: A fibre supplement such as psyllium husk or flax seed may help if constipation becomes a problem. Remember to start with a small amount and build up slowly, and always consume LOTS of water with any additional fibre!
Diet Tips for the Third Trimester:
Eat small, nutrient-dense meals frequently to manage heartburn and keep energy levels stable. Continue to structure each snack as a “mini meal”.
Focus on hydration, as dehydration can lead to premature contractions or increased discomfort. Keep a water bottle with you and sip regularly throughout the day.
Choose high-fibre foods to maintain digestive health as the baby’s size may put pressure on the intestines.
Supplementation: Should You Take Prenatal Vitamins?
Prenatal vitamins are recommended for all pregnant women, as they help fill nutritional gaps and provide essential nutrients like folic acid, iron, and vitamin D. However, it’s important to focus on a balanced, whole-foods diet as the foundation of your nutrition. Supplements should complement, not replace, a healthy diet.
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About the Author
Lizzie Stow is a clinical naturopath from Newcastle, Australia.
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