Dr. Green Mom’s Guide To Healthy Eating During Pregnancy

While the phrase "eating for two" is often misunderstood to mean doubling calorie intake, that’s not the case. Calorie needs do increase, but not drastically. Instead, I like to think of "eating for two" as a reminder that nutrient intake matters for both you and your baby—making the quality of your food even more important.

To learn more about my approach to nutrition, read this article: The Basics Of Anti-Inflammatory Eating For The Whole Family

Caloric needs gradually increase throughout pregnancy (1):

• First trimester: No significant increase in calories, but nutrient density is key to supporting early development.
• Second trimester: An additional 300–350 calories per day helps fuel growth and maternal changes.
• Third trimester: An increase of 450–500 calories per day supports rapid fetal development and prepares the body for birth.

That said, I know that not everyone can always stomach the foods they wish they could during pregnancy. Nausea, food aversions, and fatigue can make it hard to focus on nutrient density—sometimes, all you can manage is crackers or plain toast, and that’s okay. Fed is always best. Your body is incredibly efficient at prioritizing nutrients for your baby, so do what you can and know that there will be time to replenish nutrient stores postpartum. When you feel up to it, focus on eating better rather than just eating more, choosing nutrient-dense foods that support both you and your growing baby.

It is important to note that in addition to increased caloric demands, pregnancy places higher demands on macronutrients (protein, fats, and carbohydrates) and micronutrients (vitamins and minerals).

Pregnancy increases the need for protein, fats, and carbohydrates to support fetal growth, maternal health, and overall energy demands (1). I don’t generally recommend strict calorie or macro counting but rather a general mindfulness and prioritization of nutrient-dense foods and consuming a varied diet. However, it may be helpful sometimes to track intake for a day or two to get a generalized idea of whether or not you’re hitting recommended intake amounts.

Here is one recommended macronutrient breakdown for pregnancy (2):

• Protein: 20% of daily calories
• Fats: 40% of daily calories
• Carbohydrates: 40% of daily calories

Protein is essential for fetal tissue development, hormone production, and maternal blood volume expansion (3). Quality sources of protein include grass-fed meats, pasture-raised poultry, wild-caught fish, pasture-raised eggs, full-fat dairy (if tolerated), and organ meats like liver in moderation. For those following a more plant-based diet, options like beans, lentils, chickpeas, quinoa, nuts, seeds, and organic tofu or tempeh can help meet protein needs. If nausea or food aversions make protein intake difficult, bone broth and collagen powder can be useful for sneaking extra protein into meals.

Healthy fats are crucial for baby’s brain and nervous system development (4). They also help support maternal energy levels. Quality sources of dietary fats include wild-caught salmon, sardines, pasture-raised eggs, extra virgin olive oil, avocado, coconut oil, nuts, seeds, and grass-fed butter or ghee.

Carbohydrates provide essential energy for both mother and baby, supporting fetal growth and maternal metabolism (5). Quality sources of carbohydrates include fiber-rich vegetables, fruits, quinoa, oats, sweet potatoes, properly prepared legumes, and whole grains. Choosing complex carbohydrates over refined options helps prevent blood sugar spikes and supports digestive health. Resistant starches, such as cooked and cooled potatoes, green bananas, and lentils, can also benefit gut health.

To learn more about blood sugar regulation, read this article: Tips for Blood Sugar Balance Plus Dr. Green Mom’s Ginger & Apple Cider Vinegar Mocktail Recipe

Nutrient density is always important, but certain vitamins and minerals become even more essential during pregnancy.

• Folate: The CDC recommends at least 400 mcg of folate per day to support neural tube development (6). Folate is found in liver, dark leafy greens, legumes, and avocado.

• Choline: Critical for brain development, cognitive function, and methylation (7). Choline is found in egg yolks, liver, beef, and fish. To learn more about the importance of choline during pregnancy, read this article: Choline: An Essential Nutrient For Pregnancy and Lactation  

• Iron: Iron needs increase during pregnancy, to support increased blood volume and oxygen transport (8). Sources include grass-fed beef, liver, sardines, and dark leafy greens.
  To learn more about iron, read this article: A Guide to Iron Supplementation

• Calcium & Magnesium: Support fetal bone development (9) and prevent muscle cramps (10). These minerals are found in full-fat dairy, almonds, sesame seeds, leafy greens, and bone broth.

• Zinc: Crucial for immune function and cell division (11). Zinc is found in grass-fed meat, shellfish, pumpkin seeds, and eggs.

• Iodine: Supports thyroid health and brain development (12). Good sources include seaweed, fish, dairy, and iodized salt.
  To learn more about iodine, read this article: The Iodine-Thyroid Connection

• Vitamin D3 & K2: Essential for bone health and immune support (13). Found in pasture-raised eggs, fatty fish, organ meats, and fermented dairy. To learn more about how these two nutrients play well together, read this article: Better Together: Vitamins D3 & K2  

Pregnancy increases susceptibility to foodborne illnesses due to changes in the immune system (14), making it even more important to follow food safety guidelines. Certain bacteria, parasites, and toxins that may be harmless to most people can pose significant risks to a developing baby. Being mindful of food choices and preparation can help reduce the risk of infections like listeria, toxoplasmosis, and salmonella.

To learn more about food poisoning, read this article: Food Poisoning: Symptoms, Remedies, and When To Call a Doctor

• Raw or Undercooked Meats and Seafood – Avoid sushi, raw oysters, rare steak, and undercooked poultry, as they may carry harmful bacteria or parasites.

• Deli Meats and Soft Cheeses – Processed meats (unless heated until steaming) and soft cheeses made from unpasteurized milk (such as brie, feta, and blue cheese) may carry listeria, which can lead to complications.

• Raw or Undercooked Eggs – Ensure eggs are fully cooked, and avoid foods like homemade mayonnaise, Caesar dressing, and raw cookie dough that may contain raw eggs.

• High-Mercury Fish – Large fish like shark, swordfish, king mackerel, and tilefish contain high mercury levels that may affect fetal brain development. Instead, choose low-mercury options like wild-caught salmon, sardines, and trout.

• Unpasteurized Dairy and Juices – These can carry bacteria such as E. coli or listeria, so always opt for pasteurized versions.

• Wash Produce Thoroughly – Rinse all fruits and vegetables under running water to remove potential pesticides and bacteria. To learn more about avoiding pesticides, read this article: How To Avoid Pesticides In Your Produce

• Separate Raw and Cooked Foods – Prevent cross-contamination by using separate cutting boards for raw meats and fresh produce.

• Cook Meats to Safe Temperatures – Use a food thermometer to ensure meats are cooked to safe internal temperatures (e.g., poultry to 165°F/74°C, beef to 160°F/71°C).

• Refrigerate Leftovers Promptly – Store leftovers within two hours to prevent bacterial growth.

• Be Cautious with Prepared Salads and Deli Foods – Pre-made salads, sandwich meats, and deli foods from salad bars or buffets may carry bacteria if not stored at safe temperatures.

In addition to food safety considerations, there are certain additional ingredients which are best minimized or avoided during pregnancy:

• Ultra-Processed Foods: Such as fast food and highly processed snacks, which often contain inflammatory oils, artificial dyes, MSG, and nitrates. Opt for minimally processed whole foods whenever possible.

• Excess Caffeine: High caffeine intake may be linked to low birth weight and developmental concerns. Limit caffeine to 200 mg per day (about one 12-ounce cup of coffee).
  To learn more about caffeine during pregnancy, read this article: Caffeine Consumption During Pregnancy and Lactation  

Even with a nutrient-dense diet, prenatal vitamins help fill potential gaps, ensuring both mother and baby receive essential nutrients for optimal development. It is generally recommended that mothers take a prenatal vitamin several months prior to conception, throughout pregnancy, and continue until at least six months postpartum or for as long as breastfeeding continues.

To learn more about what to look for in a quality prenatal vitamin, read this article: What To Look For In A Prenatal Vitamin

Staying properly hydrated is very important, especially during pregnancy and lactation. Hydration plays an important role in circulating nutrients, maintaining amniotic fluid, supporting digestion, and preventing dehydration-related complications like headaches, swelling, and constipation (15).

Pregnant women should aim for at least 8-12 cups of water per day (16), but individual needs vary based on activity level and climate.

• Sip throughout the day rather than chugging large amounts at once.

• Infuse water with fruit, herbs, or lemon if plain water is unappealing.

• Drink coconut water or homemade electrolyte drinks for added minerals.

• Increase hydration through high-water-content foods like cucumbers, melons, oranges, and bone broth.

If nausea makes drinking water difficult, try warm herbal teas, ice chips, popsicles or diluted fruit juices to keep fluids up. If you cannot keep fluids down, contact your doctor.

Morning sickness can make it difficult to eat a well-balanced diet. Some mothers find they can only tolerate carbs like toast, crackers, or plain pasta… This is not uncommon, but it can be very frustrating!

To learn more about morning sickness, read this article: Nutrient Deficiencies Associated With Morning Sickness

If nausea makes eating difficult, here are some tips:

• Eat small, frequent meals to stabilize blood sugar.

• Try bland, easy-to-digest foods like bone broth or congee.

• Incorporate protein where possible, for example by using bone broth as the liquid in savory recipes that call for water.

• Incorporate ginger to help manage occasional nausea

• Stay hydrated, especially if vomiting occurs.

Remember, fed is best. Your body will prioritize sending nutrients to your baby. Focus on getting back to nutrient-dense foods when nausea subsides and replenish nutrient stores postpartum.

Pregnancy and childbirth deplete maternal nutrient reserves (17), and significant depletion may contribute to postnatal depletion syndrome. If you find yourself experiencing significant food aversions during pregnancy, this may be especially relevant to keep in mind.

For more information, read this article on postnatal depletion syndrome: What Is Postnatal Depletion Syndrome?

Pregnancy comes with increased nutritional demands. This guide covers calorie needs, essential macronutrients (protein, fats, and carbohydrates), key micronutrients like folate, choline, and iron, food safety considerations, and the importance of hydration. It also highlights the importance of prenatal vitamins and replenishing nutrient stores postpartum, especially if food aversions made eating well during pregnancy difficult. Fed is best, and small mindful choices add up to nourish both you and your baby.