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Pregnancy can be both an exciting and overwhelming time for women, especially if it’s your first time.  

Everyone’s experience with food during pregnancy is different. 

Whether you’re struggling to keep anything down with the dreaded morning (or all day!) sickness, or experiencing bizarre food cravings, one common question you’ll probably want answered is: 

"What should I be eating during my pregnancy?"

Below I highlight the key nutrients for a healthy pregnancy and discuss how to incorporate them into your diet.

Folate and Folic Acid (Brain and Spinal Cord Development)

Adequate intake of folate during pregnancy is essential in preventing neural tube defects, which are malformations of the baby’s brain and spinal cord.

You will commonly see folate—also known as vitamin B9—in two forms: Folate naturally occurs in foods, while folic acid is the synthetic form of the vitamin that’s found in supplements as well as fortified foods.

Sliced avocado sitting in a bowl

Avocados are a great source of folate

During pregnancy, you are recommended to consume 600 micrograms of folate a day, with good sources including green leafy vegetables (spinach), fruits (oranges and papayas) and legumes (beans and lentils).

You’ll probably find it hard to consume your daily quota of folate—600mcg is the equivalent of over 10 cups of spinach! 

So it’s recommended that  women supplement with a dose of 400 mcg of either folate or folic acid.

Calcium and Vitamin D (Strong Bones) 

Calcium and vitamin D are two minerals that work in tandem to build and maintain strong healthy bones.

Pregnant women need 1,000 milligrams a day of calcium, which can be met from dairy foods such as milk, yogurt and cheese, or from fish with soft bones such as salmon or sardines.

 If you’re lactose intolerant or practice a vegetarian/vegan diet, certain green vegetables (kale, bok choy, collard greens), non-dairy milks (which are often fortified with calcium) or soy products are good sources. 

Certain green vegetables (spinach, chard) are not as good because they contain oxalic acid that inhibits calcium absorption.

To get your correct intake, you would need to consume roughly one cup of milk, a cup of yogurt, 85g of salmon with bones and a cup of cooked kale.

Should you choose to take a calcium supplement, limiting doses to 500mg at a time and combining with vitamin D consumption will help maximize absorption.

Vitamin D

Vitamin D can either be synthesized in your skin upon exposure to UV rays or consumed in your diet.  

The U.S. National Institute of Health recommends a daily intake of at least 600 international units (IU) of vitamin D a day. 

Good food sources include low-mercury fatty fish (salmon, sardines) and eggs.

However, a combination of limited sun exposure and few naturally occurring food sources of vitamin D means that deficiency is very common, even in developed countries like Hong Kong.

It may be useful to ask your doctor to test your vitamin D levels and supplement accordingly.   

Read more on the importance and sources of vitamin D here.

Iron (Prevents Anemia)

Iron is an essential component of your red blood cells, which carry oxygen around your body.

During pregnancy, your iron needs will increase to 27mg a day as your body makes more blood to deliver oxygen to your developing baby.

Insufficient iron can cause maternal anemia, which commonly causes symptoms of fatigue. 

Cases of severe deficiency can be associated with preterm delivery or low birthweight infants.

Meal of grilled chicken and vegetables

Mix vitamin C with your iron in pregnancy to maximize absorbency

To prevent iron deficiency, consume a diet rich in lean red meats and poultry along with foods high in vitamin C (found in fruits and vegetables), which encourage iron absorption.

An iron-rich diet could include something like: lean beef (170g = 4 mg), spinach (1/2 cup cooked = 3 mg), white beans (1 cup = 8 mg), sardines (85g = 2mg) or cashew nuts (28 = 2 mg).

Vitamin A (Immune Function)

Vitamin A is important for the healthy vision and immune function of both you and your baby. 

It typically occurs in two forms: preformed vitamin A (retinol, retinyl esters) and provitamin A (carotenoids).

Good sources of the former are dairy products, fish and meat, especially liver. Provitamin A is found in root veg such as carrots, sweet potatoes and pumpkin, as well as greens like spinach, kale and broccoli, and orange, red and dark green fruits.

While vitamin A is important, deficiency is not that common—but consuming an excess of the preformed vitamin in pregnancy can increase the risk of fetal abnormalities. 

This very rarely occurs from food sources but overconsumption from supplements can occur.

To be sure, check that your supplement does not contain more than 5,000 IU a day of preformed vitamin A.

When do I need to start paying attention to my diet and nutrient intake?

As the brain and spinal cord formation takes place shortly after conception, all women who might become pregnant should take a daily supplement containing folate or folic acid.    

Additionally, because it is harder to build nutrient stores while pregnant, a good rule of thumb is to regularly maintain a healthy, balanced diet and start taking prenatal vitamins ideally three months before conception.