Nutrition during pregnancy

Eating well during pregnancy helps ensure

  • Your pregnancy advances normally
  • Your baby grows, develops, and is healthy
  • You stay healthy or improve your health

The physical transformations you undergo during pregnancy increase your body’s nutritional and energy requirements. That means you’ll need to eat a little more than usual, especially starting in the second trimester. Vary the dishes you eat and how you prepare them. Experiment with different flavours, colours, and ingredients. Pregnancy is a good opportunity to improve your diet, and that of those around you.

In addition to this section, you can also consult www.canada.ca/en/public-health/services/pregnancy/healthy-eating-pregnancy.html.

The following general advice may not apply in the following situations:

  • You are a young mother under the age of 20
  • You have a disease that requires a special diet
  • You systematically avoid one or more food groups
  • You have other special needs

Talk about your diet to your health professional. He or she can assess your situation, provide advice, or refer you to a dietician.

On the menu: variety, colours, and flavours

Essential information to rememberEating regularly is important!

Your baby depends on you for food. Avoid going for long periods without eating. Eating regularly means three meals a day plus snacks between meals as needed. This allows you to

  • Take in all the nutrients you need during pregnancy
  • Avoid drops in your energy level during the day

Eating well during pregnancy means eating regularly and making sure you have a variety of colourful and tasty foods on your plate. Try to eat foods from each of the four food groups described in Canada’s Food Guide on a daily basis:

  • Vegetables and fruit
  • Grain products
  • Milk and alternatives
  • Meat and alternatives

If you’re not used to eating foods from each of the food groups every day, you might find the suggestions in this section helpful. You can also refer to Canada’s Food Guide for examples of recommended serving size and number of portions by visiting www.canada.ca/en/health-canada/services/food-nutrition/canada-food-guide/choosing-foods/advice-different-ages-stages/pregnancy-breastfeeding.html.

Vegetables and fruit

Essential information to rememberOpt for colourful vegetables and fruit, which are rich in nutrients.

Photo: iStockphoto

Vegetables and fruit are bursting with flavour, and should be part of every meal and snack. They contain important nutrients, including the following:

  • Folic acid, which aids in the development of your baby’s brain and nervous system, her overall growth, and the formation of the placenta
  • Vitamin C, which facilitates iron absorption
  • Fibre, which helps the intestines to function properly and controls blood sugar levels

Where to start?

  • Choose colourful vegetables and fruit, as they are rich in nutrients. Try to eat at least one dark green and one orange vegetable each day, e.g., broccoli, spinach, Romaine lettuce, carrots, sweet potato, winter squash.
  • Include your favourite vegetables and fruits in your meals and snacks.

A few tips

  • Eat veggies and fruit in various forms: fresh, frozen, canned, dried, in sauces or compotes, in soups, as juice, and in cooked dishes.
  • Wash all fruit and vegetables under running potable water, whether you eat them raw or cooked, or with or without the peel (see Preventive measures for the whole family).
  • Avoid unpasteurized juice (most juices are pasteurized).

Essential nutrients: folic acid

Folic acid is an important vitamin for all pregnant women, especially at the beginning of pregnancy. It reduces the risk of certain birth defects. While a number of foods contain folic acid, you will be advised to take a folic acid supplement during pregnancy (see Vitamin and mineral supplements).

What foods contain folic acid?

  • Legumes: lentils, Roman and white beans, soybeans, chickpeas
  • Dark green vegetables: asparagus, spinach, broccoli, Romaine lettuce, Brussels sprouts, okra
  • Sunflower seeds
  • Enriched pasta and flour
  • Bread made from enriched wheat flour
  • Orange-coloured fruit: papayas, oranges and orange juice

Grain products

Essential information to rememberGrain products include pasta, rice, bread, and much much more!

Photo: iStockphoto

Grains like oats, barley, buckwheat, rye, millet, quinoa, and others can add variety to your menu. Grain products contain the following:

  • Starch and sugar, which help produce energy
  • Group B vitamins, iron, zinc, magnesium, vitamin E, and fibre, which play a role in the development and proper functioning of the nervous, cardiovascular, and digestive systems

Contrary to popular belief, pasta, bread, and rice don’t cause weight gain as long as you don’t load them up with fatty foods like butter and rich sauces.

Where to start?

  • Add grain products that contain whole grains to your diet. Try to ensure that at least half of the grain products you eat daily consist of whole grains, e.g., whole wheat bread, oatmeal, barley, multigrain spaghetti, brown rice, wild rice, fibre-rich breakfast cereal, bran muffins, etc.

A few tips

  • Opt primarily for bread, cereal, pasta, and rice, as these foods contain less fat and sugar than baked goods such as cookies, croissants, store-bought muffins, and cakes.
  • When choosing whole grain foods, don’t rely on colour! Read the ingredient list: the first ingredient must be a whole grain.

Milk and alternatives

Essential information to rememberDairy products and enriched soy beverages are good for strengthening bones.

Photo: iStockphoto

Dairy products and enriched soy beverages have lots to offer—and not just for kids!

They contain

  • Calcium and phosphorus, which help build and maintain healthy bones and teeth
  • Proteins, which help build organs and muscles

Where to start?

  • Consume the equivalent of two glasses of milk or enriched soy beverage a day.
  • Complement your meals or snacks with yogurt or cheese, depending on your preference.

A few tips

  • Make sure the milk and dairy products you consume are pasteurized.
  • If you don’t like the taste of milk or enriched soy beverages, you can
    • Add them to your cold cereal at breakfast or snacktime, or use them to replace water when making hot cereals like oatmeal or cream of wheat.
    • Flavour them with vanilla or almond extract, spices, fruit, chocolate, etc.
    • Use them in your recipes: creamy soups, blanc-mange, puddings, tapioca, smoothies, etc.
  • Are you lactose intolerant? You can find lactose-free milk and enriched soy beverages in grocery stores. You can also buy capsules and drops at the drugstore that can help you digest dairy products.

Essential nutrients: calcium and vitamin D

Calcium plays an essential role in developing bones and teeth and keeping them healthy. Your baby needs it to build all her bones! And vitamin D helps the body absorb and use calcium. That’s why they make such a great team!

What foods contain calcium and vitamin D?

Calcium

  • Dairy products: milk, yogurt, and cheese
  • Enriched soy beverages, tofu (with calcium sulphate)
  • Canned fish with bones: sardines, salmon
  • Calcium-enriched foods (e.g., some orange juices)

Vitamine D

  • Milk
  • Enriched soy beverages
  • Fatty fish, e.g., salmon
  • Margarine

Most legumes, dark green vegetables, nuts, seeds, and almonds also contain small amounts of calcium. Think of them as a bonus!

Meat and alternatives

Essential information to rememberMeats and alternative are nutritious foods that help you keep your energy level up.

Not only do meats and alternatives add variety to your plate, they also contain

  • Proteins, which help build and repair organs and muscles
  • Iron, which helps produce blood
  • Omega-3 and omega-6 fatty acids, which help your baby grow

Where to start?

  • Each day, choose from a variety of meats, poultry, fish, and alternatives such as legumes, eggs, nuts and seeds, peanut butter, and tofu.
  • Eat fish twice a week. It is a good source of omega-3 fatty acids.

A few precautions

  • Meat, poultry, eggs, fish, seafood, and any dishes that contain these foods should be well cooked (see Cooking foods).
  • While liver is an excellent source of iron, it is not recommended for pregnant women because of its excessively high levels of vitamin A.
  • If you eat wild game, it’s preferable to eat meat from game killed with lead-free ammunition. Lead can negatively affect children’s development.

What’s on the menu? Fish!

Eating fish and seafood during pregnancy provides important nutrients, including protein, vitamin D, magnesium, and iron. Fish is also high in omega-3 fatty acids, which contribute to the development of baby’s brain and eyes.

But some species of fish contain contaminants such as mercury. Women who are pregnant or plan to become pregnant, women who are breast-feeding, and young children can still enjoy fish if it is chosen carefully.

To limit exposure to contaminants:

  • Opt for fish and seafood that are low in mercury and other contaminants: shad, smelt, trout (except lake trout), Atlantic tomcod, salmon, lake white fish, haddock, anchovies, capelin, pollock (Boston bluefish), herring, mackerel, hake, flounder, sole, sardines, redfish, canned light tuna, tilapia, oysters, mussels, clams, scallops, crab, shrimp, and lobster.
  • Limit your consumption of:
    • Certain marine fish to 150 grams per month (75 grams per month for children 1 to 4 years old): fresh or frozen tuna, shark, swordfish, marlin, and orange roughy;
    • Canned white tuna to 300 grams per week. Canned light tuna is a better choice. For children, see Fish, page 490.
  • Avoid regular consumption of sport fish most vulnerable to contamination: bass, pike, walleye, muskellunge, and lake trout.

Essential nutrients: iron

Iron is essential for the growth of the baby and the placenta. That’s why you need more iron during pregnancy than at any other stage of life. What foods contain iron?

Animal-based foods

  • Meat: beef, lamb, pork (including ham), veal, game
  • Poultry: chicken, turkey
  • Fish: sardines, salmon, trout, halibut, haddock, perch
  • Seafood: shrimp, oysters, mussels
  • Seal, wild duck, moose
  • Blood sausage

Plant-based foods

  • Legumes: dried beans, lentils, chickpeas
  • Legumes: dried beans, lentils, chickpeas
  • Medium or firm tofu
  • Breakfast cereals (iron-enriched)
  • Certain vegetables: pumpkin, green peas, potatoes, spinach
  • Nuts, peanuts, sunflower and pumpkin seeds
  • Iron-enriched pasta and bread

Generally speaking, iron from animal sources is more readily absorbed than iron from plant sources. To help your body absorb the iron contained in plant-based foods, eat foods rich in vitamin C with your meal: broccoli, cantaloupe, citrus fruits and juices, kiwi, mango, potato, strawberries and peppers. Avoid drinking coffee or tea during meals to ensure the iron is absorbed properly.

Each food group is important!

No single food can provide all the nutrients your body needs to stay healthy. That’s why it is important to eat a variety of foods every day from each of the food groups in Canada’s Food Guide. Here’s an idea to help you: Concoct your meals using foods from at least three different groups, and aim for two food groups at snacktime.

Photo: Sarah Witty

Nutritious snack ideas:

  • A veggie or fruit with a piece of cheese
  • A few nuts with yogurt
  • One or two slices of toast spread with peanut butter
  • A half-pita with humus (chickpea spread)
  • A muffin with a glass of milk or enriched soy beverage
  • A handful of mixed nuts and dried fruit
  • A fruit milkshake
  • A hardboiled egg with a few crackers

Good fats

Some fats are good for you, and are important during pregnancy. These include fats from the omega-3 and omega-6 families of fatty acids. Your body can’t produce all of these fats, which is why it is important to consume them in small quantities on a daily basis.

Many of the foods we eat contain omega-6 fatty acids, including corn oil and sunflower oil, and it’s easy to get enough of them, as they are also found in many processed foods. Omega-3 fatty acids, on the other hand, are only found in certain types of foods, including:

  • Fatty fish: fresh, frozen or canned salmon, rainbow trout, mackerel, sardines, herring
  • Canola oil, flaxseed oil, and nut oils, as well as vinaigrettes and soft margarine (non hydrogenated) made with these oils
  • Ground flaxseed, chia seeds, walnuts
  • Omega-3–enriched foods (e.g., some milk and eggs)

Sweeteners

Some people prefer artificial sweeteners to sugar, or choose yogurt, drinks, jam, chewing gum, and other products containing sugar substitutes.

The sweeteners contained in processed foods are considered safe by Health Canada.

However, if you eat too many products containing sweeteners, there is a risk of diminishing your intake of nutritious foods that constitute a good source of energy.

Some sweeteners are not found in processed foods. They come in various formats, like packets, that you add yourself to food and drinks. Cyclamates fall under this category. Use them only if your doctor recommends it.

Drinks

Drink often to stay properly hydrated. Drinking water and eating dietary fibre helps your intestines do their job and reduces the risk of constipation. Other drink options are milk, 100% pure vegetable or fruit juice, and broth.

Caffeinated drinks

Coffee, tea, and cola-type drinks contain caffeine, as does chocolate and some medications. Do not exceed 300 mg of caffeine per day, regardless of the source. For example, if you limit your consumption of other products containing caffeine, you can drink a little over two cups of coffee a day (one cup equals 8 ounces, or 237 ml).

Energy drinks can contain as much caffeine as coffee, and sometimes a lot more. They are not recommended during pregnancy as they also contain products such as ginseng and taurine, which have not been proven safe for pregnant women.

Decaffeinated products are safe for consumption during pregnancy.

For more information go to www.phac-aspc.gc.ca/hp-gs/know-savoir/caffeine-eng.php.

Herbal teas

Certain plant-based products can have an adverse effect on pregnant women, by triggering contractions, for example. As for herbal teas, there is not enough scientific evidence to recommend their consumption by pregnant women.

According to Health Canada, the following herbal teas are generally safe when consumed in moderation, i.e., no more than two or three cups a day: orange or other citrus peel, ginger, lemon balm, and rosehip. Vary your herbal teas rather than drinking the same kind every day. Another tasty option is to add lemon juice or ginger slices to hot water.

Preventing food-borne infections

There’s no such thing as a world without germs. Water and food can carry viruses, bacteria, or parasites. Microbes are also present in animals, and can make their way into fertilizers and gardens. In reality, microbes are everywhere.

Fortunately, our digestive and immune systems protect us against most of these invaders. During pregnancy, however, the immune system is somewhat modified, leaving pregnant women more vulnerable to certain infections.

Some of these infections, like listeriosis and toxoplasmosis, can also be more severe in pregnant women, and can increase the risk of problems with the fetus or newborn.

Since toxoplasmosis can also be transmitted by cats, you will find more information on this disease in the section entitled Pets.

Listeriosis and pregnancy

Listeriosis is a rare disease. It is caused by a bacteria called Listeria monocytogenes. It is often relatively harmless for healthy adults.

In pregnant women, the symptoms of listeriosis are often similar to those caused by the flu: fever, shivering, fatigue, headache, and muscle or joint pain. More rarely, listeriosis causes digestive problems (vomiting, nausea, cramps, diarrhea, headaches, constipation).

However, the bacteria that causes listeriosis can pass through the placenta and trigger a miscarriage in the first trimester. Later on in pregnancy, it can cause stillborn birth, premature delivery, or serious infections in the baby (blood poisoning, meningitis).

The bacteria that causes listeriosis is present in the environment. It can contaminate certain raw foods, as well as some of those that have been cooked or pasteurized. It survives and can develop in cold temperatures, i.e., refrigeration temperatures.

Foods that are most likely to transmit listeriosis include the following:

  • Foods produced without a step that destroys bacteria, e.g., raw meat
  • Cooked foods that share the following characteristics:
    • Foods at high risk of contamination during handling after cooking or pasteurization
    • Foods with characteristics (acidity, humidity, salt content) that promote the growth of bacteria
    • Ready-to-eat foods kept for a long time in the refrigerator

Here is an example of how foods can be contaminated: Deli meats are cooked in a factory, but can be contaminated by listeria bacteria when they are sliced. The bacteria can then multiply in the sliced meat stored in the refrigerator. Then, if enough bacteria are present and the deli meats are eaten without being recooked, the people who consume them can contract the infection.

Prevention tips for pregnant women

Pregnant women are advised to avoid certain foods that can transmit listeriosis and other food-borne infections. You’ll find Health Canada’s recommendations on foods to avoid and safe alternatives on the following pages.

Safe food alternatives for pregnant women

Meat, game, poultry

Foods to avoid during pregnancy Safer alternatives

Raw or undercooked meat, game, and poultry (e.g., tartare, carpaccio, rare ground meat)

Meat, game, and poultry cooked to their safe internal temperature (see Cooking foods)

Refrigerated pâtés and meat spreads (e.g., country-style pâté, cretons))

Pâtés and meat spreads that do not need to be refrigerated until they are opened (e.g., that come in cans)

Homemade pâtés and meat spreads

Non-dried deli meats (e.g., sliced ham, mortadella, turkey breast, or sliced beef)

Dried and salted deli meats like salami and pepperoni

Non-dried deli meats that are heated until steaming hot (they can be allowed to cool before eating)

Hot dog sausages that are not reheated

Hot dog sausages that are heated until steaming hot or until they reach an internal temperature of 74°C (165°F)

Fish and seafood

Foods to avoid during pregnancy Safer alternatives

Raw or undercooked fish and seafood (e.g., tartare, sushi, raw oysters)

Fish and seafood cooked to their safe internal temperature (see Cooking foods)

Oysters, clams and mussels that are cooked until the shell has opened

Refrigerated smoked fish and seafood (e.g., smoked salmon or trout)

Smoked fish and seafood that do not need to be refrigerated until they are opened (e.g., that come in cans)

Refrigerated smoked fish and seafood that has been reheated to 74°C (165°F)

Refrigerated smoked fish and seafood used in cooked dishes

Eggs and egg-based products

Foods to avoid during pregnancy Safer alternatives

Raw or runny eggs (e.g., sunny side up)

Eggs that are well-cooked, with firm yolks and whites (e.g., omelet, boiled, scrambled)

Foods made with raw or undercooked eggs (e.g., homemade products like mayonnaise, Caesar salad dressing, eggnog, mousse, sauces, and cookie and cake dough)

Store-bought dressing, mayonnaise, and sauces

Store-bought pasteurized eggs for raw egg–based recipes made at home

Dishes made with eggs cooked to an internal temperature of 74°C (165°F) (e.g., quiche)

Homemade eggnog heated to 71°C (160°F)

Milk and dairy products

Foods to avoid during pregnancy Safer alternatives

All pasteurized and unpasteurized soft cheeses (e.g., Brie, Camembert, Feta)

All pasteurized and unpasteurized semi-soft cheeses (e.g., Saint-Paulin, Havarti)

All pasteurized and unpasteurized blue-veined cheese

Cheese made from pasteurized milk:

  • Firm cheese (e.g., cheddar, Gouda, Swiss)
  • Cheese curds
  • Cottage cheese or ricotta
  • Cream cheese
  • Cheese spreads

Pasteurized and unpasteurized hard cheeses (e.g., Parmesan and Romano)

Cheese used in cooked dishes, casseroles, or au gratin

Raw milk and dairy products made from unpasteurized milk

Pasteurized milk and dairy products made from pasteurized milk

Fruit and vegetables

Foods to avoid during pregnancy Safer alternatives

Unpasteurized fruit juice

Pasteurized fruit juice

Unpasteurized fruit juice that is brought to a boil, then cooled

Unwashed fresh fruit and vegetables

Fresh fruit and vegetables that have been thoroughly washed (see Preventive measures for the whole family)

Raw sprouts (e.g., alfalfa, clover, radish, bean sprouts)

Cooked sprouts

 

Cooking foods

To be sure food is well cooked, you can use a digital food thermometer to check the internal temperature. Here are the minimum safe temperatures for killing microbes:

  • Beef, veal, and lamb—whole cuts (e.g., roasts), pieces (e.g., steaks, chops): 63°C (145°F).
  • Pork pieces and whole cuts (e.g., ham, loins, ribs): 71°C (160°F).
  • Ground meat or meat mixtures (e.g., hamburgers, sausages, meatballs, meatloaf, casseroles): 71°C (160°F).
  • Poultry (chicken, turkey, duck, and game birds):
    • Pieces, ground poultry meat or mix of poultry meats: 74°C (165°F).
    • Whole bird: 82°C (180°F).
  • Fish: 70 °C (158 °F).
  • Other foods—hot dogs, seafood, egg-based dishes, leftovers, stuffing, game meats: 74°C (165°F).

Preventive measures for the whole family

Certain basic practices can help reduce the risk of contracting food-borne infections, including listeriosis and toxoplasmosis. These practices are applicable at all times, not only during pregnancy.

Cleanliness

  • Wash your hands thoroughly with soap before and after handling food (see Hand Washing).
  • Wash all fruit and vegetables under running potable water, whether they are to be eaten raw or cooked and with or without the peel. A vegetable brush can be used for fruit and vegetables with a firm peel, such as carrots, potatoes, melons, and squash.
  • Use hot soapy water to wash all plates, utensils, cutting boards, surfaces, and sinks used to prepare raw foods, especially raw meat and poultry. If they require disinfecting, mix 5 ml (1 tsp.) of bleach with 750 ml (3 cups) of water and rinse well. Putting them through a cycle in the dishwasher will also disinfect them.

Handling

  • Defrost foods in the fridge or microwave, not at room temperature. Those that are too big to be defrosted in the refrigerator can be immersed in cold water in their original wrapping. Change the water regularly, e.g., every 30 minutes, to ensure it stays cold.
  • Cook food right away after thawing in the microwave.
  • Do not refreeze foods.
  • Do not allow raw foods like meat, poultry and fish to come into contact with cooked or ready-to-eat foods. For example, do not put ready-to-eat foods on a dish or plate that was previously used for raw meat before washing it thoroughly.

Storage

  • Make sure your refrigerator is set at 4°C (40°F) or colder, and the freezer at -18°C (0°F) or colder.
  • Do not leave foods that should normally be kept cold or hot at room temperature for more than two hours.
  • Store raw meat, poultry, and fish away from other foods.
  • Don’t keep leftovers any longer than four days in the fridge, or freeze them right away.
  • Use foods by the best-before date, which no longer applies once the package or container is opened.

For more information on how to prevent food-borne infections, consult Health Canada’s Safe Food Handling for Pregnant Women at www.canada.ca/en/health-canada/services/food-safety-vulnerablepopulations/food-safety-pregnant-women.html

For more information on safe food preparation and preventing food-borne infections, and to consult Le Thermoguide (for safe storage times of perishable foods in the fridge and freezer), go to www.mapaq.gouv.qc.ca/fr/Consommation (in French only).

Preventing allergies

There’s no need to exclude specific foods from your diet during pregnancy in the hopes of reducing the risk of food allergies in your newborn. By eliminating certain foods from your diet, you run the risk of depriving yourself of some of the nutrients you and your baby need. If you are worried about allergies, discuss the matter with your health professional.

Vitamin and mineral supplements

Information to which you should pay special attentionAlways follow the recommended daily dosage for the product you are taking. When taken in overly large doses, certain vitamins and minerals, such as vitamin A, can adversely affect your baby’s development.

Food is by far the best possible source of nutrients, including during pregnancy. Vitamin and mineral supplements can never replace a nutritious and varied diet. The supplements your health professional may propose are designed to complement your diet, and are a simply a way of ensuring you get all the nutrients you need during your pregnancy.

Folic acid and iron

Taking a folic acid supplement helps reduce your baby’s risk of developing a neural tube malformation such as spina bifida or other birth defects.

Women are advised to start taking a multivitamin that contains folic acid two to three months before getting pregnant and to continue taking it throughout pregnancy and after giving birth. Make sure that the multivitamin contains at least 0.4 mg of folic acid.

Pregnant women are also advised to ensure that their multivitamin contains between 16 mg and 20 mg of iron. Iron deficiency can lead to anemia in expectant mothers and cause health problems for their baby.

Tips

  • Some women may need more folic acid or iron than others. Consult your health professional to find out the right quantity for you.
  • Talk to your health professional before taking any vitamin or mineral supplements he or she has not specifically recommended. The same applies to all other natural health products.
  • Iron supplements can cause constipation or digestive problems in some people. If this is the case for you, you will find tips to help alleviate these discomforts. You can also make a point of taking the supplement with food.

For more about nutrition

Eating Well withCanada’s Food Guide


Neural tube: Part of the embryo that develops into the brain and spinal cord (inside the spinal column).

Spina bifida: Birth defect of the spinal column.

Birth defect: Abnormality existing at birth but that developed during pregnancy.