The Washington Post

What to eat while pregnant

Mar 18, 2010

Eat, Drink and Be Healthy columnist Jennifer LaRue Huget will discuss healthful options for pregnant moms and their growing babies. She will be joined by Frances Largeman-Roth, a registered dietitian and author of "Feed the Belly: The Pregnant Mom's Healthy Eating Guide."

Hi Everyone,

Thanks so much for joining the chat today. You've sent in lots of great questions! Will starting answering them in just a minute or two.




Hi, everyone, and welcome to today's chat. I'm thrilled to have Frances Largeman-Roth here to answer questions about eating healthfully during pregnancy! 

Hello. I am currently five months pregnant and have a concern about hot dogs. With the summer season coming up, I plan to attend BBQs, and I love grilled hot dogs, hamburgers, etc. However, I heard that you shouldn't eat hot dogs while pregnant, because of the presence of nitrates. If the hot dog is well done and cooked thoroughly on the grill, is it okay to eat? Thanks.

You're smart to be cautious about eating hot dogs while you're pregnant. But I think the greatest risk they pose is that they're easily contaminated with listeria, which can be very harmful and even deadly to you and your unborn baby. But cooking hotdogs thoroughly should kill any listeria they may harbor.

What are some common foods that most everyone eats that should be avoided? I know most know not to smoke or consume alcohol and to avoid fish with mercury, but after that, there admitedly is much ignorance on what else should be avoided.

Great question! There are lots of weird little things to avoid in addition to the biggies (booze, tobacco, high mercury fish). Lots of women are surprised to learn that cold cuts, smoked salmon and hot dogs are on the no no list. That's because they're at risk for listeria contamination, which can happen under refrigeration. Also, unpasteurized juices are another listeria risk. And on the caffeine front, keep it to no more than 200 mg a day. That's about 18 oz cup of coffee, depending on the strength. Check out chapter 5 of the book for more!

Is it true women shouldn't eat soft cheeses while pregnant? I thought it was specifically targeted towards unpasteurized cheese, which basically means any store bought cheese in the US is consumable because they're pasteurized.

Yes -- just unpasteurized should be avoided. Enjoy the rest!

Jennifer and Frances: Is it okay to still excercise an hour a day, while pregnant? Also, is water aerobics good for the baby? How long should you do it? (Until what trimester?)

Everybody I've talked to says yes, you can safely exercise while pregnant. The amount and kind of exercise you choose depends on how fit you are to start out with. Of course you should talk to your doctor before launching a new exercise campaign. Many pregnant women love water aerobics because it takes all the weight off their legs and feet. As Dr. Artal, whom I interviewed for my blog the other day, noted, any pregnant woman can at least get up and get walking for 30 minutes or so a day. 

I was a healthy weight when I got pregnant -- 118 pounds, 5'3. I have gained about 15 pounds during my pregnancy. I have been eating my normal diet, not thinking too much about calories and weight. My husband thinks I am not gaining enough weight. Is there a problem with being on the lower end of pregnancy weight gain? Are these babies smaller?

You should probably discuss these concerns with your physician. I assume your baby's development is being monitored, and your doctor would tell you if it looks as though the little one wasn't growing adequately. Your physician can also help you determine whether your diet is adequately meeting your and your baby's nutrition needs.

First, thank you, thank you for your chocolate muffin recipe. It has gotten me through many a mid-morning snack and will probably remain in my recipe rotation long after my pregnancy is over. I'm about 10 weeks away from my due date and have been thinking about what to eat and/or bring with me during labor. What do you suggest for the last meal or two at home as well as for packing in the hospital bag?

You know, I had all these great snacks packed because I was going to have the baby in a birthing center, but then I ended up having to have an epidural and then they wouldn't let me eat or drink. By the time I pushed the baby out (the next day), I was starving! It's incredibly important to get yourself well hydrated before labor. Of course, that's a bit tricky because if you're going natural, you don't know exactly when you'll go into labor. I'd go for whatever you like during those last couple of meals at home. Live it up! And keep the water intake steady. And then in the hospital bag, I'd pack bars like Lara and Kind. Dried fruit and nuts are another great fast energy source. And hopefully you'll be allowed to eat and drink during labor! 

I gained too much too fast early on in my pregnancy. Now in my third trimester, I wonder, how can I moderate my food intake to undo some of the damage I have already done? Can I restrict calories and let the extra substance of my body give the baby what it needs? I now weigh more with two-and-a-half months to go than I did when I was past my due date with my first -- yikes!

You should check this out with your doctor. It may be that you can try to work in some extra physical activity to keep your weight gain in check. By the way, I did the same thing during my first pregnancy!

Which tea is okay to drink? Is plain Lipton tea decaffinated okay? What about just hot water and lemon?

Sure, decaf black and green teas are safe to use. And hot water and lemon is a nice, refreshing drink. I have a recipe for a ginger lemon tisane in the book, which is delicious.

How much protein is necessary during pregnancy? I am vegetarian, so do I need to be very conscious to make sure I get enough protein?

60grams of protein a day is recommended. That's about 10 more than what you needed pre-preg. You can get about 10g in an energy ba, 1/3 cup almonds, 8oz of yogurt (greek is higher in protein), or 11/2 cheese sticks. As long as you're trying to get a little protein with each meal and snack, you should be able to get to 60g. Good luck!

No conversation about pregnancy weight should omit discussion about the weight-loss benefits of breastfeeding. In addition to all the benefits for the baby, breastfeeding is a great way to drop pounds after pregnancy.

Great point! While it doesn't work for everyone, it has certainly worked for lots of people, including me.

As an obese mother who delivered one year ago, I read your Checkup item with interest. My doctors told me to try to limit gain to around 15 pounds -- I topped out at 24 pounds, which was all gone six weeks later. I know that the vast majority of the weight I gained was fluid plus baby. So, how does that work with the recommendation that fat pregnant mothers not gain any weight? Are you really recommending that women diet while pregnant? By my calculations, women would have to cut around 250 calories per day to lose 20 pounds of fat over 40 weeks. It seems like it would be difficult to get the high-quality nutrition that pregnancy requires while cutting calories. By the way, this obese (180-pound) mother (of advanced maternal age!) had no diabetes, no hypertension, and delivered a healthy 7-pound baby right on time. I know that my doctors were very vigilant about monitoring for complications related to my age and size and I almost felt that they were disappointed that things went so smoothly for me!

The issue as to whether women should diet while pregnant remains controversial. Ideally, it's recommended that obese women try to lose some weight before they become pregnant. And some experts suggest obese women skip those extra 300 daily calories that women whose weight is in a healthy range should consume to accommodate their pregnancy during the second and third trimesters. That's a bit different from actually going on a "diet."

I'm 36 weeks and exercised prior to my pregnancy and have continued to do so (in a lesser intensity and frequency) till now. Is it okay to keep going? People in my office are afraid I'll bring on labor but I think the baby will come when he's ready.

As long as your doctor says it's OK to continue, and you don't feel lightheaded during exercise, keep going! Just dial back the intensity of your workouts and make sure to stay hydrated, especially as the weather continues to warm up. I did a spin class the week before I gave birth and continued walking each day. Just listen to your body and rest if you have any pain or discomfort (beyond the typical swollen ankles,etc).

Is it possible to actually eat enough that gets used for baby and as energy for you while still maintaining a good body weight? I am heavy and am in the process of a lot of weight loss for life and future baby, but will eating the grains, etc. that i am eating now keep my waist under control even as it expands with a baby?

You should definitely read Frances's book, which addresses your concerns in a very helpful way. It sounds as though you're doing a great thing, losing some weight before you become pregnant. Your physician should be able to help you navigate this tricky task of getting adequate nutrition for you and your baby without gaining too much weight. Good luck!

I have tried cutting out artificial sweetners from my diet but they seem to be present in so much -- gum, certain yogurts, etc. What are your views on consumming artificial sweetners in pregnancy?

You're right! These days so many foods contain artificial sweeteners and they don't even tell you on the front of the package -- that's why you really need to read labels. In "Feed the Belly" I recommend avoiding artificial sweeteners during pregnancy. There's probably no harm, but why add more chemicals to your body while your baby is developing? But don't worry about the chewing gum -- the amount you'd get from that isn't worth worrying about. 

What fish is okay/good to eat, and how often?

Frances's book has a whole chapter about eating fish during pregnancy. She cites the federal government's recommendation that pregnant women eat up to 12 ounces of low-mercury fish and shellfish per week, and quotes a scientist who says the small risk posed by potential mercury in fish is far outweighed by the nutritional benefits fish offers. She also offers a list of low-mercury fish, including catfish, pollock, shrimp, salmon, tilapia and kona kampachi.

I am trying to concieve and am wondering what I should be eating (or more importantly not eating/drinking) to get prepared for a baby. Any advice?

Foods rich in folic acid and iron-rich foods are especially important when you're TTC. Folate rich foods include fortified cereal, citrus fruits, asparagus, and lentils. Iron rich foods include lean meats, raisins, beans, dried apricots, and fish. Eating a well balanced overall diet is a smart thing to do. Make sure to include healthy fats and antioxidant-rich foods too. You want your body to be a very inviting place for a baby to start growing! There are more tips in chapter 1 of Feed the Belly. Good luck!

I love your Web site and plan to try your parfait recipe this weekend. I have three weeks left in my third pregnancy where I've eaten poorly overall (I've had more than my fair share of Cinnabons) and gained 40 pounds, which is alot for me. I believe I've probably harmed my body as much as my baby's with too much sugar, etc. Can I make up for that while breastfeeding over the next year as I plan?

Don't fret! And as long as your glucose tolerance test was normal, don't beat yourself up for overdoing it with the sweets. Once the baby is born, you can get back on track with a healthy eating plan. But don't try cutting calories too quickly. If you're b-feeding, you'll need a steady influx of calories as well as fluids. Once your milk supply is established, you can talk to your doc or an RD about cutting down on calories overall. And don't forget about calcium! you'll need 1000-1200mg per day.

Is tofu/soy products safe to eat when trying to get pregnant/already pregnant? I have heard they can mess with fertility and reproductive organs.

This is a really common question and one that I had when I was pregnant, so I included it in the book. A small study came out that said that soy foods negatively impacted a man's fertility. The soy experts I interviewed said that the study was misinterpreted and that as long as we eat soy foods the way the Japanese do, they are perfectly healthy. That means eating them in the least processed form: like tofu and edamame instead of things like bars made with soy protein isolate. 

I'm about 12 weeks along with my third and all I'm craving these days is sushi!! Crazy, I know. Anyway, I've caved a few times and had some good sushi from a clean place that I really trust. I know the listeriosis concerns, but I've been eating there for YEARS and have never gotten sick. And I'm watching the high mercury fish. Is an occasional sushi lunch ok or do I really need to power through these cravings?

I had similar cravings! I handled them by ordering some rolls with cooked fish or shrimp. There are usually a few good options on the menu. I also liked the one with cooked egg (I think it's called Unagi, but I could be wrong). Anyway, I would definitely advise skipping the raw fish if you can. All the best!

Given the list of things to avoid (which, by the way it seems like you contradicted yourself about hot dogs), if I'm taking a pre-natal vitamin, how important is making sure I eat healthy foods?

First, about hot dogs. They should be okay to eat if you are sure they've been cooked to a very hot 165 degrees. But since that's hard to confirm in most situations in which you might find yourself confronted with a hot dog, it's safer to skip them. As for vitamins and healthful eating, I think most experts would tell you that of course you need to eat as healthfully as possible even when you're taking a multivitamin. But as Frances points out, you can probably afford to slip up and and indulge in a less-nutritious treat now and then. In those cases, consider your vitamin a safety net!

I'm currently 35 weeks pregnant and have noticed that I don't feel hungry like I used to during the day. I don't know if it's because I'm drinking too much water (trying to keep the Braxton-Hicks contractions down) or I'm just running out of room. Any advice?

My guess is that you're running out of room. The same thing happened to me. I would know that I needed to eat something, but nothing really appealed to me in the last few weeks. Just make sure you're eating something every 3 hours or so -- it can be light, like a fruit salad with yogurt, or a salad with grilled chicken. And that's great that you're staying hydrated! Take care.

I'm in my first trimester, and I'm not having nausea (yet). Instead, I'm freaking starving -- much hungrier than usual. Does this sound right to you?

Sounds right to me -- because that's just how my pregnancies went, too. Everyone's pregnancy experience is different. You should just enjoy your lack of nausea and try to stave off hunger with the most nutritious foods you can. Think of packing in as many nutrients-per-calorie as you can.

Are there any foods that help with nausea? When I was pregnant with my first, I found that while I didn't have any food cravings, I was nauseated by my old, healthy favorites, like grilled chicken and salad. I turned to things like peanut butter and jelly, which was sweet and easier to stomach, though a little less healthy.

Some women have just the opposite reaction -- they can't do sweet anymore, so they go for salty. As far as foods for nausea go, the best thing to do is actually eat every couple of hours. Even if you're just having a few pretzels or apple slices, making sure your stomach isn't empty will really help. And then ginger and lemon are really helpful. There are these great little ginger candies called Gin Gins. And I love the real ginger beer from Reed's -- very helpful. And fresh lemons -- even just smelling them --  can be helpful.

I'm a vegetarian. I'm concerned about eating too much soy (I am carrying a boy). Any suggestions for good non-soy/non meat sources of protein?

7.3 million Americans are vegetarian so you're in good company! And I devoted a whole chapter to women like you, as well as women who are gluten and dairy-free. Non soy protein sources include nuts, beans, some veggie burgers, quinoa, and nut butters.

I always heard warm foods were better when trying to conceive. Is the same true once pregnant? I.e., roasted veggies instead of salads?

I've never heard this, but it's interesting. Might be related to Ayurvedic medicine.

I understand that pregnant women are not supposed to eat soft cheeses (brie, goat, feta...(sob!)). But is it okay to eat soft cheeses that have been cooked? For example, can I have baked quiche with goat cheese in it, or pasta filled with a soft cheese that has been cooked?

Frances address this very question in Feed the Belly. She asked the FDA and the Partnership for Food Safety Education whether eating a souffle or casserole made with unpasteurized cheese would be safe. They said it would be safe if the food were heated to 165 degrees or above, but cautioned that the risk of cross-contamination (from cutting boards, utensils, etc.) would remain high enough that it's best to just keep those cheeses out of your house altogether while you're pregnant.

Hi. I am a working mom, pregnant with #2. Can you suggest some lunch food options since cold deli meats are out, and I don't like the taste of heated up deli meat? Bringing food with me to work is not an option (no refrigerator/microwave in my office), so I usually grab food at a lunch shop. With the warm weather approaching, I am looking for some "cold," nutritious food choices with protein. Salads (without meat) and cheese sandwiches are not cutting it. Thanks.

I hear you -- it's definitely a challenge if you don't have a fridge. How about bringing cut up fruit from home and then buying some Greek yogurt and making a little parfait? Adding some almonds or walnuts on top will add more protein and nutrients. Also, you could bring some thawed edamame from home and add those to a salad or pasta dish that you buy. And finally, it may be worth buying a mini fridge to keep in your office. Nut butter on whole grain tortillas is also tasty and nutritious. Good luck!

Wait, I can eat shrimp? I thought I couldn't have shellfish! (What about crab, real or imitation?)

You can have shellfish as long as it's fully cooked. And on the topic of seafood. These are the ones to eat during pregnancy (I saw that another user had asked this question):



Catfish: I know you'll say Ewww, but when it's cooked properly, it's delish.


Kona kampachi (also called hamachi)

POPTARTS!!! I'm only half kidding. Boy did I have a craving for them (and I never eat them, otherwise) so I gave in!! And cherries, and watermelon. Happy to report that I did not gain huge amounts of weight either. But boy oh boy, did those poptarts taste awesome! Now, they do nothing for me -- which is probably a good thing!

There are  many worse things than PopTarts you could eat while you're pregnant. (I'll confess to loving them, pregnant or not.) As long as you maintain good nutritional balance in the rest of your diet, indulging a craving such as PopTarts should be fine, so long as you don't go so overboard that you take in too many calories and thus gain too much weight.

For the people asking about the hot dogs, I just buy nitrate free ones (there's nitrate free bacon out there too, if you are looking) and cook them myself. I just check the temperature on one with a kitchen thermometer. As far as cravings go, so far my biggest one has been chocolate/peppermint. I'm statisfying this with chocolate peppermint hot chocolate (great way to get my milk in) and thin mints. But eventually the thin mint supply will dy up and it will be too hot for hot chocolate. Any suggestions?

Can you tell the other posters what brand you buy? That is fantastic that you check the temp at home. That is the way to go, it's just that most people will buy them off the street (here in NYC) or get them at BBQs, and who knows how they've been cooked or how long they've been sitting.

I would just ice your chocolate-mint drink and have that in the summer. Or, go for 1/2 cup of natural (non green!) chocolate mint ice cream, such as Breyers. I think Stonyfield might make one too. By the way, I loved choc mint chip during my pregnancy!


Of note, pregnant women are told to avoid lunchmeat due to listeria. But you know what? It's in fruits and veggies too. But if we eliminate everything with listeria, there's not much left. So there needs to be less hysteria about listeria. Other complications should get more attention -- like preeclampsia and HELLP. About 5 percent of women develop preeclampsia, and left undetected, it can cause fetal and maternal death. I had to be induced at 36 weeks due to HELLP. Essentially, my liver was failing and the only way to save both me and baby was to deliver. And my midwife thought my preeclampsia was no big deal.

You make great points. Preeclampsia is a growing concern and women need to be aware of it. It is definitely a big deal. 

Regarding fruits and vegetables and listeria, it's really important to wash all of them (even the ones with a hard rind) with running water before eating. And if you're cutting them up to eat later, make sure to refrigerate them.

Please clarify you can eat lunchmeat -- like hot dogs, it needs to be heated. So, I make my lunch at home. I keep the lunchmeat off the sandwich, in a seperate container, and microwave it before adding it to the sandwich. So, how hot is 165? Easier to say make sure there's steam coming off the lunchmeat or hotdog.

I wish there were a simple way to judge when lunch meat or a hot dog has been heated sufficiently. Unfortunately, the only way to know for sure is to use a meat thermometer. And even with your laudable efforts to keep your sandwich components separate, there's always a chance of cross contamination. Frances's book has tons of great lunch suggestions!

Seriously, what is the evidence that avoiding so many foods really protects the baby?

There are millions of cases of food borne illness each year, and pregnant women are definitely more susceptible to getting sick due to the increased demands on their bodies (kind of like being immune-compromised). So, while you might never run into any issues eating raw meat, raw milk, raw fish, etc., I don't think it's worth the risk. And it's only 9months or so!

Just wanted to clarify the sushi answer -- unagi is eel, but it's barbecued, so maybe it's still safe to eat? Other good non-raw fish sushi choices include Inari, which is a little bean curd pocket that I just love. Futo maki contains all cooked ingredients as well, I believe. Or you could always go and get chicken or salmon teriyaki and just take in the atmosphere of the sushi restaurant...

Thank you for clarifying! I should have looked it up first. I meant Tamago.

Okay, so now I'm craving PopTarts and sushi -- and I'm not even pregnant! Thanks, readers, for all your terrific questions. And to those of you who are expecting, hoping to be expecting soon or have recently given birth, best wishes for good health all 'round!

Thanks everyone for such a lively chat! If you have more questions, please do check out Feed the Belly. You can also contact me through my Web site:


Happy pregnancies and I hope you all have a great delivery experience!


In This Chat
Frances Largeman-Roth
Frances Largeman-Roth is a registered dietitian and author of "Feed the Belly: The Pregnant Mom's Healthy Eating Guide." She is also the Senior Fitness and Nutrition editor at Health magazine.
Jennifer LaRue Huget
In addition to writing the weekly Eat, Drink and Be Healthy nutrition column, Jennifer also blogs on health news for The Checkup and writes the Lean and Fit newsletter.
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