Nutrition in Pregnancy

Normal Weight Gain

  • Approximately 25 - 35 lbs for an average-weight woman with a BMI of 19.8 - 26.0 (less for obese women and
    more for thin women).
    • Excessive gain: > 1 .5 kg/mo.
    • Inadequate gain: < 1 .0 kg/mo.
  • Guidelines according to prepregnancy body mass index (BMI):
    • Underweight (BMI < 1 9.8) : 1 2- 1 8 kg.
    • Acceptable (BMI 1 9.8-26.0): 1 1 - 1 6 kg.
    • Overweight (BMI 26.1 -29.0): 7-1 1 kg.
    • Severely overweight (BMI > 29.0): 7 kg.
  • An additional 100 - 300 kcal/day is needed during pregnancy and 500 kcal/day during breast-feeding


Guidelines for nutritional supplementation:

  • An additional 1 00-300 kcal/day; 500 kcal/day during breastfeeding.
  • Folic acid supplements (-1. neural tube defects for all reproductive-age women) : 0.4 mg/day, or 4 mg/day for women with a history of neural tube defects in prior pregnancies.
  • Iron: Starting at the first visit, 30 mg/day of elemental iron (or 150 mg of iron sulfate).
  • Calcium:
    • 1,300 mg qd for < 19 years of age;
    • 1,000 mg qd for > 19 years of age.

Additional guidelines for complete vegetarians:

  • Vitamin D: 400 IU/day.
  • Vitamin B12: 2 mcg/day.

Seafood in Pregnancy

  • Fish and shellfish can be an important part of a healthy diet.
  • Fish and shellfish contain:
    • high-quality protein and other essential nutrients,
    • are low in saturated fat, and
    • contain omega-3 fatty acids.
  • A well-balanced diet that includes a variety of fish and shellfish can contribute to heart health and children’s proper growth and development.

Mercury in Fish and Shellfish:

  • However, nearly all fish and shellfish contain traces of mercury. For most people, the risk from mercury in fish and shellfish is not a health concern, but some fish and shellfish contain higher levels of mercury that may harm the developing nervous system in fetuses and young children.
  • The risks from mercury depend on the amount of fish and shellfish eaten and the levels of mercury in the fish.
  • Therefore, the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) advise women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish and to eat fish and shellfish that are lower in mercury.
  • Larger fish (swordfish, shark, king mackerel, and tilefish) pose the greatest risk to a fetus or small child because these fish have lived longer and have had more time to accumulate mercury. Other types of fish and shellfish may be eaten in the amounts recommended by the FDA and EPA.
  • All uncooked fish and shellfish should be avoided during pregnancy 
    • Raw seafood is more likely to contain bacteria and parasites than cooked seafood.
    • In addition, many shellfish filter large quantities of water through their shells, leading to increased accumulations of bacteria and viruses.


  • Thirty minutes of moderate exercise daily is recommended.