Nutritional Counseling During Pregnancy

Energy Requirements

Energy needs do not increase in the first trimester unless a woman begins pregnancy with depleted body reserves 1, 2, 3
An additional 300 kcal/day is recommended during the second and third trimesters 1, 2, 3
Protein requirements are 0.75 g/kg/day plus an additional 10 g/day 1, 2, 3, 4

Underweight women (BMI <19.8) should gain up to 18 kg (40 lbs) 2, 3
Normal-weight women should gain 1.4-2.3 kg during the first trimester and 0.5-0.9 kg/week during the remainder of pregnancy 2, 3, 4
Obese women (BMI >30) should gain 5.0-9.1 kg (11-20 lbs) 2, 3

Folic acid 400 µg/day (or 5 mg/day if obese or diabetic) should be taken starting preconception 4
Iron supplementation (30 mg/day) is recommended during the second and third trimesters 2, 3

A balanced diet with fruits, vegetables, legumes, whole grains, nuts, seeds, fish, and lean protein is recommended 6

Hypocaloric diets <1,200 calories/day should be avoided as they result in ketonemia and ketonuria 4
Excessive caloric increases that lead to gestational weight gain above recommended ranges should be avoided
Weight gain counseling should be individualized based on pre-pregnancy BMI 2, 3, 7
Alcohol should be avoided completely during pregnancy 4
Vitamin A in retinol form should be avoided during the first trimester due to teratogenic risk 4
Caffeine intake should be limited to no more than 200 mg per day during pregnancy 4, 5