Dietary advice for pregnant women

While you are pregnant, you must make sure you have a varied diet which gives you all the nutrients you need. You will need to eat more food than normal to ensure that your child can grow and develop, while your needs are met at the same time.

Pregnant women can follow the dietary recommendations

Your energy needs will gradually increase during pregnancy and should be met by eating foods which contain plenty of vitamins, minerals and essential fatty acids.

Pregnant women can follow the same dietary recommendations (in Norwegian) as the rest of the population. Your diet should be varied, mainly plant-based, and contain all the nutrients that you and your baby need.

A healthy diet should include:

  • coarse grain products
  • vegetables
  • fruit and berries
  • low-fat dairy products
  • fish
  • beans, lentils and peas
  • nuts

You should also try to limit the amount of processed meat, red meat and foods which contain a lot of saturated fat, sugar and salt.

It is a good idea to look for products marked with the Keyhole symbol. These products contain less fat, salt and sugar and more fibre than other products of the same type.

If you are a vegetarian or vegan, it is particularly important that you monitor your diet closely and make sure you take in the nutrients you need.

Even if you have a healthy and varied diet, you should still take supplements of certain vitamins and minerals.

How much more should I eat while I am pregnant?

On average, you will need to eat the following extra quantities of food every day:

  • First trimester: One piece of fruit, e.g. a banana (100 kcal).
  • Second trimester: A snack, such as a slice of bread and a piece of fruit (300 kcal).
  • Third trimester: Two snacks, such as porridge and a slice of bread (500 kcal).

Weight gain during pregnancy

Gaining weight is good both for your own health and that of your unborn child. The normal weight gain during pregnancy is between 11 and 16 kg. Most weight gain occurs towards the end of the pregnancy. Pregnant women gain weight because their unborn child is growing.

The mother's breasts, waist and uterus also grow. Placenta, amniotic fluid, increased blood volume, fluid in the body and increased fat reserves also contribute to the weight gain.

Putting on a lot of weight during pregnancy can lead to health risks for both you and your baby, particularly if you were overweight or obese before you became pregnant. It may therefore be a good idea to limit your weight gain, depending on how much weight you put on. However, you should also not lose weight while you are pregnant.

It is also not healthy to put on too little weight during pregnancy. This may cause the child to have a low birth weight. Low birth weight increases the risk of medical complications early in life and is also associated with an increased risk of disease in adulthood.

The recommended weight gain varies depending on how much you weighed before you became pregnant. The more you weighed before you became pregnant, the less weight it is recommended you put on while pregnant.

How much weight you should put on depends on your body mass index (BMI) before you became pregnant:

  • women of normal weight (BMI 18.5 - 24.9): 11.5 to 16 kg
  • underweight women (BMI below 18.5): 12.5 to 18 kg
  • overweight women (BMI 25 - 29.9): 7 to 11,5 kg
  • obese women (BMI over 30): 5 to 9 kg

During the second and third trimester, the recommended weight gain corresponds to approximately 0.5 kg per week for underweight women, 0.4 kg per week for women of normal weight and 0.3 kg per week for obese women. However, these are average figures and you may find that your weight gain varies from week to week and from month to month.

Drinking when you are pregnant

Drink water when you are thirsty and with your evening meal. You can drink milk, juice and/or plant-based drinks with bread- or cereal-based meals. Choose low-fat milk (skimmed or low-fat milk).

Coffee and tea

Drink a maximum of one to two cups of coffee or three to four cups of black tea a day. You should also limit your intake of coca cola (due to the caffeine content) and other sweet drinks.

Coffee and especially tea inhibit the absorption of iron by the body. Therefore, you should only drink coffee/tea between meals rather than with meals. Fruit teas (‘infusions’) do not inhibit iron uptake and can be drunk normally.

Alcohol

Remember that you should completely abstain from alcohol throughout your pregnancy. Alcohol can harm your child and there is no safe lower limit for alcohol during pregnancy. If you want a non-alcoholic drink with a nice meal, there are plenty of good alternatives.

Important vitamins and minerals for pregnant women

Even if you have a healthy and varied diet, there are certain vitamins and minerals you should monitor particularly closely to make sure you meet both your own needs and those of your baby.

Most people need supplements of one or more vitamins and minerals, and one solution may be to take a multi-vitamin mineral tablet daily as soon as you start trying to become pregnant or as soon as possible after you have found out that you are pregnant.

The best and safest thing is to take a supplement which contains approximately the recommended intake of the various vitamins and minerals. Avoid high doses of vitamins and minerals, unless they are recommended by a doctor.

Folate

As early as possible during your pregnancy, and ideally before you even become pregnant, you should take folate supplements, 400 micrograms per day, until week 12 of your pregnancy.

Folate supplements can prevent spina bifida.

Foods high in folate include: 

  • coarse grain products
  • fruit
  • vegetables, especially green vegetables such as 
    • broccoli
    • kale
    • Brussel sprouts
    • spinach

Vitamin D

It is recommended that you take in 10 micrograms of vitamin D per day; the same as when you are not pregnant. You need vitamin D to absorb calcium from your food. Most people need to take supplements in order to get enough vitamin D.

Some foods contain vitamin D: Oily fish, certain types of cow's milk, yogurt and plant-based drinks, butter, margarine and certain types of cheese and bread. Most people do not get enough vitamin D through their diet alone.

Vitamin D is also formed in the body when the sun shines on our skin. However, the Nordic countries do not receive a lot of sunshine, which makes it hard to get enough vitamin D in this way. There is a close correlation between the level of vitamin D in the mother's body and the child's vitamin D level at the time of birth.

Iron

Iron is essential for prenatal development, placenta and blood loss during childbirth. Iron is also needed for increased red blood cell production, but this is recovered after birth. In total, the body loses around 850 mg of iron during the nine months of pregnancy.

The amount of iron you need during pregnancy and whether you need iron supplements will depend on the iron levels in your body at the start of your pregnancy.

All pregnant women should be offered a serum ferritin test (= indicator of iron level) during their first trimester to see whether they will need to take iron supplements. One test is sufficient.

The Directorate of Health's recommendations are as follows:

  • If serum ferritin is above 70 μg/l, you do not need iron supplements (= good iron level).
  • If serum ferritin is between 30 and 70 μg/l, you should take an iron supplement containing 40 mg of iron per day from weeks 18 – 20 through to the end of your pregnancy (= medium iron level).
  • If serum ferritin is below 30 μg/l, you should take an iron supplement containing 60 mg of iron per day from weeks 18 – 20 through to the end of your pregnancy (= low iron level).
  • If you have no iron stored in your body, i.e. your serum ferritin level is below 12 μg/l, you should start taking iron supplements immediately.
  • If you do not have your serum ferritin level tested, it is recommended that you take an iron supplement containing 40 mg of iron per day from weeks 18 – 20 through to the end of your pregnancy.

It can be difficult to find preparations which contain exactly the recommended dose, but in such cases, you can take several tablets containing a lower dose. If you need to take iron supplements, ask your pharmacist what preparations they recommend.

Iron is best absorbed on an empty stomach and should ideally be taken in the evening. High iron doses (> 60 mg) tend to cause side effects more often, particularly constipation. The following foods contain iron:

  • coarse grain products
  • meat
  • liver
  • spinach
  • potatoes
  • green vegetables

Coffee and black tea inhibit iron uptake and should be avoided with bread and cereal meals.

Calcium

It is recommended that you take in 900 mg of calcium per day; slightly more than when you are not pregnant (800 mg). Calcium is essential for the development and maintenance of a healthy skeleton and strong teeth.

Good sources of calcium are cow's milk and plant-based drinks, as well as products made from cow's milk and plant-based drinks such as cheese and yogurt. If you do not drink cow's milk and/or eat/drink dairy products daily, you should use plant-based drinks and/or dairy substitutes, or take supplements.

Other sources of calcium include seeds, sardines, green leaves, broccoli, nuts, almonds and dried fruit, but you will need a lot of these foods in order to meet your calcium needs.

Iodine

It is recommended that you take in 175 mg of calcium per day; slightly more than when you are not pregnant (150 mg).

Iodine is essential for development of the child's brain and nervous system during pregnancy and the first year of their life.

Only white saltwater fish, cow's milk and certain other dairy products are good sources of iodine. White saltwater fish include cod, coalfish/pollock, haddock, tusk, common ling, plaice and angler fish.

Cow's milk, yogurt and brown cheese contain plenty of iodine, while gouda-type cheeses do not contain a lot of iodine. No iodine is added to plant-based drinks or dairy substitutes for plant-based drinks.

Marine plants and seaweed kelp meal contain iodine, but the content varies considerably and can reach harmful levels. Check that the intake of iodine from such products does not exceed the recommended intake. Avoid eating products if you do not know how much iodine a product contains. The seaweed used in sushi is low in iodine.

The Directorate of Health recommends a diet which includes low-fat dairy products daily and fish as an evening meal two or three times a week.

You should take a daily dietary supplement containing 150 μg of iodine if you:

  • eat white saltwater fish regularly, but consume less than 0.6 l of cow's milk/yogurt per day, or
  • do not eat (or rarely eat) white saltwater fish and consume less than 0.8 l of cow's milk/yogurt
  • are a vegan

You should start taking the supplement as soon as possible during your pregnancy, and preferably before you become pregnant too. An intake of more than 600 μg per day should be avoided.

Vitamin B12

It is recommended that you take in 2 μg of vitamin B12; the same as for non-pregnant women.

Vitamin B12 is essential for development of the baby's brain and nervous system, and vitamin B12 deficiency can seriously impair the child's development.

Vitamin B12 only occurs naturally in foods from the animal kingdom:

  • meat
  • fish
  • birds
  • cow's milk
  • egg

Vitamin B12 is added to plant-based drinks and dairy substitutes.

Omega-3 fatty acids

It is recommended that you take in at least 200 mg of the long-chain omega-3 fatty acid DHA (docosahexaenoic acid).

DHA is important for the child's growth and development, especially as regards the brain and nervous system. DHA occurs in fish and other seafoods; in both oily and lean fish, but mostly in oily fish.

DHA can be formed in the body from alpha-Linolenic acid, which is found in nuts, seeds and associated products, e.g.

  • walnuts
  • rapeseed oil
  • soybean oil
  • flaxseed oil
  • ground chia seeds
  • flaxseed

However, there are substantial differences from person to person as regards the extent to which this conversion takes place.

If you eat little or no fish and/or seafood, including cod liver oil, you can take DHA supplements in the form of algal oil.

Allergies

There is no scientific evidence to suggest that pregnant women can prevent allergies in their child by avoiding certain foods during pregnancy. It is important that your child gets all the nutrients it needs, so you must make sure your diet is varied and balanced.