Dietary advice for pregnant women

While you are pregnant, you need to have a varied and healthy diet. The child in the womb needs enough energy (calories), protein, fatty acids, vitamins and minerals to grow and develop. You also need to cover your own needs, but it is not necessary to eat for two.

Pregnant women can follow regular dietary recommendations

Pregnant women can follow the same dietary recommendations (in Norwegian) as the rest of the population. However, there are some foods you should be carefull with, when you are pregnant.

Your diet should be varied and mainly plant-based. A correctly composed diet can contain all the nutrients that you and your baby need, but most pregnant women also need supplements with some vitamins and minerals.

For many people, a good meal plan is to eat four main meals, breakfast, lunch, dinner and supper, and in addition one to two snacks.

Choose mostly these foods:

  • whole grain products (whole grain bread, mixed cereals, whole grain rice and whole grain pasta)
  • vegetables
  • fruit and berries
  • beans, lentils and peas
  • low-fat dairy products
  • nuts and seeds
  • low-fat dairy products or plant-based drinks with added calcium
  • fish
  • vegetable oils and soft margarine

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

Whenever possible, cook your food yourself. 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.

See also tips on how to put together breakfast, lunch, dinner and snacks (in Noewegian).

If you are a vegetarian or vegan, it is particularly important that you monitor your diet closely. There are espesially some nutriens you need to pay attentions to, like vitamin B12 and iodine.

Your energy needs gradually increase throughout pregnancy, and this should be covered by food that contains plenty of vitamins, minerals and essential fatty acids.

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 oatmeal porridge and a slice of bread (500 kcal).

Weight gain during pregnancy

Putting on some 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.

For pregnancies with twins, a somewhat higher weight gain is recommended:

  • normal weight (BMI 18.5 - 24.9): 16.8-24.5 kilos
  • underweight (BMI below 18.5): No recommendation due to lack of data.
  • overweight (BMI 25 - 29.9): 14.1-22.7 kilos
  • very overweight (BMI over 30): 11.4-19.1 kilos

The weight recommendations for twin pregnancies are more uncertain than the recommendations for pregnancies with one child.

Drinking when you are pregnant

Drink water when you are thirsty and with your evening meal. You can drink low-fat milk, juice and/or plant-based drinks with bread- or cereal-based meals. Vitamin C in juice can increase the absorption of iron from the meal. Cow's milk and soya milk are good sources of protein in a diet with mostly plant foods.

Coffee and tea

Caffeine can affect the child. Therefore you should be careful with coffee, tea and other drinks that contain caffeine, such as cola and energy drinks. Drink a maximum of one to two cups of coffee or three to four cups of black tea a day.

Herbal teas, rooibos tea and breastfeeding teas can contain plant toxins (pyrrolizidine alkaloids) which can have harmful effects on the child. The safest thing is to avoid this type of tea as much as possible and instead choose rosehip tea or tea made from pure fruit extracts.

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. Rosehip tea and tea made from pure fruit extracts do not inhibit iron absorption.

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 and neural tube defects in the child.

Foods high in folate include:

  • whole grain products (whole grain bread, mixed cereals, whole grain rice and whole grain pasta)
  • fruit (especially citrus fruit) and orange juice, berries and vegetables.

You should take a dietary supplement with folate even if you get enough folate in your diet. It is folate in the form of dietary supplements that has been proven to be able to prevent damage in the child.

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. There are 10 micrograms of vitamin D in most multivitamin-mineral supplements.

Some foods contain vitamin D:

  • oily fish,
  • certain types of cow's milk and plant-based drinks
  • butter, margarine
  • some types of cheese
  • some types of 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 necessary for the development of the child's brain and nervous system during pregnancy and the first few years of life. 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 (= good iron level)., you do not need iron supplements
  • If serum ferritin is between 30 and 70 μg/l (= medium iron level), you should take an iron supplement containing 40 mg of iron per day from weeks 18 – 20 through to the end of your pregnancy.
  • If serum ferritin is below 30 μg/l (= low iron level), you should take an iron supplement containing 60 mg of iron per day from weeks 18 – 20 through to the end of your pregnancy.
  • 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.

If you need iron supplements, more iron is needed than what is in a multivitamin-mineral supplements, and you should take iron supplements in addition. Ask the pharmacy which preparations they recommend.

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.

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. There are supplements (in pharmacies or health food stores) that do not cause constipation.

The following foods contain iron:

  • whole grain products (whole grain bread, mixed cereals, whole grain rice and whole grain pasta)
  • beans, lentils and peas
  • nuts and seedsgreen vegetables
  • potatoes
  • lean meat, poultry and fish

Vitamin C with meals increases iron absorption in the intestine. You should therefore include vitamin C-rich fruit and vegetables in your meals. Examples are citrus fruits, including orange juice, peppers, kiwi, berries and turnips.

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

Calcium

It is recommended that you take in 950 mg of calcium per day; slightly more than when you are not pregnant (950-1000 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,
  • 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
  • nuts
  • almonds
  • beans
  • sardines
  • green leaves
  • broccoli
  • dried fruit

You will need a lot of these foods in order to meet your calcium needs.

Iodine

It is recommended that you take in 200 microgram (µg) of jod per day; slightly more than when you are not pregnant (150 µg).

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

If you eat white saltwater fish regularly and consume some milk, yoghurt and brown cheese daily, you can cover your need for iodine through your diet. If not, you may need a dietary supplement that contains iodine. There is usually iodine in multivitamin-mineral supplements. The supplement should be taken as early as possible in pregnancy, and preferably before you become pregnant. Intake of more than 600 μg per day should be avoided.

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.

Vitamin B12

It is recommended that you take in 4,5 μg of vitamin B12 per day, a bit more then for non-pregnant women (4 μg vitamin of vitamin B12 per day)

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.

Especially if you have a vegetarian or vegan diet, you should be careful that you get enough vitamin B12. There is vitamin B12 in multivitamin-mineral supplements. There are vegan multivitamin-mineral supplements in pharmacies and in health food stores.

Vitamin B12 only occurs naturally in foods from the animal kingdom but it is also added to plant-based drinks and dairy substitutes.

  • Dietary sources of vitamin B12:meat (including poultry)
  • fish and shellfish
  • cow's milk and other dairy products
  • eggs
  • 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) when you are pregnant. The same applies when you are breastfeeding.

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, for example:

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

However, there are substantial differences from person to person as regards the extent to which this conversion takes place. Therefore, it is safest to take a DHA supplement.

If you have a vegetarian or vegan diet, or for other reasons eat little or no fish and seafood, including cod liver oil, you should take a DHA supplement in the form of algae oil. Ask for vegetable omega-3 at the pharmacy.

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.

Mattilsynet

Advice on safe food and drink during pregnancy, and information on breastfeeding (in norwegian).

Zanzu

Information about pregnancy, childbirth and the postnatal period in Arabic, English, Farsi, French, Norwegian, Polish, Somali, Tigrinya and Turkish aimed at immigrants and others with a short period of residence.

Content provided by The Norwegian Directorate of Health

The Norwegian Directorate of Health. Dietary advice for pregnant women. [Internet]. Oslo: The Norwegian Directorate of Health; updated Wednesday, February 1, 2023 [retrieved Friday, June 21, 2024]. Available from: https://www.helsenorge.no/en/pregnancy-and-maternity-care-in-norway/dietary-advice-for-pregnant-women/

Last updated Wednesday, February 1, 2023