At the Massachusetts General Hospital Department of Obstetrics & Gynecology, each patient is an important member of her own care team. We believe education is the cornerstone of our high-quality care. Find answers to frequently asked questions about nutrition and pregnancy.

It is important for pregnant women to eat right for themselves and for their baby. The following are some frequently asked questions about pregnancy and nutrition.

How much weight should I gain?

  • Recommendations are based on a woman’s pre-pregnancy weight for height, or Body Mass Index (BMI)
  • For a healthy pre-pregnancy BMI: recommended weight gain is 25-35 pounds total by 40 weeks. (Recommended rate of 1 pound per week throughout the second and third trimesters)
  • Twin pregnancy: overall weight gain of 37-54 pounds is recommended. (Recommended rate of 1.5 pounds per week throughout the second and third trimesters)

What are my energy requirements?

  • NRC recommends an additional 300 calories per day throughout the second and third trimesters
  • For twin pregnancy: an additional 150 calories per day above the needs of a singleton pregnancy. (Or 450-500 extra calories per day)

It is important to note that the types of foods eaten are more important than simply home much. What are my protein requirements?

  • An additional 10 gram per day above regular needs (or minimum of 71 grams per day)
  • This equates to 3-4 servings per day
  • A serving is:
    • 3 ounces meat/fish/poultry
    • 1 cup dried beans
    • 3-4 tablespoons nuts or peanut butter
    • 2 eggs
    • 4-6 ounces tofu or soy protein
    • 1/2 cup cottage cheese

It's a good idea to sprinkle a little protein into each meal and snack every 3 to 4 hours or so. In this way, you will meet your protein needs without ever having to eat a very large portion at one time. It can also help keep your energy level stable and reduce the risk of heartburn. A few ways to add protein rich snacks to your day:

  • Make a trail mix out of your favorite cereal and dry roasted nuts or seeds
  • Carry individually wrapped cheese sticks to have along with fruit or crackers
  • Dip raw carrot sticks or apple slices into peanut butter or cottage cheese
  • Spread pita wedges or whole grain crackers with a bean dip or hummus

What are my vitamin and mineral requirements?

Calcium

  • Daily Reference Intake (DRI): 1000 mg/day
  • This equates to 3-4 servings per day
  • A serving is:
    • 1 cup milk or calcium fortified juice or soy milk
    • 1.5-2 ounces hard cheese
    • 1 cup yogurt
    • 1-1.5 cups pudding or ice cream
  • Calcium from vegetables is harder to absorb

Folic Acid

The Institute of Medicine recommends all women capable of becoming pregnant should consume a supplement containing 400 mcg of folic acid in addition to folate found in foods.

  • DRI: 600 mcg/day
  • Food sources of folate:
    • Fortified cereals
    • Legumes
    • Orange juice
    • Spinach
    • Asparagus

Iron

  • DRI: 27 mg/day
  • The National Academy of Sciences recommends a supplement with 30 mg/day after 12th week for most people. If you have questions, ask your doctor.
  • Iron content of foods:
    • > 5 mg/serving: 3 ounces liver*, 1 ounces fortified cereals with less than 45% of your Daily Value
    • 3-5 mg/serving: 3 ounces beef, 1 cup legumes
    • 1-3 mg/serving: 4-5 pieces dried fruit, 1 egg yolk, 3 ounces fish or chicken

*Liver is very rich in Vitamin A so it is recommended to limit the amount of liver to occasional use only. Keep the amount of Vitamin A from supplements and fortified foods to a maximum of 5000 IU/day. Beta-carotene, the form of Vitamin A from fruits and vegetables, may be consumed in unlimited amounts, as the body will convert it only as needed. Choose a variety of brightly colored fruits and vegetables.

While eating nutritious foods is important during pregnancy, it is equally important to protect yourself from harmful bacteria and pathogens that can make you or your baby sick.

What are the food safety basics?

  • Wash your hands before preparing food, before meals and after handling raw meats or using the bathroom
  • Cook meat and poultry until well done
  • Reheat leftovers and Ready To Eat foods like deli meats and hot dogs
  • Wash fruits and vegetable under running water
  • Avoid cheeses and other products made from unpasteurized milk. Ask in restaurants if you are not sure. Some potentially unpasteurized cheeses are: feta, blue-veined cheeses, Brie and Camembert. Avoid unpasteurized juices, as well such as freshly squeezed apple cider
  • Avoid raw eggs and raw egg products, including raw cookie dough or cake batter. Some Caesar salad dressings also include raw egg
  • Store and maintain foods properly. Refrigerate items promptly and follow expiration dates

What about fish?

Fish and seafood are excellent low-fat sources of many nutrients including protein, omega-3 fatty acids and minerals such as calcium and zinc. There are a few types of fish, however, that pregnant and breastfeeding women should not eat due to their potential higher content of methyl mercury and PCB’s (polychlorinated biphenyls).

What to avoid?

  • Shark, swordfish, king mackerel, tilefish and tuna steak. These long-lived fish contain the highest levels of methyl mercury, which may harm an unborn baby’s developing nervous system
  • Freshwater fish (including trout) caught in local ponds, rivers and streams
  • Limit the use of canned tuna. While it is below the limit for mercury, to be safe use only on occasion and choose chunk light over white albacore for the lowest levels of pollutants

It is safe to select a variety of other types of fish, including well-cooked shellfish, smaller ocean fish or farm raised fish. It is safe to eat 12 ounces of cooked fish per week, with a typical serving size being 3-6 ounces.

For more information individually tailored to individual needs, consult a physician or registered dietitian.