What are the energy requirements for the pregnant woman during the second and third trimester?

Pregnant women should eat a balanced diet.

Making a baby is hard work for a woman's body. Eating right is one of the best things you can do to help your baby grow and develop normally.

Eating a balanced, healthy diet can help prevent:

• Too much weight gain
• Gestational diabetes
• The chance of needing a C-section
• Anemia and infections in the mother
• Poor healing
• An early birth of the baby
• A low birth-weight baby

The amount of healthy weight gain in pregnancy varies. These are general guidelines:

• Normal total weight gain for a healthy woman is 25 to 35 pounds (11 to 16 kilograms).
• Overweight women should gain only 10 to 20 pounds (4 to 9 kilograms) during pregnancy.
• Underweight women or women with multiples (twins or more) should gain 35 to 45 pounds (16 to 20 kilograms) in pregnancy.

Ask your health care provider how much weight you should gain.

Eating for two does not mean eating twice as much food. Pregnant women need about 300 extra calories a day. But, where these calories come from matters.

• If you eat sweets or junk food, the extra calories do not provide the nutrients your baby needs.
• As a result, your growing baby will get the vitamins and minerals it needs from your own body. Your health could suffer.

Instead of junk food, choose foods that are:

• High in protein
• Rich in omega-3 polyunsaturated fats and lower in trans fats and saturated fats
• Low in sugar (sugar provides only empty calories) or refined carbohydrates high in fiber

Other nutrients your baby needs are:

• Calcium, for healthy growth.
• Iron, for the baby's blood supply. It also prevents anemia in the mother.
• Folic acid, for reducing the risk for spina bifida (incomplete closing of the spinal column), anencephaly (defect of the brain), and other birth defects.

Eating a well-rounded diet with all of the right nutrients and getting at least 30 minutes of exercise per day is important for a healthy pregnancy. For most normal-weight pregnant women, the right amount of calories is:

• About 1,800 calories per day during the first trimester
• About 2,200 calories per day during the second trimester
• About 2,400 calories per day during the third trimester

Bread, cereal, rice, and pasta:

• Eat 9 to 11 servings a day.
• These foods give you carbohydrates. They turn into energy for your body and for your baby's growth.
• Whole-grain and fortified products have folic acid and iron.

Vegetables:

• Vegetables are a good source of vitamins A and C, folic acid, iron, and magnesium.
• Eat 4 to 5 servings a day.
• Try to get at least 2 of your daily servings from green, leafy vegetables.

Fruit:

• Eat 3 to 4 servings a day.
• Fruit gives you vitamins A and C, potassium, and fiber. Choose fresh fruits and juices. They are better for you than frozen or canned fruits. Eat plenty of vitamin C-rich foods, like citrus fruits, melons, and berries. Try to avoid juices that have sugar or sweeteners added.

Milk, yogurt, and cheese:

• Eat 3 servings a day.
• Dairy products are a great source of protein, calcium, and phosphorus. If you need to limit calories and cholesterol, choose nonfat dairy products.

Meat, poultry, fish, dry beans, eggs, and nuts:

• Eat 3 servings a day.
• Foods from this group are good sources of B vitamins, protein, iron, and zinc.

Fats and oils

You need moderate amounts of fat in your diet for you and your growing baby. Fats provide long-term energy for growth and are needed for brain development. Women with special diet needs should plan their meals carefully to make sure they get the nutrition they need. Talk to your provider or a dietitian if you have a special diet, such as:

• Vegetarian or vegan
• Lactose intolerant
• Gluten-free

Pregnant women should also drink plenty of fluids. Avoid drinks with caffeine and sugar. Ask your provider how much fluid you should get each day.

You should also take a prenatal vitamin that has folic acid, iron, and the other vitamins and minerals that all women need. Your provider may give you a prescription for vitamins. You can also get prenatal vitamins over-the-counter.

Though no one knows why, many pregnant women have cravings for certain foods. It may be because of hormone changes. These cravings will often pass after the first 3 months.

As long as you are getting all the nutrients you need for you and your baby, it is fine to have some of the foods you crave every now and then.

Sometimes, pregnant women will get strange cravings for things that are not food, such as dirt, clay, laundry detergent, or ice chips. This is called pica, and it may be caused by too little iron in the blood, which leads to anemia. Let your provider know if you have these cravings.

Prenatal care - eating right

Berger DS, West EH. Nutrition during pregnancy. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 6.

Cline M, Young N. Antepartum care. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2021. Philadelphia, PA: Elsevier 2021:1209-1216.

Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 5.

Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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