Nutrition During Pregnancy: What to Eat and Which Vitamins You Really Need?

Written by Siobhan McNulty, Pharmacist

Pregnancy is an exciting time, but it can also come with a lot of questions, particularly when it comes to nutrition.

Are you eating enough of the right foods? Do you need to take a pregnancy multivitamin? Is folic acid enough? And what about iron, vitamin D, iodine and omega-3 supplements?

With so much information available online, it's easy to feel overwhelmed by conflicting advice.

The good news is that healthy eating during pregnancy doesn't have to be complicated, expensive or restrictive.

According to the NHS and the National Institute for Health and Care Excellence (NICE), a varied, balanced diet provides most of the nutrients you need during pregnancy. However, certain vitamins and minerals are especially important, and some need to be taken as supplements.

In this guide, we'll look at the best foods to eat during pregnancy, which pregnancy vitamins are recommended by the NHS, when additional supplements may be necessary and which foods you should avoid.

Why Is Good Nutrition Important During Pregnancy?

During pregnancy, your body undergoes significant changes to support the growth and development of your baby.

Your blood volume increases, your nutritional requirements change, and your baby relies on nutrients from your diet to develop healthy organs, bones, muscles and a nervous system.

Good nutrition during pregnancy can help:

• Support your baby's brain and spinal cord development.
• Promote healthy bone and tooth development.
• Support the production of healthy red blood cells.
• Reduce the risk of certain nutritional deficiencies.
• Maintain your energy levels and general wellbeing.
• Support your baby's growth throughout pregnancy.

However, eating healthily isn't about achieving the perfect diet every day. It's about building good habits, enjoying a variety of nutritious foods and making sure you're getting enough of the nutrients that matter most.

What Are the Most Important Nutrients During Pregnancy?

Certain vitamins and minerals become particularly important when you're pregnant.

Although these nutrients are all important, not every woman needs to take them as separate supplements. Let's look at what the NHS and NICE actually recommend.

Which Vitamins and Supplements Should You Take During Pregnancy?

One of the most common misconceptions is that every pregnant woman needs to take a large selection of supplements.

In reality, the NHS recommends folic acid and vitamin D, while additional supplements depend on your individual nutritional needs.

1. Folic Acid: Essential Before and During Early Pregnancy

NHS and NICE recommendation: 400 micrograms (mcg) daily before pregnancy and until at least 12 weeks pregnant.

Folic acid is one of the most important supplements to take when planning a pregnancy.

It helps your baby's brain and spinal cord develop properly and significantly reduces the risk of neural tube defects, including spina bifida.

These structures begin developing very early in pregnancy, often before you know you're expecting. This is why timing is so important.

The NHS and NICE recommend starting folic acid ideally three months before trying to conceive and continuing for at least the first 12 weeks of pregnancy.

If your pregnancy is unplanned, start taking folic acid as soon as you discover you're pregnant.

Although folate occurs naturally in foods such as leafy green vegetables, chickpeas, beans and fortified cereals, diet alone cannot reliably provide the recommended amount.

Who Needs a Higher Dose of Folic Acid?

Some women require a prescription-strength dose of 5mg daily. According to the NHS and NICE guideline NG247, this may be recommended if:

• You have previously had a pregnancy affected by a neural tube defect.
• You or your baby's biological father have a neural tube defect, or a family history of neural tube defects.
• You have type 1 or type 2 diabetes.
• You have certain blood conditions, including sickle cell anaemia or thalassaemia.
• You take certain medicines for epilepsy or HIV.

If any of these apply to you, speak to your GP, who can prescribe the higher dose.

An important point in the updated NICE guidance is that having a higher BMI alone does not mean you automatically need a 5mg dose.

If you've had bariatric surgery, you should seek individualised advice about folic acid and other nutrients.

Pharmacist's tip: Ideally, start folic acid before you stop contraception if you're planning a baby. Don't wait until your first antenatal appointment.

2. Vitamin D: Supporting Healthy Bones and Teeth

NHS recommendation: 10 micrograms (400 IU) daily from September to March.

Vitamin D helps your body absorb calcium, supporting healthy bones, muscles and teeth. During pregnancy, it also contributes to your baby's bone development.

Our bodies make vitamin D when sunlight reaches our skin. However, in the UK, sunlight is generally not strong enough between September and March for us to produce sufficient amounts.

For this reason, the NHS recommends that pregnant and breastfeeding women take 10 micrograms of vitamin D daily between September and March.

Don't take more than 100 micrograms (4,000 IU) of vitamin D a day, as this could be harmful, unless your doctor has prescribed a higher dose.

Do You Need Vitamin D All Year Round?

Some women should consider taking vitamin D throughout the year, particularly if they:

• Spend very little time outdoors.
• Usually cover most of their skin when outside.
• Have darker skin and may produce less vitamin D from sunlight.

If you've been diagnosed with vitamin D deficiency, your GP may recommend a higher treatment dose.

Vitamin D is found in foods such as oily fish, egg yolks and fortified cereals, but getting enough through diet alone can be difficult.

Pharmacist's tip: Many pregnancy multivitamins contain 10 micrograms of vitamin D. Check the label before taking an additional supplement to avoid unnecessary duplication.

3. Iron: Helping Prevent Anaemia During Pregnancy

Iron requirements increase during pregnancy because your body produces additional blood to supply oxygen to your developing baby.

If you don't have enough iron, you may develop iron deficiency anaemia. Possible symptoms include:

• Unusual tiredness or weakness.
• Dizziness.
• Shortness of breath.
• Headaches.
• Pale skin.

However, these symptoms can occur for other reasons during pregnancy.

Does Every Pregnant Woman Need an Iron Supplement?

No. The NHS does not recommend taking extra iron if you don't need it.

Your blood count will usually be checked at your first antenatal appointment and again at around 28 weeks.

If testing identifies anaemia, your GP or midwife may recommend iron supplementation and further investigation where appropriate.

Iron supplements can sometimes cause constipation, nausea and stomach discomfort, so choosing the correct preparation and dose is important. Your pharmacist can help you find a suitable option.

How Can You Increase Iron Through Your Diet?

Good food sources include lean meat, poultry, lentils, beans, chickpeas, green leafy vegetables, dried fruit, nuts and fortified breakfast cereals.

Vitamin C improves the absorption of iron from plant-based foods. Try pairing:

• Lentils with tomatoes or peppers.
• Iron-fortified cereal with strawberries.
• Chickpeas with broccoli or other vitamin C-rich vegetables.

Tea and coffee can reduce iron absorption, so it's sensible to avoid them around iron-rich meals or when taking iron supplements.

4. Iodine: Supporting Your Baby's Brain Development

Iodine is important for producing thyroid hormones, which are essential for your baby's brain and nervous system development.

Food sources include milk, yoghurt, eggs and sea fish.

Unlike folic acid and vitamin D, the NHS does not routinely recommend a separate iodine supplement for every pregnant woman. Most people can get iodine through a balanced diet.

However, women who avoid dairy, fish and eggs may be at greater risk of inadequate iodine intake. Some plant-based milk alternatives are fortified with iodine, but many are not, so checking the label is worthwhile.

If you follow a vegan diet, have a thyroid condition or are concerned about your iodine intake, speak with your GP, midwife or pharmacist before starting a supplement.

Taking excessive iodine can interfere with thyroid function, so more isn't necessarily better.

5. Omega-3: Supporting Brain and Eye Development

Omega-3 fatty acids, particularly DHA, are important for your baby's brain and eye development. One of the best dietary sources of DHA is oily fish.

The NHS recommends eating two portions of fish each week, ideally including one portion of oily fish. Suitable options include salmon, sardines, trout, mackerel and herring.

However, pregnant women should not eat more than two portions of oily fish each week because of possible exposure to pollutants.

Should You Take an Omega-3 Supplement?

Omega-3 supplements are not routinely required for every pregnant woman under NHS guidance.

However, if you rarely eat fish, a DHA supplement may be worth discussing with your pharmacist or midwife. For vegetarians and vegans, algae-derived DHA supplements are an alternative to fish oil.

Important: Avoid cod liver oil during pregnancy, as it can contain high amounts of vitamin A in the retinol form, which may harm your baby's development.

6. Calcium: Helping Build Strong Bones and Teeth

Calcium is important for your baby's developing bones and teeth, as well as maintaining your own bone health.

The NHS recommends including calcium-rich foods as part of a balanced pregnancy diet. Good sources include:

• Milk and yoghurt.
• Suitable cheeses.
• Calcium-fortified plant-based drinks.
• Calcium-set tofu.
• Green leafy vegetables, such as kale and watercress.
• Tinned sardines or pilchards with edible bones.

If you don't consume dairy products, choose fortified alternatives and check the labels carefully.

Most women who eat a varied diet won't need a separate calcium supplement. However, supplementation may be recommended if your intake is insufficient or you have particular medical needs.

7. Vitamin B12: Especially Important for Vegan Diets

Vitamin B12 helps maintain a healthy nervous system and supports red blood cell production. It's naturally present in meat, fish, eggs and dairy products.

Women following a vegan diet need to be particularly careful because reliable natural plant-based sources are limited.

The NHS and NICE advise that people following restricted diets may need vitamin B12 from fortified foods or supplements.

If you're vegan, planning a pregnancy or already pregnant, speak to your midwife, pharmacist or a registered dietitian to make sure you're getting enough B12.

8. Choline: An Important but Often Overlooked Nutrient

Choline contributes to normal brain and nervous system development. It's found in foods such as eggs, fish, meat, dairy products, beans and some vegetables.

Although it's an important nutrient during pregnancy, a separate choline supplement isn't routinely recommended for everyone by the NHS. For most women, the first approach should be to include a variety of choline-containing foods.

Women with restrictive diets may benefit from individual nutritional assessment.

Pregnancy Vitamins and Supplements: Quick Reference Guide

Should You Take a Pregnancy Multivitamin?

Pregnancy multivitamins can be a convenient way to get essential vitamins and minerals, but they aren't automatically necessary for everyone.

If you choose to take one, make sure it's specifically formulated for pregnancy. Check that it contains an appropriate amount of folic acid and vitamin D, and consider whether other ingredients are suitable for your individual needs.

A pregnancy multivitamin should support a healthy diet, not replace one.

It's also important not to combine multiple products without checking their ingredients, as you could end up taking excessive amounts of certain nutrients.

Avoid pregnancy supplements containing vitamin A as retinol, unless specifically prescribed by an appropriate specialist.

If you're unsure which pregnancy supplement to choose, your pharmacist can help you compare formulations and avoid duplicating ingredients. One option is GiGi Pre-Conception & Pregnancy capsules, and if your midwife or GP has advised iron, GiGi Iron Bisglycinate is also available.

What Are the Best Foods to Eat During Pregnancy?

A healthy pregnancy diet should include foods from all the main food groups. According to the NHS, you don't need a special diet during pregnancy. Instead, focus on variety, balance and good food hygiene.

Fruit and Vegetables

Aim for at least five portions of fruit and vegetables daily. These provide important vitamins, minerals and fibre. Fresh, frozen and tinned varieties can all contribute to your intake. Try to include a variety of colours throughout the week.

Wholegrain Carbohydrates

Carbohydrates provide energy for you and your developing baby. Choose foods such as porridge, wholemeal bread, brown rice, potatoes and wholegrain pasta. Higher-fibre options can also help reduce constipation, which is particularly common during pregnancy.

Protein-Rich Foods

Protein provides the building blocks for your baby's growth and development. Include sources such as lean meat, poultry, fish, eggs, lentils, beans, tofu and nuts. Your protein needs increase as pregnancy progresses, so including protein in your meals and snacks can be helpful.

Dairy and Fortified Alternatives

Milk, yoghurt and cheese provide calcium and protein. If you're avoiding dairy, look for unsweetened, calcium-fortified alternatives. Not every dairy alternative contains the same nutrients as cows' milk, so always check the label.

Healthy Fats

Foods such as olive oil, avocado, nuts, seeds and suitable oily fish provide healthy fats. These help you meet your energy needs and get important fatty acids.

Do You Need to Eat for Two During Pregnancy?

One of the most persistent pregnancy myths is that you need to eat twice as much food. The NHS advises that you do not need to eat for two.

Most women don't need to significantly increase their calorie intake during the first six months of pregnancy. According to NHS guidance, during the final three months, you may need approximately 200 extra calories per day.

That's considerably less than many people imagine. For example, it could be a couple of slices of wholemeal toast with spread or another nutritious snack.

Individual energy requirements vary depending on factors such as your activity level, nutritional status and whether you're expecting more than one baby.

NICE advises focusing on a healthy diet and suitable physical activity rather than pursuing a specific weight target. Intentional weight-loss dieting during pregnancy is not recommended.

Foods to Avoid During Pregnancy: NHS Advice

Most everyday foods are safe to eat during pregnancy. However, some foods carry a higher risk of food poisoning, while others may contain substances that could harm your baby's development.

Foods to Avoid or Prepare Carefully

• Unpasteurised dairy: Avoid unpasteurised milk, cream, yoghurt, butter and ice cream. Hard cheeses such as cheddar and parmesan are safe even if unpasteurised. Soft mould-ripened cheeses (such as brie and camembert) and soft blue cheeses (such as gorgonzola) should only be eaten if cooked until steaming hot.
• Raw or undercooked meat: Avoid undercooked meat. Cold cured meats such as salami, chorizo and prosciutto should be cooked until steaming hot before eating.
• Liver and liver products: Avoid because they contain high levels of vitamin A.
• Game meats: Avoid game such as goose, partridge, pheasant and venison, as it may contain lead.
• Raw or undercooked eggs: British Lion-stamped hen eggs and eggs produced under the Laid in Britain scheme can be eaten runny. Other eggs should be cooked thoroughly.
• Raw fish and shellfish: Avoid raw seafood, including sushi made with raw fish. Cold-smoked fish (including smoked salmon) and cold pre-cooked prawns should be cooked until steaming hot.
• Fish high in mercury: Avoid shark, swordfish and marlin.
• Tuna: Limit to no more than four cans or two tuna steaks per week.
• Oily fish: Limit to a maximum of two portions per week.
• Pre-packaged sandwiches, salads and pâté: Keep chilled and eat before the use-by date, as they can carry a small risk of listeria.
• Herbal teas: Have no more than four cups a day, and avoid teas containing liquorice root.
• Alcohol: The safest approach is not to drink alcohol during pregnancy.

Always wash fruit and vegetables thoroughly, follow storage instructions and observe use-by dates.

How Much Caffeine Can You Have During Pregnancy?

The NHS recommends consuming no more than 200mg of caffeine daily. Approximate caffeine amounts include:

Filter coffee and large coffees from cafés may contain considerably more caffeine. Chocolate, some medicines and certain supplements may also contain caffeine.

How Do Nutritional Needs Change During Each Trimester?

First Trimester: Folic Acid and Managing Morning Sickness

During the first 12 weeks, your baby's major organs and nervous system begin developing. Folic acid is particularly important during this stage.

However, nausea, vomiting and food aversions can make eating well more difficult. If you're struggling with morning sickness, try:

• Eating small, frequent meals.
• Choosing plain foods such as toast, crackers or rice.
• Sipping fluids regularly.
• Avoiding strong food smells that trigger nausea.
• Trying ginger-containing foods or drinks if you find them helpful.

The NHS notes that ginger may help some women with pregnancy-related nausea, but check with a pharmacist before taking concentrated ginger supplements.

If you're unable to keep fluids down, experiencing significant weight loss or becoming dehydrated, seek medical advice promptly.

Second Trimester: Supporting Growth and Energy

Many women find that their nausea improves during the second trimester. Your baby continues growing, and your body needs a steady supply of protein, vitamins and minerals.

Focus on balanced meals containing protein, wholegrains, fruit, vegetables and calcium-rich foods. Continue vitamin D supplementation as appropriate and follow your maternity team's advice about blood tests and additional supplements.

Third Trimester: Maintaining Nutrition as Your Baby Grows

During the final trimester, your baby's growth continues, and your energy needs may increase. You may also experience heartburn, constipation or feeling full quickly.

Smaller, frequent meals can sometimes be easier to tolerate. Continue eating a varied diet, drinking enough fluids and choosing fibre-rich foods.

A Simple Example of a Healthy Pregnancy Meal Plan

Healthy eating during pregnancy doesn't need to involve complicated recipes or expensive ingredients. Here's an example of a balanced day.

• Breakfast: Porridge made with milk or calcium-fortified soya milk, topped with berries and chopped nuts.
• Mid-morning snack: Natural yoghurt and a banana.
• Lunch: Wholemeal sandwich with thoroughly cooked chicken, avocado and freshly washed salad.
• Afternoon snack: Wholegrain crackers with hummus and peppers.
• Dinner: Oven-baked salmon with potatoes, broccoli and carrots.
• Evening snack: Wholemeal toast with peanut butter or a small bowl of fortified cereal.

Water should be your main drink throughout the day.

This is only an example. Meals should be adapted to your appetite, dietary preferences, activity levels and medical needs.

Can Nutrition Help Common Pregnancy Symptoms?

Morning Sickness

Try eating little and often and avoiding an empty stomach. Plain carbohydrates may be easier to tolerate when you're feeling nauseous. Ginger-containing foods may help some women.

If vomiting is frequent or severe, don't rely on dietary changes alone. Speak to your midwife or GP.

Constipation

Constipation is common during pregnancy and can sometimes be made worse by iron supplements. If you've been advised to take iron and it's upsetting your stomach, ask your pharmacist about alternative preparations.

Increase fibre gradually through fruit, vegetables, beans and wholegrains. Drink plenty of water and remain physically active where appropriate.

Heartburn

Heartburn becomes particularly common during later pregnancy. Eating smaller meals, avoiding large meals before bedtime and identifying food triggers can help. Many women also find that propping themselves up with a supportive pregnancy pillow eases night-time heartburn.

If symptoms persist, your pharmacist can advise on suitable treatments during pregnancy.

Fatigue

Feeling tired is common during pregnancy, particularly in the first trimester. However, ongoing or severe fatigue may indicate anaemia or another health issue.

Speak to your midwife or GP if you're concerned, rather than automatically starting iron supplements.

What If You're Vegetarian or Vegan During Pregnancy?

A well-planned vegetarian or vegan diet can support a healthy pregnancy. However, certain nutrients need particular attention, including vitamin B12, iron, calcium, iodine, omega-3 fatty acids and vitamin D.

Vegetarian sources of protein include eggs, dairy, beans, lentils, tofu and nuts. If you're vegan, focus on fortified plant-based foods and reliable sources of vitamin B12.

Your pharmacist, midwife or dietitian can help identify nutritional gaps and advise whether additional supplementation is appropriate.

Can You Get Free Pregnancy Vitamins Through the NHS?

Some pregnant women may be eligible for free vitamins through the NHS Healthy Start scheme, including those who receive certain benefits and anyone who is pregnant and under 18.

Healthy Start pregnancy vitamins contain folic acid, vitamin C and vitamin D. The scheme also provides support towards buying certain foods for eligible families.

Eligibility and arrangements can change, so visit the NHS Healthy Start website for current information. Your midwife or pharmacist may also be able to explain how to access pregnancy supplements locally.

Frequently Asked Questions About Nutrition During Pregnancy

What vitamins should I take when pregnant?

The NHS recommends 400 micrograms of folic acid daily before pregnancy and until at least 12 weeks, and 10 micrograms of vitamin D daily from September to March. Some women should consider vitamin D year-round. Other supplements depend on your diet, medical history and individual requirements.

When should I start taking pregnancy vitamins?

Ideally, start folic acid three months before trying to conceive. If you're already pregnant, begin as soon as possible.

Do I need to take folic acid throughout my entire pregnancy?

The NHS and NICE recommend taking folic acid for at least the first 12 weeks of pregnancy. Continuing beyond this is generally safe, but the routine recommendation focuses on the early stages of pregnancy.

Do I need iron supplements during pregnancy?

Not necessarily. Blood tests during your antenatal care help identify anaemia. Your midwife or GP will recommend iron if required.

Is it safe to take a pregnancy multivitamin?

Yes, provided it's suitable for pregnancy and taken according to the instructions. Avoid products containing vitamin A as retinol and check before combining multiple supplements.

Do I need omega-3 supplements during pregnancy?

Not every woman needs an omega-3 supplement. The NHS recommends eating fish regularly, including oily fish within the recommended limits. If you don't eat fish, ask your pharmacist whether a pregnancy-suitable DHA supplement may be appropriate.

Can I follow a vegetarian or vegan diet while pregnant?

Yes, but careful planning is important. Vitamin B12, iodine, iron, calcium, vitamin D and omega-3 intake may need particular attention.

What is the best diet for pregnancy?

A balanced diet including at least five portions of fruit and vegetables daily, wholegrains, protein-rich foods, calcium sources and healthy fats provides a strong foundation.

Can taking too many vitamins harm my baby?

Yes. Excessive doses of certain vitamins and minerals may be harmful during pregnancy. In particular, avoid supplements containing vitamin A as retinol unless prescribed by a specialist, and don't take more than 100 micrograms of vitamin D a day unless advised by your doctor.

Final Thoughts: Looking After Yourself and Your Baby Through Good Nutrition

Pregnancy is a time when nutrition really matters, but it shouldn't become another source of worry.

You don't need a perfect diet, expensive superfoods or a cupboard full of pregnancy supplements. Instead, focus on eating a variety of nutritious foods, staying hydrated and understanding which vitamins and minerals are especially important.

For most women in the UK, folic acid and vitamin D are the main supplements recommended under NHS guidance, according to the stage of pregnancy and individual circumstances.

Other nutrients, such as iron, iodine, calcium, omega-3 and vitamin B12, may need additional attention depending on your diet and health.

If you're unsure which vitamins or supplements are right for you, speak to your pharmacist. They can help you select a pregnancy-appropriate supplement, check for duplicated ingredients and explain when you should seek further advice from your GP or midwife.

Most importantly, remember that nourishing yourself is an important part of looking after your growing baby. A healthy pregnancy isn't about eating perfectly every day. It's about making informed, balanced choices that work for you.

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Medical disclaimer: This article provides general health information based on UK NHS and NICE guidance. It is not a substitute for personalised medical advice. Always consult your GP, midwife or pharmacist before starting additional pregnancy supplements, particularly if you have an existing medical condition or take regular medicines.

Trusted Sources and Further Reading

1. NHS – Vitamins, supplements and nutrition in pregnancy
2. NICE NG247 – Maternal and child nutrition
3. NHS – Healthy eating in pregnancy
4. NHS – Foods to avoid in pregnancy
5. NHS – Iodine
6. NHS – Healthy Start scheme