At all stages of life it is important to have a healthy balance of lean proteins, carbohydrates, heart-healthy fats, vitamins, minerals, and fiber. Now that you are pregnant you may find some things just don’t taste, or smell, or sound as good to eat. Keep in mind though, you are not eating for two! You only require about an additional 300 calories a day during pregnancy and breast-feeding, which is less than you may think.

Here are some common questions patients often ask about diet and  nutrition in pregnancy:

How much weight gain is healthy? 

• This depends a lot on your weight (or BMI more specifically) prior to or at the onset of pregnancy.  For women with a normal pre-pregnancy BMI we recommend 25-30 pounds; if overweight (BMI  greater than 30) 11-20 pounds is recommended, and if obese (BMI greater than 40) 10 pounds or  less is recommended. Your provider can calculate your BMI for you to help determine what a  good amount is for you.

Do I need a prescription prenatal vitamin, and is a women’s daily vitamin good enough? 

• During pregnancy additional folic acid (at least 400 micrograms daily) and iron (27 milligrams  daily) are needed. These are routinely found in most prenatal vitamins, even over-the-counter ones which are perfectly fine for most patients. Folic acid reduces the risk of neural tube defects,  including spina bifida. And the growing baby needs iron to build red blood cells-if there isn’t enough iron for mom and baby, mom tends to get anemia. A prenatal vitamin has the appropriate amounts of vitamins and minerals for pregnancy whereas other vitamin supplements, including a women’s daily vitamin, may not. Know that more is not always better, and some vitamins in excess can be harmful.

What seafood do I need to avoid and why? 

• Some fish (especially very large deep-sea varieties) can be high in mercury which can be damaging to fetal nervous system development. Ones that are highest in mercury include shark,  king mackerel, albacore tuna and tilefish, (often used in fast-food fish sandwiches and frozen fish sticks) should be avoided-eat no more than one 6 ounce serving a week. Canned light tuna  (NOT albacore or white tuna) and salmon have more modest mercury content and you should  eat no more than 2 servings a week. Seafood that comes from local rivers and lakes are very low  in mercury, so no need to restrict your intake. The reason we suggest avoiding sushi and shellfish  is due to concerns about salmonella, which tends to thrive in raw food. If you choose to eat these  items make sure they are fresh and thoroughly cooked. If it smells “fishy” don’t eat it!

How about caffeine-do I have to stop drinking it? 

• Moderate caffeine consumption (the equivalent of 2 cups of coffee daily) does not appear to be  dangerous in pregnancy. There is controversy as to whether or not excess consumption (the  equivalent of 2 triple shot venti drinks a day) may increase the risk of very early miscarriages. It  is clear that excess caffeine can interfere with sleep and contribute to nausea, dizziness and  palpitations, and dehydration.

Am I allowed to eat deli meat? 

• We want you to limit nitrite and salt intake, both of which can be high in some processed pork products (like hot-dogs) and some deli items such as hard salamis. Items with a long shelf-life tend to be high in preservatives and should be avoided. Those with a short shelf-life, like roast turkey and roast beef, are better choices (especially if heated to kill off any possible listeria).

How can I avoid listeriosis? 

• While uncommon, listeria is very dangerous in pregnancy and can lead to miscarriage or stillbirth. It may be found in unpasteurized dairy and soft-runny cheeses. Also, it may be found in raw or undercooked meat, poultry, and shellfish. So avoid these foods altogether! It is also very important to wash all fresh fruits and vegetables before eating them as listeria can live on the outside of these foods.