6 Healthy Eating Tips for First Trimester Pregnant Mamas

Pregnant woman on light backgroundToday’s post is served by good friend to Mark’s Daily Apple, Stephanie Greunke. Stephanie has teamed up with Melissa Hartwig of Whole30® to create the Healthy Mama, Happy Baby program.

Food aversions and nausea plague up to 80% of women during the first trimester of pregnancy, which can be really frustrating for the mama who is trying to eat a healthy, nourishing diet. While there is no one specific cause of food aversions and nausea, some of the proposed factors include increased hormone levels (specifically estrogen, progesterone, and hCG), hypoglycemia, thyroid dysfunction (specifically increased serum free T4 and decreased serum TSH), a woman’s enhance sense of smell, stress, Helicobacter pylori (H. pylori) infection, and physiological changes of pregnancy such as delayed gastric emptying and constipation.

One of the largest studies to date of pregnant women, the Collaborative Perinatal Project, found nausea and vomiting in pregnancy to be more common in younger women (the incidence is highest among women younger than 20 years old and drops significantly after age 35), women pregnant for the first time (primigravida), women with less than 12 years of education, women with multiple gestation, women carrying female infants, and women who are obese. Also, women whose mothers experienced nausea and vomiting with pregnancy are more likely to experience it.

If your “morning sickness” progresses to severe and persistent vomiting with substantial weight loss, you may be experiencing a condition called Hyperemesis Gravidarum, which is a much more severe form of this common pregnancy concern and requires management and follow-up with your provider. Please, don’t try to tough it out on your own!

At Whole30 Healthy Mama, Happy Baby, we understand that morning sickness can put a halt on your dedicated efforts to eat healthy! The good news is that most women find the worst morning sickness symptoms usually end around 12-16 weeks, and typically nausea is a good sign that the pregnancy is progressing well. Researchers have found that the presence of nausea and vomiting during pregnancy is correlated with lower rates of miscarriage. Hopefully, that fact makes you feel just a little better!

So, keep your head up, mama. Today I have six tips to help you eat healthy despite aversions and nausea.

Bring the whole darn grocery store home with you.

This tip comes from Whole30 Headmistress and HMHB co-creator Melissa Hartwig. She experienced lots of food aversions during her pregnancy and used this strategy. That’s why we love Primal Kitchen® products—you can stock your pantry and fridge with them, so you’ll always have flavorful and delicious options to make meals based on what sounds good to you in the moment. The more stocked your fridge and pantry are, the better chances you’ll have that you’ll be able to find something you can stomach. Don’t be afraid to ask your partner or a friend to run out and grab something for you when the mood strikes. You might be at the grocery store a bit more often during this time, but it usually only lasts a few weeks.

Capitalize on what and when you can eat.

Are there certain times of day when you feel better or have more of an appetite? Try to think outside of the box. Maybe you can’t imagine eating an egg immediately upon waking, but perhaps it sounds a little more appetizing as an early lunch? Some women notice that their nausea is worse in the morning but better by evening. I recommend trying to have lots of options in the fridge that could work for easy-to-prepare dinners. That way you can still make dinner based on what sounds good to you in the moment.

Avoid your major problem foods.

For example, if you know that you don’t tolerate dairy well normally, then try to avoid it throughout pregnancy. If ice cream sounds really good, but typically dairy messes with your digestive system, then it’s probably going to do more harm than good. Instead of ice cream, see if a frozen, non-dairy smoothie would do. You might even be able to sneak some veggies in that way!

Balance your meals/snacks with a combination of fat/protein/and carbs.

Low blood sugar can be a trigger for nausea as well, so as best you can, try to eat throughout the day, even if you’re feeling sick. It’s commonly known that pregnant women crave carbs, and that’s okay! However, any time you can, try to combine fat, protein, and carbs, to give your body more nutrients to work with and help keep your blood sugar regulated throughout the day. Craving some gluten free crackers? Stack them with almond butter or a little rotisserie chicken and Primal Kitchen Mayo.

Stay hydrated.

Becoming dehydrated can actually aggravate symptoms of morning sickness, so try to sip on a variety of beverages throughout the day. Plain water is great, but if you find that it’s difficult to tolerate, you can try sipping on chamomile, ginger, or peppermint tea (hot or iced!). You could also try sparkling water, as some mamas say it helps settle their stomach. A small amount of ginger kombucha could be a good option as well.

Focus on key nutrients.

You don’t need to choke down an organic kale salad with wild-caught salmon to optimize your nutrition during this time. Give yourself grace and just focus on a few key nutrients for you and your growing baby during this hard time.

  • Folate (B9) is involved in making and repairing DNA as well as preventing neural tube defects, which is really important during the early weeks. Outside of liver, the best source of folate is dark leafy green vegetables (such as kale, collard greens, spinach, and dandelion leaves). You just need 2.5-3 cups of steamed spinach to meet your daily prenatal requirements. With that being said, leafy greens and liver are probably “off the menu” for most of your meals right now. You can include other sources of folate, such as chickpeas, pinto beans, lentils, avocado, and beets (if they work well for you); however, this is where a prenatal vitamin comes in handy. I like to recommend prenatal vitamins that contain a methylated version of folate (versus folic acid) for optimal absorption and utilization.
  • Omega-3 fatty acids are important for your baby’s brain and visual development. Higher intakes have been associated with improved memory, cognition, and IQ. Since the amount of these essential fatty acids baby receives depends on mom’s dietary intake, it’s important to make sure they’re included in sufficient amounts through food and/or supplements. Because of the potential for mercury contamination, it’s important to choose fish low in mercury, such as wild-caught salmon, sardines, and herring. For mamas who can’t stand the thought of fish during the first trimester (which is most), I recommend talking to your provider about adding a fish oil supplement to your regimen.
  • Vitamin B6 helps your body metabolize proteins, carbohydrates, and fats, helps form new red blood cells, and supports brain and nervous system development. It’s also well-known that vitamin B6 can help alleviate nausea and vomiting, which sets it apart as an important player in your prenatal diet during the first few months. Food sources of B6 include fish, liver, chickpeas, poultry, beef, bananas, potatoes, and pistachios. If none of these options sound good or you’re really suffering, you can talk to your provider about using a B6 supplement.
  • Choline, like folate, is important for preventing neural tube defects. It’s also important for healthy brain development and can have long-term effects on your baby’s cognitive abilities, memory, and mood regulation. According to new research from Cornell University, pregnant women who increase choline intake during their third trimester of pregnancy (930 mg/day vs. 480 mg/day), may reduce the risk of their baby developing metabolic and chronic stress-related diseases like high blood pressure and diabetes later in life. While the need for choline increases during pregnancy (and even more while breastfeeding), there aren’t many foods rich in this nutrient outside of eggs and liver. You’d need to eat about four eggs a day to reach your prenatal daily requirements. Since eggs and liver may not work for you during these tough weeks, make sure your prenatal vitamin contains choline. I like Innate Response’s Baby & Me Multivitamin.

At the end of the day, just do your best. You won’t be able to eat perfectly during this time, and that’s okay. Make sure you’re taking a good prenatal supplement (gummy versions are fine during this time!), and know that your body is relying on the stores that you had built up before you became pregnant. You’ll be able to eat your piles of green, leafy veggies again soon! Hang in there, mama—and for more information and friendly advice, check out our Healthy Mama, Happy Baby blog.

Want to take your pregnancy, pre- or post-natal nutrition to the next level? Join the Whole30 Healthy Mama / Happy Baby program. Mark’s Daily Apple & Primal Kitchen customers can use code HMHBLOVESPK to receive $40 OFF your registration!

StephanieStephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie guides and supports women locally and globally through her web-based private practice.

Thanks for stopping by today, everybody. Thoughts, questions, experience to offer on either food aversions or pregnancy health? Share them on the comment board, and have a great week!



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21 thoughts on “6 Healthy Eating Tips for First Trimester Pregnant Mamas”

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  1. Liver fills nutrition gaps more completely than any other food… rich in 3 out of the 4 nutrients you say to focus on (folate, choline and B6) not mention many other key nourishing vitamins and minerals. They don’t call me “Liver King” for nuttin.

    If homemade liver is off the menu, consider grassfed desiccated liver capsules… it’s just food… whole food, at that… nutrient dense… for mother and baby… in harmony with nature — the old fashioned way, the way that our early ancestors did it!

    1. I’m a big believer in nutritional supplementation, but don’t think I’d have the chutzpah to continually push my products in the comment section of someone else’s site.

      1. Hombre, at least Liver King contributes information of value. His name is Liver King after all and I expect him to promote liver; however, I fail to see where he has “pushed” his products. Go pick on someone else.

        1. I admire you for standing up for LK. Yes, he does seem like a good guy and imparts a lot of good info. I was a little snarky, my bad.

      2. Thanks HealthyHombre!! Sometimes you need someone to keep you in check… my position has always been health promotion, not product promotion. I will absolutely be more cognizant in future posts.

    2. I’m going to go way out on a limb here and guess you’ve never been pregnant. Perhaps this is anecdotal (though I’ve heard many other women’s anecdotes to the same effect) but I can tell you that liver is the last thing I would have been able to stomach during the first trimester of pregnancy.

      And no it’s not primal or paleo, but the simple fact of the matter is that the only things that eased my nausea at that time were very simple, bland carbs like Cheerios, saltines, and toast.

      The fact is, during the first trimester, it isn’t really so much about nutrient dense foods as about things that help you not puke. Hopefully, if you’ve been eating well up until that point, you have the necessary nutrients stored up. But even if that’s not the case, in my book, not puking is preferable to puking.

      1. I’ll anecdotally second that – I’m enjoy liver normally, but I couldn’t even stomach the thought of it during my first trimester.

        I gave up looking for foods that wouldn’t make me sick and started meal planning around foods that would be easier/ less painful to throw up just because most of what I ate came back. So glad to be well into my second trimester now and eating properly again!

  2. The food aversions I developed when pregnant were mostly to things that aren’t particularly good for a pregnant person; i.e. caffeine, sweets, and cigarettes. (Yes, I did smoke at one time. Quit years ago.) It wasn’t just that those things were unappealing; they would actually make me sick. Apparently the body knows what’s best even when the brain doesn’t.

    As for the idea that women with less education are more likely to experience vomiting and nausea when pregnant, well, I really had to laugh at that one.

    1. That entire paragraph added little of substance to the article. It’s not like a women in the throes of morning sickness can do anything about a single attribute on that list! I’m under 35 but way over 20, not my first pregnancy, graduate school education, singleton pregnancy, not carrying a girl and not obese. . . . yet here I am nauseous and heaving and craving pizza and chocolate cake. : D

    2. I had an aversion to coffee with both my pregnancies. Made it a lot easier to give the coffee up for the duration. I also couldn’t stand the smell of Play-Doh, of all things, which normally doesn’t bother me at all. I learned quickly not to take prenatal vitamins at night–they’d reliably come back up–and that chewable vitamins were much easier to stomach.

  3. Isn’t morning sickness just a signal that the developing fetus needs high quality nutrient dense food rather than the poor quality food just consumed?

    1. David, there was a whole article right above your comment that listed potential causes and what to do about it and you skipped right past that to post that 80% of women are doing pregnancy wrong and as a man you can can tell them what needs to be done. For fun, read Megan’s comment about craving pizza and chocolate cake.

    2. Mate you have no idea, I eat strict paleo for several years, sleep well, keep toxins amd sweets to a very minimum, barely drink booze, exercise, time in nature etc, the whole paleo/primal lifestyle thing. I get bloods done and I’m not lacking in anything. I get pregnant, eat very healthy and yet come week 5 I’m nauseas, vomiting all day, can’t eat any red meat as I literally vomit it straight back up and generally struggle to eat much of anything except very bland foods and food like products. I lose weight unless I’m on ondansatron. I’m 30, hold a masters degree, am not at all obese and have 1 bun in the oven. I take my prenatal vitamins preconception but once I conceive and start with the all day morning sickness I bring my multis up too.

      So your theory of it being the foetus’ way of asking for more nutrient dense food is a crock of crap. Speak to things you either have personal experience with or are actually well educated on, preferably both.

    3. No, actually, it’s not. As far as I’ve seen from the research, morning sickness is mainly a symptom of high HCG levels – which is why younger women, mothers of twins, and women whose pregnancies will come to term successfully tend to have higher levels of morning sickness. My morning sickness was generally best assuaged by things like eating Kraft macaroni and cheese or Cheerios – which I assure you is not my normal dietary practice. But they made me feel better, and you know what? I didn’t care about much else at that point in time.

  4. Ugh, this takes me back. I was pregnant for the first time winter 2015 and had HORRIBLE morning sickness. Before pregnancy I had been paleo for years, exercised regularly, all that jazz. Come week six, it was vomit city. For all the paleo pregnant ladies, I got to tell you that adding sourdough bread back into my diet really saved me then. In real sourdough, much of the gluten is broken down so I was able to eat it easily. I lived off of buttered sourdough toast and self-pity for a while there. By week sixteen I was able to tolerate meat and vegetables again, but if you’re having morning sickness, go easy on yourself. If you’ve been paleo, you’ve built up a good store of nutrients in your tissue for the baby. Don’t worry about the perfect paleo first trimester- just take care of yourself. You’ll get through. I now have a terrifically healthy almost one year old and the morning sickness was worth it.

  5. Juicing of veggies and fruits is always a good option. Add in more fruits, and it will taste sweeter. That’s what my friend was doing when she can’t eat much of the cooked veggies.

  6. Very good and informative article (Tips) for pregnant women. I liked the suggestions being hydrated, balancing meals and key nutrients the most and are helpful for a healthy woman and baby. Not eating unhealthy foods is equally useful for a good health.

  7. Great info here…wish there was good stuff like this available when I was pregnant. Sadly I was still a vegetarian, and the most popular book at the time “what to expect when you’re expecting” pushed grains more than anything else. Which is probably why I gained 55 pounds which is a lot on a 100 pound girl! I had pretty bad morning sickness In the first trimester too. Wish I knew then everything I know now!

  8. With all three of my pregnancies, I craved more carbs during first trimester. With my first pregnancy, I wasn’t as conservative with my diet and gave into my cravings half the time. However, with the my second two, I made a conscious effort to avoid my cravings. I didn’t keep unhealthy foods in my house, nor would I jump to buy them. Usually, my cravings would pass, and I’d get by eating healthier options. If I had heavy carb cravings, a bowl of rice (with stir fry) would usually do the trick, or paleo mug cakes.

    I think a large part of cravings are mental, so it’s more a matter of trying to mentally overcome the desire to eat unhealthy. Yes, your body may be telling you it’s lacking in certain nutrients/minerals, but if your craving is for something unhealthy, that’s probably not the case!

  9. Healthy eating is fresh fruits not can, vegetables cooked, sautéed, grilled however you want, lean beef or chicken if you want, eggs, milk(I only drink almond milk) sorry women that don’t cook, nothing healthy comes as instant or boxes, that processed and has sugar and salt, a lot. Chips, junk food, star he and treats go to your behind and not the baby, if you feel craving for sweet eat fruit salad with honey or even coconut macaroons , also those egg whites treats, nothing from a vending, I mean you shouldn’t anyway. I’ve met people gorging on fast food with the excuse to be pregnant, I internally laugh, idk is my opinion. Even if you are poor as I am , or work full time and you cook by batches, you also can cook fresh, but if you are lazy It won’t work. This is not for lazy people