By Reed Mangels, PhD, RD
There’s no stage in life where nutrition matters so much as it does during pregnancy. After all, you’re providing the nutrition necessary to support two lives. Since the earliest moments of life are pivotal, nutrition leading up to conception, and during pregnancy, is massively important. Many mothers, whether vegan or not, fail to eat an optimally nutritious diet during pregnancy. This guide will teach you the main things to pay attention to, as you contemplate becoming pregnant while following a vegan diet.
Prior to Pregnancy
Good pregnancy nutrition starts even before you become pregnant. Here are some things to do and think about:
- Is your Body Mass Index (BMI) in what’s considered the normal range?
- Take a folic acid supplement every day.
- Have blood work done to confirm that your iron status is normal.
- Take a reliable and adequate source of vitamin B12 (fortified foods and/or supplements) every day.
- Is your overall diet healthful and comprised mainly of whole, nutritious foods?
- Are you getting enough exercise?
- Avoiding alcohol and tobacco products is immensely important during pregnancy. It’s a good idea to eliminate these substances if you are planning to get pregnant.
The months before becoming pregnant offer a time when you can make sure that you’re in the best possible shape for pregnancy. Even though the nine months of pregnancy may seem interminable, they go by quickly and it may be hard to quickly make significant changes in your diet or physical condition during that time.
Women whose BMI is categorized as markedly underweight or overweight during conception are at a higher risk for pregnancy complications such as gestational diabetes, having a very large or very small infant, and having a premature baby. You can calculate your BMI using this calculator to see which category you’re in. If your BMI is categorized as underweight, try to gain sufficient weight before becoming pregnant to get yourself into a normal range. If you’re overweight, doing what you can to bring your weight back into a more healthful range can reduce risk to your health and your baby’s health during pregnancy.
Folic acid, a form of folate, is a crucial vitamin, especially during the very early stages of pregnancy. This vitamin plays a role in the development of the nervous system and has been shown to reduce the risk of having a child with spina bifida or other neural tube defects. The Centers for Disease Control and Prevention (CDC) urges women to take 400 micrograms of folic acid every day, starting at least one month before getting pregnant and continuing during pregnancy. They specifically call for the use of folic acid from fortified foods and/or supplements, in addition to getting folate from foods. Foods fortified with folic acid include some ready-to-eat breakfast cereals, some breads, some pasta, and enriched rice.
Many women are deficient in iron. Women suffering from iron deficiency anemia during pregnancy are at a higher risk for pregnancy complications including premature birth. It’s easier to correct iron deficiency before becoming pregnant when you only need to meet your iron needs. During pregnancy, your blood volume and iron needs are higher because of your baby’s needs. This page provides more information about iron.
Vitamin B12 is always important for vegans, but especially so heading into pregnancy since it’s needed for the development of the baby’s brain and the rest of the nervous system. Registered dietitian Virginia Messina has these suggestions for getting adequate vitamin B12 prior to pregnancy:
- Take a daily supplement providing 25 to 100 micrograms (mcg) of vitamin B12 or
- Take a supplement providing 1,000 mcg of vitamin B12 twice per week. Opt for chewable or “sub-lingual” tablets (which you allow to dissolve under your tongue), since they may allow for greater absorption or
- Eat two servings per day of foods fortified with at least 2 to 3.5 mcg of vitamin B12 each. You’ll need to eat these servings at least 4 hours apart to allow for optimal absorption.
Messina recommends taking the cyanocobalamin form of vitamin B12, which is the only one shown to be reliable as a supplement.
If you’re not already doing so, it’s good to get in the habit of eating a healthy vegan diet and exercising regularly. That way, you’ll be able to share these habits with your children and serve as a role model. Plus, you’ll already be used to eating well and exercising when you become pregnant.
Nutrition During Pregnancy
Adequate—but not excessive—weight gain is important in pregnancy. While you might think that you only need to gain seven or eight pounds to account for the baby’s weight, the baby’s weight is just a fraction of the weight you must gain. For example, your blood volume increases when you’re pregnant. This adds about four pounds. The amniotic fluid (liquid surrounding the fetus) weighs about 1-1/2 pounds. Additional weight gain is made up of the weight of the placenta, growth of breast and uterine tissue, accumulation of fat stores, and increases in body fluids. Altogether, a woman whose BMI is in the “normal” category is expected to gain around 25 to 35 pounds. The CDC website provides more information about weight gain in pregnancy.
The nutrients that pregnant vegan women should be especially aware of are:
- Vitamin B12
- Folic acid
- Iron and Zinc
- Omega-3 fatty acids
- Vitamin D
You must be aware of good sources of each of these nutrients and have a plan for meeting your needs every day. Fortunately, it’s simple to meet your needs for these nutrients with a vegan diet. In some cases, these nutrients are most easily obtained through supplements and/or fortified foods.
Protein needs increase during pregnancy because the mother must maintain her own body, while her baby develops muscles, bones and organs. That’s why protein recommendations call for an intake of 25 grams per day more than what was recommended before pregnancy. This increase in protein recommendations is for the second and third trimesters (which begin at the fourth month of pregnancy.) Although the exact protein requirement varies depending on the mother’s pre-pregnancy weight, most women will need about 75-85 grams of protein daily during pregnancy.
The protein powerhouses for vegans are found in the legume family. Legumes include dried beans, soy products, and peanuts. Tree nuts are another source of protein. If you eat 5 servings per day of legumes, as well as other foods like grains, nuts, seeds, and vegetables that provide smaller amounts of protein, it’s likely that you’ll meet your needs. A serving of legumes is any one of the following:
- ½ cup cooked dried beans, tofu, or tempeh
- 1 cup of soymilk
- ¼ cup of peanuts or soy nuts
- 2 tablespoons of peanut butter
- 2 to 3 ounces of most veggie meats, except jackfruit
It’s very easy to get your five servings of legumes. Here’s an example of how to reach five servings of legumes in one day: you could drink a smoothie made with a cup of soy milk in the morning, eat lentil soup for lunch, a tofu stir-fry for dinner, peanut butter on an apple for one snack, and trail mix with peanuts for another snack. That’s all there is to it—just by eating those foods over the course of a day you’ve taken in your five serving of legumes.
This vitamin plays a crucial role in the development of a baby’s nervous system. Although a woman’s body stores some vitamin B12, the stored vitamin B12 has not been shown to be readily available to the fetus. In other words, when you are pregnant, you need to take a vitamin B12 supplement or use foods fortified with vitamin B12 every day. Requirements in pregnancy are a bit higher than when you’re not pregnant (the recommended amount for pregnancy is 2.6 micrograms per day.) Many prenatal supplements include vitamin B12 so this is one way to get it. Another way is to take a vitamin B12 supplement, and a third way is to eat foods fortified with vitamin B12. The larger the dose of vitamin B12, the lower the percentage absorbed, which is taken into account in the following recommendations. Every day either:
- Take a daily prenatal vitamin or a vitamin B12 supplement that provides at least 25 mcg of vitamin B12 or
- Eat two servings per day of foods fortified with at least 2 to 3.5 mcg of vitamin B12 each. These products will say that a serving contains at least 33% of the Daily Value for vitamin B12 on its Nutrition Facts label. You’ll need to eat these servings at least 4 hours apart to allow for optimal absorption.
Folic acid is one form of folate, an essential vitamin. Folic acid is the form of folate that is used in supplements and fortified foods because it is the form that is most stable. It is added to enriched grain products including breads, pasta, and breakfast cereals. There are several other forms of folate that are found naturally in foods; these are called “food folates.” Foods that are naturally high in folate include green leafy vegetables, dried beans, and oranges. This vitamin, like vitamin B12, plays an essential role in the development of a baby’s nervous system.
During pregnancy, both folic acid from food folate and from supplements or fortified foods are needed. Folic acid appears to markedly reduce the risk of having a child with a neural tube defect. Foods high in folate tend to be loaded with other important nutrients, so eating them pays off in in numerous ways.
Iron and Zinc
Iron’s role in pregnancy is primarily to support the development of blood–both for the baby and for the mother’s increased blood supply. Inadequate iron results in iron deficiency anemia which can increase the risk of your baby being born prematurely. Vegan diets can (and should!) contain many foods that are high in iron including dried beans and whole grains. To promote iron absorption, be sure to have a vitamin C source at every meal that features a rich source of iron. Vitamin C sources include citrus fruits and juices, tomato products, and broccoli. Because iron needs are so high during pregnancy, many pregnant women take a low-dose iron supplement. Talk to your health care provider about whether or not you should take an iron supplement during pregnancy.
Zinc is essential for your baby’s development. Like iron, zinc is found in whole grains and beans as well as nuts and seeds. See this Vegan Nutrition Guide for more information about zinc.
Many people around the world, in both developed and developing countries, don’t get enough iodine. This is especially worrisome during pregnancy since infants who are iodine deficient face an elevated risk for developmental delays. The most reliable way to get adequate iodine during pregnancy is to use supplemental iodine. Many, although not all, prenatal supplements provide iodine. Check to see if yours has at least 150 mcg of iodine. If it doesn’t, you can use an iodine supplement. Additional iodine can also come from iodized salt. Vegetables can offer another good source of iodine but their iodine content isn’t dependable since levels can vary greatly. Sea vegetables are typically a rich source of iodine, but some sea vegetables have such extreme levels of iodine that their regular consumption can cause health problems.
Omega-3 Fatty Acids
Alpha-linolenic acid (ALA) is an essential omega-3 fatty acid that is abundant in only a few vegan foods. Virginia Messina recommends including any one of the foods below in your diet every day in order to get enough of this fatty acid:
- 1 tablespoon of ground flaxseed (note that it must be ground; otherwise you won’t absorb the ALA)
- 1 teaspoon of flaxseed oil
- 4 walnuts
- 1 tablespoon of walnut, hempseed, soy or canola oil
- 2 teaspoons of chia seeds
In addition to the above omega-3 sources, it may be wise to also take a daily vegan DHA capsule. Many experts recommend that pregnant women include DHA in their diets. Adequate DHA appears to reduce the risk of having a premature baby and may promote the baby’s brain development. Vegan women can get DHA from vegan supplements which contain DHA derived from algae. Choose a supplement that provides 200-300 milligrams of DHA per capsule.
Calcium needs are important considerations during pregnancy because this mineral builds the baby’s bones and teeth. The recommendation for how much calcium women should consume when pregnant is the same as the recommendation for non-pregnant women. Women absorb and retain more calcium during pregnancy so they don’t need to increase their intake, provided it was adequate before pregnancy.
All of these foods have about 150 milligrams (mg) of calcium in a serving:
- ½ cup calcium-fortified plant milk, calcium-fortified orange juice, tempeh, soybeans, firm tofu made with calcium and nigari, calcium-fortified yogurt
- 1 cup cooked bok choy, collards, kale, mustard greens, okra, white beans
- 2 cups cooked broccoli
- ¼ cup calcium-fortified tofu, almonds
- 2 Tablespoons almond butter or tahini
- 2 navel oranges
- 10 dried figs
- ½ calcium-fortified energy bar
To meet calcium needs while pregnant, choose at least 5-6 servings of the above foods daily, while also eating other foods that provide smaller amounts of calcium.
Vitamin D plays several crucial roles in protecting your health, one of which is to help your body absorb calcium. Like calcium, vitamin D requirements are not higher during pregnancy but it’s still essential to get sufficient vitamin D. People who live in sunny climates who make sure their skin is exposed to summer sunlight for 10 to 20 minutes daily are likely to make enough vitamin D (but they still usually need a supplement during the majority of the year). Those of us who don’t always get out in the sun, who use sunscreen, who live in more northerly or cloudier areas, or who have darker skin won’t produce sufficient vitamin D. Food sources of vitamin D that are acceptable to vegans are limited. For example, you’d need to drink 5 or more cups of vitamin D-fortified vegan milk to meet recommendations for vitamin D. Most pregnant women should therefore use a vitamin D supplement. There are several vegan brands. The RDA for vitamin D in pregnancy is 600 IU per day.
Foods and Beverages to Avoid During Pregnancy
It’s wise to avoid alcohol entirely during pregnancy. Excessive alcohol can affect the baby’s growth and development and cause lifelong problems. Since we don’t know exactly how much alcohol is safe, the best amount for pregnant women is none at all.
Hormonal changes during pregnancy affect the woman’s immune system and make her more susceptible to foodborne illnesses, especially listeria. Some foodborne illnesses can be harmful to the fetus. To reduce the risk of foodborne illnesses, it’s wise for pregnant women to avoid foods that are more likely to be contaminated with harmful bacteria, such as raw sprouts and unpasteurized juices.
Women who are carrying more than one baby will need to gain more weight, eat more food, and have a higher intake of some vitamins and minerals. A registered dietitian with expertise in prenatal nutrition can be helpful in developing meal plans for vegans who are expecting twins, triplets, or more. Similarly, women with conditions like diabetes (either pre-existing or gestational diabetes that develops during pregnancy), will benefit from individualized counseling to modify their diets during pregnancy.
Contrary to what you may have read online, food cravings in pregnancy don’t seem to indicate a nutritional deficiency. They may be triggered by hormones, lack of sleep, a need for comfort, or other factors. Cravings usually aren’t harmful unless the craved foods are nutritionally unsound and become a major part of the diet, displacing other healthier foods. Cravings to eat non-food substances (such as dirt, clay, or ice) may indicate an iron or zinc deficiency and should be evaluated by a health care provider.
Nausea, especially in the first months of pregnancy, is common. Women with nausea may find that they feel better if they eat smaller meals more frequently and if they avoid foods and odors that trigger nausea. If the nausea and vomiting are so severe that there is a risk of dehydration, medical treatment is needed.
Simple Guidelines for a Healthy Vegan Diet in Pregnancy
Let’s conclude with five recommendations that are especially useful for pregnant women. These five steps won’t alone satisfy all your needs, but when coupled with the advice offered throughout this article, you should be well-positioned to maintain excellent nutritional status throughout pregnancy.
- Eat at least 5 servings a day of beans, tofu, tempeh, soy milk, veggie meats, peanuts or peanut butter.
- Eat a variety of fruits and vegetables including those providing vitamin C (such as oranges, broccoli, cabbage, tomatoes, and strawberries), green leafy vegetables, and dark orange fruits and vegetables (carrots, winter squash, peaches, cantaloupe, etc.)
- Choose whole grains often and select healthy fat sources like nuts, nut butters, seeds, olive oil, and avocados most or all of the time.
- Eat five to six servings of calcium-rich foods every day.
- Use supplements or fortified foods daily to meet vitamin B12 and folic acid needs; make sure you’re getting at least 150 mcg of iodine from a prenatal or other supplement. Vitamin D supplements are usually advisable, and iron supplements may be needed as well. Many vegan women also choose to use a vegan supplement providing DHA during pregnancy.
Reed Mangels, PhD, RD is a nutrition adviser for The Vegetarian Resource Group. She has authored or co-authored a number of books including: the Everything Vegan Pregnancy Book, Simply Vegan, and The Dietitian’s Guide to Vegetarian Diets.