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The Mother and Child Academic Hospital Foundation
MACAH | Pregnancy and Nutrition

The first 1000 days refers to the time from conception to the second birthday of your baby. This is a critical period during which the foundations of the best possible lifelong health, growth, and development are established. It’s important to take care of yourself and your developing baby by eating a balanced diet, avoiding alcohol and smoking, leading an active lifestyle and getting plenty of rest.

 In terms of recommended weight gain:

Overweight pregnant women should gain about 6kg

Normal weight pregnant women should gain about 12kg

Underweight pregnant women should gain about 19kg

You should not try to lose weight while you are pregnant, but it is also important you do not gain too much weight. If you have concerns, ask to be referred to a dietitian.

For women with a normal pre-pregnancy body mass index (18.5 to 25kg/m2), the amount of energy required to support pregnancy is only slightly increased:

  • During the first trimester no increase in energy intake is recommended

  • During the second and third trimester only a modest increase in energy intake is necessary. This equals about 2 to 3 additional servings from any of the food groups. 

The requirements for certain micronutrients are increased during pregnancy:

All pregnant women should supplement their intake of folate, iron and calcium.

Evidence shows that the intake of other nutrients like omega-3 fatty acids and choline may be limited in the diets that pregnant women consume and that an inadequate intake of these nutrients may have detrimental effects for both the mother and developing baby. Eggs and dairy products are good sources of choline, while fatty fish such as tinned pilchards are high in omega-3 fatty acids.

The intake of certain foods should be limited or avoided during pregnancy. These include:

Foods that may be contaminated with bacteria like soft cheeses and 

Fish with high levels of lead and mercury.


Adequate dietary intake and good food choices are important for all pregnant women. Quality of food is just as important as quantity and to achieve this a variety of nutrient-dense foods rather than energy-dense, nutrient-poor foods. This will help to ensure that the nutritional requirements of both mother and baby are met.

The South African Food-based Dietary Guidelines can help you to eat a balanced diet:

Enjoy a variety of foods - this will improve your chances of consuming all the nutrients that you need. 

Make high-fibre starchy foods part of most meals.  Starches include rice, mielie meal, cereals, samp, bread, potato and pasta. These foods give you energy that is needed for your baby to grow well. 

Try to eat five portions of vegetables and fruit a day – these foods contain micronutrients and fibre that you and your baby need. Make sure you wash fruit and vegetables properly before eating them.

Eat dried beans, split peas, lentils or soya at least twice a week, since these foods are good sources of protein and fibre. 

Small portions of chicken, fish, meat or eggs can be eaten every day. These foods are good sources of good quality protein. Make sure that they are cooked properly and that you use healthy cooking methods such as grilling, steaming, microwaving, slow-cooking, stir-frying in a little oil or baking instead of deep-frying.  

Have low-fat milk, maas or yoghurt every day. Make sure that the milk you drink is pasteurised. 

Eat less fat and use the healthier type of fats or oils - choose vegetable oils rather than hard fats. Try to eat fewer fried foods and high fat foods to avoid excessive weight gain during pregnancy.

Add less salt to your food and avoid processed foods high in salt - too much salt can increase blood pressure.

Eat less sugar and avoid food or drinks high in sugar that can increase your risk for weight gain and chronic diseases.

Drink lots of clean, safe water every day. 

During pregnancy, alcohol should be avoided.

Be active.  Go for a walk, take the stairs or do your own housework to improve your fitness.  An active lifestyle will improve your health and the health of your baby.