The first trimester is a period of rapid development, and it's frequently the stretch when eating well is hardest. Nausea, food aversions and fatigue are common. Both things are true at once, and it's worth holding them together.
The most important single item: folate
Folate — or folic acid in supplement form — substantially reduces the risk of neural tube defects. Critically, the neural tube closes very early, often before many people know they're pregnant, which is why supplementation is generally advised before conception and through the first trimester.
Health Canada recommends a daily folic-acid-containing multivitamin for anyone who could become pregnant. Your provider will advise the dose appropriate to you — some circumstances warrant considerably more.
Food sources include leafy greens, legumes, citrus and fortified grains, though supplementation is still advised rather than relying on diet alone.
Iron
Blood volume expands significantly in pregnancy, raising iron needs. Deficiency is common and contributes to fatigue.
Sources include red meat, poultry, legumes, tofu and fortified cereals. Pairing plant sources with vitamin C improves absorption; tea and coffee with meals reduce it. Your provider will check your levels and advise on supplementation.
Choline
Important for fetal brain development and frequently under-consumed. Found in eggs — particularly the yolk — meat, fish, and to a lesser degree legumes and cruciferous vegetables. Many prenatal vitamins contain little or none, so it's worth asking about.
Omega-3s, particularly DHA
Supports fetal brain and eye development. Low-mercury fish such as salmon, sardines and trout are good sources. Health Canada provides guidance on fish to limit or avoid due to mercury — worth checking.
Calcium, vitamin D and protein
All matter, and needs rise modestly. Vitamin D deficiency is common through Canadian winters and worth discussing with your provider.
When nausea makes this hard
This is the practical reality for many people, and rigid advice is unhelpful here.
- Small, frequent meals often work better than three larger ones
- Dry, bland foods are frequently better tolerated early in the day
- Cold foods carry less smell, which helps with aversions
- Prioritize fluids — dehydration worsens nausea
- If your prenatal vitamin worsens nausea, ask about taking it at a different time or a different formulation
- Eating something you tolerate beats eating nothing. The perfect diet is not the goal in a week when keeping food down is
If nausea and vomiting are severe enough that you can't keep fluids down or you're losing weight, contact your provider — that may be hyperemesis gravidarum, which is treatable.
Where we fit
We're not your prenatal care provider. Where it's helpful and coordinated with your primary care, Dr. Whyte's background in applied clinical nutrition can support the dietary side, and we also offer chiropractic care during pregnancy for the musculoskeletal complaints that often accompany it.