Navigating your way through a healthy diet in pregnancy can often be overwhelming and just confusing; What is safe to eat, What do I avoid, what types of vitamins and minerals are needed and how much, Is my baby getting enough? Naturally we want to make the best choices for our baby and body but with easy access of information it can be hard knowing what is evidence based and also right for you. Renee Jennings Clinical dietitian of 10 years and co founder of Nurture the Seed, helps clarify our nutritional needs in the third and fourth trimester. Sharing her top 5 tips for food preparation, including her collagen rich, wholesome Lamb Shank and Liver Ragù recipe. Currently in my freezer ready for the birth of our second baby. I can confirm this nutritious recipe is also simple to make and delicious, with minimal to no liver taste (if that's not for you!).
Renee is a clinical dietitian of 10 years, mother of two to Norah and Freddie and wife to Warwick. Renee is also co founder of Nurture the Seed, an educational platform that provides nutritional advice and wholesome recipes for the preconception, pregnancy and postpartum journey. Building upon current prenatal nutrition guidelines with evidence-based research, Renee is passionate about empowering mothers to feel strong and healthy through nutritious food choices.
1) Do our nutrient requirements change in the third trimester?
Yes, they most certainly do. In the third trimester, your baby is rapidly growing, and its bones are strengthening. Therefore, the need for protein and many micronutrients – iron, DHA, calcium, vitamin D, zinc and vitamin A – increase. So, focusing on foods that are dense in these nutrients is essential.
However, I’ll let you in on an incredible fact. The pregnant body actually increases its ability to absorb iron and calcium as your gestation increases. So, in your third trimester, when your need for these nutrients is the highest, your body will naturally absorb more in the intestines. What a phenomenal pregnancy adaptation (how amazing are our bodies)!
2) Do our nutrient requirements in the fourth trimester differ if you are breastfeeding or formula feeding?
Your nutritional needs in the immediate postpartum period are at their peak, whether you are formula feeding or breastfeeding. Your body is recovering from nine months of carrying a child, plus the physical demand of labour and birth. Therefore, all mothers need to nourish themselves adequately in this time.
If you breastfeed, then your nutrient requirements will remain elevated for your entire breastfeeding journey. Lactating mothers have higher energy, fluid, protein and micronutrient needs than non-lactating mothers. This is to facilitate milk production.
- Protein needs increase by approximately 10g per day.
- Fluid needs increase to around 2.6 litres per day (ten cups). You will need even more fluids if you live in a hot climate or are beginning to exercise again.
- Micronutrient needs increase: namely iodine, DHA, zinc, choline, vitamin B12 and vitamin A.
To meet your heightened nutritional needs, try increasing your intake of nutrient-dense wholefoods – eggs, oily fish, organ meats, veggies, nuts and seeds.
3) Do we require a higher calorie intake during the third trimester and when breastfeeding?
You sure do! In your third trimester, your body requires an extra 450 calories per day. Rather than getting bogged down by counting calories, think of this in terms of food. For example, 450 calories is equivalent to a 200g tub of Greek yoghurt with a handful of nuts, plus half an avocado on two wholegrain crackers.
A breastfeeding mother has even higher caloric needs. It is estimated that exclusively breastfeeding mothers require an additional 500 calories per day in the first six months.
Keep in mind, that these numbers are a guide. They do not take into account individual differences and activity levels.
*** Iron is an essential nutrient needed throughout pregnancy, for recovery of childbirth and for milk production. However, it can be very difficult to meet iron needs from food, and iron supplements often exacerbate symptoms like constipation.
4) What dietary tips can you give women to keep on top of their iron stores?
There is a lot to cover on iron, so I will do my best to simplify it. Iron needs are 1.5 times higher in pregnancy. This is mostly due to a 45% increase in blood volume, the growth of your placenta, and so your baby can lay down their own iron stores. This puts the RDI at 27mg/day. This intake can be incredibly difficult to reach from food alone, as iron is not a mineral that is absorbed well.
To stay on top of your iron levels, my best advice is to eat iron rich foods multiple times/day. Iron is found in beef, lamb, chicken thighs, liver, seafood, nuts, seeds, legumes, tofu, green leafy vegetables and dried fruit.
I personally recommend eating liver once/week, as liver is the richest source of iron (100g chicken liver contains ~14g iron as opposed to ~3.5mg in 100g of beef). I know that eating liver isn’t everyone’s cup of tea, however you can easily ‘hide’ it in your meals without tasting it.
Iron is absorbed much better from animal sources than plant sources. However, if you are vegetarian or vegan, you can increase the absorption of iron in plant foods by doing the following:
- Eat with foods high in vitamin C (broccoli, citrus, kiwi fruit, capsicum, tomato and berries)
- Eat them with fermented foods (sauerkraut, kim chi)
- Soak or sprout your nuts, seeds and legumes
- Avoid eating calcium rich foods at the same time (calcium competes with iron for absorption)
5) Can you offer tips on keeping ‘regular’ leading up to birth and through to the often feared, first bowel movement?
Unfortunately, constipation is experienced by the majority of women at some point throughout their pregnancy and/or during postpartum. Luckily, they're a few ways that diet can assist, with an increase in dietary fibre and fluid being the most helpful. Fibre is found in all plant foods, including fruit, vegetables, grains (including cereals and breads), nuts, seeds and legumes. Fats and probiotic-rich foods are also essential in keeping you ‘regular’.
As some of you probably agree, dietary strategies don’t always seem to do the trick. That’s because constipation is multifactorial. Exercise, toileting position, sleep, stress, iron supplements…all of these things influence your bowels.
My top tips:
- Choose ‘wholegrains’ rather than ‘refined grains’
- Eat the skin on fruits and vegetables where possible (washed first)
- Include legumes in your day (every day!)
- Add chia seeds or psyllium husk to your smoothie or cereal
- Eat fermented foods everyday (such as sauerkraut) as they are rich in probiotics
- Don’t skimp on fats. Include lots of nuts, seeds, avocado and oily fish in your diet.
- Drink 9-10 cups of fluid/day
- If you are needing to take iron supplements discuss with your GP the different types and get one that is absorbed well with less effect on bowels.
- Move your body in some way each day – walking, yoga and swimming were my favourites when I was pregnant
- Purchase a foot stool and get into a good squat position when you go to the loo!
6) What tips do you have when preparing food for the fourth trimester?
Postpartum meal prep is one of my favourite things to talk about! You will be thanking your former self when those long days of rocking, changing nappies, washing and feeding your baby take over and give you no time to cook.
- When choosing what to prepare, the first thing you need to be certain of is that it freezes and defrosts well.
- Choose meals you enjoy and focus on those that are nutrient-dense and ‘warming/comfort foods’.
- In both of my pregnancies, I prepared soups, bone broth, casseroles, curries, bolognese mince and lots of dahl.
- Freeze some in single portions as it is common you will be eating alone.
- Include one-handed snacks that can be kept in your freezer. My favourites include bliss balls, muffins (sweet and savoury) and nut seed bars.
7) What is your favourite cooking/ kitchen item at the moment?
My food processor, by far! I invested in a good quality one a few years back and I use it every day without fail.
8) What were your go to snacks during your labours and first meal post births?
Unfortunately, I had two emergency c-sections where I never really got the chance to ‘labour’. However, I packed a peanut butter and honey sandwich, bliss balls, bananas and dried fruit and nuts both times.
Post birth, I was ridiculously spoilt, and my husband bought me in every meal (I hate hospital food, and when you work in a hospital it’s even worse). My first meal after my recent baby was my all-time favourite meal that my mother made – osso bucco pasta sauce. I ate two large bowls in my hospital bed and I somehow felt right at home.
Thank you Renee! X
- Australian Government National Health and Medical Research Council, Nutrient reference values for Australia and New Zealand: Nutrients, nrv.gov.au, 2017, accessed 5 January 2021.
- Barrett JF, Whittaker PG, Williams JG, Lind T. Absorption of non-haem iron from food during normal pregnancy. BMJ. 1994;309(6947):79-82. doi:10.1136/bmj.309.6947.79
- Kumar R, Cohen WR, Silva P, Epstein FH. Elevated 1.25-dihydroxyvitamin D plasma levels in normal human pregnancy and lactation. J Clin Invest 1979;643:342-4.
- Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89-94. doi:10.5830/CVJA-2016-021