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What Should You Eat During Pregnancy and Breastfeeding?
During pregnancy and breastfeeding, many parents-to-be feel overwhelmed by conflicting advice about what to eat, especially if there's a family history of allergies. You might have heard suggestions to avoid certain foods like peanuts, dairy, or eggs during these critical periods. However, the scientific evidence has evolved significantly over the past decade, and our understanding of how allergies develop has fundamentally changed.
The Evolution of Dietary Advice During Pregnancy
For many years, healthcare providers recommended that pregnant women with a family history of allergies avoid potentially allergenic foods, particularly peanuts. This advice was based on the theory that exposure to allergens during pregnancy might sensitise the developing baby and increase their risk of developing allergies.
However, numerous large-scale studies have consistently failed to find evidence supporting this approach. In fact, research now suggests the opposite—restricting your diet during pregnancy does not prevent allergies in your child and may even be counterproductive.
What the Science Now Tells Us
Current evidence shows that maternal dietary avoidance during pregnancy does not reduce the risk of allergic conditions in babies. Major health organisations, including the British Society for Allergy and Clinical Immunology, now advise against restricting your diet during pregnancy for allergy prevention.
The landmark EAT (Enquiring About Tolerance) study, co-led by Professor Gideon Lack, contributed valuable insights showing that early introduction of allergenic foods to infants can actually help prevent food allergies from developing. This represents a complete reversal from previous thinking, where avoidance was the standard recommendation.
Benefits of a Diverse Diet During Pregnancy
Eating a varied, nutrient-rich diet during pregnancy offers multiple benefits:
- Optimal nutritional support: Your developing baby requires a wide range of nutrients for proper growth and development.
- Immune system development: Exposure to diverse food proteins through maternal diet may help prime your baby's immune system to develop appropriate tolerance.
- Flavour exposure: Fascinating research suggests that flavours from your diet are transmitted to your baby through amniotic fluid and later through breast milk, potentially influencing their food preferences after birth.
- Maternal health maintenance: Restricting foods unnecessarily may compromise your own nutritional status during a time when your requirements are elevated.
Essential Nutrients for Pregnancy and Breastfeeding
Rather than focusing on foods to avoid, consider prioritising these important nutrients:
- Folate/Folic acid: Critical for neural tube development, especially in early pregnancy. Sources include leafy greens, fortified cereals, and supplements.
- Iron: Requirements increase during pregnancy to support expanded blood volume and the baby's iron stores. Sources include lean red meat, fortified cereals, legumes, and dark leafy greens.
- Calcium: Essential for developing your baby's bones and teeth. Sources include dairy products, fortified plant milks, leafy greens, and calcium-set tofu.
- Omega-3 fatty acids: Support brain and eye development. Sources include oily fish (within recommended limits), walnuts, flaxseeds, and chia seeds.
- Iodine: Required for thyroid function and brain development. Sources include dairy, eggs, seafood, and iodised salt.
- Vitamin D: Crucial for bone development and immune function. While some comes from foods like oily fish and egg yolks, supplementation is often recommended during pregnancy and breastfeeding.
- Protein: The building block for your baby's growth. Sources include meat, poultry, fish, eggs, dairy, legumes, nuts, and seeds.
What About Potentially Allergenic Foods?
Current recommendations support the inclusion of common allergenic foods in your diet during pregnancy and breastfeeding, unless you yourself have an allergy to those foods. These include:
- Peanuts and tree nuts
- Eggs
- Milk and dairy products
- Fish and shellfish
- Wheat and other gluten-containing grains
- Soy
There is no evidence that avoiding these foods during pregnancy or breastfeeding reduces your child's risk of developing allergies. In fact, unnecessary restriction could potentially reduce beneficial exposures and limit your nutritional intake.
Special Considerations
While a diverse diet is generally recommended, there are some evidence-based restrictions that apply to all pregnant women:
- Limit certain fish: Some fish contain higher levels of mercury, which can affect the baby's developing nervous system. Avoid shark, swordfish, king mackerel, and tilefish; limit white tuna to 170g per week.
- Food safety precautions: Pregnancy temporarily alters your immune system, making you more vulnerable to foodborne illness. Avoid raw or undercooked meat, fish, and eggs; unpasteurised dairy products; and certain soft cheeses.
- Caffeine moderation: Limit caffeine to 200mg per day (approximately one 12oz cup of coffee).
- Alcohol avoidance: No amount of alcohol has been proven safe during pregnancy.
Nutrition During Breastfeeding
The principles for healthy eating during breastfeeding are similar to those during pregnancy. A varied, nutrient-rich diet supports both your health and your ability to produce nutritious breast milk. Additional considerations include:
- Increased caloric needs: Breastfeeding typically requires an additional 300-500 calories per day.
- Continued nutrient focus: Calcium, vitamin D, zinc, magnesium, and B vitamins remain particularly important.
- Adequate hydration: Drink plenty of water and other healthy fluids.
- Potential sensitivities: While routine avoidance of allergenic foods is not recommended, occasional babies may react to specific foods in their mother's diet. If you notice consistent patterns of discomfort in your baby after you consume certain foods, consult with a healthcare provider before eliminating any major food groups.
When Dietary Restrictions May Be Necessary
There are specific situations where dietary modifications might be appropriate:
- Your own food allergies: Obviously, you should continue to avoid foods to which you are allergic.
- Medically advised restrictions: In rare cases, your healthcare provider might recommend specific dietary modifications based on individual circumstances.
- Confirmed reactions: If your breastfed baby consistently shows adverse reactions after you consume certain foods, temporary elimination might be warranted while working with healthcare providers.
If any dietary restrictions are necessary, working with a registered dietitian can help ensure you maintain optimal nutrition.
The Bottom Line
The current evidence-based recommendation for most women during pregnancy and breastfeeding is to consume a varied, nutritionally balanced diet that includes common allergenic foods (unless you yourself are allergic to them). This approach supports both maternal and infant health and does not increase—and may even decrease—your child's risk of developing allergies.
Rather than focusing on avoidance, the emphasis has shifted to ensuring nutritional adequacy and diversity. As Professor Lack's research has helped establish, it's not maternal diet restriction but rather early introduction of allergenic foods to infants that shows promise in preventing food allergies.
If you have specific concerns about your diet during pregnancy or breastfeeding, particularly if there's a strong family history of allergies, consult with healthcare providers who are up-to-date with the latest evidence-based recommendations. They can provide personalised guidance that considers your unique circumstances while ensuring optimal nutrition for both you and your baby
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