Welcome to the second trimester – home of the elusive pregnancy ‘bloom’. You will hopefully start to leave behind the troubles of morning sickness, and gain some extra energy. The second trimester (spanning weeks 13 – 26) is all about the growth or your baby and your bump. Your baby grows from the size of a peach to the size of a 35 cm long baby by the end of the second trimester!

What should I be eating?

Eating a healthy balanced diet continues to be important during this trimester. Try to include the following in your diet:

  • 5 portions of fruits and vegetables a day. Include a variety of green leafy vegetables (e.g. broccoli, kale, spinach, cabbage) to improve your folic acid and iron intake.
  • Starchy wholegrain carbohydrates at every meal, e.g. bread, cereals, potatoes, pasta and rice (choose breakfast cereals that are fortified with additional vitamins and minerals such as folic acid – the label will tell you this).
  • Low fat dairy products 2-3 times a day – this will ensure you eat enough calcium.
  • Protein-rich foods (e.g. lean meats, fish, eggs, beans, lentils and tofu) twice a day. This will help you to meet your protein and iron needs.
  • Oily fish at least once a week (but not more than twice a week) – this will ensure you get your fix of essential omega-3 fatty acids, to help with your baby’s brain development.
  • Healthy snacks and drinks instead of foods and drinks high in sugar, fat and salt – choose toast, sandwiches, fruit, veggie sticks, yoghurts and cereal.

What are my second trimester nutritional requirements?

There’s still no increase in energy (calorie) requirements this trimester, so you don’t need to eat extra calories! Eating a good variety of protein-rich foods twice a day will help you meet your increased protein needs. Folic acid requirements are slightly raised, so include green leafy veggies and starchy foods in your diet, and check the labels of your breakfast cereals to make sure they’re fortified with added vitamins and minerals.

Throughout pregnancy, vitamin D supplements are required to ensure you meet your increased requirements. Vitamin A requirements are slightly raised; including a variety of fruits, vegetables and low fat dairy products will ensure you meet these (avoid liver and liver-containing products as they contain high levels of vitamin A, which can be toxic for your baby).




How much weight should I gain during the second trimester?

Despite there being no additional calorie needs, you will likely gain just over half of your pregnancy weight this trimester. During pregnancy, you become more efficient at absorbing the nutrients you need from your diet, meaning you can gain weight without the need to eat too much more. If you were a healthy weight (BMI 18.5 – 24.9) at the start of your pregnancy, you should put on around 1lb (½ kg) per week during this trimester (half of this if you’re obese). A simple rule of thumb is to be guided by your hunger, but to choose healthy snacks and be wary of snacks high in sugar or fat.

Keeping active during pregnancy will help you keep your weight in check. If you don’t exercise at the moment, try to include exercise in your daily routine, e.g. swimming, walk to work or special pregnancy classes. Start slowly, gradually increasing to a target of 30 minutes at least 5 days a week.

Do I still need to take supplements?

You don’t need to take folic acid after week 12 if you’d prefer not to, but many women continue taking it in the form of pregnancy multivitamins or Healthy Start Vitamins. You do however, still need to take vitamin D supplements (10 micrograms per day) throughout your pregnancy. Even if you’re pregnant during the summer months, you may not get enough vitamin D simply through the action of sunlight on skin and by eating foods containing vitamin D (e.g. oily fish, fortified breakfast cereals and eggs).

Vitamin D is found in pregnancy multi-vitamin supplements and Healthy Start Vitamins, or you may decide to take a single supplement containing vitamin D. Be sure to avoid all regular vitamins or cod liver oil supplements because they contain high levels of vitamin A which could be dangerous for your growing baby.

Which prenatal vitamins

If you already consume a healthy, well-balanced diet, all you need is the basic formula that contains the recommended 400mcg of folic acid and 10mcg of vitamin D. You can get it from Boots or Holland & Barrett. Also, it’s a great option if you’re on a budget!

For those of you who feel like you could use some additional help in the nutrition department, go for a more complete supplement such as UK’s bestselling prenatal formula Pregnacare Plus Omega-3. It contains a combination of 19 vitamins and minerals, including 400mcg of folic acid and 10mcg of vitamin D, plus fish oil capsules.

Another option is New Chapter Perfect Prenatal. It’s an organic, whole food supplement rich in high quality nutrients, including multivitamin complex and probiotic blend. Although quite expensive, the supplement is very highly rated on the other side of the Atlantic and you can buy it in the UK from Amazon or small online vitamin retailers.

Foods to limit / avoid throughout pregnancy

It’s important to limit and avoid certain foods during pregnancy. These include liver and liver products (due to their potentially toxic levels of vitamin A), certain fish (swordfish, shark and marlin), paté, raw / undercooked meat, fish and eggs, unpasteurised cheeses and blue vein / mould-ripened cheeses. It’s best to wash fruit, vegetables and salads well, to remove any harmful parasites and bacteria. You should limit your intake of oily fish to twice a week, caffeine to 200mg a day and limit alcohol to 1-2 units once-twice a week.

Coping with heartburn

Heartburn is a common gripe in pregnancy, affecting as many as 80% of pregnant women. The following tips may help to reduce your symptoms of heartburn:

  • Avoid eating large meals – eating smaller portions may help, with regular snacks in between;
  • Leave at least 2-3 hours between eating and going to bed;
  • Spicy, rich and fatty foods may increase symptoms, so it’s best to avoid these (chocolate and fruit juices are well-recognised triggers);
  • Try drinking a small glass of skimmed or semi-skimmed milk before bed;
  • Propping yourself up on cushions while sleeping, so you’re not laying flat, may help;
  • Try to eat upright at a dining table, rather than on the sofa or in the car;
  • Avoid alcohol;
  • Avoid drinks containing caffeine, e.g. tea, coffee, cola and energy drinks;
  • If heartburn continues to be a problem, ask your doctor, midwife or pharmacist for advice about suitable medications.



Other second trimester niggles

Anaemia

Pregnant women are more susceptible to anaemia. Foods high in iron include red meat, oily fish, beans, lentils and fortified breakfast cereals.

Constipation

Constipation is common in pregnancy, caused by the pregnancy hormone progesterone slowing down the passage of food through the bowels. Eating plenty of fibre, found in wholegrains (e.g. porridge, granary bread, pasta and basmati rice), fruit, vegetables and pulses can help. Drink plenty of fluids (8-10 cups a day). Exercise can also help reduce constipation.

Cravings

Try not to use cravings as an excuse to over-eat or eat unhealthy foods. It’s ok to allow yourself treats of the foods your crave every now and again.

More trips to the loo

It’s important to continue drinking plenty even though you’re making extra trips to the toilet. Drinking plenty will help prevent burning, itching and other bladder problems.

Bleeding gums

Tender, swollen gums is common pregnancy, due to the hormonal changes sending more blood to your gums. Pregnancy is a good time to re-evaluate how your diet affects your dental hygiene. Limiting sugary foods, particularly in between meals is important. Choosing diet or no-added-sugar drinks instead of sugary drinks will also help.

Swelling (oedema)

Drinking plenty of fluids helps flush out the excess fluid.

  • REFERENCES

    Chief Medical Officers in the UK (2011) Vitamin D – advice on supplements for at risk groups (Accessed September 2013).

    NHS Choices (2012) Indigestion and heartburn in pregnancy (Accessed September 2013).

    Rasmussen KM, Catalano PM and Yaktine AL (2009) New guidelines for weight gain during pregnancy: what obstetricians/gynaecologists should know. Curr Opin Obstet Gynecol. 21(6):521-6.

    Specker B (2004) Vitamin D requirements during pregnancy. Am J Clin Nutr. 80(6):1740S–1747S.

    Webster-Gandy J, Madden A and Holdsworth M (2011) Oxford Handbook of Nutrition and Dietetics, 2nd Edition. Oxford University Press.