For anyone looking for advice on nutrition tips for fertility, pregnancy, or postpartum, there is no shortage of information. In two seconds you can have access to millions of hits on Google for these topics. Millions. Even if you had the time to sift through the sea of suggestions, you would likely leave feeling more confused and overwhelmed as each recommendation seems to contradict another.
It's this kind of information overload that has many people feeling lost and questioning whether nutrition even matters. Thankfully you don’t have to navigate this alone. As a Registered Dietitian Nutritionist, my job is to analyze the evidence so you don’t have to sort through the noise of social media influencers. So, you can save your energy for the things that matter most and have the information at your fingertips to feel empowered about your food choices. No time is this more important than during the reproductive journey from conception to postpartum and back again.
So let’s start at the beginning.
Does food even matter?
In a nutshell, yes.
Here are my top 3 reasons why food is essential for reproductive health:
- Eating enough is key for reproduction. The body needs enough calories and nutrients to successfully navigate each stage of the maternal journey: to ovulate, support optimal fetal growth, and produce breast milk without depleting mom’s stores. So even before considering which types of foods to incorporate, we need to acknowledge the foundational need for eating enough food overall. To read more about why it’s important to eat enough for postpartum specifically, read this article.
- Nutrient deficiencies can have real impacts. We see evidence in the research in each stage of reproduction showing that nutrient deficiencies can negatively impact outcomes such as conception rates, pregnancy complications, baby’s development, breast milk quality, and postpartum depression1-6.
- Laying the foundation for a positive relationship with food. This benefit is often overlooked though it can make a powerful difference. By creating a lifestyle that prioritizes nourishment over dieting during the reproductive stages, you are instilling habits and an eating environment that can be passed on to your growing family. The exposure to a variety of foods during pregnancy and breastfeeding can also increase the likelihood that your little ones will accept them when it comes time for starting solids17.
Now that we can appreciate how valuable food and nutrition is for reproductive health, how can we apply that to what goes on the plate?
What foods should I focus on?
Conception to Pregnancy
Avocado: Two reasons to choose avocados are for their folate and healthy fats. Folate is beneficial for fertility outcomes and preventing neural tube defects in pregnancy so it is an essential nutrient to prioritize during the transition from conception to pregnancy1. The healthy fats of avocado can also help you meet your overall calorie needs more easily to ensure adequate energy for reproduction.
Eggs: Scramble up some eggs and don’t forget the yolks! The egg yolk is where all of the choline content is located and choline is another key nutrient for this stage. Choline plays a vital role throughout all of pregnancy (and beyond into breastfeeding) but an especially critical window may be in the earliest weeks. Choline is another nutrient that plays an important role in the neurological development of baby and in preventing neural tube defects and some studies suggest that maternal intake in the months leading up to conception can influence those outcomes7.
Trout: Incorporating trout into your diet can help you get some extra Vitamin D. The research on Vitamin D shows that correcting deficiencies and providing sufficient intake can improve fertility outcomes, reduce pregnancy loss, promote optimal fetal skeletal health and may improve outcomes such as birth weight and reduce risk of pregnancy complications like gestational diabetes2. Though you may still need a supplement to meet optimal Vitamin D levels, including dietary sources is a helpful bonus.
Pregnancy to Postpartum
Lentils: This legume is rich in plant-based iron which is important as blood volume increases in pregnancy and iron needs increase. Iron deficiency has been shown to negatively impact fetal development and growth making it a critical prenatal nutrient8,9. With the blood loss that occurs during delivery and in the early weeks of postpartum recovery, continuing to emphasize dietary iron can help ensure your body has enough, which is especially important for energy levels and possibly reducing risk of postpartum depression5.
Salmon: Omega 3 fatty acids play a major role in brain development for baby which is especially relevant in the third trimester10. Some research also suggests a possible link with reduced risk for postpartum depression making salmon an ideal choice during this transition11.
Bone broth: Rich in the amino acid glycine which is thought of as a conditionally essential nutrient as pregnancy progresses and is a primary structural component of collagen, making bone broth a helpful food to support the expanding skin and tissues and subsequent repair needed in postpartum12.
Postpartum to Conception
Oysters: This pick is one of the richest sources of dietary zinc. Zinc is important not only for postpartum tissue repair and wound healing, but also for setting the stage for optimal egg quality and healthy development13. Bonus if you share some with your male partner because zinc has also been linked to improved sperm quality and male fertility14.
Nori flakes: An easy option to sprinkle onto meals, Agni's Sesame Nori Seasoning gives a boost of the critical nutrient iodine. Getting enough iodine is important for thyroid health which makes this food ideal for postpartum and setting the stage for future conception. This is because the hormonal fluctuations of pregnancy and postpartum can trigger postpartum thyroiditis or exacerbate underlying thyroid conditions. Additionally, thyroid hormone balance plays a key role in fertility and healthy pregnancy outcomes18.
Full-fat Greek yogurt: This one makes the list for several reasons. The fat content of the yogurt helps improve the feeling of satiety which is so important for the common appetite surge many experience postpartum and especially with breastfeeding. Full-fat dairy products have also been correlated with improved fertility outcomes in the research16. The probiotic content of the yogurt also supports a healthy microbiome which can be helpful especially if you required antibiotics during delivery or postpartum (common with C-section deliveries, Strep B+ diagnoses, and mastitis infections) and there is ongoing research exploring the likely link between the microbiome and fertility outcomes15.
What about supplements?
There are many benefits to focusing on food sources of nutrients but do supplements have a role in supporting fertility, pregnancy, and postpartum?
Here are the two main reasons you should have nutrient supplements on board:
- They fill the gaps in your diet. Supplements shouldn’t be replacing foods but rather supplementing them. Nutritional needs are significantly elevated for reproduction, particularly in supporting a pregnancy, postpartum recovery, and breastfeeding. These elevated needs make it challenging to meet optimal level via food alone, so supplements are a vital tool.
- To take away some pressure. Food aversions, mood-disorder induced appetite changes, medications, or busy schedules can make meeting needs through the diet challenging. Having the coverage of supplements can help you feel confident about meeting your needs without having to micromanage your meals.
Do you need a supplement for each nutrient? No. Individualization is the key. Most people would benefit from a prenatal multivitamin throughout each stage of reproductive health to have a solid foundation but beyond that, food sources of nutrients can be a viable way to boost your intake. For example, you could meet your elevated DHA needs by adding more salmon, increase egg intake to cover choline needs, or eat more Brazil nuts to optimize selenium. Work with a Registered Dietitian to help individualize your supplement routine so that it complements your diet and unique nutritional needs for whichever stage you are in.
- Gaskins AJ, Afeiche MC, Wright DL, et al. Dietary folate and reproductive success among women undergoing assisted reproduction. Obstet Gynecol. 2014;124(4):801-809. doi:10.1097/AOG.0000000000000477
- Pilz S, Zittermann A, Obeid R, et al. The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data. Int J Environ Res Public Health. 2018;15(10):2241. Published 2018 Oct 12. doi:10.3390/ijerph15102241
- Rogne T, Tielemans MJ, Chong MF, et al. Associations of Maternal Vitamin B12 Concentration in Pregnancy With the Risks of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analysis of Individual Participant Data. Am J Epidemiol. 2017;185(3):212-223. doi:10.1093/aje/kww212
- Cetin I, Berti C, Calabrese S. Role of micronutrients in the periconceptional period. Hum Reprod Update. 2010;16(1):80-95. doi:10.1093/humupd/dmp025
- Wassef A, Nguyen QD, St-André M. Anaemia and depletion of iron stores as risk factors for postpartum depression: a literature review. J Psychosom Obstet Gynaecol. 2019;40(1):19-28. doi:10.1080/0167482X.2018.1427725
- Allen LH. B vitamins in breast milk: relative importance of maternal status and intake, and effects on infant status and function. Adv Nutr. 2012;3(3):362-369. Published 2012 May 1. doi:10.3945/an.111.001172
- Korsmo HW, Jiang X, Caudill MA. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients. 2019;11(8):1823. Published 2019 Aug 7. doi:10.3390/nu11081823
- Breymann C. Iron Deficiency Anemia in Pregnancy. Semin Hematol. 2015;52(4):339-347. doi:10.1053/j.seminhematol.2015.07.003
- Georgieff MK. Iron deficiency in pregnancy. Am J Obstet Gynecol. 2020;223(4):516-524. doi:10.1016/j.ajog.2020.03.006
- Devarshi PP, Grant RW, Ikonte CJ, Hazels Mitmesser S. Maternal Omega-3 Nutrition, Placental Transfer and Fetal Brain Development in Gestational Diabetes and Preeclampsia. Nutrients. 2019;11(5):1107. Published 2019 May 18. doi:10.3390/nu11051107
- Levant B. N-3 (omega-3) Fatty acids in postpartum depression: implications for prevention and treatment. Depress Res Treat. 2011;2011:467349. doi:10.1155/2011/467349
- Betina F Rasmussen, Madeleine A Ennis, Roger A Dyer, Kenneth Lim, Rajavel Elango, Glycine, a Dispensable Amino Acid, Is Conditionally Indispensable in Late Stages of Human Pregnancy, The Journal of Nutrition, Volume 151, Issue 2, February 2021, Pages 361–369, https://doi.org/10.1093/jn/nxaa263
- Garner TB, Hester JM, Carothers A, Diaz FJ. Role of zinc in female reproduction. Biol Reprod. 2021;104(5):976-994. doi:10.1093/biolre/ioab023
- Salas-Huetos A, James ER, Aston KI, Jenkins TG, Carrell DT. Diet and sperm quality: Nutrients, foods and dietary patterns. Reprod Biol. 2019;19(3):219-224. doi:10.1016/j.repbio.2019.07.005
- Tsonis O, Gkrozou F, Paschopoulos M. Microbiome affecting reproductive outcome in ARTs. J Gynecol Obstet Hum Reprod. 2021;50(3):102036. doi:10.1016/j.jogoh.2020.102036
- Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol. 2018;218(4):379-389. doi:10.1016/j.ajog.2017.08.010
- De Cosmi V, Scaglioni S, Agostoni C. Early Taste Experiences and Later Food Choices. Nutrients. 2017;9(2):107. Published 2017 Feb 4. doi:10.3390/nu9020107
- Unuane D, Velkeniers B. Impact of thyroid disease on fertility and assisted conception. Best Pract Res Clin Endocrinol Metab. 2020;34(4):101378. doi:10.1016/j.beem.2020.101378