Pregnancy and diet

This leaflet offers advice on diet to women who are planning to become pregnant, or who are pregnant. A good diet, and avoiding the wrong foods, can help to keep you and your baby healthy, and can help to prevent some complications of pregnancy.

When pregnant, or trying to become pregnant, ideally you should:

Eat a healthy balanced diet.
Include foods rich in calcium, folate, and iron.
Avoid certain foods and drinks which can be harmful to the pregnancy.
Watch your weight gain and aim to lose weight before becoming pregnant if you are obese.
Cut right back on drinking if you drink alcohol.
Take folic acid supplements.

Read on for info about eating a healthy balanced diet during pregnancy

Eat a healthy balanced diet

A healthy diet for pregnancy is much the same as for everyone! Briefly, it is as follows:

Eat plenty of starch-based foods (complex carbohydrates)

The bulk of most meals should be starch-based foods (such as bread, cereals, potatoes, rice, and pasta), together with fruit and vegetables. Some people wrongly think that starch-based foods are 'fattening'. In fact, they contain about half the calories than the same weight of fat.

Eat at least five portions of a variety of fruit and vegetables each day

One portion is: one large fruit such as an apple, pear, banana, etc, OR two smaller fruits such as plums, satsumas, etc, OR one cup of small fruits such as grapes, OR two large tablespoons of fruit salad, stewed or canned fruit, OR one tablespoon of dried fruit, OR one glass of fresh fruit juice (150ml), OR a normal portion of any vegetable, OR one dessert bowl of salad.

Eat protein foods in moderation

Meat, fish. pulses, chicken, and similar foods are high in protein. You need some protein to keep healthy, but most people eat more protein than is needed.

Read on for more info about eating a healthy balanced diet during pregnancy

Eat a healthy balanced diet - Part 2

Don't eat too much fat

For example: try not to fry much food. It is better to grill, bake, poach, barbecue, or boil food. If you do fry, use unsaturated oil such as corn, sunflower or olive oil. Drain off the oil before eating. Choose lean cuts of meat. Use low fat spreads. Have low-fat milk, cheeses, yoghurts, and other dairy foods rather than full-fat varieties.

Don't have too many sugary foods and drinks

These are high in calories, and too much may cause weight gain.

Try not to eat too much salt

Use small amounts of salt with cooking, and don't add more salt at the table.

Include foods with plenty of iron, calcium and folic acid

A growing baby needs these nutrients right from the start of the pregnancy.

Iron is mainly in red meat, pulses, dried fruit, bread, green vegetables and fortified cereals.
Calcium is found mainly in dairy products such as milk, cheese, and yoghurt. (Low-fat milk, cheeses and yoghurts usually contain just as much calcium as the full-fat varieties.)
Folic acid is mainly in green vegetables, brown rice, fortified bread and breakfast cereals.

Read on to find out what foods to avoid during pregnancy

Foods to avoid while pregnant

Avoid foods and drinks which can be harmful to the pregnancy

Don't eat anything with a lot of vitamin A

You need a small amount of vitamin A to keep healthy. However, large amounts can harm an unborn baby. So, avoid:

liver and liver products such as liver pâté and cod liver oil supplements.
vitamin tablets or supplements which contain vitamin A.

Don't eat food which may have high levels of listeria

Listeria is a bacterium (germ) which does not usually cause problems in people who are not pregnant. However, pregnant women are more likely to become infected with listeria, and it sometimes causes miscarriage, stillbirth, or infections in the baby after birth. Foods which are most at risk of carrying listeria are:

undercooked meats and eggs. For example, this may occur in some pre-cooked meats and pre-prepared meals. Make sure all meat foods are cooked until piping hot. Eggs should be cooked until both the white and yolk are solid.
soft cheeses such as brie. (Hard cheeses and processed cottage cheese are safe.)
pâtés.
shellfish and raw fish.
unpasteurised milk. Note: goat's milk is often unpasteurised, and goat's milk products such as cheeses are often made from unpasteurised milk.

Don't eat fish which may contain a lot of mercury

A high level of mercury can damage the developing nervous system of an unborn baby. So:

Do not eat shark, merlin, or swordfish.
Limit the amount of tuna that you eat. You should eat no more than two medium sized cans (drained weight = 140 gm per can), or one fresh tuna steak per week. (This would be about six tuna sandwiches, or three tuna salads per week.)

Don't have too much caffeine

You should limit the amount of caffeine to no more than 300 mg per day. Having a lot of caffeine increases the risk of having a baby with low birth weight, and increases the risk of miscarriage. The main sources of caffeine are coffee, tea, chocolate, cola. Caffeine is also added to some 'energy' drinks and to some cough and cold remedies. As a rough guide:

One cup of brewed coffee has about 100 mg caffeine.
One cup of instant coffee has about 75 mg caffeine.
One cup of tea has about 50 mg caffeine.
One 50g chocolate bar has about 50 mg caffeine.
One can of cola has up to 40 mg caffeine.
One can of 'energy' drink may contain up to 80 mg caffeine.
Check the label on medicines for quantities of caffeine.

So, you do not have to stop your favourite drinks, but you may need to limit their amount. For example, you will reach the 300 mg limit for one day if you eat two bars of chocolate, drink two cups of tea, and have a cup of brewed coffee.

Consider if you should eat peanuts

If you have an atopic disease such as asthma, eczema, or hay fever, or if a close family member has one of these conditions, then you may wish to avoid eating peanuts when you are pregnant. This may reduce the risk of your child developing peanut allergy in later life (which can be a serious and life-threatening allergy).
This advice about peanuts in pregnancy is precautionary and further research is needed to clarify this issue.

Watch your weight

When you are pregnant, don't 'eat for two' and overeat. Too much weight gain will increase your risk of developing problems with the pregnancy, and extra weight is difficult to lose after the birth. The best way to avoid weight gain is simply to eat a healthy balanced diet detailed above.

If you are already obese or overweight, ideally you should try to lose some weight before becoming pregnant. This is to reduce the risk of pregnancy complications which are more common in obese women. See other leaflets called 'Weight Reduction - How to Lose Weight' and 'Obesity and Overweight'.

Cut right back on drinking if you drink alcohol

If you have one or two drinks of alcohol (one or two units), once or twice a week, it is unlikely to harm your unborn baby. However, the amount of alcohol that is safe in pregnancy is not definitely known. So, many women have little or no alcohol when they are pregnant. It is known that if you drink heavily you have an increased risk of miscarriage, and may cause serious harm to the baby's growth and brain development.

A unit of alcohol is 10ml (1cl) by volume (8g by weight) of pure alcohol. This is about equal to:

A half-pint of normal strength beer, cider, or lager.
A pub measure of spirits (25ml), or of fortified wine such as sherry (50ml).
A small glass (125ml) of wine containing 8% alcohol by volume.

Note: using the above 'rough guide' it is easy to underestimate how much alcohol that you drink. This is because many beers are now strong, and wines are often served in 175ml glasses. Many wines are also stronger than standard (some contain 12-14% alcohol by volume).
If you find it difficult to cut down or stop drinking alcohol, then seek advice and help from your practice nurse or GP.

Take folic acid supplements

You should take folic acid tablets for at least the first 12 weeks of pregnancy - even if you are healthy and have a good diet. Folic acid is a vitamin which occurs naturally in certain foods. However, you need a good supply of folic acid when you are pregnant. If you take folic acid tablets in early pregnancy you reduce the risk of having a baby born with a spinal cord problem such as spina bifida. You can buy folic acid tablets from pharmacies.

You should start taking folic acid tablets before becoming pregnant (from the time you plan to become pregnant). If the pregnancy is unplanned then start taking folic acid tablets as soon as you know that you are pregnant.
For most women the dose is 400 micrograms (0.4 mg) a day.

If your risk of having a child with a spinal cord problem is increased then the dose is higher (5 mg a day - you need a prescription for this higher dose). That is, if:
you have had a previously affected pregnancy.
your partner, or a first-degree relative, have a spinal cord defect.
you have coeliac disease (as your intake of folate may be affected by this condition).
you are taking medication for epilepsy.
you have sickle cell anaemia or thalassaemia.

Read on to find out how alcohol effects your baby and how much you should drink during pregnancy

Pregnancy and alcohol

If you are pregnant, or are trying to become pregnant, you should not drink alcohol.

Why should I not drink when I am pregnant?

Advice from the Department of Health is that you should not drink at all if you are pregnant or trying to become pregnant. It is known that if you drink heavily you have an increased risk of miscarriage, and it may cause serious harm to the baby's growth and brain development. For example, studies have shown that:

Pregnant women who drink more than 15 units a week have an increased risk of having a baby with a low birth weight.
Pregnant women who drink more than 20 units a week have an increased risk of having a baby with some damage to the brain causing impaired intellect.
Pregnant women who drink very heavily risk having a baby with 'Fetal Alcohol Syndrome'. Babies with this syndrome have brain damage, a low birth weight, and facial malformations.

However, the exact amount of alcohol that is safe during pregnancy is not known. This is why the advice is not to drink at all. The very early stages of pregnancy may be the most vulnerable time. This is why it is just as important to not drink alcohol when you are trying to become pregnant. If you do chose to drink alcohol when you are pregnant then limit it to one or two units, once or twice a week. And never get drunk.

What is a unit of alcohol

One unit of alcohol is in about half a pint of beer, or two thirds of a small glass of wine, or one small pub measure of spirits. See leaflet 'Alcohol and Sensible Drinking' for details.

Further information

If you find it difficult to stop drinking alcohol, then seek advice and help from your practice nurse, midwife or GP.
Department of Health - The Pregnancy Book go to their website - www.dh.gov.uk - and search for 'Pregnancy Book'.Fetal Alcohol Syndrome Aware UK - www.fasaware.co.uk A website designed to raise awareness, give informed choice, provide information and support for people affected by, or interested in, Fetal Alcohol Syndrome.

Comprehensive patient resources are available at www.patient.co.uk

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS and PiP have used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Read on for info about pregnancy scans and screenings

Get more info on pregnancy and alcohol:

Pregnancy and screening tests

This leaflet discusses the routine screening tests that should be offered to all pregnant women in the UK.

What are screening tests?

A screening test aims to detect a disease or condition in the early stages before it causes significant problems, and where treatment can be offered. The potential benefits of a screening test should outweigh any possible risks from the test.

This leaflet lists routine screening tests which should be offered to all pregnant women in the UK. Most pregnant women have normal test results. A small number of tests are abnormal. In these cases further assessment and/or treatment can be offered which may prevent serious problems.

(Various other tests may also be offered in certain circumstances during pregnancy. For example, if you have symptoms which suggest a complication then other tests may be relevant. These are not discussed further.)

A midwife or doctor should discuss each test with you before it is done. You need to agree for the tests to be done. You can refuse to have a test if you do not want it.

General history (talking to your doctor or midwife)

Early on in your pregnancy your doctor or midwife will ask various questions about your general health, family history, social history, and about any previous pregnancies which you have had. Strictly speaking, this is not a 'test'. However, it can raise issues which may need special attention during the pregnancy which may prevent problems later in the pregnancy.

For example, if you have diabetes, or if you had pre-eclampsia in a previous pregnancy, you will need closer monitoring than usual during the pregnancy. If you have social or family problems such as domestic violence then you may need special help.

Routine physical examinations

Weight and height. Early on in the pregnancy your doctor or midwife will check your weight and height. This is to see if you are significantly underweight or overweight which may increase the risk of developing problems during pregnancy. Usually, after then your weight or height need not be measured again during pregnancy.
Assessing the growth of the baby. This is done by by a midwife or doctor during routine antenatal checks. They use a tape to measure from the top of the growing uterus (womb) to the pubic bone (the bone at the bottom of your abdomen).
Blood pressure. This is measured regularly during routine antenatal checks. (Together with a urine test which detects for protein, this screens for a complication of pregnancy called pre-eclampsia. See separate leaflet called 'Pre-eclampsia' for details.)
Examination of the baby's position. About 36 weeks of pregnancy a doctor or midwife will examine your abdomen to feel the baby to detect if the baby is lying breech (bottom down). If so, treatment to turn the baby to a head down position may be considered.

If you are otherwise healthy, other physical examinations are not routinely done. For example, routine vaginal or breast examinations used to be done in the past, but are not neccessary. (They may be done if you have symptoms or problems which warrant examination.)

Routine urine tests

Urine is checked at antenatal checks using a simple dipstick test to detect:

Protein. Protein in the urine may indicate early pre-eclampsia.
Bacteria (germs). During pregnancy you can have an infection of the urine without symptoms ('asymptomatic bacteruria'). This can increase the risk of problems later in pregnancy such as early childbirth. It can be treated with antibiotics.

Routine blood tests

A sample of blood is taken early on in pregnancy and put into several tubes. These are sent to the lab to check for:

Anaemia. The common reason for anaemia is lack of iron which can usually be treated easily with iron tablets.
Blood group including rhesus D status and red cell antibodies. If you are rhesus D negative and your baby is rhesus positive then you may form anti-D antibodies in your bloodstream. These are not dangerous in the first pregnancy, but can attack the blood cells of a baby who is rhesus D positive in any future pregnancy. To prevent this you will usually be offered anti-D injections later in the pregnancy. Various other antibodies sometimes develop against red cells. Their significance varies and a doctor or midwife will explain if any action should be taken if they are detected.
Rubella status. This test checks for antibodies to the rubella virus (German measles). If antibodies are present it means that you are immune to this infection. If you are not immune, when you are pregnant you should keep away from anyone who may have rubella. Also, consider being immunised against rubella after giving birth to protect future pregnancies. (If a pregnant mother develops rubella it can seriously damage the unborn baby. Ideally, your rubella status should be checked before becoming pregnant so that, if necessary, you can be immunised before becoming pregnant.)
Certain infections. Some uncommon but serious infections are checked for. These are:

*HIV. This is the virus that causes AIDS. You can be infected with HIV for years before it causes symptoms. The risk of passing this virus on to your baby can be greatly reduced with treatment during pregnancy, and delivery by caesarean section.
*Hepatitis B. Many people are carriers of this virus but have no symptoms. In some cases it can cause serious liver damage. If you have this virus, it may be prevented from affecting your baby if the baby is immunised at birth.
*Syphilis. This is an uncommon sexually transmitted infection. Again, you can be infected with this bacteria without realising and pass it on to your baby. It can develop into a serious illness. It can be treated with antibiotics.
A repeat blood test at about 28 weeks is usually offered to re-check for anaemia and red cell antibodies.

Routine ultrasound scans

An ultrasound scan is a safe and painless test which uses sound waves to create images of structures inside your body such as an unborn baby. A routine ultrasound scan is usually offered at:

10-13 weeks of pregnancy to accurately date the age of the unborn baby and expected time of birth, and to check for twins (or more), and at:
18-20 weeks of pregnancy to look for physical abnormalities of the unborn baby.

Screening for Down's syndrome

Down's syndrome is a condition, which is caused by an abnormal chromosome. Children with Down's syndrome have learning disability and often have other medical problems. There are different screening tests for Down's syndrome and so different tests may be used in different areas. They include a blood test and a special ultrasound test, or both. Screening for Down's syndrome is offered sometime between 11 and 20 weeks of pregnancy, depending on the type of test used.

Your doctor or midwife will explain the type of test performed in your area, and the implications of the results. For example, some women opt for termination of pregnancy if they are found to have a Down's syndrome child. Note: the screening test is not a clear-cut diagnostic test. Therefore:

A 'positive' test means that you may have a child with Down's syndrome. If you have a positive screening test, further tests are needed to confirm the diagnosis. In some positive tests the baby does not have Down's syndrome (a 'false positive' result).
A negative test does not completely rule out Down's syndrome. (That is, in some cases there is a 'false negative' result.) Currently the screening tests identify about 60-80 in 100 babies who have Down's syndrome.

You do not have to have a screening test for Down's syndrome if you do not want one.

Screening for placenta previa

Placenta previa means that the placenta is covering the opening from the uterus to the cervix. This can cause serious problems during childbirth. If an earlier ultrasound scan indicates that you may have a placenta previa, a repeat scan at 36 weeks pregnancy may be advised to clarify the position of the placenta before delivery.

A final point

The above tests are the usual routine tests advised for all pregnant women. If you have symptoms or problems which suggest pregnancy complications, various other examinations and tests may be advised. See your midwife or doctor if you have any concerns about your pregnancy, or if you wish to discuss any tests in more detail.

Read on for info about pregnancy and mediciation

Pregnancy and medication

Pregnancy and Medication

If you are pregnant, or are planning to become pregnant, you should be careful about taking any medication - including drugs and herbal remedies that you can buy from the pharmacy. If in doubt, ask the pharmacist for advice.

Which drugs are safe to take when pregnant?

Some drugs have been well studied in pregnant women. Some are known to be safe (for example, penicillin), and some are known to be unsafe (for example, thalidomide).

However, for many drugs, we do not know for sure if they are safe or unsafe. So, if you are planning a pregnancy, or if you are pregnant, you should minimise your use of medication. This includes drugs that you can buy. Also, just because a drug says it is 'herbal' or 'natural' it does not necessarily mean that it is harmless or safe.

Some commonly used drugs that you can buy

Paracetamol at normal dose is safe and useful for headaches, backache, and other aches and pains that may occur during pregnancy.
Anti-inflammatory painkillers such as ibuprofen. You should not normally take these during pregnancy. Regular use during pregnancy may affect the large blood vessels of the developing baby.
Laxatives. Constipation is common in pregnancy and you may need a laxative. At first it is best to try increasing the fibre in your diet and increasing the amount that you drink. If this fails then fibre supplements such as bran, ispagula and sterculia are safe. If you need something stronger, then it is best to discuss this with a doctor. Some laxatives such as docusate and lactulose may be prescribed safely for a short time.
Antihistamines. The safest one to use in pregnancy is chlorphenamine. This is because it is the oldest, and so has a long established safety record. However, it tends to make some people drowsy. If you require an alternative then it is best to see a doctor for advice.
Decongestants such as pseudoephedrine, phenylephrine and xylometazoline are best avoided in the early stages of pregnancy. However, they are unlikely to be harmful if used just 'now and then'.

Drugs that you are prescribed

Always tell a doctor or dentist who prescribes you medication if you are pregnant, or intend to become pregnant.

If you already take regular medication, (for example, for epilepsy), it is important that you discuss this with a doctor before becoming pregnant. If you have an unplanned pregnancy, discuss any medication that you take with your doctor as early as possible. In some cases, the risk of taking the drug has to be balanced against the risk of not taking the drug, and your condition not being treated.

Further information

For information about drugs see Dyspepsia in pregnancy

Looking for natural remedies? Have a look at our foods that are better than medicine advice

Dyspepsia in pregnancy

Dyspepsia in pregnancy is commonly due to acid reflux. Acid reflux is when acid from the stomach leaks up into the gullet (oesophagus). This may cause heartburn and other symptoms. Attention to diet and lifestyle factor may help. Antacids are commonly used. A medicine which prevents your stomach from making acid may be prescribed if symptoms remain troublesome.

What is dyspepsia?

Dyspepsia is a term which includes a group of symptoms (detailed below) that come from a problem in your upper gut. The gut or 'gastrointestinal tract' is the tube that starts at the mouth, and ends at the anus. The upper gut includes the oesophagus, stomach, and duodenum. Various conditions cause dyspepsia.
Dyspepsia occurs at some point in up to half of all pregnant women. The dyspepsia in pregnancy is usually due to reflux of acid from the stomach into the oesophagus.

Understanding the oesophagus and stomach

When we eat, food passes down the oesophagus (gullet) into the stomach. Cells in the lining of the stomach make acid and other chemicals which help to digest food. Stomach cells also make a mucus which protects them from damage from the acid. The cells lining the oesophagus are different and have little protection from acid.
There is a circular band of muscle (a 'sphincter') at the junction between the oesophagus and stomach. This relaxes to allow food down, but normally tightens up and stops food and acid leaking back up (refluxing) into the oesophagus. In effect, the sphincter acts like a valve.

Acid reflux is when some acid leaks up (refluxes) into the oesophagus. The lining of the oesophagus can cope with a certain amount of acid. However, if more than the usual amount of acid refluxes it may cause some inflammation on the lining of the oesophagus, which can cause symptoms.

The causes and symptoms of acid reflux in pregnancy

What causes acid reflux during pregnancy?

The sphincter at the bottom of the oesophagus normally prevents acid reflux. It is thought that when you are pregnant:

The increased level of certain hormones that occurs has a relaxing effect on the sphincter muscle. That is, the tone (tightness) of the sphincter is reduced during pregnancy.
The size of the baby in the abdomen causes an increased pressure on the stomach.

One or both of the above increases the chance that acid will reflux into the oesophagus.

What are the symptoms of acid reflux and dyspepsia of pregnancy?

Symptoms can vary from mild (in most cases) to severe. They can include one or more of the following:

Heartburn. This is a burning feeling which rises from the upper abdomen or lower chest up towards the neck. (It is a confusing term as it has nothing to do with the heart!)
Upper abdominal pain or discomfort.
Pain in the centre of the chest behind the sternum (breastbone).
Feeling sick and vomiting.
Bloating.
Quickly feeling 'full' after eating.

Symptoms tend to occur in 'bouts' which come and go, rather than being present all the time. They may begin at any time during pregnancy, but are usually more frequent or severe in the last third of pregnancy. As soon as the baby is born, dyspepsia due to pregnancy quickly goes.

Note: various other problems both associated with pregnancy, and unrelated to pregnancy, are sometimes confused with dyspepsia. For example, pain in the right or left of the abdomen is not usually due to dyspepsia. Excessive vomiting is not usually due to dyspepsia. If symptoms change, or are not typical, or become severe, then you should see a doctor.

How to help the symptoms of acid reflux in pregnancy

What can I do to help with symptoms?

The following are commonly advised. There has been little research to prove how well these 'lifestyle' changes help to ease reflux. However, they are certainly worth a try.

Consider avoiding certain foods, drinks and large meals?

Some foods and drinks may make reflux worse in some people. (It is thought that some foods may relax the sphincter and allow more acid to reflux.) It is difficult to be certain how much foods contribute. Let common sense be your guide. If it seems that a food is causing symptoms, then try avoiding it for a while to see if symptoms improve. Foods and drinks that have been suspected of making symptoms worse in some people include: peppermint, tomatoes, chocolate, spicy foods, hot drinks, coffee, and alcoholic drinks. Also, avoid large meals if they bring on symptoms. Some women find that eating smaller meals more frequently is helpful.

Stop smoking if you are a smoker

The chemicals from cigarettes relax the sphincter muscle and make acid reflux more likely. Symptoms may ease if you are a smoker and stop smoking. (In any case, it is strongly advised that pregnant women should not smoke for other reasons too.)

Have a good posture

Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach, which may make any reflux worse.

Bedtime

If symptoms recur most nights, it may help to go to bed with an empty, dry stomach. To do this, don't eat in the last three hours before bedtime, and don't drink in the last two hours before bedtime. If you raise the head of the bed by 10-15 cms (with books under the bed's legs), this will help gravity to keep acid from refluxing into the oesophagus.

Side-effect from medicines

Some medicines may make symptoms worse. (Most pregnant women will not be taking these medicines, but they are mentioned here for completeness.) They may irritate the oesophagus, or relax the sphincter muscle and make acid reflux more likely. The most common culprits are anti-inflammatory painkillers (such as ibuprofen or aspirin). Others include: diazepam, theophyline, nitrates, and calcium channel blockers such as nifedipine. Tell a doctor if you suspect that a prescribed medicine is making symptoms worse.

Treatments for dyspepsia in pregnancy

Antacids

These are alkali liquids or tablets that neutralise the acid. A dose usually gives quick relief. You can use antacids 'as required' for mild or infrequent bouts of dyspepsia. There are many brands which you can buy. You can also get some on prescription. A doctor or pharmacist can advise. Some points about antacids are:

Antacids are considered to be safe to take in pregnancy.
They can interfere with the absorption of iron tablets. Therefore, they should be taken at a different time of day if you are taking iron supplements. (If possible, they should not be taken two hours before or after taking iron supplements.)
It is probably best to use one with a low sodium content if you have high blood pressure or pre-eclampsia (a complication of pregnancy).

Acid-suppressing medicines

If symptoms are still troublesome despite any lifestyle changes and antacids, your doctor may prescribe a medicine called ranitidine. This medicine works by reducing the amount of acid that the stomach makes. It usually eases the symptoms of dyspepsia quite well. Ranitidine is considered safe to take during pregnancy.

(Note: medicines other than ranitidine that are commonly used for heartburn, dyspepsia, acid reflux, etc should not be used if you are pregnant. For example, cimetidine, or proton pump inhibitors. It is not known whether these other medicines are safe or not to take during pregnancy.)

Where next?

Pregnancy and folic acid - the facts
Find out all you need to know about nutrition and your pregnancy
Find top tips on dealing with morning sickness, bleeding and other pregnancy symptoms
Food explained - more info about what you're eating