The Journal · Pregnancy
What to eat when you can't face eating
The first trimester advice you were given probably assumed you could eat. Here is what to do when you can’t — and why the thing you manage to keep down is the right thing.
The leaflets are cheerful about the first trimester. Eat a rainbow. Plenty of oily fish. Lots of leafy greens. All of it perfectly sound, and all of it written by someone who was not, at the time, sitting on a bathroom floor at eleven in the morning trying to decide whether a cracker was possible.
So let's start with the part that matters most. In these weeks, the food that is good for you is the food you can keep down. Not the food on the list. If that is white toast and cold apple juice for nine days, that is a completely reasonable nine days, and it is not something to feel bad about.
Why it happens, briefly
Nausea in early pregnancy is very common — it affects a large majority of pregnancies to some degree — and it is closely tied to the rapid rise in pregnancy hormones over the first weeks. It usually eases between weeks twelve and sixteen, though a minority find it lasts longer.1
Two practical facts follow from that. First, it is time-limited, which is worth holding on to at 4pm on a bad day. Second, it is not caused by anything you did or failed to eat, and it cannot be fixed by eating correctly — which means there is no version of this where being more disciplined would have spared you.
The things that tend to help
Cold food, and food that doesn't smell
Smell is a huge driver, and hot food releases far more of it. Many people who cannot face a cooked meal can manage the same food cold. Cheese and crackers, cold cooked pasta, yoghurt, a sandwich, fruit straight from the fridge, a cold jacket potato. If someone else can cook, ask them to do it with the kitchen door shut and a window open.
Never fully empty, never fully full
An empty stomach usually makes nausea worse, and a very full one does too. The pattern that works for most people is something small every couple of hours rather than three proper meals — and something dry within reach of the bed, eaten before you sit up, because the overnight gap is the longest empty stretch of the day.
Fluids in small, constant sips
Dehydration makes nausea worse, and nausea makes drinking harder, which is the loop to break first. A large glass is often impossible when small sips are not. Very cold water, ice cubes, ice lollies, diluted juice, or fizzy water all work better than tepid tap water for most people. If you can only keep down one thing today, make it fluid.
Ginger, honestly
Ginger has more evidence behind it than most remedies you'll be offered, and it does help some people with mild to moderate nausea. It is not a cure, it does nothing for many people, and it is not a substitute for medical treatment if you are really struggling. Worth trying — as ginger tea, crystallised ginger, or ginger biscuits — and worth abandoning without guilt if it doesn't work for you.
Carbohydrate, without apology
Plain starchy food is tolerated better than almost anything else, and it is also the fastest route to the calories and energy you need. Toast, plain potatoes, rice, crackers, cereal, plain pasta. This is the one time we will happily tell a client to eat beige food for a fortnight.
A cupboard worth having in the first trimester
- Dry crackers or plain oatcakes — bedside, not kitchen.
- Something cold and sweet you can sip: ice lollies count as fluid.
- Plain yoghurt and a tub of ready-cooked rice or lentils, for the days something savoury is possible.
- Tinned fruit in juice, and a jar of good peanut butter — both keep, both need nothing done to them.
- Whatever your one safe food turns out to be. Buy six of it.
The supplements question
UK guidance is to take 400 micrograms of folic acid daily until the twelfth week of pregnancy, and 10 micrograms of vitamin D daily. Iron and calcium come from food unless your midwife has told you otherwise.2,3
If tablets themselves make you queasy — which is common — try taking them with your largest tolerated meal of the day, or at bedtime rather than in the morning. If you genuinely cannot keep a supplement down, say so at your next appointment rather than quietly giving up; there are alternative forms, and missing a few days is not a crisis.
What we would not worry about
Not eating vegetables for a fortnight. Not eating fish for a month. Losing a small amount of weight in the first trimester when you are being sick — this is common and your midwife will be watching it. Living on one food. Needing a takeaway. Having the same thing every day for a week.
Babies in the first trimester are very small, and their nutritional demand is correspondingly small. The rebuilding happens later, and it happens fine.
When to ask for help
There is a spectrum here, and the severe end of it is a medical condition with real treatments — not something to endure. Contact your midwife, GP or maternity unit if you cannot keep any fluids down for a day, if you are being sick many times a day, if you are losing weight, if you feel dizzy or your urine is very dark, or if you simply feel you cannot cope.
Anti-sickness medication in pregnancy is well established and prescribed routinely. Asking for it is not failing at pregnancy. Plenty of the people we work with wish they had asked three weeks earlier than they did.
Sources & further reading
A note on what this is. This article is general information, written by registered nutritional therapists and referenced above. It is not a diagnosis and it is not a substitute for advice about you. If you are pregnant, breastfeeding, taking medication, or managing a health condition, please talk to your GP, midwife, health visitor or a registered practitioner before making changes — and always speak to them first if something is worrying you.