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Your PCOS Diet During Pregnancy

One of the questions that I am most frequently asked by women with PCOS who are finally pregnant is, “How should my diet change now that I’m pregnant?” I can totally understand the need to ask the question. It’s taken forever to fall pregnant and now that you are, you want to do everything within your power to nurture your little bean so that 9 months down the line you’ll have a beautiful, crying sleeping miracle baby in your arms.

So, I’m going to give you some information based on my own experiences and some of the research that I have done. But before I do, I just want to remind you that I am not a doctor and if you have any questions at all about your diet or pregnancy, you need to speak to your doctor.

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Why diet is so important in pregnancy?

Diet is crucial for any woman who is pregnant, whether they have Polycystic Ovarian Syndromeor not. Your body provides all of the nutrients needed for that little life to grow and develop. You need to make sure that you create just the right environment for your little one to thrive. This role will not end in pregnancy but will carry on until your little one is not so little any more.

How does PCOS impact on your Pregnancy?

PCOS diet and pregnancy fertilityI’m sure you’ve done the research on the potential pregnancy complications when living with PCOS. I’m going to break it down for you but I must warn you that it doesn’t make for happy reading. There is some hope, though. You don’t have to suffer from any of the complications and both of my pregnancies were wonderful with no complications at all. So, here goes:

Gestational Diabetes:

This is the type of Diabetes that is diagnosed whilst you are pregnant and often goes away once the baby has been born. It is often treated through diet and exercise or with medication if needed (1).

Preeclampsia:

This is when your blood pressure is too high, particularly after the 20th week of pregnancy. It can impact on your kidneys and other organs and symptoms include: sudden increased swelling in hands and feet, headache and increase in blood pressure (2).

Premature birth:

Many women with PCOS also have babies born pre term (mine were both 2 weeks late).

So, as I said, that’s doesn’t make for happy reading. You’ve waited to long for this little one and now you could be faced with a rocky pregnancy. Well, there’s good news and this is not the end of the story.

PCOS may not be the cause

One really interesting piece of research I came across is one that compared women with PCOS and those without but they matched age and weight as well (3). What the research showed is that many of the above complications may not be directly linked to PCOS but rather to the women’s weight. Being overweight leads to all of these complications as well. Women with PCOS who were lean, did not suffer from these complications.

So, there’s even more reason to get your PCOS symptoms and weight under control before you get pregnant.

Okay, so you’ve fought long and hard for this baby. Now, how can you give them the best possible start by eating well?

Your Diet During Pregnancy

As we have already said, your diet is crucial during pregnancy and your PCOS still plays a role and needs to be considered. There are a couple of elements that need to be considered.

Calories

If you are overweight with PCOS and have been following some kind of calorie controlled diet prior to falling pregnant, you may have some questions about how many calories you need. Well, you may be eating for two but that doesn’t mean you need twice the calories. If you are a healthy weight, you don’t need to have any extra calories during the first trimester, about 300 extra calories per day in the second trimester and 500 calories in the final trimester. Both you and your baby need the energy and calories for all of the growth that is taking place (4).

Protein

PCOS diet and pregnancy proteinYour protein intake also increases slightly during pregnancy. The type of protein you eat is also really important. You want to aim for good quality protein. If you’re eating animal proteins, the best type of meat to go for is grass fed organic meat. It is more expensive but it is the healthiest type of meat. If you can’t afford it or can’t get access to it, try for organic meat.

Also, oily fish like salmon are a good source of protein as well as Omega 3 so try to incorporate it into your diet. One serving a week is fine. Be careful of shellfish, marlin and swordfish.

Another huge advantage of having good quality animal protein is that it is also a good source of iron and will help to avoid anemia which is often prevalent during later pregnancy.

Fats and Lipids

Fats are really important for our own hormone health, as well as the growth of your baby. Your baby’s brain and neurological system is made largely of lipids and it is also essential for the development of the eyes (4). It’s really important that you eat good healthy fats from sources like avocados, nuts, coconut oil or milk and eggs. You should also think about taking an Omega 3 supplement.

Carbohydrates

The standard recommendations for healthy women is 170g per day of carbohydrates during your pregnancy (4). If you have been following a PCOS Diet that is relatively low carbohydrate, you should think about increasing the amount of carbs you have per day.

Just a word of caution. Your PCOS is still very real even if you are pregnant and your body still has difficulty processing carbohydrates so you need to make sure that you are making good decisions in terms of the types of carbs you are eating. Having carbohydrates with a low glycemic load is still crucial when you are pregnant. You could get your daily carbohydrate requirement from healthy vegetables or gluten free sources of grains and legumes. Some of these include beans, brown rice, quinoa, lentils. I would still recommend avoiding refined carbohydrates like pasta, white breads and pastries.

A Word on Dairy

PCOS diet and pregnancy dairyWe know that dairy should be avoided as part of our PCOS diet (see this article for more on why). However, during pregnancy women are prone to candida and yeast infections. During my last pregnancy I had thrush for 8 weeks and it really wasn’t pleasant! One way to combat this is by making sure you’re having good probiotic yoghurt. I frequently had greek yoghurt with a little bit of honey to ward off these infections. The fermenting process destroys some of the unhelpful IGF-1 so it is fairly safe for PCOS. Also, try to make sure you have an organic yoghurt.

Supplements

Supplements are also an essential aspect to a healthy pregnancy. You should check with your doctor to make sure that you are taking the correct doses and types of supplements. These are the supplements that I took during my pregnancy:

  • Prenatal Vitamins – Prenatal vitamins give you most of the vitamins you will need during your pregnancy but the should not replace a healthy diet.
  • Omega 3 – I was taking Omega 3 prior to falling pregnant as it in an important supplement for women with PCOS. This can be continued during pregnancy.
  • Vitamin D – Vitamin D is an important vitamin for women with PCOS and this continues during pregnancy. There are many advantages to supplementing with Vitamin D during pregnancy, including: lower risk of postnatal depression, decrease in insulin resistance during pregnancy, improved Apgar score at birth, stronger muscles for baby (5). The Vitamin D council recommends taking 4000-6000 IU per day for pregnant women (6). I’m sure that is much higher than what is provided for in your prenatal supplements!
  • Inositol – Inositol is a vital supplement for women with PCOS. Research has shown that it lowers miscarriage rates in women with PCOS and improves fertility. Some research suggests that it is safe to continue to take 4000mg per day for the duration of your pregnancy (7). It’s use while breastfeeding has not been safely determined so I stopped taking it while breastfeeding. You should be getting your 400mcg of folic acid with your prenatal multivitamin so there is no need to take additional folic acid with your Inositol.

 

Summing it Up

So, let’s sum up your new PCOS pregnancy diet.

  • Firstly, your risk of pregnancy complications is related to your pre pregnancy weight, not necessarily your PCOS. So, getting pregnant at a healthy weight is recommended. If you’re struggling to lose weight with your PCOS, why not check out our monthly meal plans to help you reach your pregnancy weight goals?
  • Your daily caloric needs do go up during the course of your pregnancy, particularly in the second and third trimesters.
  • You should make sure that you are following a healthy diet of whole foods with unrefined, foods. Avoid processed, sugary foods and focus on foods that will give your little one all of the nutrition it needs to grow healthy. You still need to watch your carb intake and make sure that you’re eating carbs with a low glycemic load to manage your insulin and testosterone levels.
  • Your supplements continue to play an important role in your PCOS diet and you should keep taking them.

If you are pregnant while you’re reading this, I wish you the most magical pregnancy! If you’re still waiting for your little miracle, I wish you a very short wait. If you’re holding your little miracle, I wish you all the joy that motherhood entails!

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Tarryn Poulton

Tarryn Poulton

Tarryn Poulton is a PN1 Certified Nutrition Coach and PCOS expert who has been a leader in the online PCOS space for over 8 years. Tarryn has the support of leading clinicians from around the world who support her scientific approach to understanding and talking about PCOS this includes all medical journals and ongoing research. You can read more about Tarryn and the team here.

36 Responses

36 Responses

  1. Hello Tarryn, thank you so much for your amazing advice and insight over many years – I followed you prior the pregnancy of my first little boy around 6 years ago, and am now 8 weeks pregnant again and praying with all my heart! I am sticking to your plan still but as the morning sickness etc gets worse it is trickier to face the usual foods isn’t it! Although I am avoiding refined carbs, I just wondered what your views on natural starchy carbs are during pregnancy, when combined with a healthy meal (such as incorporating potatoes back). Being able to have potatoes will really help fill me up more and give me something I can face eating!!! Hehe (-: Thanks so much xxx

  2. Hi tarryn, you mentioned to avoid pasta and bread. I’m left a bit confused my doctor doesn’t know much about pcos I have had to do my best at explaining it. Both my doctor and midwife have said to eat what I want and go for whole grain. Before I even got pregnant I was avoiding things like wheat and dairy now I won’t lie I feel im overdoing it with the wheat simply because its easy to get and quick to have. It’s been hard for me to stick to things the way I used too. But I’m still avoiding chocolate and caffeine, fizzy drinks etc but wheat is like a really hard thing to give up and keep the alternative to it going at the moment.
    Is there anything you can suggest that will help Dial it back a little bit while I’m pregnant a quick alternative? Also is honey safe to eat I’m never sure, as I found cinnamon is bad to have when your pregnant or it that just lies I’m so lost with everything. It’s my first pregnacy and I don’t want to screw up all my hard work and also babys health.

    1. Hi Alison, congratulations on your pregnancy! That is amazing news! It is still important to eat well to manage your PCOS in pregnancy. Having said that, pregnancy hormones can make things a bit more challenging. You could always look at gluten free substitutes that you can have in moderation. Just make sure that you are pairing them with lean protein and healthy fats. Also, honey is okay and cinnamon in small amounts should not have a negative effect.

  3. Hello, my pcos sisters, my name is lily. I just ran into this sit and I am super excited that I did. Thank you so much for the tips, this is exactly what I was looking for. I have pcos and I have been taking supplements for almost a year now, berberin, probiotics, omega 369, cinnamon, magnesium, milk thistle, marca powder, folic acid and recently started taking sow palmetto . Now I am 3weeks pregnant and i stopped taking all of the supplements, now I only take Prenatal vitamins, been that I have pcos, what supplements should I take to prevent the risk? can I start taking Inositol and vitamin D even though I was not taking it before I fall pregnant ? and how many mg can be taking per day? Please help me as I am in a confused state of mind now….pllllease

  4. A well balanced diet with lots of fruits and veggies and lean proteins are still good for you and your growing baby, foods to avoid is fish high in mercury, too much caffeine, alcohol, you should heat up lunch meats, undercooked/ raw meats, and unpasteurized foods. During the first trimester you do not need any extra calories, during your second and third you need to eat an extra 300 calories a day. When I was pregnant with my second child I was determined to avoid getting preeclampsia again and followed the brewers diet for pregnant women. My first was 9lbs 7ozs 6 days early and my second was 6lbs 8ozs two days past the due date.

  5. My name is archana from India I have pcos since 7 years I am 7 weeks pregnant now my weight is 85 kgs I am scared because of my weight whether I will have complications during delivery because of my weight and pcos pls help me

  6. Thanks a bunch for the tips.
    Having diagnosed with PCOS on the third month of my marriage (march 2017) I skipped O & G appoinment on august 2017 but I decided to join one intensive fitness programme including a nutrition class on sept 2017. Lost 3 kg during the programme. I’m now 6 weeks pregnant and I really need guidance for PCOS pregnancy. Hope everything will be okay for me and my pregnancy. Thanks a lot again.

  7. Thank you so much Tarryn. I found your website and followed the diet for 6 weeks, now I am pregnant! And also thank you so much for sharing the information during pregnancy. They are really helpful. Wish you and your family the best.

  8. Hi Tarryn
    Thank you so much for this enlightening information. I got pregnant 6th time with IVF after 15 years of marriage. I’m currently 11weeks, 5 days. I was diagnosed with PCOS and blocked tubes. I had to cut down on carbs during the treatment period. But with this baby, I so desire rice and bread. I’m still in my 1500 mg metformin daily.
    I live in Africa.
    Please is it safe for me to take tea? I just bought an organic pregnancy tea today – by traditional medicinals.
    Please advise ?
    Thank you again

    SarahJane

  9. Question: 8 weeks pregnant here, confirmed pcos, not on any medication or super special diet, but it took awhile. Anyway with my last child I made hardly any milk, nursing and pumping like crazy with only teaspoons to prove it. Is there anything I can be doing now to set me up for success? Supplements etc to promote milk, or get my body ready to produce it?
    Thanks! Your site has been truly helpful!

    1. Hi there, I was curious if you ever got a response to this question? I would love to hear the input as it might be helpful to me 🙂
      Thanks!

      1. Hi,

        My little guy had eating issues and my milk supply ended up dropping pretty badly. After lots of hours spent with doctors and lactation consultants who recommended lots of extra pumping and taking supplements, my supply doubled. To answer Meg’s question… Breastmilk is mainly a matter of supply and demand. Making sure that your little one is eating at least every 2 hours (or that you’re pumping) in the beginning is essential to establishing a good milk supply. There are also some supplements and foods that are associated with increasing breastmilk supply, including: fenugreek, steel cut oats, and mother’s milk tea (which contains plenty of fenugreek. Note: check with your doctor before taking any supplements or alternative herbs/meds.

        Good Luck!

  10. Dear Tarryn,

    I would like to thank you for this website and your effort of making this. As my miracle happen by following your diet plan. yes, i am 5 weeks pregnant after more than 4 years of struggle. My question to u here do i need to continue taking inositol 4g per day through out my pregnancy or just up to 12 weeks….???

    Also can i take spearmint tea during pregnancy.
    I look forward to hear from you soon.

    Thank you again and God bless you always…!

      1. I am wondering as well – is it safe to carry on drinking spearmint tea during pregnancy? I worry it can cause miscarriage, can it?

  11. Hi…
    I have been having irregular periods for years but only few months ago been diagnosed with PCOS.( I’m 34 now) That’s when I came across your blog. Straight away I stopped eating diary and started taking inositol. Two months later I found out that I’m pregnant!! We are over the moon! I’m on your blog again looking into whether I should continue taking inositol . It seems that you know more about PCOS than my GP :((
    Thank you so much for your blog…xx

  12. I enjoyed reading your article. I beat my infertility by eating healthy and exercising even though I didn’t lose any weight. HOWEVER, I’m 17 weeks along now and I’ve lost 13 pounds! I’m eating amazingly well and have even lightened my work loads around the house, but I’m still dropping! I think it’s because my hormones were imbalanced before, but now they’re balancing out and I’m losing weight and metabolizing like other women. I have insulin resistance as a result of the PCOS, so maybe this is fixing it for a while.

    1. I just looked back on this and laughed! I ended up losing 25 pounds of fat, had a healthy baby after only 5.5 hours of labor, and then my hormones for our of whack and I got huge again! When I got on Januvia, however, I started dropping it like flies. I’m now smaller than when I met my husband! He had to leave for South Korea for a year when the baby was only 2 months old, and he gets back next month. What a crazy past year and a half!

  13. Started taking inositol in December and just found out I am pregnant on February 5 🙂 I truly did not expect this to happen so quick! BUt I am happy and excited!!! Been going to the gym still every other day and I am still taking my inositol 😀

  14. Hi Tarryn. I love your website. I had become pregnant by following a lot of your tips. I appreciate all that you have helped me with. I thought I would have to take infertility drugs in order to get pregnant but it was a miracle with using vitamins and diet change. Thank you! I do have a problem. I am currently trying to breast feed and am not producing enough milk.. Do you have any tips for this? I have tried everything the lactation specialist recommended and it is still low.

  15. hi
    I am 14 weeks pregnant and have gestational diabetes
    got pregnant after 6 years my older daughter is 6.5 years old and after one year of her birth I found I have pcos
    my weight is not big matter for me
    my facial hairs and body hairs are keep increasing day by day
    I am really worrying about these hairs and cannt focus on my pregnancy
    Pleasesssssseeee help me…………….

  16. Hi tarryn i just want to share that I was diagnosed last year of May having a polycystic right ovary..The good news is I’m 10 weeks pregnant right now..and I noticed that based on my latest ultrasound report it was normal ovaries now..I’m just so happy..

  17. I am 5 weeks pregnant! So excited because one year ago I had cysts on my ovaries…my PCOS was extremely frustrating. I have been doing the Paleo diet (not a hard core Paleo, but mostly) since April and included exercise in June…since then I have lost 25 pounds! I think this diet, getting acupuncture and losing the weight is why I am now pregnant! Additionally, I no longer have cysts on my ovaries.

    Thanks for all your info on PCOS and being pregnant..I am on my way and love learning from you all.

  18. What is recommended for an upset stomach? Non-PCOS women can easily have crackers as part of their diet, but what is good to have on hand to help?

  19. Tarryn, thank you. I had my (lean) PCOS confirmed in February this year after struggling to conceive. I discovered your site a few days after and read everything I could. I already ate relatively healthily but cut down diary and started taking low dose inositol. I am now just over 9 weeks pregnant, so this article is just what I needed! I can’t believe what a difference the dietary tweaks made in just a short few months.

    @dee, I hope all is going well with your pregnancy!

      1. @Melissa I continued up until 12 weeks and then stopped as it can cause issues if you take it much longer. But by 12 weeks the embyro is embedded into the uterine lining so much more likely to stay there. I’m currently just over 30 weeks and things are mostly going well. Due to the PCOS I developed gestational diabetes (GD) but this can be controlled well if you are following a PCOS diet and doing exercise anyway. I have to monitor my blood sugar, but it isn’t as scary as it sounds. When the baby is born the GD almost always goes away, so it isn’t a lifetime thing.

  20. I unfortunately fell off the pcos eating wagon a couple of weeks ago. I’m 10 wks pregnant now and so terrified of loss due to pcos that I’m putting myself back on plan with proteins and low carbs. Thanks for this, I need to get my butt back in gear. I’m hoping I haven’t done any damage because I was listening to my husband and Dr at the time…

  21. Tarryn ever since I have found your website I have been in love yesterday marks the first day that I found out that I was expecting I read your other topics about having hope following some of your dietary suggestions Im already feeling better thank you for this post because I hate hearing suggestions from people who haven’t even experienced pcos this will be sure to help me in my new journey THANK YOU SO MUCH!!!!!❤❤❤❤

    1. Congratulations Kiwilove! That is such amazing news! I hope you have the most magical pregnancy!

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