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Eating well in the fourth trimester

Rebecca Stevens
Rebecca Stevens

By Rebecca Stevens

Rebecca Stevens (BSc, MSc) is a registered Associate Nutritionist with the Association for Nutrition. This article is for general information purposes only and is not a substitute for medical advice or treatment. You can read our full disclaimer here. If you have any allergies or are pregnant, please bear that in mind when reading this piece, particularly before eating any of the ingredients that are mentioned. You can see the NHS advice on what’s safe to eat in pregnancy here.

During your pregnancy, if you spent more time thinking about how your baby would arrive compared to how you were going to look after yourself in the postnatal phase, you would not be alone. The fourth trimester is a phase like no other. A new mother has physical, physiological and emotional changes to deal with, plus looking after the demands of a newborn baby. Keeping yourself healthy can suddenly be demoted to the bottom of the list.

I believe that the narrative around self-care has increased in recent years, due in part to social channels such as Instagram, or perhaps it’s because I now have the headspace to notice the importance of it. And that focus on self-care should continue throughout motherhood; raising children doesn’t suddenly become a doddle when they are out of nappies.

When my youngest was three, I returned to university to study for a MSc in Human Nutrition and completed a nine-month research project investigating the dietary habits of postnatal women in the UK. I felt that my nutrition hadn’t featured highly on my (and others) agenda at this time. I was pretty confident my results would show that women weren’t eating as healthily as they could after having a baby, and more could be done to support them.

As a recap, maternal nutrition supports recovery after the baby’s arrival, the nutritional demands of breastfeeding and contributes to the overall mood and wellbeing of the mother (van der Plight et al. 2016). Research also suggests that poor diets and the stress that pregnancy and lactation places on nutrient reserves is linked to postnatal depression (Gould et al. 2017). It is thought that PND affects around 10-15% of mothers post childbirth (Royal College of Psychiatrists, 2018). This doesn’t mean if you eat as healthily as possible that you won’t experience postnatal depression. It does however highlight that as there is a link between the two, it is another important reason to eat as well as you can.

The findings of my research have recently been published in a peer-reviewed journal Nutrition Bulletin. This article is not to add to a new mother’s worries, but to raise awareness and encourage mums to move nutrition higher up their list.

The findings

Overall, the results corroborated my thinking: that women in the study were not following dietary guidance. Only 26.3% were meeting their 5-a-day target and while three quarters of women felt that healthy eating was important, only 28.5% felt that they were. We all know that fruit and vegetables play an important role keeping us healthy. They are abundant in micronutrients and fibre, the latter supports our digestive health and gut health, which in turn supports our immune system.

Unsurprisingly, many women were also skipping meals with lunch being the most frequently skipped, followed by breakfast and dinner. While it can be very difficult to stick to regular meals when caring for a young baby, energy levels are important throughout the day, particularly for those breastfeeding due to the additional energy demands it places on your body. The barriers to healthy eating were also explored and lack of time, feeling stressed and tiredness were identified as the most common. Their impact was greater for women with low combined household incomes and those having three or more children.

So, here’s my advice for new parents:

  • Keep things simple – remember that you shouldn’t always aim for perfection; cutting corners is fine. Likewise, having more numerous smaller meals is okay if that fits better with feeding your baby.
  • Stock up on the basics/essentials that can be thrown together to make quick, easy and nutritious meals. Think sources of:
  • Carbohydrates: eg packets of rice, quinoa, other grains, bread, wraps;
  • Proteins: eg (well-cooked) roasted chicken, lentils, salmon*, hummus;
  • Fats: eg cheese**, nuts, avocados;
  • Vegetables: eg tomatoes, peppers, cucumber, carrots;
  • Fruits: eg bananas, berries, apples (anything that doesn’t involve lots of prep); and
  • Seeds: eg mixed bags to add to well-washed salads, soups and overnight oats.

*As this advice is suitable for all stages of parenthood, please remember that if you are pregnant again, government guidelines advise to have no more than two portions of oily fish per week.

**As above, if you are pregnant again, unpasteurised cheeses are not recommended.

  • Accept help. In my experience people are always happy to help new parents. It can be more of a struggle for new mums to accept that help.
  • Travel with a water bottle (hydration is key particularly if you are breastfeeding) and snacks – eg fresh fruit, nuts, cereal bars – if you start to feel signs of hunger, get munching!
  • Eat to fuel and nourish yourself, not to lose weight. Your body needs sufficient energy to get through the day and the many roles you are fulfilling. Your body also needs a balanced, healthy diet and reducing calorie intake or restricting food groups (other than when advised by a healthcare professional if your baby is experiencing intolerances to certain foods eg dairy) will not allow you to do this.
  • Try to remember to prioritise your own care. If you’re not eating properly it can have an impact on your overall health and wellbeing.
The full research paper ‘Exploration of the dietary habits, lifestyle patterns and barriers to healthy eating in UK post‐partum women’ can be found here.
Rebecca supports women to eat healthily at all stages of life.


This article was reviewed by Nina Sabat and edited by Anna Ceesay.
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