Empowering Motherhood: Nutrition support for athletes before, during and after pregnancy
Updated: 8 minutes ago
Author: Catherine (Cat) George
Not so long ago, “Happy retirement” or “That’s your career over” were messages some elite athletes heard when they announced a pregnancy. Pregnancy and motherhood were widely assumed to be incompatible with the demands of high-performance sport.
Over the past decade, that assumption has been steadily dismantled. In a study of 42 elite and world-class distance runners, those who intended to return to their previous level performed no worse after pregnancy, and over half improved. A 2026 scoping review of 101 studies found no consistent evidence that high training loads increase poor pregnancy outcomes, and Paris 2024 was the first Games to include a nursery in the Olympic and Paralympic Village.
Yet support has not kept pace. Many athletes reach their competitive best in the same years they may be planning a family, but fewer than half of international sport federations have policies for pregnant, postpartum and parenting athletes, and none made specific provision for childcare. Athlete-specific guidance also remains limited.
Nutrition is one of the clearest gaps. The 2026 review found few studies addressing nutrition during pregnancy or postpartum. In our recent cross-sectional study of 287 elite and active non-elite athletes across 48 sports in the United Kingdom and Republic of Ireland, only 21.6% received nutrition advice during pregnancy and 10.8% during postpartum, with no significant difference by athlete level. Most advice centred on general healthy eating and supplementation, yet almost four in five athletes wanted guidance specific to being an athlete.
General advice may not answer the questions athletes face in practice. How should fuelling change as training changes? How should recovery, infant feeding and training fit together after birth? Our qualitative research into elite athletes' pregnancy experiences and study of postpartum return to sport describe athletes navigating these questions with limited guidance. Throughout, the principle of adequacy before optimisation applies: before fine-tuning nutrient timing or supplements, an athlete needs a realistic way to eat enough, and well enough, alongside training.
Before pregnancy: build the foundations
Preconception is often the most overlooked stage. The baby's neural tube forms in the first weeks of pregnancy, often before a pregnancy has been confirmed. Iron deficiency is already common in female athletes, and pregnancy increases iron requirements further, so reviewing iron and vitamin D status early matters; low levels can take months to correct.
Folic acid is essential, but finding a sport-safe product is not always simple. NHS guidance on vitamins and supplements in pregnancy recommends a daily 400 microgram folic acid supplement from before conception until 12 weeks of pregnancy. Athletes in our pregnancy study struggled to find a product that worked for them as both mothers and athletes. As one explained:
“…the supplements that you are meant to take are not Informed Sport tested.” – Lily, team ball sport
Athletes should check certification schemes such as Informed Sport and follow UK Anti-Doping's advice to assess the need, risk and consequences before using any supplement.
Energy availability underpins reproductive health. Low energy availability can lead to Relative Energy Deficiency in Sport (REDs), and menstrual function is one of its clearest indicators. In interviews with elite athletes in North America and Europe, some linked heavy training and irregular cycles to difficulty conceiving. Missing or irregular periods are worth investigating with a doctor or sports dietitian, both for current health and when planning a pregnancy.
During pregnancy: adapt as training and symptoms change
Pregnancy does not mean eating for two, but energy needs do change. UK guidance suggests most women need no extra energy until the third trimester, and then around 200 calories a day, while energy-expenditure research has estimated roughly 350 and 500 extra calories a day in the second and third trimesters. Neither estimate accounts for training: an athlete who keeps training may need more, while one who cuts back substantially may need less than before pregnancy.
Nutrition should be reviewed each time training changes. Most athletes in our survey reduced intensity or moved towards strength-based and lower-impact work, mirroring international data. The same review noted that some athletes gain more weight than recommended, possibly because training drops sharply while intake stays the same.
Symptoms can make usual eating difficult. Fatigue was the most commonly reported symptom, especially in the first trimester (81%), followed by nausea and vomiting (70%). Adapting meal size and timing, choosing foods that are easier to tolerate and planning around revised sessions can help athletes keep eating enough on difficult days.
Supplements need a double check: are they safe for pregnancy, and are they safe for sport? Supplements containing vitamin A, such as fish liver oil, should be avoided. Caffeine, widely used for performance, needs particular care: current guidance advises less than 200 mg a day in pregnancy, including from gels, pre-workout products and energy drinks. Over half of the athletes we surveyed wanted advice on sport supplements during pregnancy, an area where evidence is limited and individual advice from a registered dietitian or appropriately qualified sports nutrition professional is essential.
Nutrition support is about more than nutrients. Expected changes in weight and body shape can be hard for athletes used to monitoring body composition, and around a third of those we surveyed wanted body image support during pregnancy.
After birth: support the whole return
Return to sport can sound like a single event: an athlete receives clearance, resumes training and moves towards competition. The reality is more varied. In our survey, the median time to return was six months, while 30% of postpartum participants had not yet returned. Most elite athletes resume some training within six to 12 weeks, but reaching pre-pregnancy training volumes can take three to nine months. These figures describe a range of experiences, not targets.
The barriers extend well beyond physical readiness. Childcare was the most frequently reported barrier, followed by sleep and infant feeding, and around two thirds of athletes reported a lack of energy.
Postpartum brings some of the highest nutritional demands of the journey, yet received the least support. Priorities may be regular meals and snacks, hydration, access to food during long training days and enough support at home to make eating possible. Iron status is worth checking, particularly after significant blood loss at birth.
Breastfeeding increases energy and fluid needs. Nearly three quarters of athletes wanted advice on breastfeeding or mixed feeding, and elite distance runners in earlier research raised similar questions, including whether hard training affects breast milk. Advice should support all feeding choices without judgement.
Fuelling, bone health and body image need attention as training builds. Very few athletes made specific nutrition changes for their return; those who did fuelled before and after sessions and accounted for breastfeeding. Reports of postpartum bone stress injuries in elite runners have pointed to rapid increases in training load, a history of REDs or eating disorders, and possibly low calcium and vitamin D intake. In our survey, 42% wanted postpartum body image support, and pressure to regain a pre-pregnancy body quickly can increase the risk of low energy availability.
A useful plan sets regular review points instead of one return date. Return-to-running guidance for postpartum elite athletes recommends monitoring nutrition, pelvic floor function, bone and muscle reloading and breastfeeding within a multidisciplinary approach. The plan should flex around a difficult week without turning a temporary adjustment into a judgement about the athlete's commitment.
Share responsibility across the athlete’s support team
Disclosing a pregnancy can feel risky. Some athletes in our research delayed disclosure because they worried their commitment would be questioned or their finances affected, mirroring international findings. Once they disclosed, medical staff could often advise on general safety but had fewer answers about elite training and nutrition.
Athletes want advice from people who understand both pregnancy and sport. Many wanted advice from their midwife or GP, but half also wanted to hear from fellow athletes who had been pregnant, and almost half from registered nutritionists and dietitians working in sport. In practice, most advice came from general maternity care and the internet, reflecting wider evidence that athletes often rely on peers and their own research.
The athlete should remain central, but should not have to coordinate care alone. Coaches, nutrition, medical, physiotherapy, psychology and performance-lifestyle staff each bring different expertise, and clear roles reduce conflicting advice. UK Sport's pregnancy guidance offers a useful model, recommending case-by-case planning, regular communication and multidisciplinary support, principles that can be scaled for clubs and active non-elite athletes. Contact should remain athlete-led, as repeated questions about return dates can create pressure.
What better support can look like
Sport has moved a long way from “happy retirement”, but nutrition remains one of the least supported parts of the journey. Supporting a pregnant or postpartum athlete requires ongoing conversations and permission for the plan to change. Instead of opening with “When will you be back?”, we can ask: “What do you need at this stage, and who will help provide it?”
Athletes, practitioners and sporting organisations can start by reviewing their current pathway:
Does it begin before pregnancy?
Does it name who provides nutrition and health advice?
Does it account for life outside training, such as childcare, sleep and infant feeding?
If you have been through pregnancy as an athlete, or support athletes who have, share what helped and where support fell short in the comments, and pass this blog on. Together, the WiSEAN community can turn a growing evidence base into better experiences for athletes.
Author information
Catherine (Cat) George is a Registered Associate Nutritionist (ANutr) and a PhD candidate in Population Health at the Royal College of Surgeons in Ireland (RCSI). A former Princeton University and US Women's National Team (field) hockey player, her research and practice focus on nutrition, physical activity and support across preconception, pregnancy and postpartum. She is the founder of Catherine George Nutrition.
Research and social media: ResearchGate | LinkedIn | @catherinegeorgenutrition | @nutritionandpregnancy
Blog editor: Dr Tess Flood
Blog admin: Dr Jacky Forsyth
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