How to Reduce Swelling in Pregnancy: Diet and Daily Habits

Mild swelling in the feet and ankles is very common in pregnancy, and it can often be eased with daily habits: avoiding standing for long periods, raising your feet when resting, drinking water regularly through the day, cutting back on salty and processed foods, and staying active with your doctor's approval. However, swelling that suddenly increases in the face, hands or feet means you should see a doctor straight away.

Swelling (oedema) becomes more noticeable especially in the last months of pregnancy and on hot summer days. Below you will find why it happens, how much diet can help, and which “water-shifting” methods you should stay away from in pregnancy.

Why Does Swelling Happen in Pregnancy?

In pregnancy the body holds more water than usual, and the growing womb can slow blood circulation in the legs. When these two effects combine, fluid collects in the lowest parts of the body during the day, that is the feet, ankles and legs.

The NHS notes that swelling increases particularly at the end of the day, as pregnancy progresses, in hot weather and after standing for a long time. This kind of gradually developing swelling is usually not harmful to mother or baby, but it is uncomfortable. If you are curious about the general mechanism of oedema, you can also look at the article on what oedema is and what causes it.

Which Swelling Is Normal and Which Is Dangerous?

Swelling that builds up in the evening, eases when you wake up rested in the morning, is similar in both legs and develops slowly is mostly normal. Swelling that appears suddenly, spreads to the face and hands, or comes with other symptoms needs urgent assessment.

Call your doctor or the maternity unit straight away if you have:

• Sudden, marked swelling in the face, hands or feet
• A severe headache that does not go away
• Blurred vision or flashing lights in the eyes
• Severe pain just below the ribs
• Feeling very unwell, with nausea and vomiting
• Painful, red and warm swelling in one leg

The first five symptoms can be a sign of pre-eclampsia; painful swelling in one leg should be assessed for a clot. In these situations, a medical examination takes priority over dietary advice. I explained the role of diet in high blood pressure in pregnancy in the article on high blood pressure and salt in pregnancy.

Should I Drink Less Water to Reduce Swelling?

No. Cutting back on water does not reduce swelling; on the contrary, it upsets the body's fluid balance and can increase constipation and the risk of urinary tract infection. Unless your doctor has suggested a specific restriction, keep getting enough fluid spread through the day.

A practical method is to carry a water bottle with you and drink a glass of water with every meal. In the summer months the fluid lost through sweat rises, so the need rises too; if you are out on a hot day, keep drinking small sips without waiting to feel thirsty. Pale yellow urine is a rough sign that you are getting enough fluid. Ayran (Turkish salted yoghurt drink), plain mineral water, cucumber, watermelon and soups also add to your fluid intake; sugary drinks should be limited because they speed up weight gain.

Does Salt Increase Swelling, and Should I Cut It Out Completely?

Excess salt can increase water retention in the body, so it makes sense to reduce your salt load; but cutting salt out completely is not recommended in pregnancy. The aim is to reduce hidden sources of salt and to choose iodised salt for what you do use.

The World Health Organization recommends less than 5 grams of salt a day for adults. Most of the salt comes not from the salt shaker but from ready-made and processed foods:

• Pickles, brined olives and cheeses (you can reduce the salt in olives and cheese by soaking them in water)
• Processed meats such as sucuk (Turkish spiced sausage) and salami (these also should not be eaten in pregnancy unless thoroughly cooked)
• Ready-made soups, stock cubes, sauces and crisps
• Bakery products and some breakfast cereals

Using lemon, thyme, mint, black pepper and cumin instead of salt in your cooking keeps the flavour while cutting the salt. For the general health effects of salt, you can look at the article on high salt intake and the risk of hypertension.

Which Foods Can Help Reduce Swelling?

No single food “flushes out” swelling; however, a lightly processed way of eating, supported by potassium-rich vegetables and fruit, helps the body's fluid balance. These foods also provide fibre, so they help with constipation, which is common in pregnancy.

A sample day that suits swelling

• Breakfast: Boiled egg, a small amount of cheese with the salt reduced by soaking in water, plenty of tomato, cucumber and greens, wholemeal bread; a glass of water alongside.
• Snack: A banana or a slice of melon and a bowl of yoghurt.
• Lunch: Courgettes or spinach cooked in olive oil, lentil soup, bulgur pilaf and unsalted cacik (Turkish yoghurt and cucumber dip).
• Snack: A handful of unsalted nuts and a few dried apricots; water or low-salt ayran alongside.
• Dinner: Baked chicken or well-cooked fish, a jacket potato baked in its skin and a seasonal salad; lemon and spices instead of salt.

This is an example; portions vary with your week of pregnancy, your weight and any conditions such as gestational diabetes or high blood pressure. Finishing dinner two or three hours before going to bed reduces both heartburn and discomfort through the night. To avoid getting up to use the toilet at night, try taking most of your fluid during the daytime; but do not restrict it to the point of going thirsty in the evening.

Getting enough protein is also important, so add at least one of meat, chicken, fish, eggs, dairy products or pulses to every main meal. I explain in detail how to build a balanced plate in pregnancy on my nutrition during pregnancy page.

Can You Use Herbal Teas for Swelling in Pregnancy?

No, do not use them unless your doctor recommends them. Herbal blends sold as “swelling relievers” and diuretic medicines are not considered safe in pregnancy; the effects of some herbs in pregnancy have not been studied enough.

The NHS advises limiting herbal teas in pregnancy to four cups a day and avoiding teas that contain liquorice root. Do not make your own decisions about parsley juice, corn silk or similar “cures” either. For other foods and drinks to avoid in pregnancy, you can look at the article on what not to eat during pregnancy.

What Daily Habits Reduce Swelling?

As important as diet are your posture and movement habits through the day. The NHS's advice is simple and brings marked relief for most expectant mothers.

• Avoid standing for long periods; if you work at a desk, get up once an hour and walk for a few minutes.
• When resting, raise your feet on a cushion to close to heart level.
• Wear comfortable shoes and socks that do not squeeze; avoid bands that tighten the ankle.
• Do foot exercises while seated: bend your foot up and down 30 times and draw circles in each direction 8 times.
• With your doctor's approval, keep up light activity such as daily walks or swimming.
• Stay somewhere cool on hot days and do not wait in the sun for long.

The pace of weight gain can also be linked to swelling; if you see a marked rise on the scales within a few days, tell your doctor. You can use the tables in the article on how much weight to gain in pregnancy for the expected ranges.

If you need an individual nutrition plan for swelling, blood pressure or weight monitoring, we can work together, in line with your obstetrician's advice, within nutrition counselling for pregnancy.

Sources

• NHS – Swollen ankles, feet and fingers in pregnancy
• NHS – Pre-eclampsia
• NHS – Foods to avoid in pregnancy
• WHO – Healthy diet

This article is for general information only; please consult your doctor and dietitian about your own situation.