If you're thinking about having a baby, you may have noticed that most pregnancy advice starts after the positive test. But did you know by then, some of the most important groundwork that contributes to your future baby’s health has already been laid? This isn’t meant to scare you. In fact, it’s good news, because it means that with a little planning, you can implement some really simple changes that could have a huge impact on the growth, development and life of your child. We think that is pretty amazing.
What is preconception care and why does it matter?
Preconception care refers to the timeframe before falling pregnant, ideally around 3-6 months, sometimes longer depending on your personal circumstances. Research confirms the health of both parents around the time of conception influences pregnancy and the child's long-term health, and the links are strong (Stephenson, 2018). Parental diet, body composition, nutrient deficiencies, metabolism, lifestyle choices and stress around conception can influence a child's later risk of chronic conditions (Fleming, 2018). Spending time to rectify these things before falling pregnant is strongly recommended.
Physiologically, sperm take about 3 months to develop. Lifestyle and environmental exposures during that window can impact sperm development, including its epigenetic patterns (the chemical tags that help regulate which genes are switched on) (Macho, 2021).
Eggs are present from birth, but their final stages of growth and maturation happen over the 3 to 4 months leading up to ovulation. Diet and lifestyle changes, as well as targeted supplementation may assist in optimising the environment around the egg to improve overall quality and chances of successful pregnancy (Alesi, 2023).
Don’t stress if you’ve “run out of time”, start as soon as you can, even a few weeks is going to be more beneficial than nothing at all.
How does preconception care connect to the first 1,000 days?
The first 1,000 days is defined as the period from conception to a child’s second birthday. Your baby’s brain, immune system and body are growing and developing at a rapid pace, and early life exposures to the environment, relationships, stress, and nutrition can all impact on their long-term health and wellbeing (Cusick, 2016).
The Developmental Origins of Health and Disease (DOHaD) hypothesis goes further. It proposes that conditions around conception, in the womb and in early infancy can influence a child’s risk of metabolic conditions later in life (Lacagnina, 2019). Preconception care sits right at the start of this window. Parental diet, body composition and metabolism around the time of conception have been linked with a child’s later risk of cardiovascular, metabolic, immune and neurological conditions (Fleming, 2018).
It also matters because pregnancy can sometimes be unplanned or unnoticed. The neural tube, which becomes the brain and spinal cord, forms in the first weeks after conception, often before a positive test. Waiting until you know you’re pregnant to start key nutrients like folic acid means missing part of that window, which is why the advice is to start earlier. None of this means your child’s future is fixed. These are associations and risks, not guarantees, and the first 1,000 days gives you plenty of time to nourish and support your child well beyond conception.
Where do I start with preconception care?
Six steps to focus on:
1. Start folic acid and iodine. Australian guidelines recommend 500 micrograms of folic acid daily from at least one month before conception and through the first three months of pregnancy, and 150 micrograms of iodine daily when planning a pregnancy, during pregnancy and while breastfeeding.
2. Move towards a Mediterranean-style way of eating. Think vegetables, fruit, legumes, wholegrains, nuts, olive oil and fish, with fewer ultra-processed foods. Of the dietary patterns studied, the Mediterranean diet has the strongest and most consistent link with clinical pregnancy (Alesi, 2023, Yang 2023). The evidence for any one fertility diet is still limited, so this isn't a fertility guarantee, but it is a great low-risk (and delicious) place to start.
3. Support a weight that works for your body. Higher body weight in either parent is linked with reduced fertility and a higher risk of obesity in children, and undernutrition carries its own risks (Fleming, 2018). This isn't about a number or a quick fix. Gentle, sustainable, food-first changes are the aim, and crash dieting before conception isn't. If you have a difficult history with food or weight, seek support from a qualified health professional, such as a degree-qualified Clinical Nutritionist or Naturopath.
4. Bring your partner in. Preconception health isn't only a women's job. As mentioned earlier, male fertility matters too. Eating the same way, cutting back on alcohol and quitting nicotine together is often easier than doing it alone.
5. Reduce alcohol. The National Health and Medical Research Council (NHMRC) advises that women who are pregnant or planning a pregnancy should not drink alcohol (NHMRC, 2020). The main reason for that is we don’t have enough research to understand what the safe level of alcohol consumption is for preconception and pregnancy (and it would not be ethical to study it). For partners, less alcohol is better as well.
6. Stop smoking, vaping and recreational drug use. Quitting smoking before conception is linked with a lower risk of miscarriage and other pregnancy complications. Vaping evidence is still emerging, so quitting both is the safest plan.
Where to next?
One more step worth adding: book a preconception check-up with your GP. It's a good time to review medications, vaccinations, blood tests (cholesterol, blood glucose, iron and vitamin D at minimum), and anything else specific to your situation.
If this all feels a little too nerve wracking, or you’d like someone to keep you accountable and provide you with simple, actionable changes to your diet and lifestyle, book a preconception appointment with our Clinical Nutritionist or Naturopath.
This article is general information and isn't a substitute for individual medical advice. Speak with your GP or health professional about what's right for you.
References & further reading
Stephenson J, et al. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. The Lancet. 2018;391(10132):1830-1841. https://eprints.soton.ac.uk/419694
Fleming TP, et al. Origins of lifetime health around the time of conception: causes and consequences. The Lancet. 2018;391(10132):1842-1852. https://pubmed.ncbi.nlm.nih.gov/29673874/
Alesi S, et al. Assessing the influence of preconception diet on female fertility: a systematic scoping review of observational studies. Human Reproduction Update. 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10663051/
National Health and Medical Research Council (NHMRC). (2023). Iodine supplementation for pregnant and breastfeeding women. Retrieved from: https://www.nhmrc.gov.au/about-us/publications/iodine-supplementation-pregnant-and-breastfeeding-women
NHMRC. Australian guidelines to reduce health risks from drinking alcohol (2020). https://www.nhmrc.gov.au/health-advice/alcohol
Queensland Health. Before the baby bump: preconception health, folic acid and iodine. https://hw.qld.gov.au/beforethebabybump/?p=469
Fertility Society of Australia. Micronutrient (folic acid, iodine and vitamin D) supplements pre-conception and during pregnancy. https://www.yourfertility.org.au/sites/default/files/2018-08/FSA%20Micronutrient%20%28folic%20acid%2C%20iodine%20and%20vitamin%20D%29%20supplements%20pre-conception%20and%20during%20pregnancy_0.pdf
Marcho C, et al. The preconception environment and sperm epigenetics. Andrology. 2020;8(4):924-942. https://pubmed.ncbi.nlm.nih.gov/31901222/
Cusick SE, Georgieff MK. The Role of Nutrition in Brain Development: The Golden Opportunity of the "First 1000 Days". Journal of Pediatrics. 2016 Aug;175:16-21. https://doi.org/10.1016/j.jpeds.2016.05.013
Yang J, et al. Mediterranean diet and female reproductive health over lifespan: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 2023;229(6):617-631. https://pubmed.ncbi.nlm.nih.gov/37506751/
