WEEKS 28 TO BIRTH — NUTRITION, EXERCISE & HEALTHY BABY PLAN: THIRD TRIMESTER PREGNANCY DIET
Weeks 28–Birth: The Third Trimester
The journey from the first positive pregnancy test to the final weeks of pregnancy is filled with physical, emotional and nutritional changes.
After completing the first trimester and second trimester, the pregnancy now enters its final stage.
Weeks 28 until birth are known as the third trimester.
During these weeks, the baby continues growing and gaining weight while important organs, including the brain and lungs, continue to mature. At the same time, the mother's body becomes increasingly prepared for labour and breastfeeding.
This doesn't mean that a pregnant woman suddenly needs expensive foods or complicated supplements.
A healthy third-trimester diet can still be built around simple, affordable foods such as:
Rice, dhal, eggs, fish, green leafy vegetables, beans, chickpeas, green gram, seasonal fruits, milk, yoghurt, vegetables and whole grains.
Sri Lanka's Ministry of Health food-based dietary guidance specifically encourages pregnant women to consume pulses, small fish, eggs or lean meat along with fruits and vegetables, while emphasizing appropriate pregnancy weight gain and professional antenatal care. (Nutrition Division)
Important: This article is for general education. Every pregnancy is different. A woman's doctor, obstetrician, midwife or antenatal-care team should guide her individual diet, supplements, exercise, weight gain and treatment.
What Happens During the Third Trimester?
The third trimester generally begins at week 28 and continues until birth.
During this period, the baby continues to:
- Gain weight
- Develop and mature the brain
- Continue lung development
- Develop body fat
- Strengthen muscles
- Continue bone development
- Practice movements needed after birth
- Prepare for life outside the womb
For the mother, the increasing size of the baby can make everyday activities more difficult.
She may experience:
- Backache
- Pelvic discomfort
- Heartburn
- Constipation
- Leg cramps
- Swollen feet or ankles
- Increased urination
- Difficulty sleeping
- Tiredness
- Shortness of breath
- Feeling full quickly
Some symptoms are common in late pregnancy, but not every symptom should automatically be considered normal. New, severe or unusual symptoms should be discussed with the maternity-care team.
1. Nutrition Becomes Especially Important
The third trimester is a period of continued fetal growth and increasing maternal nutritional demands.
However, the goal is still quality rather than simply quantity.
Sri Lanka's Nutrition Division promotes balanced meals with whole grains, vegetables, green leafy vegetables, fruits, pulses, fish or eggs, lean meat, dairy and nuts or seeds as part of healthy eating. (Nutrition Division)
A simple meal formula is:
Carbohydrate + Protein + Vegetables + Fruit
For example:
Rice + dhal + fish + leafy vegetables + guava
or:
String hoppers + dhal + egg + vegetables + banana
or:
Oats + milk + banana + nuts
Simple food can provide a surprisingly useful nutritional foundation.
2. Don't "Eat for Two"
Even in the third trimester, pregnancy does not mean eating twice as much food.
Some guidance suggests a modest increase in energy intake in late pregnancy rather than doubling portions. The NHS, for example, notes that there is no need to "eat for two" and describes only a small additional energy requirement in the third trimester. (nhs.uk)
Instead of increasing portions dramatically, improve the nutritional value of meals.
Instead of:
Biscuits + sugary tea
Try:
Fruit + yoghurt
Instead of:
Fried snacks
Try:
Boiled chickpeas + fruit
Instead of:
Sugary drinks
Try:
Water + fresh fruit
The additional nutrition should ideally come from useful foods.
3. Protein: Keep It in Every Main Meal
Protein remains important throughout pregnancy.
The baby continues growing rapidly, while the mother's body is preparing for birth and breastfeeding.
Affordable protein choices:
- Eggs
- Dhal
- Chickpeas
- Green gram
- Cowpea
- Fish
- Chicken
- Milk
- Yoghurt
- Curd
- Lean meat when affordable
Sri Lanka's Food-Based Dietary Guidelines specifically encourage pregnant women to consume pulses together with fish, eggs or lean meat. (Nutrition Division)
A budget-friendly meal could therefore be:
Rice + dhal + egg + leafy vegetable
There is no need to eat expensive meat at every meal.
4. Iron: Continue Paying Attention to Anaemia
Iron remains an important nutrient during the final trimester.
The mother's blood volume is substantially affected by pregnancy, while the fetus also needs iron for development.
Iron deficiency can lead to anaemia.
WHO recommends antenatal iron and folic acid supplementation, with the exact regimen determined according to the applicable clinical guidance and individual circumstances. (World Health Organization)
Affordable iron-containing foods include:
- Dhal
- Lentils
- Chickpeas
- Green gram
- Cowpea
- Dark green leafy vegetables
- Eggs
- Fish
- Lean meat
Combine iron-containing foods with vitamin C
For example:
Dhal + leafy greens + tomato
followed by:
Guava or orange
Vitamin C can help the body absorb non-haem iron from plant foods.
If the antenatal clinic has prescribed iron, it should be taken according to those instructions.
5. Folic Acid and Micronutrients
Folate remains an important nutrient during pregnancy.
Pregnancy also increases the need for several vitamins and minerals.
Depending on the mother's health, diet and local antenatal programme, healthcare professionals may provide or recommend:
- Iron
- Folic acid
- Calcium
- Vitamin D
- Vitamin C
- Iodine
- Vitamin B12
- Other micronutrients when indicated
Sri Lanka's Ministry of Health has introduced guidance relating to multiple micronutrient supplementation for pregnant women, and its current Family Health Bureau resources include a 2024 guideline on distribution of multiple micronutrient tablets. (Family Health Bureau)
This is important because supplement recommendations can differ between countries and according to a woman's medical condition.
Therefore:
Do not create your own combination of pregnancy vitamins. Use the supplements provided or recommended by the antenatal-care team.
WHO also emphasizes continued micronutrient supplementation and nutrition counselling as part of antenatal care. (World Health Organization)
6. Calcium for the Final Months
The baby's skeleton continues developing throughout pregnancy.
Calcium is therefore an important nutrient for both mother and baby.
Food sources include:
- Milk
- Yoghurt
- Curd
- Small fish eaten with edible bones
- Certain leafy vegetables
- Calcium-fortified foods where available
Sri Lanka's Family Health Bureau has specific 2024 guidance on calcium supplementation for the maternal-care programme, so pregnant women should follow the supplementation plan provided through their healthcare service. (Family Health Bureau)
WHO also recommends calcium supplementation in populations where dietary calcium intake is low as a strategy to reduce the risk of pre-eclampsia and its complications. (World Health Organization)
7. Vitamin D
Vitamin D supports calcium metabolism and bone health.
Sources can include:
- Eggs
- Fish
- Fortified foods
- Some dairy products
- Appropriate sunlight exposure
Whether supplementation is needed depends on individual circumstances and local guidance.
Avoid taking high-dose vitamin D without medical advice.
8. Omega-3: Think About Fish Quality, Not Expensive Fish
The baby's brain and eyes continue developing during the third trimester.
Fish can provide protein as well as omega-3 fatty acids such as DHA.
Affordable options can include appropriate locally available fish such as:
- Sardines
- Mackerel
- Other suitable oily fish
However, fish safety matters.
Pregnant women should avoid high-mercury fish such as shark, swordfish and marlin, and follow local advice regarding other fish. Raw fish and raw shellfish should also be avoided. (nhs.uk)
Fish should be thoroughly cooked.
9. Fruits for Weeks 28 to Birth
There is still no single "best pregnancy fruit."
Instead, choose different fruits according to availability, affordability and tolerance.
🍌 Banana
Useful as an easy snack and provides carbohydrates, fibre and potassium.
🍊 Orange
Provides vitamin C and can complement iron-containing meals.
🍈 Guava
A practical source of vitamin C and fibre.
🍉 Watermelon
Refreshing and contributes to fluid intake.
🥭 Mango
A useful seasonal fruit when available.
🍍 Pineapple
Can be included as part of a normal varied diet.
🥑 Avocado
Provides fibre and unsaturated fats, although it may cost more than local seasonal fruit.
🍎 Apple
Convenient and provides fibre.
🍈 Ripe papaya
Ripe papaya can be included as part of a varied diet. Social-media claims that normal amounts of ripe papaya automatically cause miscarriage should not be treated as reliable medical advice.
The main principle is:
Choose variety rather than searching for one miracle fruit.
10. Vegetables Should Remain a Daily Habit
Vegetables provide fibre, vitamins, minerals and other beneficial plant compounds.
Affordable choices can include:
- Pumpkin
- Carrot
- Beans
- Cabbage
- Brinjal
- Okra
- Beetroot
- Gotukola
- Mukunuwenna
- Other leafy greens
- Tomato
- Cucumber
- Drumstick
- Sweet potato
Sri Lanka's Nutrition Division recommends eating vegetables and green leafy vegetables regularly and promotes minimally processed, locally available foods as healthy choices. (Nutrition Division)
11. Constipation During the Third Trimester
Constipation can become more noticeable as pregnancy progresses.
It may be influenced by:
- Hormonal changes
- Reduced physical activity
- Changes in diet
- Iron supplements
- Pressure from the growing uterus
Helpful habits may include:
💧 Drink enough fluids
🥬 Eat vegetables
🍌 Eat fruit
🥣 Include oats and whole grains
🫘 Eat dhal and other pulses
🚶 Stay appropriately active
Budget-friendly fibre foods:
- Dhal
- Chickpeas
- Green gram
- Oats
- Sweet potatoes
- Fruits
- Vegetables
- Whole grains
If constipation becomes severe or persistent, speak with the healthcare team before using laxatives or herbal preparations.
12. Managing Heartburn
Heartburn is common during pregnancy and can become more noticeable as the uterus grows.
Some women find these habits helpful:
- Eat smaller meals
- Eat slowly
- Avoid very large meals
- Avoid lying down immediately after eating
- Identify foods that trigger symptoms
- Avoid very heavy meals close to bedtime
Spicy foods do not necessarily need to be completely eliminated unless they trigger symptoms.
If heartburn becomes severe or persistent, ask the doctor or pharmacist about pregnancy-safe treatment.
13. Hydration Becomes Especially Important
Water is one of the simplest and most important parts of the pregnancy diet.
Sri Lanka's Food-Based Dietary Guidelines identify water as the healthiest drink and provide general guidance around regular fluid intake. Individual needs can vary with climate, activity, diet and medical circumstances. (Nutrition Division)
Hydration can come from:
- Water
- Milk
- Soups
- Water-rich fruits
- Other appropriate non-alcoholic drinks
Keep a water bottle nearby.
This simple habit can make regular drinking much easier.
14. Exercise During the Third Trimester
If the pregnancy is uncomplicated and the healthcare team has not restricted activity, physical activity can generally continue according to comfort.
Walking remains one of the simplest choices.
Other activities may include:
- Swimming
- Gentle pregnancy exercise
- Prenatal yoga
- Pelvic-floor exercises
- Appropriate light strength exercises
The NHS advises pregnant women to remain active for as long as they feel comfortable and notes that activity can help the body adapt to pregnancy and prepare for labour. (nhs.uk)
A woman who was previously inactive should not suddenly begin strenuous exercise.
15. A Simple Third-Trimester Walking Routine
A practical example could be:
Weekday routine
Morning or evening
10–30 minutes of comfortable walking
The duration can be adjusted according to:
- Fitness level
- Weather
- Pregnancy symptoms
- Energy levels
- Medical advice
She does not need to force herself to complete a particular distance.
The conversation test
During comfortable exercise, she should generally be able to speak.
If she becomes unusually breathless, dizzy or uncomfortable, she should slow down or stop and seek appropriate advice.
16. Pelvic-Floor Exercises
The pelvic-floor muscles support the bladder, bowel and reproductive organs.
Pregnancy and childbirth place additional demands on these muscles.
Pelvic-floor exercises can be incorporated into a daily routine when appropriately taught.
A physiotherapist, midwife or other qualified professional can explain the correct technique.
17. Sleep May Become Difficult
As the abdomen grows, finding a comfortable sleeping position can become harder.
Common problems include:
- Back discomfort
- Frequent urination
- Heartburn
- Leg cramps
- Difficulty turning in bed
- Feeling uncomfortable
Helpful habits can include:
- Keeping a regular sleep schedule
- Using pregnancy-support pillows if comfortable
- Avoiding very large meals close to bedtime
- Reducing caffeine
- Keeping the bedroom comfortable
- Resting when tired
Pregnant women should follow the sleeping-position advice given by their own maternity team, especially in later pregnancy.
18. Healthy Weight Gain: Don't Compare With Another Mother
Every woman's pregnancy is different.
Appropriate pregnancy weight gain depends on factors such as:
- Pre-pregnancy BMI
- Height
- Number of babies
- Maternal health
- Pregnancy complications
Sri Lanka's national nutrition guidance specifically recognizes pre-pregnancy BMI and the number of fetuses as factors affecting appropriate pregnancy weight gain. (Nutrition Division)
Therefore, avoid comparing one pregnant woman's weight with another woman's.
The healthcare team should monitor maternal weight and fetal growth throughout pregnancy.
19. Important Antenatal Appointments
The third trimester is not the time to stop regular antenatal care simply because the pregnancy is progressing normally.
WHO antenatal-care recommendations include ongoing monitoring of maternal and fetal wellbeing, nutritional counselling, blood pressure and other assessments throughout pregnancy. Birth-preparedness and complication-readiness counselling become particularly important during the third trimester. (World Health Organization)
Depending on the healthcare system and individual circumstances, appointments may include monitoring:
- Blood pressure
- Weight
- Urine
- Blood tests
- Baby's growth
- Baby's position
- Fetal movements
- Maternal symptoms
- Pregnancy-related complications
Follow the schedule provided by the maternity clinic.
20. Learn About Baby Movements
As pregnancy progresses, fetal movements become an important part of monitoring the baby's wellbeing.
There is no single universal number of movements that every baby must make each day.
Instead, the mother should become familiar with her baby's usual movement pattern.
If she notices that the baby is moving significantly less than usual or there is a concerning change in the pattern, she should contact her maternity-care provider promptly rather than waiting until the next appointment.
WHO includes monitoring fetal movements among third-trimester antenatal-care interventions. (World Health Organization)
21. Preparing for Labour
The third trimester is also the right time to prepare practically for birth.
Discuss with the healthcare team:
- Expected place of delivery
- Transportation
- Emergency contact numbers
- Warning signs
- Birth preferences
- Who will accompany the mother
- What to bring to hospital
- Breastfeeding plans
- Newborn-care preparations
Prepare important documents
Keep together:
- Antenatal records
- Identification documents
- Medical reports
- Scan reports
- Important contact numbers
- Hospital information
The exact requirements will depend on the hospital.
22. Build a Hospital Bag Early
Don't wait until labour begins to prepare everything.
A simple hospital bag may include:
For mother
- Comfortable clothes
- Maternity pads
- Underwear
- Toiletries
- Slippers
- Phone charger
- Water bottle
- Important documents
- Any prescribed medicines
For baby
- Newborn clothes
- Diapers
- Soft towels
- Blankets
- Appropriate clothing for leaving hospital
Check with the chosen hospital for its own recommended list.
23. Preparing for Breastfeeding
Breastfeeding preparation should begin before birth.
Learn about:
- Early skin-to-skin contact
- Breastfeeding soon after birth where medically appropriate
- Correct positioning
- Proper attachment/latch
- Colostrum
- Feeding frequency
- When to ask for lactation support
Antenatal care can include breastfeeding counselling in the later stages of pregnancy. WHO's antenatal-care recommendations specifically include breastfeeding counselling in late pregnancy. (World Health Organization)
24. Foods and Drinks to Continue Avoiding or Limiting
The third trimester does not mean food-safety restrictions disappear.
Continue to avoid or limit:
❌ Alcohol
❌ Raw or undercooked meat
❌ Raw fish and raw shellfish
❌ High-mercury fish such as shark, swordfish and marlin
❌ Unpasteurized dairy products
❌ Liver and liver products because of their high vitamin-A content
❌ Supplements containing high amounts of retinol unless specifically prescribed
❌ Excessive caffeine
The NHS recommends keeping caffeine below 200 mg per day during pregnancy. (nhs.uk)
Always follow local food-safety guidance as well.
25. Be Careful With Herbal Drinks and Traditional Remedies
The final trimester is not the time to experiment with unknown herbal products simply because they are described as "natural."
Be cautious with:
- Herbal medicines
- Concentrated herbal drinks
- Detox products
- Weight-loss products
- Unregulated supplements
- High-dose vitamins
- Traditional preparations with unknown ingredients
Some substances may interact with medicines or have not been adequately studied during pregnancy.
Always check with a healthcare professional before taking a new supplement or herbal preparation.
26. A Budget-Friendly 7-Day Third-Trimester Meal Plan
This is an example educational meal rotation, not an individualized prescription.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
27. How to Make the Third-Trimester Diet More Affordable
A healthy pregnancy diet does not need to become a luxury diet.
Buy seasonal fruits
Choose whichever nutritious local fruits are affordable that week.
Use pulses regularly
Dhal, chickpeas, green gram and cowpea can stretch the food budget while providing protein and other nutrients.
Use eggs
Eggs can be a practical and relatively inexpensive protein source.
Choose appropriate local fish
There is no requirement to purchase expensive imported fish.
Cook in batches
Prepare dhal, chickpeas or certain vegetables in larger quantities where food-safety practices allow.
Reduce packaged snacks
Biscuits, cakes, sweetened drinks and processed snacks can increase the grocery bill without providing the same nutritional value as whole foods.
Sri Lanka's current Nutrition Division campaign also promotes natural, minimally processed snacks such as fruits, vegetables, nuts, pulses, boiled yams and unsweetened dairy products. (Nutrition Division)
28. The Husband's Role in the Third Trimester ❤️
The final trimester can be physically demanding.
This is an excellent time for the husband to become more involved.
Help with meals
Prepare healthy food instead of expecting her to do everything.
Go walking together
If her healthcare team has approved physical activity, a gentle evening walk can become a shared routine.
Help with household work
Carrying heavy objects and physically demanding tasks may become uncomfortable.
Attend appointments when possible
Understanding the pregnancy together helps both parents prepare.
Prepare the hospital bag
Don't leave everything for the mother.
Arrange transportation
Know how you will reach the hospital at any time of day or night.
Keep emergency numbers available
Have important contacts saved in both phones.
Provide emotional support
Sometimes the most useful thing a husband can do is simply listen.
29. Warning Signs That Should Not Be Ignored
Not every pregnancy symptom is an emergency, but certain symptoms require prompt medical assessment.
Contact the maternity-care team urgently if there is:
- Vaginal bleeding
- Severe or persistent abdominal pain
- Severe headache, especially with visual changes
- Sudden significant swelling of the face or hands
- Fluid leaking from the vagina
- Regular painful contractions before the expected time
- Severe dizziness or fainting
- Chest pain
- Significant difficulty breathing
- Fever or serious illness
- Persistent vomiting with inability to keep fluids down
- A significant reduction or concerning change in baby's usual movements
- Any symptom that feels seriously wrong or unusual
For emergencies, seek immediate medical care rather than waiting for an online answer.
30. What Should Be on the Daily Checklist?
A simple third-trimester checklist can help the family stay organized.
Every Day
☐ Eat a variety of nutritious foods
☐ Include a protein source
☐ Eat vegetables
☐ Eat fruit
☐ Drink enough fluids
☐ Take prescribed supplements
☐ Stay appropriately active
☐ Get adequate rest
☐ Avoid alcohol and smoking
☐ Follow food-safety precautions
☐ Pay attention to baby's usual movement pattern
31. The Final-Trimester Nutrition Formula
If you remember only one thing from this article, remember:
Protein + Vegetables + Fruit + Whole/Unrefined Carbohydrates + Healthy Fats + Water
For example:
Rice + dhal + fish + leafy greens + vegetables + fruit + water
This is much more useful than searching for one expensive "pregnancy superfood."
32. From Week 28 to Birth: Think Consistency
The final trimester isn't about making dramatic changes.
It's about continuing good habits.
A mother doesn't need to have a perfect meal every day.
She needs a generally nutritious pattern over time.
One day might include:
Rice + dhal + fish + vegetables
Another might be:
String hoppers + egg + dhal + fruit
Another might be:
Oats + milk + banana + nuts
Variety and consistency matter more than perfection.
33. The Complete Pregnancy Journey
From the first trimester through birth, the priorities gradually change.
Weeks 1–13
Foundation
- Folic acid
- Balanced nutrition
- Hydration
- Managing nausea
- Food safety
- Rest
- Appropriate activity
Weeks 14–27
Growth
- Protein
- Iron
- Calcium
- Vitamin D
- Fruits and vegetables
- Appropriate weight gain
- Regular physical activity
- Antenatal monitoring
Weeks 28–Birth
Final growth and preparation
- Continued balanced nutrition
- Protein and iron
- Calcium and other recommended micronutrients
- Hydration
- Appropriate exercise
- Rest and sleep
- Monitoring fetal movements
- Birth preparation
- Hospital preparation
- Breastfeeding education
WHO's antenatal-care framework emphasizes nutrition counselling throughout pregnancy, ongoing maternal and fetal assessment, birth preparedness and complication readiness. (World Health Organization)
34. A Final Message for Expecting Parents
A healthy pregnancy does not require a wealthy household.
A family can create a nutritious pregnancy diet using simple foods:
The important thing is learning how to combine these foods into a varied diet and following the supplements and medical advice provided by the antenatal-care team.
Pregnancy is also not only about food.
Most importantly, parents should not feel pressured to achieve a "perfect pregnancy."
The goal is to make healthy choices consistently, attend antenatal appointments, recognize warning signs and seek professional care when needed.
From the First Trimester to Birth
A baby's development happens over many months.
There is no single food, fruit, vitamin or exercise that guarantees a perfectly healthy baby.
Instead, a healthy pregnancy is supported by thousands of small decisions:
And together, those small habits can become a strong foundation for the mother, the baby and the family.
Good Food Today… A Healthier Tomorrow. ❤️
Important Medical Note
This educational series should not be used to diagnose pregnancy symptoms or replace professional medical care.
Pregnant women should follow the advice of their obstetrician, doctor, midwife or antenatal clinic, particularly regarding supplements, medicines, exercise restrictions, pregnancy weight gain, gestational diabetes, anaemia, high blood pressure, fetal growth and other pregnancy complications.
For families in Sri Lanka, the Ministry of Health and Family Health Bureau provide national maternal-care and nutrition guidance, including current resources on calcium and micronutrient supplementation. (Family Health Bureau)
First Trimester Pregnancy Diet
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