Pregnancy represents an ideal time for health promotion activities. Many women, including adolescents, are interested and willing to change health behaviors to improve the chance that they will deliver a healthy infant. This paper focuses on improving nutrition in pregnant adolescents. Seven recommendations are presented to help achieve this goal: 1) Focus on foods, not nutrients; 2) individualize and work within the pregnant adolescent's current eating habits; 3) consider the context of family and peer groups; 4) reward efforts; 5) make it easy; 6) focus on weight gain patterns for optimal birth outcomes; and 7) refer to a dietician, as needed. Use of these recommendations comprehensively addresses adolescent developmental needs to improve nutrition during pregnancy. These recommendations are not meant to be all-inclusive; rather, they are meant to serve as a guide for clinical management of nutrition for pregnant adolescents.