Diet during & after pregnancy.pptx

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Copyright © 2014 Well Woman Clinic. All rights reserved.
Diet during
Pregnancy & Lactation
Dr Nupur Gupta

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Diet
during &
post
pregnancy

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Why additional diet is required during
pregnancy and lactation ?
Pregnancy is a demanding physiological state.
Additional foods during
pregnancy and lactation
Similar diet in Pre-pregnant,
Pregnant and Lactating periods
Widespread maternal malnutrition
Lead to
• high prevalence of low birth
weight infants
• high maternal mortality
Improve
• Weight gain in pregnancy (10-12
Kg)
• Birth weight of infants (about 3
Kg).

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Nutrients that require special
attention
Additional foods are required to improve:
 weight gain in pregnancy (10-12 kg)
 birth weight of infants (≈3 kg).
Daily diet of women requires
First trimester
-
Second trimester
-
Third trimester -
Additional 350 calories, 0.5 g of protein

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Nutrients that require special
attention
Some micronutrients are specially required in extra amounts during
these physiological periods.
Iron
Calcium
Iodine
Vitamin A
Folic acid
Vitamin D

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NIN Guideline
 Folic acid during pregnancy,
 reduces risk of congenital malformations
 ↑birth weight
 Iron, folate and calcium supplements:
recommended regularly after 14 -16 weeks
of pregnancy and continued during lactation.

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Recommended Daily
Allowances
Particulars
Body
weight
(kg)
Net
energy
(kcal/d)
Protein
(g/d)
Visible
fat (g/d)
Calciu
m
(mg/d)
Iron
(mg/d)
Women
Sedent
ary
work
55
1900
55
20
600 21
Moderat
e work
2230 25
Heavy
work
2850
30
Pregnant women +350 +23
1200
35
Lactation
(months)
0 – 6 +600 +19
21
6 – 12 +520 +13
Source: NIN guideline.

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Particulars
Vitamin A (mg/d)
Thiami
n
(mg/d)
Ribofla
vin
(mg/d)
Niacin
equival
ent
(mg/d)
Pyridox
in
(mg/d)
Retinol
Β-
caroten
e
Women
Sedent
ary
work
600 4800
1 1.1 12
2.0
Moderat
e work
1.1 1.3 14
Heavy
work
1.4 1.7 16
Pregnant women 800 6400 +0.2 +0.3 +2
2.5
Lactation
(months)
0 – 6
950 7600
+0.3 +0.4 +4
6 – 12 +0.2 +0.3 +3
Recommended Daily Allowances

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Particulars
Ascorbic
acid
(mg/d)
Dietary
folate
(mg/d)
Vitamin
B12
(mg/d)
Magnesi
um
(mg/d)
Zinc
(mg/d)
Women
Sedentar
y work
40 200 1
310
10
Moderate
work
Heavy
work
Pregnant women 60 500 1.2
12
Lactation
(months)
0 – 6
80 300 1.5
6 – 12
Recommended Daily Allowances

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Iodine requirements
International Federation of Gyneacology and Obstetrics (FIGO)-2015 states that even with
use of iodized salt and eating seafood 2-3 days/week, a woman's daily iodine intake would
be approx. half the amount recently recommended during pregnancy & lactation
Pregnancy Lactation
FIGO 220 mcg 290 mcg
WHO 250 mcg 250 mcg
American Thyroid Association 150 mcg 150 mcg
NIN (India) 250 mcg 250 mcg
RDA

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Iodine
Ensures proper mental health of growing fetus & infant.
Baked cod (99 mcg in 3 oz), Plain yogurt, low-fat (75 mcg in 1
cup) Milk, low-fat (56 mcg in 1 cup) are some sources to get
iodine.
Age Recommendations
Women and men aged 19 years and
over
150 µg
Pregnant women 220 µg
Lactating women 270 µg

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Folic Acid
 It is a B vitamin (folate) - important for pregnant women.
 400 mcg daily helps in preventing major birth defects of
fetal brain & spine called neural tube defects.
 Dietary guidelines recommends at least 600 mcg daily in
pregnancy.
 All pregnant women & who wants to become pregnant need
a daily vitamin supplement containing folic acid.

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Iron
 Needed to meet high demands of erythropoiesis i.e. RBC
formation that carries oxygen to organs & tissues.
 Daily recommended dose in pregnancy is 27 mg.
 Iron-rich foods including lean red meat, poultry, fish,
dried beans & peas, iron-fortified cereals & prune juice
can be taken.
 Vit-C rich foods such as citrus fruits & tomatoes helps in
absorption of Iron.

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Calcium
 Essential for proper bones & teeth formation of
offspring, for secretion of breast-milk & prevent
osteoporosis in mother.
 All women
 19 yrs & older (including pregnant women) should
get 1,000 mg of calcium daily
 14–18 yrs should get 1,300 mg daily
 Best sources of calcium are - Milk & other dairy
products (cheese and yogurt).
 Other sources include - broccoli, dark, leafy greens,
sardines or calcium supplement.

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Vitamin A
Required during lactation to improve child survival.
Good sources of vitamin A (retinol) include: cheese, eggs, oily
fish, fortified low-fat spreads, milk and yoghurt, liver and liver
products such as liver pâté

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Vitamin D
 Along with calcium it helps in fetus’s bones and teeth
develop.
 Also essential for healthy skin & eyesight.
 All women, including pregnant females, need 600 IU of
vitamin D/day.
 Good sources - are milk fortified with vitamin D & fatty
fish such as salmon.
 Sunlight also converts a chemical in skin to vitamin D.

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How much weight should I gain
during pregnancy?
 The amount of weight gain depends on health
and body mass index (BMI) before pregnancy.
 Normal weight before pregnancy – should
gain between 25 pounds and 35 pounds
during pregnancy.
 Underweight before pregnancy - should
gain more weight than a woman who was a
normal weight before pregnancy.
 Overweight or obese before pregnancy -
should gain less weight.

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Can being overweight or obese
affect my pregnancy?
 Overweight and obese women are at increased risk
of pregnancy problems including:
 Gestational diabetes
 High blood pressure
 Preeclampsia
 Preterm birth
 Cesearean delivery
 Babies are also at greater risk of having birth
defects, macrosomia with possible birth injury, and
childhood obesity.

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Caffeine in pregnancy
Results of risk of miscarriage with the use
of caffeine is unclear.
200 mg of caffeine (one 12-ounce cup of
coffee) a day during pregnancy is
considered as safe.

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Benefits of including fish and
shellfish in diet during pregnancy
 Rich in omega-3-fatty acids (Natural fat)
 Important for fetus’s brain development both
before and after birth.
 Recommendation: Take 2 servings of fish or
shellfish (about 8–12 ounces)/week before getting
pregnant, while pregnant and breastfeeding.

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How can food poisoning affect
my pregnancy?
 Food poisoning in a pregnant woman can
cause serious problems like
 Vomiting
 Diarrhoea
 Vomiting and diarrhoea can cause too much
loss of water and can disrupt body’s chemical
balance.

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Steps to prevent food poisoning in
pregnant women
 Wash food. Rinse all raw produce thoroughly under
running tap water before eating.
 Keep kitchen clean. Wash hands, knives, countertops
& cutting boards after handling & preparing uncooked
foods.
 Avoid all raw and undercooked seafood, eggs, and
meat. Do not eat sushi made with raw fish (cooked
sushi is safe).

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THANK YOU!!!

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