The document discusses nutritional needs and guidelines for women during pregnancy and lactation. It notes that pregnancy requires additional calories, protein, iron, and calcium to support the growth of the fetus and development of breast tissue. Not getting adequate nutrition can increase risks for complications in both mother and baby. The document also outlines nutritional risks like inadequate weight gain and developing gestational diabetes. Nurses can help pregnant women by providing education on diet, exercise, and glucose monitoring to prevent issues like hypoglycemia and hyperglycemia. Nutritional guidelines recommend eating smaller, more frequent meals and snacks that are balanced in carbohydrates, fiber, and healthy fats.

1. Presented by
Kousar Perveen
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2. Objectives:
Maternal Nutrition:
At the end of this lect. learner
will be to understand
 Nutritional need in pregnancy and Lactation.
 Nutritional risk factor of pregnancy
 Concerns during pregnancy / weight gain/DM
in pregnancy.
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3. Nutritional need in pregnancy and
Lactation
Nutritional need in pregnancy and Lactation.
The nutritional needs during pregnancy include
the normal requirement of the mother, those of
the developing fetus including uterus and
placenta and the building up of reserves in
preparations for labour and lactation.
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4. Cont…
Energy requirement:
 During first half of pregnancy additional needs of
calories is small while an increase of 3oo calories
per day is estimated for the second half of the
pregnancy.
 During lactation, 130 calories is require for each
100 ml of milk and thus the daily production of
600 to 800 ml of milk would necessitate an
addition of 800 to 1000 calories.
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5. Cont…
Protein :
A liberal protein intake is desirable throughout
the entire period of pregnancy to compensate
for any possible inadequate protein intake
before conception and during the early weeks
of pregnancy. (meat, milk, egg)
In lactation period: Protein requirement during
lactation is maximum. About 2 grams of food
protein are required to produce 1 gm of milk
protein
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6. Sources of protein
Sources:
Animal source like cow milk
Dried beans
Peas
Fish
Pulses
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7. Cont…
Iron:
From 700 to 1000 mg of iron must be absorbed
and utilized by the mother throughout the span
of pregnancy, of total 240 mg are saved by
cessation of menstrual flow. The reminder must
be made available from diet. A daily increase
of 8 to 100 mg will provide sufficient iron
except for the anemic women
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8. Sources of iron
Sources:
Animal sources like red meat, red organs,
poultry, fish
Fortified food
Green leafy vegetables
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9. Cont…
Calcium:
An increased retention of calcium is required
both for foetal bones, teeth and for storage in
the material skeleton during lactation. During
pregnancy 1.5 gm of calcium is needed while
demand increases to 2 gm during lactation
when the mother loses a substantial amount of
calcium in the breast milk.
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10. Sources of calcium
Sources:
Milk and milk products
Green leafy vegetables
Fish
Legumes
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11. Nutritional Risk Factor of
Pregnancy
Nutritional risk factor of pregnancy:
For maternal health: Increased risk of
Maternal complications and death
Infection
Anemia
Lethargy and weakness
Low productivity
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12. Cont…
Infant health: Increased risk of
Fetal, neonatal and infant death
Intra-utrine growth retardation
Low birth weight
Prematurity
Birth defects like neural tube defect
Brain damage
Infections
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13. weight Gain:
Weight gain:
The gain in the weight for a healthy woman
during pregnancy is 14 to 20 pounds. This is
accounted for by the weight of full term baby,
i.e.6 pounds, and increase in breast tissue, etc.
Failure to gain weight at a normal rate during
the first 2 trimesters as well as underweight at
the initial stage increases the probability of
premature baby.
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14. Cont…
On the other hand, overweight at the beginning
of pregnancy or an excessive rate of gain
during the second and third trimesters results in
greater likelihood of pre-eclampsia or
eclampsia.
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15. Diabetes mellitus in pregnancy
Definition:
Gestational diabetes mellitus (GDM)
is defined as carbohydrate intolerance of
varying degrees of severity with onset or first
recognition during pregnancy.
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16. Cont…
Consequences of gestational diabetes mellitus:
1.Hypoglycemia
2. Hyperglycemia
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17. Hypoglycemia in pregnancy
Hypoglycemia:.
When blood glucose levels are too low, your
body can’t get the energy it needs. This
condition is called hypoglycemia.
 Usually, hypoglycemia is mild and can easily
be treated by eating or drinking something with
sugar. But if left untreated, hypoglycemia can
make you pass out.
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18. Cont…
Factors cause hypoglycemia:
 Meals or snacks that are too small, delayed or
skipped
 Doses of insulin that are too high
 Increased activity or exercise
Hyperglycemia:
When your body doesn’t have enough insulin
or isn’t able to use insulin correctly, you could
be at risk of having high blood glucose and this
termed as hyperglycemia.
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19. Cont…
Hyperglycemia caused by:
 A mismatch between food and medication i-e
Eating the wrong kinds of food
 Eating more food than usual
 Being less active than usual
 Illness
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20. Nursing responsibilities
 Proper diet
 Exercise
 Insulin level
Nurses responsibilities
Can help client avoid these problems by
providing continued screening, education and
counseling during pregnancy.
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21. Nutritional Guidelines
Nutritional Guidelines for Women With
Gestational Diabetes:
 Eat 3 meals and 3 snacks daily.
 Space snacks so that there is no more than 3
hours without eating.
 Omit foods high in sugar and concentrated
sweets
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22. Cont…
 Avoid adding sugar (white sugar, brown sugar,
or honey) to foods. Avoid soda pop, and
sweetened yogurt
 Spread carbohydrates throughout the day.
 If after-breakfast blood glucose levels are
outside the target range, you may be asked to
shift some carbohydrates (starch and fruit) to
other snacks or meals
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23. Cont…
 Choose foods high in fiber: whole grains,
whole fruits and vegetables, beans and
legumes, oats.
 Choose foods low in fat and avoid adding extra
fat, such as oil, or butter. Choose low-fat meat
selections, such as lean cuts of beef, pork, and
lamb
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24. Cont…
 Unbuttered popcorn, or bread sticks instead of
foods fried in oil, such as doughnuts, chips, and
French fries
 baked, broiled, or roasted instead of fried
chicken or fish
 low-fat yogurt instead of butter and sour
cream on a potato
 herbs to season vegetables instead of cream
or butter sauces
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25. References.
 Ansari, I. M. (2003). Community Medicine and
Public Health. (6th ed.). Karachi: Time
Publisher.
 Delaunne, S. C., & Lader, P. K. (2002).
Fundamental of Nursing Standard and
Practice. (2nd ed.). Lippincott William &
Wilkins.
 Gupta, LC.,Gupta, K.,& Gupta, A.(2006) Food
and Nutrition facts and figure. (6th ed.)
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