Diet during & after pregnancy.pptx

Diet plays an important role in pregnancy & nutrition

1. Diet during Pregnancy & Lactation Dr Nupur Gupta

2. Diet during & post pregnancy

3. 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).

4. N utrients 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 Additional 350 calories, 6.9 g of protein Additional 350 calories, 22.7 g of protein

5. N utrients 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

6. 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.

7. Recommended Daily Allowances Particulars Body weight (kg) Net energy (kcal/d) Protein (g/d) Visible fat (g/d) Calcium (mg/d) Iron (mg/d) Women Sedentary work 55 1900 55 20 600 21 Moderate work 2230 25 Heavy work 2850 30 Pregnant women +350 [phone] Lactation (months) – 6 +600 +19 21 6 – 12 +520 +13 Source: NIN guideline.

8. Source: NIN guideline. Particulars Vitamin A (mg/d) Thiamin (mg/d) Riboflavin (mg/d) Niacin equivalent (mg/d) Pyridoxin (mg/d) Retinol Β -carotene Women Sedentary work 600 4800 1 1.1 12 2.0 Moderate 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) – 6 950 7600 +0.3 +0.4 +4 6 – 12 +0.2 +0.3 +3 Recommended Daily Allowances

9. Source: NIN guideline. Particulars Ascorbic acid (mg/d) Dietary folate (mg/d) Vitamin B 12 (mg/d) Magnesium (mg/d) Zinc (mg/d) Women Sedentary work 40 200 1 310 10 Moderate work Heavy work Pregnant women 60 500 1.2 12 Lactation (months) – 6 80 300 1.5 6 – 12 Recommended Daily Allowances

10. 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

11. 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

12. 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.

13. 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.

14. 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.

15. 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  

16. V itamin 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.

17. 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.

18. 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.

19. 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.

20. B enefits 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.

21. 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.

22. 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).

23. Thank You!!!