BATAAN PENINSULA STATE UNIVERSITY

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College of Nursing and Midwifery

NUTRITION ACROSS LIFESPAN  Achieve and maintain a healthy weight before

becoming pregnant.
NUTRITION IN PREGNANCY AND LACTATION  Do not drink alcohol because alcohol can cause
PREPREGNANCY NUTRITION negative behavioral or neurologic effect to the baby.
Women of Childbearing Age Who May Become Pregnant VITAL NUTRIENTS FOR A PREGNANT WOMAN
 Choose foods that supply heme iron.  Folic Acid
 Consume 400 micrograms (ug) per day of synthetic  Omega 3
folic acid (from fortified foods forms of folate  B complex
 U.S. Department of Health and Human Services  Protein
[USDHHS], 2010), and March of Dimes (MOD, 2012)  Vitamin C
are among the many experts who recommend that  Fiber
synthetic folic acid be consumed prior to conception to  Iron
prevent neural tube defects.  Antioxidants
 Because neural tube defects originate in the first  Calcium
month of pregnancy before a woman may even know  Selenium
she is pregnant, all women of childbearing age who  Zinc
are capable of becoming pregnant.  Nutrition requirements increases tremendously during
 Sources of naturally occurring folate pregnancy and lactation as the expectant or nursing
 Leafy green vegetables, such as spinach mother not only has to nourish herself but also the
 Citrus fruits growing fetus and the infant being breastfed.
 Dried peas and beans, such as lentils,  Pregnancy is a period of great physiological stress for
 soybeans, pinto beans a woman as she is nurturing a growing fetus in her
FOLIC ACID synthetic form of folate found in body.
multivitamins, fortified breakfast cereals,  Some changes occur in mother’s body which
and enriched grain products. influences the need for nutrients and the efficacy with
FOLATE natural form of the B vitamin involved in which the mother’s body uses the nutrients.
the synthesis of DNA; only one-half is
available to the body as synthetic folic
acid.
HEME IRON Heme is found only in animal flesh like
meat, poultry, and seafood.
NON-HEME IRON found in plant foods like whole grains,
nuts, seeds, legumes, and leafy greens.
NEUTRAL TUBE a serious central nervous system birth
DEFECT defect, such as anencephaly (absence of
a brain) and spina bifida (incomplete
closure of the spinal cord and its bony
encasement)

fetal growth and development increases

the BMR by 5% during the 1st trimester
BASIC METABOLIC 12% during the 2nd and 3rd trimester,
RATE (BMR) thus increases the total energy
requirement.
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There is an alteration in GI function c) Calcium

which causes nausea, vomiting, and d) Magnesium
GI CHANGES constipation. e) Vitamin B (Folate)
In later trimester of pregnancy f) Omega 3, fatty acid
absorption of nutrients like vitamin B12, OPTIMAL WEIGHT GAIN DURING PREGNANCY
iron, and calcium increases in order to BMI before Ideal Weight Rate of Weight Gain
meet the nutritional needs of mother pregnancy Gain after 1st Trimester
and fetus Under weight 12.5 – 18 kg 0.5 kg/week
Mother’s blood volume increases so as (BMI <18.5)
to carry the appropriate amount of Normal 11.5 -16 kg 0.4 kg/week
CHANGES IN BODY nutrients to the fetus and metabolic (BMI 18.5 – 24.9)
FLUIDS waste away from the fetus. With Over weight 7 – 11.5 kg 0.3 kg/week
increase in the volume the (BMI 25 – 29.9)
concentrations of plasma proteins, Obesity <7 kg 0.3 kg/week
hemoglobin, and other blood (BMI > 30)
constituents is lowered.
IMPORTANCE OF GOOD NUTRITION IN PREGNANCY
1. Mother has to nurture the fetus, health of the newborn
depends on nutritional status of the mother during and
prior to conception.
2. A well nourished woman prior to conception enters to
pregnancy with reserve of several nutrients that meets
that needs of the growing fetus without affecting her own
health.
3. A well nourished woman suffer fewer complications, and
few chances of premature births. REQUIREMENT DURING PREGNANCY
4. A well nourished mother will give birth to a healthy child.
During pregnancy additional energy is required to support
5. Maternal diet during pregnancy has a direct influence on
The growth of fetus,
fetal growth, size and health of the newborn.
Development of placenta & maternal tissues
6. Poor diet affects mother’s health, a malnourished mother
To meet the needs for increased basal metabolic rate
provides nutrients to the fetus at the expense of her own
To deposit fat which will be used during lactation
tissue
Additional 300 kcal of energy is required during 2nd &
7. Poor nutrition increases the risk of complications such as
3rd trimester of pregnancy
prolonged labor and death
8. Inadequate diet affect the health of the baby during early Group Energy Requirement (kcal)
infancy (anemia, rickets, etc. due to lack of good Sedentary worker 1875+300=2175
immunity) Moderate worker 2225+300=2525
a time of rapid cell division, organ Heavy worker 2925+300=3225
development, and preparation for the During pregnancy additional calcium is needed for
demands of rapid fetal growth that Growth and development of bones as well as teeth of
occur during second and third trimester the fetus
no significant increase in the size of the Calcium intake decreases risk of hypertension, pre-
fetus thus only qualitative improvement clampsia in mothers and low birth weights and chronic
hypertension in newborns
FIRST TRIMESTER in nutrients intake is required during this Maintaining bone strength
time.
Critical nutrition during this phase Proper muscle contraction
a) Protein Blood clotting
b) Folic Acid If calcium intake is inadequate during pregnancy then
c) Vitamin B12 calcium is mobilized from maternal bones to meet fetal
d) Zinc calcium needs and this demineralization of maternal
an increase nutrient intake is suggested. bones leading to easy fractures.
Energy intake is equally important since Recommended Daily Allowance (RDA) for calcium
SECOND AND during pregnancy is 1g.
90% of fetal growth occurs during the
THIRD TRIMESTER last half of gestation. During pregnancy iron is essential for
Critical nutrition during this phase. Fetal growth
a) Protein Expansion of maternal tissues including the red blood
b) Iron cell mass
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Maintaining additional iron content of placenta a) sushi, sashimi, , uncooked fish

Building the iron stores in fetal liver 3. Red meat and chicken
Compensate blood loss during delivery a) all meet and chicken thoroughly cooked or well
Group Pre-
pregnancy
Basal
µ/kg
Iron Requirement done
Growt Total Total Dietary iron
body h µ/kg µ/kg mg/d requirement on 4. Deli foods
weight
(kg)
mixed cereal diet
(mg/d)
a) high risk for listeria, has the ability to cross the
Pregnant 50 14 46 60 3000 37.5 placenta and may infect the baby leading to
woman infection or blood poisoning which maybe life
PROTEIN AND FAT REQUIREMENTS DURING PREGNANCY threatening
During pregnancy additional protein is required for b) processed and sliced meats (salami, smoked
Growth of fetus meats), and any foods served from open
Development of placenta containers (cheeses, olives, salads)
Enlargement of maternal tissue 5. Fruits and vegetables
Increased maternal blood volume a) washed thoroughly before eating
Formation of amniotic fluid b) do not use any that have gone moldy
Protein reserves prepares the mother for labour, 6. Soft serve ice cream and yogurts
delivery and lactation a) there is a list of listeria
Additional 15g of protein is required 2nd & 3rd 7. Eggs and mayonnaise
trimester of pregnancy a) raw egg can contain salmonella, make sure all
Good quality protein rich foods should be eaten during eggs are cooked
pregnancy b) avoid sauces and Caesar dressing
Fat (Omega 3 fatty acid) requirement during pregnancy c) avoid fresh mayonnaise as it could contain raw
Omega 3 fatty acid (DHA):300mg/d eggs
Omega 3 fatty acid like DHA (Docosahexaenoic acid) 8. Peanuts
supplementation during pregnancy is essential for a) to reduce chance of allergy
brain development and prevents preterm births 9. Eating out
It is required for fetal visual development a) eat food that is served steaming hot
It reduces the incidence of heart diseases and heart b) avoid prepared salad (salad bars)
disease related deaths in infants c) check your burger patties if thoroughly cooked
10. Food additives (artificial sweeteners, MSG- can cause
MINERALS REQUIREMENT DURING PREGNANCY headache and stomach upset )
During pregnancy, maternal blood 11. Water – drink purified, filtered, bottled water
Folic Acid formation increases thus folic acid 12. Alcohol – can caused detrimental effects on the unborn
(RDA-400µ/d) increases baby
Folic acid supplementation during
pregnancy prevents fetal neural tube IMPORTANCE OF NUTRITION DURING LACTATION
defects and improves birth weights of the 1. During lactation adequate nutrition is required as infant
fetus. derives all its nutrition from the mother’s milk
It is required for synthesis of nucleic 2. Mother needs extra nutrition as she has to nourish a fully
acids DNA & RNA and it is having developed & rapidly growing infant. She needs extra
Zinc nutrient to meet baby’s needs in addition to her own
(RDA-12mg/d) important role in reproduction
Zinc deficiency during pregnancy can requirements
cause poor pregnancy outcomes and 3. Any inadequacy in mothers diet influence both the
abnormal deliveries including congenital quality & quantity of mother’s milk increased
malformations. 4. If mother’s diet is inadequate then she will draw her own
lack of iodine causes still birth, birth body reserves to meet the needs of lactation at the cost
defects & decreased fetal brain of her own health
Iodine 5. Nutrient deficiency can lead to lower levels of nutrients in
development.
the mother’s milk
FOODS TO AVOID
1. Fish and seafoods with metals, mercury ENERGY REQUIREMENT
a) shark, ray, swordfish, barramundi, germ fish, 1. Lactating mothers need additional energy for production
bluefin tuna of milk
b) eat other type of fish twice a week to obtain 2. During pregnancy approximately 600-850 ml milk is
nutritional benefits secreted daily.
c) avoid all types of shellfish, prawns and smoked 3. Energy content of mother’s milk and efficacy of
fish conversion of food energy into milk energy determines
2. Raw and seared fish the energy requirement of a lactating woman
4. During first 6 months of lactation- additional 550kcal/d
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 BATAAN PENINSULA STATE UNIVERSITY
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College of Nursing and Midwifery

energy is required
5. During 6-12 months of lactation- additional 400kcal/d
energy is required
PROTEIN REQUIREMENT
1. During lactation protein needs also increases as mothers
milk contains 1.15g of protein/100ml
2. For proper milk production, adequate amounts of good
quality protein or good quality protein should be included
in the mother’s diet
3. During first 6 months of lactation- 75g of protein is
required everyday
4. During 6-12 months of lactation- 68g of protein is
required everyday
CALCIUM:1g/d
1. Additional calcium is required for breast milk secretion.
30-40mg of calcium is secreted per 100ml or 300mg of
calcium per 850ml of milk
2. Additional intake of calcium is essential to enable the
retention of calcium in breast milk.
3. Adequate dietary calcium intake during lactation meets
the mother’s calcium needs and extra calcium
requirement for breast milk production.
IRON: 30mg/d
1. Iron requirement during lactation is the addition of the
requirement of the mother & required to make up the iron
secreted in breast milk.
2. Most of the lactating woman have lactation amenorrhea,
resulting in saving 1mg of iron per day which would
otherwise lost in the menstrual blood
3. The requirement of iron is same as the non-pregnant
woman
DIET AND FEEDING PATTERNS
1. Lactating mother requires larger quantities of body
building and protective and protective foods to facilitate
the formation and secretion of breast milk
2. Fluid intake should be increased as fluids are essential
for adequate quantity of milk production.
3. No foods should be restricted except highly spiced and
strongly flavored foods, as they impart flavor to milk
which may be repulsive to baby
4. To enhance nutrients, lactating mother should have 5-6
meals in a day.
COMPARISON OF NUTRINT REQUIREMENTS IN PREGNANCY AND LACTATIONS
NUTRIENT NORMAL RECOMMENDED RECOMMENDED
RECOMMENDED INTAKE DURING INTAKE DURING
INTAKE PREGNANCY LACTATION
Energy 2,000 2,450 2,500
(kcal)
Protein 46 71 71
(g)
Vitamin A 700 770 1,300
(µg)
Iron (mg) 18 27 9
Folic 400 600 500
Acid (µg)
Iodine 150 220 290
(µg)
Zinc (mg) 8 11 12

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