Course: Post basic Midwifery program.

Module three, unit five

Topic: Nutritional requirements of the

mother in pregnancy and lactation

Tutor: Sister Tacourdeen Prince.

Group members: Shantrise
wright Malika courtman
Candacy Wilson
Objectives

Introduction

Definition of terms

Identify the six basic meal/food groups

Identify the main nutrients found in each food group

Review the components of a balanced diet

Describe the principles of nutrition in relation to midwifery

Food the pregnant woman should avoid

Conclusion

References
Introduction

Ensuring women have nutritious diet and adequate services and care is fundamental for the
survival and well-being of mothers and their children.

Before pregnancy, women need nutritious and safe diet to establish sufficient reserves for
pregnancy. During pregnancy and breastfeeding, energy nutrient needs increase. Meeting them is
critical for women’s health and that of their child in the womb and throughout early childhood.
Definition of terms

 Nutrition

This is the process or science of food and how it is obtained, prepared, absorbed and converted
by the body for its development, sustainability and maintenance.

 Nutrients

These are substances in the food that the body needs for energy, functioning, growth and
maintenance

 Food

Anything that nourishes or stimulate something to grow and stay alive or active.

 Diet

Diet is food that contains nutrients the body may need for development and growth. It can be:

Balanced Diet: this is a diet that contains all the nutrients, in the appropriate amount that the
body need.

Unbalanced diet: contains too little or too much of one or more nutrients the body need.

 Dietetics

Is the application of the principles of nutrition, it includes the planning of meals for the well and
sick.

 Dietitian

This is a certified individual who uses the science of nutrition to treat medical conditions. They
promote good health by helping to facilitate a positive change in food choices.

 Nutritionist

Nutritionist is person who gives advice on food and its importance and disadvantages. A
nutritionist may not always be certified.

 Body Mass Index (BMI) or Quetelet

This is a reflection of weight for height. It is calculated by dividing the weight in kilograms (kg)
by the height in meter square M2. The BMI desirable weight ranges between 18.5-24.9.

 Lactation

Lactation is the secretion of milk from the breast.

Food groups in our country

Like many other countries Guyana was tasked with implementing its guide to healthy meals. In
2004 the first set of food based dietary guidelines was launched and was revised in 2015. The
revised version was officially launched in 2018.

The guide chosen by Guyana to represent its guidelines is a, ’stew pot’, representing the
country’s six food groups. These groups are;

 Staple

Staples is Guyana main food source, it includes; cereals; bread (from whole grain or enriched
flour ) corn meal, macaroni ,spagatt, chowmein and rice (brown or white).

Starchy fruits, roots tubers and their product: banana plantain, breadfruit,yam,irish potatoes ,
sweet potatoes, dasheen, coco/cassava.

 Legumes Nuts and seeds

Staples are followed by legumes nuts and seeds; sources of these include: Red peas, pigeon peas,
black eye peas, peanuts and other dried beans and nuts.

 Dark green leafy, yellow vegetables

Also known as green leafy vegetables or greens are plants we consume. Some can be eaten raw
while others may require cooking. These include: spinach, bora , cabbage ,callaloo, lettuce ,
pakchoi, broccoli.

Yellow vegetables: these include: pumpkin, corn, carrot , yellow pepper

 Fruits

These are the edible product of plants.

These include : Mangoes, bananas, apples , passion fruit, papaya, cherry ,oranges, grapes ,
tangerine , pear, coconut, cucumber , guava , pineapples ,five fingers , watermelon, star apples
guinnip and grapefruits.

 Foods from Animals

As the name suggests food sources are mainly animals and animal products. some sources are:
lean meat, fish , poultry , eggs , cheese ,milk (Fresh, evaporated ,skimmed or
powdered ) ,yogurt, ham sardine , liver ,heart, tripe, bacon and mince
  Fats and oils

This is the sixth food group. This food source can be produced from plants as well as animals.
These include: Polyunsaturated fats: vegetable oils (except coconut oil).

Saturated: butter, margarine, bacon, salt pork, coconut oil, fat on meat and fat in whole milk.

Nutrients found in each food groups

Nutrients can be identified as: Macro nutrients; are nutrients needed in large quantity, which the
body need for energy and maintenance or micro nutrients; which the body requires in smaller
amount, however both nutrients are equally imperative for the body’s function and sustainability.

Each food group contains specific nutrients our body requires in order to function. Knowing your
food groups and its nutrients can help you to plan and execute a balanced meal/diet.

The table below are illustrates the food group with some of the main nutrients found in each;

FOOD GROUP Nutrients

Staples
Carbohydrates, B vitamins, vitamin E ,
minerals and fiber.

Legumes nuts and seeds

Protein, carbohydrates , the minerals calcium
and iron and fiber.

Dark green leafy, yellow vegetables Vitamin A, C , B complex vitamins, minerals

and fiber
Fruits Carbohydrates, Vitamin C , Vitamin A, B
complex vitamins, minerals and fiber.
Food from animals Protein, carbohydrates , B complex
vitamins( thiamine and riboflavin) , fat soluble
vitamins , fat , iron, haeme iron , calcium,
vitamin A and D .
Fats and oils Fats, fat soluble vitamins ( A, D ,E and K)
Components of a balanced diet

Components of a balanced diet are the elements that make up a healthy diet. These include
Carbohydrates, protein, fat, fiber, vitamins minerals and water, all which can be found in the six
food groups .

A normal healthy diet plate should have;

Half of your plate with vegetables and fruits

Quarter with carbohydrates

Quarter of your plate with meat or meat substitutes

Principles of nutrition in relation to midwifery

The woman’s health status, lifestyle and history prior to conception and post conception
influence the pregnancy outcome. Nutritional intake is an indicator for antenatal clinic: whether
healthy, unhealthy or high risked.

Guidelines governing nutrition in relation to midwifery are:

 Eat more starchy foods

Rich sources of carbohydrates including whole grains, cereals, bread ,legumes and starchy
vegetables such as sweet potatoes and squash.

 Increase portion of vegetables

Increase to five portion sizes per day. Choose large portions of a variety of non-starchy
vegetables such as leafy greens, broccoli, carrots, tomatoes and cabbage.

Increase your portion of fruits

Choose a variety of whole fruits, limiting juice and dried fruits .Increase portion size to 5 serving
per day.

 Consume less fat

Choose foods that are low in fat and easily digested. Aim for 2 to 3 serving of nonfat or 1 percent
milk or yogurt (unsweetened or slightly sweetened).

 Adjust choices of protein sources

Choose protein sources like poultry, beans, nuts,eggs, tafu, and cheese . Aim for 8-12 ounces of
low-mercury seafood each week.

 Reduce sodium/salt intake

Low sodium intake in pregnancy can aid in promoting healthy blood pressure levels decreasing
risks of gestational hypertension.

 Reduce sugar intake

High sugar consumption during pregnancy may contribute to increased excessive gestational
weight gain and possible development of pregnancy complications such as gestational
diabetes,preeclampsia and preterm birth.

 Consume mostly water or tea

This help to keep the body hydrated aiding in prevention of constipation.

Postnatal

 Consume high protein diet Eating a high protein diet helps to maintain muscle mass while
providing nutrients for the newborn. Protein also plays an important role in synthesis of
milk protein and increases the production of milk protein and milk. Protein intake should
increase to 65 -71g per day.
 Consume a high calorie diet

Breastfeeding requires more calories, calories intake increase to 500- 600 per day

to supply the mother and the newborn. Calorie intake increases your milk supply.

Nutritional requirement of the pregnant woman

Nutrient RDA / AI non RDA/AI Pregnant Importance

pregnant Adult women
women
Vitamin A 700mcg 770mcg Forms healthy skin
and eyesight : helps
with bone growth
Vitamin B 6 1.3mg 1.9mg Helps with red blood
cells; helps the body
metabolize
macronutrients.
Vitamin B12 2.4mcg 2.6mcg Maintains nervous
system; helps form
red blood cells
Vitamin C 75mg 85mg Promotes healthy
gums , teeth and
bones
Vitamin D 600IU 600IU Builds fetal bones and
teeth;promotes
healthy eyesight and
skin
Folate 400mcg 600mcg Helps prevent neural
tube defects ; supports
growth and
development of fetus
and placenta
Calcium 1000mg 1000mg Builds strong bone
and teeth
Iron 18mg 27mg Helps red blood cells
delver oxygen to fetus
Iodine 150mcg 220mcg Essential for healthy
brain development
Choline 425mg 450mg Important for
development of fetal
brain and
development
Foods the pregnant woman should avoid

If you are pregnant, it is best to avoid the use of;

1 Foods containing high levels of mercury

Foods as, shark, sword fish and marlin. This can be harmful to the neurological development of
the fetus.

2 Excessive Intake of vitamin A.

A high intake of retinol form of vitamin A is known to be teratogenic. A high intake of vitamin
A produces an increased frequency of craniofacial and heart defects among women who
consumed high level before the 7th week of pregnancy. Retinol comes from animal and plant
sources with higher concentration in animal sources such as meat and poultry; the highest being
in calf liver, therefore women are asked to avoid eating liver, liver products, or supplements
including fish liver oils containing retinol during pregnancy.

3 Foods which contains listeria.

Listeria monocytogenes is a bacterium that can cause spontaneous abortion, preterm labour or
stillbirth. Although the incident during pregnancy is rare , pregnant women should be advised to
avoid eating mould-ripened cheese such as brie or camembert, blue veined cheese or pate and to
ensure that meat or reheated food are thoroughly cooked .
Conclusion

In conclusion, healthy eating habits are essential for pregnancy and lactation. The nutritional
needs of women increase during pregnancy to supply the fetus with sufficient nutrients for
growth and development and prepare the body for delivery and breastfeeding. A healthy diet
paves way for a nutritionally healthy pregnancy and delivery.
References

 Marshall, Jayne E., Raynor, Maureen D., Myles, Margaret F. (2003). Myles textbook for
midwives (14th). Oxford; Malden, MA: Churchill Livingstone

 Diane M . Fraser , Margret A Cooper , Myles textbook for midwives (15th edition),evolve
learning system, Churchill Livingstone Elsevier.

 Denise Tiran, Baillieres Midwives Dictionary

 Eatwell guide annex 2 Pdf

 Eatwell guide boolet 2018v4.pdf

https://www.fao.org