Nutrition during pregnancy and lactation

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Nutrition during pregnancy and lactation
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Nutrition and Pregnancy

• What aspects of diet are particularly important
  during pregnancy?
• The need for some nutrients increases during
  pregnancy, but the increase in requirement for
  dietary energy is small in most women,
  particularly early on in pregnancy.
• Adequate attention to food hygiene is
  particularly important for pregnant women.

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• What is considered a normal weight gain (and
  energy intake)?

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• What about smoking?
• Women should be discouraged from smoking before
  and during pregnancy, because it is associated
  with decreased fertility and lower birthweight.
• If women are unable to comply with this advice,
  special attention should be paid to their overall
  nutrient intake, especially that of vitamin C, in
  order to help counteract the harmful effects of
  smoking on the fetus.

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• What about caffeine?
• Claims that consumption of caffeinated beverages
  is associated with reduced fertility and defects
  in fetal development have not been substantiated.
  Whilst moderate intakes (up to four or five cups
  of instant coffee a day) are unlikely to be
  harmful for most pregnant women.
• those at high risk of miscarriage should reduce
  their intake to one or two cups per day.
• Cola and tea also contain caffeine and their
  consumption should be taken into account.

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• Are there any particular recommendations for
  women with a history of allergic disease?
• Babies whose parents have a history of allergic
  disease are more likely to go on to develop
  allergy themselves. It has been suggested that
  sensitisation to foreign proteins that cross the
  placenta (or reach the infant via breast milk)
  may occur in such babies.

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• Some women experience constipation or
  haemorrhoids when they are pregnant. Can diet
  help?
• These conditions are common during pregnancy.
  Practical advice to pregnant women should be to
  increase intake of fibre, by increasing intake of
  complex (starchy) carbohydrate, particularly
  wholegrain cereals and breads .
• An adequate fluid intake is also important, along
  with gentle exercise.

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• Nausea and vomiting are common in early
  pregnancy. Can diet help?
• Morning sickness, nausea and vomiting occur in
  around half to threequarters of pregnant women
  during the first trimester.
• Consumption of small, frequent meals can help if
  these symptoms are experienced.
• Plenty of carbohydrate foods should be encouraged
  and plenty of fluids.
• A warm drink and a dry biscuit or dry toast may
  also be helpful.

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• What is toxoplasmosis?
• Toxoplasmosis is caused by a parasite found in
  raw meat, cat faeces and occasionally in
  unpasteurised goats milk.
• In rare cases, the infection can be passed on to
  an unborn baby and cause eye and brain damage.
• A high regard for food hygiene is therefore very
  important for pregnant women .
• In particular, they should avoid eating raw or
  uncooked meat, unpasteurised goats milk or
  goats cheese, or unwashed fruit and vegetables.
• After handling raw meat, chopping boards,
  utensils and hands should be washed thoroughly.
• When gardening or emptying cat litter trays,
  rubber gloves should always be worn.

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Nutrition and Lactation

• Which aspects of diet are particularly important
  for women who are breast-feeding?
• It has been calculated that breast-feeding
  carries a daily energy cost of 650 kcal.
• However, some of this is obtained by using up fat
  stored during pregnancy for this purpose.
• Consequently, women who exclusively breast-feed
  for 34 months need an extra 500 kcal/day, on
  average, which corresponds to an average milk
  output of 750 ml/day.
• Assuming that this extra energy is obtained via
  consumption of a balanced and varied diet, the
  additional needs for essential vitamins and
  minerals will also be met.
• Additional requirements for calcium are
  particularly high

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• What is colostrum and how does the composition of
  milk change, both during a feed and as the baby
  grows?
• Colostrum is the first milk produced after the
  baby is born.
• It is of a different composition to the milk
  that follows and is particularly rich in
  protective factors and growth factors.
• As well as changing in composition over time,
  breast milk also changes in composition during a
  feed.
• The milk available at the start of a feed is
  richer in nutrients and energy.

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• Should women who are breast-feeding avoid any
  particular foods?
• Some women report that, after they have consumed
  certain foods, e.g. spicy foods or onions, their
  babies experience abdominal discomfort.
• If this occurs, such foods should perhaps be
  avoided, provided omission of the trigger foods
  does not result in an unbalanced diet.
• Non-nutritive substances such as caffeine,
  nicotine and other amines and alkaloids can pass
  into breast milk, and heavy consumption of
  coffee, tea and cola drinks has been reported to
  cause restlessness in some infants.
• With regard o the prevention of allergy or other
  food intolerance in the baby, the benefits of
  mothers avoiding specific foods during pregnancy
  and lactation are not proven.
• Furthermore, exposure via the mother may be an
  important factor in establishing a normal immune
  response to proteins in the diet.
• Avoidance of foods associated with allergic
  reactions, e.g. milk, eggs or nuts, should be
  seriously considered only when there is a strong
  family history of atopy.

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• Is fluid intake important?
• An adequate fluid intake is crucial postpartum
  for establishing breast-feeding and remains
  important throughout, given that, by 23 months
  of age, a baby may be taking as much as 820 ml of
  milk a day.
• The best guide to requirement is thirst, and
  forced drinking of extra fluid will not increase
  milk quality or quantity.