Nutrition in Pregnancy
Nutrition in pregnancy can affect maternal health and
infant size and well-being. Pregnant women should have nutrition counseling
early in prenatal care and access to supplementary food programs if necessary.
Counseling should stress abstention from alcohol, smoking, and recreational
drugs. Caffeine and artificial sweeteners should be used only in small amounts.
"Empty calories" should be avoided, and the diet should contain the following
foods: protein foods of animal and vegetable origin, milk and milk products,
whole-grain cereals and breads, and fruits and vegetables—especially green leafy
vegetables.
Weight gain in pregnancy should be 20–40 lb, which includes
the added weight of the fetus, placenta, and amniotic fluid and of maternal
reproductive tissues, fluid, blood, increased fat stores, and increased lean
body mass. Maternal fat stores are a caloric reserve for pregnancy and
lactation; weight restriction in pregnancy to avoid developing such fat stores
may affect the development of other fetal and maternal tissues and is not
advisable. Obese women can have normal infants with less weight gain (15–20 lb)
but should be encouraged to eat high-quality foods. Normally, a pregnant woman
gains 2–5 lb in the first trimester and slightly less than 1 lb/wk thereafter.
She needs approximately an extra 200–300 kcal/d (depending on energy output) and
30 g/d of additional protein for a total protein intake of about 75 g/d.
Appropriate caloric intake in pregnancy helps prevent the problems associated
with low birth weight.
Rigid salt restriction is not necessary. While consumption
of highly salted snack foods and prepared foods is not desirable, 2–3 g/d of
sodium is permissible. The increased calcium needs of pregnancy (1200 mg/d) can
be met with milk, milk products, green vegetables, soybean products, corn
tortillas, and calcium carbonate supplements.
The increased need for iron and folic acid should be met
from foods as well as vitamin and mineral supplements. (See section on anemia in
pregnancy.) Megavitamins should not be taken in pregnancy, as they may result in
fetal malformation or disturbed metabolism. However, a balanced prenatal
supplement containing 30–60 mg of elemental iron, 0.5–0.8 mg of folate, and the
recommended daily allowances of various vitamins and minerals is widely used in
the United States and is probably beneficial to many women with marginal diets.
There is evidence that periconceptional folic acid supplements can decrease the
risk of neural tube defects in the fetus. For this reason, the United States
Public Health Service recommends the consumption of 0.4 mg of folic acid per day
for all pregnant and reproductive age women. Women with a prior pregnancy
complicated by neural tube defect may require higher supplemental doses as
determined by their providers. Lactovegetarians and ovolactovegetarians do well
in pregnancy; vegetarian women who eat neither eggs nor milk products should
have their diets assessed for adequate calories and protein and should take oral
vitamin B12 supplements during pregnancy and lactation.
Resources:
Current Medical Diagnosis &
Treatment 2008
Stephen J. McPhee, Maxine A. Papadakis, and Lawrence M.
Tierney, Jr., Eds.
Ralph Gonzales, Roni Zeiger, Online Eds.
- See more at: http://medicalinfo4me.blogspot.com/2015/05/diagnosis-of-pregnancy.html#sthash.BXoPdnnj.dpufRalph Gonzales, Roni Zeiger, Online Eds.