Nutrition requirements increases tremendously during pregnancy and lactation as the expectant or nursing mother not only has to nourish herself but also growing foetus and the infant who is being breast fed

1. -NUTRITION IN PREGNANCY AND
LACTATION-
Amal George
SBS MGU
george.oa.jr@gmail.com
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2. “Nutrition requirements increases
tremendously during pregnancy and lactation
as the expectant or nursing mother not only
has to nourish herself but also growing foetus
and the infant who is being breast fed”
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3. Pregnancy (gestation ) is a period of great physiological
stress for woman as she is nurturing a growing fetus in
her body.
Some changes occur in mother’s body which influences
the need for nutrients & the efficacy with which the
mother’s body uses the nutrients.
A. ↑Basal metabolic rate (BMR): Fetal growth & development
increases the BMR by 5% during 1st trimester and 12% during 2nd
& 3rd trimester. This increases the total energy requirement.
B. Gastrointestinal changes: There is an alteration in GI functions
which causes nausea, constipation & vomiting. In later trimester
of pregnancy absorption of nutrients like vitamin B12, iron and
calcium increases in order to meet the increased needs of the
mother & fetus.
C. Changes in body fluid: Mother’s blood volume increases so as to
carry the appropriate amount of nutrients to the fetus and
metabolic waste away from the fetus. With increase in the blood
volume the concentrations of plasma proteins, hemoglobin and
other blood constituents is lowered
Pregnancy 3

4. Importance of good nutrition during
pregnancy• Mother has to nurture the fetus, health of the newborn depends on nutritional status of the
mother during and prior to conception.
• A well nourished woman prior to conception enters pregnancy with reserve of several
nutrients that meets the needs of the growing fetus without affecting her own health.
• A well nourished woman suffers fewer complications during pregnancy & there are few
chances of premature births.
• A well nourished mother will give birth to a healthy child
• Maternal diet during pregnancy has a direct influence on fetal growth, size & health of the
newborn.
• Poor diet during pregnancy affects mother’s health, a malnourished mother provides
nutrients to the fetus at the expense of her own tissues
• Poor nutrition during pregnancy increases the risk of complications such as prolonged
labour and even death.
• Inadequate diet during pregnancy affects the health of the baby during early infancy. If the
infants survive they develop nutritional diseases like anemia, rickets etc or suffer from
infectious diseases due to lack of good immunity
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5. Importance of Nutrition in pre maternal
period & pre natal period
 During pregnancy the nutrient needs increases
 To develop maternal organs such as uterus, placenta and breast tissues
 To build up body reserves to be utilized at the time of delivery and
lactation.
 First trimester: During 1st trimester there is no significant increase in
the size of fetus thus only qualitative improvement in nutrients intake is
required during this time.
 2nd & 3rd trimester: An increased nutrient intake is suggested in
second & third trimester of pregnancy thus need for almost all the
nutrients is increased during pregnancy.
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6. Energy
requirement
during
pregnancy
To deposit fat
which will be used
during lactation.
To meet the needs
for increased
basal metabolic
rate
Development of
placenta &
maternal tissues
The growth of
fetus
Energy requirement during pregnancy
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7. Protein, Ca, and Fe requirements during pregnancy
 Growth of fetus
 Development of placenta
 Enlargement of maternal tissues
 Increased maternal blood volume
 Formation of amniotic fluid
 Protein reserves prepares the mother for labour, delivery and
lactation
Proteins
Growth and development of bones as well as teeth of the fetus.
Calcium intake decreases risk of hypertension, pre-eclampsia in
mothers and low birth weights and chronic hypertension in
new-borns.
Maintaining bone strength
Proper muscle contraction
Blood clotting
Expansion of maternal tissues including the red blood cell mass
Maintaining additional iron content of placenta
Building the iron stores in fetal liver
Compensate blood loss during delivery
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8. Vitamin requirements during pregnancy
Vitamins A (600 µg/d retinol): It is needed in small amounts to
protect the fetus from immune system problems, blindness,
infections and death.
Vitamin D (5µg/d): It is required for
formation of fetal bones.
Vitamin K: Vitamin K is required for normal coagulation of
blood & prevents new born infants hemorrhages.
Vit B12 (1.2 µg/d) : Vitamin B12 supplementation
during pregnancy helps in brain & nervous system
development of the fetus.
Vit C (60mg/d): It increase iron absorption and also helps
in fetal growth. Deficiency of vitamin C increases the
chances of preterm delivery
Vit B6 (2.5mg/d): It is required for normal
fetal development & positive pregnancy
outcomes.
Vit B1 (+0.2mg/d), B2 (+0.2 mg/d),
B3(+2mg/d): As total energy requirement
increases during pregnancy so B vitamin
requirement also increases.
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9. Vitamin & Mineral requirements during pregnancy
Folic acid (Vit B9) (RDA- 400 µg/d):
 During pregnancy maternal blood formation increases thus
folic acid requirement also increases
 Folic acid supplementation during pregnancy prevents fetal
neural tube defects and improves birth weights of the fetus.
Zinc (RDA-12mg/d) :
 It is required for synthesis of nucleic acids DNA & RNA and it
is having important role in reproduction.
 Zinc deficiency during pregnancy can cause poor pregnancy
outcomes and abnormal deliveries including congenital
malformations.
Iodine : Lack of iodine causes still birth, birth defects
& decreased fetal brain development.
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Minerals

10. Other considerations during pregnancy
 Alcohol: During pregnancy alcohol consumption causes low birth weight infants &
growth retardation, fetal impaired central & nervous system performance including
growth retardation.
 Smoking: During pregnancy smoking results in placental abnormalities & fetal
damage, including prematurely & low birth weights. Smoking impairs oxygen &
nutrient transport through the placenta due to reduced blood flow
 Drugs: During pregnancy drugs consumption lead to poor prenatal
weight gain, very short or prolonged labour, operative delivery and
other perinatal problems.
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11. Nutritional requirement during lactation
Protein requirement: During lactation protein needs also
increases as mothers milk contains 1.15g of protein/100ml.
Adequate amounts of good quality protein should be included
in the mother’s diet. During first 6 months of lactation- 75g of
protein is required everyday During 6-12 months of lactation –
68g of protein is required everyday
Calcium: 1g /d Additional calcium is required for breast milk
secretion. 30-40mg of calcium is secreted per 100ml or 300mg
of calcium per 850 ml of milk. Additional intake of calcium is
essential to enable the retention of calcium in breast milk.
Adequate dietary calcium intake during lactation meets the
mother’s calcium needs and extra calcium requirement for
breast milk production.
Iron: 30mg/d Iron requirement during lactation is the addition
of the requirement of the mother & required to make up the
iron secreted in breast milk. Most of the lactating woman have
lactation amenorrhea, resulting in saving of 1mg of iron per day
which would otherwise lost in the menstrual blood. The
requirement of iron is same as the non pregnant woman
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12. Nutritional requirement during lactation
Vitamin A (950µg/d): Breast milk is rich in vit. A so lactating
mother needs adequate amount of vitamin A in their diet.
Vitamin B6 (2.5mg/d): It’s requirement increases during
lactation.
Vitamin B12 (1.5mg/d): Additional Vitamin B12 is required to
meet the needs of the lactation.
Folic acid (150µg/d): Additional folic acid intake will meet the
needs of the lactation
Vitamin C (25mg/d): Appreciable amount of vitamin C is
secreted in breast milk. Additional intake will meet the need of
the lactation.
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13. Intrauterine growth restriction (fetal growth
restriction)
A condition in which a baby doesn't grow to normal weight during pregnancy.
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14. Gestational diabetes mellitus
Gestational diabetes is caused
by hormonal changes in
pregnancy which can change
the body’s ability to use a
substance called insulin. Insulin
is important because it helps
keep blood sugar at a healthy
level. Whilst all women
undergo hormonal changes,
only some women develop
gestational diabetes. This is
likely due to pregnancy related
factors such as the presence of
human placental lactogen that
interferes with susceptible
insulin receptors
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15. Congenital malformations
Atrial septal defect (ASD)
A birth defect that causes a
hole in the wall between
the heart's upper chambers
(atria).
Ventricular septal defect (VSD)
A heart defect due to an
abnormal connection between
the lower chambers of the
heart (ventricles).
Neural tube defects (NTD) are birth
defects of the brain, spine, or spinal
cord. The two most common neural
tube defects are spina bifida and
anencephaly
Caudal regression syndrome (CRS), or
sacral agenesis (or hypoplasia of the
sacrum), is a congenital disorder in
which there is abnormal fetal
development of the lower spine—the
caudal partition of the spine
Polycystic kidney disease (PKD) is an
inherited disorder in which clusters of
cysts develop primarily within your
kidneys, causing your kidneys to enlarge
and lose function over time.
Renal agenesis is a condition in which a newborn is missing one
or both kidneys. Unilateral renal agenesis (URA) is the absence
of one kidney. Bilateral renal agenesis (BRA) is the absence of
both kidneys.
Duodenal atresia is the congenital
absence or complete closure of a portion
of the lumen of the duodenum. It causes
increased levels of amniotic fluid during
pregnancy (polyhydramnios) and intestinal
obstruction in newborn babies.
1st TRIMESTER
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16. Congenital
malformations
1.The term "fetal macrosomia“ is
used to describe a newborn who's
significantly larger than average. A
baby diagnosed with fetal
macrosomia has a birth weight of
more than 8 pounds, 13 ounces
(4,000 grams), regardless of his or
her gestational age
1.Perinatal asphyxia, neonatal asphyxia or birth asphyxia is
the medical condition resulting from deprivation of oxygen to a
newborn infant that lasts long enough during the birth process
to cause physical harm, usually to the brain.
2.Shoulder dystocia is a specific case
of obstructed labour whereby after
the delivery of the head, the anterior
shoulder of the infant cannot pass
below, or requires significant
manipulation to pass below, the pubic
symphysis. It is diagnosed when the
shoulders fail to deliver shortly after
the fetal head
2nd TRIMESTER
Delivery
After Delivery
1.Respiratory distress syndrome (RDS)
is a common problem in premature
babies. It causes babies to need extra
oxygen and help with breathing
2.Neonatal jaundice is a yellowish discoloration of the white
part of the eyes and skin in a newborn baby due to high
bilirubin levels
3. Neonatal polycythemia defined as a
venous hematocrit ≥65% (0.65)
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17. Thankyou..!
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18. guys wake wake up, its
over….!!