DIET FOR VULNERABLE GROUPS pregnancy lactation.pptx

Diet for pregnant women
Nutrition- Unit II
Diet for vulnerable groups

DIET FOR PREGNANT AND LACTATING
WOMEN
• Pregnancy is physiologically and nutritionally, a
highly demanding period.
• Extra food is required to meet the nutritional
requirements of the mother and development
of fetus as well as for healthy pregnancy
outcome.
• Regular physical activity and exposure to
sunlight are important for appropriate
utilization of nutrients and for vitamin D.

• Special focus should be given for certain nutrients such as
iron, folic acid, B12, iodine and long chain n-3 poly
unsaturated fatty acids (LCn-3PUFAs).
• Iron and folic acid supplements must be taken.
• Iodine is not an issue now as iodine fortified salt is
available.
• B12 can be sourced from yoghurt or curd and flesh foods.
• Fatty fish is a good source of LCn-3PUFA.
• Vegetarian can get their LCn-3PUFA from green leafy
vegetables, seeds and nuts.

Why additional nutrients are required during
pregnancy and lactation and what is 1000 days
nutrition?
• The first 1000 days includes the period from
women's conception to birth of the child (270
days) and from birth to her child's 2nd birthday
(365+365 days).
• The first 1000 days is a crucial period that
shapes the child's future.
• During this period, the embryo in the mother's
womb is growing very rapidly and draws
nutrition from the mother.

• For this, the mother at the start of pregnancy, should
be healthy and well-nourished.
• To provide the required vitamins, minerals, fatty
acids, amino acids and energy in adequate amounts
to maintain her own health, and for nourishing the
developing immune system, brain and other organs of
the fetus in addition to the child's growth.
• Poor nutritional status of pregnant women and
inadequate diet can have adverse impact on the
growth and development of the fetus.

• Undernourished women are at a higher risk of
giving birth to small for gestational age (SGA)/low
birth weight (LBW=<2.5kg birth weight) babies,
and/or may deliver preterm (PT).
• SGA/LBW babies are at a higher risk of childhood
infections and short stature (stunting: low height
for age), and as adults they are at higher risk of
metabolic diseases such as diabetes, hypertension,
cardiovascular diseases (CVD-heart attack, stroke,
etc.).

• Pregnant women receiving a balanced diet,
and who gain appropriate weight during
pregnancy (10 to 12 kg).
• After birth, the diet /nutrition of infants,
especially for the first two years, is also very
important as most organs including brain are
still developing.

How much weight gain is recommended
during pregnancy?
• If BMI of a pregnant woman is normal (BMI 18.5–23
kg/m2
) at the time of conception, one should aim to
gain at least 10–12 kg.
• All underweight women (BMI <18.5 kg/m2
) should
increase the dietary intake and their weight gain
should be monitored closely at ICDS or healthcare
facilities.
• Women who are overweight (BMI 23–27.5 kg/m2
)
and those who are obese (BMI >27.5 kg/m2
) should
aim to gain not more than 5 g–9 kg.

Important nutrition tips for pregnant and
lactating women
• Eat more food during pregnancy.
• Eat more whole grains, sprouted grams and fermented foods.
• Take milk/meat/eggs in adequate amounts.
• Eat plenty of vegetables and fruits.
• Avoid superstitions and food taboos.
• Do not use alcohol and tobacco.
• Take medicines only when prescribed.
• Take iron, folate and calcium supplements regularly, after 14-
16 weeks of pregnancy and continue the same during
lactation

Nutrients that require special attention
during pregnancy and lactation period
• The daily diet of a pregnant woman of normal weight for
height should contain an additional 350 calories of energy
from second to third trimester.
• An additional 8g of protein is required during second
trimester and 18g during the third trimester of
pregnancy.
• Folic acid, taken in the pre-pregnancy and the first 28 days
of pregnancy reduces the risk of anemia.
• A mother as well as the growing fetus need additional iron
as well as folic acid to meet the high demands of
erythropoiesis (red blood cell formation).

• Calcium and vitamin D are essential (during
pregnancy and lactation) for proper formation
of bones and teeth of the offspring, for
secretion of breast milk that is rich in these
nutrients and to prevent osteoporosis in the
mother.

• In addition to LCn-3PUFA, adequate intake of
folate-rich foods and iodine intake through
use of iodized salt are essential for proper
growth of brain of the growing fetus and
during early period of infancy.
• Vitamin A rich food is required during
pregnancy and lactation to improve child
growth and development

What additional care is required during
pregnancy and lactation?
• Dietary care : It is advised to consume plenty of fluids
(over 2 litres per day). This amount of fluid includes water
and other beverages.
• Excess intake of beverages containing caffeine like coffee
and tea adversely affect fetal growth and hence should be
minimized.
• The expectant mother should choose foods rich in fibre
(around 25g/1000 Kcal) like whole grain cereals, pulses and
vegetables.
• Intake of these fibre containing foods and enough fluids
prevents constipation.

• Food safety : The most important food safety
problem is microbial food-borne illness.
Avoiding contaminated foods is an important
protective measure against food-borne illness.
Extra care needs to be exercised to avoid
food-borne illness by following food safety
practices.

• Health care: In addition to satisfying dietary requirements, a
pregnant woman should undergo a minimum of four antenatal
checkups (ANC) for monitoring weight gain, blood pressure,
testing for haemoglobin levels for prevention and treatment of
anemia and immunization with tetanus toxoid.
• She requires enough physical exercise with adequate day time
rest of 2–3hrs.
• Pregnant and lactating women should not indiscriminately take
any drugs without medical advice, as some of these could be
harmful to the fetus/baby.
• Smoking, chewing tobacco and consumption of alcohol should
be avoided.

Additional nutrition required during
lactation
• During the first six months of lactation, an
additional 600 calories of energy and 13.6g of
proteins are required in the daily diet.
• In the next six months, additional requirements
are 520 calories of energy and 10.6g of protein.
• Though it is possible to meet the requirements
for most of the nutrients through a balanced
diet, lactating women are advised to take daily
supplements of iron and folic acid.

Importance of eating Folate-Rich Foods
• Folic acid is essential for the synthesis of hemoglobin and
prevention of anemia.
• Folic acid is essential for the synthesis of hemoglobin and
prevention of anemia.
• Folic acid supplements in early period of pregnancy in the first 28
days is essential.
• Green leafy vegetables, legumes, nuts and liver are good sources
of folic acid.
• Folic acid supplement (500µg or 0.5mg) is advised during the first
trimester (first 12 weeks of pregnancy).

Importance of eating Iron-Rich Foods
• Iron is essential for the synthesis of hemoglobin and prevention of
anemia.
• Iron is also needed for brain development of fetus.
• Iron deficiency during pregnancy increases maternal mortality and
may decrease birth weight of infants.
• In children, deficiency of iron increases susceptibility to infections
and impairs learning ability.
• Iron bio-availability is poor from plant foods but is good from flesh
foods such as meat, fish and poultry products. Plant food items
such as green leafy vegetables, pulses and dry fruits contain iron.

• Consumption of rich sources of vitamin C fruits like
guava, pineapple and citrus fruits (lemon, orange)
improve iron absorption from plant foods
• Beverages (like tea) bind dietary iron and make it
unavailable. Tea should be avoided before, during or
soon after a meal or while taking IFA supplements.
• Iron, folic acid supplementation comprising 60mg
elemental iron, 0.5mg folic acid is recommended from
the 12thweek of pregnancy onwards up to the first six
months of lactation.

Diet chart for normal sedentary pregnant
women
• (Weighing 55 kgs before conception with
normal BMI 18.5–23).
• Total calorie: ~2020 Kcal, Crude protein: 72g
Energy production
• Carbohydrates provide 4 calories per gram,
• Protein provides 4 calories per gram, and
• Fat provides 9 calories per gram.

Sample menu
• Early morning - 6 am - 150ml Milk - 110 Kcal
• Breakfast (425 Kcal)- 8 am - Whole grains 60g; Vegetable
75g; Pulses 20g; Nuts 20g; Oil-5g
• Lunch (830 Kcal) - 1 pm - Rice (100g) or Phulka (100g);
Pulses (30g); or meat Vegetable curry with roots 1¼ cup; Oil
15g GLV curry (75g), Curd 200ml; Fruits 100g
• Evening (135 Kcal) - 4 pm - Nuts (almond, walnut, peanut &
other nuts) and oilseeds (Sesame etc.) (20g); Milk 50ml
• Dinner (485 Kcal) - 8 pm - Rice or Phulka (60g); Red gram or
chana (25g)(½ cup); GLV curry (75g) (½ cup); Vegetable curry
with roots 1¼ cup; Oil 10g Fruit 50g

Rajma per 100 g - Calories: 165kcal | Fat: 7.08g | Carbs:
19.77g | Prot: 7.04g
Other sizes: 1 cup - 363kcal

DIET FOR VULNERABLE GROUPS pregnancy lactation.pptx

DIET FOR VULNERABLE GROUPS pregnancy lactation.pptx

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DIET FOR VULNERABLE GROUPS pregnancy lactation.pptx