nutrition%20in%20pregnancy
NUTRITION IN PREGNANCY

Nutrition is the intake of food necessary for optimal health.

Choices regarding maternal nutrition & lifestyle affect maternal & child health.

The World Health Organization (WHO) recommends that women develop healthy dietary behaviors prior, during & after their pregnancy for optimal maternal & infant health outcomes.

The goal of prenatal nutrition is to provide for the optimal development of the fetus & to support maternal health.

Lifestyle Modification

Alcohol, Smoking and Recreational Drugs

  • Should be avoided during pregnancy due to the harmful effects on the nutrition, growth and development of the fetus
    • Alcohol consumption can lead to fetal disorders such as growth deficiency, facial abnormalities and neurological defects
    • Smoking can cause preterm birth and low birth weight
  • Patient also needs to reduce exposure to second-hand smoke

Caffeine

  • Caffeine is found in coffee, tea, soft drinks, chocolates, energy drinks, and some over-the-counter medications
  • High caffeine intake (>300 mg/day) may increase the risk of miscarriage and low birth weight
  • Limit intake to <200 mg/day, approximately the amount of caffeine in a 12-oz cup of coffee, or consider decaffeinated options
  • It is advised that pregnant women avoid energy drinks as many of the substances contained in it have not been studied for safety during pregnancy

Herbal Products

  • During pregnancy, it is recommended to avoid herbal products and supplements except for ginger

Physical Activity

  • Exercise during pregnancy can lower the risk of gestational diabetes, preeclampsia, pelvic girdle pain, urinary incontinence, cesarean delivery and macrosomia in the newborn
    • It can also lessen mental stress, anxiety and depression, decrease backache, fatigue, and swelling, improve muscle strength and posture, and make the patient ready for labor
  • Patient should be counseled first regarding their fitness for exercise and the type of exercise that can be performed
  • 30 minutes of moderate daily exercise is recommended and may be in the form of yoga, low-impact aerobics, swimming, brisk walking or cycling
    • In women of normal preconception BMI, an exercise (regardless of its intensity) and prenatal nutrition program has demonstrated a decrease in excessive weight gain during pregnancy and a reduction in weight retention at 2 months postpartum
  • Exercise during pregnancy is considered safe in women with gestational diabetes, chronic hypertension or overweight/obesity
    • Regular exercise, eg 30-minute walk after a meal, is advised for women with gestational diabetes mellitus as it also helps improve glycemic control
  • Patient should be advised to avoid sudden and strenuous exercise if she has not had any regular exercise prior to conceiving, to not exercise on her back beyond 16 weeks of gestation as uterine compression onto the great vein will affect circulation, and to decrease exercise intensity if due date is near
  • Moderate aerobic exercise 4 days/week and decreasing caloric intake would result in a gradual postpartum weight loss of up to 0.5 kg/week
    • There is little data that show that gradual postpartum exercise and weight loss adversely affect the volume or nutrient content of breastmilk
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