Nutrition for the Pregnant Woman

At no other time in a woman's life is good nutrition more essential than during pregnancy. While the need for calories increases only about 15 per cent, the requirements for some nutrients more than doubles, and a woman needs 10 plan her diet carefully to meet these requirements. She should work with her doctor or other health professionals providing prenatal care to design an eating programme that supplies optimal nutrition for her and her baby. As a matter of fact any woman planning a pregnancy should also evaluate her eating habits.

Even before trying to conceive, she should achieve her ideal weight. Women who are too thin often have low-birth-weight babies, while those who are over-weight have a greater risk of gestational diabetes and giving birth to an oversized baby. Infants who are either too small or too large at birth often suffer serious problems, including respiratory disorders, and may even die.

The use of any vitamin supplement also should be evaluated, in particular high doses of Vitamin A should be stopped several months before attempting pregnancy, because large stores of this vitamin can cause birth defects.

Women planning a pregnancy may be asked to forego eating liver because it has high Vitamin A con-tent. A pregnant woman needs to consume approximately 60g of protein daily. Because most Bangladeshi women tend to eat less protein, and in rural areas women cannot afford protein-based foods, most women will need to make a specific effort to increase their protein consumption during pregnancy. Protein-rich foods are lean meat, poultry and fish, which are also good sources of B vitamins and iron and other trace minerals. Other high-protein foods are eggs, cheese, and a combination of grains and legumes. Lacto-ovo-vegetarians can obtain protein from milk and eggs; vegans, who eat only plant foods should consult a dietitian for planning an adequate diet.

Experts agree that women should take folate and iron supplements during pregnancy, but there are differing views about whether other supplements are necessary. A woman's iron requirement almost doubles during pregnancy, going from 13mg to 23 mg daily.

This increase is necessary because the woman's blood volume doubles and because the foetus must store iron to last through the first few months of life. Iron-rich foods include red meat, fish, poulrty, enriched breads and cereals, legumes , eggs, dried fruits and leafy green vegetables.

However the haeme iron in animal products are absorbed more efficiently than the non-haeme iron in plants and eggs. Absorption of non-haeme iron can be increased by eating foods high in calcium such as orange juice. Most women also need to take a 25g iron supplement daily during the last 6 months of pregnancy. The supplements are to be taken with orange, lime or grapefruit juices between meals.

Adequate folate or folk acid can help prevent birth defects, especially those involving the brain and spinal cord such as spina bifida - a condition in which the spine does not form normally. It is estimated that 50 to 70 per cent of such defects could be prevented if all women of childbearing age consume sufficient Recommended Nutrient Intakes (RNIs).

For folate this is 180 micrograms for women who are not pregnant, increasing to 400mcg during pregnancy and dropping to 260-280mcg during breast feeding.

Many Bangladeshi women have low levels of folate, particularly those who have been taking birth-control pills. The most critical period for folate consumption is during the first four to six weeks of pregnancy, when the foetal central nervous system is being formed.

Women planning to become pregnant may be advised by their physicians to take a supplement even before they conceive. Good dietary sources of folate are citrus fruits and juices, peanuts and other legumes, whole grains, fortified breakfast cereals, and dark green leafy vegetables.

A pregnant woman needs 1200 mg of calcium a day, about 50 per cent more than normal. Because most Bangladeshi women do not get enough calcium and other nutrients, it's necessary to increase the intake of calcium-rich foods even before becoming pregnant, particularly for women under 30.

Low-fat or nonfat milk and butter are the best dietary sources of calcium. Other sources are dark green leafy vegetables, tuna, sardines, hilsha (with bones).

Calcium-enriched foods are now available in cities and towns and the urban women can eat them.

Calcium supplements, if recommended by the doctor, should be eaten with meals.

Avoid smoking, and all drugs unless prescribed by the doctor who is attending to your pregnancy, and cut down on tea and coffee.

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