“Pregnancy is a great balance in life; it brings out the worst mood swings in a wife and the best level of tolerance in a husband”. This experience is a mixture of all emotions a person can feel while coping with physiological changes that a growing fetus brings, including the physical and sometimes even emotional exhaustion new parents can feel while nursing the neonate as they face a transition period in their lives.
Changes During Pregnancy
Levels of progesterone and estrogens rise continuously throughout pregnancy. Women also experience elevated human chorionic gonadotropin (β-hCG), prolactin level. Parathyroid hormone and adrenal hormones such as cortisol and aldosterone also rise. These hormones do affect the pregnant women cardiovascular, hematologic, renal and metabolic wise. It can manifest in various forms such as a larger breast size, weight gain which differs from 2.3 kg to over 4kg, edema of the lower extremities to mention a few. However, During the postpartum period the intermittent uterine contractions, known as “after pains”, are a source of discomfort for many women. In addition, perineal or post-operative incision pain is also often stated by most mothers.
Nutritional Needs During Pregnancy
It is undeniable that diet modification is an essential key to meet the needs of the baby inside the uterus and to safeguard the mother. During pregnancy an increased need for various nutrients and minerals is apparent.
Protein in the diet
The intake of proteins should be at around 60 grams in this period, if overall protein needs are met, overall nutritional needs are more likely to be met as well (with the possible exception of ascorbic acid, vitamin A and Vitamin D). Extra protein is best supplied by meat, poultry, fish, yogurt, eggs and milk, because proteins in these forms contain all nine essential amino acids.
Fat in the Diet
Only linoleic acid, an important fatty acid for new cell growth, cannot be manufactured in the body from other sources. Thus, women must be concerned about consuming a source of this. Vegetable oils in the likes of sunflower, corn, olive, peanut and cottonseed are high in linoleic acid.
Vitamins in the Diet
Requirements for both fat soluble and water soluble vitamins increase during pregnancy to support the growth of new fetal cells. Vitamin deficiency can result in several problems. For instance, Severe folate deficiency can lead to megaloblastic anemia to the woman and fetal neural tube defects. Lack in Vitamin D can diminish both fetal and maternal bone density. Commonly, a specifically designed multivitamins is prescribed. However, women should be cautioned to avoid mega dose of vitamins since there may be an association between excessive vitamin intake and fetal malformation. Folic Acid, a vitamin B component, which is predominantly found in fresh fruits and vegetables, is essential during pregnancy for it prevents not only neural tube defects but also megaloblastic anemia by producing more red blood cells.
Minerals in the Diet
Minerals are necessary for new cell building in the fetus, because they are found in so many foods and since mineral absorption improves on pregnancy, mineral deficiency with exceptions of calcium, iodine and iron is rare. The skeleton and teeth constitutes a major portion of the fetus. Tooth formation begins as early as 8 weeks in utero. Bones begin to calcify at 12 weeks. The recommended amount of calcium is 1,200 to 1,500 mg. If a woman cannot drink or eat milk products such as cheese, she can be prescribed with a daily calcium supplement. It is more likely that inadequate calcium ingestion during pregnancy will result to diminished maternal bone density while with adequate calcium intake during pregnancy enables the fetus to receive the needed calcium for growth and mineralization of fetal skeleton without taking away from the maternal bones and teeth.
Food rich in Iodine should also be a key part of a pregnant woman’s diet to supply the needs of her thyroid gland function during this time. In extreme cases of iodine deficiency, hypothyroidism in the fetus may occur which may result to cognitive impairment. The RDA for iodine during pregnancy is 175 ug per day and the best source is seafood. In areas which are known to be deficient in iodine, it is suggested that women use iodized salt and include a serving of seafood in their diet at least once per week.
Iron is also important since it is needed to build a high level of hemoglobin in the fetus. In addition, after week 20 of pregnancy, the fetus begins to store iron in the liver to last through the 3 months of life, when intake will consist mainly of milk, typically low in iron. Aside from that, the mother needs iron to build an increased red blood cell volume for herself and protect iron lost in blood at delivery. The RDA for iron is 30 mg and dietary supplementation with 15 mg iron per day helps ensure that sufficient iron is ingested and absorbed. Food rich in iron can also be eaten such as organ meats, green leafy vegetables, whole grain, enriched breads and dried fruits.
Zinc, is significant for the synthesis of DNA and RNA. Although there are no enough evidence, zinc deficiency may be associated with pre-term birth. Most people who take in enough protein also take in adequate zinc since it is contained in the same food sources.
Fluid in the Diet
Extra amounts of water are needed during pregnancy to promote kidney function because the woman must excrete for two.
Fibre in the Diet
Fibre rich diet to prevent constipation which typically occurs due to the slowed peristalsis during pregnancy. Eating plenty of fruits and vegetables and more fluid intake is the key to avoid this.
Being a new mom means you're going to experience serious fatigue until you adjust to your new routine, so you need a diet that can help carry you, not one that will leave you constantly hungry and feeling deprived. Postpartum diet must make you feel fuller longer which will make you have the “get-up-and-go mentality” you need for those 3 a.m. feeding calls. It is suggested to feed more on fruits and vegetables, whole grains, lean protein, like fish, beef, and soy foods, skim or low-fat milk, leafy greens. Iron, especially if you suffer from postpartum symptoms. You can find this in things like fortified cereals, prune juice, and lean meats. Vitamin C, which can help with wound healing for mothers who delivered via C-section. Find this in oranges, tomatoes, and natural fruit juices.
An unarguable fact that diet modification must be a top priority to ensure that the needs of the fetus and mother is met since there are vast changes experienced by women in the course of pregnancy. Deficiency in vitamins, minerals and nutrients can often lead to serious fetal congenital and physical malformations and can also jeopardize the safety of the mother. Women should as much as possible eat nutritious food that are rich in vitamins, minerals and other nutrient for a healthy baby and a happy pregnancy, in addition to the prevention of fetal congenital anomalies which can be attributed to poor nutrition and lack of knowledge of the parents. Good diet should also be a priority during postpartum to ensure a fast recovery to the mother and a quality nutrition for the new born.
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- Maternal and Child Health Nursing, Care of the Childbearing and Childrearing Family, 4th Ed, Adelle Pilliteri