Monday, June 29, 2009

Nutrition in Pregnancy

There are numerous changes in nutritional needs for a pregnant woman. such changes are partly due to the nourishment demands of the foetus and partly due to the nourishment demands of the foetus and partly to other physiological variations that affect absorption and metabolism of nutrients. These changes help insure normal development of the baby and fill the subsequent demands of lactation, or nursing i.e breastfeeding. Man requires food to live and grow. This is also applied to the foetus. In pregnancy, the foetal development within the uterus demands that the mother should take additional nutrient. Pregnancy women requires different amounts of iron, folic acid, sodium, and sugar intake. The consequences of maternal malnourishment may include health problems for the mother and the an infant of low birth weight who may have nutritional and other deficiences. It is therefore essential that a pregnant mother should eat regular, well-balanced meals. According to the American College of Obstetricians and Gynaecologists, pregnant women should increase their usual servings of a variety of foods from the four basic food groups to include more servings of fruits and vegetables, more servings or enriched bread and cereal, more servings of milk and milk products, meat, poultry, fish, eggs, nuts, and dried beans and peas. One thing is certain, the baby will be the last to suffer in case of, malnutrition. This is because the baby will continue to draw the amount of nutrient that will be sufficient for her irrespective of her mother's economic and financial ability. Abortion, stillbirths, neonatal deaths and infant mortality rate will be much less when the nutritional status of the people is improved therefore health education is very important during antenatal clinic. It is not the quantity of food that matters but the quality.In recommending diet in pregnancy, the following should be considered: maternal health maintenance, needs of the growing foetus, and strength during labour and milk production during lactation.

At present, there is no comprehensive physiological information concerning the needs of women in pregnancy. This is because women have different-physiques, occupation, and live in different climates only that they are pregnant. The modern teaching is that every pregnant woman should be taught the classes of food nutrient, source and their function. They should be encouraged also to try as much as possible each day to drink a pint of milk which could be either raw or made up in milk drinks; one egg daily; about 120g of meat or fish; eat on oranges; an apple or slice of paw-paw each day. And have leafy green vegetables at least thrice each week. Apart from this, she can eat whatever she likes provided that she pays attention to her weight gain.

However, vitamin and mineral supplements can be prescribed especially to those in the remote areas where carbohydrate is the chief source of food and also to those pregnant mothers whose haemoglobin concentration is below 10.5g/d/ (70%)

It is important to note that during pregnancy some food like caffeine (from drugs, coffee, cola, cocoa etc) is not metabolized in the body as quickly as normal. Such people may complain that they are sensitive to it. For instance, it may make it more difficult for them to get sleep. There is no evidence that caffeine can harm the foetus, but for the comfort of the mother, she may be advised to cut down or avoid foods containing caffeine. It has been proved that smoking is dangerous to health; it has also been proved begond doubt that smoke (carbon monoxide, which mother inhale) can harm the foetus by retarding its growth. The danger of smoking in pregnancy include: Risk of post partum haemorrhage, Risk of premature delivery, Risk of baby being under weight, Foetal distress (heart beat beyond 160/min), Accumulation of carbon dioxide and less oxygen in the foetal circulation may give rise to intrauterine growth retardation. Breathing other peoples smoke can also increase the risk of abnormal sperm cells. Placenta permits the passage of alcohol into the foetal blood stream and can negatively affect its development during the week no matter how little the mother drinks.

Classes of food nutrient

The six classes of food nutrient are: proteins, carbohydrates, fats, fibre, vitamins, and minerals. Carbohydrates, proteins and fats contain calories, that is, they are nutrients that produce energy, while fibre, vitamins and minerals, although essential to a healthy diet, do not contain any calories. In addition, plenty of water is needed to maintain life.

Carbohydrates: Carbohydrates are compounds made up of carbon, hydrogen and oxygen. Carbohydrates are cheap and readily available in our community. It is required at minimum during pregnancy for energy. Excessive weight gain may be due to excessive intake of carbohydrate mostly sugary foods. The major sources of carbohydrates are bread, cereals, potatoes, honey, cakes, biscuits, confectionery and soft drinks. Sugars taste good and they may encourage people to overeat and in turn cause weight gain.

Fats: Fats (technically referred to as lipids) are, like carbohydrates, compounds of carbon, hydrogen and oxygen. They are, however, a more concentrated source of energy (calories). Fats are found mainly in foods of animal origin such as lard, fatty meats, butter, full-fat milk, pastry, fried food and cheese. They are also found in some vegetable oils, such as palm oil and cocoanut oil. A high intake of saturated fatty acids may lead to increased blood cholesterol levels; this in turn increases the risk of coronary heart disease. Excessive fat intake will cause increase in weight. During pregnancy, fat deposits may increase by more than a third the total amount a woman had before she became pregnant. Most women lose this extra weight in the birth process or within several weeks thereafter. Breast-feeding helps to deplete the fat deposited during pregnancy. A woman who breast-feeds expends 600 to 800 more calories than one who does not. The woman who nurses her baby also has increased needs for specific nutrients.

Proteins: Proteins are essential components of all body cells, providing structural material and regulating body processes including the formation and development of the foetus. 80g of protein is required daily for a pregnant woman of which sixty per cent should be first class. We need a regular daily supply of protein for the growth, repair and replacement of our tissues, but if we eat more than is needed for these purposes, the excess is used for energy. Its chief source includes meat, milk, fish, Soya milk, Soya beans, yoghurt, liver, eggs, peas, pulses and nuts.
Fibre: The human digestive tract is unable to digest the structural material in plant foods – known collectively as fibre – but it has a vital role to play in the body. Cereal grains, vegetables and fruit all contain fibre of various types. “Insoluble” types, such as cellulose predominate in wheat, maize and rice and in pulse vegetables and many fruits. Insoluble cereal fibre provides bulk and helps the intestine to work efficiently, preventing constipation and probably also protecting against other bowel disorders such as haemorrhoids.

Water: This is the major constituent of the body. The body is made up of about 70 per cent water. About 2 litres (31/2 pints) is lost every day in expiration, urine, faeces and sweat. The lost fluid must be replaced, but about 70 per cent of most foods are water, so one does not necessarily need to drink 2 litres of fluid at a time in order to replace lost amounts.

Vitamins and Minerals:
Vitamins are chemicals. Nausea and vomiting and sometimes mal-absorption couples with insufficient intake can lead to vitamin deficiency. The demand of vitamin B is on the high increase during pregnancy and lactation. Naturally, the body produces some amounts of vitamins, such as vitamin D, which is made in the skin when it is exposed to sunlight; however, most vitamins can be obtained only from food or supplements. Anyone who eats a varied diet of fresh fruits and vegetables, grains, diary products, fish and meat generally gets enough vitamins.

Minerals such as iron, calcium, iodine and sodium are of major nutritional importance. An apparently reasonable diet may be deficient in iron, calcium or iodine. And in parts of the world where the soil is deficient in iodine, it is often added to our table salt (iodized salt). A well-balanced diet usually provides enough iron, calcium and iodine. Many people eat too much sodium (salt), and this is known to increase the risk of heart disease for people who already have high blood pressure.

Iron is needed in larger doses, especially in the later stages of pregnancy, and cannot be met by diet alone, according to the American National Research Council. More iron is needed not only because of foetal demands, but also because the mother’s blood volume may be increased as much as 30 per cent. This mineral is essential to the formation of healthy red blood cells, and it is difficult for a woman to consume enough of it from foods to maintain an adequate supply for herself and her foetus. Without enough iron, the foetus will draw its supply from the mother, often leaving her anaemic exhausted. An iron supplement can alleviate this condition. So pregnant women are advised to always meet Gynaecologists for expert advice during pregnancy stages and this will help to reduce maternal morbidity.

More articles will be published on this blog on maternal health so don’t miss it.

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