Nutrition in pregnancy can be compared to molding of blocks in readiness for erection of a building. If the block are soft and brittle you can predict how strong the building will be, whereas a hard and well vibrated block will give peace of mind to the owner of the house. The same is applicable to a child delivered by a mother who fed on balanced diets throughout the gestation period. We must be conscious of the fact that the health of a child is more important than the sex of that child.
During pregnancy the body goes through lots of physical and hormonal changes. Great food choices becomes inevitable in order to fuel the mother and the growing baby. The food you eat is the main source of baby’s nourishment; then it becomes imperative to get all the required nutrients. Talking about the required nutrients, variety of sources will serve the mother better during this period. There is an increased nutrients requirement at this period. But let me correct an impression that you are eating for two at this time. You don’t need to double your ration in order to feed your baby well. One thing that is certain is that you need more of micronutrients and macronutrients. Micronutrients are the vitamins and minerals which are required in small quantities as the name denotes. On the other hand, macronutrients are nutrients that provide calories or energy. These are carbohydrates, proteins and fats (oils). Every pregnant mother will need to eat more of each type of nutrients during pregnancy.
NUTRITION AND CONCEPTION
Fertility and healthy nutrition are linked in both men and women. Having a healthy weight is important when trying to conceive. It has been shown that women that are underweight have lower rates of fertility than women who have a healthy BMI. BMI is the relationship between our height and weight. If you are underweight or overweight can cause irregular periods and interfere with ovulation. Some foods must be avoided if you are trying to get pregnant apart from maintaining healthy weight, food like: –
- Alcohol
- Trans-fat
- High glycerimic index foods e.g. Watermelon, Honey, Doughnuts, French fries, White rice, Cereal, Millet and white bread.
- High mercury fish
- Low fat diary
- Unpasteurized soft cheese
- Deli meat
- Soda (soft-drinks)
One may argue that she takes all these and get pregnant easily, yet but you must be aware that when a woman has problem in getting pregnant every issue becomes important and magnified. Remember that pregnant women in rural areas go to farm and deliver healthy baby on the same day whereas another is required to observe bed rest for months ahead of delivery.
During the nine months of pregnancy, the woman needs to increase her daily intake of both micronutrients and macronutrients as mentioned above. These are few important nutrients that are required to be adjusted based on your needs.
- Calcium 1200mg (DR)
- Folate 600 – 800mcg
- Iron 27mg
- Protein 70 – 100m/day
By choosing a variety of healthy diets most pregnant women can meet these increased nutritional needs. You choose from food components that has:
- Protein
- Complex Carbohydrates
- Healthy types of fat like Omega – 3
- Vitamins and minerals
In order to simplify things; you are required to eat normally as you do but choosing healthy foods during the first trimester (first three months) of the pregnancy. You are to increase this by 350 calories daily during the second trimester while the last trimester you increase by 450 calories as the baby grows.
The mother should avoid processed (junk) food as much as possible. They have no nutritional values. You and the fetus will benefit more from fresh fruits, vegetables, lean proteins such as chicken, fish, beans or lentils. It will not be practicable to avoid all your favourites foods during this period but you need to balance them with nutrition foods so that you don’t lack any of the important vitamins and minerals.
FUNCTIONS AND SOURCES OF FOOD COMPONENTS
PROTEINS
It helps in the growth of organs and tissues of the baby. Organs are Kidney, Liver and others including the Brain which is the central processors for the baby. It has role to play in the increasing blood supply that feeds the baby. The need for protein increases from one trimester to the other. A daily requirement of protein is between 70–100g depending on the stage of the pregnancy.
SOURCES OF PROTEIN
- Lean Beef Or Pork
- Chicken
- Salmon
- Beans
- Cheese
- Nuts Generally
IRON
This has role to play in increased blood flow. It allows oxygen to be available to the baby and the mother in sufficient quantity. These are the sources of Iron.
- Eggs
- Dark green vegetables
CALCIUM
Formation of bones requires adequate supply of calcium. Daily requirement for a pregnant woman is 1000mg. sources include the following;
- Milk
- Dark green vegetable
- Yoghourt
- Cheese
FOLIC ACID
Folic Acid is important in the proper formation of brain and spinal cord of the baby. The daily requirement is between 600 to 800mg. Sources of folic acid include the followings:
- Liver
- Eggs
- Dried beans
- Nuts
WEIGHT GAIN DURING PREGNANCY
An amount of weight gain is normal during pregnancy. This should not be a source of worry to an average woman once it is within acceptable limit. Women gain an average of 11.35kg – 15.89kg during the pregnancy period. Balance diet will help to keep your weight at optimum level but you may need to discuss with your doctor whenever you notice anything unusual.
Exercise engaged in during pregnancy will help you to have a stress free pregnancy. You are advised to avoid strenuous sports. You may have to start slowly by trekking which is a good form of exercise. Do not overdo anything.
DANGER OF CONTAMINATED WATER IN PREGNANCY
Contaminated water contains toxins which could be dangerous to the mother as well as the unborn child. These are threats posed by drinking contaminated water during pregnancy. Below are some of the contaminants that you need to avoid;
LEAD:
This can come from rusted pipes and other sources. It can effect cognitive functions of the babies and also has an impact on their IQ level. It also increases attention – related behavioral problems among kids after birth. Lead causes bone marrow suppression which leads to a type of cancer.
PESTICIDES;
These could increase the risk of reduced fetal growth.
ARSENIC
Industrial pollution could cause this in contaminated water. It increases chances of abortion, birth defects or preterm birth.
MICROORGANISMS
Leaking sewage system can seep into water thereby contaminating it. It could lead to compromised immune system of the expectant mother or severe gastrointestinal diseases.
USE OF MEDICINAL PRODUCTS DURING PREGNANCY
There is no doubt that a pregnant woman will need to use supplements in order to get enough micronutrients during this period when there is an increased demand through the child in the womb. It might be practically impossible to have enough through our day to day feeding; especially in an environment like ours where attention is not paid to quality of feeding especially the general populace.
But a note of caution though, use of drugs is generally not encouraged during pregnancy, unless necessary because many of those drug product can harm the baby in the womb. It should be noted that to treat any ailments during pregnancy, you must consult your doctor.
It is important to take some vitamins as they are considered safe during this period. Same cannot be said of herbal supplements, as they have not been proven to be safe during pregnancy. Pregnant mothers are advised to eat quality food during this period in order to have enough nutrients for the foetus. The most important vitamins you need at this period are folic acid and vitamin D which are available at relatively low cost. There is no need to waste money on these expensive vitamins supplements.
FOODS TO AVOID AND THEIR EFFECTS
RAW EGGS
This may contain salmonella which is a deadly bacteria. It can put you and your baby at risk. Eat thoroughly cooked egg.
CAFFEINE
It is better to drop drinking of tea and coffee during this period. High caffeine intake during pregnancy may limit baby growth and cause low birth weight.
UNPASTEURIZED MILK
Cheese or milk unpasteurized increase the risk of bacterial infection.
ALCOHOL
This increase the risk of miscarriage, stillbirth and fetal alcohol syndrome. Also it can affect baby’s brain development.
JUNK FOODS
These increase your risk of excess weight gain, gestational diabetes and complications and other diseases.
HOW TO BOOST YOUR MILK SUPPLY FAST
It could be worrisome at the initial stage when you are breastfeeding to know whether you are producing enough milk. The best thing is to be relaxed and trust your baby to help out by sucking well. Once a baby is sleeping well and the diapers are getting wet often, then be assured that you are doing well. In case you feel that the milk supply is not enough, there are ways you can boost supply.
- DRINK ENOUGH FLUIDS
In this environment our progenitors believe so much in drinking hot corn pap to boost lactation. Nowadays, the Mother is encouraged to also drink hot beverages that can support lactation. Water is very essential too, you may have to carry water bottle around.
- BREAST MASSAGE OR PUMPING
Massaging of the breast is another way of boosting milk production. This can involve power pump as well. If you can pump after every nursing session for 2 to 3 days, the production level will be improved.
Pumping sends signal to your body to produce more milk once you empty the breast milk. Remember our body is system that relies on feedback mechanism to function optimally.
- BREASTFEED OFTEN
The more your child suck often the better your milk production. The child should be encouraged to latch on the two sides each time he is being breastfed.
- GET ENOUGH REST
Rest is very essential. When the body is well rested, then it can perform at optimum level. You need to sleep well so that the body will produce milk optimally.
- AVOID THINGS THAT DECREASED MILK SUPPLY
Breast milk supply can be affected by a number of factors. Starting birth control pills during the first six weeks after your baby is born can make it difficult to make breast milk. Caffeine and alcohol consumption or smoking can also interfere with the amount of breast milk that you produce.
MANAGEMENT OF HYPERTENSION BEFORE, DURING AND AFTER PREGNANCY
Hypertension is an important cause of maternal and foetal morbidity and mortality. This is very common in pregnancy and it complicates 15% of pregnancies and it causes about 25% of antenatal admissions.
We need to understand that early in the first trimester, there is a fall in blood pressure which is brought about by active vasodilation which is caused by local mediators called Protacyclin and Nitric Oxide. After 24 weeks of pregnancy, there is a gradual increase in blood pressure until term when pre-pregnancy levels are attained. After delivery, it will fall only for it to increase during the first five postnatal days. Women who have enjoyed normal blood pressure before going through pregnancy do experience transient hypertension in the early period after child birth.
TYPES OF HYPERTENSION
There are three types of hypertension disorder:
- Chronic hypertension
- Gestational hypertension
- Pre-eclampsia
CHRONIC HYPERTENSION
This complicates about 3-5% of pregnancies. The risk is high in women who postponed childbirth into their 30s and 40s. Diagnosis is based on known history before conception.
The presence of mild pre-existing hypertension approximately doubles the risk of pre-eclampsia but also increase the risk of placenta abruption and growth restriction in the foetus. When the blood pressure is well managed such women do well.
GESTATIONAL HYPERTENTION
When hypertension occurs during the second half of the pregnancy in a woman with normal blood pressure who is not having protein in the urine. It is called gestational or pregnancy induced hypertension. This affect about 6-7% pregnancies and it normally disappears post-partum.
PRE-ECLAMPSIA AND ENCLAMPSIA
This occurs after 20 weeks of pregnancy. It involves edema (retention of fluids characterized by swollen legs) and protein in urine.
Eclampsia is defined as the occurrence of a grand mal seizure in association with pre-eclampsia, although it may be the first presentation of the condition. Pre-eclampsia complicates 5-6% of pregnancies. The risk from pre-eclampsia include growth restriction which is secondary to placental insufficiency and premature delivery.
In all these it should be borne in mind that we can avoid the condition when the diet of the pregnant woman is well controlled without underlining diseases.
Hypertension in pregnancy is a common condition, it affects about 10% of pregnant women as said earlier. After the diagnosis, this should be managed in such a way to get the best result that will not put both the lives at risk i.e. mother and child. A mild therapy is advisable when introducing drug for hypertension in pregnancy. This is usually done with adjustment of lifestyle. Methyldopa remains the drug of choice as the first line therapy especially in chronic hypertension. For emergency treatment in pre-eclampsia, intravenous therapy might be applied with the woman under supervision of a qualified medical practitioner.
In case these are not controlling the blood pressure or there are side effects that could not be tolerated; other anti-hypertensive agents might be employed especially when it becomes severe at about 160mmHg systolic or ≥105mmHg diastolic. For some category of women, diet control and lifestyle adjustment will reduce the blood pressure drastically. Some may have to go on diet to reduce weight which will in turn put less pressure on the heart. Reduction of salt intake might work wonders for some. When we talk about table salt please note that you have to remove seasonings from your cooking as well.
DIABETES IN PREGNANCY
This is a form of high blood sugar affecting pregnant women. Those who develop this disease are at higher risk of developing type 2 diabetes later in life.
SYMPTOMS
There may be no symptoms. Usually blood sugar test during pregnancy which is a routine test is used for diagnosis.
TREATMENTS
Blood sugar monitoring is paramount. Diet and I mean a healthy one is also important. In case the blood sugar is too high, then medication is compulsory.
DIET
- Plenty of whole fruits and vegetables
- Moderate amount of lean proteins and healthy fats.
- Moderate amounts of cereal, pasta and rice. Also whole grains in moderate quantity
- Avoid sugar drinks and pastries
PHYSICAL EXERCISE
It has been proved that exercise is beneficial in improving pregnancy outcomes in women with gestational diabetes mellitus. Exercise of moderate intensity for 30-60minutes at a time for five times a week is recommended. Simple walking will do the magic. A minimum of 6000 steps per day has been found to be adequate.
MEDICATION
Anti-diabetic medication and insulin could be applied depending on the need as prescribed by a qualified medical practitioners.
CONCLUSION
The overall objective is to have a healthy child and mother that enjoys quality life during pregnancy and after delivery.
SOLA ADEYI GM Daily-Need Industries Ltd.