Woman's alimentation during pregnancy and nursingThe pregnancy and nursing period is characterized by a series of fundamental structural and functional changes of the maternal body: uterus enlargement, placenta formation, mammary glands increase, endocrine gland modification, blood volume increase, metabolism intensification etc.
All these changes impose the decisions taking about how to help the maternal body to go through this period without health damages for the mother or child.
The alimentation plays an important role in the structure of these measures.
Research concerning a pregnant woman's metabolism showed that the nutritive needs increase in comparison to the needs of an adult woman who is not pregnant, especially during the second period of the pregnancy and during nursing.
The caloric needs increase in the first period of pregnancy with 5-10% and in the second part the caloric needs are up to 15-20% higher. During nursing, the increase may be of 30% or of 1000 calories more than at a non-pregnant adult-woman.
The proteins need of the pregnant woman is of 1,5-2 g/kg/day or 100g/day during the first part of pregnancy, increasing to 120g in the last pregnancy trimester and 125 g during nursing. That is why 2/3 or at least half of them will have a high biological value, first of all out of milk, dairies above all, eggs, meat and fish.
A poor proteins quota can lead to pregnancy complications: anemia, eclampsia, edemas or some fetus deficiencies, premature birth, malformations as well as different deficient states of the fetus, a greater receptivity to diseases after birth and diminished callousness. Latter on, it can also influence the quality and the quantity of the milky secretion.
Vegetal proteins from the dry vegetables (bean, pea and lentil) should be avoided as they usually contain a high degree of cellulose which renders their digestion difficult and possible postprandial distention, endured with difficulty by the pregnant woman.
The quantity of the lipids should be low as they overtax the liver's functions and favor the acidity. That is why a small quantity, of 90 g/day, should be consumed in the first period of the pregnancy and 110g/day during nursing. Half of them will be consumed by eating vegetables, the rest through animal fats, including the fats contained by the aliments.
The quantity of glucose should be of 5-6 g/kg/day or 350-420 g/day and can increase to 500 g a day during nursing, without excesses since they can lead to obesity and diabetes. One should eat more vegetables and fruits which bring vitamins and minerals or cereals and aliments from cereals, without exaggerating the pastries consumption.
During the pregnancy and nursing, the need of mineral salts, calcium, phosphor and iron, in particular, increases and since it cannot be satisfied by the usual alimentation, one should consume aliments which contain them such as: milk, dairies, eggs, meat, liver, spinach, tomatoes, lettuce, etc.
The calcium and phosphor need is of 1.5 g/day in comparison to de 0,8 g/day, for the adult, non-pregnant woman, during nursing can grow up to la 2 g/day. The iron need grows from 15-16 mg/day, the necessary for the adult non-pregnant woman, to 20 mg/day during pregnancy and to 25 mg/day during nursing.
As for the sodium quantity, it should be diminished, especially in the last period of pregnancy, as it favors the edemas which may provoke complications at birth.
The need of some vitamins is higher for the pregnant woman. Thus, the thiamin need increases to 2mg/day during pregnancy instead of 1,5 mg/day in normal conditions and to 2,3-2,5 mg/day during nursing. The riboflavin need is of 2,5 mg/day during the pregnancy instead of 2 mg/day in normal conditions, and goes up to 3-3,2 mg/during nursing. The pyridoxine need is of 5 mg/day, the PP vitamin need grows from 14- 15mg/day to 18- 20mg/ day to the pregnant woman and to 24-25 mg/day to the nursing woman. Vitamin K need is of 0,5-1 mg/day for the pregnant woman, growing especially in the last period of the pregnancy, taking into account the blood loss during the birth process. The vitamin A need is of 6 000 U.I. for the pregnant woman and of 8 000 U.I. for the nursing woman, in comparison to 5 000 U.I. for the normal woman. The necessary quantity of vitamin D is of 400 U.I. for the pregnant woman and of 500-600 U.I. for the nursing woman. This can be provided by aliments (dairies) but also by sun exposure during summer. Vitamin E, necessary especially during pregnancy, as it favors the normal growth of the embryo, is necessary in quantities of 10-12 mg/day, being provided by the consumption of vegetal oil, eggs, meat, germinative cereals. Vitamin C, whose necessary quantity grows from 50-55 mg/day, the quantity for normal women, to 100 mg/ day for the pregnant woman and to 130-150 mg/day for the nursing woman, will be provided through the consumption of fresh aliments of vegetal origin (fruits and green vegetables). Vitamins from the group B will be provided especially by bread, meat, milk, eggs, green vegetables, and the vitamin A by dairies, eggs, fish as well as some fresh vegetables which bring it as carotene, which will convert in organism in active vitamin.
All nutritive needs of the pregnant or nursing woman will be ensured by the consumption of the aliments from the main groups.
The quantity of meat and meat products consumed daily will be of 200-250 g/day, the milk quantity is 600-1000ml/ day, the cheeses quantity should be around 50g/ day, and at least one egg everyday. The alimentary fats will be provided through: 20g butter a day, 20-25 g oil a day. Out of the aliments of vegetal origin, rye bread will be preferred (brings more vitamins and minerals and doesn�t provoke constipation) 250-350 g/day, 30-40g/day pastries or other cereal products, 400-500 g/day vegetables and 250-300 g/day potatoes. The quantity of fruits can be of 350-400 g/day, fresh or stewed, cooked, and sugar daily quantity should be around 40-50 g/day.
Alimentation should be sufficient qualitative and quantitative, no excesses, it should vary and the aliments as fresh as possible. It is advisable to have frequent and reduced meals, especially in the first period of the pregnancy when the dyspeptic disorders (nausea, vomiting) can affect nourishment. Avoid fatty, spicy, salty aliments, smoked meat, fish or meat preserves, alcohol and coffee. They usually irritate the digestive mucosa with hypersecretion of gastric juice. If endured, occasionally, are allowed small quantities of wine with soda or coffee, without making any excess or converting it into a rule.
Aliments with fried sauces or fried in fats, are not recommended for the pregnant or nursing woman.
The weight gain will be closely followed. It should be almost inexistent in the first months of pregnancy, than it will increase with 1.5 kg/month in the last 6 months, taking care that the weight gain won�t exceed 10 kg during the entire pregnancy.
During travail all kinds of aliments are forbidden. After birth should be consumed fortifying easily digestible and stimulant aliments: natural coffee, coffee with milk, vegetable sauce, meat sauce, eggs, fruit juices, etc. Starting with the third day after birth, the diet recommended for the nursing woman will start.
The nursing woman, beside the mentioned elements, should be aware that some of the substances can reach the milk, giving a bad taste or provoking digestive disorders to the baby, which is why they should be avoided. These are: onion, garlic, alcohol, which can also provoke nervosity, agitation, insomnia, explained by the excitability growth of the nervous system of the infant.
The pregnant woman as well as the nursing woman should respect a set of rules regarding the alimentation hygiene, absolutely necessary such as: respect the meals hours, a good repartition of calories for each meal� With respect to this aspect, we already mentioned that it is preferable to have more meals and less consistent, in order to be better assimilated by the body. Mastication will be lent and long. Avoid any kind of emotions during meals and take a postprandial pause.
Try, if possible, not to change the pregnant woman's alimentary customs, if they aren't too different from the rational alimentation limits. One won't impose useless interdictions or excesses which can damage the nutritive factors contribution, such as salt diet or minerals and vitamins intake in excess.
Keep the optimal proportion between the nutritive factors as it has a positive influence over the absorption and their utilization.
If the pregnant woman presents nutritional disequilibrium, they will be taken into account, trying to correct them.
When the pregnant woman has a job which solicit her physically and psychically, the nutritive contribution will be adjust according to her need which surpass the usual values for a sedentary pregnant woman or for one who makes little effort.
It is also very important if the pregnant woman is an adolescent. Because of the growing needs from this period, the pregnant adolescent�s ratio will be increased in calories and nutritive factors, in order to cover the needs of the adolescent's growing body.
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