Pregnancy and Nutrition

Pregnancy is a specially important time in women's life to focus on proper health care and nutrition. Nutrition during childhood and adolescence influence a women's preconceptional nutritional status which subsequently influence the outcome of pregnancy and health of the baby. Good nutrition is the key to a successful pregnancy for both mother and child. The mother's nutrition from the moment of conception is an important factor in the development of the infant's metabolic pathway and future wellbeing. The diet during pregnancy should be adequate to provide maintenance of maternal health, the need of growing fetus, the strength and vitality required during labour and successful lactation. All women need to gain weight during pregnancy. Weight gain during pregnancy depends on pre-pregnancy weight. A healthy weight gain for most of the women is between 25-35Lb. During pregnancy a women has different nutritional need for different trimester to meet extra food needs and extra caloric requirement. Normal weight women need an extra 300 kcal /day during the 2 nd and 3 rd trimester of pregnancy. The total amount of needed calorie 2000-2500 kcal/day for a normal weight women. Needs for almost all nutrients are greater during pregnancy for own bodies growth, for baby and successful lactation. The dietetic advice given to the mother should be reasonable and realistic to the individual women. Introduction Good nutrition is the key to a successful pregnancy for both mother and child. It is especially important during child bearing years. The types and amount of food taken during pregnancy can affect the growth and development of the baby. What pregnant women eat will have a great impact on her unborn child during development and in the future. Eating well can help her have a healthy pregnancy and a healthy newborn. It can also contribute to the development of wholesome eating habits for the growing child.


Introduction
Good nutrition is the key to a successful pregnancy for both mother and child.It is especially important during child bearing years.The types and amount of food taken during pregnancy can affect the growth and development of the baby.What pregnant women eat will have a great impact on her unborn child during development and in the future.Eating well can help her have a healthy pregnancy and a healthy newborn.It can also contribute to the development of wholesome eating habits for the growing child.
During pregnancy, there is increased calorie requirement due to increased growth of maternal tissue, fetus, placenta and increased BMR.The increased calorie requirement is to extent of 300 kal over nonregnant state during 2 nd half of pregnancy 1 .
The diet during pregnancy should be adequate to provide -Maintenance of maternal health, the need of growing fetus, the strength and vitality require during labour, successful lactation 2 .
The mother's nutrition from the moment of concep-tion is an important factor in the development of the infants' metabolic pathways and future well being.
The pregnant women should be encouraged to eat a balanced diet and should be made aware of special needs for iron, folic acid, calcium and zinc 3,4 .

Weight Gain During Pregnancy
All women need to gain weight during their pregnancy.The fetus gain most of the weight and has rapid brain growth in last weeks of pregnancy 5,6,7 .
A women should not try to loose weight during pregnancy, because it she do not eat required calories or variety of foods, the baby will not get the nutrients, she or he needs to grow 1,8,9 .

Table-II:
Based on a "normal" pre-pregnancy weight, this chart shows how the weight gained during pregnancy is distributed: 6,7,8.

Daily Food Guide And Calorie Requirement
The pregnancy diet ideally should be light, nutritious, easily digestible and rich in protein minerals and vitamins.Dietetic advice should be given with due consideration to the socioeconomic condition, food habit and the test of the individual.

Food Groups
Needs for almost all nutrients (vitamin and minerals) are greater during pregnancy.Nutrients are important for own body's growth for baby and later for breast feeding 11 .

Healthy protein:
At least half of the total protein should be first class containing all essential amino acid.Good source of protein are chicken, fish, lean meat, low fat dairy products, eggs, bean and nut.Fish is the source of DHA.If any one is not able to eat fish, she should try other source of DHA like, walnuts, wheat germ, omega 3 enriched eggs or consider taking a supplement with DHA.Healthy fat: Majority of the fat should be animal type contain vit.A and D. Pregnant and breast feeding women needs healthy fat for baby's development.One should avoid transfat as food with hydrogenated or partially hydrogenated fat like many packaged and processed foods, friend foods and fast food.Limits saturated fat like butter, whole milk dairy products, high fat meat.Healthy fat, are found in olive oil, fatty fish, canola oil, peanut butter, nuts, seeds etc. Healthy carbohydrates: Fruits and vegetables are healthy source of carbohydrates.Dark and bright colour fruits and vegetables are richer source of vitamins and minerals.Whole fruit rather than juice is acceptable.Eat grain products like brown rice, whole wheat bread etc. Limit instant grains and refined carbohydrate like cookies, soda etc. Fluid: One should drink enough water to never feel thirsty.So urine is light in colour.Choose pasteurize low fat milk, limit juice and beverage which are high in calories.Vitamins and minerals: If any one is planning for pregnancy, she should take vitamins and minerals supplement that includes 400mg of folic acid to prevent birth defect and 200-400 I.U of vit.D. In some cases a women's diet may not include enough of a certain nutrient such as iron, or calcium and additional supplement may be necessary.Women, who follow vegetarian diet, usually require vit.B12, D and zinc.During pregnancy she should take prenatal vitamin and mineral supplement that includes 220 µg of iodine and does not contain more than 30 mg of iron.To get calcium, drink 2-3 cup of low fat milk.If any body cannot to get needed calcium through food to take calcium supplement.The pregnant women may need vit.B12 supplement, if she is complete vegetarian, calcium supplement under age 25 years specially if she does not drink enough milk 10,11,12   .

Iron and Folate:
The amount of iron and folate in diet is very important.So one should eat food containing these nutrients often.Iron; More iron is needed during pregnancy for the baby.But it is hard to get enough iron from food alone.There is a negative iron balance during pregnancy and the dietetic iron is not enough to meet the daily requirement specially in the 2 nd half of pregnancy.Thus the supplement iron therapy is needed for all pregnant mothers from 16 weeks onwards.Iron should be taken in between meals or at bed time on an empty stomach for its better absorption 1,2 .The iron in meat, fish and poultry is more readily absorbed by the body than the iron in plant foods.To increase iron absorption, eat plant foods with meat or with foods that contain vit.C Sodium: Salt does not need to be restricted in pregnancy for most of the women to avoid excessive salt, limit intake of highly process food such as canned soup, salted snacks etc.

Food Safety And Preparation
During pregnancy women are at increased risk of food born illness because of hormonal changes during pregnancy weakens the immune systems.So, one should wash hands before and after food preparation.Wash fruits and vegetable well.Food should be cook well.Meat, fish, eggs and poultry should properly handled.Egg should be cooked until firm.Avoid half done food, raw meat, unpasturized milk 17 .

Avoidance Of Food
There are certain foods and beverage that are harmful for the fetus, if they are taken during pregnancy.Fish with high level of methyl mercury Soft cheese -goat cheese, ready to eat meat-contain bacteria (listeria) which are harmful for unborn baby.
Raw or undercooked fish, meat or poultry.
Drinking alcohol can be dangerous to unborn child.More than 50% of the child born alcoholic mother syndrome, miscarriage, low birth weight.So both the RDA and the US surgeon general have recommended that pregnant women should avoid drinking any alcohol during pregnancy 18 .
Large amount of caffeine containing beverage.Caffeine is stimulant found in coffee, tea, Coca-Cola and some drugs.Pregnant women should take controlled food containing tea/coffee.
Women who smoke, put their babies at much higher risk of premature birth, low birth weight and still birth compared to non smoker, so pregnant women should avoid smoking 5,19 .
Some drugs are appropriate for use during pregnancy.But there are some drugs, those are contraindicated during pregnancy.Women should avoid taking drugs in the first trimester unless it is indicated for any medical indication 8 .
Anything that are not food.Some pregnant women may have crave for something that are not food such as laundry starch, clay etc 20 .
Women during her pregnancy period should avoid taking lots of cookies, candies, cakes, chips, soft drinks and fats such as butter, margarine, gravy, fried foods, salad dressings and mayonnaise.These high calorie foods provide very little nourishment for the mother and the baby 21,22 .

Conclusion
Pregnancy is a specially important time in women's life to focus on proper health care and nutrition.It is important to take a life cycle approach to the issue improving nutrition among child bearing women and their children rather than focusing solely on nutrition during pregnancy and postpartum period.Nutrition during childhood and adolescence influence a women's pre-conceptional nutritional status which subsequently influence the outcome of pregnancy and health of the baby.Malnutrition is perpetuated across generation via this cycle.For this reasons, programme to improve the nutrition of women and children must be comprehensive targeting all stages of life cycle 23, 25-27.Policy makers and service provider's can take action by making maternal and child nutrition and integral part of the comprehensive programme that serve women and children.
During pregnancy a women has different nutritional needs for different trimester.To meet extra food needs, a women need to add an average 300 Kcal extra calories per day to her diet after first trimester.At this extra calories, with extra servings of milk, low fat cheese, lean meats, poultry, fish, leafy and dark green vegetables, dried beans and pear, fruits, Eating a variety of foods that provide enough calories help the mother and the body gain the proper amount of weight.During the first three month of pregnancy the pregnant women do not need to change the number of calories, she get from her food she eat.Normal weight women need an extra 300 cal/day, during the last 6 month of pregnancy.This total amount 2000-2500 cal/day.If any one is under weight or over weight or obese before become pregnant or it is a twin pregnancy need of calories may