Nutrient needs in pregnancy & lactation. Megan Kendall, MS, RD, LD

Increased energy while pregnant & nursing. Increased metabolic rate 15% No increase in the 1 st trimester Based on 2002 DRI add 340 calories for 2 nd trimester & 452 for 3 rd trimester.(information provided in chp 2 supplement by Brown) Lactation energy increase first 6 months 500 calories day 2 nd 6 months of baby’s life mother would need 400 extra calories per day

Interesting information on lactation Some of energy required to nurse a baby comes from maternal fat stores (170 per day) Thus you would recommend a nursing mom eat 330 calories a day over her nonpregnant energy requirements

Carbohydrate Needs Carbohydrates will be the primary energy source during pregnancy and lactation. Average 160 grams per day This is important to prevent ketosis & to maintain proper blood glucose levels.

Protein Needs Pregnant & lactating women add an additional 25 gm of protein per day based on current DRI(Dietary Reference Intakes). Quick formula: protein needs calculated based on prepregnant weight 1.1g/kg/day Additional protein needed to help form fetal & maternal tissues.

Fat Needs Pregnancy needs are adequate intake of fatty acids per day. Fatty acids are used by the body to create other fatty acids: AA, DHA, & EPA These are critical for fetal growth & development. Fat should contribute about 20-35% of calories roughly.

Micronutrient Intakes Most micronutrients increase during pregnancy except vitamins D, E, and K and the mineral calcium, that do not increase at all. Very important to not consume more than 3000 micrograms/ day of Vitamin A. Iron is extremely important. Most females are deficient when they get pregnant. Iron is used to form hemoglobin & for the growth and development of the fetus & placenta. Pregnant iron needs: 27 mg/day versus 18mg/day for nonpregnant.

Vitamin A question Name a food with Vitamin A in it??

Vitamin A Foods Liver Sweet potatoes Carrots Mangoes Spinach Cantaloupe Dried apricots Milk Egg yolks Mozzarella cheese

Folate RDA (recommended daily allowance) of folate during pregnancy is 600 micrograms/day Important to prevent neural tube development All women of child bearing age should consume 400 micrograms/ day Folate foods: fortified breakfast cereal, spinach, broccoli, avocado, peanuts, lettuce, orange, asparagus

Vitamin C & Nursing Vitamin C needs go up to 120 mg/ day while nursing A large amount of vitamin c is secreted into a mother’s milk

Pop quiz Name some foods with vitamin c.

Pop quiz answer Orange juice Oranges, grapefruits Broccoli Tomato Peppers Potatoes Kiwi fruit

Water Needs Water is important for everyone. However, lactating females need more to maintain their milk supply. Increase fluid does not increase production but decrease fluid will decrease production. All adults should drink 8 glasses of water per day but lactating females may need up to 12 glasses per day.

Things that add risk to a pregnancy Poor nutrition status before & during pregnancy Nutrient inadequacies in the womb may cause permanent changes in the structure and/or function of organs & tissues, predisposing the baby to chronic diseases later. Obesity increases risk of gestational diabetes, pregnancy-induced hypertension, and cesarean section.

3 most high risk pregnant groups Teenagers Multiple births Women diagnosed with gestational diabetes

Quick tip on benefits of breastfeeding Burn more calories per day Mothers have shown to return to prepregnancy weights quicker. Infant gets your immunities and breastfeed babies are less sick in the 1 st 6 months than bottle feed babies.

Weight gain recommendations for pregnant females bases on BMI BMI (body mass index) Calculated by dividing weight(kg) by height(m) squared Underweight (BMI under 19.8) pounds Normal(BMI ) pounds Overweight (BMI over 26) – 15 to 25 pounds **Institute of Medicine, 1990

Reference Life Cycle Nutrition by Sari Edelstein. Article “Weight Gain in High Risk Pregnant Women…” Chapter 2 supplement by Brown