Nutritional Health During Pregnancy

One of the most important aspects in pregnancy is the woman’s nutritional status. Despite the discomfort she may feel towards eating early in pregnancy, she should never take her nutrition for granted because of the life that is dependent inside of her.

Recommended Weight Gain

• An average weight gain during pregnancy is 11.2 to 15.9 kg or 25 to 35 lbs.
• For a more precise estimation of adequate weight gain, compute using the body mass index, which is the ratio of weight to height.
• Weight gain during pregnancy occurs due to fetal growth and accumulation of maternal stores.
• On the first trimester, approximately 0.4 kg or 1 lb per month weight gain is recommended.
• On the last two trimesters, a weight gain of 0.4 kg or 1 lb per week is recommended.
• Excessive weight gain occurs with 3 kg or 6.6 lbs of weight gain per month during the last two trimesters.
• A weight gain of less than 1kg or 2.2 lbs in the second and third trimesters is less than usual.

Nutrition for the Pregnant Woman

Energy Needs

• The DRI or Dietary Reference Intake of calories of women of childbearing age is 2200.
• For pregnant women, an additional of 300 calories for a total of 2500 calories is recommended.
• This addition in calories provides more energy to the fetus and an elevated metabolic rate to the woman.
• Advise woman to obtain calories from complex carbohydrates like cereals and grains because these are digested more slowly to regulate glucose and insulin.
• Encourage women to prepare healthy snacks such as carrot sticks, cheese, and crackers at the start of the day.
• Assess the weight that the woman is gaining so you can determine if the woman’s caloric intake is adequate.
• Advice the woman not to restrict caloric intake as the fetus is rapidly growing in the final weeks.

Protein Needs

• The DRI for protein in women is 46g/d.
• If protein needs are met, overall nutritional needs are met as well except for vitamins C, A, and D.
• Vitamin B12 is found in animal protein; therefore inadequate protein means vitamin B12 deficiency.
• Complete protein or protein that contains the nine essential amino acids can be found in meat, poultry, fish, eggs, yogurt, and milk.
• Incomplete protein or the protein that does not contain all essential amino acids comes from non animal sources.
• When the woman has a history of hypercholesterolemia, advise her to consume lean meat, olive oil, and to remove the skin from poultry.
• Milk is also a rich source of protein, and for women who are lactose intolerant, she can add lactase supplement, take calcium supplements, or buy lactose-free milk.
• Yogurt or cheese can also be a substitute for milk.

Fat Needs

• Linoleic acid is a fatty acid that cannot be manufactured by the body and must therefore be obtained from other sources.
• Vegetable oils such as olive, corn, and safflower contains linoleic acid that must be consumed by the pregnant woman.
• Advise the woman to avoid animal fats such as butter.
• Encourage intake of omega-3 oils found in fish, omega-3 fortified eggs, and spreads.

Vitamin Needs

• Vitamin D which is essential for calcium absorption, when lacking in a pregnant woman would result to diminished maternal and fetal bone density.
• Lack of vitamin A results in tender gums and poor night vision.
• Advise the woman to consume plenty of fruits and vegetables and her daily prenatal vitamins to meet the daily vitamin intake requirements.
• Advise the woman not to use mineral oils as laxative because it prevents the absorption of fat-soluble vitamins.
• Folic acid is important for the production of red blood cells and can be found mostly in fresh fruits and vegetables.

Mineral Needs

• Calcium and phosphorus is needed for bone and teeth formation and should be consumed by the pregnant woman.
• The woman needs to ingest iodine for the proper functioning of the thyroid gland, and it is most commonly found in seafood.
• The DRI for iron for pregnant women is 27 mg, so the woman must ingest foods rich in iron and iron supplements to build more hemoglobin for the fetus.
• Sodium maintains fluid in the body, so it is advisable for the pregnant woman to continue adding salt into her food if not restricted.

Fluid Needs

• Advise the woman to drink extra amounts of water to promote kidney function.
• Encourage intake of 2 to 3 glasses of fluid daily over three servings of milk.

Fiber Needs

• To prevent constipation, encourage the woman to eat plenty of fruits and green, leafy vegetables to provide fiber.
• Fiber can also lower cholesterol levels and removes carcinogenic contaminants from the intestine.

Healthy Signs of Good Nutrition

• The hair is shiny and strong with good body.
• The woman has good eyesight especially at night; the conjunctivae are moist and pink.
• There are no cavities in the teeth, no swollen or inflamed gingiva, no cracks or fissures at the corners of the mouth, the mucous membranes are moist and pink, the tongue is smooth and non tender.
• The neck has a normal contour of the thyroid gland.
• The skin is smooth with normal color and turgor, no ecchymosis and petechiae present.
• The extremities have a normal muscle mass and circumference; normal strength and mobility, and edema are minimal.
• The fingernails and toenails are smooth, pink, and normal in contour.
• The weight should be within normal limits of ideal weight before the pregnancy.
• The blood pressure is within normal limits for length of pregnancy.

The woman must stay healthy through the entirety of her pregnancy, and most of the nutrients she needs come from food sources. Proper health and nutrition education should be discussed by the healthcare provider to ensure that the pregnant woman is getting the right amount of nutrients that she and the fetus needs.