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NUTRITION FOR MOTHER AND CHILD*

 Dr. Vimal Verma***

Mother’s diet is one of the most important determinants of the baby's health and development. Regulation and attention to the diet should begin before pregnancy. It is known that good nutrition before child bearing is important because of the amount of "resources" childbirth requires. Pre-pregnancy nutrition is a process of "building up" the immune system and is known as being one of the major factors in determining the success of having healthy children.

For the embryo, the time of conception, and the subsequent weeks afterwards is the time when it is most vulnerable, as it is the time when the organs and systems develop. The energy used to create these systems comes from the energy and nutrients in the mother's circulation systems and around the lining of the womb. For this reason correct nutrient intake during pregnancy is important.

Low maternal weight, inadequate weight gain during pregnancy and inadequate intake of protein and calories by the expectant mother are associated with increased mortality of the new born and retarded growth in child.

During the early stages of pregnancy, the placenta is not formed, so there is no mechanism to protect the embryo from the deficiencies which may be inherent in the mother's circulation. Thus it is critical that the correct amount of nutrients and energy are taken in by expectant mothers before and during pregnancy. Nutritional recommendations during pregnancy, stress the importance of adequate intake of energy, protein, vitamins and minerals. This is essential for maternal health as also for foetal development. Expectant mothers must not only increase the total calorie and protein intake, but must also enhance the vitamin and mineral intake to cope with the nutrient requirements of the growing foetus and maternal tissue. Many expectant mothers develop nutritional anaemia which is mostly associated with inadequate iron intake.

Nutrition During Lactation
Maternal milk is the best food for infants. It provides a number of dietary components and hosts resistance factors for the baby. Thus the nutrition needs of a nursing mother are much more, because the kind of nutrition she consumes, determines the quantity and quality of milk that directly affects the health of her baby. Under ordinary circumstances breast feeding is recommended for all infants for at least the first six months of life and preferably for all of the first year in combination with appropriate supplementation from solid foods. The levels of most nutrients in milk such as calcium and foliate are maintained at the expense of maternal reserves.

The food that the mother consumes not just fulfills her nutritional requirements, but is also used in the production of milk. A nursing mother produces 23 to 27 ounces of milk per day and thus, there arises a need to consume about 600 extra calories per day.
The nutrition for nursing mothers plays a vital role in defining the quality of breast milk. There is a possibility that the nursing mother might have a healthy baby, despite the fact that she had not fed herself properly during pregnancy. It is during the time of lactation that the body makes milk production as its first priority, leaving the nursing mother deprived of nutrition.

Newborns generally double their weight by five months of age. This means that within five months the mother must supply the infant with the same energy, protein and other nutrients through breast feeding that she supplied during nine months period in uterus via the placenta. Quite clearly, the nutritional demands of lactating mother are much bigger than the demand of expectant mothers.

Nutrient

Recommended intake for non-pregnant women

Recommended intake for pregnant women

Recommended intake for Lactating mothers

Energy(kcal/day)

2,200

2,600

2,800

Protien(g/day)

50

+1 (fist trimester)

+9 (second trimester)

+31 (third trimester)

+19 (0-6 months)

+13 (-12 months)

Vitamin A (µg/day)

700

770

1300

Vitamin D(µg/day)

5

5

5

Vitamin C (mg/day)

75

85

120

Vitamin E (mg/day)

15

15

19

Folate(µg/day)

400 

600

500

Thiamin(mg/day)

0.9-1.2 

+0.2

+0.3

Riboflavin (mg/day)

1.1-1.

+0.2

+0.3

Naacon(mg/day)

12-16

+2.0

+4.0

Vitamin B6 (mg/day)

2

2.5

2.5

Vitamin B12 (µg/day)

2.4

2.6

2.8

Iron (mg/day)

30

38

30

Calcium(mg/day)

1000

1000

1000

Magnesium(mg/day)

310

350

310

Iodine(µg/day)

150

220

290

 

Nutrient

Source

Why?

Protein

Pulses, beans, tops, chicken, fish, meat, eggs, nuts and oil seeds

Essential for the growth of the baby.

Calcium

Milk and milk products, peanuts, dried apricots, raisins, dates, sesame seeds  (if necessary supplements can be given)

Essential for development of the baby's bones. For preventing tooth decay and osteoporosis in mother. Most needed in the last three months.

Folic Acid

Green leafy vegetables, citrus fruits and legumes

Important in the development of the baby's brain and spinal cord. Most needed in the 1st three months.

Iron

Green leafy vegetable, beans, lean meats, eggs, whole grains, legumes, jaggery

Essential for both baby and mother for proper development of red blood cells.

Fiber

Whole wheat, beans, fruits, raw vegetables, dry fruits.

Prevents constipation, a very major problem during pregnancy.

Fluids

6 - 8 glasses of water, juice

Needed to feed the increased blood volume and for the amniotic fluid that protects the baby. Too little fluid can tax expecting mother’s kidneys.

Some nutrition guidelines for the nursing mother:
It is during lactation that the nursing mothers tend to feel thirstier, owing to the fact that part of their water consumption is utilized by the body for the formation of milk. It thus becomes necessary to increase water intake by one litre per day.

To increase the calorie consumption to about 2800 calories per day mothers should opt for healthy foods that are rich in nutrients required by the body.

She should eat more of protein rich foods.

She should eat multiple small meals. Follow a five-meal routine: breakfast, lunch, after- noon snack, an extra snack during the evening and dinner.

Keep away from tobacco, as the nicotine would get transferred into the child's body through breast milk.

Say no to alcohol, as alcohol can retard the growth of the baby. (PIB Features)
*(Based on DGHS Handbook for Physicians, Diaticians and Nurses, Authors- Dr.RK Srivastava, Dr. Yatish Agrawal, D. BK Tiwari)
 

**Freelance Writer

Disclaimer : The views expressed by the author in this feature are entirely his own and do not necessarily reflect the views of PIB

RTS/VN
SS-98/SF-98/03.09.2009

PIB Aizawl

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