Nutrition & Pregnancy

- Not really eating for 2! Most women need only 300-400 more calories/day, but really need to concentrate on increasing the nutritional value of what they eat!

- Nutrtional counseling: consider culture, economic status, individual dietary habits (very few people can make major changes and stick to them), symptoms effecting intake (nausea), motivation of mother...

- Maternal Malnutrition: poor intake or inability to properly absorb nutrients results in reduced blood volume, which results in inadequate increase in Cardiac Output which results in decreased placental blood flow, which results in placental size decrease and reduced nutrients to fetus, which results in SGA infants (always at risk!)

- Weight gain: 25-35 pounds for average person, if underweight to begin with: 28-40, if overweight: 15-25 but even overweight women should see some weight gain. NO ONE should lose weight during pregnancy; mom’s can eat more when lactating without gaining excess weight, Pregnant women should NEVER skip meals, especially nighttime meals d/t risk of hypoglycemia

- Nutritional Intervention: Calcium may help prevent preeclampsia, Folate and Iron are absolutely NECESSARY! (And of course an increase in Vitamin C is needed to absorb Iron), there is a possible link between anemia and postpartum depression (but remember to tell mom’s that iron supplement overdose is the #2 leading cause of childhood poisoning because iron supplements look like candy)

            - Protein: pregnant women can eat 5 eggs/week instead of just 3, peanut butter is a good protein/fat source

            - Fat: necessary for vitamin A, D, E, & K

            - Carbs: complex carbs are always better...

            - Vitamins: B6 is a placental stabilizer (whole grains), B12 is needed so eat BEEF

            - Folic acid: should be supplemented before women get pregnant if possible... reduce Neural Tube Defects

            - Minerals: zinc (in high protein foods) aids in hormone development; flouride needed for teeth/bones

            - Iron: women need twice as much during pregnancy

            - Iodine: aids in thyroid regulation

            - Calcium: regulates smooth muscle, may prevent HTN/preeclampsia, need 1200-1500mg and 1 glass skim milk is about 300mg

            - Sodium: no sodium restrictions unless there’s hx of heart disease (rheumatic fever, valvular problems), most sodium intake comes from: 77% processed foods, 12% naturally occurring, 6% table salt, 5% during cooking

- Diet improvement: no dieting, no artificial sweeteners (pregnant moms need the calories)

- Nutritional Don’ts: caffeine (not actually a problem in moderation, but make sure mom gets plenty of fluids otherwise), alcohol: it’s not known how much is too much; Drugs: never, don’t be stupid; Smoking: the fetus gets the full effects of smoking, smoking is always dangerous during pregnancy

- Fetal Alcohol Syndrome: this is really very preventable