Nutrition in Pregnancy and Lactation

Prepared By:
Anita Credo
Froilan Enolpe
Meloaise Feliciano
Zeny Jean Gallegos
 Pregnancy is the most critical and
unique. Critical because during
pregnancy, the foundation of a new life
is being laid that will influence the future
of succeeding generation.
 Unique in that at no other time in life
does the well being of an individual
depends so much on the well being of
other.
The health of the mother before and
during the pregnancy has profound
effect on the status of her infant in the
womb and birth.
NUTRITIONAL NEEDS IN
PREGNANCY
 Pregnancy or gestation is the period from

conception to birth and for human beings last
38 to 40 wks. Divided into thirds or trimesters.
The 1st,2nd and 3rd trimesters. Pregnancy has
three stages namely , implantation,
organogenesis and growth.
 Implantation
 - is the period in which the fertilized ovum implants itself
in the uterus and begins to develop. Usually occurs during

the first two weeks of conception. During organogenesis,
the embryo undergoes differentiation or rapid cell division
that occurs from two to eight weeks after conception.
Called critical period.
 Critical period is an interval of time during which cells of a
tissue or organ are genetically programmed to multiply.
 Hormones
 - pregnant woman secretes more than 30 different
hormones during pregnancy.One most interesting
special functions of placenta is the production of
hormone to regulate the activities of pregnancy.
 Progesterone
 - causes relaxation of smooth muscles of uterus
other smooth muscles in the body. Other effects of
progesterone are to favor maternal fat deposition
and increase renal sodium excretion.
 Estrogen
 - the role of estrogen is to promote the growth and
control the function of uterus.
 WEIGHT GAIN
 All woman need to gain weight during pregnancy for
fetal growth and maternal health.
 Two characteristic of a mother’s weight that influence
infant’s weight at birth are: her weight prior to

conception and her weight during pregnancy.
New Recommendations for Total and Rate of Weight
Gain During Pregnancy, by Pregnancy Body Mass Index (BMI)
Second and Third

Total Weight Gain Trimesters
Range (kg) Range (lb) Mean (Range) Mean
Prepregnancy (kg/wk) (Range)
BMI (kg/m2) (lb/wk)
Underweight 12.5–18.0 28.0–40.0 0.51 (0.44–0.58) 1.0 (1.0–
(less than 18.5) 1.3)
Normal weight 11.5–16.0 25.0–35.0 0.42 (0.35–0.50) 1.0 (0.8–
(18.5–24.9) 1.0)
Overweight 7.0–11.5 15.0–25.0 0.28 (0.23–0.33) 0.6 (0.5–
(25.0–29.9) 0.7)
Obese (30.0 or 5.0–9.0 11.0–20.0 0.22 (0.17–0.27) 0.5 (0.4–
higher) 0.6)
components of weight gain during
pregnancy
component Weight gain (kg) Weight gain (lbs)
Fetus 3.2-3.7 7-8

Placenta and amniotic 1.4-2.5 3-5.5
fluid 4-6
Tissue fluid 1.8-2.7 3-4.5
Maternal blood 1.4-2.0 2- 3
Enlargement of uterus 0.9-1.4 1-1.5
Breast 0.5-0.7 4-6.5
Fat stores 1.8-2.0
11 to 16 kg 24 to 35 lbs
 Pregnant woman’s rate of weight gain should follows
this trend. Thus , she should gain 0.9-1.8 kg (2-4 lbs)
by the end of first trimester and approximately 0.45 kg
( 1 lb) a week thereafter. A sudden weight gain the
exceeds the usual rate especially during the 20th week
of gestation is an indication of toxemia.
 Underweight woman BMI <18.5 have a high risk of
having a low birth weight infant (<5lbs), pre term
infant.
 Overweight woman BMI 25-29 are the high risk for
complication of pregnancy such as hypertension,
gestational diabetes and postpartum infection.
 THE ROLE OF PLACENTA

 placenta is an amazing organ that plays a crucial role
in pregnancy in keeping the baby alive and well. When
it is delivered after the birth of the baby, it looks
somewhat like a piece of liver, and usually weighs
about one sixth of the baby’s weight.
 The main function of the placenta is to supply the
baby with adequate nutrition. Blood from the mother
goes through the placenta then into the umbilical cord
attached, before reaching the baby. This blood
contains oxygen, glucose and an array of other
nutritional substances. Before the blood goes to the
baby, the placenta works like a kidney to filter it of
harmful substances, while also letting those that are
good for the baby pass through.
 Simple Diffusion
 only diffuse a small category of substances. For a
compound to be able to pass through a cell membrane
via simple diffusion, it must be able to penetrate the
cell's phospholipid bilayer. Since the core of the
phospholipid bilayer is hydrophobic, compounds must
be hydrophobic themselves, and they must also be
small. Common molecules that utilize simple diffusion
include carbon dioxide and oxygen.
 Facilitated Diffusion
Involves carrier in the cell membrane so the rate of
transfer is faster than simple diffusion. Active
transport moves a nutrient against an electrochemical
gradient and requires a carrier protein and energy to
this.
NUTRIENT REQUIREMENTS
 ENERGY
 Two factors that determine energy requirements are
the mother usual physical activity and the increase in
metabolic rate to support the work required for growth
of thee fetus. The cumulative cost of this extra work is
80,000 calories. Translates into 300 kcal per day.
 PROTEIN
 Nutrients is essential as it forms the structural basis
for all new cells and tissues in the mother and fetus.
About 925 g of protein are deposited in the normal
fetus and maternal tissues.
Extra protein requirements for
pregnancy and lactation
 FATS
 During pregnancy, the additional demand for uterine ,
placental and fetal growth together with the increased
maternal blood volume and mammary gland
development, raises the EFA requirement by 1.5%
energy in the maternal diet, adding up at least 4.5%
energy EFA.
 VITAMINS
 - Vitamins are important during pregnancy, most
importantly cited are folic acid, ascorbic acid and B-
vitamins.
 ASCORBIC ACID RNI
 For pregnancy 80 mg/day, which is an individual 10

mg/day. Studies showing the role of vitamin C in
premature rupture of membranes. Low plasma levels of
vitamin C has been observed in cases of pre-eclampsia.
 THIAMIN, RIBOFLAVIN AND NIACIN
 Related to caloric intake.
 FOLIC ACID
 Suggest that deficiency of folic acid influences the
occurrence of low birth weight and preterm.
 VITAMIN B6
 Requirements increases in pregnancy because of
greater need for nonessential amino acid for growth
and also because the body is making more niacin from
tryptophan.
 VITAMIN B12
 Status is associated with intrauterine growth retardation in

infants.
 VITAMIN A
 Is an essential nutrient because of its critical role in

reproduction.
 VITAMIN D
 Has a positive effect on calcium balance during pregnancy. Maternal

ingestion of large amounts of vitamin D is linked to neonatal
hypocalcemia, calcification of soft tissues and craniofacial
abnormalities.
 MINERALS
 Need during pregnancy are increased so that if the
mother’s diet does not provide what is required by the
fetus, pregnant woman needs access their stores to ensure
the fetus adequate support.
 IRON
 Iron is 34-38 mg/day during the second and third trimester

of pregnancy . During pregnancy , iron is needed for the
manufacture of hemoglobin in maternal and feral red
blood cells.
 CALCIUM
 Promote adequate mineralization of the fetal skeleton
and deciduous teeth during pregnancy. Fetus acquires
most of its calcium.
 MAGNESIUM
 Fetus accumulates about gram magnesium during
gestation.
 IODINE
 Should be adequately provided during pregnancy
because of increased basal metabolic rate.
 ZINC
 Severe reduction of circulating zinc occurs in the

mother’s blood , there is possibility of increased risk of
spontaneous abortion and congenital malformation.
 FLUORIDE
 Development of primary dentition of fetus starts on

the 10 to 12th weeks of pregnancy.
 COMMON NUTRITION-RELATED CONCERNS
DURING PREGNANCY AND DIETARY
INTERVENTION
 NAUSEA AND VOMITING

 HEARTBURN
 CONSTIPATION
 EDEMA
 LEG CRAMPS
 RAPID WEIGHT GAIN OR LOSS
 OTHER NUTRITION-RELATED CONCERNS
DURING PREGNANCY
 PREGNANCY-INDUCED HYPERTENSION
- PRE-ECLAMPSIA
- ECLAMPSIA
 ANEMIA
 GESTATIONAL SIABETES
 OTHER PRE-EXISTING MEDICAL PROBLEMS
 The major factors that directly influence birth weight are:
 Duration of pregnancy
 Prenatal weight gain
 Pregnancy weight
 Smoking
*CIGARETTE SMOKING
*ALCOHOL ABUSE
*OVER THE COUNTER DRUGS AND HERBAL
SUPPLEMENTS
• ILLICIT DRUGS
• * CAFFEINE
PHYSIOLOGY OF LACTATION
 Lactation is the period of milk production by the
mammary gland. Preparation for lactation starts
during adolescene when hormonal changes.
NUTRITIONAL REQUIREMENTS
DURING LACTATION
 ENERGY
 WATER AND OTHER FLUIDS
 LIPID
 MINERALS
 VITAMINS
ADVANTAGES OF BREAST FEEDING
 TEN ADVANTAGES OF BREAST FEEDING
 Human milk is nutritionally superior to other kinds of
milk.
 Breast milk is bacteriologically safe.
 Breast milk is always fresh and at the right
temperature for the baby.
 It contains immune cells and antibodies that will give
natural immunity for the baby.
 It is inexpensive compared to commercial milks.
 Breast-feeding is convenient.
 It promotes closer mother baby ties or contact.
 Babies are lest likely to be overload with breast-
feeding.
 Brest feeding promotes good tooth and jaw
development.
Thank
you 

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 Pregnancy or gestation is the period from

 - is the period in which the fertilized ovum implants itself

in the uterus and begins to develop. Usually occurs during

infant’s weight at birth are: her weight prior to

Second and Third

Fetus 3.2-3.7 7-8

 THE ROLE OF PLACENTA

 ASCORBIC ACID RNI

 For pregnancy 80 mg/day, which is an individual 10

 Status is associated with intrauterine growth retardation in

 Is an essential nutrient because of its critical role in

 Has a positive effect on calcium balance during pregnancy. Maternal

 Iron is 34-38 mg/day during the second and third trimester

 Severe reduction of circulating zinc occurs in the

 Development of primary dentition of fetus starts on

 NAUSEA AND VOMITING

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