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IV. Life Stages

         

Changes with age: Pregnancy and Lactation

General principles:

1. The critical issue is to provide adequate vitamins, minerals and calories to support normal growth of the fetus/baby and the placenta and uterus. In humans the developing brain is the major (60%) consumer of energy at birth; materials and energy for this prodigious growth must be supplied by and to the mother in order to assure the best possible outcome.
2. Excellent nutrition should be in place at least 60 to 90 days prior to conception, and should continue throughout pregnancy. Numerous serious problems, from low birthweight to neural tube defects, can be prevented with adequate nutrition.

Specific nutritional concerns:

1. Weight gain during pregnancy is important for all women, and should occur at an appropriate rate.
   • Underweight women should gain more than average women.
   • Overweight women should gain less, but they should gain some weight in order to assure having a normal birthweight baby.
   • Circumstances such as intent to breastfeed, having twins, being biologically immature (some teen pregnancies), etc., alter the ideal weight gain pattern. It is important to tailor weight gain to individual circumstances.
2. Special nutritional concerns for pregnant women resemble those for adolescents:
   • The diet must contain adequate protein to support growth of the fetus, placenta and uterus.
   • Adequate iron is essential, both for the mother and to assure that the infant has a good store of iron at birth.
   • Adequate folic acid (400 micrograms/day) significantly reduces incidence of neural tube defects.
   • As for all women, sufficient dietary calcium is important for pregnant and lactating women.
   • Excess vitamin A and retinoic acid (used for acne treatment) have been linked to birth defects; excess vitamin A should be avoided.