NUTRITIONAL REQUIREMENTS

ACROSS ALL AGES

Pregnancy & Lactation

OBJECTIVE

1. Identify the nutritional requirements

across all ages (pregnancy,
lactation, infancy, toddler, adolescent,
adult and elderly)
2. Modify the normal diet to meet the
needs of each life stage
3. Describe and discuss the different
nutrition related disorder of each life
stage.
 DIRECTIONS/MODULE ORGANIZER
1. Read the lesson and as you do, you may have
with you any of the reference books to help you
understand topics which need further explanation.
2. Do the learning activities at the end of the
lessons.
3. Consult or make an interview with a
nutritionist/dietician or any expert to further
enhance the understanding of the concepts you
have learned from the module.
 Pregnancy & Lactation

Energy and Nutrient Requirement

During Pregnancy
The energy needs of pregnant women are greater
than those of nonpregnant women
an additional 340 kcalories during the second
trimester and an extra 450 kcalories during the third.
Underweight women and physically active women
may require more. A woman can easily get these
added calories with an extra serving from each of
the five food groups
 Pregnancy & Lactation

Protein. The protein RDA is

an additional 25 grams per
day. increase by 20% for
pregnant women over 25
y/o. By 25 % for pregnant
adolescent.
 Pregnancy & Lactation

Protein.
Proteins are essential for tissue
building
Protein rich foods are excellent
sources of may other essential
nutrients especially iron,
copper , zinc and B vitamins
 Dietary Needs of Pregnancy & Lactation

Essential Fatty Acids.

Long-chain polyunsaturated fats are
particularly important to the growth and
development of the fetus.
The brain is largely made of lipid material,
and it depends heavily on the long-chain
omega-3 and omega-6 fatty acids for its
growth, function and structure.
 Dietary Needs of Pregnancy & Lactation

Iron. 27 mg/day it increases

because of inc blood volume and to
provide for placental and fetal needs.
Fetus increases its hemoglobin level
to 20-22 gms/day per 100 ml of blood:
this is twice the normal hemoglobin
level of 13-14 mg/ 100 ml of blood.
 Dietary Needs of Pregnancy & Lactation

Zinc. It is required for DNA and

RNA synthesis and thus for
protein synthesis and cell
development. The RDA is:
12 mg/day ( 18 yr.)
11 mg/day ( 19-50 yr)
 Dietary Needs of Pregnancy & Lactation

Vitamin D
vitamin D does not increase during
pregnancy.
Regular exposure to sunlight and
consumption of vitamin D- fortified mil are
usually sufficient to provide the
recommended amount of vitamin D during
pregnancy.
10 mcg/day
 Dietary Needs of Pregnancy & Lactation

B vitamins. The need is

slightly greater because it
is needed for the
activation of the folate
enzyme- vitamin B12.
 Dietary Needs of Pregnancy & Lactation

Folate.
For the synthesis of DNA and new cells.
Sources are: fortified foods that includes
fruits, juices, green veg and whole grains.
To prevent Neural Tube Defect during
critical time.
600 mg
 Dietary Needs of Pregnancy & Lactation

Vitamin A No increase on Vit. A

More than 3,000 Retinol Equivalent (RE)
causes birth defects such as hydrocephaly
( enlargement of the fluid filled spaces of
the brain), microcephaly (small head),
mental retardation, eye & ear
abnormalities, cleft lip, cleft palate and
heart defects.
 Dietary Needs of Pregnancy & Lactation

Vitamin C increased.
For collagen formation and to increase
absorption of iron.
Increase consumption of Milk, cheese,
yogurt and other calcium rich foods if
pregnant, is under 25 and if calcium
intake of less than 600mg/day
 Dietary Needs of Pregnancy & Lactation

Vitamin deficiency
interferes w/ calcium
metabolism, produce abnormal
fetal bones and teeth and will
result in rickets (fetus),
osteomalacia (mother)
 Dietary Needs of Pregnancy & Lactation

Ca, Iron, Iodine

and selenium, are in
great demand for
bone building .
 Dietary Needs of Pregnancy & Lactation

Calcium
For development of the infants bone
and teeth, help in blood clotting and
muscle action
If the mother is not consuming
adequate calcium in her diet, the baby
will get its calcium from her bones
 Dietary Needs of Pregnancy & Lactation

Prenatal supplements
help reduce risks of preterm births, low
infant birth weights and birth defects,
especially to women who belong to high
risk groups, - w/ multiple foetuses, cigarette
smokers, alcohol and drug abusers.
because they have inadequate intake of
nutritious foods.
 Dietary Needs of Pregnancy & Lactation

The Mypyramid suggest

3 servings of milk for
women who are pregnant
or breastfeeding.
 CONCERNS DURING PREGNANCY.

1. NAUSEA
caused by the increased level
of the pregnancy hormones
HCG and estrogen circulating
in the body.
 CONCERNS DURING PREGNANCY.
Strategies to alleviate
1. on waking, arise slowly
2. eat dry, toast/crackers or consume CHO
before getting out of bed in AM.
3. chew gum/ suck hard candies
4. eat small, frequent meals
5. avoid foods w/ offensive odors
6. when nauseated, dont drink citrus juice,
water, milk, coffee or tea.
 CONCERNS DURING PREGNANCY.
2. CONSTIPATION AND HEMORRHOIDS
- due to increased estrogen and
progesterone.
Constipation tends to cause straining and
straining puts pressure on the rectal veins,
producing hemorrhoids during pregnancy
and pressure on the pelvic veins would
cause hemorrhoids during pregnancy.
 CONCERNS DURING PREGNANCY.

Strategies to Alleviate Constipation

1. Eat fiber rich food (fruits & veg, & whole
grain cereals.
2. Exercise regularly
3. Drink plenty of water
4. Respond promptly to the urge to defecate
5. You may use laxative only if with
prescription
 CONCERNS DURING PREGNANCY.

3. HEARTBURN.
Due to the hormones of pregnancy that
may relax the digestive muscles and the
growing fetus puts pressure on the
mothers stomach.
With these, it allows stomach acid to back
up into the Lower Esophageal Sphincter
and create a burning sensation.
 CONCERNS DURING PREGNANCY.

Strategies to Alleviate Heartburn

1. Relax and eat slowly
2. Avoid drinking fluids immediately
after meals
3. Eat small frequent meals
4. Avoid spicy foods/ greasy foods
and coffee
 CONCERNS DURING PREGNANCY.

Strategies to Alleviate Heartburn

5. Sit up while eating
6. Elevate the head while sleeping
7. Wait an hour after eating before lying
down
8. wait 2 hours after eating before
exercising.
 CONCERNS DURING PREGNANCY.

4. FOOD CRAVINGS AND AVERSION

- some women develop cravings or an
aversion to particular foods and beverages
and its fairly common. And its due to
hormone- induced changes in sensitivity to
taste and smell.
Non-food Cravings is called as PICA
e.g.- starch, clay/soil, or ice or dirt. Craving for
clay/dirt its called GEOPHAGIA
 CONCERNS DURING PREGNANCY.

5. PREGNANCY-INDUCED HYPERTENSION
(PIH)
- Formerly called toxemias of pregnancy
or preeclampsia. It is characterized by
high blood pressure, proteinuria and
edema. It occurs during the 3rd trimester.
 CONCERNS DURING PREGNANCY.

6. Excessive Weight gain

if weight gain becomes excessive, the woman should reevaluate her
diet and eliminate foods except for extra pint of milk
Foods to eliminate or limit: candy cookies, rich desserts, chips, salad
dressings, sweetened beverages
Reduce caloric intake but not intake of proteins, vitamins and
minerals
A bowl of clean, crisp, raw vegetables such as broccoli or cauliflower
tips, carrots, celery, cucumber, succinic sticks, or rdishes dipped in a
fat free salad dressing are nutritious, satisfying and low calories
Fruits and custards made with fat free milk
Boiling, baking or boiling foods instead of frying is ideal
 CONCERNS DURING PREGNANCY.

7. ANEMIA
Insufficient RBC, hemoglobin and
blood volume
Iron Deficiency- most common
form of anemia
During pregnancy the increased blood
volume of blood creates the need for
additional iron
 CONCERNS DURING PREGNANCY.

7. Anemia cntd.
Megaloblastic anemia
Due to folate deficiency
Characterized by too few RBC and
by large immature red blood cells.
Folate supplement of 400-600 ug
a day
 PRACTICES INCOMPATIBLE WITH PREGNANCY

1. Alcohol drinking
may cause irreversible mental
(intelligence deficit)and physical
retardation of fetus and its called
Fetal Alcohol Syndrome (have low
birth weightcharacteristics are, small
head, short eye slits, a flat mid-face
and thin upper lip
 PRACTICES INCOMPATIBLE WITH PREGNANCY

1. Alcohol drinking cntd

Effects on the mother
placenta previa, abruptio
placenta, PROM,
Hypertension, decrease
appetite and infertility
 PRACTICES INCOMPATIBLE WITH PREGNANCY

2. Caffeine
moderate to heavy use may
inc. spontaneous abortion. Limit
it to at least 2 12oz.caffeine
containing beverages / day or
less than 300mg/day.
 PRACTICES INCOMPATIBLE WITH PREGNANCY

3. Drugs
may impair fetal growth
and development. Causes
preterm births, peri-natal
deaths and SIDS.
 PRACTICES INCOMPATIBLE WITH PREGNANCY

4. Smoking and chewing

tobacco- it will restrict blood flow
to the fetus that may lead to
limited oxygen and nutrients going
to the baby. And so with the waste
removal is limited. Causes low birth
weight and complicated births.
 PRACTICES INCOMPATIBLE WITH PREGNANCY

Diet for pregnant women with

Diabetes Mellitus/Gestational
Diabetes Mellitus.
CHO intake be limited to
30-40% to maintain normal
blood glucose.
 NUTRITION DURING LACTATION

Lactation
The period during which the
mother is nursing the baby
is the production and secretion
of breast milk for the purpose
of nourishing an infant.
 NUTRITION DURING LACTATION

Lactation
It is an automatic physiological process
that virtually all mothers are capable of
doing it. Breastfeeding, on the other
hand, is a learned behaviour that not all
mothers decide to do.
Recommended duration is 6 months to
1 year.
 Pregnancy & Lactation

Lactation CNTD
It takes 2-3 weeks to have a fully
established feeding routine.
And breastfeed infant 10 -15 minutes
each breast. The American Academy
of Pediatrics recommends breast milk
for the first 6-12 months of life.
 CALORIE REQUIREMENT DURING LACTATION

A nursing mother produces over 35

gallons of milk during the 1 st six
months. To produce 3 oz of milk, it
needs about 85 kcal.
To produce an adequate supply of milk, a
woman needs extra energy almost 500
calories a day above her regular need.
 CALORIE REQUIREMENT DURING LACTATION

1st 6 months average milk production is 750

ml or 25 oz/ day so it needs an additional 640
kcal/day
2nd 6 months average milk production is 20 oz
or 600 ml (baby begins to eat).It needs
additional 510 kcal/day.
1st month feed baby 8-12x/day
Succeeding months feed the baby by demand.
 CALORIE REQUIREMENT DURING LACTATION

Increase Carbohydrate (to replace the glucose

used to make the lactose in breast milk),
fiber, Vitamins & minerals, Iron, Protein
(10gms of protein are secreted in the milk
daily). And
increase in water to prevent Dehydration.
Adequate vitamins and minerals is needed to
produce milk.
 BENEFITS OF BREASTFEEDING

1. Contains right amount of water, EFA

and AA for brain development, and
growth and development.
2. Lower incidence of ear infections,
diarrhea and allergies.
3. Through sucking it promotes good jaw,
growth of straight and healthy teeth.
 BENEFITS OF BREASTFEEDING

4. Babies, receives immunities from the

mother.
5. The child can be protected against SIDS
6. Lower risk of childhood onset diabetes
7. Decreased risk of asthma and eczema
8. Decreased risk of obesity later in life
 Benefits for Breastfeeding Mothers

1. it helps the uterus to contract and

bleeding to cease more quickly after
delivery.
2. Breastfeeding can reduce the risk
of breast and ovarian cancer
3. Also, it provides a great way for
mothers to bond with their babies.
 Benefits for Breastfeeding Mothers

4. The skin-to-skin contact can boost

the mothers oxytocin levels
5. Saves money.
6. Conserves iron store by prolonging
amenorrhea
7. Delays the return of ovulation thus
lengthening birth intervals.
 Other Considerations in Breastfeeding

1. Infants for the first 6 months be

fed 8-12 times per day and the
succeeding months, be fed by
demand or whenever the infant
cries with hunger, promote optimal
milk production and infant growth.
 Other Considerations in Breastfeeding

2. Avoid spicy flavours Such

as garlic because it alter the
flavour of breast milk
 Other Considerations in Breastfeeding

3. Babies who develop symptoms

of food allergies exclude from the
diet the common offenders such as
cows milk, eggs, fish and
peanuts. But infant with strong
family history of food allergy
benefit from breast feeding.
 Components of breast milk and the nutrients they provide for the baby.

Proteins. Human milk contains two types of

proteins:wheyandcasein.Approximately
60-80% of all protein in human milk is whey
protein. These proteins have great infection-
protection properties.
Another protein present is the alpha-
lactalbumin, the major protein in breast milk
which is efficiently digested and absorbed
 Components of breast milk and the nutrients they provide for the baby.

Proteins cntd.
Another protein present is the
alpha-lactalbumin, the major
protein in breast milk which is
efficiently digested and absorbed
 Components of breast milk and the nutrients they provide for the baby.

Lactose. Enhances
calcium absorption.
Vitamins. Vitamin D in breast
milk is low. Exposure to
sunlight daily is needed.
 Components of breast milk and the nutrients they provide for the baby.

Lipids.
Contains a generous proportion of the
essential fatty acids linoleic acid and
linolenic acid as well as the arachidonic
acid and docosahaexanoic acid (DHA),
which they are important to the mental
and visual development.
 Components of breast milk and the nutrients they provide for the baby.

Minerals.
The calcium content of breast milk is ideal for
infant bone growth and the calcium is well
absorbed
It has a relative small amount of Iron, but Iron
and Zinc has a high bioavailability, thanks to the
zinc-binding protein.
Breast milk is low in Sodium another benefit for
immature kidney.
 Specific proteins that are found in breast milk and their benefits:

Lactoferrininhibits the growth of iron-

dependent bacteria in the gastrointestinal
tract. This inhibits certain organisms,
such as coliforms and yeast, that require
iron.
 Specific proteins that are found in breast milk and their benefits:

Early breast milk is liquid gold

Known as colostrum - a thick yellow
first breast milk / pre-milk substances
that is made during pregnancy and just
after birth. It contains mostly of serum
with antibodies and white blood cell
that helps the infant against infection.
 Specific proteins that are found in breast milk and their benefits:

The breast milk changes as the baby

grows Colostrum changes into what is
called mature milk on the third to fifth day
after birth. It has the right amount of fat,
sugar, water, andproteinto help the baby
continue to grow. It is a thinner type of milk
than colostrum, but it provides all of the
nutrients and antibodies the baby needs.
 Specific proteins that are found in breast milk and their benefits:

Secretory IgA
also works to protect the infant from viruses and bacteria,
specifically those that the baby, mom, and family are
exposed to.
It also helps to protect against E. Coli and possibly allergies.
Other immunoglobulins, including IgG and IgM, in breast milk
also help protect against bacterial and viral infections.
Eating fish can help increase the amount of these proteins in
your breast milk.
 Specific proteins that are found in breast milk and their benefits:

Lysozymeis an enzyme that

protects the infant against E. Coli
and Salmonella. It also promotes
the growth of healthy intestinal
flora and has anti-inflammatory
functions.
 Specific proteins that are found in breast milk and their benefits:

Bifidus
factorsupports the growth of
lactobacillus.
Lactobacillus is a beneficial bacteria
that protects the baby against harmful
bacteria by creating an acidic
environment where it cannot survive
 Practices Incompatible with Lactation

1. Spicy flavours (garlic) may alter flavour of b-milk.

2. Smoking reduces milk volume. And milk produce contains
nicotine w/c alters smell and flavour.
3. Caffeine because it makes the baby wakeful and irritable.
And large amount or doses may interfere with the bioavailability
of iron from breast milk and impair the infants iron status.
4. Alcohol. It alter milks flavour, suppress feeding, causes
sleepiness and it inhibits the oxytocin.
5. Illicit Drugs. Breast milk can deliver such high doses of illicit
drugs as to cause irritability, tremors, hallucination, and even
death in infants.