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 Nutrition for pregnancy includes before, during, and after pregnancy

Nutrition

• Nutrition during pregnancy is important to ensure the healthy growth of the fetus and the management of pregnancy.

• here are increased energy requirements and specific micronutrient requirements.

• Nutrition and pregnancy refer to the nutrient intake and dietary planning that is undertaken before, during, and after pregnancy.

• the nutrition of the mother is important from before conception (probably several months before) as well as throughout pregnancy and breastfeeding.

• An inadequate or excessive amount of some nutrients may cause malformations or medical problems in the fetus, and neurological disorders and handicaps are a risk that is run by mothers who are malnourished.

• An estimated 24% of babies worldwide are born with lower than optimal weights at birth due to a lack of proper nutrition.

• Personal habits such as the consumption of alcohol or large amounts of caffeine can negatively and irreversibly affect the development of the baby, which happens in the early stages of pregnancy,(find out Signs and symptoms of pregnancy).

Contents
1-Nutrition before pregnancy 2-Nutrition during pregnancy 1-Vitamin and mineral supplements. 2-Folic acid. 3-Vitamins C and E. 4-Vitamin B12. 5-Food safety. 6-Water. 7-Caffeine. 8-Alcohol. 9-Fish and omega-3 fatty acids. 3-Nutrition after pregnancy

Nutrition before pregnancy

• As general advice, both state and medical recommendations are that mothers follow instructions listed on special vitamin packaging as to the correct or recommended daily allowance (RDA). Daily prenatal use of iron substantially improves birth weight, potentially reducing the risk of low birth weight.

• Folic acid supplementation is recommended before conception, to prevent the development of spina bifida and other neural tube defects. It should be taken at least 0.4 mg/day throughout the first trimester of pregnancy, 0.6 mg/day through the pregnancy, and 0.5 mg/day while breastfeeding in addition to eating foods rich in folic acid such as green leafy vegetables.

• Iodine is necessary for normal thyroid function and mental development of the fetus, Pregnant women should take prenatal vitamins containing iodine, Iodine levels are frequently too low in pregnant women.

• Vitamin D recent studies of Vitamin D levels throughout the United States and many other countries have shown a large number of women with low levels. For this reason, there is a growing movement to recommend supplementation with 1000 IU of Vitamin D daily throughout pregnancy.

• Long-chain polyunsaturated fatty acids, specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are beneficial for fetal development. Several studies have shown a lower risk of preterm delivery and low birth weight in mothers with higher intakes.

• Iron is essential before pregnancy for the production of hemoglobin.

• Iron is needed for the healthy growth of the fetus and placenta, especially during the second and third trimesters, iron supplementation reduces the risk of maternal anemia and iron deficiency in pregnancy but the positive effect on other maternal and infant outcomes is less clear, It is recommended that the first and third trimesters retain concentrations greater than 11 grams/deciliter and that the second trimester has levels above 10.5 grams per deciliter.

Nutrition during pregnancy

The United States and the European Union have established vitamin and mineral recommendations for during pregnancy and lactation.

Term Adequate Intake (AI) is used based on what appears to be sufficient.

†Not established. EU has not identified an AI for sodium or chloride and does not consider chromium to be an essential mineral nutrient.

*Adequate Intake.

Nutrient	U.S. RDA or AI	EU PRI or AI	Unit
Vitamin A	900	1300	µg
Vitamin C	90	155	mg
Vitamin D	15	15*	µg
Vitamin K	120*	70*	µg
α-tocopherol (Vit E)	15	11*	mg
Thiamin (Vit B1)	1.2	1.0	mg
Riboflavin (Vit B2)	1.3	2.0	mg
Niacin (Vit B3)	16	16	mg
Pantothenic acid (Vit B5)	5*	7*	mg
Vitamin B6	1.3	1.8	mg
Biotin (Vit B7)	30*	45*	µg
Folate (Vit B9)	400	600	µg
Cyanocobalamin (Vit B12)	2.4	5.0*	µg
Choline	550*	520*	mg
Calcium	1000	1000	mg
Chloride	2300*	NE†	mg
Chromium	35*	NE†	µg
Copper	900	1500*	µg
Fluoride	4*	2.9*	mg
Iodine	150	200*	µg
Iron	18	16	mg
Magnesium	420	300*	mg
Manganese	2.3*	3.0*	mg
Molybdenum	45	65*	µg
Phosphorus	700	550*	mg
Potassium	4700*	4000*	mg
Selenium	55	85*	µg
Sodium	1500*	NE†	mg
Zinc	11	14.9	mg

Vitamin and mineral supplements during pregnancy

• These supplements reduce the number of low birth weight babies, small for gestational age babies, and stillbirths in women who may not have many micronutrients in their usual diets.

• Undernourished women can benefit from having dietary education sessions and, balanced energy and protein supplements.

• Prenatal vitamins typically contain increased amounts of folic acid, iodine, iron, vitamin A, vitamin D, zinc, and calcium over the amounts found in standard multi-vitamins

• Approximately 30 grams (1.1 oz) of calcium is accumulated during pregnancy, almost all of it in the fetal skeleton (25 g). For women with low calcium diets, there is low-quality evidence to suggest that calcium supplementation during pregnancy may reduce the risk of preeclampsia.

• A mother's nutritional intake during pregnancy is believed to influence and possibly offer protective effects against the development of allergenic diseases and asthma in children.

Folic acid is critical both in pre-and peri-conception

• Deficiencies in folic acid may cause neural tube defects (NTDs). Women who had 0.4 mg of folic acid in their systems due to supplementing 3 months before childbirth significantly reduced the risk of NTDs.

• More than 80 countries use fortification of certain foods with folic acid as a measure to decrease the rate of NTDs.

Vitamins C and E

The combination of vitamin E and vitamin C supplemented in pregnant women does not appear to be efficacious for reducing the risk of stillbirth, neonatal death, preterm birth, preeclampsia, or any other maternal or infant outcomes, either in healthy women or those considered at risk for pregnancy complications.

Vitamin B12

• For vitamin B12, the U.S. Recommended Dietary Allowance (RDA) for pregnancy is 2.6 µg/day, and for lactation 2.8 µg/day.

• Determination of these values was based on an RDA of 2.4 µg/day for non-pregnant women plus what will be transferred to the fetus during pregnancy and what will be delivered in breast milk.

• Low maternal vitamin B₁₂, defined as serum concentration less than 148 pmol/L, increases the risk of miscarriage, newborn low birth weight, and preterm birth.
  

• During pregnancy, the placenta concentrates B12, so that newborn infants have a higher serum concentration than their mothers.

Ladies who consume a small percentage of their diet from animal-sourced foods or who by choice consume a vegetarian or vegan diet are at higher risk than those consuming higher amounts of animal-sourced foods for becoming vitamin depleted during pregnancy, which can lead to anemia, and also an increased risk that their breastfed infants become vitamin deficient.

Food safety

Pregnant women are advised to pay attention to the foods they eat during pregnancy to reduce the risk of exposure to substances or bacteria that may be harmful to the developing fetus, Intake of large amounts of retinol has been linked to birth defects and abnormalities.

Water

During pregnancy, a woman's mass increases by about 12 kg (26 lb)
The European Food Safety Authority recommends an increase of 300 mL per day compared to the normal intake for non-pregnant women, taking the total adequate water intake (from food and fluids) to 2,300 mL, or approximately 1,850 mL/ day from fluids alone.

Caffeine

• Caffeine consumption during pregnancy is associated with an increased risk of pregnancy loss and an increased risk of low birth weight, defined as below 2500 grams (5.5 pounds).

• The European Food Safety Authority and the American Congress of Obstetricians and Gynecologists concur that habitual caffeine consumption of up to 200 mg per day by pregnant women does not give rise to safety concerns for the fetus.

• High doses of caffeine intake during pregnancy may increase the risk of miscarriage.

• The United Kingdom Food Standards Agency had recommended that pregnant women should limit their caffeine intake to less than 300 mg of caffeine a day, but in 2009 revised that downward to less than 200 mg of caffeine a day.

Alcohol

• The American Academy of Pediatrics established a conservative set of recommendations in 2015: "During pregnancy: no amount of alcohol intake should be considered safe; there is no safe trimester to drink alcohol; all forms of alcohol, such as beer, wine, and liquor, pose a similar risk; and binge drinking poses a dose-related risk to the developing fetus.

• The World Health Organization recommends that alcohol should be avoided entirely during pregnancy, given the relatively unknown effects of even small amounts of alcohol during pregnancy.

• Fetal alcohol spectrum disorders are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. The most severe form of the condition is known as fetal alcohol syndrome.

• Problems may include an abnormal appearance, short height, low body weight, small head size, poor coordination, low intelligence, behavior problems, hearing loss, and vision problems.

Fish and omega-3 fatty acids

• American guidelines Australia, and European encourage fish consumption during pregnancy.

• The reason given is that fat-containing fish such as salmon and tuna contain eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

• These are termed long-chain, omega-3, and polyunsaturated fatty acids, and are considered important for fetal neurodevelopment. Additionally, fish are good sources of vitamins A, D, and B12, as well as the mineral iodine.

• many mothers are concerned about eating fish during pregnancy, Due to the risks of heavy-metal toxicity on fetal neurodevelopment, An alternative to consuming fish is to use fish oil dietary supplements containing both EPA and DHA, or algae-derived DHA-only oils.

Nutrition after pregnancy

• Proper nutrition is important after delivery to help the mother recover, and to provide enough food energy, and nutrients for a woman to breastfeed her child, Women having serum ferritin less than 70 µg/L may need iron supplements to prevent iron deficiency anemia during pregnancy and postpartum.

• During lactation, water intake may need to be increased. Human milk is made of 88% water, and the IOM recommends that breastfeeding women increase their water intake by about 300 mL/day to a total volume of 3000 mL/day (from food and drink), approximately 2,400 mL/day from fluids.