Nutrition during Breast Feeding

A lactating mother requires extra food to secrete adequate quantity/ quality of milk and to safeguard her own health. The nutritional link between the mother and the child continues even after birth. The new born baby depends for some period solely on breast milk for his existence. Breastfeeding is one of the most effective ways to ensure child health and survival. However, nearly 2 out of 3 infants are not exclusively breastfed for the recommended 6 months a rate that has not improved in 2 decades. Breast milk is the ideal food for infants. It is safe, clean and contains antibodies which help protect against many common childhood illnesses. Breast milk provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one third during the second year of life.

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Breastfeed children perform better on intelligence tests, are less likely to be overweight or obese and less prone to diabetes later in life. Studies shows Women who breastfeed also have a reduced risk of breast and ovarian cancers. Inappropriate marketing of breast-milk substitutes continues to undermine efforts to improve breastfeeding rates and duration worldwide.

At parturition, major hormonal changes lead to the onset of lactation. Estrogen and progesterone secretion fall markedly while the elevated prolactin concentrations are maintained. Prolactin causes the breasts to begin milk secretion. During the first 2 to 7 days postpartum, colostrum is secreted, a thick yellow fluid containing large amounts of immune factors, protein, minerals, and carotenoids. Colostrum can provide the newborn infant with large amounts of maternal antibodies, important because the immune system does not develop fully for some months. Between about 7 and 21 days postpartum the milk is transitional, and after 21 days mature milk is secreted. Suckling is required to empty the breast, which stimulates continued synthesis of prolactin and maintenance of milk production; once lactation is established suckling once a day can sustain milk production but synthesis stops within a few days of suckling cessation. Continued suckling inhibits release of luteinizing hormone and gonadotropin releasing hormone so the return of ovulation and menses is delayed, providing very effective birth control.

The volume of breast milk secreted increases rapidly to about 500 mL on day 5, 650 mL at 1 month, and 700 mL. A supplementation during the first 6 weeks postpartum, while there is minimal chance of conception, is recommended by WHO for increasing breast milk retinol and improving infant vitamin A status in developing countries. Vitamin B 12 concentrations in milk from Guatemalan women were one – tenth of those in California, and correlated with both maternal and infant serum B 12 with both groups having a high prevalence of deficiency. Human milk provides sufficient fluoride for the first 6 months of life, but the infant should be given 0.05 mg/kg/day starting at age 6 months.

Iodine can be very low in breast milk in populations with endemic iodine deficiency, and infants and young children consume little iodized salt. Even in Switzerland, for example, weaning infants are at risk of iodine deficiency, especially if they are not consuming infant formulas.

NUTRITIONAL REQUIREMENTS

Lactating mother’s nutritional requirements should meet (1) her own daily needs (2) provide enough nutrients in milk for the growing infant and (3) furnish the energy for the mechanics of milk production. Diet of lactating mother and her nutritional status during pregnancy affect to a certain extent quality and quantity of breast milk. Nutritional needs exceed during lactation compared to pregnancy. In six months a normally developing infants doubles the birth weight equivalent of which is accumulated in 9 months of pregnancy.

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DIETARY GUIDELINES

  • Nutritional requirements are maximum during lactation compared to any other age group in a woman’s life hence the diet should be balanced and meet the requirement. Number of meals can be increased.
  • Galactogogue or lactogogue act by increasing the prolactin secretion which is turn increases milk production. They also work psychologically and have a marginal effect on milk production. Sucking is the best lactogogue. The diet can include lactogogues which stimulate the production of milk. Garlic, milk, almonds and garden cress seeds are considered to increase the milk production in certain regions of India. Some also believe foods of animal origin like animal origin like goats meat, fish and mutton increase the secretions of breast milk. Special foods like sonth laddu and gond laddu are given during lactation. This practice can be encouraged.
  • Weight gain beyond that desirable for body size, should be avoided. When the baby is weaned, the mother must reduce her food intake in order that obesity may be avoided.
  • It is better to control constipation by inclusion in the diet of raw and cooked fruits and vegetables, whole grains and adequate amount of water than by use of laxatives.
  • No food need be withheld from the mother unless it causes distress to the infant. Occasionally, tomatoes, onions, members of cabbage family, chocolate, spices, and condiments may cause gastric distress or loose stools in the infant.
  • If the mother is under 17 years of age and if she has multiple gestation, she needs to take additional care in meeting the nutritional requirements.
  • If the mother looses rapid weight loss while breast-feeding, her choice intake is to be increased.

Maternal Nutrient Requirements During Lactation

The daily nutrient requirements of the lactating woman are higher than requirements during pregnancy. The higher recommended intakes are based primarily on the amounts secreted in milk. The most recent RDA assume that the mother secretes about 500 kcal/day in milk, including about 5% as protein, more than 50% as fat, and 38% as lactose (Institute of Medicine). This falls to 400 kcal/day in the second 6 months. In the first 6 months about 170 kcal/day are obtained from maternal weight loss. Thus the energy requirements in lactation are higher than those of the non – pregnant woman. Energy restriction to induce weight loss should not be attempted while breast feeding due to the risk of inadequate intakes of other nutrients in the diet. Exclusive breastfeeding and exercise, combined with a high quality diet, should lead to gradual weight loss during the postpartum period. The recommended intake of most micronutrients is also increased to cover the amounts secreted in milk. The only nutrient that is needed in lower amounts during lactation is iron, except for women who need to synthesize large amounts of blood to replace major blood losses during delivery.

Galactagogues are generally herbs or foods like these that, when ingested, increase a lactating mother’s milk supply. They’re often taken in supplement form or teas, but you can consume them as really delicious prepared foods too. Galactagogues and their milk-promoting functions generally aren’t scientifically proven, but instead are used because of anecdotal evidence passed on from mother to mother. Galactagoues include Almonds, Oats, Alfalfa, sprouts, Fennel, Fenugreek, Brewer’s yeast, Spinach, Flaxseed. Galactagogues are grand foods that can help spur your milk supply into overdrive.

Some moms find it helpful to cook with galactagogues items, grouping as many items together as possible. You can make cookies with almonds, oats, and flax seed. Tea with the fennel, fenugreek, and blessed thistle or a balanced green juice made up of spinach and sprouts.

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Nutrient requirements during breastfeeding

Nutritional needs during breastfeeding are increased in response to breast milk production. They must meet the requirements of both baby and mother.

Energy

An additional 500 kcal for the first six months, and 400 kcal during the next six months, are required for a lactating mother. This can be met by eating, simply eating more of the usual balanced diet should allow you to meet the higher energy demand while you breastfeed. On average, 100 ml of human milk gives 70 kcal of energy. During the first six months after delivery, 750 ml of breast milk is produced daily. If the extra demand for energy is not met from dietary sources, then your reserved fat stores will be used instead.

Protein

The increase in protein requirements during lactation are minimal compared to that of energy. However, if your energy intake is low, protein will be used for energy production. The additional protein requirements during lactation can be met by consuming protein rich foods. If you do not have a high enough protein intake, then the proportion of casein in your milk may be reduced. Casein protein is an important component of human milk, and helps to provide our baby with calcium and phosphate. It also forms a clot in the stomach that allows more efficient nutrition. Insulin resistance is modulated by protein quality, rather than quantity. Proteins derived from fish might have the most desirable effects on insulin sensitivity.

Carbohydrate

Lactose is the predominant carbohydrate in human milk and is essential to the nutrition of the infant’s brain. While the concentration of lactose is less variable than that of other nutrients, the total production is reduced in mothers with severe malnutrition.

Fat

The lipids in breast milk are the fraction that most contributes to its energy content; they are the components that vary most in their distribution and quality. Maternal malnutrition is associated with lower concentrations of lipids in breast milk. The distribution pattern of fatty acids in breast milk is also sensitive to the mother’s diet.

DHA omega-3

DHA (docosahexaenoic acid) is a nutrient with a limited endogenous biosynthesis, so it must be obtained through the diet, as it is the most important omega-3 acid for the optimal development of the brain, retina and ear. The cholesterol content of breast milk is highly variable and is related to the duration of breastfeeding, maternal age, maternal diet, season and place of residence  omega-3 polyunsaturated fat.  Omega-3s are considered essential fats because your body alone cannot make them.

Water

Water accounts for 85—95% of the total milk volume. There is a widespread belief that increasing water intake will increase milk production, but several studies have demonstrated that forcing the intake of fluids beyond that needed to quench thirst has no beneficial effects on lactation.

Salt

The concentration of sodium is higher in colostrum than in mature milk. Research has found no evidence of an association between sodium intake during lactation and sodium levels in breast milk. However, it is always advisable to consume small amounts of salt, always enriched with iodine (iodised salt)

Folic acid

The recommended concentration of folic acid in breast milk can be easily achieved through dietary intake or supplementation, if needed.

Dietary elements and minerals

The concentration of several vitamins and minerals in human milk is influenced by maternal diet and/or vitamin status. The concentrations of these nutrients in normal milk show the effect of maternal deficiency and supplementation on milk content and the infant. To predict risks caused by infant or maternal micronutrient deficiencies in lactation, and for planning interventions, it is useful to categorize nutrient deficiencies based on their effect on the nutrient in milk. Priority nutrients include vitamin A, thiamin, riboflavin, vitamins B 6 and B 12, iodine, and selenium. These nutrients are of most concern because low maternal intake or stores reduces their content in milk, which affects the infant adversely. However, the concentration in milk can be restored rapidly by maternal supplementation. Also infant stores of these nutrients are more readily depleted, increasing the infant’ s dependence on an adequate supply from breast milk or complementary foods. Lower – priority nutrients include folate, calcium, iron, copper, and zinc.

Maternal intake and stores of these nutrients have little or no effect on breast – milk concentrations or infant status, or on the amount required from complementary foods. Consequently the mother is less likely to become depleted, and maternal supplementation is more likely to benefit herself than her infant. Milk vitamin D may below if women are very deficient but their infants will respond readily to vitamin D supplements.

Vitamin B

Low milk vitamin B 12 and subsequent infant deficiency as a result of strict maternal vegetarianism, and low milk vitamin D and abnormal vitamin D status of infants receiving insufficient exposure to sunlight. The American Academy of Paediatrics recommends that all infants who are breastfed should receive 400 IU vitamin D per day as a supplement. Infants fed formula but drinking < 1 L (1 quart) per day should also receive supplemental vitamin D.

Low concentrations of nutrients in breast milk imply that maternal and/or infant supplementation is needed; breastfeeding is always the best way to feed young infants.

Vitamin B 12 concentrations in milk from Guatemalan women were one – tenth of those in maternal and infant serum B 12 with both groups having a high prevalence of deficiency. Human milk provides sufficient fluoride for the first 6 months of life, but the infant should be given 0.05 mg/kg/day starting at age 6 months.

Vitamin A

Vitamin A in breast milk is adequate in industrialized countries, but high – dose (200 000 to 300 000 IU) vitamin A supplementation during the first 6 weeks postpartum, while there is minimal chance of conception, is recommended by WHO for increasing breast milk retinol and improving infant vitamin A status in developing countries.

Vitamin C

The plasma and tissue concentrations of vitamin C in smokers are lower than in nonsmokers, so an increase in vitamin C intake is recommended in mothers that smoke.

Vitamin E

The concentration of vitamin E in breast milk is sensitive to maternal intake, so the maternal diet must be assessed and supplemented if intake is inadequate.

Vitamin K

Vitamin K is also synthesized by bacteria lining the gastrointestinal tract. If the diet is adequate, the lactating mother does not require vitamin K supplementation. Newborns usually have low levels of vitamin K, as this vitamin is not easily mobilized through the placenta and the bacterial flora of the newborn is inadequate for its synthesis in the first days of life.

Copper and zinc

Concentrations seem to correlate strongly to maternal stores in the liver during the third trimester of the pregnancy, and maternal intake has little influence on them, although their bio -availability in milk is very high. Iodine, iron, copper, magnesium and zinc have a high bio-availability in breast milk. The selenium content is strongly influenced by the mother’s diet.

Iron

Iron supplementation is usually recommended to make up for losses sustained during childbirth, although it must be noted that women that practice exclusive breastfeeding usually experience amenorrhoea for a minimum of six months and thus do not lose iron through menstruation during that time. Therefore, it could be said that breastfeeding exerts a protective effect against maternal iron deficiency.

Calcium

Calcium is essential during lactation, during which it is subject to special regulatory mechanisms that lead to increased absorption, decreased renal excretion and greater mobilization of bone calcium. To meet maternal calcium requirements, the American Academy of Pediatrics recommends lactating mothers to consume five servings a day of calcium-rich foods of any kind, such as low-fat yogurt or cheese, and other nondairy foods that contain calcium, such as fish consumed with its bones (for example, canned sardines), salmon, broccoli, sesame seeds or cabbages, which may provide the 1000—1500 mg daily recommended allowance for lactating women.

Zinc

Zinc is essential to growth, cell immunity and enzyme synthesis. While zinc concentrations in human milk are not high, they suffice to satisfy the needs of the child due to its high bio-availability. We recommend increasing zinc intake by 50% during lactation.

Selenium

Selenium is a mineral involved in the immune system, cholesterol metabolism and thyroid function. The concentration of selenium in breast milk is three times that in artificial formulae.

Iodine

The iodine requirements of lactating women nearly double those of healthy adult women, as in addition to meeting maternal requirements, iodine levels must guarantee that the baby receives sufficient iodine from the milk to synthesize thyroid hormones. The iodine content of human milk is variable and depends on maternal intake.

Most Commonly Asked Questions

What about a vegetarian diet and breast-feeding?

Choose foods rich in iron, protein and calcium. Good sources of iron include lentils, enriched cereals, leafy green vegetables, peas, and dried fruit, such as raisins. Body absorb iron; eat iron-rich foods with foods high in vitamin C, such as citrus fruits. For protein, consider plant sources, such as soy products and meat substitutes, legumes, lentils, nuts, seeds, and whole grains. Eggs and dairy are other options. Good sources of calcium include dairy products and dark green vegetables. Other options include calcium-enriched and fortified products, such as juices, cereals, soy milk, soy yogurt and tofu. Consider supplements.

A daily vitamin B-12 supplement is recommended. Vitamin B-12 is found almost exclusively in animal products, so it’s difficult to get enough in vegetarian diets. If you don’t eat fish, you might consider talking to your health care provider about taking an omega-3 supplement. If you don’t eat enough vitamin D-fortified foods — such as cow’s milk and some cereals — and you have limited sun exposure, you might need vitamin D supplements. Your baby needs vitamin D to absorb calcium and phosphorus. Too little vitamin D can cause rickets, a softening and weakening of bones. Tell your doctor and your baby’s doctor if you’re also giving your baby a vitamin D supplement.

What foods and drinks should I limit or avoid while breast-feeding?

Certain foods and drinks deserve caution while you’re breast-feeding. For example:

  • Alcohol: There’s no level of alcohol in breast milk that’s considered safe for a baby. If you drink, avoid breast-feeding until the alcohol has completely cleared your breast milk. This typically takes two to three hours for 12 ounces (355 millilitres) of 5% beer, 5 ounces (148 millilitres) of 11% wine or 1.5 ounces (44 millilitres) of 40% liquor, depending on your body weight. Before you drink alcohol, consider pumping milk to feed your baby later.
  • Caffeine: Avoid drinking more than 2 to 3 cups (16 to 24 ounces) of caffeinated drinks a day. Caffeine in your breast milk might agitate your baby or interfere with your baby’s sleep.
  • Fish: Seafood can be a great source of protein and omega-3 fatty acids. Most seafood contains mercury or other contaminants, however. Exposure to excessive amounts of mercury through breast milk can pose a risk to a baby’s developing nervous system. To limit your baby’s exposure, avoid seafood that’s high in mercury, including swordfish, king mackerel and tile fish.

ELIMINATION DIET:

This advice has been handed down for year not to eat beans, as they will make your baby gassy and don’t eat spicy food because your milk will become too spicy. This is based on the assumption that what you eats goes directly into your milk supply and that your baby will suffer from food specific allergies and intolerance. The theory goes: gas is due to red meats and beans and acid reflux from broccoli. Occasionally these things are true that sometimes babies do have allergies and when you cut out various foods from your diet, it makes a big difference. However, most babies who suffer from allergic reactions due to something you’re eating are often accompanied with other symptoms such as: hives, watery diarrhea, large patches of relentless eczema and very painful gassy.

Do we really burn extra calories while breastfeeding or during lactation?

Many breastfeeding moms report feeling extra hungry throughout their days of breastfeeding. This hunger is for an excellent reason.  Your body is working very hard to produce its “liquid gold” – breast milk.  The rumors you heard are correct: you burn an additional 500 calories a day while breastfeeding. While breastfeeding, it is essential to eat enough calories to fuel both you and your baby. It is not the time to try the latest diet or weight loss fad. In fact, you should not go on any specific “diets” Unless your baby has special dietary needs.

Do we need to consume extra calories while breast-feeding?

Yes, you might need to eat a little more — about an additional 330 to 400 calories a day — to give you the energy and nutrition to produce milk.To get these extra calories, opt for nutrient-rich choices, such as a slice of whole-grain bread with a tablespoon (about 16 grams) of peanut butter, a medium banana or apple, and 8 ounces (about 227 grams) of yogurt.

How can I plan meals to get the nutrients I need during pregnancy?

You should join the programme of Foodnwellness. This program gives you a personalized plan that includes the kinds of foods in the amounts that you need to eat for each trimester of pregnancy.

How Foodnwellness helps during this phase?

During lactation or breastfeeding, motivation for eating a healthy diet may change relative to the non-pregnant state as women prepare for motherhood and consider the impact of their dietary intake on the baby’s health. Personal values and beliefs about nutrition in pregnancy and lactation, advice from health professionals, and physical and physiological changes may interact with determinants of eating behaviors present in the non-pregnant state to change diet-related behaviors. Although most women are aware that healthy eating is important during pregnancy and lactation, women may lack knowledge of specific dietary recommendations or may not have the skills required to improve their diet. Women may receive plenty of advice from everywhere but it is worthy when you receive correct knowledge from panel of health professionals. Foodnwellness will always guide regarding every issue you face and it will be taken care of by our Dietitians.

Nutrition during Pregnancy

Pregnancy is physiologically and nutritionally a highly demanding period. Extra food is required to meet the requirements of the fetus. A woman prepares herself to meet the nutritional demands by increasing her own body fat deposits during pregnancy. Nutrition and lifestyle before and during pregnancy, lactation, infancy and early childhood have been shown to induce long-term effects on later health of the child, including the risk of common non-communicable diseases such as obesity, diabetes, and cardiovascular disease.

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There are other diseases also such as an increased risk of adverse pregnancy outcomes including low birth weight, preeclampsia, pre-term birth, and neurodevelopment problems such as fatal alcohol spectrum disorder. This phenomenon is referred to as “Early metabolic programming of long-term health and disease” or “Developmental origins of adult health and disease”.

The additional nutrient requirements of the mother and her fetus during pregnancy are met by a combination of physiological events that affect maternal nutrient utilization and fatal nutrient transfer, and increased dietary intakes. The physiological changes complicate the interpretation of nutritional status measures in pregnancy. It is clear that the body composition of the mother in the periconceptional period affects pregnancy weight gain, so the newly revised weight-gain recommendations continue to be based on maternal body mass index (BMI) at conception. The adverse effects of consuming an inadequate amount of most vitamins and minerals during pregnancy are partially understood, often from research in developing country populations, but little is known about sub clinical or long –term effects of deficiencies or their role in specific adverse pregnancy outcomes. Estrogens synthesis is increased from early in pregnancy, and its functions include altering carbohydrate and lipid metabolism, increasing the rate of maternal bone turnover.

Ho A, et al., Nutrition in pregnancy, Obstetrics, Gynaecology and Reproductive Medicine (2016), http:// dx.doi.org/10.1016/j.ogrm.2016.06.005

A healthy, balanced diet during pregnancy is essential to support optimal growth and development of the fetus and the physiological changes that occur in the mother. Fundamental aspects of healthy dietary behaviours during pregnancy include consuming foods that contain optimal amounts of energy as well as macro and micronutrients, achieving appropriate weight gain, adhering to general and pregnancy-specific food safety recommendations, and avoiding ingestion of harmful substances. The protein, fat, minerals, and vitamins deposited in fatal and maternal tissues come from increased maternal food intake and/or more efficient intestinal absorption or renal re-absorption, depending on the specific nutrient.

The dietary recommendations for pregnant women are to meet their increased caloric and nutrient needs. Additional recommendations include increasing water intake and avoiding foods associated with food-borne illnesses such as under cooked fish and meat, raw eggs, unpasteurized products, and raw sprouts. These guidelines exist to help women select a healthy diet. Good nutrition is the most important requirement of a mother during pregnancy. Effects of a Poor Diet – Premature birth, Low birth weight babies, Feeble, weak babies. Inability to breast-feed Malformed babies Complications at birth Depression in mother Babies with impaired brain cells. A pregnant woman should: choose nutrient-dense foods- consume 300 extra calories per day. Eat not more than 12 ounces of low-mercury fish weekly.

Healthy eating in pregnancy

The requirements for selected nutrients increase appreciably during pregnancy. The recommended intakes for the following nutrients are >25% higher than are the amounts recommended for non pregnant women: protein, α-linolenic acid, iodine, iron, zinc, folate, niacin, riboflavin, thiamin, and vitamin B6. The needs for protein, iron, folate, and vitamin B6 are about 50% higher. Good food sources of these nutrients are grains, dark green or orange vegetables, and the meat, beans, and nuts groups. Additional energy is also required to meet the needs for moving a heavier body, the rise in metabolic rate, and tissue deposition. Approximately 340–450 kcal are needed in the second and third trimesters, respectively. Although these increased nutrient requirements are significant, the same food pattern recommended for non pregnant women can be recommended to pregnant women because that food pattern meets pregnancy nutrient Recommended Daily Allowances (RDA) for all nutrients except iron and vitamin E. The shortfall in iron and vitamin E can be provided by any vitamin–mineral supplement supplying at least 10 mg iron and 9 mg vitamin E. Use of a common food pattern for women at all stages in the reproductive cycle enables dietitians and other health care providers to teach pregnant women the elements of a quality diet that will better ensure good health for a life time

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Calorie restriction is not advised and recommendations focus on achieving and maintaining a healthy weight during pregnancy by basing meals on starchy foods (wholegrain if possible), eating fibre rich foods and consuming at least five portions a day of fruit and vegetables. Food high in fat and sugar (including fried, some drinks and confectionery) should be avoided. Pregnant women are also advised to eat breakfast, and to watch portion sizes and how often they are eating.

Low-fat dairy foods for a source of calcium are encouraged with a daily intake of protein in the form of lean meat, two portions of fish a week (one of which should be oily) or lentils, beans and tofu.

 

Nutrient requirements in pregnancy

Energy

Energy requirements are increased to cover energy deposited in the mother and foetus. The actual amount of energy required varies greatly among women because of differences in the amount of weight and fat gain, and energy expenditure. Excessive weight gain in pregnancy tends to cause excessive weight retention postpartum.

Excessive weight gain in pregnancy tends to cause excessive weight retention postpartum. Exclusive breastfeeding for at least 6 months reduces the risk of long – term retention of this weight.

Carbohydrates

Carbohydrates form the main substrate for foetal growth, fueling maternal and foetal organ function, and biosynthesis. Maternal and foetal brain functions use glucose from carbohydrate as their preferred source of energy with glucose providing at least 75% of foetal energy requirements.

The glycaemic index (GI) refers to the area under the curve for blood glucose concentrations during a 2 hr period after consuming a test food. A low GI suggests slower rates of digestion and absorption of a food’s carbohydrate, potentially relating to a lower insulin demand. It is therefore a modifiable macronutrient in the management of diabetes mellitus (gestational, type 1 and type 2).

Protein

Protein forms the building blocks for both structural and functional components of cells. Requirements are highest during the second and third trimesters due to extra development and growth of both maternal and foetal tissue. It is an alternative energy source when carbohydrate intake is insufficient therefore adequate carbohydrate intake is required in order for cell synthesis to continue. Plasma concentrations of most amino acids are higher in foetal circulation. Over 15 different amino acid transporters mediate their transport against a concentration gradient.

The RDA for an additional 925 g of protein deposited in the mother and fetus, of which 8 g/day are needed during the second trimester and 17 g/day during the third (Institute of Medicine). Thus the total RDA is 1.1 g/kg/ day or + 25 g/day additional protein. Most pregnant women in industrialized countries, and probably the majority in developing countries, consume at least the recommended intake of protein.

Fat

There are no specific recommendations for fats in pregnancy, apart from following normal dietary guidelines. Fats should make up 25 to 35 percent of daily calories, and those calories should come from healthy fats, such as avocados and other dry fruits. Foods with unhealthy fats, including French fries and other fast food, should be avoided. Also, it is not recommended for pregnant women to be on a very low-fat diet, since it would be hard to meet the needs of essential fatty acids and fat-soluble vitamins. Fatty acids are important during pregnancy because they support the baby’s brain and eye development. In particular, the brain depends on omega-3 and omega-6 fatty acids, such as the kind found in salmon and sunflower or safflower oil, for function, structure, and growth. Fats can also help the placenta grow and may help to prevent premature birth and low birth weight.

Essential polyunsaturated fatty acids (PUFAs), which must be consumed in the diet, found mainly in seed oils, the major sources are egg yolk and lean meat. DHA is found in meat and fatty fish.

Fibre

Fibre affects the postprandial insulin response by influencing the accessibility of carbohydrates and nutrients to digestive enzymes thus delaying their absorption. Fibre supports maternal digestive health, providing bulk to stool and absorbing water to aid transit time. This is especially beneficial as progesterone levels in pregnancy can result in constipation by increasing relaxation of intestinal smooth muscle.

Micronutrients

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Pregnancy requires certain conditionally essential nutrients, which are nutrients that are supplied only under special conditions, such as stress, illness, or aging. The daily requirements for non pregnant women change with the onset of a pregnancy. Taking a daily prenatal supplement or multivitamin helps to meet many nutritional needs. However, most of these requirements should be fulfilled with a healthy diet. The following table compares the normal levels of required vitamins and minerals to the levels needed during pregnancy. For pregnant women, the RDA of nearly all vitamins and minerals increases.

Vitamin A

Vitamin A deficiency during pregnancy and lactation is not a public health problem in industrialized countries. There is more concern about the dangers of excessive supplementation with retinol or the analog isotretinoin which is used to treat severe cystic acne. Ingestion of large amounts of retinol has been associated with birth defects including abnormalities of the central nervous system, craniofacial and cardiovascular defects, and thymus malformations (Rothman et al. , 1995 ). The first trimester is most critical because the malformations are derived from cranial neural crest cells. There are about 20 case reports of retinol toxicity during pregnancy although their interpretation is confounded by the fact that the retinol was usually consumed as part of a multinutrient supplement

The upper safe limit has been set at 3000 μ g daily for women of reproductive age and in pregnancy. In pregnant and non – pregnant individuals the serum concentration of 25 – hydroxyvitamin D, the main circulating form of the vitamin, is a good indicator of tissue stores of vitamin D. It crosses the placenta and is converted to the active form, 1,25 – dihydroxyvitamin D, by the neonate. The placenta synthesizes 1,25 – dihydroxyvitamin D; maternal serum levels are more

Calcium

Calcium is made available to the foetus by the substantial increase in the efficiency of maternal calcium absorption starting early in pregnancy. Calcium is carried across the placenta by active transport involving calcium binding protein and 1,25 – dihydroxyvitamin D. Although maternal bone resorption increases during pregnancy, there is no detectable change in bone mineral content between conception and parturition.

There is little need for additional dietary calcium during pregnancy, and calcium supplements do not improve maternal bone calcium or infant bone in the first year of life, even when maternal intakes are very low. Recommended intakes are 1000 mg/day, the same as for non – pregnant women (Institute of Medicine, 2011).

Sodium

Normal sodium intake is needed during pregnancy to support the large prenatal expansion of tissues and fluids. Sodium should not be restricted.

Iron

Helps red blood cells deliver oxygen to your baby. Sources include lean red meat, dried beans, peas, and iron-fortified cereals. During pregnancy you need 28 mg daily, which can be found in most prenatal vitamin supplements. Women who do not have enough iron stored in their bodies before pregnancy may develop anemia. Some women may need extra iron in the form of an iron supplement. On average an additional 6 mg iron per day needs to be absorbed during pregnancy. Iron is retained by the foetus (300 mg), deposited in the placenta (60 mg), used for the synthesis of additional maternal red blood cells (450 mg), lost in blood during delivery (200 mg), and retained by the mother’s increased red cell mass after parturition (200 mg).

Folate

Folate, also known as folic acid, plays an important part in reducing the risk of neural tube defects.  Folic acid is a B vitamin that is also known as folate. Before pregnancy and during the first 12 weeks of pregnancy, you need 0.4 milligrams (or 400 micrograms) of folic acid daily in order to reduce the risk of neural tube defects. All women of childbearing age should take a multivitamin supplement containing 0.4 milligrams of folic acid a day. Women who have had a child with a neural tube defect or who are taking certain drugs need much higher doses of folic acid—4 milligrams daily. Women who need 4 milligrams should take folic acid as a separate supplement, not as part of a multivitamin. These are major birth defects that affect the baby’s brain and spinal cord, such as Spina bifida and anencephaly. The American College of Obstetrics and Gynecology (ACOG) recommends 600 to 800 mg of folate. Sources include liver, nuts, dried beans and lentils, eggs, nuts and peanut butter, dark green and leafy vegetables.

 Common questions that are always been asked

 If a pregnant woman is Vegetarian, what will be her diet?

Pregnant women consuming vegetarian diets need careful nutritional assessment. The type of vegetarian diet will determine the potential for nutrient deficiencies with increased risk as more foods are excluded. Most pregnant women consuming milk and eggs can meet the increased nutrient needs of pregnancy. Vegan diets will require careful planning to consume adequate protein from complementary plant proteins. Alternate sources of Vitamin B12 and calcium will be needed in a vegan diet. Iron status should be carefully monitored. Low pre-pregnancy weight and less than optimal weight gain are common problems for vegans. High calorie foods such as nuts, nut butter, wheat germ, avocados, dried fruit, coconut, honey and salad dressings may be needed. If you are a vegetarian, you will need to plan your meals with care to ensure you get enough protein. You will probably need to take supplements, especially iron, vitamin B12, and vitamin D.

Can being overweight or obese affect pregnancy?

Overweight and obese women are at increased risk of several pregnancy problems. These problems include gestational diabetes, high blood pressure, preeclampsia, and cesarean delivery. Babies of overweight and obese mothers also are at greater risk of certain problems, such as congenital abnormalities, macrosomia with possible birth injury, and childhood obesity. For women with a BMI of 30 or greater, a weight gain of between 11 pounds and 20 pounds is recommended during pregnancy. For women with a BMI of 40 or greater, a modest weight loss during pregnancy may be recommended.

Can consuming caffeine be harmful during pregnancy?

Moderate caffeine intake (200 milligrams per day—the amount in approximately two 8-ounce cups of brewed coffee) does not appear to lead to miscarriage or preterm birth. It is not clear whether caffeine increases the risk of having a low birth weight baby.

Excess caffeine can interfere with sleep and contribute to nausea and light-headedness. It also can increase urination and lead to dehydration.

How can I plan meals to get the nutrients I need during pregnancy

You should join the programme of Foodnwellness. This program gives you a personalized plan that includes the kinds of foods in the amounts that you need to eat for each trimester of pregnancy.

How Foodnwellness helps during this phase

During pregnancy, motivation for eating a healthy diet may change relative to the non-pregnant state as women prepare for motherhood and consider the impact of their dietary intake on the baby’s health. Personal values and beliefs about nutrition in pregnancy, advice from health professionals, and physical and physiological changes may interact with determinants of eating behaviours present in the non-pregnant state (e.g., personal preferences, time, money) to change diet-related behaviours. Although most women are aware that healthy eating is important during pregnancy, women may lack knowledge of specific dietary recommendations or may not have the skills required to improve their diet. Healthy eating may also be challenging during pregnancy as women face barriers such as food aversions, cravings, nausea, vomiting, tiredness, constipation, hemorrhoids, and heartburn. Women may receive plenty of advice from everywhere but it is worthy when you receive correct knowledge from panel of health professionals. Foodnwellness will always guide regarding every issues you face and it will be taken care of by our Dietitians.

Minestrone Soup

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Minestrone Soup

  • Author: Banhishikha
  • Prep Time: 10 Minutes
  • Cook Time: 30 - 40 Minutes
  • Total Time: 40 - 50 Minutes
  • Yield: 4 1x

Description

Minestrone soup is a thick Italian soup, made with vegetables, addition of pasta, noodles or rice. Common ingredients include beans, onions, celery, carrots and tomatoes. The food is a traditional dish in Italy. Milestrone soup was traditionally made to use up leftover vegetables, so feel free to use any seasonal vegetables and greens. It can be used as detoxification and also helps to stimulate the purification of the liver and the entire body and a good source of multiple Vitamins and Minerals. Essentially, minestrone is a thick, hearty variety of vegetable soup. There is no set recipe for minestrone, since it can be usually made out of whatever vegetables are at one’s disposal. it can be vegetarian, contain meat, or contain an animal bone based stock (such as chicken stock)

Minestrone soup is a healthy and quick to make nutritious recipe, can be consumed in breakfast, lunch, dinner or as a snack item. always try to serve hot to enjoy the taste.


Scale

Ingredients

  • Onion 30 gm
  • Carrot – 50 gm
  • French Beans – 40 gm
  • Celery – 20 gm
  • Salt – 0.5 tsp
  • Freshly grounded
  • Black pepper – 0.5 tsp
  • Small macaroni – 100 gm
  • Kidney beans – 50 gm
  • Tomato – 100 gm
  • Garlic- 8 cloves
  • Oil – 20 ml

Instructions

  1. Chop onion, garlic, carrot, French beans, celery and tomatoes.
  2. Heat oil in a pan.
  3. Add the chopped onions, garlic, carrot, French beans and celery over a medium flame and cook until the vegetables soften and stir occasionally.
  4. Add vegetable stock, salt, pepper and bring it to boil and cook about for 10 minutes.
  5. Add tomatoes and macaroni and peas; simmer for 15 to 20 minutes more.
  6. Taste for seasoning and adjust to taste.


Nutrition

  • Serving Size: 1
  • Calories: 90 - 92 kcal
  • Fat: 5 - 6 gm
  • Carbohydrates: 10 - 12 gm
  • Protein: 15 - 16 gm

Keywords: #HEALTHYSOUP

Chenna

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Chhena

  • Author: Banhishikha
  • Cook Time: 15 Minutes
  • Total Time: 15 Minutes
  • Yield: 350 gm

Description

Chhena are cheese curds from the Indian subcontinent, made from buffalo or cow milk by adding food acids such as lemon juice and calcium lactate. Chhena is pressed and further processed to make paneer and also used to make desserts such as Khira Sagara, Chhena Kheer, Rasa malai as well as sweets such as Chhena jalebi, Chhena gaja, Pantua, Rasgulla and Sandesh.

Chhena is an incredible source of healthy fat calories with protein, calcium which helps to have a healthy strong bones, Vitamin B2, Vitamin B1 which protects nerves, helps in carbohydrate  metabolism, prevents heart heart diseases and helps to produce red blood cells. this is ideal to consume during breakfast or snack time.


Ingredients

  • Milk – 1 litre
  • Lemon Juice – 15 – 20 ml

Instructions

  1. Bring milk to boil in a saucepan.
  2. Add lime juice. Keep on stirring and until milk gets curdled.
  3. Ideally the milk should get curdled at once after you stir lime juice or vinegar. Just keep extra lime juice ready, in case milk does not curdle.
  4. When the greenish liquid (whey) separates from the milk, pour the curdled milk into pan with the help of a sieve or muslin cloth.
  5. Usually from 1 litre of whole fat milk, yield 350 gram of chhenna.

Notes

Instead of lemon juice you can also use 1 tablespoon (15 ml) of vinegar or 3 tablespoons (45 g) of Curd or 1 tsp of Citric Acid powder (5 g) .

Nutrition

  • Serving Size: 4
  • Calories: 468 - 470 kcal
  • Fat: 14 - 15 gm
  • Carbohydrates: 48 - 50 gm
  • Protein: 16 -18 gm

Keywords: #HEALTHY

Healthy Pop

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Healthy Wheels

  • Author: Banhishikha
  • Prep Time: 20 Minutes
  • Cook Time: 15 Minutes
  • Total Time: 35 Minutes
  • Yield: 15 - 16 pcs

Description

Healthy Pops are high energy food products containing cereals and energy giving foods targeted at people who require quick energy, or athletes and don’t have time for meals.

 

This recipe contains good fat, protein, and carbohydrates and healthy as it contains no added sugar and mix of dry fruits and nuts which can be easily varied as per preferences. This is ideal to consume after work out, a fasting season like Iftar or just satisfying the hunger or can be served to the children or Sports person after their evening games.


Ingredients

  •  Dates – 250 g
  • Oats- 100 g
  • Pistachios- 8 pcs
  • Almonds- 25 pcs
  • Walnuts- 15 pcs
  • Melon seeds- 2 tbsp
  • Sunflower seeds- 2 tbsp
  • Pumpkin seeds- 2 tbsp
  • Poppy seeds- 2 tbsp
  • Chia seeds- 2 tbsp

Instructions

  1. Dry roast all the ingredients except chia seeds separately.
  2. Rinse the dates and de-seeded them.
  3. Grind the dates in the mixer and make a pulp.
  4. Heat the pulp for 2 mins by adding 1 cup of hot water.
  5. Chop Pistachios, Almonds and Walnuts.
  6. Add all the chopped ingredients except poppy seeds to it.
  7. Pour it on the aluminium foil and sprinkle it with roasted poppy seed.
  8. Roll it with the help of an aluminium foil.
  9. Freeze it for 10 mins.
  10. Cut it like a size of a cookie (3 – 4 inches).
  11. Again freeze it for 30 mins.
  12. Your healthy pops are ready.

Notes

Please be careful about the exact time when the dates pulp is cooked.


Nutrition

  • Serving Size: 1 - 2
  • Calories: 133 - 134 kcal
  • Fat: 5 gm
  • Carbohydrates: 17 - 18 gm
  • Protein: 4 - 5 gm

Keywords: #HEALTHYPROTEINBAR

Baked Carrot Delight

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Baked Carrot Delight

  • Author: Banhishikha
  • Prep Time: 15 mins
  • Cook Time: 10 mins
  • Total Time: 25 mins
  • Yield: 4 - 5 pcs

Description

Baked Carrot Delight, a carrot flavoured sweet can be consumed by  diabetic, weight loss, weight management, obese, over weight and any age group will enjoy the taste and flavour of the healthy sweet. Carrots are rich in beta- carotene and lutein, which lowers the chances of cataracts and other eye problems.

This dish is ideal to consume as a sweet dish or dessert item at lunch or dinner and can also be served as a home made healthy sweets to our guest.


Ingredients

  • Cottage cheese (low fat) – 100 gm
  • Carrot – 150 gm
  • Almonds/ Pistachios (finely chopped) – 8 pcs

Instructions

  1. Peel and grate the carrot.
  2. Keep aside 2 tsp of the grated carrot.
  3. Use the rest grated carrot to make juice.
  4. Heat the juice until it become ¼th
  5. Hang the cottage cheese for few minutes and squished.
  6. Then the carrot syrup and grated carrot was added to it.
  7. Mash the cottage cheese till smoothly texture.
  8. Use butter paper to avoid oil greasing, and put the mixture in a baking tray and level it.
  9. Bake it at 1500c for 5 minutes.
  10. Cut it into square shape.
  11. Garnish with finely chopped almonds or pistachios. Serve it cold.
  12. Storage life of 5 days if kept in a refrigerator.

 


Notes

Make sure chenna mixture becomes smooth.


Nutrition

  • Serving Size: 1
  • Calories: 38 - 40 kcal
  • Fat: 0.95 - 1 gm
  • Carbohydrates: 2 - 3 gm
  • Protein: 3 - 4 gm

Keywords: #HEALTHYSWEETS