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Smoking during pregnancy lowers the mean birth weight and increases the risk of
perinatal mortality. Smoking seems to affect the conversion of dietary calories into weight gain.
It is postulated that smoking increases the mother’s level of carboxyhemoglobin and nicotine
causing a decrease in the oxygenation of the fetus. Increasing the food intake of pregnant
smokers can compensate for some of the effects of smoking.
Excessive maternal alcohol ingestion is linked to fetal alcohol syndrome (FAS). Its major
features are CNS disorders, mental retardation, growth deficiencies, and facial deformities.
Caffeine crosses the placenta to the fetus very rapidly. The drug-metabolizing ability of a
fetus is extremely limited. The fetus can metabolize alcohol to a limited extent but not caffeine.
Alcohol, caffeine, and nicotine dramatically increase the circulating levels of
catecholamine.
Recommended amounts
Food Groups Pregnant Lactating
Woman Woman
Rice Rice and 5½-6 cups, cooked 6-7, cooked
alternatives others 1 cup rice, cooked = 4 pieces 1 cup rice cooked = 4 pieces
pan de sal (17 g each) pan de sal (17 g each)
4 slices of loaf bread 4 slices of loaf bread
1 pack of 60 g instant noodles 1 pack of 60 g instant noodles
1 cup cooked macaroni or 1 cup cooked macaroni or
spaghetti spaghetti
1 small root crop, cooked (3 1 small root crop, cooked (3
times a week) times a week)
Meat and Fish/meat/ At least 3½ servings At least 3½ servings
alternatives poultry/ 1 serving cooked meat = 30 g 1 serving cooked meat = 30 g
Dried beans/ Fish = 2 pcs medium sized Fish = 2 pcs medium sized
nuts (50-60 g each) (50-60 g each)
1 cup cooked dried beans/ 1 cup cooked dried beans/ nuts
nuts preferably taken 3 times preferably taken 3 times a
a week week
milk 1 glass whole milk, (240 mL) 1 glass whole milk, (240 mL)
equivalent to 4 tbsp powdered equivalent to 4 tbsp powdered
whole milk or ½ cup whole milk or ½ cup
evaporated milk diluted to 1 evaporated milk diluted to 1
glass water glass water
Vegetables Green leafy/ ¾ cup, cooked ¾ cup, cooked
Yellow
Repeated Pregnancies
As parity increases, the tendency toward lower nutrient intake also increases. Moreover,
gestation in close interval depletes the maternal reserves of nutrients. Since replenishment of
reserves does not take place, the mother’s nutritional status, and consequently that of the infant,
are greatly affected.
LACTATION
The preparation for assuring an adequate supply of good quality breast milk must begin at
the onset of pregnancy. Most of the dietary essentials are increased over and above the
requirements during pregnancy to meet the demands of milk production, namely;
a. Calories e. Thiamin
b. Proteins f. Riboflavin
c. Calcium g. Niacin
d. Vitamin A h. Ascorbic acid
NUTRITION IN LACTATION
Calorie Allowances
The chief concern during lactation is the loss of the food material in the milk and the
storage of a certain amount of food which cannot be entirely accounted for by the chemical
composition of the milk. Also, extra calories may be needed for additional activity necessitated
by the care of the infant.
The extra energy required for lactation depends on the amount of milk produced. The
food requirements are not uniform during the entire period of lactation, they depend on the
demands of the infant. It is generally suggested that the extra food calories should be about twice
those secreted in the milk of approximately 700 to 1500 calories of food for 500 to 1000 mL of
the milk. FNRI recommends an increase by 1000 calories above the normal requirement for an
average production of 850 mL of milk, with an energy value of about 600 calories. Human milk
is approximately 0.70 calories per mL or approximately 20 calories per ounce, and it contains 1.2
g protein per 100 mL.
Protein Allowances
During lactation, the demand for calcium and phosphorus is increased above the
requirement of the pregnant woman. The calcium allowance is 1.0 g daily for good milk
production. If the protein requirement and other essentials of the diet are fulfilled, the increased
need for phosphorus will be met. The vitamin D requirement of 400 IU remains the same as
during pregnancy.
Iron Allowances
Some lactating women tend to be anemic unless the iron allowance n the diet is increased
to the same level as that during pregnancy. During lactation, the loss of iron which is considered
on an annual basis is probably similar to that which is lost in the menstrual flow.
The baby is born with a relatively large reserve of iron. Since milk is not a good source of
iron, a good allowance of iron in the mother’s diet during lactation does not convey additional
iron to the infant. Nevertheless, iron-rich foods are essential for the mother’s own health while
supplements are included early in the infant’s diet.
Vitamin Allowances
There is an increase demand for vitamin A, niacin, riboflavin, thiamine, and ascorbic acid
above the requirements of pregnancy during lactation.
Nutritional Requirements
The nutritional requirements in lactation are greater than in pregnancy to ensure enough
supply of milk for the baby.
1. Calories – An addition of 1000 calories above the normal allowance needed. An
approximate amount of 120 calories is required to produce 100 mL of milk. Thus, the
daily production of 850 mL of milk will require an additional 1000 calories in the
diet. Energy-giving foods are good sources of calories.