Chapter 10: Nutrition during Pregnancy and
Lactation
Nutritional Demands of Pregnancy
Energy needs
Reasons for increased need
To supply the increased fuel demanded by the metabolic workload for
both the mother and the fetus
To spare protein for the added tissue-building requirements
Amount of energy increase
First trimester: no increased energy need
Second trimester: energy need increases by 340 kcal/day
Third trimester: energy need increases by 452 kcal/day
Carbohydrate Needs
AMDR: 45%-65% total daily kilocalories
Minimum daily requirement increases from 130 g/day to 175 g/d
Fat needs
AMDR: 20-35% of total daily kilocalories
Reasons for increased need
Fetal growth and development
EPA and DHA recommendations
Recommendations vary between organizations
Protein needs
Reasons for increased need
Development of the placenta
Growth of maternal tissues
Increased maternal blood volume
Amniotic fluid
Growth of the fetus
Amount of protein increase
Minimum daily requirement increases from 46 g/day to 71 g/day
Food sources
Complete: eggs, milk, beef, poultry, fish, pork, cheese, soy products,
and other animal products
Incomplete: legumes and grains
Key mineral and vitamin needs
, Minerals
Calcium
Iron
Vitamins
Folate
Vitamin D
Folate
Builds mature red blood cells during pregnancy
Especially important during early periconceptional period (~2 months
before conception to week 6 of gestation)
Decreases incidence of neural tube defects (such as spina bifida and
anencephaly)
DRIs: daily folate intake of 600 mcg during pregnancy and 400 mcg/day
for nonpregnant women during childbearing years
May require folate supplements
Spina Bifida – A Neural Tube Defect
Weight gain during pregnancy
Amount and quality
Set weight goals according to mother’s pre-pregnancy nutritional
status and body mass index
Rate of weight gain
First trimester: about 1 to 2 kg (2 to 4 lb)
Thereafter: women with a prepregnancy BMI between 18.5 and
24.9 kg/m2 generally gain about 0.4 kg (14 oz) per week during the
remainder of the pregnancy
An insufficient or low maternal weight gain is a predictor of small for
gestational age (SGA) infants with increased risks for complications
Weight Gain During Pregnancy
Lactation
Nutritional Demands of Pregnancy
Energy needs
Reasons for increased need
To supply the increased fuel demanded by the metabolic workload for
both the mother and the fetus
To spare protein for the added tissue-building requirements
Amount of energy increase
First trimester: no increased energy need
Second trimester: energy need increases by 340 kcal/day
Third trimester: energy need increases by 452 kcal/day
Carbohydrate Needs
AMDR: 45%-65% total daily kilocalories
Minimum daily requirement increases from 130 g/day to 175 g/d
Fat needs
AMDR: 20-35% of total daily kilocalories
Reasons for increased need
Fetal growth and development
EPA and DHA recommendations
Recommendations vary between organizations
Protein needs
Reasons for increased need
Development of the placenta
Growth of maternal tissues
Increased maternal blood volume
Amniotic fluid
Growth of the fetus
Amount of protein increase
Minimum daily requirement increases from 46 g/day to 71 g/day
Food sources
Complete: eggs, milk, beef, poultry, fish, pork, cheese, soy products,
and other animal products
Incomplete: legumes and grains
Key mineral and vitamin needs
, Minerals
Calcium
Iron
Vitamins
Folate
Vitamin D
Folate
Builds mature red blood cells during pregnancy
Especially important during early periconceptional period (~2 months
before conception to week 6 of gestation)
Decreases incidence of neural tube defects (such as spina bifida and
anencephaly)
DRIs: daily folate intake of 600 mcg during pregnancy and 400 mcg/day
for nonpregnant women during childbearing years
May require folate supplements
Spina Bifida – A Neural Tube Defect
Weight gain during pregnancy
Amount and quality
Set weight goals according to mother’s pre-pregnancy nutritional
status and body mass index
Rate of weight gain
First trimester: about 1 to 2 kg (2 to 4 lb)
Thereafter: women with a prepregnancy BMI between 18.5 and
24.9 kg/m2 generally gain about 0.4 kg (14 oz) per week during the
remainder of the pregnancy
An insufficient or low maternal weight gain is a predictor of small for
gestational age (SGA) infants with increased risks for complications
Weight Gain During Pregnancy
