Nutrition for pregnant women

Many scientific studies show that the mother's health and nutrition status has a direct influence on her child from the time she is a fetus to an adult.

Although there have been many activities and programs to support the health of the people in general and women of childbearing age, pregnant women have brought many results, but the lack of energy and micronutrients is still common, variable and this is the main cause of low birth weight.

Risk factors for low birth weight babies are:

- Poor nutritional status of the mother before and during pregnancy
- Too young to give birth and get married, especially when giving birth when under 23 years old
- Short interval between births, less than 2 years
- Over-working during pregnancy
- Insufficient weight gain during pregnancy

1. NUTRITION DURING PREGNANCY
1.1. The role of proper nutrition

When the child is still in the womb, the child's nutrition depends on the mother's nutrition. Nutrients from the mother will follow the blood through the placenta to supply to the baby. Adequate nutrition will help mothers have good resistance to disease, be strong enough to give birth, recover quickly after giving birth, and have enough milk to breastfeed.  

Mothers are well-nourished before and during pregnancy to prevent fetal malnutrition, fetal distress, mental and motor retardation.

1.2. Energy demand and key nutrients

Energy demand

The average energy requirement in women is 2,200 kcal/day. Pregnant women in the second trimester need to increase their energy needs by 360 kcal/day, in the third trimester need an extra 475 kcal/day. Provide enough energy needs during pregnancy to ensure weight gain for the mother

The rate of weight gain should be maintained at 0.4kg/week during the second and third trimesters for women of normal pre-pregnancy weight gain 0.5kg/week for underweight and 0.3 kg/week for overweight women.

Protein: Protein is needed to build the fetus, placenta, mother's body tissues. Should eat foods rich in protein such as meat, fish, eggs, milk, beans.

Fat:  Fat is necessary for building cell membranes and the nervous system of the fetus, providing energy and helping the mother absorb fat-soluble vitamins. Pregnant women need lipids at higher than normal levels

Use both saturated and unsaturated fatty acids. Saturated fatty acids (found in animal fat, coconut oil, palm oil) but should not exceed 10% of dietary energy. Increase the use of vegetable oils (soybean oil, peanut oil, sesame oil, fish fat) to provide more unsaturated fatty acids.

1.3. Need for vitamins and minerals

The need for many vitamins and minerals increases during pregnancy.

Calcium

- Calcium is needed for the fetus to build bones and create teeth. Daily calcium requirements in pregnant women need to increase by 300mg/day to reach 1000mg/day
- Foods rich in calcium such as milk and dairy products, fish, beans, green vegetables. Milk and dairy products such as yogurt, cheese, kefir, ice cream are good sources of calcium for the body.

Folic Acid

- Folic acid is necessary for the normal growth of the body. When folic acid deficiency in pregnant women easily causes macrocytic anemia and neural tube defects in the fetus.
- Folic acid is abundant in leafy vegetables, cabbage, asparagus, broccoli and white, oranges, bananas, kidneys, eggs
- The need for folic acid in pregnant women is higher than normal: 600 µg is needed.
- Currently, the use of folic acid supplements for pregnant women 400 µg/day is widely applied in the world. It should be noted that the supplement must be taken as soon as pregnancy is detected and continuously until the 12th week.

Vitamin A

- The mother's body needs a sufficient amount of vitamin A to provide for the baby and increase the mother's resistance. The need for vitamin A of pregnant women is higher than normal, 800 µg/day. However, if pregnant women consume too much vitamin A, it can cause birth defects.
- Vitamin A is found in many foods of animal origin: liver, egg yolk, butter, milk, meat... green, yellow, and red vegetables.

Vitamin D

- Vitamin D is necessary for the absorption of calcium and phosphorus, contributing to bone structure. Vitamin D deficiency will lead to osteomalacia, hypocalcemia convulsions, osteoporosis.
- An important source of vitamin D for the body (80%) is due to synthesis in the skin under the effect of sunlight.
- Foods of animal origin rich in vitamin D are cod liver, eggs, butter, milk, fatty fish.

Vitamin B1

- The need for vitamin B1 in pregnant women should be sufficient to prevent edema.
- The need for vitamin B1 will be met when using unmilled rice too, a diet high in legumes. Foods that are deficient in vitamin B1 are processed foods such as white milled rice, grains, refined fats and alcohol. Foods rich in vitamin B1 are pork, legumes, vegetables, mold products, yeast, and some fish.
1.4. Micronutrient needs 

Iron

- Iron is essential for both mother and child.
- Forage feed of animal origin such as meat, animal liver iron levels are not quite high and easily absorbed. Some processed foods are fortified with iron such as nutritional powder, flour, fish sauce, instant noodles, etc. are also important sources of iron in the prevention of anemia. 

Iodine

- Iodine plays a very important role for pregnant women. The most serious consequence of iodine deficiency is affecting the development of the fetus. Iodine-deficient pregnant women are at risk of miscarriage, stillbirth, premature birth, and birth defects due to brain damage, low birth weight, and birth defects. birth such as paralysis of limbs, slurred speech, deafness, muteness, and strabismus. Iodine deficiency leads to increased perinatal mortality.

- Iodine deficiency leads to increased perinatal mortality
- Iodine-rich foods are sea fish and seaweed. Using iodized table salt is the main solution to prevent disorders caused by iodine deficiency
- Iodine needs in pregnant women need to be higher than normal, 200 µg/day

1.5. Diet
- Pregnant women should not abstain. Breakfast food need food variety, recommended daily minimum of 15 different foods that can provide enough nutrients. You should eat a lot of vegetables because in addition to vitamins and minerals also provide fiber to prevent constipation.
- Do not use stimulants such as alcohol, coffee, tobacco. Limit spices such as chili, pepper, garlic, vinegar
- Choose fresh, clean foods with high nutritional value, ensure food hygiene and safety
- If morning sickness should divide meals and spread evenly in day
2. LIVING AND WORKING STYLE
- Pregnant women should work according to their ability, not overworked

- Avoid working at height and immersing in water. Take breaks during work time. The last month of pregnancy needs to rest so that the mother has strength and the baby gains weight. Should exercise gently by doing housework, should not rest passively

- Make sure to sleep at least 8 hours a day, nap for 30 minutes to 1 hour - Keep a comfortable mental life, avoid stress, worry anxiety. Limit travel. - Keep a clean, airy living environment, avoid tobacco smoke and dust
3. MEDICAL CARE
- Monthly prenatal check-ups at medical facilities, at least 3 times during pregnancy. Immediate antenatal check-up if there are abnormal manifestations such as vaginal bleeding, abdominal pain intermittently, severe abdominal pain, low or absent pregnancy...

- Examine the breast and note abnormal nipples such as short nipples, pacifier to guide mothers on how to care to facilitate breastfeeding.

- Complete 2 doses of tetanus vaccination.

SOME HEALTH PROBLEMS RELATED TO FREQUENT NUTRITION AND HOW TO TREAT

- Iron deficiency anemia: Usually occurs between 3 months, especially the last 3 months of pregnancy. Nutritional anemia prevention program: Take an iron supplement with 60mg elemental iron and 400 µg folic acid. Take 1 tablet per day continuously from the time you find out you are pregnant until 1 month after giving birth. Drink between meals, do not drink with milk, tea, coffee.          

- Indigestion: Due to the pressure of the uterus on the digestive system. Eat small meals, do not eat before going to bed. Eat slowly, sit up straight when eating.        

- Constipation occurs in 30-40% of pregnant women. Drink plenty of water (8 glasses/day), eat foods high in fiber.        

- vomiting: Usually occurs in 6-16 weeks. Smelly foods should be avoided . Eat foods high in carbohydrates and low in fat. Wake up early in the morning, drink a glass of hot water with bread and cookies.