National Nutrition and HIV/AIDS Guidelines for Service Providers of ...

7.1.2 Protein Requirements
The protein requirements of an HIV infected woman is the same as that of a non infected woman of the
same age, physiologic stage and physical characteristics. However, HIV infected pregnant/lactating
adolescents and adults may need additional protein over the level recommended for healthy non-HIV
infected pregnant/lactating adolescents and adult women. This is likely if they are symptomatic.
° Daily recommended protein intake is 1 g/kg body weight in healthy non pregnant women.
° Non-HIV infected healthy pregnant and lactating women require an additional 6g/day and
16 g/day respectively.
th
° Additional protein is reduced to 12 g/day for lactating mothers after the 6 month and to 11
th
g/day after the 12 month
The protein should contain the entire range of essential amino acids. This requires consumption of a
large variety of plant proteins or a mixture of plant and animal food sources.
7.1.3 Micronutrients Requirements
Adequate intake of vitamins and minerals is crucial in the care and support of pregnant adolescents
and adults. Pregnant adolescents and adults should consume diets that ensure micronutrient
intakes at RDA levels. In addition, HIV infected pregnant women should be given iron, folate, and
vitamin A supplement as is standard antenatal care for all pregnant women in Botswana.
Pregnant HIV positive women who are not gaining weight for 2 to 3 month (especially in the
second and third trimester) or have a BMI less than 18.5, and women who are practicing
exclusive breastfeeding in the first 6 months after delivery and have a BMI of less than 18.5
should be provided with the vulnerable group ration for pregnant / lactating mothers.
7.2 Nutritional Assessment and Support
In addition to the recommendations for all PLWHA provided in the preceding chapters service providers
should:
7.2.1 Support pregnant adolescents and adults to monitor their nutritional status.
Providers should:
° Ensure that every pregnant adolescent / woman has an antenatal card to record weight
changes during pregnancy.
° Educate HIV infected mothers about the importance monitoring their nutritional status.
(e.g. keeping a record of their body weight ): This will enable mothers to
° Know whether they are gaining adequate weight (as in pregnancy) or are losing weight at a
rate that is detrimental to their health.
° Be able to plan appropriately so that they may address their dietary needs.
° Ensure that nutrition interventions are individualized for every woman.
7.2.2 Women gaining less than one kilogram per month in the second and third trimester should be
referred to a health facility immediately where they can receive more care.
32