LB2882MaternalNutriti+ - Mead Johnson Nutrition

Nutrient Needs during Pregnancy and Lactation
A balanced diet that supports appropriate maternal weight gain and meets maternal and fetal nutrient needs
contributes to creating a favorable intrauterine environment. 5 However, for a variety of reasons, pregnant and
lactating women often do not consume the recommended amounts of essential nutrients. Inadequate micronutrient
intake during pregnancy and lactation has been attributed to factors such as increased nutritional needs, maternal
age, geography, and socioeconomic status. 21,65
In the following sections, recommended intakes for energy, macro- and micronutrients during pregnancy and
lactation are summarized.
Energy
The energy cost of pregnancy (measured in calories or kilojoules) includes energy needed for accretion of maternal,
fetal and placental tissues, increases in the mother’s basal metabolism, and the mother’s physical activity level.
Table 4 summarizes recommendations for additional daily calorie intakes during pregnancy and lactation. The FAO/
WHO/UNU Expert Consultation on human energy requirements recommended an additional intake of 85, 285 and
475 kcal/d during the first, second and third trimesters of pregnancy, respectively. 6 The IOM Dietary Reference
Intakes do not recommend an increase in daily calorie intake during the first trimester of singleton pregnancies. 5
Women are advised to increase their daily calorie intakes during pregnancy according to their pre-pregnancy body
weight, physical activity level, and weeks gestation. The suggested calorie increase for women who conceive at a
body weight in the normal range is 340 calories a day in the second trimester and 450 calories a day in the third
trimester. 5 It has been suggested that in the US, women pregnant with multiple fetuses need about 500 calories a
day beyond what is required for a singleton pregnancy starting in the first trimester. 66
The amount of milk that a woman produces and secretes as well as the milk’s energy content influence the energy
cost of lactation. 67 The FAO/WHO/UNU Expert Consultation on human energy requirements recommended
that well-nourished lactating women consume an additional 505 kcal/d during the first 6 months of lactation.
Undernourished women should consume more: an additional 675 kcal/d. The expert consultation did not make
recommendations for the second 6 months of lactation since milk production is more highly variable during this
time. 67 The IOM daily calorie intake recommendations for lactating women are based on pre-pregnancy calorie
requirements for weight maintenance for women within the normal weight range. The IOM recommends that women
in the normal weight range consume 330 additional calories per day for the first six months after delivery and 400
additional calories each day for months six through 12 of their infant’s life. 5 Overweight and obese women and
women who gained too much weight during pregnancy may not need to consume additional energy. Research
indicates that once lactation is established, breastfeeding women with a post-pregnancy BMI >25 may restrict their
intake by 500 kilocalories per day and exercise to promote weight loss without affecting infant growth. 27,68
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