LB2882MaternalNutriti+ - Mead Johnson Nutrition

TAbLE 4. RECOMMENDATIONS FOR ADDITIONAL DAILY CALORIE INTAkE DURING PREGNANCY AND
LACTATION 5,6,67
Pregnancy IOM FAO/WHO/UNU
1 st Trimester 0 85
2 nd Trimester 340 285
3 rd Trimester 450 475
Lactation
1 st 6 Months 330 505 a
2 nd 6 Months 400 Varies depending on milk output
a For women with adequate gestational weight gain. The recommendations for undernourished women and those with insuffi cient gestational
weight gain is 675 kcal/d.
Carbohydrate
The primary role of dietary carbohydrate is to provide energy to cells. Sugars and starches supply energy in the
form of glucose, which is the only energy source for red blood cells and is the preferred energy source for the brain,
central nervous system, and fetus. 5 The U.S. Dietary Reference Intake (DRI) for carbohydrate for a pregnant woman
19 to 50 years of age is a minimum of 175 grams of carbohydrate daily to provide adequate glucose for her body
and for a single fetus. 5 This represents a daily increase of 45 grams above the non-pregnancy state and is easily
achieved by most pregnant women who are eating a balanced diet. The DRI for lactation is higher (210 grams daily)
to compensate for the carbohydrate secreted in breast milk. 5
Fiber is non-digestible carbohydrate and lignin found in plant foods. 5 Benefi ts of dietary fi bers include feelings of
fullness and improved laxation, which could help reduce the chances for hemorrhoids during pregnancy. Some
types of dietary fi ber are also associated with lower postprandial blood glucose levels and reduced blood cholesterol
concentrations. The Adequate Intake (AI) for fi ber during pregnancy and lactation is 14 grams per 1,000 calories. 5
Thus, a pregnant woman with an estimated energy requirement of 2,400 calories should consume about 34 grams of
fi ber daily. Most women do not consume enough fi ber and require counseling about including high-fi ber foods in their
diet, such as dried beans and peas, vegetables, fruits, nuts, and whole grains, to meet the suggested intake.
Protein
Protein is a constituent of all cells and a component of enzymes, membranes, transport carriers, and many
hormones. The amino acids from dietary proteins are utilized by the body for endogenous synthesis of structural
proteins as well as enzymes, numerous hormones, immune factors and a plethora of other vital mediators of
physiological function. 5 Pregnancy signifi cantly increases protein needs due to the increase in hormone production
and plasma volume expansion, along with increased tissue formation for the placenta, fetus and breasts. During
lactation, additional protein intake compensates for protein and non-protein nitrogen output in breast milk. 5
The U.S. Dietary Reference Intakes recommended 0.8 g/kg/day of dietary protein for non-pregnant women. Starting
in the second trimester, the recommended protein intake for pregnancy is 1.1 g/kg/day or about 25 g of additional
protein per day. An additional 50 grams a day of protein is suggested for twin pregnancies beginning in the second
trimester. 5 The WHO recommends that pregnant women consume 1, 9 and 31 g of additional protein daily during the
fi rst, second and third trimesters, respectively. 7
MATERNAL NUTRITION 10