Nutrition and HIV/AIDS: A Training Manual - Linkages Project

These recommendations are universally accepted. The FAO/WHO recommendationspublished in 1985 are the most commonly used in developing countries.The healthy non-HIV-infected woman needs about an additional 200 kcal per day andmore if her pre-pregnancy weight is low. For the healthy lactating woman, separateallowances have been set for the first and second 6 months of lactation, reflectingthe differences in the amount of milk produced. Table 3 shows FAO/WHOrecommendedenergy and protein requirements. Most breastfeeding women indeveloping countries need an extra 500 kcal per day to meet the energy demands oflactation.Table 3 Recommended energy and protein requirements for healthy womenduring lactation (slide 22)Energy (FAO/WHO, 1985)Protein (FAO/WHO, 1985)Extra 500 kcal/day above nonlactatinglevels (increase if the motheris breastfeeding more than one child)Extra 16g/day for the first 6 months oflactation, 12g/day for the second 6months, and 11g/day thereafterMicronutrient supplementation for pregnant and lactating women and adolescentgirlsPregnant women and infants are the most vulnerable to iron deficiency. Anemiaduring pregnancy is a risk factor for infant and probably maternal morbidity andmortality. Iron deficiency anemia of up to 80 percent is found in some countries ofsub-Saharan Africa. Because anemia is so prevalent, iron and folic acidsupplementation is recommended during pregnancy and lactation for 6 months inpregnancy. If started late, this supplementation should extend into the post-natalperiod for 6 months where the prevalence of anemia is < 40 percent. Where theprevalence is > 40 percent, supplementation is recommended for 6 months inpregnancy and 3 months post-partum for a total of 9 months (WHO/BASICS/UNICEF1999). Iron and folic acid supplements should be provided to HIV-infected pregnantwomen as per existing national standards for antenatal care for all pregnant women.134