ANTENATAL AND POSTNATAL DIET

The diet during pregnancy should be adequate to provide (a) good maternal health (b) optimum fetal growth (c) the strength and vitality required during labor (d) successful lactation. During pregnancy, there is increased calorie requirement due to increased growth of the maternal tissues, fetus, placenta and increased basal metabolic rate. The increased calorie requirement is to the extent of 300 over the non pregnancy state during second half of pregnancy. Generally the diet in pregnancy should be with woman`s choice as regard the quantity and the type. Woman with normal BMI should eat adequately so as to gain the optimum weight (11kg). Overweight women with BMI between 26-29 should limit weight gain to 7 kg and obese women (BMI greater than 29) should gain less weight. Excessive weight gain increases ante-partum and intrapartum complications including fetal macrosomia. The pregnancy diet ideally should be light, nutritious, easily digestible and rich in protein, minerals and vitamins.

Physiological Changes in the Gastro Intestinal System during Pregnancy:

Gums become edematous, soft and spongy during pregnancy, probably owing to the effect of estrogen, which can lead to bleeding when mildly traumatized as with a tooth brush. Profuse salivation or ptyalism is an occasional complaint in pregnancy, caused by stimulation of the salivary glands due to ingestion of starch. Pica, the term given to the bizarre craving for and compulsive, secret chewing of food or ingestion of non-food substances (eg. Ice,coal, chalk) Marked reduction of gastric and intestinal tone and motility plus relaxation of the lower oesophageal sphincter predispose to heart burn, constipation and haemorrhoids. Changes in metabolism: - Accelerated fat metabolism. - It is recommended that pregnant women neither fast, skip meals nor restrict carbohydrate intake. Maternal Weight:

Weight gain during pregnancy comprises the products of conception (fetus, placenta and amniotic fluid) and hypertrophy of several maternal tissues (uterus, breasts, fat stores and extracellular and extravascular fluid)

Fetal weight gain is slow in the first half of pregnancy and increases more rapidly in the second 20 weeks. An optimal weight gain for an average pregnancy is 12.5 kg, 9 kg of which is gained in the last 20 weeks.

Diet In Pregnancy
A healthy diet and lifestyle during pregnancy is important for the development of a healthy baby, and may have long-term beneficial effects on the health of the child. It is also important for a pregnant woman to have regular checks with a midwife throughout pregnancy, to ensure that any conditions that may pose a risk to the babys health can be identified and treated. NEED OF NUTRITIOUS DIET : By taking healthier diet , a pregnant lady can prevent minor infections and diseases. In pregnancy the risk for anemia is highest due to increase in the blood plasma volume.

Some nutritious food items which are necessary for the mother and fetus during pregnancy: Recipies made from milk Paneer products Boiled eggs, fish oil [if you are a non vegetarian] Fruits and vegetables Rice and cereals Green leafy vegetables and green vegetables Ghee, jaggerry, dry fruits Sweets made from ghee and mawa Iron rich food like jaggery, dates, brinjal, spinach and all green leafy vegatables. Calcium rich food like banana, milk etc.

FOODS TO BE AVOIDED FOR HEALTHY PREGNANCY:

Tea and coffee should not be taken before or after meal, because it will lead to deficiency of iron because of decreased iron absorption. Alcohol ,tobacco chewing ,cigarette etc. should be avoided during pregnancy. Avoid consuming unpasteurized milk Avoid alcoholic drinks during pregnancy.

PUERPERIUM: Haemorrhoids and constipation is not uncommon during pregnancy and is a result of the influence of progesterone on smooth muscle. Women who have haemorrhoids should be given advice on following a diet high in fibre and fluids, preferably water and the use of appropriate laxatives to soften the stools as well as topical application to reduce the oedema and pain. Some women might experience loss of bowel control and whether this is faecal incontinence.

Daily dietary allowances for a woman of reproductive age, pregnancy and lactation
Non-pregnant Energy(k. Cal) Protein Iron Calcium Zinc mg) Iodine (g) Vitamin A Vitamin D Thiamine Riboflavine Nicotinic acid Ascorbic acid Folic acid Vitamin B12 2200 k.cal 50 gm 18mg 500 mg 12 mg 150g 5000 I.U 200 I.U 1.1 mg 1.1 mg 15 mg 60 mg 200 g 2 g Pregnancy Second half 2500 k.cal 60 gm 40 mg 1000 mg 15 mg 175 g 6000 I.U 400 I.U 1.5 mg 1.6 mg 17 mg 70 mg 400 g 2.2 g Lactation 2700 k.cal 65 gm 30 mg 1500 mg 19 mg 200 g 8000 I.U 400 I.U almost same as in pregnancy Sources Protein ,fat, carbohydrate Meat, fish, poultry, dairy product Meat, egg, grains Dairy products Meat, egg, sea food Iodised salt, sea food Vegetables, liver, fruits Dairy products grains, cereals Meat, liver, grains Meat, nuts, cereals Citrus fruits, tomato Leafy vegetables, liver Animal proteins

Exchange list- Ante natal diet (Vegetarian) Calorie requirement: 2500 k.cal Protein : 60 gm
Time 7 am 9 am 11 am Item Milk & milk products(200ml) Cereals Fruit Milk product(Tea-100ml) Cereals Cereals+ Fat Cereals Calorie 100+20 300 50 50+20 100+20 200 300+30 Protein 5 2 2.5 2 4 6+2

1 pm

3 pm 4 pm 5 pm 7 pm 9 pm

Veg B+Veg A Pulse (30gm) Fruit juice Cereals + Milk product Fruit Pulses +Veg A+ Veg B Cereals Milk Fruit TOTAL

50+50 100 50+20 200 50 100+50+50 300+100 100+20 50 2,550 KCal

6 5 5 6+2 5 60.5gm

Diet Plan
Time 7 am 9 am 11 am Item Milk Biscuit Banana Tea Poha Bada bread with butter Chapatti Rice Palak & Potato Sabji Dhal Fruit juice Bread butter Apple Mixed vegetable sabji Chapatti Rice Milk Apple Amount 200ml 1 packet Parle G 1 100ml 30 gm 2 Slice 3Nos 60 gm 30 gm 30 gm 200ml 2 slice 1 30 gm 3Nos 60 gm 200ml 1

1 pm

3 pm 4 pm 5 pm 7 pm

9 pm

Exchange list- Ante natal diet (Non vegetarian)

Time 7 am 9 am 11 am 1 pm Item Milk & milk products(200ml) Cereals Fruits Cereals Boiled egg Cereals Flesh food +Veg B Pulse Fruit juice Cereals + Milk product Fruit Pulses +Veg A+ Veg B Cereals Flesh food+ Fat Veg A+ Milk product Milk Fruit TOTAL Calorie 100+20 300 100 100+20 35 300+100+15 70+50 100 50+20 200 50 100+50+50 300+100+15 70+ 15 100 100+20 50 2,600 k Cal Protein 5 2 2 5 6+2 10 6 5 5 6+2 10 5 5 76 gm

3 pm 4 pm 5 pm 7 pm

9 pm

Time 7 am 9 am 11 am 1 pm

3 pm 4 pm

Item Milk Biscuit Banana Poha Boiled egg Chapatti Rice Flesh food+ Veg B Dhal Fruit juice Bread butter

Amount 200ml 1 packet Parle G 2 30 gm 1 3Nos 30 gm 30 gm 30 gm 200ml 2 slice

5 pm 7 pm

9 pm

Apple Mixed vegetable sabji Chapatti Chicken rice Salad Milk Apple

1 30 gm 3Nos 60 gm 30 gm 200ml 1

Exchange list- Post natal diet (vegetarian) Calorie requirement: 2700kCal

Time 7 am 9 am 11 am 1 pm

Protein: 65 gm
Item Milk & milk products(200ml) Cereals Fruits Milk product Cereals Cereals Pulse +Veg B Pulse Fruit juice Cereals + Milk product Fruit Pulses +Veg A+ Veg B Cereals Milk product+ Veg A Veg A Milk Fruit TOTAL Calorie 100+20 300 100 100+20 100+20 300+100 100+50 200 50+20 200 50 100+50+50 300+100+15 100+ 50 50 100+20 50 2,800 k Cal Protein 5 2 5 2 6+2 6 12 5 5 6+2 5 5 68gm

3 pm 4 pm 5 pm 7 pm

9 pm

DIET PLAN Time 7 am 9 am 11 am 1 pm Item Milk Biscuit Banana Tea Poha Chapatti Rice Rajmah+ Veg B Dhal Fruit juice Bread butter Apple Mixed vegetable sabji Chapatti Rice PaneerTomato sabji Salad Milk Apple Amount 200ml 1 packet Parle G 2 200ml 30 gm 3Nos 30 gm 30 gm 60 gm 200ml 2 slice 1 30 gm 3Nos 30 gm 60 gm 30 gm 200ml 1

3 pm 4 pm 5 pm 7 pm

9 pm

Exchange list- Post natal diet (Non vegetarian)

Time 7 am 9 am 11 am Item Milk & milk products Cereals Fruit Milk product Cereals Boiled egg Cereals Flesh food +Veg B Pulse Fruit juice Calorie 100+20 300 50 100+20 100+20 35 300+30+15 70+50 200 50+20 Protein 5 2 5 2 5 6+2 10 12 -

1 pm

3 pm

4 pm 5 pm 7 pm

9 pm

Cereals + Milk product Fruit Pulses +Veg A+ Veg B Cereals Flesh food+ Fat Veg A+ Milk product Milk Fruit TOTAL

200 50 100+50+50 300+100+15 70+ 15 100 100+20 50 2700 KCal

5 5 6+2 10 5 5 83 gm

DIET PLAN
Time 7 am 9 am 11 am Item Milk Biscuit Banana Tea Poha Boiled egg Chapatti Rice Flesh food+ Veg B Dhal Fruit juice Bread butter Apple Mixed vegetable sabji Chapatti Chicken rice Salad Milk Apple Total Amount 200ml 1 packet Parle G 1 200ml 30 gm 1 3Nos 60 gm 30 gm 60 gm 200ml 2 slice 1 30 gm 3Nos 60 gm 30 gm 200ml 1

1 pm

3 pm 4 pm 5 pm 7 pm

9 pm

Bibliography
1. .Diane M.Fraser, Margaret A.cooper. Myles textbook of Midwives.14th edition. Philadelphia: Elsevier publication;2003.chapter.no.7.p.99-108. 2. Dr C.S.Dawn.Textbook of obstetrics, neonatology& reproductive & Child health education.16th edition. Kolkata: Smt. Arati Dawn, Debabrata Dawn publishers;2004.chapter.10.p.68-71 3. Santi Ghosh.Text book of nutrition child care.1st edition. Jaypee brothers. New Delhi:2005;Pp:1-25. 4. Nix Staci .Williams basic nutrition diet therapy.12 th ed. Mosby. New Delhi :2005;pp.173 . 5. Rekha Sharma .Diet management .3rd ed. Elsevier Publishers .New Delhi :2004 ;pp.4,7-8,337. 6. Joshi Y.K. Basics of clinical nutrition ,1st ed. Jaypee publishers .New Delhi :2003;pp.17 7. Sohi Darshan .A text book of nutrition .1st ed.P.V.Books Jalandar :2010;pp.3-4

SANDRA SHROFF ROFEL COLLEGE OF NURSING

HEALTH EDUCATION ON ANTE NATAL AND POST NATAL DIET

Submitted to: Mrs. Nisha Oommen Associate Professor

Submitted by: Mrs. Bini P Samuel IInd Year MSc Nursing