Nutritional care during pregnancy, a challenging task
By Jeewanadee Hettiarachchi
A healthy baby and a secure pregnancy is the sole dream of each and
every expecting parent. Sri Lanka being an eastern country has a higher
concern towards motherhood and care during pregnancy. It is a well known
fact that adequate nutrition during pregnancy plays a major role in a
child's and mother's health.
Hence, special care should be taken regarding a mother's food intake
as naturally the demand for quantity and quality of food increases with
the development of the baby inside the uterus. However, during
pregnancy, the body goes through a series of changes and fulfillment of
the special nutrient requirements would be challenging at some points.
To cope up with these nutritional challenges and to assure the
well-being of both mother and the baby, it is important to have a better
understanding on the nutritional complications and possible remedies.
The common nutritional problems among Sri Lankan pregnant women are
mainly the iron deficiency, folic acid deficiency, vitamin B12
deficiency and inadequate weight gain during pregnancy, and for a minor
extent the excessive weight gained during pregnancy. Among the
above-mentioned, the most prevalent in Sri Lanka is the iron deficiency
anemia. This is characterised by quick fatigue, paleness of skin and
lethargy in day to day activities. During pregnancy the iron requirement
is almost doubled and adequate intake is essential for producing new
blood cells that carry enough oxygen to the baby. Blood volume of mother
should be increased to avoid delivery complications due to severe blood
loss.
The preferred practice to avoid iron deficiency, is to have a diet
rich in iron by eating fish, meat, range of green leafy vegetables,
cereals and pulses. The iron from animal sources such as meat and fish
is more efficiently absorbed compared to plant sources. Further, iron is
much easier to absorb if body has enough vitamin C and it is always
better to drink a glass of fruit juice or have a piece of fruit after
meals every day. However in Sri Lanka, free distribution of iron tablets
is done at pregnancy clinics.
The best time to take the tablets is around one to two hours after
dinner, before going to sleep. Since the demand of iron is high during
pregnancy and typical Sri Lankan diets do not contain much animal
sources, it is better for all Sri Lankan pregnant women to be in the
safe side by taking supplementary iron tablets.
The next common nutritional issue in pregnancy is the folic acid and
B12 deficiency. Folic acid is vital for the baby's nerve tissue
development which takes place during the first two weeks after
conceiving. Since many of the pregnancies among Sri Lankans are not pre
planned and pregnancy identifications are done normally after one month,
adequate intake of foliate prior to pregnancy is important.
This can be effectively achieved through an intake of balanced diet
containing more green leafy vegetables. Hence, promotion of a balanced
diet among females from the stage of adolescents is important to assure
safe and healthy pregnancies in adult life. Added to this, it is equally
important to plan your pregnancies and be physically ready once you
decide to be an expecting mother.
Vitamin B12 is important to maintain the functions of folic acid and
adequate amounts are only found in animal sources. Therefore, B12
deficiency is common among Sri Lankan mothers who are vegetarians and
who have low accessibility to animal foods due to economical issues.
Vegan mothers are advised to go for B12 pills under prescription by the
physician.
It is a common fact that pregnant women often experience nausea and
vomiting. Further, they have strong dislikes and cravings for certain
food items. However, if the combined effect of all these factors,
contribute for the reduction of mothers' food intake, it will give rise
to number of complications in mother as well as in developing baby.
The low energy levels of mother result in growth retardation of the
baby and it often leads to inadequate weight gain of mother during
pregnancy. The required weight gain varies with the mother's
pre-pregnancy weight and it is important to know whether a pregnant
woman is having a healthy weight gain adequate for different stages of
pregnancy. So, care should be taken in order to attend antenatal clinics
and be assured that you have healthy weight gain.
Nausea and vomiting can be managed by making simple dietary
adjustments. Eating small meals throughout the day instead of three
large meals, staying away from fried and fatty foods and avoiding foods
with bothersome smells can be done.
Intake of more carbohydrates and starchy foods such as rice, and
other flour products reassure the adequate carbohydrate intake where as
porridges like kola kenda, liquids such as king coconut water and fruit
juices are important to compensate the fluid losses, due to excessive
vomiting. If the condition is uncontrolled it is better to consult the
physician.
Problems in digestion and associated heartburns (burning sensation in
chest area) can be a regular irritation for many pregnant women and it
is a common complaint reported in most of the pregnancy clinics. If the
discomfort is quite severe, it is better to take advice from public
health midwives. Frequent constipation is another type of discomfort
experienced by most of the expecting mothers. Frequent intake of
liquids, semi solid foods, fruits and veggies with proper hygiene is
quite important to avoid these kinds of problems. Further, if the
mothers are having difficulties in eating large meals at the three main
meal times, it is always good to have frequent healthy snacks such as
fruits and boiled vegetables, nuts and seeds etc in between major meals.
The overriding point that should be pinpointed is that a mother's
nutritional intake during pregnancy directly affects the health and
development of the unborn baby and will continue to affect both mother
and baby for many months, years and even throughout their lives. As lack
of nutritional care can result in low birth weight or slower development
of baby and complications in mother, assurance of proper nutrition
during pregnancy is mandatory. After all, "we are not only what we eat,
but also what our mothers have eaten while we were in her tummy".
The writer is a third year undergraduate at the Department of Applied
Nutrition, Wayamba University of Sri Lanka
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