Pregnancy Nutrition and Supplementation

Nutrition is a very important aspect during pregnancy as the quality of nutrition the mother receives determines her, as well as her foetus’s health during and after pregnancy. However, this is typically neglected as most neither eat a healthy, balanced and nutritious diet prior to conception nor do they do so during term. By the time they realise it, it could be too late.

Underweight women tend to give birth to smaller babies and experience a higher occurrence of neonatal mortality (death of an infant during the first 28 days after birth). Likewise, overweight women face their own sets of problems such as gestational diabetes and high blood pressure.

During pregnancy, the mother needs an average of 300 kcal on top of her daily energy intake in order to meet the growing/increasing demands of pregnancy as the average weight gain over the entire course of pregnancy is approximately 12kg. Food sources to meet this increased energy intake should ideally be healthy and nutrient-dense for optimal health.

That said, it may be confusing at times when it comes to nutrition for you and your foetus especially with a plethora of information available. Therefore, in this article, we aim to narrow it down to four nutrients (protein, calcium, iron, and folate)

Protein

During pregnancy, there are many physiological adaptations in the female body to accommodate the growth of the baby. The synthesis of placental tissues and growth of the foetus itself require protein to occur optimally. This is especially of concern to Asians because diets in Asian countries tend to be higher in carbohydrates whilst lacking in protein. Therefore we should aim to consume 2-3 portions of meat and alternative protein sources. A serving is typically a palm-sized piece of meat, 2 tau kwas (pressed beancurd), 2 glasses of milk etc. Doing so will ensure that you meet your daily protein requirement along with other important nutrients such as iron and calcium for the growth and development of the foetus.

Calcium

Calcium is an important nutrient required for the maintenance and formation of teeth and bones for the mother and child. To accommodate the calcium requirement of the foetus, there is increased calcium absorption in the gut and increased bone resorption from maternal skeletal stores. Therefore it is essential to consume adequate calcium from whole foods during the course of pregnancy to meet the 1000mg requirement for pregnant ladies. Excellent sources of calcium include milk, yoghurt, calcium-enriched soy milk, tau kwa, fish with edible bones such as sardines and green leafy vegetables.

If you are lactose intolerant, you could always opt for lactose-free milk or choose products derived from soy. Alternatively, you could request for a calcium supplement from your healthcare provider. However, as much as possible, obtain calcium from whole foods because these foods tend to come with other nutrients the body requires.

NB: To further increase calcium absorption, consider taking a Vitamin D supplement or spending 15 minutes in the sun as our bodies are capable or synthesising our own Vitamin D from sunlight!

Iron

Iron is required for the formation of red blood cells in the body which is responsible for transporting oxygen from the lungs to other parts of the body. Being deficient in iron results in anaemia, making you feel fatigued or faint. During pregnancy, consuming adequate amounts of iron (about 19mg) is vital because blood volume expands during pregnancy.

Foods typically high in iron are red meat, poultry, green leafy vegetables, legumes and iron-fortified grains and cereals. Along with whole food, an iron supplement can be helpful in attaining your iron intake.

NB: Although innards, sweetbreads and liver is high in iron, steer clear of it because of its high concentration of Vitamin A, a teratogen, which could cause foetal abnormalities.

Folate

Folate or folic acid is probably one of the more important nutrients but the least understood by the general population. Also known as Vitamin B9, folate is needed for DNA reproduction, repair and the growth of the foetus. It is especially important before and during the first 28 days of pregnancy because that is the period when the baby is most susceptible to neural tube defects (birth defects of the brain, spine or spinal cord) such as spina bifida and, more severely, anencephaly. Spina bifida and anencephaly is where the spinal cord and vertebrae fail to fuse causing damage to the nerves and resulting in paralysis, blindness, deafness and even death.

Women who intend to get pregnant should be consume 400 micrograms (mcg) of folate daily and 600 mcg once pregnant to prevent the occurrences of the aforementioned deformities.

Foods high in folate are folate-enrich cereals, legumes, dark green leafy vegetables, peas and liver. However, due to the high levels of vitamin A in liver, it should be avoided as much as possible. It is usually difficult for one to meet her daily folate requirement through food consumption alone. This is because folate is heat sensitive and is not easily absorbed by the body. In contrast, folic acid – its synthetic counterpart usually found as a supplement – is more stable and readily absorbed. Therefore it would be recommended to speak to your healthcare provider in order to better meet your daily requirement of folate.