Topic 4.2: Nutrient requirements and dietary considerations of pregnant and lactating women
Why is an adequate diet important before and during pregnancy and lactation?
- A diet providing all key nutrients is important for women’s health and wellbeing in all stages of their maternal life: from adolescence, to preconception, pregnancy and breastfeeding.
- For expecting women, following an adequate nutrient-dense diet before pregnancy is very important to provide nutrient reserves for the pregnancy, while during pregnancy and breastfeeding energy and nutrient requirements are increasing.
Figure sourced from United Nations Children’s Fund (UNICEF) 2021. Women’s nutrition across the life course. Source: https://www.unicef.org/media/115361/file/Maternal%20Nutrition%20Programming%20Guidance.pdf
- Poor nutrition prior to and during pregnancy has been associated with adverse health outcomes such as gestational hypertension, gestational diabetes, preterm birth, stillbirth and infants born with low birthweight.
- Following a healthy diet before and during pregnancy reduces the risk of these adverse outcomes and has been associated with a healthy pregnancy.
- Maintaining a healthy weight before pregnancy and gaining the recommended gestational weight is also important for optimal pregnancy outcomes.
- During breastfeeding, the production and composition of human milk is influenced by women’s dietary intake and adipose nutrient stores. Women should follow a healthy diet to restore maternal nutrient reserves after childbirth and ensure they meet the additional energy needs associated with breastfeeding. This is particularly important among women who are undernourished.
Click on each bar below to learn more about the nutrient requirements during pregnancy and lactation
- During pregnancy, energy requirements are increasing during the second and third trimester. However, energy requirements depend on individual’s characteristics such as women’s pre-pregnancy weight, age and activity level and whether it is a singleton or multiple pregnancy.
- For adult pregnant women with a healthy pre-pregnancy body weight, energy requirements can be covered via a balanced and diversified diet, focusing on eating foods rich in nutrients rather than eating more.
- Energy requirements are also increased in women who breastfeed exclusively.
Carbohydrates
- Carbohydrate requirements during pregnancy and lactation can be covered by basing meals on starchy foods (one third of what they eat), preferably whole grains and at least five portions of fruit and vegetables per day.
Protein
- Protein requirements increase slightly during pregnancy and lactation, particularly in undernourished pregnant women.
- Pregnant and women who breastfeed should eat protein-rich foods such as beans, pulses, fish, eggs, meat (except liver), poultry, dairy, and nuts. Lean meat and low fat dairy should be preferred.
Fat
- Fat requirements do not increase during pregnancy and lactation. Pregnant and lactating women should reduce the intake of foods that are high in saturated fat and replace those by foods high in unsaturated fat such as vegetable oils.
- The requirements of many vitamins and minerals are increasing during pregnancy.
- Folate is particularly important in early pregnancy to prevent congenital birth defects.
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| The World Health Organization recommends 400 µg of folic acid supplementation per day for all pregnant women. In addition to supplements, the intake of foods rich in iron (meat, fish, eggs) and folate (dark green leafy vegetables, citrus fruit) are recommended. |
- Other micronutrients such as calcium, vitamin D, iodine and iron supplementation may be needed in pregnant women at risk.
- During lactation, an adequate intake of most vitamins and minerals such as vitamin D, vitamin C, B vitamins and zinc is also important as they are secreted into breast milk.
Food insecurity of pregnant and lactating women
Women who are undernourished, underweight or overweight with nutritional deficiencies, adolescent pregnant girls and other groups such as women with disabilities, infectious diseases (e.g., HIV), from ethnic and racial minorities or those facing gender-based violence or living in emerging settings are at risk of food insecurity.
What to consider when providing food aid for pregnant and lactating women?
- Those involved in programmes that provide food aid to pregnant and lactating women should be aware of their nutrient requirements in order to provide nutrient-dense foods and meals.
- They should also be aware of the foods that pose a risk to the mother and the foetus (e.g., liver, large fish, uncooked eggs) and take all necessary measures to reduce exposure to food-related risk factors.
- During meal preparation, all food safety rules should be followed to reduce the risk of contamination and food poisoning.
The infographic below shows which foods and drinks to avoid and how to prepare food safely when providing food aid in pregnant and lactating women.
