Pregnancy and Lactation Nutrition

Caloric Needs

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Protein Needs

>1.1 g/kg/day

Folate

• Supports: Neural tube development & fetal growth

• RDA: 600 µg/d • Sources: leafy greens, legumes, fortified grains, prenatal vitamins

• ACOG recommends supplementation: 400 µg before conception through 1 st trimester

Iron

• Supports: Maternal blood volume & fetal oxygen deliver

• RDA: 27 mg/d

• Source: Red meat, poultry, beans, fortified cereals

Calcium

• Supports: fetal bone & teeth development; maintain maternal bone health

• RDA: 1,300 mg/d (<18yo); 1,000 mg/d (>19yo)

• Sources: dairy products, fortified plant milks, leafy greens

Iodine

• Supports: maternal thyroid function during pregnancy; fetal brain development

• RDA: 220 μg/d • Source: Iodized salt, seafood, dairy products

• At risk of deficiency: vegan diets, smokers, severe nausea/vomiting

Other Key Micronutrient

Omega-3 (DHA), Chlorine, B-complex vitamins, Vit D, Magnesum and Zinc

Chart of the micronutrients:

Information in chart

Additional dietary consideration

• Alcohol intake

  • Avoid throughout pregnancy

  • No definitive data to establish safe limits

  • Heavy Alcohol Consumption increases risk of:

    • Fetal alcohol spectrum disorder (FASD)

    • Growth restrictions

    • Neurodevelopmental impairment

• Caffeine intake

• Limit to <200 mg/day (≈ 1–2 cups of coffee)

• Caffeine metabolized more slowly during pregnancy and metabolites can cross the placenta

  • High intake-> placental and uterine vasoconstriction, ↑ fetal heart rate

• Vitamin A

  • Avoid high-dose supplementations

  • Excessive doses can accumulate and are teratogenic

  • UL: 3,000 μg/day (10,000 IU/day)

• Methylmercury

  • Avoid seafood high in methylmercury

    • shark, king mackerel, tilefish, swordfish, marlin, orange roughy, bigeye tuna

  • Can cross the placenta

    • High consumption -> impaired fetal brain development

    • Given the health benefits of fish, pregnant women are advised to consume 8–12 oz of seafood low in mercury per week

• Listeria-> Listeriosis

  • Can result in miscarriage, neonatal sepsis, meningitis

  • Sources: unpasteurized milk, soft cheeses, deli meats*, hot dogs

    • If consumed, it should be heated to 165°F to kill Listeria

• Toxoplasma gondii->Toxoplasmosis

  • Can result in: miscarriage or severe birth defects

  • Source: undercooked meat or poultry or contact with cat feces

Gestational Weight Gain

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Mediterranean Diet

Suggests Mediterranean Diet may be associated with a reduction in adverse outcome of pregnancy, such as gestational diabetes, overweight or obesity, sleep quality, complications of childbirth, UTIs, and alteration in fetal growth