Pediatric Nutrition in Practice

2 Nutrition of Healthy Infants, Children and Adolescents

Key Words

Pregnancy · Lactation · Gestational weight gain ·

Nutrient requirements, during pregnancy,

lactation · Supplements

Key Messages

• Appropriate gestational weight gain is determined
  by the pre-pregnancy body mass index


• Most nutritional requirements of most pregnant
  and lactating women can be met by consuming
  a variety of foods according to government-en-
  dorsed guidelines


• There are almost universal recommendations for
  periconceptional folic acid supplementation to pre-
  vent neural tube defects. Supplementation with io-
  dine during pregnancy and lactation, and with iron
  during pregnancy, is also recommended in differ-
  ent countries. Additional nutrient supplementation
  may be required for vegetarians, women having
  multifetal pregnancies and women diagnosed with
  deficiencies


• High-listeria-risk foods and alcohol should be
  avoided during pregnancy, and caffeine intake
  should be limited © 2015 S. Karger AG, Basel

Introduction

Maternal nutrition from preconception through
to lactation has both short- and long-term health
effects on the offspring [1]. While requirements

for many nutrients increase in pregnancy and lac-

tation, and some dietary changes are required,

hormonal changes lead to physiological adapta-

tions which help the body balance maternal and

fetal demands, making ‘eating for two’ largely un-

necessary.

There is a negligible increase in energy re-

quirements in the first trimester, followed by an

average extra requirement of 1.4 MJ/day (335

kcal/day) in the second trimester, of 1.9 MJ/day

(450 kcal/day) in the third trimester and of 2.0–

2.1 MJ/day (275–500 kcal/day) during lactation

for women with a normal pre-pregnancy body

mass index (BMI). Energy requirements vary ac-

cording to the pre-pregnancy BMI, with lower re-

quirements for overweight and obese women and

higher requirements for underweight women.

Healthy weight gain targets for pregnancy are

also based on the pre-pregnancy BMI and are

shown in table 1 [2]. Weight gain should be mon-

itored throughout pregnancy to achieve the ap-

propriate weight gain goal. Dieting to prevent

weight gain or achieve weight loss is not recom-

mended during pregnancy as it may result in in-

adequate intake of essential nutrients, which

could adversely affect fetal growth and develop-

ment. In the post-partum period, return to pre-

pregnancy weight is faster in lactating women as

fat stores laid down in pregnancy are mobilised

to support lactation.

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 127–133
DOI: 10.1159/000367872

2.8 Nutrition in Pregnancy and Lactation

Lenka Malek  Maria Makrides

2