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Doc... don’t feel like eating...

Nutrition during pregnancy is the most important intervention. The primary challenges during pregnancy for the care giving doctor are hypertension, preterm births, diabetes during pregnancy and growth restriction in the baby . The common answer for all these situations is good nutrition . There are many myths and facts about nutrition during pregnancy . Many of it can be anything which swings from one side of the pendulum saying “eat what you want to” to “eat for two” . At one end of the spectrum there are women who just can’t control their nausea and have excessive vomiting while the other end is a woman who just can’t contain her appetite and is always hungry .Luckily enough this is rare but some issues about wrong nutritional practices exist . It’s surprising as to why such a magnanimous level of ignorance about the food content and preparation exists . On analysis of various dietary recalls I have realised that most of the diet is convenience cooking .Very less importance is given to tailor make the food for various needs of the members of the family . During pregnancy correct energy , protein content and fibre and nutrients are essential . The baby has its needs so also the wear and tear of the mothers body needs to be adequately supported by proper nutrition. Evidence has shown that folic acid deficiency leads to neural tube defects in the foetus which are serious structural defects affecting the nervous system These deficiencies also cause suboptimal placentation and serious consequences of the same in the later part of pregnancy . Calcium and Vitamin D deficiency can cause pregnancy hypertension ( abnormal rise in blood pressure ), diabetes and increased possibility of operative delivery due to prolonged labour . Occurrence of acidity , constipation , swelling on feet , gas formation, improper weight gain ( excessive as well as less ) are all suggestive of improper food practices . It is important to self audit the food that one takes . Ask following simple questions which should help

  1. Do I feel satisfied after food ? or do I feel hungry and inadequately fed ?

  2. Do I crave for food ?

  3. Do I feel drained out and tired always despite eating ?

  4. Am I putting on excessive weight ? or am bloating ?

  1. Do I get constipation / gases / loose motions ?

  2. Do I have burning sensation or stomach aches on and off ?

All these questions needs to be answered.Do I feel satisfied after food ? or do I feel hungry and inadequately fed ? If the food is rich in proteins and roughages such as fibres it will make you feel complete and full and sustain you for long. Just carbohydrates will make you wanting more and make you feel hungry soon. A huge dose of salads, sprouts and fruits is helpful. one can make good combinations fruit or vegetable smoothies to feel satisfiedDo I crave for food ? Craving can be overcome to an extent by above mentioned measures. In addition the food timings are important . It’s better to have food more often and do not delay eating to avoid cravings . Also anxiety and negative attitudes or fears can cause cravings.Do I feel drained out and tired always despite eating ? Audit the content of your food. Are your daily specific requirements of nutrients , fibres , energy proteins met ? are you doing any physical activity at all . physical activity such as simple walks help in increasing blood circulation and dispersion of stagnated fluid in the dependent areas of the body . It also helps in digestion and assimilation of food . Walk at least for 20 mins twice daily .Am I putting on excessive weight ? or am bloating ? Weight gain during pregnancy has to be gradual and optimal . also the weight gains should not be as a result of excessive water retention which can occur if balanced diet is not taken . pregnancy hormones increase the tendency of salt and water retention which can get exaggerated by lack of mobility dependency and the pressure of the growing womb .inadequate protein consumption, iron deficiency and no exercise can add fuel to the fire . this increase weight can signal rise in blood pressure complicating the pregnancy .Do I get constipation / gases / loose motions ? All these symptoms are signs of improper composition of the diet. The diet has to be rich in roughages and fibre as pregnancy causes slowing down of the bowel movements leading to constipation. Additionally some prescription medicines can enhance constipation. salads , bran, fruits in large quantities are mandatory as not only this helps in clear and smooth bowel activity, aid digestion but prevents excessive weight gain and considerably helps in overcoming gestational or pregnancy diabetes . Gases are signs of indigestion caused either due to overeating , under- eating or untimely eating . Unclean , spicy ,over processed foods can cause gases . Loose motions commonly can be due to infection due to unhygienic food ,

water and food handling methods . All these symptoms also are responsible to prevent the assimilation of valuable nutrients from the food ingested.Do I have burning sensation or stomach aches on and off ? Cravings may lead to eating food with extreme tests such as sour pickles, spicy foods and these in excessive amounts can injure the delicate lining of the digestive system and thus further deprive mother from proper assimilation of food contents. Balanced diet structured in a fashion which takes into account the needs of the growing baby, adaptations of the maternal body, the altered physiology of the digestive system and satisfies all the nutritional needs of the mother -baby duo goes a long way and achieving optimum pregnancy outcomes. A sustained supply of important food contents is mandatory for proper development of the baby.

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