Nutrition during pregnancy is a single most intervention which will help us bring about healthier outcomes at birth and program the babies for a healthy future. The challenges of pregnancy today remain the same as in the past but have in fact increased due to life style changes and also probably due to awareness and documentation. Miscarriages, abnormalities in babies, low birth weight babies, hypertension, diabetes, preterm deliveries all are related to nutritional abnormalities. What is most alarming is the sheer ignorance amongst women about a basic issue such as the right nutrition. Additionally, now there is a lot of evidence supporting the fact that diseases such as diabetes, anemia, hypertension, obesity can bring about epigenetic modulations in the baby and program it to future health issues and this awareness is therefore very important. Prenatal or pregnancy period is an important time line to help bring about vital changes to help deliver healthy offsprings programmed for a healthy future and this can be brought about by nutritionWhat is the evidence doc for what you are saying ? So how do I plan my eating during pregnancy ? Many global organizations such as the WHO and the FIGO have resolved to highlight maternal and adolescent age nutrition as a priority as it is now confirmed that healthy adolescent will lead to a healthy adult woman and a mother who will bring forth a healthy baby and thus a healthy future. This will help in battling against the looming threat of non-communicable diseases such as obesity, diabetes, hypertension, and asthma to name a few. From “eat for two” to “eat what you like” to “eat what is right” There is a huge evolution in nutritional requirements during pregnancy. Also, it is based on the pre pregnancy BMI ( weight to height ratio ), existing disorders in the mother such as anemia, thyroid disorders, diabetes and emerging issues such as small babies, eating disorders etc. Every trimester ( section consisting of 3 months of the 9 months of pregnancy ) has specific needs. Also, the amount of physical activity needs to be accounted for.
Doc I have just been diagnosed to be pregnant and feel sick, queasy, moody all the while and don’t feel like eating ? The first trimester ( the three months ) of pregnancy is the time of most symptoms especially for the first time pregnant mother. This happens because every day the pregnancy hormones are doubling and the growing baby and the associated bodily functions consume sugar making the mother always low on sugars. This makes her feel tired, drained and hungry. Also, nausea and sometimes excessive vomiting can make mothers miserable. Many a time the baseline acidity is unveiled. Acceptance of these symptoms, mood modulation, distraction and certain food changes help. What should I eat during the first trimester ? This time period is very vital as the babies body parts are differentiating and forming. This needs some important micro nutrients to be taken to avoid abnormalities. The food should be rich in folates which are present in leafy vegetables, salads, fruits and everything that is colorful. The food shouldn’t be spicy and should be fresh and healthy. Nutrients such as iron, iodine, vitamins C, B complex are vital and deficiencies can cause abnormalities in the baby. Also, food should not be hard to digest and instigate nausea or vomiting and cause constipation. Can you suggest any sample diet for the first trimester?
Wake up and have warm water with fresh lime and honey to detox
Eat a handful of roasted chana, 2 dates, 4 soaked almonds, 2 walnuts
Breakfast: Upma with vegetables, sprouts and udad dal and curds
Milk shake with almonds, apples, chikoo, fig, strawberry or any fruit smoothie
Have coconut water / buttermilk at around 11 am
Lunch: 1 katori each of thick dal, sprouts usal (saucy preparation with onions
and tomatoes and sprouts eaten with roti or rice ), vegetable, raita with 2 chapatis and half katori rice 7. Evening snacks: thalipeeth ( Indian pancake made of pulses and chopped vegetables and condiments ) with fruit salad
Supper: thick vegetable soup
Mixed dal and brown rice khichadi with bhakri and green leafy vegetable
10. Warm turmeric milk or masala milk 11. Drink atleast 2 liters of water or liquids such as lemonade, ginger ale, buttermilk , coconut water, fresh fruit juices Remember to start the day with dry stuff such as fruits and nuts and avoid unhealthy bakery products. But I still feel pukey and constipated !! Find out foods which you can tolerate. Usually daliya, soft smooth rice, rice gruel, porridge or dry bland parathas, boiled eggs, dry nutritious biscuits, dry nuts, cut- fruits, yogurt, ice cream, roasted chana, mashed potato etc are better tolerated. Also plan, get charged and make cooking interesting. Foods containing ginger reduce
nausea. Turmeric, amla, kokum, and alovera are known to reduce the nausea and acidity and are nutritious and are best consumed. To overcome constipation increase the fibre content in the food and take enough fluids. I don’t want to eat and I feel being empty stomach is better Fasting or going without food is detrimental to the baby’s health as the ketone bodies released due to starving can be harmful. Also reduced sugar levels in the blood can cause giddiness, irritability and muscle breakdown for the mother. Don’t ever starve. Timely and regular food intake is very important. Also eat small, meals more frequently. Don’t eat too much as it will pressurise the digestive system. Eat foods that are easily digestible What is food hygiene ? Clean food and water should be consumed. Stale, uncovered food can cause infections which can be life threatening. Infections such as hepatitis leading to jaundice, dysentery, typhoid fever are all acquired through unclean food and water. It’s a good practice to boil water before consuming. Hand washing is very important before touching food. Foods served in the restaurants may not always be clean and may have been handled in improper way making it unsafe. Especially foods sold by hawkers and unlicensed food sellers can be unsafe. Hands should be washed before and after meals thoroughly and the nails should be clipped and kept clean. Are prescription medicines safe during the first trimester ? First trimester medications usually are folic acid supplements and vitamin B6 for prevention of nausea and these are best started before the nausea sets in and can also be effective to curb the vomiting or nausea-tic feeling. These are to be taken atleast till 14 weeks. It’s better not to take other medications without the doctor’s consultation. And if you chose to consult another doc ( such as a family physician surgeon, skin specialist, dentist etc ) other than your gynec definitely mention that you are pregnant to avoid wrong prescriptions. Illustrations 1. Leena was 11 weeks pregnant and felt like eating paneer. She made a tasty paneer butter masala at home and had it with roti for lunch. After one hour she was brought in casualty with breathlessness and swelling all over the body. She was immediately treated for severe allergy. On investigation, it was found that she had bought the paneer from a new vendor and stored it in the fridge for 15 days before cooking .it was slightly smelly but she felt it will be fine after cooking. Refrigeration is not always safe and strict temperature maintenance is needed 2. Swati at 8 weeks made a vegetable cheese sandwich with brown bread for the evening snack. After she had it, was hospitalized with severe vomiting and diarrhea. This was food poisoning due to 5 days stale bread. 3. Simmi takes prescription medicines only when she feels nauseated. And then she keeps on vomiting at least thrice in a week. This has made her very irritable.