FOCUS 55
Nutrition in pregnancy Midwives can influence the long-term health of pregnant women and their babies through offering nutrition advice, writes Eileen O’Brien
to three times per week. If she does not eat red meat, advise the woman to include pork chops, chicken or salmon. Non-haem iron is not as readily absorbed and includes fortified breakfast cereal, baked beans, spinach, egg, whole- meal bread, broccoli and dried fruit. Absorption of non-haem iron can be enhanced with concurrent intake of vita- min C from fruit, fruit juice and certain vegetables. Tannins found in tea and coffee should be avoided at meal times as they can inhibit iron absorption. What should I eat to help with constipation? Encourage women to increase fibre intake and to take a variety of whole grains, fruit, vegetables, legumes (starchy beans, lentils and pulses), nuts and seeds (eg. flaxseed). Ensure the woman is drinking at least 2,300ml per day as dehy- dration can cause constipation. Some women find stewed prunes or prune juice helpful. Physical activity can also help bowel movements. Can I eat fish? Oily fish (salmon, mackerel, trout, her- ring etc) should be included once a week to provide omega-3 fatty acids (EPA and DHA), which are necessary for the normal development of the brain and retina. Vege- tarians and vegans can get omega 3 from a variety of nuts, seeds and their oils. Many women are concerned about the safety of fish. Mercury is a cumulative neu- rotoxin and exposure to high levels can lead to significant neurological and behav- ioural disorders. Excessive dietary mercury intake is mainly from large, predatory fish that are high in the food chain. Advise women to avoid shark, swordfish, ray and marlin. Tuna should be limited to one fresh
You are what your mother ate, and maybe even what your grandmother ate. Not a catchy tagline for the promotion of nutrition in pregnancy, however current evidence suggests that the influence of nutrition in pregnancy has a transgenera- tional effect, impacting not only her child’s health, but also that of her grandchildren. 1 Pregnancy is a golden opportunity to improve the health of future generations and help to promote healthier societies with reduced chronic disease. Pregnancy has been described as a stim- ulus for positive behaviour change 2 and is a time when women are in regular contact with healthcare professionals, 3 which is in line with the National Standards for Safer Better Maternity Services. 4 Pregnancy, therefore, is an ideal time for midwives and nurses to provide top-line nutrition advice to women who can influence the health of future generations. Resources • Healthy Eating in Pregnancy booklet (HSE) – order at healthpromotion.ie • My Pregnancy book (HSE) – to be given at antenatal clinic • www.mychild.ie Energy requirements increase as preg- nancy progresses, with the greatest increases (450-500kcal per day) observed in the third trimester. However, given that most women slow down with less physical activity, the increases in energy can be met through reduced energy expenditure and an additional snack. Advise the woman to focus on eating a wide variety of whole foods that will provide the nourishment she and her baby need for growth. I’m concerned about iron, what should I eat? Iron requirements increase in pregnancy. Advise the woman to include haem iron dietary sources such as beef and lamb, two Common questions Should I eat for two?
central nervous system in the developing foetus and include anencephaly and spina bifida. Advise women to take a 400µg folic acid supplement daily before con- ception and through to the 13th week of pregnancy. Women with a BMI >30kg/m 2 or with pre-existing diabetes should be prescribed a higher dose of 5mg folic acid supplement daily. Many women in Ireland have low vitamin D status. A daily vitamin D supple- ment of 10µg/day is recommended during pregnancy to promote calcium absorption. Learn more about nutrition A one-day, expert-led study day on nutrition for preconception and preg- nancy is being organised by Maternity Dietitians Ireland on November 4 in RCPI, Kildare Street, Dublin 2. It is a free event funded by the Health Research Board and CPD has been applied for. The conference will launch the revised Nutrition for Preg- nancy Clinical Practice Guideline (Institute of Obstetricians and Gynaecologists and HSE). Keynote speakers will include Prof Fionnuala McAuliffe and Prof Michael Turner and topics on the day will cover all aspects of nutrition in pregnancy and prac- tical tools for healthcare professionals. To register, go to the Eventbrite page: www.bit.ly/nutritionforpregnancy Eileen O’Brien is a senior dietitian at the National Maternity Hospital Developmental origins of metabolic disease: lifecourse and intergenerational perspectives.Trends Endocrinol Metab 2010; 21(4):199-205 2.O’Brien et al. Influences on the food choices and physical activity behaviours of overweight and obese pregnant women: A qualitative study.Midwifery 2017; 47; 28-35 3.Jackson et al. Improving diet and exercise in pregnancy with Video Doctor counselling: A randomized trial. Patient Educ Couns 2011; 83(2): 203-209 4.Health Information and Quality Authority (2016) National Standards for Safer Better Maternity Services. Dublin, Ireland References 1.Godfrey KM,Gluckman PD,Hanson MA.
steak or two 240g tins per week. Do I need to take supplements?
Neural tube defects are the most common major malformation of the
Powered by FlippingBook