There are nearly 30 million low birth weight babies born annually. These babies often face severe short- and long-term health consequences. Low birth weight is a major factor of mortality, morbidity and disability in infancy and childhood. This also has a long-term impact on health outcomes in adult life. The consequences of poor nutritional status and inadequate nutritional intake for women during pregnancy not only directly affects women’s health status, but also has a negative impact on birth weight and early development. Low birth weight also results in substantial costs to the health sector and imposes a significant burden on society as a whole. Whereas the global prevalence of such births is slowly dropping, it is as high as 30% in many developing countries.
Birth weight is affected by weight gain during pregnancy. Weight should be gained throughout pregnancy but is most critical in the second trimester. Even if overall weight gain is poor, birth weight is usually acceptable with appropriate second-trimester weight gain. Women who are underweight are advised to gain a total of 12.5-18 kg. This translates to 0.5 kg/wk in the second and third trimesters. Women of normal weight are advised to gain a total of 11.5-16 kg (25-35 lb), or 0.4 kg/wk, in the second and third trimesters. Women who are overweight or obese should limit their weight gain to 7-11.5 kg (15-25 lb), or 0.3 kg/wk, in the second and third trimesters. The demands of pregnancy necessitate additional dietary requirements. Obviously, additional caloric intake is required to support recommended weight gain. Because energy requirements in pregnancy are increased by 17% over the non-pregnant state, a woman of normal weight should consume an additional 300 calories a day of high nutrient density. Nutrient density reflects the amount of protein, vitamins, and minerals per 100 calories of food. Protein should comprise 20% of a normal pregnancy diet. Pregnant women should be aware that many animal sources of protein are very high in fat and might contribute to excessive weight gain; therefore, animal proteins should be taken sparingly. Fat should only comprise 30% of a normal pregnancy diet. Carbohydrates should comprise the remaining 50%. Total energy intake should vary by BMI, but the average recommendation is 2500 calories per day.
Several minerals and vitamins are of critical importance and dosages must be increased during pregnancy. These include Vitamin A, B-1, B-2, B-3, B-6, B12, C, D, E, K, folate, niacin, iron, phosphorous, calcium, and zinc. Folate is of particular importance. A well rounded diet should cover all dietary needs but a vitamin supplement is recommended.
In India, of particular interest is the vegetarian diet. Well-balanced vegetarian diets that include dairy products provide adequate energy and nutrient intake and do not require special supplementation. However, vegan diets may be deficient in vitamins D and B-12. It may also be extremely low in fat, making satisfaction of energy requirements a challenge. Pregnant women who follow vegan diets require supplemental vitamin D, and vitamin B-12. These women also have to pay careful attention to energy intake.
In lower socio-economic regions, there are several steps that are being taken and can be taken to combat poor maternal nutrition. Education is one of the most important components. Teaching women what foods need to be eaten as well as the proper quantity needed to be consumed. Also, providing food to women who do not have access to fresh food needs to be done. Also of critical importance is providing women with necessary supplements such as folate and iron.
Varun Renjen is a physician who has been in cancer research. He is now moving on to medical strategy. He is based in New York and is a Save A Mother volunteer.
Photo taken by Save A Mother staff.
Solution: From polio to HIV, cell phones are playing an important role in Zambia’s child health strategies. Check out this link to learn more.
