July 25, 2020 12:22:18 pm
By Dr Girija Wagh
The first 1,000 days refers to the period from conception up to two years of a child’s life. It offers a critical window of opportunity to shape the baby’s short-term and long-term health. It is a period of maximum growth and accelerated development of the brain, digestive system and immune system. Nutrition during this critical phase plays a significant role in influencing the development of key organ systems and their functions in the body. Evidence suggests that good nutrition during this period can influence the likelihood of developing conditions such as obesity, allergies, heart disease and diabetes in later life.
A woman’s nutritional status both before conception and during pregnancy is important for the health of the mother and baby. This in turn improves the overall health of the mother and baby and pregnancy outcomes. A mother is the sole source of nutrition for the developing foetus during pregnancy.
A woman should eat a healthy and balanced diet to nourish the growing foetus and to build optimal maternal body reserves in preparation for breastfeeding. Key nutrients essential for pregnant women are energy, protein, vitamin A, C, B12, folic acid, iron, iodine, and calcium. Further, DHA – docosahexaenoic acid content of a mother’s diet has also been associated with positive cognitive development and function.
Adequate maternal dietary energy and protein intake during pregnancy are essential for positive pregnancy outcomes. Protein is one of the most important nutrients. Pregnant and breastfeeding women need to consume almost 50 per cent additional protein to support foetal growth and expansion of maternal tissues. As per the latest Indian Council of Medical Research recommendations, 55gm protein per day must be taken by a sedentary woman whereas the need in a pregnant and breastfeeding woman is quite higher. It is about 82 gm during pregnancy and 79 gm for breastfeeding.
Protein is not only necessary for healthy growth and development of the foetus, but also for accretion in maternal tissues. Proteins help to build and maintain tissue and muscle mass. It is also essential for extra blood production and promotes healthy weight gain during pregnancy.
In addition to pregnancy, protein requirements are higher during the breastfeeding period. Breast milk is the sole source of nutrition for infants up to six months of age; hence the maternal diet needs to provide nutrients in the right quantity and quality to meet the nutritional requirement of the infant. One of the key nutrients which impacts breast milk production is protein. Dietary protein not only supports adequate supply of breast milk but also has an impact on overall growth and development of the infant. It also helps in synthesising hormones, enzymes and antibodies.
Additionally, protein also plays a vital role in development of the immune system of both the mother and foetus. During pregnancy, changes in reproductive hormones and immune systems during pregnancy collectively make them more susceptible to certain infections. Studies have indicated that pregnant women are more susceptible to COVID-19, and special attention should be paid to the selection of drugs that are both effective for maternal diseases and friendly to the foetus.
Suboptimal maternal nutrition during pregnancy may result in Intra Uterine Growth Restriction and higher chance of Low Birth Weight and Small-for-Gestational-Age babies. Currently, it has been reported that close to 75 per cent pregnant and lactating women are not meeting their protein requirement. It is imperative that the diets of these women are evaluated, and they are given appropriate recommendations to meet the daily protein requirements.
Rich sources of protein need to be included in day-to-day diet. Some of the vegetarian sources include whole pulses and cereals, nuts, milk and milk products whereas non-vegetarian sources of protein are eggs, chicken, meat and seafood. Since meeting the protein and other nutrient requirements through diet alone may be challenging on a day-to-day basis, nutritional supplements could be considered to bridge the gap of these vital nutrients from the diet.
‘Healthy bodies make healthy babies’ and hence nutrition needs to be given paramount importance, especially in case of pregnant and breastfeeding women.
(The writer is Professor, Obstetrics & Gynecology, Bharati Vidyapeeth University Medical College, Pune.)
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