Pregnant ladies, beware of your diet!

Maria Endah Hulupi, The Jakarta Post, Jakarta

Nourishment is essential for all living creatures, and is particularly important to have a proper diet for expectant mothers. Careful and proper diets are suggested for pregnant mothers for their own health and to ensure the babies' proper growth.

However, due to insufficient information on nutrition or fear of becoming fat, there are still a few women who continue their often-unbalanced eating patterns. Others, thinking of eating for two, opt to eat more than their bodies require.

Endang Darmoutomo, a nutritionist with the Siloam Gleneagles Hospital in Karawaci, Tangerang, said an improper diet might jeopardize the pregnancy.

"It's true that pregnant women have to eat for herself and her baby but it doesn't mean they have to double their consumption," she said.

The normal weight gains during pregnancies varies from an average of 12 kilograms (kgs) to 15 kgs for average-sized women, seven kgs to 12 kgs for obese women, 14 kgs to 20 kgs for underweight women and 17 kgs and 22 kgs for those expecting twins.

Endang said the weight addition includes 500 grams of milk glands, 600 grams for the placenta, three kilograms to 3.5 kilograms for the fetus, a kilogram for the uterus, a kilogram of the amniotic fluid in which the baby will grow, 1.5 kilograms of blood and 1.5 kilograms of extra cell fluid.

To achieve healthy weight gain, a mother's caloric intake will be gradually increased. Generally, in the first trimester caloric intake should go up from 50 to 150 calories per day, while the second and third trimesters, it should be increased to between 200 and 350 calories.

Such a diet plan is essential to ensure an average of one kilogram of weight gain during the first trimester, five kilograms for the second and six kilograms for the third trimester.

"Excess caloric intake will be accumulated as fat in the mother's body," Endang said.

A pregnant woman must eat a balanced diet, comprising all the food groups, to ensure that adequate nutritional needs are properly fulfilled.

For the food, apart from extra calories, ensuring sufficient protein (0.8 gram to 1 gram of protein per kilogram body weight), fat, carbohydrates and minerals (including folate, zinc, iron, calcium, magnesium, among others) intake is also important.

"When these requirements are not fulfilled, the baby will rob the mother's nutrient supply to meet his daily need," Endang warned.

Women with nausea -- which can be caused by hormonal imbalances during pregnancy -- or a loss of appetite can fulfill their nutritional needs by increasing milk intake from two glasses daily to three or four glasses per day.

Morning sickness can also be soothed by adjusting eating patterns and this includes eat smaller portions of balanced meals but more frequently (five meals daily).

Mothers are suggested to avoid fatty foods, hot and spicy foods (chili stimulates the stomach to work faster and would prompt nausea). They are also encouraged to eat light crackers or drink a glass of orange juice, and not to skip breakfast because the accumulated gastric juice may trigger nausea. It is also recommended to increase the intake of vitamin B (preferably with your gynecologist's consultation).

Endang said pregnant women are particularly prone to anemia due to zinc deficiency and hemorrhoids because of extra pressure in the lower abdominal area that affects blood circulation. Hemorrhoids are preventable by consuming plenty of fruits, vegetables and water as well as doing at least 30 minutes of exercise several times a week.

"During exercise, the muscles constrict and it helps pump the blood through the veins to improve circulation. Walking is the best exercise," Endang said.

Pregnant women, she added, must limit their sodium intake (as it may increase blood pressure and can cause swelling). They also need to avoid food they are allergic to and alcohol which could hamper the circulation of the oxytocin hormone that stimulates the contraction of the uterine muscle and the secretion of milk.

Expecting mothers also need to avoid drinking coffee as it can rob the body of calcium and tea because its tannin helps the absorption of micronutrients.

"Many Indonesian women believe in jamu (traditional herbal medicine) but it is advisable to stop drinking those during the pregnancy," said Endang, explaining that ingredients used to make jamu are not clearly mentioned and how they are dried and processed are not described.

As for lactating women, they need about 300 to 500 additional calories with 1.5 to 1.7 grams of protein per kilogram of body weight per day. As for their normal water intake, it should be about three liters to ensure adequate milk production.

"If this need is not fulfilled, the milk glands will not produce sufficient, good quality breast milk to feed the baby six times a day," she said.

In the first few days, the breastmilk is usually secreted in a small quantity and is called colostrum, which contains a large amount of protein and antibodies that protects the baby against infection before they get immunization injections, she said.

Normal breastfeeding periods range from four months (of exclusively breastmilk) to two years.

Therefore, expecting mothers are encouraged to consult with their gynecologists and nutritionists about dietary needs to help them when they are expecting, so as to avoid any problems.