Eating well is not optional

We’ve been hearing about , it for a long time: practice good nutrition to ensure a healthy pregnancy! A lot has been done to get the message across, but it is apparently just not working, Doctors and nutritionists have been telling us that our ignorance about nutrition during pregnancy sets women and their children up for a life unnecessarily at risk or filled with disease, disability and despair.

The most recent estimates in Kenya confirm that only a minority of women access quality maternal and child health care services, including good nutrition during pregnancy. Only about 43 per cent of women access these vital services. These figures indicate a significant number of women are at least somewhat benefiting from nutrition care during pregnancy. However, how much do women truly know about healthy eating during pregnancy and the required nutritional follow-ups?

The World Heath Organization (WHO) recommends that women can benefit from just a few antenatal care visits as long as those visits are thorough and comprehensive to include aspects such as nutritional monitoring and follow-up. Ideally, women should receive at least four thorough, comprehensive and personalized antenatal care visits during the pregnancy.

Keeping the tabs                                                                                                                                                        The gestation period is a – rapid growth period. Growth of the foetus and other developments that take place to facilitate its maintenance throughout pregnancy and delivery of the child involve an increase in the nutritional requirements of the pregnant woman. The fertilized ovum attaches itself to the uterine wall with the help of the placenta, enabling the developing foetus to breathe, acquire nourishment and eliminate wastes. Exchange of nutrients and wastes takes place in the placenta much as it does in the gastro-intestinal tract; oxygen and nutrients pass from mother to the foetus; carbon dioxide and metabolic wastes pass through the opposite direction.

• So, the increase in the nutritional requirements of a pregnant woman can be attributed to:
• Rapid growth of the foetus.
• Development of the placenta.
• Enlargement of maternal tissues namely the breast and uterine tissues.
• Increase in maternal circulating blood volume.
• Formation of amniotic fluid.
• Storage reserves for nutrients.
• Mineralization of the skeletal and bone structure of the foetus as well as tooth buds.

To meet the additional nutritional requirement, foods which supply all nutrients in greater amounts to sustain and support the pregnancy must be consumed by the pregnant woman. The Ministry of Public Health’s Nutrition Division recommends a personalised nutritional follow-up plan for all pregnant mothers during antenatal care visits. These follow-ups must ensure pregnant women practice good nutrition by eating a variety of foods providing calories and nutrients needed by them and their babies, adopting guidelines to improve health during pregnancy, proper nutritional supplementation and advice on safe food preparation.
Good nutrition helps to:

• Increase weight gain of at least 12kg during pregnancy, with an average of 1kg weight gain per month.
• Prevent anaemia.
• Improve the physical and mental development of the baby.
• Prepare the body for breastfeeding. The energy and nutrients needed during breastfeeding are higher than during pregnancy.
• Decrease the chances of having a low, birth weight baby, premature delivery or a still birth.

The Health ministry’s nutritional guidelines emphasize eating balanced meals and indicate how to plan a balanced meal. At least three balanced meals plus snacks must be consumed every day. Foods should be selected from each of the following groups, which are locally available:

• Cereals, tubers and roots: These should be eaten in plenty to provide sufficient energy. They include maize,sorghum, rice, millet, wheat, cassava, cooked bananas, sweet potatoes, yams and arrow roots.
• Legumes and animal products: Their intake should be increased to meet increased need for protein during pregnancy. Good quality protein as obtained from beans, peas, ground nuts, pigeon peas, cow peas, meat, eggs, milk, fish, omena, and chicken should be eaten. Additional requirement of protein for vegetarians may be obtained from a combination of whole grains, legumes and nuts.
• Fruits: Mangoes, bananas, paw paws, guavas, oranges, pineapples, passion fruits, avocados etc, should be consumed in plenty.
• Vegetables: Dark green leafy vegetables, carrots, tomatoes, cucumbers, pumpkins, okra, and traditional varieties should be consumed in plenty.
• Fats and oils: Sunflower, olive and corn oils, and oil seeds should be used in little amounts while limiting intake of hard fats and cholesterol. Oil added to vegetables and other foods improves the absorption of some vitamins and provides extra energy to the body.

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