Nutrition in prepregnancy, pregnancy and postpartum: ensuring maternal and child health through balanced diet

VIDEO 18

Adolescent, preconception and maternal nutrition represent a major public health issue that affects not only the health of adolescents and women, but also that of future generations. The FIGO recommendations aim to address several issues relating to nutrition in adolescent and young women before, during and after pregnancy.

Nutrition plays a critical role in every stage of life, but during the reproductive years, it takes on a heightened importance. A well-balanced diet not only affects the health and wellbeing of women but also influences fertility, pregnancy outcomes and the future health of their children. By focusing on nutrition during the reproductive, periconceptional and postpartum periods, women can optimize their health, enhance fertility, ensure a healthy pregnancy and promote their postpartum recovery. This presentation delves into the importance of nutrition across these critical stages and offers practical strategies for implementing a healthy diet tailored to each period.

NUTRITION DURING THE REPRODUCTIVE PERIOD

The reproductive period, typically encompassing adolescence to menopause, represents a crucial time for women to prioritize their health. Proper nutrition during these years supports hormonal balance, a healthy menstrual cycle and reproductive-system function.

Key nutritional components for reproductive health

• Folate: folate, or vitamin B9, is essential for DNA synthesis and repair, making it crucial for women of reproductive age, especially those planning for pregnancy. Adequate folate intake can prevent neural tube defects in developing fetuses. Women should consume folate-rich foods like leafy green vegetables, legumes, citrus fruits and fortified cereals.
• Iron: iron deficiency is common among women of reproductive age, primarily due to menstrual blood loss. Insufficient iron can lead to anemia, fatigue and reduced fertility. Women should consume iron-rich foods such as lean meats, poultry, fish, beans and fortified grains. Pairing iron-rich foods with vitamin C sources (like oranges, tomatoes and bell peppers) helps enhance iron absorption.
• Omega-3 fatty acids: omega-3 fatty acids, particularly EPA and DHA, are vital for reducing inflammation, supporting brain health and promoting hormonal balance. Women can incorporate oily fish such as salmon, mackerel and sardines into their diets or consider plant-based sources like flaxseeds, chia seeds and walnuts.
• Calcium and vitamin D: both calcium and vitamin D are necessary for bone health and maintaining normal reproductive functions. Dairy products, fortified plant-based milks and leafy green vegetables are excellent sources of calcium. Sunlight, fortified foods and supplements are reliable sources of vitamin D.

Implementation strategies

• Prioritize a well-balanced diet with a variety of fruits, vegetables, lean proteins and whole grains.
• Plan regular meals and snacks rich in key nutrients to maintain consistent energy levels and hormonal balance.
• Consider supplements, such as multivitamins containing folic acid and vitamin D, if dietary intake is inadequate.

NUTRITION IN THE PERICONCEPTIONAL PERIOD

The periconceptional period, which refers to the time before conception and the early weeks of pregnancy, is critical for ensuring the optimal health of both the mother and the developing fetus. Proper nutrition during this time can reduce the risk of complications and ensure that the mother's body is prepared for pregnancy.

Nutritional priorities in the periconceptional period

• Preconception folate supplementation: the most well-known recommendation for women during the periconceptional period is folate supplementation. Women planning to conceive are often advised to take 400–800 μg of folic acid daily at least 1 month before pregnancy to reduce the risk of neural tube defects.
• Healthy body weight: maintaining a healthy body weight before pregnancy is important for fertility and pregnancy outcomes. Underweight women may face difficulty conceiving, while overweight women are at an increased risk of gestational diabetes, pre-eclampsia and other complications. A balanced diet rich in whole grains, lean proteins, fruits and vegetables can support weight management.
• Limit processed foods and refined sugars: processed foods high in sugar and unhealthy fats can increase inflammation and negatively impact fertility. Focus on whole, nutrient-dense foods that promote overall reproductive health.
• Adequate protein intake: protein is essential for tissue growth and repair, including the reproductive system. Women should consume sufficient amounts of high-quality protein from sources like eggs, fish, chicken, nuts and seeds.

Implementation strategies (use FIGO preconception checklist)

• Begin taking a prenatal vitamin or folic acid supplement prior to conception.
• Monitor and adjust dietary habits to ensure a healthy preconception weight.
• Focus on a nutrient-dense diet, minimizing junk food, and prioritize lean protein sources and healthy fats.

Nutrition during pregnancy

Pregnancy is a time when the body’s nutritional needs are greatly increased, as both the mother and the growing fetus require essential nutrients for optimal health. Proper nutrition during pregnancy supports fetal development, reduces the risk of birth defects, and helps the mother maintain her energy levels.

Key nutritional focuses during pregnancy

• Increased caloric intake: while “eating for two” is a common phrase, pregnant women need only about 300 extra calories per day during the second and third trimesters. These calories should come from nutrient-dense sources like fruits, vegetables, whole grains and lean proteins.
• Protein and iron: protein needs increase during pregnancy to support fetal growth and maternal tissue development. Women should aim for around 70–100 grams of protein daily. Additionally, iron needs are higher to support increased blood volume and prevent anemia. Iron-rich foods and iron supplements may be necessary, especially for those with a history of low iron.
• Omega-3 fatty acids for fetal development: DHA, an omega-3 fatty acid, is crucial for fetal brain and eye development. Consuming at least two servings of fatty fish per week or considering a DHA supplement is beneficial during pregnancy.
• Calcium for bone health: calcium needs increase during pregnancy to support fetal bone formation and prevent maternal bone loss. Dairy products, leafy greens, and calcium-fortified foods should be consumed regularly.
• Special advice FOR GESTATIONAL DIABETES AND OTHER HIGH-RISK PREGNANCIES

Implementation strategies

• Prioritize meals that are balanced with protein, healthy fats and complex carbohydrates.
• Stay hydrated and avoid processed foods high in salt, sugar and unhealthy fats.
• Work closely with healthcare providers to ensure adequate iron, calcium and omega-3 intake.

NUTRITION IN THE POSTPARTUM PERIOD

The postpartum period is a time of recovery for the mother, and good nutrition is essential for healing, breastfeeding and regaining energy levels.

Nutritional considerations in the postpartum period

• Caloric and nutrient needs for breastfeeding: breastfeeding women need an additional 300–500 calories per day to support milk production. The quality of the diet is also important, as certain nutrients, like DHA, vitamin D and calcium, are essential for both the mother and the baby.
• Focus on healing nutrients: protein, zinc, vitamin C and iron are essential for tissue repair and recovery post-childbirth. Foods like lean meats, citrus fruits, nuts, seeds and leafy greens should be incorporated into daily meals.
• Hydration: Staying hydrated is crucial for both milk production and the mother’s overall wellbeing. Drinking water, herbal teas and soups can help maintain hydration levels.
• Addressing nutrient deficiencies: After childbirth, some women may experience deficiencies in key nutrients, such as iron or vitamin B12. A well-balanced diet along with supplements may be necessary to address any deficiencies.

Implementation strategies

• Plan easy-to-prepare meals that include a variety of fruits, vegetables, lean proteins, and whole grains.
• Stay hydrated by drinking plenty of fluids, especially if breastfeeding.
• Consider postpartum supplements, including vitamins and minerals, to address any nutrient deficiencies.

CONCLUSION

Good nutrition is the foundation of health during the reproductive, periconceptional, and postpartum periods. By prioritizing nutrient-dense foods, managing caloric intake, and focusing on key nutrients like folate, iron, calcium, and omega-3 fatty acids, women can ensure they are giving their bodies and their babies the best possible start. Implementing these nutrition concepts through mindful eating habits, meal planning and regular check-ins with healthcare providers can lead to better outcomes for both mother and child, ultimately fostering a healthier future for families.

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