Maternal nutrition is nutrient intake and dietary planning undertaken before, during and after pregnancy.

• Fetal nutrition begins at conception, thus the nutrition of the mother is important from before conception [probably several months before], as well as throughout pregnancy, and breast feeding
• Nutrients can either be inadequate or excessive. It is possible to over-supplement
• Development of the baby can be affected in the early stages of pregnancy
• It involves:
  • Smoking
  • Alcohol
  • Caffeine
  • Use of prescribed drugs
  • Use of illicit drugs

• Folic acid, as folic acid is required for the development of every human cell. Deficiency thus causes defective cellular growth, and effects are most obvious on tissue which grows most rapidly. It can cause:
  • Spina bifida
  • Neural tube defects
• Iodine deficiency, can cause cretinism. It is required for normal thyroid function and mental development of the fetus
• Vitamin D deficiency, can cause rickets (i.e. disease causing weak bones)
• Higher intakes of polyunsaturated fatty acids have shown to decrease preterm delivery and low birth weight
• Iron is needed for healthy growth of the fetus and placenta, especially during trimester 2-3. It is essential before pregnancy for the production of hemoglobin
• Excess vitamin A (retinol) intake, which has been linked to birth defects and abnormalities
• Excessive alcohol causes FAS
• Low birth weight
• Malformations
• Neurological disorders
• Handicaps
• Affects risk throughout the child's life, for:
  • Cancer
  • CVD
  • HTN
  • Diabetes

• Diets should provide sufficient calories for pregnancy, typically 2,000-2,5000 calories
• Mothers should follow instructions listed on particular vitamin packaging as to the correct/recommended daily intake (RDI) and maximal allowances if listed
• Prenatal vitamins contain levels of the following, found over the amounts in standard multivitamins:
  • Folic acid supplementation, is recommended prior to conception, 0.4mg/day throughout trimester 1, 0.6mg/day through trimester 2-3, and 0.5mg/day whilst breast feeding. This is in addition to eating foods rich in folic acid (e.g. oranges, dark green leafy vegetables)
  • Iodine supplementation, as iodine is frequently too low in pregnant women
  • Vitamin D supplementation, which varies with exposure to sunlight. Although it was previously only supplemented in areas of high latitudes, there is a move to recommend supplementation of 1,000mg of vitamin D daily throughout pregnancy
  • Polyunsaturated fatty acids, specifically DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), which is very beneficial for fetal development. The best dietary source of omega-3 fatty acids is oily fish. Other omega-3 fatty acids not found in fish, can be found in flaxseeds, walnuts, pumpkin seeds, and enriched eggs
  • Iron, where although there is no evidence hemoglobin>7g/100mL is detrimental to pregnancy, maternal hemorrhage is a major source of maternal mortality worldwide, and a reserve capacity to carry oxygen is desirable. Giving 100mg of elemental iron 3 times weekly is adequate during pregnancy. After pregnancy, if serum ferritin<70µg/L, iron supplements may be required to prevent iron deficiency anemia
  • Vitamin A
  • Zinc
  • Calcium
• There is INSUFFICIENT evidence for:
  • Vitamin B12 supplementation
• Regarding diet, pay attention to foods:
  • Reduce the risk fo exposure to substances or bacteria that may be harmful to the developing fetus, including:
    • Soft cheese
    • Certain fish
    • Food pathogens, including listeria, toxoplasmosis, and salmonella
    • Toxic food components
    • Alcohol, which should be avoided entirely during pregnancy given the unknown effects of even small amounts of alcohol during preg
    • Vitamin A, including as a dietary supplement, or in liver and fish liver oils. Also, in the form of carotene (vitamin A precursor) found in many fruits and vegetables
  • Hydration, which should be increased 300mL/day compared to normal intake, from 1,500 to 1,800mL/day [in addition to 400mL obtained from food]. Because human milk is made of 88% water, during lactation, water intake may need to be increased by 700mL/day, from 1,500mL/day to 2,200mL/day

• 23% of babies worldwide are born with lower than optimal weights due to lack of proper nutrition