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Opinion: Importance Of Maternal Nutrition And Its Inter-generational Impact

Positive effects of preconception care are pivotal as the right start for pregnancy begins well before the conception itself

Opinion Importance Of Maternal Nutrition And Its Inter-generational Impact

Bihar: What, when, and how much we eat is an important roadmap of our health. This becomes more important during pregnancy when the health of a pregnant woman and that of her growing baby inside the womb are at stake. Nutrition at this stage has a generational impact. In India, 26.8 per cent of women (20-24 years) marry before 18 years and 8 per cent of girls get pregnant when they are adolescents. Leading to this, 22.9 per cent of women in India enter pregnancy as underweight (Body Mass Index<18.5). An average weight gain in pregnancy is about 7 kg only. Around 58 per cent of pregnant women are anaemic in India. (Data source: NFHS-4 2015-16, SRS 2016 & 2017, SRS 2016-18, CNNS 2016)

Also Read: POSHAN Maah: Nutri-Gardens Adopted To Improve Dietary Diversity And Nutritional Status Of Undernourished Children In Udaipur

Intergenerational Effects Of Maternal Nutrition

Maternal nutrition is the foundation stone for a child’s growth and development. It is critical for a woman’s health and well-being across life stages. Fetal Growth Restriction (FGR) is one of the leading risks of stunting (low height for age) worldwide. The FGR contributes to one-quarter of newborn deaths globally. Fetal stunting is evident in 8 weeks of pregnancy. Also, 70 per cent of brain develops inside the mother’s womb. If nutrition is not adequate, this physical and mental growth will be hampered.

Stunted growth in girls leads to short stature and poor nutritional status in adult life. Short maternal stature is a risk factor for small weight age babies. Poor maternal nutritional status at conception leads to inadequate gestational weight gain due to poor dietary intake. Short maternal stature is also a risk factor for childhood stunting,  increases with small for gestenational age babies and preterm birth. Some of these babies have poor cognitive development and impaired learning achievements in school. This may lead to poor productivity in adult life.

Also Read: How Air Pollution Impacts Pregnant Women And Foetus

The fetal origin of adult disease- it is now widely accepted that chronic diseases of adulthood are merely a result of lifestyle change and have a strong fetal life influence affecting the epigenetic. Diseases like coronary heart disease, diabetes mellitus and hypertension are the by-product of fetal life nutrition. Starvation in fetal life leads to a syndrome of insulin resistance. This is a fertile ground for development or aggravation of the same factors in adult life when there is relative prosperity.

Positive effects of preconception care are pivotal as the right start for pregnancy begins well before the conception itself. This is associated with a reduction in maternal and child mortality, prevent unintended pregnancies. It reduces stillbirth, preterm birth and low birth weight babies. There is a scope for preventing birth defects and neonatal infections.

Also Read: This Delhi Based NGO Aims To Improve The Quality Of Neonatal Care And Helps New Mothers And Children Be Healthy

Impact of adequate nutrition

These are some critical impact of adequate nutrition of mother:

  1. Improvement in micronutrient status of a mother
  2. Reduction in low birth weight babies
  3. Reduction in maternal mortality rate (MMR) from post delivery bleeding
  4. Reduction in maternal anaemia, sepsis, low birth weight and premature babies
  5. Reduction in MMR from pre-eclampsia/eclampsia
  6. Reduction in abortion/stillbirth, brain damage & congenital defects

Interventions To Improve The Maternal Nutrition

Counselling on healthy eating including dietary diversity and physical activity. In undernourished populations, balanced energy and protein dietary supplements can be initiated. Folic acid supplementation (400 microgram) during peri-conception and first trimester stage is recommended. Iron and folic acid supplementation (60mg elemental iron) daily from the second trimester (180 days). Calcium supplementation (1gm) daily from the second trimester (180 days). Deworming (albendazole 400mg) in the second trimester. Use of double fortified (iron and iodine) salt and restrict caffeine intake.

Also Read: National Nutrition Month: Benefits Of Eating Locally Produced Nutritious Foods At Complementary Feeding Stage

Food-acquired infections; pregnant women should be informed on how to reduce the risk of listeriosis by drinking only pasteurised milk, not eating ripened soft cheese such as Camembert, Brie and blue-veined cheese (there is no risk with hard cheeses, such as cheddar, or cottage cheese and processed cheese). The uncooked or undercooked, ready-prepared meal should not be taken.

Pregnant women should reduce the risk of salmonella infection by avoiding raw or partially cooked eggs or food that may contain them (such as mayonnaise). They should avoid raw or partially cooked meat, especially poultry.

Pregnant women should be informed of primary prevention measures to avoid toxoplasmosis infection, such as washing hands before handling food and thoroughly washing all fruits and vegetables, including ready-prepared salads; before eating, thoroughly cooking raw meats and ready-prepared chilled meals. They should be wearing gloves and thoroughly washing hands after handling soil and gardening, avoiding cat faeces in cat litter or in soil.

Also Read: Experts Recommend Early Breastfeeding Initiation, Awareness At Panchayat Level To Fight Malnutrition

Diet During pregnancy

In pregnancy, there is an additional energy requirement of 350 kcal and 23g protein. Three full meals and 2 nutritious snacks are recommended in the second and third trimester. Diet diversity indicates diet quality, associated with micronutrient adequacy. Minimum diet diversity is defined as the consumption of food items from at least 5 out of 10 defined food groups per day. Severely underweight pregnant women are advised to have one additional energy dense snack (350 kcal). Overweight/obese women are advised to take small meals throughout the day and replace two small meals with two nutritious low calorie (100-150 kcal) snacks, avoid fried, oily, and sweetened foods.

Also Read: Poshan Maah 2020: ‘Proper Nutrition Is Vital To Build A Prosperous Nation,’ Says Prime Minister Narendra Modi

Problems Leading To Poor Nutrition In Pregnancy

Many mothers face problems of nausea and vomiting, loss of appetite and unusual cravings. All of these may affect the nutrition of the mother. Most of these can be tackled with time and doctor’s prescription. Knowledge about the right food is essential for the mother and her family members. There may be a low intake of nutrient-dense foods (fruits and vegetables) and a high intake of added sugars and fats (fried foods, processed foods, desserts). There may be a more serious issue of lack of resources for adequate nutrition.

Overweight or obesity may pose challenges to the adequate nutrition of the woman. Medical history of bariatric surgery or other conditions that cause malabsorption. Substance misuse, worm infestation, chronic illness like tuberculosis may aggravate the nutritional deficiencies.

Also Read: Poshan Month: Understanding Nutrition, What To Have And What To Avoid

Opinion: Importance Of Maternal Nutrition And Its Inter-generational Impact

Dr Meena Samant

 

Dr. Meena Sawant is the Secretary at Indian Society of Perinatology and Reproductive Biology (ISOPARB), Patna, Bihar.

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

26,27,61,966Cases
22,35,18,265Active
3,40,28,506Recovered
52,15,195Deaths
Coronavirus has spread to 196 countries. The total confirmed cases worldwide are 26,27,61,966 and 52,15,195 have died; 22,35,18,265 are active cases and 3,40,28,506 have recovered as on December 1, 2021 at 3:56 am.

India

3,45,96,776 8,954Cases
99,0231,520Active
3,40,28,506 10,207Recovered
4,69,247 267Deaths
In India, there are 3,45,96,776 confirmed cases including 4,69,247 deaths. The number of active cases is 99,023 and 3,40,28,506 have recovered as on December 1, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

66,35,658 678

11,226 299

64,83,435 942

1,40,997 35

Kerala

51,41,814 4,723

44,314 824

50,57,368 5,370

40,132 177

Karnataka

29,96,148 291

6,445 462

29,51,492 745

38,211 8

Tamil Nadu

27,26,917 720

8,244 47

26,82,192 758

36,481 9

Andhra Pradesh

20,72,909 184

2,149 47

20,56,318 134

14,442 3

Uttar Pradesh

17,10,399 12

89 3

16,87,399 8

22,911 1

West Bengal

16,16,083 705

7,731 2

15,88,866 694

19,486 13

Delhi

14,40,934 34

287 2

14,15,549 32

25,098

Odisha

10,49,108 228

2,188 23

10,38,509 203

8,411 2

Chhattisgarh

10,06,813 34

318 0

9,92,902 34

13,593

Rajasthan

9,54,785 15

193 6

9,45,637 9

8,955

Gujarat

8,27,475 40

275 13

8,17,108 27

10,092

Madhya Pradesh

7,93,170 20

119 7

7,82,523 27

10,528

Haryana

7,71,709 17

163 2

7,61,492 19

10,054

Bihar

7,26,223 4

36 3

7,16,524 7

9,663

Telangana

6,75,994 196

3,591 10

6,68,411 184

3,992 2

Assam

6,16,852 144

2,625 30

6,08,124 109

6,103 5

Punjab

6,03,279 21

325 4

5,86,352 22

16,602 3

Jharkhand

3,49,244 12

98 3

3,44,006 9

5,140

Uttarakhand

3,44,255 28

141 9

3,36,706 19

7,408

Jammu And Kashmir

3,36,852 171

1,625 1

3,30,751 172

4,476

Himachal Pradesh

2,27,195 102

834 10

2,22,513 91

3,848 1

Goa

1,78,928 38

284 8

1,75,260 30

3,384

Mizoram

1,35,175 365

3,751 54

1,30,927 415

497 4

Puducherry

1,28,924 31

284 12

1,26,768 43

1,872

Manipur

1,25,205 36

649 6

1,22,579 40

1,977 2

Tripura

84,805 14

81 3

83,900 10

824 1

Meghalaya

84,480 19

294 9

82,713 9

1,473 1

Chandigarh

65,465 9

65 7

64,580 2

820

Arunachal Pradesh

55,276 3

35 0

54,961 3

280

Sikkim

32,242 9

124 3

31,715 6

403

Nagaland

32,122 13

133 7

31,293 20

696

Ladakh

21,578 38

276 26

21,088 12

214

Dadra And Nagar Haveli

10,683

1 0

10,678

4

Lakshadweep

10,394

24 0

10,319

51

Andaman And Nicobar Islands

7,683

6 2

7,548 2

129

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