Pregnancy, Lactation, and Weaning

Pregnancy is a normal physiological process. The diet and well being of the mother is important to maximise the prospects for the baby’s future life.

1. The expectant mother needs a good, mixed diet before and during the pregnancy. Breast feeding and anorexia nervosa reduce the chances of conception.

2. The weight of the baby is influenced by the protein-energy intake of the mother. The provision of nutrients for brain development is important. If the mother weighs under 40 kg then the baby is liable to a reduced birth weight. Young, growing mothers are another group whose babies are vulnerable.

3. Pica is a craving for a normal food constituent or unusual substances. This may be secondary to some explicable or inexplicable nutritional deficiency. Unless the substance is toxic or there is an underlying deficiency then the phenomenon is

1. Breast milk is the best food for the baby and does not require supplementation in the first months of life. The nutritional constituents of milk reduce with time.

2. The maternal lactational capacity is important, and is determined by genetic heritage, age, parity and nutritional history. Seasonal food shortages and dietary intake may reduce milk production.

3. Supplementary feeds introduce the risk of infection and harmful constituents, e.g. excess sodium.

4. The bioavailability of nutrients in human breast milk is high. Human milk protects the baby against infections. Milk-borne hormones may be of importance to the baby. The human milk content of essential and long-chain fatty acids is of paramount importance in brain development.

5. Viruses can be intermittently transmitted in human milk.

1. Weaning is the process of withdrawal from dependence upon breast milk to prepared semi-solid and then solid food. The age of weaning varies with culture, country and economic status.

2. Cereals are the most common first weaning food with added milk and other protein sources. The weaning food must be adequate in energy, protein and essential dietary constituents and water.

3. The mode of preparation will vary, with the major risks being bacterial contamination of the feed.

4. The correct amount of nutrients given is critical to the baby’s future well-being. Depending upon the economic environment in which the infant lives there is the potential for under or overprovision.

Further Reading —

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Maas YGH, Gerrisen JG, Hart AAM, Hadders-Algra M, Ruijter JM, Tamminga P, Mirmiran M, Spekreijse H ( 1998) Development of the macronutrient composition of very preterm human milk. British Journal of Nutrition 80, 35-40.
Rasmussen, K.M. (1992) The influence of maternal nutrition on lactation.Annual Review of Nutrition, 12, 103–19.
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Symposium ‘Meeting the needs of lactation.’ Proceedings of the Nutrition Society. 56, 149-191.
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Wharton, B. (I992) Food and biological clocks. Proceedings of the Nutrition Society, 51, 145–53.
Barker, D.J.P. (1992) Infant Origins of Common Diseases in Human Nutrition; A Continuing Debate (eds M.A. Eastwood, C. Edwards and D. Parry D), Chapman & Hall, London, pp. 17–30.
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Leader (1991) Solving the weanling’s dilemma: power-flour to fuel the gruel.Lancet, 338, 604–5.
Wharton,B. (1997) Weaning in Britain: practice, policy and problems . Proceedings of the Nutrition Society, 56, 105-119.

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