Baby Nutrition Care

Some pregnant women may be advised or choose to restrict milk consumption and may not take appropriate supplements. We hypothesized that maternal milk restriction during pregnancy, which can reduce intakes of protein, calcium, riboflavin and vitamin D, might represent a health risk by lowering infant birth weight.

Milk is an important source of vitamin D, calcium, riboflavin, protein and energy during pregnancy, yet many women choose or are advised to avoid drinking milk for a variety of reasons, including the prevention of allergies in their children. Limiting milk intake compromises the quality of the maternal diet; women who avoid milk may not obtain adequate levels of vitamin D, calcium, protein or riboflavin. Milk restriction is a risk factor for pregnancy-associated hypertension. Low vitamin D intake is associated with neonatal rickets and decreased birth weight. Inadequate consumption of riboflavin is associated with decreases in weight, length and head circumference of babies at birth.

Although most nutrients in milk may be replaced from other foods or with supplements, vitamin D is found in few commonly consumed foods except for milk fortified with the vitamin. Dermal conversion of the precursor cholecalciferol to activated vitamin D is a seasonally unreliable source, particularly when the exposure of skin to sunlight is limited, and may not compensate for low nutritional intake. Under optimal conditions, 15 minutes of daily exposure of the hands and face to sun is required to produce adequate vitamin D, but this conversion is reduced by the prolonged winter season at more polar latitudes, by use of sunscreens with a sun protection factor (SPF) above 8, and by ozone air pollution. People whose skin pigmentation is dark are more vulnerable than others to insufficient vitamin D conversion.

According to a study, women whose daily consumption of milk during pregnancy was 1 cup (250 mL) or less consumed less protein and vitamin D. As a result, they gave birth to smaller babies than did mothers who drank more milk. The conclusion is every 1-cup increase in daily milk consumption increased birth weight by 41 g; 0.000001g increase in daily vitamin D intake increased it by 11 g.

Clinicians should be alert to the effects of milk restriction and its associated reduction in vitamin D intake, and encourage pregnant women to maintain milk consumption. Adequate intake of vitamin D is especially important during winter months.

In order to help prevent birth defects, women need to get enough folic acid every day, even if they are not planning a pregnancy. About 4,000 babies are born with neural tube defects (NTDs) each year, and many other affected pregnancies end in miscarriage or stillbirth. This is especially necessary during both pregnancy and infancy when cell growth is extremely rapid. Both adults and children need folic acid to make normal red blood cells and to prevent anemia. According to one study, only 10% of women know that folic acid should be taken before pregnancy.

Folic acid is rapidly absorbed from gastrointestinal tract following oral administration. Peak folate activity in blood is 30 to 60 minutes after oral administration. Folic acid is needed for the development of your baby’s spine and brain in the early weeks of pregnancy.

Folic acid is also required for the production of DNA, which is necessary for the rapid cell growth needed to make fetal tissues and organs early in pregnancy. That is why it is important for a woman to have enough folic acid in her body both before and during pregnancy. Folic acid is a B vitamin used by cells as they grow and divide. The naturally occurring form, folate, is found in spinach and leafy green vegetables, dried beans, liver and citrus fruits. A higher dose of 5,000 micrograms (5mg) of folic acid is recommended for women who have previously had a baby with a neural tube defect, or are taking medicine for epilepsy. If you have a family history of neural tube defects then you should also take the higher dose.

Folic acid is responsible for assuring an adequate supply of thymidylate. Thymidylate is one of four nucleotide bases needed to construct DNA molecules. Folic acid is needed during the first few weeks, often before a woman knows she is pregnant. That is why it is so important to start taking folic acid each day, even when you are not planning to get pregnant.

Folic acid is generally thought of as a “good” nutrient. Mothers who get enough folic acid before and during pregnancy have a far lower risk of having a baby with a spinal birth defect.