A woman should be aware of and prepared for the many changes that will occur during pregnancy. Her uterus and breasts grow, and her total blood volume increases. The placenta develops, the heart and kidneys work harder, stores of body fat increase, and, toward the latter part of the pregnancy, mammary glands prepare to produce milk. The nutrients needed to support these changes are listed below:
Increased calorie needs; about 400 more kcal per day is necessary during the second and third trimesters. This amount should allow adequate weight gain (25 to 35 pounds for a woman who begins pregnancy at a healthy weight).
Protein needs are also increased, by about 25 grams per day. She likely eats enough protein to meet her needs already. This extra protein should help support adequate growth.
Carbohydrate intake should be at least 175 grams per day, partly to prevent ketosis.
Vitamin D should be increased to 10 micrograms per day by either increasing sunlight exposure or increasing vitamin D–fortified milk consumption. This amount will support fetal bone growth.
Folate intake should increase to 600 micrograms DFE per day to support red blood cell formation and DNA synthesis.
Iron intake should increase to about 27 milligrams per day. This will support hemoglobin synthesis.
Calcium is needed to promote mineralization of fetal bones and teeth. Calcium intake should meet 1000 milligrams per day.
Zinc is important for growth and development. Intake should increase to
11 milligrams per day to support this.
These nutrients can be obtained from foods. However, prenatal supplements can aid in supplying these nutrients to the pregnant woman, especially in circumstances that may prevent her from adequately consuming sufficient nutrients from foods.
As the pregnancy advances, the uterus continues to grow to accommodate the growing fetus. As it does, it presses against the stomach as well as the intestines. Also, hormones produced in increased amounts during pregnancy relax muscles. This explains why heartburn may occur; the lower esophageal (cardiac) sphincter relaxes somewhat, allowing some foods and acid to regurgitate back into the esophagus—hence the heartburn. It is recommended that smaller quantities of foods be ingested and that the woman not recline after eating. Since hormones relax muscles, the rate of peristalsis may also decrease and constipation may develop. It would be wise to gradually increase the amount of fiber in Sandy's diet to improve her digestive system’s peristaltic activity.
