Clinical problems
Mild nausea. Early morning nausea during the first trimester can usually be overcome by eating some high-carbohydrate food, such as dry toast, crackers, or hard candy before arising. Fatty and fried foods should be restricted. Several small meals a day, rather than three large meals, may be more desirable. Fluids should be taken between meals and not at meal time.
Food cravings. Women often experience cravings for certain foods during pregnancy. When these foods are a part of a nutritious diet or don’t displace essential foods, these cravings can be satisfied. Pica, or craving for abnormal substances such as laundry starch, clay, chalk, or coal, is found among some women, especially in low-income groups. Consuming large amounts of these substances seriously interferes with the intake of nutritious foods, and should be corrected by education and by assuring the means to obtain an adequate diet.
Anemia. Iron-deficiency anemia during pregnancy increases the likelihood of premature birth. The baby at birth is less well supplied with hemoglobin and thus is likely to become anemic during the first year of life. Macrocytic anemia caused by insufficient folacin sometimes occurs in pregnancy. These anemias are prevented or treated by supplements of iron and folacin, respectively.
Constipation is rather common during the latter part of pregnancy. It can usually be avoided by placing more emphasis upon raw fruits and vegetables, some whole-grain breads and cereals, a liberal intake of liquids, and a regular program of exercise.
Toxemia of pregnancy. This condition is characterized by increased blood pressure, swelling of the hands, face, and ankles, and proteinuria. A sudden gain in weight after the twentieth week of pregnancy indicates water retention. The causes of toxemia are little understood, but lack of prenatal care and poverty are associated with the condition. Restriction of calories, protein, and/or sodium has often been tried in the past. These dietary restrictions are no longer considered to be useful, and are potentially dangerous.

The lactating woman will produce 550 to 850 ml (20 to 30 oz) of milk each day, representing 20 to 30 gm protein and 400 to 600 kcal. In order to produce this milk, her nutritive allowances are increased. The calorie needs are best met by choosing more foods from the four food groups. She should continue to consume the amounts of milk recommended for pregnancy.

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