Nutrition for a healthy pregnancy

      

Pregnancy is a very crucial period in a woman's life during which good nutrition is very important to ensure that mother and baby are healthy. The calorie needs of a pregnant woman is said to increase by about 150kcals per day during the first trimester. This figure is said to further increase to about  350 to 450 kcals per day during the second and third trimesters respectively. The increased need is necessitated by the increased metabolism during pregnancy which often leads to hunger pangs and food cravings.  Pregnancy increases the need for micro-nutrients  such as Iron, Folate, Calcium etc. by up to 50%  hence many medical practitioners recommend dietary supplements during pregnancy; where as the need for macro-nutrients  (protein, carbohydrates and fat) increases by about 20% during the second and third trimesters. All these needs can be met by choosing a diet full of healthy foods.The "eating for two" concept does not refer to doubling the food and calorie intakes, rather it refers to the increased need for several vitamins and minerals.

Rather than binge on sugary or fat filled snacks, increasing the serving size of foods should be sufficient to satisfy the increased calorie needs . The extra calories needed should come from  foods like whole grains, fruits, vegetables, lean meat, yogurt, snails, fish etc. Lucky enough, Nigeria is blessed with an abundance of nutrient-dense foods such as meat, beans, different sea foods, many varieties of vegetables and fruits most of which are easily accessible . Pregnant women should strive to maintain good nutrition during pregnancy and avoid both too little and too much food intake.Sadly, there are many Myths surrounding nutrition in our part of the world, most of which are baseless. 

  

 Gradual weight gain during pregnancy is necessary, with most of the weight gained in the last trimester. Pregnancy diet should allow  for approximately 0.9kg to 1.8kg(2 to 4 pounds) of weight gain during the first trimester and then subsequent weight gain of 0.3kg to 0.5kg (0.75lbs to 1lbs) weekly during the second and last trimesters.
  

 A healthy goal for total weight gain for women of normal weight ( based on Body Mass Index((BMI) 18.6 to 24.9) averages about 11.5kg to 16kg (25lbs to 35lbs). Women carrying more than one baby gain between 15kg to 23kg (35lb to 50lbs). For women who begin pregnancy with low BMI,  the goal increases to 12.5kg to 18kg (28lbs to 40lbs). It decreases to 7kg to 11.5kg for women who begin pregnancy with high BMI  .

   

To calculate your BMI,  measure your weight in kg and divide it by your height in meters square as shown in the image below.  

   

The chart below gives an idea of the range of a healthy BMI. 

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Nutritional needs of toddlers

A child is expected to triple its birth weight by his/her first birthday. At this stage, specific nutrients are needed for the child's optimal growth. Protein, fats, carbohydrate, vitamins and minerals should be provided from a variety of food sources. It is expected that a child's meal should contain at least 4 kinds of nutrients at suitable proportions before it can be said to be adequate. An adequate meal contains lots of different foods, offered in a variety of combinations to ensure a toddler gets all the necessary nutrients he needs to grow, explore and develop. Offering a variety of meals to a toddler helps him learn about new flavours and develop healthy eating habits.

Providing an adequate diet for a toddler at every meal can be challenging. As long as he eats most of what is offered, he would likely get the necessary nutrients his body requires. One does not

have to stick to a particular food to provide a certain nutrient. If a toddler refuses a particular food (as they are wont to) due to its texture, taste or flavour (especially vegetables), the food item can be blended or mashed, and added to his favorite food. A toddler should learn to get used to new textures, tastes and more regular meal times. Toddlers will be able to meet their nutritional needs if they are offered a variety of healthy family foods at regular times.

   A toddler should be offered a variety of healthy fruits and snacks (banana, pear, apple, smoothies, etc). Toddlers are known to be picky eaters so creativity in the preparation and presentation of their foods can go a long way towards improving their feeding habits.

Important nutrients for toddlers

Almost all healthy toddlers get enough protein, fat and carbohydrate in their diets. The nutrients most likely to be low in a toddler’s diet are calcium and iron, both of which are very important for the toddler’s growth and development.

Good sources of iron include: meat,  liver, kidney beans, and green leafy vegetables.  Some toddlers do not like eating meat as they find it hard to chew. Such toddlers should be offered well cooked,  soft or semi mashed meat , so they could be easily chewed.

Giving your toddler Vitamin C rich foods such as strawberries, citrus fruits, and vegetables increases the amount of iron that is absorbed from other plant-based foods like bread, Peas, spinach, and legumes. So aim to offer your toddler a Vitamin C rich food or drink at every meal  to improve his body’s absorption of dietary Iron.

Good sources of calcium include egg, seafoods such as crayfish and fish, legumes such as beans, groundnut and soybeans, milk, yogurt, and other dairy products.  It is important a toddler gets at least a portion of these each day.  

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Baby dies after contracting herpes. Please parents take note of how to avoid this.

Babies are born very fragile and their protection is always left to the adults around them, especially their parents. Their fragility and cuteness often make people want to kiss them on the cheek, lips, forehead, hands or whatever part of their body. Mothers are usually advised not to allow anyone kiss their newborn babies, in fact anyone who wants to touch a newborn should be required to wash their hands in clean soapy water. These may seem so much to ask for given the Nigerian culture of everyone coming to welcome newborn babies and longing to carry them in their arms; but reading this Iowa mum's story should make every mother rethink allowing whoever wishes to carry her baby or give the baby a kiss. 

Mariana Sifrit was born July 1 2017 and returned home few days later with her mother Nicole  and father Shane after being declared fit to go.

Little Mariana was born healthy and declared fit to go home

 By July 7th the newborn was taken to Blank Children's Hospital in Des Moines Iowa in USA; unable to eat and having difficulty waking up  where they learned that she had contracted HSV-1, a viral infection that which can be transmitted from one infected person to another even if they do not have an open sore. How Mariana contracted the virus was uncertain since both parents tested negative to the virus. 

Nicole's Facebook post while they fought for Mariana's life

Little Mariana fighting for her life in hospital

Little Mariana died on July 18 despite all efforts made to save her life as recounted by her mother Nicole on her Facebook page. 

Here are some things you may need to know about the Herpes Simplex Virus (HSV) as written by the World Health Organization (WHO);

• The herpes simplex virus (known as herpes in short) is categorized into two types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
• HSV-1 is mainly transmitted by oral contact and can cause cold sores, while HSV-2 is a sexually transmitted infection that causes genital herpes.
• Symptoms of herpes include sores or blisters at the site of the infection but most cases of herpes are asymptomatic; that is they do not show any visible symptoms. Therefore you cannot by mere looking at a person determine he or she carries the virus.
• Herpes is highly contagious and when contracted is lifelong; that is, there is no cure . Drugs exist to reduce the severity or frequency of symptoms but no drug exists for the cure of herpes.
• 87% of the African population is said to carry the virus.
• A person can carry the virus all his/her life without showing any symptoms but can transmit it to others especially those with weak immune systems.
• Complications are rare and when they occur do so in newborn babies and immuno-compromised persons. Neonatal (newborn)herpes can lead to neurologic disability or death. 

There is therefore every need to protect your newborn baby. Be nice but firm when requesting that people wash their hands before touching your baby but do not allow anyone kiss your baby, it is safest if you don't also do so especially when the baby is still very young. You could read up some tips on newborn care here. 

Kale and Spinach vegetable soup

There is hardly any Nigerian who has not heard of Edikaikong, a soup native to the people of Cross River and Akwa Ibom states in Southern Nigeria but eaten across all the regions of the country. This soup is made with fresh vegetables with water leaf being the primary one. It is one soup many Nigerians outside the shores of Nigeria often crave to eat.  Getting the right vegetables to make Edikaikong may be difficult outside Nigeria but one can make its look-alike. 

It occurred to me that I could use Spinach and Kale to replace Water leaf and Ugu respectively after using them at different times for different soups. Just like I do whenever I intend adding a twist to any of my recipes, I went online to research the vegetables and their use in Nigerian recipes and saw that Dunni of Dooney's Kitchen had used them in the very manner I intended to. That gave me the guts to try it out. So here is my Kale and Spinach Vegetable soup; an Edikaikong's look-alike.  Luckily, this look alike tastes just as delicious and will make you feel just as good as the version you are used to eating in Nigeria. 

Recipe (for 4 servings)

400g of Spinach leaves

150g of Kale

Meat

Prawns

Crayfish

Palm oil

A bulb of Onion, Pepper, Salt and a Cube of Knor seasoning

Method

•  Boil the meat with salt, pepper, chopped onions and as little water as possible because spinach just like water leaf contains a lot of moisture.  So you need to control the water content of your meat stock else you end up with a very watery soup.
• Wash and chop your vegetables
• Wash and clean your prawns and whatever other protein source you intend adding to your soup.

Spinach leaves

Kale leaves

Prawns

Prawns with heads pulled off. They taste better to me this way than when their shells are completely removed

• When the meat must have been cooked, add the prawns and then the chopped Spinach. Prawns are not meant to be cooked for long lest they become hard and almost tasteless. 

• Let the  Spinach simmer a little then add the palm oil, crayfish and whatever other protein source you wish to add, and let the mixture cook at medium heat for about 5 minutes or till the spinach is wilted. You may choose to be stirring the mixture at intervals. Do not worry if the water seems very small; Nigerian vegetable soups are known to not be watery, besides the spinach leaches water into the soup so if you are misled to add more water at this stage, you will very likely end up with very watery vegetable soup. 
• Add the chopped Kale when the spinach is properly wilted and stir in. Depending on the quantity of pepper and salt you added to your meat stock, you may need to add more salt and pepper to your taste at this stage. 

 Crayfish

Palm Oil

The Spinach left to wilt

Addition of the chopped Kale

What the soup looked like. Noticed the quantity of water in the pot? Addition of water besides that in the meat stock would have made the soup very watery

The soup; plated and ready for consumption. 

Healthy eating while breastfeeding

Good nutrition is important for everyone. It is particularly important for breastfeeding mothers to eat healthy, varied and well-balanced meals. During pregnancy, body stores of certain nutrients such as iron, calcium and vitamin D, can become depleted.  Eating healthy, balanced meals could help replenish these stores. If a poor diet is consumed during pregnancy and while breastfeeding, the mother's nutrient stores will be reduced which could in turn affect the nutrients supply to the baby. It is therefore very important that a healthy diet plan is followed by pregnant and nursing mothers so as to fulfill both their nutritional needs as well as that of their babies. 

 

Making breast milk is hard work for the body. Energy requirements increase during lactation (it has been estimated that the energy cost of breastfeeding is around 650 kcal/day). Mothers who exclusively breastfeed are said to require an extra 500 kcal/day on average. Some of this energy is obtained from fat stored during pregnancy. There are additional requirements for other nutrients,  most of which can be met by eating healthy balanced meals.

Some nutrient-dense foods a breastfeeding mum could eat include fish and other sea foods, meat, fruits and vegetables, nuts such as groundnuts and walnuts, as well as diary products such as milk, cheese, yogurt etc. 

Nutrients in Breast Milk:

With the exception of vitamin D, breast milk contains everything a baby requires for proper development during the first six months of  its life. The composition of breast milk is highly regulated, and a mother's diet can have significant effects on the concentrations of some nutrients. If a mother's diet does not provide sufficient amounts of nutrients, it can affect both the quality of her breast milk as well as her own health. 

Generally, an ounce (28 ml) of breast milk is said to contain about 19–23 calories, with 3.6–4.8% being from protein, 28.8–32.4% from fat and 26.8–31.2% from carbs, mostly lactose. Unlike baby formula, the calorie content and composition of breast milk varies. Breast milk changes during each feeding and throughout a mother's lactation period in order to meet her baby's nutrient needs. At the beginning of a feeding session, the milk is more watery and usually quenches the baby's thirst. The milk that comes later is thicker, higher in fat content and more nutritious; and  may contain 2–3 times as much fat as milk from the beginning of a feeding, and 7–11 more calories per ounce. Therefore, to get to the most nutritious milk, it's important that a baby "empties" one breast before switching to the other.

A new mum might be tempted to lose weight quickly after delivery. It is completely normal to not lose any weight, or even gain some during the first 3 months of breastfeeding. Due to hormonal changes in her body, a new mum may have a bigger appetite and be more prone to holding on to body fat. Restricting calories too much, especially during the first few months of breastfeeding, may decrease both a mother's milk supply and her much-needed energy level.

However, she will likely experience a spontaneous increase in fat burning after 3–6 months of breastfeeding and start losing more weight than mothers who don't breastfeed. By then, losing about 0.5 kg body weight per week through a combination of diet and exercise should not affect her milk supply or milk composition, assuming that she is not undernourished . All in all, a breastfeeding mum should remember that it took her body several months to put on the weight, and it may take months to lose it.

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Thai-inspired Shrimp Spaghetti

It is very easy for food and feeding to become monotonous and therefore boring. At times just adding a little twist to the foods you eat regularly can make a lot of difference especially when you have picky eaters in the home. Children, just like adults are attracted to colorful things and when a dish is not just colorful but contains strings that children can pick and eat, then chances are high that the dish will be loved by children. This dish has a melt-in-the-mouth savory taste that will appeal to both adults and children. 

Prepare  this easy-to-cook, pleasant-looking food for your family and watch everyone relish the meal.   

To prepare this food you will need

•  Spaghetti
• Fresh Parsley leaves
• And sauce. 

To prepare the sauce you need the following

• Shrimps
• Onions
• Ginger
• 2 cloves of garlic
• Red, Green and Yellow bell peppers
• A cube of Knorr seasoning (optional)
• Salt
• Pepper
• About 20g of butter (or any oil of your choice)
• Curry and  thyme

Method

Pour the spaghetti into boiling water, add some salt and let it cook slightly for about 3 to 5 minutes then drain off the water. It should not be completely cooked as it would be cooked further in a sauce.

Then prepare the sauce by first blending together the onions, ginger, bell peppers and garlic.

Green, Red and Yellow Bell peppers

Fresh Parsley leaves

 

Melt the butter in a pot and pour in the shrimp to saute. Then add the curry, thyme, seasoning cube and whatever spice or seasoning you want to add.

Then you pour in the blended mixture and bring to boil

Pour the slightly cooked Spaghetti into the boiling sauce and cook. The sauce should be just enough to cook the spaghetti until al dente; that is firm to the bite  and not soggy

Once the spaghetti is completely cooked,  dish into a plate and sprinkle some chopped, fresh parsley on your food.

The parsley not only enhances the taste and nutritional value of the food, it makes the food quite colorful and attractive to picky eaters and everyone alike

Beauty in a plate

Non-essential baby care items that can make baby care easier.

When it comes to newborn and child care, there are things a mother cannot do without; the essentials such as baby wears and diapers. There are also those that may not be essential but can make the daunting tasks of childcare a tad easier; those that can be described as non-essential but very helpful. They include 

1. A pacifier. While not exactly essential, a pacifier can be helpful especially during those moments when the baby just keeps looking for something to nibble on even after being fed, or those moments when you are trying to round off a task and need the baby distracted. It could also help replace the comfort of a mum's nipple when the baby wants to sleep for babies who like sleeping while latched on to their mums# breasts. Pacifiers also serve as better alternatives for babies who want to suck their thumbs as the habit can easily be broken, unlike thumb sucking. Finally, research seems to suggest a relationship between pacifier usage and reduction in cases of Sudden Infant Death Syndrome (SIDS). 

2. Diaper bucket/pail. In baby care, diaper disposal can be a major source of headache to mothers especially when the baby's poop begins to smell very bad and necessitates throwing away the thrash each time one such poop-filled diaper shows up. This cannot always be realistic no matter the part of the world you live in, more so a place like Nigeria that lacks an effective refuse disposal system. A diaper bucket/pail can take away the stress of daily diaper disposal.
 The diaper bucket is used to discard soiled diapers.  Having one means you do not need to dispose of used diapers daily without bothering about the smell of baby poo or urine as they are usually airtight and have odor suppressing mechanisms that does not allow smell sift out. A diaper bucket allows you the convenience of discarding soiled diapers at your convenience while keeping your house diaper-stink free.

Diaper buckets/pails

3. Diaper bag. While a mum can do without a diaper bag, having one makes going out with a baby much more convenient as compared to using a handbag. Most diaper bags come with different compartments that can contain different baby items as well as what a mum would want to put in her handbag, with everything in its compartment you don't need to search to find an item as each item has a location meant for it. Besides, a mum can decide to always leave certain baby supplies like diapers, wipes or baby cloths in the bag to reduce the risk of forgetting to take one item or the other her baby may need outside the home. Few handbags are as big as diaper bags that can contain all a mother and her baby may need outside the house. 

An open diaper bag showing how different baby items can be fitted into different compartments for easy accessibility

4. Breast Pump. Every mother knows that there are times when she needs her "me time" and would be willing to pay so much to be relieved of her mummy duties no matter how short the duration. There are also those moments at night when a mother needs her much-deserved sleep but cannot afford to because she has to nurse.The breast pump can be of help in such situations provided the mum has someone who can take care of her baby. The breast pump helps extract breast milk faster than using the hands. All the mum needs to do is pump out the much milk she believes her baby will need, store in the refrigerator and go rejuvenate. A breast pump can help a nursing mother work towards keeping her baby fed when she is not available. Some baby pumps can be manually operated while others are electrically operated. The electric ones can be quite pricey but they make pumping a lot easier than when using the manual ones. This baby care equipment can be of immense value for mums who after their maternity leave need to resume work but want to sustain exclusive breastfeeding.

A manual breast pump

An electrically operated breast pump

5. Baby carrier/wrap. Our mothers used to carry their babies on their backs with a wrapper tied at the front and sometimes a shawl to hold the baby's leg in place. The baby carrier brings a modern twist to that and what's more,  a mother can carry her baby in front and have a complete view of the baby unlike when the baby is tied to the back. Reminds one of an Igbo proverb that talks about not vouching for anyone, not even the baby tied to your back. Perhaps the carrier can make a mum vouch for the baby in her front since she has it in her complete view. 
Before buying a carrier or wrap, the mum needs to find out  the strength of the carrier/wrap , it should come with weight specifications stating the maximum weight of a child it can support so she doesn't carry a baby heavier than it can support and risk throwing the baby to the ground from a height as high as it's mum's chest.

A baby carrier

A mum carrying her baby in a  baby wrap

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Red flags every pregnant woman should take note of.

The maternal mortality rate in Nigeria is unacceptably high and necessitates a critical review of our healthcare system with the aim of improving not just  maternal outcomes but every other health indicator. While we wait and clamour for an improvement, we need to look out for ourselves and for those around us.

Just like in every aspect of health, there are certain things that could signal problems when they happen to a pregnant woman. Since our emergency healthcare system leaves so much to be desired, every pregnant woman should be aware of these and take necessary steps to get medical attention as fast as possible for her sake and that of her unborn baby. It it usually better that one gets to the hospital and it turns out there was no need to have panicked than one failing to get there and things turn awry. Most times, early medical attention  makes the difference between life and death.
 Any of these occurrences should make a pregnant woman get medical attention as fast as possible as they could signal that something is wrong.
(1)Spotting or bleeding at whatever stage of the pregnancy.

(2) A throbbing headache that paracetamol does little or nothing to relieve.

(3) Excessive dizziness. Dizziness often comes with pregnancy but if it becomes excessive that you can't stand please get medical attention fast.

(4) Severe cramping anytime during the pregnancy.

(5) Greenish or black vaginal discharge

(6) Sickness. We have perfected the art of self-medication in Nigeria; often to our peril. Pregnancy is not a time to engage in self medication. Whenever you feel sick. let a medical practitioner do the diagnosis and prescribe the appropriate drug . Not all drugs are safe in pregnancy. Some drugs could expose you and/or your unborn baby to harm. 

(7) Painful and rhythmic contractions when your pregnancy is not yet full term.

(8) A fall face-down on your belly or any other hard, strong painful contact with your bump.

(9) Any instinctive feeling that something is wrong with you or your pregnancy

(10) Not feeling your baby's kick for 12 to 24 hours after 27 weeks of your pregnancy.

While any of these occurrences does not necessarily mean that something is wrong with you or your unborn baby, they mean you need medical attention ASAP, in fact FAST to rule out something wrong. And it's important for you to insist on getting medical attention.  If your registered hospital is being slow or cannot attend to you, it is not a time to wait it out, go to an equally good medical center with skilled and licensed health workers in attendance and get attention. No mother wants to loose her life in the process of bringing forth another human, no mother should. Most times, early medical attention can make the difference.