U trudnoći je važna pravilna ishrana bogata nutritijentima. Tokom trudnoće povećavaju se potrebe za makronutrijentima (energija koju sačinjavaju ugljeni hidrati, proteni i masti) i mikronutrijentima (vitaminima i mineralima), a još je važnije da buduća majka konzumira hranu koja će joj dati i energiju i specifične mikrohranjive sastojke koji su neophodni za održavanje kako njenog zdravlja tako i zdravlja bebe.

Svi smo nekada čuli izraz da trudnica „jede za dvoje“. Međutim, to nije u potpunosti tačno. Da, beba u stomaku dobija hranljive materije od majke i činjenica je da kalorijski unos trudnice u toku trudnoće raste ali nije neophodno da trudnica udvostruči unos kalorija, već će taj unos porasti za nekoliko stotina kalorija do kraja trudnoće. Na primer, ženama je potrebno dodatnih 240 kalorija dnevno u drugom tromesečju i 452 kalorije dnevno u trećem tromesečju trudnoće da bi beba imala pravilan rast i razvoj.

U pogledu kvaliteta ishrane u trudnoći je nešto povećana potreba vitamina i minerala.

Uobičajena dnevna ishrana sadrži dovoljnu količinu svih vitamina i minerala, pa tokom trudnoće nisu potrebne dodatne količine. Izuzetak je gvožđe, jer žene često počinju trudnoću manjkom gvožđa, kao i vitamin C u zimskim i ranim prolećnim mesecima. U trudnoći se zato preporučuje preventivno davanje tableta gvožđa u kombinaciji sa multivitaminskim preparatima, naravno uz konsultaciju lekara.

S obzirom da je u trudnoći pojačan apetit (zbog pojačanog lučenja insulina), glad treba utoliti, pa se preporučuje da se dnevna ishrana trudnice sastoji iz više manjih obroka.

Većini trudnica potrebno je oko 2300 kalorija na dan. Od toga 250 kalorija treba da budu belančevine (oko gram, na kilogram težine), a ostatak od oko 2000 kalorija treba podmiriti jednom trećinom mastima i dve trećine ugljenim hidratima, odnosno skrobnim namirnicama.

U slučaju da trudnica miruje i leži u krevetu njene kalorijske potrebe se smanjuju i iznose oko 1800 kalorija na dan.

Prekomerna ili nedovoljna ishrana

Prekomerna ishrana trudnice koja će proizvesti prekomerni porast težine dovešće do prekomernog rasta deteta. Dete može biti toliko veliko da postaje mahanička zapreka u porođaju, pa će porođaj češće biti produžen i težak.

Kod nas se prekomernim porastom težine u trudnoći smatra porast težine od 17kg ili više.

Iskustvo pokazuje da trudnice sa prekomernim porastom težine češće boluju od EPH gestoze (E-edemi, P-proteinurija, H-hipertenzija), što može dovesti do teških komplikacija kod masjki, a ideca su ugroženija. Lečenje se sastoji u mirovanju i u dijetalnoj ishrani, a često je potrebna i hospitalizacija.

Druga bolest povezana sa prekomernim porastom težine u trudnoći je gestacijski dijabetes ili trudnički dijabetes. Trudnice sa gestacijskim dijabetesom nemaju pravu šećernu bolest i obično im ne treba davati isulin. Međutim, deca su krupna i sklona brojnim komplikacijama u trudnoći i nakon rođenja.

Sa druge strane, nedovoljna ishrana trudnice koja se prezentuje nedovoljnim porastom telesne težine, može dovesti do usporenog rasta deteta. Takva deca su ugroženija i često imaju nedostatak kiseonika, takođe sklonija su novorođenačkim komplikacijama.

Kod nas se nedovoljnim porastom težine u trudnoći smatra porast težine koji iznosi manje od 8kg.

Kako telesna težina treba da se menja tokom trudnoće?

Porast težine u trudnoći je usko vezan sa ishranom majke, a i jedno i drugo su povezani sa težinom novorođenčeta.

Od 13. nedelje trudnoće posteljica izlučuje sve veće količine humanog placentnog laktogena, hormona koji sprečava korišćenje glukoze i podiže oslobađanje masti. Zbog toga se kod trudnice pojačano luči insulin koji dovodi do sniženja visine glukoze u krvi i osećaja gladi. Zato prekomerna ishrana i porast telesne težine obično počinju nakon 13. nedelje trudnoće.

Detetu je za rast i razvoj u materici potreban dodatni broj kalorija, koji ne zavisi ili neznatno zavisi od stanja uhranjenosti majke pre trudnoće. Bitno je istaći da trudnoća nije razdoblje života za korekciju stanja uhranjenosti žene, jer dete u materici zahteva svoje, ni previše, ni premalo.

Zato je preporučeni porast težine u trudnoći je između 11 i 13kg. Prva tri meseca ili 14 nedelja porast će biti minimalan, tek nešto iznad 1kg. Od tada, pa sve do kraja 36. nedelje, nedeljni porast treba da iznosi oko 500gr ili 2kg mesečno, a u zadnjem mesecu trudnoće tek nešto iznad 1kg.

Smanjenje telesne težine nakon porođaja

Nakon porođaja će se već za nekoliko dana smanjiti nakupljena težina.

Tokom porođaja izašli su beba, posteljica i plodova voda, što iznosi oko 5kg. U periodu od 6 d 8 nedelja (period babinja) nakon porođaja izmokriće se oko 1.5kg izvantelesne tečnosti, krv se vraća na normalni volumen, a materica se za 2 do 3 nedelje vraća na svoju normalnu težinu.

Nakon toga preostaje oko 3kg „pričuvane“ masti koju će majka u sledećih nekoliko meseci potrošiti za stvaranje mleka i dojenje. Međutim, ako tokom dojenja žena nastavi prekomerno da se hrani, neće samo izostati trošenje stvorenih zaliha, nego se te zalihe mogu i povećati. Neke žene se tako, u periodu dve-tri trudnoće, mogu ugojiti za 10 do 15kg.

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