Tips to Follow During Pregnancy and Lactation
* Eat more food during pregnancy and lactation.
* Eat more whole whole grains, sprouted grams and fermented foods.
* Take milk/meat/eggs.
* Eat plenty of vegetables and fruits.
* Avoid superstitious and food taboos.
* Do not use alcohol and tobacco. take medicines only when prescribed.
* Take iron, folate and calcium supplements regularly, sfter 14-16 weeks of pregnancy and continue the same during lactation.
EAT FOLATE- RICH FOODS :
* Folic acid is essential for the synthesis of haemoglobin.
* Folic acid deficiency leads to macrocytic anaemia.
* Pregnant women need more of folic acid.
* Folic acid supplements increase birth weight and reduce congenital anomkaltes.
* Green leafy vegetables, legumes, nuts and liver are good sources of folic acid.
EAT IRON- RICH FOODS:
* Iron is needed for haemoglobin synthesis, mental function and body defence.
* Deficiency of iron leads to anaemia.
* Iron deficiency is common particularly in women of reproductive age and in children.
* In children, it increases susceptiability to infection and impairs learning ability.
* Plant foods like legumes, dried fruits and green leafy vegetables contain iron.
* Iron is also obtained through meat, fish and poultry products.
* Iron bio-availability is poor from plant foods but is good from animal foods.
* Fruits rich in vitamin C like amla, guava and citrus fruits improve iron absorption from plant foods.
* Beverages like tea bind dietary iron and make it unavailable. hence they should be avoided before, during or soon after a meal.
Subscribe to the comments for this postBreast Feeding and Advantages of Breast Feeding
“EXCLUSIVE BREAST-FEEDING SHOULD BE PRACTISED AT LEAST FOR 4-6 MONTHS. BREAST-FEEDING CAN BE CONTINUED UPTO TWO YEARS”.
* Breast milk is the most natural and perfect food for normal growth and healthy development of infants.
* colostrum is rich in nutrients and anti-infective factors and should be fed to infants.
* Breast-feeding reduces risk of infections.
* It establishes mother-infant contact and promotes mother-child bonding.
* It prolongs birth interval by fertility control.
* Breast feeding helps in retraction of the uterus.
* Incidence of breast cancer is lower in mothers who breast feed their children.
Why breast-feed the infant ?
Breast milk contains all essential nutrients needed for the infant; it provides the best nutrition and protects the infant from infections. Breast milk is a natural food and is more easily digested and absorbed by the infant as compared to formula milk prepared from other sources. Colostrum, which is the milk secreted during the first 3 days after child birth, is rich in proteins, minerals, vitamins especially vitamin A and antibodies. In addition, it has a laxative effect as well. Breast-feeding helps in reducing fertility and facilitates spacing of children. Lactation provides emotional satisfaction to the mother and the infant. Therefore, breast milk is the best milk for the newborn and growing infant.
What are the advantages of breast-milk ?
In addition to providing nutrients, breast milk has several special components such as growth factors, enzymes, hormones and anti infective factors. The amount of milk secreted increases gradually in the first few days after delivery, reaching the peak during the second month, at which level it is maintained until about 4-6 months of age. An average Indian woman secretes about 750 ml of milk per day during the first 6 months and 600 ml/day subsequently up to one year. Many essential components are in concentrated amounts in colostrum as compared to mature milk, compensating for the low output during early lactation.
Breast-milk provides good quality proteins, fat, vitamins, calcium, iron and other minerals even beyond four months. In fact, its quality can be improved by supplementing the diet of the mother nutrients. Growth performance of breast-fed infants is satisfactory up to 4-6 months of age.
Food Groups and Classification according to their Functions
Foods are conventionally grouped as:
(1) Cereals, Millet’s and pulses
(2) Vegetables and fruits
(3) Milk and Milk products, egg, meat and fish
(4) oils and fats and nuts and oil seeds
However, foods may also be classified according to their functions.
What are Nutrient Requirements and recommended dietary allowances (RDA) ?
Requirements are the quantities of nutrients that healthy individuals must obtain from estimates of nutrients to be consumed daily to ensure the requirements of all individuals in a given population. the recommended dietary allowances (RDAs) are estimates of nutrients to be consumed daily to ensure the requirements of all individuals in a given population. The recommended level depends upon the bio availability of nutrients from a given diet. the term bioavailability indicates what is absorbed and utilized by the body. In addition, RDA include a margin of safety to cover variation between individuals, dietary traditions and practices. The recommended dietary allowances are suggested for physiological groups such as infants, pre-schoolers, adolescents, pregnant women and lactating mothers, and adult males and females, taking into account their physical activity. In fact, RDA are suggested averages/day. However in practice, fluctuations in intake may occur depending on the food availability and demands of the body. But the average requirements need to be satisfied over a period of time.
The diet that one consumers must provide adequate calories, proteins and micro nutrients to achieve maximum growth potential. There may be situations where adequate amounts of nutrients may not be available through diet alone. In such high risk situations where specific nutrients are lacking, fortified food, such as iodized salt, is necessary.
* Choose a variety of foods in amounts appropriate for age, gender, physiological status and physical activity.
* Use a combination of grains, grams and greens. Include Jaggery or sugar and cooking oils to bridge the calorie or energy gap.
* Prefer fresh vegetables and fruits in plenty.
* Include in diets, foods of animal origin such as milk, eggs and meat, particularly for pregnant and lactating women and children.
* Adults should choose low-fat protein rich foods such as lean meat, fish, pulses and low fat milk.
* Develop healthy eating habits and exercise regularly.
Treatment of Boils and Boils on Skin
TREATMENT:
The best way to deal with boils is to prevent them occurring. Avoid getting tired and run down and make sure you eat a healthy, balanced diet. Drink plenty of water (around two litres per day), don’t drink too much alcohol and takesome exercise.
If you have a long-term condition that affects your immune system, then it’s important to make even more effort to keep healthy.
If you do get a boil, then you should:
* Keep the area around it clean, preferably using an antiseptic soap.
* Soak a clean cloth in warm salty water (mix a couple of spoonfuls of salt in a
bowl of water) and press it against boil, gently squeezing at the same time.
* Do not ‘lance’ (pierce) the boil and squeeze out the pus as this can spread the
germs more widely and cause more boils.
* If the boil does not start to heal within a few days, then make an appointment
to see your GP.
If you have a very large boil or carbuncle, you may need to see your GP for treatment. They may use a needle and syringe to drain the pus out. Sometimes a small cut in the skin is needed to let out the pus.
In some cases a course of antibiotics is prescribed to help clear infection from the skin.
COMPLICATIONS:
Carbuncles (large, multiple boils) can sometimes cause problems. Starting off as a smooth dome shaped lesion (area of abnormal tissue), carbuncles develop into painful swellings that may release pus from different parts. This spreads a large amount of bacteria onto the skin and increases the risk of infection getting into the bloodstream. If this happens, serious infections affecting other organs
can develop.
Boils on Skin and Diagnosis of Boils on Skin
Boils On Skin:
PUS:
It is a White or yellow oozing fluid.
CAUSES:
The following medical conditions are some of the possible causes of Pus. There are likely to be other possible causes:
* Possible causes of pus on the skin include:
1. Acne
2. Folliculitis
3. Boils
* Possible causes of pus under the skin include:
1. Abscess
DIANOSIS:
If pus is on the skin, this suggests acne, folliculitis or boils. If pus is under the skin, this suggests an abscess. Acne vulgaris pimples are common on the face, but the neck, upper chest, upper back and shoulders may also be affected; hidradenitis suppurativa occurs in axilla, on breasts, around the anus and in the groin.
DIAGNOSIS TESTS:
The list of diagnostic tests mentioned in various sources as used in the diagnosis of Pus includes:
* Physical examination
1. Examine pus-filled lesion (pustule) and determine if pus is on the skin (which suggests acne, folliculitis or boils) or under the skin with surrounding skin redness (which suggests an abscess)
2. Determine if the pus-filled lesion (pustule) arises from a hair follicle (which suggests folliculitis) or arises independently
* Blood tests
1. Fasting blood sugar, especially if boils are recurrent
2. Blood culture, if person is unwell and has a fever
3. Free testosterone, FSH, LH, DHEA-S if suspect polycystic ovarian Syndrome in a female with acne
4. Swab of pus-filled lesions (pustules) - for microscopy and culture and identification of bacteria and fungi. The most common organism responsible is Staphlococcal aureus bacteria.
Boils and Symptoms of Boils
BOILS:
Infected puseous hair follicle on the skin. A boil is an inflamed, pus-filled swelling usually caused by an infected hair follicle (a follicle is the root of a hair). Any hair follicle can become infected, so this includes eyelashes too (a boil in an eyelash follicle is called a stye).
The most common cause of infection are germs called staphylococci. These germs already exist on the skin and in the nose of some people without causing any problems.
Often, several or many boils may develop together. This is known as folliculitis. Boils often occur in places where clothing catches on the skin, where the body rubs against itself, or where the skin is sweaty. For example:
* on the neck,
* under the armpits,
* in the groin, or
* between the buttocks.
Swelling:
Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
PAIN:
Pain is an unpleasant physical or emotional feeling that your body produces
as a warning sign that it has been damaged.
SWELLING:
Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
The list of signs and symptoms mentioned in various sources for Boil includes the 8 symptoms listed below:
* Infected hair follicle
* Boil on skin
* Painful red skin swelling
* Painful red skin lump
* Local lymph node swelling
* Fever
* Pus head appears on the boil
* Burst boil
It is often a small swelling, larger than an ordinary spot. It will be raised, red and angry looking. It will often have a yellow head caused by pus near the surface of the inflamed and stretched skin.
Boils tend to get larger and more painful over a few days, before bursting and releasing the pus. This usually eases the pain, although a small scar may be left at the site of the boil.
Fluorine Sources, Deficiency and Daily requirements
Fluorine: fluorine is the most abundant element in nature. being so highly reactive, it is never found in its elemental gaseous form but only in combimed form. About 96% pf the fluoride in the body is found in bones and teeth. Fluorine is essential for the normal mineralization of bones and formation of dental enamel.
Sources: The principal sources of fluorine available to man are:
a) Drinking Water: The major source of fluorine to man is drinking water. In most parts of India, the fluoride content of drinking water is about 0.5 mg/L but in fluorosis endemic areas, it may be as high as 3 to 12 mg/L.
b) Foods: Fluorides occur in traces in many foods, but some foods such as sea fish,, cheese and tea are reported to be fich in fluorides.
Deficiency/Excess: Fluorine is often called a two-edged sword. Prolonged ingestion of fluorides through drinking water in excess of the daily requirement is associated with dental and skeletal fluorosis; and inadequate intake with dental caries. The use of fluoride is recognised as the most effective means available for the prevention of dental caries.
Requirement: The recommended level of fluorides in drinking water in this country is accepted as 0.5 to 0.8 mg per litre. In temperate countries where the water intake is low, the optinun level of fluorides in drinking water is accepted as 1 to 2 mg per litre.
Daily requirements of Iodine and Epidemiological Assesment
Requirement: The daily requirement of iodine for adults is placed at 150 micrograms per day. This amount is normally supplied by well-balanced diets and drinking water except in regions where food and water are deficient in iodine.
Epidemiological assessment of iodine deficiency: This is necessary before initiating an iodization programme and for surveillance of goitre control programmes. The following indicators are useful in this regard.
* Prevalence of goitre.
* prevalence of cretinism.
* urinary iodine excretion.
* Measurement of thyroid function by determination of serum levels of thyroxine and pituitary thyrotropic hormone.
* prevalence of neonatal hypothyroidism.
Since the objective of goitre control programme is to increase iodine intake, indices of urinary excretion are particularly recommended for use in surveillance. Neonatal hypothyroidism has been found to be a sensitive indicator of environmental iodine deficiency. Serum T4 level is amore sensitive indicator of thyroid insufficiency than T3.
Iodine Uses, Sources, Goitrogens and Iron Deficiency
Iodine: Iodine is essential micronutrient. It is required for the synthesis of thyroid hormones, thyroxine and triiodothyronine containing respectively 4 and 3 atoms of iodine. Iodine is essential in minute amounts for the normal growth and development and well being of all humans. The adult human body contains about 50 mg of iodine, and the blood level is about 8-12 micrograms/dl.
Sources: The best sources of iodine are sea foods and cod liver oil. Smaller amounts occur in other foods like Milk, meat, vegetables, cereals, etc. The iodine content of fresh water is small and very variable about 1-50 micrograms/L.
About 90% of iodine comes from foods eaten; the remainder from drinking water. The iodine content of the soil determines its presence in both water and locally grown foods. The deficiency is geochemical in nature.
Goitrogens: “Goitrogens” are chemical substances leading to the development of goitre. They interfere with iodine utilization by the thyroid gland. They may occur in food and water. The brassic group of vegetables may contain goitrogens. Most important among the dietary goitrogens are probably cyanoglycosides and the thiocyanales.
Deficiency: The most obvious consequence of iodine deficiency is goitre but recent studies have indicated that there is a much wider spectrum of disorders some of them so severe as to be disabiling. They include:
a) hypothyroidism
b) retarded physical development and impaired mental function.
c) increased rate of spontaneous absorption and stillbirth
d) neurological cretinism, including deaf-mutism;
e) myxedematous cretinism including dwarfism and severe mental retardation. To express this state of affairs more accurately the term “endemic goitre” is now replaced bby the term “Iodine Deficiency Disorders” to refer to all the effects of iodine deficiency on human growth and development which can be prevented by correction of iodine deficiency.
Iron Deficiency Diagnosis and Evaluation of Iron Status
Iron Deficency: Three stages of iron deficency have been decribed:
a)First stage characterised by decreased storage of iron without any other detectable abnormalities.
b)An intermediate stage of “latent iron deficency” that is iron stores are exhausted, but anaemia has not occured as yet. Its recognition depends upon measurement of serum ferritin levels. The percentage saturation of transferrin falls from a normal value of 30% to lesss than 15%. This stage is the most widely prevalent stage in India. The third stage is that of overt iron deficiency when there is a decrease in the concentration of circulating haemoglobin due to impaired haemoglobin synthesis.
The end result of iron deficiency is nutritional anaemia which is not a disease entity. It is rather syndrome caused by malnutrition in its widest sense. Besides anaemia there may be other functional disturbances such as impaired cell mediated immunity, reduced resistance to infection, increased morbidity and mortality and diminished work performance.
Diagnosis of Anaemia: A WHO Expert Group proposed that “anaemia or deficiency should be considered to exist” when haemoglobin is below levels
Evaluation of Iron Status:
a) Haemoglobin Concentration: haemoglobin concentration is a relatively insentive index of nutrient depletion. Its value is less in population goups in which anaemia is not sever. This isbecause anaemia is a late manifestation of iron deficiency which can frequently occur without the manifestation of anaemia.
b) Serum iron concentration: This is a more useful index than haemoglobin concentration. The normal range is 0.80 to 1.80 mg/L indicate probable iron deficiency.
c) Serum Ferritin: The single most sensitive tool for evaluating the iron status is by measurement of serum ferritin. It reflects the size of iron stores in the body. It is the most useful indicator of iron status in a population where theprevalence of iron deficiency is not high. values below 10 mcg/L probably indicate an absence of stored iron.
d) Serum Transferrin Saturation: This should be above 16%. Normal value is 30%.