Introduction: Nutritional requirements increase during lactation. However, maternal dietary intakes of Malaysian mothers are subjected to restrictions commonly included in traditional postpartum practices. This study aimed to assess the maternal dietary intake status during the recommended six month exclusive breastfeeding (part of which included the traditional confinement) period. Methods: Thirty-two Malay mothers aged 18-35 years, who had delivered full-term (at ≥37 weeks) singleton babies and were exclusively breastfeeding, were included in the study. Maternal dietary intake was assessed using multiple-pass diet recall on Days 10, 30, 60, 90, 120, 150, and 180, postpartum. The average total energy and macronutrient intakes were compared against recommended values. Results: The findings of this study demonstrated that maternal intakes of total energy ranged from 1,500-2,000kcal/day, carbohydrate 189-272g/day, protein 58-72g/day, and total fat 32-70g/day. Total calorie intake was the lowest during confinement period (Days 10 and 30) compared to the rest of the exclusive breastfeeding period. This is similar with total fat consumption. On the other hand, protein intake was the highest during confinement period whereas carbohydrate intake was consistent throughout the six-month period. Despite the increased requirements, intakes of total calories, protein, total fat, dietary fibre, and water, did not meet the recommended values throughout the exclusive breastfeeding period. Conclusion: Mothers’ inability to fulfil their nutritional requirements during exclusive breastfeeding period may be associated with traditional postpartum dietary practices. Dietary advice with consideration for cultural food taboos practiced by local mothers during confinement may help to improve maternal nutritional intakes during this crucial time.
Maternal diet

Adult ; Child ; Diet ; Female ; Fetus ; immunology ; Humans ; Hypersensitivity ; embryology ; immunology ; Maternal Behavior ; Pregnancy ; immunology ; Risk Factors

Recently, the incidence of hypertension (HT) and coronary artery disease is increasing because of the change of diet and life pattern. But, coronary artery disease is relatively uncommon in young women of pregnant age. The trend towards delayed marriage and child-bearing may results in an increasing number of women with coronary heart disease. Myocardial infarction complicates approximately 1 in 20,000 pregnancies. Myocardial infarction in pregnancy carries substantial maternal and fetal risks. Overall maternal mortality rate is 21% to 35% and the fetal mortality rate is 13%. Importantly, the maternal mortality rate approaches 50% when women deliver within 2 weeks of the initial MI event. We experienced a case of pregnancy with acute myocardial infarction (AMI) and chronic HT. The patient had a myocardial attack at gestational age 36(+5) weeks and medical treatment was administered. Labor inuction was begun at gestational age 39+3 weeks and the patient delivered by spontaneous vaginal delivery. We report this case with a brief review of the concerned literatures.
Coronary Artery Disease ; Coronary Disease ; Diet ; Female ; Fetal Mortality ; Gestational Age ; Humans ; Hypertension ; Incidence ; Marriage ; Maternal Mortality ; Myocardial Infarction* ; Pregnancy*

Nowadays in Korea, the number of pregnant women with diabetes mellitus is steadily growing due to increases in advanced maternal age and obesity in combination with changes in lifestyle and diet patterns. Pregnancy complicated with diabetes mellitus, whether it is gestational or pregestational, is associated with an increased number of maternal morbidities and adverse obstetric outcomes. Therefore, it is very important to screen, diagnose, manage, and prevent diabetes mellitus during, and even before, pregnancy. In order to improve maternal and perinatal outcomes of pregnancies complicated by diabetes mellitus, research is needed on the standardization of screening and the diagnostic criteria for gestational diabetes, appropriate surveillance techniques for diabetic mothers and fetuses, and the optimal timing of delivery. To facilitate compliance of women with diabetes, randomized studies on the long-term safety and effects of oral hypoglycemics are also needed.
Compliance ; Diabetes Mellitus ; Diabetes, Gestational ; Diet ; Female ; Fetus ; Humans ; Hypoglycemic Agents ; Korea ; Life Style ; Mass Screening ; Maternal Age ; Mothers ; Obesity ; Pregnancy in Diabetics ; Pregnancy* ; Pregnant Women

PURPOSE: This study investigated self-food restriction during breastfeeding, reviewed the literature showing the effect of maternal diet on the health of breast-fed infants, and explored the validity of dietary restrictions. METHODS: Questionnaire data were collected from breastfeeding Korean mothers who visited the pediatric clinic of Cheil General Hospital & Women's Healthcare Center from July 2015 through August 2015. The survey included items assessing maternal age, number of children, maternal educational attainment, household income, degree of difficulty with self-food restriction, types of self-restricted foods, dietary customs during breastfeeding, and sources of information about breastfeeding. RESULTS: The questionnaire was completed by 145 mothers. More than a third (n=56, 39%) had discomfort from and usually avoided 4–5 types of food (mean, 4.92). Mothers younger than 40 years had more discomfort (odds ratio [OR], 12.762; P=0.017). Primiparas felt less discomfort than multiparas (OR, 0.436; P=0.036). Dietary practices were not influenced by maternal educational attainment or household income. The most common self-restricted foods were caffeine (n=131, 90.3%), spicy foods (n=124, 85.5%), raw foods (n=109, 75.2%), cold foods (n=100, 69%), and sikhye (traditional sweet Korean rice beverage) (n=100, 69%). Most mothers (n=122, 84.1%) avoided foods for vague reasons. CONCLUSION: Most mothers restricted certain foods unnecessarily. Literature review identified no foods that mothers should absolutely avoid during breastfeeding unless the infant reacts negatively to the food.
Breast Feeding* ; Caffeine ; Child ; Delivery of Health Care ; Diet ; Family Characteristics ; Female ; Health Care Surveys ; Hospitals, General ; Humans ; Infant ; Lactation ; Maternal Age ; Mothers ; Raw Foods

OBJECTIVETo analyze possible risk factors for diarrhea in breast fed infants and provide evidences for prevention and treatment of diarrhea, reducing allergic and other diseases in infants and for renewing the definition of "physiological diarrhea".

METHODSTotally 334 infants (207 boys and 127 girls, mean age 3.0 +/- 0.4 months) who were solely breast fed and seen between August 2004 and June 2006 at the outpatient clinic of the Department of Pediatrics, the 3rd Hospital of Peking University were enrolled in this study. The following information concerning parental and the infants' possible risk factors was obtained through a questionnaire that included parents' age, education, smoking, alcohol consumption, weight, height, maternal pregnancy weight, weight gain and health status during pregnancy and family history of hypersensitivity, family history of digestive tract disease, diet of mother in lactation, the infants' age, height, weight, head circumference, chest circumference, rash, eczema, diet, vomiting, abdominal distention, and blubber. The levels of PGE(2), fat and lactose in breast milk, serum allergen and skin prick test were performed in all the 334 infants. Logistic regression analysis was performed by using the software SPSS 10.0.

RESULTSMaternal smoking (OR = 2.3), hypersensitivity (OR = 2.7), family history of hypersensitivity (OR = 2.8), diet of mother included seafood (OR = 1.8), egg (OR = 2.3) and peanut (OR = 2.0), infants' eczema (OR = 2.9), blubber (OR = 2.7), high level of PGE(2) (OR = 2.4) and fat in breast milk (OR = 3.0), serum allergen positive (OR = 4.0), positive skin prick test (OR = 2.7) were the risk factors for diarrhea in breast fed infants (P < 0.05).

CONCLUSIONSDiarrhea in breast fed infants is not a simple physiologic process. It may be associated with many factors and the underlying mechanism remains to be clarified via further studies.

Breast Feeding ; adverse effects ; Dermatitis, Atopic ; complications ; Diarrhea, Infantile ; etiology ; Diet ; Female ; Humans ; Hypersensitivity ; complications ; Infant ; Logistic Models ; Male ; Maternal Behavior ; Milk, Human ; chemistry ; Risk Factors ; Smoking

Pregnancy consists of a series of small, continuous physiologic adjustments that affect the metabolism of all nutrients. The adjustments undoubtedly vary widely from woman to woman depending on her prepregnancy nutrition, genetic determinants of fetal size, and maternal lifestyle behavior. A healthy and varied diet is important during pregnancy because the maternal diet must provide sufficient energy and nutrients to meet the mother's usual requirements, as well as the needs of the growing fetus, and enable the mother to lay down stores of nutrients required for fetal development as well as for lactation. The dietary recommendations for pregnant women are actually very similar to those for other adults, but with a few notable exceptions. There is an increased requirement for energy, protein and several micronutrients during pregnancy. The importance of good dietary advice during pregnancy is a healthy, balanced diet, in particular plenty of iron- and folate-rich foods. In addition, a folic acid supplement (400 microgram/day) is recommended prior to and up to 12th week of gestation, and vitamin D supplement (10 microgram/day) is recommended throughout pregnancy. As well as following a healthy, balanced diet, staying physically active is also very important during pregnancy. Exercise can help prevent excess weight gain during pregnancy and help the mother return to a normal weight after the birth. Regular aerobic exercises (walking, swimming) during pregnancy help improve or maintain physical fitness and body image. Certain population groups may require closer attention during pregnancy, including teenage girls, women from certain ethnic group, and women from lower socio-economic backgrounds. Efforts to achieve good maternal nutritional status preconception as well as throughout gestation best assure a good milieu for fetal growth and development and maternal health.
Adult ; Body Image ; Diet ; Ethnic Groups ; Exercise ; Female ; Fetal Development ; Fetus ; Folic Acid ; Food Safety ; Humans ; Lactation ; Life Style ; Micronutrients ; Mothers ; Nutritional Status ; Parturition ; Physical Fitness ; Population Groups ; Pregnancy ; Pregnant Women ; Vitamin D ; Weight Gain ; Maternal Health

The objective of this study was to investigate the association of nutrient intake and pregnancy outcome mediated by weight gain during pregnancy, job status, and household income. Maternal age, educational level, self-reported pre-pregnancy weights, educational level, and household income were collected from the women at 2 months postpartum. For each offspring, weight at birth, length at birth, and gestational age were collected. Participants were asked to report the frequency of consumption of foods between 28–42 weeks into the pregnancy. Diet was assessed by using a validated 106-item semi-quantitative food-frequency questionnaire (SQFFQ) and women were asked portions and quantities based on pictures, food models, and measuring tools such as cups or teaspoons. Results showed that women who gained below the recommended weight gain during pregnancy, within, and over were 25.3%, 38.7%, 36.0%, respectively. In comparison to weight gain and the offspring's length and weight at birth, the offspring of mothers with a lower weight gain had a higher length. Energy, protein, vitamin B2, vitamin C, calcium, and potassium were significantly lower at employed group. We did not observe a significant difference between birth characteristics and maternal nutrient intake by income. Infants with a higher ponderal index at birth were born to women with a higher pre-pregnancy body mass index (BMI).
Ascorbic Acid ; Body Mass Index ; Calcium ; Diet ; Family Characteristics* ; Female ; Gestational Age ; Humans ; Infant ; Maternal Age ; Mothers ; Parturition ; Postpartum Period ; Potassium ; Pregnancy Outcome ; Pregnancy* ; Riboflavin ; Weight Gain* ; Weights and Measures

OBJECTIVETo explore the mechanism and effect of maternal high-fat diet before and during pregnancy on bone growth of neonatal offspring rats.

METHODSForty female Sprague-Dawley rats were divided into high-fat diet and control groups (n=20) that were fed with 35% high-fat diet and standard chow, respectively. After 8 weeks, 8 female rats from each group were sacrificed for liver pathological examinations and the other female rats were mated with male rats and fed continuously with 35% high-fat diet and standard chow throughout gestation, respectively. The body lengths (from apex nasi to end of tail) of the offspring rats from both groups were measured within 24 hours after birth. Enzyme-linked immunosorbent assay was used to detect serum insulin-like growth factor (IFG-I) levels. Liver pathological changes were observed under a light microscope. The expression of insulin receptor substrate 1 (IRS-1) and phosphorylation IRS-1 (Phospho-IRS-1) in tibia and femur samples were detected by immunohistochemistry. The expression of mitogen-activated protein kinase (MAPK) and phosphorylation MAPK (Phospho-MAPK), phosphatidylinositol 3-kinase (PI3K) and phosphorylation PI3K (Phospho-PI3K), protein kinase B (AKT1) and phosphorylation AKT1 (Phospho-AKT1) in tibia and femur samples were detected by Western blot.

RESULTSThe offspring rats from the high-fat diet group showed a significant shorter body length compared with those from the control group (P<0.05). The level of serum IGF-I in offspring rats from the high-fat diet group decreased by 20.1% in comparison to those from the control group, but there was no significant difference between the two groups (P>0.05). Fatty degeneration was found in livers of both high-fat diet-fed maternal rats and their offspring rats under a light microscope. There were no significant differences in IRS-1 and Phospho-IRS-1 expression in chondrocytes of tibia and femur samples between the offspring rats of the two groups (P>0.05). The protein expression of MAPK in chondrocytes of tibia and femur samples of offspring rats from the high-fat diet group was higher than that from the control group (P<0.05). There were no significant differences of PI3K and AKT1/Phospho-AKT1 between the offspring rats of the two groups (P>0.05).

CONCLUSIONSA maternal high-fat diet before and during pregnancy may affect the bone growth of offspring rats in utero, which is possibly associated with the decreased IGF-I level. However, further study on the exact mechanism of IGF-I on the bone growth is needed.

Animals ; Bone Development ; Diet, High-Fat ; Female ; Insulin-Like Growth Factor I ; analysis ; Liver ; pathology ; MAP Kinase Signaling System ; Maternal Nutritional Physiological Phenomena ; Phosphatidylinositol 3-Kinases ; physiology ; Pregnancy ; Proto-Oncogene Proteins c-akt ; physiology ; Rats ; Rats, Sprague-Dawley

Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.
Body Mass Index ; Breast Feeding ; Diabetes Mellitus, Type 2* ; Diabetes, Gestational* ; Diet ; Epidemiology ; Female ; Glucose ; Glucose Intolerance ; Humans ; Incidence ; Insulin ; Life Style ; Maternal Age ; Motor Activity ; Postpartum Period ; Pregnancy ; Risk Factors