The health and development of the child depends on the nutrition of the expectant mother. Please tell us what the child’s diet should be during its intrauterine life.
– Health programming begins long before the birth of the child and continues for at least a couple of years after birth. This means that during the entire nine months that the fetus is in the mother’s belly, its health is being programmed. The mother’s diet, her lifestyle, and everything that surrounds her make a significant contribution.
It is no secret that humanity has gone through different stages throughout its history. And even during my work as a pediatrician, there were different trends. For example, women once believed that in order to give birth well, to avoid stretch marks, you need to limit yourself in protein. And even those who always ate meat began to go on a plant-based diet. Of course, the children of such mothers were born underweight. But it was easier for them to pass through the birth canal.
But if we turn to scientific data, there is an interesting phenomenon of the hungry Dutch winter. In the Netherlands, during one of the war years, women were very hungry. As a result, they gave birth to underweight babies. The most interesting thing began later, when these children very quickly, as compensation, began to gain weight and became fat. But the main thing is that this was passed on to the next generation. That is, years later, these people became parents of underweight children again, who again quickly became fat. This must be realized: obesity in a child is laid down at the moment when the mother approaches her own nutrition irrationally.
Therefore, it is very important that the diet of the expectant mother is balanced, especially in terms of protein, there should not be an imbalance in favor of carbohydrates. The longer the term, the more the body’s need for protein increases. Therefore, it is necessary to follow the recommendations of doctors, monitor how the child gains weight. As for drinking, this is individual.
– What to do with selective taste during pregnancy?
– There is nothing wrong with that. For example, I really wanted tomato juice during my pregnancies, although I am indifferent to it in everyday life. But it is a question of volume. If I drank a three-liter jar of juice, I would probably have some problems. But one glass did not cause anything.
It is very important that the pregnant woman’s diet is generally balanced. Of course, there should be sources of vitamins and minerals, vegetables and fruits, that is, in addition to protein, all other components of the diet.
And another very important point – from the first days of pregnancy, the mother must tune in to breastfeeding. The dominant lactation must be formed all nine months. And when the baby is born and the mother puts it to the breast, the body will immediately receive an impetus to produce milk. If a woman does not tune in for nine months, the dominant will not form in a second.
– So, the psychological attitude is important?
– Of course. And the whole family should support the woman in this desire – to feed her child. Then she will definitely have enough breast milk. It works very clearly: you put the child to the breast – and the milk comes, you take it away from the breast – and there is nothing to express. He drank exactly as much as the body gave him. This is a psychological phenomenon that must be prepared in advance. If a woman thinks about whether to feed or not to feed the child only after birth, it may be too late. You need to work towards this decision throughout the pregnancy.
– What should a mother’s diet be like when she breastfeeds her child so that he has a strong immune system? What should you pay attention to?
– Good question. Here we must divide the answer into several parts.
First. Does the mother herself have an allergy? If so, she should immediately exclude those products to which she reacts. But only in this case. In this situation, it is not necessary to exclude all products that are allergenic, as was recommended earlier. There are eight of them, and first of all, these are cow’s milk proteins (as well as eggs, nuts and peanuts, fish and seafood, gluten and soy).
If the mother is not allergic to them, she simply drinks milk in the usual amount that is not harmful to health. But there is no need to overdo it. For example, I knew women who, wanting to feed a child, set themselves the goal of drinking four liters of milk a day. This will not improve the production of breast milk, but problems will arise.
Second. Everything should be balanced. For example, there are mothers who have given birth to a second and third child. They have little time for themselves, they are busy with children, and it is not always possible to eat normally. The family should create conditions in which the woman can eat normally herself, not snack. She feeds the baby – this is a very big burden and responsibility. Of course, she should receive a sufficient amount of vitamins and minerals. And all family members should be responsible for the health of the nursing woman.
In summer, you need to use the opportunity to eat fresh berries, vegetables, as they say, from the garden. But again, you need to carefully monitor whether there is a reaction in both the mother and the child, for example, to the same strawberries. It is imperative to get rid of chemicals in the garden. It is better if the berries are not very beautiful, with spots. Sometimes it is difficult to distinguish an allergic reaction to a product and a pseudo-allergic reaction to chemicals.
– At what age can you introduce complementary foods, what products are best to start with? When can you give fermented milk products, fish?
– In the last 20–30 years, approaches to these issues have changed. Previously, they taught that children should be given carrot or apple juice drop by drop literally from the third week of life. I dripped it to my eldest daughter, and she squealed all the time, apparently her tummy hurt, and I did not understand. It turned out that children at this age are not yet able to digest juice, since the enzymatic system is not developed.
Today, everything is clear. Up to four months, breast milk is all that a child needs. He does not even need to be given water if he does not ask for it. Nothing needs to be added to the diet if the child gains weight according to the schedule month by month.
Then the “window of tolerance” opens – from four to six months – during this period the child is ready to learn to digest other foods. This is the time when we should introduce complementary foods. Before this, he was accustomed to digesting only mother’s milk, which is produced especially for him. By the way, did you know that the composition of each woman’s breast milk is unique? It is created especially for her baby, for his special needs.
If you introduce complementary foods too early or too late, the body may lose its ability to digest other foods. And then the problems begin. After all, most often, both allergies and digestive problems begin when complementary foods are introduced either too early or too late. For example, new foods are introduced after a year. The “window” has already closed. At the same time, breastfeeding can continue for up to a year.
The website of the Union of Pediatricians has all this information, a schedule of when to introduce what products: cereals, meat, cottage cheese, fish. If the child is plump, you need to start with vegetables, if, on the contrary, he is skinny – with cereals. From seven to eight months you can give fruit purees and juices.
– We have many people with excess weight. For example, parents – one or both – are overweight. And they are very concerned that they will pass this problem on to their children. They underfeed the child, even if he was born normal, they minimize carbohydrates, put him on vegetables, fruits, protein. How can we protect our child so that he does not suffer from excess weight later?
– Yes, it happens. For example, it has already been proven that if a child is breastfed, he gains less weight in the first year of life than a child on artificial feeding. That is, if someone in the family already has problems with excess weight, it is better to be a supporter of breastfeeding from the very beginning.
But there is a catch here too. Even on breast milk, children of women with a higher body weight gain almost a kilogram more in the first two years of life than women with a normal body weight. Therefore, such a mother should be attentive to both her diet and to the weight gain of her child in the first and second years of life. For complementary feeding, you should choose vegetables, not porridge. At the same time, meat should still be consumed. And it is important not to overeat yourself.
– But excess body weight can be formed not only under the influence of excess nutrition.
– Yes, there are many factors. We have already discussed incorrect programming. The second is incorrect use of antibiotics.
Why? Because if a child starts taking antibiotics in the first, second or third year of life (mostly in the first year), he or she is at risk of becoming obese much faster than children who are not given antibiotics during the first three years.
What’s the catch here? In the work of the intestines. By the way, it has also been proven that children born by C-section also suffer more often from allergies and excess weight. Because the child, passing through the birth canal, naturally receives the mother’s microbiota. And it is the colonization of the child’s gastrointestinal tract with normal microbiota that allows him to maintain a normal weight. It has already been proven that the microbiota of people with excess weight differs from the microbiota of people with normal weight. And this is formed already in childhood.
Antibiotics kill normal microbiota. And if this process is not controlled further, if the gastrointestinal tract is not populated with normal microbes, then metabolic changes may occur in the future, including due to changes in the intestinal microbiota – “enemy microbes” will populate, not “friends”, and problems will begin.
Previously, antibiotics were included in the list of free medicines, and sometimes they were too often and absolutely unjustifiably “prescribed” to their children by parents themselves. We have long fought for such medicines to be dispensed in pharmacies only with a doctor’s prescription.
We, the pediatric community, also have a responsibility. There are doctors who prescribe antibiotics too broadly when they are not indicated. But there are also parents who self-medicate. And from this desire to quickly help the child, a whole new layer of problems is formed.
Why are we discussing this? So that everyone understands that if there are already some prerequisites in the family, you need to be more careful. You need to read special literature. There is also a huge section for parents on the website of the Union of Pediatricians. And anyone can always ask for clarification, write their question – we will always help.
I would also like to note that every Saturday we hold webinars for colleagues, we discuss all current issues in pediatrics. You can also get information there.
– Let’s talk about seasonal nutrition. Is it true that in summer you need to feed your child with vitamins to the maximum in order to get a supply for the whole year? What features should be taken into account?
– The opportunity to get fresh fruits and berries is wonderful, we need to take advantage of it. Of course, it won’t be enough for the whole year, but it will still be a reserve.
There is also such a problem as a lack of vitamin D. We have very little sun. And even in the south, some children only produce enough of this vitamin by August. Unfortunately, its amount does not depend on nutrition, but on how much time we spend in the sun, and without any sunscreen.
All other vitamins, of course, should be obtained from vegetables and fruits. The fresher they are, the better.
As for nutrition in the heat, of course, you need to eat less protein, and more easily digestible food, drink more liquid. This also applies to those moments when the child gets sick, when he has a high temperature. You can’t “push” too much food into him. It is better to give easily digestible food, for example, puree on water, not on cream, not protein. During fever, the kidneys work with special load, and it will be hard for them. As for the benefits of chicken broth, in some situations it can be useful, but it is not a panacea. Especially for allergy sufferers.
– We realized that in summer we should try to eat fresh fruits and vegetables. But what to do if there is no opportunity to pick them from the garden, from the bush? Is it possible to use some vitamin complexes as additives? And is it necessary?
– Of course, you can. And you should. But in the spring and summer, it is still better to try to make up for the lack of vitamins and microelements with food. If we are talking about the northern region or the autumn and winter period, when there is a high incidence of diseases, you should start taking vitamin complexes in a timely manner and carefully. Vitamin D is a must, you don’t even need to take tests. It is also necessary for nursing and pregnant women, as it has a positive effect on the development of the child. As for other nuances, there can be no universal advice here.
– So there should be a doctor who looks at a specific situation and prescribes a vitamin complex?
– True. There are certain signs of vitamin deficiency, such as increased irritability, decreased attention, dry skin. A competent doctor will see this right away. He can prescribe therapeutic or prophylactic doses of vitamins. This is selected individually.
– What should the diet be like if, on the contrary, it is minus 30 outside?
– There should be a lot of fats, which give a lot of energy. If you pay attention, in the classic diet of the peoples of the north there is a lot of fatty food. And the fish that lives in the northern seas is fatty. This is not just like that.
– Let’s talk about school age. For example, a child is in primary school. Do you think breakfast is important for him?
– I think so. By feeding your child a hearty meal in the morning, you will ensure that he or she will perform well at least for half a day. He or she will be able to comprehend the material that is given to him or her at school. Provided that he or she receives other necessary types of nutrition during the day. As a snack, you can give your child not chips, but celery or carrots, cut them up nicely. In many ways, choosing food is a habit that parents should cultivate.