Folic acid:
Folate is essential for production and growth of healthy cells in the body, particularly embryonic development. Its deficiency can result in a form of anemia called megaloblastic anemia in the mother, but the most detrimental effect on the fetus is that it can drastically affect the brain and spinal cord development of the baby. It is collectively grouped under the heading Neural Tube Defects. These can range from spins bifida, i.e. malformation of bone around spinal cord to anencephaly, which is absence of formation of cerebral part of brain along with the absence of the covering skull bone. These defects occur very early in pregnancy and hence adequate folic acid supplementation is mandatory during the start of pregnancy or even earlier, during pre-pregnancy planning.
Iron:
Iron forms an essential part in the formation of hemoglobin which carries oxygen to the various tissues n the body. In India 60-80% women have deficient stores of iron, which gets manifested during pregnancy as pregnancy is an iron demanding state. The fetus absorbs the maternal iron irrespective of the status of maternal iron stores, resulting in further depletion of iron stores in the mother. Iron deficiency causes tiredness, easy fatigability in the mother as well as increases the chances of a preterm delivery. Anemia can cause bleeding during pregnancy, or post partum hemorrhage, thereby accentuating the anemia. This mandates us to have adequate iron stores during the entire pregnancy. Iron supplementation is the cornerstone of nutritional supplementation in pregnancy, in addition to dietary modification to have iron rich food.
Natural sources of iron are dry fruits like almonds and dates, spinach and other green leafy vegetables, jaggery, fruits like apples, plums, lentils and beans and non-vegetarian sources like chicken and fish. It is advisable to avoid consuming beverages like tea, coffee or aerated drinks along with iron rich food, whereas including vitamin C rich foods like orange juice or amla to improve iron absorption. Kindly have adequate amount of water and fluids to avoid constipation experienced by a few women with iron supplements intake.
Calcium:
As the second trimester starts calcium supplements are included in prescription by the doctor. As the baby starts growing, calcium is required for its bone development along with small amounts of vitamin D. If this supplementation is not made optimal, the baby can develop vitamin D deficiency or Rickets, a disease of growing bones with reduced bone strength leading to bending of long bones off hands and feet. It also causes dental deformities, softening of bones as well as poor muscle strength.
The natural sources of calcium are milk and dairy products, fruits like custard apple, cereals like ragi and nachni, and non-vegetarian food like chicken and meat. The rich source of vitamin D is exposure to sun light. The calcium and vitamin D supplementation should be carried out throughout the pregnancy as well as during the periods of breastfeeding to ensure adequate supply to the growing baby.