The quantitative effects of maternal dietary energy intake on pregnancy and lactation in rural Gambian women

Abstract

The quantitative relationships between dietary energy intake and weight gain in pregnancy, birthweight and lactation performance during the first three months of infancy have been studied in such a way as to take account of major differences in the patterns of heavy manual labour at different times of the year in a subsistence farming community. Maternal weight gain and the accumulation of subcutaneous fat were significantly lower when the last trimester of pregnancy fell during the time of heaviest farm work and lowest energy intakes. The birth-weight of babies was also significantly correlated with differences in energy intake throughout the year. During early lactation breast milk yields were significantly related to concomitant alterations in the subcutaneous fat stores. Evidence has been produced which suggests that in undernourished nursing women there could be a competition for dietary energy between the repleting maternal subcutaneous fat organs and the mammary glands at the expense of milk production.

PIP: The attempt was made to define more exactly the relationship between food intake, maternal nutritional and anthropometric status, the infant's birth weight and the mother's subsequent lactation performance in relation to changes in the pattern of farming activities in the Gambia village of Keneba. From January to December 1977, 29 women were studied longitudinally from the 7th month of pregnancy to the 3rd month of lactation. The mothers ranged in age from 16-40 and the older women had as many as 10 children. The food intake of the women was measured on 4-6 days each month by weighing all meals eaten. Maternal weight gain and the accumulation of subcutaneous fat were found to be significantly lower when the last trimester of pregnancy fell during the time of heaviest farm work and lowest energy intakes. The birth weight of the infants was significantly correlatd with differences in energy intake throughout the year. During early lactation breast milk yields were significantly related to concomitant alterations in the subcutaneous fat stores. The findings suggest that maternal energy balance has a quantifiable effect both on weight gain during pregnancy and the infant's weight at birth. The exact relationship between food intake and the progress of pregnancy is dependent upon the level of activity of the mother as well as the energy content of the food. Strong circumstantial evidence was provided that dietary intake during pregnancy is of crucial importance for lactation capacity because of the building up of subcutaneous fat stores.