Adequacy of Nutrition for Pregnant Women during the Fasting Month

Friends of Hermina must know, is it okay for Hermina's friends who are currently pregnant in both the early and final trimesters to fast in the month of Ramadan?

Fasting during the month of Ramadan is an obligation for all Muslims, and of course Hermina's best friend, who is currently waiting for the arrival of a baby, definitely wants to take part in fulfilling this obligation.

Fasting is in principle permissible if the mother and her baby-to-be are declared healthy by the doctor and do not have certain medical conditions that need to be watched out for. There are several concerns that are usually felt by pregnant women about fasting during the month of Ramadan, especially the effect on the health and weight of the baby.

Based on research conducted in 2018 which involved more than thirty thousand pregnant women, of which nearly 19,000 of them were fasting during the month of Ramadan, it was found that there was no difference in the average baby's weight if the mother was still getting adequate nutrition. Therefore fasting will not only result in low baby weight, as long as the daily calorie and nutritional needs needed by pregnant women can be met at dawn and breaking the fast. In addition, fasting also does not increase the risk of preterm birth in healthy pregnancies.

There are things that need to be understood before the mother performs fasting, especially regarding the nutritional needs of pregnant women.

Pregnant women have higher daily calorie needs in each trimester than women who are not pregnant. In the first trimester, pregnant women with ideal body weight will need 1,800 kcal/day, in the second trimester, 2,200 kcal/day, while in the third trimester, pregnant women's calorie needs reach 2,400 kcal/day.

The calorie needs of pregnant women also vary according to the nutritional status of the mother before pregnancy. Pregnant women with low body weight tend to require higher calorie intake and are targeted to gain more weight than those with normal nutritional status. The following is the recommended weight gain target during pregnancy for pregnant women in Indonesia. Mothers with BMI < 18.5 are advised to gain 12.5-18 kg in weight during pregnancy, BMI 18.5-22.8 is targeted to increase body weight 11.5-16 kg, BMI between 22.9-27.5 is expected to maintain weight gain between 7-11.5 kg, whereas For mothers with a BMI > 27.5 it is expected to be able to maintain a weight gain of < 7 kg.

Monitoring body weight is one method of monitoring the adequacy of calories for pregnant women. Generally, the dominant weight gain occurs when the gestational age enters the end of the second trimester to the end of the third trimester (0.3-0.5 kg/week). This needs to be considered and paid attention to when the mother decides to fast during the month of Ramadan. the adequacy of the target calories and weight to be achieved must be met from the consumption of food and drinks at dawn and breaking the fast.

The type of food consumed should also be considered. Consumption of balanced nutrition containing enough carbohydrates, protein, fat, vitamins and minerals must be fulfilled to meet the needs of mother and baby.

Food choices that should be consumed during pregnancy must meet the needs of carbohydrates, proteins, fats, vitamins and minerals. Bread, cereal, rice and pasta are examples of high-carb foods. They turn into the main energy for the body of mother and baby. Whole grain and fortified products contain folic acid and iron. Consumption of vegetables and fruits which are the main sources of vitamins A and C, folic acid, iron, potassium, magnesium and fiber which are good for the fetus is recommended up to 4-5 servings a day. Choose fresh fruit and juice, of course, better than frozen or canned fruit with added sugar or sweeteners.

It is recommended to consume 3 servings of meat, poultry, fish, dried beans, eggs and nuts a day to meet the needs of B vitamins, protein, iron and zinc. In addition, protein, calcium and phosphorus can also be obtained from the consumption of milk, yogurt and cheese. Pregnant women still need fat in moderation. Fat provides long-term energy for growth and is needed for brain development.

Therefore, the amount and type of food consumed needs to be prepared properly at dawn and breaking the fast.

Apart from nutrition, fluid requirements must also be considered, pregnant women are advised to consume at least 2-3 liters of fluids per day to avoid fluid deficiency or dehydration. This liquid includes the consumption of water, milk, juice, and liquid foods such as soup. Consumption of liquids such as milk and juice, of course, apart from meeting the mother's fluid needs, can also help meet her daily calorie needs.

However, there are other studies which show that pregnant women who fast in the first trimester tend to have a 1.5 times higher risk of experiencing fetal growth disorders than those who do not fast. This is related to the process of formation of the placenta and important organs which all occur in the first trimester and this is greatly influenced by the adequacy of micronutrients, vitamins and minerals in early