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Suggest Treatment For Malnutrition During Pregnancy

Posted on Fri, 11 Jul 2014

Question: I am 22, almost 23 weeks pregnant with twins. I had a very very bad first trimester and even the beginning of second trimester in terms of morning sickness. Diet was very bland...I am certain, that while I got some protein and fruits and veggies, I didn't get in as much as I should have....
Baby A is in the 47th percentile....Baby B is on verge on IUGR at 11th percentile....very scared that both are damaged due to malnutrition....I have had a hard time getting in the 2500 calories/day dr suggested. I am very worried both are suffering from malnutrition and will be damaged?
Now that I am feeling better is it possible for them to catch up as far as nutrients or is damage done?
I should mention that I took prenatal vitamin every day even when sick, and was prescribed Folgard for MTHFR, their spines looked fine at anomaly scan...so did cleft lip/palate...all good....
Baby B also has small brain structures but she could just be a tiny baby, had a fetal MRI today because she is always in a weird position when they try and do ultrasound
I also started out pregnancy with extra weight....BMI about 32 I think when I got pregnant
Are babies OK? Is their IQ permanently damaged?
ps I have gained about 14 pounds so far...can babies be malnourished if I have gain weight?
Please help

Answered by Dr. Dr. Soumen Patra (50 minutes later)

Brief Answer:
MALNUTRITION CAN CAUSE IUGR BABY.

Detailed Answer:
Hello,

Thanks for writing to us. I have 3 comments regarding your queries:

1) Malnutrition during pregnancy period is often associated with IUGR or delayed development. You have taken prenatal vitamin supplements regularly and it will definitely help in babies growth & development. I suggest you to take adequate healthy protein diet and green vegetables throughout the pregnancy period as you feel better now. Drink more water or fruit juice for better feto -placental circulation.

2) Small brain structure in Baby B may be associated with neuro-developmental anomaly. However, your baby may be neurologically normal in generalized IUGR. Kindly, upload recent anomaly scan and MRI report to assist you better.

3) Total weight gain in pregnancy period is around 11-15 kg (1+ 5-7 + 5-7 kg according to each trimester). If you are gaining weight recently, then chance of malnourished baby will be quite low and it will be corrected over the time. You should do periodic check up to your doctor and undergo necessary ultrasound scan & other investigations for monitoring.

Hope, it helps for your information. Kindly, close the discussion if you don't have any other query.

Wish your good health and successful motherhood.

Regards,
Dr Soumen

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Soumen Patra (26 minutes later)

My weight gain has been small but steady throughout pregnancy pretty much. I read for someone with my BMI, I should gain between 15-25 lbs....but there are two babies, so I am trying to get to 35 lb mark. Is that enough

Can malnourishment be corrected during remainder of pregnancy or is damage already done? Does this effect IQ of baby?

I have been trying to eat the whole time, was just very sick and baby A is measuring perfect...

I don't have the MRI to upload at this time, test was just done today

Answered by Dr. Dr. Soumen Patra (15 hours later)

Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for follow up queries.

1) According to your BMI (32), you are under obese mother category and 25-42 lbs weight gain (as per latest data) will be ideal in your pregnancy period.

2) You should take healthy protein diet and other supplements as advised earlier for better growth and development of babies. IUGR can be corrected over the time with appropriate management.

3) Your weight gain (14 lbs) at 23 weeks is slight UNDER normal range. If you don't gain weight much in the later weeks, then IUGR may turn into severe form and in that case, baby I.Q may be affected.

Do periodic check up to your obstetrician and follow advices accordingly. Drink more water or fruit juice. Try to avoid mental stress and take adequate rest.

Hope, it helps for you. kindly, close the discussion.

Good luck and all the best.

Regards,
Dr Soumen

Above answer was peer-reviewed by : Dr. Prasad