Dietary Choices of New Zealand Women during Pregnancy and Lactation

Abstract

Dietary recommendations during pregnancy and lactation have become increasingly complex, and sources of information more numerous but not always reliable, potentially causing confusion and unsafe choices. Women were recruited during pregnancy or within six months postpartum and completed questionnaires on dietary choices, food safety, and sources of nutrition information. Women (n = 458) from around New Zealand participated in the study. They consumed a wide range of foods and beverages and reported various dietary changes. In pregnancy, women commonly avoided alcohol (92%), raw milk products (86%), and raw, smoked, or pre-cooked seafood and fish (84%), and made changes due to food safety concerns. Influential advice was acquired from a range of sources including midwives (37%) and the New Zealand pregnancy and breastfeeding guidelines (25%) during pregnancy. Food avoidance was less common in lactation. However, fewer women consumed milk products during lactation (64%) than pregnancy (93%). Potentially unreliable sources were used more frequently in lactation including alternative health practitioners (26%) and family or friends (12%), and dietary changes were often made in response to infant symptoms without supporting evidence. This study highlighted a need for good communication of evidence-based recommendations to women, especially during lactation.

Adherence to Dietary Guidelines among Women with and without Gestational Diabetes: Evidence from the Growing up in New Zealand Study

“…A survey of 400 pregnant women in Australia found that 65% of women were not familiar with the Australian Guide to Healthy Eating for pregnancy and reported limited differences in women’s nutrition knowledge according to whether women had accessed a dietitian/nutritionist [ 40 ]. There are no reports of women’s knowledge of dietary guidelines in New Zealand; however, there are reports indicating that women in New Zealand do make dietary changes during pregnancy [ 34 , 41 , 42 ]. A survey of 458 women in New Zealand found that, although some women reported using the Ministry of Health’s FNGPB, midwives were the most influential source of dietary information during pregnancy, with over 75% of women reporting receiving dietary advice from their lead maternity carer, consistent with findings previously reported in the same cohort of women included in this study [ 34 ].…”

Standardized Recipes and Their Influence on the Environmental Impact Assessment of Mixed Dishes: A Case Study on Pizza

“…The population average of the daily pizza intake was determined by the day 1 reported intake in three survey cycles (2011-2012, 2013-2014, and 2015-2016) for participants older than 25 years old, excluding pregnant and lactating women (N = 13,332). Pregnant and lactating women were excluded from this analysis due to the special diet that they typically follow that is likely not to be representative of the average population, especially in the case for pizza that often contains processed meat-a food item that is often avoided during pregnancy and lactation [20,21]. Furthermore, this analysis focused on the diets of adults >25 years old in alignment with dietary risk factors by the Global Burden of Disease reports [22], which is critical for the evaluation of healthy and sustainable foods [23][24][25][26].…”

Maternal food‐avoidance diets and dietary supplements during breastfeeding

“…In a study from Poland, 29.1% of breastfeeding mothers reported eliminating certain foods (Karcz et al, 2020 ), while 70% of breastfeeding women in a New Zealand study (Brown et al, 2020 ) and 100% (145) in a Korean study (Jeong et al, 2017 ) avoided specific foods or beverages. The types of foods avoided vary, as do the reasons for avoiding them.…”

“…Prevention of allergies, cultural background, peer pressure and symptoms in the child were reported in Poland (Karcz et al, 2020 ). In New Zealand, dairy products were avoided due to a belief that dairy causes infant colic, reflux or allergic symptoms (Brown et al, 2020 ). In Korea, caffeine (90.3%), spicy foods (85.5%) and raw foods (75.2%) were most frequently avoided during breastfeeding, adding to the 12.4% who avoided milk and the 13.1% avoiding wheat without a specified reason (Jeong et al, 2017 ).…”

“…In Norway, supplementation with vitamin D or cod liver oil is recommended (The Norwegian Directorate of Health, 2019a ), while in Sweden, women are advised to choose foods rich in vitamin D, omega‐3 fats and folic acid (Swedish Food Agency, 2019 ). Two recent reports found that 70% of breastfeeding women in the United States used one or more dietary supplements (Jun et al, 2020 ) while a study from New Zealand found that 26% used folic acid, 63% iodine and 60% alternative supplements during breastfeeding (Brown et al, 2020 ). Dietary supplements during breastfeeding should be used with care: women should be sure that composition and purity are known (Berlin & van den Anker, 2013 ; Swedish Food Agency, 2019 ) and avoid high doses or intake of several supplements containing the same nutrient (The Norwegian Directorate of Health, 2014 ).…”