Being a mother is full of challenges. Many of these challenges are obvious, but from a nutritional perspective there are many hidden challenges that start even before pregnancy, continue throughout pregnancy, during breast-feeding and for many years beyond.

QUESTION: What are the major nutritional challenges prior to becoming pregnant?

ANSWER: Supporting a successful pregnancy requires starting off with a healthy body that has been well nourished for some time. Although women generally need fewer calories than men, there are some key nutrients that women require in greater amounts.

For example, recommended iron intake for a woman is more than double the recommendation for a man. During pregnancy it increases to more than three times what men need. Starting pregnancy with low iron stores can be difficult and potentially damaging for both the mother and developing child — especially the child’s brain development.

Meeting the need for iron and dozens of other nutrients prior to pregnancy is essential.

Q: What are the major nutritional concerns during pregnancy?

A: Along with eating enough to gain the appropriate amount of weight during pregnancy, a woman needs to consume adequate amounts of all essential nutrients. The nutrients most likely to be in short supply and to compromise the normal development of a fetus include iron, iodine, folic acid and choline. Short supply of these can impair brain and neural tube development in the fetus.

During a normal childbirth a woman loses almost a pint of blood and about twice that much with a cesarean birth. This represents a substantial loss of iron from a woman’s body on top of the iron provided to the developing fetus.

Consequently, many women are iron-depleted and iron-deficient after giving birth. This can result in exhaustion and depression, among other things, and can cause postpartum depression in many new mothers.

Q: How does breast-feeding affect a mother’s nutritional needs?

A: Production of breast milk requires calories, protein and calcium, among other things. Much of the needed calories can come from a woman’s body fat stores that are established during a healthy pregnancy. However, an inadequate supply of protein and calcium in the diet causes the body to pull these components from the mother’s bones.

One often overlooked nutritional need for breast milk is iodine. Recommended intake almost doubles for a woman who is breast-feeding. Inadequate iodine has been linked to increased risk for the infant developing autism. Iodine levels in the American diet have declined over recent decades, largely due to reduced iodized salt intake.

Of course, the nutritional challenges of being a mother continue after breast-feeding. Life gets busy in ways that can decrease physical activity and opportunities for exercise.

Despite declining calorie needs, a woman’s diet still requires adequate amounts of all essential nutrients. Until after menopause, women still need more than twice as much iron as men and even more with a vegetarian or vegan diet. Taking a basic daily multivitamin/mineral supplement can help to provide these nutrients in a lower-calorie diet.

Without a doubt, from a nutritional perspective, it is much more challenging to be a woman than a man, and it’s even more challenging to be a mother! Happy Mother’s Day!

Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa. Dobbs also works with University Health Services.