How does the macro need change in pregnancy and breastfeeding?

In the pregnancy and breastfeeding periods the energy percentages of the macronutrients do not change, but the absolute floors rise. In the table Türkiye Beslenme Rehberi (TÜBER), Türkiye's national dietary guideline, has prepared for these periods, carbohydrate stays at 45-60 percent of energy, protein at 12-20 percent and fat at 20-35 percent, the same as for adult women; what changes are the floors given in grams.

The change on the carbohydrate side

For adult women the lower limit of carbohydrate is at least 130 grams a day. In pregnancy this floor rises to 175 grams, and in the breastfeeding period to 210 grams. The percentage range staying fixed while the floor rises means that daily energy rises as well. The guideline writes this floor as an adequate intake; that is, it is not a ceiling that is risky to exceed but a threshold that should not be gone below.

On the sucrose side the limit is the same in all three groups: at most 10 percent of energy. The dietary fiber target does not change either, it is 25 grams a day in all three groups; the guideline stresses this separately for gut health in the pregnancy and breastfeeding period.

The change on the protein side

For these periods the guideline sets a moderate level of protein intake as the best level. The amount of protein recommended to be taken in daily is on average 70 grams, or 12-20 percent of energy; in the guideline's words this amount is 25 grams more than the protein requirement of women who are not pregnant and not breastfeeding.

There are two more criteria. Daily protein intake should not fall below 70 grams, and at least 50 percent of that amount should come from animal-based proteins. In the protein table the additional amounts are given period by period: 1 gram a day in the first three months of pregnancy, 9 grams in the second three months, 28 grams in the last three months; 19 grams in the first six months of breastfeeding and 13 grams after that.

The change on the fat side

The total fat share stays at 20-35 percent, and the statement given for saturated fat is the same in all three groups: as little as possible. The item that changes is omega-3. While the value given for the total of EPA and DHA in adult women is 250 milligrams a day, in pregnant and breastfeeding women it rises to 250-350 milligrams.

On the cholesterol side the limit goes down. Cholesterol intake, which is recommended to be kept below 300 milligrams a day in adults, is kept below 200 milligrams in pregnant women.

An additional criterion in choosing fish

While the omega-3 target rises, the choice of source narrows. The guideline recommends eating 300-400 grams of fish a week in these periods, and preferring oven cooking, steaming or grilling over frying. It asks that a balanced meal be built alongside it with plenty of salad, soup and whole grain bread.

The choice criterion is fish whose EPA and DHA content is high and whose mercury content is lowest; the ones the guideline counts are salmon, herring and trout. Avoiding raw fish because of the risk of bacterial illness is stated separately. In the pregnancy section it is asked that anchovy, horse mackerel, bonito, mackerel, sea bass, trout, tuna and farmed salmon, whose mercury content is low, be preferred, and that shellfish such as mussels, which live in the deep and whose mercury content may be higher, and fish such as turbot and swordfish, not be preferred.

The fluid side

The adequate intake given for water rises in these periods too. The value, which is 2.0 liters a day in adult women, goes up to 2.3 liters in pregnancy and to 2.7 liters in the breastfeeding period.

Why are these periods calculated separately?

The guideline builds the reason over the health of both sides: the composition and the quality of the diet in the pregnancy and breastfeeding period is decisive for the health of both the mother and the baby. That is why the macro tables are given in a column separate from that of adult women.

On the omega-3 side the reason is more concrete still. The body cannot produce omega-3 fatty acids itself, and regular fish consumption in these periods can improve the health of both the baby and the mother; the guideline states that EPA and DHA play an active role in retina and brain development in babies.

The reason for the rise on the fluid side is written down as well: the fluid that gathers in the mother's tissues in the pregnancy and breastfeeding period, and the requirement that rises with it, pull the daily intake target up.

The numbers here are reference intake values; in the pregnancy and breastfeeding period the plan is carried out not with a table but with follow-up. This content has been prepared to support general nutrition literacy; it does not take the place of medical diagnosis or treatment and does not carry the character of personal nutrition advice. A personalized plan is prepared only by a qualified dietitian; if there is pregnancy, chronic illness, regular medication use, child nutrition or a clinical condition, supervision by a doctor and a dietitian is required before starting a plan.