Long-term energy balance in child-bearing Gambian women

The energy intake of 143 pregnant and lactating Gambian women was measured prospectively each week for a year. Anthropometric, birth weight, and breast milk output measurements were also obtained. The average energy intakes (+/- SE) during the dry and wet seasons respectively were: pregnancy, 1483 +/- 22 and 1417 +/- 41 kcal/day; lactation (1st trimester), 1773 +/- 31 and 1474 +/- 42 kcal/day; lactation (subsequent trimesters), 1662 +/- 16 and 1413 +/- 37 kcal/day. Pregnant women gained 1.4 kg body weight per month in the dry season, but only 0.4 kg in the wet season. Lactating women gained weight in the dry season and lost weight in the wet season. Maternal nutritional status did not deteriorate with increasing parity. Mean birth weights (+/- SE) were: 2.94 +/- 0.07 and 2.78 +/- 0.11 kg in dry and wet seasons, respectively. Breast milk output and quality and early infant growth were close to values from well-nourished communities during the dry season, but deteriorated markedly during the wet season. Wet season energy intakes were clearly inadequate, but these results indicate that, despite being low by international standards, the dry season intake was compatible with a good lactational performance. Except for a somewhat low birth weight, which is partly explained by small maternal stature, progress during pregnancy was also remarkably normal during the dry season.