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Energy requirements during pregnancy and lactation

  • Nancy F Butte (a1) and Janet C King (a2)

To estimate the energy requirements of pregnant and lactating women consistent with optimal pregnancy outcome and adequate milk production.


Total energy cost of pregnancy was estimated using the factorial approach from pregnancy-induced increments in basal metabolic rate measured by respiratory calorimetry or from increments in total energy expenditure measured by the doubly labelled water method, plus energy deposition attributed to protein and fat accretion during pregnancy.


Database on changes in basal metabolic rate and total energy expenditure during pregnancy, and increments in protein based on measurements of total body potassium, and fat derived from multi-compartment body composition models was compiled. Energy requirements during lactation were derived from rates of milk production, energy density of human milk, and energy mobilisation from tissues.


Healthy pregnant and lactating women.


The estimated total cost of pregnancy for women with a mean gestational weight gain of 12.0 kg, was 321 or 325 MJ, distributed as 375, 1200, 1950 kJ day-1, for the first, second and third trimesters, respectively. For exclusive breastfeeding, the energy cost of lactation was 2.62 MJ day-1 based on a mean milk production of 749 g day-1, energy density of milk of 2.8 kJ g-1, and energetic efficiency of 0.80. In well-nourished women, this may be subsidised by energy mobilisation from tissues on the order of 0.72 MJ day-1, resulting in a net increment of 1.9 MJ day-1 over non-pregnant, non-lactating energy requirements.


Recommendations for energy intake of pregnant and lactating women should be updated based on recently available data.

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4 A Kelly , J Kevany , M de Onis , PM Shah . A WHO collaborative study of maternal anthropometry and pregnancy outcomes. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics 1996; 53: 219–33.

6 KM Merchant , J Villar , E Kestler . Maternal height and newborn size relative to risk of intrapartum caesarean delivery and perinatal distress. BJOG: an International Journal of Obstetrics and Gynaecology 2001; 108: 689–96.

7 KE Pickett , B Abrams , S Selvin . Maternal height, pregnancy weight gain, and birthweight. American Journal of Human Biology: the Official Journal of the Human Biology Council 2000; 12: 682–7.

17 NGJ Pipe , T Smith , D Halliday , CJ Edmonds , C Williams , TM Coltart . Changes in fat, fat-free mass and body water in normal human pregnancy. British Journal of Obstetrics and Gynaecology 1979; 86: 929–40.

19 NF Butte , JM Hopkinson , K Ellis , WW Wong , MS Treuth , EO Smith . Composition of gestational weight gain impacts maternal fat retention and infant birth weight. American Journal of Obstetrics and Gynecology 2003; 189: 1423–32.

30 NJ Fuller , SA Jebb , MA Laskey , WA Coward , M Elia . Four-component model for the assessment of body composition in humans: comparison with alternative methods, and evaluation of the density and hydration of fat-free mass. Clinical Science 1992; 82: 687–93.

50 PJ Illingworth , RT Jung , PW Howie , TE Isles . Reduction in postprandial energy expenditure during pregnancy. British Medical Journal 1987; 294: 1573–6.

56 MJ Edward , J Metcalfe , MJ Dunham , MS Maul . Accelerated respiratory response to moderate exercise in late pregnancy. Respiration Physiology 1981; 45: 229–41.

58 JVGA Durnin . Energy requirements of pregnancy. Diabetes 1991; 40: 152–6.

60 D Schoeller . Limitations in the assessment of dietary energy intake by self-report. Metabolism Clinical and Experimental 1995; 44: 1822.

61 CA Lindsay , L Huston , SB Amini , PM Catalano . Longitudinal changes in the relationship between body mass index and percent body fat in pregnancy. Obstetrics and gynecology 1997; 89: 377–82.

65 L Gortzak-Uzan , M Hallak , F Press , M Katz , I Shoham-Vardi . Teenage pregnancy: risk factors for adverse perinatal outcome. Journal of Maternal-fetal Medicine 2001; 10: 393–7.

66 J Larsson , L Svanberg . Teenage deliveries in a Swedish population in the 1970's. Acta Obstetricia et Gynecologica Scandinavica 1983; 62: 467–72.

68 T Lao , L Ho . The obstetric implications of teenage pregnancy. Human reproduction 1997; 12: 2303–5.

69 M Jolly , N Sebire , J Harris , S Robinson , L Regan . Obstetric risks of pregnancy in women less than 18 years old. Obstetrics and Gynecology 2000; 96: 962–6.

70 A Prentice , A Paul , A Black , T Cole , R Whitehead . Cross-cultural differences in lactational performance. In: M Hamosh , AS Goldman , eds. Human Lactation 2: Maternal and Environmental Factors. New York: Plenum Press, 1986; 1344.

73 C Garza , NF Butte . Energy concentration of human milk estimated from 24-hour pools and various abbreviated sampling schemes. Journal of Pediatric Gastroenterology and Nutrition 1986; 5: 943–8.

74 AM Prentice , A Prentice . Energy costs of lactation. Annual Review of Nutrition 1988; 8: 6379.

79 NB Brent , B Redd , A Dworetz , F D'Amico , JJ Greenberg . Breast-feeding in a low-income population. Archives of Pediatrics and Adolescent Medicine 1995; 149: 798803.

85 PJ Illingworth , RT Jung , PW Howie , P Leslie , TE Isles . Diminution in energy expenditure during lactation. British Medical Journal 1986; 292: 437–41.

90 SB Roberts , AA Paul , TJ Cole , RG Whitehead . Seasonal changes in activity, birth weight and lactational performance in rural Gambian women. Transactions of the Royal Society of Tropical Medicine and Hygiene 1982; 76: 668–78.

96 SA Lederman , A Paxton , SB Heymsfield , J Wang , J Thornton , RN Pierson Jr. Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstetrics and Gynecology 1997; 90: 483–8.

102 NF Butte , C Garza , EO Smith , BL Nichols . Human milk intake and growth of exclusively breast-fed infants. Journal of Pediatrics 1984; 104: 187–95.

103 NF Butte , WW Wong , L Ferlic , EO Smith . Energy expenditure and deposition of breast-fed and formula-fed infants during early infancy. Pediatric Research 1990; 28: 631–40.

104 KG Dewey , MJ Heinig , LA Nommsen , B Lonnerdal . Adequacy of energy intake among breast-fed infants in the DARLING study: relationships to growth velocity, morbidity, and activity levels. Journal of Pediatrics 1991; 119: 538–47.

105 KJ Motil , H-P Sheng , CM Montandon , WW Wong . Human milk protein does not limit growth of breast-fed infants. Journal of Pediatric Gastroenterology and Nutrition 1997; 24: 10–7.

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Public Health Nutrition
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