Pregnant and Breastfeeding Women: Drinking for Two?

The primary aim of this cross-sectional survey was to assess the total fluid intake (TFI; sum of drinking water and all other fluids) and the intake of water and all other types of beverages in a sample of pregnant and breastfeeding women representative of Java-Island, Indonesia. Therefore, 299 pregnant and 296 breastfeeding women completed a 7-day fluid-specific record. A secondary aim was to estimate the total water intake (TWI; sum of water from fluids and food moisture), and one 24-h recall was performed to determine water intake from food moisture. The median TFI of pregnant and breastfeeding women were 2,250 (1,800-2,800) and 2,360 (1,954-2,968) mL/day, respectively. The largest contributor to TFI was water (72 and 77% for pregnant/breastfeeding women, respectively). Pregnant women to the extent of 42% and 54% of breastfeeding women did not reach the adequate intake (AI) of water from fluids. In pregnant and breastfeeding women, the median water intake from foods was 592 and 613 mL/day, representing 21 and 20% of TWI. Concluding that a high proportion of the pregnant and breastfeeding subjects did not reach the AI of water from fluid, it seems important to put in place actions such as providing education materials and ensuring access to safe water. Moreover, future surveys should dedicate attention to the assessment of fluid intake and hydration status among pregnant and breastfeeding women in other countries.

Fluid Intake of Pregnant and Breastfeeding Women in Indonesia: A Cross-Sectional Survey with a Seven-Day Fluid Specific Record.

During pregnancy and lactation, the adequate intake (AI) for total water intake is increased. This cross-sectional survey aimed to assess Total Fluid Intake (TFI; sum of drinking water and all other fluids) of 300 pregnant and 300 breastfeeding women in Indonesia. A seven-day fluid specific record was used to assess TFI. Mean TFI of pregnant and breastfeeding women were 2332 ± 746 mL/day and 2525 ± 843 mL/day, respectively. No significant difference in TFI between pregnancy trimesters was observed, while TFI of women breastfeeding for 12-24 months postpartum (2427 ± 955 mL/day) was lower than that of the two other groups (0-5 months: 2607 ± 754 mL/day; 6-11 months: 2538 ± 807 mL/day, respectively). Forty-two and 54% of the pregnant and breastfeeding subjects, respectively, did not reach the AI of water from fluids. These AI were actually known by only 14% and 23% of the pregnant and breastfeeding subjects. However, having the knowledge about the AI did not increase the odds of reaching the AI. Concluding that a high proportion of the pregnant and breastfeeding subjects did not reach the AI of water from fluid, it seems pertinent to further assess the fluid intake, as well as their hydration status, in other countries.

Total fluid intake assessed with a 7-day fluid record versus a 24-h dietary recall: a crossover study in Indonesian adolescents and adults.

PURPOSE: To compare total fluid intake (TFI), defined as the sum of water and all other fluid types, assessed with a 24-h dietary (food and fluid) recall with mean TFI assessed with a 7-day fluid-specific record among adolescents and adults. METHODS: This repeated cross-sectional study compared TFI as assessed by two fluid assessment instruments using a crossover approach. 290 adolescents (17.3 ± 0.8 years, 50 % boys) and 289 adults (43 ± 9.3 years, 50 % men) from Indonesia completed the study. RESULTS: Significant correlations were observed between fluid intake assessed with the 24-h recall and the 7-day fluid record (r = 0.333; p < 0.001). The Bland-Altman method, however, showed an underestimation (bias) of mean TFI by a 24-h recall when compared with the 7-day fluid record [mean difference (95 % CI) -382 mL (-299, -465); p < 0.001]. The mean difference also increased with increasing TFI: Mean difference for the lowest and highest quartiles of TFI was 139 versus -1265 mL/day. The 7-day fluid record recorded two (95 % CI -1.9, -2.4; p < 0.0001) extra drinking acts compared with the 24-h recall, whereas the mean volume per drinking act was significantly higher with the 24-h recall [mean difference (95 % CI) 39 mL (31, 47); p < 0.001]. CONCLUSION: Compared with a 7-day fluid record, a 24-h dietary recall significantly underestimated TFI. Subjects recalled two less drinking acts, while estimating the volume consumed per drinking act to be larger. Since the adequate intakes for total water intake are based on median intakes observed in national surveys that most frequently used the 24-h recall method, they may potentially be underestimated.