Dietary choices of New Zealand women during pregnancy and lactation : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
Background: A woman and her offspring’s health is affected by the maternal diet during
pregnancy and lactation. Because of the importance of the diet, there is a large emphasis on
women making optimal dietary choices, as recommended by specific guidelines, in pregnancy
and lactation. Dietary recommendations are different from other life stages because of
altered nutrient requirements and a heightened need for food safety practices. Currently,
there is limited evidence available about dietary choices, food safety practices, and sources
of nutrition information of New Zealand women during pregnancy and lactation. This
information is important to inform strategies to improve the support that women receive
during pregnancy and lactation as it identifies what recommendations are currently being
Aim: To investigate New Zealand women’s dietary choices, food safety practices, and sources
of nutrition information during pregnancy and lactation.
Methods: Women from New Zealand were invited to participate in this observational study
between January and June 2019. Participants were required to be pregnant or within six
months postpartum. Women completed a demographic, pregnancy food frequency, and food
choice questionnaire during or retrospectively to their pregnancy. Postpartum women also
completed a lactation food frequency and food choice questionnaire.
Results: Women (n=458) consumed a range of foods from the four food groups (fruit and
vegetables, breads and cereals, milk and milk products, and meat/meat alternatives/eggs). A
large percentage reported adding or increasing, limiting, and avoiding foods. Cow’s milk, the
most frequently daily consumed dairy product, was more commonly reported in pregnancy
(93%) than lactation (64%). A range of fruit, vegetables, protein, and grain foods were
consumed daily in pregnancy and lactation. The majority of women followed food safety
recommendations in particular avoidance of alcohol (92%), raw milk products (86%), and
raw/smoked/precooked fish/seafood (84%). Dietary information was acquired from a range
of sources. The greatest dietary influences included midwives, New Zealand pregnancy and
breastfeeding guidelines, and family/friends. Women also frequently reported receiving
dietary advice from their lead maternal carer, handouts, the internet, and alternative health
practitioners. During lactation, women received information from more potentially unreliable
sources including family/ friends, the internet, and alternative health practitioners. Infant
symptoms also frequently affected women’s food choices in lactation.
Conclusion: Women implement significant dietary changes during pregnancy and lactation.
Women are likely to add, remove, and limit food during pregnancy following the New
Zealand pregnancy guidelines; advice from health professionals, the internet,
magazines/books/newspapers; or because of food safety concerns. Lactating women are
likely to make dietary changes because of infant symptoms or advice received from
midwives, alternative health practitioners, family/ friends, and the internet.