Energy and Protein Intake Deficits in the Immediate Postpartum Period: A Prospective Observational Study

BackgroundThe early postpartum period requires increased energy and protein for wound healing, involution, and lactogenesis.In India, maternal diets are frequently suboptimal and influenced by cultural food restrictions, yet quantitative data on intake during the first days after delivery are limited.This study aimed to quantify daily energy and protein intake and calculate deficits during the initial postpartum days. Materials and methodsThis prospective longitudinal observational study was conducted in a tertiary care hospital from February 2025 to July 2025.Women aged 18-40 years with singleton pregnancies who were admitted for delivery were enrolled and followed until discharge (up to postpartum Day 5).Daily energy and protein intakes were assessed using 24-hour dietary recalls administered by a dietitian and trained resident physicians.An intake deficit was defined as the difference between the recommended dietary allowance (RDA) and reported intake, using the 2020 Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN) lactation RDA for sedentary women (2,260 kcal/day and 62.6 g/day of protein) as a fixed benchmark.Trends across Days 1-3 (complete data, N = 100) were analyzed using repeated-measures analysis of variance (ANOVA), whereas data from Days 4-5 (N = 52, hospitalized cesarean subgroup) were analyzed descriptively. ResultsMean energy intake rose from 791.44 ± 132.20 kcal on Day 1 to 874.63 ± 158.94 kcal by Day 3 (F(2,198) = 11.73,p < 0.001), and protein rose from 18.09 ± 4.82 to 22.85 ± 4.74 g/day (F(2,198) = 30.01,p < 0.001).Among the 52 women with cesarean delivery who remained hospitalized, descriptive Day 5 intake was 885.52 ± 121.81 kcal and 23.89 ± 4.91 g/day.Reported intake remained substantially below the RDA throughout, with deficits of 1,468.56 ± 132.20 kcal and 44.51 ± 4.82 g on Day 1 (N = 100) and 1,374.48± 121.81 kcal and 38.71 ± 4.91 g on Day 5 (N = 52).All participants received iron and folic acid supplementation. ConclusionsReported energy and protein intake improved significantly from the first to the third postpartum day but remained substantially below the ICMR-NIN 2020 lactation RDA throughout the first five hospital days.This reflects an intake gap against a population benchmark, not a measured physiological deficiency.Multicenter studies with objective dietary measurement and maternal-infant outcomes are needed.