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59 Cards in this Set
- Front
- Back
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Pre-pregnancy Weight
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BMI 18.5 – 24.5
Underweight women who fail to gain weight during pregnancy will have a low-birth-weight (LBW) baby, which is <5 ½ lb or 2500 g |
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Low Birth Weight Infants
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Indicator of poor nutrition status of mother before &/or during pregnancy;
Influenced by: food intake, heredity, disease conditions, smoking, alcohol use & drug abuse Results in: o High risks of mortality (40x in 1st y); o Lower adult IQ, o Educational disadvantage, o Short stature, o High risk for chronic diseases in later life |
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Premature Babies
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Born early but right size for gestational age
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SGA Babies
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Small for gestational age
Small for date; may/may not be premature |
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Overweight Women & Pregnancy
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Strive for healthy weight before pregnancy to minimize medical risks for would-be mother & her future child
Infant is large, even if born prematurely; so special medical care needs not given or recognized 2x risk for neuro-tube defects but the reasons WHY are unknown Risks for gestational diabetes, hypertension, infections after birth Surgical Caesarian-section; may require drugs to induce labor Greater risk of giving birth to infants with heart defects & other abnormalities |
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What is macrosomia
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Birth after birth babies get larger and larger
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Men and Pregnancy
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Need for a healthy sperm - provides half of child’s inheritance
• Limited evidence of low fertility or genetic material damage due to o Too few fruits and vegetables consumed o Sedentary lifestyle o Too much alcohol: may damage sperm’s genetic material o Smoking: environmental tobacco smoke (ETS, second-hand smoke) affects fetus |
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Placenta
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• Active, metabolic organ
• Supplies nutrients, hormones, and oxygen to the fetus – maintains pregnancy • A means for waste removal from the fetus • Prepares mother’s breast for lactation |
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Umbilical Cord and Cord Blood
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Umbilical Cord
• A pipeline from the placenta to the fetus Cord Blood • Can be used for stem cell research |
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Uterus
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Supports implantation of fertilized ovum & growth of placenta
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Critical Periods During Pregnancy
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Nutrients must be supplied on time
Heart & brain – 14 weeks Lungs - 24 weeks Damaging effects irreversible Even one alcohol containing drink during a critical period can seriously impair development |
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Zygote
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Fertilized ovum embeds itself in the uterine wall within two weeks Placenta begins to grow
Malnutrition, smoking, drug abuse may lead to failure to implant, NTDs, loss of zygote |
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Embryo
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At 8 weeks the fetus has complete central nervous system, beating heart, fully formed GIT, well-defined fingers & toes, beginning facial features
In last 7 months fetus grows 50x heavier & 20x longer Critical periods of cell division & development occur in all organs |
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Increased Energy Needs During Pregnancy
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370 additional calories in 2nd trimester
450 additional calories in 3rd trimester Best if met by adding 2 healthy snacks or 1 additional meal To meet calories and nutrient needs, select more nutrient-dense foods such as whole grain breads & cereals, legumes, dark green leafy veggies, citrus fruits, low-fat milk products, lean MFP |
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Carbohydrates During Pregnancy
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Fetus
Fuel for fetal brain Spare protein for fetal growth Mother Fiber helps with constipation Normal people need 130 grams/day Preggo people need ideally 175 grams/day or more |
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Protein During Pregnancy
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DRI higher by 25 grams/day
Canadian women’s intake already exceeds this Protein supplements can be harmful, discourage its use Vegetarian women should meet food energy & have generous servings of plant-protein foods Legumes, tofu, whole grains, nuts & seeds |
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Fat During Pregnancy
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Healthy Fats are important for brain development of the fetus, post-partum depression, etc.
Omega 6 and omega 3 fatty acids are needed |
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Folate & B12 During Pregnancy
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Both are needed in large amounts for cell reproduction
Mothers need 600 ug folate/day from synthetic folic acid in supplements & fortified foods (better absorbed) in addition to eating folate-rich foods Greater amounts of vitamin B12 needed to assist folate in manufacture of new cells Vitamin B12 from meats, eggs, or dairy products Vegans need B12 fortified foods or supplements |
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Folate and NTDs
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The early weeks of pregnancy is the critical period for the formation & closure of neural tube (brain & spinal cord)
If tube fails to close properly, NTDs (spina bifida & anencephaly) may result |
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Calcium During Pregnancy
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In final weeks of pregnancy, more than 300 mg/day of calcium is transferred to fetus
Adequate calcium intake aimed at conserving mother’s bone mass while supplying fetal needs |
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Magnesium During Pregnancy
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Essential for bone & tissue growth
In great demand for normal development of bones & teeth in infant and sparing bones and teeth in mother |
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Iron During Pregnancy
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Absorption increases 3x during pregnancy to about 30% - 40%
Daily iron supplement of 30 mg recommended during 2nd & 3rd trimesters Fetus draws heavily on its mother’s iron to store 3-6 months supply after birth |
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Zinc During Pregnancy
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Required for protein synthesis & cell development & sperm
Severe deficiency predicts low body weight |
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What do prenatal supplements provide more of?
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Provides more folate, iron, calcium than regular versions
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Canadian Recommended Weight Gain During Pregnancy
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Underweight women (BMI <20) = 28-40 pounds; 12.5-18 kg
Normal-weight women (BMI 20-25) = 25-35 pounds; 11.5-16 kg Overweight women (BMI >27) = 15-25 pounds; 7-11.5 kg Ideal pattern of weight gain = 1.5 kg (3 ½ pounds) in 1st trimester & 0.5 kg (1 pounds) per week thereafter |
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Exercise & Pregnancy
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Improves physical fitness; facilitates labor; helps prevent or manage gestational diabetes; reduces psychological distress
Swimming & water aerobics – water cools & supports body; provides natural resistance; lessens impact of body’s movement; reduces intensity of back pain Stay out of saunas, steam rooms, hot whirlpools - prevent excessively high body temp, dehydration Babies that have mothers that exercise during exercise have a leaner body mass |
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Smoking During Pregnancy
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May cause placenta previa
Nicotine & cyanide are toxic to fetus Restricts blood supply, leads to low body weight Oxidants in cigarette smoke lower maternal intakes of fiber, vitamin A, B-carotene, folate, vitamin C SIDS – observed even with second hand smoke (environmental tobacco smoke) |
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What is placenta previa?
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The placenta slips over the cervix and may break & bleed
Life threatening for both mother and fetus |
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Alcohol During Pregnancy
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Halts delivery of oxygen through umbilical cord – central nervous system development affected
Slows cell division - birth defects or abnormalities, especially facial characteristics Major detrimental effect on growing fetal brain -brain damage Interferes with placental transport of nutrients to fetus - LBW Damages ovum or sperm -abnormalities in child |
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Fetal Alcohol Syndrome
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Irreversible brain damage
Growth retardation Mental retardation Facial abnormalities Vision abnormalities |
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Medicinal Drugs during Pregnancy
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Aspirin, ibuprofen; may cause excessive bleeding during delivery
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Herbal Supplements during Pregnancy
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Unknown components pose danger; none have been tested for safety or effectiveness during pregnancy
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Drug Abuse during Pregnancy
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Marijuana or cocaine; impair fetal growth & development; low birth weight, heart abnormalities, nervous system disorders
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Sugar Substitutes during Pregnancy
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Aspartame or other sweeteners could replace nutrient-dense, energy-yielding foods
Women with PKU should not use products with aspartame |
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Caffeine during Pregnancy
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Crosses the placenta; fetus has limited ability to metabolize it;
Limit consumption to 1 cup coffee or two 355 mg cola beverages |
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Dieting during Pregnancy
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Hazardous during pregnancy
Low carbohydrate diets or fasts that cause ketosis impair development of fetal brain; energy restriction dangerous |
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Environmental Contaminants during Pregnancy: Fish
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Pb, Hg, pesticides, PCBs in ocean fish (tuna, mackerel) may lead to impaired cognitive development, severe damage to fetal NS
Skipjack tuna is recommended for pregnant women, at about 1 – 2 cans a week … It contains less mercury because it is a smaller fish If women are limiting their fish intake they could get fatty acids from eggs, flax seed, milk, nuts, avocado, olive oil |
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Food borne Illness During Pregnancy
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Listeriosis (Listeria monocytogenes) can cause miscarriage, stillbirth, or severe brain infections
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Diet Complaints during Pregnancy
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“Morning” (or anytime) sickness due to hormonal changes; eat dry toast or crackers before getting up
“Hyperemesis gravidarum” – prolonged N & V; need medical attention Constipation – consume high-fiber foods; drink plenty of fluids; exercise routine Heartburn – have small frequent meals, no spicy or greasy foods |
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Gestational Diabetes
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Resolves after infant’s birth
May lead to type 2 diabetes |
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Edema
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Fluid retention late in pregnancy especially in lower legs
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Toxemia
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Pregnancy-induced hypertension (PIH) or pre-eclampsia; proteinuria
Whole body edema, especially swollen face & arms |
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Breastfeeding
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Breastfeeding for 3 months or longer seems to have accelerated weight loss
Gradual loss of 1 lb/week is safe & does not reduce milk output Breastfeeding burns some energy, but diet & physical activity are still cornerstones for weight control |
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Energy Needs for Lactation
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Baby takes about 750 mL breast milk/day
Mom needs 500 calories to produce it in addition to meeting her own caloric needs Eat extra 330 kcal/d; 170 kcal drawn from fat stores |
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Fluid Needs for Lactation
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Mom needs about 13 c fluids/d to prevent dehydration
This can be via milk, juice or water after breastfeeding & at meals |
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Nutritional Deprivation During Lactation
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Reduces quantity of breastmilk
Women produce milk with adequate protein, carbohydrate, fat & folate even when their supplies are limited Milk quality maintained at expense of maternal stores Baby benefits when mom’s diet is rich in fruits, vegetables, whole grains, adequate dairy, lean meats, and healthy fats Infants tend to be sensitive to cow’s milk lactose/protein, garlic, onions, beans, peppers, and other common “gassy foods” |
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Alcohol & Breastfeeding
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Enters breastmilk
Affects production, volume, composition, & ejection reflex Alcohol concentration peaks within 1 hour Overwhelms infant’s alcohol-degrading system; can become addicts by way of breastfeeding |
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Cigarettes & Breastfeeding
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Produce less milk, of lower fat content
Infants gain less weight Transfers nicotine & other chemicals via breastmilk Infant exposed to second-hand smoke = poor growth, hearing impairment, vomiting, breathing difficulties, SIDS Dyslexia, ADHD and overall poor brain development due to smoke |
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Caffeine & Breastfeeding
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Excess makes baby jittery, fretful, wakeful
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Medications & Breastfeeding
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Some can be secreted in breast milk or suppress lactation
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Oral Contraception & Breastfeeding
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Combined estrogen-progestin may suppress milk output, lower nutrional content, shorten duration of breastfeeding
Progestin only has no affect |
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Maternal Illness & Breastfeeding
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With common cold, ok to breastfeed With TB or hepatitis (but with appropriate treatment, ok to breastfeed
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HIV/AIDS & Pregnancy
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Transferable in pregnancy, at birth, or through breast milk
NO breastfeeding, if mother tests positive & safe alternatives available such as formula supply & clean, safe water |
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Feeding Babies
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Birth weight – doubles at 5 months; triples at 1 year
BMR – remarkably high; 2x of an adult, based on body weight Early nutrition - affects growth & later development |
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Nutrient Needs in the First Year of Life
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Most rapid growth period in life
Special needs for energy nutrients, vitamins A & D and calcium 100 cal/kg BW/d; as % of BW Babies need more than 2x as much of nutrients Vitamin K – single dose at birth to prevent uncontrolled bleeding Vitamin K producing bacteria takes weeks to establish Water – breast milk or infant formula provides enough water to replace losses in healthy infant Vitamin D - supplement sometimes needed because babies don’t spend too much time outside |
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Breast Milk Nutrition
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Breastmilk provides all the nutrients a healthy infant needs for first 6 months
Carbohydrates in milk, lactose, easily digested; enhances calcium absorption Lipids are a main source of energy; generous amounts of EFA linoleic & linolenic acids, arachidonic & DHA (for brain & eye retina) Proteins – alpha-lactalbumin = easy to digest; lactoferrin = iron-gathering compound (helps absorb iron) Vitamin C – generous amounts Vitamin D – low amounts in breastmilk; supplement needed for breastfed baby not sufficiently exposed to sunlight = daily 10 ug (40 IU) Calcium – ideal for bone growth; well-absorbed Sodium – low in breastmilk Iron – limited amount highly absorbable; supplement needed after 4-6 months… Recall that the baby absorbs 4 – 6 months of iron while in the womb Zinc – absorbed better due to zinc-binding protein |
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Breastfeeding Benefits for Mom
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Contracts uterus
Lose weight faster Delays return of regular ovulation (not a reliable form of birth control though!) Conserves iron stores |
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Cows Milk and Babies
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Never an option – whole cow’s milk before 12 months of age
Until first birthday: cow’s milk inappropriate replacement for formulas due to little iron & vitamin C Proteins may cause intestinal bleeding and increase risk for iron deficiency After 12 months, use cow’s milk fortified with vitamin A & D or soy milk fortified with calcium, vitamin A and D Before 2 years, reduced-fat milk not recommended because children need the fat |
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Diet at 1 Year Old
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Whole milk at about 2 cups/day
Iron-fortified cereal Variety from all food groups o See Table 13-17 in your text for an example day (pg. 522) They can also drink liquids from a cup at this point |
