17 - Nutrition, pregnancy and development

Question 1

What are the 3 stages of unborn baby development?

Answer 1

Zygote: a single, fertilized cell
Embryo: weeks 3 to 8 after fertilization
Foetus: week 9 to birth

Question 2

When are the first, second and third trimesters?

Answer 2

First trimester - 1 - 13 weeks
Second tri - 14-27 weeks
Third tri - 28 - Birth (38-42weeks)

Question 3

How many extra calories per day are needed in 2nd and 3rd trimesters?

Answer 3

350-450

Question 4

How much protein and carbohydrate is needed in pregnancy?

Answer 4

1.1 gm/kg body weight/day of protein

175 grams/day minimum of carbohydrates

Question 5

What are the dietary fat guidelines in pregnancy? (4)

Answer 5

1) Same % of calories as in non-pregnancy
2) Limit saturated fat; avoid trans fats
3) Omega-3 polyunsaturated fatty acid docosahexaenoic acid (DHA)
4) Arachidonic acid

Question 6

Why are micro nutrients are important in pregnancy? (3)

Answer 6

1) Expand maternal blood supply
2) Growth of maternal tissues: uterus, placenta, breast, body fat
3) Growth of foetus

Question 7

Which micronutrients are important in pregnancy? (9)

Answer 7

Folate, B12, C, A, D, Calcium, iron, zinc, sodium, iodine

Question 8

1) What is the RDA of folate for pregnant women?
2) What is it required for?
3) What is deficiency associated with? (4)

Answer 8

1) 600 µg/day
2) cell division
3) Neural tube defects, macrocytic anaemia, foetal neurodevelopment [problems, pregnancy complications

Question 9

What are 3 conditions resulting from neural tube defects associated with folate deficiency?

Answer 9

1) Spina bifida - vertebrae do not enclose the spinal cord - causing protrusion
2) Anencephaly - partial absence of brain tissue
3) Down syndrome

Question 10

Why is macrocytic anaemia?

Answer 10

Blood cells do not mature
Low birth weight
Preterm

Question 11

What pregnancy problems for the mother (3) are associated with folate deficiency?

Answer 11

Placental abruption
Preeclampsia
Spontaneous abortion

Question 12

What is homocysteine re-converted into with the help of folate and vitamin B12?

Answer 12

Methionine

Question 13

What is the RDA for iron during pregnancy?

Answer 13

27mg per day

Question 14

What is the distribution of body iron?

Answer 14

RBC = 75-80%
Tissues (proteins) = 10%
Storage = 10-15%

Question 15

What is 1000mg of additional iron needed for? (2)

Answer 15

• Expanding maternal RBC and plasma volume

- Growth of foetal-placental unit

Question 16

What is maternal anaemia associated with?

Answer 16

• Lower cord Hb concentration
• Severe depletion of storage iron
  = brain iron deficiency

Question 17

What is perinatal iron deficiency caused by? (3)

and characterised by? (2)

Answer 17

Causes: Intrauterine growth restriction, maternal smoking, poorly controlled diabetes

Results in: Foetal hypoxia an augmented erythropoiesis (RBC production)

Question 18

What developmental problems does iron deficiency cause?

Answer 18

• Affects growth and function of multiple organ systms
• affects immune function and temperature
• affects neurodevelopment
• postnatal iron deficiency

Question 19

What does an excess of iron cause?

What must be done?

Answer 19

Neonatal haemochromatosis

Multiple RBC transfusions

Question 20

What is a teratogen?

Answer 20

an agent or factor which causes malformation of an embryo e.g. alcohol

Question 21

Give some consequences of alcohol during pregnancy

Answer 21

Fetal alcohol syndrome
Fetal alcohol effects (less severe and do not show at birth)
Immature liver
Spontaneous abortion, delivery complications, LBW, SIDS etc.

Question 22

Explain the hypertensive disorders that can arise during pregnancy

Answer 22

• Gestational hypertension
• Preeclampsia: sudden increase in maternal blood pressure
  Risk increased by deficiencies in vitamins C and E, calcium and magnesium

Question 23

What is:
Prolactin
Oxytocin
Colostrum

Answer 23

Prolactin: milk synthesis
Oxytocin: “let down” of milk
Colostrum: first milk produced (introduces friendly bacteria)

Question 24

What extra nutrients are required during breastfeeing?

Answer 24

Milk production requires 700-800kcal daily
Should consume 300-400kcal per day more than pre-preg for gradual weight loss
Take suppliments

Question 25

What are the advantages of beastfeeding (7)

Answer 25

• Best quality nutrition
• nutrients more absorbable (iron calcium magnesium)
• Antibodies
• Helps in weight loss
• Suppresses ovulation
• Bonding
• Cost-efficient

Question 26

What are some potential challenges in breastfeeding? (5)

Answer 26

• Possibly uncomfortable and needs practice
• Harmful substances passed from mother to baby
• HIV
• Mothers employment
• Social concerns

Question 27

What characteristics of infants makes their nutritional needs unique?

Answer 27

• High energy needs per unit body weight (40-50kcal/lb) and 40-50% from fat
• immature digestive tracts and kidneys

Question 28

What specific fatty acids to infants need?

Answer 28

• Arachidonic acid (AA)

- Docosahexaenoic acid (DHA)

Question 29

Other than macro-nutrients, what are the specific nutrient needs for infants?

Answer 29

• Higher need for iron, vitamin D, zinc, fluoride, B12
• Vitamin K injections
• Need 2 oz fluid per lb bodyweight