Chapter 15

Question 1

How does gestational diabetes affect pregnancy?

Answer 1

Usually developed during second half of pregnancy, gestational diabetes may cause complications during labor and HBW. Birth defects associated with gestational diabetes include: heart damage, limb deformities, and neural tube defects. Diet + exercise may control gestational diabetes.

Question 2

How does hypertension affect pregnancy?

Answer 2

Depending on severity, hypertension may increase risks of fetal growth restriction, preterm birth, and separation of the placenta from the uterine wall, resulting in stillbirth

Question 3

How does gestational hypertension affect pregnancy?

Answer 3

Usually developed during second half of pregnancy, gestational hypertension is usually mild; however, it may increase risks of subsequent hypertension and T2 diabetes. Also an early sign of preeclampsia

Question 4

What is preeclampsia?

Answer 4

A condition characterized by high blood pressure and some protein in the urine. It affects the mother’s organs and diminishes blood flow. Oxygen and nutrients to the placenta diminishes as a result. In some cases, the placenta separated from the uterus

Question 5

What is the ideal childbearing age?

Answer 5

20-25

Question 6

What are some complications of pregnancy in adolescents?

Answer 6

Nourishing a growing fetus adds to a teenage girl’s nutrition burden. Inadequate nutrition increases risk of LBW infants, preterm infants, and stillbirth. Complications include: iron-deficiency anemia and prolonged labor. Teens are recommended to gain 35 lbs to support both mother and fetus

Question 7

What are some complications of pregnancy in older women?

Answer 7

Complications often reflect chronic conditions such as hypertension and diabetes. These complications may result in cesarean delivery which increase maternal death rates. Preterm births and LBW are also more common. Risks such as Down Syndrome also increase.

Question 8

What are some teratogenic practices that can affect pregnancy, causing abnormal fetal development and birth defects?

Answer 8

• Alcohol: can cause irreversible physical/mental retardation known as FAS
• Medicinal/Herbal drugs
• Illicit drugs: cross the placenta and impair fetal growth/development
• Smoking: restricts blood supply to fetus, complicates birth and LBW
• Environmental: lead delays mental and psychomotor development; mercury can impair fetal growth and harm developing brain and nervous system

Question 9

What does a nursing mother need to do to produce an adequate supply of milk?

Answer 9

A woman needs extra energy - almost 500 kcal extra per day in the first 6 mo. of lactation. To meet this need, she can eat an extra 330 kcal of food per day and fat reserves accumulated during pregnancy can provide the rest

Question 10

What energy nutrients does a nursing mother need?

Answer 10

Protein and fatty acid recommendations remain the same during lactation as during pregnancy. Nursing mothers, however, need to increase carbs to replace the glucose used to make lactose in breast milk. Fibre should also be increased

Question 11

What do nutrient inadequacies do to breast milk?

Answer 11

Nutrient inadequacies reduce the quantity, not the quality, of breast milk. Milk quality is maintained at the expense of maternal stores (e.g. calcium in bones may be used for milk, resulting in bone density loss for mother)

Question 12

Why might some nursing mothers need an iron supplement?

Answer 12

Some may need supplements, not to enhance the iron in breast milk, but to refill depleted iron stores. Mother’s iron stores during pregnancy deplete as she supplies the fetus with enough iron to last through the first 4 to 6 months of infant’s life

Question 13

What foods may alter the flavour of breast milk?

Answer 13

Foods with strong or spicy flavours, such as garlic

Question 14

What are some benefits of breastfeeding?

Answer 14

• provides appropriate composition and balance of nutrients
• provides hormones that promote development
• improve cognitive development
• protects against infections, chronic diseases, and food allergies

For mother:

• conserves iron stores
• increases energy expenditure
• contracts uterus

Question 15

What is prolactin and oxytocin? How is it released?

Answer 15

Prolactin and oxytocin are hormones that coordinate lactation. The infant’s demand for milk stimulates the release of these hormones, which signal the mammary glands to supply milk. Prolactin is responsible for milk production. Oxytocin causes the mammary glands to eject milk into the ducts

Question 16

What is the difference between lactation and breastfeeding?

Answer 16

Lactation is an automatic physiological process while breastfeeding is a learned behaviour

Question 17

What are some factors that affect breastfeeding behaviour?

Answer 17

• receiving early/repeated information
• receiving partner and family support
• obtaining adequate nutrition and rest

Question 18

Can a woman with HIV breastfeed?

Answer 18

Generally, it is not advised as the HIV infection can be transmitted through breast milk. In developing countries, however, formula may not be available, affordable, sustainable, or safe so breastfeeding may be the only option. Also, infants may be protected by receiving antiretroviral treatment while being breastfed

Question 19

What might a woman with T1 diabetes need to do to ensure successful lactation?

Answer 19

Adjust energy intakes and insulin doses. Maintaining good glucose control helps to initiate lactation and support milk production

Question 20

What effect does estrogen-containing oral contraceptives have in breast milk?

Answer 20

Nursing mothers experience prolonged postpartum amenorrhea but this absence of menstrual periods does not protect against pregnancy. Estrogen-containing oral contraceptives reduce the volume and protein content of breast milk

Question 21

What effect does alcohol have on breast milk?

Answer 21

Alcohol easily enters breast milk and has the following effects on infants:

1) alters the flavour = infant drinks less
2) causes sleepiness: infants metabolize alcohol inefficiently
3) inhibits oxytocin

Question 22

What effect do medicinal drugs have on breast milk?

Answer 22

Most medicines are compatible with breastfeeding, but some may either suppress lactation or may secrete into breast milk and harm the baby

Question 23

What effects do illicit drugs have on breast milk?

Answer 23

Illicit drugs are harmful to both the mother and nursing infant. Illicit drugs secrete into breast milk and can cause: irritability, tremors, hallucinations, and even death

Question 24

What effects does smoking have on breast milk?

Answer 24

Cigarettes lower the concentration of lipids and proteins and reduces milk volume. This milk may not meet the infant’s energy needs

Question 25

Canadian Prenatal Nutrition Program (CPNP)

Answer 25

High quality, cost effective food assistance program that offers:

• health care referrals
• nutrition education
• prenatal vitamins
• food packages or vouchers for food