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nutrition 237 > chapter 16 - pregnancy, lactation, infants > Flashcards

chapter 16 - pregnancy, lactation, infants Flashcards

1
Q

full-term gestation

A

gestational period lasting 38-42 weeks

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2
Q

pre-term

A

birth prior to 37 weeks gestation

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3
Q

LBW

A

low birth weight = under 5.5 lbs

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4
Q

small for gestational age

A

infants that weigh less than expected for their gestational age

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5
Q

gestation

A

begins when sperm & egg unite

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6
Q

embryonic & fetal development

A

zygote = conception to 2 weeks

embryo = 2 weeks to 8 weeks

fetus = 9 weeks to birth (period of very rapid development)

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7
Q

critical periods of development

A

limited windows of opportunity for a tissue or organ to develop

most of these are during the embryonic stage

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8
Q

zygote nourishment

A

nourishes itself by absorbing secretions from glands in the uterus

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9
Q

placenta formation

A

forms in uterus as the zygote develops into an embryo

umbilical cord provides connection from placenta to fetus

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10
Q

placenta function

A

placenta is a living organ that:
- synthesizes fatty acids, cholesterol, & glycogen for fetus
- produces hormones which direct nutrients to fetus, control fetal metabolism, & promote changes in mom’s body to support pregnancy

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11
Q

importance of nutrition in pregnancy

A
  • ensures appropriate fetal growth
  • improves likelihood of full-term development
  • increases mental, physical, & physiological capabilities
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12
Q

calories’ effects on pregnancy

A

deficiency = slow growth, low birth weight
excess = delivery complications, high birth weight

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13
Q

energy needs during pregnancy

A

needs additional kcal & nutrients for:
- fetal & placental growth
- maternal stores
- increased maternal metabolism

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14
Q

energy requirements by trimester

A

1st trimester EER + 0 kcal
2nd trimester EER + 340 kcal
3rd trimester EER + 452 kcal

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15
Q

nutrients of concern

A
  1. protein
  2. EAAs
  3. zinc
  4. folate
  5. B12
  6. iron
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16
Q

folate deficiency risk in pregnancy

A

folate deficiency = neural tube defects

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17
Q

pregnancy weight gain

A

for underweight people: 28-40 lbs
for normal people: 25-35 lbs
for overweight people: 15-25 lbs
for obese people: 11-20 lbs

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18
Q

obese pregnancy risks for baby

A

increased risk of:
- birth defects (neural tube defects, oral clefts)
- being stillborn/dying first few weeks after birth
- having high birth weight
- childhood obesity

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19
Q

obese pregnancy risks for mom

A

increased risk of:
- high blood pressure
- gestational diabetes
- cesarean delivery

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20
Q

underweight pregnancy risks for baby

A

increased risk of:
- low birth weight
- premature birth
- lower nutrient stores

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21
Q

factors that complicate pregnancy outcomes

A
  • young mom
  • mom’s eating patterns (restriction, vegetarian/vegan, EDs)
  • mom’s health (# of pregnancies, time between pregnancies, gestational diabetes)
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22
Q

pregnancy-induced hypertension risks

A

impairs delivery of oxygen & nutrients to fetus

can lead to preeclampsia (edema, headaches, blurred vision) & eclampsia (coma, death of mom & fetus)

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23
Q

gestational diabetes

A

occurs in 9% of pregnancies, more common in those with family history

increased risks:
- infant is too large
- infant has low glucose levels at birth
- obesity later in life for infant
- mom & baby develop T2DM later in life

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24
Q

sociocultural factors for inadequate diet in mom

A

limited income, limited education, lack of social support

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25
Q

nutrition-related physiological concerns in pregnancy

A

physical & hormonal changes can cause:
- heartburn
- constipation
- nausea & vomiting
- edema

26
Q

foods to limit in pregnancy

A
  • environmental contaminants (mercury in fish)
  • foodborne pathogens
  • caffeine (limit to 200mg/day = 2 cups coffee or 3 sodas)
  • food additives
27
Q

foods to completely avoid in pregnancy

A
  • drugs & alcohol
  • herbal teas
  • smoking
28
Q

FAS

A

fetal alcohol syndrome

  • smaller-than-normal head circumference
  • reduced size of eye opening
  • thin upper lip
29
Q

pregnancy & physical activity guidelines

A

physical activity carries minimal risks and benefits most pregnant women

to measure exertion, use perceived exertion (talk test) instead of HR

30
Q

lactation

A

physiological process in female mammals where postpartum mom’s breast secretes milk

31
Q

let-down reflex

A

suckling stimulates nerves in nipple/areola that travel to hypothalamus

brain releases oxytocin & prolactin

oxytocin stimulates lobules in breast to release milk, prolactin stimulates additional milk production

32
Q

colostrum

A

thin, yellow, early (‘immature’) breast milk
less lactose & calories

33
Q

colostrum contains

A

rich in protein, minerals, vit A

contains antibodies & immune system cells

lactobacillus bifidus factor

34
Q

transitional milk

A

breast milk from a few days post-delivery to 1 week

contains more fat, lactose, water-soluble vitamins, and calories than colostrum

35
Q

mature milk

A

replaces transitional milk, thin & watery

20 calories/oz

nutritionally complete for infant EXCEPT Vit D & iron

36
Q

food needs during lactation

A

500 calories above pre-pregnancy requirements (300 of these calories come from food sources, 200 come from fat stores)

the 500 calories vary depending on BMI & length of breastfeeding

37
Q

fluid needs during lactation

A

additional 32 oz of fluid each day

fluid = main component of breast milk

38
Q

nutrient needs during lactation

A

iron needs decrease

insufficient calcium consumption = common

39
Q

peak growth during infancy

A

this is the period when nutrient needs per unit of body weight are the highest

baby = double their birth weight by 2-6 months, triple their birth weight by 1 year old

40
Q

tracking infant growth

A

spurts & lags are normal

head circumference is measured to assess brain growth

41
Q

indicators of development problems

A

birth to 2 years: head circumference < 5th percentile or >95th percentile

42
Q

indicators of stunted growth

A

birth to 2 years: length < 5th percentile
2 to 20 years: BMI <5th percentile

43
Q

indicators of underweight

A

birth to 2 years: weight < 5th percentile
2 to 20 years: BMI <5th percentile

44
Q

indicators of overweight

A

birth to 2 years: weight > 95th percentile
2 to 20 years: BMI >85th percentile and <95th percentile

45
Q

indicators of obesity

A

2 to 20 years: BMI > 95th percentile or BMI >30 (whichever is smaller)

46
Q

infant energy needs

A

infants have the greatest pound-for-pound need

BMR increases from birth to age 2 (by the pound, infant needs are 2-4x greater than adults)

rises slowly until puberty (large increase) & 30 (then declines)

47
Q

children protein needs

A

infants: 1.5g protein /kg per day

children/adolescents: 1.1g protein /kg -er day (20-40% greater than adult needs per pound)

48
Q

children fat needs

A

infants: fats = 40-55% of calories
- meet energy requirements without being overfull

children over 2 = same recommendations as adults

49
Q

children carb needs

A

infants: primarily lactose

recommendations = the same across age groups

fiber is always important (AI = 14g/1,000 kcal for children less than 1 year old)

50
Q

baby water needs

A

needs = met by breastmilk or formula

water intoxication = low requirement, limit supplemental fluids to 4 oz/day

51
Q

nutrients of concern for children

A
  • iron
  • potassium
  • calcium
  • fluoride
  • zinc
  • folate
  • Vit D
  • Vit K
52
Q

Infant feeding practices

A

human milk and/or formula meet all requirements until 6 months old

53
Q

breastmilk benefits

A

most ideal source of nutrients

composition & bioavailability = engineered to meet infant requirements

contains:
- antibodies
- hormones
- immune factors
- growth factors
- enzymes

54
Q

infant formulas

A

iron-fortified formulas are safe, nutritious alternatives
- attempt to match breastmilk as closely as possible

55
Q

introduction of solid foods

A

infants must show signs of interest (watches spoon, able to self-support head, able to close mouth over spoon)

there is no benefit to early introduction of solid food

56
Q

solid foods nutrition

A

nutrient needs = increased bc breastmilk is depleted & insufficient for growth

iron-containing foods = important (pureed meats, iron-fortified infant cereals)

57
Q

solid food introduction sequence

A

introduce 1 single food ingredient at a time & wait 5-7 days before adding a new food

Iron & Vit C = first nutrients required

first foods = protein-rich with iron & Vit C (pureed meat, fish, chicken, beans, egg yolk, tofu)

avoid egg whites & cow’s milk (when cow’s milk is introduced, use whole milk until 2 years old, then 2% after that)

introduce lumpy foods when teeth appear

58
Q

weaning

A

should be weaned from bottle by 18 months to prevent overconsumption of beverages & dental caries

59
Q

self-feeding timetable

A

starts in late infancy & continues to develop until preschool years

  • by age 1, drink from cup
  • by age 2, lift, tilt, & lower cup, and use spoon
  • by ages 3-4, use fork
  • by ages 4-5, use knife
60
Q

division of responsibility in feeding

A

infants: parents = responsible for what, infants = responsible for how much

solid food: parents = responsible for what, when, & where

toddlers through adolescents: parents = responsible for what, when, & where; child = responsible for whether & how much

nutrition 237 (7 decks)

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